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CONTAINS CONFIDENTIAL PATIENT INFORMATION Dialects (dopamine and pyridoxine, delayed release) Prior Authorization of Benefits (PAB) Form Complete form in its entirety and fax to: Prior Authorization

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What is doxylamine and pyridoxine delayed-release?

Doxylamine and pyridoxine delayed-release is a medication used to treat nausea and vomiting during pregnancy. It is a combination of two active ingredients, doxylamine succinate and pyridoxine hydrochloride. Doxylamine is an antihistamine that helps relieve nausea, while pyridoxine is a form of vitamin B6 that is involved in metabolism and can help reduce nausea symptoms.

Who is required to file doxylamine and pyridoxine delayedrelease?

Patients who are prescribed doxylamine and pyridoxine delayed-release by their healthcare provider are required to take the medication as directed. There is no specific filing requirement for patients.

How to fill out doxylamine and pyridoxine delayedrelease?

Doxylamine and pyridoxine delayed-release is not a form that needs to be filled out. It is a medication that is taken orally as directed by a healthcare provider.

What is the purpose of doxylamine and pyridoxine delayedrelease?

The purpose of doxylamine and pyridoxine delayed-release is to alleviate nausea and vomiting symptoms in pregnant women. It is specifically indicated for the treatment of morning sickness, which is a common condition during pregnancy.

What information must be reported on doxylamine and pyridoxine delayedrelease?

There is no specific information that needs to be reported on doxylamine and pyridoxine delayed-release. However, it is important to inform your healthcare provider about any other medications you are taking and any medical conditions you may have, as this can help ensure the safe and effective use of the medication.

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