Limited Coverage Drugs – Perampanel tablets
Generic Name |
perampanel | |
Strength |
2 mg, 4 mg, 6 mg, 8 mg, 10 mg, 12 mg | |
Form | tablet |
Special Authority Criteria |
Approval Period |
For the treatment of partial-onset seizures in adults and to be used:
AND
|
Indefinite |
Practitioner Exemptions
- None
Special Notes
- Special Authority requests should include documentation stating which other anti-epileptic drugs have been tried in adequate doses. Examples of other anti-epileptic drugs include:
- phenytoin (Dilantin®)
- carbamazepine (Tegretol®)
- gabapentin (Neurontin®)
- topiramate (Topamax®)
- lamotrigine (Lamictal®)
- levetiracetam (Keppra®)
- lacosamide (Vimpat®)
- vigabatrin (Sabril®)
- eslicarbazepine acetate (Aptiom™)
- valproic acid (Epival®)