Zohydro
Drug - Zohydro (extended-release hydrocodone) [Zogenix]
June 2014
Therapeutic Area - Long-Acting Opioid Analgesics
Approval criteria
- Patient has a diagnosis of chronic pain AND
- Provider is a physician certified in Pain Management AND
- Provider attests that the Prescription Monitoring Program has been reviewed and provides date of review AND
- Patient tried morphine ER and found to be intolerant to morphine ER AND
- Patient has tried and failed oxycodone ER AND
- Patient has tried and failed fentanyl AND
- Patient has tried and failed hydromorphone ER AND
- Patient has tried and failed oxymorphone ER AND
- Provider has submitted a patient specific pain management plan AND
- Patient and Provider documented in the pain management plan that the patient will abstain from alcohol
Intolerance to morphine defined as
- Patient has renal insufficiency
- Patient has a true morphine allergy (as manifested by skin rash, facial swelling, or difficulty breathing)
- Patient develops morphine-related itching
- Patient cannot tolerate the nausea and vomiting of morphine
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411