UNC Health Medication Formulary
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UNC Health Medication Formulary
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filgrastim

filgrastim
Drug Name Form Strength ARHS Blue Ridge Caldwell Chatham Johnston Lenoir Medical Center Nash Pardee Rex Rockingham Southeastern Wayne Youth Behavioral Health
Filgrastim-aafi (Nivestym) SOLUTION, INJECTABLE 300 mcg/mL (300 mcg/1 mL)                
Filgrastim-aafi (Nivestym) SOLUTION, INJECTABLE 300 mcg/mL (480 mcg/1.6 mL)                    
Tbo-Filgrastim (Granix) SOLUTION, INJECTABLE 300 mcg/mL (300 mcg/1 mL)                        
Tbo-Filgrastim (Granix) SOLUTION, INJECTABLE 300 mcg/mL (480 mcg/1.6 mL)                      
Filgrastim-aafi (Nivestym) SOLUTION, INJECTABLE 600 mcg/mL (300 mcg/0.5 mL)        
Filgrastim-aafi (Nivestym) SOLUTION, INJECTABLE 600 mcg/mL (480 mcg/0.8 mL)      
Filgrastim-sndz (Zarxio) SOLUTION, INJECTABLE 600 mcg/mL (300 mcg/0.5 mL)              
Filgrastim-sndz (Zarxio) SOLUTION, INJECTABLE 600 mcg/mL (480 mcg/0.8 mL)            
Tbo-Filgrastim (Granix) SOLUTION, INJECTABLE 600 mcg/mL (300 mcg/0.5 mL)              
Tbo-Filgrastim (Granix) SOLUTION, INJECTABLE 600 mcg/mL (480 mcg/0.8 mL)                

UNC Health

     System Formulary Restriction:

     Use of Granix injection is restricted to patients in outpatient or clinic encounters (ie, no inpatient use) who meet one of the following criteria:

  • Initiation of therapy in patients with insurance restrictions that do not cover Nivestym

     Use of Zarxio injection is restricted to patients in outpatient or clinic encounters (ie, no inpatient use) who meet the following criteria:

  • Initiation of therapy in patients with insurance restrictions that do not cover Granix or Nivestym

UNC Health IV Compendium Guideline

Med Center

Rex

     Rex Hematology-Oncology Formulary Restrictions
     Rex Therapeutic Interchange

Rockingham
     Therapeutic Interchange Policy

Wayne
     Wayne Therapeutic Interchange


Last updated: Sep. 8, 2023







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