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.
Search results for:

nirsevimab

nirsevimab
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Beyfortus SOLUTION, INTRAMUSCULAR 50 mg/0.5 mL, 100 mg/mL      
Comments:

Restricted to children aged 8 to 19 months who remain vulnerable to severe RSV and are entering their second RSV season while in the  intensive care unit and discharging home during the months of October through March.

Exclusion criteria: Mother vaccinated with respiratory syncytial virus vaccine (Abrysvo) ≥ 14 days prior to birth

 

At HHWC, Beyfortus is offered through the Vaccines for Children (VFC) program at no cost to patients based on the following eligibility criteria:

  • Medicaid/Medicaid eligible
  • Uninsured
  • American Indian or Alaskan Native

 

Reviewed: Sept 2023 (Beyfortus)

Updated: June 2026                     

Nirsevimab (Beyfortus)

Last updated: Jul. 1, 2026






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