Diclofenac (Flector)

SELF-ADMINISTRATION - TOPICAL

Indications for Prior Authorization:

  • Treatment of acute pain due to minor strains, sprains and contusions

Patients must meet the following criteria for the indication(s) above:

  • Diagnosis of minor strain/sprain/contusion, AND
  • 18 years or older, AND
  • Patient has tried and failed 2 preferred oral prescription NSAIDs, AND
  • Patient has tried and failed diclofenal 1% gel

Dosing:

  • Apply 1 patch twice daily to most painful area

Approval:

  • 1 month

Last review date: June 5, 2017