Product Details
Hydromorph Contin
Hydromorphone HCl24 mg
CR Capsule
DIN/PIN/NPN
02125382
Manufacturer
Purdue Pharma
Formulary Listing Date
1998-12-31
Unit Price
4.1810
Amount MOH Pays
4.1810
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
Analgesics, Opiate Agonists (28:08:08): Narcotic analgesics can produce dependence and may be abused. Physical dependence, psychological dependence and tolerance may develop. Prescribers are cautioned about ordering these drugs for patients with a history of either emotional disturbances or drug abuse, including alcohol.
ATC Code
N02AA03
Interchangeable Products
NOLU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
High Dose Opioids – Telephone Request Service (TRS) Drugs | Effective January 31, 2017, meperidine 50mg tabs and the higher strengths of long-acting opioids including: morphine SR 200mg tabs; hydromorphone CR 24mg and 30 mg caps and fentanyl 75mcg/hr and 100mcg/hr patches were delisted from the ODB Formulary. Access to the higher strengths of long-acting opioids is currently maintained for patients requiring palliative care through the ODB program’s:
Standard Approval Duration: 12 months Renewals are considered with same criteria as above. A new consult from a PCFA-registered prescriber must be provided for each renewal. |