Psychiatric Medications Plan (Plan G)

Requesting Plan G Coverage for Your Patient

To request Plan G coverage, an individual and their prescriber must complete an Application for PharmaCare Plan G (PDF) (HLTH 3497).

Physicians and nurse practitioners can apply for Plan G on behalf  of eligible patients by completing the application and faxing it to the local Mental Health and Substance Use Centre (PDF), Child and Youth Mental Health Services Centre (PDF), or mental health contact at the local health authority.

Plan G Drugs that Require Special Authority Approval

For a list of Plan G drugs that require Special Authority approval, please see the Special Authority Drug List. Plan G drugs are indicated as "LCD—Psychiatric Medications Plan" in the Special Authority Category column.

Plan G Regular Benefits

The table below lists Plan G regular benefits. PharmaCare fully or partially covers these benefits.

Important Notes

  • PharmaCare Plan G may not cover all available formulations and strengths of the drugs listed below.
    • examples of drug formulation include tablet, capsule, liquid, and injection
    • examples of drug strength include 5 mg and 10 mg/ml
  • If PharmaCare covers a generic version of a drug, PharmaCare generally covers only part of the cost of the brand product. Some generic versions may not be covered under the Low Cost Alternative Program.
  • This list is intended as a general reference only of the products covered by Plan G. It may not reflect the most recent changes to the formulary.
  • PharmaCare formularies are not a replacement for professional medical judgment and advice.

Generic Drug Name

Brand Drug Name

alprazolam

Xanax ®

amantadine

Symmetrel ®

amitriptyline

Elavil ®

amitriptyline hydrochloride

PMS-Amitriptyline

atenolol

Tenormin ®

benztropine

Bensylate ®

bromazepam

Lectopam ®

bromocriptine

Parlodel ®

buprenorphine/naloxone

Suboxone ®

busiprone

Buspar ®

carbamazepine

Tegretol ®

chloral hydrate

Noctec ®

chlordiazepoxide

Librium ®

chlorpromazine

Largactil ®

citalopram

Celexa ®

clomipramine

Anafranil ®

clonazepam

Rivotril ®

clonidine

Catapres ®

clonidine

Dixarit ®

clorazepate

Tranxene ®

clozapine

Clozaril ®

desipramine

Norpramin ®

dextroamphetamine

Dexedrine ®

diazepam

Valium ®

diazepam

Vivol ®

diphenhydramine injection

diphenhydramine injection USP

disulfiram

Antabuse ®

divalproex

Epival ®

doxepin

Sinequan ®

droperidol

Inapsine ®

escitalopram

Cipralex ®

fluoxetine

FXT 40 ®

fluoxetine

Prozac ®

flupenthixol

Fluanxol ®

flupenthixol decanoate

Fluanxol Depot ®

fluphenazine

Moditen ®

fluphenazine decanoate

Modecate Concentrate ®

fluphenazine decanoate

Modecate Injection ®

flurazepam

Dalmane ®

fluvoxamine

Luvox ®

imipramine

Impril ®

imipramine

Tofranil ®

lamotrigine

Lamictal®

levodopa / carbidopa combination tablet

Sinemet ®

levothyroxine

Eltroxin ®

levothyroxine

Synthroid ®

liothyronine

Cytomel ®

lithium carbonate

Carbolith ®

lithium carbonate

Duralith ®

lithium carbonate

Lithane ®

lorazepam

Ativan ®

loxapine

Loxapac ®

maprotiline

Ludiomil ®

methadone

Methadose™, Metadol-D®

methotrimeprazine

Nozinan ®

methylphenidate

Ritalin ®

mirtazapine

Remeron ®

moclobemide

Manerix ®

morphine (24-hour slow-release)

Kadian ®

nitrazapam

Mogadon ®

nortriptyline

Aventyl ®

oxazepam

Serax ®

paliperidone

Invega ®

paroxetine

Paxil ®

pericyazine

Neuleptil ®

perphenazine

Trilafon ®

phenelzine

Nardil ®

pimozide

Orap ®

pindolol

Visken ®

pipotiazine

Piportil-L4 Injection ®

procyclidine

Kemadrin ®

propranolol

Inderal ®

quetiapine

Seroquel ®

risperidone

Risperdal ®

sertraline

Zoloft ®

temazepam

Restoril ®

tetrabenazine

Nitoman ®

thiothixene

Navane ®

tranylcypromine

Parnate ®

trazodone

Desyrel ®

triazolam

Halcion ®

trifluoperazine

Stelazine ®

trihexyphenidyl

Artane ®

trimipramine

Surmontil ®

tryptophan

Tryptan ®

valproic acid

Depakene ®

venlafaxine

Effexor ®

yohimbine

Yocan ®

zuclopenthixol

Clopixol ®