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Special Authority Criteria – Methylphenidate Long-acting
| Generic Name / Strength / Form |
| methylphenidate long-acting |
| Criteria |
Approval Period |
For patients 6 to 18 years of age diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) who require 12 hours of continuous coverage for significant and problematic disruptive behaviour or problems with inattention that interfere with learning AND have been previously tried on one of the following with unsatisfactory results*: immediate‑ or sustained-release methylphenidate OR immediate- or sustained-release dextroamphetamine.
*See Special Notes below |
Up to the patient’s 19th birthday |
Practitioner Exemptions
- Pediatricians, child psychiatrists, and general practitioners are invited to apply for individual specialist exemption from completing SA forms. See Collaborative Prescribing Agreement (PDF 206K).
Special Notes
- Unsatisfactory results are defined as continuing symptoms of ADHD or functional impairment secondary to ADHD, while on a trial of immediate- or sustained-release ADHD medication of adequate dose and 4-week duration (specific details of dose and duration required, including justification if applicable).
- Coverage is not intended for “performance enhancement” in children or youth who do not have symptoms or functional impairment.
Special Authority Request Forms
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