Add Formweb to your mobile device
Following is a P and T Committee update (from the May 24th meeting). Starting date for specific programs is 30 May 2016, 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 |
| Oral Cephalosporin Update |
cefuroxime – Formulary workhorse cefixime – Reclassified as nonformulary Therapeutic interchanges approved |
Cefixime use in the ED for STD is no longer recommended. In pediatrics, all orders for oral 2nd and 3rd generation cephalosporins, except cefdinir, interchange to cefpodoxime at an equivalent/appropriate weight based dose. Cefuroxime remains a formulary agent for adults. In adults, new interchanges for for cefditoren and cefprozil to cefpodoxime. |
| Injectable Cephalosporin Update |
cefOXitin – Formulary workhorse cefoTEtan – Restricted Automatic interchange approved |
Orders for cefoTEtan will be automatically converted to cefOXitin unless ordered no substitution. |
| cobimetinib fumarate (Cotellic) | Non-formulary | Patient may use home supply. |
| elbasvir-grazoprevir (Zepatier) | Non-formulary | Patient may use home supply. |
| ferric citrate (Auryxia) |
Formulary, Restricted Automatic therapeutic interchange approved |
Automatic interchange to sevelamer approved. Requires order for no substitution. |
| sucroferric oxyhydroxide (Velphoro) |
Formulary, Restricted Automatic therapeutic interchange approved |
Automatic interchange to sevelamer approved. Requires order for no substitution. |
| amphetamine liquid extended release (Dyanavel XR) | Non-formulary Automatic interchange approved | Interchange to generic formulations of Adderall XR. May be opened and sprinkled on applesauce to assist with administration if necessary. |
| fenoldopam (Corlopam) – Formulary Deletion | Non-formulary | Hydration with saline should be recommended for prevention of radiocontrast-induced nephropathy. |
| carbapenem Update |
meropenem, doripenem, imipenem-cilastatin is restricted to use by infectious disease specialists. Approved automatic interchange to continue. ertapenem - Unrestricted |
The Committee approved an extension of the Carbapenem restrictions and automatic therapeutic interchange policy. A final decision on the carbapenem classification within the health system is expected in July 2016. |
| Exparel Update – Ravindra Mailapur (Colo-rectal, Bariatric Surgeries) |
Exparel Approved Use Expanded – Use includes Dr. Mailapur and Trauma surgeons in Colorectal procedures. Use in Bariatric Surgeries was not approved |
Remains restricted to Plastic Surgery and Colorectal procedures. Physicians should complete a manufacturer sponsored training program prior to using Exparel. |
| vancomycin Dosing in Hemodialysis | Dosing guidelines approved | PKS to utilize approved guidance for vancomycin dosing in patients undergoing intermittent hemodialysis. |
| Antibiotic Dosing Guidelines in CRRT | Dosing guidelines approved | PKS to utilized approved guidance for anti-infective dosing in patients receiving continuous renal replacement therapy. |
|
Fecal Microbiota Transplant (FMT) Order Sets |
Protocols approved Use of FMT restricted to GI and ID specialists |
Protocol for capsules may be utilized for inpatients or at OPM. Protocol for colonoscopy administration to be utilized in endoscopy. |
| T2 Antifungal Monitoring MUE | Utilization of this rapid diagnostic test was presented |
T2Candida panel is more sensitive (96.4%) at detecting candidemia vs. blood cultures (40-60%). Average time to de-escalation of antifungal therapy was 2 days. Micafungin drug expense was unaffected. |