Product Details
Wyost (Preservative Free)
Denosumab120 mg/1.7 mL
Solution for Subcutaneous Injection
Single-Use Vial Pack
DIN/PIN/NPN
02545764
Manufacturer
Sandoz Canada Inc.
Formulary Listing Date
2024-08-30
Unit Price
312.0000
Amount MOH Pays
312.0000
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
M05BX04
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 686 | 1 year | For the treatment of bony metastases for patients with hormone refractory prostate cancer as determined by an elevated PSA level, or evidence of progressive bony disease, despite castrate serum testosterone levels (less than 1.7nmol/L or less than 50ng/dL) or having undergone orchidectomy. Dose: 120mg SC every 4 weeks |