New Brunswick Drug Plans Formulary - gnb.ca · tuberculosis (TB) infection. Public Health : October...

New Brunswick Drug Plans

Formulary

October 2015

Administered by Medavie Blue Cross on Behalf of the Government of New Brunswick

TABLE OF CONTENTS

Page

Introduction ..................................................................................................................................................................... I New Brunswick Drug Plans ............................................................................................................................................ II Exclusions ................................................................................................................................................................... IV Legend .................................................................................................................................................................... V

Anatomical Therapeutic Chemical (ATC) Classification of Drugs

A Alimentary Tract and Metabolism ................................................................................................ 1 B Blood and Blood Forming Organs ............................................................................................. 25 C Cardiovascular System ............................................................................................................. 35 D Dermatologicals ........................................................................................................................ 85 G Genito Urinary System and Sex Hormones ............................................................................... 98 H Systemic Hormonal Preparations, Excluding Sex Hormones .................................................. 111 J Antiinfectives for Systemic Use ............................................................................................... 119 L Antineoplastic and Immunomodulating Agents ....................................................................... 146 M Musculo-Skeletal System ........................................................................................................ 165 N Nervous System ...................................................................................................................... 177 P Antiparasitic Products, Insecticides and Repellants ................................................................ 241 R Respiratory System ................................................................................................................. 243 S Sensory Organs ...................................................................................................................... 255 V Various .................................................................................................................................... 264

Appendices I-A Abbreviations of Dosage Forms ............................................................................................ A - 1 I-B Abbreviations of Routes ........................................................................................................ A - 4 I-C Abbreviations of Units ........................................................................................................... A - 6 I-D Abbreviations of Manufacturers’ Names ............................................................................... A - 8 II Extemporaneous Preparations ............................................................................................ A - 10 III Special Authorization .......................................................................................................... A - 11 III Special Authorization Drug Criteria ..................................................................................... A - 13

October 2015 v.2 I

New Brunswick Drug Plans Formulary

Introduction The New Brunswick Drug Plans provides prescription drug coverage to eligible New Brunswick residents (see pages II and III).

The New Brunswick Drug Plans Formulary is a list of the drugs which are eligible benefits under the drug plans. All drugs considered for listing as benefits must be reviewed according to the drug review process.

Most drugs listed in the New Brunswick Drug Plans Formulary are “regular” benefits which are reimbursed with no criteria or prior approval requirements. Some drugs require special authorization in order to be reimbursed. Certain drug products are not eligible benefits and are identified on the exclusion list (see Formulary page IV).

October 2015 v.2 II


Plans Fees Eligibility Authority

A $9.05 per prescription up to an annual copay ceiling of $500 for GIS recipients. $15.00 per prescription with no annual copay ceiling for non-GIS recipients

Eligible residents of the province who are sixty-five years of age or older

Prescription Drug Payment Act and Regulations

B $50 per year registration fee;

20% of cost of prescription to a maximum of $20 per prescription up to an annual copay ceiling of $500 per family unit

Persons with cystic fibrosis who are eligible residents and registered with the Department of Health


D Premiums and copays are based

on income Uninsured New Brunswick residents Prescription and

Catastrophic Drug Insurance Act and

Regulation

E $4 per prescription(1); up to an annual copay ceiling of $250 per person

Persons in licensed residential facilities who hold a valid health card issued by the Department of Social Development

Health Services Act and Regulations

F $4 per prescription(1) for adults (18 years and over) $2 per prescription(1) for children (under 18 years); up to an annual copay ceiling of $250 per family unit

Department of Social Development clients

Regional Health Authorities Act and Regulations

G None Children in care of the Minister of the Department of Social Development and special needs children

Health Services Act and Regulations

H $50 per year premium; copay ranges from zero to 100 per cent for each prescription

Persons with multiple sclerosis who are eligible residents and registered with the Department of Health


I None Publicly Funded, Pharmacist Administered Seasonal Influenza Vacccine

Public Health

P None Publically funded drugs for the

management of active or latent tuberculosis (TB) infection.

Public Health

October 2015 v.2 III


Plans Fees Eligibility Legislative Authority

R $50 per year registration fee;

20% of cost of prescription to a maximum of $20 per prescription up to an annual ceiling of $500 per family unit

Solid organ transplant recipients who are eligible residents and registered with the Department of Health


T $50 per year registration fee;


Persons with growth hormone deficiency who are eligible residents and registered with the Department of Health


U $50 per year registration fee;


HIV-infected persons who are eligible residents and registered with the Department of Health


V None Eligible residents of Nursing Homes

as defined in the Nursing Home Act operated by a licensee under the Act


W $9.05 per prescription Extra Mural Program patients who are in possession of a Prescription Drug Authorization Form

Regional Health Authorities Act

(1) Does not apply to prescriptions for certain drugs (e.g. contraceptives, methadone for opioid dependence).

October 2015 v.2 IV

Exclusions The following classes of products, except those specifically listed on the Formulary, are excluded as benefits under the New Brunswick Drug Plans.

• Drugs not authorized for sale and use in Canada • Over-the-counter (OTC) or non-prescription drugs, vitamins, and minerals • Dietary or nutritional supplements and food products • Weight loss products • Products for the treatment of erectile/sexual dysfunction, or infertility • Products for esthetic or cosmetic purposes • Soaps, cleansers, shampoos, antiseptics, or disinfectants • Drugs for the prevention of travel acquired diseases • Diagnostic agents and point-of-care testing kits • Medical supplies, devices and equipment (e.g. prostheses, first aid supplies, ostomy supplies, diabetes test

strips and syringes, etc.) • Vaccines

October 2015 v.2 V

Legend 1. ATC-Therapeutic subgroup 2. ATC- Pharmacological subgroups 3. ATC- Chemical Substance 4. Dosage form, route and strength. Strength represents

the amount of ingredients present in a solid dose form (Tablet) or in one gram or one millilitre of a preparation (Cream, Liquid, etc.)

5. Brand or manufacturers' product name

6. Drug Identification Number (DIN) 7. Manufacturers' identification code. See

Appendix I-D for details 8. Drug plans for which the product is considered

to be a benefit 9. Manufacturer has discontinued this product it

will be deleted from the list as a benefit on the date indicated

October 2015 v.2 1

A01 STOMATOLOGICAL PREPARATIONS PRODUITS STOMATOLOGIQUES

A01A STOMATOLOGICAL PREPARATIONS PRODUITS STOMATOLOGIQUES

A01AA CARIES PROPHYLACTIC AGENTS AGENTS PROPHYLACTIQUES DES CARIES

A01AA01 SODIUM FLUORIDE FLUORURE DE SODIUM

Liq Den 0.2% Fluorinse 00782882 MLA EF-18G Liq

A01AC CORTICOSTEROIDS FOR LOCAL ORAL TREATMENT CORTICOSTÉROÏDES POUR TRAITEMENT BUCCAL LOCALISÉ

A01AC01 TRIAMCINOLONE TRIAMCINOLONE

Pst Den 0.1% Oracort 01964054 TAR ADEFGVW Pst

A01AD OTHER AGENTS FOR LOCAL ORAL TREATMENT AUTRES MÉDICAMENTS POUR TRAITEMENT BUCCAL LOCALISÉ

A01AD02 BENZYDAMINE BENZYDAMINE

Liq Buc 0.15% Pharixia 02229777 PMS ADEFGVW Liq

A02 DRUGS FOR ACID RELATED DISORDERS MÉDICAMENTS CONTRE LES TROUBLES DUS À L'HYPERACIDITÉ

A02A ANTACIDS ANTIACIDES

A02AD COMBINATIONS AND COMPLEXES OF ALUMINIUM, CALCIUM AND MAGNESIUM COMPOUNDS

COMBINAISON DE COMPOSÉS DE MAGNÉSIUM, D'ALUMINIUM ET DE CALCIUM

A02AD01 ORDINARY SALT COMBINATIONS COMPOSES DE SEL ORDINAIRE

ALUMINUM / MAGNESIUM ALUMINIUM / MAGNÉSIUM

Sus Orl 45.6mg/40mg Diovol 01966529 CHU G Susp Sus Orl 120mg/60mg Diovol EX 00491217 CHU G Susp

