| 430 | As adjunctive therapy in the treatment of patients with partial onset seizures who have had an inadequate response or have significant intolerance to at least 3 less costly anticonvulsant therapies; AND
Patients are under the care of a physician experienced in the treatment of epilepsy.
Note: Less costly anticonvulsant therapies may include the following:
Phenytoin, Carbamazepine, Gabapentin, Lamotrigine, Vigabatrin, Topiramate, etc. |
| | LU Authorization Period: Indefinite |
| 564 | For adjunctive therapy in the management of primary generalized tonic-clonic (PGTC) seizures in patients with epilepsy who have had an inadequate response or have significant intolerance to at least 3 less costly anticonvulsant therapies;
AND
Patients are under the care of a physician experienced in the treatment of epilepsy.
Note: Less costly anticonvulsant therapies may include the following:
Phenytoin, Carbamazepine, Gabapentin, Lamotrigine, Vigabatrin, Topiramate, etc. |
| | LU Authorization Period: Indefinite |
