Product Details

Sandoz Tacrolimus

Tacrolimus
5 mg
Capsule


DIN/PIN/NPN

02416832

Manufacturer

Sandoz Canada Inc.

Formulary Listing Date

2014-01-30  

Unit Price

6.4993

Amount MOH Pays

6.4993

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
02175983 Prograf 12.9986 6.4993
02416832 Sandoz Tacrolimus 6.4993 6.4993
02456109 Ach-Tacrolimus 6.4993 6.4993
 

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