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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remifentanil

remifentanil
  • Restricted Miscellaneous Program Formulary
  • Restricted Ultiva --> Pediatric restrictions: anesthesia during supinal cord fusion surgeries, critical care neurological patients requiring frequent neurological evaluations, critical care in patients with difficult airways who need to be extubated.
  • Restricted Ultiva --> Restricted to anesthesiology for craniotomy.
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Ultiva POWDER FOR INJECTION, INTRAVENOUS 1 mg, 2 mg, 5 mg      

VIEW MORE Opioid Agonists
CLASS
280808

Comments:

Restricted to anesthesiology use in craniotomy, pediatric anesthesia during spinal fusion surgeries, pediatric critical care patients requiring frequent neurological evaluations or pediatric critical patients with difficult airways who need to be extubated. 


Reviewed: August 27, 2013 (TEE pilot) and 25 March 2015 (Pediatric indications)


Last updated: Dec. 27, 2017







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