Product Details

PMS-Ipratropium

Ipratropium Bromide
0.03%
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

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.

 

EAP Criteria

NO

Product Monograph

View Monograph