Therapeutic Interchange Program and Prescription ...

1 Therapeutic Interchange Program and Prescription Interpretations at Vancouver Community of Care (includes VGH, UBCH, GFS, VC). Red text denotes V P&T approved TIP or Pharmacist Authority for Clinical or Dispensary Pharmacists). The following interchanges have been implemented to ensure rational use of select drugs, to decrease drug expenditures, and to allow interpretation of orders when the strength or dosage form is not indicated or not available. In exceptional clinical situations, the physician may override the Interchange by writing "Do not substitute". This list pertains to adult patients only, unless otherwise specified. ADULT PATIENTS: Drug ordered Drug Supplied Exceptions Acetaminophen 650 mg suppository acetaminophen suppository Comment: No strength indicated V P&T May 23, 2013.

2 Acetaminophen 325 mg tablet acetaminophen tablet Comment: No strength indicated V P&T May 23, 2013. If on prior to admission, dose given 7 days from date order is written aledronate 70 mg once weekly Comment: New starts in hospital excluded V P&T June 27 2013. aluminum hydroxide + magnesium V P&T September 26, 2013. aluminum hydroxide + magnesium hydroxide + simethicone (ALMAGEL PLUS, approved PHARMACIST. hydroxide (ALMAGEL, DIOVOL, DIOVOL PLUS, MAALOX PLUS) AUTHORITY (CLINCIAL &. MAALOX) DISPENSARY). ampicillin PO TID or QID amoxicillin (same dose) PO TID. anidulafungin micafungin 100 mg IV daily Artificial tear drop with preservative; same number of drops and frequency If preservative-free drop is ordered, artificial eye lubricant drops preservative-free will be supplied Eye lubricant ointment with preservative at same frequency If preservative-free ointment is ordered, artificial eye lubricant ointment preservative-free will be supplied candesartan azilsartan See Table 12.

3 ASA 650 mg suppository ASA suppository Comment: No strength indicated V P&T May 23, 2013. ASA 325 mg tablet ASA tablet Comment: No strength indicated V P&T May 23, 2013. Exception: Patients on Highly beclomethasone dipropionate fluticasone INHALER 125 mcg / puff (same Active Anti-retroviral Therapy INHALER 100 mcg / puff (QVAR ) number of puffs and frequency) (HAART). ramipril benazapril See Table 10. bimatoprost and latanoprost drops (same number of drops (LUMIGAN RC, LUMIGAN) drops and frequency). Bowel protocol appropriate for specific bowel protocol nursing unit V P&T May 23, 2013. budesonide turbuhaler (no dose specified) budesonide 200 mcg turbuhaler V P&T April 25, 2013. budesonide nasal spray (RHINOCORT AQ, RHINOCORT beclomethasone aqueous nasal spray TURBUHALER) See Table 3.

4 Caspofungin micafungin 100 mg IV daily cefUROXime axetil tablet (same dose) PO. cefaCLOR capsule PO TID BID. ceFAZolin less than or equal to cefazolin Q8H. Q6H dosing interval Comment: Dose per interval same V P&T February 28, 2013. ceFAZolin (same dose) + metronidazole Exceptions: cefOXITIN IV 500mg IV obstetric/gynecological infections BCHA Formulary Updated 29 Jun 2017. Therapeutic Interchange Program and VA Prescription Interpretations Updated 04 Oct 2017 Page 1 of 13. Therapeutic Interchange Program and Prescription Interpretations at Vancouver Community of Care (includes VGH, UBCH, GFS, VC). Red text denotes V P&T approved TIP or Pharmacist Authority for Clinical or Dispensary Pharmacists). ADULT PATIENTS: Drug ordered Drug Supplied Exceptions If the ordered interval is less than or equal OR Mycobacterium abscessus to Q8H (eg.

5 Q4H or Q6H), the interval infections supplied will be Q8H. If the ordered interval is greater than Q8H. (eg. Q12H), the ordered interval will be supplied. (eg. cefOXITIN 1 g IV Q6H = ceFAZolin 1 g IV + metronidazole 500 mg IV Q8H). cetirizine PO loratadine 10 mg PO daily Exceptions: Patients on Highly fluticasone Active Anti-retroviral Therapy ciclesonide inhaler See Table 2 (HAART). beclomethasone aqueous nasal spray ciclesonide nasal spray See Table 3. ramipril cilazapril See Table 10. Exception: if CrCl less than 50. mL/min, an adjustment of the cimetidine PO ranitidine 150 mg PO BID dose is recommended ciprofloxacin 500 mg IV ciprofloxacin 400 mg IV V P&T February 28, 2013. clarithromycin tablet 250 mg regular release PO BID .. 500 mg XL tablet PO DAILY.

