FormWeb • sofosbuvir-velpatasvir

Children's of Alabama

Approved Formulary

Alabama Medicaid Formulary Questions or Suggestions? CHS Homepage

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Children's of Alabama

Approved Formulary

Alabama Medicaid Formulary Questions or Suggestions? CHS Homepage

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sofosbuvir-velpatasvir

sofosbuvir-velpatasvir

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-formulary	Interchange
Epclusa	GRANULE	150 mg/37.5mg pellet pack
Epclusa	TABLET	400mg - 100mg

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Comments:

Epclusa Pellets are a RESTRICTED formulary item: Epclusa Pellets are only stocked when a qualifying patient (< 17kg) is listed for transplant. It is the responsibility of the transplant service to notify pharmacy when listing a patient.

Last updated: Feb. 7, 2022

Pharmacy Phone Numbers:

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

This site is intended for Children's Health System health professionals and employees only.
Use by pharmaceutical/medical representatives or non-CHS personnel is strictly prohibited.