Product Details
Sumatriptan Injection, USP
Sumatriptan Succinate6 mg/0.5 mL
Solution for Injection
0.5-mL Prefilled Syringe Pack
DIN/PIN/NPN
02532387
Manufacturer
Dr. Reddy's Laboratories Inc.
Formulary Listing Date
2026-09-29
Unit Price
42.4650
Amount MOH Pays
42.4650
Coverage Status
Off-Formulary Interchangeable Exceptional Access Program Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N02CC01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02361698 | Taro-Sumatriptan | 42.4650 | 42.4650 |
| 02212188 | Imitrex | 55.3600 | 42.4650 |
| 02532387 | Sumatriptan Injection, USP | 42.4650 | 42.4650 |
LU Clinical Criteria
NORequirements