Histamine 2 blocker drugs – cimetidine
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|
Generic name |
cimetidine |
|---|---|
|
Strength |
200 mg, 300 mg |
|
Form |
tablet |
|
Special Authority criteria |
Approval period |
|---|---|
|
Treatment failure on prescription dose of, or intolerance to, ranitidine |
Indefinite |
Practitioner exemptions
Practitioners in the following specialty are not required to submit a Special Authority request form for coverage:
- Pediatrics
- Pediatric cardiology
- Pediatric general surgery
Special notes
- Prescription dose of ranitidine for adults is considered to be 150 mg twice daily or 300 mg once daily
