Rytary (carbidopa & levodopa ER) — Point32Health
postencephalitic Parkinsonism
Preferred products
- generic immediate-release carbidopa/levodopa
- generic extended-release carbidopa/levodopa
- carbidopa & levodopa ER tablets
- carbidopa & levodopa tablets
- carbidopa & levodopa ODT tablets
- carbidopa & levodopa ER capsules
Initial criteria
- Patient has had a trial with one of the following Step-1 medications within the previous 180 days as evidenced by a paid claim under the prescription benefit or physician’s documented use, excluding the use of samples: generic immediate-release carbidopa/levodopa OR generic extended-release carbidopa/levodopa
- OR patient has a physician documented contraindication or intolerance to ONE Step-1 medication