Product Details

Hydroxychloroquine

Hydroxychloroquine Sulfate
200 mg
Tablet

DIN/PIN/NPN

02519348

Manufacturer

Sanis Health Inc.

Formulary Listing Date

2022-07-29

Unit Price

0.1576

Amount MOH Pays

0.1576

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

08:20:00 Plasmodicides (Antimalarials)

Therapeutic Note

NO

ATC Code

P01BA02

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02017709	Plaquenil	0.6516	0.1576
02424991	Mint-Hydroxychloroquine	0.1576	0.1576
02491427	Jamp-Hydroxychloroquine	0.1576	0.1576
02246691	Apo-Hydroxyquine	0.1576	0.1576
02519348	Hydroxychloroquine	0.1576	0.1576
02511886	NRA-Hydroxychloroquine	0.1576	0.1576

LU Clinical Criteria

NO

EAP Criteria

NO

Product Monograph

View Monograph