Product Details
Bomyntra
Denosumab120 mg/1.7 mL
Solution for Subcutaneous Injection
1.7-mL Single-Use Prefilled Syringe (Preservative-Free)
DIN/PIN/NPN
02567687
Manufacturer
Fresenius Kabi Canada Ltd.
Formulary Listing Date
2026-10-30
Unit Price
278.5536
Amount MOH Pays
278.5536
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