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Medications listed are available on OH EPIC Formulary, unless otherwise noted.
Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.
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caplacizumab

caplacizumab
Drug Name Form Strength Infusion Center Available Restricted Non-formulary Ambulatory Available Interchange REMS
Cablivi KIT, INJECTABLE yhdp 11 mg          
VIEW MORE von Willebrand Factor-related Antithrombotics
CLASS
201210
Additional Information and Links

OH Epic Formulary restricted to:

  • Indication: treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP), in combination with plasma exchange and immunosuppressive therapy
  • Service line: Hematology
  • Formulary location: Inpatient
  • Service location: Inpatient
  • Patient population: Adults
  • Prior authorization required: Yes for continuing outpatient
  • Restriction/criteria of use (all will apply unless specified):
    • A hematology attending would be required to prescribe and sign caplacizumab-yhdp (Cablivi) order
    • Diagnosis of acquired thrombotic thrombocytopenic purpura (severe ADAMTS13 deficiency defined as <10% of activity or <10 IU/dL)
    • Confirmation of outpatient coverage, unless:
      • Neurologic changes/decreased level of consciousness
      • Elevated troponins
      • Signs of critical illness
    • Receiving plasma exchange and immunosuppressive therapy such as corticosteroids and/or rituximab
Last updated: Aug. 29, 2024

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