UNC Health

System Formulary Restriction:

Inpatient

• • Avsola: may be used inpatient in those who meet one of the following:
    • Acute graft-versus-host disease
    • Acute steroid-refractory ulcerative colitis or Crohn's disease exacerbation
    • Acute steroid-refractory complications of immune-oncology therapy (eg, colitis, hepatitis, nephritis)
    • Refractory Kawasaki Disease (persistent or recrudescent fever ≥36 hours after initial IVIG infusion)
  • Renflexis: no inpatient use allowed
  • Remicade: no inpatient use allowed

Outpatient

• • Avsolar: recommended first line product
  • Renflexis: may be used outpatient if the following criteria are met
    • Continuation of therapy in patients who previously received Renflexis
    • Initiation of therapy in patients with insurance restrictions that do not cover Avsola
  • Remicade: may be used outpatient if the following criteria are met
    • Continuation of therapy in patients who previously received Remicade
    • Initiation of therapy in patients with insurance restrictions that do not cover Renflexis or Avsola

UNC Health IV Compendium Guideline

Med Center

UNC Medical Center Formulary Restrictions

Pardee

Pardee Therapeutic Interchange

Rex

Rex Hematology-Oncology Formulary Restrictions

Rockingham

Therapeutic Interchange Policy

• Lexicomp
• Micromedex
• UpToDate
• FDA Daily Med