PHAR210 | PHAR214 AUTOMATIC THERAPEUTIC SUBSTITUTION POLICY CENTENNIAL COLLEGE PHARMACY TECHNICIAN PROGRAM
AUTOMATIC THERAPEUTIC
SUBSTITUTION POLICY
Non-Formulary Drug Ordered Formulary Drug Supplied Non-Formulary Drug Ordered Formulary Drug Supplied
ORAL ANTIHISTAMINES - All dosing and frequency of any including: ADVAIR
Cetirizine (Reactine) Loratadine 10mg po daily Advair DISKUS 100/50 1 inhalation: Advair MDI 125/25 2 Puffs:
Desloratadine (Aerius) Loratadine 10mg po daily Fluticasone 100mcg, Salmeterol 50mcg Fluticasone 250mcg, Salmeterol 50mcg
Advair DISKUS 250/50 1 inhalation: Advair MDI 125/25 2 Puffs:
TOPICAL ANTI-FUNGALS Fluticasone 250mcg, Salmeterol 50mcg Fluticasone 250mcg, Salmeterol 50mcg
Nystatin Cream Clotrimazole 1% Cream Advair DISKUS 500/50 1 inhalation: Advair MDI 250/25 2 Puffs:
Miconazole Cream Clotrimazole 1% Cream Fluticasone 500mcg, Salmeterol 50mcg Fluticasone 500mcg, Salmeterol 50mcg
DILTIAZEM H2 ANTAGONISTS
Famotidine 20mg BID Famotidine 40mg DAILY
Diltiazem SR (X)mg BID Diltiazem XC (X × 2mg) QHS
Nizatidine 150mg BID Famotidine 40mg BID
Diltiazem ER (X)mg DAILY Diltiazem XC (X)mg QHS
Ranitidine 150mg DAILY Famotidine 40mg BID
Diltiazem CD (X)mg DAILY Diltiazem XC (X)mg QHS
CORTICOSTEROID NASAL SPRAY LINAGLIPTIN
All corticosteroid nasal sprays and frequencies Beclomethasone AQ 50mcg Saxagliptin ALL Strengths Linagliptin 5mg PO DAILY
will be automatically substituted to 2 sprays in each nostril BID Sitagliptin ALL Strengths Linagliptin 5mg PO DAILY
ACE INHIBITORS BUPROPION
Enalapril 2.5mg, 5mg, 10mg Bupropion SR 150mg DAILY Bupropion XL 150mg DAILY
Lisinopril 2.5mg, 5mg, 10mg Bupropion SR 150mg BID Bupropion XL 300mg DAILY
Ramipril 1.25mg, 2.5mg Perindopril 2mg DAILY
Trandolapril 1mg OCULAR LUBRICANTS
Cilazapril 1mg, 2.5mg
All ocular lubricants and frequency of any including will be automatically substituted to:
Enalapril 15mg, 20mg
Lisinopril 15mg, 20mg Isopto Tears 0.5%, Tear Plus, Eyelube, Tear Gel,
Tears Naturale II
Ramipril 5mg Perindopril 4mg DAILY Duratears, Lacri-lube, Duolube, Liquifilm, Systane
Trandolapril 2mg INSULIN
Cilazapril 5mg
Humulin 30/70 Novolin 30/70
Ramipril 7.5mg Perindopril 6mg DAILY
Humulin NPH Novolin N
Enalapril 40mg
Lisinopril 40mg Humulin R Novolin R
Ramipril 10mg, 20mg Perindopril 8mg DAILY Humalog NovoRapid
Trandolapril 4mg
All doses and frequency for Insulin order will remain the same
Cilazapril 10mg
All original orders with BID dosing will be switched to an PROTON PUMP INHIBITORS (PPIs) All dosing and frequency of any including:
equivalent total daily dose with Perindopril a once daily schedule Lansoprazole Pantoprazole 40mg PO QAMAC
METOPROLOL Esomeprazole Pantoprazole 40mg PO QAMAC
Metoprolol SR 100mg PO DAILY Metoprolol 50mg PO BID Rabeprazole Pantoprazole 40mg PO QAMAC
Metoprolol SR 200mg PO DAILY Metoprolol 100mg PO BID Omeprazole Pantoprazole 40mg PO QAMAC
Revised 2023 CENTENNIAL HOSPITAL INPATIENT PHARMACY DEPARTMENT
PHAR210 | PHAR214 AUTOMATIC THERAPEUTIC SUBSTITUTION POLICY CENTENNIAL COLLEGE PHARMACY TECHNICIAN PROGRAM
AUTOMATIC THERAPEUTIC
SUBSTITUTION POLICY
Non-Formulary Drug Ordered Formulary Drug Supplied Non-Formulary Drug Ordered Formulary Drug Supplied
DALTEPARIN ENOXAPRIN
4,000 units to 6,249 units 5,000 unit pre-filled syringe 25 mg to 34 mg 30 mg pre-filled syringe
6,250 units to 8,749 units 7,500 unit pre-filled syringe 35 mg to 44 mg 40 mg pre-filled syringe
8,750 units to 11,249 units 10,000 unit pre-filled syringe 45 mg to 54 mg 50 mg pre-filled syringe
11,250 units to 13,749 units 12,500 unit pre-filled syringe 55 mg to 64 mg 60 mg pre-filled syringe
13,750 units to 16,499 units 15,000 unit pre-filled syringe 65 mg to 74 mg 70 mg pre-filled syringe
16,500 units to 19,000 units 18,000 unit pre-filled syringe 75 mg to 84 mg 80 mg pre-filled syringe
85 mg to 94 mg 90 mg pre-filled syringe
95 mg to 104 mg 100 mg pre-filled syringe
105 mg to 114 mg 110 mg pre-filled syringe
115 mg to 124 mg 120 mg pre-filled syringe
125 mg to 134 mg 130 mg pre-filled syringe
135 mg to 144 mg 140 mg pre-filled syringe
145 mg to 154 mg 150 mg pre-filled syringe
Revised 2023 CENTENNIAL HOSPITAL INPATIENT PHARMACY DEPARTMENT
