Limited coverage drugs – entacapone

Last updated on October 7, 2022

Generic name

levodopa/carbidopa/entacapone

Strength

  • 50 mg/12.5 mg/200mg
  • 75 mg/18.75 mg/200mg
  • 100 mg/25 mg/200mg
  • 125 mg/31.25 mg/200mg
  • 150 mg/37.5 mg/200mg

Form

tablet

Special Authority criteria

Approval period

As adjunct therapy for patients with an inadequate response (defined as significant "wearing off" and/or severe motor complications i.e. fluctuations) after alterations of levodopa/carbidopa doses.

Indefinite

Practitioner exemptions

  • None

Special notes

  • Entacapone/levodopa/carbidopa combination tablets are eligible for coverage effective June 5, 2009

Special Authority request form(s)