FormWeb • immune globulin subcutaneous

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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immune globulin subcutaneous

immune globulin subcutaneous

Formulary Miscellaneous Programs

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-Formulary	Interchange
Hizentra, Vivaglobin	SOLUTION, SUBCUTANEOUS	160 mg/mL

Comments:

Formulary, but not routinely stocked; available only by direct physician authorization and specific patient registration through a specialty pharmacy. Great potential for medication errors- must be used per approved protocol and automatic pharmacist consult. Order only as needed.

Reviewed: July 25, 2006

Last updated: Oct. 16, 0002

Black Box Warning: Renal dysfunction, acute renal failure

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