Generic Brand HICL GCN Exception/Other

ACETAMINOPHEN/IBUPROFEN

COMBOGESIC

 

49820

 

Guidelines for Use

Our guideline named ACETAMINOPHEN/ IBUPROFEN (Combogesic) requires the following rule be met for approval:

  1. Your doctor has submitted documentation that the agents’ separate components (acetaminophen tablets and ibuprofen tablets) will not work for you

Created: 9/12/2025 1:52:39 PM


Last Modified: Monday, October 13, 2025