Product Details
Xcopri
Cenobamate12.5 mg & 25 mg
Tablet (Starter Kit)
DIN/PIN/NPN
02538776
Manufacturer
Endo Ventures Ltd.
Formulary Listing Date
2025-05-30
Unit Price
8.8000
Amount MOH Pays
8.8000
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N03AX25
Interchangeable Products
NOLU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
719 | Indefinite | As adjunctive therapy in the treatment of patients with partial onset seizures (POS) who have had an inadequate response or have significant intolerance to at least 2 other less costly anticonvulsant therapies (prior or current use); AND Patients are under the care of a physician experienced in the treatment of epilepsy. Note: Less costly anticonvulsant therapies may include the following: Phenytoin, Carbamazepine, Gabapentin, Lamotrigine, Vigabatrin, Topiramate, etc. |