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The Policy VaultThe Policy Vault

Xtampza ER (oxycodone 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

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