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GENERIC NAME 
Ibuprofen Lysine Injection Non Formulary

The neonatogists and pediatric cardiologists decided against the use of this agent as it can not be used for prophylaxis of intraventricular hemorrhage.

 

Imipenem-Cilastatin

Below is the package insert dosing recommendations.

 

 

 

 

Infusion Rate Charts Drip Rate Charts, Adult Standard
Drip Rate Calculator, Adult Standard
Institute for Safe Medication Practices Web Site  
Insulin 70/30 (Human NPH/Human Regular) Non-formualary

        NovoLog Mix 70/30 will be used in place of Humalog Mix 75/25 and Novolin 70/30. 

        Humalog Mix 75/25 and NovoLog Mix 70/30 (rapid acting mixes) produce similar blood sugar control and may be therapeutically interchanged.

        Pharmacy will automatically substitute the most cost-effective, rapid-acting biphasic mix.

        This conversion is recommended during hospitalization only.

 

Insulin 75/25 (Lispro protamine/lispro) Non-formulary

NovNovoLog Mix 70/30 will be used in place of Humalog Mix 75/25 and Novolin 70/30. 

        Humalog Mix 75/25 and NovoLog Mix 70/30 (rapid acting mixes) produce similar blood sugar control and may be therapeutically interchanged.

        Pharmacy will automatically substitute the most cost-effective, rapid-acting biphasic mix.

        This conversion is recommended during hospitalization only.

 

Insulin Aspart Autosubstituted for Humalog (lispro)

        Novolog (insulin aspart) will be auto-substituted for Humalog (Lispro) as the onset and duration are similar and Novolog is less expensive. 

 

Insulin Aspart Mix 70/30 (aspart protamine/aspart)

NovNovLog Mix 70/30 (aspart protamine /aspart) will be used in place of Humalog Mix 75/25 and Novolin 70/30. 

        Humalog Mix 75/25 and NovoLog Mix 70/30 (rapid acting mixes) produce similar blood sugar control and may be therapeutically interchanged.

        Pharmacy will automatically substitute the most cost-effective, rapid-acting biphasic mix.

        This conversion is recommended during hospitalization only.

 

Insulin Detemir Detemir is Non-formulary
  • Patients using detemir at home will be asked to continue their own supply
  • Physicians will be asked to use NPH twice daily or Lantus daily for patients being initiated on Detemir as
    • Detemirís duration of action is dose dependent, doses less than 0.4 units/kg do not allow for once daily dosing (see graphic below).  Determination of the proper once daily dose requires that the patient be started on twice daily dosing with dosage titration to an effective dose. The total daily dose can then be converted to once daily. The dose response curve for once daily dosing is not flat and is not comparable to glargine, which may cause higher rates of hypoglycemia (see graphic below).
      • There is only one published study comparing detemir to glargine [Pieber 2005 Diabetologia 2005;48(suppl1):A92]

Plank  J, Diabetes Care 2005;28(5):1107-1112

Insulin Glargine (Human)  
Insulin Lente (Human)  
Insulin Inhaled (Exubera) Non formulary
  • Exubera is not recommended for addition to formulary
  • Patients using Exubera at home may continue to use their own supply in the hospital if they are capable of self administration.
  • Patients using Exubera at home who can not self administer will be converted to an equivalent dose of regular insulin at the same dosage frequency. (see chart below)

Dosage Conversion Chart

Exubera

Regular Insulin Equivalent Dose

Inhaled Dose (mg)

Units

1

3

2

6

3

8

4

11

5

14

6

16

7

19

 

Note: One 3 mg insulin blister is not equivalent to three 1 mg blisters.

The insulin AUC is 40% higher when three 1 mg blisters are administered.

 

Insulin NPH (Human)  
Insulin Regular (Human)  
IV Compatibility Chart  
IVIG P&T/MEC allow Chemotherapy, monoclonal antibodies, and IVIG orders to be rounded up or down by 5% to minimize wastage.

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