trastuzumab
Form | Strength | ANAN | ASMP | LACH | LALK | LOHH | LOLR | LOWC | SDSD | SESE | SFSF | Formulary Status |
---|---|---|---|---|---|---|---|---|---|---|---|---|
POWDER FOR INJECTION, INTRAVENOUS | 150 mg; anns 150 mg; anns 420 mg; dkst 150 mg; dkst 420 mg; dttb 150 mg; dttb 420 mg; pkrb 150 mg; pkrb 420 mg; qyyp 150 mg; qyyp 420 mg |
Chemotherapy Chart
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments)
Biosimilar and Reference Products Interchange List for Adults
Medication
Reference Drug or Biosimilar
Formulary Status
Automatic Therapeutic Interchange
Inpatient1
Outpatient
*New Starts/New Authorizations Only*
Ogivri (trastuzumab-dkst)
Biosimilar
Formulary
(preferred)
Use Ogivri
Use Ogivri unless third party payer requires other trastuzumab product
Kanjinti (trastuzumab-anns)
Ontruzant (trastuzumab-dttb) Herzuma (trastuzumab-pkrb) Trazimera (trastuzumab-qyyp)
Biosimilars
Formulary, restricted to OP
(not preferred)
Interchange to Ogivri
Interchange to Ogivri unless third party payer requires other trastuzumab product
Herceptin (trastuzumab)
Reference