Product Details
Sandoz Guanfacine XR
Guanfacine2 mg
ER Tablet
DIN/PIN/NPN
02563193
Manufacturer
Sandoz Canada Inc.
Formulary Listing Date
2026-05-29
Unit Price
0.9353
Amount MOH Pays
0.9353
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02409119 | Intuniv XR | 3.7413 | 0.9353 |
| 02523736 | Apo-Guanfacine XR | 0.9353 | 0.9353 |
| 02523566 | Jamp Guanfacine XR | 0.9353 | 0.9353 |
| 02563193 | Sandoz Guanfacine XR | 0.9353 | 0.9353 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 540 | 1 year | For the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in patients aged 6 to 17 years who meet the following criteria: (i) As adjunctive therapy to psychostimulants; OR (ii) As monotherapy in patients who have significant intolerance to psychostimulants AND who have had an inadequate response to either atomoxetine or other non-stimulant alternative(s). |
Requirements