Limited Coverage Drugs - Formoterol

Generic Name / Strength / Form

formoterol OR formoterol in combination with budesonide

Special Authority Criteria

Approval Period

Diagnosis of asthma
inadequate response on optimal dose of inhaled corticosteroid.

Practitioner Exemptions

  • Allergists
  • Respirologists

Special Notes

  • None

Special Authority Request Form(s)

Online Forms (PDF, 523KB)
Click on the link to complete a special authority request form.