October 2015 v.2 2

A02B DRUGS FOR PEPTIC ULCER AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD) MÉDICAMENTS CONTRE L'ULCÈRE GASTRODUODÉNAL ET LE REFLUX GASTRO

OESOPHAGIEN

A02BA H2-RECEPTOR ANTAGONISTS ANTAGONISTES DES RÉCEPTEURS H2

A02BA01 CIMETIDINE CIMÉTIDINE

Tab Orl 200mg Apo-Cimetidine 00584215 APX ADEFGVW Co. Tab Orl 300mg Apo-Cimetidine 00487872 APX ADEFGVW Co. Mylan-Cimetidine 02227444 MYL ADEFGVW Tab Orl 400mg Apo-Cimetidine 00600059 APX ADEFGVW Co. Mylan-Cimetidine 02227452 MYL ADEFGVW Tab Orl 600mg Apo-Cimetidine 00600067 APX ADEFGVW Co. Mylan-Cimetidine 02227460 MYL ADEFGVW Tab Orl 800mg Apo-Cimetidine (Disc/non Disp Mar 7/16) 00749494 APX ADEFGVW Co.

A02BA02 RANITIDINE

RANITIDINE

Liq Inj 25mg/mL Zantac 02212366 GSK W Liq Liq Orl 15mg/mL Apo-Ranitidine 02280833 APX DEFGVW Liq Teva-Ranidine 02242940 TEV DEFGVW Tab Orl 150mg Zantac 02212331 GSK ABDEFGVW Co. Act Ranitidine 02248570 ATV ABDEFGVW Apo-Ranitidine 00733059 APX ABDEFGVW Mylan-Ranitidine 02207761 MYL ABDEFGVW Myl-Ranitidine 02367378 MYL ABDEFGVW pms-Ranitidine 02242453 PMS ABDEFGVW Ranitidine 02353016 SAS ABDEFGVW Ranitidine 02385953 SIV ABDEFGVW Ran-Ranitidine 02336480 RAN ABDEFGVW Sandoz Ranitidine 02243229 SDZ ABDEFGVW Teva-Ranidine 00828564 TEV ABDEFGVW

October 2015 v.2 3

A02BA02 RANITIDINE RANITIDINE

Tab Orl 300mg Zantac 02212358 GSK ABDEFGVW Co. Act Ranitidine 02248571 ATV ABDEFGVW Apo-Ranitidine 00733067 APX ABDEFGVW Mylan-Ranitidine 02207788 MYL ABDEFGVW Myl-Ranitidine 02367386 MYL ABDEFGVW pms-Ranitidine 02242454 PMS ABDEFGVW Ranitidine 02353024 SAS ABDEFGVW Ranitidine 02385961 SIV ABDEFGVW Ran-Ranitidine 02336502 RAN ABDEFGVW Sandoz Ranitidine 02243230 SDZ ABDEFGVW Teva-Ranidine 00828556 TEV ABDEFGVW

A02BA03 FAMOTIDINE

FAMOTIDINE

Tab Orl 20mg Apo-Famotidine 01953842 APX ADEFGVW Co. Famotidine 02351102 SAS ADEFGVW Mylan-Famotidine 02196018 MYL ADEFGVW Teva-Famotidine 02022133 TEV ADEFGVW Tab Orl 40mg Apo-Famotidine 01953834 APX ADEFGVW Co. Famotidine 02351110 SAS ADEFGVW Mylan-Famotidine 02196026 MYL ADEFGVW Teva-Famotidine 02022141 TEV ADEFGVW

A02BB PROSTAGLANDINS PROSTAGLANDINES

A02BB01 MISOPROSTOL MISOPROSTOL

Tab Orl 100mcg Misoprostol 02244022 AAP ADEFGVW Co. Tab Orl 200mcg Misoprostol 02244023 AAP ADEFGVW Co.

A02BC PROTON PUMP INHIBITORS INHIBITEURS DE LA POMPE À PROTONS

A02BC01 OMEPRAZOLE OMÉPRAZOLE

SRC Orl 20mg Losec 00846503 AZE ABDEFGVW Caps.L.L. Apo-Omeprazole 02245058 APX ABDEFGVW Mylan-Omeprazole 02329433 MYL ABDEFGVW Omeprazole 02348691 SAS ABDEFGVW Omeprazole 02411857 SIV ABDEFGVW pms-Omeprazole 02320851 PMS ABDEFGVW Ran-Omeprazole 02403617 RAN ABDEFGVW Sandoz Omeprazole 02296446 SDZ ABDEFGVW

October 2015 v.2 4

A02BC01 OMEPRAZOLE OMÉPRAZOLE

SRT Orl 20mg Losec 02190915 AZE ABDEFGVW Co.L.L. Jamp-Omeprazole 02420198 JPC ABDEFGVW Omeprazole 02416549 AHI ABDEFGVW Nat-Omeprazole DR 02439549 NAT ABDEFGVW pms-Omeprazole DR 02310260 PMS ABDEFGVW Ran-Omeprazole 02374870 RAN ABDEFGVW Teva-Omeprazole 02295415 TEV ABDEFGVW

A02BC02 PANTOPRAZOLE

PANTOPRAZOLE

ECT Orl 20mg Pantoloc 02241804 TAK (SA) Co.Ent Apo-Pantoprazole 02292912 APX (SA) Jamp-Pantoprazole 02408414 JPC (SA) Pantoprazole 02385740 SIV (SA) Ran-Pantoprazole 02305038 RAN (SA) Sandoz Pantoprazole 02301075 SDZ (SA) Teva-Pantoprazole 02285479 TEV (SA) ECT Orl 40mg Pantoloc 02229453 TAK (SA) Co.Ent Abbott-Pantoprazole 02412969 ABB (SA) Act Pantoprazole 02300486 ATV (SA) Apo-Pantoprazole 02292920 APX (SA) Jamp-Pantoprazole 02357054 JPC (SA) Mar-Pantoprazole 02416565 MAR (SA) Mint-Pantoprazole 02417448 MNT (SA) Mylan-Pantoprazole 02299585 MYL (SA) Pantoprazole 02437945 PMS (SA) Pantoprazole 02370808 SAS (SA) Pantoprazole 02385759 SIC (SA) pms-Pantoprazole 02307871 PMS (SA) Ran-Pantoprazole 02305046 RAN (SA) Sandoz Pantoprazole 02301083 SDZ (SA) Teva-Pantoprazole 02285487 TEV (SA) Tab Orl 40mg Tecta 02267233 TAK ABDEFGVW Co.

A02BC03 LANSOPRAZOLE

LANSOPRAZOLE

SRC Orl 15mg Prevacid 02165503 ABB (SA) Caps.L.L. Apo-Lansoprazole 02293811 APX (SA) Lansoprazole 02433001 PMS (SA) Lansoprazole 02357682 SAS (SA) Lansoprazole 02385767 SIV (SA) Mylan-Lansoprazole 02353830 MYL (SA) pms-Lansoprazole (Disc/Non-Disp Feb 25/17) 02395258 PMS (SA) Ran-Lansoprazole 02402610 RAN (SA) Sandoz Lansoprazole 02385643 SDZ (SA) Teva-Lansoprazole 02280515 TEV (SA)

October 2015 v.2 5

A02BC03 LANSOPRAZOLE LANSOPRAZOLE

SRC Orl 30mg Prevacid 02165511 ABB (SA) Caps.L.L. Apo-Lansoprazole 02293838 APX (SA) Lansoprazole 02433028 PMS (SA) Lansoprazole 02357690 SAS (SA) Lansoprazole 02410389 SIV (SA) Mylan-Lansoprazole 02353849 MYL (SA) pms-Lansoprazole (Disc/Non-Disp Feb 25/17) 02395266 PMS (SA) Ran-Lansoprazole 02402629 RAN (SA) Sandoz Lansoprazole 02385651 SDZ (SA) Teva-Lansoprazole 02280523 TEV (SA) SRT Orl 15mg Prevacid FasTab 02249464 ABB (SA) Co.L.L SRT Orl 30mg Prevacid FasTab 02249472 ABB (SA) Co.L.L.

