Limited coverage drugs – dipyridamole-acetylsalicylic acid

Last updated on October 7, 2022

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Generic name	dipyridamole-acetylsalicylic acid
Strength	dipyridamole + acetylsalicylic acid combination 200/25 mg (there is 200 mg of dipyridamole and 25 mg of ASA)
Form	tablet

Special Authority criteria	Approval period
For secondary prevention of cerebrovascular occlusion and embolization in patients who have experienced recurrent TIA or stroke while receiving ASA alone.	Indefinite

Practitioner exemptions

None

Special notes

None

Special Authority request form(s)

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5328 - General Special Authority Request (PDF, 656KB)

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Limited coverage drugs – dipyridamole-acetylsalicylic acid

Practitioner exemptions

Special notes

Special Authority request form(s)