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System Formulary Update
Non-Oral NSAIDs

Situation
The non-steroidal anti-inflammatory drugs, non-oral class review and formulary standardization was approved at the July 2020 System Pharmacy and Therapeutics Committee meeting.

Background
The following medications were reviewed:
• Ophthalmic Route – bromfenac, diclofenac sodium, nepafenac, flurbiprofen, ketorolac
• Injection Route – ibuprofen, ibuprofen lysine, indomethacin, ketorolac, meloxicam
• Other (eg, rectal, topical, intranasal) Routes – diclofenac epolamine, diclofenac sodium, indomethacin, ketorolac

Assessment/Recommendation
Changes effective: Tuesday September 1, 2020

System P&T voted to include the following products on the UNC Health Medication Formulary:
• Diclofenac sodium topical gel: 1%
• Flurbiprofen ophthalmic solution: 0.03%
• Ketorolac ophthalmic solution: 0.5%
• Ketorolac injection: 15 mg/mL, 30 mg/mL, 60 mg/2 mL
• Ibuprofen lysine injection: 10 mg/mL
• Indomethacin injection: 1 mg/mL
• Indomethacin rectal suppository: 50 mg

Note: Stock of these products may vary at individual entities

As a result, the following products will be removed from the UNC Health Medication Formulary: 
• Bromfenac ophthalmic solution
• Diclofenac sodium ophthalmic solution
• Diclofenac injection
• Diclofenac epolamine topical patch
• Ibuprofen injection
• Ketorolac intranasal spray
• Meloxicam injection
• Nepafenac ophthalmic solution
• Combination products