Product Details
Jamp Eplerenone
Eplerenone25 mg
Tablet
DIN/PIN/NPN
02543389
Manufacturer
Jamp Pharma Corporation
Formulary Listing Date
2024-08-30
Unit Price
1.3730
Amount MOH Pays
1.3730
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
C03DA04
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02471442 | Mint-Eplerenone | 1.3730 | 1.3730 |
02323052 | Inspra | 3.1617 | 1.3730 |
02543389 | Jamp Eplerenone | 1.3730 | 1.3730 |
LU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
458 | Indefinite | For persons suffering from New York Heart Association (NYHA) class II chronic heart failure with left ventricular systolic dysfunction (with ejection fraction less than or equal to 35 percent), as a complement to standard therapy. Note: Patients must be on optimal therapy with an angiotensin-converting-enzyme (ACE) inhibitor, an angiotensin-receptor blocker (ARB), or both and a beta-blocker (unless contraindicated) at the recommended dose or maximal tolerated dose. |
EAP Criteria
Therapeutic Class | Reimbursement Criteria |
---|---|
Cardiology Drugs | Eplerenone
For the treatment of patients who have heart failure and left ventricular systolic dysfunction due to acute myocardial infarction. Patients must have:
|