A02BC04 RABEPRAZOLE

RABÉPRAZOLE

ECT Orl 10mg Pariet 02243796 JAN ABDEFGVW Co.Ent Abbott-Rabeprazole 02422638 BGP ABDEFGVW Apo-Rabeprazole 02345579 APX ABDEFGVW Mylan-Rabeprazole 02408392 MYL ABDEFGVW pms-Rabeprazole EC 02310805 PMS ABDEFGVW Rabeprazole 02385449 SIV ABDEFGVW Rabeprazole EC 02356511 SAS ABDEFGVW Ran-Rabeprazole 02298074 RAN ABDEFGVW Sandoz Rabeprazole 02314177 SDZ ABDEFGVW Teva-Rabeprazole EC 02296632 TEV ABDEFGVW ECT Orl 20mg Pariet 02243797 JAN ABDEFGVW Co.Ent Abbott-Rabeprazole 02422646 BGP ABDEFGVW Apo-Rabeprazole 02345587 APX ABDEFGVW Mylan-Rabeprazole 02408406 MYL ABDEFGVW pms-Rabeprazole EC 02310813 PMS ABDEFGVW Rabeprazole 02385457 SIV ABDEFGVW Rabeprazole EC 02356538 SAS ABDEFGVW Ran-Rabeprazole 02298082 RAN ABDEFGVW Sandoz Rabeprazole 02314185 SDZ ABDEFGVW Teva-Rabeprazole EC 02296640 TEV ABDEFGVW

A02BD COMBINATIONS FOR ERADICATION OF HELICOBACTER PYLORI ASSOCIATIONS POUR L’ÉRADICATION DU HELICOBACTER PYLORI

A02BD99 LANSOPRAZOLE, CLARITHROMYCIN AND AMOXICILLIN LANSOPRAZOLE, L’AMOXICILLINE ET CLARITHROMYCINE

Kit Orl 30mg, 500mg, 500mg Hp-Pac Kit 7 blister cards 02238525 ABB (SA) Tro

October 2015 v.2 6

A02BX OTHER DRUGS FOR PEPTIC ULCER AND GASTROESOPHAGEAL REFLUX DISEASE (GORD) AUTRES MÉDICAMENTS CONTRE L’ULCÈRE GASTRODUODÉNAL ET LE REFLUX GASTRO OESOPHAGIEN

A02BX02 SUCRALFATE SUCRALFATE

Sus Orl 1g/5mL Sulcrate Suspension Plus 02103567 AXC ADEFGVW Susp Tab Orl 1g Sulcrate 02100622 AXC ADEFGVW Co. Apo-Sucralfate 02125250 APX ADEFGVW Teva-Sulcralfate 02045702 TEV ADEFGVW

A03 DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS MÉDICAMENTS CONTRE LES TROUBLES GASTROINTESTINAUX FONCTIONNELS

A03A DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS MÉDICAMENTS CONTRE LES TROUBLES GASTROINTESTINAUX FONCTIONNELS

A03AA SYNTHETIC ANTICHOLINERGICS, ESTERS WITH TERTIARY AMINO GROUP ANTICHOLINERGIQUES SYNTHÉTIQUES A ESTERS AVEC GROUPE AMINO TERTIAIRE

A03AA05 TRIMEBUTINE TRIMÉBUTINE

Tab Orl 100mg Trimebutine 02245663 AAP ADEFGVW Co. Tab Orl 200mg Modulon 00803499 AXC ADEFGVW Co. Trimebutine 02245664 AAP ADEFGVW

A03AA07 DICYCLOVERINE (DICYCLOMINE)

DICYCLOVERINE (DICYCLOMINE)

Cap Orl 10mg Protylol 00287709 PDL ADEFGVW Caps Syr Orl 10mg/5mL Bentylol 02102978 AXC ADEFGVW Sir. Tab Orl 10mg Bentylol 02103087 AXC ADEFGVW Co. Jamp-Dicyclomine 02391619 JPC ADEFGVW Tab Orl 20mg Bentylol 02103095 AXC ADEFGVW Co. Protylol-20 (Disc/non disp Jul 24/16) 00513059 PDL ADEFGVW Jamp-Dicyclomine 02366088 JPC ADEFGVW

A03AB SYNTHETIC ANTICHOLINERGICS, QUATERNARY AMMONIUM COMPOUNDS ANTICHOLINERGIQUES SYNTHÉTIQUES, ESTERS, COMPOSES D’AMMONIUM QUATERNAIRE

A03AB02 GLYCOPYRRONIUM (GLYCOPYRROLATE) GLYCOPYRRONIUM (GLYCOPYRROLATE)

Liq Inj 0.2mg/mL Glycopyrrolate 02039508 SDZ ADEFVW Liq

October 2015 v.2 7

A03AX OTHER DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS AUTRES MÉDICAMENTS POUR LES TROUBLES FONCTIONNELS DE L’INTESTIN

A03AX04 PINAVERIUM PINAVÉRIUM

Tab Orl 50mg Dicetel 01950592 ABB ADEFGVW Co. Tab Orl 100mg Dicetel 02230684 ABB ADEFGVW Co.

A03C ANTISPASMODICS IN COMBINATION WITH PSYCHOLEPTICS ANTISPASMODIQUES EN COMBINAISON AVEC DES PSYCHOLEPTIQUES

A03CA SYNTHETIC ANTICHOLINERGIC AGENTS IN COMBINATION WITH PSYCHOLEPTICS AGENTS ANTICHOLINERGIQUES SYNTHÉTIQUES EN COMBINAISON AVEC DES PSYCHOLEPTIQUES

A03CA02 CLIDINIUM AND PSYCHOLEPTICS CLIDINIUM ET PSYCHOLEPTIQUES

CHLORDIAZEPOXIDE / CLIDINIUM CHLORDIAZÉPOXIDE / CLIDINIUM

Cap Orl 5mg/2.5mg Librax 00115630 VLN ADEFGVW Caps Chlorax 00618454 AAP ADEFGVW

A03E ANTISPASMODICS AND ANTICHOLINERGICS IN COMBINATION WITH OTHER DRUGS

ANTISPASMODIQUES ET ANTICHOLINERGIQUES EN COMBINAISON AVEC D’AUTRES MÉDICAMENTS

A03ED ANTISPASMODICS IN COMBINATION WITH OTHER DRUGS ANTISPASMODIQUES EN COMBINAISON AVEC D’AUTRES MÉDICAMENTS

A03ED99 ANTISPASMODICS, COMBINATIONS ANTISPASMODIQUES, COMBINAISONS

PHENOBARBITAL / ERGOTAMINE / BELLADONNA PHÉNOBARBITAL / ERGOTAMINE / BELLADONE

SRT Orl 40mg / 0.6mg / 0.2mg Bellergal spacetabs 00176141 PAL ADEFGVW Co.L.L.

A03F PROPULSIVES PROPULSIFS

A03FA PROPULSIVES PROPULSIVES

A03FA01 METOCLOPRAMIDE MÉTOCLOPRAMIDE

Liq Inj 5mg/mL Metoclopramide 02185431 SDZ ADEFVW Liq Syr Orl 1mg/mL Metonia 02230433 PDP ADEFGVW Sir.

October 2015 v.2 8

A03FA01 METOCLOPRAMIDE MÉTOCLOPRAMIDE

Tab Orl 5mg Metonia 02230431 PDP ADEFGVW Co. Tab Orl 10mg Metonia 02230432 PDP ADEFGVW Co.

