Product Details

Rifabutin Capsules, USP

Rifabutin
150 mg
Capsule


DIN/PIN/NPN

09858390

Manufacturer

SteriMax Inc.

Formulary Listing Date

2026-01-30  

Unit Price

23.0000

Amount MOH Pays

23.0000

Coverage Status

Temporary Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

For the prevention of Mycobacterium Avium Intracellular (MAI) in:

  1. Patients with a CD4+ cell count less than 200/mm³ with an AIDS-defining diagnosis;
  2. Patients with a CD4+ cell count less than 100/mm³ without an AIDS-defining diagnosis.

ATC Code

J04AB04

Interchangeable Products

NO  

LU Clinical Criteria

NO  

Requirements


EAP Criteria

  NO

Product Monograph

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