Aptiom
Drug - Aptiom™ (eslicarbazepine) [Sunovion Pharmaceuticals, Inc.]
December 2017
Therapeutic area - Antiepileptic
Approval criteria
- Patient is 4 years of age or older AND
- Patient has a diagnosis of partial-onset seizures AND
- Patient has tried and failed THREE or more anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, ethosuximide, oxcarbazepine, topiramate or carbamazepine OR
- Prescriber is a neurologist AND patient has tried and failed at least TWO anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, ethosuximide, oxcarbazepine, topiramate or carbamazepine
Quantity limits
- 200 mg, 400 mg, 800 mg tablets: 34 tablets per 34 days
- 600 mg: 68 tablets per 34 days
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411