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Thiazolidinediones (Teds) & Dipeptide peptidase-4 (DPP-4) inhibitors PRIOR AUTHORIZATION REQUEST FORM Complete ENTIRE form and Fax to: 866-940-7328 Today s Date: SECTION A — PATIENT INFORMATION
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How to fill out dipeptidyl peptidase-4 dpp-4 inhibitors

01
Dipeptidyl peptidase-4 (DPP-4) inhibitors are medications that are commonly prescribed to individuals with type 2 diabetes.
02
These inhibitors work by blocking the action of the DPP-4 enzyme, which breaks down a hormone called GLP-1 (glucagon-like peptide 1). By inhibiting DPP-4, these medications help increase the levels of GLP-1 in the body, which then leads to improved blood sugar control.
03
When it comes to filling out a prescription for DPP-4 inhibitors, it is crucial to follow the instructions given by your healthcare provider. Here is a step-by-step guide on how to fill out DPP-4 inhibitors:
3.1
Consult your healthcare provider: Before starting any new medication, it is important to consult your healthcare provider to determine if DPP-4 inhibitors are appropriate for you. They will assess your medical history, current medications, and other factors to make an informed decision.
3.2
Obtain the prescription: Once your healthcare provider has determined that DPP-4 inhibitors are suitable for your condition, they will provide you with a prescription. Make sure to collect the prescription from your healthcare provider or ask it to be sent to your preferred pharmacy.
3.3
Visit the pharmacy: Take the prescription to your chosen pharmacy and inform the pharmacist that you need to fill it out with DPP-4 inhibitors. Provide them with any necessary information, such as insurance details, to ensure a smooth process.
3.4
Verify the medication: When you receive the medication from the pharmacy, carefully check the label to ensure it is the correct prescription and strength as prescribed by your healthcare provider.
3.5
Read the patient information: Inside the medication package, you will find a patient information leaflet. It is crucial to read this leaflet thoroughly to familiarize yourself with the medication's dosage, administration instructions, possible side effects, and any precautions or contraindications.
3.6
Follow the dosage instructions: Take the DPP-4 inhibitors exactly as prescribed by your healthcare provider. Typically, these medications are taken orally, usually once a day with or without food. However, dosage instructions may vary depending on the specific medication you are prescribed.
3.7
Monitor your blood sugar levels: It is essential to monitor your blood sugar levels regularly while taking DPP-4 inhibitors. Follow your healthcare provider's instructions on how to check your blood sugar and maintain a record of your readings. This will help you and your healthcare provider assess the effectiveness of the medication.
3.8
Attend follow-up appointments: Regularly schedule appointments with your healthcare provider to monitor your diabetes management and discuss any concerns or changes in your condition. They may adjust your medication dosage or provide additional guidance based on your progress.
04
DPP-4 inhibitors are primarily prescribed to individuals with type 2 diabetes who struggle with managing their blood sugar levels through lifestyle modifications alone. These medications may be considered when other oral anti-diabetic medications, such as metformin, have not provided sufficient control. However, the decision to prescribe DPP-4 inhibitors will depend on several factors, including your individual medical history, current medications, and overall health. It is crucial to consult your healthcare provider to determine if DPP-4 inhibitors are suitable for you.
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What is dipeptidyl peptidase-4 dpp-4 inhibitors?
Dipeptidyl peptidase-4 (DPP-4) inhibitors are a class of oral medications used to treat type 2 diabetes by helping to lower blood sugar levels.
Who is required to file dipeptidyl peptidase-4 dpp-4 inhibitors?
Healthcare providers and individuals prescribed dipeptidyl peptidase-4 (DPP-4) inhibitors are required to file information related to the medication.
How to fill out dipeptidyl peptidase-4 dpp-4 inhibitors?
To fill out information related to dipeptidyl peptidase-4 (DPP-4) inhibitors, healthcare providers and individuals can follow the specific guidelines provided by regulatory bodies or healthcare institutions.
What is the purpose of dipeptidyl peptidase-4 dpp-4 inhibitors?
The purpose of dipeptidyl peptidase-4 (DPP-4) inhibitors is to help manage blood sugar levels in individuals with type 2 diabetes.
What information must be reported on dipeptidyl peptidase-4 dpp-4 inhibitors?
Information that must be reported on dipeptidyl peptidase-4 (DPP-4) inhibitors may include dosage, frequency of use, and any side effects experienced.
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