Product Details
Idenos
Denosumab120 mg/1.7 mL
Solution for Subcutaneous Injection
1.7-mL Single-Use Vial (Preservative-Free)
DIN/PIN/NPN
02566273
Manufacturer
Apotex Inc.
Formulary Listing Date
2026-08-31
Unit Price
290.1600
Amount MOH Pays
290.1600
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
M05BX04
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 686 | 1 year | For the treatment of bony metastases for patients with hormone refractory prostate cancer as determined by an elevated PSA level, or evidence of progressive bony disease, despite castrate serum testosterone levels (less than 1.7nmol/L or less than 50ng/dL) or having undergone orchidectomy. Dose: 120mg SC every 4 weeks |
Requirements