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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hydrOXYzine

hydrOXYzine
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Vistaril CAPSULE, ORAL pamoate 25 mg, pamoate 50 mg, pamoate 100 mg      
Vistaril, Orgatrax SOLUTION, INTRAMUSCULAR hydrochloride 25 mg/mL, hydrochloride 50 mg/mL      
Vistaril SUSPENSION, ORAL pamoate 25 mg/5 mL    
Atarax SYRUP, ORAL hydrochloride 10 mg/5 mL      
Atarax TABLET, ORAL hydrochloride 10 mg      
Atarax TABLET, ORAL hydrochloride 25 mg, hydrochloride 50 mg, hydrochloride 100 mg    


Comments:

Formulary Interchange: use VISTARIL (pamoate salt) for ATARAX (HCL salt) oral 25 mg, 50 mg, 100 mg tabs/caps.

Use 10 mg HCL tablet as ordered.

 

Interchange suspension on 1 mg:1 mg ratio.

 

Only HCL injection is available.


Last updated: Feb. 9, 2022
  • Formulary, Not Routinely Stocked: Vistaril 100 mg







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