fenofibrate 150 mg — Medica
hypertriglyceridemia
Preferred products
- generic fenofibrate capsules (43 mg, 67 mg, 130 mg, 134 mg, 200 mg)
- generic fenofibrate tablets (48 mg, 54 mg, 145 mg, 160 mg)
- generic fenofibric acid capsules (45 mg, 135 mg)
- generic fenofibric acid tablets (35 mg, 105 mg)
Initial criteria
- Patient has tried one Step 1 Product (generic fenofibrate capsules [43 mg, 67 mg, 130 mg, 134 mg, 200 mg], generic fenofibrate tablets [48 mg, 54 mg, 145 mg, 160 mg], generic fenofibric acid capsules [45 mg, 135 mg], or generic fenofibric acid tablets [35 mg, 105 mg])
Approval duration
1 year