FormWeb • Therapeutic Substitutions

CHI Memorial

Approved Hospital Formulary

Epic Issue Reporting Pharmacy Google Site AUC CALCULATOR FEEDBACK Huddle Board End of Shift Google Form

Webpage Links

Add Formweb to your mobile device

Android iOS

CHI Memorial

Approved Hospital Formulary

Epic Issue Reporting Pharmacy Google Site AUC CALCULATOR FEEDBACK Huddle Board End of Shift Google Form

Therapeutic Substitutions

Please review each of these drugs carefully.

abacavir-lamivudine	For Epzicom: substitute individual components
abacavir/dolutegravir/lamivudine	For Triumeq: substitute individual components.
acetylcysteine	For CETYLEV effervescent tabs, sub oral liquid (nebulizer solution)
aclidinium bromide	See substitution
aclometasone dipropionate topical	See topical corticosteroid substitutions
acyclovir topical	Substitute Abreva
albuterol-ipratropium	For Combivent Respimat, see substitution
alfuzosin	Substitute tamsulosin
almotriptan	Triptan Therapeutic Substitution Guidelines
amcinonide topical	See topical steroid substitutions
amoxicillin-clavulanate	For Augmentin XR, substitute Augmentin + amoxicillin per chart
ampicillin	Substitute amoxicillin per chart
anidulafungin	autosub to Mycamine (micafungin)
apraclonidine ophthalmic	Substitute brimonidine per chart
aprepitant	See substitution
armodafinil	Substitute Provigil
ASA/butalbital/caffeine	Subsitute APAP/Butalbital/Caffeine (Esgic/Fioricet)
aspirin-butalbital-caffeine-codeine	Substitute Esgic + Codeine
aspirin-calcium carbonate-magnesium oxide-magnesium carbonate	Substitute enteric-coated aspirin
aspirin-oxyCODONE	autosub to Percocet or if allergic to acetaminophen use plain oxycodone and aspirin
atenolol-chlorthalidone	autosub to atenolol (50 or 100mg) and chlorthalidone (25mg)
atropine/hyoscyamine/PB/scopolamine	For GI Cocktail, substitute antacid monotherapy (Mylanta)
azelastine ophthalmic	Substitute ketotifen
azilsartan	See substitution
azithromycin ophthalmic	See substitution
bacitracin ophthalmic	See substitution
bacitracin-polymyxin B ophthalmic	See substitution
bacitracin/HC/neomycin/polymyxin B ophthalmic	Substitute Maxitrol
bacitracin/HC/neomycin/polymyxin B topical	For Cortisporin, substitute Neosporin + Hydocortisone 2.5%
beclomethasone	Substitute Asmanex per chart
benazepril	See substitution
besifloxacin ophthalmic	See substitution
beta-carotene multivitamin	Substitute MVI
betamethasone topical	See topical steroid substitutions
betamethasone-clotrimazole topical	See topical antifungal/steroid combination substitutions
betaxolol	Substitute atenolol
betaxolol ophthalmic	Substitute timolol per chart
bimatoprost ophthalmic	Substitute Xalatan at equal dose
brexpiprazole	Substitute aripiprazole per chart
brimonidine ophthalmic	Brimonidine 0.2% substituted for Alphagan 0.15% or 0.1%
brimonidine-brinzolamide ophthalmic	Substitute brimonidine + dorzolamide per chart
brimonidine-timolol ophthalmic	Dispense separate components for Combigan
brinzolamide ophthalmic	Substitute dorzolamide per chart
bromfenac opthalmic	See substitution
brompheniramine-phenylephrine-dextromethorphan	See Cough & Cold substitutions
brompheniramine/dextromethorphan/PSE	See cough & cold substitutions
budesonide	For budesonide DPI, substitute Asmanex per chart
budesonide nasal	Substitute Flonase per chart
budesonide-formoterol	Autosub Dulera
budesonide/formoterol/glycopyrrolate	See substitution
buprenorphine-naloxone	See substitutions
canagliflozin	Substitute empagliflozin
candesartan	See substitution
carisoprodol	Substitute cyclobenzaprine
carteolol ophthalmic	Substitute timolol per chart
carvedilol	Substitute Coreg for Coreg CR (see chart)
caspofungin	autosub to Mycamine (micafungin)
cefaclor	autosub to cefuroxime (Ceftin) q12 hrs
cefditoren	Sub Omnicef
cefixime	Sub Omnicef
cefotaxime	Sub Rocephin
cefotetan	autosub to Mefoxin
cefpodoxime	Sub Omnicef
cefprozil	autosub to Ceftin
ceftazidime	Ceftazidime Q 8-12 hrs use Cefepime Q 12 hrs
