Product Details
Banzel
Rufinamide200 mg
Tablet
DIN/PIN/NPN
02369621
Manufacturer
Eisai Limited
Formulary Listing Date
2025-01-31
Unit Price
1.9047
Amount MOH Pays
1.0083
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N03AF03
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays | 
|---|---|---|---|
| 02369621 | Banzel | 1.9047 | 1.0083 | 
| 02545985 | Auro-Rufinamide | 1.0083 | 1.0083 | 
LU Clinical Criteria
NOEAP Criteria
| Therapeutic Class | Reimbursement Criteria | 
|---|---|
| Anticonvulsants | Rufinamide
 For the treatment of seizures associated with Lennox-Gastaut Syndrome (LGS) in patients who meet the following criteria: 
 
 1If an adequate trial of lamotrigine and/or topiramate is not possible due to intolerance or contraindication, a less costly AED that is listed as a benefit on the Ontario drug benefit formulary must be tried in its place Dose: Maximum daily dose is 1,300 mg per day for patients less than 30 kg; and 3,200 mg per day for patients 30 kg or greater Exclusion Criteria: Funding will not be approved for the following circumstances: 
  |