Vesicare — Medica
overactive bladder symptoms in a patient with benign prostatic hypertrophy
Preferred products
- generic darifenacin extended-release tablets
- generic fesoterodine fumarate extended-release tablets
- generic mirabegron extended-release tablets
- generic oxybutynin immediate-release tablets
- generic oxybutynin immediate-release syrup
- generic oxybutynin extended-release tablets
- generic solifenacin succinate tablets
- generic tolterodine tartrate tablets
- generic tolterodine tartrate extended-release capsules
- generic trospium chloride tablets
- generic trospium chloride extended-release capsules
Initial criteria
- Step therapy applies: patient must have tried one Step 1 Product
- If the patient cannot swallow or has difficulty swallowing tablets or capsules, approve Gelnique, Myrbetriq Granules, or Oxytrol (prescription or over-the-counter)
- If the patient is < 3 years of age, approve Vesicare LS
- Approve Gemtesa if being requested for the treatment of overactive bladder symptoms in a patient with benign prostatic hypertrophy
Approval duration
1 year