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Prior Authorization Form Combination Beta2-Agonist/Corticosteroid Inhalers This form is based on Express Scripts standard criteria and may not be applicable to all patients; certain plans and situations
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How to fill out combination beta2-agonistcorticosteroid inhalers

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How to fill out combination beta2-agonistcorticosteroid inhalers:

01
Make sure to read the instructions provided with the inhaler thoroughly before use.
02
Shake the inhaler well to mix the medications inside.
03
Remove the cap from the mouthpiece of the inhaler.
04
Exhale fully, away from the inhaler.
05
Hold the inhaler upright, with your thumb on the base and your index and middle fingers on either side of the mouthpiece.
06
Tilt your head back slightly and breathe out completely.
07
Place the mouthpiece between your teeth, closing your lips tightly around it.
08
Begin inhaling slowly and deeply, pressing down on the canister at the same time to release the medication.
09
Continue inhaling until your lungs are full, then remove the inhaler from your mouth and hold your breath for a few seconds.
10
Exhale slowly.
11
Repeat steps 6-10 if your healthcare provider has prescribed more than one dose.
12
After use, replace the cap on the mouthpiece to protect it from dirt and debris.

Who needs combination beta2-agonistcorticosteroid inhalers:

01
Combination beta2-agonistcorticosteroid inhalers are typically prescribed to patients with asthma.
02
They may be recommended for individuals who have moderate to severe asthma symptoms, including chronic bronchitis and wheezing.
03
These inhalers are often used as maintenance therapy to control asthma symptoms and prevent flare-ups.
04
Combination inhalers are usually prescribed when a person's asthma cannot be adequately controlled with a beta2-agonist inhaler or a corticosteroid inhaler alone.
05
It is important to use combination inhalers as directed by a healthcare provider and to follow up regularly to ensure the best management of asthma symptoms.
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Combination beta2-agonistcorticosteroid inhalers are inhalers that contain both a beta2-agonist and a corticosteroid medication.
Healthcare providers or pharmacists who prescribe or dispense these inhalers are required to file information about them.
The required information about combination beta2-agonistcorticosteroid inhalers can be filled out on a specific form provided by the regulatory authorities.
Combination beta2-agonistcorticosteroid inhalers are used to treat asthma and COPD by providing bronchodilation and reducing inflammation in the airways.
Information such as the brand name, dosage, frequency of use, and any side effects experienced by the patient must be reported on combination beta2-agonistcorticosteroid inhalers.
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