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System Formulary Update
Non-LAI Second Generation Antipsychotic

Situation

The Non-LAI Second Generation Antipsychotic class review and formulary standardization was approved at the April 2023 System Pharmacy and Therapeutics Committee meeting.

Background

The following medications were reviewed: aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lumateperone, lurasidone, olanzapine, paliperidone, pimavanserin, quetiapine, risperidone, ziprasidone

The recommendations, below, do NOT impact long-acting depot injections for aripiprazole, aripiprazole lauroxil, olanzapine, paliperidone, quetiapine, or risperidone. These formulations were not reviewed by the System P&T Committee.

Assessment/Recommendations

System P&T voted to include the following products on the UNC Health System Medication Formulary:

• Aripiprazole tablets: 2 mg, 5 mg, 10 mg, 15 mg
• Cariprazine capsules: 1.5 mg, 3 mg
  • RESTRICTED TO CONTINUATION OF HOME THERAPY
• Clozapine tablet: 25 mg, 100 mg
• Olanzapine
  • Tablet: 2.5 mg, 5 mg, 10 mg, 20 mg
  • Oral disintegrating tablet: 5 mg, 10 mg
  • Injection: 10 mg
• Quetiapine IR tablet: 25 mg, 100 mg, 200 mg, 300 mg
• Risperidone
  • Tablet: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg
  • Oral disintegrating tablet: 0.5 mg, 1 mg, 2 mg
  • Oral solution: 1 mg/mL
• Ziprasidone
  • Capsule: 20 mg, 40 mg
  • Injection: 20 mg

As a result, the following products will be removed from the System Medication Formulary:

• Asenapine sublingual tablets
• Brexpiprazole oral tablets
• Iloperidone oral tablets
• Olanzapine-fluoxetine combination tablets
• Paliperidone ER oral tablets
• Quetiapine XR oral tablets

Note: Stock of this formulary product may vary at individual entities

Formulary/Epic changes will Go-Live on Tuesday, June 13, 2023.