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System Formulary Update
Narrow Spectrum and Miscellaneous Anticonvulsants

Situation

The narrow spectrum and miscellaneous anticonvulsants class review and formulary standardization was approved at the July 2021 System Pharmacy and Therapeutics Committee meeting.

Background

The following medications were reviewed: carbamazepine, cenobamate, eslicarbazepine, lacosamide, oxcarbazepine, phenytoin, primidone, stiripentol, tiagabine, vigabatrin, ethosuximide, fosphenytoin, methsuximide, cannabidiol

Assessment/Recommendation

Changes effective: Tuesday August 31, 2021

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

• Cannabidiol (Epidiolex) oral solution – restricted to continuation of home therapy; requires approval by Neurology providers for new initiations
• Carbamazepine chewable tablet, IR tablet, ER capsule, ER tablet, and oral suspension
• Fosphenytoin injection solution
• Lacosamide injection solution, oral solution, and tablet
• Oxcarbazepine tablet and oral suspension
• Phenytoin injection solution, chewable tablet, ER capsule, and oral suspension
• Primidone tablet
• Vigabatrin oral powder packet

Note: Stock of these formulary products may vary at individual entities

As a result, the following products will be removed from the UNC Health Medication Formulary

• Cannabidiol oil
• Cenobamate tablet
• Eslicarbazepine tablet
• Ethosuximide capsule and oral solution
• Methsuximide capsule
• Oxcarbazepine ER tablet
• Stiripentol capsule and oral powder packet
• Tiagabine tablet and oral suspension
• Vigabatrin tablet

Non-formulary orders will be converted according to the following therapeutic interchange: