Therapeutic interchange program mhs acute care



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THERAPEUTIC INTERCHANGE PROGRAM

MHS ACUTE CARE

Pharmacy and Therapeutics Committee APPROVED LIST


Note: Orally disintegrating tablet formulations may be interchanged to standard oral tablet or capsule at equivalent doses (and vice versa) based on availability and cost, except in cases where the patient has difficulty swallowing a standard oral tablet or capsule.

Drug/Dose

Therapeutic Interchange


Medication Class

Date approved

Date reviewed

Acebutolol (Sectral) Oral

200mg PO BID

400mg PO BID

ATENOLOL Oral


50mg PO DAILY

100mg PO DAILY



CARDIOVASCULAR

4/94

11/00

Acidophilus with Pectin

1-2 capsule PO daily



Culturelle GG (Lactobacillus casei, subspecies rhamnosus GG) Oral, 10 billion CF units/capsule. (Adults and Pediatrics)

1 capsule PO daily


MISCELLANEOUS

10/08

10/08

Acyclovir (Zovirax) Oral

**FORMULARY**


ANTI-VIRAL

11/96

(2/96)


6/02

Aerobid® or Aerobid M®

See Flunisolide Inhaler











Albuterol (Proventil®/Ventolin®)

** FORMULARY **

ORAL CORTICOSTEROIDS SYMPATHOMIMETIC (ADRENERGIC)

10/99

11/00

Aldactazide® (spironalactone/HCTZ)

50/50


Spironolactone 50mg

+ HCTZ 50 mg

CARDIOVASCULAR

11/93

11/00

Aldactazide® (spironolactone/HCTZ) 25/25


Spironolactone 25mg

+ HCTZ 25mg

CARDIOVASCULAR

11/93

11/00

Alfuzosin (Uroxatral®) Oral (Adults)

10 mg PO daily



TAMSULOSIN (Flomax®) Oral (Adults)

0.4 mg PO daily



MISCELLANEOUS

10/06

10/06

Almotriptan (Axert®) Oral

6.25-12.5mg PO may repeat in 2 hrs

NTE 2 tablets/24 hrs


SUMATRIPTAN (Imitrex®) Oral

50mg PO may repeat in 2 hrs

NTE 200mg/24 hrs


MISCELLANEOUS

10/01

10/03

Alora® Estrogen Patch

See Estrogen Patch










Alupent®

See Metaproterenol










Amoxicillin/Clav (Augmentin) Oral

(Adults)

250mg PO TID

500mg PO TID

(Peds)

30-50mg/kg/day PO divided TID



AMOXICILLIN/CLAV (Augmentin)

Oral (Adults)

500mg PO BID

875mg PO BID

(Peds)

30-50mg/kg/day PO divided BID



ANTI-INFECTIVE

11/96

04/04

Amoxicillin/Clavulanic Acid extended release (Augmentin XR®) Oral (Adults)

1000mg/62.5mg, 1 tablet PO twice daily

1000mg/62.5mg, 2 tablets PO twice daily


AMOXICILLIN/CLAVULANIC ACID (AUGMENTIN®) Oral (Adults)

875mg/125mg PO twice a day

875mg/125mg PO twice a day


ANTI-INFECTIVE

04/04

04/04

Ampicillin Oral


250mg PO Q6H

500mg PO Q6H


AMOXICILLIN Oral


250mg PO Q8H

500mg PO Q8H



ANTI-INFECTIVE

2/94

11/00

Liposomal Amphotericin B (Ambisome®) IV

mg for mg



Lipid Complex Amphotericin B (Abelcet®) IV

mg for mg



ANTI-INFECTIVE

2/05

10/08

Amprenavir (Agenerase®) Oral (Adults)

1200mg PO twice daily



Fosamprenavir (Lexiva®) Oral (Adults)

