Limited coverage drugs – febuxostat
Last updated on August 26, 2024
|
Generic name |
febuxostat |
|---|---|
|
Strength |
80 mg |
|
Form |
tablet |
|
Special Authority criteria |
Approval period |
|---|---|
|
For the reduction of serum uric acid levels in patients with gout who demonstrate immune-mediated hypersensitivity to allopurinol. |
Indefinite |
Practitioner exemptions
None
Special notes
- Details regarding a patient’s immune-mediated hypersensitivity reaction to allopurinol is required.
Special Authority request form(s)
- Log in to eForms
- HLTH 5328 - General Special Authority Request (PDF)