Zegerid for suspension — United Healthcare
Patients unable to ingest a solid oral dosage form and require proton pump inhibitor therapy
Preferred products
- Nexium suspension
- lansoprazole ODT
Initial criteria
- ONE 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 OR (b) Patient utilizes a feeding tube for medication administration
- AND Patient has a history of trial and failure, intolerance, or contraindication to BOTH of the following: Nexium suspension (esomeprazole) AND lansoprazole orally disintegrating tablets (generic Prevacid SoluTabs)
Approval duration
12 months