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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chlorpheniramine-HYDROcodone-PSE

chlorpheniramine-HYDROcodone-PSE
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Zutripro LIQUID, ORAL 4 mg-5 mg-60 mg/5 mL    
Comments:

ORDER FORMULATION

THERAPEUTIC INTERCHANGE

chlorpheniramine/HYDROcodone/PSE (Zutripro)                                                                                        

  • 4 mg-5 mg-60 mg/5 mL liquid oral Dose: 5 mL

promethazine-phenylephrine-codeine (Phenergan VC with Codeine)

  • 6.25 mg-5 mg-10 mg/5 mL syrup oral Dose: 5 mL

Zutripro medication guide

Zutripro – Non-formulary, not stocked, interchange to Promethazine VC with codeine at a 5mL : 5 mL ratio, or proportionately.

Reviewed: October 25, 2011 (Zutripro)

Last updated: Dec. 19, 2017






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