Product Details
Advagraf
Tacrolimus1 mg
ER Capsule
DIN/PIN/NPN
02296470
Manufacturer
Astellas Pharma Canada Inc.
Formulary Listing Date
2009-04-01
Unit Price
2.8396
Amount MOH Pays
2.1297
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
L04AD02
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02296470 | Advagraf | 2.8396 | 2.1297 |
| 02528606 | Sandoz Tacrolimus XR | 2.1297 | 2.1297 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 410 | Indefinite | For prophylaxis of organ rejection in adult patients receiving allogeneic kidney transplants |
Requirements