A03FA03 DOMPERIDONE

DOMPÉRIDONE

Tab Orl 10mg Domperidone 02238341 SIV ADEFGVW Co. Domperidone 02350440 SAS ADEFGVW Apo-Domperidone 02103613 APX ADEFGVW Jamp-Domperidone 02369206 JPC ADEFGVW Mar-Domperidone 02403870 MAR ADEFGVW Mylan-Domperidone 02278669 MYL ADEFGVW pms-Domperidone 02236466 PMS ADEFGVW Ran-Domperidone 02268078 RAN ADEFGVW ratio-Domperidone 01912070 RPH ADEFGVW Teva-Domperidone 02157195 TEV ADEFGVW

A04 ANTIEMETICS AND ANTINAUSEANTS ANTIEMÉTIQUES ET ANTINAUSÉEUX

A04A ANTIEMETICS AND ANTINAUSEANTS ANTIEMÉTIQUES ET ANTINAUSÉEUX

A04AA SEROTONIN (5HT3) ANTAGONISTS ANTAGONISTES DE LA SÉROTONINE (5HT3)

A04AA01 ONDANSETRON ONDANSÉTRON

Liq Orl 4mg/5mL Zofran 02229639 GSK (SA) Liq Ondansetron 02291967 AAP (SA) ODT Slg 4mg Zofran ODT 2239372 GSK (SA) Co.D.O Ondissolve 02389983 TAK (SA) ODT Slg 8mg Zofran ODT 2239373 GSK (SA) Co.D.O Ondissolve 02389991 TAK (SA) Liq Inj 2mg/mL Zofran (PF) 02213745 GSK W Liq Ondansetron (PF) 02390019 MYL W Ondansetron (PF) 02265524 TEV W Liq Inj 2mg/mL Zofran 02213745 GSK W Liq Jamp-Ondansetron with preservative 02420422 JPC W Ondansetron with preservative 02265532 TEV W

October 2015 v.2 9

A04AA01 ONDANSETRON ONDANSÉTRON

Tab Orl 4mg Zofran 02213567 GSK W (SA) Co. Apo-Ondansetron 02288184 APX W (SA) Co Ondansetron 02296349 COB W (SA) Jamp-Ondansetron 02313685 JPC W (SA) Mar-Ondansetron 02371731 MAR W (SA) Mint-Ondansetron 02305259 MNT W (SA) Mylan-Ondansetron 02297868 MYL W (SA) Nat-Ondansetron 02417839 NAT W (SA) Ondansetron 02421402 SAS W (SA) Ondansetron-Odan 02306212 ODN W (SA) Phl-Ondansetron 02278618 PHL W (SA) pms-Ondansetron 02258188 PMS W (SA) Ran-Ondansetron 02312247 RAN W (SA) Ratio-Ondansetron 02278529 RPH W (SA) Sandoz Ondansetron 02274310 SDZ W (SA) Septa-Ondansetron 02376091 SPT W (SA) Teva-Ondansetron 02264056 TEV W (SA) Tab Orl 8mg Zofran 02213575 GSK W (SA) Co. Apo-Ondansetron 02288192 APX W (SA) Co Ondansetron 02296357 COB W (SA) Jamp-Ondansetron 02313693 JPC W (SA) Mar-Ondansetron 02371758 MAR W (SA) Mint-Ondansetron 02305267 MNT W (SA) Mylan-Ondansetron 02297876 MYL W (SA) Nat-Ondansetron 02417847 NAT W (SA) Ondansetron 02421410 SAS W (SA) Ondansetron-Odan 02306220 ODN W (SA) Phl-Ondansetron 02278626 PHL W (SA) pms-Ondansetron 02258196 PMS W (SA) Ran-Ondansetron 02312255 RAN W (SA) ratio-Ondansetron 02278537 RPH W (SA) Sandoz Ondansetron 02274329 SDZ W (SA) Septa-Ondansetron 02376105 SPT W (SA) Teva-Ondansetron 02264064 TEV W (SA)

A04AA02 GRANISETRON

GRANISÉTRON

Tab Orl 1mg Kytril (Disc/non disp Jan 1/17) 02185881 HLR W (SA)

Co. Granisetron 02308894 AAP W (SA)

A04AD OTHER ANTIEMETICS AUTRES ANTIEMÉTIQUES

A04AD01 SCOPOLAMINE SCOPOLAMINE

Liq Inj 0.4mg/mL Scopolamine Hydrobromide 00541869 HOS ADEFVW Liq

October 2015 v.2 10

A04AD01 SCOPOLAMINE SCOPOLAMINE

Liq Inj 0.6mg/mL Scopolamine Hydrobromide 00541877 HOS ADEFVW Liq Liq Inj 20mg/mL Buscopan 00363839 BOE W Liq Hyoscine Butylbromide 02229868 SDZ ADEFGVW Srd Trd 1.5mg Transderm-V 80024336 NVR AEFGVW Srd Tab Orl 10mg Buscopan 00363812 BOE ADEFGVW Co.

A04AD11 NABILONE

NABILONE

Cap Orl 0.25mg Cesamet 02312263 VLN (SA) Caps Ran-Nabilone 02358077 RAN (SA) Teva-Nabilone 02392925 TEV (SA) Cap Orl 0.5mg Cesamet 02256193 VLN (SA) Caps Act Nabilone 02393581 ATV (SA) pms-Nabilone 02380900 PMS (SA) Ran-Nabilone 02358085 RAN (SA) Teva-Nabilone 02384884 TEV (SA) Cap Orl 1mg Cesamet 00548375 VLN (SA) Caps Act Nabilone 02393603 ATV (SA) pms-Nabilone 02380919 PMS (SA) Ran-Nabilone 02358093 RAN (SA) Teva-Nabilone 02384892 TEV (SA)

A04AD12 APREPITANT

APRÉPITANT

Cap Orl 80mg Emend 02298791 FRS W (SA)

Caps Cap Orl 125mg Emend 02298805 FRS W (SA)

Caps Kit Orl 80mg, 125mg Emend-Tri-Pack 02298813 FRS W (SA)

Tro

A04AD99 DIMENHYDRINATE DIMENHYDRINATE

Liq Inj 50mg/mL Gravol 00013579 CHU W Liq Dimenhydrinate IM 00392537 SDZ W Syr Orl 15mg/5mL Gravol 00230197 CHU G Sir.

October 2015 v.2 11

A04AD99 DIMENHYDRINATE DIMENHYDRINATE

Tab Orl 15mg Gravol (Disc/non disp. Jun 26/16) 00511196 CHU G Co.

A05 BILE AND LIVER THERAPY TRAITEMENT DU FOIE ET BILIAIRE

A05A BILE THERAPY TRAITEMENT BILIAIRE

A05AA BILE ACID PREPERATIONS PREPARATIONS POUR L’ACIDE BILIAIRE

A05AA02 URSODEOXYCHOLIC ACID ACIDE URSODÉOXYCHOLIQUE

Tab Orl 250mg Urso 02238984 AXC (SA) Co. pms-Ursodiol C 02273497 PMS (SA) Tab Orl 500mg Urso DS 02245894 AXC (SA) Co pms-Ursodiol C 02273500 PMS (SA)

A06 LAXATIVES LAXATIFS

A06A LAXATIVES LAXATIFS

A06AD OSMOTICALLY ACTING LAXATIVES LAXATIFS AGISSANT OSMOTIQUEMENT

A06AD11 LACTULOSE LACTULOSE

Syr Orl 667mg Apo-Lactulose 02242814 APX (SA) Sir Jamp-Lactulose 02295881 JPC (SA) Lactulose 02412268 SAS (SA) pms-Lactulose 00703486 PMS (SA) ratio-Lactulose 00854409 RPH (SA) Teva-Lactulose 02331551 TEV (SA)

A07 ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS ANTIDIARRHÉIQUES, AGENTS ANTI-INFECTIEUX/ANTI-INFLAMMATOIRES POUR L’INTESTIN

A07A INTESTINAL ANTIINFECTIVES ANTI-INFECTIEUX INTESTINAUX

A07AA ANTIBIOTICS ANTIBIOTIQUES

A07AA02 NYSTATIN NYSTATINE

Susp Orl 100000IU/mL Jamp-Nystatin 02433443 JPC ABDEFGVW Susp. pms-Nystatin Suspension 00792667 PMS ABDEFGVW ratio-Nystatin 02194201 RPH ABDEFGVW

October 2015 v.2 12

A07AA12 FIDAXOMICIN FIDAXOMICINE

Tab Orl 200mg Dificid 02387174 CBP (SA) Co.

