Limited Use Note(s) |
|
DIENOGEST2mg Tab
| Reason For Use Code | Clinical Criteria |
|---|---|
| 432 | For the management of pelvic pain associated with endometriosis in patients for whom one or more less costly options are either ineffective or cannot be used. Note: For example for patients who are refractory to 6 months of continuous combined oral contraceptives and/or medroxyprogesterone therapy OR have contraindications to these therapies. |
| LU Authorization Period: 1 year |