Post on 07-Jun-2018
Formulary June 2018
Copyright 1996 Nova Scotia Department of Health. All rights reserved. No part of this publication may be reproduced, photocopied, stored on a retrieval system, or transmitted without the express written consent of the publisher.
July 2011 was the last printed publication of
the Nova Scotia FormularyMonthly updates of the Nova Scotia
Formularyare published online and can be
accessedat:
www.nspharmacare.ca
A - Alimentary Tract and Metabolism B - Blood and Blood Forming Organs C - Cardiovascular System D - Dermatologicals G - Genito-Urinary System & Sex Hormones H - Systemic Hormonal Preparations, Excluding Sex Hormones J - General Antiinfectives, Systemic L - Antineoplastics and Immunomodulating Agents M - Musculo-Skeletal System N - Nervous System P - Antiparasitic Products, Insecticides and Repellents R - Respiratory System S - Sensory Organs V - Various
1-2324-3132-7677-8687-99100-106107-128129-144145-157158-220221-222223-232233-239240-242
ATC CLASSIFICATION OF DRUGS
MISCELLANEOUS
Diabetic Supplies Benefit List Ostomy Supplies Benefit List Compounds
APPENDICES
Appendix I - Abbreviations Appendix II - Abbreviations of Manufacturers' Names Appendix III - Criteria for Coverage of Exception Status Drugs
PRODUCT INDEX
TABLE OF CONTENTS
INTRODUCTION How to Use the Formulary Legend
INTRODUCTIONThe Nova Scotia Formulary details which drugs and supplies are benefits under the Nova Scotia Seniors'Pharmacare Program, Family Pharmacare Program, Diabetes Assistance Program, Community ServicesPharmacare Programs and Drug Assistance for Cancer Patients.
The Formulary is provided on our website at www.nspharmacare.ca in PDF.
The ATC Classification System
All medications are classified according to the Anatomical Therapeutic Chemical (ATC) Classification System whichis used by the World Health Organization for pharmacoepidemiological purposes and by the Patented MedicinePrices Review Board for pricing purposes.
The ATC Classification System groups chemically similar products according to their site of action and facilitates thecomparison of new medicines with previously available medicines. There are fourteen main groups in the ATCsystem:
A Alimentary tract and metabolism B Blood and blood forming organs C Cardiovascular system D Dermatologicals G Genito-urinary system and sex hormones H Systemic hormonal preparations, excluding sex hormones J General antiinfectives, systemic L Antineoplastic and immunomodulating agents M Musculo-skeletal system N Nervous system P Antiparasitic products, insecticides and repellents R Respiratory system S Sensory organs V Various
Each group is subdivided into anatomical, therapeutic and chemical subgroups as shown in the Legend.
A drug may be given more than one ATC code. If it is available in two or more strengths or formulations with clearlydifferent therapeutic uses, the drug would appear in various categories depending on its different forms. If a drughas more than one clinical indication, the main indication is chosen for the listing of the various brands and strengthsof this drug.
June 2018 Page i
Interchangeability, Maximum Reimbursable Price (MRP) and Pharmacare Reimbursement Price (PRP)
The Formulary indicates those products which have been deemed interchangeable by the Drugs and TherapeuticsCommittee of the Nova Scotia Department of Health and Wellness (see the Legend). For generic products thatmeet the criteria for interchangeability a Maximum Reimbursable Price (MRP) may be applied. MRP is the maximumprice established by the Pharmacare Programs for an interchangeable generic drug. MRP is applied to those drugswhich are Pharmacare benefits, and have been deemed interchangeable (e.g., brand name drugs and their genericequivalents) The MRP is the maximum amount that the Pharmacare Programs will reimburse providers for one unit(tablet, capsule, millilitre, etc.) of a drug.
For each interchangeable, generic drug category, a maximum reimbursable price per unit (e.g., tablet, capsule,millilitre) is determined by calculating a percentage of the cost of the equivalent brand name drug. The percentage of the MRP is reimbursed at 25% of the cost of the manufacturer list price of the equivalent brand drug.
Some generic drugs may have exceptions to the MRP formula, and their MRP will also be included in theReimbursement List. Exemptions to the MRP are available for beneficiaries who have experienced a severe or life threatening reaction with lower cost alternatives. A request must be received from the prescriber detailing the reaction.
Providers shall not charge any cost difference between the MRP of the drug and amount reimbursed by thePharmacare Programs unless the beneficiary requests the higher priced drug. If the beneficiary requests the higherpriced drug the extra cost is not counted toward their annual maximum copayment or annual maximum deductible.
In addition, a Pharmacare Reimbursement Price (PRP) is the maximum cost assigned to:
- certain groups of drugs that are similar in effect; - specific services for which coverage is established; - certain unit dose and special delivery formats that are also available in less expensive bulk formats; and - certain supplies that are used for the same function.
The PRP is the maximum amount the Pharmacare Program reimburses providers for one unit of a drug (tablet,capsule, millilitre, etc.) supply or service.
Providers may charge the beneficiary the portion of their AAC that exceeds the PRP. The extra cost is not countedtoward the beneficiary's annual maximum copayment or annual maximum deductible.
In all pricing categories, except AAC, the Pharmacare Programs will reimburse pharmacies the lesser of the amountsubmitted, or as applicable, MLP, MRP, or PRP.
All Manufacturer List Prices (MLPs) will be updated on a quarterly basis unless otherwise notified directly by the manufacturer.
Prescriber
The Formulary provides prescriber codes (see Legend) associated with each benefit under the PharmacarePrograms. These codes indicate which benefits will be reimbursed when prescribed by a specific prescriber.
June 2018 Page ii
The Nova Scotia Government Pharmacare Programs
1. Seniors' Pharmacare Program - available to all Nova Scotia seniors 65 years or older who have a valid Nova Scotia Health Card, and do not have private drug coverage.
2. Community Services Pharmacare Programs - The Department of Community Services provides drug benefits as part of the Income Assistance Programs (including Special Needs Pharmacare and Transitional Pharmacare), the Low Income Pharmacare Program for Children, Services for Persons with Disabilities and the Children in Care Programs. Eligibility is determined by the Department of Community Services.
3. Drug Assistance for Cancer Patients, an income based assistance program covering medication for the treatment of cancer.
4. Diabetes Assistance Program, an income based assistance program covering medication and supplies needed for diabetes treatment.
5. Under 65-Long Term Care (LTC) Pharmacare, provides drug coverage for long term care residents under 65 years of age who have no drug insurance.
6. Family Pharmacare Program, an income based program available to all Nova Scotians with a valid Nova Scotia Health Card who are not currently receiving drug benefits through Seniors', Community Services, Diabetes Assistance or the Under 65-Long Term Care Pharmacare Programs.
The benefit status of medications reimbursed under these programs are indicated, in the fourth column of the ATCclassification, by the letters S (Seniors' Pharmacare), F (Community Services Pharmacare / Under 65-Long TermCare Pharmacare / Family Pharmacare), C (Drug Assistance for Cancer Patients), D (Diabetes Assistance) or E(Exception Status Drug - see Appendix III). If this column is blank, the product is not a benefit under any of theseprograms.
