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Pharmacy & Therapeutics Committee – Meeting Minutes
o Empagliflozin (Jardiance) restriction criteria updated
o Inclisiran (Leqvio) approved for outpatient use
o Methylene blue product change approved
o Topical benzocaine 20% spray added to formulary with restrictions
o Dexamethasone ophthalmic drops product change approved
o Bevacizumab-maly (Alymsys) added to formulary
o Guaifenesin with codeine antitussive liquid restricted to adults
o Methocarbamol (Robaxin) IV duration limit
o Eszopiclone (Lunesta) added to formulary with restrictions
o Levetiracetam (Keppra) doses of up to 1500 mg to be given as IV push.
o Vibegron (Gemtasa) interchange approved
o Electrolyte replacement guideline changes approved for potassium
o Hydralazine IV – default comments in Epic to hold for HR > 100
o Clinimix E – added to formulary to be used in place of custom TPN for certain patients
o Spesolimab-sbzo (Spevigo) – added to outpatient formulary with restrictions
o Aminolevulinic acid (Gleolan) – dose rounding approved
o Sulfadiazine – removed from formulary
o Acetaminophen with codeine oral liquid – removed from formulary
o Clinimix E approved to formulary (go live planned late March)
o Pantoprazole (Protonix) drips removed from formulary
o Removal of COVID vaccines from formulary
o Paxlovid use criteria updated
o New Botox alternative approved to formulary (incobotulinum toxin A)
o Sublingual dexmedetomidine (IGALMI) – designated non-formulary
o Hydralazine – hold instructions needed for heart rates exceeding 100 beats per minute
o IVIG – changing from Octagam to Privigen
o Ophthalmic non-anti-infective class review
o Iron product shortages – approved automatic conversion to iron sucrose (Venofer) when both sodium ferric gluconate and iron dextran are unavailable
o Bebtelovimab – no longer authorized for emergency use due to lack of efficacy against select Omicron sub-variants
o Posaconazole (Noxafil) – added to formulary with restrictions
o Ceftazidime/avibactam (Avycaz) – replaced Vabomere on formulary
o Ammonia smelling salts – removed from formulary
o Banana bag – removed from formulary
o Dexmedetomidine (Precedex) – taper approved
o Tecovirimat (Tpoxx) – added to formulary
o Pfizer-BioNTech COVID-19 bivalent booster vaccine – added to formulary
o Pentobarbital added to formulary with restrictions
o Hepatitis B vaccine product changes
o Tezepelumab (Tezspire) added to formulary with restrictions
o Inclisiran (Leqvio) designated non-formulary
o Paricalcitol (Zemplar) designated non-formulary
o Anavip replacing CroFab
o Promethazine (Phenergan) IV restrictions
· May 2022
o Post-splenectomy vaccines updated
o Bezlotuxumab (Zinplava) restricted to outpatient
o C. diff treatment guidelines updated
o Cobicistat (Tybost) added to formulary with restrictions
o Anifrolumab-fnia (Saphnelo) restricted to outpatient
o Pafolacianine (Cytalux) non-formulary
o Olanzapine/samidorphan (Lybalvi) interchange approved
o Azelastine nasal spray non-formulary for inpatient use
o Lantus to Semglee conversion approved
o PCC (Kcentra) Dosing for DOAC reversal updated
o SUP Discontinuation Protocol approved
o Remifentanil (Ultiva) added to formulary with restrictions
o Aggrastat removed from formulary, eptifibitide (Integrilin) only IIb/IIIa inhibitor on formulary
o Aminolevulinic acid (Gleolan®) added to formulary with restrictions
o Empagliflozin (Jardiance) – restriction criteria modified to remove the ejection fraction requirement
o Albuterol-ipratropium (Combivent Respimat®) substitutions approved
o Ivermectin restriction criteria approved
o COVID-19 medications: automatic pharmacist interchange approved for tocilizumab/baricitinib based on product availability; also for bamlanivimab/etesevimab or casirivimab/imdevimab
o Crotalidae immune F(ab’)2-Equine (Anavip®) added to formulary; will remove Crofab
o Eptinezumab (Vyepti®) added to formulary
o Polidocanol injectable foam (Varithena®) added to formulary with restrictions
o Venetoclax (Venclexta®) added to formulary with restrictions
o Budesonide, glycopyrrolate, formoterol (Breztri®) interchange approved
o Rituximab-arrx (Riabni®) biosimilar for Rituxan added to formulary
o Alteplase for stroke formulary status revised
o Darbepoetin alfa (Aranesp®) formulary interchange
o Isosorbide dinatrate-hydralazine (BiDil) – removed from formulary; substitute individual components
o Demeclocycline 150 mg – removed from formulary due to very low use and high cost; patients to use own supply
o Droperidol – added to formulary with restrictions
o Lurbinectedin (Zepzelca) – added to formulary with restrictions to outpatient setting
o Empagliflozin (Jardiance) – approved use criteria
o Benazepril (Lotensin) – removed from formulary; interchange approved
o Simvastatin (Zocor) – removed from formulary; interchange approved
o Gemfibrozil (Lopid) – removed from formulary; interchange approved
o Tenecteplase (TNKase) – approved for AIS treatment (replacing alteplase)
o Quinidine gluconate – removed from formulary (patients may use home supply)
o Nebivolol – removed from formulary (patients may use home supply)
o Nitrofurantoin macrocrystals (Macrodantin) – restricted to patients requiring med admin via feeding tube. Otherwise interchange to Macrobid.
o Dehydrated alcohol – restrictions added
o Sodium zirconium cyclosilicate (Lokelma) - restrictions removed
o Oritavancin (Orbactiv) - more restrictive approach adopted
o Filgrastim-sndz (Zarxio) – biosimilar added to formulary
o Argatroban removed from formulary
o New biosimilar additions (Nivestym, Renflexis, Zirabev)
o Levalbuterol (Xopenex) added to formulary with restrictions
o Levothyroxine (Synthroid) injection restriction criteria
o Lurasidone (Latuda) added to formulary with restrictions
o Vabomere restriction criteria updated
o Vaccine product changes: Vaqta à Havrix, Adacel à Boostrix, Acthib à Hiberix; usage criteria approved for Prevnar-13 and Engerix-B
o Respiratory product changes: Utibron NeoHaler à Stiolto Respimat, Seebri NeoHaler à Spiriva Respimat
o Sugammadex updated restriction criteria
o Urea oral powder (Ure-Na) added to formulary with restrictions
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