Product Details

Lorazepam Sublingual

Lorazepam
2 mg
SL Tablet


DIN/PIN/NPN

02410761

Manufacturer

A A Pharma Inc.

Formulary Listing Date

2013-10-31  

Unit Price

0.2152

Amount MOH Pays

NA

Coverage Status

Off-Formulary Interchangeable

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N05BA06

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02410761 Lorazepam Sublingual 0.2152 NA
02041472 Ativan NA NA
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph