Product Details

PMS-Dapagliflozin

Dapagliflozin
5 mg
Tablet


DIN/PIN/NPN

02531550

Manufacturer

Pharmascience Inc.

Formulary Listing Date

2023-07-31  

Unit Price

0.6825

Amount MOH Pays

0.6825

Coverage Status

General Benefit Chronic-Use Medication Insulin or Oral Hypoglycemic Product

ODB Formulary Therapeutic Classification

Therapeutic Note

Dapagliflozin 5 mg Tablet: Added on to metformin for patients: - Who have inadequate glycemic control on metformin and - Who have a contraindication or intolerance to a sulfonylurea or - For whom insulin is not an option. Added on to a sulfonylurea for patients: - Who have inadequate glycemic control on a sulfonylurea and - Who have a contraindication or intolerance to metformin or - For whom insulin is not an option. For the treatment of adult patients with New York Heart Association (NYHA) class II and III heart failure, as an adjunct to standard of care therapy, for the treatment of heart failure with reduced ejection fraction (HFrEF) [Left ventricular ejection fraction (LVEF less than or equal to 40%)]. Standard of care therapies include beta-blockers, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), plus a mineralocorticoid receptor antagonist.

ATC Code

A10BK01

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02435462 Forxiga 2.7300 0.6825
02527189 Apo-Dapagliflozin 0.6825 0.6825
02531402 Auro-Dapagliflozin 0.6825 0.6825
02519852 GLN-Dapagliflozin 0.6825 0.6825
02531364 Jamp Dapagliflozin 0.6825 0.6825
02535297 M-Dapagliflozin 0.6825 0.6825
02531550 PMS-Dapagliflozin 0.6825 0.6825
02518732 Sandoz Dapagliflozin 0.6825 0.6825
02538334 NRA-Dapagliflozin 0.6825 0.6825
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph