Limited coverage drugs – zoledronic acid
Last updated on October 20, 2022
|
Generic name |
zoledronic acid |
|---|---|
|
Strength |
5 mg / 100 ml |
| Form | intravenous solution |
|
Special Authority criteria |
Approval period |
|---|---|
|
For women with postmenopausal osteoporosis or men with osteoporosis AND a clinical or radiographically documented fracture due to osteoporosis AND contraindication to oral bisphosphonates due to abnormalities of the esophagus that delay esophageal emptying (e.g., stricture or achalasia). |
Indefinite |
Practitioner exemptions
- None
Special notes
- The Special Authority request must include details about the patient’s contraindication to oral bisphosphonates.
- Clinical fracture is a symptomatic (painful) fracture.
- Radiographically documented fracture is a fracture identified by x-ray (e.g., vertebral compression fracture). This may be asymptomatic.
Special Authority requests