Close Window
Aetna
Aetna Aetna
Pharmacy Clinical Policy Bulletins
Aetna Non-Medicare Prescription Drug Plan
Subject: Analgesics, Narcotics and Narcotic Combinations

Status Drug PR PR-QL PR-AL ST M EX‡
Short Acting
P butorphanol ns   X      
P fentanyl transmucosal lozenge X X      
P hydromorphone          
P levorphanol          
P meperidine          
P morphine sulfate tab/soln          
P oxycodone          
P oxymorphone          
P tramadol          
P Nucynta™  (tapentadol)   X   X X
NP Demerol®  (meperidine)          
NP Dilaudid®  (hydromorphone)          
NP Roxicodone®  (oxycodone)          
FE Abstral®  (fentanyl citrate sublingual tab) X X   X X
FE Actiq®  (fentanyl transmucosal lozenge) X X     X
FE Fentora®  (fentanyl citrate buccal tab) X X     X
FE Lazanda®  (fentanyl nasal spray) X X   X X
FE Onsolis™  (fentanyl buccal soluble film) X X     X
FE Opana®  (oxymorphone HCl)       X X
FE Oxecta™  (oxycodone)         X
FE Rybix®  (tramadol)         X
FE Subsys™  (fentanyl sublingual spray) X X   X X
FE Ultram®  (tramadol)         X
Long Acting
P fentanyl patches   X      
P methadone   X      
P methadose   X      
P morphine sr tab 12hr   X      
P morphine sr cap 24hr   X      
P oxycodone hcl tab sr 12hr   X      
P oxymorphone er   X      
P tramadol er   X      
P Butrans™  (buprenorphine TD patch weekly)   X      
P Embeda™  (morphine/naltrexone)   X      
P Nucynta ER®  (tapentadol extended release)   X      
P Opana ER®  (oxymorphone er)   X      
P OxyContin CR®  (oxycodone hcl tab sr 12hr)   X      
NP Dolophine®  (methadone)   X      
NP MS Contin®  (morphine sr tab 12hr)   X      
FE Avinza®  (morphine beads sr cap 24hr)   X   X X
FE ConZip™  (tramadol er)   X     X
FE Duragesic®  (fentanyl transdermal)   X   X X
FE Exalgo®  (hydromorphone extended release)   X   X X
FE Kadian CR®  (morphine sr cap 24hr)   X   X X
FE Ryzolt™  (tramadol sr)   X     X
FE Ultram ER®  (tramadol sr)   X     X
Combinations
P acetaminophen /butalbital/ caffeine          
P acetaminophen/codeine          
P aspirin/butalbital/caffeine          
P butalbital/caffeine/codeine/ASA          
P dihydrocodeine combination          
P hydrocodone/acetaminophen          
P hydrocodone/ibuprofen          
P meperidine/promethazine          
P oxycodone/acetaminophen          
P oxycodone/aspirin          
P oxycodone/ibuprofen   X      
P pentazocine/acetaminophen          
P pentazocine/naloxone          
P tramadol/apap          
P vicodin hp (hydrocodone/apap)          
NP Anexsia®  (hydrocodone/APAP)          
NP Capital/Codeine®  (codeine/APAP)          
NP Fioricet/Codeine®  (butalbital/ APAP/caffeine/codeine)          
NP Fiorinal/Codeine®  (butalbital/ aspirin/caffeine/codeine)          
NP Hycet™  (hydrocodone-acetaminophen)          
NP Liquicet®  (Hydrocodone-Acetaminophen)          
NP Lorcet/Lorcet HD/Lorcet Plus ®  (hydrocodone/APAP))          
NP Lortab/Lortab elixir®  (hydrocodone/APAP)          
NP Norco®  (hydrocodone/APAP)          
NP Panlor SS/DC  (acetaminophen-caff-dihydrocod)          
NP Percocet®  (oxycodone/apap)          
NP Percodan®  (oxycodone/aspirin)          
NP Reprexain®  (hydrocodone/ ibuprofen)          
NP Roxicet®  (oxycodone/ acetaminophen)          
NP Synalgos DC®  (dihydrocodeine compound)          
NP Tylenol #3®  (codeine/APAP)          
NP Tylox®  (oxycodone/APAP)          
NP Vicodin/Vicodin ES/Vicodin HP®  (hydrocodone/APAP)          
NP Vicoprofen®  (hydrocodone/ ibuprofen)          
NP Xodol®  (hydrocodone/APAP)          
FE Alagesic LQ  (butalbital/APAP/caffeine)         X
FE Bupap  (butalbital/ acetaminophen)         X
FE Cocet  (codeine/APAP)         X
FE Cocet Plus®  (codeine/APAP)         X
FE Ibudone ®  (hydrocodone-ibuprofen tab)         X
FE Magnacet™  (oxycodone w/ Acetaminophen)         X
FE Maxidone®  (hydrocodone/ acetaminophen)         X
FE Orbivan®  (butalbital-acetaminophen-caffeine)         X
FE Percocet®  (oxycodone/ acetaminophen)         X
FE Roxicet 5/500®  (oxycodone/ acetaminophen)         X
FE Ultracet®  (tramadol/APAP)         X
FE Xolox®  (oxycodone/acetaminophen)         X
FE Zolvit™  (hydrocodone-acetaminophen)         X
FE Zydone®  (hydrocodone/APAP)         X
Note: Criteria for Migraine medications are discussed in the Pharmacy Clinical Policy Bulletin: Click Here 


