Add Formweb to your mobile device
Following is a P and T Committee update (from the April 25th meeting). Starting date for specific programs is 1 May 2017, unless otherwise noted. Please let me know if you have any questions or comments. Don’t forget to check the “New Drug Monitoring Spotlight” section of the website, which provides important monitoring information about newly approved drugs. Also, attached is the updated version of the “Not Stocked, Not Ordered” drug list with the new additions highlighted in red.
Below is the memo with links to the drug monographs, protocols, and formulary documents. Click to access the full P&T packet for this month, or here to access the P&T packet archive.
|
Drug or Drug Class |
Formulary Decision |
Comments |
| quinolone-steroid otic solution combination |
Otovel – Formulary CiproDex – Reclassified as NonFormulary. Automatic interchange to Otovel approved. |
Otovel has an advantage of being available in unit-dose amps, rather than dispensing an entire bottle to an inpatient. Efficacy and safety are very similar between the 2 products. |
| clonidine epidural solution (Duraclon) |
Formulary, Restricted Restricted to pediatric anesthesiology for use in caudal epidural analgesia. |
Some studies show that caudal administration of clonidine adjunctively may improve analgesia in some situations in children. |
| bupivacaine liposomal (Exparel) |
Formulary, with restrictions expanded to thoracotomy cases (pilot project via CV surgeons). |
Data from pilot project will determine if approved for future use in thoracotomy procedures. |
| 4-factor prothrombin complex concentrate (KCentra) Update |
Formulary, Restricted Approved Restricted Uses Expanded |
Remains restricted to certain specialties. Restricted indications expanded to include use in severe, lifethreatening non-anticoagulant induced bleeding unresponsive to alternative therapies. |
| factor IX complex (Profilnine) – [3-Factor Prothrombin Complex Concentrate] Update |
Formulary, Restricted Therapeutic Interchange to KCentra approved unless meeting restriction criteria. |
Therapeutic interchange unless patient is on ECMO, has a history of HIT, an allergy to albumin, No Substitution is specified, or the patient has received NOVOSEVEN prior to PCC order. |
| poractant alfa (Curosurf) |
Formulary, Restricted to short term to pilot study in neonates. Infasurf - Will not be stocked in neonatal ICU during pilot program. |
Results of pilot study will determine if Infasurf is continued as our formulary agent, or if formulary agent will be changed to Curosurf. |
| nusinersen (Spinraza) |
Non-Formulary |
Given intrathecally at a maintenance dose of every 4 months for spinal muscular atrophy; cost for first year of therapy is about $750,000; no regional candidates currently. If ordered, notify member of pharmacy administration. |
| tiotropium (Spiriva Respimat) |
Non-formulary Therapeutic Interchange Approved |
Interchange to ipratropium inhaler in adults, if nebulization not desired by MD, interchange to Spiriva Handihaler in adults. For pediatrics, no automatic interchange, tiotropium not generally recommended for use in pediatrics by peds pulmonologists, contact MD to discuss therapy. Patient may use own supply if judged necessary. |
| canagliflozin/metformin extended-release (Invokamet XR) |
Non-Formulary Interchange Approved |
Available in 4 strengths, Interchange to canagliflozin plus metformin given separately, at same daily dose. |
| theophylline tablet national shortage |
Therapeutic Interchange Approved |
The 8-hr and 12-hr 100 mg and 200 mg tablets are on national shortage. If ordered, give theophylline 24 hour tablet regimen once daily at same daily dose. |
| H-2 Blocker Cost Update |
Informational |
Ranitidine injection cost has recently increased by 10 x the previous cost. Efforts to change ranitidine inj. use to famotidine inj. in specific areas such as some surgery stations and pediatrics have been successful. |
| Infusion Reaction Treatment Order Set for OPM – Update |
Protocol Updated |
Designed to address reactions from injectable drugs (IV, subcutaneous, other). Implementation pending additional committee review and docushare posting process. |
| arformoterol (Brovana) with DuoNeb or albuterol |
Discussed Potential Therapeutic Duplication |
If arformoterol is order with active orders for scheduled albuterol or DuoNeb, the physician should be contacted to discuss possible duplication of therapy. No automatic discontinuation. |
| Erythropoiesis Stimulating Agents REMS Update | Informational APPRISE REMS No Longer in Effect | Orders for epoetin alfa (Procrit, Epogen) will no longer require the completion of the erythropoiesisstimulating agent (ESA) order sheet. |
| Drug Shortage Update – Sodium Bicarbonate IV | Discussion | Prescribers should be contacted to discuss alternatives for IV sodium bicarbonate. Oral sodium bicarbonate may be appropriate in non-emergent scenarios. |