Product Details

Vfend

Voriconazole
40 mg/mL
Powder for Oral Suspension
3-g Bottle

DIN/PIN/NPN

02279991

Manufacturer

Pfizer Canada 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

J02AC03

Interchangeable Products

NO  

LU Clinical Criteria

NO  

EAP Criteria

Therapeutic Class Reimbursement Criteria
Anti-Infectives

Voriconazole

  • Brand(s): VFend
  • Dosage Form/Strength: 50 mg, 200 mg tablets, 200 mg/vial injection

For the treatment of patients who have culture positive candidemia, due to Candida species, AND with documented resistance to fluconazole.

This will be for patients whose therapy is initiated in the hospital by a hospital physician and who require continuation of therapy when they are discharged as an outpatient. Oral tablets will be authorized for those with a properly functioning gastrointestinal (GI) tract and the parental injection will be authorized for those who do not have a properly functioning GI.

Case-by-case consideration for other indications will be provided.

Duration of Approval: 1 month

EAP Drug Request Form:

Standard Form for EAP Drug Requests

Product Monograph

View Monograph