Product Details
PMS-Ipratropium
Ipratropium Bromide0.03%
Nasal Spray
DIN/PIN/NPN
02239627
Manufacturer
Pharmascience Inc.
Formulary Listing Date
2000-07-17
Unit Price
0.8693
Amount MOH Pays
0.8693
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
- 12:08:00 Parasympatholytic (Cholinergic Blocking) Agents
- 52:36:00 Other Eye, Ear, Nose and Throat Agents
Therapeutic Note
NO
ATC Code
R03BB01
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02239627 | PMS-Ipratropium | 0.8693 | 0.8693 |
02163705 | Atrovent | NA | NA |
LU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
3 | 1 year | For the treatment of non-allergic vasomotor rhinitis. |