Tadalafil zeigt eine konstante Resorption im Gastrointestinaltrakt, mit maximalen Plasmaspiegeln nach rund zwei Stunden. Der Wirkstoff verteilt sich gut im Gewebe und weist eine hohe Plasmaproteinbindung auf. Seine lange Halbwertszeit erlaubt eine verlängerte Wirkphase. Der Metabolismus erfolgt über das hepatische Enzymsystem CYP3A4, mit der Bildung inaktiver Metaboliten. Exkretion geschieht primär über den Stuhl. Die Häufigkeit von Nebenwirkungen steigt mit der Dosis, wobei vor allem vasodilatatorische Effekte dominieren. Ein gängiger Bezugspunkt in pharmakologischen Analysen ist cialis ohne rezept, das mit dieser Wirkstoffklasse assoziiert ist.
Microsoft word - pharmacy general form 2-07.doc
Pharmacy Pre-authorization Request Form *Note: Please use specific forms available on the provider website when prescribing the following drugs: Proton Pump Inhibitors (i.e. Aciphex, Nexium, omeprazole, Prevacid, Protonix), Non-sedating antihistamines (i.e. Allegra, Clarinex, Zyrtec, incl. Singulair), Celebrex, Statins (i.e. Lipitor, Vytorin) and Infertility Treatments Date: _______________________________________ Physician Name: _________________________________
Member Name: _______________________________ Physician Specialty: ______________________________
Member ID Number: ___________________________ Physician Address: _______________________________
Member Age: ________________________________ Physician Telephone: _____________________________
Fax/E-mail: ____________________________
Please provide all requested information. Incomplete forms will be returned for additional information.
Medication requested: __________________________________________________________________________
Dose/expected duration of treatment: ______________________________________________________________
Diagnosis: ___________________________________________________________________________________
Reason for request (please be as specific as possible): _________________________________________________
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Other medications used to treat condition and dates used: ______________________________________________
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For ConnectiCare Use Only:
Approved/denied (circle one) by: ______________________________Approval expiration date*: ____________
Comments: __________________________________________________________________________________
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*If the physician wishes to request further continuation of the pre-authorization for a period of time that exceeds the approved expiration date, the physician will need to supply clinical information to support the need. Authorizations are not given for >1 year. If required, submit an extension request prior to the end of the authorization period. ConnectiCare Pharmacy Services: fax - (860) 674-2851, or e-mail - pharmacy@connecticare.com To speak to a Medical Director or Pharmacist regarding a pre-authorization decision, call 1-800-828-3407. This is confidential information. If you receive this form in error, please notify Provider Services at 1-800-828-3407