40:00 Electrolytic, Caloric and Water Balance

40:08.00 ALKALINIZING AGENTS

CITRIC ACID, SODIUM CITRATE

Table: CITRIC ACID, SODIUM CITRATE
Drug strength and dosage form DIN Brand name Manufacturer code
66.8MG & 100MG/ML Solution 00721344 DICITRATE PMS

POTASSIUM CITRATE

Table: POTASSIUM CITRATE
Drug strength and dosage form DIN Brand name Manufacturer code
1080MG Tablet 02243768 KCITRA 10 UNK

SODIUM BICARBONATE

Table: SODIUM BICARBONATE
Drug strength and dosage form DIN Brand name Manufacturer code
325MG Tablet 00481912 XENEX SODIUM BICARBONATE XEN

40:10.00 AMMONIA DETOXICANTS

LACTULOSE

Table: LACTULOSE
Drug strength and dosage form DIN Brand name Manufacturer code
667MG Solution 02469391 PMS-LACTULOSE-PHARMA PMS
ST667MG/ML Syrup 02242814 APO-LACTULOSE APX
ST667MG/ML Syrup 02295881 JAMP-LACTULOSE JMP
ST667MG/ML Syrup 02412268 LACTULOSE SAN
ST667MG/ML Syrup 02247383 PHARMA-LACTULOSE PMS
ST667MG/ML Syrup 00703486 PMS-LACTULOSE PMS
ST667MG/ML Syrup 00854409 RATIO-LACTULOSE TEV
ST667MG/ML Syrup 02331551 TEVA-LACTULOSE TEV

40:10.20 

BENRALIZUMAB

Limited use benefit (prior approval required).

Initial coverage criteria (12 months):

For the adjunctive treatment of severe eosinophilic asthma in adults who are inadequately controlled with high-dose inhaled corticosteroids* plus one or more additional asthma controller(s) (e.g. long-acting beta-agonist); and

  • patient has had a blood eosinophil count of ≥0.15x109/L before initiation of benralizumab; and
  • patient is receiving maintenance treatment with oral corticosteroids (at a dose equivalent to ≥5mg prednisone per day) prior to starting benralizumab;
  • or
  • patient has had a blood eosinophil count of ≥0.3x109/L within the 12-month period prior to starting benralizumab; and
  • patient has experienced two or more clinically significant asthma exacerbations** within the 12-month period prior to starting benralizumab;
  • and
  • a baseline assessment of asthma symptom control using a validated asthma control questionnaire has been completed prior to the initiation of benralizumab; and
  • patient is managed by a physician with expertise in the treatment of asthma.

Coverage for benralizumab is provided for a maximum dose of 30 mg administered subcutaneously once every 4 weeks for the first 3 doses, then once every 8 weeks thereafter.

Fasenra will not be funded as a dual therapy with another biologic for the treatment of asthma.

Patients will be permitted to switch from one biologic agent to another following an adequate trial of the first biologic agent if unresponsive to therapy, or due to serious adverse effects or contraindications. An adequate trial is defined as at a minimum the completion of induction dosing (e.g. initial coverage period). Patients will not be permitted to switch back to a previously trialed biologic agent if they were deemed unresponsive to therapy.

Criteria for renewal or for initial NIHB coverage in patients currently maintained on Fasenra (12 months):

  • patient has not experienced an increase in clinically significant asthma exacerbations** with benralizumab treatment; and
  • for patients receiving maintenance oral corticosteroids, patient's oral corticosteroid maintenance dose has decreased from the pre-treatment dose. After the first 12 months, subsequent oral corticosteroid dose should be maintained; and
  • the 12-month asthma control questionnaire score has improved from baseline, where baseline represents the initiation of treatment. After the first 12 months, subsequent scores should be maintained.

* High-dose inhaled corticosteroid is defined as ≥ 500mcg of fluticasone propionate or equivalent daily.

** A clinically significant asthma exacerbation is defined as worsening of asthma such that the treating physician elected to administer systemic glucocorticoids for at least three days or the patient visited an emergency department or was hospitalized.

