VIMIZIM (elosulfase alfa)
OFFICE ADMINISTRATION
Indications for Prior Authorization:
- Treatment of patient with mucopolysaccharidosis type IVA (Morquio A syndrome)
Patients must meet the following criteria for the indications above:
- Patients must have Morquio A syndrome, a genetic lysosomal storage disorder
This Medication is Not Approvable for the following condition(s):
- Any condition not listed above.
Dosing:
- Administer 2 mg/kg intravenously once weekly
- Administer over 3.5 to 4.5 hours
Approval Period:
One year
Last review date: May 5, 2014