RAYOS (prednisone)

RAYOS (prednisone)

SELF-ADMINISTRATION - ORAL

Indications for Prior Authorization:

• As an anti-inflammatory or immunosuppressive agent for certain allergic, dermatologic, gastrointestinal, hematologic, ophthalmologic, nervous system, renal, respiratory, rheumatologic, specific infectious diseases or conditions and organ transplantation
• For the treatment of certain endocrine conditions
• For palliation of certain neoplastic conditions

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

• Rayos is being used for an FDA approved indication, AND
• The patient has tried and failed BOTH preferred generic prednisone immediate-release AND at least 1 other oral corticosteroid (chart note documentation required confirming a medically appropriate reason for preferred alternative failure)

Dosing:

• The initial dosage of Rayos® may vary from 5 to 60 mg per day depending on the specific disease entity being treated. Patients currently on immediate release prednisone, prednisolone, or methylprednisolone should be switched to Rayos® at an equivalent dose based on relative potency.