Methadone Tablets — CareFirst (Caremark)
Management of severe and persistent pain that requires an extended treatment period with a daily opioid analgesic and for which alternative treatment options are inadequate
Initial criteria
- Reserve for use only in patients for whom alternative analgesic treatment options (non-opioid analgesics or opioid combination products or immediate-release opioid analgesics) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain
- Not indicated as an as-needed (prn) analgesic
- For detoxification or maintenance treatment of opioid addiction, must comply with conditions for distribution and use required under 42 CFR 8.12