Product Details

Norprolac

Quinagolide HCl
0.15 mg
Tablet


DIN/PIN/NPN

02223775

Manufacturer

Ferring Inc.

Formulary Listing Date

2006-10-23  

Unit Price

1.7294

Amount MOH Pays

1.7294

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

G02CB04

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
405 5 years

For the treatment of hyperprolactinemia in patients who have:

* Failed to respond to a greater than or equal to 3-month trial of bromocriptine; or
* Failed to tolerate bromocriptine; or
* Failed to shrink a prolactinoma by greater than 1 cm after 12 months of bromocriptine therapy
 

EAP Criteria

NO

Product Monograph

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