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SKIN AND MUCOUS MEMBRANE PREPARATIONS › MISCELLANEOUS SKIN AND MUCOUS MEMBRANE AGENTS

ALITRETINOIN (Hanzema · Toctino)

10mg30mgCap
LU442
QUICK SCAN

For adult patients with severe (see note 1 below) chronic (see note 2 below) hand eczema AND unresponsive to an 8 week course of high potency topical corticosteroids.

LU Authorization Period: 1 year
Complete Ontario criteria

For adult patients with severe (see note 1 below) chronic (see note 2 below) hand eczema AND unresponsive to an 8 week course of high potency topical corticosteroids. 1. Severe defined based on the Physician Global Assessment (PGA), including: - At least one of the following cardinal features present at baseline as moderate or severe: erythema, scaling, hyperkeratosis/lichenification; and - one of the following features present as severe: vesiculation, edema, fissures, pruritus/pain; and - with an area of greater than 30% of affected hand surface 2. Chronic defined as: - persists for greater than 3 months; OR - reoccurs greater than or equal to 2 times within 12 months

Clinical verification required

Quick summaries support scanning only. Confirm eligibility against the complete Ontario criteria and current Ontario e-Formulary before billing.

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