PHARMACEUTICAL MANAGEMENT and FORMULARY MANUAL Approved by: The Chief Medical Officer Washington State Department of Corrections Note: Appendices II – Formulary Drug Listings and IV – Alternate Choices for Non-formulary Medications may be updated frequently as clinical data or contract prices change. Page 1 of 170 Formulary 600-HA002 Washington Department of Corrections (December 2019) DOC Formulary Table of Contents Definitions.......................................................................................................................... 5 Definitions...................................................................................................................... 5 Section I.............................................................................................................................. 7 Purpose ........................................................................................................................... 7 Section II ............................................................................................................................ 8 Promulgation of Policy ................................................................................................. 8 Section III ........................................................................................................................... 9 Voting Members ............................................................................................................ 9 Section IV ......................................................................................................................... 10 Consultants/Guests ..................................................................................................... 10 Section V .......................................................................................................................... 11 Meeting Operations ..................................................................................................... 11 Section VI – Medication Categories .............................................................................. 12 Formulary .................................................................................................................... 12 Restricted Formulary ...................................................................................................... 12 Non Formulary ............................................................................................................ 13 Authorization of Non Formulary Medications ........................................................ 14 Pharmacist Evaluation of a Non Formulary Request .............................................. 14 Appeal of a Non-Formulary Decision ....................................................................... 15 Special Criteria on Therapeutic Class of Medication ............................................... 16 Violator Pharmaceutical Requests ............................................................................. 17 Off Label Uses ............................................................................................................. 18 Emergency Use ............................................................................................................ 18 OTC Medications ........................................................................................................ 18 Section VII ....................................................................................................................... 19 Generic or Biosimilar Product Substitution .............................................................. 19 Section VIII ...................................................................................................................... 20 Therapeutic Interchange ............................................................................................. 20 Section IX......................................................................................................................... 21 Medication Sources ..................................................................................................... 21 Section X .......................................................................................................................... 22 Pharmaceutical Representatives ................................................................................. 22 Section XI......................................................................................................................... 23 Formulary Addition Requests .................................................................................... 23 Section XII ....................................................................................................................... 24 Page 2 of 170 Formulary 600-HA002 Washington Department of Corrections (December 2019) Refusal to Fill or discontinue an order ...................................................................... 24 Section XIII ...................................................................................................................... 25 Prescription discontinuation, renewal and refill ....................................................... 25 Section XIV ...................................................................................................................... 26 Telephone and Verbal orders ...................................................................................... 26 Section XV ....................................................................................................................... 27 Written Prescription Guidelines ................................................................................ 27 Section XVI ...................................................................................................................... 28 Issuable and medline medications ............................................................................. 28 Section XVII .................................................................................................................... 31 Urgent stock medication ............................................................................................. 31 Section XVIII ................................................................................................................... 32 Crushing of medications ............................................................................................. 32 Section XIX...................................................................................................................... 33 Labeling ........................................................................................................................ 33 Section XX ....................................................................................................................... 34 Adverse Events ............................................................................................................ 34 Section XXI...................................................................................................................... 35 Medication Incidents................................................................................................... 35 Section XXII .................................................................................................................... 36 Transfer and release medications ............................................................................... 36 Section XXIII ................................................................................................................... 37 Drug recalls .................................................................................................................. 37 Appendices ........................................................................................................................... 38 Overview .......................................................................................................................... 38 Introduction ................................................................................................................. 38 Contents ....................................................................................................................... 38 A – Commonly Mistaken Abbreviations....................................................................... 39 Mistaken Abbreviations .............................................................................................. 39 B – Formulary Drug Listing ........................................................................................... 42 Notes: ........................................................................................................................... 42 Table ............................................................................................................................. 42 C – AHFS Pharmacological-Therapeutic Drug Classification ...................................... 131 4:00 Antihistamine Drugs ........................................................................................... 132 8:00 Anti-infective Agents .......................................................................................... 132 10:00 Antineoplastic Agents ....................................................................................... 137 12:00 Autonomic Drugs .............................................................................................. 137 16:00 Blood Derivatives ............................................................................................