Product Details

Imitrex DF

Sumatriptan Succinate
25 mg
Tablet


DIN/PIN/NPN

02239738

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
02286815 Teva-Sumatriptan DF 8.9900 NA
02239738 Imitrex DF NA NA
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph