P H A R M A G R A M    

...an educational memo from your Pharmacy and Therapeutics Committee

March, 2005

Formulary Autosubstitutions:

 

The following autosubstitutions were approved by the Pharmacy and Therapeutics Committee:

bullet PICU cream, which is a combination of Eucerin ®, Zinc Oxide and Aquaphor®, will now be substituted with Creamy Desitin®. This new product was judged to provide similar efficacy as PICU cream, and be less costly and reduce the need for compounding by the Pharmacy.
bullet Medrol DosePak® is a product that provides a 6-day tapering dosage schedule using 4mg methylprednisolone tablets. The complicated daily dosing frequency of the DosePak®  posed potential medication errors and will now be substituted to allow for the whole dose to be taken once a day instead of divided doses.
bullet Candesartan (Atacand®), Eprosartan (Teveten®), Olmesartan (Benicar®), and Telmisartan (Micardis®), will now be autosubstituted to valsartan (Diovan®) using a pharmacologically equivalent dose. The Pharmacy will continue to carry losartan (Cozaar®) and irbesartan (Avapro®). Non-formulary angiotensin blocker combination products which contain hydrochlorothiazide will be converted to valsartan combined with hydrochlorothiazide.
bullet Selected drugs which are ordered as PRN and do not indicate a frequency will have an as needed frequency substituted. For example, milk of magnesia 10ml po PRN will be changed to a frequency of daily PRN. Physicians are reminded to specify how frequently an ‘as needed’ medication may be taken. Other medications included in this procedure and the substituted PRN frequencies are the following:

                                                           

Acetaminophen (Tylenol)

Every 6 hr

Hydrocodone/acetaminophen (Vicodin and Vicodin ES),

Codeine/acetaminophen (Tylenol #3) Oxycodone/acetaminophen (Percocet)

Every 4 hr

Ibuprofen (Motrin)

Every 8 hr

Milk of Magnesia (MOM), Psyllium (Metamucil), Bisacodyl tablet or suppository (Dulcolax)

Daily

Miconazole powder

4 times daily

Ondansetron (Zofran)

Once

 

Formulary Addition:

 Clozapine (Clozaril®) is an ‘atypical antipsychotic’ which is not a frequently prescribed drug, and pharmacies dispensing this medication must be certified.  In order to insure availability for patients taking clozapine, but whose home medications are not accessible, the P&T Committee decided to add clozapine to the Formulary and allow the Pharmacy to be certified for dispensing.   

ADE (Adverse Drug Event) Hotline: 655-6805

Drug Information Service – 655-2382 (Mon-Fri; 8am – 4pm)

 

Visit the Pharmacy Website for past issues of the PharmaGram: http://library.osfhealthcare.org/druginfo.asp