Table: BENRALIZUMAB
Drug strength and dosage form DIN Brand name Manufacturer code
30MG Solution 02473232 FASENRA AZC

40:12.00 REPLACEMENT PREPARATIONS

CALCIUM

Table: CALCIUM
Drug strength and dosage form DIN Brand name Manufacturer code
ST500MG Caplet 80001408 OYSTER SHELL CALCIUM NUR
ST500MG Caplet 80001122 PHARMA-CAL PED
ST5ML Liquid 80004123 CARBOCAL EUR
ST20MG/ML Liquid 80054754 M-CAL MAN
ST20MG/ML Liquid 80002626 SOLUCAL JMP
ST20MG/ML Liquid 80006877 WAMPOLE MINERAL CALCIUM WAM
ST100MG Liquid 80043628 NU-CAL ODN
ST100MG Liquid 80025527 SOLUCAL GREEN APPLE JMP
ST100MG Liquid 80025523 SOLUCAL RASPBERRY JMP
ST100MG Oral Liquid 80034595 WAMPOLE CALCIUM FOR CHILDREN PED
ST500MG Tablet 80017732 CAL500 PDL
ST500MG Tablet 02240240 CALCIUM PMT
ST500MG Tablet 02246040 CALCIUM JMP
ST500MG Tablet 80003658 CALCIUM WNP
500MG Tablet 80076097 CALCIUM UNK
ST500MG Tablet 80003773 CALCIUM 500 TRI
ST500MG Tablet 80062015 CALCIUM CARBONATE SAN
ST500MG Tablet 02237352 EUROCAL EUR
ST500MG Tablet 80055526 M-CAL MAN
ST500MG Tablet 00618098 NU-CAL ODN
ST500MG Tablet 00622443 O-CALCIUM VTH
500MG Tablet 80079608 PROCAL 500 PDL
ST500MG Tablet 00705373 WAMPOLE CALCIUM WAM
ST500MG Tablet 02239356 WAMPOLE CALCIUM WAM
ST500MG Tablet (Chewable) 80027026 JAMP-CALCIUM CARBONATE JMP
500MG Tablet (Film Coated) 80066648 BIOCALCIUM BMI

CALCIUM GLUCONATE,VIT D

Table: CALCIUM GLUCONATE,VIT D
Drug strength and dosage form DIN Brand name Manufacturer code
ST25MCG Liquid 80068920 SOLUCAL D FORT CITRUS JMP
ST25MCG Liquid 80069353 SOLUCAL D FORT GREEN APPLE JMP

CALCIUM, VITAMIN D

Table: CALCIUM, VITAMIN D
Drug strength and dosage form DIN Brand name Manufacturer code
ST10ΜG Caplet 80008566 PROCALD 400 PDL
ST500MG & 400IU Caplet 80012594 BIOCALD FORTE BMI
ST500MG & 1,000IU Liquid 80025038 SOLUCAL D FORT JMP
ST500MG & 400IU Liquid 80061575 CALCITE LIQUIDE D 400 RIV
ST500MG & 400IU Liquid 80054755 M-CAL D MAN
ST500MG & 400IU Liquid 80008126 SOLUCAL D JMP
ST500MG Liquid 80025543 SOLUCAL D CITRUS JMP
ST500MG Liquid 80025541 SOLUCAL D RASPBERRY JMP
ST500MG& 800IU Liquid 80025722 JAMP CALCIUM LACTOGLUCONATE VITAMIN D JMP
500MG & 1,000IU Tablet 80066093 CALCIUM 500 VITAMINE D1000 UNK
ST500MG & 1,000IU Tablet 80018540 JAMP CALCIUM CARBONATE VITAMIN D JMP
ST500MG & 1,000IU Tablet 80019536 M CALCIUM VITAMINE D MAN
ST500MG & 400IU Tablet 80004963 CALCITE 500 D 400 RIV
ST500MG & 400IU Tablet 80004969 CALCIUM 500 D 400 TRI
500MG & 400IU Tablet 80066082 CALCIUM 500 VITAMINE D400 UNK
500MG & 400IU Tablet 80066089 CALCIUM 500 VITAMINE D400 UNK
ST500MG & 400IU Tablet 80002623 CALCIUM VITAMIN D LEMON FLAVOUR JMP
ST500MG & 400IU Tablet 80009628 CALODAN D 400 ODN
ST500MG & 400IU Tablet 02245511 CARBOCAL D EUR
ST500MG & 400IU Tablet 80002901 CARBOCAL D EUR
ST500MG & 400IU Tablet 99100832 JAMP-CALCIUM + VITAMIN D JMP
ST500MG & 400IU Tablet 80002122 J-CAL+D JMP
500MG & 400IU Tablet 80025360 J-CAL+D JMP
ST500MG & 400IU Tablet 80013329 M-CAL D MAN
ST500MG & 400IU Tablet 80002703 NU-CAL D ODN
ST500MG & 400IU Tablet 80020974 OPUS CAL D OPU
500MG & 400IU Tablet 80065914 RIVA-CAL D RIV
ST500MG & 400IU Tablet 80006794 WAMPOLE CALCIUM VITAMIN D WAM
ST500MG & 800IU Tablet 80019533 M CALCIUM VITAMINE D MAN
ST500MG & 1,000IU Tablet (Chewable) 80029083 JAMP CALCIUM CITRATE VITAMIN D JMP
ST500MG & 1,000IU Tablet (Chewable) 80027787 JAMP-CALCIUM VITAMIN D JMP
ST500MG & 1,000IU Tablet (Chewable) 80050701 M-CAL D MAN
ST500MG & 400IU Tablet (Chewable) 80009412 CALCIUM CARBONATE VITAMINE D MAN
ST600MG & 400IU Tablet (Chewable) 80021716 WAMPOLE CALCIUM AND D WAM
500MG & 400IU Tablet (Film Coated) 80066647 BIOCALCIUMD BMI

