FormWeb • ipilimumab

Children's of Alabama

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Children's of Alabama

Approved Formulary

Alabama Medicaid Formulary Questions or Suggestions? CHS Homepage

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ipilimumab

ipilimumab

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-formulary	Interchange
Yervoy	SOLUTION FOR INFUSION	50 mg/10 ml vial; 200 mg/40 ml vial

VIEW MORE antineoplastics, biologicals
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Comments:

Ipilimumab is a RESTRICTED formulary medication. Ipilimumab use is RESTRICTED to hem/onc prescribers and will only be stocked pursuant to active patients.

Last updated: Jun. 17, 2022

Pharmacy Phone Numbers:

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

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Use by pharmaceutical/medical representatives or non-CHS personnel is strictly prohibited.