Product Details

Lovenox HP

Enoxaparin
150 mg/mL
Solution for Injection
1-mL Prefilled Syringe (Preservative-Free)

DIN/PIN/NPN

02378469

Manufacturer

Sanofi Aventis Pharma

Formulary Listing Date

2013-01-29  

Unit Price

34.3750

Amount MOH Pays

34.3750

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

B01AB05

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
186 1 year

For acute treatment of deep venous thrombosis (DVT), for a maximum of three weeks;
187 1 year

For DVT in pregnant or lactating females;
188 1 year

For DVT in patients whom treatment with warfarin is not tolerated, or contraindicated;
189 1 year

For DVT in patients who have failed treatment with warfarin.
323 1 year

For the acute treatment of pulmonary embolism, maximum of three weeks.
678 1 year

For the treatment of pulmonary embolism, deep vein thrombosis who meet the following criteria:

  • Patients who become pregnant during the transition period of July 31, 2024, to January 31, 2025.
679 1 year

For the treatment of pulmonary embolism, deep vein thrombosis who meet the following criteria:

  • Patients who require palliative care during the transition period of July 31, 2024, to January 31, 2025.
 

EAP Criteria

NO

Product Monograph

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