Policy:

Additional Review Criteria for Opioids:

Under some plans including plans that use an open or closed formulary, Aetna applies  a more focused and targeted clinical review on predetermined designated drugs, groups of drugs or therapeutic classes being prescribed and used for specific  indications or in combination with other agents, to ensure appropriate use and safety based on FDA approved labeling, nationally recognized guidelines and accepted clinical compendia.

Aetna applies the above to the following drugs below when being used with the drug(s) listed:

For ALL Narcotic, Narcotic combination analgesics and Narcotic containing cough suppressants:

  • Documented concurrent therapy with Suboxone, Subutex or buprenorphine sublingual
  • Documented current diagnosis of opioid dependency or detox

Additional Review Criteria Medical Exception:

Aetna requires the drug(s) below when being used with the drug(s) listed be clinically reviewed and determined medically necessary for those members who meet the following criteria:

For ALL Narcotic, Narcotic combination analgesics and Narcotic containing cough suppressants documented with concurrent therapy with Suboxone, Subutex or buprenorphine sublingual:

• Documented Peer to Peer communication of the Suboxone, Subutex or buprenorphine sublingual prescriber with the Aetna designated review Pharmacist.

  1. Precertification Criteria
  2. Under some plans, including plans that use an open or closed formulary, Abstral, Actiq, Avinza, butorphanol ns, Butrans, ConZip, Duragesic, Embeda, Exalgo, fentanyl patch, fentanyl transmucosal lozenge, Fentora, Kadian CR, Lazanda, methadone, methadose, morphine sr tab 12hr, morphine sr cap 24hr, MS Contin,  Nucynta, Nucynta ER, Onsolis, Opana ER, oxycodone/ibu, oxycodone hcl tab sr 12hr, OxyContin CR, Ryzolt, Subsys, tramadol er and Ultram ER are subject to precertification. If precertification requirements apply, Aetna considers these to be medically necessary for those members who meet the following precertification criteria:

    For Abstral, Actiq, fentanyl transmucosal lozenge, Fentora, Lazanda,Onsolis, Subsys 

    • A documented diagnosis of cancer AND concomitant use of long acting opioid therapy* OR
    • Member's resident state or contract state is California and the member is terminally ill

    According to the manufacturer and/or clinical literature, Abstral, Actiq, Avinza, butorphanol ns, Butrans, ConZip, Duragesic, Embeda, Exalgo, fentanyl patch, fentanyl transmucosal lozenge Fentora, Kadian CR, Lazanda, methadone, methadose, morphine sr tab 12hr, morphine sr cap 24hr, MS Contin, Nucynta, Nucynta ER, Onsolis, Opana ER, oxycodone/ibu, oxycodone hcl tab sr 12hr OxyContin CR, Ryzolt, Subsys, tramadol er and Ultram ER can be dosed as indicated in the table below. A quantity of each drug will be considered medically necessary as indicated in the table below

    Drug Maximum Daily Dose Dosage Strength Quantity Limits Quantity Limits for Fully Insured PPO/Self-Insured PPO
    fentanyl transmucosal lozenge(lpop); Actiq 1 lpop four times daily 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, 1600 mcg Up to 15 lpop in 30 days**