June 2018 Page iii
Miscellaneous Section
Diabetes and ostomy supplies are listed in this section. These products are benefits under the Seniors' andCommunity Services Pharmacare Programs and are cross-referenced in the appropriate ATC classification.Diabetes supplies are also benefits under the Diabetes Assistance Program.
Legend
1. Therapeutic Main Group2. Therapeutic Subgroup3. Chemical/Therapeutic Subgroup4. Subgroup for Chemical Substance5. Brand or Manufacturer's Name of the Drug, including dosage form and/or route and strength6. Interchangeable Product Heading7. Prescriber Codes: D - Physician / Dentist N - Nurse Practitioner P - Pharmacist M - Midwife O - Prescribing Optometrist8. Unit Price9. M = Maximum Reimbursement Price P = Pharmacare Reimbursement Price L = Manufacturer's List Price10. Benefit Status (plans for which the product is a benefit): S - Seniors' Pharmacare F - Community Services Pharmacare - Under 65-Long Term Care Pharmacare - Family Pharmacare C - Drug Assistance for Cancer Patients D - Diabetes Assistance Program E - Exception status applies (see Appendix III)11. Drug Identification Number (DIN)12. Abbreviation of Manufacturer (see Appendix II)13. Interchangeable Product Indicator
June 2018 Page iv
1June 2018
CCA
A01
A02
STOMATOLOGICALS, MOUTH PREPARATIONS
DRUGS FOR ACID RELATED DISORDERS
A01A
A02A
A02B
STOMATOLOGICALS, MOUTH PREPARATIONS
ANTACIDS
DRUGS FOR PEPTIC ULCER AND GASTROESOPHAGEAL REFLUX DISEASE(GERD)
A01AB
A01AC
A01AD
A02AB
A02AD
A02AF
A02AH
ANTIINFECTIVES FOR LOCAL ORAL TREATMENT
CORTICOSTEROIDS FOR LOCAL ORAL TREATMENT
OTHER DRUGS FOR LOCAL ORAL TREATMENT
ALUMINIUM COMPOUNDS
COMB OF ALUMINIUM,CALCIUM AND MAGNESIUM COMPOUNDS
ANTACIDS WITH ANTIFLATULENTS
ANTACIDS WITH SODIUM BICARBONATE
A01AB03
A01AB22
A01AC01
A01AD02
A02AB01
A02AD01
A02AF02
A02AH01
CHLORHEXIDINE
DOXYCYCLINE
TRIAMCINOLONE
BENZYDAMINE
ALUMINIUM HYDROXIDE
ANTACIDS, ORDINARY SALT COMBINATIONS
ANTACIDS, ORDINARY SALT COMBINATIONS AND ANTIFLATULENTS
SODIUM BICARBONATE
chlorhexidine 0.12% oral rinse
triamcinolone acetonide 0.1% oral paste
benzydamine 0.15% oral rinse
Perichlor 0.12% Oral Rinse Peridex 0.12% Oral Rinse
Periostat 20mg Cap
Oracort 0.1% Oral Paste Kenalog 0.1% in Orabase (discontinued)
Pharixia 1.5mg/mL Oral Rinse pms-Benzydamine 1.5mg/mL Mouthwash Tantum Oral Rinse (discontinued)
Basaljel 500mg Cap
Diovol Regular O/L
Diovol Plus O/L Diovol Plus Tab Mylanta Double St Tab
Jamp-Sodium Bicarbonate 500mg Tab Sandoz Sodium Bicarbonate 500mg Tab
DNP
DNP
DNP
DNP DNP
1.4710
0.0384
0.1500
0.0720 0.0754
M
M
L
LL
SF
E
SF
E E
02240433 02237452
02247104
01964054 01999788
02229777 02239537 01966065
02135620
01966529
00116815 00116882 02019787
80030520 80022194
PMSZIA
PDP
TARBRI
PDPPMSMDS
AUR
CHU
CHUCHUJNJ
JPCSDZ
YY
N
YY
YYY
N
N
NNN
NN
Alimentary Tract and Metabolism
2June 2018
A
A02BA H2-RECEPTOR ANTAGONISTS
A02BA01
A02BA02
A02BA03
CIMETIDINE
RANITIDINE
FAMOTIDINE
cimetidine 200mg tab
cimetidine 300mg tab
cimetidine 400mg tab
cimetidine 600mg tab
ranitidine 15mg/mL o/l
ranitidine 25mg/mL inj
ranitidine 75mg tab
ranitidine 150mg tab
ranitidine 300mg tab
Apo-Cimetidine 200mg Tab Tagamet 200mg Tab (discontinued)
Apo-Cimetidine 300mg Tab Tagamet 300mg Tab (discontinued)
Apo-Cimetidine 400mg Tab Tagamet 400mg Tab (discontinued)
Apo-Cimetidine 600mg Tab MYLAN-Cimetidine 600mg Tab (discontinued) Tagamet 600mg Tab (discontinued)
Apo-Ranitidine 15mg/mL O/L Novo-Ranitidine 15mg/mL O/L Zantac 15mg/mL O/L (discontinued)
Ranitidine 25mg/mL Inj Zantac 25mg/mL Inj
Apo-Ranitidine 75mg Tab Zantac 75mg Tab (discontinued)
Apo-Ranitidine 150mg Tab CO Ranitidine 150mg Tab pms-Ranitidine 150mg Tab RAN-Ranitidine 150mg Tab Ranitidine 150mg Tab Ranitidine-150mg Tab Sandoz Ranitidine 150mg Tab Zantac 150mg Tab (discontinued)
Apo-Ranitidine 300mg Tab CO Ranitidine 300mg Tab pms-Ranitidine 300mg Tab RAN-Ranitidine 300mg Tab Ranitidine 300mg Tab Ranitidine-300mg Tab Sandoz Ranitidine 300mg Tab Zantac 300mg Tab (discontinued)
DNP
DNP
DNP
DNP
DNP
DNP DNP
DNP DNP DNP DNP DNP DNP DNP
DNP DNP DNP DNP DNP DNP DNP
0.3284
0.1791
0.2930
0.3405
0.0932
1.3976 1.3976
0.1197 0.1197 0.1197 0.1197 0.1197 0.1197 0.1197
0.2253 0.2253 0.2253 0.2253 0.2253 0.2253 0.2253
M
M
M
M
M
MM
MMMMMMM
MMMMMMM
SF
SF
SF
SF
SFC
SFC SFC
SFC SFC SFC SFC SFC SFC SFC
SFC SFC SFC SFC SFC SFC SFC
00584215 01916793
00487872 01916815
00600059 01916785
00600067 02227460 01916777
02280833 02242940 02212374
02256711 02212366
02230507 02230287
00733059 02248570 02242453 02336480 02353016 02385953 02243229 02212331
00733067 02248571 02242454 02336502 02353024 02385961 02243230 02212358
APXSKR
APXGSK
APXGSK
APXMYLGSK
APXTEVGSK
SDZGSK
APXJNJ
APXATVPMSRANSASSIVSDZGSK
APXATVPMSRANSASSIVSDZGSK
YY
YY
YY
YYY
YYY
YY
YY
YYYYYYYY
YYYYYYYY
Alimentary Tract and Metabolism
3June 2018
A
A02BB
A02BC
PROSTAGLANDINS
PROTON PUMP INHIBITORS
A02BA04
A02BB01
A02BC01
NIZATIDINE
MISOPROSTOL
OMEPRAZOLE
famotidine 10mg/mL inj
famotidine 10mg/mL inj (pf)
famotidine 20mg tab
famotidine 40mg tab
misoprostol 100mcg tab
misoprostol 200mcg tab
omeprazole 10mg cap
omeprazole 10mg cap/tab
omeprazole 20mg cap
Famotidine Omega 10mg/mL Inj Pepcid 10mg/mL Inj (discontinued)
Famotidine Omega (PF) 10mg/mL Inj Pepcid (PF) 10mg/mL Inj (discontinued)
Apo-Famotidine 20mg Tab Famotidine 20mg Tab MYLAN-Famotidine 20mg Tab Novo-Famotidine 20mg Tab Pepcid 20mg Tab (discontinued)
Apo-Famotidine 40mg Tab Famotidine 40mg Tab MYLAN-Famotidine 40mg Tab (discontinued) Novo-Famotidine 40mg Tab Pepcid 40mg Tab (discontinued)
Axid 150mg Cap
Misoprostol 100mcg Tab Cytotec 100mcg Tab (discontinued)
Misoprostol 200mcg Tab Cytotec 200mcg Tab (discontinued)
MYLAN-Omeprazole 10mg Cap Sandoz Omeprazole 10mg Cap Losec 10mg Cap (discontinued) *exception status when daily dose exceeds once daily
MYLAN-Omeprazole 10mg Cap Teva-Omeprazole 10mg Tab Losec 10mg Tab *exception status when daily dose exceeds once daily.
