Limited Coverage Drugs - Dutasteride

Generic Name                            
dutasteride
 

Strength

0.5 mg

Form
 
capsule

Special Authority Criteria

Approval Period


Diagnosis of benign prostatic hyperplasia

PLUS

Treatment failure or intolerance to alpha-blocking agents.
 

Indefinite

Practitioner Exemptions

  • No practitioner exceptions.

Special Notes

  • None

Special Authority Request Form(s)