1400mg PO twice daily



ANTIVIRAL

2/04

06/05

Anidulafungin (Eraxis®) injection
Invasive Candidiasis

Anidulafungin 200mg IV on day one, followed by 100mg IV daily


Esophageal Candidiasis

Anidulafungin 100mg IV on day one, followed by 50mg IV daily



CASPOFUNGIN (CANCIDAS®) INJECTION
Caspofungin 70mg IV on day one, followed by 50mg IV daily

Caspofungin 50mg IV daily



ANTIFUNGAL

6/06

6/06

Antacids

MAALOX TC OR MYLANTA





GASTROINTESTINAL

11/93

11/00

Antihistamine Decongestant Regular Release


Tablet/capsule

ACTIFED

1 TAB Q4-6H UP TO 4 TABS/DAY



ANTIHISTAMINE/

DECONGESTANT



10/94

11/00

AntihistamineDecongestant Sustained Release Tablet/capsule

DIMETAPP EXTENTABS


1 TAB Q12H


ANTIHISTAMINE/

DECONGESTANT



10/94

11/00

Arformoterol (Brovana) Adults

15 mcg SVN Q12H



Albuterol , Adults

2.5 mg SVN Q6H



INHALENT

6/07

6/07

Aripiprazole (Abilify) Injection, (Adults)

5.25mg IM every 2 hours

9.75mg IM every 2 hours

15mg IM every 2 hours


Ziprasidone (Geodon®) Injection (Adults)


10mg IM every 2 hours

20mg every 4 hours

20mg every 2 hours


ANTIPSYCHOTIC

2/07

2/07

Asmanex Twisthaler®

See Mometasone furoate











Atorvastatin (Lipitor) Oral

10mg PO DAILY

20mg PO DAILY

40mg PO DAILY

80mg PO DAILY

SIMVASTATIN (Zocor®) Oral


10mg PO DAILY

20mg PO DAILY

40mg PO DAILY

80mg PO DAILY



limit the simvastatin dose per day to 20mg when used concomitantly with amiodarone

CARDIOVASCULAR

6/97

11/00, 11/08 higher strengths

Atripla® (efavirenz, emtricitabine, tenofovir), Oral, (Adults)
1 tablet (efavirenz 600mg, emtricitabine 200mg, tenofovir 300mg) once daily

Efavirenz/Emtricitabine/Tenofovir, Oral (Adults)
1 tablet Efavirenz 600mg once daily +

1 tablet Emtricitabine 200mg once daily +

1 tablet Tenofovir 300mg once daily


ANTIVIRAL

2/07

2/07

Avandaryl (Rosiglitazone/Glimepiride) Oral, Adults

4mg/1mg once daily

4mg/2mg once daily

4mg/2mg two tablets once daily (8mg/4mg total)

4mg/4mg once daily

Note: Maximum daily dose is 8mg/4mg.



ROSIGLITAZONE (Avandia®) + GLIMEPIRIDE (Amaryl®), Oral, Adults

4mg + 1mg once daily

4mg + 2mg once daily

8mg + 4mg once daily


4mg + 4mg once daily

ANTIDIABETIC

10/06

10/06

Rosiglitazone/metformin (Avandamet®) Oral, Adults
1 mg/500 mg PO TWICE DAILY

(2 mg/1000 mg total daily)

1 mg/500 mg, 2 tabs PO TWICE DAILY

(4 mg/2000 mg total daily)

2 mg/500 mg PO TWICE DAILY

(4 mg/1000 mg total daily)

2mg/500 mg, 2 tabs PO TWICE DAILY

(8 mg/2000 mg total daily)

4 mg/500 mg PO TWICE DAILY

(8 mg/1000 mg total daily)

2 mg/1000 mg PO TWICE DAILY

(4 mg/2000 mg total daily)

4 mg/1000 mg PO TWICE DAILY

(8 mg/2000 mg total daily)

Maximum daily dose is 8 mg/2000 mg

ROSIGITAZONE (AVANDIA®) + METFORMIN (GLUCOPHAGE®), Oral, Adults
2 mg (1/2 tab) + 500 mg PO TWICE DAILY

