cleo-ddi-check - SKILL.md Agent Skill

name: cleo-ddi-check description: "Check drug-drug interactions (DDI) between two or more medications using FDB data. Triggered by questions like 'do X and Y interact?', 'is it safe to take A with B?', 'check interactions for these drugs', 'what are the interactions between drug1 and drug2?', or any multi-drug safety question. Returns severity level, monograph title, mechanism, clinical effects, and patient management guidance." metadata: openclaw: emoji: "⚠️" requires: bins: ["node"]

Drug-Drug Interaction (DDI) Checker

Check for interactions between 2+ drugs using FDB's full DDI monograph database.

When to Use

✅ USE this skill when:

User asks if two or more drugs interact
Questions like "is it safe to take X with Y?"
Medication reconciliation checks
Multi-drug interaction screening
Questions about drug combination safety

❌ DON'T use this skill when:

Looking up a single drug (use cleo-medid-lookup or cleo-drug-search)
Side effects of a single drug (use cleo-side-effects)
Allergy/cross-reactivity questions

Data Source

FDB DDI Database: fdb_20260326 (or latest fdb_YYYYMMDD db)
4,551 DDI monographs, 712,650 GCN→DDI links
Drug resolution uses fdb_ok_20250925 for name→GCN lookups

Severity Levels

Level	Label	Meaning
1	🔴 CONTRAINDICATED	Should not be dispensed/administered together
2	🟠 SEVERE	Action required to reduce risk
3	🟡 MODERATE	Assess risk, take action as needed
9	🔵 UNDETERMINED	Alternative therapy interaction; assess risk

Usage

# By drug name (recommended)
node ~/.openclaw/workspace/skills/cleo-ddi-check/scripts/ddi_check.js "drug1" "drug2"
node ~/.openclaw/workspace/skills/cleo-ddi-check/scripts/ddi_check.js "atorvastatin" "gemfibrozil"
node ~/.openclaw/workspace/skills/cleo-ddi-check/scripts/ddi_check.js "warfarin" "aspirin" "ibuprofen"

# By MEDID
node ~/.openclaw/workspace/skills/cleo-ddi-check/scripts/ddi_check.js --medids 283712 304570

# By GCN_SEQNO
node ~/.openclaw/workspace/skills/cleo-ddi-check/scripts/ddi_check.js --gcns 29967 45890

Run from the scripts directory (has symlinked node_modules):

cd ~/.openclaw/workspace/skills/cleo-ddi-check && node scripts/ddi_check.js "drug1" "drug2"

Output Format

{
  "ddiDatabase": "fdb_20260326",
  "drugs": [
    { "input": "atorvastatin", "resolved": "atorvastatin calcium", "gcnCount": 5, "codexCount": 68 }
  ],
  "interactionCount": 1,
  "interactions": [
    {
      "pair": ["atorvastatin calcium", "gemfibrozil"],
      "title": "Atorvastatin/Gemfibrozil",
      "severity": "1",
      "severityLabel": "🔴 CONTRAINDICATED",
      "displayAction": "Interrupt",
      "pharmacodynamic": true,
      "pharmacokinetic": false,
      "text": "full monograph text..."
    }
  ]
}

Interpreting Results

No interactions found: The drug pair has no FDB monograph — may still have minor interactions; always recommend clinical review
CONTRAINDICATED (1): Flag clearly — should not be co-administered
SEVERE (2): Recommend clinical review and action
MODERATE (3): Present with context; patient-specific assessment needed
Multiple drugs: All pairs are checked (n*(n-1)/2 combinations)

Formatting for Users

When presenting DDI results:

Lead with severity badge and drug pair
Summarize clinical effects in plain language
Include key patient management points
Note predisposing factors if present (age, renal function, etc.)
Remind: this is clinical decision support, not a substitute for clinical judgment

Important Notes

FDB DDI operates at the GCN_SEQNO (generic ingredient + strength + form) level
The checker resolves drug names → HICL_SEQNO → GCN_SEQNOs → DDI_CODEXes for matching
Brand names should also resolve correctly via ingredient matching
Always clarify that DDI checking is for clinical decision support only