Product Details

Symbicort 200 Turbuhaler

Budesonide + Formoterol Fumarate Dihydrate
200 mcg + 6 mcg/Metered-Dose
Powder for Inhalation
120-Dose Pack

DIN/PIN/NPN

02245386

Manufacturer

AstraZeneca

Formulary Listing Date

2003-01-30  

Unit Price

99.3394

Amount MOH Pays

99.3394

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

R03AK07

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
330 Indefinite

For the treatment of asthma in patients who are using optimum anti-inflammatory treatment and are still experiencing breakthrough symptoms.
 

EAP Criteria

NO

Product Monograph

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