Limited coverage criteria – ondansetron

Last updated on May 16, 2025

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Generic name	ondansetron
Strength & form	4 mg, 8 mg oral disintegrating film 4 mg, 8 mg rapid dissolve tablet 4 mg, 8 mg tablet 2 mg/mL vial 4 mg/5 mL solution

Special Authority criteria	Approval period
Prevention and treatment of nausea and vomiting associated with chemotherapy	Initial: 6 months Renewal: 6 months

Special Authority criteria

Approval period

Prevention and treatment of nausea and vomiting associated with chemotherapy

Initial: 6 months

Renewal: 6 months

Practitioner exemptions

Oncologist (medical)
Oncologist (radiation)

Special notes

None

Special Authority request form(s)

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

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