Monoclonal Antibody System Formulary Restrictions

The System Pharmacy and Therapeutics (P&T) Committee recently approved a system-wide formulary change restricting certain medications to the clinic/outpatient setting as of Feb. 24.

The following medications have been restricted to the clinic/outpatient setting as of Feb. 24:

  • Adalimumab (Humira®)
  • Omalizumab (Xolair®)
  • Ramucirumab (Cyramza®)
  • Pertuzumab (Perjeta®)
  • Bevacizumab (Avastin®)
  • Cetuximab (Erbitux®)
  • Obintuzumab (Gazyva®)
  • Trastuzumab (Herceptin®)

Clinic/outpatient restrictions were approved for these medications as they are not typically considered urgent or require inpatient administration.  As of Feb. 24, Epic@UNC will be updated to no longer include these medications on the inpatient medication lists (Facility lists); no changes will be made to the clinic lists for these medications nor the drug builds themselves. 

Of note, if withholding administration of any of these medications while in the inpatient setting would lead to clinical deterioration or a delay in discharge an exception to this restriction is appropriate and the medication may be ordered via the non-formulary pathway in Epic (or equivalent in non-Epic hospitals). 

Please contact Ashley Pappas ( if you have any questions.