RAPAFLO (silodosin)

RAPAFLO (silodosin)

SELF ADMINISTRATION - ORAL

Indications for Prior Authorization:

• The treatment of the signs and symptoms of benign prostatic hyperplasia (BPH)
• Rapaflo® is NOT indicated for the treatment of hypertension

Patients must meet the following criteria for the indications above:

• Use is for the treatment of BPH, AND
• The member has tried and failed preferred alternatives (e.g. tamsulosin, terazosin, doxazosin, alfuzosin)

The following conditions do not met criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:

• Treatment of hypertension

Dosing:

• 8 mg orally once daily with a meal
• Moderate renal impairment (creatinine clearance 30-50 mL/min): 4 mg orally once daily
• Contraindicated for use in patients with severe renal impairment (creatine clearance < 30 mL/min), severe hepatic impairment (Child-Pugh score > 10), or concomitant administration with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, itraconazole, ritonavir)

Approval:

• 1 year