Product Details

Elmiron

Pentosan Polysulfate Sodium
100 mg
Capsule


DIN/PIN/NPN

02029448

Manufacturer

Janssen 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

C05BA04

Interchangeable Products

NO  

LU Clinical Criteria

NO  

EAP Criteria

Therapeutic Class Reimbursement Criteria
Unclassified EAP Drugs

These drugs are not currently listed in the Exceptional Access Program Reimbursement Criteria for Frequently Requested Drugs – August 8, 2023 Edition

Physicians may wish to contact the EAP directly by phone at 416-327-8109 or 1-866-811-9893 or by email at EAPFeedback.MOH@ontario.ca to see if an unlisted drug product and/or indication may be considered for EAP funding.

Product Monograph

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