Gastrointestinal Drugs

Gastrointestinal Drugs Gastrointestinal Drugs

56:08 ANTIDIARRHEA AGENTS DIPHENOXYLATE HCL/ ATROPINE SULFATE 2.5 MG * 0.025 MG ORAL TABLET 00000036323 LOMOTIL PFI 0.4994 56:14 CHOLELITHOLYTIC AGENTS URSODIOL 250 MG ORAL TABLET 00002273497 -URSODIOL C 00002426900 URSODIOL TABLETS USP 00002238984 URSO 500 MG ORAL TABLET 00002273500 00002426919 00002245894 -URSODIOL C URSODIOL TABLETS USP URSO DS GLM GLM 0.7636 0.7636 1.4941 1.4483 1.4483 2.8339 56:16 DIGESTANTS LIPASE/ AMYLASE/ PROTEASE 10,440 UNIT * 56,400 UNIT * 57,100 UNIT ORAL TABLET 00002230019 VIOKACE 20,880 UNIT * 113,400 UNIT * 112,500 UNIT ORAL TABLET 00002241933 VIOKACE 8,000 UNIT * 30,000 UNIT * 30,000 UNIT ORAL CAPSULE 00000263818 COTAZYM MFC 4,000 UNIT * 12,000 UNIT * 12,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00000789445 PANCREASE MT 4 JAI 4,500 UNIT * 20,000 UNIT * 25,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00002203324 ULTRASE MS4 MICROSPHERES 8,000 UNIT * 30,000 UNIT * 30,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00000502790 COTAZYM ECS 8 MFC 10,000 UNIT * 30,000 UNIT * 30,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00000789437 PANCREASE MT 10 JAI 10,000 UNIT * 33,200 UNIT * 37,500 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00002200104 CREON 10 MINIMICROSPHERES 12,000 UNIT * 39,000 UNIT * 39,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00002045834 ULTRASE MT12 MINITABLETS 16,000 UNIT * 48,000 UNIT * 48,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00000789429 PANCREASE MT 16 JAI 20,000 UNIT * 55,000 UNIT * 55,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00000821373 COTAZYM ECS 20 MFC 20,000 UNIT * 65,000 UNIT * 65,000 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00002045869 ULTRASE MT20 MINITABLETS 25,000 UNIT * 74,000 UNIT * 62,500 UNIT ORAL CAPSULE (ENTERIC-COATED PELLET) 00001985205 CREON 25 MINIMICROSPHERES 0.2525 0.3874 0.2025 0.5670 0.2366 0.3655 1.4172 0.2723 0.4626 2.2673 0.9582 0.8017 0.8507 UNIT OF ISSUE - REFER TO PRICE POLICY 157 EFFECTIVE APRIL 1, 2018

56:22.08 ANTIEMETICS (ANTIHISTAMINES) DIMENHYDRINATE 10 MG / ML INJECTION 00000392731 DIMENHYDRINATE I.V. 50 MG / ML INJECTION 00000392537 DIMENHYDRINATE I.M. 0.9807 1.4490 PROCHLORPERAZINE 5 MG ORAL TABLET 00000886440 PROCHLORAZINE 10 MG ORAL TABLET 00000886432 PROCHLORAZINE 10 MG RECTAL SUPPOSITORY 00000789720 SANDOZ PROCHLORPERAZINE 0.1728 0.2109 1.7573 56:22.20 ANTIEMETICS (5-HT3 RECEPTOR ANTAGONISTS) GISETRON HCL 1 MG (BASE) ORAL TABLET 00002308894 00002452359 APO-GISETRON NAT-GISETRON NTP 9.0000 9.0000 ONDANSETRON 4 MG ORAL DISINTEGRATING TABLET/FILM 00002389983 ONDISSOLVE ODF 00002444674 SANDOZ ONDANSETRON ODT 00002239372 ZOF ODT 8 MG ORAL DISINTEGRATING TABLET/FILM 00002389991 00002444682 00002239373 ONDISSOLVE ODF SANDOZ ONDANSETRON ODT ZOF ODT TAK TAK 13.6760 20.8690 PRODUCT IS NOT INTERCHANGEABLE 158 EFFECTIVE APRIL 1, 2018

