Limited coverage drugs – amlodipine oral solution

Last updated on September 27, 2024

Generic name

  amlodipine oral solution

Strength

  1 mg/ml

Form

  oral solution

Special Authority criteria

Approval period

Initial

For patients with an inability to swallow oral amlodipine tablets due to age or disability (includes J-tube or G-tube patients). Provide supporting details regarding the patient’s inability to swallow amlodipine tablets.

  1 year

Renewal

Confirmation that the patient is not able to swallow amlodipine tablets.

  1 year

Practitioner exemptions

  • None

Special notes

  • None

Special Authority request form(s)