Special Authority drug list

Last updated on November 5, 2024

Related pages: About Special Authority | Limited coverage drugs |​ SA request forms by condition | SA eForms 

Click the limited coverage drug name to see Special Authority criteria and form(s). Prescribers can submit requests online using an SA eForm.

An asterisk (*) indicates drugs eligible for automatic approval (only through eForms)

Generic drug name Brand drug name
abatacept for polyarticular juvenile idiopathic arthritis Orencia®
abatacept for rheumatoid arthritis Orencia®
abobotulinumtoxinA Dysport Therapeutic™
abrocitinib Cibinqo™
acetaminophen 500 mg* Tylenol 500 mg®
aclidinium Tudorza™ Genuair™
aclidinium-formoterol Duaklir™ Genuair®
adalimumab Abrilada™, Amgevita®, Hadlima®, Hulio®, Hyrimoz®, Idacio®, Simlandi™, Yuflyma®
adalimumab for non-infectious uveitis Abrilada™, Amgevita®, Hadlima®, Hulio®, Hyrimoz®, Idacio®, Simlandi™, Yuflyma®
alemtuzumab Lemtrada®
alendronate 10/70 mg — regular benefit as of August 29, 2024 Fosamax® 10 mg / 70 mg
alendronate with vitamin D 10/70 mg — regular benefit as of August 29, 2024 Fosavance® 70 mg / 5600 IU
alitretinoin Toctino®
ambrisentan Volibris®
amifampridine Ruzurgi®
amifampridine phosphate Firdapse®
amlodipine oral solution Pendopharm
aprepitant Emend®
aripiprazole — (Plan G) Abilify®
aripiprazole monohydrate — (Plan G) Abilify Maintena®
asenapine — (Plan G) Saphris™
atomoxetine — (Plan G) Strattera®
aztreonam Cayston™
baclofen intrathecal Lioresal® Intrathecal
benazepril  —  (RDP - ACE Inhibitor Drugs) Lotensin®
benzydamine Tantum®
benralizumab Fasenra®
bimekizumab Bimzelx®
bosentan Tracleer®
botulinum neurotoxin type A, free from complexing proteins, also known as incobotulinumtoxinA Xeomin®
botulinum neurotoxin type A, with complexing proteins, also known as onabotulinumtoxinA Botox®
brexpiprazole — (Plan G) Rexulti®
brivaracetam Brivlera®
budesonide capsules Entocort Capsules®
budesonide enema Entocort Enema®
budesonide-formoterol Symbicort®
budesonide in combination with glycopyrronium and formoterol Breztri Aerosphere™ 
budesonide nebules Pulmicort®
bupropion — (Plan G)* Wellbutrin® SR and XL, Zyban®
candesartan* Atacand®, Atacand Plus®
captopril — (RDP - ACE Inhibitor Drugs) Capoten®
carvedilol* Coreg®
celecoxib* Celebrex®
certolizumab for ankylosing spondylitis Cimzia®
certolizumab for psoriatic arthritis Cimzia®
certolizumab for rheumatoid arthritis Cimzia®
chlorambucil Leukeran®
chloroquine Aralen®
ciclopirox 1% Loprox®
cilazapril with/without HCTZ (RDP - ACE Inhibitor Drugs) Inhibace®, Inhibace Plus®
cimetidine - prescription strength (RDP - H2 Blocker Drugs) Tagamet®
ciprofloxacin ophthalmic Ciloxan®
cladribine Mavenclad®
clioquinol topical Locacorten Vioform, Vioform Hydrocortisone
clobazam — (Plan G) Frisium®
clotrimazole Canesten Topical®
codeine sustained release Codeine Contin®
continuous glucose monitor* Dexcom G6®G7®
cyclosporine Neoral®
cyproterone — (Plan G) Androcur®
cysteamine ophthalmic solution Cystadrops®
dabigatran* Pradaxa®
dalteparin Fragmin®
deferasirox Exjade®
deferiprone Ferriprox®
denosumab Jubbonti
desmopressin oral DDAVP Tablets®, DDAVP Melt®
