Limited coverage drugs – estradiol

Last updated on October 24, 2022

Generic name

estradiol
Form patch, transdermal gel    

Special Authority criteria

Approval period

For indications of menopausal and post-menopausal symptoms

PLUS

extreme intolerance to oral preparations at the minimum dose required to control symptoms

OR

diagnosis of severe liver disease.

Indefinite

Practitioner exemptions

  • None

Special notes

  • The following brands will be considered for coverage: Climara®, Divigel®, Estalis®, Estalis-Sequi®, Estracomb®, Estraderm®, Estradot®, Estrogel®, Oesclim®, Vivelle®.

Special Authority requests