FormWeb • lusutrombopag

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

Search results for:

lusutrombopag

lusutrombopag

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-Formulary	Interchange
Mulpleta	TABLET, ORAL	3 mg

Comments:

Non-formulary, not stocked. Drug is only shipped directly to patient home or provider office. Inpatients are to use home supply. If inpatient requires Mulpleta, provider will complete enrollment form and have drug shopped to hospital as a patient specific prescription.

Review: 22 Jan 19 (Mulpleta)

Last updated: Jan. 22, 2019

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