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Drug classes requiring specialist consultation on Oladoctor

Discover which meds — hormones, psychotropics, cancer therapies, GLP-1 & more — need a specialist consult, not express prescriptions.

Updated over 2 weeks ago

How specialist consultations work

All drugs listed below are prescribed only during a live video consultation. Your doctor will review your medical history and lab results, adjust your treatment plan, and — if needed — issue referrals for additional tests (e.g., hormone panels, liver function).

Note: If you don’t yet have recent test results, your doctor can still issue lab referrals so you can obtain them before your next prescription.

Hormonal therapies

  • Examples: Prednisone, dexamethasone; estradiol/progesterone; levothyroxine; ethinylestradiol/gestagen; inhaled fluticasone, budesonide

  • Risks: Osteoporosis, metabolic syndrome, hypertension, adrenal suppression

  • Why a specialist: An endocrinologist or gynecologist interprets TSH, cortisol and sex-hormone levels to tailor a safe dose

  • Prepare ahead: TSH + free T4, serum cortisol, CBC

Psychotropic medications

  • Examples: Sertraline, fluoxetine; risperidone, olanzapine; lithium, valproate; diazepam, lorazepam

  • Risks: Suicidal ideation, cognitive impairment, withdrawal syndromes, drug interactions

  • Why a specialist: A psychiatrist safely manages titration schedules, monitors mood and side effects

  • Prepare ahead: ECG, CBC, LFTs

Immunosuppressants & biologics

  • Examples: Methotrexate, azathioprine; infliximab, adalimumab

  • Risks: Opportunistic infections, hepatotoxicity, bone-marrow suppression

  • Why a specialist: A rheumatologist/immunologist monitors CBC, liver enzymes and infection risk

  • Prepare ahead: CBC with differential, ALT/AST

Antineoplastic agents

  • Examples: Cisplatin, doxorubicin; imatinib; pembrolizumab

  • Risks: Severe myelosuppression, cardiotoxicity, hypersensitivity reactions

  • Why a specialist: An oncologist calculates dosing by body-surface area, prescribes supportive care and closely monitors labs

  • Prepare ahead: CBC with differential, ALT/AST, ECG

GLP-1 agonists at initiation

  • Examples: Semaglutide (Wegovy®, Ozempic®); Tirzepatide (Mounjaro®, Zepbound®)

  • Risks: Severe nausea, hypoglycemia, pancreatitis

  • Why a specialist: An endocrinologist/diabetologist selects starting dose, titrates slowly and monitors tolerability

  • Prepare ahead: Fasting glucose, lipid panel, amylase/lipase

Systemic antibiotics & anti-TB drugs

  • Examples: Amoxicillin, ciprofloxacin; isoniazid, rifampicin

  • Risks: Resistance, severe allergic reactions, dysbiosis

  • Why a specialist: A general practitioner selects therapy based on culture and sensitivity results

  • Prepare ahead: Sputum/blood cultures, CBC

Antiviral agents

  • Examples: Tenofovir, lamivudine; sofosbuvir, daclatasvir; remdesivir (COVID-19)

  • Risks: Hepatotoxicity, viral resistance, serious drug interactions

  • Why a specialist: A GP tailors regimens to viral genotype and monitors liver function

  • Prepare ahead: Viral load, LFTs

Systemic antifungals

  • Examples: Fluconazole, voriconazole

  • Risks: Hepatotoxicity, dangerous drug interactions

  • Why a specialist: A GP or infectious-disease expert adjusts dose/duration based on infection severity

  • Prepare ahead: LFTs, CBC

Cardiology drug initiations

  • Examples: Amiodarone, sotalol; furosemide, spironolactone

  • Risks: Arrhythmias, electrolyte imbalances, hypotension

  • Why a specialist: A cardiologist reviews ECGs and labs to safely tailor dosing

  • Prepare ahead: ECG, electrolytes (K⁺, Na⁺), CBC

Anticoagulants & antiplatelets (initiation)

  • Examples: Warfarin, rivaroxaban; aspirin, clopidogrel

  • Risks: Major bleeding, hemorrhagic stroke

  • Why a specialist: A hematologist or cardiologist monitors INR/coag panels and balances clot vs. bleed risk

  • Prepare ahead: INR, CBC

Narrow-therapeutic-index antiepileptics

  • Examples: Valproate, carbamazepine, phenytoin

  • Risks: Neurotoxicity, severe toxicity from small dose changes

  • Why a specialist: A neurologist measures blood levels and steers dosing for efficacy without toxicity

  • Prepare ahead: Drug levels, CBC

Opioids & strong sedatives

  • Examples: Morphine, oxycodone, zolpidem

  • Risks: Dependence, respiratory depression, cognitive impairment

  • Why a specialist: A pain specialist or psychiatrist controls dosing and screens for misuse risk

  • Prepare ahead: Respiratory function check (pulse oximetry), opioid use history

Systemic retinoids & fertility drugs

  • Examples: Isotretinoin, clomiphene

  • Risks: Teratogenicity, hormone imbalances, severe side effects

  • Why a specialist: A dermatologist or reproductive endocrinologist manages pregnancy planning and lab monitoring

  • Prepare ahead: LFTs, pregnancy test

DMARDs (disease-modifying antirheumatic drugs)

  • Examples: Methotrexate, leflunomide, hydroxychloroquine

  • Risks: Hepatotoxicity, bone-marrow suppression, infection risk

  • Why a specialist: A rheumatologist follows clinical guidelines, reviews labs, and adjusts therapy to minimize harm

  • Prepare ahead: CBC, LFTs, rheumatoid factor

Important: None of these drug classes can be safely renewed via express prescription. Please schedule a specialist video consultation on Oladoctor for expert assessment, accurate dosing, and ongoing monitoring.

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