BELVIQ (lorcaserin)

BELVIQ (lorcaserin) 

SELF ADMINISTRATION - ORAL

Indications for Prior Authorization

• Indicated as an adjunct to a reduced calorie diet and exercise for weight management.

Patients must meet the following criteria for the indications above:

• BMI > 30 kg/m2 AND
• At least one comorbid condition confirmed by chart note documentation/prescription data:
  • Hypertension
  • Diabetes
  • Hyperlipidemia

The following conditions do not meet the criteria for use as established by the WHA P&T Committee:

• All non-FDA approved indications
• Patients who are pregnant or may become pregnant during therapy

Dosing:

• Lorcaserin 10mg every 12 hours orally
• Discontinue if weight loss >5% not achieved in 12 weeks

Approval:

• Initial approval: 12 weeks
• Renewal: 6 months
• Renewal requires chart note documentation of reduction in patient weight