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.
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alpha 1-proteinase inhibitor

alpha 1-proteinase inhibitor
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Prolastin-C, Zemaira, Aralast POWDER FOR INJECTION, INTRAVENOUS 500 mg, 1,000 mg      
Comments:

Alpha-1- Proteinase Inhibitor (Aralast, Prolastin, Zemaira)- Formulary restricted to outpatient infusion areas. Once weekly IV infusion and cost varies from $300 to $1500 or more depending on weight. 

Reviewed: January 31, 2006

Last updated: Aug. 17, 2025






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