Approved Formulary
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Approved Formulary
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viltolarsen

viltolarsen
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-formulary Interchange
Viltepso SOLUTION FOR INFUSION 250 mg/5 ml      

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CLASS
m00028

Comments:

Viltolarsen is a RESTRICTED formulary item.  Infusion is restricted to outpatient infusion clinics, and medication must be white bagged (supplied by a specialty pharmacy patient specific and shipped to COA pharmacy prior to infusion).


Last updated: Apr. 27, 2026


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

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