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Special Formulations

  • Millipred
  • Veripred
prednisolone oral solution (Millipred®, Veripred 20®)

PA criteria:

Veripred™ 20 (Prednisolone Sodium Phosphate Oral Solution 20mg/5mL) and Millipred™ (Prednisolone Sodium Phosphate Oral Solution 10mg/5mL) Approval Criteria:

  • Authorization of Veripred™ 20 or Millipred™ requires a patient-specific, clinically significant reason why the member cannot use a tablet or an alternative strength liquid formulation.

Prior Authorization form

Last Modified on Nov 10, 2020
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