ceftibuten	Sub Omnicef
cephalexin	Substitute Cefadroxil per chart
cerefolin	Substitute folic acid 1 mg
cetirizine	Claritin is the formulary non-sedating antihistamine
chlordiazepoxide-clidinium	Substitute Librium
chlorothiazide	For PO chlorothiazide, substitute HCTZ (see chart)
chlorpheniramine-HYDROcodone	See cough & cold subsitutions
chlorzoxazone	Substitute cyclobenzaprine
ciclesonide inhaled	Substitute Asmanex per chart
ciclesonide nasal	Substitute Flonase per chart
ciclopirox topical	See topical antifungal substitutions
cimetidine	autosub to Pepcid
ciprofloxacin	Substitute levofloxacin
ciprofloxacin ophthalmic	For the ophthalmic ointment, sub ophthalmic solution
ciprofloxacin-dexamethasone otic	autosub to individual agents (ciprofloxacin + dexamethasone)
clemastine	Substitute diphenhydramine (sedating antihistamine)
clocortolone topical	See topical steroid substitutions
cobicistat-darunavir	For Prezcobix substitute individual components
cobicistat/darunavir/emtricitabine/tenof	For Symtuza: substitute individual components
cobicistat/elvitegravir/emtricitabine/tenofovir disoproxil fumarate	If home Stribilid cannot be obtained, substitute Genvoya.
codeine-guaifenesin	Cough & Cold Product Substitution Guidelines
colesevelam	See substitution
colestipol	Substitute cholestyramine per chart
conjugated estrogens topical	Substitute estradiol cream
cycloSPORINE ophthalmic	Substitute artificial tears
cytarabine liposomal-daunorubicin liposomal	See Therapeutic Restrictions to Outpatient Locations
dalteparin	Substitute Lovenox. Dose according to renal function, indication.
dapagliflozin	Substitute empagliflozin
darbepoetin alfa	For inpatients, see substitution to Retacrit
darifenacin	Substitute trospium per chart
desloratidine	Substitute Claritin
desonide topical	See topical corticosteroid substitutions
desoximetasone topical	See topical steroid substitutions
desvenlafaxine	Substitute Effexor XR
dexamethasone-tobramycin ophthalmic	See substitution
dexlansoprazole	Substitute pantoprazole
dextromethorphan	See cough & cold substitutions
diclofenac	For Dyloject, substitute Toradol
diclofenac ophthalmic	See substitution
diflorasone topical	See topical steroid substitutions
diflunisal	Substitute ibuprofen
dihydrocodeine-chlorpheniramine-phenylephrine	Substitute Robitussin AC
docusate	For Surfak, substitute Colace
dolutegravir-lamivudine	For Dovato: substitute individual components
donepezil	For Aricept 23 mg, use Aricept 20 mg
Donnatal-Antacid	Substitute antacid monotherapy (Mylanta)
doripenem	Substitute meropenem
econazole topical	See topical antifungal substitutions
efavirenz/emtricitabine/tenofovir	Atripla - dispense separate components
efavirenz/lamivudine/tenofovir	For Symfi and Symfi Lo: substitute individual components
eletriptan	Triptan Therapeutic Substitution Guidelines
emedastine ophthalmic	Substitute ketotifen
emtricitabine-tenofovir	Descovoy is formulary. For Truvada, sub individual components
enalapril-hydrochlorothiazide	autosub enalapril 10mg and HCTZ 25mg
epinastine ophthalmic	Substitute ketotifen
epoetin alfa	For inpatients, substitute Retacrit
eprosartan	See substitution
ertugliflozin	Substitute empagliflozin
erythromycin	For IV route, substitute IV azithromycin
esomeprazole	autosub to Protonix
estazolam	See sedative/hypnotic substitutions
estradiol	See Estradiol Transdermal Systems substitutions
estradiol topical	See Estradiol Transdermal Systems substitutions
eszopiclone	See sedative/hypnotic substitutions
ethanol	See restrictions for dehydrated alcohol
etodolac	autosub to ibuprofen
famotidine	Pepcid Dosing/H2-Antagonist Substitutions
felodipine	See substitution
fenofibrate	TriCor & Trilipix autosub to Lofibra (closest strength)
fenoprofen	sub Ibuprofen 600mg
ferrous fumarate	Substitute ferrous sulfate
ferrous gluconate	Substitute ferrous sulfate
ferrous sulfate	For Slow FE autosub one per one with FeSo4. (If ordered BID, substitute FeSo4 BID). Slow FE (50 mg elemental iron) per cap = FeSo4 (65 mg elemental iron) per dose.