    Up to 120 lpop in 30 days

    fentanyl patch; Duragesic 1-2 patches every 72 hours 12.5 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr, 100 mcg/hr Up to 20 patches in 30 days (2 patches per 3 days)
    Abstral 4 sublingual tablets 4 times daily 100 mcg, 200 mcg, 300 mcg, 400 mcg, 600 mcg, 800 mcg Up to 15 tablets in 30 days**

    Up to 120 tablets in 30 days

    Avinza 2 capsules daily 30 mg, 45 mg, 60 mg, 75 mg, 90 mg, 120 mg Up to 60 capsules in 30 days
    Butrans patch 20 mcg/hour; Every 7 days 5, 10, 15, and 20 mcg /hour Up to 4 patches in 30 days
    ConZip 2 capsules daily 100mg, 200mg, 300mg Up to 60 capsules in 30 days
    Dolophine; methadone; methadose; 2 tablets three times daily 5 mg, 10 mg Up to 180 tablets in 30 days
    methadone solution/concentraion 10 mg three times daily daily 5 mg/5 ml, 10 mg/5 ml, 10 mg /1 ml Up to 1800 mg in 30 days
    Embeda 1 capsule once or twice daily 20-0.8 mg 30-1.2 mg 50-2 mg 60-2.4 mg 80-3.2 mg 100-4 mg Up to 60 capsules in 30 days
    Exalgo 2 tablets daily 8 mg, 12 mg, 16 mg, 32mg Up to 60 tablets in 30 days
    Fentora 1 buccal tablet four times daily 100 mcg, 200 mcg, 300 mcg, 400 mcg, 600 mcg, 800 mcg Up to 15 buccal tablets in 30 days**

    Up to 120 buccal tablets in 30 days

    Kadian CR; morphine sr cap 24hr 2 capsules once daily; 1 capsule twice daily 10 mg, 20 mg, 30 mg, 50 mg, 60 mg, 80 mg, 100 mg, 200 mg Up to 60 capsules in 30 days
    Lazanda 4 doses per 24 hours 100 mcg; 400 mcg Up to 4 bottles for 30 days

    Up to 30 bottles per 30 days

    MS Contin; morphine sr tab 12hr 2 tablets twice daily 15 mg, 30 mg, 60 mg, 100 mg, 200 mg Up to 120 tablets for 30 days
    Nucynta 1 tablet every 4-6 hrs 50 mg, 75 mg, 100 mg Up to 180 tablets in 30 days
    Nucynta ER 1 tablets every 12 hours 50 mg; 100 mg; 150 mg; 200 mg; 250 mg Up to 60 tablets in 30 days
    Opana ER; oxymorphone er 2 tablets every 12 hours 5 mg, 10 mg, 15 mg, 20 mg, 30 mg, 40 mg Up to 120 tablets in 30 days
    Onsolis 1 buccal film four times daily 200 mcg; 400 mcg; 600 mcg; 800 mcg; 1200 mcg Up to 15 buccal films in 30 days**

    Up to 120 buccal films in 30 days

    oxycodone hcl tab sr 12hr; OxyContin CR 2 tablets every 12 hrs 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg Up to 120 tablets in 30 days
    oxycodone/ibuprofen 1 tablet four times daily 5 mg/ 400 mg Up to 28 tablets in 30 days
    butorphanol 2-3 times daily Nasal solution 10 mg/ml Up to 2 bottles in 30 days
    Subsys 1 spray per every 4 hours (maximum 4 doses /24 hours) 100mcg; 200mcg; 400mcg; 600mcg; 800mcg; 1200 mcg; 1600 mcg Up to 15 units in 30 days

    Up to 120 units in 30 days

    Ryzolt; tramadol er 2 tablets daily 100mg, 200mg, 300mg Up to 60 tablets in 30 days
    tramadol hcl er cap 2 capsules daily 150 mg Up to 60 capsules in 30 days
    Ultram ER; tramadol er 2 tablets daily 100mg, 200mg, 300mg Up to 60 tablets in 30 days


    For coverage of additional quantities, member's treating physician must request prior authorization through the Aetna Pharmacy Management Precertification Unit.  Additional quantities of the above medications will be considered medically necessary for those members who meet the following criterion:    

