Dosing & Uses
Dosage Forms & Strengths
lyophilized powder for injection plus diluent
- 0.9mg/vial (Xiaflex)
- 0.92mg/vial (Qwo)
- 1.84mg/vial (Qwo)
Dupuytren Contracture
Xiaflex only
Indicated for Dupuytren contracture with a palpable cord
Inject 0.58 mg into palpable Dupuytren cord with a contracture of metacarpophalangeal (MP) joint or proximal interphalangeal (PIP) joint
If contracture persists 24-72 hr following injection, perform finger extension procedure
May repeat injection and finger extension procedures up to 3 times per cord at 4-week intervals
Inject only 1 cord at a time; if other cords with contractures exist, inject each cord in sequential order
Each vial of drug and sterile diluent should only be used for a single injection; if 2 joints on the same hand are to be treated during a treatment visit, separate vials and syringes should be used for each reconstitution and injection
Approximately 24-72 hr after injection, perform a finger extension procedure if a contracture persists to facilitate cord disruption
May reinject four weeks after the initial injection if MP or PIP contracture still present; may reinject with a single dose of collagenase C histolyticum
2 injections on same hand per treatment visit
- Perform up to 2 injections in the same hand during a treatment visit
- Two palpable cords affecting 2 joints may be injected or 1 palpable cord affecting 2 joints in the same finger may be injected at 2 locations during a treatment visit
- If a patient has other palpable cords with contractures of MP or PIP joints, these cords may be injected at other treatment visits ~4 wk apart
Peyronie Disease
Xiaflex only
Available for treatment of Peyronie disease only through a restricted Risk Evaluation and Mitigation Strategy (REMS) program called the XIAFLEX REMS Program
Indicated in men with a palpable plaque and curvature deformity of at least 30 degrees at the start of therapy
Inject 0.58 mg into a Peyronie plaque; if >1 plaque present, inject into the plaque causing the curvature deformity
Treatment course consists of a maximum of 4 treatment cycles; each treatment cycle consists of 2 injection procedures and 1 penile modeling procedure for a maximum of 8 injection procedures and 4 modeling procedures
Perform 2nd injection procedure 1-3 days after the 1st
Interval between treatment cycles is ~6 weeks
Induce a penile erection; to achieve it, may use a single intracavernosal injection of 10 or 20 mcg of alprostadil
With the penis in the erect state, identify and mark the target area in the Peyronie plaque to be injected
The penis should be in flaccid state before injecting
Inject 0.58 mg into target plaque once on each of 2 days, 1 to 3 days apart, according to injection procedure
Perform a penile modeling procedure 1 to 3 days after second injection of each treatment cycle
For each plaque causing the curvature deformity, may administer up to four treatment cycles; may repeat each treatment cycle at approximately six-week intervals; if curvature deformity is <15 degrees after 1st, 2nd, or 3rd treatment cycle, or if further treatment not clinically indicated, do not administer subsequent treatment cycles
If curvature deformity is <15 degrees after 1st, 2nd, or 3rd treatment cycle, or if healthcare provider determines that further treatment not clinically indicated, then do not administer subsequent treatment cycles
Cellulite
Qwo only
Up to twelve 0.07-mg (0.3-mL) SC injections totaling 0.84 mg per treatment area (ie, single buttock)
Treatment visit may consist of up to 2 treatment areas
Repeat q21Days for 3 treatment visits
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (13)
- antithrombin alfa
antithrombin alfa increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- antithrombin III
antithrombin III increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- argatroban
argatroban increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- aspirin
aspirin increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- bivalirudin
bivalirudin increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- dabigatran
dabigatran increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- dalteparin
dalteparin increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- desirudin
desirudin increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- enoxaparin
enoxaparin increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- fondaparinux
fondaparinux increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- heparin
heparin increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- protein C concentrate
protein C concentrate increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- rivaroxaban
rivaroxaban increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
Minor (0)
Adverse Effects
>10%
Dupuytren contracture
- Peripheral edema (ie, swelling of injected hand) (73%)
- Contusion (70%)
- Injection site hemorrhage (38%)
- Injection site reaction (35%)
- Pain in injected extremity (35%)
- Tenderness (24%)
- Injection site swelling (24%)
- Pruritus (15%)
- Lymphadenopathy (13%)
Peyronie Disease
- Penile hematoma (65.5%)
- Penile swelling (55%)
- Penile pain (45.4%)
- Penile ecchymoses (14.5%)
Cellulite
- Bruising (84%)
- Pain (48%)
- Nodule (33%)
- Pruritus (15%)
1-10%
Dupuytren contracture
- Skin laceration (9%)
- Lymph node pain (8%)
- Erythema (6%)
- Axillary pain (6%)
Peyronie Disease
- Blood blister (4.5%)
- Penile blister (3.3%)
- Pruritus genital (3.1%)
- Painful erection (2.9%)
- Erectile dysfunction (1.8%)