6 500 mg regular release PO BID .. 1000 mg XL tablet PO DAILY. Comment: Do not use Interchange if via NG. route/dysphagia. V P&T June 27, 2013. clindamycin (same dose) IV/IM/PO Q8H. clindamycin IV/IM/PO Q6H or less Exception: toxoplasmosis dosing V P&T February 28, 2013. clotrimazole vaginal insert 200 mg PV HS x 3 days and clotrimazole 1% cream to clotrimazole vaginal tablet/insert vaginal area PRN. (any strength) See Table 9. clotrimazole vaginal cream 1%; 1. clotrimazole vaginal cream (any applicatorful PV HS x 6 days strength) See Table 9. colchicine mg colchicine mg Comment: strength not available V P&T June 27, 2013. corticosteroids, topical See Table 8. desloratadine PO loratadine 10 mg PO daily dexlansoprazole See Table 7. enalapril maleate ramipril enalapril sodium See Table 10.

7 Candesartan eprosartan See Table 12. dextran 40 in Normal Saline dextran 40 Comment: No diluent specified V P&T May 23, 2013. diltiazem CD. Comment: Formulation not stated; excludes diltiazem once daily Tiazac XC V P&T June 27, 2013. diltiazem regular release tablets Comment: See Therapeutic Interchange for diltiazem CD for NG use specific conversions V P&T June 27, 2013. docusate 100 mg docusate capsule Comment: No strength indicated V P&T June 27, 2013. Exception: NG use or dysphagia esomeprazole See Table 7 patients BCHA Formulary Updated 29 Jun 2017. Therapeutic Interchange Program and VA Prescription Interpretations Updated 04 Oct 2017 Page 2 of 13. Therapeutic Interchange Program and Prescription Interpretations at Vancouver Community of Care (includes VGH, UBCH, GFS, VC).

8 Red text denotes V P&T approved TIP or Pharmacist Authority for Clinical or Dispensary Pharmacists). ADULT PATIENTS: Drug ordered Drug Supplied Exceptions Acute care: TIP to cycle of calcium etidronate and calcium elemental 500 mg PO daily for 76 days then Exception: Didrocal Kits are (DIDROCAL) etidronate 400 mg PO daily for 14 days restricted to residential care Exception: if CrCl less than 50. ranitidine 150 mg PO BID, or ranitidine 50 mL/min, an adjustment of the famotidine mg IV Q8H dose is recommended amLODipine felodipine See Table 6. fenofibrate See Table 4. ferrous fumarate 300 mg (100 mg Fe++) V P&T May 23, 2013. Comment: Same number of tablets and approved PHARMACIST. FERAMAX (polysaccharide iron interval. AUTHORITY (CLINCIAL &. complex) 150 mg DISPENSARY).

9 Ferrous gluconate 300 mg ferrous gluconate tablet Comments: No strength indicated V P&T April 25, 2013. ferrous sulphate 300 mg ferrous sulphate tablet Comments: No strength indicated V P&T April 25, 2013. fexofenadine PO loratadine 10 mg PO daily fleet enema sodium phosphate enema V P&T May 23, 2013. beclomethasone aqueous nasal spray flunisolide nasal spray (RHINALAR) See Table 3. temazepam (same dose) at HS. flurazepam HS dosing See Table 1. fluticasone propionate (FLONASE). or fluticasone furoate (AVAMYS) beclomethasone aqueous nasal spray nasal spray See Table 3. fluticasone inhaler (FLOVENT) Restricted to doses greater than 250 mcg. V P&T April 25, 2013. Exception: HIV/AIDS patients atorvastatin with HAART (highly active anti- fluvastatin See Table 5 retroviral therapy).

10 Ramipril fosinopril See Table 10. framycetin dressing bactigras dressing (same frequency) Note: Stores Item moxifloxacin ophthalmic drops (same gatifloxacin ophthalmic drops number of drops and frequency). glysennid 12 mg glysennid tablets Comment: no strength indicated V P&T May 23, 2013. Exception: meningitis cystic fibrosis imipenem IV meropenem IV. 500 mg Q6H .. 500 mg Q6H V P&T/ASPIRES May 23, 2013. 500 mg Q8H .. 500 mg Q8H ( approved PHARMACIST. 500 mg Q12H . 500 mg Q12H (dialysis = 1000 mg Q24H) AUTHORITY CLINCAL AND. DISPENSARY). insulin lispro (same number of units and insulin glulisine frequency). insulin lispro (same number of units and insulin aspart frequency). candesartan irbesartan See Table 12. see FERAMAX (polysaccharide iron iron polysaccharide complex complex).