Limited Coverage Drugs - Hydromorphone Injection
|
Generic Name |
hydromorphone |
|---|---|
|
Strength |
50 mg/mL |
|
Form |
injection |
|
Special Authority Criteria |
Approval Period |
|---|---|
|
Relief of severe pain in patients who require subcutaneously, intravenously or intramuscularly administered opioids in doses or concentrations higher than those usually needed. |
1 year |
Practitioner Exemptions
- No practitioner exemptions.
Special Notes
- Hydromorphone 10 mg/mL and 20 mg/mL are available as regular benefits on the PharmaCare formulary for the indication of severe pain only.
- Hydromorphone 50 mg/mL is a benefit for the treatment of severe pain under Plans B and P.