- Procedural pain (1.6%)
- Injection site vesicles (1.3%)
- Localized edema (1.3%)
- Dyspareunia (1.1%)
- Injection site pruritus (1.1%)
- Nodule (1.1%)
- Suprapubic pain (1.1%)
Cellulite
- Erythema (9%)
- Discoloration (8%)
- Swelling (8%)
- Warmth (3%)
<1%
Peyronie Disease
- Corporal rupture
Postmarketing Reports
Back pain
Localized skin and soft tissue necrosis, occurring as sequelae of penile hematoma
Cellulite
- Immune system disorders: serious hypersensitivity reactions including anaphylaxis
Warnings
Black Box Warnings
Peyronie disease
- Corporal rupture (penile fracture) was reported as adverse reaction in clinical trials
- Promptly evaluate signs or symptoms reflecting serious penile injury to assess for corporal rupture or severe penile hematoma which may require surgical intervention
- Because of risks of corporal rupture or other serious penile injury, available for the treatment of Peyronie’s disease only through the XIAFLEX REMS Program
Contraindications
Hypersensitivity
Peyronie plaques that involve the penile urethra
Cautions
Do not substitute injectable collagenase products (ie, do not use Xiaflex for cellulite treatment of use Qwo for Dupuytren contracture or Peyronie disease)
Serious hypersensitivity, including anaphylaxis, reported; if hypersensitivity occurs, discontinue and institute appropriate medical therapy
Pruritus experienced especially after more injections
Use with caution in patients with coagulation disorders, including in patients who have received anticoagulant medications other than low- dose aspirin within 7 days of the injection
Administration in patients with abnormal coagulation may result in ecchymosis/contusion or an injection site hemorrhage
Post-injection back pain
- Acute post-injection back pain reactions reported in postmarketing period in patients treated for Peyronie’s disease; these events typically have an onset immediately or within minutes of injection
- The acute lower back pain can be mild to severe in intensity and can radiate to the legs, arms and chest; other systemic symptoms, such as chest pain, headache, and dyspnea, reported along with back pain episodes
- None of the events were reported to occur after the patient’s first injection and a few were reported to occur during a second treatment course
- Reported events typically resolved within 15 minutes, but some lasted up to 30 minutes, and one event lasted 1.5 hours; reported events typically did not require intervention, but some required observation and treatment with analgesics
Dupuytren contracture
- Tendon rupture of other serious injury to the injected extremity reported in clinical trials; avoid injecting into tendons, nerves, blood vessels, or other collagen-containing structure of the hand
- Healthcare providers should be prepared to address hypersensitivity reactions, including anaphylaxis, following injections
- Incidence of skin laceration (22%) was higher when treating 2 concurrent injections compared with up to 3 single injections in the placebo-controlled premarketing trials (9%)
- Postmarketing cases of skin laceration requiring skin graft after finger extension procedures and local skin and soft-tissue necrosis, some requiring skin grafting or, other surgical interventions including finger amputation reported; signs or symptoms that may reflect serious injury to injected finger/hand should be promptly evaluated because surgical intervention may be required
Peyronie Disease
- Advise patients not to have sex between first and second injections of treatment cycle; patients should wait 2 weeks after second injection of treatment cycle before resuming sexual activity, provided pain and swelling have subsided
- May cause corporal rupture (penile fracture) or other serious injury to penis; avoid injecting into urethra, nerves, blood vessels, corpora cavernosa or other collagen-containing structures of the penis since may result in possible permanent injury (eg, corporal rupture)
- If patient experiences severe pain or swelling of the penis, severe purple bruising and swelling of the penis, difficulty urinating or blood in the urine, sudden loss of ability to maintain an erection, should contact health care provider
- In the postmarketing setting, cases of localized skin and soft tissue necrosis occurring as sequelae of penile hematoma reported; some cases required surgical intervention
Cellulite
- Injection site bruising is common; patients with coagulation disorders or using anticoagulants or antiplatelets (except aspirin <150 mg/day) were excluded from clinical trials
- Caution if administered to patients with coagulation disorders or coadministered with anticoagulant or antiplatelet agents
Drug interaction overview
- Safety and efficacy when coadministered with anticoagulants (other than low-dose aspirin up to 150 mg/day) within 7 days of administration is unknown
Pregnancy & Lactation
Pregnancy
Data are not available regarding use in pregnant females to evaluate for a drug- associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
Animal studies
- IV administration to pregnant rats during organogenesis at doses up to 0.13 mg/rat (43x human equivalent dose [HED] on a mg/kg basis) revealed no evidence of fetal harm
Lactation
Data are not available regarding presence in human milk, effects on breastfed children, or on milk production
Following SC injection, systemic concentrations were below the bioanalytical assay limit of quantification
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.Pharmacology