(2 mg/1000 mg total daily)

2mg + 1000mg PO TWICE DAILY

(4 mg/2000 mg total daily)

2 mg + 500 mg PO TWICE DAILY

(4 mg/1000 mg total daily)

4 mg + 1000 mg PO TWICE DAILY

(8 mg/2000 mg total daily)

4 mg + 500 mg PO TWICE DAILY

(8 mg/1000 mg total daily)

2 mg + 1000 mg PO TWICE DAILY

(4 mg/2000 mg total daily)

4 mg + 1000 mg PO TWICE DAILY

(8 mg/2000 mg total daily)


ANTIDIABETIC

2/03

10/06

Azatadine (Optimine) Oral

1-2mg PO Q12H


CYPROHEPTADINE (Periactin®) Oral


4mg PO Q8H

ANTIHISTAMINE

10/94

11/00

Azmacort®

See Triamcinolone Inhaler










Beclomethasone 42mcg (Vanceril®) (Peds)

2 puffs QID

4 puffs BID
4 puffs QID

Beclomethasone(Vanceril,Beclovent)

(Adults)

1 puff QID

2 puffs QID


FLUTICASONE 44mcg (Flovent®)

(Peds)

2 puffs BID

2 puffs BID

FLUTICASONE 110mcg (Flovent®)

2 puffs BID



MOMETASONE FUROATE 220 mcg (ASMANEX TWISTHALER) (Adults)

1 puff BID

2 puffs BID


INHALENT/NASAL CORTICOSTEROIDS

2/00

(10/99)


10/05

Beclomethasone 84mcg (Vanceril DS®) (Peds)

2 puffs BID



Beclomethasone 84 mcg (Vanceril DS)

(Adults)

1-2 puffs BID

3-4 puffs BID

FLUTICASONE 44mcg (Flovent®)

(Peds)


2 puffs BID

MOMETASONE 220mcg (ASMANEX TWISTHALER®) (Adults)

1 puff DAILY

2 puffs DAILY


INHALENT/NASAL CORTICOSTEROIDS

2/00

(10/99)


10/05

Beclomethasone 40mcg (QVAR®)

(Adults)

any puff ordered, any frequency, eg. 1 puff BID



Beclomethasone 80mcg (QVAR®)

any puff ordered, any frequency, eg. 1 puff BID



MOMETASONE 220mcg (ASMANEX TWISTHALER®) (Adults)

1 puff DAILY


MOMETASONE 220mcg (ASMANEX TWISTHALER®) (Adults)

2 puffs DAILY


INHALENT/NASAL CORTICOSTEROIDS

10/02

10/05

Beclomethasone Nasal Inhaler products

Vancenase Pockethaler


1 spray BID-QID

Vancenase AQ (DS)


1-2 sprays DAILY

Beconase AQ


1 spray BID- 2 BID

Vancenase /Beconase

1 spray BID – QID




FLUTICASONE (Flonase) Nasal Inhaler 2 sprays DAILY

INHALENT/NASAL CORTICOSTEROIDS ADRENALS

10/99

10/05

Beclovent

See Beclomethasone Inhaler



INHALENT/NASAL CORTICOSTEROIDS







BENAZEPRIL (Lotensin) Oral

5mg PO DAILY

10mg PO DAILY

20mg PO DAILY

40mg PO DAILY


LISINOPRIL (Zestril®) Oral (Adults)

5mg PO DAILY

10mg PO DAILY

20mg PO DAILY

40mg PO DAILY


CARDIOVASCULAR

4/94, 10/01

10/02

Betaxolol (Kerlone) Oral

5 mg PO DAILY

10mg PO DAILY

20mg PO DAILY


ATENOLOL Oral


25mg PO DAILY

50mg PO DAILY

100mg PO DAILY


CARDIOVASCULAR

4/94

11/00

Bethanecol Oral

10mg PO

Bethanecol Oral


25mg PO (max 50mg in 6H period)



