Limited Use Note(s)

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Reason For Use CodeClinical Criteria
371For the prophylaxis (max: 75mg daily) of institutionalized individuals during confirmed* outbreaks of Influenza A or Influenza B.
NOTE: Network will limit supply to 6 weeks.
*The outbreak must be confirmed by Public Health.
LU Authorization Period: 1 year
372For the treatment (max: 75mg bid) of institutionalized individuals during confirmed* outbreaks due to: Influenza B or, Influenza A (as an alternative to amantadine) or, Influenza A where new cases have developed despite amantadine prophylaxis.
NOTE: Network will limit supply to 5 days.
*The outbreak must be confirmed by Public Health.
LU Authorization Period: 1 year
639For treatment of individuals during the 2023-2024 influenza season who are at high risk* of complications from influenza infection and have either: 1. Laboratory-confirmed influenza A or influenza B infection; OR 2. Illness consistent with influenza A or influenza B infection *High risk of complications from influenza infection is defined by the presence of one or more of the following medical conditions, age-related factors, or other characteristics: - Asthma and other chronic pulmonary diseases, including bronchopulmonary dysplasia, cystic fibrosis, chronic bronchitis, and emphysema - Cardiovascular disease (excluding isolated hypertension), including congenital and acquired heart disease, such as heart failure and symptomatic coronary artery disease - Renal disease - Chronic liver disease - Diabetes mellitus and other metabolic diseases - Anemia and hemoglobinopathies, such as sickle cell disease - Cancer, immunosuppression, or immunodeficiency due to disease (e.g., HIV infection, especially if CD4 is less than 200 per microlitre) or management of underlying conditions (e.g., solid organ transplant or hematopoietic stem cell transplant recipients, those receiving immunosuppressive therapies for autoimmune conditions or other disorders) - Neurological disease and neurodevelopmental disorders that compromise handling of respiratory secretions (cognitive dysfunction; spinal cord injury; neuromuscular, neurovascular, neurodegenerative, and seizure disorders; cerebral palsy; metabolic disorders) - Children aged younger than 5 years - Individuals aged 65 years or older - Individuals of any age who are residents of nursing homes or other chronic care facilities - Pregnancy and up to 4 weeks postpartum regardless of how the pregnancy ended - Obesity with a body mass index (BMI) greater than or equal to 40 or a BMI greater than 3 z-scores above the mean for age and gender - Children and adolescents aged younger than 18 years undergoing treatment for long periods with acetylsalicylic acid - Indigenous peoples Maximum dosage: 75mg twice daily for 5 days Treatment should be initiated as soon as possible (ideally no more than 48 hours) after onset of symptoms to achieve optimal benefits.
LU Authorization Period: 6 Months
NOTE: Prescribers and dispensers should be informed of the drug product's official indications as set out in Health Canada's approved product monograph. Aspects of the above funding criteria may differ from the official indications in the product monograph. Where there is a difference between the product monograph and the above reimbursement criteria, the criteria govern for the purpose of the drug product's funding under the Ontario Drug Benefit Program. The reimbursement criteria are intended for information purposes only and do not provide any medical diagnosis, symptom assessment, health counselling, or medical opinion for Ontario Drug Benefit Program recipients. This information also does not constitute medical advice for prescribers or dispensers.