Limited Coverage Drugs – tazarotene topical

Last updated on April 9, 2024

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Limited coverage criteria – tazarotene topical
Generic name		tazarotene topical
Strength & form		0.045% topical lotion

Special Authority criteria	Approval period
For the topical treatment of acne vulgaris in patients 10 years of age and older	Indefinite

Practitioner exemptions

None

Special notes

None

Special Authority requests

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HLTH 5328 — General Special Authority request (PDF, 656KB)

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Limited Coverage Drugs – tazarotene topical

Limited coverage criteria – tazarotene topical

Generic name

tazarotene topical

Strength & form

Special Authority criteria

Approval period

Practitioner exemptions

Special notes

Special Authority requests