Non Steroidal Anti Inflammatory Drugs - Naproxen Enteric Coated

Generic Name

naproxen                                                                               
 

Strength

250 mg, 375 mg, 500 mg
 

Form

enteric-coated tablet
 

 

Criteria

Approval Period

1. Diagnosis of rheumatoid or psoriatic arthritis, ankylosing spondylitis, gout or lupus.

OR

2. Treatment failure on optimal dose of, or intolerance to, at least one of the following: ASA-enteric coated, ibuprofen, or naproxen regular release.

Indefinite

Practitioner Exemptions

Practitioners in the following specialty are not required to submit a Special Authority request form for coverage:

  • Paediatrics
  • Paediatric Cardiology
  • Paediatric General Surgery
  • Physical Medicine and Rehabilitation
  • Rheumatology

Special Notes

  • Full coverage for naproxen 750 mg sustained release products is provided only for individuals who have documented breakthrough symptoms while on the regular release form for a trial period at usual adult doses for at least 4 weeks. Full coverage cannot be provided for dosage convenience.

Special Authority Request Form(s)