ELECTROLYTES

Table: ELECTROLYTES
Drug strength and dosage form DIN Brand name Manufacturer code
ST5G/L Liquid 80074173 PEDIALYTE ABB
ST Miscellaneous 80023410 HYDRALYTE ELECTROLYTE HYD
ST3.56G & 300MG & 470MG & 530MG Powder 01931563 GASTROLYTE REGULAR SAC
ST Powder For Solution 80026860 HYDRALYTE ELECTROLYTE HYD
ST Powder For Solution 80027403 JAMP REHYDRALYTE JMP
ST0.856MG/ML Solution 80026861 HYDRALYTE ELECTROLYTE HYD
ST25MG & 2.2MG & 2.2MG & 0.9MG/ML Solution 00630365 PEDIALYTE ABB
25MG & 2.2MG & 2.2MG & 0.9MG/ML Solution 02219883 PEDIATRIC ELECTROLYTE PMS

MAGNESIUM

Table: MAGNESIUM
Drug strength and dosage form DIN Brand name Manufacturer code
25MG Caplet 80005079 MAGNESIUM COMPLEX JAM
100MG Tablet 80041590 JAMP-MAGNESIUM JMP
100MG Tablet 02068400 MAGNESIUM JAM

MAGNESIUM GLUCOHEPTONATE

Table: MAGNESIUM GLUCOHEPTONATE
Drug strength and dosage form DIN Brand name Manufacturer code
ST25MG Liquid 80009357 MAGNESIUM JMP
ST100MG/ML Oral Liquid 00026697 ROUGIER-MAGNESIUM TEV
ST100MG/ML Solution 80004109 MAGNESIUM-ODAN ODN

MAGNESIUM GLUCONATE

Table: MAGNESIUM GLUCONATE
Drug strength and dosage form DIN Brand name Manufacturer code
29MG Tablet 80062929 MMAGNESIUM GLUCONATE MAN
ST500MG Tablet 80009539 JAMP MAGNESIUM GLUCONATE JMP
500MG Tablet 00555126 MAGLUCATE PED

POTASSIUM CHLORIDE

Table: POTASSIUM CHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST600MG Capsule 80062704 JAMP POTASSIUM CHLORIDE ER JMP
ST600MG Capsule 02042304 MICRO K PAL
ST1,500MG Liquid 80024835 JAMP-POTASSIUM CHLORIDE JMP
ST1.33MEQ/ML Solution 02238604 PMS-POTASSIUM PMS
ST8MMOL Tablet 02246734 EURO K EUR
ST8MMOL Tablet 80035346 MK 8 MAN
ST8MMOL Tablet 02244068 RIVA-K 8 RIV
ST20MMOL Tablet 80026265 BIO K-20 POTASSIUM BMI
ST20MMOL Tablet 02242261 EURO K EUR
ST20MMOL Tablet 80013007 JAMP K JMP
ST20MMOL Tablet 80004415 ODAN K20 ODN
ST20MMOL Tablet 02243975 RIVA-K 20 RIV
ST780MG Tablet 80025624 MK 20 MAN
ST8MMOL Tablet (Extended Release) 80013005 JAMP-K 8 JMP
ST600MG Tablet (Extended Release) 80008214 ODAN K8 ODN
20MEQ Tablet (Film Coated), Extended Release 80071412 MK20 SOLUBLE MAN
ST600MG Tablet (Sugar Coated) 80040226 SLOWK NVR
ST780MG Tablet (Time Release) 80040412 K20 POTASSIUM UNK
ST1,500MG Tablet (Time Release) 80040416 PHARMA-K20 PMS

