bosentan (Tracleer, generic) — Medica

Initial criteria

• Patient has tried Adempas; OR according to the prescriber, use of Adempas is contraindicated (examples: patient receiving nitrates or nitric oxide donors, a phosphodiesterase inhibitor such as sildenafil or tadalafil, or patient is hypotensive or at risk for hypotension); OR patient is currently receiving bosentan (Tracleer, generic)
• The medication is prescribed by or in consultation with a cardiologist or a pulmonologist

Reauthorization criteria

• The medication is prescribed by or in consultation with a cardiologist or a pulmonologist

Approval duration

1 year