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PRIOR AUTHORIZATION FORM DPenamine Commercial/Medicaid Unless otherwise indicated below, authorization quantities are limited to the manufacturer recommended dosageComplete online at www.selecthealth.org/pa

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How to fill out d-penamine

01

Read the instructions provided with the d-penamine medication.

02

Wash your hands thoroughly before handling the medication.

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Take the prescribed dosage of d-penamine as instructed by your healthcare provider.

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Swallow the tablet whole with a glass of water. Do not crush, chew, or break the tablet.

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It is advisable to take d-penamine with food to reduce the risk of stomach upset.

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If you miss a dose, take it as soon as you remember. However, if it is near the time for your next dose, skip the missed dose and resume your regular dosing schedule.

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Do not double the dose to make up for the missed one.

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Store d-penamine in a cool, dry place away from direct sunlight.

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Keep the medication out of the reach of children.

Who needs d-penamine?

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D-penamine is commonly prescribed to individuals with certain medical conditions, such as:

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- Attention deficit hyperactivity disorder (ADHD)

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- Narcolepsy (a sleep disorder characterized by excessive daytime sleepiness)

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- Obesity (in some cases)

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It is important to consult with a healthcare professional to determine if d-penamine is suitable for your specific condition.

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What is d-penamine?

D-penamine is a prescription medication that is used to treat obesity and assist with weight loss.

Who is required to file d-penamine?

D-penamine does not require any filing as it is a medication and not a document.

How to fill out d-penamine?

D-penamine does not require any filling out as it is a medication and not a document.

What is the purpose of d-penamine?

The purpose of d-penamine is to help individuals who are obese or struggling with weight loss to achieve their weight goals.

What information must be reported on d-penamine?

There is no specific information that needs to be reported on d-penamine as it is a medication and not a reporting document.

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