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Approved Hospital Formulary
Pharmacy & Therapeutics Committee – Meeting Minutes

Pharmacy & Therapeutics Committee – Meeting Minutes

 

·        October 2021

o   Aminolevulinic acid (Gleolan®) added to formulary with restrictions

o   Empagliflozin (Jardiance) – restriction criteria modified to remove the ejection fraction requirement

o   Albuterol-ipratropium (Combivent Respimat®) substitutions approved

o   Ivermectin restriction criteria approved

o   COVID-19 medications: automatic pharmacist interchange approved for tocilizumab/baricitinib based on product availability; also for bamlanivimab/etesevimab or casirivimab/imdevimab

·        August 2021

o   Crotalidae immune F(ab’)2-Equine (Anavip®) added to formulary; will remove Crofab

o   Eptinezumab (Vyepti®) added to formulary

o   Polidocanol injectable foam (Varithena®) added to formulary with restrictions

o   Venetoclax (Venclexta®) added to formulary with restrictions

o   Budesonide, glycopyrrolate, formoterol (Breztri®) interchange approved

o   Rituximab-arrx (Riabni®) biosimilar for Rituxan added to formulary

·        June 2021

o   Alteplase for stroke formulary status revised

o   Darbepoetin alfa (Aranesp®) formulary interchange

·        April 2021

o   Isosorbide dinatrate-hydralazine (BiDil) – removed from formulary; substitute individual components

o   Demeclocycline 150 mg – removed from formulary due to very low use and high cost; patients to use own supply

o   Droperidol – added to formulary with restrictions

o   Lurbinectedin (Zepzelca) – added to formulary with restrictions to outpatient setting

·        February 2021

o   Empagliflozin (Jardiance) – approved use criteria

o   Benazepril (Lotensin) – removed from formulary; interchange approved

o   Simvastatin (Zocor) – removed from formulary; interchange approved

o   Gemfibrozil (Lopid) – removed from formulary; interchange approved

·        December 2020

o   Tenecteplase (TNKase) – approved for AIS treatment (replacing alteplase)

o   Quinidine gluconate – removed from formulary (patients may use home supply)

o   Nebivolol – removed from formulary (patients may use home supply)

o   Nitrofurantoin macrocrystals (Macrodantin) – restricted to patients requiring med admin via feeding tube. Otherwise interchange to Macrobid.

o   Dehydrated alcohol – restrictions added

·        October 2020

o   Sodium zirconium cyclosilicate (Lokelma) - restrictions removed

o   Oritavancin (Orbactiv) - more restrictive approach adopted

o   Filgrastim-sndz (Zarxio) – biosimilar added to formulary

·        August 2020

o   Argatroban removed from formulary

o   New biosimilar additions (Nivestym, Renflexis, Zirabev)

o   Levalbuterol (Xopenex) added to formulary with restrictions

o   Levothyroxine (Synthroid) injection restriction criteria

o   Lurasidone (Latuda) added to formulary with restrictions

o   Vabomere restriction criteria updated

·        June 2020

o   Vaccine product changes: Vaqta à Havrix, Adacel à Boostrix, Acthib à Hiberix; usage criteria approved for Prevnar-13 and Engerix-B

o   Respiratory product changes: Utibron NeoHaler à Stiolto Respimat, Seebri NeoHaler à Spiriva Respimat

o   Sugammadex updated restriction criteria

o   Urea oral powder (Ure-Na) added to formulary with restrictions

o   Tolvaptan (Samsca) usage criteria updated

o   Levonorgestrel (Plan B) added to formulary with restriction criteria

·        December 2019

o   Revefenacin (Yupelri) to glycopyrrolate (Seebri) interchange approved

o   Aprepitant (Cinvanti) to fosaprepitant interchange approved

o   Hexaminolevulinate Hydrochloride (Cysview) approved with restrictions

o   Caplacizumabyhdp (Cablivi) approved with restrictions

o   Sugammadex (Bridion) MUE reviewed

·        October 2019

o   SGLT2 Inhibitor Class Review, empagliflozin added to formulary

o   Rituximab biosimilars approved for substitution

o   Cyclosporine ophthalmic (Restasis) emulsion removed from formulary, approved substitute to artificial tear product

o   Fluconazole IV Dosing changed approved

o   HIT Ab Assay Ordering with 4T score calculation

o   Renal Dose Adjustment and Timeliness of Scheduled Medications policies reviewed

