DECEMBER 2005

Drug Policy

Intravenous Immune Globulin (IVIG) Policy

In anticipation of a national drug shortage, the Pharmacy and Therapeutics Committee approved a new policy addressing indications of use for intravenous immune globulin (IVIG). This policy was developed by a multi-disciplinary committee with representation from Hematology, Neurology, Infectious Diseases, Neonatology, Pharmacy and others.

All other uses of IVIG outside of the policy’s indications will require secondary review and approval by a member of the Medication Use and Policy Management Subcommittee, after consultation with the prescribing physician.

Protocol for use of Optison in Echocardiography

The Pharmacy and Therapeutics Committee approved a protocol for the use of either Optison or agitated saline in Echocardiography, in order to improve safety and standardize care. The new order set for echocardiography procedures (ECHO) will require a physician’s signature. These agents will now be stored on the floors for convenience and increased accessibility.

FDA Alert

Withdrawal of Hydromorphone Extended Release (Palladone)

On July 13, 2005, the Food and Drug Administration (FDA) requested the withdrawal of extended release hydromorphone capsules (Palladone, Purdue Pharma) due to safety concerns. Palladone was marketed as a once-daily formulation of hydromorphone indicated for use in opioid-tolerant patients experiencing persistent, moderate-to-severe chronic pain.

Recent information provided by Purdue Pharma showed a serious and potentially fatal dose-dumping effect when taken with alcohol, secondary to a compromise of the extended release mechanism of the capsule. Dose-dumping refers to the rapid release of hydromorphone from the extended release product into the bloodstream. All sales and marketing of Palladone in the Untied States have been suspended.

Additional information can be found on the FDA website: http://www.fda.gov/cder/drug/infopage/palladone/default.htm

FormWeb

http://www.formularyproductions.com/kumc/

Formulary Additions and Deletions (January 1, 2005 - Present)
Generic Name	Trade Name	Therapeutic Class	Action	Date	Comments
Alcoholic Beverages			Deleted	1/4/05
Bupivacaine 0.25%, 30ml vial	Marcaine, Sensorcaine	Anesthetic	Added	1/6/05
Carbamide Peroxide 6.5%	Debrox	Otic Preparation	Added	1/6/05
Chlorpromazine 100 mg/mL	Thorazine	Antipsychotic	Deleted	1/11/05
Cold Cream	Cold Cream	Topical	Deleted	1/14/05
Daptomycin	Cubicin	Antibiotic	Added	1/18/05
Diazepam 5 mg/5 ml solution	Valium	Benzodiazepine	Added	1/25/05
Edrophonium 10 mg/mL	Tensilon	Cholinergic	Deleted	1/25/05
Ergocalciferol 500,000 Int Units/ml	Calciferol, Vitamin D	Vitamin	Deleted	1/31/05
Fenofibrate 48 mg & 145 mg	Tricor	Antilipidemic	Added	2/2/05
Flexible Hydroactive Dressing	DuoDerm	Topical Dressing	Deleted	2/21/05
Insulin 70/30	Novolin 70/30 Innolet	Insulin	Deleted	2/21/05
Insulin aspart mix 70/30	Novolog 70/30 Flexpen	Insulin	Deleted	3/14/05
Insulin aspart mix 70/30 100 units/ml	Novolog 70/30	Insulin	Added	3/14/05
Insulin regular	Novolin R Innolet	Insulin	Added	3/16/05
Levofloxacin 25 mg/ml oral solution	Levaquin	Antibiotic	Added	3/16/05
Magnesium Sulfate 4% 20 gm/800 ml	Magnesium Sulfate	Electrolyte	Added	4/18/05
Medroxyprogesterone acetate estrogen conjugate 0.3/1.5	Prempro	Hormone	Added	4/26/05
Medroxyprogesterone acetate estrogen conjugate 0.45/1.5 mg	Prempro	Hormone	Added	5/9/05
NPH Insulin	Novolin N Innolet	Insulin	Deleted	5/9/05
Ofloxacin 0.3% Otic Solution	Floxin	Fluoroquinolone	Added	5/9/05
Potassium Phosphate Monodibasic 100 UD	Neutra Phos K	Electrolyte	Added	5/24/05
Prismasate	Prismasate	Dialysis Solution	Added	6/23/05
Procainamide 375 mg	Procanbid	Antiarrhythmic, Group Ia	Deleted	7/1/05
Rasburicase	Elitek	Recombinate Urate Oxidase	Added	7/6/05
Regular Insulin	Novolin R Innolet	Insulin	Added	7/6/05
Sevelamer 403 mg	Renagel	Phosphate Binder	Deleted	7/6/05
Somatrem 5 mg Injection	Protropin	Hormone	Deleted	7/6/05
Somatropin 5 mg Injection	Saizen	Hormone	Added	7/12/05
Thyroid, Dessicated 120 mg, 200 mg, 300 mg	Armour Thyroid	Thyroid Hormone	Deleted	7/12/05
Tirofiban	Aggrastat	Glycoprotein IIb/IIIa Inhibitor	Deleted	7/12/05
Triethanolamine Polypeptide Oleate 10%	Cerumenex	Otic Preparation	Deleted	7/12/05
Triethylperazine 10 mg	Torecan	Antiemetic	Deleted	7/12/05
Trimethobenzamide 300 mg	Tigan	Antiemetic	Added	7/25/05
Zonisamide 25 mg	Zonegran	Anticonvulsant	Added	8/8/05
Elamax 4% Cream	LMX4	Topical Anesthetic	Added	8/8/05	Line Item Extension
Pentamidine	Nebupent	Antibiotic	Added	8/17/05	Line Item Extension
Glycerin 99% Liquid	Glycerin	Laxative	Added	8/23/05	Line Item Extension
Penicillin G Procaine 2.4 Million Units	Wycillin	Antibiotic	Deleted	8/31/05	No longer available
Folic Acid 0.4 mg		Vitamin	Added	9/15/05	Line Item Extension
Atazanavir	Reyataz	Antiretroviral, Protease Inhibitor	Added	8/23/05	August 2005 P&T
Fosamprenavir	Lexiva	Antiretroviral, Protease Inhibitor	Added	8/23/05	August 2005 P&T
Duloxetine	Cymbalta	Antidepressant	Added	9/27/05	September 2005 P&T
Diazepam Rectal Gel	Diastat AcuDial	Anticonvulsant	Added	9/27/05	September 2005 P&T
Diltiazem 5 mg/mL Injection	Cardizem	Calcium Channel Blocker	Added	11/7/05	Deletion of 5 mL vial; Addition of 25 mL vial
Diltiazem 5 mg/mL Injection	Cardizem	Calcium Channel Blocker	Deleted	11/7/05	Deletion of 5 mL vial; Addition of 25 mL vial
Prismasate	Prismasate	Dialysis Solution	Added	11/3/05	Line Item Extension; Addition of BGK2/0 and BGK4/2.5 strengths
Sodium Tetradecyl Sulfate	Sotradecol	Sclerosing Agent	Added	11/15/05	Line Item Extension
Hydrochlorothiazide		Thiazide Diuretic	Added	11/18/05	Line Item Extension