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)
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