ZORVOLEX (diclofenac)

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