    • A Documented diagnosis of cancer and prescription is written by an  oncologist or pain specialist OR 
    • Member is enrolled in a hospice program or meets hospice criteria OR
    • Member's resident state or contract state is California and the member is terminally ill OR
    • Patient has signed opioid agreement in support of clinical guidelines by the American Pain Society and the American Academy of Pain Medicine    
      (Note: ALL additional quantities above what is allowed in the chart above require that a Patient have a signed opioid agreement in support of clinical guidelines by the American Pain Society and the American Academy of Pain Medicine (note: bullets below have examples of these agreements as reference)
      Healthcare Provider verbal confirmation that an agreement has been signed by the patient meets the criteria requirement.
      *Exceptions to requiring the signed opioid agreement for additional quantities above what are in the chart above are only for those patients that have a diagnosis of cancer or that are enrolled in a hospice program)   

    AND   
    Documentation of one of the following:

    • If the request is for Avinza, Butrans, Dolophine, Embeda, Exalgo, Kadian CR,  methadone, methadose, morphine sr tab 12hr, morphine sr cap 24hr, MS Contin, Nucynta, Opana ER, oxycodone/ibuprofen, oxymorphone er, Ryzolt, tramadol er, and Ultram ER

    • A documented  diagnosis of moderate to severe chronic pain
      AND
    •  formal pain evaluation has been documented
      AND
    • Other pain management regimens have been inadequate

    • If request is for oxycodone hcl tab sr 12hr, OxyContin CR, Nucynta ER

    • A documented  diagnosis of moderate to severe chronic pain
      AND
    • Other pain management regimens have been inadequate
      AND
      • Documentation of failed dosing every 12 hours along with a prescription for immediate-release (IR) medication
        OR
      • Member's physician provides documentation (controlled clinical trial) from the peer-reviewed medical literature for use of a more frequent dosing interval
        OR
      • Member requires a dose every 12 hours(BID) and the total daily dose is <320mg, AND the member has prior history of dose titration increasing incrementally (oxycodone 12 hr products only)

    • If request is for Duragesic or fentanyl patch

    • Member has failed an every-72-hours regimen and requires dosing every 48 hours  OR
    • Member requires a regimen of Duragesic with more than one patch every 72 hours

    • If request is for fentanyl transmucosal lozenge(lpop), Abstral, Actiq,  Fentora, Lazanda, Onsolis, or Subsys

    • Member has current diagnosis of cancer(*see exception to opioid agreement above) as the primary cause of the pain and is currently on long-acting opioid and  is being titrated on the long-acting opioid by physician
      AND
    • Member has tried and failed an adequate trial of two weeks of a single entity or combination pain medication containing an immediate release acting opioid (ex. oxycodone, morphine sulfate oral(Roxanol); oxymorphone(Opana); hydromorphone(Dilaudid); oxycodone/apap(Percocet))

      NOTE: Diffuse to pharmacist for further review. Pharmacist approval for titration is based on member information and education of provider. Requests for additional quantities beyond pharmacist approval will be directed to the appeals process

    • If request is for ConZip 

    • Member may receive up to 75 capsules/30 days of  ConZip 100mg for initial titration

    • If request is for butorphanol ns 

    • Documented diagnosis of migraine AND member is receiving prophylactic* migraine therapy (approve up to 2 times the set qty limit) OR
    • Documented diagnosis of migraine AND member is being treated by a headache clinic, neurologist, or specialist(approve up to 2 times the set qty limit) OR
    • Documented diagnosis of cluster headaches AND member is being treated by a headache clinic, neurologist, or specialist (approve up to 3 times the set qty limit for indefinite period of time)


  3. Step Therapy Criteria
  4. Under some plans, including plans that use an open or closed formulary, Abstral, Avinza, Duragesic, Exalgo,Kadian CR,  Lazanda, Nucynta, Opana and Subsys are subject to step-therapy.  Aetna considers these drugs to be medically necessary for those members who meet the following step-therapy criterion:

     

    For Duragesic

    A documented trial of two days of the preferred generic fentanyl patch

     

    For Exalgo 
    A documented trial of two days of the preferred generic morphine sr cap 24hr
     

    For Abstral, Lazanda and Subsys

    A documented trial of one week of the preferred generic fentanyl transmucosal lozenge

     

    For Avinza and Kadian CR
    A documented trial of two days of the preferred generic morphine sr cap 24hr

    For Nucynta and Opana
    A documented trial of two days of a single entity or combination form of a preferred generic immediate release oxycodone or morphine


    If it is medically necessary for a member to be treated initially with a medication subject to step-therapy, the member, a person appointed to manage the member’s care, or the member's treating physician may contact the Aetna Pharmacy Management Precertification Unit to request coverage as a medical exception at 1-800-414-2386. (See criteria under section III below).


