Product Details

Alysena 21

Ethinyl Estradiol + Levonorgestrel
20 mcg + 100 mcg
Tablet
21's Pack

DIN/PIN/NPN

02387875

Manufacturer

Apotex Inc.

Formulary Listing Date

2012-11-27

Unit Price

3.9425

Amount MOH Pays

3.9425

Coverage Status

General Benefit

ODB Formulary Therapeutic Classification

68:32:00 Progestogens and Oral Contraceptives

Therapeutic Note

NO

ATC Code

G03AA07

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02298538	Aviane 21	3.9425	3.9425
02387875	Alysena 21	3.9425	3.9425
02236974	Alesse 21	15.7700	3.9425
02532174	Audrina 21	3.9425	3.9425

LU Clinical Criteria

NO

EAP Criteria

NO

Product Monograph

View Monograph