C1 Esterase Inhibitor (Cinryze)

Cinryze is covered for prophylaxis of HAE attacks (FDA‑approved) and compendial treatment of acute HAE in patients with confirmed C1‑INH deficiency (Type I or II); patients without diagnostic labs showing functional C1‑INH <50% and low serum C4 are not eligible. Coverage requires baseline labs (functional C1‑INH <50% and low C4), prescription by or in consultation with an allergist/immunologist or HAE specialist, adherence to dosing/frequency limits (≤2,500 U IV or ≤100 U/kg every ≥3 days for ≥12 years; 1,000 U IV every ≥3 days for ages 6–11), 12‑month approvals, and documentation of clinical benefit for reauthorization.

"Cinryze is indicated for prophylaxis against Hereditary Angioedema (HAE) attacks."

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