thyroid desiccated (Rx)

Brand and Other Names:Armour Thyroid, Nature-Throid
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 15mg, 16.25mg, 30mg, 32.5mg, 48.75 mg, 60mg, 65mg, 81.25, 90mg, 97.5 mg, 113.75 mg
  • 120mg, 130mg, 146.25, 162.5mg, 180mg, 195mg, 240mg, 260 mg, 300mg, 325 mg

Hypothyroidism

Mild: initial 15-30 mg PO qDay, may increase by 15 mg/day q2-3Weeks (or 30 mg/day q30Days)

Myxedema: start 15 mg PO qDay, THEN after 2 weeks 30 mg PO qDay, THEN after 2 weeks 60 mg PO qDay

Maintentance: 60-120 mg PO qDay

Administration: before breakfast

Other Indications & Uses

As diagnostic agents in suppression tests to differentiate suspected mild hyperthyroidism or thyroid gland autonomy

Dosing Considerations

Readjustment of thyroid hormone dosage should be made within the first four weeks of therapy, after proper clinical and laboratory evaluations, including serum levels of T4, bound and free, and TSH

Desicated thyroid form contains variable amounts of T3, T4, and other triiodothyronine compounds which are more likely to cause signs or symptoms due to fluctuating levels

Dosage Forms & Strengths

tablet

  • 15mg, 16.25mg, 30mg, 32.5mg, 48.75 mg, 60mg, 65mg, 81.25, 90mg, 97.5 mg, 113.75 mg
  • 120mg, 130mg, 146.25, 162.5mg, 180mg, 195mg, 240mg, 260 mg, 300mg, 325 mg

Hypothyroidism

6 months: 4.8-6 mg/kg PO qDay  

6-12 months: 3.6-4.8 mg/kg PO qDay

1-5 years: 3-3.6 mg/kg PO qDay

6-12 years: 2.4-3 mg/kg PO qDay

12 years or older: 1.2-1.8 mg/kg PO qDay

Not recommended

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Interactions

Interaction Checker

and thyroid desiccated

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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             activity indicator 

            Contraindicated (1)

            • sodium iodide I-131

              thyroid desiccated will decrease the level or effect of sodium iodide I-131 by Other (see comment). Contraindicated. Use of thyroid products or iodine before and during treatment with sodium iodide I-131 decreases uptake of sodium iodide I-131 by the thyroid gland

            Serious - Use Alternative (13)

            • antithrombin alfa

              thyroid desiccated increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • antithrombin III

              thyroid desiccated increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • argatroban

              thyroid desiccated increases effects of argatroban by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • bemiparin

              thyroid desiccated increases effects of bemiparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • bivalirudin

              thyroid desiccated increases effects of bivalirudin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • dalteparin

              thyroid desiccated increases effects of dalteparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • enoxaparin

              thyroid desiccated increases effects of enoxaparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • fondaparinux

              thyroid desiccated increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • heparin

              thyroid desiccated increases effects of heparin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • lycopus

              lycopus decreases effects of thyroid desiccated by pharmacodynamic antagonism. Contraindicated. Lycopus blocks peripheral conversion of T4 to T3.

            • phenindione

              thyroid desiccated increases effects of phenindione by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • protamine

              thyroid desiccated increases effects of protamine by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            • warfarin

              thyroid desiccated increases effects of warfarin by pharmacodynamic synergism. Avoid or Use Alternate Drug.

            Monitor Closely (20)

            • carbonyl iron

              carbonyl iron decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • cholestyramine

              cholestyramine decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • colesevelam

              colesevelam will decrease the level or effect of thyroid desiccated by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer thyroid hormones at least 4 hr before colesevelam. Elevated thyroid-stimulating hormone (TSH) in patients receiving thyroid hormone.

            • digoxin

              thyroid desiccated decreases effects of digoxin by unknown mechanism. Use Caution/Monitor.

            • eluxadoline

              eluxadoline increases levels of thyroid desiccated by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered OATP1B1 substrates.

            • ferric maltol

              ferric maltol decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • ferrous fumarate

              ferrous fumarate decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • ferrous gluconate

              ferrous gluconate decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • ferrous sulfate

              ferrous sulfate decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • insulin degludec

              thyroid desiccated decreases effects of insulin degludec by pharmacodynamic antagonism. Use Caution/Monitor. Thyroid hormones regulate carbohydrate metabolism, gluconeogenesis, and glycogen stores mobilization; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.

            • insulin degludec/insulin aspart

              thyroid desiccated decreases effects of insulin degludec/insulin aspart by pharmacodynamic antagonism. Use Caution/Monitor. Thyroid hormones regulate carbohydrate metabolism, gluconeogenesis, and glycogen stores mobilization; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.

            • insulin inhaled

              thyroid desiccated decreases effects of insulin inhaled by pharmacodynamic antagonism. Use Caution/Monitor. Thyroid hormones regulate carbohydrate metabolism, gluconeogenesis, and glycogen stores mobilization; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.

