Hospital formulary

1. Hospital Formulary
By
Mr. Krushna K. Zambare
HOD, Pharmacology
SBSPM B. Pharmacy College, Ambajogai

2. Definition
 Formulary
The official Publication containing list of medicines authorized and
approved by medical staff for use in the hospital of state or country or
region of country for the therapy of patients.
 Hospital Formulary
It is the continuously revised list of pharmaceutical Medicines and
dosage forms with its important information's which reflects the
current views of medical staff and Pharmacy and therapeutic
committee which are considered to be most useful in the patient care.

3. Introduction
 No hospital pharmacy can possibly stock every medication which are
prescribed by their affiliated doctors to patients.
 Hence medical and pharmacy staffs of hospitals prepare hospital
formulary, which is a list of the medications that the hospital
pharmacy keeps, with information of medication
 Doctors use the formulary to find out which medications the hospital
has available to treat a given symptom or disease
 It is also useful to avoid drug interaction
 Hospital formulary generally contain generic drugs as compared to
costly other brands

4. Introduction
 Hospital formulary is required as too many pharmacy
companies manufacture so many medicines.
 The newer drugs have various untoward effects
 Peoples need effective drugs at lowest possible cost
 For rational use of drugs formulary is needed.
 For Education of medical staff, pharmacy persons, nurses.
 Hospital formulary is prepared by Pharmacy and therapeutic
committee consisting of Physicians and Pharmacists.

5. Contents of hospital formulary
1) Title Page
2) Name and title of PTC members
3) Table of contents
4) List of drugs approved by PTC
5) Introductory information

6. Contents of hospital formulary
6) Information on hospital policies and procedures for uses of drugs
a) Objective of formulary
b) Hospital rules and regulations for distribution of drugs
c) Hospital pharmacy services rule and procedures
d) Directions for how to use formulary

7. Contents of hospital formulary
7) Information on drugs
8) Special information of drugs
a) Drug related hospital policies
b) Drug Product listing
c) Particular information

8. Introductory Information
 Acknowledgement
 List of Abbreviations
 Usage manual for usage of formulary

9. Hospital Policies and Procedures
 How to use the drug
 Details of the PTC
 Pharmacy operating procedures
 Information on how to use formulary
 Rules decided by hospital for prescription, dispensing and
administration of drug
 Rules for use emergency and controlled drugs
 Patients Counseling information

10. Drug Product Listing
Formulary List of Drugs
 Alphabetically with the generic
name
 Alphabetically with the
Pharmacotherapeutic Class
Index of Dosage forms of drug
 Brand name or Generic name of
drug
 Therapeutic index
Information of drug
a) Dosage form
b) Dose of drug: Pediatric
and Geriatric
c) Strength of drug
d) ADR, Side Effects
e) Mode of action
f) Active Pharmaceutical
ingredient
g) Packaging
h) Cost of Drug

11. Special Information
 Abbreviations approved by
hospital
 Calculation of Dose of drugs
 Poison control information
 Strength of drug as per
accepted metric system
 Formulas for diagnostic stains
 List of Sugar free drugs
 List of drug Interaction
 List of Dialyzable Poisons
 Diagnostic aids
 Storage Information
 Table of Common values
 Labeling Information

12. Differentiation of hospital formulary
and Drug list
 List of drug as per Generic
names also has strength, form,
toxicology, use, Posology and
quantity to be dispensed
 Prepared locally by own medical
staff
 Details given is for local needs
and desire
 Generic names of drugs with its
strength and form
 Prepared by country’s
Pharmacists, clinical and
Pharmacological staff
 Information is written as per
their Pharmacological Property
 Eg. I.N.F.
Hospital Formulary Drug List

13. Preparation of Formulary
 Pharmacist play leading role in Preparation
 Pharmacist collects details of drug from Pharmacopoeias
 Also he Checks the drugs as per PTC guidelines
 He Prepares formulary under policies of PTC
 Further he is responsible for revision
Typical formulary will be prepared as,
 Title page
 Details of PTC

14. Preparation of Formulary
 Table of contents
 Policy of hospital
 Basic Information of Drug: All Pharmacological Details
 Prescribing and Dispensing Guidelines
 Avoid ADR and Interactions
 Proper Strength
 Size of Formulary
 Size should be small to be carried easily by medical staff
 Hospital decides the size

15. Preparation of Formulary
 Format
 Loose leaf or Bound & Printed or Mimeographed
 Formats of different hospitals are checked before preparing
 Formulary sent to Gov of India, PCI, General health
services
 Index: General and Pharmacological
 The formulary should be visually pleasing, readable and
professional in look

16. Revision of Formulary
 PTC will decide the revision of formulary
 Meeting is held by PTC for the revision
 Annual revision is done and is must because of alterations in drug
products, removal of some drugs from market, new drugs and
changes in hospital policies
 Drug details are added at the end of formulary by attaching the
sheets at the back or last of formulary
 The addition or deletion of drug is only done after reporting to
medical staff

17. Addition of drug
 The drug should be present in NFI or Pharmacopoeia
 The dosage form of drug should be manufactured by Licensed
company with good record
 The dosage form with all contents written can only be added in
formulary
 The specified dosage form should get approval from local physician
for its therapeutic activity
 The drug only with reported therapeutic efficacy be added to the
formulary

18. Addition of drug
 Before adding new drug following parameters checked,
 Efficacy
 Potency
 Safety
 Quality
 After checking above parameters a request for addition is done by
submitting formulary addition request along with supporting
literature along with signed disclosure of interest of PTC
 After receiving request PTC may Approve with or without
restriction or deny or deferment (Until specific information
available)

19. Deletion of drug
 Suggestion for deletion is given by medical staff to PTC
 Suggestion should provide superiority or inferiority of drug
depending on MOA or with specific indication
 To control growth of formulary, some addiction are balanced by
deletions of drugs
 PTC periodically review the deletion of drugs on the basis of
duplication and less use of drugs
 Further deletion of drug also done in case of availability of cheaper
and equally efficacious and potent drug as compared to costlier
ones.