ceritinib (Zykadia®)

SELF ADMINISTRATION - ORAL

Indications for Prior Authorization:

  • Treatment of anaplastic lymphoma (ALK)-kinase positive metastatic non-small cell lung cancer

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

  • Patient must have progressed on or are intolerant to Xalkori (crizotinib)

The Following Conditions Do Not Meet the Criteria for Use as Established by the WHA P & T Committee:

  • All non-FDA approved uses not listed in the approved indications

Dosing:

  • Recommend dose: 750 mg orally once daily until disease progression or toxicity

Approval:

One year


 

Last review date: August 4, 2014