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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Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
SandoSTATIN LAR Depot POWDER FOR INJECTION, INTRAMUSCULAR 10 mg, 20 mg, 30 mg    
SandoSTATIN SOLUTION, INJECTABLE 50 mcg/mL, 100 mcg/mL, 500 mcg/mL      
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CLASS
920000
Comments:

ORDERED FORMULATION

FORMULARY INTERCHANGE

ocetrotide (SandoSTATIN LAR Depot)

  • 10 mg powder for injection intramuscular monthly
  • 20 mg powder for injection intramuscular monthly
  • 30 mg powder for injection intramuscular monthly

ocetrotide (SandoSTATIN)

  • 0.05 mg injectable solution QID
  • 0.1 mg injectable solution QID
  • 0.2 mg injectable solution TID

SandoSTATIN LAR is restricted to outpatient medical, and if ordered for inpatient three options may be considered: 1. Patient can use their home supply 2. Dose can be delayed for a short time to be given as an outpatient 3. Drug dose can be converted to an equivalent daily dose of immediate release injection (See substitution table).

Reviewed: September 28, 2005 (SandoSTATIN LAR)

Last updated: Dec. 21, 2017






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