Cleviprex to replace Cardene?

[ellepharm]

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We are considering the addition of Cleviprex to formulary. In comparison to Cardene it does seem to have a more advantageous profile (quicker onset, no accumulation in the tissues, lower volume infused v. Cardene, and pre-mixed). Our concerns are around the lipid formulation and 4 hour hang time limit. Also, the price of Cleviprex is much less than Cardene. We prefer to have only one CCB on formulary.

Any info on how your hospital evaluated Cleviprex would be welcome (pros and cons).
Thanks.

 

[StaviZFingerZ]

We are considering the addition of Cleviprex to formulary. In comparison to Cardene it does seem to have a more advantageous profile (quicker onset, no accumulation in the tissues, lower volume infused v. Cardene, and pre-mixed). Our concerns are around the lipid formulation and 4 hour hang time limit. Also, the price of Cleviprex is much less than Cardene. We prefer to have only one CCB on formulary.

Any info on how your hospital evaluated Cleviprex would be welcome (pros and cons).
Thanks.

Cleviprex is cheaper than Nicardipine? I don't think so.
Clinically, read "ECLIPSE" trial.

 

[bigpharmD]

We are considering the addition of Cleviprex to formulary. In comparison to Cardene it does seem to have a more advantageous profile (quicker onset, no accumulation in the tissues, lower volume infused v. Cardene, and pre-mixed). Our concerns are around the lipid formulation and 4 hour hang time limit. Also, the price of Cleviprex is much less than Cardene. We prefer to have only one CCB on formulary.

Any info on how your hospital evaluated Cleviprex would be welcome (pros and cons).
Thanks.

NO way it is cheaper.....our hospital said no way but the rep keeps taking the mds out to dinner and giving them samples to use

 

[Farmercyst]

We are considering the addition of Cleviprex to formulary. In comparison to Cardene it does seem to have a more advantageous profile (quicker onset, no accumulation in the tissues, lower volume infused v. Cardene, and pre-mixed). Our concerns are around the lipid formulation and 4 hour hang time limit. Also, the price of Cleviprex is much less than Cardene. We prefer to have only one CCB on formulary.

Any info on how your hospital evaluated Cleviprex would be welcome (pros and cons).
Thanks.

You post like you have a say in the decision process, but you're listed as a student. I'm confused.

 

[njac]

You post like you have a say in the decision process, but you're listed as a student. I'm confused.

I participated in P&T and Med Safety Committee meetings as a student at the hospital where I interned.

And on rotations there were times where I had to gather the data and argue a position at P&T. So students can be involved in the actual decision making, scary enough!

 

[VancTheTank]

.

 

[StaviZFingerZ]

Ok, to be fair, Cleviprex folks did decrease their cost dramatically to match the pricing of IV Nicardipine.

Cleviprex 0.5mg/ml 50ml = $84
Cleviprex 0.5mg/ml 100ml = $168

Cardene 20mg/200ml = $82.


Here is what gets tricky...there's not an equivalent dosing conversion established between Cleviprex and Cardene..both drugs require titration.

Cleviprex average use was around 13mg per hour in Eclipese trial...up to 30mg per hour with 500ml max per day... It's not easy to decipher what the dose was for Nicardipine. Typical Nicardipine dose titration ranges from 50mg - 150mg per hour.

So, I would be interested in seeing how OP's hospital ran the cost comparison.

 

[VancTheTank]

.

 

[StaviZFingerZ]

😱

Sorry, ml.

 

[njac]

Sorry, ml.

at how concentrated? Sometimes we compound uberconcentrated bags.

 

[PharmaTope]

Our formulary agent is nicardipine for the following reasons:

- Cost
- 4 hour max hang-time
- Potential look-like issue with propofol
- Did I mention cost?

Cardene is available in a premix if you want to spend the $$. Concentration was a bit of an issue at first, now a 40mg/200ml bag is marketed so it is not as bad. Admixing with generic vials would be most cost-effective.

I think it's cool you're involved in this sort of thing as a student. Even if it just data collection at least it gets you thinking. 👍

cleviprex also needs its own line.

 

[StaviZFingerZ]

at how concentrated? Sometimes we compound uberconcentrated bags.

standard premixed bag

 

[Farmercyst]

I participated in P&T and Med Safety Committee meetings as a student at the hospital where I interned.

And on rotations there were times where I had to gather the data and argue a position at P&T. So students can be involved in the actual decision making, scary enough!

I did P&T competition in P1, but didn't have the time to put into it last year. I would enjoy sitting in on an actual P&T, but not sure how much I'd be able to contribute as a student.

 

[StaviZFingerZ]

I'd have students run cost analysis then have them present monographs.