FormWeb • dibucaine topical

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UNC Health

UNC Health Medication Formulary

Change Request Form Chemical/SDS Search UNC Health.org

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dibucaine topical

dibucaine topical

Drug Name	Form	Strength	ARHS	Blue Ridge	Caldwell	Chatham	Johnston	Lenoir	Medical Center	Nash	Pardee	Rex	Rockingham	Southeastern	Wayne	Youth Behavioral Health
Dibucaine	OINTMENT, TOPICAL	1% (28 g)

UNC Health

Therapeutic Interchange

Non-Formulary Order	Formulary Equivalent Order
Hydrocortisone 2.5% rectal cream	Dibucaine 1% ointment
Apply to the affected area once daily	Apply to the affected area once daily
Apply to the affected area twice daily	Apply to the affected area twice daily

Med Center
Medical Center Therapeutic Interchange

Rockingham
Therapeutic Interchange Policy

Last updated: Jul. 18, 2023

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