FormWeb • dextranomer-sodium hyaluronate

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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dextranomer-sodium hyaluronate

dextranomer-sodium hyaluronate

Non-formulary Miscellaneous Programs

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-Formulary	Interchange
Solesta	GEL, INJECTABLE	50 mg-15 mg

Comments:

SOLESTA is classified as non-formulary, not stocked. It should be deferred to after discharge (i.e., physician office).

Reviewed: May 27, 2014

Last updated: Jun. 27, 2017

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