Product Details
Vyvanse
Lisdexamfetamine Dimesylate70 mg
Capsule
DIN/PIN/NPN
02458071
Manufacturer
Takeda Canada Inc.
Formulary Listing Date
2024-07-31
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Not a Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N06BA12
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02546302 | Sandoz Lisdexamfetamine Capsules | 4.6968 | NA |
| 02545942 | Teva Lisdexamfetamine | 4.6968 | NA |
| 02458071 | Vyvanse | NA | NA |
| 02546728 | Apo-Lisdexamfetamine | 4.6968 | NA |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| Note: C.N.S. Stimulants (28:20): Stimulant medication should only be used when diagnostic criteria for narcolepsy or attention deficit disorder have been met and when stimulant medication has been demonstrated to produce clinical benefits. The use of conventional-release medication should almost always precede the use of extended-release preparations. |