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DrugZohydro (extended-release hydrocodone) [Zogenix]

June 2014

Therapeutic Area - Long-Acting Opioid Analgesics

Approval criteria

  • Patient has a diagnosis of chronic pain AND
  • Provider is a physician certified in Pain Management AND
  • Provider attests that the Prescription Monitoring Program has been reviewed and provides date of review AND
  • Patient tried morphine ER and found to be intolerant to morphine ER AND
  • Patient has tried and failed oxycodone ER AND
  • Patient has tried and failed fentanyl AND
  • Patient has tried and failed hydromorphone ER AND
  • Patient has tried and failed oxymorphone ER AND
  • Provider has submitted a patient specific pain management plan  AND
  • Patient and Provider documented in the pain management plan that the patient will abstain from alcohol

Intolerance to morphine defined as

  • Patient has renal insufficiency
  • Patient has a true morphine allergy (as manifested by skin rash, facial swelling, or difficulty breathing)
  • Patient develops morphine-related itching
  • Patient cannot tolerate the nausea and vomiting of morphine 


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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