            • iron dextran complex

              iron dextran complex decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • iron sucrose

              iron sucrose decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • lanthanum carbonate

              lanthanum carbonate decreases levels of thyroid desiccated by cation binding in GI tract. Use Caution/Monitor. Administer oral thyroid products at least 2 hr before or after lanthanum. Interaction applies only to oral thyroid products only. .

            • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

              levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will decrease the level or effect of thyroid desiccated by unknown mechanism. Modify Therapy/Monitor Closely. The estrogen component of combined hormonal contraceptives (CHCs) may raise the serum concentrations of thyroxine-binding globulin. Women on thyroid hormone replacement therapy may need increased doses of thyroid hormone with use of CHCs.

            • metformin

              thyroid desiccated decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor. Patient should be closely observed for loss of blood glucose control; when drugs are withdrawn from a patient receiving metformin, patient should be observed closely for hypoglycemia.

            • nateglinide

              thyroid desiccated decreases effects of nateglinide by pharmacodynamic antagonism. Use Caution/Monitor. Coadministration may reduce nateglinide's hypoglycemic action.

            • polysaccharide iron

              polysaccharide iron decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • rose hips

              rose hips decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            Minor (26)

            • amobarbital

              amobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • butabarbital

              butabarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • butalbital

              butalbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • carbamazepine

              carbamazepine decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • colestipol

              colestipol decreases levels of thyroid desiccated by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • dexlansoprazole

              dexlansoprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • eslicarbazepine acetate

              eslicarbazepine acetate decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • esomeprazole

              esomeprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • ethotoin

              ethotoin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

              ethotoin decreases levels of thyroid desiccated by plasma protein binding competition. Minor/Significance Unknown.

            • fosphenytoin

              fosphenytoin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

              fosphenytoin decreases levels of thyroid desiccated by plasma protein binding competition. Minor/Significance Unknown.

            • glandular products

              glandular products increases effects of thyroid desiccated by pharmacodynamic synergism. Minor/Significance Unknown. Additive effects with thyroid glandular extract.

            • guggul

              guggul decreases effects of thyroid desiccated by pharmacodynamic antagonism. Minor/Significance Unknown.

            • lansoprazole

              lansoprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • omeprazole

              omeprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • oxcarbazepine

              oxcarbazepine decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • pantoprazole

              pantoprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • pentobarbital

              pentobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • phenobarbital

              phenobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • phenytoin

              phenytoin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

              phenytoin decreases levels of thyroid desiccated by plasma protein binding competition. Minor/Significance Unknown.

            • piracetam

              piracetam, thyroid desiccated. Mechanism: unknown. Minor/Significance Unknown. Combination of piracetam and T3+T4 produced confusion, sleep disorder in single case.

            • primidone

              primidone decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • rabeprazole

              rabeprazole decreases levels of thyroid desiccated by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown. Conflicting evidence regarding this interaction exists.

            • rifampin

              rifampin decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • secobarbital

              secobarbital decreases levels of thyroid desiccated by increasing metabolism. Minor/Significance Unknown.

            • shepherd's purse

              shepherd's purse decreases effects of thyroid desiccated by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

            • theophylline

              thyroid desiccated decreases levels of theophylline by increasing elimination. Minor/Significance Unknown.

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            Adverse Effects

            Frequency Not Defined

            Tachycardia

            Alopecia

            Myalgia

            Arrhythmias

            Nervousness

            Tremor

            Diarrhea

            Cramps

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            Warnings

            Black Box Warning

            Drugs with thyroid hormone activity, alone or together with other therapeutic agents, used for the treatment of obesity; in euthyroid patients, doses within range of daily hormonal requirements are ineffective for weight reduction

            Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects

            Contraindications

            Hypersensitivity to thyroid hormone

            Untreated thyrotoxicosis, untreated adrenal insufficiency

            Cautions

            Use caution; symptoms may be exaggerated or aggravated; glucocorticoid treatment should precede thyroid replacement therapy in patients with adrenal insufficiency

            Use with caution in cardiovascular disease, angina, HTN, endocrine disorders, elderly

            Use cautioin in diabetes mellitus and insipidus; therapy may aggravate or exaggerate symptoms

            Judicious use in AMI complicated or caused by hypothyroidism may be considered

            Ineffective in the treatment of obesity or of infertility uncomplicated by hypothyroidism

            Myxedema symptoms may be exaggerated or aggravated; therapy of myxedema coma requires simultaneous administration of glucocorticoids; use caution; administer low dose to patients with long-standing myxedemay

            Drug interaction overview

            Hypothyroidism decreases and hyperthyroidism increases sensitivity to oral anticoagulants; prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants and dosage of the latter agents adjusted on the basis of frequent prothrombin time determinations; in infants, excessive doses of thyroid hormone preparations may produce craniosynostosis

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            Pregnancy & Lactation

            Pregnancy

            Thyroid hormones do not readily cross the placental barrier; clinical experience to date does not indicate any adverse effect on fetuses when thyroid hormones are administered to pregnant women

            On the basis of current knowledge, thyroid replacement therapy to hypothyroid women should not be discontinued during pregnancy

            Lactation

            Minimal amounts of thyroid hormones are excreted in human milk; thyroid is not associated with serious adverse reactions and does not have a known tumorigenic potential; however, caution should be exercised when thyroid is administered to a nursing woman

