Limited coverage drugs – methotrexate pre-filled syringes

Last updated on August 23, 2024

Generic name

methotrexate sodium

Strength

pre-filled syringes: 7.5 mg/0.3mL, 10 mg/0.4 mL, 15 mg/0.6 mL, 20 mg/0.8 mL, 25 mg/mL

Form

sterile solution

Special Authority criteria

Approval period

Pre-filled syringes:

For the treatment of rheumatoid arthritis, when the patient demonstrates failure on or intolerance to oral methotrexate, and they are unable to handle or use vials.

Indefinite

Practitioner exemptions

  • None

Special notes

  • Oral methotrexate sodium and methotrexate sodium vials are regular benefits under Plan I (Fair PharmaCare) and Plans B (Permanent Residents of Licensed Residential Care Facilities), C (Income Assistance), F (Children in the At-Home Program), and W (First Nations Health Benefits).

Special Authority request form(s)