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Brand name products with an equivalent generic may not be available to order at Henry Ford Health. For questions, contact inpatient pharmacy.

Henry Ford Health

Approved Enterprise Formulary

FormWeb QuickStart Questions or Suggestions? Pharmacy Shared Services Center

Policy

Please review each of these drugs carefully.

acetaminophen	Therapeutic Interchange and Custom Therapeutic Alternates
albumin human	Albumin Dosing and Duration of Therapy Guidelines
alvimopan	Alvimopan (Entereg) Policy
ambrisentan	Inpatient endothelin receptor antagonist dispensing procedure
angiotensin II	Treatment of Refractory Vasoplegic Shock
anti-inhibitor coagulant complex	Anticoagulation Reversal Guidelines
antihemophilic factor	Inpatient use of antihemophilic factor recombinant, porcine sequence (Obizur) Injection
apixaban	Inpatient Anticoagulation Management Anticoagulation Reversal Guidelines Guidelines for Initial Anticoagulation in Venous Thromboembolism and Atrial Fibrillation Perioperative Medication Management
argatroban	Inpatient Anticoagulation Management Heparin Induced Thrombocytopenia (HIT) Guidelines
ARIPiprazole	Long Acting Injectable Antipsychotics
avacopan	Avacopan (Tavneos) Use in the Inpatient Setting
avibactam-ceftazidime	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
aztreonam-avibactam	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
baricitinib	COVID-19 Clinical Management Guideline Pharmacist Initiated Renal Dose Adjustment for Adult Patients
bebtelovimab	Clinical Indications for use of COVID-19 Monoclonal Antibody Therapy
bortezomib	Bortezomib for inpatient use
bosentan	Inpatient endothelin receptor antagonist dispensing procedure
bupivacaine liposome	Bupivacaine Liposome (Exparel) Injection
bupivacaine-meloxicam	Appropriate use of bupivacaine and meloxicam solution (Zynrelef)
buprenorphine	Therapeutic Interchange and Custom Therapeutic Alternates
calcitonin	Inpatient Use of Calcitonin Injection (Miacalcin)
cangrelor	Appropriate Use of Cangrelor (Kengreal)
cefiderocol	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
ceftolozane-tazobactam	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
clevidipine	Clevidipine Policy
coagulation factor VIIa	Anticoagulation Reversal Guidelines
colistimethate	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
cytarabine liposomal-daunorubicin liposomal	Appropriate Inpatient Administration of Daunorubicin and Cytarabine Liposomal (Vyxeos®) Policy
dabigatran	Inpatient Anticoagulation Management Anticoagulation Reversal Guidelines Guidelines for Initial Anticoagulation in Venous Thromboembolism and Atrial Fibrillation Perioperative Medication Management
dalbavancin	Utilization of Long-acting Lipoglycopeptides (LaLGP)
dantrolene	Dantrolene Injection
darbepoetin alfa	Use of Biosimilars at Henry Ford Health System
degarelix	Use of Degarelix at Henry Ford Health System
dofetilide	Dofetilide and Sotalol for Hospitalized Patients
droperidol	Droperidol Policy Prevention and Treatment of Postoperative Nausea and Vomiting in Adults
eculizumab	Use of Biosimilars at Henry Ford Health
epoetin alfa	Use of Biosimilars at Henry Ford Health System
epoprostenol	Intravenous Prostacyclin Policy
eravacycline	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
esketamine	Esketamine (Spravato) administration at Henry Ford Health System
etanercept	Inpatient Etanercept Policy
etranacogene dezaparvovec	Cell and Gene Therapy SOP
fentaNYL	Inpatient HFHS Transdermal Fentanyl Patch
