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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 |
Practitioner Exemptions
- No practitioner exemptions
Special Notes
- 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.
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Last Revised: June 21, 2006
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