  5. Medical Exception Criteria
  6. Nucynta is currently listed on the Aetna Formulary Step-Therapy list.* Therefore, Nucynta is excluded from coverage for members enrolled in prescription drug benefit plans that require step-therapy criteria, unless a medical exception is granted.  Aetna considers this drug to be medically necessary for those members who meet the criteria specified below:

    Abstral, Avinza, Duragesic, Exalgo, Kadian CR, Lazanda, Opana, and Subsys are currently listed on the Aetna Formulary Exclusions and Step-Therapy lists.* Therefore, they are excluded from coverage for members enrolled in prescription drug benefit plans that use a closed formulary or that require step-therapy criteria, unless a medical exception is granted.  Aetna considers these drugs to be medically necessary for those members who meet the criteria specified below:

    Actiq, Alagesic LQ, Bupap, Cocet, Cocet Plus, ConZip, Fentora, Ibudone, Magnacet, Maxidone, Orbivan, Onsolis, Oxecta, Percocet, Roxicet 5/500, Rybix, Ryzolt, Ultracet, Ultram, Ultram ER, Xolox, Zolvit, and Zydone are currently listed on the Aetna Formulary Exclusions List.* Therefore, these drugs are excluded from coverage for members enrolled in prescription drug benefit plans that use a closed formulary, unless a medical exception is granted.  Aetna considers these drugs to be medically necessary for those members who meet the criteria specified below:

    For Alagesic LQ, Bupap, Cocet, Cocet Plus, Ibudone, Magnacet, Maxidone,  Orbivan, Oxecta, Percocet, Roxicet 5/500, Ultracet, Xolox, Zolvit, and Zydone

    • A documented contraindication or intolerance or allergy or failure of an adequate clinical trial of two days of a preferred generic alternative

    For Avinza and Kadian CR

    • A documented contraindication or intolerance or allergy or failure of an adequate clinical trial of two days of the preferred generic morphine sr cap 24hr

    For Exalgo

    • A documented contraindication or intolerance or allergy or failure of an adequate clinical trial of two days of the preferred generic morphine sr cap 24hr.

    For Nucynta and Opana

    • A documented contraindication or intolerance or allergy or failure of an adequate clinical trial of two days of a preferred generic immediate release oxycodone or morphine alternative

    For Duragesic

    • A documented contraindication or intolerance or allergy or failure of an adequate clinical trial of two days of the preferred generic fentanyl patch

    For ConZip, Rybix, Ryzolt, Ultram and Ultram ER

    • A documented contraindication or intolerance or allergy or failure of an adequate clinical trial of two days of a preferred generic tramadol/er alternative

    For Abstral, Actiq, Fentora, Lazanda, Onsolis and Subsys

    • A documented diagnosis of cancer AND concomitant use of long acting opioid therapy* OR
    • Member's resident state or contract state is California and the member is terminally ill

    AND 

    • A documented contraindication or intolerance or allergy or failure of an adequate trial of one week of the preferred generic fentanyl transmucosal lozenge

Special Notes:

Medical literature does not support the concurrent use of narcotics, narcotic analgesic combinations, narcotic containing cough suppressants, tramadol, and tramadol combination products for patients taking Suboxone/Subutex/buprenorphine as part of opioid drug dependence treatment.  All ONGOING use of narcotic, narcotic combinations analgesics, narcotic containing cough suppressants, tramadol and  tramadol combination products will NOT be covered with documented concurrent  therapy with Suboxone, Subutex or buprenorphine sublingual.  A Pharmacist will  review emergency situations on a case by case basis.

*Examples of Long acting opioid therapy
  controlled-release morphine (MS Contin, Oramorph SR, Kadian CR)
  extended-release morphine (Avinza)
  controlled-release oxycodone (Oxycontin CR)
  extended-release oxymorphone (Opana ER)
  fentanyl transdermal (Duragesic)
  methadone (Dolophine, Methadose)

Approximate Equianalgesic Dosing of Opioid Analgesics in Adults, please click here. 

