Purixan suspension (brand and generic) — Cigna

Preferred products

• generic mercaptopurine tablets

Initial criteria

• Patient meets ONE of the following (A or B):
• A) Patient meets BOTH of the following (i and ii):
• i. Patient has tried mercaptopurine tablets; AND
• ii. Patient cannot continue to use the Preferred medication due to a formulation difference in the inactive ingredient(s) [e.g., difference in dyes, fillers, preservatives] which, per the prescriber, would result in a significant allergy or serious adverse reaction; OR
• B) Patient cannot swallow or has difficulty swallowing tablets.

Approval duration

1 year