dextroamphetamine-amphetamine — (Plan G) Adderall XR®
diclofenac IR/SR Voltaren®, Arthrotec®
diclofenac IR with misoprostol Arthrotec®
dienogest Visanne®
diflunisal Dolobid®
dimethyl fumarate Tecfidera™
diphenoxylate HCI-atropine sulfate Lomotil®
dipyridamole-acetylsalicylic acid Aggrenox® 
donepezil — (Plan G)* Aricept®
dorzolamide-timolol preservative free Cosopt non-preserved®
dronedarone Multaq®
duloxetine generics
dupilumab (for ages 6 years to 11 years) Dupixent®
dupilumab (for ages 12 and up) Dupixent®
dutasteride* Avodart®
edaravone (intravenous solution, oral suspension) Radicava® , Radicava ORS®
empagliflozin and empagliflozin-metformin* Jardiance®, Synjardy®
enalapril without HCTZ (RDP - ACE Inhibitor Drugs) Vasotec®
enalapril with HCTZ (RDP - ACE Inhibitor Druugs) Vasotec Plus®
enoxaparin Inclunox®, Inclunox® HP, Noromby®, Noromby® HP, Redesca®, Redesca® HP,  Elonox®, Elonox® HP
entacapone and entacapone/levodopa/carbidopa combination Comtan®, Stalevo®
entecavir Baraclude®
epoprostenol Caripul®, Flolan®
eprosartan with/without HCTZ (RDP - ARB Drugs and LCD) Teventen®, Teveten Plus®
eptinezumab Vyepti®
eslicarbazepine acetate Aptiom™
esomeprazole — (RDP - PPI Drugs and LCD) Nexium®
estradiol patches Climara®, Estalis®, Estalis-Sequi®, Estracomb®, Estraderm®, Estradot®, Oesclim®, Vivelle®
estradiol transdermal gel Divigel®, Estrogel®
etanercept Brenzys®, Erelzi®, Rymti®
evolocumab Repatha™
ezetimibe Ezetrol®, generics
famotidine  —  (RDP - H2 Blocker Drugs) Pepcid®
febuxostat Uloric®
felodipine  —  (RDP - Calcium Channel Blockers) Plendil®, Renedil®
fentanyl patch — (covered under Plan G when approved for Special Authority coverage in patients at risk of harm from the toxic illicit drug supply) Duragesic®
fentanyl tablet — (Plan G) Fentora®
fidaxomicin Dificid®
filgrastim Grastofil®, Nivestym®, Nypozi™
finasteride* Proscar®
finerenone Kerendia®
fingolimod generics, Gilenya® (partial benefit)
flash glucose monitor* FreeStyle Libre 2®
fluconazole oral solids Diflucan®
flurbiprofen Ansaid®, Froben®
fluticasone furoate-umeclidinium-vilanterol Trelegy® Ellipta®
fluticasone furoate-vilanterol Breo® Ellipta®
fluticasone propionate-salmeterol Advair®
fluvastatin  —  (RDP - Statin Drugs) Lescol®
foslevodopa/foscarbidopa Vyalev™
formoterol Foradil®, Oxeze® Turbuhaler®
fosinopril  —  (RDP - ACE Inhibitor Drugs) Monopril®
fremanezumab Ajovy®
gabapentin — (Plan G) Neurontin®
galantamine — (Plan G) Reminyl®
galcanezumab Emgality®
glatiramer acetate Glatect™, Mylan-Glatiramer
glecaprevir-pibrentasvir Maviret™
gliclazide* Diamicron®
glucagon foreign label
glycopyrronium Seebri® Breezhaler®
golimumab Simponi®
goserelin Zoladex®
granisetron Kytril®
glycerol phenylbutyrate Ravicti®
glycopyrronium-indacaterol Ultibro® Breezhaler®
hydromorphone controlled release Hydromorph Contin®
hydromorphone injection Hydromorphone HP 50
hydroxyurea Hydrea®
hydroxyzine — (Plan G)* Atarax®
icatibant Firazyr®
icosapent ethyl Vascepa®
indacaterol-glycopyrronium-mometasone furoate Enerzair® Breezhaler®
indacaterol-mometasone furoate Atectura® Breezhaler®
indapamide Lozide®
indomethacin Indocid®
