NOCDURNA (desmopressin acetate)

NOCDURNA (desmopressin acetate)

SELF ADMINISTRATION

Indications for Prior Authorization:

• Treatment of nocturia due to nocturnal polyuria in adults who awaken at least 2 times per night to void

Patients must meet the following criteria for the indication(s) above:

• Patient is 18 years of age or older, AND
• Prescribed by or in consultation with a urologist, a geriatrician, or an endocrinologist, AND
• Diagnosis of nocturnal polyuria, as confirmed by a 24-hour urine collection, before treatment initiation and the patient meets one of the following:
  • Nocturnal urine volume exceeds 20% of the total 24-hour urine volume in patients <65 years of age, OR
  • Nocturnal urine volume exceeds 33% of the total 24-hour urine volume in patients 65 years of age or older, AND
• The patient has tried non-pharmacologic techniques or lifestyle interventions to manage the nocturia (e.g. nighttime fluid restriction, avoidance of caffeine and alcohol, earlier timing of medications, leg elevation and/or use of compression stockings), AND
• Prior to desmopressin therapy, the patient awakens at least two times per night to void, AND
• The patient has serum sodium concentrations within the normal range (135-145 mmol/L), AND
• The prescribing physician has verified that the patient does not have the following conditions/circumstances in which use of Nocdurna is not recommended:
  • Currently receiving loop diuretics (e.g. furosemide, torsemide, bumetanide), OR
  • Currently receiving systemic or inhaled glucocorticoids, OR
  • Renal impairment with an eGFR <50 mL/min/1.73m², OR
  • Heart failure, OR
  • Polydipsia, OR
  • Known or suspected syndrome of inappropriate antidiuretic hormone (SIADH) secretion

Dosing:

• Women: 27.7 mcg once daily, one hour before bedtime
• Men: 55.3 mcg once daily, one hour before bedtime

Approval:

• 1 year