Limited coverage criteria – isavuconazole

Last updated on March 18, 2025

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Generic name		isavuconazole
Strength & form		100 mg capsules

Special Authority criteria	Approval period
For the treatment of invasive mucormycosis (IM) in adults when: Special Authority request is submitted by an infectious disease specialist AND The patient is established on isavuconazole in hospital	8 weeks

Special Authority criteria

Approval period

For the treatment of invasive mucormycosis (IM) in adults when:

Special Authority request is submitted by an infectious disease specialist

AND

The patient is established on isavuconazole in hospital

8 weeks

Practitioner exemptions

None

Special notes

Isavuconazole is not indicated and reimbursed for prophylaxis of IM
PharmaCare coverage of isavuconazole is limited to 600 mg per day for the first two days (loading doses), followed by the expectation to use 200 mg daily (maintenance dosing)

Special Authority request form(s)

Log in to eForms
HLTH 5328 – General Special Authority request (PDF, 656KB)

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