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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hydrocortisone-lidocaine topical

hydrocortisone-lidocaine topical
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Ana-Lex, BP Ana-Lex HC, Peranex HC KIT, RECTAL 2 %-2 %    
Xyralid LP, Senatec HC, LidaMantle HC LOTION, TOPICAL .05 %-3 %    
Comments:

ORDERED FORMULATION

THERAPEUTIC INTERCHANGE

NOTES

hydrocortisone-lidocaine topical

  • 2 %-2 % kit rectal
  • .05 %-3 % lotion topical

pramoxine-hydrocortisone topical

  • 1 %-2.5 % rectal cream
  • 1 %-2.5 % rectal cream

Apply to affected area 3-4 times a day

Xyralid LP lotion (hydrocortisone 0.5%/lidocaine 3%) is non-formulary, not stocked. For hemorrhoids, interchange to formulary product, Analpram-HC 2.5% cream (hydrocortisone 2.5%/pramoxine 1%). For other indications, the components may be dispensed separately in cream form (hydrocortisone 1% cream and lidocaine 5% cream).

Xyralid RC (plus oral laxative) and Peranex HC were classified as non-formulary, not stocked or ordered. Interchange to Analpram-HC. A laxative may be continued with Xyralid RC.

Reviewed: October 30, 2007 (Xyralid RC and Peranex HC)

Last updated: Dec. 21, 2017






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