Limited coverage drugs – tiaprofenic acid

Generic name	tiaprofenic acid
Strength	200 mg, 300 mg
Form	tablet

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, all of the following: ibuprofen, naproxen, diclofenac AND either celecoxib or meloxicam	Indefinite

Practitioner exemptions

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

• 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. Treatment failure on or intolerance to the following NSAIDs is not sufficient: ketorolac, mefenamic acid, diclofenac potassium, naproxen sodium.

Special Authority requests

• Log in to eForms
• 5328 - General Special Authority Request form (PDF, 656KB)