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.
Search results for:

sildenafil

sildenafil
  • Restricted Revatio --> Restricted to pulmonology, cardiology, rheumatology, and pediatric critical care for the treatment of pulmonary hypertension.
  • Restricted Revatio IV --> Restricted to pulmonology, cardiology, rheumatology, or pediatric critical care.
  • Restricted Miscellaneous Program Formulary
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Revatio IV SOLUTION, INTRAVENOUS 10 mg/12.5 mL      
Revatio SUSPENSION, ORAL 10 mg/mL      
Revatio TABLET, ORAL 20 mg      
Viagra TABLET, ORAL 25 mg, 50 mg, 100 mg      
VIEW MORE Phosphodiesterase Type 5 Inhibitors
CLASS
240812
Comments:

 

Initiation of therapy: Revatio is restricted to pulmonology, cardiology, rheumatology, and pediatric critical care for the treatment of pulmonary hypertension.

Maintenancy therapy: Revatio may be continued by any prescriber.

 

REVATIO IV is classified as FORMULARY, NOT ROUTINELY STOCKED, RESTRICTED to Pulmonology, Cardiology, Rheumatology, or Pediatric Critical Care as above. Reviewed: April 27, 2010.

Reviewed (Revatio): September 28, 2005

Reviewed (Viagra): December 15, 2005

Viagra tablets (sildenafil 25 mg, 50 mg, 100 mg) are non-formulary and should not be stocked.

Last updated: Apr. 15, 2024
  • Formulary, Not Routinely Stocked: Revatio --> 10 mg/mL oral suspension






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