Limited coverage criteria – pamidronate

Last updated on April 15, 2025

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Generic name	pamidronate
Strength & form	30 mg/10 mL, 60 mg/10 mL, 90 mg/10 mL vial

Special Authority criteria	Approval period
Diagnosis indicating bone metastases associated with cancer (except breast cancer)	1 year

Practitioner exemptions

None

Special notes

None

Special Authority request form(s)

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HLTH 5328 – General Special Authority request (PDF, 656KB)

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Limited coverage criteria – pamidronate

Generic name

Strength & form

Special Authority criteria

Approval period

Practitioner exemptions

Special notes

Special Authority request form(s)