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Limited Coverage Drugs - Special Authority Criteria
| Generic Name / Strength / Form |
| entacapone |
| Criteria |
Approval Period |
| As adjunct therapy for patients with an inadequate response (defined as significant "wearing off" and/or severe motor complications i.e. fluctuations) after alterations of levodopa/carbidopa doses |
Indefinite |
Practitioner Exemptions
- No practitioner exemptions
Special Notes
Online Forms (PDF)
Click on the link to complete a special authority request form.
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Last Revised: June 21, 2006
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