Product Details
Elidel
Pimecrolimus1%
Cream
DIN/PIN/NPN
02247238
Manufacturer
Valeant Canada Ltd.
Formulary Listing Date
2004-04-06
Unit Price
2.9052
Amount MOH Pays
2.9052
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
D11AH02
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 383 | 1 year | For use in combination with moisturizers or oral antihistamines in patients with atopic dermatitis who have failed or are intolerant to an 8-week trial of an intermediate potency topical steroid. Therapy should be reassessed at 6 months. |