DrugBalancer

1. Product vision & target users

Vision

Long-term pharmacotherapy is the norm for chronic disease, and a substantial body of evidence links common medications to clinically meaningful nutrient depletion: metformin and vitamin B12, acid suppressants and magnesium, statins and coenzyme Q10, diuretics and thiamine, corticosteroids and bone minerals. These effects are rarely surfaced in prescribing systems and are often addressed reactively, if at all.

DrugBalancer exists to make this knowledge operational: instantly available at the point of care, honestly graded by evidence quality, translated into food-first and supplement recommendations that respect a patient's dietary reality, and screened for safety against everything else the patient takes. The product is a professional tool — calm, fast, and trustworthy — that a practitioner opens for every medication review.

Positioning statement

For integrative health practitioners, pharmacists, naturopaths, and clinic teams who manage patients on long-term medications, DrugBalancer is a subscription decision-support platform that turns a medication list into an evidence-graded nutritional plan with built-in interaction safety — unlike generic drug references that ignore nutrition or consumer supplement apps that ignore pharmacology.

Target users

Non-goals (v1)

• Not a prescribing or dispensing system; no dose calculators for pharmaceuticals.
• Not a patient-facing app; patients receive printed or PDF handouts produced by the practitioner.
• Not an EHR; patient context is lightweight and identifier-minimal by design.

2. Core feature set & user flows

2.1 Medication search & depletion profile

• Global search by brand or generic name, drug class, or therapeutic area, with type-ahead results in <150 ms.
• Profile page shows: class, brands, clinical summary, monitoring notes, and a list of nutrient impacts sorted by evidence grade (Strong → Moderate → Emerging).
• Each impact expands to reveal mechanism, who is most at risk, depletion signs to ask about, and lab markers to consider.
• Medications with no established depletions say so explicitly — honesty is a feature.

2.2 Food & supplement recommendations with dietary filtering

• Every nutrient has a curated food table (food, serving, amount) and a supplement option (form, typical range, timing, notes, cautions).
• Dietary filter chips — Plant-based, Vegetarian, Pescatarian, Kosher, Halal, Gluten-free, Dairy-free, Nut-free, Low-FODMAP — filter foods in real time and can be combined.
• Supplement options flag sourcing concerns (e.g., gelatin softgels, lanolin-derived D3) when a plant-based, kosher, or halal preference is active.
• Filters persist per patient and can be set as a clinic default in Settings.

2.3 Interaction checker (side panel & standalone)

• Add any combination of drugs, supplements, botanicals, and foods; the checker returns all pairwise flags.
• Five severities: Avoid, Caution, Monitor, Info, Supportive. Supportive pairs surface evidence-informed replenishment strategies rather than only risks.
• Each flag states mechanism, effect, and a concrete recommendation (e.g., “separate by 4 hours”) plus an evidence grade.
• Available as a slide-over on any medication page (pre-loaded with that drug) and as a full-page tool.

2.4 Practitioner workflow

• Patient context: chart reference, age range, sex, dietary preferences, conditions, current medications and supplements, free-text notes. No names or DOB required.
• Protocol builder: select one or more medications → the system merges nutrient impacts across the regimen, highlights convergence (two drugs hitting the same nutrient), pre-selects Strong/Moderate items, and screens suggested supplements against the regimen.
• Clinician trims, edits notes (clinician-facing and patient-facing), saves as Draft or Final.
• Export: Chart view (mechanism, evidence, monitoring) and Patient handout view (plain-language, food-first, supplement details) — print or save to PDF via the browser.

2.5 Accounts, roles, onboarding

• Onboarding wizard: profile & credential → role → clinic & default dietary preferences → plan selection → land in the workspace with a guided first search.
• Roles: Clinician (full authoring rights) and Support staff (read reference data, manage patient context, print finalized protocols; cannot create or finalize protocols). Enforced server-side on every write.

2.6 Primary user flows

3. Information architecture & key screens

Navigation model

A persistent left sidebar (collapsing to a bottom bar on tablets in portrait) holds the five workspace areas. A global search field sits in the top bar on every workspace screen and accepts medication names first, with agents (supplements/botanicals) as a secondary result group. Context-specific actions (Check interactions, Add to protocol, Print) live in the page header so they are reachable without scrolling.

4. UI/UX principles & visual direction

Principles

• Clinical calm. Generous whitespace, one accent color, restrained motion. The interface should lower cognitive load during a busy clinic day.
• Evidence is visible. Grades and severities are never hidden behind hover states; they appear inline on every claim.
• Food first, supplements second. Layout order reflects clinical priority; supplement cards always show cautions alongside dose ranges.
• Progressive disclosure. Mechanism, risk factors, and lab markers expand on demand so the default view is scannable.
• Print is a first-class surface. Every protocol renders cleanly on paper with no navigation chrome, using a dedicated print stylesheet.
• Tablet-ready. Minimum 44 px touch targets, responsive grids at 768 px and 1024 px, and side panels that become full-screen sheets on narrow viewports.

