Product Details

Auro-Valganciclovir

Valganciclovir
50 mg/mL
Powder for Oral Solution
100-mL Pack

DIN/PIN/NPN

02535483

Manufacturer

Auro Pharma Inc.

Formulary Listing Date

2023-12-29  

Unit Price

150.9900

Amount MOH Pays

150.9900

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

J05AB14

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02306085 Valcyte 308.1394 150.9900
02535483 Auro-Valganciclovir 150.9900 150.9900
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
571 1 year

For those unable to swallow or tolerate solid oral dosage form AND

For the treatment of Cytomegalovirus (CMV) retinitis in patients with HIV/AIDS.

572 Up to 6 months

For those unable to swallow or tolerate solid oral dosage form AND

For the prevention of Cytomegalovirus (CMV) in solid organ transplant patients (not lung or heart-lung).

573 Up to 12 months

For those unable to swallow or tolerate solid oral dosage form AND

For the prevention of Cytomegalovirus (CMV) in lung or heart-lung transplant patients.

 

EAP Criteria

NO

Product Monograph

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