Skip to content
The Policy VaultThe Policy Vault

Lyrica CR (pregabalin extended-release)CareFirst (Caremark)

Neuropathic pain associated with diabetic peripheral neuropathy

Preferred products

  • gabapentin immediate-release
  • duloxetine
  • venlafaxine
  • tricyclic antidepressant

Initial criteria

  • If the request is for Lyrica (pregabalin immediate-release), and if oral solution is requested, the patient has difficulty swallowing oral solid dosage forms OR requires a dose that cannot be obtained using the commercially available capsules.
  • The patient experienced an inadequate treatment response, intolerance, or has a contraindication to gabapentin immediate-release.
  • If the request is for Lyrica CR, the patient experienced an inadequate treatment response, intolerance, or has a contraindication to TWO of the following: gabapentin immediate-release, pregabalin immediate-release, duloxetine, venlafaxine, or a tricyclic antidepressant.

Reauthorization criteria

  • The request is for Lyrica (pregabalin immediate-release) or Lyrica CR (pregabalin extended-release).
  • If the request is for Lyrica oral solution, the patient has difficulty swallowing oral solid dosage forms OR requires a dose that cannot be obtained using the commercially available capsules.
  • The patient has achieved or maintained a positive clinical response to the requested drug.

Approval duration

12 months