Limited coverage drugs – zoledronic acid

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

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• HLTH 5328 - General Special Authority Request (PDF, 656KB)