Product Details

Ondansetron

Ondansetron Hydrochloride
4 mg
Tablet


DIN/PIN/NPN

02541424

Manufacturer

Sivem Pharmaceuticals ULC

Formulary Listing Date

2024-05-31  

Unit Price

3.3495

Amount MOH Pays

2.5450

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

A04AA01

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02213567 Zofran NA NA
02376091 Septa-Ondansetron 3.3495 2.5450
02274310 Sandoz Ondansetron 3.3495 2.5450
02258188 PMS-Ondansetron 3.3495 2.5450
02421402 Ondansetron 3.2720 2.5450
02417839 Nat-Ondansetron 3.3495 2.5450
02297868 Mylan-Ondansetron 3.3495 2.5450
02305259 Mint-Ondansetron 3.3495 2.5450
02371731 Mar-Ondansetron 3.3495 2.5450
02313685 Jamp-Ondansetron 3.3495 2.5450
02288184 Apo-Ondansetron 3.3495 2.5450
02296349 Teva-Ondansetron 3.3495 2.5450
02478927 Accel-Ondansetron 2.5450 2.5450
02541424 Ondansetron 3.3495 2.5450
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
215 1 year

For the treatment of emesis in cancer patients receiving highly emetogenic chemotherapy

216 1 year

For patients receiving intravenous chemotherapy or radiation therapy who have not experienced adequate control with other available anti-emetics

217 1 year

For patients receiving intravenous chemotherapy or radiation therapy who experience intolerable side effects with other anti-emetics

218 1 year

For the treatment of emesis in patients receiving radiation therapy which consists of single fraction treatment to the abdominal cavity, hemi-body irradiation and total body irradiation.

454 1 year

For the treatment of emesis in cancer patients receiving moderately emetogenic chemotherapy (MEC) regimens

696 1 year

For the treatment of emesis in patients receiving palliative care who are refractory to, intolerant to, or have a contraindication to at least two other anti-emetics.

Note: Pharmacists and prescribers should be informed of and stay current with a drug product's official indications in accordance with Health Canada's approved product monograph. Some aspects of the above criteria may differ from the official indications as described in the product monograph for the ondansetron product. The Executive Officer's funding of drug products is informed by advice from experts that consider evidence regarding the safety, clinical efficacy, and cost-effectiveness of drug products.

 

EAP Criteria

NO

Product Monograph

View Monograph