Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines (Note: “Therapeutic Interchange” should be placed in the order comments)
Topical Calcineurin Inhibitors (as of 10/2024)
Medication Ordered
Brand Name
Dosage form
ERX
Dose and Frequency
Formulary Medication
Dosage Form
ERX
Dose and Frequency
Ipratropium bromide 0.03%
Atrovent
Nasal Solution
16070
2 sprays each nostril as directed
Ipratropium 0.06% nasal solution
Nasal Solution
16071
2 sprays each nostril same as ordered
Age Restriction: Age greater than or equal to 2 years old
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments)
Topical Calcineurin Inhibitors (as of 10/2024)
Medication Ordered
Brand Name
Dosage form
ERX
Dose and Frequency
Formulary Medication
Dosage Form
ERX
Dose and Frequency
Ipratropium bromide 0.03%
Atrovent
Nasal Solution
16070
2 sprays each nostril as directed
Ipratropium 0.06% nasal solution
Nasal Solution
16071
2 sprays each nostril same as ordered
Age Restriction: Age greater than or equal to 2 years old