Product Details
Aptiom
Eslicarbazepine Acetate400 mg
Tablet
DIN/PIN/NPN
02426870
Manufacturer
Sunovion Pharmaceuticals Canada Inc.
Formulary Listing Date
2015-11-26
Unit Price
9.8700
Amount MOH Pays
9.8700
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N03AF04
Interchangeable Products
NOLU 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: |