aclidinium (Rx)

Brand and Other Names:Tudorza Pressair
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

metered-dose inhaler (dry powder)

  • 400mcg/actuation

Chronic Obstructive Pulmonary Disease

Breath-activated dry powder inhaler indicated for maintenance treatment of chronic obstructive pulmonary disease (COPD)

400 mcg (1 actuation) inhaled PO BID

Dosage Modifications

Renal impairment: No dosage adjustment required

Hepatic impairment: Not studied

Safety and efficacy not established

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Interactions

Interaction Checker

and aclidinium

No Results

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (1)

            • umeclidinium bromide/vilanterol inhaled

              aclidinium, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Duplicate therapy.

            Serious - Use Alternative (4)

            • glucagon

              glucagon increases toxicity of aclidinium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

            • glucagon intranasal

              glucagon intranasal increases toxicity of aclidinium by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

            • pramlintide

              pramlintide, aclidinium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

            • revefenacin

              revefenacin and aclidinium both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

            Monitor Closely (97)

            • abobotulinumtoxinA

              abobotulinumtoxinA increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

            • amantadine

              aclidinium, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

            • amitriptyline

              aclidinium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • amoxapine

              aclidinium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • anticholinergic/sedative combos

              anticholinergic/sedative combos and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • aripiprazole

              aclidinium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.

              aripiprazole increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • atracurium

              atracurium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine

              atropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine IV/IM

              atropine IV/IM and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • belladonna alkaloids

              belladonna alkaloids and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • benperidol

              aclidinium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              benperidol increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • benztropine

              benztropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • bethanechol

              bethanechol increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbachol

              carbachol increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cevimeline

              cevimeline increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpromazine

              aclidinium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

              chlorpromazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • cisatracurium

              cisatracurium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • clomipramine

              aclidinium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • clozapine

              aclidinium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.

              clozapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • cyclizine

              cyclizine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • cyclobenzaprine

              cyclobenzaprine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • darifenacin

              darifenacin and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • desipramine

              aclidinium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • dicyclomine

              dicyclomine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • donepezil

              donepezil increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • donepezil transdermal

              donepezil transdermal, aclidinium. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.

            • dosulepin

              aclidinium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • doxepin

              aclidinium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • droperidol

              aclidinium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              droperidol increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • echothiophate iodide

              echothiophate iodide increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fesoterodine

              fesoterodine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • flavoxate

              flavoxate and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • fluphenazine

              aclidinium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

              fluphenazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • galantamine

              galantamine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • glycopyrrolate

              glycopyrrolate and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • glycopyrrolate inhaled

              glycopyrrolate inhaled and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • glycopyrronium tosylate topical

              glycopyrronium tosylate topical, aclidinium. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

            • haloperidol

              aclidinium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              haloperidol increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • henbane

              henbane and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • homatropine

              homatropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • huperzine A

              huperzine A increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hyoscyamine

              hyoscyamine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • hyoscyamine spray

              hyoscyamine spray and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • iloperidone

              aclidinium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              iloperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • imipramine

              aclidinium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • ipratropium

              ipratropium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • levodopa

              aclidinium, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

            • lofepramine

              aclidinium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • loxapine

              aclidinium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              aclidinium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.

              loxapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • loxapine inhaled

              loxapine inhaled increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              aclidinium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

            • maprotiline

              aclidinium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • meclizine

              meclizine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • methscopolamine

              methscopolamine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • neostigmine

              neostigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nortriptyline

              aclidinium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • olanzapine

              aclidinium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              aclidinium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.

              olanzapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • oliceridine

              aclidinium increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.

            • onabotulinumtoxinA

              onabotulinumtoxinA and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • orphenadrine

              aclidinium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin

              oxybutynin and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin topical

              oxybutynin topical and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin transdermal

              oxybutynin transdermal and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • paliperidone

              aclidinium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              paliperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • pancuronium

              pancuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • perphenazine

              aclidinium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

              perphenazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • physostigmine

              physostigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pilocarpine

              pilocarpine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              aclidinium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

              pimozide increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • pralidoxime

              pralidoxime and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • prochlorperazine

              aclidinium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              prochlorperazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • promethazine

              aclidinium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.

              promethazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • propantheline

              propantheline and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • protriptyline

              aclidinium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • pyridostigmine

              pyridostigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quetiapine

              aclidinium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

              quetiapine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • rapacuronium

              rapacuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • rimantadine

              aclidinium, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

            • risperidone

              aclidinium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              risperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • rivastigmine

              rivastigmine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • rocuronium

              rocuronium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • scopolamine

              scopolamine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • solifenacin

              solifenacin and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • succinylcholine

              succinylcholine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • thioridazine

              aclidinium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.

              thioridazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • thiothixene

              aclidinium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

              thiothixene increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • tolterodine

              aclidinium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • trazodone

              aclidinium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • trifluoperazine

              aclidinium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • trihexyphenidyl

              aclidinium and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • trimipramine

              aclidinium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • trospium chloride

              aclidinium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • umeclidinium bromide

              umeclidinium bromide and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents

            • vecuronium

              aclidinium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • ziprasidone

              aclidinium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.

              ziprasidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • zotepine

              aclidinium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.

