Aptiom

Drug - Aptiom™ (eslicarbazepine) [Sunovion Pharmaceuticals, Inc.]

December 2017

Therapeutic area - Antiepileptic

Approval criteria

• Patient is 4 years of age or older AND
• Patient has a diagnosis of partial-onset seizures AND
• Patient has tried and failed THREE or more anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, ethosuximide, oxcarbazepine, topiramate or carbamazepine OR
• Prescriber is a neurologist AND patient has tried and failed at least TWO anti-epileptic drugs which include: gabapentin, lamotrigine, levetiracetam, ethosuximide, oxcarbazepine, topiramate or carbamazepine

Quantity limits

• 200 mg, 400 mg, 800 mg tablets: 34 tablets per 34 days
• 600 mg: 68 tablets per 34 days

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411