Limited coverage criteria – fluvastatin

Last updated on March 4, 2025

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Generic name	fluvastatin
Strength & form	20 mg, 40 mg, 80 mg capsule, extended-release tablet

Special Authority criteria	Approval period
Treatment failure on optimal doses of, or specified intolerance to, BOTH reference drugs: atorvastatin AND rosuvastatin.	Indefinite

Practitioner exemptions

No practitioner exemptions

Special notes

None

Special Authority request form

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HLTH 5328—General Special Authority request

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Limited coverage criteria – fluvastatin

Generic name

Strength & form

Special Authority criteria

Approval period

Practitioner exemptions

Special notes

Special Authority request form