Dihydropyridine Calcium Channel Blocker Drugs - Special Authority Criteria

Generic Name / Strength / Form
nifedipine tablets

Criteria Approval Period
1. Treatment failure or intolerance to felodipine.

OR

2. Co-existing disease, e.g., diabetes, asthma or heart disease.

 Indefinite

Practitioner Exemptions

  • Nephrologists
  • Cardiologists
  • Internists specializing in cardiology

Special Notes

  • Immediate-release nifedipine capsules will only be covered by Special Authority for a person with a diagnosis of vasopastic angina (Prinzmetal angina).

Online Form (PDF)
Click on the link to complete a special authority request form.