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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:

polatuzumab vedotin

polatuzumab vedotin
Drug Name Form Strength Infusion Center Available Restricted Non-formulary Ambulatory Available Interchange REMS
Polivy POWDER FOR INJECTION, INTRAVENOUS 140 mg        
VIEW MORE Antineoplastic Agents
CLASS
100000
High Alert Drug : Policy
Additional Information and Links

OH Formulary Restrictions:

  • Restricted to hematology/oncology service with an attending signature for ordering for FDA approved indications.
    • Treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (in combination with bendamustine and a rituximab product) not otherwise specified, after at least two prior therapies.
  • Restricted to outpatient use only.
Last updated: Mar. 21, 2024

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