ZORVOLEX (diclofenac)

SELF ADMINISTRATION - Oral

Indications for Prior Authorization:
  • Management of mild to moderate acute pain
  • Management of osteoarthritis pain
Patients must meet the following criteria for the indication(s) above:
  • Used for the management of mild to moderate acute pain OR osteoarthritis pain, AND
  • Chart note documentation is provided and confirms: patient has tried and failed generic Diclofenac tablets OR there is a medically appropriate reason why generic Diclofenac tablets cannot be tried
Dosing:
  • Management of mild to moderate acute pain: 18 mg OR 35 mg orally three times daily
  • Management of osteoarthritis pain: 35 mg orally three times daily

Last review date: January 15, 2019