Product Details
Nat-Granisetron
Granisetron HCl1 mg
Tablet
DIN/PIN/NPN
02452359
Manufacturer
Natco Pharma (Canada) Inc.
Formulary Listing Date
2016-07-28
Unit Price
4.5000
Amount MOH Pays
4.5000
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A04AA02
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02452359 | Nat-Granisetron | 4.5000 | 4.5000 |
02185881 | Kytril | NA | NA |
02472686 | Jamp Granisetron | 4.5000 | 4.5000 |
02308894 | Apo-Granisetron | 4.5000 | 4.5000 |
LU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
91 | 1 year | For the treatment of emesis in cancer patients receiving highly emetogenic chemotherapy. |
92 | 1 year | For patients receiving intravenous chemotherapy or radiation therapy who have not experienced adequate control with other available anti-emetics. |
93 | 1 year | For patients receiving intravenous chemotherapy or radiation therapy who experience intolerable side effects with other anti- emetics. |
326 | 1 year | For the treatment of emesis in patients receiving radiation therapy which consists of single fraction treatment to the abdominal cavity, hemi-body irradiation and total body irradiation. Note: The therapeutic value of GRANISETRON HCL more than 24 hours after the last dose of chemotherapy is unproven. |
454 | 1 year | For the treatment of emesis in cancer patients receiving moderately emetogenic chemotherapy (MEC) regimens |