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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golimumab
  • Restricted Simponi Aria --> Restricted to Outpatient Medical. Each patient should be evaluated for reimbursement issues prior to starting.
  • Restricted Miscellaneous Programs
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Simponi Aria SOLUTION, INTRAVENOUS 50 mg/4 mL      
Simponi SOLUTION, SUBCUTANEOUS 50 mg/0.5 mL      
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Simponi medication guide

Simponi Aria medication guide

SIMPONI ARIA is classified as formulary status, restricted to hospital OUTPATIENT/CLINIC use. 

SIMPONI is classified as NON-FORMULARY, NOT STOCKED, NOT ORDERED. Defer initiation to after discharge. If absolutely needed in hospital, patient may use home supply.

Reviewed: September 22, 2009 (Simponi), and July 22, 2014 (Simponi Aria)

Last updated: Aug. 21, 2017






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