- For the treatment of chronic gout in adult patients refractory to conventional therapy.
Coverage of drugs is first determined by the member’s pharmacy or medical benefit. Please consult with or refer to the Evidence of Coverage document.
AND
Drug | Dosing Regimen | Dose Limit/ Maximum Dose |
---|---|---|
allopurinol (AloprimR/ ZyloprimR) | Gout (mild) 100 to 300 mg/day PO as a single or divided dose (2-3 time daily) Gout (moderate to severe) 400 to 600 mg/day PO as a single or divided dose (2-3 times daily) | 800 mg /day |
colchicine (ColcrysR) | Gout flare - Treatment 1.2 mg PO at the first sign of flare followed by 0.6 mg one hour later Gout flare - Prophylaxis 0.6 mg PO QD to BID | Treatment - 1.8 mg over 1 hour Prophylaxis - 1.2 mg/day Maximum dose in patients with risk factors for colchicine toxicity (e.g. elderly, renal or hepatic impairment, weight < 50 kg): Severe renal impairment (< 30 ml/min CrCl) and hepatic impairment: do not repeat course more than once every 2 weeks |
UloricR (febuxostat) * | Hyperuricemia - Chronic Management 40 mg PO QD; may be increased to 80 mg PO QD if serum uric acid levels are not less than 6 mg/dL after 2 weeks | Specific maximum dosage |
probenecid (BenurylTM) | Hyperuricemia - Initial 250 mg PO BID for 1 week Hyperuricemia - Prophylaxis 500 mg PO BID; if symptoms persist or 24 hour urate excretion is below 700 mg, may incrementally increase by 500 mg every 4 weeks as tolerated | 2000 mg/day |
Drug | Dosing Regimen | Authorization Limit |
---|---|---|
Krystexxa | 8 mg IV over 2 hours every 2 weeks Before receiving each Krystexxa dose, patients should be pre-medicated with an oral antihistamine, IV corticosteroid, and acetaminophen. Patients should also receive prophylaxis for gout flares with an NSAID and/or colchicines starting 1 week prior to initiating therapy unless not tolerated or otherwise contraindicated. Serum uric acid levels should be monitored before each infusion. Krystexxa should be diluted and only be administered by intravenous infusion over no less than 120 minutes via gravity feed, syringe-type pump, or infusion pump. Krystexxa should be administered in a healthcare setting | 6 months or renewal date, whichever is longer |