OxyContin (oxycodone hydrochloride extended-release) — 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 in adults and opioid-tolerant pediatric patients 11 years of age and older who are already receiving and tolerate a minimum daily opioid dose of at least 20 mg oxycodone orally or its equivalent
Initial criteria
- Reserve for use only in patients for whom alternative treatment options (non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain
- Not indicated as an as-needed (prn) analgesic