Prialt

(ziconotide)
1 ML ziconotide acetate 0.1 MG/ML Injection [Prialt]20 ML ziconotide acetate 0.025 MG/ML Injection [Prialt]
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Dosage & administration

PRIALT is a non-opioid and non-NSAID analgesic agent used for the management of severe and chronic pain. Administer PRIALT intrathecally by or under the direction of a physician experienced in the technique of intrathecal administration and who is familiar with the drug and device labeling.

drug label

Prialt prescribing information

prior authorization

Prialt prior authorization resources

Most recent Prialt prior authorization forms

View By Payer
Verified: Feb 07, 2024Kaiser Foundation Health Plan - Chronic High-Dose Opioid Therapy Prior Authorization Form Washington
Verified: Mar 02, 2024Highmark BCBS Northeastern NY - Medicare Prescription Drug Medication Request Form
Verified: Mar 02, 2024Highmark BCBS Northeastern NY - Short Acting Opioid Prior Authorization Form
Verified: Mar 02, 2024Highmark BCBS Western NY - Specialty Drug Prior Authorization Form
Verified: Mar 02, 2024Highmark BCBS Western NY - Non-Formulary Drug Coverage Prior Authorization Form

Most recent state uniform prior authorization forms

Verified: Feb 27, 2024Arizona - Uniform Prior Authorization Form
Verified: Feb 27, 2024Colorado - Uniform Prior Authorization Form
Verified: Feb 27, 2024Hawaii - Uniform Prior Authorization Form
Verified: Feb 27, 2024Illinois - Uniform Prior Authorization Form
Verified: Feb 27, 2024Indiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Louisiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Michigan - Uniform Prior Authorization Form
Verified: Feb 27, 2024Minnesota - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Mexico - Uniform Prior Authorization Form
Verified: Feb 27, 2024Oregon - Uniform Prior Authorization Form
Verified: Feb 27, 2024Texas - Uniform Prior Authorization Form
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Benefits investigation

Prialt Prescription & TeraSera Support Enrollment Form
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financial assistance

Prialt financial assistance options

Co-pay savings program

commercial only
Prialt Prescription & TeraSera Support Enrollment Form
Enroll in Patient Savings Program
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Foundation programs

under insured
no insurance
goverment insurance
65+
Prialt Prescription & TeraSera Support Enrollment Form
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PubMed™ | Prialt

Prialt PubMed™ News

patient education

Prialt patient education

To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link

Patient toolkit

About Prialt
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Nurse Support
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Patient Brochure
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Doctor Discussion Guide
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
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people also ask

Prialt FAQs

How is the dosage of Prialt?Prialt is available in 3 dosages, including 0.025 mg/ml Injection 20 ml, 0.1 mg/ml Injection 1 ml and 0.5 mg/5ml Injection 5 ml
What does Prialt treat?Prialt treats Chronic Pain
What is Prialt made of?Prialt contains ziconotide which is a N-type Calcium Channel Antagonist
How Is Prialt Administered?Prialt is administered as a Injectable
What Are The Prialt Mechanism Of Action?Prialt mechanism of action is N-Calcium Channel Receptor Antagonists
FAQ Data Source