Limited Use Note(s) |
|
DENOSUMAB120mg/1.7mL Inj Sol-Vial Pk
| Reason For Use Code | Clinical Criteria |
|---|---|
| 686 | For the treatment of bony metastases for patients with hormone refractory prostate cancer as determined by an elevated PSA level, or evidence of progressive bony disease, despite castrate serum testosterone levels (less than 1.7nmol/L or less than 50ng/dL) or having undergone orchidectomy. Dose: 120mg SC every 4 weeks |
| LU Authorization Period: 1 year |