Limited coverage drugs – rufinamide

Last updated on October 7, 2022

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Generic name		rufinamide
Strength		100 mg, 200 mg, 400 mg
Form		tablet

Special Authority criteria	Approval period
For the treatment of Lennox-Gastaut syndrome (LGS) when prescribed by a neurologist as adjunctive therapy in a patient who is currently taking at least two other anti‑epileptic drugs.	Indefinite

Special Authority criteria

Approval period

For the treatment of Lennox-Gastaut syndrome (LGS) when prescribed by a neurologist as adjunctive therapy in a patient who is currently taking at least two other anti‑epileptic drugs.

Indefinite

Practitioner exemptions

None

Special notes

None

Special Authority requests

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HLTH 5328 Special Authority request form (PDF, 523KB)

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Limited coverage drugs – rufinamide

Practitioner exemptions

Special notes

Special Authority requests