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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interferon beta-1a

interferon beta-1a
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Avonex POWDER FOR INJECTION, INTRAMUSCULAR 30 mcg      
Rebif Prefilled Syringe SOLUTION, SUBCUTANEOUS 22 mcg/0.5 mL, 44 mcg/0.5 mL      
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CLASS
920000
Comments:

Avonex medication guide

Rebif medication guide

Rebif and Avonex are formulary not routinely stocked, may use home supply.

Last updated: Apr. 27, 2022
  • Formulary, Not Routinely Stocked: Rebif --> 44 mcg/0.5 mL
  • Formulary, Not Routinely Stocked: Avonex --> 30 mcg






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