ferrous sulfate & ascorbic acid	Substitute ferrous sulfate
fesoterodine	Substitute trospium per chart
filgrastim	Substitute Filgrastim-aafi (biosimilar)
flunisolide	autosub to Flovent HFA per chart
flunisolide nasal	Substitute Flonase per chart
fluocinolone topical	See topical corticosteroid substitutions
fluocinonide topical	See topical steroid substitutions
fluorometholone ophthalmic	Substitute dexamethasone
fluoxetine-olanzapine	Substitute individual components (see dosing)
flurandrenolide	See topical corticosteroid substitutions
flurazepam	Substitute Ambien
flurbiprofen	autosub 50mg with ibuprofen 400mg q6 hrs and 100mg with ibuprofen 600mg q6 hrs
flurbiprofen ophthalmic	See substitution
fluticasone	Substitute Asmanex per chart
fluticasone nasal	Flonase is formulary nasal corticosteroid - click for chart
fluticasone propionate topical	See topical corticosteroid substitutions
fluticasone-salmeterol	Substitute Dulera
fluticasone-vilanterol	Substitute Dulera
fluticasone/umeclidinium/vilanterol	See substitution
fluvastatin	See substitution
folic acid-cyanacobalamin-pyridoxine	autosub Foltx to folic acid 1 mg
folic acid-vitamin B complex-vitamin C-biotin	Substitute folic acid 1 mg
formoterol	Substitute Brovana
formoterol-glycopyrrolate	See substitution
fosaprepitant	See substitutions & restrictions
fosinopril	See substitution
frovatriptan	Triptan Therapeutic Substitution Guidelines
gabapentin ER	Substitute immediate release gabapentin per chart
gatifloxacin ophthalmic	See substitution
gemfibrozil	See substitution
gentamicin ophthalmic	For the ophthalmic ointment, sub ophthalmic solution
gentamicin-prednisolone ophthalmic	See substitution
glycopyrrolate (inhaled)	See substitution
glycopyrrolate-indacaterol	See substitution
griseofulvin	Subtitute fluconazole per chart
halcinonide topical	See topical steroid substitutions
halobetasol topical	See topical steroid substitutions
Halog cream	Substitute betamethasone dipropionate
hemin	See restrictions
homatropine-HYDROcodone	See cough & cold substitutions
HYDROcodone extended-release	Substitute OxyContin per chart
hydrocodone-ibuprofen	autosub Lortab 7.5 and Advil
hydrocortisone butyrate topical	See topical corticosteroid substitutions
hydrocortisone topical	See topical corticosteroid substitutions
hydrocortisone valerate topical	See topical corticosteroid substitutions
hydrocortisone/neomycin/polymyxin B ophth	See substitution
hydrocortisone/neomycin/polymyxin B otic	Substitute Maxitrol
hyoscyamine	For IV Levsin, substitute sublingual at same dose
icosapent ethyl	Substitute Promega
iloperidone	Not on formulary - patient may use own med.
imipenem-cilastatin	Substitute meropenem
imipramine	Autosub Tofranil in divided doses for Tofranil PM.
indacaterol	Substitute Brovana per chart
insulin aspart	Substitute Humalog
insulin aspart-insulin aspart protamine	Substitute Humalog 75/25
insulin aspart-insulin degludec	Subtitute Lantus (short-acting component ordered separately)
insulin degludec	Substitute Semglee
insulin degludec-liraglutide	Substitute Semglee
insulin detemir	Substitute Semglee
insulin glargine	For Toujeo, sub Lantus on a 1:1 basis.
insulin glargine-lixisenatide	Substitute Semglee
insulin glulisine	Substitute Humalog (1:1 conversion)
insulin isophane	For Novolin N, substitute Humulin N
insulin isophane-insulin regular	Substitute Humulin 70/30
insulin regular	For Novolin R, substitute Humulin R
insulin, inhaled	Substitute Humalog 1:1
ipratropium	For Atrovent MDI, sub ipratropium neb
irbesartan	See substitution
iron sucrose	Inpts use Ferrlecit/Nulecit
isosorbide mononitrate	autosub Monoket for Ismo
isradipine	See substitution
ivermectin	See restriction criteria
ketoconazole topical	See topical antifungal substitutions
ketoprofen	autosub to ibuprofen
lactobacillus acidophilus and bulgaricus	Substitute Florastor
