Product Details
Sandoz Tacrolimus XR
Tacrolimus5 mg
ER Capsule
DIN/PIN/NPN
02528630
Manufacturer
Sandoz Canada Inc.
Formulary Listing Date
2025-12-30
Unit Price
10.6654
Amount MOH Pays
10.6654
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
L04AD02
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02296489 | Advagraf | 14.2205 | 10.6654 |
| 02528630 | Sandoz Tacrolimus XR | 10.6654 | 10.6654 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 410 | Indefinite | For prophylaxis of organ rejection in adult patients receiving allogeneic kidney transplants |
Requirements