Fulyzaq
Drug - Fulyzaq™ [Salix]
October 2013
Therapeutic area - Antidiarrheal
Approval criteria
- Patient is 18 years of age or older AND
- Patient has a diagnosis of HIV/AIDS AND
- Patient has a history of antiretroviral therapy AND
- Patient has a diagnosis of non-infectious diarrhea AND
- Patient has a history of 3 prior trials of antidiarrheal therapy (bismuth subsalicylate, diphenoxylate, loperamide)
Quantity limit
Dose is one tablet orally twice daily; quantity limit is 68 tablets per 34-day supply.
Background information
Fulyzaq™(crofelemer) is an anti-diarrheal indicated for the relief of non-infectious diarrhea in adult patients with HIV/AIDS on anti-retroviral therapy.
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411