NUBEQA (darolutamide)
SELF-ADMINISTERED - ORAL
Indications for Prior Authorization:
- Treatment of patients with non-metastatic castration-resistant prostate cancer
Patients must meet the following criteria for the indications(s) above:
- Prescribed by or in consultation with an oncologist, AND
- Diagnosis of non-metastatic castration-resistant prostate cancer (progression after either GnRH therapy or bilateral orchiectomy), AND
- Patient will receive a gonadotropin-releasing hormone (GnRH) analog concurrently or has had bilateral orchiectomy
The following conditions do not meet the criteria for use as established by WHA P&T committee:
- All non-FDA approved uses not listed in the approved indications
Dosing:
- 600 mg twice daily
Approval:
- 1 year
Last review date: October 15, 2019