Product Details
Ondansetron
Ondansetron Hydrochloride8 mg
Tablet
DIN/PIN/NPN
02541432
Manufacturer
Sivem Pharmaceuticals ULC
Formulary Listing Date
2024-05-31
Unit Price
5.1110
Amount MOH Pays
3.8840
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 |
|---|---|---|---|
| 02213575 | Zofran | 23.6170 | 3.8840 |
| 02376105 | Septa-Ondansetron | 5.1110 | 3.8840 |
| 02274329 | Sandoz Ondansetron | 5.1110 | 3.8840 |
| 02312255 | Ran-Ondansetron | 5.1110 | 3.8840 |
| 02258196 | PMS-Ondansetron | 5.1110 | 3.8840 |
| 02421410 | Ondansetron | 4.9930 | 3.8840 |
| 02417847 | Nat-Ondansetron | 5.1110 | 3.8840 |
| 02297876 | Mylan-Ondansetron | 5.1110 | 3.8840 |
| 02305267 | Mint-Ondansetron | 5.1110 | 3.8840 |
| 02371758 | Mar-Ondansetron | 5.1110 | 3.8840 |
| 02313693 | Jamp-Ondansetron | 5.1110 | 3.8840 |
| 02458802 | CCP-Ondansetron | 5.1110 | 3.8840 |
| 02288192 | Apo-Ondansetron | 5.1110 | 3.8840 |
| 02296357 | Teva-Ondansetron | 5.1110 | 3.8840 |
| 02478935 | Accel-Ondansetron | 3.8840 | 3.8840 |
| 02541432 | Ondansetron | 5.1110 | 3.8840 |
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 |