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Main Medications

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Diabetes

 

Step Therapy Drugs (basic tier 1 medications)

Actos (pioglitazone)

Metformin/Metformin ER (some brand names below)

     - Gluchophage

     - Glumetza

     - Riomet

Sulfonylurea

     - Amaryl (glimepiride)

     - Glucotrol (glipizide)

     - Glynase/Diabeta (glibenclamide)

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Basal Insulins (long-acting) 

Basaglar (insulin glargine)

     - pen (100 units/mL)

Humulin N (NPH)

     - vial (100 units/mL)

     - pen (100 units/mL)

Insulin Glargine-yfgn (unbranded)

     - vial (100 units/mL)

     - pen (100 units/mL)

Lantus (insulin glargine)

     - vial (100 units/mL)

     - pen (100 units/mL)

Levemir (insulin detemir)

     - vial (100 units/mL)

     - pen (100 units/mL)

Novolin N (NPH)

     - vial (100 units/mL)

     - pen (100 units/mL)

Semglee (insulin glargine-yfgn)

     - vial (100 units/mL)

     - pen (100 units/mL)

Soliqua (insulin glargine-lixisenatide)

     - pen (100-33 units-mcg/mL)

     - this is a mixed GLP-1 & long-acting

Toujeo (insulin glargine)

     - pen (300 units/mL)

Tresiba (insulin degludec)

     - vial (100 units/mL)

     - pen (100 units/mL)

     - pen (200 units/mL)

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Bolus Insulins (short-acting/meal-time) 

Admelog (insulin lispro)

     - vial (100 units/mL)

     - pen (100 units/mL)

Afrezza (regular insulin)

     - it's complicated; rare medication

Apidra (insulin glulisine)

     - vial (100 units/mL)

     - pen (100 units/mL)

Fiasp (insulin aspart)

     - vial (100 units/mL)

     - pen (100 units/mL)

Humalog (insulin lispro)

     - vial (100 units/mL)

     - pen (100 units/mL)

     - pen (200 units/mL)

Humulin R (regular insulin)

     - vial (100 units/mL)

     - pen (100 units/mL)

     - vial (500 units/mL)

     - pen (500 units/mL)

Insulin Lispro (generic)

     - vial (100 units/mL)

     - pen (100 units/mL)

Insulin Aspart (generic)

     - vial (100 units/mL)

     - pen (100 units/mL)

Lyumjev (insulin lispro)

     - vial (100 units/mL)

     - pen (100 units/mL)

     - pen (200 units/mL)

Novolin R (regular insulin)

     - vial (100 units/mL)

     - pen (100 units/mL)

Novolog (insulin aspart)

     - vial (100 units/mL)

     - pen (100 units/mL)

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Insulins (hybrid) 

Humalog 50/50 pen or vial

Humolog 75/25 pen or vial

Humulin 70/30 pen or vial

Novolin 70/30 pen or vial

Novolog 70/30 pen or vial

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SGLT-2 Inhibitors (cardiovascular & renal protection)

Invokana (canagliflozin)

     - 100 mg tablets

     - 300 mg tablets

Jardiance (empagliflozin)

     - 10 mg tablets

     - 25 mg tablets

Farxiga (dapagliflozin)

     - 5 mg tablets

     - 10 mg tablets

Steglatro (ertugliflozin)

     - 5 mg tablets

     - 15 mg tablets

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GLP-1 Agonists (GI issues & weight loss)

Byetta (exenatide) - twice daily

     - 5 mcg/0.02 mL pen

     - 10 mcg/0.04 mL pen

Bydureon (exenatide) - discontinued

Bydureon BCise (exenatide) - weekly

     - 2 mg/0.85 mL auto-injector

Trulicity (dulaglutide) - weekly

     - 0.75 mg/0.5 mL auto-injector

     - 1.5 mg/0.5 mL auto-injector

     - 3 mg/0.5 mL auto-injector

     - 4.5 mg/mL auto-injector

Victoza (liraglutide) - daily

     - 18 mg/3 mL pen (0.6 mg, 1.2 mg, & 1.8 mg doses)

Ozempic (semaglutide) - weekly

     - 2 mg/1.5 mL pen (0.25 mg or 0.5 mg dose)

     - 4 mg/3 mL pen (1 mg dose)

     - 8 mg/3 mL pen (2 mg dose)

Adlyxin (lixisenatide) - daily

     - 10 mcg/0.2 mL pen

     - 20 mcg/0.2 mL pen

Rybelsus (semaglutide) - daily

     - 3 mg tablet

     - 7 mg tablet

     - 14 mg tablet

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DPP-4 Inhibitors (cannot be taken w/ GLP-1)

Januvia (sitagliptin)

Onglyza (saxagliptin)

Tradjenta (linagliptin)

Nesina (alogliptin)

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DPP-4 Inhibitors (mixed)

Janumet (sitagliptin & metformin)

Janumet XR (sitagliptin & metformin ER)

Kombiglyze XR (saxaglitpin & metformin ER)

Glyxambi (linagliptin & empagliflozin) 

Jentadueto (linagliptin &metformin)

Kazano (alogliptin & metformin)

Oseni (alogliptin & pioglitazone)

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Hyperlipidemia/Hypercholesterolemia