infliximab Avsola®, Inflectra™, Renflexis™
insulin detemir Levemir®, Levemir® FlexTouch®
insulin glargine* Basaglar®, Semglee®
insulin pumps OmniPod Insulin Management System, YpsoPump, MiniMed Insulin Pump System
interferon alfa Intron A®
interferon beta-1a Avonex®, Rebif®
interferon beta-1b Betaseron®, Extavia®
ipratropium nebules Atrovent®
ipratropium and salbutamol combination nebules Combivent® UDV
irbesartan with/without HCTZ — (RDP - ARB Drugs and LCD) Avapro®, Avalide®
iron isomaltoside Monoferric®
iron sucrose Venofer®
isavuconazole Cresemba®
itraconazole Sporanox®
ivabradine Lancora™
ixekizumab Taltz™
ketoconazole 2% cream Nizoral®
ketoprofen enteric-coated Orudis E®
ketoprofen SR Orudis®
lacosamide tablets Vimpat®
lactulose Laxilose®
lamivudine Heptovir®
lansoprazole 15 mg or 30 mg (RDP - PPI Drugs and LCD) Prevacid®
ledipasvir-sofosbuvir Harvoni™
letermovir Prevymis™
leuprolide — (Plan G) Lupron®
levetiracetam* Keppra®
levetiracetam (oral solution) pdp-levetiracetam
levodopa-carbidopa Duodopa®
linagliptin and linagliptin-metformin Trajenta™, Jentadueto™
linezolid 600 mg tablet Zyvoxam®
lisdexamfetamine — (Plan G) Vyvanse®
lisinopril with or without HCTZ  — (RDP - ACE Inhibitor Drugs) Prinivil®, Zestril®, Zestoretic®
loperamide Imodium®
losartan* Cozaar®, Hyzaar®
lovastatin — (RDP - Statin Drugs) Mevacor®
lurasidone — (Plan G) generics
luspatercept Reblozyl®
meloxicam Mobicox®
mepolizumab Nucala®
mercaptopurine Purinethol®
methotrexate pre-filled syringes PharmaScience
methylphenidate extended-release — (Plan G) Concerta®
miconazole 2% topical Micatin Cream®
miconazole topical Monistat Derm Cream®
modafinil — (Plan G) Alertec®
mometasone-formoterol Zenhale™
mometasone nasal spray Nasonex®
mycophenolate mofetil CellCept®
nabumetone Relafen®
nadroparin Fraxiparine®
naproxen enteric-coated  — (RDP - NSAIDs) Naprosyn EC®
naproxen SR  — (RDP - NSAIDs) Naprosyn®
natalizumab Tysabri®
netupitant-palonosetron Akynzeo®
nifedipine  — (RDP - Calcium Channel Blockers) Adalat®
nintedanib Ofev®
nitisinone Orfadin®
nizatidine  — (RDP - H2 Blocker Drugs) Axid®
obeticholic acid Ocaliva®
ocrelizumab Ocrevus®
ocriplasmin Jetrea®
ofloxacin ophthalmic drops Ocuflox®
olanzapine  — (Plan G) Zyprexa®, Zyprexa Zydis®
olmesartan Olmetec®, Olmetec Plus®
oseltamivir Tamiflu®
omeprazole 20 mg  — (RDP - PPI Drugs and LCD) Losec® 20 mg
ondansetron Zofran®
ozanimod Zeposia®
paliperidone palmitate injection  — (Plan G) Invenga Sustenna®, Invega Trinza®
pamidronate Aredia®
pantoprazole magnesium  — (RDP - PPI Drugs and LCD)* Tecta®
pantoprazole sodium 40 mg  — (RDP - PPI Drugs and LCD) Pantoloc® 40 mg
pentazocine Talwin®
perampanel Fycompa™
perindopril  — (RDP - ACE Inhibitor Drugs)* Coversyl®
pimecrolimus cream Elidel® Cream
pioglitazone Actos®
pirfenidone Esbriet®
piroxicam capsule Feldene®
pramipexole Mirapex®
pravastatin  — (RDP - Statin Drugs) Pravachol®
propranolol hydrochloride Hemangiol®
prostaglandin compounded injection Prostaglandin®
quinapril with HCTZ  — (RDP - ACE Inhibitor Drugs) Accuretic®
rabeprazole  — (RDP - PPI Drugs and LCD)* Pariet®
raloxifene Evista®
ribavirin  — discontinued in Canada Ibavyr™