Mechanism of Action
Proteinase that hydrolyzes collagen in its native triple-helical conformation, resulting in lysis of collagen deposits
Injection of into a Dupuytren’s cord, which is comprised mostly of collagen, may result in enzymatic disruption of the cord
Believed to work for Peyronie’s disease by breaking down the buildup of collagen (a structural protein in connective tissue) that causes the curvature deformity
Mechanism for treatment of moderate-to-severe cellulite is unknown
Pharmacokinetics
Absorption: Not absorbed
Administration
Xiaflex Preparation
Reconstitution of lyophilized powder
- Must reconstitute lyophilized powder with provided diluent prior to use
- Remove lyophilized powder and diluent from refrigerator and allow to stand at room temperature for at least 15 min (not to exceed 60 min)
- Remove flip off cap from each vial, utilize aseptic technique and swab rubber stoppers of each vial with sterile alcohol
- Use only the supplied diluent for reconstitution (contains calcium required for activity of collagenase clostridium histolyticum
- Use 1-mL syringe with 0.01 mL gradations and 27-ga 0.5-in needle to withdraw diluent
- Inject diluent slowly into side of lyophilized powder vial, then slowly swirl solution to ensure al powder has gone into solution
- Do not invert vial or shake the solution
Sterile diluent volume for specific indication
-
Dupuytren contracture
- MP joints: Reconstitute with 0.39 mL diluent (resulting concentration 0.58 mg/0.25 mL)
- PIP joints: Reconstitute with 0.31 mL diluent (resulting concentration 0.58 mg/0.2 mL)
-
Peyronie disease
- Reconstitute with 0.39 mL diluent (resulting concentration 0.58 mg/0.25 mL)
Qwo Preparation
Before reconstitution, remove vials from refrigerator and let stand at room temperature for at least 15 minutes
Inspect vials; lyophilized powder cake should be white in color and intact, showing no signs of erosion; diluent solution should appear colorless and free of particulate matter
After removal of the flip-off cap from the vial(s), using aseptic technique swab the rubber stopper and surrounding surface of the vial(s) with sterile alcohol (no other antiseptics should be used)
Use only the supplied diluent for reconstitution
Using appropriate sized syringe and needle (not supplied), withdraw the amount of supplied diluent based on the number of injection sites
Inject diluent slowly into the sides of vial containing lyophilized powder
Do not invert or shake solution; slowly swirl solution to ensure that all of the lyophilized powder has gone into solution
Sterile diluent volume
- 1 treatment area: Reconstitute 0.92-mg vial with 4 mL diluent
- 2 treatment areas: Reconstitute 1.84-mg vial with 8 mL diluent
- Resulting concentration is 0.23 mg/mL
Xiaflex Administration
See prescribing information for specific injection techniques for Dupuytren contracture or Peyronie disease
Dupuytren contracture: Follow-up visit needed 24-72 hr following injection for finger extension procedure
Peyronie disease: Follow-up visit needed 24-72 hr following injection for penile modeling procedure
Qwo SC Administration
Using 1-mL syringes with removable needles (not supplied), draw up 0.9 mL of the reconstituted solution into each syringe (0.21 mg/0.9 mL)
Single treatment visit: Four syringes totaling 0.84 mg
Two treatment visit: Eight syringes totaling 1.68 mg
Mark injection sites while the patient is standing
Inject SC while patient is in prone position
Each injection should be administered as three 0.1-mL aliquots to 3 different positions (see prescribing information image for angle and direction of each injection); for a total injection volume of 0.3 mL
Injection depth is 0.5 inches (corresponding to the length of the needle) without downward pressure
Each treatment area may receive up 12 injections
Patient should remain prone for at least 5 minutes after completion
Storage
Xiaflex
- Before reconstitution: Refrigerate lyophilized powder for injection and diluent at 2-8ºC (36-46ºF); do not freeze
- Reconstituted solution: May store at room temperature (20-25ºC [68-77ºF]) up to 1 hr, or refrigerate (2-8ºC [36-46ºF) up to 4 h before administration
Qwo
- Before reconstitution: Refrigerate lyophilized powder and diluent at 2-8ºC (36-46ºF); do not freeze
- Reconstituted solution: May store at room temperature (20-25ºC [68-77ºF]) up to 8 hr, or refrigerated (2-8ºC [36-46ºF) up to 72 hr before administration
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Xiaflex injection - | 0.9 mg vial |  | |
| Santyl topical - | 250 unit/gram ointment |  | |
| Santyl topical - | 250 unit/gram ointment |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
collagenase clostridium histolyticum injection
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM - INJECTION
(KOL-a-JEN-ase klos-TRID-ee-um HIS-toe-LIT-ik-um)
COMMON BRAND NAME(S): Xiaflex
WARNING: When used to treat a certain penis condition (Peyronie's disease), this drug has rarely caused very serious injury to the penis (such as penile fracture/hematoma). The injury could be permanent and/or require surgery to fix. Tell your doctor right away if you develop symptoms of serious injury to your penis, such as severe pain/bruising/swelling of the penis, loss of ability to maintain an erection, difficulty urinating, blood in the urine, or a popping sound/feeling in an erect penis.Because of the risk of serious injury to the penis, this medication is only available through a restricted program when used to treat Peyronie's disease.
