Product Details
PDP-Amlodipine
Amlodipine1 mg/mL
Oral Solution
DIN/PIN/NPN
02484706
Manufacturer
Pendopharm, Division of Pharmascience Inc.
Formulary Listing Date
2023-04-28
Unit Price
1.1667
Amount MOH Pays
1.1667
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
C08CA01
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 645 | 1 year | For patients unable to swallow or tolerate oral solid dosage forms of amlodipine. |
| 706 | 1 year | For pediatric patients (less than 18 years of age) where the appropriate dose cannot be achieved using a listed solid oral dosage form of amlodipine. |