Apo-Omeprazole 20mg Cap MYLAN-Omeprazole 20mg Cap (discontinued) Omeprazole 20mg Cap
DNP
DNP
DNP DNP DNP DNP
DNP DNP
DNP
DNP
DNPM
DNPM
DNP DNP
DNP DNP DNP
DNP
DNP
1.9850
1.9850
0.1800 0.1800 0.1800 0.1800
0.3600 0.3600
0.3600
0.1800
0.2691
0.4481
0.2059 0.2059
0.2059 0.2059 0.2059
0.2287
0.2287
M
M
PPPP
PP
P
P
M
M
PP
PPP
M
M
SF
SF
SF SF SF SF
SF SF
SF
SF
SF
SF
SFC* SFC*
SFC* SFC* SFC*
SFC*
SFC*
02247745 00728128
02247735 00728128
01953842 02351102 02196018 02022133 00710121
01953834 02351110 02196026 02022141 00710113
00778338
02244022 00813966
02244023 00632600
02329425 02296438 02119579
02329425 02295407 02230737
02245058 02329433 02348691
OMGFRS
OMGFRS
APXSASMYLTEVFRS
APXSASMYLTEVFRS
PDP
AAPPFI
AAPPFI
MYLSDZAZE
MYLTEVAZE
APXMYLSAS
YY
YY
YYYYY
YYYYY
N
YY
YY
YYY
YYY
YYY
Alimentary Tract and Metabolism
4June 2018
A
A02BC02 PANTOPRAZOLE
omeprazole 20mg cap/tab
pantoprazole magnesium 40mg EC tab
pantoprazole sodium 20mg EC tab
pantoprazole sodium 40mg EC tab
Omeprazole-20mg Cap pms-Omeprazole 20mg Cap Sandoz Omeprazole 20mg Cap Losec 20mg Cap *exception status when daily dose exceeds once daily.
Apo-Omeprazole 20mg Cap Jamp-Omeprazole DR 20mg Tab MYLAN-Omeprazole 20mg Cap (discontinued) NAT-Omeprazole DR 20mg Tab Novo-Omeprazole Delayed-Release 20mg Tab Omeprazole 20mg Cap Omeprazole DR 20mg Tab pms-Omeprazole DR 20mg Tab RAN-Omeprazole 20mg Tab (discontinued) Losec 20mg Tab *exception status when daily dose exceeds once daily.
MYLAN-Pantoprazole T 40mg Tab Pantoprazole Magnesium 40mg Tab Pantoprazole T 40mg Tab Teva-Pantoprazole Magnesium 40mg Tab Tecta 40mg Tab
Apo-Pantoprazole 20mg DR Tab Jamp-Pantoprazole 20mg Tab Pantoprazole-20mg Tab RAN-Pantoprazole 20mg Tab Sandoz Pantoprazole 20mg DR Tab Teva-Pantoprazole 20mg DR Tab Pantoloc 20mg Tab *exception status when daily dose exceeds once daily.
Apo-Pantoprazole 40mg DR Tab Auro-Pantoprazole 40mg Tab Jamp-Pantoprazole 40mg Tab Mar-Pantoprazole 40mg DR Tab MINT-Pantoprazole 40mg DR Tab MYLAN-Pantoprazole 40mg DR Tab Pantoprazole 40mg DR Tab Pantoprazole 40mg Tab Pantoprazole-40mg Tab pms-Pantoprazole 40mg DR Tab RAN-Pantoprazole 40mg Tab Sandoz Pantoprazole 40mg DR Tab Teva-Pantoprazole 40mg DR Tab Pantoloc 40mg Tab
DNP DNP DNP DNP
DNP DNP
DNP DNP DNP DNP DNP
DNP
DNP DNP DNP DNP DNP
DNP DNP DNP DNP DNP DNP DNP
DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP
0.2287 0.2287 0.2287 0.2287
0.2287 0.2287
0.2287 0.2287 0.2287 0.2287 0.2287
0.2287
0.1875 0.1875 0.1875 0.1875 0.1875
0.1803 0.1803 0.1803 0.1803 0.1803 0.1803 0.1803
0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016 0.2016
MMMM
MM
MMMMM
M
MMMMM
MMMMMMM
MMMMMMMMMMMMMM
SFC* SFC* SFC* SFC*
SFC* SFC*
SFC* SFC* SFC* SFC* SFC*
SFC*
E E E E E
SFC* SFC* SFC* SFC* SFC* SFC* SFC*
SFC* SFC* SFC* SFC* SFC* SFC* SFC* SFC* SFC* SFC* SFC* SFC* SFC* SFC*
02411857 02320851 02296446 00846503
02245058 02420198 02329433 02439549 02295415 02348691 02416549 02310260 02374870 02190915
02408570 02441853 02466147 02440628 02267233
02292912 02408414 02428172 02305038 02301075 02285479 02241804
02292920 02415208 02357054 02416565 02417448 02299585 02437945 02370808 02428180 02307871 02305046 02301083 02285487 02229453
SIVPMSSDZAZE
APXJPCMYLNATTEVSASAHIPMSRANAZE
MYLAPRSASTEVTAK
APXJPCSIVRANSDZTEVTAK
APXAROJPCMARMNTMYLPMSSASSIVPMSRANSDZTEVTAK
YYYY
YYYYYYYYYY
YYYYY
YYYYYYY
YYYYYYYYYYYYYY
Alimentary Tract and Metabolism
5June 2018
A
A02BC03
A02BC04
A02BC05
LANSOPRAZOLE
RABEPRAZOLE
ESOMEPRAZOLE
lansoprazole 15mg cap
lansoprazole 30mg cap
rabeprazole 10mg EC tab
rabeprazole 20mg EC tab
*exception status when daily dose exceeds once daily.
