Search results with tag "Lupron depot"
For the Patient - BC Cancer
www.bccancer.bc.caLeuprolide For the Patient: Leuprolide injection Other names: ELIGARD®, LUPRON®, LUPRON DEPOT® • Leuprolide (loo' proe lide) is a drug that is used to treat prostate cancer, breast cancer, and other cancers. In men, leuprolide decreases testosterone (a male sex
CVS Specialty Drug List
www.cvsspecialty.comleuprolide acetate (lupron) lupron depot natpara aza supprelin la trelstar zoladex immune deficiencies & related disorders asceniv bivigam cutaquig cuvitru cytogam flebogamma dif gamastan gamastan s/d gammagard liquid gammagard s/d gammaked gammaplex gamunex c hepagam b hizentra halav hyperhep b s/d hyperrho s/d
DRUG NAME: Leuprolide - BC Cancer
www.bccancer.bc.caLeuprolide DRUG NAME: Leuprolide SYNONYM: Leuprorelin acetate1 COMMON TRADE NAME(S): ELIGARD®, LUPRON®, LUPRON DEPOT® CLASSIFICATION: hormonal agent Special pediatric considerations are noted when applicable, otherwise adult provisions apply.
Oncology Medications - Cigna
static.cigna.comintolerance or not a candidate for ONE of the following*: Lupron Depot, Trelstar, Firmagon, or Eligard According to the prescriber, the individual is at risk of cardiovascular disease Individual is using for intermittent androgen deprivation therapy Individual is …
January 2022 2022 EMPIRE PLAN FLEXIBLE FORMULARY …
www.caremark.comLUPRON DEPOT SGM valsartan MISCELLANEOUS AVASTIN SGM ERIVEDGE SGM LYNPARZA SGM RUBRACA SGM ZEJULA SGM CARDIOVASCULAR fosinopril lisinopril erindopril quinapril ramipril trandolapril § ACE INHIBITOR / CALCIUM CHANNEL BLOCKER COMBINATIONS amlodipine-benazepril trandolapril-verapamil ext-rel
Gonadotropin Releasing Hormone Analogs - …
www.uhcprovider.comFor Lupron Depot, for recurrence of symptoms, the prescriber should consider the impact to bone mineral density prior to retreatment. Leuprolide must be used in combination with add back therapy (e.g., norethindrone acetate) for 6 months; greater than …
Accredo® Specialty Medication List Updated 10/04 ... - Cigna
medicareproviders.cigna.comleuprolide acetate zelboraf lexiva zemaira liletta zepatier lonsurf zeposia lopinavir-ritonavir zerit lorbrena ziagen lovenox zidovudine lucentis ziextenzo lumakras zirabev lumizyme zoladex lupron depot zoledronic acid luxturna zolgensma lynparza zolinza macrilen zomacton macugen zometa
Oncology Medication Clinical Coverage - UHCprovider.com
www.uhcprovider.comLupron Depot 3.75 mg (J1950) *Biosimilar means that the biological product is FDA-approved based on data demonstrating that it is highly similar to an already FDA-approved biological product, known as a reference product, and that there are no clinically meaningful differences between the biosimilar product and the reference product.
Lupron Depot®, Lupron Depot-Ped®, Eligard® (leuprolide ...
specialtydrug.magellanprovider.comMay 01, 2018 · Lupron Depot-Ped 3-Month 30 mg J1950 00074-9694-xx Eligard 7.5 mg J9217 62935-0753-xx Eligard 22.5 mg J9217 62935-0223-xx Eligard 30 mg J9217 62935-0303-xx Eligard 45 mg J9217 62935-0453-xx *J1950: Injection, leuprolide acetate (for depot suspension), per 3.75 mg *J9217: Leuprolide acetate (for depot suspension), 7.5 mg VII.
LUPRON DEPOT (leuprolide acetate for depot suspension ...
www.lupronprostatecancer.comLUPRON DEPOT is a prescription medication that must be administered in your doctor’s office. Reference: LUPRON DEPOT 7.5 mg for 1-month, 22.5 mg for 3-month, 30 mg for 4-month, and 45 mg for 6-month [package insert]. 1891386-1740907
Lupron Depot® (leuprolide acetate for depot suspension ...
www.aetna.comLupron Depot® (leuprolide acetate for depot suspension) Medication Precertification Request Aetna Precertification Notification . Phone: 1-866-752-7021. FAX: 1-888-267-3277 . For Medicare Advantage Part B: Phone: 1-866-503-0857. FAX: 1-844-268-7263 (All fields must be completed and legible for Precertification Review) Please indicate: Start of ...
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