Triptorelin Extended-Release Suspension (Triptodur) - Oscar
EVICORE-MEDICAL_DRUG-EA938795
Triptodur (triptorelin ER) is covered only for the FDA‑approved treatment of central precocious puberty in pediatric patients ≥2 years (coverage ceiling ≤11 years for females and ≤12 years for males); off‑label uses are not covered. Initial authorization requires confirmed CPP (pubertal response to a GnRH agonist stimulation test or elevated basal LH), CNS abnormalities ruled out, advanced bone age ≥1 year over chronological age, and onset of secondary sexual characteristics before age 8 (female) or 9 (male); reauthorization requires documented maintenance of LH suppression to prepubertal levels, and approvals are issued for 12 months.
"Triptodur indication lower age limit: pediatric patients 2 years of age and older (FDA age floor)."
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