Apo-Lansoprazole 15mg DR Cap Lansoprazole 15mg Cap Lansoprazole 15mg Cap Lansoprazole 15mg DR Cap MYLAN-Lansoprazole 15mg DR Cap RAN-Lansoprazole 15mg Cap Sandoz Lansoprazole 15mg DR Cap Teva-Lansoprazole 15mg DR Cap Prevacid 15mg Cap
Prevacid FasTab 15mg Tab
Apo-Lansoprazole 30mg DR Cap Lansoprazole 30mg Cap Lansoprazole 30mg DR Cap Lansoprazole-30mg Cap MYLAN-Lansoprazole 30mg DR Cap RAN-Lansoprazole 30mg Cap Sandoz Lansoprazole 30mg DR Cap Teva-Lansoprazole 30mg DR Cap Prevacid 30mg Cap
Prevacid FasTab 30mg Tab
Apo-Rabeprazole 10mg EC Tab MYLAN-Rabeprazole 10mg Tab (discontinued) pms-Rabeprazole 10mg EC Tab Rabeprazole EC 10mg Tab Rabeprazole-10mg Tab RAN-Rabeprazole 10mg Tab Sandoz Rabeprazole 10mg EC Tab Teva-Rabeprazole-EC 10mg Tab Pariet 10mg Tab
Apo-Rabeprazole 20mg EC Tab MYLAN-Rabeprazole 20mg Tab (discontinued) pms-Rabeprazole 20mg EC Tab Rabeprazole EC 20mg Tab Rabeprazole-20mg Tab RAN-Rabeprazole 20mg Tab Sandoz Rabeprazole 20mg EC Tab Teva-Rabeprazole-EC 20mg Tab Pariet 20mg Tab
DNP DNP DNP DNP DNP DNP DNP DNP DNP
DNP
DNP DNP DNP DNP DNP DNP DNP DNP DNP
DNP
DNP
DNP DNP DNP DNP DNP DNP DNP
DNP
DNP DNP DNP DNP DNP DNP DNP
0.2500 0.2500 0.2500 0.2500 0.2500 0.2500 0.2500 0.2500 0.2500
2.0420
0.5000 0.5000 0.5000 0.5000 0.5000 0.5000 0.5000 0.5000 0.5000
2.0420
0.0669
0.0669 0.0669 0.0669 0.0669 0.0669 0.0669 0.0669
0.1338
0.1338 0.1338 0.1338 0.1338 0.1338 0.1338 0.1338
PPPPPPPPP
L
MMMMMMMMM
L
M
MMMMMMM
M
MMMMMMM
E E E E E E E E E
E
E E E E E E E E E
E
SFC
SFC SFC SFC SFC SFC SFC SFC
SFC
SFC SFC SFC SFC SFC SFC SFC
02293811 02385767 02433001 02357682 02353830 02402610 02385643 02280515 02165503
02249464
02293838 02433028 02357690 02410389 02353849 02402629 02385651 02280523 02165511
02249472
02345579 02408392 02310805 02356511 02385449 02298074 02314177 02296632 02243796
02345587 02408406 02310813 02356538 02385457 02298082 02314185 02296640 02243797
APXSIVPMSSASMYLRANSDZTEVABB
ABB
APXPMSSASSIVMYLRANSDZTEVABB
ABB
APXMYLPMSSASSIVRANSDZTEVJAN
APXMYLPMSSASSIVRANSDZTEVJAN
YYYYYYYYY
N
YYYYYYYYY
N
YYYYYYYYY
YYYYYYYYY
Alimentary Tract and Metabolism
6June 2018
A
A03 DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS
A03A DRUGS FOR FUNCTIONAL BOWEL DISORDERS
A02BD
A02BX
A03AA
A03AB
COMBINATIONS FOR ERADICATION OF HELICOBACTER PYLORI
DRUGS FOR PEPTIC ULCER AND GASTROESOPHAGEAL REFLUX DISEASE(GERD)
SYNT ANTICHOLIN ESTERS WITH TERTIARY AMINO GROUP
SYNT ANTICHOLINERGICS,ESTERS,QUATER AMMONIUM COMP
A02BD07
A02BX02
A03AA05
A03AA07
LANSOPRAZOLE, CLARITHROMYCIN AND AMOXICILLIN
SUCRALFATE
TRIMEBUTINE
DICYCLOVERINE (DICYCLOMINE)
esomeprazole 20mg tab
esomeprazole 40mg cap/tab
sucralfate 1g tab
trimebutine 200mg tab
ACT Esomeprazole 20mg Tab Apo-Esomeprazole 20mg DR Tab Esomeprazole 20mg Tab MYLAN-Esomeprazole 20mg DR Tab RAN-Esomeprazole 20mg Tab Nexium 20mg Tab
ACT Esomeprazole 40mg Tab Apo-Esomeprazole 40mg DR Tab Esomeprazole 40mg DR Tab Esomeprazole 40mg Tab MYLAN-Esomeprazole 40mg DR Tab pms-Esomeprazole DR 40mg Cap RAN-Esomeprazole 40mg Tab Nexium 40mg Tab
Hp-PAC *quantity limit of one pack per year
Apo-Sucralate 1g Tab Novo-Sucralate 1g Tab Sulcrate 1g Tab
Sulcrate 1g/5mL Plus Susp
Trimebutine 100mg Tab
Trimebutine 200mg Tab Modulon 200mg Tab
Bentylol 10mg Tab (discontinued) Dicyclomine 10mg/mL Inj
Jamp-Dicyclomine 20mg Tab Bentylol 20mg Tab (discontinued)
DNP
DNP DNP DNP
DNP
DNP
DNP DNP
DNP
89.2500
0.3236 0.3236 0.3236
0.1207
0.2744
0.5537 0.5537
0.6990
L
MMM
L
L
MM
L
SF*
SF SF SF
SF
SFC
SFC SFC
SFC
02423855 02339099 02442493 02383039 02423979 02244521
02423863 02339102 02431173 02442507 02383047 02379171 02423987 02244522
02238525
02125250 02045702 02100622
02103567
02245663
02245664 00803499
02103087 00392812
02366088 02103095
ATVAPXSIVMYLRANAZE
ATVAPXSASSIVMYLPMSRANAZE
ABB
APXTEVAXC
AXC
AAP
AAPAXC
AXCSDZ
JPCAXC
YYYYYY
YYYYYYYY
N
YYY
N
N
YY
NN
NN
Alimentary Tract and Metabolism
7June 2018
A
A03B
A03C
A03E
A03F
BELLADONNA AND DERIVATIVES, PLAIN
ANTISPASMODICS IN COMBINATION WITH PSYCHOLEPTICS
ANTISPASMODICS,ANTICHOLINERGICS WITH ANALGESICS
PROPULSIVES
A03AD
A03AX
A03BA
A03CA
A03ED
