Limited coverage drugs – cariprazine

Last updated on March 26, 2025

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Generic name		cariprazine
Strength & form		1.5 mg, 3 mg, 4.5 mg, 6 mg oral capsule

Special Authority criteria	Approval period
For the management of schizophrenia in adult patients with treatment failure or intolerance to at least one anti-psychotic agent	Indefinite

Practitioner exemptions

None

Special notes

Details of anti-psychotic agent(s) previously tried must be documented in the Special Authority request form
Criteria applicable to all plans including Plan G

Special Authority request form(s)

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HLTH 5328 – General Special Authority request (PDF, 656KB)

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Limited coverage drugs – cariprazine

Generic name

Strength & form

Special Authority criteria

Approval period

Practitioner exemptions

Special notes

Special Authority request form(s)