Limited coverage drugs – zopiclone

Last updated on September 27, 2024

Generic name

zopiclone

Special Authority criteria

Approval period

1. Treatment of insomnia PLUS diagnosis of HIV/AIDS

OR

2. Treatment of insomnia PLUS identified psychiatric diagnosis

OR

3. Treatment of insomnia PLUS patient intolerant to or failed on at least three benzodiazepines

OR

4. Treatment of insomnia PLUS patient intolerant to or failed on at least two benzodiazepines and one other hypnotic agent

OR

5. Treatment of insomnia PLUS patient with a history of drug or alcohol addiction

OR

6. Treatment of insomnia PLUS fragile, elderly patient

Indefinite

Practitioner exemptions

  • None

Special notes

  • Criteria applicable for all plans, including Plan G

Special Authority requests