Product Details

Atovaquone Proguanil

Atovaquone + Proguanil HCl
250 mg + 100 mg
Tablet


DIN/PIN/NPN

02421429

Manufacturer

Sanis Health Inc.

Formulary Listing Date

2020-07-31  

Unit Price

4.1308

Amount MOH Pays

4.1308

Coverage Status

Off-Formulary Interchangeable Exceptional Access Program Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

P01BB51

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02380927 Teva-Atovaquone Proguanil 4.1308 4.1308
02402165 Mylan-Atovaquone/Proguanil 4.1308 4.1308
02238151 Malarone 6.2008 4.1308
02421429 Atovaquone Proguanil 4.1308 4.1308
02466783 Atovaquone and Proguanil Hydrochloride 4.1308 4.1308
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph