CAMBIA (diclofenac)

CAMBIA (diclofenac) 

SELF ADMINISTRATION - Oral

Indications for Prior Authorization:

• Acute treatment of migraine attacks with or without aura in adults (18 years of age or older).
• Limitations of use:
  • Cambia® is not indicated for the prophylactic therapy of migraine.
  • The safety and effectiveness of Cambia® have not been established for cluster headache, which is present in an older, predominantly male population.

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

• Used for the acute treatment of migraine attacks, AND
• Patient is 18 years of age or older, AND
• Chart note documentation is provided and confirms: patient has tried and failed two preferred generic prescription strength oral NSAIDs (nonsteroidal antiinflammatory drugs), one of the two must be generic Diclofenac OR there is a medically appropriate reason why generic alternatives cannot be tried

Dosing:

• Empty the contents of one packet (50 mg) into a cup containing 1 to 2 ounces or 2 to 4 tablespoons (30 to 60 mL) of water, mix well and drink immediately.  Do not use with liquids other than water.
• The safety and effectiveness of a second dose have not been established.