Understanding SMS Failures Related to Medication Names

Some outbound text messages in Akute may fail to send when they include prescription medication names. This is not specific to Akute, but the result of carrier-level filtering rules that all healthcare platforms must follow. In the United States and Canada, carriers have recently tightened enforcement of policies that classify prescription-related content as a forbidden message category, even when sent by licensed medical providers.

Because of this, messages containing drug names (for example, “tramadol”) may be blocked before they reach the patient.

Why This Happens

Mobile carriers use automated filtering systems to detect content that could be associated with drug solicitation or misuse. These filters do not distinguish between:

  • legitimate medical communication
  • illegal drug solicitation

If a medication name appears in an SMS message, the carrier may flag and block it automatically. This can happen inconsistently, depending on ongoing changes in filtering models.

Workarounds We Recommend

To avoid failed outbound messages:

1. Censor medication names in SMS

  • Example:
    • tramadol → trama****
    • oxycodone → oxy****

2. Or use secure messaging instead of SMS

Secure messages are not subject to SMS carrier filtering and will reliably deliver the full medication name and instructions.

Reference

For more detail, you can review Twilio’s carrier-regulated forbidden messaging categories here.

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