Visual system

Accessibility

• Color is always paired with a label, so no severity or evidence grade depends on hue alone. Contrast is NOT yet AA across the palette: 44 pairs were computed and 10 fail, including the caution chip at 2.157:1 and slate-400 body text at 2.628:1. Re-derive with the contrast calculator in tests/unit/chip.test.ts; the palette correction is a separate ruled batch because the caution token is a design change, not a one-class fix.
• Full keyboard operability for search, filter chips, side panels, and the protocol builder.
• Reduced motion: smooth scrolling is gated behind prefers-reduced-motion, and transitions and animations inside the clinical workspace (.db-workspace) are zeroed under it. Routes OUTSIDE .db-workspace - the marketing pages, /login and this page - still animate the .btn-* transitions, so the coverage is not yet total. No information is conveyed by animation alone.

5. Data & safety considerations

Scope & intended use

DrugBalancer is informational decision support for licensed professionals. It does not diagnose, does not recommend pharmaceutical dosing, and requires the practitioner to make the final decision. A persistent disclaimer appears in the workspace and on every export.

Evidence grading

Content governance

• Each reference entry records mechanism, clinical note, risk factors, and grade. A clinical editorial process (pharmacist + dietitian review) is the single path to change.
• Monthly review cycle against labeling changes and notable literature; versioned dataset with change notes surfaced to users.
• Supplement ranges are conservative, include cautions and upper-limit warnings, and always reference prescriber coordination where a therapy is co-prescribed (e.g., folate with methotrexate, pyridoxine with isoniazid).
• Bidirectional interaction logic: nutrient effects on drug absorption (e.g., calcium on levothyroxine, minerals on fluoroquinolones) are modeled as first-class interactions, not footnotes.

Privacy & security posture

• Data minimization: patient records use a chart reference, age range, and sex — no name, DOB, or contact data fields exist in v1.
• Role-based authorization enforced server-side; support staff cannot create or finalize protocols.
• Session cookies are HTTP-only; all traffic TLS in production; database access limited to the application service.
• Audit trail: protocols retain created/updated timestamps and owner; Group plan adds exportable audit logs.
• Print/PDF exports are generated client-side so no document leaves the clinic's browser by default.
• Production roadmap: encryption at rest, SSO, regional data residency, and a business-associate/data-processing agreement for clinics that choose to store more context.

Failure modes considered

• Over-reliance: emerging evidence is visually de-emphasized and excluded from handouts by default.
• Omission: the checker only reports known pairs; the UI states that absence of a flag is not proof of safety.
• Stale content: dataset version and last-reviewed date are displayed in Settings and on exports.

6. Monetization & go-to-market

Pricing structure

• 14-day free trial with no card; demo workspace for instant evaluation.
• Annual billing includes two months free; seat add-ons for Clinic at $15 / seat / month.
• Value anchor: one prevented adverse interaction or one improved adherence conversation per month exceeds the subscription cost.

Go-to-market motion

• Professional channels first. Continuing-education partnerships with integrative medicine, naturopathic, and pharmacy associations; sponsored case-based webinars on depletion counseling.
• Content as acquisition. Publicly searchable, non-gated medication depletion summaries with a “see the full profile and interactions” upgrade path.
• Champion-led clinic expansion. Solo Practitioner subscribers convert to Clinic plans when support staff need access; in-product prompts when a second person prints a protocol.
• Dispensary and lab partnerships. Optional mapping of supplement recommendations to a clinic's preferred professional dispensary, and lab panel suggestions linked to monitoring markers (revenue-share opportunities, clearly disclosed).
• Trust signals. Published editorial policy, named clinical advisory board, evidence grading methodology, and transparent change logs.

Retention levers

• Saved patient context and protocol library create durable value.
• Monthly evidence digest e-mail tied to the medications a practice searches most.
• Clinic-branded handouts and templates.

7. Roadmap & success metrics

Post-v1 roadmap

• Lab integration: import 25-OH D, B12, ferritin, magnesium to personalize priority.
• EHR export: FHIR DocumentReference for finalized protocols.
• Formulary mapping to professional dispensaries; kosher/halal/vegan certification badges per product.
• Localization (metric/imperial, regional brand names) and additional dietary frameworks (e.g., renal, low-oxalate).
• Team analytics: most-searched medications, protocol completion rates.

Success metrics