Vistogard

(uridine triacetate)
Vistogard 10 GM Oral Granules
NO BOXED WARNING

Dosage & administration

Recommended Dosage

Preparation and Administration


drug label

Vistogard prescribing information

prior authorization

Vistogard prior authorization resources

Most recent Vistogard prior authorization forms

View By Payer
Verified: Feb 07, 2024Kaiser Foundation Health Plan - Chronic High-Dose Opioid Therapy Prior Authorization Form Washington
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Medicare Prescription Drug Medication Request Form
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Short Acting Opioid Prior Authorization Form
Verified: Feb 01, 2024Highmark BCBS Western NY - Specialty Drug Prior Authorization Form
Verified: Feb 01, 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
Learn More

Benefits investigation

Vistogard Prescription Referral Form
Learn More

pharmacy

Vistogard preferred pharmacy

Pharmacy List

financial assistance

Vistogard financial assistance options

Co-pay savings program

commercial only
Enroll in Patient Savings Program
Vistogard Prescription Referral Form
Learn More

Foundation programs

under insured
no insurance
goverment insurance
65+
Patient Assistance Program
Vistogard Prescription Referral Form
Learn More

PubMed™ | Vistogard

Vistogard PubMed™ News

patient education

Vistogard 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 Vistogard
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Learn More

people also ask

Vistogard FAQs

How is the dosage of Vistogard?Vistogard is available in 1 dosages, including 10 g Granules
What does Vistogard treat?Vistogard treats Drug Overdose
How Is Vistogard Administered?Vistogard is administered as a Oral Granules
FAQ Data Source