Product Details

Baclofen

Baclofen
20 mg
Tablet


DIN/PIN/NPN

02287048

Manufacturer

Sanis Health Inc.

Formulary Listing Date

2011-09-15  

Unit Price

0.3104

Amount MOH Pays

0.3104

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

Therapeutic Note

Skeletal Muscle Relaxants (12:20): Muscle relaxants, other than baclofen and dantrolene sodium, are not indicated for spasticity due to cerebral palsy, multiple sclerosis, spinal cord injury, etc.

ATC Code

M03BX01

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02236508 Ratio-Baclofen 0.3104 0.3104
02063743 PMS-Baclofen 0.3104 0.3104
02088401 Mylan-Baclofen 0.3104 0.3104
00636576 Lioresal DS 1.7122 0.3104
02287048 Baclofen 0.3104 0.3104
02139391 Apo-Baclofen 0.3104 0.3104
02544679 Baclofen 0.3104 0.3104
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph