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OPTIMA HEALTH PLAN
PHARMACY PRIOR AUTHORIZATION/STEPPED REQUEST*
Directions: The prescribing physician must sign and clearly print name (preprinted stamps not valid) on this
request. All other information
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What is an alogliptin?
Alogliptin is a medication used to treat type 2 diabetes by helping to control blood sugar levels.
Who is required to file an alogliptin?
Patients prescribed alogliptin for managing type 2 diabetes are required to follow their healthcare provider's guidance regarding the medication.
How to fill out an alogliptin?
Alogliptin is typically prescribed by a healthcare provider and is taken orally as directed, usually with or without food.
What is the purpose of an alogliptin?
The purpose of alogliptin is to lower blood sugar levels in adults with type 2 diabetes, often used in conjunction with diet and exercise.
What information must be reported on an alogliptin?
Patients should report any side effects, current medications, and their blood sugar levels to their healthcare provider when using alogliptin.
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