Product Details
Act Ezetimibe
Ezetimibe10 mg
Tablet
DIN/PIN/NPN
02414716
Manufacturer
Actavis Pharma Company
Formulary Listing Date
2014-11-27
Unit Price
0.1811
Amount MOH Pays
0.1811
Coverage Status
Limited Use Product Chronic-Use Medication
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
C10AX09
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02354101 | Teva-Ezetimibe | 0.1811 | 0.1811 |
| 02416778 | Sandoz Ezetimibe | 0.1811 | 0.1811 |
| 02419548 | Ran-Ezetimibe | 0.1811 | 0.1811 |
| 02416409 | PMS-Ezetimibe | 0.1811 | 0.1811 |
| 02481669 | NRA-Ezetimibe | 0.1811 | 0.1811 |
| 02423243 | Mint-Ezetimibe | 0.1811 | 0.1811 |
| 02467437 | M-Ezetimibe | 0.1811 | 0.1811 |
| 02422662 | Mar-Ezetimibe | 0.1811 | 0.1811 |
| 02423235 | Jamp-Ezetimibe | 0.1811 | 0.1811 |
| 02460750 | GLN-Ezetimibe | 0.1811 | 0.1811 |
| 02247521 | Ezetrol | 2.0415 | 0.1811 |
| 02431300 | Ezetimibe | 0.1811 | 0.1811 |
| 02429659 | Ezetimibe | 0.1811 | 0.1811 |
| 02469286 | Auro-Ezetimibe | 0.1811 | 0.1811 |
| 02427826 | Apo-Ezetimibe | 0.1811 | 0.1811 |
| 02475898 | AG-Ezetimibe | 0.1811 | 0.1811 |
| 02414716 | Act Ezetimibe | 0.1811 | 0.1811 |
| 02425610 | Ach-Ezetimibe | 0.1811 | 0.1811 |
| 02536420 | NRA-Ezetimibe Tablets | 0.1811 | 0.1811 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 380 | Indefinite | For use in combination with a HMG-CoA reductase inhibitor ('statin') in patients with hypercholesterolemia who have not reached target LDL levels despite the use of maximally tolerated doses. |
| 381 | Indefinite | For use as monotherapy in the management of hypercholesterolemia in patients who are intolerant to HMG-CoA reductase inhibitors or where HMG-CoA reductase inhibitors are contraindicated. |