Limited coverage drugs – dienogest

Last updated on October 24, 2022

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Generic name	dienogest
Strength	2 mg
Form	tablet

Special Authority criteria	Approval period
For the management of pelvic pain associated with endometriosis for patients who have failed or who are unable to use combined hormonal contraceptives.	Indefinite

Practitioner exemptions

None

Special notes

None

Special Authority requests

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5328 - General Special Authority Request form (PDF, 656KB)

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Limited coverage drugs – dienogest

Practitioner exemptions

Special notes

Special Authority requests