A03FA
PAPAVERINE AND DERIVATIVES
OTHER DRUGS FOR FUNCTIONAL BOWEL DISORDERS
BELLADONNA ALKALOIDS, TERTIARY AMINES
SYNTHETICS,PSYCHOLEPTICS COMBINATIONS
ANTISPASMODICS IN COMBINATION WITH OTHER DRUGS
PROPULSIVES
A03AB02
A03AD01
A03AX04
A03AX13
A03BA01
A03BA03
A03CA02
A03ED99
A03FA01
GLYCOPYRROLATE (GLYCOPYRRONIUM)
PAPAVERINE
PINAVERIUM
SILICONES
ATROPINE
HYOSCYAMINE
CLIDINIUM AND PSYCHOLEPTICS
ANTISPASMODICS, COMBINATIONS
METOCLOPRAMIDE
chlordiazepoxide HCl 5mg & clidinium Br 2.5mg cap
metoclopramide HCl 1mg o/l
Glycopyrrolate 0.2mg/mL Inj
Papaverine HCl 32.5mg/mL Inj
Dicetel 50mg Tab
Dicetel 100mg Tab
Ovol 80 (80mg) Tab
Atropine Sulfate 0.4mg/mL Inj
Atropine Sulfate 0.6mg/mL Inj
Levsin 0.125mg SL Tab
Apo-Chlorax 5/2.5mg Cap Librax Cap
Bellergal Spacetabs
Metonia 1mg/mL Liq Maxeran 1mg/mL O/L (discontinued)
DNP
DNP
DNP
DNP
DNP
DNP
DN DN
DN
DNP
3.9775
0.3607
0.6289
2.2880
2.4880
0.4935
0.2451 0.2451
1.6918
0.0529
L
L
L
L
L
L
MM
L
M
SFC
SFC
SFC
SFC
SFC
SFC
SFC SFC
SFC
SFC
02039508
00009881
01950592
02230684
00292990
00392782
00392693
00125857
00618454 00115630
00176141
02230433 00314714
SDZ
SDZ
ABB
ABB
CHU
SDZ
SDZ
AXS
AAPVLN
PAL
PDPNRD
N
N
N
N
N
N
N
N
YY
N
YY
Alimentary Tract and Metabolism
8June 2018
A
A04 ANTIEMETICS AND ANTINAUSEANTS
A04A ANTIEMETICS AND ANTINAUSEANTS
A04AA SEROTONIN (5HT3) ANTAGONISTS
A03FA03
A04AA01
DOMPERIDONE
ONDANSETRON
metoclopramide HCl 5mg tab
metoclopramide HCl 10mg tab
domperidone maleate 10mg tab
ondansetron 4mg tab
ondansetron 4mg/5mL o/l
ondansetron OD 4mg tab/film
ondansetron 8mg tab
Metonia 5mg Tab Maxeran 5mg Tab (discontinued)
Metoclopramide 5mg/mL Inj
Metonia 10mg Tab Maxeran 10mg Tab (discontinued)
Apo-Domperidone 10mg Tab Domperidone 10mg Tab Domperidone-10mg Tab Jamp-Domperidone 10mg Tab Mar-Domperidone 10mg Tab pms-Domperidone 10mg Tab RAN-Domperidone 10mg Tab ratio-Domperidone 10mg Tab Motilium 10mg Tab (discontinued)
Apo-Ondansetron 4mg Tab CO Ondansetron 4mg Tab Jamp-Ondansetron 4mg Tab Mar-Ondansetron 4mg Tab MINT-Ondansetron 4mg Tab MYLAN-Ondansetron 4mg Tab NAT-Ondansetron 4mg Tab Novo-Ondansetron 4mg Tab Ondansetron 4mg Tab pms-Ondansetron 4mg Tab Sandoz Ondansetron 4mg Tab Septa-Ondansetron 4mg Tab Zofran 4mg Tab
Ondansetron 4mg/5mL O/L Zofran 4mg/5mL O/L
Ondissolve ODF 4mg Film Sandoz Ondansetron ODT 4mg Tab Zofran ODT 4mg Tab
DNP
DNP
DNP
DNPM DNPM DNPM DNPM DNPM DNPM DNPM DNPM
DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP
DNP DNP
DNP DNP DNP
0.0645
3.3925
0.0676
0.0428 0.0428 0.0428 0.0428 0.0428 0.0428 0.0428 0.0428
2.5556 2.5556 2.5556 2.5556 2.5556 2.5556 2.5556 2.5556 2.5556 2.5556 2.5556 2.5556 2.5556
1.6028 1.6028
2.5556 2.5556 2.5556
M
L
M
MMMMMMMM
PPPPPPPPPPPPP
MM
PPP
SFC
SFC
SFC
SFC SFC SFC SFC SFC SFC SFC SFC
E E E E E E E E E E E E E
E E
E E E
02230431 02099195
02185431
02230432 02099209
02103613 02350440 02238341 02369206 02403870 02236466 02268078 01912070 00855820
02288184 02296349 02313685 02371731 02305259 02297868 02417839 02264056 02421402 02258188 02274310 02376091 02213567
02291967 02229639
02389983 02444674 02239372
PDPMRR
SDZ
PDPMRR
APXSASSIVJPCMARPMSRANTEVJAN
APXATVJPCMARMNTMYLNATTEVSASPMSSDZSPTNVR
AAPNVR
TAKSDZNVR
YY
N
YY
YYYYYYYYY
YYYYYYYYYYYYY
YY
YYY
Alimentary Tract and Metabolism
9June 2018
A
A04AD OTHER ANTIEMETICS
A04AA02
A04AA05
A04AD01
A04AD11
GRANISETRON
PALONOSETRON
SCOPOLAMINE
NABILONE (CANNABINOID (THC) DERIVATIVES)
ondansetron OD 8mg tab/film
granisetron 1mg tab
hyoscine butylbromide 20mg/mL inj
nabilone 0.25mg cap
nabilone 0.5mg cap
Apo-Ondansetron 8mg Tab CO Ondansetron 8mg Tab Jamp-Ondansetron 8mg Tab Mar-Ondansetron 8mg Tab MINT-Ondansetron 8mg Tab MYLAN-Ondansetron 8mg Tab NAT-Ondansetron 8mg Tab Ondansetron 8mg Tab pms-Ondansetron 8mg Tab Sandoz Ondansetron 8mg Tab Septa-Ondansetron 8mg Tab Teva-Ondansetron 8mg Tab Zofran 8mg Tab
Ondissolve ODF 8mg Film Sandoz Ondansetron ODT 8mg Tab Zofran ODT 8mg Tab
Apo-Granisetron 1mg Tab NAT-Granisetron 1mg Tab Kytril 1mg Tab (discontinued)
Aloxi 0.5mg Cap
Scopolamine 0.4mg/mL Inj Scopolamine 0.6mg/mL Inj
Transderm-V 1.5mg Patch
Buscopan 10mg Tab
