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IMPORTANT SAFETY INFORMATION:

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Important Safety Information for Sucraid® (sacrosidase) Oral Solution

  • Do not prescribe Sucraid® to patients known to be hypersensitive to yeast, yeast products, papain, or glycerin (glycerol).
  • Sucraid® may cause a serious allergic reaction. Patients should stop taking Sucraid® and get emergency help immediately if any of the following side effects occur: difficulty breathing, wheezing, or swelling of the face. Care should be taken when administering initial doses of Sucraid® to observe any signs of acute hypersensitivity reaction.
  • Although Sucraid® provides replacement therapy for the deficient sucrase, it does not provide specific replacement therapy for the deficient isomaltase.
  • Adverse reactions as a result of taking Sucraid® may include worse abdominal pain, vomiting, nausea, diarrhea, constipation, difficulty sleeping, headache, nervousness, and dehydration.
  • Before prescribing Sucraid® to diabetic patients, the physician should consider that Sucraid® will enable sucrose hydrolysis and the absorption of those hydrolysis products, glucose and fructose.
  • The effects of Sucraid® have not been evaluated in patients with secondary (acquired) disaccharidase deficiency.
  • DO NOT HEAT SOLUTIONS CONTAINING SUCRAID®. Do not put Sucraid® in warm or hot fluids. Do not reconstitute or consume Sucraid® with fruit juice since the acidity of the juice may reduce the enzyme activity of Sucraid®. Half of the reconstituted Sucraid® should be taken at the beginning of the meal or snack and the other half during the meal or snack.
  • Sucraid® should be refrigerated at 36°F-46°F (2°C-8°C) and should be protected from heat and light; single-use containers can be removed from refrigeration and stored at 59°F-77°F (15°C-25°C) for up to 3 days (72 hours). Refer to Instructions for Use for full information on how to take Sucraid®.

Indication

Sucraid® (sacrosidase) Oral Solution is indicated for the treatment of sucrase deficiency, which is part of congenital sucrase-isomaltase deficiency (CSID), in adult and pediatric patients 5 months of age and older.

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IMPORTANT SAFETY INFORMATION:

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Prior Authorization Information

Here is some helpful information for submitting the prior authorization form correctly.

1

Enter Patient Diagnosis Code (ICD-10)

Here is a list of possible ICD-10 codes that may apply to a CSID patient (may not be an all-inclusive list):

Sucrase-isomaltase deficiencyE74.31
Other disorders of intestinal carbohydrate absorptionE74.39
Malabsorption due to intolerance, not elsewhere classifiedK90.49
Diarrhea, unspecifiedR19.7
FlatulenceR14.3
Abdominal distension (gaseous)R14.0
NauseaR11.0

2

Identify Patient Symptoms

Experiencing symptoms of Congenital Sucrase-Isomaltase Deficiency (CSID), including diarrhea, gas, bloating, abdominal cramping, nausea, or other.

3

Detail Patient History

  • Prior treatment
  • Medical history
  • Dietary counseling
  • Other

4

Indicate Patient Tests and Results

Evidence of deficient sucrase activity through one of the following recommended diagnoses:

  1. 13C-sucrose breath test
  2. Sucrose hydrogen-methane breath test
  3. EGD biopsy and disaccharidase assay
    • 2 extra distal duodenal biopsy samples
    • Sent to specialty disaccharidase testing lab; results evaluated
DisaccharidaseNormal Range
Lactase5 - 55 U/g protein
Sucrase26 - 110 U/g protein
Maltase105 - 380 U/g protein
Palatinase9 - 32 U/g protein

Hackenmueller SA, Grenache DG. Reference intervals for intestinal disaccharidase activities determined from a non-referenced population. J Appl Lab Med. 2016;1(2):172-80.

5

Download Authorization Form

Search your patient’s healthcare provider below to access the corresponding form.

Popular Providers

AetnaAnthem BlueCross BlueShield KentuckyBlueCross BlueShield of Texas
Harvard Pilgrim Health CareCignaUnitedHealthcare of Texas

Important Safety Information for Sucraid® (sacrosidase) Oral Solution

  • Do not prescribe Sucraid® to patients known to be hypersensitive to yeast, yeast products, papain, or glycerin (glycerol).
  • Sucraid® may cause a serious allergic reaction. Patients should stop taking Sucraid® and get emergency help immediately if any of the following side effects occur: difficulty breathing, wheezing, or swelling of the face. Care should be taken when administering initial doses of Sucraid® to observe any signs of acute hypersensitivity reaction.
  • Although Sucraid® provides replacement therapy for the deficient sucrase, it does not provide specific replacement therapy for the deficient isomaltase.
  • Adverse reactions as a result of taking Sucraid® may include worse abdominal pain, vomiting, nausea, diarrhea, constipation, difficulty sleeping, headache, nervousness, and dehydration.
  • Before prescribing Sucraid® to diabetic patients, the physician should consider that Sucraid® will enable sucrose hydrolysis and the absorption of those hydrolysis products, glucose and fructose.
  • The effects of Sucraid® have not been evaluated in patients with secondary (acquired) disaccharidase deficiency.
  • DO NOT HEAT SOLUTIONS CONTAINING SUCRAID®. Do not put Sucraid® in warm or hot fluids. Do not reconstitute or consume Sucraid® with fruit juice since the acidity of the juice may reduce the enzyme activity of Sucraid®. Half of the reconstituted Sucraid® should be taken at the beginning of the meal or snack and the other half during the meal or snack.
  • Sucraid® should be refrigerated at 36°F-46°F (2°C-8°C) and should be protected from heat and light; single-use containers can be removed from refrigeration and stored at 59°F-77°F (15°C-25°C) for up to 3 days (72 hours). Refer to Instructions for Use for full information on how to take Sucraid®.

Indication

Sucraid® (sacrosidase) Oral Solution is indicated for the treatment of sucrase deficiency, which is part of congenital sucrase-isomaltase deficiency (CSID), in adult and pediatric patients 5 months of age and older.