Health Net
Sustol (granisetron)
Drugs for the Stomach : Drugs for Vomiting and Nausea
  • Prior Authorization: Chemo-induced Nausea and Vomiting (CINV):
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Reauthorization Required: Yes

  • Step Therapy: Chemo-induced Nausea and Vomiting (CINV):
    ST Multiple Generics

  • Chemo-induced Nausea and Vomiting (CINV):
    Age Requirement: >= 18
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: Variable
    NV associated with highly emetogenic cancer chemotherapy (HEC): Yes
    NV associated with moderately emetogenic cancer chemotherapy (MEC): Yes
    Concomitant therapy with Corticosteroid: No
    Concomitant therapy with 5-HT3 Antagonist: No

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