Effective March 26, 2020
Effective March 26, 2020, the Department will implement a limitation on the starting dose of zolpidem immediate release (IR) in females to 5mg per day. Females who have already received at least 30 days of zolpidem IR 10mg per day will not require a prior authorization. Subsequent fills for zolpidem IR up to 10mg per day will be approved for females who tolerate the 5mg dose, but do not have adequate response.
These limitations are in response to the U.S. Food and Drug Administration (FDA) label changes specifying new dosing recommendations and a request from the Montana Healthcare Programs’ Drug Utilization Review (DUR) Board. The new dosing recommendations were approved by the FDA due to an increase in the risk of next day impairment of driving and other activities that require full alertness. This increased risk is especially pronounced in females. Current limitations on the dosages and quantities of other sedative hypnotics reflect FDA approved dosages.
For questions regarding this policy, please contact Shannon Sexauer, PharmD, Medicaid Pharmacist at (406) 444-5951 or Dani Feist, Pharmacy Program Officer at (406) 444-2738.
Contact Information
Drug Prior Authorization Unit
Mountain-Pacific Quality Health
3404 Cooney Drive
Helena, MT 59602
406-443-6002 or (800) 395-7961 (Phone)
406-513-1928 or (800) 294-1350 (Fax)
For claims questions or additional information, contact Montana Provider Relations at (800) 624-3958 or (406) 442-1837 or email MTPRHelpdesk@conduent.com.
Visit the Montana Healthcare Programs Provider Information website at https://medicaidprovider.mt.gov