56:22.20 ANTIEMETICS (5-HT3 RECEPTOR ANTAGONISTS) ONDANSETRON HCL DIHYDRATE 4 MG (BASE) ORAL TABLET 00002288184 APO-ONDANSETRON 00002458810 CCP-ONDANSETRON 00002296349 CO ONDANSETRON 00002313685 JAMP-ONDANSETRON 00002371731 MAR-ONDANSETRON 00002305259 MINT-ONDANSETRON 00002297868 MYLAN-ONDANSETRON 00002417839 NAT-ONDANSETRON 00002421402 ONDANSETRON 00002258188 -ONDANSETRON 00002274310 SANDOZ ONDANSETRON 00002376091 SEPTA-ONDANSETRON 00002448440 VAN-ONDANSETRON 00002213567 ZOF 8 MG (BASE) ORAL TABLET 00002288192 APO-ONDANSETRON 00002458802 CCP-ONDANSETRON 00002296357 CO ONDANSETRON 00002313693 JAMP-ONDANSETRON 00002371758 MAR-ONDANSETRON 00002305267 MINT-ONDANSETRON 00002297876 MYLAN-ONDANSETRON 00002417847 NAT-ONDANSETRON 00002421410 ONDANSETRON 00002258196 -ONDANSETRON 00002274329 SANDOZ ONDANSETRON 00002376105 SEPTA-ONDANSETRON 00002448467 VAN-ONDANSETRON 00002213575 ZOF 0.8 MG / ML (BASE) ORAL SOLUTION 00002291967 ONDANSETRON 00002229639 ZOF 2 MG / ML (BASE) INJECTION 00002420414 JAMP-ONDANSETRON (PRESERVATIVE FREE) 00002390019 ONDANSETRON (PRESERVATIVE FREE) 00002279428 ONDANSETRON (UNPRESERVED) 00002213745 ZOF 2 MG / ML (BASE) INJECTION 00002420422 00002279436 00002390051 00002274418 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 14.2080 21.6830 1.6028 2.1360 10.4695 UNIT OF ISSUE - REFER TO PRICE POLICY 159 EFFECTIVE APRIL 1, 2018

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 00002298791 EMEND MFC 32.6083 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 00002298813 EMEND TRI-PACK MFC 32.6083 DOXYLAMINE SUCCINATE/ PYRIDOXINE HCL 10 MG * 10 MG ORAL SUSTAINED-RELEASE TABLET 00002413248 00002406187 00000609129 NABILONE 0.5 MG ORAL CAPSULE 00002393581 ACT NABILONE 00002380900 -NABILONE 00002384884 A-NABILONE 00002256193 CESAMET 1 MG ORAL CAPSULE 00002393603 00002380919 00002384892 00000548375 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) 0.6402 0.6402 1.2803 0.7756 0.7756 0.7756 3.3874 1.5513 1.5513 1.5513 6.7746 CIMETIDINE 200 MG ORAL TABLET 00000584215 APO-CIMETIDINE 300 MG ORAL TABLET 00000487872 APO-CIMETIDINE 400 MG ORAL TABLET 00000600059 FAMOTIDINE 20 MG ORAL TABLET 00001953842 APO-FAMOTIDINE 00002351102 FAMOTIDINE 00002196018 MYLAN-FAMOTIDINE 00002022133 A-FAMOTIDINE 40 MG ORAL TABLET 00001953834 00002351110 00002196026 00002022141 APO-CIMETIDINE APO-FAMOTIDINE FAMOTIDINE MYLAN-FAMOTIDINE A-FAMOTIDINE 0.3284 0.1791 0.2930 0.2657 0.2657 0.2657 0.2657 0.4833 0.4833 0.4833 0.4833 PRODUCT IS NOT INTERCHANGEABLE 160 EFFECTIVE APRIL 1, 2018

