Limited Use Note(s)

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LEVODOPA & CARBIDOPA100mg & 25mg CR Tab
Reason For Use CodeClinical 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