POTASSIUM CITRATE

Table: POTASSIUM CITRATE
Drug strength and dosage form DIN Brand name Manufacturer code
1080MG Liquid 80011529 POTASSIUM CITRATE UNK
10MEQ Tablet 80023817 JAMPKCITRATE JMP
ST10MMOL Tablet 80026332 MK 10 MAN
ST25MEQ Tablet (Effervescent) 80033602 JAMP-K EFFERVESCENT JMP
ST25MEQ Tablet (Effervescent) 02085992 K LYTE WPC
ST25MMOL Tablet (Effervescent) 80011428 EURO K EUR

SODIUM CHLORIDE

Table: SODIUM CHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
1G Capsule 90726364 SODIUM CHLORIDE 1G MDS
0.9% Injection 99002329 SODIUM CHLORIDE (SMALL VOL.) UNK
0.9% Solution 00037818 BACTERIOSTATIC SODIUM CHLORIDE PFI
0.9% Solution 00037796 SODIUM CHLORIDE PFI
0.9% Solution 00060208 SODIUM CHLORIDE BAX
0.9% Solution 00402249 SODIUM CHLORIDE OMG
0.9% Solution 02150204 SODIUM CHLORIDE OMG
Syringe 09991564 NACL SALINE PF UNK

40:18.00 ION-REMOVING AGENTS

SODIUM POLYSTYRENE SULFONATE

Table: SODIUM POLYSTYRENE SULFONATE
Drug strength and dosage form DIN Brand name Manufacturer code
Oral Liquid 01902776 KAYEXALATE SAC

40:18.18 POTASSIUM - REMOVING AGENTS

CALCIUM POLYSTYRENE SULFONATE

Table: CALCIUM POLYSTYRENE SULFONATE
Drug strength and dosage form DIN Brand name Manufacturer code
1G Powder For Solution 02017741 RESONIUM CALCIUM SAC

SODIUM POLYSTYRENE SULFONATE

Table: SODIUM POLYSTYRENE SULFONATE
Drug strength and dosage form DIN Brand name Manufacturer code
1G Powder 00765252 K-EXIT OMG
1G Powder For Suspension 02026961 KAYEXALATE SAC
1G Powder For Suspension 02473941 ODAN-SODIUM POLYSTYRENE SULFONATE ODN
1G Powder For Suspension 00755338 SOLYSTAT PED
250MG Suspension 02473968 ODAN-SODIUM POLYSTYRENE SULFONATE ODN
250MG/ML Suspension 00769541 SOLYSTAT PED

40:18.19 PHOSPHATE - REMOVING AGENTS

IRON (SUCROFERRIC OXYHYDROXIDE)

Limited use benefit (prior approval required).

For patients with elevated phosphate levels or elevated phosphate X calcium product despite dietary restriction of phosphate and use of calcium-based phosphate binders (short term elevations should be managed with aluminium based binders).

For patients with elevated calcium levels despite discontinuation of calcium binder, and Vitamin D analogue and/or modification of dialysate calcium.

For patients with adynamic bone disease and low PTH levels (<100 pg/ml or <0.9 pmol/L) with normal or elevated calcium levels.

Table: IRON (SUCROFERRIC OXYHYDROXIDE)
Drug strength and dosage form DIN Brand name Manufacturer code
500MG Tablet (Chewable) 02471574 VELPHORO UNK

LANTHANUM CARBONATE HYDRATE

Limited use benefit (prior approval required).

For patients with elevated phosphate levels or elevated phosphate X calcium product despite dietary restriction of phosphate and use of calcium-based phosphate binders (short term elevations should be managed with aluminium based binders).

For patients with elevated calcium levels despite discontinuation of calcium binder, and vitamin D analogue and/or modification of dialysate calcium.

For patients with adynamic bone disease and low PTH levels (<100 pg/ml or <0.9 pmol/L) with normal or elevated calcium levels.

Table: LANTHANUM CARBONATE HYDRATE
Drug strength and dosage form DIN Brand name Manufacturer code
250MG Tablet (Chewable) 02287145 FOSRENOL UNK
500MG Tablet (Chewable) 02287153 FOSRENOL UNK
750MG Tablet (Chewable) 02287161 FOSRENOL UNK
1000MG Tablet (Chewable) 02287188 FOSRENOL UNK

SEVELAMER CARBONATE

Limited use benefit (prior approval required).

