Product Details
Mar-Fluconazole-150
Fluconazole150 mg
Capsule
DIN/PIN/NPN
02428792
Manufacturer
Marcan Pharmaceuticals Inc.
Formulary Listing Date
2017-01-31
Unit Price
3.9424
Amount MOH Pays
3.9424
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
Anti-Infectives, Fungicides (84:04:08): Due to its efficacy and significantly lower cost, clotrimazole should be the first line of treatment for Tinea corporis and cruris. In Tinea pedis, topical terbinafine should be considered the first line of treatment due to its efficacy and lower rate of relapse.
ATC Code
J02AC01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02433702 | Priva-Fluconazole | 3.9424 | 3.9424 |
| 02428792 | Mar-Fluconazole-150 | 3.9424 | 3.9424 |
| 02432471 | Jamp-Fluconazole | 3.9424 | 3.9424 |
| 02141442 | Diflucan-150 | 15.7697 | 3.9424 |
| 02241895 | Apo-Fluconazole-150 | 3.9424 | 3.9424 |
| 02521229 | Fluconazole-150 | 3.9424 | 3.9424 |
| 02255510 | Riva-Fluconazole | 3.9424 | 3.9424 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 235 | 1 year | For the treatment of vaginal candidiasis. Dose: 150mg orally once daily for 1 day. Note: Repeats within a 25-day period will not be reimbursed. |