Product Details
Zaxine
Rifaximin550 mg
Tablet
DIN/PIN/NPN
02410702
Manufacturer
Salix Pharmaceuticals Inc.
Formulary Listing Date
2016-06-29
Unit Price
8.3030
Amount MOH Pays
8.3030
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A07AA11
Interchangeable Products
NOLU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
475 | Indefinite | For reducing the risk of overt hepatic encephalopathy (HE) recurrence (i.e., 2 or more episodes) in patients who are unable to achieve adequate control of HE recurrence with maximal tolerated dose of lactulose alone. Rifaximin should be used in combination with a maximal tolerated dose of lactulose. For patients not maintained on lactulose, the nature of the patient's intolerance to lactulose should be documented. |