Non Steroidal Anti Inflammatory Drugs - Ketoprofen
|
Generic Name |
ketoprofen | |
| Strength | 50 mg, 100 mg, 200 mg | |
|
Form |
capsule and enteric-coated forms | |
|
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. |
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 ketoprofen 200 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.
