FormWeb • Axona

Huntsville Hospital

Approved Hospital Formulary

Suggestions or Corrections? Above and Beyond Nominations Formulary Request

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Medications not yet evaluated by P&T are considered NON-FORMULARY . . . . . Always check 2 unique patient identifiers - NAME and DATE OF BIRTH - at every step! . . . . . Please be sure to document all clinical activities daily.

Huntsville Hospital

Approved Hospital Formulary

Suggestions or Corrections? Above and Beyond Nominations Formulary Request

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Axona

Axona

Non-formulary Miscellaneous Programs

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-Formulary	Interchange
Axona	POWDER FOR RECONSTITUTION, ORAL	40 grams

Comments:

AXONA is a medical food. Patient to use own supply if necessary or defer to outpatient use. Non-formulary, not stocked.

Reviewed: September 22, 2009

Last updated: Nov. 16, 0002

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