fidaxomicin	Treatment of Clostridioides difficile Infection
hemin	Hemin for Injection (PanhematinÂ®) Inventory and Preparation
heparin	Inpatient Anticoagulation Management Anticoagulation Reversal Guidelines Heparin Induced Thrombocytopenia (HIT) Guidelines
inFLIXimab	Use of Biosimilars at Henry Ford Health System
insulin regular	Concentrated U500 Human Insulin Policy
levoFLOXacin	Pharmacist Initiated Renal Dose Adjustment for Adult Patients
macitentan	Inpatient endothelin receptor antagonist dispensing procedure
meropenem-vaborbactam	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
methadone	Methadone use in the inpatient or emergency department settings
miFEPRIStone	Mifepristone Policy
nadofaragene firadenovec	Urology Intravesicular Administration Policy
nirsevimab	Inpatient Use of Nirsevimab (Beyfortus)
ondansetron	Antiemetic Management of Chemotherapy-Induced Nausea and Vomiting Prevention and Treatment of Postoperative Nausea and Vomiting in Adults
oritavancin	Utilization of Long-acting Lipoglycopeptides (LaLGP)
paliperidone	Long Acting Injectable Antipsychotics
palonosetron	Antiemetic Management of Chemotherapy-Induced Nausea and Vomiting
pentamidine	Aerosolized Antimicrobials
phentolamine	Guideline for the Management of Infiltration and Extravasation Injuries Secondary to Cytotoxic and Non-Cytotoxic Agents
polymyxin B sulfate	Guidance for the Management of Multi-Drug Resistant Gram-Negative Infections
prothrombin complex concentrate (four-factor)	Four Factor Prothrombin Complex Concentrate Anticoagulation Reversal Guidelines
rasburicase	Rasburicase Policy
remdesivir	COVID-19 Clinical Management Guideline for Adults
rifAXIMin	Inpatient Use of Rifaximin
riociguat	Inpatient oral soluble guanylate cyclase (sGC) stimulator dispensing procedure
risperiDONE	Long Acting Injectable Antipsychotics
riTUXimab	Use of Biosimilars within HFHS
rivaroxaban	Inpatient Anticoagulation Management Anticoagulation Reversal Guidelines Guidelines for Initial Anticoagulation in Venous Thromboembolism and Atrial Fibrillation Perioperative Medication Management
romiPLOStim	Criteria for Use of Romiplostim in the Inpatient Setting
romosozumab	Romosozumab Injection (Evenity)
selexipag	Inpatient use of selexipag
sofosbuvir-velpatasvir	Use of HCV Antibody Positive Lung Donors to HCV Negative Recipients Use of HCV Antibody Positive Kidney Donors to HCV Negative Recipients Use of HCV Antibody Positive Liver Donors to HCV Negative Recipients
sotalol	Dofetilide and Sotalol for Hospitalized Patients
sugammadex	Appropriate Use of Sugammadex
suzetrigine	Appropriate use of suzetrigine (Journavx)
talquetamab	Tecvayli (teclistamab-cqyv) and Talvey (talquetamab-tgvs) REMS Program
teclistamab	Tecvayli (teclistamab-cqyv) and Talvey (talquetamab-tgvs) REMS Program
terlipressin	Terlipressin (Terlivaz)
tixagevimab-cilgavimab	Clinical Indications for use of COVID-19 Monoclonal Antibody Therapy
tocilizumab	Use of Biosimilars within HFHS
tolvaptan	Inpatient Tolvaptan (Samsca) Criteria for Use
treprostinil	Intravenous Prostacyclin Policy Subcutaneous Treprostinil (Remodulin) Policy Oral Treprostinil Diolamine (Orenitram) Policy
uridine	Uridine Triacetate Policy
valoctocogene roxaparvovec	Cell and Gene Therapy SOP
warfarin	Inpatient Anticoagulation Management Guidelines for Initial Anticoagulation in Venous Thromboembolism and Atrial Fibrillation Anticoagulation Reversal Guidelines Anticoagulation Management of Patients on Durable Mechanical Circulatory Support at Henry Ford Health System

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