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If prescribed for asthma, member should also be utilizing inhaled corticosteroid therapy for long-term control.

As a general rule, maternal use of topical preparations such as creams, nasal sprays or inhalers would be expected to carry less risk to a breastfed infant than systemically administered drugs.

This is due to lower maternal concentrations and therefore lower transfer into breast milk.

Milk composition varies within and between feeds and this may also affect transfer of drugs into breast milk.

For example, milk at the end of a feed (hindmilk) contains considerably more fat than foremilk and may concentrate fat-soluble drugs.

Contraindication to all lower tiered products, or 3.

Allergic reaction to all lowered tiered products, or 4.PA criteria: Nasal allergy medications will be included in product-based prior authorization effective 4/28/08.Tier 1 products will be covered with no prior authorization necessary. Treatment failure with all lower tiered products, or 2.The infant dose (mg/kg) can then be expressed as a percentage of the maternal dose (mg/kg).An arbitrary cut-off of 10% has been selected as a guide to the safe use of drugs during lactation.If the appropriate criteria are detected, these claims will be paid with no prior authorization required.