FormWeb • baricitinib

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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baricitinib

baricitinib

Restricted Miscellaneous Programs
Restricted Baricitinib Criteria For Use
Patient Fact Sheets Patient Fact Sheet for PEDIATRICS (English)
Patient Fact Sheets Patient Fact Sheet for PEDIATRICS (Spanish)

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-Formulary	Interchange
Olumiant	TABLET, ORAL	1 mg, 2 mg

Comments:

Formulary restricted for EUA in treatment of COVID-19 in patients who meet FDA and EUA specifications and Huntsville Hospital approved criteria.

Criteria & Recommended Dosing

This drug has not yet been evaluated at Huntsville Hospital for use in the FDA approved indication, rheumatoid arthritis.

Reviewed: February 2021 (COVID-19)

Updated: August 2021 (COVID-19)

Last updated: Jun. 27, 2022

HAZ-MED: Group 1

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