ADEMPAS (riociguat)

SELF ADMINISTRATION - ORAL 

Indications for Prior Authorization:

  • Indicated in adults for the treatment of pulmonary arterial hypertension (PAH) [WHO group 1] to improve exercise capacity, WHO functional class and to delay clinical worsening. 
  • Also indicated in the adults for the treatment of persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) [WHO group 4] after surgical treatment, or inoperable CTEPH, to improve exercise capacity and WHO functional class. 

Patients must meet the following criteria for the indication(s) above:

  • Patient is 18 years of age or older, AND
  • Diagnosis of PAH or CTEPH confirmed by chart note documentation, AND
  • Prescribed by or in consultation with a cardiologist or pulmonologist, AND
  • Patient has had a right heart catheterization confirmed by chart note documentation, OR
  • Results of the right heart catheterization confirms diagnosis of WHO group 1 PAH
  • For CTEPH: disease is persistent/inoperable

Dosing:

  • 1 mg by mouth 3 times daily
  • For oral use only 
  • Dose does not exceed 7.5 mg per day

Approval: 

  • 1 year

Last review date: February 24, 2020

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