Sarecycline (Seysara™)

SELF ADMINISTRATION

Indications for Prior Authorization:

  • Treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris in patients 9 years of age and older

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

  • Patient is 9 years of age or older, AND
  • Patient has a diagnosis of acne vulgaris as confirmed by chart note documentation, AND
  • Patient has tried and failed generic minocycline and generic doxycycline capsules, AND
  • Seysara™ will not be used in combination with oral retinoids or penicillin, AND
  • Current weight is required

Dosing:

  • Recommended dosage of Seysara™ is weight based, to be taken once daily
    Weight (kg) Dose
    33-54 60mg
    55-84 100mg
    85-136 150mg

Approval:

  • 12 weeks 
  • Efficacy of Seysara™ beyond 12 weeks and safety beyond 12 months have not been established

 

Last review date: September 3, 2019