IONAMIN (phentermine)

IONAMIN (phentermine)

SELF ADMINISTRATION - ORAL

Indications for Prior Authorization

• Indicated as a short-term (few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity

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:

• 15 mg to 37.5 mg/day in 1 to 2 divided doses

• 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 patients weight