Approved Hospital Formulary
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Brand name products with an equivalent generic may not be available to order at Henry Ford Health. For questions, contact inpatient pharmacy.
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LVP solution
LVP solution
| Drug Name | Form | Strength | Clinic Use Only | Inpatient Restrictions | Outpatient Restrictions | Non-Formulary |
|---|---|---|---|---|---|---|
| Dianeal Low Calcium with 1.5% Dextrose | SOLUTION, INTRAPERITONEAL | Dextrose 1.5% with Electrolytes (Dianeal Low Calcium) | ||||
| Dianeal Low Calcium with 2.5% Dextrose | SOLUTION, INTRAPERITONEAL | Dextrose 2.5% with Electrolytes (Dianeal Low Calcium) | ||||
| Dianeal Low Calcium with 4.25% Dextrose | SOLUTION, INTRAPERITONEAL | Dextrose 4.25% with Electrolytes (Dianeal Low Ca/Delflex Low Mag-Low Ca) | ||||
| Dianeal PD-2 with 1.5% Dextrose | SOLUTION, INTRAPERITONEAL | Dextrose 1.5% with Electrolytes (Dianeal PD-2) | ||||
| Dianeal PD-2 with 2.5% Dextrose | SOLUTION, INTRAPERITONEAL | Dextrose 2.5% with Electrolytes (Dianeal PD-2) | ||||
| Dianeal PD-2 with 4.25% Dextrose | SOLUTION, INTRAPERITONEAL | Dextrose 4.25% with Electrolytes (Dianeal PD-2) | ||||
| Extraneal | SOLUTION, INTRAPERITONEAL | ; Icodextrin 7.5% with Electrolytes (Extraneal) | ||||
| Dextrose 5% and 0.2% Sodium Chloride | SOLUTION, INTRAVENOUS | Dextrose 5% with 0.2% NaCl | ||||
| Dextrose 5% and 0.3% Sodium Chloride | SOLUTION, INTRAVENOUS | Dextrose 5% with 0.3% NaCl | ||||
| Dextrose 5% and 0.33% Sodium Chloride | SOLUTION, INTRAVENOUS | Dextrose 5% with 0.33% NaCl | ||||
| Dextrose 5% and 0.45% Sodium Chloride | SOLUTION, INTRAVENOUS | Dextrose 5% with 0.45% NaCl | ||||
| Dextrose 5% and 0.9% Sodium Chloride | SOLUTION, INTRAVENOUS | Dextrose 5% with 0.9% NaCl | ||||
| Dextrose 5% and Lactated Ringers | SOLUTION, INTRAVENOUS | Dextrose 5% in Lactated Ringers Injection | ||||
| Dextrose 5% and Water | SOLUTION, INTRAVENOUS | Dextrose 5% in Water | ||||
| Dextrose 5% and Water ADD-Vantage | SOLUTION, INTRAVENOUS | Dextrose 5% in Water | ||||
| Lactated Ringers, Intravenous | SOLUTION, INTRAVENOUS | Lactated Ringers Injection | ||||
| Plasma-Lyte A PH-7.4 | SOLUTION, INTRAVENOUS | Electrolyte Solution (Plasma-Lyte) | ||||
| Ringers, Intravenous | SOLUTION, INTRAVENOUS | Ringers Injection | ||||
| Sodium Chloride 0.45%, Intravenous | SOLUTION, INTRAVENOUS | Sodium Chloride 0.45% | ||||
| Sodium Chloride 0.9% ADD-Vantage, Intravenous | SOLUTION, INTRAVENOUS | Sodium Chloride 0.9% | ||||
| Sodium Chloride 0.9%, Intravenous | SOLUTION, INTRAVENOUS | Sodium Chloride 0.9% |
High Alert Drug
: Policy
Last updated: Mar. 3, 2021
- Black Box Warning Extraneal: Unrecognized Hypoglycemia Resulting From Drug-Device Interaction
- REMS View FDA REMS Info
