Limited Use Note(s) |
|
INDACATEROL ACETATE & GLYCOPYRRONIUM BROMIDE & MOMETASONE FUROATE150mcg & 50mcg & 160mcg Inh Pd-Cap
| Reason For Use Code | Clinical Criteria |
|---|---|
| 627 | For the treatment of asthma in adult patients inadequately controlled with a maintenance combination of a long-acting beta-2 agonist (LABA) and a medium or high dose of an inhaled corticosteroid (ICS), who experienced one or more asthma exacerbations in the previous 12 months. |
| LU Authorization Period: Indefinite |