Hyoscine Butylbromide 20mg/mL Inj Buscopan 20mg/mL Inj (discontinued)
RAN-Nabilone 0.25mg Cap (discontinued) Teva-Nabilone 0.25mg Cap Cesamet 0.25mg Cap
CO Nabilone 0.5mg Cap pms-Nabilone 0.5mg Cap RAN-Nabilone 0.5mg Cap (discontinued) Teva-Nabilone 0.5mg Cap Cesamet 0.5mg Cap
DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP DNP
DNP DNP DNP
DNP DNP
DNP DNP
DNP
DNP
DN DN
DN DN
DN DN
5.1111 5.1111 5.1111 5.1111 5.1111 5.1111 5.1111 5.1111 5.1111 5.1111 5.1111 5.1111 5.1111
4.9930 4.9930 4.9930
9.0000 9.0000
4.8900 5.3600
0.3484
4.5200
1.0471 1.0471
0.7756 0.7756
0.7756 0.7756
MMMMMMMMMMMMM
MMM
MM
LL
L
M
MM
MM
MM
E E E E E E E E E E E E E
E E E
E E
SFC SFC
SF
SF
SFC SFC
SFC SFC
SFC SFC
02288192 02296357 02313693 02371758 02305267 02297876 02417847 02421410 02258196 02274329 02376105 02264064 02213575
02389991 02444682 02239373
02308894 02452359 02185881
02381729
00541869 00541877
80024336
00363812
02229868 00363839
02358077 02392925 02312263
02393581 02380900 02358085 02384884 02256193
APXATVJPCMARMNTMYLNATSASPMSSDZSPTTEVNVR
TAKSDZNVR
APXNATHLR
PFR
HOSHOS
NVR
SAV
SDZBOE
RANTEVVLN
ATVPMSRANTEVVLN
YYYYYYYYYYYYY
YYY
YYY
N
NN
N
N
YY
YYY
YYYYY
Alimentary Tract and Metabolism
10June 2018
A
A05
A06
BILE AND LIVER THERAPY
LAXATIVES
A05A
A06A
BILE THERAPY
LAXATIVES
A05AA
A06AA
BILE ACIDS AND DERIVATIVES
SOFTENERS, EMOLLIENTS
A04AD12
A04AD99
A05AA02
A06AA02
APREPITANT
DIMENHYDRINATE
URSODIOL (URSODEOXYCHOLIC ACID)
DOCUSATE SODIUM
nabilone 1mg cap
dimenhydrinate 10mg/mL IV inj
dimenhydrinate 50mg/mL IM inj
ursodiol 250mg tab
ursodiol 500mg tab
CO Nabilone 1mg Cap pms-Nabilone 1mg Cap RAN-Nabilone 1mg Cap (discontinued) Teva-Nabilone 1mg Cap Cesamet 1mg Cap
Emend Tri-Pack Cap
Emend 80mg Cap
Emend 125mg Cap
Dimenhydrinate 10mg/mL IV Amp Gravol 10mg/mL IV Amp (discontinued)
Gravol 15mg/5mL O/L
Gravol 25mg Supp
Dimenhydrinate 50mg/mL IM Inj Gravol l 50mg/mL IM Inj
Dimenhydrinate 50mg Supp Gravol 50mg Tab
Dimenhydrinate 100mg (Adult) Supp Gravol 100mg Supp
pms-Ursodiol C 250mg Tab Ursodiol 250mg Tab Urso 250mg Tab
pms-Ursodiol C 500mg Tab Ursodiol 500mg Tab Urso DS 500mg Tab
pms-Docusate Sodium 4mg/mL Syr
DN DN
DN DN
DNP
DNP
DNP
DNP DNP
DN DN DN
DN DN DN
DNP
1.5513 1.5513
1.5513 1.5513
32.8900
32.8900
32.8900
1.4490 1.4490
0.7636 0.7636 0.7636
1.4483 1.4483 1.4483
0.0254
MM
MM
L
L
L
MM
MMM
MMM
L
SFC SFC
SFC SFC
E
E
E
SFC SFC
E E E
E E E
C
02393603 02380919 02358093 02384892 00548375
02298813
02298791
02298805
00392731 00013560
00230197
00783595
00392537 00013579
00392553 00013803
00392545 00013609
02273497 02426900 02238984
02273500 02426919 02245894
00703508
ATVPMSRANTEVVLN
FRS
FRS
FRS
SDZCHU
CHU
CHU
SDZCHU
SDZCHU
SDZCHU
PMSGLMAXC
PMSGLMAXC
PMS
YYYYY
N
N
N
YY
N
N
YY
NN
NN
YYY
YYY
N
Alimentary Tract and Metabolism
11June 2018
A
A06AB
A06AD
CONTACT LAXATIVES
OSMOTICALLY ACTING LAXATIVES
A06AB02
A06AB06
A06AB56
A06AD10
A06AD11
BISACODYL
SENNA GLYCOSIDES
SENNA GLYCOSIDES, COMBINATIONS
MINERAL SALTS IN COMBINATION
LACTULOSE
docusate sodium 100mg cap
lactulose 667mg/mL o/l
pms-Docusate Sodium 10mg Drp (discontinued) Colace 10mg/mL Drp
Colace 20mg/5mL Syrup
ratio-Docusate Sodium 20mg/5mL Syr Selax 20mg/5mL USP Syr
Docusate Sodium 100mg Cap pms-Docusate Sodium 100mg Cap
Docusate Sodium 100mg Cap Jamp-Docusate Sodium 100mg Cap Novo-Docusate 100mg Cap ratio-Docusate Sodium 100mg Cap Colace 100mg Cap Selax 100mg Cap
Apo-Bisacodyl 5mg Tab
Jamp-Bisacodyl 5mg Tab Bisacodyl-ODAN 5mg Tab Dulcolax ECT 5mg Tab Jamp-Bisacodyl 5mg Supp
pms-Bisacodyl 10mg Supp (discontinued) Dulcolax 10mg Supp Jamp-Bisacodyl 10mg Supp
Senokot 1.7mg/mL Syr
Jamp-Sennosides 8.6mg Tab pms-Sennosides 8.6mg Tab Senokot 8.6mg Tab
Senokot S 8.6mg/50mg Tab
CoLyte Powder for Solution Peglyte Powder for Solution
Apo-Lactulose 667mg/mL O/L Jamp-Lactulose 667mg/mL O/L ratio-Lactulose 667mg/mL O/L Teva-Lactulose 667mg/mL O/L Chronulac 667mg/mL O/L (discontinued)
DNP
DNP
DNP DNP
DNP DNP
DNP DNP
DNP DNP DNP
DNP
DNP DNP DNP DNP
DNP DNP
DNP
DNP DNP DNP
DNP
DNP DNP
DNP DNP DNP
0.1770
0.0232
0.0523 0.0220
0.0378 0.0378
0.0383 0.0250
0.0258 0.1567 0.0383
0.0450
