FormWeb • palifermin

Huntsville Hospital

Approved Hospital Formulary

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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:

palifermin

palifermin

Restricted Kepivance --> Restricted to use by oncology for stem-cell transplant patients.
Restricted Miscellaneous Program Formulary

Drug Name	Form	Strength	Formulary Unrestricted	Formulary Restricted	Non-Formulary	Interchange
Kepivance	POWDER FOR INJECTION, INTRAVENOUS	6.25 mg

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CLASS

Comments:

Kepivance used for decreasing severe oral mucositis in patients with hematologic malignancies receiving high-dose chemotherapy with stem-cell transplant. Approved for formulary status, use restricted to oncologists .

Reviewed: August 25, 2009

Last updated: Feb. 3, 2025

palifermin

HAZ-MED: Table 2H

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