For patients with elevated phosphate levels or elevated phosphate X calcium product despite dietary restriction of phosphate and use of calcium-based phosphate binders (short term elevations should be managed with aluminium based binders).

For patients with elevated calcium levels despite discontinuation of calcium binder, and Vitamin D analogue and/or modification of dialysate calcium.

For patients with adynamic bone disease and low PTH levels (<100 pg/ml or <0.9 pmol/L) with normal or elevated calcium levels.

Table: SEVELAMER CARBONATE
Drug strength and dosage form DIN Brand name Manufacturer code
800MG Tablet 02461501 ACCEL-SEVELAMER ACP
800MG Tablet 02354586 RENVELA SAC

SEVELAMER HYDROCHLORIDE

Limited use benefit (prior approval required).

For patients with elevated phosphate levels or elevated phosphate X calcium product despite dietary restriction of phosphate and use of calcium-based phosphate binders (short term elevations should be managed with aluminium based binders).

For patients with elevated calcium levels despite discontinuation of calcium binder, and vitamin D analogue and/or modification of dialysate calcium.

For patients with adynamic bone disease and low PTH levels (<100 pg/ml or <0.9 pmol/L) with normal or elevated calcium levels.

Table: SEVELAMER HYDROCHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
800MG Tablet 02244310 RENAGEL SAC

40:20.00 CALORIC AGENTS

GLUCOSE

Table: GLUCOSE
Drug strength and dosage form DIN Brand name Manufacturer code
Tablet 97799899 BD GLUCOSE BTD
4G Tablet 09991092 DEX-4 GLUCOSE UNK

LEVOCARNITINE

Limited use benefit (prior approval required).

For treatment of carnitine deficiency.

Table: LEVOCARNITINE
Drug strength and dosage form DIN Brand name Manufacturer code
100MG Solution 02492105 ODAN LEVOCARNITINE ODN
100MG/ML Solution 02144336 CARNITOR UNK
200MG/ML Solution 02144344 CARNITOR UNK
330MG Tablet 02144328 CARNITOR UNK

40:28.08 LOOP DIURETICS

ETHACRYNIC ACID

Table: ETHACRYNIC ACID
Drug strength and dosage form DIN Brand name Manufacturer code
ST25MG Tablet 02258528 EDECRIN VAE

FUROSEMIDE

Table: FUROSEMIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST10MG/ML Solution 02224720 LASIX SAC
ST20MG Tablet 00396788 APO FUROSEMIDE APX
ST20MG Tablet 02247371 BIO-FUROSEMIDE BMI
ST20MG Tablet 00496723 FUROSEMIDE PDL
ST20MG Tablet 02351420 FUROSEMIDE SAN
ST20MG Tablet 02466759 MINT-FUROSEMIDE MIN
ST20MG Tablet 02247493 PMS-FUROSEMIDE PMS
ST20MG Tablet 00337730 TEVA-FUROSEMIDE TEV
ST40MG Tablet 00362166 APO FUROSEMIDE APX
ST40MG Tablet 02247372 BIO-FUROSEMIDE BMI
ST40MG Tablet 00397792 FUROSEMIDE PDL
ST40MG Tablet 02351439 FUROSEMIDE SAN
ST40MG Tablet 02466767 MINT-FUROSEMIDE MIN
ST40MG Tablet 02247494 PMS-FUROSEMIDE PMS
ST40MG Tablet 00337749 TEVA-FUROSEMIDE TEV
ST80MG Tablet 00707570 APO FUROSEMIDE APX
ST80MG Tablet 00667080 FUROSEMIDE PDL
ST80MG Tablet 02351447 FUROSEMIDE SAN
ST80MG Tablet 02466775 MINT-FUROSEMIDE MIN
ST80MG Tablet 00765953 TEVA-FUROSEMIDE TEV
ST500MG Tablet 02224755 LASIX SPECIAL SAC

40:28.16 POTASSIUM SPARING DIURETICS

AMILORIDE

Table: AMILORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG Tablet 02249510 MIDAMOR AAP

AMILORIDE, HYDROCHLOROTHIAZIDE

Table: AMILORIDE, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST5MG & 50MG Tablet 00784400 AA-AMILZIDE AAP
ST5MG & 50MG Tablet 00870943 AMI-HYDRO PDL
ST5MG & 50MG Tablet 01937219 NOVAMILOR TEV

