Limited coverage drugs – acamprosate

Generic name

  acamprosate

Strength

  333 mg 

Form

  tablet

Special Authority criteria

Approval period

For the maintenance of abstinence in patients who have been abstinent from alcohol for at least four days OR for the treatment of alcohol use disorder for patients who have contraindications to naltrexone (e.g., concurrent opioid use, acute hepatitis, or liver failure).

AND

In combination with behavioral intervention therapy (e.g., psychosocial counselling) as necessary.

  1 year

Practitioner exemptions

  • PharmaCare coverage will be provided only for a patient who meets the Limited Coverage criteria, and whose prescription is written by a prescriber who has entered into a Collaborative Prescribing Agreement - Naltrexone and Acomprosate (PDF, 119KB)
  • Due to the individual nature of each Collaborative Prescribing Agreement, the Agreement must be signed by the prescriber and not his/her delegate

Special notes

  • The above criteria is applicable for all PharmaCare coverage plans, including the Psychiatric Medications Plan (Plan G)

Special Authority request form(s)

PharmaCare coverage is only available with a valid Collaborative Prescribing Agreement - Naltrexone and Acomprosate (PDF, 119KB). Special Authority request forms are not needed and will not be accepted.