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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oritavancin

oritavancin
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
KIMYRSA POWDER FOR INJECTION, INTRAVENOUS 1,200 mg      
Orbactiv POWDER FOR INJECTION, INTRAVENOUS 400 mg    


Comments:

For Updated Formulary Preferred Products (Inpatient and Outpatient): Preferred Products for Select Agents 

Dalbavancin is the preferred lipoglycopeptide in the outpatient or ED setting.

 

KIMYRSA: Restricted to use by infectious disease physicians for (1) outpatient administration when dalbavancin (DALVANCE) is not a viable option or (2) used inpatient as a patient’s own med/patient assistance program. 

 

If ordered for an inpatient by an infectious disease specialist in an attempt to expedite discharge, may be used with proper administrative approval (contact a member of AMT).
If after-hours or weekend, please send patient name, FIN, and ID provider ordering the medication to HHRxAMT@hhsys.org.

 


ORBACTIV: Non-formulary, not stocked. An automatic interchange from ORBACTIV to KIMYRSA on 1:1 dosing ratio was approved.

 


Reviewed: 27 January 2015 (Orbactiv), August 2022 (KIMYRSA)

Updated: November 2021


Last updated: Jul. 16, 2024







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