Limited Coverage Drugs – celecoxib

Generic Name

celecoxib

Strength

100 mg, 200 mg

Form

capsule

Special Authority Criteria

Approval Period

For the treatment of patients who have a:

  • Diagnosis of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout or lupus

OR

  • Treatment failure on optimal doses of, or intolerance to, both ibuprofen and naproxen.

Indefinite

Practitioner Exemptions

  • Paediatrics
  • Paediatric cardiology
  • Paediatric general surgery
  • Physical medicine and rehabilitation
  • Rheumatology

Special Notes

  • Treatment failure on or intolerance to the specific medications listed in the above criteria is required.

Special Authority Request Form(s)