rifaximin Zaxine®
risedronate 3 / 35 mg — regular benefit as of August 29, 2024 Actonel®
risedronate 30 mg Actonel® 30 mg
risperidone microspheres — (Plan G) Risperdal Consta®
rituximab  Truxima™, Riximyo and Ruxience
risankizumab for plaque psoriasis Skyrizi™
risankizumab for Crohn's disease Skyrizi™
rivastigmine — (Plan G) Exelon®
romosozumab Evenity™
ropinirole ReQuip®
rotigotine Neupro®
rufinamide Banzel®
ruxolitinib Jakavi®
sacubitril-valsartan Entresto
salbutamol nebules Ventolin®
salmeterol Serevent®
sapropterin Kuvan®
sarilumab Kevzara®
satralizumab Enspryng®
saxagliptin and saxagliptin-metformin Onglyza®, Komboglyze
secukinumab Cosentyx®
selexipag Uptravi®
semaglutide* Ozempic®
sildenafil Viagra®
simvastatin  — (RDP - Statin Drugs) Zocor®
siponimod Mayzent®
sodium phenylbutyrate Pheburane®
sofosbuvir Sovaldi®
sofosbuvir-velpatasvir Epclusa®
sofosbuvir-velpatasvir-voxilaprevir Vosevi™
solifenacin generics only
somatropin Genotropin®, Humatrope®, Norditriopin® Nordiflex, Norditropin® Flexpro, Nutropin AQ®, Omnitrope®, Saizen®
stiripentol Diacomit™
sulindac Clinoril®
sumatriptan injection Imitrex® Injection
tacrolimus ointment Protopic® Ointment
tadalafil 20 mg Adcirca®
tazarotene topical Arazlo®
telmisartan without HCTZ  — (RDP - ARB Drugs and LCD)* Micardis®
telmisartan with HCTZ  — (RDP - ARB Drugs and LCD)* Micardis Plus®
telmisartan + amlodipine combination  — (RDP - ARB Drugs and LCD) Twynsta®
tenofovir Viread®
tenoxicam Mobiflex®
terbinafine tablets Lamisil® tablets
teriflunomide Aubagio™
testosterone cypionate* Depo-testosterone®
testosterone enanthate* Delatestryl®
tezepelumab Tezspire
tiaprofenic acid regular release Surgam®
ticagrelor* Brilinta®
ticlopidine Ticlid®
tinzaparin Innohep®
tiotropium-olodaterol Inspiolto® Respimat®
tizanidine Zanaflex®
tobramycin Tobi®, Tobi® Podhaler®
tocilizumab for giant cell arteritis Actemra®
tocilizumab for active polyarticular juvenile idiopathic arthritis Actemra®
tocilizumab for active systemic juvenile idiopathic arthritis Actemra®
tocilizumab for rheumatoid arthritis Actemra®
tocilizumab for neuromyelitis optica spectrum disorder Actemra®
tofacitinib for rheumatoid arthritis Xeljanz®
tofacitinib for ulcerative colitis Xeljanz®
trandolapril  — (RDP - ACE Inhibitor Drugs) Mavik®
treprostinil Remodulin®
tretinoin topical Rejuva-A Cream®, Retin-A Cream®, Stieva-A Cream®, Vitamin A Acid Cream®
trientine Mar-Trientine, Waymade-Trientine
umeclidinium-vilanterol Anoro® Ellipta®
upadacitinib for Crohn's disease Rinvoq®
ustekinumab for Crohn's disease Steqeyma®, Wezlana™
ustekinumab for ulcerative colitis Wezlana™
ustekinumab for plaque psoriasis Jamteki™, Steqeyma®, Wezlana™
ustekinumab for psoriatic arthritis Jamteki™, Steqeyma®, Wezlana™
upadacitinib for atopic dermatitis Rinvoq®
valganciclovir Valcyte®
valsartan  — (RDP - ARB Drugs and LCD)* Diovan®, Diovan HCT®
vancomycin oral* Vancocin®
varenicline  — (Plan G) Champix®
vedolizumab Entyvio®
vericiguat Verquvo®
voriconazole Vfend®
vortioxetine — (Plan G) Trintellix™
zanamivir Relenza®
ziprasidone  — (Plan G) Zeldox®
zoledronic acid Aclasta™
zopiclone  — (Plan G)* Imovane®