Product Details
Imitrex
Sumatriptan Succinate50 mg
Tablet
DIN/PIN/NPN
02163764
Manufacturer
GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care
Formulary Listing Date
2007-06-06
Unit Price
NA
Amount MOH Pays
NA
Coverage Status
Off-Formulary Interchangeable
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N02CC01
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02286521 | Sumatriptan | 9.0650 | 9.0650 |
| 02263025 | Sandoz Sumatriptan | 9.0650 | 9.0650 |
| 02271583 | Ratio-Sumatriptan | 9.0650 | 9.0650 |
| 02256436 | PMS-Sumatriptan | 9.0650 | 9.0650 |
| 02268914 | Mylan-Sumatriptan | 9.0650 | 9.0650 |
| 02163764 | Imitrex | NA | NA |
| 02257890 | Co Sumatriptan | 9.0650 | 9.0650 |
| 02268388 | Apo-Sumatriptan | 9.0650 | 9.0650 |
| 02546035 | Sumatriptan | 9.0650 | 9.0650 |