Product Details

Sandoz Omeprazole DR Cap

Omeprazole
20 mg



DIN/PIN/NPN

09857314

Manufacturer

Sandoz Canada Inc.

Formulary Listing Date

2008-12-03  

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

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
09857314 Sandoz Omeprazole DR Cap 0.2287 0.2287
02403617 Ran-Omeprazole DR Cap 0.2287 0.2287
02320851 PMS-Omeprazole DR Cap 0.2287 0.2287
02348691 Omeprazole DR Cap 0.2287 0.2287
00846503 Losec DR Cap NA NA
09857285 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.

 

EAP Criteria

NO

Product Monograph

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