Product Details
Baqsimi
Glucagon3 mg/Device
Nasal Powder
Single Use Nasal Dosing Device
DIN/PIN/NPN
02492415
Manufacturer
Eli Lilly Canada Inc.
Formulary Listing Date
2022-01-31
Unit Price
154.0500
Amount MOH Pays
154.0500
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
H04AA01
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 625 | 1 year | For the treatment of severe hypoglycemia (SH) reactions in patients with diabetes mellitus who are receiving insulin therapy and are at high risk for SH, when impaired consciousness precludes oral carbohydrate |