0.0405 0.0550 0.2010 0.4500
1.2033 0.8333
0.0477
0.0488 0.0588 0.1740
0.1960
0.0048 0.0730
0.0145 0.0145 0.0145
L
L
LL
MM
LL
LLL
L
LLLL
LL
L
LLL
L
LL
MMM
C
C
C C
C C
C C
C C C
C
C C C C
C C
C
C C C
C
C C
E E E
00880140 02090163
02086018
00870226 00695033
02426838 00703494
00716731 02245946 02020084 00870196 02106256 00514888
00545023
02246039 02273411 00254142 02410893
00582883 00003875 02361450
00367729
80009595 00896411 00026158
00026123
00677442 00777838
02242814 02295881 00854409 02331551 00534528
PMSANB
ANB
TEVODN
SASPMS
TARJPCTEVTEVANBODN
APX
JPCODNBOEJPC
PMSBOEJPC
PFR
JPCPMSPFR
PFR
PDPPDP
APXJPCTEVTEVMER
NN
N
NN
YY
NNNNNN
N
NNNN
NNN
N
NNN
N
NN
YYYYY
Alimentary Tract and Metabolism
12June 2018
A
A07 ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS
A07A INTESTINAL ANTIINFECTIVES
A06AG
A06AH
A06AX
A07AA
ENEMAS
PERIPHERAL OPIOID RECEPTOR ANTAGONISTS
OTHER DRUGS FOR CONSTIPATION
ANTIBIOTICS
A06AD15
A06AD19
A06AG01
A06AH01
A06AX04
A06AX05
A07AA02
A07AA06
A07AA11
A07AA12
MACROGOL
MAGNESIUM CITRATE
SODIUM PHOSPHATE
METHYLNALTREXONE BROMIDE
LINACLOTIDE
PRUCALOPRIDE
NYSTATIN
PAROMOMYCIN
RIFAXIMIN
FIDAXOMICIN
lactulose 667mg/mL syrup
nystatin 100,000iu o/l
Lactulose 667mg/5mL Syr pms-Lactulose 667mg/mL Syr
PEG 3350 Pwd Sol
Citro Mag 50mg/mL O/L Citrodan 50mg/mL O/L
Fleet Enema
Relistor 20mg/mL Inj
Constella 145mcg Cap
Constella 290mcg Cap
Resotran 1mg Tab
Resotran 2mg Tab
ratio-Nystatin 100,000iu/mL Oral Drops Mycostatin 100,000iu/mL Oral Susp (discontinued)
Jamp-Nystatin 100,000iu/mL Oral Susp pms-Nystatin 100,000iu/mL Oral Susp
Humatin 250mg Cap
Zaxine 550mg Tab
Dificid 200mg Tab
DNP DNP
DNP DNP
DNP
DNP DNP
DNP
DNP
0.0145 0.0145
0.0156 0.0138
0.0740
0.0740 0.0598
7.8400
94.6000
MM
LL
M
LL
L
L
E E
C C
SFC
SFC SFC
E
E
02412268 00703486
02358034
00262609 80001809
00009911
02308215
02417162
02417170
02377012
02377020
02194201 00248169
02433443 00792667
02078759
02410702
02387174
SASPMS
MSC
ROGODN
JNJ
PFI
ALL
ALL
JAN
JAN
TEVBRI
JPCPMS
ERF
LUP
FRS
YY
N
NN
N
N
N
N
N
N
YY
NN
N
N
N
Alimentary Tract and Metabolism
13June 2018
A
A07B
A07C
A07D
A07E
INTESTINAL ADSORBENTS
ELECTROLYTES WITH CARBOHYDRATES
ANTIPROPULSIVES
INTESTINAL ANTIINFLAMMATORY AGENTS
A07BB
A07CA
A07DA
A07EA
A07EB
BISMUTH PREPARATIONS
ORAL REHYDRATE SALT FORMULATIONS
ANTIPROPULSIVES
CORTICOSTEROIDS ACTING LOCALLY
ANTIALLERGIC AGENTS, EXCL CORTICOSTEROIDS
A07BB99
A07CA99
A07DA01
A07DA02
A07DA03
A07EA02
A07EA04
A07EA06
BISMUTH SUBSALICYLATE
ELECTROLYTES
DIPHENOXYLATE
OPIUM
LOPERAMIDE
HYDROCORTISONE
BETAMETHASONE
BUDESONIDE
loperamide HCl 0.2mg/mL o/l
loperamide 2mg caplet
PeptoBismol 17.6mg/mL O/L
PeptoBismol 262mg Cap
Gastrolyte Sachet
Lomotil 2.5mg Tab
Sandoz Opium & Belladonna 65mg/15mg Supp
pms-Loperamide 0.2mg/mL O/L Imodium 0.2mg/mL O/L (discontinued)
Apo-Loperamide 2mg Caplet Novo-Loperamide 2mg Caplet pms-Loperamide 2mg Caplet Imodium 2mg Caplet (discontinued)
Jamp-Loperamide 2mg Tab
Cortifoam
Cortenema 100mg/60mL Susp
Betnesol 5mg/100mL Retention Enema
Entocort 0.02mg/mL Enema
Entocort 3mg Cap
DN
DN
DNP
DNP DNP DNP
DNP
DNP
DNP
DNP
DNP
DNP
0.5023
5.2717
0.1677
0.0953 0.0953 0.0953
0.0953
7.4847
0.1262
0.1182
9.1571
1.7583
L
L
M
MMM
P
L
L
L
L
L
SFC
SFC
SFC
SFC SFC SFC
SFC
SF
SF
SF
SF
SF
02097079
02177994
01931563
00036323
01901869
02016095 02183323
02212005 02132591 02228351 02183862
02256452
00579335
02112736
02060884
02052431
02229293
PGA
PGA
SAV
PFI
SDZ
PMSJNJ
APXTEVPMSJNJ
JPC
PAL
ALL
PAL
AZE
AZE
N
N
N
N
N
YY
YYYY
N
N
N
N
N
N
Alimentary Tract and Metabolism
14June 2018
A
A08
A09
ANTIOBESITY PREPARATIONS, EXCL DIET PRODUCTS
DIGESTIVES, INCL ENZYMES
A07F
A08A
A09A
ANTIDIARRHOEAL MICROORGANISMS
ANTIOBESITY PREPARATIONS, EXCL DIET PRODUCTS
DIGESTIVES, INCL ENZYMES
A07EC
A07FA
A08AB
A09AA
AMINOSALICYLIC ACID AND SIMILAR AGENTS
ANTIDIARRHOEAL MICROORGANISMS
PERIPHERALLY ACTING ANTIOBESITY PRODUCTS
ENZYME PREPARATIONS
A07EB01
A07EC01
A07EC02
A07EC03
A07FA01
A08AB01
CROMOGLYCATE SODIUM
SULFASALAZINE
5-AMINOSALICYLIC ACID (MESALAMINE)
OLSALAZINE (5-ASA)
LACTIC ACID PRODUCING ORGANISMS
ORLISTAT
5-aminosalicylic acid 400mg tab
