Limited Use Note(s) |
|
LEVODOPA & CARBIDOPA100mg & 25mg CR Tab
| Reason For Use Code | Clinical Criteria |
|---|---|
| 64 | For patients with Parkinson's disease who have been treated with conventional therapy (Prolopa or conventional Sinemet), and experienced adverse effects related to drug level fluctuations, such as ON/OFF or wearing off phenomena. |
| LU Authorization Period: Indefinite. | |
| 65 | For patients presently requiring anti-parkinsonian drug administration (levodopa/carbidopa) more than three times daily. |
| LU Authorization Period: Indefinite. |