A07D ANTIPROPULSIVES ANTIPROPULSIFS

A07DA ANTIPROPULSIVES ANTIPROPULSIFS

A07DA01 DIPHENOXYLATE DIPHÉNOXYLATE

DIPHENOXYLATE / ATROPINE DIPHÉNOXYLATE / ATROPINE

Tab Orl 2.5mg/0.025mg Lomotil 00036323 PFI ADEFGVW Co.

A07DA03 LOPERAMIDE

LOPÉRAMIDE

Liq Orl 0.2mg/mL pms-Loperamide Hydrochloride 02016095 PMS AEFGVW Liq Tab Orl 2mg Apo-Loperamide 02212005 APX AEFGVW Co. Loperamide 02256452 JPC AEFGVW Novo-Loperamide 02132591 TEV AEFGVW pms-Loperamide 02228351 PMS AEFGVW Sandoz Loperamide (Disc/non disp Nov 15/15) 02257564 SDZ AEFGVW

A07E INTESTINAL ANTIINFLAMMATORY AGENTS AGENTS ANTI-INFLAMMATOIRES INTESTINAUX

A07EA CORTICOSTEROIDS ACTING LOCALLY CORTICOSTÉROÏDES AGISSANT LOCALEMENT

A07EA02 HYDROCORTISONE HYDROCORTISONE

Aer Rt 10% Cortifoam 00579335 PAL ADEFGVW Aér. Enm Rt 100mg/60mL Cortenema 02112736 AXC ADEFGVW Lav. Hycort (Disc/non disp Apr 22/16) 00230316 VLN ADEFGVW

A07EA04 BETAMETHASONE

BÉTAMÉTHASONE

Enm Rt 5mg/100mL Betnesol 02060884 PAL ADEFGVW Lav.

October 2015 v.2 13

A07EA06 BUDESONIDE BUDÉSONIDE

Cap Orl 3mg Entocort 02229293 AZE ADEFGVW Caps Enm Rt 2.3mg Entocort 02052431 AZE ADEFGVW Lav.

A07EB ANTIALLERGIC AGENTS, EXCL. CORTICOSTEROIDS AGENTS ANTIALLERGIQUES, À L’EXCLUSION DES CORTICOSTÉROÏDES

A07EB01 CROMOGLICIC ACID CROMOGLYCATE DISODIQUE

Cap Orl 100mg Nalcrom 00500895 SAV ADEFGVW Caps

A07EC AMINOSALICYLIC ACID AND SIMILAR AGENTS ACIDE AMINOSALICYLIQUE ET AGENTS SEMBLABLES

A07EC01 SULFASALAZINE SULFASALAZINE

ECT Orl 500mg Salazopyrin EN 02064472 PFI ADEFGVW Co.Ent pms-Sulfasalazine EC 00598488 PMS ADEFGVW Tab Orl 500mg Salazopyrin 02064480 PFI ADEFGVW Co. pms-Sulfasalazine 00598461 PMS ADEFGVW

A07EC02 MESALAZINE

MÉSALAZINE

ECT Orl 400mg Asacol 01997580 WNC ADEFGVW Co.Ent ECT Orl 500mg Mesasal 01914030 GSK ADEFGVW Co.Ent Salofalk 02112787 AXC ADEFGVW ECT Orl 800mg Asacol 02267217 WNC ADEFGVW Co.Ent ERT Orl 500mg Pentasa 02099683 FEI ADEFGVW Co.L.P. ERT Orl 1000mg Pentasa 02399466 FEI ADEFGVW Co.L.P. Sup Rt 500mg Salofalk 02112760 AXC ADEFGVW Supp. Sup Rt 1g Pentasa 02153564 FEI ADEFGVW Supp. Salofalk 02242146 AXC ADEFGVW Sup Rt 1g/100mL Pentasa 02153521 FEI ADEFGVW Susp

October 2015 v.2 14

A07EC02 MESALAZINE MÉSALAZINE

Sup Rt 2g/60g Salofalk 02112795 AXC ADEFGVW Susp. Sup Rt 4g/60g Salofalk 02112809 AXC ADEFGVW Susp. Sup Rt 4g/100mL Pentasa 02153556 FEI ADEFGVW Susp. Tab Orl 1.2g Mezavant 02297558 SHI ADEFGVW Co.

A07EC03 OLSALAZINE

OLSALAZINE

Cap Orl 250mg Dipentum 02063808 SLP ADEFGVW Caps

A07F ANTIDIARRHEAL MICROORGANISMS MICRO-ORGANISMES ANTIDIARRHÉIQUES

A07FA ANTIDIARRHEAL MICROORGANISMS MICRO-ORGANISMES ANTIDIARRHÉIQUES

A07FA01 LACTIC ACID PRODUCING ORGANISMS ORGANISMES PRODUISANT DE L’ACIDE LACTIQUE

Cap Orl 1B Bacid 80017987 ERF AEFGVW Caps

A09 DIGESTIVES, INCLUDING ENZYMES AGENTS DIGESTIFS, Y COMPRIS LES ENZYMES

A09A DIGESTIVES, INCLUDING ENZYMES AGENTS DIGESTIFS, Y COMPRIS LES ENZYMES

A09AA ENZYME PREPARATIONS PRÉPARATIONS D’ENZYMES

A09AA02 MULTIENZYMES (LIPASE, PROTEASE ETC) MULTIENZYMES (LIPASE, PROTÉASE ETC)

Cap Orl 4500U/ 20000U/20000U Ultrase MS 4 02203324 AXC ABDEFGV Caps. Cap Orl 8000U/30000U/30000U Cotazym 00263818 FRS ABDEFGV Caps. Cap Orl 12000U/39000U/39000U Ultrase MT 12 02045834 AXC ABDEFGV Caps. Cap Orl 20000U/ 65000U/65000U Ultrase MT 20 02045869 AXC ABDEFGV Caps.

October 2015 v.2 15

A09AA02 MULTIENZYMES (LIPASE, PROTEASE ETC) MULTIENZYMES (LIPASE, PROTÉASE ETC)

ECC Orl 4000U/12000U/12000U Pancrease MT 4 00789445 JAN ABDEFGV Caps.Ent ECC Orl 5000U/16600U/18750U Creon 5 Minimicrospheres 02239007 ABB ABDEFGV Caps.Ent (Disc/non disp Dec 31/15) ECC Orl 6000U/30000U/19000U Creon 6 Minimicrospheres 02415194 ABB ABDEFGV Caps.Ent ECC Orl 8000U/30000U/30000U Cotazym ECS 8 00502790 SCH ABDEFGV Caps.Ent ECC Orl 10000U/33200U/37500U Creon 10 Minimicrospheres 02200104 ABB ABDEFGV Caps.Ent ECC Orl 1000U/30000U/30000U Pancrease MT 10 00789437 JAN ABDEFGV Caps.Ent ECC Orl 16000U/48000U/48000U Pancrease MT 16 00789429 JAN ABDEFGV Caps.Ent ECC Orl 20000U/55000U/55000U Cotazym ECS 20 00821373 SCH ABDEFGV Caps.Ent

ECC Orl 25000U/ 74000U/62500U Creon 25 Minimicrospheres 01985205 ABB ABDEFGV Caps.Ent Tab Orl 8000U/ 30000U/30000U Viokase 8 02230019 AXC ABDEFGV Co. Tab Orl 16000U/ 60000U/60000U Viokase 16 02241933 AXC ABDEFGV Co.

