Limited coverage drugs – levetiracetam

Last updated on August 22, 2024

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

This drug is eligible for automatic approval when patient meets criteria and the request is submitted through eForms

Generic name	levetiracetam
Strength	250 mg, 500 mg, 750 mg, 1000 mg
Form	tablet

Special Authority criteria	Approval period
Diagnosis of epilepsy PLUS As adjunctive therapy in patients who are refractory to conventional therapy	Indefinite

Practitioner exemptions

No practitioner exemptions

Special notes

None

Special Authority requests

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Limited coverage drugs – levetiracetam

Practitioner exemptions

Special notes

Special Authority requests