            Minor (4)

            • dimenhydrinate

              dimenhydrinate increases toxicity of aclidinium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • donepezil

              donepezil decreases effects of aclidinium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • galantamine

              galantamine decreases effects of aclidinium by pharmacodynamic antagonism. Minor/Significance Unknown.

            • rimantadine

              rimantadine increases effects of aclidinium by pharmacodynamic synergism. Minor/Significance Unknown.

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            Adverse Effects

            1-10%

            Headache (6.6%)

            Nasopharyngitis (5.5%)

            Cough (3%)

            Diarrhea (2.7%)

            Sinusitis (1.7%)

            Rhinitis (1.6%)

            Toothache (1.1%)

            Fall (1.1%)

            Vomiting (1.1%)

            Postmarketing reports

            Anaphylaxis

            Angioedema (including swelling of lips and tongue or throat)

            Urticaria

            Rash

            Bronchospasm

            Itching

            Nausea

            Dysphonia

            Blurred vision

            Urinary retention

            Tachycardia

            Stomatitis

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            Warnings

            Contraindications

            Hypersensitivity to drug or formulation components or severe hypersensitivity to milk proteins

            Cautions

            Not for acute episodes of bronchospasm (ie, not for rescue therapy)

            May cause paradoxical bronchospasm; if this occurs, discontinue and consider other treatments

            Worsening of narrow-angle glaucoma may occur; use with caution in patients with narrow-angle glaucoma; prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (eg,eye pain or discomfort, blurred vision, visual halos, or colored images in association with red eyesfrom conjunctival congestion and corneal edema; instruct patients to consult a physician immediately if it occurs

            Worsening of urinary retention may occur (eg, prostatic hyperplasia, bladder-neck obstruction); use with caution in patients with prostatic hyperplasia or bladder-neck obstruction; instruct patients to consult a physician immediately if it occurs

            Immediate hypersensitivity reactions, including angioedema, bronchospasm, or anaphylaxis, may occur after administration; if hypersensitivity occurs, discontinue immediately and consider alternate treatment

            Coadministration with other anticholinergics may increase risk for adverse effects

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            Pregnancy & Lactation

            Pregnancy

            There are no adequate and well-controlled studies of aclidinium in pregnant women to assess drug-associated risks

            Animal studies

            • No adverse developmental effects were seen with inhalation administration of aclidinium bromide to pregnant rats and rabbits during organogenesis at 15 or 20 times, respectively, the maximum recommended human daily inhaled dose (MRHDID)

            Lactation

            There are no available data on the breastfed child or on milk production or presence in human milk

            Aclidinium bromide is present in rat milk; when a drug is present in animal milk, it is likely that the drug will be present in human milk

            Animal studies

            • Aclidinium bromide reduced pup weights when pregnant rats continued inhalation administration through lactation at 5 times the MRHDID

            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

            Long-acting muscarinic antagonist (LAMA), often referred to as an anticholinergic; selective muscarinic antagonist with affinity for the M3 (subscript) receptor in the airways; produces bronchodilation by inhibiting acetylcholine’s effect on muscarinic receptors in the airway smooth muscle

            Absorption

            ~55% of administered dose is swallowed, but negligible oral absorption is observed; fraction of inhaled dose that reaches systemic circulation is low (<5%)

            Peak Plasma Time: 10-15 minutes (in COPD)

            Peak Plasma Concentration: 80 pg/mL (in COPD)

            Distribution

            Whole lung deposition: 30% of the metered dose

            Vd: 300 L (IV administration)

            Metabolism

            Aclidinium bromide is rapidly hydrolyzed in plasma into its alcohol (LAS34823) and acid (LAS34850) metabolites by both enzymatic and non-enzymatic cleavage; neither of these metabolites are active

            Elimination

            Half-life: 5-8 hr following repeat BID administration

            Renal clearance: Low

            Total clearance: 170 L/hr (IV administration)

            Excretion: Urine 0.1% (as aclidinium bromide), 65% (as metabolites); feces 33% (as metabolites)

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Tudorza Pressair inhalation
            -
            400 mcg/actuation aerosol
            Tudorza Pressair inhalation
            -
            400 mcg/actuation aerosol
            Tudorza Pressair inhalation
            -
            400 mcg/actuation aerosol
            Tudorza Pressair inhalation
            -
            400 mcg/actuation aerosol

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            A Patient Handout is not currently available for this monograph.
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            Formulary

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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.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
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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.