A10 DRUGS USED IN DIABETES MÉDICAMENTS UTILISÉS CHEZ LES DIABÉTIQUES

A10A INSULINS AND ANALOGUES INSULINES ET ANALOGUES

A10AB INSULINS & ANALOGUES FOR INJECTION, FAST-ACTING INSULINES ET ANALOGUES POUR L’INJECTION, À ACTION RAPIDE

A10AB01 INSULIN (HUMAN); FAST-ACTING INSULINE (HUMAINE); ACTION RAPIDE

Liq Inj 100U/mL Humulin R 00586714 LIL ADEFGVW Liq Humulin R (cartridge) 01959220 LIL ADEFGVW Novolin GE Toronto 02024233 NNO ADEFGVW Novolin GE Toronto(penfill) 02024284 NNO ADEFGVW Liq Inj 100U/mL Humalog 02229704 LIL (SA) Liq Humalog (cartridge) 02229705 LIL (SA) Humalog (kwikpen) 02403412 LIL (SA)

October 2015 v.2 16

A10AB05 INSULIN ASPART INSULINE ASPARTE

Liq Inj 100U/mL Novorapid 02245397 NNO (SA) Liq Novorapid (penfill) 02244353 NNO (SA)

A10AB06 INSULIN GLULISINE

INSULINE GLULISINE

Liq Inj 100U/mL Apidra (cartridge) 02279479 SAV DEFG-18 (SA) Liq Apidra Solostar 02294346 SAV DEFG-18 (SA) Apidra 02279460 SAV DEFG-18 (SA)

A10AC INSULINS & ANALOGUES FOR INJECTION, INTERMEDIATE-ACTING INSULINES ET ANALOGUES POUR INJECTION, ACTION INTERMÉDIAIRE

A10AC01 INSULIN (HUMAN); INTERMEDIATE-ACTING INSULINE (HUMAINE); ACTION INTERMÉDIAIRE

Sus Inj 100U/mL Humulin N 00587737 LIL ADEFGVW Susp Humulin N (cartridge) 01959239 LIL ADEFGVW Humulin N (kwikpen) 02403447 LIL ADEFGVW Novolin GE NPH 02024225 NNO ADEFGVW Novolin GE NPH (penfill) 02024268 NNO ADEFGVW

A10AD INSULINS & ANALOGUES FOR INJECTION INTERMEDIATE-ACTING, FAST-ACTING INSULINES ET ANALOGUES POUR INJECTION, ACTION INTERMÉDIAIRE, À ACTION RAPIDE

A10AD01 INSULIN (HUMAN), INTERMEDIATE-ACTING IN COMBINATION INSULINE (HUMAINE); ACTION INTERMÉDIAIRE, COMBINASON

Sus Inj 30U/70U Humulin 30/70 00795879 LIL ADEFGVW Susp Humulin 30/70 (cartridge) 01959212 LIL ADEFGVW Novolin GE 30/70 02024217 NNO ADEFGVW Novolin GE 30/70 (penfill) 02025248 NNO ADEFGVW Sus Inj 40U/60U Novolin GE 40/60 (Penfill) 02024314 NNO ADEFGVW Susp Sus Inj 50U/50U Novolin GE 50/50 (Penfill) 02024322 NNO ADEFGVW Susp

A10AE INSULINS & ANALOGUES, FOR INJECTION LONG ACTING INSULINES ET ANALOGUES POUR INJECTION, À ACTION LENTE

A10AE04 INSULIN GLARGINE INSULINE GLARGINE

Liq Inj 100U/mL Lantus Cartridge 02251930 SAV (SA) Liq Lantus SoloSTAR pre-filled pen 02294338 SAV (SA) Lantus Vial 02245689 SAV (SA)

A10AE05 INSULIN DETEMIR

INSULINE DÉTÉMIR

Liq Inj 100U/mL Levemir Penfill Cartridge 02271842 NNO (SA) Liq

October 2015 v.2 17

A10B BLOOD GLUCOSE LOWERING DRUGS, EXCLUDING INSULINS MÉDICAMENTS HYPOGLYCÉMIANTS, À L’EXCLUSION DES INSULINES

A10BA BIGUANIDES BIGUANIDES

A10BA02 METFORMIN METFORMINE

Tab Orl 500mg Glucophage 02099233 SAV ADEFGVW Co. Act Metformin 02257726 ATV ADEFGVW Apo-Metformin 02167786 APX ADEFGVW Jamp-Metformin 02380196 JPC ADEFGVW Jamp-Metformin Blackberry 02380722 JPC ADEFGVW Mar-Metformin 02378620 MAR ADEFGVW Metformin 02353377 SAS ADEFGVW Metformin FC 02385341 SIV ADEFGVW Mylan-Metformin 02148765 MYL ADEFGVW pms-Metformin 02223562 PMS ADEFGVW Ran-Metformin 02269031 RAN ADEFGVW ratio-Metformin 02242974 RPH ADEFGVW Sandoz Metformin FC 02246820 SDZ ADEFGVW Septa-Metformin 02379767 SPT ADEFGVW Teva-Metformin 02045710 TEV ADEFGVW Tab Orl 850mg Glucophage 02162849 SAV ADEFGVW Co. Act Metformin 02257734 ATV ADEFGVW Apo-Metformin 02229785 APX ADEFGVW Jamp-Metformin 02380218 JPC ADEFGVW Jamp-Metformin Blackberry 02380730 JPC ADEFGVW Mar-Metformin 02378639 MAR ADEFGVW Metformin 02353385 SAS ADEFGVW Metformin FC 02385368 SIV ADEFGVW Mylan-Metformin 02229656 MYL ADEFGVW pms-Metformin 02242589 PMS ADEFGVW Ran-Metformin 02269058 RAN ADEFGVW ratio-Metformin 02242931 RPH ADEFGVW Sandoz Metformin FC 02246821 SDZ ADEFGVW Septa-Metformin 02379775 SPT ADEFGVW Teva-Metformin 02230475 TEV ADEFGVW

A10BB SULFONAMIDES, UREA DERIVATIVES SULFONAMIDES, DÉRIVÉS DE L’URÉE

A10BB01 GLIBENCLAMIDE (GLYBURIDE) GLIBENCLAMIDE (GLYBURIDE)

Tab Orl 2.5mg Diabeta 02224550 SAV ADEFGVW Co. Apo-Glyburide 01913654 APX ADEFGVW Glyburide 02350459 SAS ADEFGVW Mylan-Glybe 00808733 MYL ADEFGVW ratio-Glyburide (Disc/non disp Sept 19/16) 01900927 RPH ADEFGVW Sandoz Glyburide 02248008 SDZ ADEFGVW Teva-Glyburide 01913670 TEV ADEFGVW

October 2015 v.2 18

A10BB01 GLIBENCLAMIDE (GLYBURIDE) GLIBENCLAMIDE (GLYBURIDE)

Tab Orl 5mg Diabeta 02224569 SAV ADEFGVW Co. Apo-Glyburide 01913662 APX ADEFGVW Glyburide 02350467 SAS ADEFGVW Mylan-Glybe 00808741 MYL ADEFGVW ratio-Glyburide (Disc/non disp Sept 19/16) 01900935 RPH ADEFGVW Sandoz Glyburide 02248009 SDZ ADEFGVW Teva-Glyburide 01913689 TEV ADEFGVW

A10BB02 CHLORPROPAMIDE

CHLORPROPAMIDE

Tab Orl 100mg Apo-Chlorpropamide 00399302 APX ADEFGVW Co. Tab Orl 250mg Apo-Chlorpropamide 00312711 APX ADEFGVW Co.

A10BB03 TOLBUTAMIDE

TOLBUTAMIDE

Tab Orl 500mg Tolbutamide 00312762 AAP ADEFGVW Co.

