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Clinical Prior Authorization Criteria Updates for Promethazine Scheduled for December 7, 2021

Last updated on 11/24/2021

The Texas Health and Human Services Commission (HHSC) will remove the following products from the Promethazine/Promethazine Containing Products Prior Authorization Criteria Guide:

  • Promethazine VC syrup
  • Promethazine VC-codeine syrup
  • Promethazine-codeine syrup
  • Promethazine-DM syrup

This revision is necessary to ensure the appropriate prior authorization duration and age-based prescribing restrictions. The Cough and Cold Criteria Guide contains criteria for promethazine VC syrup and promethazine-DM syrup. However, Promethazine VC-codeine syrup and promethazine-codeine syrup are not included in the Cough and Cold Criteria Guide. These agents contain codeine and are not intended for patients under 18 years of age.

Additionally, the title of the clinical prior authorization criteria will change to Promethazine Agents.

HHSC requires all managed care organizations to implement the Promethazine Agents prior authorization by December 7, 2021.

Email vdp-advisory@hhsc.state.tx.us with comments or any questions.