·        August 2019

o   Estrogen class review

o   Rectal products class review

o   Amitiza (lubiprostone) and Linzess (linaclotide) restrictions approved

o   Co-enzyme Q-10 (ubiquinone) capsule removed from formulary

o   Diclofenac potassium removed from formulary

o   Lokelma (sodium zirconium cyclosilicate) added to formulary

o   Mvasi (bevacizumab-awwb) added for outpatient use

o   Kanjinti (trastuzumab-anns) added for outpatient use

o   Digifab dosing guidelines

·        May 2019

o   Opthalmic anti-infectives class review

o   Formulary removals: chlorpheniramine, Hemocyte Plus, piroxicam, cabergoline, trimehobenzamide, oxandrolone, tolnaftate, NAC fuel

o   Vabomere/Avycaz formulary interchange

o   Panehmatin restriction criteria approved

·        February 2019

o   Ambulatory Care/chronic disease med class review (new substitutions and formulary removals)

o   Suboxone, Subutex added to formulary

o   Otic preparations reviewed

o   Biktarvy added to formulary

o   Cinvanti/Emend formulary interchange

o   Morphabond, Xtampza formulary interchange

·        August 2018

o   ACE Inhibitor substitutions approved

o   ARB substitutions approved

o   Statin substitutions approved

o   Removed from formulary – niacin, pindolol, colesevelam, felodipine, isradipine, disoldipine, edoxaban, sildenafil 25 mg, aliskiren, indapamide, conivaptan, vabomere, malarone, mefloquine, primaquine, interferon alfa-2b, fluorouracil topical, butorphanol pentazocine/naloxone, felbamate, tiagabine, oxazepam, triazolam, hetastarch

o   Respiratory formulary changes

o   Giapreza – added to formulary

o   Embeda interchange approved

·        November 2017

o   Portrazza® (necitumumab) – added to outpatient formulary

o   Rydapt® (midostaurin) – approved with restrictions

o   Elitek® (rasburicase) – approved order set to assist with dosing

o   Bevyxxa® (betrixaban) – not approved for formulary addition

o   GLP-1 receptor agonists – formulary interchange approved

o   Northera® (droxidopa) – not approved for formulary addition

o   Atenolol drug shortage – substitution to metoprolol approved if/when atenolol supply is depleted

·        August 2017

o   Ocrevus® (ocrelizumab) – added to outpatient formulary

o   Zinplava® (bezlotoxumab) – not added to formulary

o   Mivacron® (mivacurium) – MUE being prepared

o   Gazyva® (obinutuzumab) – added to outpatient formulary

o   Glycoprotein IIb/IIIa Inhibitors – Aggrastat added to formulary, Integrilin removed

o   HIV Antiretroviral Formulary Review – see formulary changes

·        April 2017

o   Sotalol IV – removed from formulary

o   Latuda® (lurasidone) – designated non-formulary

o   Invega® (paliperidone) – designated non-formulary

o   Relistor® (methylnaltrexone) – interchange approved for SC Relistor

·        February 2017

o   Tecentriq® (atezolizumab) – approved for outpatient use

o   Cetylev® (N-acetylcysteine) – interchange approved

o   Relistor® (methylnaltrexone) oral – interchange approved

o   Ophthalmic Glaucoma Agents Class Review – interchanges approved

o   Blood factor products for inherited bleeding disorders – approved

o   Specialty Pharmacy Medications – approved “non-formulary, specialty” process

·        October 2016

o   Entresto® - restrictions approved

o   Clevidipine® - removed from formulary

o   Nitroprusside – removed from formulary (limited supply maintained)

