Gastrointestinal Drugs
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1 Gastrointestinal Drugs Gastrointestinal Drugs
2 56:08 ANTIDIARRHEA AGENTS DIPHENOXYLATE HCL/ ATROPINE SULFATE 2.5 MG * MG ORAL TABLET LOMOTIL PFI :14 CHOLELITHOLYTIC AGENTS URSODIOL 250 MG ORAL TABLET URSODIOL C URSODIOL TABLETS USP URSO 500 MG ORAL TABLET URSODIOL C URSODIOL TABLETS USP URSO DS GLM GLM :16 DIGESTANTS LIPASE/ AMYLASE/ PROTEASE 10,440 UNIT * 56,400 UNIT * 57,100 UNIT ORAL TABLET VIOKACE 20,880 UNIT * 113,400 UNIT * 112,500 UNIT ORAL TABLET VIOKACE 8,000 UNIT * 30,000 UNIT * 30,000 UNIT ORAL CAPSULE COTAZYM MFC 4,000 UNIT * 12,000 UNIT * 12,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) PANCREASE MT 4 JAI 4,500 UNIT * 20,000 UNIT * 25,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) ULTRASE MS4 MICROSPHERES 8,000 UNIT * 30,000 UNIT * 30,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) COTAZYM ECS 8 MFC 10,000 UNIT * 30,000 UNIT * 30,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) PANCREASE MT 10 JAI 10,000 UNIT * 33,200 UNIT * 37,500 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) CREON 10 MINIMICROSPHERES 12,000 UNIT * 39,000 UNIT * 39,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) ULTRASE MT12 MINITABLETS 16,000 UNIT * 48,000 UNIT * 48,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) PANCREASE MT 16 JAI 20,000 UNIT * 55,000 UNIT * 55,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) COTAZYM ECS 20 MFC 20,000 UNIT * 65,000 UNIT * 65,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) ULTRASE MT20 MINITABLETS 25,000 UNIT * 74,000 UNIT * 62,500 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) CREON 25 MINIMICROSPHERES UNIT OF ISSUE - REFER TO PRICE POLICY 157 EFFECTIVE APRIL 1, 2018
3 56:22.08 ANTIEMETICS (ANTIHISTAMINES) DIMENHYDRINATE 10 MG / ML INJECTION DIMENHYDRINATE I.V. 50 MG / ML INJECTION DIMENHYDRINATE I.M PROCHLORPERAZINE 5 MG ORAL TABLET PROCHLORAZINE 10 MG ORAL TABLET PROCHLORAZINE 10 MG RECTAL SUPPOSITORY SANDOZ PROCHLORPERAZINE :22.20 ANTIEMETICS (5-HT3 RECEPTOR ANTAGONISTS) GISETRON HCL 1 MG (BASE) ORAL TABLET APO-GISETRON NAT-GISETRON NTP ONDANSETRON 4 MG ORAL DISINTEGRATING TABLET/FILM ONDISSOLVE ODF SANDOZ ONDANSETRON ODT ZOF ODT 8 MG ORAL DISINTEGRATING TABLET/FILM ONDISSOLVE ODF SANDOZ ONDANSETRON ODT ZOF ODT TAK TAK PRODUCT IS NOT INTERCHANGEABLE 158 EFFECTIVE APRIL 1, 2018