56:28.12 ANTIULCER AGENTS AND ACID SUPPRESSANTS (HISTAMINE H2-ANTAGONISTS) NIZATIDINE 150 MG ORAL CAPSULE 00000778338 AXID PPH 1.1199 ITIDINE HCL 150 MG (BASE) ORAL TABLET 00002248570 ACT ITIDINE 00000733059 APO-ITIDINE 00002242453 -ITIDINE 00002336480 -ITIDINE 00002353016 ITIDINE 00002385953 ITIDINE 00002243229 SANDOZ ITIDINE 00000828564 A-ITIDINE 300 MG (BASE) ORAL TABLET 00002248571 ACT ITIDINE 00000733067 APO-ITIDINE 00002242454 -ITIDINE 00002336502 -ITIDINE 00002353024 ITIDINE 00002385961 ITIDINE 00002243230 SANDOZ ITIDINE 00000828556 A-ITIDINE 15 MG / ML (BASE) ORAL SOLUTION 00002280833 APO-ITIDINE 00002242940 A-ITIDINE 25 MG / ML (BASE) INJECTION 00002256711 00002212366 ITIDINE ZANTAC GSK 0.1480 0.1480 1.3975 1.4210 56:28.28 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROSTAGLANDINS) MISOPROSTOL 100 MCG ORAL TABLET 00002244022 MISOPROSTOL 200 MCG ORAL TABLET 00002244023 MISOPROSTOL 0.2691 0.4481 56:28.32 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTECTANTS) SUCRALFATE 1 G ORAL TABLET 00002045702 A-SUCRALFATE 00002100622 SULCRATE 200 MG / ML ORAL SUSPENSION 00002103567 SULCRATE SUSPENSION PLUS 0.1443 0.6227 0.1120 UNIT OF ISSUE - REFER TO PRICE POLICY 161 EFFECTIVE APRIL 1, 2018

56:28.36 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTON-PUMP INHIBITORS) LANSOPRAZOLE 15 MG ORAL DELAYED-RELEASE CAPSULE 00002293811 00002357682 00002385767 00002433001 00002353830 00002402610 00002385643 00002280515 00002165503 LANSOPRAZOLE/ AMOXICILLIN TRIHYDRATE/ CLARITHROMYCIN 30 MG * 500 MG (BASE) * 500 MG ORAL TABLET/CAPSULE 00002238525 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 00002293838 APO-LANSOPRAZOLE 0.1875 00002357690 LANSOPRAZOLE 0.1875 00002410389 LANSOPRAZOLE 0.1875 00002433028 LANSOPRAZOLE 0.1875 00002353849 MYLAN-LANSOPRAZOLE 0.1875 00002402629 -LANSOPRAZOLE 0.1875 00002385651 SANDOZ LANSOPRAZOLE 0.1875 00002280523 A-LANSOPRAZOLE 0.1875 00002165511 PREVACID 0.1875 MAC pricing will be applied based on the LCA Price for Pantoprazole Magnesium 1 X 40 mg enteric-coated tablet. 2.0420 2.0420 90.5388 PRODUCT IS NOT INTERCHANGEABLE 162 EFFECTIVE APRIL 1, 2018

56:28.36 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTON-PUMP INHIBITORS) OMEPRAZOLE 10 MG ORAL CAPSULE/SUSTAINED-RELEASE TABLET 00002329425 00002296438 00002295407 00002230737 20 MG ORAL CAPSULE/SUSTAINED-RELEASE TABLET 00002245058 00002422220 00002420198 00002329433 00002439549 00002348691 00002416549 00002411857 00002320851 00002310260 00002296446 00002295415 00002432404 00000846503 00002190915 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. 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 MAC pricing will be applied based on the LCA Price for Pantoprazole Magnesium 1 X 40 mg enteric-coated tablet. 0.8166 0.8166 0.8166 1.8940 1.1320 2.3820 PANTOPRAZOLE MAGNESIUM 40 MG ORAL ENTERIC-COATED TABLET 00002408570 00002441853 00002466147 00002440628 00002267233 MYLAN-PANTOPRAZOLE T PANTOPRAZOLE MAGNESIUM PANTOPRAZOLE T A-PANTOPRAZOLE MAGNESIUM TECTA ALH TAK 0.1875 0.1875 0.1875 0.1875 0.7500 UNIT OF ISSUE - REFER TO PRICE POLICY 163 EFFECTIVE APRIL 1, 2018