o   Oxybutynin IR and ER – added to formulary

o   Rexulti® - interchange approved

o   Phenazopyridine – interchange approved

o   DPP-4 – interchange approved

o   Entyvio® - approved for outpatient use only with restrictions

o   Inflectra® - approved for outpatient use only

·        August 2016

o   Respiratory meds – new interchanges approved

o   Bladder antimuscarinics class review

o   PPI for tube administration

o   Nucynta® (tapentadol) – substitution approved

o   Tresiba® (insulin degludec) – substitution approved

o   Briviact® (brivaracetam) – added with restrictions

o   Darzalex® (daratumumab) – added to formulary

·        April 2016

o   Kengreal® (cangrelor) – restrictions approved

o   Exparel® (liposomal bupivacaine) – removed from formulary

o   Veltassa® (patiromer) – not added to formulary

o   Movantik® (naloxegol) – added with restrictions

o   Bridion® (sugammadex) – added with restrictions (for use in surgery)

o   Opthalmic antihistamines – reviewed; new substitutions added

·        February 2016

o   Keytruda® - formulary non-stock

o   Blincyto® – formulary non-stock

o   Voraxaze® – formulary non-stock

o   Nucala® – outpatient infusion use only

o   Cresemba® - added to formulary (ID restriction)

·        November 2015

o   Orbactiv® - not added

o   Nexavar® - patient own use whenever possible

o   Specialty Pharmacy Medications process approved

o   Cimzi® – not approved for outpatient formulary

o   Praxbind® - added to formulary

o   High Dose Influenza Vaccine – approved for 2016-17 flu season

o   Fentanyl IV Use Restrictions – approved for palliative care use

o   Statin formulary interchange approved for Crestor®

o   Entresto monitoring criteria approved

o   Phosphate Binder Class Review – new agents not added to formulary (Velphoro®, Auryxia®)

