Limited Coverage Drugs - Alendronate 40 mg

Generic Name

alendronate

Strength

40 mg
Form tablet

Special Authority Criteria

Approval Period

Diagnosis of Paget's disease

PLUS

an adequate trial of etidronate that has failed to reduce symptoms and/or has not reduced levels of alkaline phosphatase

Indefinite

Practitioner Exemptions

  • None

Special Notes

  • Adequate trial is defined as at least two months of etidronate therapy.

Special Authority Request Form(s)