Limited Coverage Drugs - rotigotine


Generic Name		 rotigotine

Strength		 2 mg/24h, 4 mg/24h, 6 mg/24h, 8 mg/24h

Form		 transdermal patch

Special Authority Criteria		 Approval Period

For the treatment of advanced stage Parkinson’s disease, when the patient is receiving treatment with levodopa and requires additional adjunctive therapy.

Indefinite

Practitioner Exemptions

  • None

Special Notes

  • PharmaCare does not provide coverage of rotigotine for restless leg syndrome.

Special Authority Request Form