NUBEQA (darolutamide)

SELF-ADMINISTERED - ORAL

Indications for Prior Authorization:
  • Treatment of patients with non-metastatic castration-resistant prostate cancer
Patients must meet the following criteria for the indications(s) above:
  • Prescribed by or in consultation with an oncologist, AND
  • Diagnosis of non-metastatic castration-resistant prostate cancer (progression after either GnRH therapy or bilateral orchiectomy), AND
  • Patient will receive a gonadotropin-releasing hormone (GnRH) analog concurrently or has had bilateral orchiectomy
The following conditions do not meet the criteria for use as established by WHA P&T committee:
  • All non-FDA approved uses not listed in the approved indications
Dosing:
  • 600 mg twice daily
Approval:
  • 1 year

Last review date: October 15, 2019

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