Health Net
Relistor (Kit) (methylnaltrexone)
Drugs for Overdose or Poisoning : Drugs for Overdose or Poisoning
  • Step Therapy: Opioid Induced Constipation:
    ST Multiple Generics

  • Opioid Induced Constipation:
    Duration: 6 Month(s)
    Failed or intolerant to increase in dietary fiber or conventional laxative therapy: Yes
    Documented Diagnosis: No
    Medical Test Required: No
    Reauthorization Required: No
    Patient must have chronic use of opioids: No
    Patient must not be using methadone: No

  • Prior Authorization: Opioid Induced Constipation:
    Duration: 6 Month(s)