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Non Steroidal Anti Inflammatory Drugs - Special Authority Criteria
| Generic Name / Strength / Form |
|
salsalate |
| Criteria |
Approval Period |
| 1. Diagnosis of rheumatoid or psoriatic arthritis or ankylosing spondylitis or gout or lupus.
OR
2. Treatment failure or intolerance to at least one of the following: ASA-enteric, naproxen, or ibuprofen. |
Indefinite |
Practitioner Exemptions
Special Notes
Online Form (PDF)
Click on the link to complete a special authority request form.
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Last Revised: June 21, 2006
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