A hospital formulary is a continuously updated collection of pharmaceuticals designed to enhance patient care through the evaluation and selection of useful drugs by medical staff. The guidelines emphasize the importance of multidisciplinary collaboration, establishing a formulary committee, and maintaining essential information about drugs while considering cost-effectiveness and safety. Development of the formulary involves clear organization, publication format, and accessibility for healthcare professionals.

1. Hospital formulary
Ravish Yadav

2. Definition:
• Hospital Formulary is a continually revised compilation of
pharmaceuticals including important ancillary information that
reflects the current clinical judgement of the medical staff.
• Formulary system is method whereby the medical staff of an
institution, working through the PTC, evaluates, appraises, and
selects from among the numerous available drug entities & drug
products those that considered most useful in patient care.

3. The need for Hospital Formulary:
•The increasing no. of new drugs manufactured and
marketed by drug companies
•Increasing complexity of untoward effects of
modern potent drugs
•Newer sales promotion strategies of pharmaceutical
industry.
•The public interest in getting possible health care at
lowest possible cost.

4. Guidelines
• A multidisciplinary PTC is appointed for organization of various
hospital day to day activities.
• The formulary system shall be sponsored by the medical staff based
upon the recommendations of the PTC.
• The medical staff should adopt the principles of the system to the
needs of the particular institution.
• The PTC shall adopt written policies & procedures governing the
formulary system.

5. •Non proprietary names should be included in the
formulary
•Limiting the number of drug entities and drug
products routinely available from the pharmacy
can produce substantial patient care and
financial benefits.
•The formulary system is informed to the entire
medical and nursing staff.
•The pharmacist shall be responsible for the
specification as to the quality, & source of supply
of all drugs, chemicals, biological &
pharmaceutical preparations.

6. Pre requisites in developing a hospital formulary
•Establish a formulary committee
•Establish and secure agreement on content
,structure and format of the formulary
•Appointing an editor
•Reviewing the draft
•Revise and produce new editions

7. Preparation of Hospital
Formulary

8. 1. Introductory information
•Acknowledgement
•List of abbreviations
•Intended usage of the formulary
manual

9. 2. Basic information of the drug
• Generic name, dosage form, strength
• Indications
• Pharmacological action
• Precautions
• Side effects
• Dosage – form, frequency
• Instructions
• Drug interactions

10. •Price
•Regulatory category
•Storage guidelines
•Patient counselling information
•Brand names
3. Supplementary information on each drugs

11. 4. Prescribing and dispensing guidelines
• Principles of prescription writing
• Name and address of the patient
• Prescribed drug should be written in formulary terminology
• Strength of prescribed medication must be given in accepted metric
system.
• Correct dispensing guidelines
• Prevention and reporting of ADRs

12. 5. General drug use advice
•Use of IV additives
•Prescribing in special situations
•Poisoning and antidotes

13. 6. Other components
• Formulas for various diagnostic stains, diagnostic aids
• Table of common Lab-values
• Posological tables
• Index of the drugs included in the formulary
• Metric units
• Indexes(by generic name, brand name, therapeutic category)

14. 7. The Format
• Pharmacist decides the format before commencing work on printing
and publishing in the hospital.
• He has to collect formularies of some leading hospitals as well as
their format.
• Copies of finally published formulary may be sent to bodies like
directorate general of health services, Govt of India, PCI etc.

15. 8. Size
• It is sufficiently small in size so that it could be easily carried by
clinicians, nurses etc, in the pockets of their uniform or lab coats.
• The hospitals may determine their own size of the formulary.

16. 9. Type of format
• Loose leaf or Bound
• Printed or Mimeographed
• Indexing and Assigning categories

17. Types of formularies
•Open formularies
•Closed formularies

18. Reference:
• William E Hassan, Hospital pharmacy, 124-140
• H.P.Tipnis et al, Hospital Pharmacy 135-137
• N.K.Jain, G.D.Gupta, Modern Dispensing and Hospital Pharmacy,386-
391
• S.H.Merchant and Dr. J.S.Quadry, A textbook of hospital pharmacy, 4th
edition, 39-50
• A.V.Yadav, B.V.Yadav, Hospital and clinical pharmacy, 2nd edition, 112-
117