Limited Coverage Drugs - Special Authority Criteria
| Generic Name / Strength / Form |
| desmopressin oral 0.1mg, 0.2mg tablet |
| desmopressin oral 60mcg, 120mcg, 240mcg disintegrating tablet |
| Criteria |
Approval Period |
| Treatment of diabetes insipidus. |
Indefinite |
Practitioner Exemptions
- No practitioner exemptions
Special Notes
- Desmopressin oral will not be available as a benefit for the indication of nocturnal enuresis
Online Forms (PDF)
Click on the link to complete a special authority request form.
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