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Following is a P and T Committee update (from the February 23rd meeting). Starting date for specific programs is 29 February 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 |
| mepolizumab (Nucala) | Formulary, Restricted to use in hospital outpatient/hospital clinic. | Not routinely stocked. |
| osimertinib (Tagrisso) | Non-Formulary, not stocked. |
Supplied by specialty pharmacy directly to patient. Patient to use own supply if needed. Defer initiation to after discharge. |
| elotuzumab (Empliciti) | Formulary, Restricted to use in hospital outpatient/hospital clinic. | Not routinely stocked. |
| talimogene laherparepvec (Imlygic) | Non-Formulary, Not stocked. | Defer administration until after discharge. |
| necitumumab (Portrazza) | Formulary, Restricted to use in hospital outpatient/hospital clinic. | Not routinely stocked |
| patiromer (Veltassa) |
Formulary, Restricted to continuation of maintenance therapy (Home Med) or initiation by a Nephrologist.
|
Veltassa has a BBW to avoid administration of other oral agents to 6 hours before or after Veltassa administration. PO-to-IV conversions or schedule adjustments of PO medications may be required. |
|
Vitamin D2/D3 Interchange |
cholecalciferol (Vitamin D3) tablets/capsules will be the formulary workhorse for Vitamin D products.
|
Interchange orders for “Vitamin D” or Vitamin D2 to cholecalciferol (Vitamin D3). Dosage interchange to available dosage forms. Pediatric liquid stocking for review in March. |
| buPROPion XL | Formulary, dispense buPROPion products as written. | Discontinue interchange program from buPROPion XL to SR. |
| cefepime Renal Dose Adjustment Update | New Automatic Renal Adjustments Approved | Updated to include recommendations for dose and frequency. |
| piperacillin-tazobactam (Zosyn) Extended Infusion protocol | Interchange of Zosyn orders to extended-infusion approved by P&T pending approval from various committees. |
Implementation date to be announced. Normal extended infusion regimen: 3.375 g IV q8h, infuse over 4 hours. |
| maggot Use Procedure | Pharmacy Guidelines Approved |
Any physician can order maggot debridement therapy. Wound care will be automatically consulted. Keith can usually receive orders overnight. |
| DAPtomycin MUE | MUE Results Discussed | 30% of DAPtomycin orders reviewed over the 5 month period did not meet use criteria (at a cost of $70,000). This was a 17% decrease from the 2014 review. |
| acetaminophen IV (Ofirmev) Bariatric Protocol | Protocol Approved (required) |
Bariatric Surgery: Ofirmev 1 g IVPB q6h x 3 doses post-op. Do not give, contact MD if patient has hepatic dysfunction or CrCl < 30 ml/min |
| methocarbamol IV-to-PO Conversion | Automatic IV to PO Conversion Approved |
methocarbamol conversion: 1 g IV q8h = 1000 mg PO q6h or 1500 mg PO TID |
| Kabiven Parenteral Nutrition | Non-Formulary, not stocked |
Kabiven is a non-customizable TPN product. At HH, we will continue to make our own customizable TPNs. |
| Hypertonic Sodium Chloride 3% | Non-Formulary, not stocked |
Initiation of sodium chloride 3% should not be delayed awaiting nephrologist consult/approval. Nephrologists should be consulted for management of hyponatremia upon initiation of 3% saline orders. |