Approved Hospital Formulary
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Approved Hospital Formulary
FDA Patient Safety Videos
IV Medications Requiring Filtration during Administration
Generic Name Brand Name Filter Size (Micron) Reference
Abatacept Orencia 0.2 Up to Date
Abciximab Reopro 0.2 Up to Date
Agalsidase Beta Fabrazyme 0.2 Up to Date
Alpha-1-Proteinase Inhibitor Prolastin (only) use filter provided Clin. Pharma.
Amiodarone  Cordarone 0.2 Clin. Pharma.
Antithymocyte Globulin (equine) Atgam 0.2 Up to Date
Asparaginase Elspar 5 Up to Date
Cetuximab Erbitux 0.2 Up to Date
Cladribine (7 day infusion only) Leustatin 0.2 Clin. Pharma.
Digoxin Immune Fab infusion DigiFab, Digibind 0.2 Clin. Pharma.
Etoposide VePesid, Toposar 0.2 Up to Date
Immune Globulin Polygam S/D (only) use filter provided Clin. Pharma.
Infliximab Remicade 0.2 Up to Date
Itraconazole  Sporanox use filter provided Clin. Pharma.
Ixabepilone Ixempra 0.2 Up to Date
Mannitol Osmitrol 0.2 Clin. Pharma.
Paclitaxel Taxol 0.2 Up to Date
Panitumumab Vectibix 0.2 Up to Date
Phenytoin infusion Dilantin 0.2 Up to Date
Temsirolimus Torisel 0.2 Up to Date
TPN/PPN 1.2

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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