56:28.36 ANTIULCER AGENTS AND ACID SUPPRESSANTS (PROTON-PUMP INHIBITORS) PANTOPRAZOLE SODIUM 40 MG ORAL ENTERIC-COATED TABLET 00002292920 00002415208 00002357054 00002416565 00002417448 00002299585 00002370808 00002437945 00002428180 00002307871 00002305046 00002301083 00002285487 00002428164 00002229453 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 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 0.1875 MAC pricing will be applied based on the LCA Price for Pantoprazole Magnesium 1 X 40 mg enteric-coated tablet. 2.0803 RABEPRAZOLE SODIUM 10 MG ORAL ENTERIC-COATED TABLET 00002345579 APO-RABEPRAZOLE 00002310805 -RABEPRAZOLE EC 00002385449 RABEPRAZOLE 00002356511 RABEPRAZOLE EC 00002298074 -RABEPRAZOLE 00002314177 SANDOZ RABEPRAZOLE 00002296632 A-RABEPRAZOLE 00002243796 PARIET 20 MG ORAL ENTERIC-COATED TABLET 00002345587 00002310813 00002385457 00002356538 00002298082 00002314185 00002296640 00002243797 APO-RABEPRAZOLE -RABEPRAZOLE EC RABEPRAZOLE RABEPRAZOLE EC -RABEPRAZOLE SANDOZ RABEPRAZOLE A-RABEPRAZOLE PARIET JAI JAI 0.8129 1.6259 PRODUCT IS NOT INTERCHANGEABLE 164 EFFECTIVE APRIL 1, 2018

56:32 PROKINETIC AGENTS DOMPERIDONE MALEATE 10 MG (BASE) ORAL TABLET 00002103613 00002238341 00002350440 00002369206 00002403870 00002236466 00002268078 00001912070 00002157195 APO-DOMPERIDONE DOMPERIDONE DOMPERIDONE JAMP-DOMPERIDONE MAR-DOMPERIDONE -DOMPERIDONE -DOMPERIDONE RATIO-DOMPERIDONE MALEATE A-DOMPERIDONE MAR METOCLOPRAMIDE HCL 5 MG ORAL TABLET 00002230431 METONIA 10 MG ORAL TABLET 00002230432 METONIA 1 MG / ML ORAL LIQUID 00002230433 METONIA 5 MG / ML INJECTION 00002185431 METOCLOPRAMIDE HYDROCHLORIDE PPH PPH PPH 0.0676 0.0708 0.0551 3.3925 56:36 ANTI-INFLAMMATORY AGENTS MESALAZINE 1.2 G ORAL DELAYED AND EXTENDED-RELEASE TABLET 00002297558 MEZAVANT 500 MG ORAL EXTENDED-RELEASE TABLET 00002099683 PENTASA 1 G ORAL EXTENDED-RELEASE TABLET 00002399466 PENTASA 400 MG ORAL ENTERIC-COATED TABLET 00002171929 O-5 ASA 00001997580 ASACOL 500 MG ORAL ENTERIC-COATED TABLET 00002112787 SALOFALK 00001914030 MESASAL 800 MG ORAL ENTERIC-COATED TABLET 00002267217 ASACOL 800 500 MG RECTAL SUPPOSITORY 00002112760 SALOFALK 1 G RECTAL SUPPOSITORY 00002153564 PENTASA 1,000 MG RECTAL SUPPOSITORY 00002242146 SALOFALK 1 G / ENM RECTAL ENEMA 00002153521 PENTASA (1G/100ML) 2 G / ENM RECTAL ENEMA 00002112795 SALOFALK (2G/60G) 4 G / ENM RECTAL ENEMA 00002153556 00002112809 PENTASA (4G/100 ML) SALOFALK (4G/60G) SHB FEI FEI ASC GSK ASC FEI FEI FEI 1.6710 0.5800 1.1583 0.4758 0.5648 0.5845 0.6559 1.1400 1.2964 1.7147 1.8977 3.9647 4.1496 4.7759 7.0474 UNIT OF ISSUE - REFER TO PRICE POLICY 165 EFFECTIVE APRIL 1, 2018

56:36 ANTI-INFLAMMATORY AGENTS OLSALAZINE SODIUM 250 MG ORAL CAPSULE 00002063808 DIPENTUM ATH 0.5750 56:92 MISCELLANEOUS GI DRUGS PINAVERIUM BROMIDE 50 MG ORAL TABLET 00001950592 DICETEL 100 MG ORAL TABLET 00002230684 DICETEL 0.3607 0.6289 TRIMEBUTINE MALEATE 100 MG ORAL TABLET 00002245663 TRIMEBUTINE 200 MG ORAL TABLET 00002245664 00000803499 TRIMEBUTINE MODULON 0.2802 0.6275 0.7200 PRODUCT IS NOT INTERCHANGEABLE 166 EFFECTIVE APRIL 1, 2018