Nocdurna (desmopressin acetate sublingual tablets [27.7 mcg and 55.3 mcg]) — Cigna

Initial criteria

• Patient age ≥ 18 years; AND
• The diagnosis of nocturnal polyuria has been confirmed with a 24-hour urine collection before treatment initiation; AND
• Patient meets ONE of the following: (i) Patient age < 65 years with nocturnal urine volume > 20% of total 24-hour urine volume; OR (ii) Patient age ≥ 65 years with nocturnal urine volume > 33% of total 24-hour urine volume; AND
• Prior to desmopressin therapy, patient awakens at least two times per night to void; AND
• Patient has serum sodium concentrations within normal range (135 to 145 mmol/L); AND
• Prescriber verified that the patient does NOT have any of the following: (i) currently receiving loop diuretics; OR (ii) currently receiving systemic or inhaled glucocorticoids; OR (iii) renal impairment with estimated glomerular filtration rate < 50 mL/min/1.73 m2; OR (iv) heart failure; OR (v) polydipsia; OR (vi) known or suspected syndrome of inappropriate antidiuretic hormone secretion; AND
• Patient has tried non-pharmacologic techniques or lifestyle interventions to manage nocturia (e.g., nighttime fluid restriction, avoidance of caffeine and alcohol, earlier medication timing, leg elevation, compression stockings); AND
• Medication is prescribed by or in consultation with a nephrologist, urologist, geriatrician, or endocrinologist.

Approval duration

1 year