finasteride (Rx)

Brand and Other Names:Propecia, Proscar
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 1mg (Propecia)
  • 5mg (Proscar)

Benign Prostatic Hyperplasia

Proscar: 5 mg PO qDay; assess response after 12 weeks to 6 months

Androgenic Alopecia (Men Only)

Propecia: 1 mg PO qDay for at least 3 months

Female Hirsutism (Off-label)

5 mg PO qDay

Dosage Modifications

Renal impairment: Dose adjustment not necessary

Hepatic impairment: Caution in liver dysfunction; monitor

Not indicated

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Interactions

Interaction Checker

and finasteride

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                Monitor Closely (15)

                • carbamazepine

                  carbamazepine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • clarithromycin

                  clarithromycin will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • erythromycin base

                  erythromycin base will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • erythromycin ethylsuccinate

                  erythromycin ethylsuccinate will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • erythromycin lactobionate

                  erythromycin lactobionate will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • erythromycin stearate

                  erythromycin stearate will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • isoniazid

                  isoniazid will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • itraconazole

                  itraconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • ketoconazole

                  ketoconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • letermovir

                  letermovir increases levels of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • nefazodone

                  nefazodone will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • nevirapine

                  nevirapine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • rifabutin

                  rifabutin will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • rifampin

                  rifampin will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • St John's Wort

                  St John's Wort will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                Minor (55)

                • amobarbital

                  amobarbital will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • aprepitant

                  aprepitant will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • armodafinil

                  armodafinil will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • artemether/lumefantrine

                  artemether/lumefantrine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • atazanavir

                  atazanavir will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • bosentan

                  bosentan will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • budesonide

                  budesonide will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • butabarbital

                  butabarbital will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • butalbital

                  butalbital will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • conivaptan

                  conivaptan will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • cortisone

                  cortisone will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • darifenacin

                  darifenacin will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • darunavir

                  darunavir will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • dasatinib

                  dasatinib will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • dexamethasone

                  dexamethasone will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • DHEA, herbal

                  DHEA, herbal will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • dronedarone

                  dronedarone will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • efavirenz

                  efavirenz will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • eslicarbazepine acetate

                  eslicarbazepine acetate will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • etravirine

                  etravirine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fluconazole

                  fluconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fludrocortisone

                  fludrocortisone will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fosamprenavir

                  fosamprenavir will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • fosphenytoin

                  fosphenytoin will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • grapefruit

                  grapefruit will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • griseofulvin

                  griseofulvin will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • hydrocortisone

                  hydrocortisone will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • indinavir

                  indinavir will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • lapatinib

                  lapatinib will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • lumefantrine

                  lumefantrine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • marijuana

                  marijuana will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • methylprednisolone

                  methylprednisolone will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • metronidazole

                  metronidazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • miconazole vaginal

                  miconazole vaginal will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • modafinil

                  modafinil will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • nelfinavir

                  nelfinavir will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • nifedipine

                  nifedipine will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • nilotinib

                  nilotinib will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • oxcarbazepine

                  oxcarbazepine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • pentobarbital

                  pentobarbital will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • phenobarbital

                  phenobarbital will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • phenytoin

                  phenytoin will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • posaconazole

                  posaconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • prednisone

                  prednisone will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • primidone

                  primidone will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • quinupristin/dalfopristin

                  quinupristin/dalfopristin will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • rifapentine

                  rifapentine will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • ritonavir

                  ritonavir will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • rufinamide

                  rufinamide will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • saw palmetto

                  saw palmetto increases effects of finasteride by pharmacodynamic synergism. Minor/Significance Unknown.