TRIAMTERENE, HYDROCHLOROTHIAZIDE

Table: TRIAMTERENE, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST50MG & 25MG Tablet 00441775 APO TRIAZIDE APX
ST50MG & 25MG Tablet 00532657 TEVA-TRIAMTERENE/HCTZ TEV

40:28.20 TIAZIDE DIURETICS

HYDROCHLOROTHIAZIDE

Table: HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST12.5MG Tablet 02327856 APO-HYDRO APX
ST12.5MG Tablet 02425947 MINT-HYDROCHLOROTHIAZIDE MIN
ST12.5MG Tablet 02274086 PMS-HYDROCHLOROTHIAZIDE PMS
ST25MG Tablet 00326844 APO HYDRO APX
ST25MG Tablet 02247170 BIO-HYDROCHLOROTHIAZIDE BMI
ST25MG Tablet 02360594 HYDROCHLOROTHIAZIDE SAN
25MG Tablet 02426196 MINT-HYDROCHLOROTHIAZIDE MIN
ST25MG Tablet 02247386 PMS-HYDROCHLOROTHIAZIDE PMS
ST25MG Tablet 00021474 TEVA-HYDROCHLOROTHIAZIDE TEV
ST50MG Tablet 00312800 APO HYDRO APX
ST50MG Tablet 02247171 BIO-HYDROCHLOROTHIAZIDE BMI
ST50MG Tablet 02360608 HYDROCHLOROTHIAZIDE SAN
ST50MG Tablet 02247387 PMS-HYDROCHLOROTHIAZIDE PMS
ST50MG Tablet 00021482 TEVA-HYDROCHLOROTHIAZIDE TEV
ST100MG Tablet 00644552 APO HYDRO APX
ST pDIN For Extemporaneous Mixture 99503000 HYDROCHLOROTHIAZIDE ORAL LIQUID UNK

SPIRONOLACTONE, HYDROCHLOROTHIAZIDE

Table: SPIRONOLACTONE, HYDROCHLOROTHIAZIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST25MG & 25MG Tablet 00613231 TEVA-SPIRONOLACTONE/HCTZ TEV
ST50MG & 50MG Tablet 00657182 TEVA-SPIRONOLACTONE/HCTZ TEV

40:28.24 THIAZIDE LIKE DIURETICS

CHLORTHALIDONE

Table: CHLORTHALIDONE
Drug strength and dosage form DIN Brand name Manufacturer code
ST50MG Tablet 00360279 CHLORTHALIDONE AAP

INDAPAMIDE

Table: INDAPAMIDE
Drug strength and dosage form DIN Brand name Manufacturer code
ST1.25MG Tablet 02245246 APO-INDAPAMIDE APX
ST1.25MG Tablet 02373904 JAMP-INDAPAMIDE JMP
ST1.25MG Tablet 02179709 LOZIDE SEV
ST1.25MG Tablet 02240067 MYLAN-INDAPAMIDE MYL
ST2.5MG Tablet 02223678 APO-INDAPAMIDE APX
ST2.5MG Tablet 02373912 JAMP-INDAPAMIDE JMP
ST2.5MG Tablet 00564966 LOZIDE SEV
ST2.5MG Tablet 02153483 MYLAN-INDAPAMIDE MYL
ST2.5MG Tablet 02312549 PRO-INDAPAMIDE PDL

METOLAZONE

Table: METOLAZONE
Drug strength and dosage form DIN Brand name Manufacturer code
ST2.5MG Tablet 00888400 ZAROXOLYN SAC

40:36.00 IRRIGATING SOLUTIONS

SODIUM CHLORIDE

Table: SODIUM CHLORIDE
Drug strength and dosage form DIN Brand name Manufacturer code
0.9% Solution 00801267 SODIUM CHLORIDE UNK

40:40.00 URICOSURIC AGENTS

SULFINPYRAZONE

Table: SULFINPYRAZONE
Drug strength and dosage form DIN Brand name Manufacturer code
200MG Tablet 00441767 SULFINPYRAZONE AAP

40:50.00 IRRIGATING SOLUTIONS

WATER

Table: WATER
Drug strength and dosage form DIN Brand name Manufacturer code
100% Solution 00038202 BACTERIOSTATIC WATER PFI
100% Solution 00402257 STERILE WATER OMG
100% Solution 02142546 STERILE WATER PFI
Date modified: