Product Details

Champix

Varenicline Tartrate
0.5 mg
Tablet


DIN/PIN/NPN

02291177

Manufacturer

Pfizer Canada Inc.

Formulary Listing Date

2011-08-04  

Unit Price

1.8473

Amount MOH Pays

0.4618

Coverage Status

Discontinued Drug Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N07BA03

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02426226 Teva-Varenicline 0.4618 0.4618
02291177 Champix 1.8473 0.4618
02419882 Apo-Varenicline 0.4618 0.4618
02542951 NRA-Varenicline 0.4618 0.4618
 

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
423 12 weeks

For smoking-cessation treatment in adults, in conjunction with smoking-cessation counseling.

Network Note: Limited to 12 weeks (168 tablets) of reimbursement per 365 days per patient

 

EAP Criteria

NO

Product Monograph

View Monograph