Ertugliflozin (Steglatro™)

SELF ADMINISTRATION

Indications for Prior Authorization:

  • Indicated as an adjunct to diet and exercise to improve glycemic control in adults with Type 2 Diabetes Mellitus
  • Limitation of use: Steglatro™ is not recommended for the treatment of Type 1 Diabetes Mellitus or Diabetic Ketoacidosis

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

  • Patient has a diagnosis of Type 2 Diabetes Mellitus, AND
  • Patient has tried and failed Invokana® or Jardiance®, AND
  • Patient does not have a contraindication to therapy: severe renal impairment, end-stage renal disease (ESRD), or patients on dialysis

Dosing:

  • Starting dose: 5mg once daily
  • Maximum dose: 15mg once daily

Approval:

  • 1 year

Last review date: May 13, 2019