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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:

tezepelumab

tezepelumab
Drug Name Form Strength Infusion Center Available Restricted Non-formulary Ambulatory Available Interchange REMS
Tezspire SOLUTION, SUBCUTANEOUS 210 mg/1.91 mL      
VIEW MORE Respiratory Tract Agents, Miscellaneous
CLASS
489200
Additional Information and Links

Formulary restrictions:

  • Service Line: Pulmonology, Allergy, Immunology
  • Formulary Location: Ambulatory/ Outpatient
  • Service Location: Ambulatory clinic, infusion center
  • Patient Population: Pediatrics ≥ 12 years of age, adults
  • Prior Authorization Required: Yes
  • Restriction/Criteria of Use (all applied unless specified):
    • ≥12 years of age
    • Diagnosis of severe asthma
    • At least a 3-month trial and inadequate response, intolerance, or contraindication to high-dose ICS plus another controller medication (long-acting beta2 agonist [LABA] inhaler, long-acting muscarinic antagonists [LAMA] inhaler, or leukotriene modifier) with or without OCSs
    • Two or more asthma exacerbations requiring systemic corticosteroid treatment or one asthma exacerbation resulting in hospitalization in the past 12 months           
Last updated: Nov. 30, 2022
  • Ambulatory: Ambulatory clinic
  • Ambulatory: Infusion center

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