Product Details
Firazyr
Icatibant30 mg/3 mL
Solution for Subcutaneous Injection
Single-Use 3-mL Pre-Filled Syringe
DIN/PIN/NPN
02425696
Manufacturer
Takeda Canada Inc.
Formulary Listing Date
2015-11-05
Unit Price
2,700.0000
Amount MOH Pays
2,700.0000
Coverage Status
Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
B06AC02
Interchangeable Products
NOLU Clinical Criteria
NOEAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Blood Modifiers | Icatibant
For the treatment of acute attacks of type I or type II hereditary angioedema (HAE) in adults with lab confirmed c1-esterase inhibitor deficiency if the following conditions are met:
Notes:
Doses for acute treatment are limited to a single dose for self-administration per attack. |