Approved Hospital Formulary
Add Formweb to your mobile device
Approved Hospital Formulary
Search results for:
pegfilgrastim
pegfilgrastim
- Restricted Fulphila, Neulasta, Neulasta Onpro, Nyvepria, Udenyca, Ziextenzo, Fylnetra, Stimufend --> Restricted to hospital outpatient oncology.
| Drug Name | Form | Strength | Formulary Unrestricted | Formulary Restricted | Non-Formulary | Interchange |
|---|---|---|---|---|---|---|
| Neulasta Onpro | DEVICE, SUBCUTANEOUS | 6 mg/0.6 mL | ||||
| Nyvepria | INJECTION, SUBCUTANEOUS | 6 mg/0.6 mL | ||||
| Stimufend | INJECTION, SUBCUTANEOUS | 6 mg/0.6 mL | ||||
| Ziextenzo | INJECTION, SUBCUTANEOUS | 6 mg/0.6 mL | ||||
| Fulphila | SOLUTION, SUBCUTANEOUS | 6 mg/0.6 mL | ||||
| Fylnetra | SOLUTION, SUBCUTANEOUS | 6 mg/0.6 mL | ||||
| Neulasta | SOLUTION, SUBCUTANEOUS | 6 mg/0.6 mL | ||||
| Udenyca | SOLUTION, SUBCUTANEOUS | 6 mg/0.6 mL |
Last updated: Mar. 19, 2024
Neulasta Adult Criteria for Use
For Updated Formulary Preferred Products (Inpatient and Outpatient): Preferred Products for Select Agents
Fulphila, Neulasta, Nyvepria, Udenyca, Fylnetra, Stimufend and Ziextenzo are classified as formulary status, restricted to hospital OUTPATIENT oncology use.
Fulphila, Nyvepria, Udenyca, Fylnetra, Stimufend and Ziextenzo are a pegfilgrastim biosimilars that have been approved as a therapeutic equivalent of Neulasta. The most cost effective product will be used in a specific setting, time period, or patient case.
A useage criteria for patient selection has been approved for Neulasta.
Neulasta Onpro is restricted to use in the outpatient setting in patients that are unable to return for injection and are ineligible for Huntsville Hospital Home Care to visit for an in-home injection. Neulasta Onpro requires professional education prior to use.
Neulasta or biosimliars (Fulphila, Nyvepria, Udenyca, Fylnetra, Stimufend or Ziextenzo) are to be used in place of Neulasta Onpro in patients not meeting above restrictions.
Pediatric: Fulphilia, Nyvepria, Udenyca, Fylnetra, Stimufend and Ziextenzo have been approved by St. Jude and may be utilized for outpatient/inpatient St. Jude patients.
Reviewed: 26 May 2015 (Neulasta Onpro), and 26 June 18 (Adult Protocol for Use), and 29 Aug 2018 (Fulphila), 23 April 19 (Udenyca), March 2020 (Ziextenzo), September 2020 (Nyvepria), Sept. 2022 (Fylnetra), Nov 2022 (Stimufend)
Updated: July 2021 (Neulasta Onpro)
Pegfilgrastim-atow (Fylnetra)