FMOLHS P&T - 2025

May

(System P&T)

 Siltuximab:  Siltuximab was approved for the treatment of refractory cytokine release syndrome (CRS) 

Axatilimab-csfr (Niktimvo):  Axatilimab-csfr was approved for use in Graft versus Host disease 

Buprenorphine/naloxone sublingual tablets (Zubsolv) will be formulary restricted or psychiatry for microinduction dosing.  

Anesthesia Gases (N/A) 

• Desflurane changed to non-formulary. 

 Central Alpha Agonists 

• Clonidine XR changed to non-formulary.  

Phosphate Binders 

• Velphoro add to formulary restricted to patients with Gastroparesis/GI motility issues 

April 

(System P&T)

New Guidelines for P2Y12 Inhibitors 

1. Clopidogrel, ticagrelor, and prasugrel will be formulary.
2. Cangrelor is formulary restricted to use in patients that have not been preloaded with an oral antiplatelet drug prior to arriving in the Cath Lab, use in patients that are experiencing a cardiac arrest that cannot swallow and oral antiplatelet drug, or as a bridge in patients anticipated to undergo Cardiac Surgery.

Crofab approved for use in copperhead or water moccasin envenomations. Anavip is formulary for rattlesnake or unknown envenomations.

Class Reviews:

Newer Agent Tetracyclines:

1. Tigecycline and eravacycline will be formulary-restricted to Infectious Diseases. When ID is not available, critical care may order for up 72 hours if ID consult is placed or culture results support need for therapy.
2. Omadacycline and sarecycline will be non-formulary.

Azole Antifungals:

1. Fluconazole, itraconazole, and voriconazole will be formulary.
2. Posaconazole and isavuconazole will be formulary restricted to Infectious Diseases or Oncology. When ID is not available, critical care may order for up to 72 hours with ID consult.
3. Terconazole and oteseconazole will be non-formulary

Echninocandins:

1. Micafungin will be formulary restricted to Infectious Diseases, Critical Care, and Oncology.
2. Anidulafungin and caspofungin will be non-formulary.

Activated Charcoal:

1. Activated charcoal, aqua formulation is on formulary.
2. Activated charcoal, sorbitol formulation is non-formulary.

March 

(System P&T)

February

(System P&T)

• Axicabtagene ciloleucel (Yescarta)  
  • Action:  Approved for Formulary use 
• Brexucabtagene autoleucel (Tecartus)  
  • Action:  Approved for Formulary Use 
• Interleukin-1 (IL-1) Inhibitor Class Review 
  • Action:  Approved for Formulary Use 
• Mexthoxsalen (Uvadex)  
• Action:  Approved for formulary use  
  1. 1. Methoxsalen injection will be formulary restricted to sites that provide photopheresis therapy.  
     2. Methoxsalen oral will be non-formulary.  

• Prolaryn gel & Prolaryn implant 

  • Action:  Both products approved by the Committee for use in Vocal Cord Paralysis 

Class Reviews: 

• • Idarucizumab (Praxbind)  
    • Idarucizumab will be formulary 
  • Botulism Antitoxin (BAT) Class Review  
    • BAT (botulism antitoxin heptavalent) is available by contacting state Department of Health and/or Centers for Disease Control and Prevention (CDC). 
  • Isoproterenol Monograph  
    • Isoproterenol will be formulary.  
  • Pralidoxime Monograph  
    • Pralidoxime will be formulary. 
  • Prussian Blue Monograph  
    • Radiogardase (Prussian Blue) will be non-formulary.  
  • Spider Antivenin (Lactrodectus Mactans) Monograph 
    • Latrodectus mactans will be formulary – Pharmacy must call Merck to obtain  
  • Digoxin Immune Fab Monograph  
    • Digoxin immune fab will be formulary.  

January

(System P&T)

• Tetracyclines - UPDATE  
  1. Doxycycline immediate release and minocycline immediate release oral will be formulary.  
  2. Tetracycline will be formulary restricted for treating H. pylori only. 
  3. Minocycline IV and demeclocyline will be non-formulary.  
  4. Doxycycline extended release and minocycline extended release will be non-formulary.  

1. Tigecycline and eravacycline will be formulary-restricted to the infectious disease and critical care specialties. 
2. Omadacycline and sarecycline will be non-formulary. 

• Antihemorrhagic Agents - UPDATE  
  • Review of recent literature updates for andexanet alfa  
  • Recommendation:  Andexanet alfa will be non-formulary. 

• Acetylcysteine Monograph  
  1. Acetylcysteine will be formulary.  

• Anticoagulant Reversal Class Review  
  1. Phytonadione/Vitamin K3 and protamine sulfate will be formulary.  

• NK Antagonists, Part 1  
  1. Emend (aprepitant) PO and Emend (fosaprepitant) IV will be formulary restricted to use by medical oncologists for the prevention of acute and delayed emesis for moderately or highly emetogenic chemotherapy. 
  2. Cinvanti (aprepitant) will be restricted to use in the outpatient setting by Hem/Onc only. 
  3. Focinvez (fosaprepitant) and Aponvie (aprepitant) will be non-formulary. 

• NK Antagonists, Part 2  
  1. Varubi (rolapitant), Akynzeo PO (Netupitant/palonosetron), and Akynzeo IV (Fosnetupitant/palonosetron) will be non-formulary. 
• 5-HT3 Receptor Antagonists (56:22.20) 
  1. 1. Ondansetron will be formulary.  
     2. Palonosetron will be formulary restricted to outpatient setting and inpatients on cisplatin therapy. use in outpatient oncology setting and inpatients on cisplatin therapy, stem cell transplant plans, and induction acute leukemia plans where appropriate. 
     3. Granisetron will be restricted to pediatrics who have failed ondansetron therapy. 
     4. Netupitant-palonosetron, fosnetupitant-palonosetron, and dolasetron will be non-formulary.