icosapent ethyl — Medica
Hypertriglyceridemia with triglyceride levels of 150 mg/dL to < 500 mg/dL
Initial criteria
- Fasting baseline triglyceride level of 150 mg/dL to < 500 mg/dL prior to initiation of therapy
- Patient has tried, or is currently receiving, niacin (immediate-release or extended-release), a fibrate, or a statin
Approval duration
1 year