desvenlafaxine succinate extended-release tablets (Pristiq or generics) — Medica
major depressive disorder
Preferred products
- generic venlafaxine HCl extended-release tablets
- generic vilazodone hydrochloride tablets
- Viibryd
- Wellbutrin SR
- Wellbutrin XL
- Zoloft
Initial criteria
- If the patient has tried one Step 1 Product, approve a Step 2 Product (Standard Criteria) OR if the patient has tried two Step 1 Products, approve a Step 2 Product (High Impact Criteria).
- If the patient is currently taking or has taken any of the following at any time in the past and discontinued its use, approve the Product that they have used: Desvenlafaxine extended-release tablets, desvenlafaxine succinate extended-release tablets (Pristiq or generics), Fetzima, Pexeva, vilazodone hydrochloride tablets (Viibryd or generics), or Trintellix.
- If the patient cannot swallow or has difficulty swallowing tablets or capsules, approve generic escitalopram oral solution or generic paroxetine HCl oral suspension.
- If the patient has suicidal ideation, approve Desvenlafaxine extended-release tablets, desvenlafaxine succinate extended-release tablets (Pristiq or generics), Fetzima, Pexeva, vilazodone hydrochloride tablets (Viibryd or generics), or Trintellix.