Limited coverage criteria – benazepril

Generic name	benazepril
Strength & form	5 mg, 10 mg, 20 mg tablet

Special Authority criteria	Approval period
Treatment failure on optimal doses of, or intolerance to, ramipril OR Complex patient requiring medication(s) for co-existing chronic condition(s)	Indefinite

Practitioner exemptions

• Practitioners in the following specialty are not required to submit a Special Authority request form for coverage:
  • Pediatrics
  • Pediatric cardiology

Special notes

• Patients with co-existing chronic condition(s) requiring use of multiple medications will be considered complex for the purposes of Special Authority criteria

Special Authority request form

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