Product Details

Mint-Acyclovir

Acyclovir
800 mg
Tablet


DIN/PIN/NPN

02524724

Manufacturer

Mint Pharmaceuticals Inc.

Formulary Listing Date

2022-10-31  

Unit Price

1.2673

Amount MOH Pays

1.2673

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

J05AB01

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
01911635 Zovirax 5.0692 1.2673
02285975 Teva-Acyclovir 1.2673 1.2673
02242464 Mylan-Acyclovir 1.2673 1.2673
02207656 Apo-Acyclovir 1.2673 1.2673
02524724 Mint-Acyclovir 1.2673 1.2673
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph