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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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tafasitamab

tafasitamab
Drug Name Form Strength Infusion Center Available Restricted Non-formulary Ambulatory Available Interchange REMS
Monjuvi POWDER FOR INJECTION, INTRAVENOUS 200 mg        
VIEW MORE Antineoplastic Agents
CLASS
100000
Additional Information and Links

Restrictions:

  • Indication: second-line treatment for relapsed/refractory DLBCL in patients who are not candidates for transplant 
  • Formulary location: Outpatient Infusion 
  • Service Line: Oncology/Hematology 
  • Service Location: Infusion Center 
  • Prior Authorization Required: Yes 
  • Criteria of Use/Restriction: (all apply unless specified)
    • Restricted to Beacon treatment protocol 
    • Patients 18 years of age or older 
    • Must have a diagnosis of relapsed or refractory diffuse large B-cell lymphoma not otherwise specified, including DLBCL arising from low grade lymphoma 
    • Must have previously received one or more lines of systemic therapy 
    • Must be ineligible for transplant 
Last updated: Jan. 27, 2022

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