Nalcrom 100mg Cap
pms-Sulfasalazine 500mg Tab pms-Sulfasalazine EC 500mg Tab Salazopyrin 500mg Entabs Salazopyrin 500mg Tab
Pentasa 1g Supp Salofalk 1g Supp
Pentasa 1g/100mL Rectal Susp
Mezavant 1.2g Tab
Salofalk 2g/60g Rectal Susp
Salofalk 4g/60g Rectal Susp
Pentasa 4g/100mL Rectal Susp
Novo-5-ASA 400mg EC Tab Asacol 400mg Tab
Pentasa 500mg Tab Salofalk 500mg Supp Salofalk 500mg Tab
Asacol 800 (800mg) Tab
Dipentum 250mg Cap
Bacid Cap
Xenical 120mg Cap
DNP
DNP DNP DNP DNP
DNP DNP
DNP
DNP
DNP
DNP
DNP
DNP DNP
DNP DNP DNP
DNP
DNP
DNP
1.5491
0.2550 0.3880 0.5031 0.3298
1.9213 2.0638
0.0461
1.7079
0.0733
0.1244
0.0581
0.4899 0.4899
0.5895 1.4050 0.6295
1.1357
0.6143
1.0000
L
LLLL
LL
L
L
L
L
L
MM
LLL
L
L
L
SF
SF SF SF SF
SF SF
SF
SF
SF
SF
SF
SF SF
SF SF SF
SF
SF
SF
00500895
00598461 00598488 02064472 02064480
02153564 02242146
02153521
02297558
02112795
02112809
02153556
02171929 01997580
02099683 02112760 02112787
02267217
02063808
80017987
02240325
SAV
PMSPMSPFIPFI
FEIALL
FEI
SHI
ALL
ALL
FEI
TEVATV
FEIALLALL
ATV
SLP
ERF
HLR
N
NNNN
NN
N
N
N
N
N
YY
NNN
N
N
N
N
Alimentary Tract and Metabolism
15June 2018
A
A10 DRUGS USED IN DIABETES
A10A INSULINS AND ANALOGUES
A10AB
A10AC
INSULINS & ANALOGUES FOR INJECTION, FAST-ACTING
INSULINS & ANALOGUES FOR INJECTION, INTERMEDIATE-ACTING
A09AA02
A09AA04
A10AB01
A10AB04
A10AB05
A10AB06
A10AC01
MULTIENZYMES (LIPASE, PROTEASE, ETC)
TILACTASE
INSULIN (HUMAN)
INSULIN LISPRO
INSULIN ASPART
INSULIN GLULISINE
INSULIN (HUMAN)
Cotazym Cap Viokase Tab
Pancrease MT 4 Cap
Creon 6 Minimicrospheres Creon Minimicrospheres Micro
Cotazym ECS 8 Cap
Creon 10 Minimicrospheres Pancrease MT 10 Cap
Pancrease MT 16 Cap Viokase 16 Tab
Cotazym ECS 20 Cap
Creon 25 Minimicrospheres
Lactaid Regular Strength Tab
Humulin R Cartridges Humulin R Insulin Novolin GE Toronto Insulin Novolin GE Toronto Penfill
Humalog Cartridges Humalog Insulin Humalog KwikPen *full benefit for children 18 years and younger.
NovoMix 30 Penfill
NovoRapid 100iu/mL Penfill Ins NovoRapid 100iu/mL Vial Ins NovoRapid Flextouch 100iu/mL Pre-Filled Pen
Apidra 3mL Cartridges Apidra Solostar 3mL Prefilled Pen
Apidra 10mL Vial
DNP DNP
DNP
DNP DNP
DNP
DNP DNP
DNP DNP
DNP
DNP
DNP DNP DNP DNP
DNP DNP DNP
DNP DNP DNP
DNP DNP
DNP
0.2205 0.2608
0.6928
0.1703 1.7030
0.3980
0.2723 1.7322
2.7714 0.4002
1.0436
0.8507
3.2220 2.4630 2.3290 3.0480
3.9253 2.9640 3.8973
4.0420 2.9900 4.2080
3.4300 3.4633
2.5960
LL
L
LL
L
LL
LL
L
L
LLLL
LLL
LLL
LL
L
SF SF
SF
SF SF
SF
SF SF
SF SF
SF
SF
SFD SFD SFD SFD
E* E* E*
SFD SFD SFD
SFD SFD
SFD
00263818 02230019
00789445
02415194 02445158
00502790
02200104 00789437
00789429 02241933
00821373
01985205
02230653
01959220 00586714 02024233 02024284
02229705 02229704 02403412
02265435
02244353 02245397 02377209
02279479 02294346
02279460
FRSALL
JAN
ABBBGP
FRS
ABBJAN
JANALL
FRS
ABB
JNJ
LILLILNNONNO
LILLILLIL
NNO
NNONNONNO
SAVSAV
SAV
NN
N
NN
N
NN
NN
N
N
N
NNNN
NNN
N
NNN
NN
N
Alimentary Tract and Metabolism
16June 2018
A
A10B BLOOD GLUCOSE LOWERING DRUGS, EXCL. INSULINS
A10AD
A10AE
A10BA
INSULINS & ANALOGUES FOR INJEC. INTERMEDIATE-ACTING + FAST-ACTING
INSULINS & ANALOGUES, FOR INJECTION LONG-ACTING
BIGUANIDES
A10AD01
A10AD04
A10AE04
A10AE05
A10BA02
INSULIN (HUMAN)
INSULIN LISPRO
INSULIN GLARGINE
INSULIN DETEMIR
METFORMIN
metformin HCl 500mg tab
Humulin N Cartridges Humulin N Insulin Humulin N KwikPen Novolin GE NPH Insulin Novolin GE NPH Penfill
Humulin 30/70 Cartridges Humulin 30/70 Insulin Novolin GE 30/70 Insulin Novolin GE 30/70 Penfill
Novolin GE 40/60 Penfill
Novolin GE 50/50 Penfill
Humalog Mix25 Cartridges Humalog Mix25 KwikPen Humalog Mix25 Vial
Humalog Mix50 Cartridges Humalog Mix50 KwikPen
Basaglar 100iu/mL Cartridge Basaglar 100iu/mL Kwikpen Basaglar 100iu/mL Kwikpen Lantus 100iu/mL Cartridge Lantus 100iu/mL Solostar Pre-Filled Pen Lantus 100iu/mL Vial
Levemir 100iu/mL Penfill Levemir FlexTouch 100iu/mL Pre-Filled Pen
ACT Metformin 500mg Tab Apo-Metformin 500mg Tab Auro-Metformin 500mg Tab Jamp-Metformin 500mg Tab Jamp-Metformin Blackberry 500mg Tab Mar-Metformin 500mg Tab Metformin 500mg Tab (MAR)