Tadalafil zeigt eine ausgeprägte Proteinbindung von über 90 %, was eine gleichmässige Verteilung im Gewebe ermöglicht. Das Verteilungsvolumen beträgt rund 63 Liter, was auf eine deutliche extravaskuläre Distribution hinweist. Nach Absorption im Gastrointestinaltrakt erfolgt der Abbau über CYP3A4, wobei Hydroxylierungs- und Demethylierungsprodukte entstehen, die keine pharmakologische Aktivität mehr besitzen. Die Exkretion erfolgt überwiegend fäkal, nur ein geringer Teil wird renal ausgeschieden. Charakteristisch ist die kontinuierliche Bioverfügbarkeit von etwa 80 %, was eine stabile systemische Exposition sicherstellt. Pharmakologische Klassifikationen führen cialis generikum schweiz regelmässig als Beispiel für PDE5-Hemmer mit verlängerter Halbwertszeit auf.

Chpw.org2

Pharmacy and Therapeutics Committee Decisions
March 19, 2010
Drug/Therapeutic Class
P&T Decision
Bepreve® (bepotastine besilate ophthalmic solution) • Non-formulary
Medications
– Treatment of Allergic Conjunctivitis
Effient® (prasugrel) – Platelet Aggregation Inhibitor • Formulary
Multaq® (dronedarone) – Treatment of Arrhythmias • Non-formulary
Sabril® (vigabatrin) – Treatment of Seizures and
• Formulary with Prior
Authorization
Samsca® (tolvaptan) – Treatment of Hyponatremia
• Formulary with Prior
Authorization
Votrient® (pazopanib) – Treatment of Renal Cell
• Formulary with Prior
Authorization
Therapeutic
Acne Vulgaris
• Formulary: benzoyl peroxide,
Acanya® (benzoyl peroxide/clindamycin), Aczone® (dapsone), Avita® (tretinoin), Azelex® (azelaic peroxide/erythromycin), benzoyl peroxide, benzoyl peroxide/erythromycin, clindamycin topical, • Non-formulary: Acanya, Aczone,
peroxide/clindamycin), Epiduo® (adapalene/benzoyl peroxide), erythromycin topical, Retin-A® Micro (tretinoin), sulfacetamide, Tazorac® (tazarotene), tretinoin, Ziana® (clindamycin/tretinoin) Gel, Duac, Epiduo, Retin-A Micro, Tazorac, Ziana Dipeptidyl Peptidase-4 (DPP-4) Inhibitors
• Non-formulary: Janumet, Januvia,
Janumet® (sitagliptin phosphate/metformin), Januvia® (sitagliptin phosphate), Onglyza®
(saxagliptin)
Central Nervous System Stimulants
• Formulary: amphetamine/
amphetamine/dextroamphetamine, amphetamine/ (methylphenidate ER), Daytrana® (methylphenidate dextroamphetamine, dextroamphetamine SR, Focalin® XR (dexmethylphenidate ER), Intuniv® (guanfacine ER), Metadate® CD (methylphenidate ER), Metadate® ER (methylphenidate ER), • Non-formulary: Daytrana,
methamphetamine, Methylin® (methylphenidate), methylphenidate, methylphenidate ER, Ritalin® LA (methylphenidate SR), Strattera® (atomoxetine), 720 Olive Way, Suite 300 Seattle WA 98101 | www.chpw.org | 1.800.440.1561 | 206.521.8833 Drug/Therapeutic Class
P&T Decision
Vyvanse® (lisdexamfetamine)
Fibromyalgia Agents
• Formulary: Cymbalta (prior auth)
Cymbalta® (duloxetine), Lyrica® (pregabalin), • Non-formulary: Lyrica, Savella
Savella® (milnacipran)
Pulmonary Arterial Hypertension
• Formulary: Adcirca (prior auth),
Adcirca® (tadalafil), Letairis® (ambrisentan), Revatio® (sildenafil citrate), Tracleer® (bosentan), Tyvaso® (treprostinil inhalation), Ventavis® • Non-formulary: Tyvaso, Ventavis
(iloprost inhalation)
Atypical Antipsychotics
• Formulary: Abilify (step therapy 2nd
Abilify®/Abilify® Discmelt/Abilify® Solution (aripiprazole), Fanapt® (iloperidone), Geodon®
(ziprasidone), Invega® (paliperidone), risperidone, risperidone orally disintegrating, risperidone solution , Saphris® (asenapine), Seroquel® (quetiapine), Seroquel® XR (quetiapine extended- release), Symbyax® (olanzapine/fluoxetine), • Non-formulary: Abilify Discmelt,
Abilify Solution, Fanapt, Geodon, Invega, Saphris, Symbyax, Zyprexa Zydis Bowel Evacuants
• Formulary: NuLytely, Nulytely
Colyte® with Flavor Packets, GoLytely®, Half- Lytely-Bisacodyl® with Flavor Packs, MoviPrep®, • Non-formulary: Colyte with Flavor
