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      Erectile Dysfunction Prior Authorization Request Form (Page 1 of 2) DO NOT COPY FOR FUTURE USE. FORMS ARE UPDATED FREQUENTLY AND MAY BE BARCODED . Member Information ... Does the member have a history of failure, contraindication, or intolerance to sildenafil (generic Viagra)**? ...


    • [PDF File]Erectile Dysfunction (ED) Practical Prescribing

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      Medication can be used to successfully manage erectile dysfunction (ED) in at least two-thirds of men. Phosphodiesterase-5 inhibitors (PDE5 inhibitors) are the first line recommended pharmacological treatment. Vacuum pumps and alprostadil preparations are alternatives to PDE5 inhibitors for the treatment of ED, offered by secondary care.


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      Men with Erectile Dysfunction (ED) Any adult man who honors their sexual potency and is interested in natural, safe and effective non-surgical alternatives to the oral medications like Viagra or complicated surgical implants. In fact, the solutions we will discuss have proven to enhance sexual performance and sensation with no harmful side effects!


    • [PDF File]Clinical Policy: Tadalafil BPH - ED (Cialis)

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      Revision Log See . Important Reminder at the end of this policy for important regulatory and legal information. Description Tadalafil (Cialis ®) is a phosphodiesterase-5 (PDE-5) inhibitor. *For Health Insurance Marketplace (HIM), tadalafil 2.5 mg, 10 mg, and 20 mg tablets are non-formulary and cannot be approved using these criteria; refer to the formulary exception policy, HIM.PA.103.


    • [PDF File]Express Scripts 2020 National Preferred Formulary Exclusions

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      Drug Class Excluded Medications Preferred Alternatives The excluded medications shown below are not covered on the Express Scripts drug list. In most cases, if you fill a prescription for one of these drugs, you will pay the full retail price. Take action to avoid paying full price.


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      2. Sato Y et al, How long do patients with erectile dysfunction continue to use sildenafil citrate? International Journal of Urology. (2007) 14, 339-342 3. Carvalheira AA, Pereira NM, Maroco J, and Forjaz V. Dropout in the treatment of erectile dysfunction with PDE5: A study on predictors and a Qualitative analysis of reasons for discontinuation.


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