Drizalma Sprinkle — Medica
panic disorder
Preferred products
- citalopram tablets (Celexa, generic)
- generic citalopram oral solution
- generic duloxetine delayed-release 20 mg, 30 mg, 60 mg capsules
- escitalopram tablets (Lexapro, generic)
- escitalopram oral solution (Lexapro, generic)
- fluoxetine immediate-release capsules and tablets (Prozac, Sarafem, generic)
- generic fluoxetine oral solution
- generic fluoxetine delayed-release capsules
- generic fluvoxamine immediate-release tablets
- generic fluvoxamine extended-release capsules
- paroxetine HCl immediate- and controlled-release tablets (Paxil, Paxil CR, generic)
- paroxetine oral suspension (Paxil, generic)
- Pexeva
- sertraline tablets (Zoloft, generic)
- sertraline oral solution (Zoloft, generic)
- Trintellix
- Viibryd
- generic venlafaxine immediate-release tablets
- generic venlafaxine extended-release capsules
Initial criteria
- Patient has tried one Step 1 Product; OR
- Patient is currently taking or has taken brand name Desvenlafaxine extended-release tablets, desvenlafaxine succinate extended-release tablets (Pristiq or generics), or Fetzima at any time in the past and discontinued its use; OR
- Patient has suicidal ideation (approve Desvenlafaxine extended-release tablets, desvenlafaxine succinate extended-release tablets (Pristiq or generics), or Fetzima)
Approval duration
1 year