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System Formulary Update
Non-Contraceptive Estrogens & Estrogen Derivatives Standardizati
Situation:
The Non-Contraceptive Estrogens and Estrogen Derivatives standardization was approved by the System Pharmacy & Therapeutics Committee in November 2023.
Background:
The following medications were reviewed: estradiol valerate, estradiol cypionate, estradiol, conjugated estrogens, esterified estrogens, esterified estrogens/methyltestosterone, conjugated estrogens/bazedoxifene, conjugated estrogens/medroxyprogesterone, estradiol/elagolix/norethindrone, estradiol/drosperinone, estradiol/levonorgestrel, estradiol/norethindrone, estradiol/progesterone, ethinyl estradiol/norethindrone.
Assessment/Recommendations:
System P&T voted to include the following products on the UNC Health Care System Drug Formulary:
- Estradiol oral tablet: 0.5 mg, 1 mg, 2 mg
- Estradiol weekly transdermal patch: 0.05 mg/day, 0.1 mg/day
- Estradiol vaginal cream: 0.01% (42.5 g)
- Conjugated estrogen tablet: 0.3 mg, 0.625 mg
As a result, the following products will be removed from the System Medication Formulary:
- Estradiol semi-weekly transdermal patch
- Conjugated estrogen cream 0.625 mg/g (30 g)
- Estradiol IM injection
- Esterified estrogens tablet
- Esterified estrogens-methyltestosterone tablet
Additionally, the following therapeutic interchange will also go into effect:
|
Non-Formulary Order |
Formulary Equivalent Order |
|
Estradiol semiweekly transdermal patch (i.e., VIVELLE-DOT) 0.05 mg/day transdermal patch 2 times a week 0.1 mg/day transdermal patch 2 times a week |
Estradiol weekly transdermal patch (i.e., CLIMARA) 0.05 mg/day transdermal patch once weekly 0.1 mg/day transdermal patch once weekly |
|
Conjugated estrogen vaginal cream Any dose or frequency |
Estradiol vaginal cream Same dose and frequency |
Note: Stock of this formulary product may vary at individual entities
Formulary/Epic Changes will Go-Live on Tuesday, February 20, 2024