Product Details

Taro-Bupropion XL

Bupropion HCl
300 mg
ER Tablet


DIN/PIN/NPN

02475812

Manufacturer

Sun Pharma Company

Formulary Listing Date

2019-07-31  

Unit Price

0.2927

Amount MOH Pays

0.2927

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N06AX12

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02275104 Wellbutrin XL 1.2674 0.2927
02475812 Taro-Bupropion XL 0.2927 0.2927
02439662 Act Bupropion XL 0.2927 0.2927
02565846 Odan-Bupropion XL 0.2927 0.2927
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
315 Indefinite

For the treatment of depression.

 

Requirements


EAP Criteria

  NO

Product Monograph

View Monograph