For Migraine Prophylactic meds, please click here. 



Place of Service:

Outpatient

The above policy is based on the following references:

1. AHFS Drug Information® with AHFSfirstReleases®. ( www.statref.com), American Society Of Health-System Pharmacists®, Bethesda, MD. Updated periodically.
2. DRUGDEX® System [Internet database]. Greenwood Village, Colo: Thomson Micromedex. Updated periodically.
3. Drug Facts and Comparisons on-line. (www.drugfacts.com), Wolters Kluwer Health, St. Louis, MO. Updated periodically.
4. PDR® Electronic Library™ [Internet database]. Greenwood Village, Colo: Thomson Micromedex. Updated periodically.
5. Clinical Pharmacology [Internet database]. Gold Standard Inc. Tampa, FL. Updated periodically.
6. Caldwell JR, Rapoport RJ, Davis JC, et al. Efficacy and safety of a once-daily morphine formulation in chronic, moderate-to-severe osteoarthritis pain: results from a randomized, placebo-controlled, double-blind trial and an open label extension trial. J Pain Symptom Management 2002;23:278-91.
7. Portenoy RK, Sciberras A, Eliot L, et al. Steady-state pharmacokinetic comparison of a new, extended-release, once-daily morphine formulation, Avinza, and a twice-daily controlled-release morphine formulation in patients with chronic moderate-to-severe pain. J Pain Symptom Management 2002;23:292-300. 
8. Quigley C. Hydromorphone for acute and chronic pain. Cochrone Database Syst Rev. 2002;(1):CD003447.
9. Kerr R, Tester W.  A patient preference study comparing two extended-release morphine sulfate formulations (once-daily Kadian versus twice-daily MS Contin) for cancer pain.  Clin Drug Invest 2000; 19 (1): 25-32.
10. Rischitelli DG, Karbowicz SH. Safety and efficacy of controlled-release oxycodone: A systematic literature review. Pharmacotherapy 2002;22(7):898-904.
11. National Cancer Institute. Basic Principles of Cancer Pain Management. NCI website. http://www.cancer.gov/cancertopics/pdq/supportivecare/ pain/healthprofessional/.
12. Pereira J, Lawlor P, Vigano A, et al. Equianalgesic dose ratios for opioids. a critical review and proposals for long-term dosing. J Pain Symptom Manage 2001;22:672-87.
13. Anderson R, Saiers JH, Abram S, Schlicht C. Accuracy in equianalgesic dosing conversion dilemmas. J Pain Symptom Manage 2001;21:397-406
14. OxyContin generic approved by Mallinckrodt manufacturer. CDER site accessed 9-5-08 at: http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Generics 
15. Palangio M, Morris E, Doyle RT Jr, et al. Combination hydrocodone and ibuprofen versus combination oxycodone and acetaminophen in the treatment of moderate or severe acute low back pain. Clin Ther. 2002;24(1):87-99.
16. McIlwain H, and Ahdieh H. Safety, tolerability, and effectiveness of oxymorphone ER for moderate to severe osteoarthritis pain. Amer J of Therapeutics 2005; 12: 106-112
17. Adams M and Ahdieh H. Single and multiple dose pharmacokinetic and dose-proportionality study of oxymorphone IR tablets. Drugs R D 2005; 6(2): 91-99.
18. Matsumoto A, Babul N, and Ahdlieh H. Oxymorphone ER tablets relieve moderate to severe pain and improve physical function in osteoarthritis. Pain Medicine 2005;6(5): 357-366.
19. Gimbel JS, Walker D, Ma t, and Ahdieh H.  Efficacy and safety of oxymorphone IR for the treatment of mild to moderate pain after ambulatory orthopedic surgery. Arch Phys Med Rehabil 2005; 86: 2284-2289.
20. Abramowicz M. Acetaminophen safety-déjà vu. The Medical Letter. 2009; 51:53-4, 56.
21. Kuehn BM. Patients warned about risks of drugs used for analgesia, fevers, addiction. JAMA 2009;301:2315-6.

Copyright Aetna Inc. All rights reserved. Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change.

November 8, 2013
email this page   
Aetna
Skip Past Footer Links
Company Information   |   Site Map Aetna.com Home   |   Help   |   Contact Us   |   Search
Web Privacy Statement   |   Legal Statement   |   Privacy Notices   |   Member Disclosure

Back to top