Product Details

Auro-Silodosin

Silodosin
4 mg
Capsule


DIN/PIN/NPN

02478501

Manufacturer

Auro Pharma Inc.

Formulary Listing Date

2022-04-29  

Unit Price

0.4742

Amount MOH Pays

0.4742

Coverage Status

Limited Use Product Chronic-Use Medication

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

G04CA04

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02475421 Sandoz Silodosin 0.4742 0.4742
02361663 Rapaflo NA NA
02478501 Auro-Silodosin 0.4742 0.4742
02517779 PMS-Silodosin 0.4742 0.4742
02539519 Jamp Silodosin 0.4742 0.4742
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
351 Indefinite

For the management of benign prostatic hyperplasia where six weeks of treatment with other formulary alpha blockers (e.g., doxazosin, terazosin, tamsulosin) have been ineffective

352 Indefinite

For the management of benign prostatic hyperplasia where other formulary alpha blockers (e.g., doxazosin, terazosin, tamsulosin) have produced intolerable side effects.

 

EAP Criteria

NO

Product Monograph

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