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Prescriber Attitudes Toward NTI Drugs and Substitution Practices

Prescriber Attitudes Toward NTI Drugs and Substitution Practices

Caspian Mortensen Jan, 29 2026 15

Prescribers remain divided on substituting generic versions of narrow therapeutic index (NTI) drugs like warfarin, lithium, and levothyroxine. While generics are FDA-approved, many doctors worry about small changes in blood levels causing serious harm. State laws, patient safety, and emerging data are shaping how these swaps happen.

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