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Natural thyroid hormone from animals; increase basal metabolic rate, increase utilization and mobilization of glycogen store, promotes gluconeogenesis

            Pharmacokinetics

            Onset: Initial effect: 3hr

            Bioavailability: 48-80%

            Protein Bound: >99%

            Metabolism: Hepatic; also in kidney and intestinal walls

            Metabolites: Levothyroxine (T4), liothyronine (T3), reverse triiodothyronine (rT3)

            Excretion: Urine (major), feces (partially)

            Time to peak

            • T4: 2-4 hr
            • T3: 2-3 days

            Half-Life

            • T4: 6-7 days (euthyroid); 3-4 days (hyperthyroid); 9-10 (hypothyroid)
            • T3: 2.5 days
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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Armour Thyroid oral
            -
            180 mg tablet
            Armour Thyroid oral
            -
            120 mg tablet
            Armour Thyroid oral
            -
            90 mg tablet
            Armour Thyroid oral
            -
            60 mg tablet
            Armour Thyroid oral
            -
            30 mg tablet
            Armour Thyroid oral
            -
            15 mg tablet
            Armour Thyroid oral
            -
            300 mg tablet
            Armour Thyroid oral
            -
            240 mg tablet
            NP Thyroid oral
            -
            60 mg tablet
            NP Thyroid oral
            -
            30 mg tablet
            NP Thyroid oral
            -
            90 mg tablet
            NP Thyroid oral
            -
            15 mg tablet
            NP Thyroid oral
            -
            120 mg tablet
            Westhroid oral
            -
            195 mg tablet
            Westhroid oral
            -
            130 mg tablet
            Westhroid oral
            -
            97.5 mg tablet
            Westhroid oral
            -
            32.5 mg tablet
            Westhroid oral
            -
            65 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            thyroid (pork) oral

            THYROID - ORAL

            (THYE-royd)

            COMMON BRAND NAME(S): Armour Thyroid

            WARNING: This medication should not be used for weight loss. Normal doses of this medication will not work for weight loss, and large doses of this medication may cause serious, possibly fatal side effects, especially when taken with diet pills.

            USES: Thyroid hormone is used to treat underactive thyroid (hypothyroidism). It is a natural product made from animal thyroid glands (usually a pig's). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Having enough thyroid hormone is important for maintaining normal mental and physical activity. In children, having enough thyroid hormone is important for normal mental and physical development.This medication is also used to treat other types of thyroid disorders (such as certain types of goiters, thyroid cancer) and also to test for thyroid function.This medication should not be used to treat infertility unless it is caused by low thyroid hormone levels.Older adults should discuss the risks and benefits of this medication with their doctor or pharmacist.

            HOW TO USE: Take this medication by mouth as directed by your doctor, usually once daily on an empty stomach, 30 minutes to 1 hour before breakfast.Dosage is based on your medical condition, laboratory test results, and response to treatment. For children, the dosage is also based on age/weight.Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.Do not stop taking this medication without first consulting with your doctor. Thyroid replacement treatment is usually taken for life.Certain medications (cholestyramine, colestipol, colesevelam, antacids, sucralfate, simethicone, iron, sodium polystyrene sulfonate, calcium carbonate, orlistat) can decrease the amount of thyroid hormone that is absorbed by your body. If you are taking any of these drugs, separate them from this medication by at least 4 hours.There are different brands of thyroid hormone available. Do not change brands without first consulting your doctor or pharmacist.Symptoms of low thyroid hormone levels include tiredness, muscle aches, constipation, dry skin, weight gain, slow heartbeat, or sensitivity to cold. Tell your doctor if your condition worsens or persists after several weeks of taking this medication.

            SIDE EFFECTS: Hair loss may occur during the first few months of treatment. This effect is usually temporary as your body adjusts to this medication. If this effect persists or worsens, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious effects of high thyroid hormone levels occur: increased sweating, sensitivity to heat, mental/mood changes (such as nervousness, mood swings), tiredness, diarrhea, shaking (tremor), headache, shortness of breath.Get medical help right away if any of these rare but serious effects of high thyroid hormone levels occur: chest pain, fast/pounding/irregular heartbeat, swelling hands/ankles/feet, seizures.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking thyroid hormone, tell your doctor or pharmacist if you are allergic to it; or to pork products; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: increased thyroid hormones (thyrotoxicosis), decreased adrenal gland function, heart disease (such as coronary artery disease, irregular heartbeat), high blood pressure, diabetes.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially chest pain, fast/pounding/irregular heartbeat.Current information shows that this drug may be used during pregnancy. Tell your doctor if you are pregnant because your dose may need to be adjusted.Thyroid hormone passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: See also How to Use Section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: "blood thinners" (such as warfarin), digoxin, estrogen-containing products (including birth control pills).

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/pounding/irregular heartbeat, loss of consciousness, confusion, seizures.

            NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as thyroid function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up unless your doctor tells you to do so. Call your doctor if you miss 2 or more doses in a row. Ask your doctor ahead of time what to do about a missed dose and follow your doctor's specific directions.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised June 2018. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
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            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.