Limited Use Note(s) |
|
QUINAGOLIDE HCL0.15mg Tab
| Reason For Use Code | Clinical Criteria |
|---|---|
| 405 | For the treatment of hyperprolactinemia in patients who have: * Failed to respond to a greater than or equal to 3 month trial of bromocriptine; or * Failed to tolerate bromocriptine; or * Failed to shrink a prolactinoma by greater than 1 cm after 12 months of bromocriptine therapy |
| LU Authorization Period: 5 years. |