Eprontia — United Healthcare
Patients unable to ingest solid oral dosage forms requiring topiramate
Preferred products
- Topamax Sprinkle
Initial criteria
- BOTH of the following: (a) Patient is unable to ingest a solid dosage form (e.g. an oral tablet or capsule) due to age OR oral/motor difficulties OR dysphagia AND (b) Patient has a history of trial and failure, intolerance or contraindication to topiramate sprinkles (Topamax Sprinkle)
- OR Patient utilizes a feeding tube for medication administration
Approval duration
12 months