Product Details
PMS-Ipratropium
Ipratropium Bromide0.03%
Nasal Spray
DIN/PIN/NPN
02239627
Manufacturer
Pharmascience Inc.
Formulary Listing Date
2000-07-17
Unit Price
0.9127
Amount MOH Pays
0.9127
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 | 0.9127 | 0.9127 |
| 02163705 | Atrovent | NA | NA |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 3 | 1 year | For the treatment of non-allergic vasomotor rhinitis. |
Requirements