Sumycin overdose

General Criteria for all PDL categories. For specific criteria on a drug or category please see PDL with Criteria ; A: To apply to all categories with brand and generic versions on different sides of the PDL: Prior Authorizations for non-preferred brands or in certain cases non-preferred generic form -- 1. Requests will be approved for patients that show reduced objective outcomes on the preferred version relative to the non-preferred version. 2. Requests will be approved for patients experiencing side effects on the preferred generic version only if the side effect has not been reported in the literature for the brand version. The completion and submission of the medwatch form will then also be required. B: To apply to all requests for non-preferred brands and other drugs with PA conditions for non FDA approved indications. Decisions will be made on a case by case basis until the DUR committee is able to review the evidence and make a recommendation. Interim approvals and DUR recommendations for approval of a drug for a non FDA approved indication will require a minimum of two published, peer reviewed, non contradicted, double-blinded, placebo-controlled, randomized studies establishing both safety and efficacy. C: PDL drugs may also be affected by dose consolidation requirements. See list of limited drugs start on the last page of PDL. D: 1. The minimum trial periods for each preferred drug is two weeks, unless otherwise stated within specific PDL drug categories. 2. A trial will not be considered valid if non preferred products were readily available paid by override, cash, or samples ; . 3. Certain drug trials, such as with preferred narcotics, may require evidence that the preferred drugs were actually tried example: with urine drug tests ; . 4. Trials with less than a two week duration will be reviewed on a case-by-case basis. E: Other Criteria: Drugs that must be submitted on specific prior authorization forms may contain additional criteria that has not been repeated below in this document. ASSORTED ANTIBIOTICS BETA-LACTAMS CLAVULANATE COMBO'S AMOXICILLIN AMOXIL1 AMPICILLIN AUGMENTIN AUGMENTIN ES-600 SUSR AUGMENTIN XR TB12 BEEPEN BICILLIN L-A SUSP DICLOXACILLIN SODIUM CAPS DYNAPEN SUSR GEOCILLIN TABS OXACILLIN SODIUM SOLR PENICILLIN V POTASSIUM TICAR SOLR TIMENTIN SOLR TRIMOX UNASYN SOLR VEETIDS ZOSYN CEPHALOSPORINS CEFADROXIL HEMIHYDRATE CEFAZOLIN SODIUM SOLR CEFUROXIME AXETIL TABS CEFZIL CEPHALEXIN MONOHYDRATE DURICEF SUSR FORTAZ SOLR KEFZOL SOLR MAXIPIME SOLR OMNICEF ROCEPHIN SUPRAX VANTIN MACROLIDES ERYTHROMYCIN'S BIAXIN XL3 E.E.S. E-MYCIN TBEC ERYPED 200 SUSR ERYPED 400 SUSR ERY-TAB TBEC ERYTHROCIN STEARATE TABS ERYTHROMYCIN TETRACYCLINES ZITHROMAX1, 2 DOXYCYCLINE HYCLATE MINOCYCLINE HCL CAPS SUMYCIN TETRACYCLINE HCL CAPS VIBRAMYCIN SYRP DECLOMYCIN TABS DORYX CPEP DOXYCYCLINE MONO CAPS DYNACIN CAPS MONODOX CAPS PERIOSTAT Use PA Form # 20420 or 10220 if applicable ; BIAXIN DYNABAC D5-PAK TBEC ERYPED CHEW PCE TBEC Use PA Form # 20420 or 10220 if applicable ; 1. QL ZPAC 250mg 6 script month 2. QL TRI-PAC 3 script month 3. 7 - Day supply per month w o PA CECLOR1 CEDAX CEFACLOR1 CEFADROXIL MONOHYDRATE TABS CEFTIN DURICEF TABS FORTAZ SOLN KEFLEX CAPS SPECTRACEF TABS TAZICEF SOLR Use PA Form # 20420 or 10220 if applicable ; 1. Both brand and generic are clinically nonpreferred. Use PA Form # 20420 or 10220 if applicable ; AMOXICILLIN POTASSIUM CLA CHEW AMOXICILLIN POTASSIUM CLA SUSR AMOXICILLIN POTASSIUM CLA TABS AMOXIL 500mg TABS PRINCIPEN CAPS2 PRINCIPEN SUSR 1. Amoxil 500mg tabs are non-preferred. All other Amoxil products are preferred. 2.Principen 250 mg is available without PA.

Alstrom, I.: Effect of the Digitalis Glucoside Digitoxin on the Phosphorus Metabolism in Heart and Liver of Rats, Measured by the Radioactive Phos.

Sumycin 500mg