Product Details

Diane-35

Cyproterone Acetate + Ethinyl Estradiol
2 mg + 0.035 mg
Tablet
21's Pack

DIN/PIN/NPN

02233542

Manufacturer

Bayer Inc., Consumer Care Division

Formulary Listing Date

2007-12-19  

Unit Price

NA

Amount MOH Pays

NA

Coverage Status

Off-Formulary Interchangeable

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

G03HB01

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02309556 Teva-Cyproterone/Ethinyl Estradiol 23.3400 NA
02425017 Ran-Cyproterone/Ethinyl Estradiol 23.3394 NA
02233542 Diane-35 NA NA
02290308 Cyestra-35 23.3394 NA
02436736 Cleo-35 23.3394 NA
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph