Approved Hospital Formulary
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Approved Hospital Formulary
05/05/2021 tb New Relistor rules in Sentri7
May 13, 2021
From: "Travis Ball" <travis.ball@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>
Sent: Wednesday, May 5, 2021 11:25:35 AM
Subject: New Relistor rules in Sentri7
Two new rules for methylnaltrexone (Relistor) have been added to Sentri7.
The "methylnaltrexone (Relistor) review" is under the Clinical Alerts Tab. This rule looks for patients where SQ Relistor can be discontinued, limited to 3 days or converted to PO.
Criteria from FormWeb:
- Restricted to use in the treatment of opioid induced constipation unrelieved by at least 1 day of treatment with at least 2 selected agents in non-cancer pain or chronic pain palliative care patients
o Selected agents: bisacodyl, erythromycin, glycerin suppository, lactulose enema, magnesium citrate or hydroxide, metoclopramide, mineral oil enema, senna, and sorbitol
- Pharmacists automatically add a duration of 3 doses if ordered without a duration or stop time specified
o Prescribers may order for methylnaltrexone to continue further than 3 doses if desired
The second rule is located under the Renal Dosing (other) Tab. This rules helps identify patients on PO or SQ Relistor that could have their dose adjusted based on renal function and weight range.
Criteria from FormWeb:
- Pharmacists automatically perform renal dose adjustments based on indication and CrCl < 60 mL/min:
o Opioid-induced constipation with advanced illness: SubQ:
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- <38 kg: 0.075 mg/kg every other day (round dose up to nearest 0.1 mL of volume)
- 38 to <62 kg: 4 mg every other day
- 62 to 114 kg: 6 mg every other day
- >114 kg: 0.075 mg/kg every other day (round dose up to nearest 0.1 mL of volume)
o Opioid-induced constipation with non-cancer pain:
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- Oral: 150 mg once daily
- SubQ: 6 mg once daily