Product Details

Teva-Rasagiline

Rasagiline Mesylate
1 mg
Tablet


DIN/PIN/NPN

02418444

Manufacturer

Teva Canada Limited

Formulary Listing Date

2016-07-28  

Unit Price

6.1285

Amount MOH Pays

6.1285

Coverage Status

Off-Formulary Interchangeable Exceptional Access Program Product Monoamine Oxidase Inhibitor Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

N04BD02

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02418444 Teva-Rasagiline 6.1285 6.1285
02491982 Jamp Rasagiline 6.1285 6.1285
02284650 Azilect 9.0617 6.1285
02404699 Apo-Rasagiline 6.1285 6.1285
 

LU Clinical Criteria

NO  

EAP Criteria

Therapeutic Class Reimbursement Criteria
Parkinson’s Disease Treatments

Rasagiline

  • Brand(s): Azilect
  • Dosage Form/Strength: 0.5 mg, 1 mg tablet

For the treatment of patients with Parkinson’s disease who experience about 25% of the waking day in the off-state despite maximally tolerated doses of levodopa. 

Duration of Approval of Initials and Renewals: 5 Years

EAP Drug Request Form:

Standard Form for EAP Drug Requests

Product Monograph

View Monograph