- Step Therapy: Opioid Induced Constipation:
ST Single Brand
- Quantity Limit: limit maximum 1 EA PER 1 day(s)
- Opioid Induced Constipation:
Failed or intolerant to increase in dietary fiber or conventional laxative therapy: No
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: Unspecified
Patient must have chronic use of opioids: No
Patient must not be using methadone: No
- Prior Authorization: Opioid Induced Constipation:
Reauthorization Required: Yes
|