Limited coverage drugs – indapamide
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|
Generic Name / Strength / Form |
|
|---|---|
| indapamide |
|
Criteria |
Approval period |
|---|---|
|
Treatment failure or intolerance to a thiazide diuretic. |
Indefinite |
Practitioner exemptions
- No practitioner exemptions
Special notes
- None
Special Authority request form(s)
- Log in to eForms
- Online Form (PDF, 524KB)
