NUPLAZID (pimavanserin)
SELF ADMINISTRATION
FDA Approved Indications:
- Treatment of hallucinations and delusions associated with Parkinson's disease psychosis
Prior authorization criteria:
- Prescribed by or in collaboration with a specialist (neurologist or psychiatrist), AND
- Diagnosis of Parkinson's disease with hallucinations and delusions, AND
- Dose of 34mg once daily
- Not recommended in patients with severe renal impairment (CrCL < 30mL/min), or hepatic impairment
Reauthoriztion criteria:
- Medical record documentation supporting progress on medication
Dosing:
- Recommended dose is 34mg, taken orally as two 17 mg tablets once daily, without titration
Approval:
- Initial: 3 months