Product Details

Bimatoprost RC

Bimatoprost
0.01%
Ophthalmic Solution
5-mL Pack

DIN/PIN/NPN

02529580

Manufacturer

Juno Pharmaceuticals Corp.

Formulary Listing Date

2026-05-29  

Unit Price

30.0945

Amount MOH Pays

30.0945

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

S01EE03

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
09857368 Lumigan RC 60.1892 30.0945
02529580 Bimatoprost RC 30.0945 30.0945
02565773 Jamp Bimatoprost Solution RC 30.0945 30.0945
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
171 Indefinite

As first line treatment of elevated intraocular pressure in patients who cannot tolerate an ophthalmic beta-blocking agent or where beta-blocking agents are contraindicated

172 Indefinite

As second line monotherapy or combination therapy in patients who do not have an adequate intraocular pressure lowering response to ophthalmic beta-blocking agents

387 Indefinite

For use as adjunctive therapy with an ophthalmic beta-blocking agent in an urgent situation (e.g., patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective

 

Requirements


EAP Criteria

  NO

Product Monograph

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