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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.
Search results for:

faricimab ophthalmic

faricimab ophthalmic
Drug Name Form Strength Infusion Center Available Restricted Non-formulary Ambulatory Available Interchange REMS
Vabysmo SOLUTION, INTRAVITREAL svoa 6 mg/0.05 mL        
VIEW MORE Vascular Endothelial Growth Factor Antagonists
CLASS
525600
Additional Information and Links

Restricted to:

  • Service Line: Ophthalmology
  • Formulary Location: Outpatient/Ambulatory
  • Service location: Ophthalmology Clinics
  • Patient Population: Adult
  • Prior Authorization Required: Yes
  • Restriction/Criteria of Use (all will apply unless specified):
    • Tried and failed, intolerant, or contraindicated to intravitreal bevacizumab (Avastin)
    • Will not be used concurrently with other ophthalmic VEGF inhibitors (e.g., aflibercept (Eylea), ranibizumab (Lucentis), bevacizumab (Avastin))
    • Patient does not have uncontrolled glaucoma and/or active ocular inflammation
    • For women of childbearing potential: Negative pregnancy test prior to the treatment
Last updated: Feb. 10, 2023

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