Prialt Prescribing & Dosing Schedule

Dosage & Administration Drug label Prior authorization Financial assistance Patient education People also ask

Prialt (ziconotide acetate)

prialt 100 MCG in 1 ML Injection

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.

* PRIALT is not for intravenous administration.
* PRIALT is delivered using a programmable implanted variable-rate microinfusion device or an external microinfusion device and catheter.
* PRIALT 25 mcg/mL is used undiluted. The 100 mcg/mL formulation must be used diluted until an appropriate dose has been established.
* Saline solutions containing preservatives must not be used.
* Refrigerate but do not freeze all PRIALT solutions after preparation. Begin infusion within 24 hours.
* Initiate PRIALT at no more than 2.4 mcg/day (0.1 mcg/hr) and titrated to patient response. Doses may be titrated upward by up to 2.4 mcg/day (0.1 mcg/hr) at intervals of no more than 2–3 times per week, up to a recommended maximum of 19.2 mcg/day (0.8 mcg/hr) by Day 21.

drug label

Prialt Prescribing Information

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prior authorization

Prialt Prior Authorization Resources

Most recent state uniform prior authorization forms

Verified: Jun 26, 2024Arizona - Uniform Prior Authorization Form

Verified: Jun 26, 2024Colorado - Uniform Prior Authorization Form

Verified: Jun 26, 2024Hawaii - Uniform Prior Authorization Form

Verified: Jul 26, 2024Illinois - Uniform Prior Authorization Form

Verified: Jun 26, 2024Indiana - Uniform Prior Authorization Form

Verified: Jun 26, 2024Louisiana - Uniform Prior Authorization Form

Verified: Jun 26, 2024Minnesota - Uniform Prior Authorization Form

Verified: Jun 26, 2024New Hampshire - Uniform Prior Authorization Form

Verified: Jun 26, 2024New Mexico - Uniform Prior Authorization Form

Verified: Jun 26, 2024Oregon - Uniform Prior Authorization Form

Verified: Jun 26, 2024Texas - Uniform Prior Authorization Form

Verified: Jul 07, 2024Washington - Uniform Prior Authorization Form

Verified: Jul 07, 2024Wisconsin - Uniform Prior Authorization Form

Benefits investigation

Prialt Prescription & TeraSera Support Enrollment Form

financial assistance

Prialt Financial Assistance Options

Copay savings program

Prialt Prescription & TeraSera Support Enrollment Form

Enroll in Patient Savings Program

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Overview

Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)

Patient benefit

A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max

Patient eligibility

Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
May never be used with government insurance

How to sign up

Cards may be downloadable digital cards or hard copies
Some pharmacos offer debit cards with pre-loaded copay benefit
Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form

Foundation programs

Prialt Prescription & TeraSera Support Enrollment Form

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Overview

Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned

Patient benefit

Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and copays) until the grant is exhausted

Patient eligibility

Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.

How to sign up

Patients submit proof of out-of-pocket drug costs to charities for reimbursement

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

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

Dosage & Administration

Dosage & Administration

drug label

Prialt Prescribing Information

prior authorization

Prialt Prior Authorization Resources

Most recent state uniform prior authorization forms

Benefits investigation

financial assistance

Prialt Financial Assistance Options

Copay savings program

Foundation programs

patient education

Prialt Patient Education

Patient toolkit

people also ask

Prialt FAQs