Approved Hospital Formulary
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Approved Hospital Formulary
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Synvisc

sodium hyaluronate
Brand names: Amvisc Plus, Duovisc, Euflexxa, Healon, Hyalgan, Hyaluronate derivatives, HYLAN G F 20, Provisc, SODIUM HYALURONATE OPHTHALMIC, Supartz, Synvisc, Synvisc One
Form Strength
KIT, INTRAOCULAR -
LIQUID, INTRAOCULAR 10 mg/mL; 16 mg/mL
SOLUTION, INTRA-ARTICULAR 10 mg/mL; 16 mg/2 mL; 48 mg/6 mL


Additional Information:

LH current has 7 hyaluronate products available on formulary.

For orthopedic indications: Synvisc and Euflexxa are available as formulary preferred agents.

For ophthalmic indications: Duovisc, Healon, Healon 5, Provisc (0.55mL), and Viscoat (combination product) are available as formulary preferred agents

NON-formulary products include Provisc (0.85mL), Supartz, Hyalgan, Synvisc One, Orthovisc. Requests for a trial to use non-formulary products must be submitted to the P&T committee.


Last updated: May. 17, 2017







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