Limited Use Note(s)

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FAMCICLOVIR500mg Tab
Reason For Use CodeClinical Criteria
147Herpes zoster in patients 50 years of age or older, up to 72 hours* after appearance of lesions. Dose: 500mg 3 times/day for 7 days.
*The patient must begin treatment within the time frame specified for the product to be reimbursed. There is no benefit from the therapy begun after this time frame.
NETWORK NOTE: Network will limit supply to 7 days and 21 tablets.
LU Authorization Period: 1 year