Triptodur (triptorelin)
EVICORE-MEDICAL_DRUG-A6A954A4
Triptodur (triptorelin ER) is covered for pediatric patients ≥2 years with central precocious puberty and for compendial off‑label use in gender‑dysphoric/gender‑incongruent individuals or those undergoing gender reassignment (other non‑compendial indications are not covered); dosing 22.5 mg IM every 24 weeks and approvals are limited to 12 months. Approval requires documentation of the diagnosis/compendial use and meeting the policy’s coverage and safety criteria, and transgender‑related use must be prescribed by or in consultation with an endocrinologist or a physician who specializes in transgender care.
"Treatment of pediatric patients 2 years of age and older with central precocious puberty (CPP)."
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