Limited Coverage Drugs - Testosterone cypionate

Generic Name / Strength / Form

Testosterone cypionate or enanthate or propionate injection

Criteria

Approval Period

For the treatment of testosterone deficiency in one of the following diagnoses:

  1. Hypogonadism

OR

  1. Orchiectomy

OR

  1. Undescended testes

OR

  1. Klinefelter's syndrome

OR

  1. Female-to-male (gender) transformation

OR

  1. Pituitary tumour

OR

  1. Removal of pituitary gland
Indefinite

OR

For the indication of:

  1. Surgery of pituitary gland AND where low testosterone levels have been documented

OR

  1. AIDS-wasting syndrome AND where low testosterone levels have been documented.
Indefinite

Practitioner Exemptions

  • No practitioner exemptions

Special Notes

  • For any cancer-related condition, please contact the British Columbia Cancer Agency at (604) 877-6098 ext. 4610

Forms