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Texas Standard Prior Authorization Form Addendum Molina Healthcare of Texas
17P (17Alpha Medroxyprogesterone Capote Injection) (Medicaid)
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How to fill out 17-alpha-hydroxyprogesterone caproate and 17p
How to fill out 17-alpha-hydroxyprogesterone caproate and 17p
01
To fill out 17-alpha-hydroxyprogesterone caproate and 17p, follow these steps:
02
Wash your hands thoroughly with soap and water.
03
Open the medication vial and clean the rubber stopper with an alcohol swab.
04
Draw up the prescribed dosage of the medication into a syringe.
05
Choose an injection site, such as the upper outer quadrant of the buttock or the thigh.
06
Clean the injection site with an alcohol swab.
07
Pinch a fold of skin at the injection site and insert the needle at a 90-degree angle.
08
Slowly push the plunger to inject the medication.
09
Withdraw the needle and apply gentle pressure with a cotton ball or sterile gauze to the injection site.
10
Dispose of the syringe and needle in a sharps container.
11
Wash your hands again to ensure proper hygiene.
Who needs 17-alpha-hydroxyprogesterone caproate and 17p?
01
alpha-hydroxyprogesterone caproate and 17p are prescribed for individuals at risk of preterm birth.
02
This medication is commonly recommended for women with a history of preterm birth, multiple pregnancies, or cervical incompetence.
03
Additionally, it may be prescribed to women with a short cervix detected during routine prenatal ultrasound.
04
Consult with a healthcare professional to determine if 17-alpha-hydroxyprogesterone caproate and 17p are suitable for your specific condition.
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