![Amides / Anti-diabetic drugs / Alcohols / Nitriles / Sitagliptin / Saxagliptin / Metformin / Pharmacist / Dipeptidyl peptidase / Chemistry / Dipeptidyl peptidase-4 inhibitors / Organic chemistry Amides / Anti-diabetic drugs / Alcohols / Nitriles / Sitagliptin / Saxagliptin / Metformin / Pharmacist / Dipeptidyl peptidase / Chemistry / Dipeptidyl peptidase-4 inhibitors / Organic chemistry](https://www.pdfsearch.io/img/4330021520ec1b9177b12bc5efb93578.jpg) Date: 2014-08-07 16:26:15Amides Anti-diabetic drugs Alcohols Nitriles Sitagliptin Saxagliptin Metformin Pharmacist Dipeptidyl peptidase Chemistry Dipeptidyl peptidase-4 inhibitors Organic chemistry | | UTAH DEPARTMENT OF HEALTH, PRIOR AUTHORIZATION REQUEST FORM Dipeptidyl Peptidase IV (DPP-4) Inhibitors (alogliptin, linagliptin, saxagliptin, sitagliptin and combination products) Patient name:_________________________
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