Limited Coverage Drugs - Special Authority Criteria

Generic Name / Strength / Form

risedronate 5mg & 35mg

Criteria	Approval Period
Radiographically documented fractures due to osteoporosis PLUS an adequate trial of etidronate that has failed to prevent clinically significant fractures (i.e. those that are painful, produce disability, or both)	Indefinite

Adequate trial for osteoporosis is defined as at least one year of etidronate therapy

Online Forms (PDF)
Click on the link to complete a special authority request form.