Product Details
Emend Tri-Pack
Aprepitant125 mg + 80 mg
Kit, Capsule
DIN/PIN/NPN
02298813
Manufacturer
Merck Canada Inc.
Formulary Listing Date
2014-09-25
Unit Price
105.9246
Amount MOH Pays
105.9246
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A04AD12
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 452 | 1 year | In combination with a 5HT3 receptor antagonist and dexamethasone for highly emetogenic chemotherapy (HEC) regimens: - Cisplatin-based chemotherapy where a single daily dose is greater than or equal to 70 mg per meter squared - Cisplatin and cyclophosphamide combinations where the single daily dose is greater than or equal to 50mg per meter squared - Cisplatin (any dose) given for 3 to 5 consecutive days - Non-cisplatin based highly emetogenic chemotherapy (such as those containing anthracycline greater than or equal to 60mg per meter squared plus cyclophosphamide) Dosage: Recommend aprepitant 125mg orally on Day 1 of HEC followed by 80mg orally on Days 2 to 3 post-chemotherapy for each cycle. |
| 453 | 1 year | For patients receiving moderately emetogenic chemotherapy (MEC) regimens AND who have had inadequate symptom control using a 5HT3 antagonist and dexamethasone in a previous cycle. Dosage: Recommend aprepitant 125mg orally on Day 1 of MEC followed by 80mg orally on Days 2 to 3 post-chemotherapy for each cycle. |
EAP Criteria
| Therapeutic Class | Reimbursement Criteria |
|---|---|
| Oncology – Supportive Management | Aprepitant
Effective September 25, 2014, Emend transitioned to the ODB formulary for reimbursement in patients who meet the Limited Use criteria. Dosage regimens not meeting the LU criteria may be submitted to the EAP for consideration of reimbursement. EAP Drug Request Form: |