October 2007 Pharmagram

Formulary Additions:

Cefpodoxime (Vantin®), an oral, third-generation cephalosporin, was added to the Formulary based on CDC recommendations in treating fluoroquinolone-resistant gonorrhea.

Raloxifene (Evista®), a selective estrogen modulator, was added to the Formulary based on recent evidence of efficacy in breast cancer prevention.

After a review of OAB drugs and based on safety efficacy and cost, the following changes were approved by the P&T Committee:

Formulary additions: Oxybutynin SR (Ditropan XR®)

Solifenacin (VESIcare®)

Formulary deletions/denials Autosubstitutions

Flavoxate (Urispas®) Oxybutynin liquid (Ditropan®)

Oxybutynin (Ditropan®) tabs Oxybutynin SR

Oxybutynin Transdermal patch Oxybutynin SR

Darifenacin (Enablex®) Solifenacin (VESIcare®)

Tolterodine reg rel & LA (Detrol®) Solifenacin (VESIcare®)

Trospium (Sanctura®) Solifenacin (VESIcare®)

Changes to Overactive Bladder (OAB) Drug Formulary:

Belladonna and opium suppositories, used for bladder spasms, will be unavailable for the foreseeable future. Alternatives may include oxybutynin (Ditropan®) or dicylcomine (Bentyl®).

Drug Manufacturer Shortage and Discontinuation:

Concentrated esmolol (Brevibloc®) 250mg/ml is no longer available which will result in limiting the drug infusion to the pre-mixed

2500mg in 250ml NS.

Bulk Laxative Changes:

Psyllium (Metamucil®, Konsyl®) and calcium polycarbophil (Fibercon®) were removed from the Formulary and will be replaced by guar gum (Benefiber®) powder packets and chewtabs. Equal efficacy, superior dosage form, and better patient acceptance were reasons for the changes.

Opioid Agonist-Antagonist Formulary Deletions:

In order to reduce the potential occurrence of adverse outcomes involving opioid agonist/antagonist analgesics, the following drugs have been removed from the Formulary: buprenorphine (Buprenex®), pentazocine (Talwin®) and butorphanol (Stadol®).

Nalbuphine (Nubain®) will remain available on the Formulary.

HIV Drug Formulary Changes:

The Formulary drug list for treating HIV infections was updated to reflect current practice. Deleted items were indinavir (Crixivan®), nelfinavir (Viracept®), and saquinavir (Invirase®). Formulary additions were didanosine EC (Videx EC®), emtricitabine (Emtriva®), darunavir (Prezista®), fosamprenavir (Lexiva®), and tipranavir (Aptivus®). Combination products Truvada® and Combivir® were also added to the Formulary.