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i Texas Vendor Drug Program
Drug Use Criteria:
Hydrocodone Bitartrate/
Hydrocodone Polistirex
Publication History
1.
Developed:
April 1994
2.
Revised: November 2017;
December 2016; October
2014; February 2013;
June 2011; January 2009; March 2003; April 2002; March 2001; March
2000; February 1999; February 1998; March 1997; September 1995.
Notes: Information on indications for use or diagnosis is assumed to be unavailable.
All criteria may
be applied retrospectively; prospective application is indicated with
an asterisk [*]. The information contained is for the convenience of the public. The
Texas Health and Human Services Commission is not responsible for any errors in
transmission or any
errors or omissions in the document.
Medications listed in the tables and non
-FDA approved indications included in these
retrospective criteria are not indicative of Vendor Drug Program formulary
coverage.
Prepa
red by:
Drug Information Service, UT Health
San Antonio.
The College of Pharmacy,
the University of Texas at Austin.
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