MISCELLANEOUS

10/00

11/00

Bidil® - Hydralazine 37.5mg/Isosorbide Dinitrate 20mg

1 tablet PO BID

1 tablet PO TID

2 tablets PO BID

2 tablets PO TID


Hydralazine 37.5mg + Isosorbide Dinitrate 20mg

1 tablet of each product PO BID

1 tablet of each product PO TID

2 tablets of each product PO BID

2 tablets of each product PO TID


CARDIOVASCULAR

2/06

2/06

Bisoprolol (Zebeta) Oral

5mg PO DAILY

10mg PO DAILY

ATENOLOL Oral


50mg PO DAILY

75mg PO DAILY



CrCl 15-35mL/min max rec atenolol dose=50mg/day

CrCl <15mL/min max rec atenolol dose=25mg/day

Hemodialysis: 50mg atenolol following each dialysis




CARDIOVASCULAR

4/94

11/00

BISOPROLOL/HCTZ (Ziac®) Oral

2.5mg/6.25mg

5mg/6.25mg

10mg/6.25mg



***FORMULARY***

CARDIVASCULAR

10/01

10/01

Bitolterol (Tornalate®)

1-2 inhalations Q8H



ALBUTEROL (Proventil®/Ventolin®)

1-2 inhalations Q6H



INHALENT/NASAL CORTICOSTEROIDS SYMPATHOMIMETIC (ADRENERGIC)

10/99


11/00

Brimonidine 0.15% (Alphagan P®) Ophthalmic

Any regimen


Brimonidine 0.2% (Generic) Ophthalmic


Same regimen

ANTIGLAUCOMA

5/05

5/05

Bromfenac (Duract®) Oral

25mg every 6-8 hours

Max dose = 150mg/day

IBUPROFEN Oral (Adults)


600mg every 6-8 hours

Max dose = 3200mg/day



NSAIDS

5/05

5/05

Bromfenac (Xibrom) Ophthalmic
1 drop 2 times/day

FLURBIPROFEN (OCUFEN) Ophthalmic

1 drop 4 times/day


OPHTHALMIC

6/06

6/06

Brompheniramine (Dimetane®) Oral

4mg PO Q4-6H



CHLORPHENIRAMINE Oral

4mg PO Q4-6H



ANTIHISTAMINE

10/94

11/00

Bronkometer®

See Isoetharine










Budesonide 200mcg (Pulmicort®) (Peds)

1 inhalation BID

2 inhalations BID

Budesonide (Pulmicort ®)

(Adults)

1puff BID

2 puffs BID

3-4 puffs BID



FLUTICASONE 110mcg (Flovent®)

(Peds)


2 puffs BID

3 puffs BID



MOMETASONE 220mcg (ASMANEX TWISTHALER®) (Adults)

1 puff DAILY

1 puff DAILY

2 puffs DAILY



INHALENT/NASAL CORTICOSTEROIDS ADRENALS

2/00

(10/99)


10/05

Budesonide Flexhaler 90mcg/inh
2-4 puffs twice daily

6-8 puffs twice daily


Mometasone furoate (Asmanex® 220mcg/inh) (Adults)

1 puff once daily

2 puffs once daily


INHALER/NASAL CORTICOSTEROIDS ADRENALS

6/07

6/07

Budesonide Flexhaler 180mcg/inh
1-2 puffs twice daily

3-4 puffs twice daily


Mometasone furoate (Asmanex® 220mcg/inh) (Adults)

1 puff once daily

2 puffs once daily


INHALER/NASAL CORTICOSTEROIDS ADRENALS

6/07

6/07

Budesonide (Rhinocort®) Nasal Inhaler


2 sprays BID or

4 sprays DAILY



FLUTICASONE (Flonase) Nasal Inhaler


2 sprays DAILY

INHALENT/NASAL CORTICOSTEROIDS ADRENALS

10/99

10/05



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