Product Details
Imitrex
Sumatriptan Succinate25 mg
Tablet
DIN/PIN/NPN
09857299
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
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02256428 | PMS-Sumatriptan | 8.9900 | 8.9900 |
| 02268906 | Mylan-Sumatriptan | 8.9900 | 8.9900 |
| 09857299 | Imitrex | NA | NA |
| 02257882 | Co Sumatriptan | 8.9900 | 8.9900 |