Limited coverage drugs – pramipexole

Last updated on October 6, 2022

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Generic name		pramipexole
Strength		0.25 mg, 1.0 mg, 1.5 mg
Form		tablet

Special Authority criteria	Approval period
For the treatment of idiopathic Parkinson's disease, when the patient is receiving treatment with levodopa and requires additional adjunctive therapy OR the patient cannot tolerate or has contraindications to levodopa	Indefinite

Special Authority criteria

Approval period

For the treatment of idiopathic Parkinson's disease, when

the patient is receiving treatment with levodopa and requires additional adjunctive therapy
OR
the patient cannot tolerate or has contraindications to levodopa

Indefinite

Practitioner exemptions

None

Special notes

Pramipexole for restless leg syndrome is not eligible for PharmaCare coverage
Pramipexole 0.5 mg tablet is not a PharmaCare benefit

Special Authority requests

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HLTH 5328: Special Authority request (PDF, 656KB)

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Limited coverage drugs – pramipexole

Practitioner exemptions

Special notes

Special Authority requests