Restricted Medications
 Per policy, use of these medications is restricted as noted below last updated: 05/20/2025
generic (Brand) Restrictions
abatacept (Orencia) Restricted from being administered at IMH, including ICS.
  Actemra - see tocilizumab
  Actonel - see risedronate
adalimumab (Humira) Restricted from being administered at IMH, including ICS.
albuterol (ProAir, Ventolin) Inhalers restricted to ventilator patients only. Inpatient/SNF orders will be converted to albuterol nebs.
albuterol-ipratropium (Combivent) Inhalers restricted to ventilator patients only. Inpatient/SNF orders will be converted to albuterol-ipratropium (DuoNeb) nebs.
alendronate (Fosamax) HB-SNF only, hold for inpatients
aprepitant (Emend) ANES use only for PONV.
  Aredia - see pamidronate
  Atrovent - see ipratropium
  Avelox - see moxifloxacin
  Avycaz - see cefTAZidime - avibactam
belimumab (Benlysta) Restricted from being administered at IMH, including ICS.
  Benlysta - see belimumab
  Betapace - see sotalol
  Boniva - see ibandronate
buprenorphine (Subutex, Suboxone) New starts of buprenorphine for pain or dependence treatment will not be allowed at IHS. Indications for buprenorphine are limited to the following:
(1) Continuation of buprenorphine therapy for the maintenance of opioid dependence when the patient is admitted for a medical condition other than opioid addiction.
(2) Continuation of chronic pain management if buprenorphine was taken prior to admission.
See policy for more details.
calcitonin (Miacalcin) Use injection for Paget's disease and hypercalcemia (for hypercalcemia, restricted to ICS and 24 hours duration for inpatients).
Use nasal spray for osteoporosis.
ceftaroline (Teflaro) ID use only
cefTAZidime - avibactam (Avycaz) ID use only
ceftolozane - tazobactam (Zerbaxa) ID use only
  Cinqair - see reslizumab
colistimethate (Colistin) ID use only
  Colistin - see colistimethate
  Combivent - see albuterol-ipratropium
  Cubicin - see DAPTOmycin
dalfopristin-quinupristin (Synercid) ID use only
DAPTOmycin (Cubicin) ID use only
denosumab (Prolia, Xgeva) Restricted from being administered at IMH, including ICS.
  Depo-Testosterone - see testosterone
  Dificid - see fidaxomicin
  Diflucan - see fluconazole
  Dolophine - see methadone
droperidol (Inapsine) Restricted to ED and Anesthesia departments only (IV/IM)
  Emend - see aprepitant
  Entyvio - see vedolizumab
ertapenem (INVanz) A patient must qualify for one of the following:
1) ID consult
2) One dose prior to discharge for outpatient IV therapy
3) ESBL Bacteremia for patients not in the ICU.
Otherwise, orders will have therapeutic substitution to meropenem..
fidaxomicin (Dificid) ID use only
fluconazole (Diflucan) If patient indication is for vulvovaginal candidiasis, dose and duration will be automatically adjusted to 150 mg PO x 1. If additional doses are needed, provider will need to re-order (recommended to reorder after 3 days if symptoms persist).
  Fosamax - see alendronate
  Humira - see adalimumab
ibandronate (Boniva) HB-SNF only, hold for inpatients
  Inapsine - see droperidol
  Inflectra - see inFLIXimab
inFLIXimab (Remicade, Inflectra) Restricted from being administered at IMH, including ICS.
  INVanz - see ertapenem
ipratropium (Atrovent) Inhalers restricted to ventilator patients only. Inpatient/SNF orders will be converted to ipratropium nebs.
leuprolide (Lupron) Restricted from being administered at IMH, including ICS.
levalbuterol (Xopenex) DNS orders
  Lupron - see leuprolide
methadone (Dolophine) A. Methadone may be dispensed for the treatment of pain. This includes using methadone as a part of a formal pain management program in which a patient is switched from other licit drugs to methadone to control or gradually reduce dosage.
B. Methadone may only be used to maintain narcotic addiction or to detoxify a patient when the prescriber is registered by the DEA as a narcotic treatment facility (NTF). In such cases, the drug may only be administered by the NFT.
See policy for more details.
  Miacalcin - see calcitonin
moxifloxacin (Avelox) Reserved for CNS infections only in patients with severe penicillin allergies.
octreotide (SandoSTATIN LAR) Restricted from being administered at IMH, including ICS.
  Orencia - see abatacept
pamidronate (Aredia) Outpatient Only (for osteoporosis)
  Phenergan - see promethazine
  ProAir - see albuterol
  Prolia - see denosumab
promethazine IV (Phenergan) Intravenous promethazine is restricted to Obstetric patients with hyperemesis ONLY, where other treatments have failed.
  Reclast - see zoledronic acid
  Remicade - see inFLIXimab
reslizumab (Cinqair) Restricted from being administered at IMH, including ICS.
risedronate (Actonel) HB-SNF only, hold for inpatients
  SandoSTATIN LAR - see octreotide
  Sivextro - see tedizolid
sotalol (Betapace) IV form orderable by Cardiologists Only (Use CARD - Anti-Arrhythmic Agents Order Set).
May be administered on Critical Care, PCU, or 2 North (TELE) only.
Specialty item - 48 Hour notification from Cardiology Clinic for planned admission is required.
  Stelara - see ustekinumab
  Suboxone - see buprenorphine
  Subutex - see buprenorphine
  Synercid - see dalfopristin-quinupristin
tedizolid (Sivextro) ID use only
  Teflaro - see ceftaroline
testosterone (Depo-Testosterone) testosterone injection is special-order only for ICS, hold for inpatients/SNF.
tigecycline (Tygacil) ID use only
tocilizumab (Actemra) Restricted from being administered at IMH, including ICS.
  Tygacil - see tigecycline
ustekinumab (Stelara) Restricted from being administered at IMH, including ICS.
vedolizumab (Entyvio) Restricted from being administered at IMH, including ICS.
  Ventolin - see albuterol
  Xgeva - see denosumab
  Xopenex - see levalbuterol
  Zerbaxa - see ceftolozane - tazobactam
zoledronic acid (Reclast, Zometa) Reclast (osteoporosis): Outpatient Only
Zometa (hypercalcemia): not restricted.
  Zometa - see zoledronic acid

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556



This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.