belinostat (Beleodaq®)

OFFICE ADMINISTRATION

Indications for Prior Authorization:

  • Indicated for second line therapy for patients with relapsed or refractory peripheral T-cell lymphoma

Patient must meet the following criteria for the above indications:

  • Patients must have failed first line therapy with CHOP or CHOP-like regimens

The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:

  • For any indications not mentioned above

Dosing:

  • Days 1 to 5 of a 21 day cycle: 1 g/m2 given once daily as an IV infusion over 30 minutes
  • May be repeated until disease progression or unacceptable toxicity

Approval:

6 months


 

Last review date: September 1, 2014

The site you are transferring to is not hosted by WHA. WHA's Terms of Use and internet Privacy Practices do not apply to your use of this linked site. Please review the policies on privacy and terms of use for the linked site. WHA does not control the accuracy, completeness, or timeliness of the content on the linked site.

Press Esc to cancel

El sitio Web al que está siendo transferido no es provisto por WHA. Las Condiciones de Uso y las Prácticas de Privacidad en Internet de WHA no se aplican a este sitio Web asociado que usted está usando. Revise las políticas sobre la privacidad y condiciones de uso de este sitio Web asociado. WHA no tiene control sobre la exactitud, la totalidad o la actualidad del contenido del sitio Web asociado. WHA no puede garantizar que los servicios de traducción de idiomas estarán disponibles en el sitio vinculado.

Presione «Esc» para cancelar