Limited Coverage Drugs - Ropinirole


Generic Name
ropinirole

Strength
0.25 mg, 1 mg, 2 mg, 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

Practitioner Exemptions

  • None

Special Notes

  •  

Special Authority Request Form