·        August 2015

o   Afrezza® (inhaled insulin) interchange approved

o   Extended release morphine interchange approved

o   Entresto added to formulary

o   Kengreal® (cangrelor) added to formulary

o   Cyramza® (ramucirumab) added to outpatient formulary

o   Panhematin® (hemin) added to formulary

o   Dalvance® (dalbavancin) not added

o   GI Cocktail formulary interchange

o   Combigan formulary interchange

·        June 2015

o   Antitussive class review

o   Vitamin class review

o   Respiratory formulary interchange review

o   Nivolumab (Opdivo®) – added to outpatient formulary

o   Eculizumab (Soliris®) – protocol approved

o   C1 esterase inhibitor (Berinert®) – added to formulary

o   Vitam D analogues – formulary interchange approved

o   Symbyax – formulary interchange approved

o   Buprenorphine (Buprenex®) – removed from formulary

·        April 2015

o   Anti-fungal class review

o   EpiPen – removed from formulary

o   Endothelin receptor antagonist class review – not added

o   Zerbaxa® and Avycaz® - added with restrictions

o   Soliris – protocol to be developed

o   Toujeo® - interchange approved

·        February 2015

o   New inhaled corticosteroid interchange

o   Peramivir (Rapivab®) – added with restrictions

o   Pneumonia vaccine changes

o   Edoxaban (Savaysa®) – added

o   Denosumab (Prolia®) – restrictions not lifted

o   IV ibuprofen (Caldolor®) – approved for trial use with restrictions

o   Cisatracurium (Nimbex®) – added

o   IV acetaminophen (Ofirmev®) – removed from formulary

·        October 2014

o   Empagliflozin (Jardiance®) – not added

o   Extended release budesonide (Uceris®) – added

o   Crystalloid cardioplegia (Custodial HTK®) – approved for trial use

o   Fluid resuscitation – LR vs NS recommendations

o   Azithromycin/erythromycin IV – substitution approved

o   Testosterone replacement products removed

·        August 2014

o   Albiglutide (Tanzeum®) – not added

o   Tedizolid (Sivextro®) – substitution approved

o   Mometasone/formoterol (Dulera®) – substitution approved

o   Hydrocodone ER (Zohydro®) – substitution approved

o   Metronidazole & ciprofloxacin standardized dosing

·        June 2014

o   Remifentanil (Ultiva®) – added

o   Umeclidinium/vilanterol (Anoro Ellipta®) – added

o   Outpatient iron formulary changes

o   Memantine (Namenda XR®) – substitutions approved

·        April 2014

o   Dapagliflozin (Farxiga®) – not added to formulary

o   Obinutuzumab (Gazyva®) – added

o   Clevidipine (Cleviprex®) – added with restrictions

o   Creon 24 – added

o   Omega-3 (Vascepa® and Lovaza®) – substitutions approved

o   Changes to pharmacist ordering of lab values

o   Antimicrobial Surgical Prophylaxis – dose changes

o   C.diff therapy review by stewardship pharmacist

·        February 2014

o   Ofatumumab (Arzerra®) – added

o   Combivent® - substitute with Duoneb

o   Aclidinium (Tudorza®) – possible switch from Spiriva pending updated pricing contracts

o   Breo Ellipta® - substitute with Symbicort

o   Oseltamivir (Tamiflu®) – automatic 5-day stop

·        October 2013

o   Alogliptin (Nesina®) – substitute Januvia®

o   Dolutegravir (Tivicay®) added

o   Golimumab (Simponi Aria®) – added to outpt infusion formulary

o   Alpha-1 Proteinase Inhibitor (Aralast®, Prolastin®) – removed

o   Ado-trastuzumab (Kadcyla®) – added to formulary

o   Tbo-filgrastim (Granix®) – once available, will be substituted for filgrastim

·        August 2013

o   Tadalafil (Adcirca®) – substitute sildenafil

o   Silodosin (Rapaflo®) – substitute tamsulosin

o   Azilsartan (Edarbi®) added

o   C1 Inhibitor (Cinryze®) - new restrictions

o   Angiomax weight based protocol

o   Injectable iron changes

o   Rh(d) immune globulin changes

·        June 2013

o   Invokana® (canagliflozin) not added

o   Mesalamine substitution changes

o   Topical antiviral substitutions approved

o   Neupro® (rotigotine) added

o   Viibryd® (vilazodone) added

·        February 2013

o   Tolvaptan (Samsca®) – new restriction for new starts

o   Apixaban (Eliquis®) added

o   Linaclotide (Linzess®) added

o   Carfilzomib (Kyprolis®) added

o   Lansoprazole (Prevacid®) added for patients intolerant to pantoprazole

o   Liposomal bupivacaine (Exparel®) approved for trial use

o   Azithromycin (Zithromax®) 5 day automatic stop approved (with exceptions)

·        December 2012

o   Infliximab (Remicade®) new restriction for NEW orders

o   Tafluprost (Zioptan®) not added to formulary; sub Xalatan®

o   Mirabegron (Myrbetriq®) added

o   Romiplostim (Nplate®) added (restricted to Hematology)

o   Butorphanol nasal spray (Stadol NS®) removed

o   Penicilloyl polylysine (Pre-Pen®) added (restricted to ID)

·        October 2012

o   Lepirudan (Refludan) to argatroban interchange

o   Roflumilast (Daliresp®) added

o   Denosumab (Prolia®) restricted use defined

o   IVIG (Octagam®) approved

o   Sulphan Blue instead of isosulfan blue

o   Pred-G substituted for TobraDex

·        June 2012

o   Febuxostat (Uloric®) added

o   Fosfomycin (Monurol®) added

Pharmacy Phone Numbers
Memorial Pharmacy (Glenwood) 423-495-8380
Memorial Hixson Pharmacy 423-495-7137
Stat 423-495-7470
Outpatient 423-495-8981
Chemo 423-495-7475
Surgery 423-495-8779

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