4 56:22.20 ANTIEMETICS (5-HT3 RECEPTOR ANTAGONISTS) ONDANSETRON HCL DIHYDRATE 4 MG (BASE) ORAL TABLET APO-ONDANSETRON CCP-ONDANSETRON CO ONDANSETRON JAMP-ONDANSETRON MAR-ONDANSETRON MINT-ONDANSETRON MYLAN-ONDANSETRON NAT-ONDANSETRON ONDANSETRON ONDANSETRON SANDOZ ONDANSETRON SEPTA-ONDANSETRON VAN-ONDANSETRON ZOF 8 MG (BASE) ORAL TABLET APO-ONDANSETRON CCP-ONDANSETRON CO ONDANSETRON JAMP-ONDANSETRON MAR-ONDANSETRON MINT-ONDANSETRON MYLAN-ONDANSETRON NAT-ONDANSETRON ONDANSETRON ONDANSETRON SANDOZ ONDANSETRON SEPTA-ONDANSETRON VAN-ONDANSETRON ZOF 0.8 MG / ML (BASE) ORAL SOLUTION ONDANSETRON ZOF 2 MG / ML (BASE) INJECTION JAMP-ONDANSETRON (PRESERVATIVE FREE) ONDANSETRON (PRESERVATIVE FREE) ONDANSETRON (UNPRESERVED) ZOF 2 MG / ML (BASE) INJECTION JAMP-ONDANSETRON (WITH PRESERVATIVE) ONDANSETRON (PRESERVED) ONDANSETRON (WITH PRESERVATIVE) ONDANSETRON HYDROCHLORIDE DIHYDRATE (PRESERVED) CEL MAR MPI NTP SEP VAN CEL MAR MPI NTP SEP VAN UNIT OF ISSUE - REFER TO PRICE POLICY 159 EFFECTIVE APRIL 1, 2018
5 56:22.92 APREPITANT RESTRICTED BENEFIT - This drug product must be prescribed by the Directors of Alberta Health Services - Cancer Care "Cancer Centres" (or their designates). 80 MG ORAL CAPSULE EMEND MFC APREPITANT/ APREPITANT RESTRICTED BENEFIT - This drug product must be prescribed by the Directors of Alberta Health Services - Cancer Care "Cancer Centres" (or their designates). 80 MG * 125 MG ORAL CAPSULE EMEND TRI-PACK MFC DOXYLAMINE SUCCINATE/ PYRIDOXINE HCL 10 MG * 10 MG ORAL SUSTAINED-RELEASE TABLET NABILONE 0.5 MG ORAL CAPSULE ACT NABILONE NABILONE A-NABILONE CESAMET 1 MG ORAL CAPSULE APO-DOXYLAMINE/B6 -DOXYLAMINE-PYRIDOXINE DICLECTIN ACT NABILONE -NABILONE A-NABILONE CESAMET 56:28.12 ANTIEMETICS (MISCELLANEOUS ANTIEMETICS) DUI VCL VCL ANTIULCER AGENTS AND ACID SUPPRESSANTS (HISTAMINE H2-ANTAGONISTS) CIMETIDINE 200 MG ORAL TABLET APO-CIMETIDINE 300 MG ORAL TABLET APO-CIMETIDINE 400 MG ORAL TABLET FAMOTIDINE 20 MG ORAL TABLET APO-FAMOTIDINE FAMOTIDINE MYLAN-FAMOTIDINE A-FAMOTIDINE 40 MG ORAL TABLET APO-CIMETIDINE APO-FAMOTIDINE FAMOTIDINE MYLAN-FAMOTIDINE A-FAMOTIDINE PRODUCT IS NOT INTERCHANGEABLE 160 EFFECTIVE APRIL 1, 2018
6 56:28.12 ANTIULCER AGENTS AND ACID SUPPRESSANTS (HISTAMINE H2-ANTAGONISTS) NIZATIDINE 150 MG ORAL CAPSULE AXID PPH ITIDINE HCL 150 MG (BASE) ORAL TABLET ACT ITIDINE APO-ITIDINE ITIDINE ITIDINE ITIDINE ITIDINE SANDOZ ITIDINE A-ITIDINE 300 MG (BASE) ORAL TABLET ACT ITIDINE APO-ITIDINE ITIDINE ITIDINE ITIDINE ITIDINE SANDOZ ITIDINE A-ITIDINE 15 MG / ML (BASE) ORAL SOLUTION APO-ITIDINE A-ITIDINE 25 MG / ML (BASE) INJECTION ITIDINE ZANTAC GSK :28.28 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROSTAGLANDINS) MISOPROSTOL 100 MCG ORAL TABLET MISOPROSTOL 200 MCG ORAL TABLET MISOPROSTOL :28.32 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTECTANTS) SUCRALFATE 1 G ORAL TABLET A-SUCRALFATE SULCRATE 200 MG / ML ORAL SUSPENSION SULCRATE SUSPENSION PLUS UNIT OF ISSUE - REFER TO PRICE POLICY 161 EFFECTIVE APRIL 1, 2018
7 56:28.36 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTON-PUMP INHIBITORS) LANSOPRAZOLE 15 MG ORAL DELAYED-RELEASE CAPSULE LANSOPRAZOLE/ AMOXICILLIN TRIHYDRATE/ CLARITHROMYCIN 30 MG * 500 MG (BASE) * 500 MG ORAL TABLET/CAPSULE APO-LANSOPRAZOLE LANSOPRAZOLE LANSOPRAZOLE LANSOPRAZOLE MYLAN-LANSOPRAZOLE -LANSOPRAZOLE SANDOZ LANSOPRAZOLE A-LANSOPRAZOLE PREVACID HP-PAC (KIT) MAC pricing will be applied based on the LCA Price for Rabeprazole Sodium 1 X 10 mg enteric-coated tablet. 30 MG ORAL DELAYED-RELEASE CAPSULE APO-LANSOPRAZOLE LANSOPRAZOLE LANSOPRAZOLE LANSOPRAZOLE MYLAN-LANSOPRAZOLE LANSOPRAZOLE SANDOZ LANSOPRAZOLE A-LANSOPRAZOLE PREVACID MAC pricing will be applied based on the LCA Price for Pantoprazole Magnesium 1 X 40 mg enteric-coated tablet PRODUCT IS NOT INTERCHANGEABLE 162 EFFECTIVE APRIL 1, 2018
8 56:28.36 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTON-PUMP INHIBITORS) OMEPRAZOLE 10 MG ORAL CAPSULE/SUSTAINED-RELEASE TABLET MG ORAL CAPSULE/SUSTAINED-RELEASE TABLET MYLAN-OMEPRAZOLE (DELAYED-RELEASE SANDOZ OMEPRAZOLE (SUSTAINED- RELEASE A-OMEPRAZOLE (DELAYED-RELEASE TABLET) LOSEC (SUSTAINED-RELEASE TABLET) AZC APO-OMEPRAZOLE (DELAYED-RELEASE AURO-OMEPRAZOLE (DELAYED-RELEASE AUR JAMP-OMEPRAZOLE DR (DELAYED- RELEASE TABLET) MYLAN-OMEPRAZOLE (DELAYED-RELEASE NAT-OMEPRAZOLE DR (DELAYED-RELEASE NTP TABLET) OMEPRAZOLE (DELAYED-RELEASE OMEPRAZOLE (DELAYED-RELEASE TABLET) AHI OMEPRAZOLE-20 (DELAYED-RELEASE -OMEPRAZOLE (SUSTAINED-RELEASE CAP) -OMEPRAZOLE DR (DELAYED-RELEASE TAB) SANDOZ OMEPRAZOLE (SUSTAINED- RELEASE CAP) A-OMEPRAZOLE (DELAYED-RELEASE TABLET) VAN-OMEPRAZOLE (DELAYED-RELEASE VAN TABLET) LOSEC ( SUSTAINED-RELEASE AZC LOSEC (SUSTAINED-RELEASE TABLET) AZC MAC pricing will be applied based on the LCA Price for Rabeprazole Sodium 1 X 10 mg enteric-coated tablet MAC pricing will be applied based on the LCA Price for Pantoprazole Magnesium 1 X 40 mg enteric-coated tablet PANTOPRAZOLE MAGNESIUM 40 MG ORAL ENTERIC-COATED TABLET MYLAN-PANTOPRAZOLE T PANTOPRAZOLE MAGNESIUM PANTOPRAZOLE T A-PANTOPRAZOLE MAGNESIUM TECTA ALH TAK UNIT OF ISSUE - REFER TO PRICE POLICY 163 EFFECTIVE APRIL 1, 2018