USES: This medication is used to treat certain conditions (Dupuytren's contracture, Peyronie's disease) that are caused by a certain protein (collagen) in your body. Collagen is a tough and strong substance and is found in the knots/cords of the hand in Dupuytren's contracture or plaques in the penis in Peyronie's disease. Collagenase is a substance (enzyme) that breaks down the collagen in these knots/cords/plaques.
HOW TO USE: Read the Medication Guide provided by your healthcare professional before each injection. If you have any questions, ask your doctor or pharmacist.If you are using this medication to treat Dupuytren's contracture, the medication is injected into the tissue knot (cord) of the affected hand by your healthcare provider. Your hand will be wrapped in soft gauze after the injection. Limit hand movement and keep the hand elevated until bedtime. Do not try to straighten, curl, or move the injected finger until your doctor tells you it is okay to do so. Tell your doctor right away if you start to feel numbness, tingling, or a feeling of "pins and needles" in your hand during the procedure.You must return to your doctor's office within 1 to 3 days after the procedure. Your doctor will check your hand, try to straighten the finger if needed, and apply a splint. Wear the splint every night at bedtime as long as directed by your doctor (for up to 4 months). Do finger exercises several times a day exactly as directed. Do not do any strenuous activity with the treated hand until your doctor tells you it is okay to do so. Tell your doctor if you have trouble bending the finger after the swelling goes down or problems using your hand.If you are still unable to straighten your finger after 4 weeks, your doctor may give a repeat injection into the same area of the hand. No more than 3 injections, each 4 weeks apart, should be given in the same area.If you are using this medication to treat Peyronie's disease, the medication is injected into the plaque in the penis by your healthcare provider. Each treatment cycle consists of two injections 1 to 3 days apart and a modeling (straightening) procedure 1 to 3 days after the second injection. Do not have sex between the first and second injections of a treatment cycle. Also, do not have any sexual activity for at least 4 weeks after the second injection of a treatment cycle and only after your doctor says that it is safe to do so (usually after all the pain/swelling has gone away). You might have as many as 4 treatment cycles. Each treatment cycle is about 6 weeks apart. In between cycles, follow your doctor's instructions on straightening and stretching the penis. Tell your doctor if you have trouble stretching or straightening your penis or if new pain occurs.
SIDE EFFECTS: See also How to Use and Warning sections.Pain, swelling, bruising, bleeding, redness, itching at or around the injection site may occur. Swollen, painful areas in the elbow and underarm (swollen lymph nodes) may also occur when this medication is injected in the hand. If any of these effects last or get worse, tell your doctor promptly.Remember that this medication has been prescribed because your doctor 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.If treating Dupuytren's contracture, tell your doctor right away if you have any serious side effects, including: signs of infection (such as fever, chills, increasing redness/swelling), signs of nerve injury (such as numbness/tingling/pain/strange feeling in the treated hand), tears in the skin around the injection site (lacerations).Serious (possibly permanent) injury to the tendons/ligaments of the hand is a rare side effect of this drug/procedure. The injury may require surgery to repair. Tell your doctor right away if you have difficulty moving your fingers or hand after your doctor has told you it is okay to move them.Some people using this medication for Peyronie's disease have developed lower back pain soon after receiving an injection. Tell your doctor right away if you have sudden lower back pain or back pain that spreads to your legs, feet, arms, or chest. The back pain may also include spasms and make it hard to walk. These symptoms usually go away after 15 minutes but may last longer.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 using collagenase, tell your doctor or pharmacist if you are allergic to it; 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: bleeding/clotting problems.If you are using this medication to treat Peyronie's disease, do not use a vacuum erection device during your treatment with this medication. Also, avoid straining your stomach/abdominal muscles, such as straining during bowel movements.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Tell your doctor if you are pregnant before using this medication.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: 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: drugs that can cause bleeding/bruising (including aspirin, antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin).Your doctor may tell you to stop taking these medications 7 days before your injection. If so, ask your doctor when it is safe to start taking them again.If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist about using those products safely.
OVERDOSE: Not applicable.
NOTES: Keep all regular medical and laboratory appointments.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor right away for a new dosing schedule.
STORAGE: Not applicable. This medication is given in a doctor's office and will not be stored at home.
Information last revised February 2022. Copyright(c) 2022 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.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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