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leuprolide
leuprolide
Brand names: Camcevi, Eligard, Fensolvi, Leuprolide Acetate, Lupron, Lupron Depot, Lupron Depot-Ped
| Form | Strength | ANAN | ASMP | LACH | LALK | LOHH | LOLR | LOWC | SDSD | SESE | SFSF | Formulary Status |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EMULSION, SUBCUTANEOUS | 42 mg/6 months | Camcevi - Restricted | ||||||||||
| KIT, INTRAMUSCULAR | 7.5 mg/month; 22.5 mg/3 months; 30 mg/4 months; 45 mg/6 months | Lupron Depot- Restricted | ||||||||||
| KIT, SUBCUTANEOUS | 1 mg/0.2 mL | Lupron - Formulary | ||||||||||
| POWDER FOR INJECTION, EXTENDED RELEASE, INTRAMUSCULAR | 3.75 mg/month; 11.25 mg/3 months; 11.25 mg/month; 30 mg/3 months | Lupron Depot-Ped - Restricted | ||||||||||
| POWDER FOR INJECTION, EXTENDED RELEASE, SUBCUTANEOUS | 7.5 mg/month; 22.5 mg/3 months; 45 mg/6 months | Eligard/Fensolvi - Restricted | ||||||||||
| SOLUTION, SUBCUTANEOUS | 5 mg/mL | Lupron - Formulary |
Comments:
| HCPC | Product |
| J1950 | Lupron Depot 3.75mg & 11.25mg doses & all Lupron Depot-Ped doses |
| J1951 | Fensolvi |
| J1952 | Camcevi |
| J1954 | Cipla brand |
| J9217 | Lupron Depot 7.5mg, 22.5mg, 30mg, 45mg, & all Eligard doses |
Last updated: Feb. 7, 2024
- Hazardous Drugs: View Hazardous Waste List
- Restricted: Restricted to outpatient use only
- Restricted: EXCEPTION: Lupron Depot restricted and available through non-formulary process for patient's with prostate cancer with spinal metastasis that requires urgent treatment
