FormWeb • cytomegalovirus immune globulin

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Children's of Alabama

Approved Formulary

Alabama Medicaid Formulary Questions or Suggestions? CHS Homepage

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cytomegalovirus immune globulin

cytomegalovirus immune globulin

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-formulary	Interchange
Cytogam	SOLUTION	50 mg/mL

VIEW MORE immune globulins, immunologic agents
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Comments:

Cytomegalovirus immune globulin is a RESTRICTED formulary item. Use is restricted to patients with resistant CMV with unresolving CMV logs and requires ID approval prior to use.

Last updated: May. 26, 2025

Pharmacy Phone Numbers:

Inpatient Pharmacy: 205-638-9641
IV Room: 205-638-9716
Pharmacy Offices: 205-638-9718

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