Limited coverage drugs – varenicline

Generic name	varenicline
Strength	0.5 mg, 1 mg, 0.5 (11)-1
Form	tablet

Special Authority criteria	Approval period
Smoking cessation for patients who want to stop smoking or using other tobacco products	12 weeks within a calendar year—no Special Authority required

Practitioner exemptions

• No Special Authority required when prescribed under the Smoking Cessation Program. See details below.

Special notes

For smoking cessation

• When prescribed under the Smoking Cessation Program, no Special Authority request is required.
• Maximum amount covered per calendar year: One 12-week (84-day) course of varenicline or Zyban®
• Prescription must indicate "dispense in 28-day supply".

Special Authority requests

• Not applicable