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Objectives: To gain insight on the knowledge, opinions, barriers, and practices of pharmacists regarding drug risk-minimization tools. Design: Descriptive, nonexperimental, cross-sectional survey. Setting: 20 states in the United States, fall 2004. Participants: 2.052 randomly selected licensed pharmacists employed in a position requiring an active pharmacist license at the time of the survey and who responded to the survey. Intervention: Participants completed a four-page survey regarding their experience with different types of risk-minimization tools. Main outcome measure: Univariate distributions for each question were analyzed. Results: 50% of survey recipients responded to the mailing; 88% of respondents had an active pharmacist license. Of respondents, 18% reported never having received a Dear Healthcare Professional letter and 29% stated that they were not familiar with Medication Guides, Patient package inserts were thought to be somewhat effective by 53% of respondents. Of pharmacists who dispensed a drug with programs for special stickers to be affixed on prescriptions to indicate that the labeled risk had been addressed by the prescriber, 41% reported receiving a prescription without a sticker; 45% dispensed the prescription when stickers were missing. Sixty percent of pharmacists stated that risk-minimization programs have a negative impact on the dally practice of pharmacy; nevertheless, many acknowledged that it was a necessary duty. Conclusion: Pharmacists might benefit from additional training on risk-minimization strategies. The successful implementation and impact of risk-minimization programs on the practice of pharmacy should be carefully considered by drug manufacturers and regulators. [ABSTRACT FROM AUTHOR]