NuLytely®, Nulytely® with Flavor Packs, PEG- Bisacodyl with Flavor Packs, MoviPrep, TriLyte with Flavor Packs Leukotriene Pathway Inhibitors
• Formulary: Singulair (step therapy)
Accolate® (zafirlukast), Singulair® (montelukast), • Non-formulary: Accolate, Zyflo CR
Zyflo® CR (zileuton extended-release)
Oral Hepatitis B Agents
• Formulary: Baraclude, Epivir HBV,
Baraclude® (entecavir), Epivir® HBV (lamivudine), Hepsera® (adefovir dipivoxil), Tyzeka® • Non-formulary: Hepsera, Tyzeka
(telbivudine), Viread® (tenofovir)
Macrolide/Ketolide Antibiotics
• Formulary: azithromycin,
azithromycin, clarithromycin, clarithromycin ER, erythromycin, Ketek®, PCE® Dispertab, Zmax® • Non-formulary: clarithromycin ER,
Multiple Sclerosis Drugs
• Formulary: Avonex, Betaseron,
Avonex® (interferon beta-1a [IM]), Betaseron® (interferon beta-1b), Copaxone® (glatiramer
acetate), Extavia® (interferon beta-1b), Rebif®
(interferon beta-1a [SC])
Nasal Steroids
• Formulary: fluticasone propionate
Beconase® AQ (beclomethasone), flunisolide, • Non-formulary: Beconase AQ,
(mometasone), Omnaris® (ciclesonide), Rhinocort® Aqua (budesonide), Veramyst® (fluticasone furoate) Copayment/Coinsurance for all pharmaceuticals & pharmaceutical classes above:
• Healthy Options, Basic Health Plus, Children’s Health Insurance Program, & General Assistance Unemployable = $0 • Basic Health Plan = $10 copay for formulary generic products; 50% coinsurance for formulary brand products 720 Olive Way, Suite 300 Seattle WA 98101 | www.chpw.org | 1.800.440.1561 | 206.521.8833
Prior Authorization Criteria for:
• Abilify = trial of Seroquel or Seroquel XR first (step therapy; 2nd step); treatment of major depressive
disorder after trial of three antidepressants; treatment of irritability with autistic disorder after trial of risperidone or clinical concerns regarding use of risperidone first • Adcirca = FDA-approved indications and not currently taking nitrates
• Cymbalta = Trial of a tricyclic antidepressant, gabapentin and an SSRI first for treatment of
fibromyalgia; trial of 2 formulary SSRIs and Effexor XR or 1 formulary SSRI and venlafaxine IR for treatment of depression; trial of gabapentin for the treatment of diabetic peripheral neuropathy • Letairis = FDA-approved indications after trial of Adcirca or Revatio first (step therapy) unless
contraindication to Adcirca or Revatio; diagnosis of World Health Organization (WHO) class IV symptoms • Revatio = FDA-approved indications and not currently taking nitrates
• Sabril = Treatment of refractory complex seizures after trial of ≥ 4 other antiepileptic drugs and infantile
• Samsca = FDA-approved indications
• Seroquel/Seroquel XR = trial of risperidone first (step therapy; 1st step) in patients < 65 years of age;
treatment of major depressive disorder after trial of three antidepressants; bipolar depression or depressive episodes associated with bipolar disorder • Singulair = Covered for patients < 12 years of age; for non-asthmatic patients ≥ 12 years of age trial of
non-sedating antihistamine and nasal steroid first (step therapy); for asthmatic patients ≥ 12 years of age trial with an inhaled corticosteroid first (step therapy); interstitial cystitis if the patient has tried two alternative therapies for this condition • Tracleer = FDA-approved indications after trial of Adcirca or Revatio first (step therapy) unless
contraindication to Adcirca or Revatio; diagnosis of World Health Organization (WHO) class IV symptoms • Votrient = FDA-approved indications
• Zyprexa = trial of Seroquel or Seroquel XR first (step therapy; 2nd step)
720 Olive Way, Suite 300 Seattle WA 98101 | www.chpw.org | 1.800.440.1561 | 206.521.8833

Source: http://www.chpw.org/assets/file/PTDecisions.pdf