Product Details
Jamp Linezolid
Linezolid600 mg
Tablet
DIN/PIN/NPN
02520354
Manufacturer
Jamp Pharma Corporation
Formulary Listing Date
2023-01-31
Unit Price
19.3041
Amount MOH Pays
19.3041
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
J01XX08
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02243684 | Zyvoxam | NA | NA |
| 02422689 | Sandoz Linezolid | 19.3041 | 19.3041 |
| 02426552 | Apo-Linezolid | 19.3041 | 19.3041 |
| 02520354 | Jamp Linezolid | 19.3041 | 19.3041 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 362 | 1 year | For the treatment of patients with: Methicillin-resistant Staphylococcus species (MRSA, MRSE) infections* in patients who are intolerant or have failed vancomycin therapy, or have contraindications to venous access. *Infections must be documented and culture proven. Not approved for colonization (e.g. nares, urine, etc). Maximum 28 days supply. |
| 363 | 1 year | For the treatment of patients with: Vancomycin resistant Enterococcus species (VRE) infections* in patients switching from IV linezolid. *Infections must be documented and culture proven. Not approved for colonization (e.g., nares, urine, etc.). Maximum 28 days supply. |
| 364 | 1 year | Step-down therapy for the treatment of methicillin-resistant Staphylococcus species or vancomycin resistant Enterococcus species (VRE) infections* after parenteral therapy or hospital/ emergency department discharge. *Infections must be documented and culture proven. Not approved for colonization (e.g. nares, urine, etc). Maximum 28 days supply. |
EAP Criteria
| Therapeutic Class | Reimbursement Criteria |
|---|---|
| Unclassified EAP Drugs | These drugs are not currently listed in the Exceptional Access Program Reimbursement Criteria for Frequently Requested Drugs – August 8, 2023 Edition Physicians may wish to contact the EAP directly by phone at 416-327-8109 or 1-866-811-9893 or by email at EAPFeedback.MOH@ontario.ca to see if an unlisted drug product and/or indication may be considered for EAP funding. |