Limited coverage drugs – levetiracetam

Generic name

 levetiracetam
Strength 250 mg, 500 mg, 750 mg, 1000 mg
Form tablet

Special Authority criteria

Approval period

Diagnosis of epilepsy
PLUS
As adjunctive therapy in patients who are refractory to conventional therapy

Indefinite

Practitioner exemptions

  • No practitioner exemptions

Special notes

  • None

Special Authority requests