Limited coverage criteria – dienogest

Last updated on March 5, 2025

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Generic name	dienogest
Strength & form	2 mg tablet

Special Authority criteria	Approval period
For the management of pelvic pain associated with endometriosis for patients who have failed or who are unable to use combined hormonal contraceptives	Indefinite

Practitioner exemptions

None

Special notes

None

Special Authority request form(s)

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HLTH 5328 – General Special Authority request (PDF, 656KB)

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The B.C. Public Service acknowledges the territories of First Nations around B.C. and is grateful to carry out our work on these lands. We acknowledge the rights, interests, priorities, and concerns of all Indigenous Peoples - First Nations, Métis, and Inuit - respecting and acknowledging their distinct cultures, histories, rights, laws, and governments.

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Limited coverage criteria – dienogest

Generic name

Strength & form

Special Authority criteria

Approval period

Practitioner exemptions

Special notes

Special Authority request form(s)