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Migraine Pain: two(2) vials per month maximum therapy
Non-Migraine Pain: one(1) vial per month maxium therapy
Initial dose of one vial (2.5 ml) or one vial (2.5 ml)
per 30 day period does not require prior approval.
| Rational Drug Therapy
Program
West Virginia University School of Pharmacy P.O. Box 9511 Morgantown, WV 26506-9511 Phone 800 847 3859 Fax 800 531 7787 |