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  • Buprenorphinenaloxone Prior Authorization Form - Dhhr Wv

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West Virginia Medicaid Drug Prior Authorization Form Rational Drug Therapy Program WVU School of Pharmacy PO Box 9511 HSCN Morgantown, WV 26506 Fax: 18005317787 Phone: 18008473859 /Naloxone.

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/Naloxone Prior Authorization Form - WV DHHR
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The first day's total dose should be no more than 8 mg, with daily increases of 2 to 4 mg as necessary. The optimal dose relieves cravings and symptoms of withdrawal for a full 24 hours, without causing sedation. The usual therapeutic range is 8 to 16 mg daily, to a maximum of 24 mg a day.

Under the new guidelines, providers may now prescribe to up to 30 patients without completing an 8-hour (for physicians) or 24-hour (for all other providers) training to receive a waiver from the federal Drug Enforcement Agency (DEA).

Not more than one day's medication may be administered to the person or for the person's use at one time. Such emergency treatment may be carried out for not more than three days and may not be renewed or extended.” This is called the “Three-Day” Rule.

However, if the combination product is injected the naloxone portion becomes active and may result in opioid withdrawal. Formulations less used in patients with serious illness include alone without naloxone (brand name ) and extended release injectable (brand name Sublocade).

Effective August 1, West Virginia Medi- caid will require prior authorization for all and prescriptions. Prior authorization (PA) criteria have been developed and will provide ade- quate doses of both and , when appropriate, for pharma- cologic support of addiction treatment.

The following products are FDA approved for the treatment of OUD: Generic /naloxone sublingual tablets. sublingual tablets () /naloxone sublingual films () /naloxone) sublingual tablets ()

Adults—8.4 milligrams (mg) of and 1.4 mg of naloxone taken as a single dose once a day. Your doctor may adjust your dose as needed. Children—Use and dose must be determined by your doctor.

Clinicians should start with an initial dose of 2 mg/0.5 mg or 4 mg/1 mg /naloxone and may titrate upwards in 2 or 4 mg increments of , at approximately 2-hour intervals, under supervision, to 8 mg/2 mg /naloxone based on the control of acute withdrawal symptoms.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232