How to use the “Naranjo Scale”?

How to use the “Naranjo Scale”. This scale is for determining the adverse drug reaction probability; it was designed by Naranjo et al.

The scale consists of series of questions that will give the healthcare provider an idea about the likelihood of whether the ADR was a result of the drug itself, or some other factors behind the scene.

The Naranjo criteria classify the probability that an adverse event is related to drug therapy based on a list of weighted questions, which examine factors such as the temporal association of drug administration and event occurrence, alternative causes for the event, drug levels, dose-response relationships and previous patient experience with the medication. The ADR is assigned to a probability category from the total score as follows:

• definite if the overall score is 9 or greater
• probable for a score of 5-8
• possible for 1-4
• doubtful if the score is 0

The Naranjo criteria doesn’t take into account drug-drug interactions. Drugs are evaluated individually for causality, and points deducted if another factor may have resulted in the adverse event, thereby weakening the causal association.

Use the calculator below to get the Naranjo Scale:

Calculate!

	Yes	No	Do not know or not done.
1. Are there previous conclusive reports on this reaction?
2. Did the adverse event appear after the suspected drug was given?
3. Did the adverse reaction improve when the drug was discontinued or a specific antagonist was given?
4. Did the adverse reaction appear when the drug was re-administered?
5. Are there alternative causes that could have caused the reaction?
6. Did the reaction reappear when a placebo was given?
7. Was the drug detected in any body fluid in toxic concentrations?
8. Was the reaction more severe when the dose was increased, or less severe when the dose was decreased?
9. Did the patient have a similar reaction to the same or similar drugs in any previous exposure?
10. Was the drug interaction confirmed by any objective evidence?

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MCQ based Naranjo Calculator

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Naranjo Scale Calculator

Naranjo Scale Calculator

1) Are there previous conclusive reports on this reaction?

A. Yes

B. No

C. Do not know or not done.

2) Did the adverse event appear after the suspected drug was given?

A. Yes

B. No

C. Do not know or not done.

3) Did the adverse reaction improve when the drug was discontinued or a specific antagonist was given?

A. Yes

B. No

C. Do not know or not done.

4) Did the adverse reaction appear when the drug was re-administered?

A. Yes

B. No

C. Do not know or not done.

5) Are there alternative causes that could have caused the reaction?

A. Yes

B. No

C. Do not know or not done.

6) Did the reaction reappear when a placebo was given?

A. Yes

B. No

C. Do not know or not done.

7) Was the drug detected in any body fluid in toxic concentrations?

A. Yes

B. No

C. Do not know or not done.

8) Was the reaction more severe when the dose was increased, or less severe when the dose was decreased?

A. Yes

B. No

C. Do not know or not done.

9) Did the patient have a similar reaction to the same or similar drugs in any previous exposure?

A. Yes

B. No

C. Do not know or not done.

10) Was the drug interaction confirmed by any objective evidence?

A. Yes

B. No

C. Do not know or not done.

Your score is

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