Viberzi
Drug - Viberzi™ (eluxadoline) [Allergan]
May 2016
Therapeutic area - IBS-D
Approval criteria
- Patient must be 18 years of age or older AND
- Have a diagnosis of irritable bowel syndrome with diarrhea (IBD-D) AND
- Patient has not responded adequately to at least two drugs considered to be conventional therapy [e.g., dicyclomine, hyoscyamine, loperamide, diphenoxylate/atropine, fiber supplementation] for IBS
Denial criteria
- Severe hepatic impairment (Child-Pugh Class C)
- History of pancreatitis or other disease of the pancreas or pancreatic duct obstruction
- Biliary duct obstruction, or sphincter of Oddi disease or dysfunction
- Alcoholism, alcohol abuse, alcohol addiction, or intake of more than 3 alcoholic beverages per day
- Severe constipation or sequelae from constipation, or known or suspected mechanical gastrointestinal obstruction
Quantity limit
Maximum of 2 tablets daily.
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411