Tazarotene (Fabior; Tazorac)


FDA Approved Indications:

  • Fabior and Tazorac 0.1%: acne vulgaris

  • Tazorac 0.05% and 0.1%: psoriasis

Treatment NOT authorized for the following conditions/products:

  • Palliatin of fine facial wrinkles, facial mottled hyper-/hypopigmentation, benign facial lentigines
  • Avage

Prior authorization criteria:

  • Tazorac 0.05% or 0.1%: diagnosis of psoriasis OR
  • Fabior or Tazorac 0.1%: Diagnosis of acne vulgaris (supported by chart note documentation); AND
  • Failure to respond to the following (supported by chart note documentation):
    • Prescription strength topical antibiotics (e.g. clindamycin, erythromcyin). NOTE: if patient has non-inflammatory acne, prescription strength topical antibiotics are not required; AND
    • Differin OTC; AND
    • tretinoin topical
  • In addition to the criteria above, requests for brand Tazorac 0.1% gel: patients must try and fail generic tazarotene 0.1% cream


  • One Year

Last review date: February 18, 2020

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