Product Details
Val-Vancomycin
Vancomycin HCl500 mg/Vial
Powder for Solution for Injection
Single-Dose Vial Pack
DIN/PIN/NPN
02342855
Manufacturer
SteriMax Inc.
Formulary Listing Date
0000-00-00
Unit Price
Amount MOH Pays
Coverage Status
Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
J01XA01
Interchangeable Products
NOLU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Anti-Infectives | Vancomycin
Effective September 30, 2019, Vancomycin oral tablets for the treatment of Uncomplicated Clostridium difficile infection may be accessed upon meeting Limited Use Criteria on the Ontario Drug Benefit Formulary. Vancomycin Injection to be used as an oral solution for Clostridium difficile Infection may be accessed through the Telephone Request Service. Case-by-case consideration for requests not meeting the Limited Use criteria (e.g., higher doses, longer durations, tapering regimens exceeding the dosing limits under LU, complicated C. difficile Infections) may be considered through external review. Please submit requests to EAP providing adequate and relevant clinical details to support the request. EAP Drug Request Form: |