                • secobarbital

                  secobarbital will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • topiramate

                  topiramate will decrease the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • verapamil

                  verapamil will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • voriconazole

                  voriconazole will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • zafirlukast

                  zafirlukast will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

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                Adverse Effects

                1-10%

                Erectile dysfunction (1.3-8.1%)

                Decrease libido (1.8-6.4%)

                Breast enlargement (0.5-1.8%)

                Ejaculation disorder (0.8-1.2%)

                <1%

                Breast tenderness (0.4-0.7%)

                Rash (0.5%)

                Postmarketing Reports

                Neoplasms: Male breast cancer

                Breast disorders: Breast tenderness and enlargement

                Nervous system/psychiatric: Depression

                Hypersensitivity reactions: Rash, pruritus, urticaria, and angioedema (including swelling of the lips, tongue, throat, and face)

                Reproductive system: Sexual dysfunction that continued after discontinuation of treatment, including erectile dysfunction, libido disorders, ejaculation disorders, and orgasm disorders; male infertility and/or poor seminal quality (normalization or improvement of seminal quality has been reported after discontinuation of finasteride); testicular pain, hematospermia

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                Warnings

                Contraindications

                Hypersensitivity

                Women of childbearing potential

                Cautions

                Use with caution with obstructive uropathy; carefully monitor patients with large residual urinary volume or severely diminished urinary flow

                Use caution in liver disease

                May cause decreased serum PSA in presence of prostate cancer; increases in PSA levels from nadir while on finasteride may signal the presence of prostate cancer and should be carefully evaluated (even if PSA value within normal range)

                Pregnant and potentially pregnant women should not handle crushed or broken tablets or semen of male partner; may have negative impact in fetal development

                Rare reports of male breast cancer observed with use; any breast tenderness, enlargement, pain, lumps, nipple discharge or any other type of breast changes should be reported immediately to healthcare provider

                5-ARIs and prostate cancer risk

                • June 9, 2011: Recent data from 2 large, randomized, controlled trials observed a reduction in overall incidence of prostate cancer but an increased risk of being diagnosed with a more serious form of prostate cancer (high-grade prostate cancer) in trial participants taking 5-alpha reductase inhibitors (5-ARIs)
                • The 2 trials are the Prostate Cancer Prevention Trial (PCPT) and the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial
                • The revised prescribing information recommends that prior to initiating therapy with 5-ARIs, appropriate evaluation should be performed to rule out other urologic conditions, including prostate cancer, that might mimic benign prostatic hyperplasia (BPH)
                • A minimum of 6 months may be necessary to assess response in BPH
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                Pregnancy & Lactation

                Pregnancy

                Therapy is contraindicated in pregnant females and not indicated for use in females; based on animal studies and mechanism of action, drug may cause abnormal development of external genitalia in a male fetus if administered to pregnant female

                Animal data

                • In an embryo-fetal development study in rats, there was a dose-dependent increase in hypospadias that occurred in 3.6 to 100% of male offspring of pregnant rats administered oral finasteride during period of major organogenesis at doses approximately 0.1 to 86 times the maximum recommended human dose (MRHD) of 5 mg/day (based on AUC at animal doses of 0.1 to 100 mg/kg/day)
                • Decreased prostatic and seminal vesicular weights, delayed preputial separation and transient nipple development were also observed in male offspring at oral maternal doses approximately 0.03 times the MRHD (based on AUC at animal dose of 0.03 mg/kg/day), along with decreased anogenital distance in male offspring at oral maternal doses approximately 0.003 times the MRHD (based on AUC at animal dose of 0.003 mg/kg/day)
                • Finasteride is a Type II 5α-reductase inhibitor that prevents conversion of testosterone to 5α-dihydrotestosterone (DHT), a hormone necessary for normal development of male genitalia
                • If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of potential hazard to male fetus
                • Abnormal male genital development is an expected consequence when conversion of testosterone to 5α-dihydrotestosterone (DHT) is inhibited by 5α-reductase inhibitors
                • These outcomes are similar to those reported in male infants with genetic 5α-reductase deficiency; females could be exposed to finasteride through contact with crushed or broken finasteride tablets or semen from a male partner taking finasteride
                • With regard to finasteride exposure through skin, finasteride tablets are coated and will prevent skin contact with finasteride during normal handling if tablets have not been crushed or broken
                • Females who are pregnant or may potentially be pregnant should not handle crushed or broken tablets because of possible exposure of a male fetus; with regard to potential finasteride exposure through semen
                • Three studies have been conducted that measured finasteride concentrations in semen in men receiving 5 mg/day finasteride; in these studies the highest amount of finasteride in semen was estimated to be 50-to 100-fold less than dose of finasteride (5 μg) that had no effect on circulating DHT levels in men

                Reproductive potential

                • Females: Drug not indicated for use in females
                • Males: Treatment for 24 weeks to evaluate semen parameters in healthy male volunteers revealed no clinically meaningful effects on sperm concentration, mobility, morphology, or pH. A 0.6 mL (22.1%) median decrease in ejaculate volume with a concomitant reduction in total sperm per ejaculate was observed
                • These parameters remained within normal range and were reversible upon discontinuation of therapy with average time to return to baseline of 84 weeks
                • There have been postmarketing reports of male infertility and/or poor seminal quality; normalization or improvement of seminal quality has been reported after discontinuation of finasteride

                Lactation

                Drug is not indicated for use in females

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Selective inhibitor of type 1 & type 2 isoforms of 5-alpha-reductase; suppresses serum dihydrotestosterone levels by inhibiting the conversion of testosterone to dihydrotestosterone

                Absorption

                Bioavailability: 65%

                Onset: 6 months (BPH); >3 months (hair loss)

                Peak plasma time: 2-6 hours

                Distribution

                Protein bound: 90%

                Vd: 76 L

                Metabolism

                Hepatic CYP3A4

                Metabolites: t-butyl side chain monohydroxylate, monocarboxylic acid metabolite (active)

                Elimination

                Half-life: 6 hours

                Excretion: Feces (57%); urine (39%)

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                1 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                1 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                1 mg tablet
                finasteride oral
                -
                1 mg tablet
                finasteride oral
                -
                5 mg tablet
                finasteride oral
                -
                1 mg tablet
                finasteride oral
                -
                1 mg tablet
                Proscar oral
                -
                5 mg tablet
                Propecia oral
                -
                1 mg tablet

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                finasteride oral

                FINASTERIDE (HAIR GROWTH) - ORAL

                (fin-AST-er-ide)

                COMMON BRAND NAME(S): Propecia

                USES: This medication is used to treat male pattern baldness (androgenetic alopecia) at the crown and in the middle of the scalp. It should be used by adult men only.This medication works by decreasing the amount of a natural body hormone (DHT). Decreasing the amount of DHT leads to increased hair regrowth and slower hair loss. Hair growth on other parts of the body is not affected by finasteride.Women and children should not use this medication.Finasteride is not approved for prevention of prostate cancer. It may slightly increase the risk of developing a very serious form of prostate cancer. Talk to your doctor about the benefits and risks.

                HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start taking finasteride and each time you get a refill. If you have any questions regarding the information, consult your doctor or pharmacist.Take this medication by mouth, with or without food, usually once daily, or as directed by your doctor.If the tablet is crushed or broken, it should not be handled by a woman who is pregnant or by a woman who may become pregnant (see also Precautions section).Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day. It may take up to 3 months to notice a benefit.You must continue to take this medication to maintain your hair growth. When you stop taking finasteride, any gain in hair quantity is generally lost within 12 months.Inform your doctor if your condition persists or worsens.

                SIDE EFFECTS: Decreased sexual ability/desire may occur. In some men, this medication can decrease the amount of semen released during sex. This is harmless, but has continued in some men even after stopping treatment. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: lump in the breast, nipple discharge, breast enlargement/tenderness/pain, pain in the testicles, inability to urinate.A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before taking finasteride, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, prostate cancer, infections, urinary problems.Finasteride should not be used by children.The drug can be absorbed through the skin. If the film coating of the tablet has been broken or the tablet crushed, it should not be handled by a woman who is pregnant or planning to become pregnant. Exposing a developing male infant to finasteride can result in abnormalities of the genitals.This medication should not be used in women, especially during pregnancy or breast-feeding. It may harm an unborn or breast-feeding baby. Consult your doctor if you have any questions about this medication.

                DRUG INTERACTIONS: Your healthcare professionals (such as your doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.This medication can affect the results of the blood test used to detect prostate cancer (prostatic-specific antigen or PSA levels). If you have a PSA test done, make sure laboratory personnel and your doctors know you use this drug.This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this drug with others.Follow your doctor's instructions for examining your breasts and testicles, and report any lumps right away.

                MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture in a tightly closed container. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised June 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.