Cerner Bulletin
Providers and Nursing
Issued: February 12, 2015
Therapeutic Substitutions
MD/PA/NP and Nursing – 2/17/15
S
New therapeutic substitutions were recently approved
B
Currently, nonformulary medications approved for therapeutic substation have to be
discontinued by pharmacy and re-entered per pharmacy protocol
A/R
These recently approved therapeutic substitutions will be built into Cerner as a safer
and more efficient process beginning 2/17/15.
Alpha-1 Blockers, Urinary
Drug Ordered
Silodosin (Rapaflo) 8 mg daily
Drug Dispensed
Tamsulosin (Flomax) 0.4 mg daily
Isradipine
Drug Ordered
Isradipine 2.5 mg BID
Isradipine 5 mg BID
Isradipine 10 mg daily
Isradipine 10 mg BID
Drug Dispensed
Amlodipine 5 mg daily
Amlodipine 10 mg daily
Amlodipine 10 mg daily
Amlodipine 10 mg daily
Anticholinergics, Urinary
Drug Ordered
Drug Dispensed
Darifenacin (Enablex) 7.5 mg daily
Darifenacin (Enablex) 15 mg daily
Trospium (Sanctura) 20 mg BID
Fesoterodine (Toviaz) 4 mg daily
Fesoterodine (Toviaz) 8 mg daily
If CrCL<30 mL/min, trospium 20 mg daily
Solifenacin (Vesicare) 5 mg daily
If age > 75 years, trospium 20 mg daily*
Solifenacin (Vesicare) 10 mg daily
Tolterodine (Detrol LA) 2 mg daily
Tolterodine (Detrol LA) 4 mg daily
Tolterodine (Detrol) 1 mg BID
Tolterodine (Detrol) 2 mg BID
Trospium (Sanctura XR) 60 mg daily
*If patient is > 75 years and is on trospium (Sanctura) at home, continue home dose. Do not adjust.
Clinical Informatics
615.222.4300
[email protected]
Cerner Bulletin
Providers and Nursing
Issued: February 12, 2015
Theophylline
Drug Ordered
Drug Dispensed
Theophylline (Theo-24) 200 mg
Theophylline (Theo-Dur) 100 mg BID
Theophylline (Theo-24) 400 mg
Theophylline (Theo-Dur) 200 mg BID
Theophylline IV bolus/continuous
Aminophylline IV bolus/continuous
(IV theophylline dose is 80% of aminophylline
dose)
Convert using formula:
Theophylline dose/0.8 = Aminophylline dose
Iron Supplements
Drug Ordered
Drug Dispensed
Ferric carboxymaltose (Injectafer) 15mg/kg – up
to 750mg/dose – X 2 doses
Contact prescriber
Ferumoxytol (Feraheme) 510mg X 2 doses
Contact prescriber
Iron Dextran – high molecular weight
(DexFerrum) – ANY dose
Iron Dextran* – low molecular weight (INFeD) –
SAME dose
Iron Sucrose (Venofer) 100mg IV daily (or per
dialysis session) X 10 doses
Sodium ferric gluconate (Ferrlecit) 125mg IV
daily (or per dialysis session) X 8 doses
Iron Sucrose (Venofer) – doses up to 300mg
Sodium ferric gluconate (Ferrlecit) – round dose to
nearest 125mg to 250mg dose (adjust frequency
based on dose/treatement course)
Iron Sucrose (Venofer) – doses ≥ 300mg
Contact prescriber
Clinical Informatics
615.222.4300
[email protected]