Product Details

Forxiga

Dapagliflozin
10 mg
Tablet


DIN/PIN/NPN

02435470

Manufacturer

AstraZeneca

Formulary Listing Date

2016-11-30  

Unit Price

2.7300

Amount MOH Pays

0.6825

Coverage Status

General Benefit Chronic-Use Medication Insulin or Oral Hypoglycemic Product

ODB Formulary Therapeutic Classification

Therapeutic Note

Dapagliflozin 10 mg Tablet: Added on to metformin for patients: - Who have inadequate glycemic control on metformin and - Who have a contraindication or intolerance to a sulfonylurea or - For whom insulin is not an option. Added on to a sulfonylurea for patients: - Who have inadequate glycemic control on a sulfonylurea and - Who have a contraindication or intolerance to metformin or - For whom insulin is not an option. For the treatment of adult patients with New York Heart Association (NYHA) class II and III heart failure, as an adjunct to standard of care therapy, for the treatment of heart failure with reduced ejection fraction (HFrEF) [Left ventricular ejection fraction (LVEF less than or equal to 40%)]. Standard of care therapies include beta-blockers, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), plus a mineralocorticoid receptor antagonist.

ATC Code

A10BK01

Interchangeable Products

DIN/ PIN/ NPN Brand name Unit Price Amount MOH pays
02435470 Forxiga 2.7300 0.6825
02527197 Apo-Dapagliflozin 0.6825 0.6825
02531410 Auro-Dapagliflozin 0.6825 0.6825
02519860 GLN-Dapagliflozin 0.6825 0.6825
02531372 Jamp Dapagliflozin 0.6825 0.6825
02535300 M-Dapagliflozin 0.6825 0.6825
02531569 PMS-Dapagliflozin 0.6825 0.6825
02518740 Sandoz Dapagliflozin 0.6825 0.6825
02538342 NRA-Dapagliflozin 0.6825 0.6825
 

LU Clinical Criteria

NO  

EAP Criteria

NO

Product Monograph

View Monograph