9 56:28.36 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTON-PUMP INHIBITORS) PANTOPRAZOLE SODIUM 40 MG ORAL ENTERIC-COATED TABLET APO-PANTOPRAZOLE AURO-PANTOPRAZOLE JAMP-PANTOPRAZOLE MAR-PANTOPRAZOLE MINT-PANTOPRAZOLE MYLAN-PANTOPRAZOLE PANTOPRAZOLE PANTOPRAZOLE PANTOPRAZOLE-40 -PANTOPRAZOLE -PANTOPRAZOLE SANDOZ PANTOPRAZOLE A-PANTOPRAZOLE VAN-PANTOPRAZOLE PANTOLOC AUR MAR MPI VAN TAK MAC pricing will be applied based on the LCA Price for Pantoprazole Magnesium 1 X 40 mg enteric-coated tablet RABEPRAZOLE SODIUM 10 MG ORAL ENTERIC-COATED TABLET APO-RABEPRAZOLE RABEPRAZOLE EC RABEPRAZOLE RABEPRAZOLE EC RABEPRAZOLE SANDOZ RABEPRAZOLE A-RABEPRAZOLE PARIET 20 MG ORAL ENTERIC-COATED TABLET APO-RABEPRAZOLE -RABEPRAZOLE EC RABEPRAZOLE RABEPRAZOLE EC -RABEPRAZOLE SANDOZ RABEPRAZOLE A-RABEPRAZOLE PARIET JAI JAI PRODUCT IS NOT INTERCHANGEABLE 164 EFFECTIVE APRIL 1, 2018
10 56:32 PROKINETIC AGENTS DOMPERIDONE MALEATE 10 MG (BASE) ORAL TABLET APO-DOMPERIDONE DOMPERIDONE DOMPERIDONE JAMP-DOMPERIDONE MAR-DOMPERIDONE -DOMPERIDONE -DOMPERIDONE RATIO-DOMPERIDONE MALEATE A-DOMPERIDONE MAR METOCLOPRAMIDE HCL 5 MG ORAL TABLET METONIA 10 MG ORAL TABLET METONIA 1 MG / ML ORAL LIQUID METONIA 5 MG / ML INJECTION METOCLOPRAMIDE HYDROCHLORIDE PPH PPH PPH :36 ANTI-INFLAMMATORY AGENTS MESALAZINE 1.2 G ORAL DELAYED AND EXTENDED-RELEASE TABLET MEZAVANT 500 MG ORAL EXTENDED-RELEASE TABLET PENTASA 1 G ORAL EXTENDED-RELEASE TABLET PENTASA 400 MG ORAL ENTERIC-COATED TABLET O-5 ASA ASACOL 500 MG ORAL ENTERIC-COATED TABLET SALOFALK MESASAL 800 MG ORAL ENTERIC-COATED TABLET ASACOL MG RECTAL SUPPOSITORY SALOFALK 1 G RECTAL SUPPOSITORY PENTASA 1,000 MG RECTAL SUPPOSITORY SALOFALK 1 G / ENM RECTAL ENEMA PENTASA (1G/100ML) 2 G / ENM RECTAL ENEMA SALOFALK (2G/60G) 4 G / ENM RECTAL ENEMA PENTASA (4G/100 ML) SALOFALK (4G/60G) SHB FEI FEI ASC GSK ASC FEI FEI FEI UNIT OF ISSUE - REFER TO PRICE POLICY 165 EFFECTIVE APRIL 1, 2018
11 56:36 ANTI-INFLAMMATORY AGENTS OLSALAZINE SODIUM 250 MG ORAL CAPSULE DIPENTUM ATH :92 MISCELLANEOUS GI DRUGS PINAVERIUM BROMIDE 50 MG ORAL TABLET DICETEL 100 MG ORAL TABLET DICETEL TRIMEBUTINE MALEATE 100 MG ORAL TABLET TRIMEBUTINE 200 MG ORAL TABLET TRIMEBUTINE MODULON PRODUCT IS NOT INTERCHANGEABLE 166 EFFECTIVE APRIL 1, 2018
92:00. Miscellaneous Therapeutic Agents. 92:00 Miscellaneous Therapeutic Agents
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