 

Statins (often cause myalgia/muscle pain)

Altoprev (lovastatin)

Crestor (rosuvastatin)

Lescol XL (fluvastatin)

Lipitor (atorvastatin)

Livalo (pitavastatin)

Pravachol (pravastatin)

Zocor (simvastatin)

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Expensive Alternatives (generally for ASCVD patients)

Nexletol (bempedoic acid)

     - tablet

Nexlizet (bempedoic acid & ezetimibe)

     - Nexletol & Jardiance

     - tablet

Repatha (evolocumab) 

     - PCSK-9 inhibitor

     - Rx & PA SureClick 140 mg Q 2 weeks

     - injectable

Praluent (alirocumab)

     - PCSK-9 inhibitor

     - 75 or 150 mg Q 2 weeks (provider's choice)

     - injectable

 

NOTE: most common ASCVD we see is CAD

ASCVD = atherosclerotic cardiovascular disease

CAD = coronary artery disease

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Hypertriglyceridemia

 

Medications (oral)

Lovaza (omega 3 ethyl esters)

Omega-3 Polyunsaturated Fatty Acids

Tricor (fenofibrate)

Vascepa (icosapent ethyl capsules)

     - Take 2 tablets by oral route BID (360 per 90 days)

     - We always Rx the 1 gram tablets

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Thyroid Medications

 

Medications (oral)

Armour Thyroid (thyroid desiccated)

Cytomel (liothyronine)

Euthyrox (levothyroxine)

Levo-T (levothyroxine)

Levoxyl (levothyroxine)

NP Throid (thyroid desiccated)

Synthroid (levothyroxine)

     - can use Synthroid Delivers for $75/90 days

Tirosint (levothyroxine capsules)

     - capsules generally work better for malabsorption.

     - can use Tirosint Direct for $150/90 days

Unithroid (levothyroxine)

WP Thyroid (thyroid desiccated)

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Levothyroxine = LT4

Liothyronine = LT3

Thyroid Desiccated = LT3 & LT4

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Osteoporosis 

 

Bisphosphonates

​Actonel (risendronate)

     - oral only

     - daily, weekly, monthly, or 2 days in a row monthly

Boniva (ibandronate) 

     - oral once monthly

     - IV once every 3 months

Fosamax (alendronate) 

     - oral only

     - daily or weekly

Reclast (zoledronic acid) 

     - IV only

     - once yearly in medical office/outpatient

     - Jenn handles these, generally goes to NWR

     - CPT code: J3489

     - Administration CPT codes: 96365 or 96366

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PTH Analogs

Forteo (teriparatide)

     - 7.44 mL per 90 days (3 pens)
     - inject 20 mcg by subq route once daily

     - generic available: Teriparatide

Tymlos (abaloparatide)

     - 4.68 mL per 90 days (3 pens)

     - inject 80 mcg by subq route once daily

     - cheaper than Forteo & generic Teriparatide

     - only approved for women, FDA reviewing for men

 

*Therapy limited to 24 months total between both meds; PA for 24 months as duration of therapy for either (Tymlos is 18-24 months, Forteo is 24 months)

*Be sure to Rx pen needles (BD nano) w/ these meds

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Other

Prolia (denosumab)

     - inject 60 mg every 6 months (120 mg per year)

     - administered in medical office/outpatient

     - Holli handles these, generally goes to NWR

     - CPT code: J0897

Evenity (romosozumab)

     - inject 210 mg every month (2x 105 mg injections)

     - therapy duration limited to 12 months

     - administered in medical office/outpatient

     - Holli handles these, generally goes to NWR

     - CPT code: J3590

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Hypogonadism

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Medications (topical)

Androderm (patches)

Androgel 1% Gel  (pump/packets)

Androgel 1.62% Gel  (pump/packets)

Testosterone Cypionate (intramuscular injection)

     - AKA depo testosterone

     - 200 mg/mL, 10 mL vials or 1 mL vials

     - inject 1 mL by IM route once every 14 days (this is just standard, sometimes it does vary)

Foresta (pump)

Testim (packets)

     - testosterone 50 mg/5 gram (1%) - this is generic

 

*Testosterone comes in pumps, packets, patches, and injections. Pumps, packets, and patches are topical (on skin). There is a generic testosterone for all (or close to) testosterone products.

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Growth Hormone Disorder

 

Acromegaly Specialty Meds (injectable)

Sandostatin 

Somatuline Depot 

Somavert 

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Acromegaly Meds (oral)

Mycapssa 

Cabergoline 

Bromocriptine 

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Growth Hormone Deficiencies (injectable)

Genotropin 

Humatrope

Norditropin 

Nutropin/Nutropin AQ

Omnitrope

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Clinic: 503-297-3336

Scheduling: 503-274-4880

Billing: 503-274-4808 

Scheduling: 801

Medical Records: 802

Billing: 803 

Prior Authorizations: 808

NP Coordinator: 328

Fax: 503-297-3338   

NP Records Fax: 503-972-7573

Lab Fax: 503-292-1948

MA Fax: 503-296-8632

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9135 SW Barnes Road, Suite 985

Portland, OR 97225

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portal@pdec.org

 

These will forward to Spencer and he will distribute appropriately

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https://pdec.org/​

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