Product Details
Phenobarbital Injection
Phenobarbital120 mg/mL
Solution for Injection
1-mL Ampoule Pack
DIN/PIN/NPN
02304090
Manufacturer
Sandoz Canada Inc.
Formulary Listing Date
2018-01-31
Unit Price
15.7000
Amount MOH Pays
15.7000
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N03AA02
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 481 | 1 year | For the management of patients receiving palliative care*. *Note: The patient must have a progressive life-limiting illness and require this medication for palliative purposes. |