lamivudine-tenofovir	For Cimduo and Temixys: substitute individual components
lamivudine-zidovudine	For Combivir: substitute individual components
lamotrigine	Subtitute regular release - total daily dose divided BID.
lansoprazole	Substitute pantoprazole (may use for any patient intolerant of pantoprazole)
latanoprostene bunod ophthalmic	Substitute Xalatan
lepirudin	Obtain new order for argatroban or bivalirudin per protocol (and contact prescriber)
levalbuterol	Substitute albuterol
levetiracetam	Keppra XR autosub with the equivalent dosage of Keppra IR divided into twice daily doses
levobunolol ophthalmic	Substitute timolol per chart
levocetirizine	Claritin is the formulary non-sedating antihistamine
levofloxacin ophthalmic	See substitution
levomefolate-mecobalamin-pyridoxal 5 phosphate	Substitute folic acid 1 mg
lidocaine topical	For lidocaine 5% patch, substitute lidocaine 4% patch
linagliptin	Substitute alogliptin per chart
lindane topical	Call prescriber and offer Permethrin cream as an alternative to lotion
lodoxamide ophthalmic	Substitute ketotifen per chart
loratadine-pseudoephedrine	Substitute loratadine
loteprednol ophthalmic	Substitute dexamethasone
loteprednol-tobramycin ophthalmic	See substitution
lovastatin	See substitution
magnesium chloride	autosub to Mag Ox 200mg (1/2 of 400mg tab)
meclofenamate	50mg sub Ibuprofen 400mg; 100mg sub Ibuprofen 600mg
megestrol	Autosub 800 mg regular suspension for 625 mg Megace ES
memantine	Substitute standard formulation for Namenda XR (see chart)
mepenzolate	autosub to Bentyl 10mg 4XD
meropenem-vaborbactam	See restrictions
metaxalone	Substitute cyclobenzaprine
metFORMIN	For Metformin XR, sub standard formulation
methenamine mandelate	Substitute methenamine hippurate (Hiprex) - see dosing
methylnaltrexone	See substitution
metipranolol ophthalmic	Substitute timolol per chart
miconazole topical	See topical antifungal substitutions
minocycline	IV formulation restricted to ID
moexipril	See substitution
mometasone nasal	Substitute Flonase per chart
mometasone topical	See topical corticosteroid substitutions
morphine	See product-specific substitutions above
morphine-naltrexone	See substitution
moxifloxacin	Substitute levofloxacin
multivitamin with iron	See multivitamin substitutions
multivitamin with minerals	Multivitamin with minerals no longer carried, sub regular MVI (no minerals)
multivitamin, prenatal	Use Multivitamin + folic acid
nadolol-bendroflumethiazide	Substitute nadolol + HCTZ (see chart)
nafcillin	Substitute oxacillin
naftifine topical	Substitute clotrimazole 1% cream
naproxen	Naproxen 550 mg no longer stocked, sub two 250 mg tabs
naratriptan	Triptan Therapeutic Substitution Guidelines
nepafenac ophthalmic	See substitution
netupitant-palonosetron	See substitution
nisoldipine	See substitution
nizatidine	autosub to Pepcid
norfloxacin ophthalmic	Substitute ciprofloxacin 1-2 drops every 2-4 hr while awake
nystatin topical	See topical antifungal substitutions (vaginal tablet is non-formulary)
ofloxacin ophthalmic	Substitute ciprofloxacin ophthalmic 1-2 drops q 2-4 hours while awake.
ofloxacin otic	Substitute cipro ophthalmic for OTIC use
olanzapine-samidorphan	See substitution
olmesartan	See substitution
olodaterol	Substitute Brovana
olopatadine ophthalmic	Substitute ketotifen
omega-3 polyunsaturated fatty acids	For Lovaza, Epanova, & Vascepa, substitute Promega.
omeprazole	autosub to Protonix
orphenadrine	autosub to methocarbamol QID
orphenadrine-aspirin-caffeine	autosub to methocarbamol QID
oxaprozin	autosub to relafen
oxiconazole topical	See topical antifungal substitutions
oxybutynin	See bladder antispasmodic subsitutions
oxyCODONE controlled release	For Xtampza ER, substitute OxyContin per chart
oxymorphone ER, oxymorphone IR	autosub to Oxycontin or Oxycodone IR
pancrelipase	Pancrelipase Subsitution Guidelines
paroxetine	For Paxil CR, substitute regular release per chart
pegfilgrastim-jmdb	Restricted to outpatient use
penbutolol	Substitute atenolol 50 mg
penciclovir topical	Substitute Abreva
perindopril	See substitution
phenazopyridine	For Pyridium 100 mg, use phenazopyridine 95 mg; for Pyridium 200 mg use phenazopyridine 190 mg
phenytoin	Substitute Cerebyx for all IV Dilantin orders.
pirbuterol	Substitute albuterol
pitavastatin	See substitution
prednisoLONE	For oral prednisolone, substitute methylprednisolone at 20% dose reduction
prednisoLONE-sulfacetamide sodium ophthalmic	For the ophthalmic ointment, sub ophthalmic solution
Promethazine/Codeine	Cough and Cold Product Substitution Guidelines
Promethazine/Phenylephrine	Cough and Cold Product Substitution Guidelines
propantheline	Substitute dicyclomine per chart
QUEtiapine ER	Substitute Seroquel on a 1:1 mg/mg basis
quinapril	See substitution
rabeprazole	Substitute Protonix
ramelteon	Substitute melatonin
ranitidine	autosub to Pepcid
repaglinide	Substitute nateglinide per chart
revefenacin	See Substitution
rifaximin	Substitute 550 mg BID when ordered for hepatic encephalopathy
rituximab-arrx	See Therapeutic Restrictions to Outpatient Locations
rizatriptan	Triptan Therapeutic Substitution Guidelines
rolapitant	See substitution
saccharomyces boulardii lyo	Probiotic Therapeutic Substitution
salmeterol	Substitute Brovana
saxagliptin	Substitute alogliptin per Chart
sertaconazole topical	See topical antifungal substitutions
silodosin	Substitute Flomax per chart
simvastatin	See substitution
sitaGLIPtin	Substitute alogliptin per Chart
solifenacin	Substitute trospium per chart
starch topical	Substitute Anusol HC suppository for Anusol plain suppository
sufentanil	Substitute fentanyl
sulconazole topical	See topical antifungal substitutions
suvorexant	See sedative/hypnotic substitutions
tadalafil	Substitute sildenafil
tafluprost	Substitute Xalatan
tapentadol	For Nucynta ER, substitute Nucynta IR
tbo-filgrastim	Substitute Filgrastim-aafi (biosimilar)
tedizolid	Substitute Zyvox
telmisartan	See substitution
temazepam	See sedative/hypnotic substitutions
terbinafine topical	See topical antifungal substitutions
terconazole topical	See topical antifungal substitutions
tetracycline	Substitue doxycycline
theophylline	For non-24 hr formulations, sub ER product ONCE daily
ticarcillin-clavulanate	Substitute Zosyn
timolol ophthalmic	For gel forming solution, substitute regular solution per chart
tioconazole topical	See topical antifungal substitutions
tobramycin ophthalmic	For the ophthalmic ointment, sub ophthalmic solution
tolmetin	autosub to ibuprofen
tolnaftate topical	See topical antifungal substitutions
tolterodine	Substitute trospium per chart
trandolapril	See substitution
travoprost ophthalmic	Substitute Xalatan at equal dose
triamcinolone aerosol for oral inhalation	autosub to Flovent HFA per chart
triamcinolone nasal	Substitute Flonase per chart
triamcinolone topical	See topical steroid substitutions
triamterene	Substitute per chart
triazolam	Substitute Ambien
trospium	For Sanctura XR, substitute immediate release trospium
umeclidinium	See substitution
umeclidinium-vilanterol	See substitution
vancomycin	For Vancomycin PO 250 mg, sub 125 mg
verapamil	Formulary products are: Calan, Calan SR, Covera-HS, & Verelan PM; sub Calan SR for Isoptin SR & Verelan
vibegron	Substitute mirabegron 25 mg daily
zafirlukast	Substitute montelukast
zaleplon	Substitute Ambien
zolmitriptan	Triptan Therapeutic Substitution Guidelines
zolpidem	See sedative/hypnotic substitutions
zolpidem CR	Substitute Ambien (immediate release)

Pharmacy Phone Numbers
Memorial Pharmacy (Glenwood) 423-495-8380
Memorial Hixson Pharmacy 423-495-7137
Stat 423-495-7470
Outpatient 423-495-8981
Chemo 423-495-7475
Surgery 423-495-8779

This site is intended for the staff of Memorial Health Care System.
While others may view accessible pages, Memorial Health Care System makes no warranty, express or implied,
as to the use of this information outside of Memorial Health Care System.