Limited coverage criteria – salmeterol

Last updated on March 21, 2025

Special Authority requests can now be submitted online. It's simple and quick!

Generic name		salmeterol
Strength & form		50 mcg dry powder for oral inhalation

Special Authority criteria	Approval period
Diagnosis of asthma AND inadequate response on optimal dose of inhaled corticosteroid	Indefinite
Diagnosis of chronic obstructive pulmonary disease (COPD) defined where a spirometry measure is: Post-bronchodilator fixed ratio of forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) < 0.70 AND Contraindication or intolerance to a long-acting muscarinic receptor antagonist (LAMA)	Indefinite

Special Authority criteria

Approval period

Diagnosis of asthma AND inadequate response on optimal dose of inhaled corticosteroid

Indefinite

Diagnosis of chronic obstructive pulmonary disease (COPD) defined where a spirometry measure is:

Post-bronchodilator fixed ratio of forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) < 0.70

AND

Contraindication or intolerance to a long-acting muscarinic receptor antagonist (LAMA)

Indefinite

Practitioner exemptions

The following practitioners are not required to submit a Special Authority request form for coverage:

Respirologists for asthma and COPD
Allergists for asthma

Special notes

In remote areas where spirometry access is limited, spirometry measurements are to be provided within 6 months

Special Authority request form(s)

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