Anthem Blue Cross (HMO, PPO, EPO) |
Symproic (naldemedine) |
Drugs for Overdose or Poisoning : Drugs for Overdose or Poisoning |
- Step Therapy: Opioid Induced Constipation:
ST Multiple Generics
- Prior Authorization: Opioid Induced Constipation:
Duration: 1 year(s)
- Quantity Limit: 1 tablet per 1 day(s).
- Opioid Induced Constipation:
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Patient must have chronic use of opioids: No
Patient must not be using methadone: No
Failed or intolerant to increase in dietary fiber or conventional laxative therapy: Yes
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