UNC Health

     System Formulary Restriction:

     Use of donanemab injection is restricted to outpatient/clinic encounters only (i.e., no inpatient use) in patients who meet the following criteria:

• Orders must be signed by a neurology attending physician at designated clinics, including the following:
  • UNC Hospitals Neurology Clinic (Aging Brain Clinic)
  • Pardee Neurology Associates (Hendersonville or Arden locations)
  • Boone Neurological Services
  • High Country Neurology
• Donanemab cannot be initiated in patients who:
  • Are ApoE4 homozygotes (ApoE4 status must be confirmed prior to initiation)
  • Have had a TIA/CVA in the past 6 months prior to initiation
• A benefits investigation must be completed prior to use

• Lexicomp
• Micromedex
• UpToDate
• FDA Daily Med