Health Net
Aloxi 0.075 Mg/1.5 Ml Soln (palonosetron)
Drugs for the Stomach : Drugs for Vomiting and Nausea
  • Step Therapy Applies
  • Prior Authorization: Chemo-induced Nausea and Vomiting (CINV):
    Documented Diagnosis: Yes
    Reauthorization Required: Yes

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

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