Triptorelin Extended-Release Suspension (Triptodur)
EVICORE-MEDICAL_DRUG-2575BA81
Triptodur (triptorelin ER) is covered only for the FDA‑approved treatment of central precocious puberty in pediatric patients aged ≥2 years (approval limited to females ≤11 years and males ≤12 years); off‑label uses are not covered. Approval (12 months) requires documented CPP by GnRH stimulation test or basal LH, and for initial authorization CNS abnormalities must be ruled out, bone age ≥1 year advanced, and onset of secondary sexual characteristics before age 8 (females) or 9 (males); reauthorization requires documented maintenance of LH suppression to prepubertal levels.
"Triptodur is indicated for the treatment of pediatric patients 2 years of age and older with central precocious puberty (CPP)."
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