Product Details
Omeprazole-20 DR Cap
Omeprazole20 mg
DIN/PIN/NPN
02411857
Manufacturer
Sivem Pharmaceuticals ULC
Formulary Listing Date
2020-04-30
Unit Price
0.2287
Amount MOH Pays
0.2287
Coverage Status
Limited Use Product Chronic-Use Medication
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A02BC01
Interchangeable Products
DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
---|---|---|---|
02295415 | Teva-Omeprazole DR Tab | 0.2287 | 0.2287 |
02296446 | Sandoz Omeprazole DR Cap | 0.2287 | 0.2287 |
02260867 | Ratio-Omeprazole DR Tab | 0.2287 | 0.2287 |
09857342 | PMS-Omeprazole DR Cap | 0.2287 | 0.2287 |
02411857 | Omeprazole-20 DR Cap | 0.2287 | 0.2287 |
02504294 | Omeprazole Magnesium Delayed Release Tab | 0.2287 | 0.2287 |
02416549 | Omeprazole Magnesium Delayed Release Tab | 0.2287 | 0.2287 |
02439549 | Nat-Omeprazole DR Tab | 0.2287 | 0.2287 |
02190915 | Losec DR Tab | NA | NA |
02420198 | Jamp-Omeprazole DR Tab | 0.2287 | 0.2287 |
02245058 | Apo-Omeprazole Cap | 0.2287 | 0.2287 |
LU Clinical Criteria
LU Code | Auth. Period | Clinical Criteria |
---|---|---|
293 | 1 year | Gastroesophageal Reflux Disease (GERD) For the treatment of erosive GERD or upper GI malignancy; OR For the treatment of non-erosive GERD after failure of H2-receptor antagonist therapy. Patients with GERD should be reassessed within 6 months after initial treatment with a PPI. The reassessment could include confirmation of need for PPI with endoscopy, a trial of PPI withdrawal, or step-down therapy to H2-receptor antagonist therapy. Note: There is a lack of published evidence to support double-dose PPI therapy in this setting. |
297 | 1 year | Confirmed Peptic Ulcers or NSAID-induced Ulcer Prophylaxis: For the treatment of confirmed peptic ulcers and NSAID-induced ulcers; OR For the prophylaxis of NSAID-induced ulcers for patients at increased risk of GI bleeding. Note: There is a lack of published evidence to support double-dose PPI therapy in this setting. |
401 | 1 year | Other Gastrointestinal Disorders: For the treatment of gastroduodenal Crohn's disease, short-gut syndrome, scleroderma, or pancreatitis. Note: There is a lack of published evidence to support double-dose PPI therapy in these settings. |
402 | 1 year | Severe Conditions: For the treatment of severe esophagitis, Zollinger-Ellison syndrome, esophageal stricture, persistent symptoms of GERD or persistent erosive esophagitis, or upon hospital discharge following a gastrointestinal bleed. For patients receiving double-dose therapy, the need to continue treatment at higher doses should be reassessed after eight weeks. For re-treatment at higher doses, a four-week period should have elapsed from the end of the previous treatment. Reassessment could include a procedural assessment of the condition or step-down therapy to lower-dose proton pump inhibitor (PPI) therapy. |