OZURDEX (dexamethasone intravitreal implant)
OFFICE ADMINISTRATION - Sterile Environment / Aseptic Technique
Indications for Prior Authorization:
- Macular edema following branch vein occlusion
- Macular edema following central retinal vein occlusion
- Non-infectious uveitis
- Diabetic macular edema
The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:
- Any other diagnosis not listed in the approved indications
Dosing:
- Ozurdex implant 0.7 mg intravitreal implant x 1 every 6 months as needed
Monitoring:
- Elevation in intraocular pressure
Last review date: July 21, 2016