Product Details
Cosopt Preservative free
Dorzolamide HCl + Timolol Maleate2% + 0.5%
Ophthalmic Solution
0.2-mL Unit Dose Pipette
DIN/PIN/NPN
02258692
Manufacturer
Elvium Life Sciences
Formulary Listing Date
2010-04-23
Unit Price
0.8100
Amount MOH Pays
0.8100
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
S01ED51
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 310 | Indefinite | As second-line therapy for patients who do not have an adequate intraocular pressure lowering response to monotherapy with ophthalmic beta-blocking agents |
| 393 | Indefinite | For use as initial therapy in an urgent situation (e.g., patients with a high baseline intraocular pressure) where monotherapy is unlikely to be effective |