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Office of Medical Assistance Programs FeeforService, Pharmacy Division Phone 18005378862 Fax 18663270191STIMULANTS AND RELATED AGENTS PRIOR AUTHORIZATION FORM (form effective 01/05/2021) Prior authorization
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01
Step 1: Start by gathering all the necessary information and documents, such as the prescription for the stimulant or related agent.
02
Step 2: Read the instructions provided with the medication carefully. Pay attention to the dosage, frequency of administration, and any special instructions.
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Step 3: Wash your hands thoroughly before handling the medication to ensure cleanliness.
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Step 4: Use a clean and dry medication dropper or spoon to measure the prescribed dosage accurately.
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Step 5: Administer the medication as directed. This could involve swallowing a pill with water, applying a transdermal patch, or using an inhaler.
06
Step 6: Store the medication in a cool, dry place as per the instructions provided.
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Step 7: Dispose of any leftover medication properly according to local regulations or return them to a pharmacy for safe disposal.
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Step 8: Keep track of the medication's effectiveness and any side effects experienced. Report any concerns to your healthcare provider.

Who needs stimulants and related agents?

01
Stimulants and related agents are typically prescribed to individuals who have been diagnosed with conditions like attention-deficit hyperactivity disorder (ADHD) or narcolepsy.
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People with ADHD often have difficulties with hyperactivity, impulsivity, and inattention. Stimulants can help improve focus, attention span, and reduce hyperactive and impulsive behaviors in these individuals.
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Stimulants may be prescribed for people with narcolepsy to help manage excessive daytime sleepiness and sudden sleep attacks.
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It is important to note that the use of stimulants and related agents should only be done under the guidance and supervision of a healthcare professional who can determine if the individual truly needs such medication.
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Stimulants and related agents are substances that increase activity and alertness in the body by stimulating the central nervous system.
Any individual or entity involved in the manufacturing, distribution, or sale of stimulants and related agents is required to file.
You can fill out stimulants and related agents by providing accurate information about the substances being manufactured, distributed, or sold, as well as details about the quantities and intended use.
The purpose of filing stimulants and related agents is to track the production, distribution, and sale of these substances to ensure compliance with regulations and monitor potential misuse.
Information such as the name of the substance, quantity produced or sold, intended use, and contact information of the manufacturer or distributor must be reported.
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