Product Details
Xatral
Alfuzosin Hydrochloride10 mg
Prolonged-Release Tablet
DIN/PIN/NPN
02245565
Manufacturer
Sanofi Aventis Pharma
Formulary Listing Date
2003-01-30
Unit Price
1.0900
Amount MOH Pays
0.2601
Coverage Status
Limited Use Product Chronic-Use Medication
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
G04CA01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02245565 | Xatral | 1.0900 | 0.2601 |
| 02304678 | Sandoz Alfuzosin | 0.2601 | 0.2601 |
| 02443201 | Auro-Alfuzosin | 0.2601 | 0.2601 |
| 02315866 | Apo-Alfuzosin | 0.2601 | 0.2601 |
| 02447576 | Alfuzosin | 0.2601 | 0.2601 |
| 02519844 | Alfuzosin | 0.2601 | 0.2601 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 351 | Indefinite | For the management of benign prostatic hyperplasia where six weeks of treatment with other formulary alpha blockers (e.g., doxazosin, terazosin, tamsulosin) have been ineffective |
| 352 | Indefinite | For the management of benign prostatic hyperplasia where other formulary alpha blockers (e.g., doxazosin, terazosin, tamsulosin) have produced intolerable side effects. |