Product Details

Sandoz Lacosamide

Lacosamide
200 mg
Tablet


DIN/PIN/NPN

02474700

Manufacturer

Sandoz Canada Inc.

Formulary Listing Date

2018-11-29  

Unit Price

1.4500

Amount MOH Pays

1.4500

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N03AX18

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02357658 Vimpat 5.8000 1.4500
02472937 Teva-Lacosamide 1.4500 1.4500
02474700 Sandoz Lacosamide 1.4500 1.4500
02478234 Pharma-Lacosamide 1.4500 1.4500
02499592 NRA-Lacosamide 1.4500 1.4500
02490579 Mint-Lacosamide 1.4500 1.4500
02487837 Mar-Lacosamide 1.4500 1.4500
02488426 Jamp-Lacosamide 1.4500 1.4500
02475367 Auro-Lacosamide 1.4500 1.4500
02489317 Ach-Lacosamide 1.4500 1.4500
02512904 Lacosamide 1.4500 1.4500
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
430 Indefinite

As adjunctive therapy in the treatment of patients with partial onset seizures who have had an inadequate response or have significant intolerance to at least 3 less costly anticonvulsant therapies; AND

Patients are under the care of a physician experienced in the treatment of epilepsy.

Note: Less costly anticonvulsant therapies may include the following:
 
Phenytoin, Carbamazepine, Gabapentin, Lamotrigine, Vigabatrin, Topiramate, etc.

 

EAP Criteria

NO

Product Monograph

View Monograph