Product Details

Prograf

Tacrolimus
0.5 mg
Capsule


DIN/PIN/NPN

02243144

Manufacturer

Astellas Pharma Canada Inc.

Formulary Listing Date

2009-04-01  

Unit Price

2.0291

Amount MOH Pays

1.0146

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
02243144 Prograf 2.0291 1.0146
02416816 Sandoz Tacrolimus 1.0146 1.0146
02454068 Ach-Tacrolimus 1.0146 1.0146
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
173 Indefinite

For solid organ transplant and bone marrow transplant.

 

EAP Criteria

NO

Product Monograph

View Monograph