Product Details
Trispan
Triamcinolone Hexacetonide20 mg/mL
Injectable Suspension
1-mL Ampoule Pack
DIN/PIN/NPN
02470632
Manufacturer
Medexus Inc.
Formulary Listing Date
2020-06-30
Unit Price
18.0000
Amount MOH Pays
18.0000
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
H02AB08
Interchangeable Products
NOLU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
580 | Indefinite | For intra-articular, intrasynovial, or periarticular use in adults and adolescents for the symptomatic treatment of subacute and chronic inflammatory joint diseases including: - Rheumatoid arthritis *Note: triamcinolone hexacetonide injectable suspension may also be used as an intra-articular injection in children aged 3-12 years with Juvenile Idiopathic Arthritis. |