A10BB09 GLICLAZIDE

GLICLAZIDE

ERT Orl 30mg Diamicron MR 02242987 SEV ADEFGVW Co.L.P. Act Gliclazide MR 02429764 ATV ADEFGVW Apo-Gliclazide MR 02297795 APX ADEFGVW Mint-Gliclazide MR 02423286 MNT ADEFGVW ERT Orl 60mg Diamicron MR 02356422 SEV ADEFGVW Co.L.P. Apo-Gliclazide MR 02407124 APX ADEFGVW Tab Orl 80mg Diamicron 00765996 SEV ADEFGVW Co. Apo-Gliclazide 02245247 APX ADEFGVW Gliclazide 02287072 SAS ADEFGVW Mylan-Gliclazide 02229519 MYL ADEFGVW Teva-Gliclazide 02238103 TEV ADEFGVW

A10BB12 GLIMEPIRIDE

GLIMÉPIRIDE

Tab Orl 1mg Amaryl 02245272 SAV ADEFGVW Co. Apo-Glimepiride 02295377 APX ADEFGVW Novo-Glimepiride 02273756 TEV ADEFGVW Ratio-Glimepiride 02273101 TEV ADEFGVW Sandoz Glimepiride 02269589 SDZ ADEFGVW

October 2015 v.2 19

A10BB12 GLIMEPIRIDE GLIMÉPIRIDE

Tab Orl 2mg Amaryl 02245273 SAV ADEFGVW Co. Apo-Glimepiride 02295385 APX ADEFGVW Novo-Glimepiride 02273764 TEV ADEFGVW Ratio-Glimepiride 02273128 TEV ADEFGVW Sandoz Glimepiride 02269597 SDZ ADEFGVW Tab Orl 4mg Amaryl 02245274 SAV ADEFGVW Co. Apo-Glimepiride 02295393 APX ADEFGVW Novo-Glimepiride 02273772 TEV ADEFGVW Ratio-Glimepiride 02273136 TEV ADEFGVW Sandoz Glimepiride 02269619 SDZ ADEFGVW

A10BD COMBINATIONS OF ORAL BLOOD GLUCOSE LOWERING DRUGS ASSOCIATIONS DE MEDICAMENTS ORAUX

A10BD07 METFORMIN AND SITAGLIPTIN METFORMINE ET SITAGLIPTINE

Tab Orl 500mg/50mg Janumet 02333856 FRS (SA) Co. Tab Orl 850mg/50mg Janumet 02333864 FRS (SA) Co. Tab Orl 1000mg/50mg Janumet 02333872 FRS (SA) Co. ERT Orl 1000mg/50mg Janumet XR 02416794 FRS (SA) Co.L.P.

A10BD10 METFORMIN AND SAXAGLIPTIN

METFORMINE ET SAXAGLIPTINE

Tab Orl 500mg/2.5mg Komboglyze 02389169 AZE (SA) Co. Tab Orl 850mg/2.5mg Komboglyze 02389177 AZE (SA) Co. Tab Orl 1000mg/2.5mg Komboglyze 02389185 AZE (SA) Co.

A10BF ALPHA GLUCOSIDASE INHIBITORS INHIBITIEURS D’ALPHA-GLUCOSIDASE

A10BF01 ACARBOSE ACARBOSE

Tab Orl 50mg Glucobay 02190893 BAY ADEFGVW Co. Tab Orl 100mg Glucobay 02190885 BAY ADEFGVW Co.

October 2015 v.2 20

A10BG THIAZOLINEDIONES THIAZOLINEDIONES

A10BG03 PIOGLITAZONE PIOGLITAZONE

Tab Orl 15mg Actos 02242572 TAK (SA) Co. Accel Pioglitazone 02303442 ACC (SA) Act Pioglitazone 02302861 ATV (SA) Apo-Pioglitazone 02302942 APX (SA) Auro-Pioglitazone 02384906 ARO (SA) Jamp-Pioglitazone 02397307 JPC (SA) Mint-Pioglitazone 02326477 MNT (SA) Mylan-Pioglitazone 02298279 MYL (SA) Phl-Pioglitazone 02307669 PHL (SA) Pioglitazone Hydrochloride 02391600 AHI (SA) pms-Pioglitazone 02303124 PMS (SA) Ran-Pioglitazone 02375850 RAN (SA) Sandoz Pioglitazone 02297906 SDZ (SA) Teva-Pioglitazone 02274914 TEV (SA) Zym-Pioglitazone (Disc/non disp Jun 16/16) 02320754 ZYM (SA) Tab Orl 30mg Actos 02242573 TAK (SA) Co. Accel Pioglitazone 02303450 ACC (SA) Act Pioglitazone 02302888 ATV (SA) Apo-Pioglitazone 02302950 APX (SA) Auro-Pioglitazone 02384914 ARO (SA) Jamp-Pioglitazone 02365529 JPC (SA) Mint-Pioglitazone 02326485 MNT (SA) Mylan-Pioglitazone 02298287 MYL (SA) Phl-Pioglitazone 02307677 PHL (SA) Pioglitazone HCL 02339587 AHI (SA) pms-Pioglitazone 02303132 PMS (SA) Ran-Pioglitazone 02375869 RAN (SA) Sandoz Pioglitazone 02297914 SDZ (SA) Teva-Pioglitazone 02274922 TEV (SA) Zym-Pioglitazone (Disc/non disp Jun 16/16) 02320762 ZYM (SA) Tab Orl 45mg Actos 02242574 TAK (SA) Co. Accel Pioglitazone 02303469 ACC (SA) Act Pioglitazone 02302896 ATV (SA) Apo-Pioglitazone 02302977 APX (SA) Auro-Pioglitazone 02384922 ARO (SA) Jamp-Pioglitazone 02365537 JPC (SA) Mint-Pioglitazone 02326493 MNT (SA) Mylan-Pioglitazone 02298295 MYL (SA) Phl-Pioglitazone 02307723 PHL (SA) Pioglitazone HCL 02339595 AHI (SA) pms-Pioglitazone 02303140 PMS (SA) Ran-Pioglitazone 02375877 RAN (SA) Sandoz Pioglitazone 02297922 SDZ (SA) Teva-Pioglitazone 02274930 TEV (SA) Zym-Pioglitazone (Disc/non disp Jun 16/16) 02320770 ZYM (SA)

October 2015 v.2 21

A10BH DIPEPTIDYL PEPTIDASE 4 (DPP-4) INHIBITORS INHIBITEURS DE LA DIPEPTIDYL PEPTIDASE-4 (DPP-4)

A10BH01 SITAGLIPTIN SITAGLIPTINE

Tab Orl 25mg Januvia 02388839 FRS (SA) Co. Tab Orl 50mg Januvia 02388847 FRS (SA) Co. Tab Orl 100mg Januvia 02303922 FRS (SA) Co.

A10BH03 SAXAGLIPTIN

SAXAGLIPTINE

Tab Orl 2.5mg Onglyza 02375842 AZE (SA) Co. Tab Orl 5mg Onglyza 02333554 AZE (SA) Co.

A10BH05 LINAGLIPTIN

LINAGLIPTINE

Tab Orl 5mg Trajenta 02370921 BOE (SA) Co.

A10BX OTHER BLOOD GLUCOSE LOWERING DRUGS, EXCL INSULINS AUTRES MEDICAMENTS HYPOGLYCEMIANTS, EXCL INSULINES

A10BX02 REPAGLINIDE REPAGLINIDE

Tab Orl 0.5mg Gluconorm 02239924 MNO (SA) Co. Act Repaglinide 02321475 ATV (SA) Apo-Repaglinide 02355663 APX (SA) pms-Repaglinide 02354926 PMS (SA) Sandoz Repaglinide 02357453 SDZ (SA) Tab Orl 1mg Gluconorm 02239925 MNO (SA) Co. Act Repaglinide 02321483 ATV (SA) Apo-Repaglinide 02355671 APX (SA) pms-Repaglinide 02354934 PMS (SA) Sandoz Repaglinide 02357461 SDZ (SA) Tab Orl 2mg Gluconorm 02239926 MNO (SA) Co. Act Repaglinide 02321491 ATV (SA) Apo-Repaglinide 02355698 APX (SA) pms-Repaglinide 02354942 PMS (SA) Sandoz Repaglinide 02357488 SDZ (SA)

October 2015 v.2 22

A10BX11 CANAGLIFLOZIN CANAGLIFLOZIN

Tab Orl 100mg Invokana 02425483 JAN (SA) Co. Tab Orl 300mg Invokana 02425491 JAN (SA) Co.

A11 VITAMINS VITAMINES

A11A MULTIVITAMINS, COMBINATIONS MULTIVITAMINES, EN COMBINAISON

A11AA MULTIVITAMINS WITH MINERALS MULTIVITAMINES ET MINÉRAUX

A11AA03 MULTIVITAMIN AND OTHER MINERALS, INCLUDING COMBINATIONS MULTIVITAMINE ET AUTRES MINÉRAUX, Y COMPRIS LES COMBINAISONS

Tab Orl Centrum Junior 02246236 WCH G Co.

A11C VITAMIN A AND D, INCLUDING COMBINATIONS OF THE TWO VITAMINE A ET D, Y COMPRIS LES COMBINAISONS DES DEUX

A11CC VITAMIN D AND ANALOGUES VITAMINE D ET ANALOGUES

A11CC01 ERGOCALCIFEROL ERGOCALCIFÉROL

Cap Orl 50000IU D-Forte 02237450 EUR ADEFGVW Caps Osto-D2 02301911 PAL ADEFGVW Dps Orl 8288IU Erdol (Drisodan) 80003615 ODN ADEFGVW Gttes

A11CC03 ALFACALCIDOL

ALFACALCIDOL

Cap Orl 0.25mcg One-Alpha 00474517 LEO ADEFGVW Caps Cap Orl 1mcg One-Alpha 00474525 LEO ADEFGVW Caps

A11CC04 CALCITRIOL

CALCITRIOL

Cap Orl 0.25mcg Rocaltrol 00481823 HLR ADEFGVW Caps Cap Orl 0.5mcg Rocaltrol 00481815 HLR ADEFGVW Caps

October 2015 v.2 23

A11CC05 CHOLECALCIFEROL CHOLÉCALCIFÉROL

Tab Orl 1000IU Vitamin D 80000436 JAM EF-18G Co.

A11H OTHER PLAIN VITAMIN PREPARATIONS AUTRES PRÉPARATIONS VITAMINIQUES ORDINAIRES

A11HA OTHER PLAIN VITAMIN PREPARATIONS AUTRES PRÉPARATIONS VITAMINIQUES ORDINAIRES

A11HA03 TOCOPHEROL (VIT E) TOCOPHÉROL (VIT E)

Cap Orl 100IU Vitamin E 00189227 JAM BEF-18G Caps Vitamin E Natural 00122823 JAM BEF-18G Cap Orl 200IU Vitamin E 00189235 SWS BEF-18G Caps Vitamin E Natural 00122831 JAM BEF-18G Cap Orl 400IU Vitamin E 00266108 PMT BEF-18G Caps Vitamin E 02040816 PMT BEF-18G Vitamin E (Disc/non disp Apr 28/16) 02247190 HHC BEF-18G Vitamin E Natural 00122858 JAM BEF-18G Vitamin E Natural 00201995 WAM BEF-18G Vitamin E Synthetic 00274259 WAM BEF-18G Dps Orl 50IU Aquasol E 02162075 CLC BEF-18G Gttes

A11J OTHER VITAMIN PRODUCTS, COMBINATIONS AUTRES PRODUITS VITAMINIQUES, EN COMBINAISON

A11JA COMBINATIONS OF VITAMINS COMBINAISONS DE VITAMINES

Liq Orl Infantol 00558079 CHU BEFG Liq

A12 MINERAL SUPPLEMENTS SUPPLÉMENTS DE MINÉRAUX

A12B POTASSIUM POTASSIUM

A12BA POTASSIUM POTASSIUM

A12BA01 POTASSIUM CHLORIDE CHLORURE DE POTASSIUM

Liq Orl 100mg/mL K-10 80024360 GSK ADEFGVW Liq pms-Potassium 02238604 PMS ADEFGVW SRC Orl 600mg Micro-K 02042304 PAL ADEFGVW Caps.L.L.

October 2015 v.2 24

A12BA01 POTASSIUM CHLORIDE CHLORURE DE POTASSIUM

SRT Orl 600mg Slow-K 80040226 NVR ADEFGVW Co.L.L. Apo-K 00602884 APX ADEFGVW Jamp-K8 80013005 JPC ADEFGVW SRT Orl 1500mg Odan K-20 80004415 ODN ADEFGVW Co.L.L. Jamp-K20 80013007 JPC ADEFGVW

A12C OTHER MINERAL SUPPLEMENTS AUTRES SUPPLÉMENTS MINÉRAUX

A12CD FLUORIDE FLUORURE

A12CD01 SODIUM FLUORIDE FLUORURE DE SODIUM

Dps Orl 5.56mg/mL Fluor-a-Day 00610100 PDP EF-18G Gttes Tab Orl 2.21mg Fluor-a-Day 00575569 PDP EF-18G Co.

A16 OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS AUTRE PRODUITS LIÉS AU TRACTUS DIGESTIF ET AU MÉTABOLISME

A16A OTHER ALIMENTARY TRACT AND METABOLISM PRODUTS AUTRE PRODUITS LIÉS AU TRACTUS DIGESTIF ET AU MÉTABOLISME

A16AA AMINO ACIDS AND DERIVATIVES DÉRIVÉS ACIDES AMINÉS

A16AA01 LEVOCARNITINE LÉVOCARNITINE

Liq Orl 100mg/mL Carnitor 02144336 QGT (SA) Liq Tab Orl 330mg Carnitor 02144328 QGT (SA) Co.

A16AB ENZYMES ENZYMES

A16AB07 ALGLUCOSIDASE ALFA ALGLUCOSIDASE ALFA

Pws IV 50mg Myozyme 02284863 GZM (SA) Pds.

October 2015 v.2 25

B01 ANTITHROMBOTIC AGENTS AGENTS ANTITHROMBOTIQUES

B01A ANTITHROMBOTIC AGENTS AGENTS ANTITHROMBOTIQUES

B01AA VITAMIN K ANTAGONISTS ANTAGONISTES DE LA VITAMINE K

B01AA03 WARFARIN WARFARINE

Tab Orl 1mg Coumadin 01918311 BRI ADEFGVW Co. Apo-Warfarin 02242924 APX ADEFGVW Mylan-Warfarin 02244462 MYL ADEFGVW Taro-Warfarin 02242680 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344025 SAS ADEFGVW Tab Orl 2mg Coumadin 01918338 BRI ADEFGVW Co. Apo-Warfarin 02242925 APX ADEFGVW Mylan-Warfarin 02244463 MYL ADEFGVW Novo-Warfarin 02265281 TEV ADEFGVW Taro-Warfarin 02242681 TAR ADEFGVW Warfarin (Disc/non dip Aug 1/16) 02344033 SAS ADEFGVW Tab Orl 2.5mg Coumadin 01918346 BRI ADEFGVW Co. Apo-Warfarin 02242926 APX ADEFGVW Mylan-Warfarin 02244464 MYL ADEFGVW Novo-Warfarin 02265303 TEV ADEFGVW Taro-Warfarin 02242682 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344041 SAS ADEFGVW Tab Orl 3mg Coumadin 02240205 BRI ADEFGVW Co. Apo-Warfarin 02245618 APX ADEFGVW Mylan-Warfarin 02287498 MYL ADEFGVW Taro-Warfarin 02242683 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344068 SAS ADEFGVW Tab Orl 4mg Coumadin 02007959 BRI ADEFGVW Co. Apo-Warfarin 02242927 APX ADEFGVW Mylan-Warfarin 02244465 MYL ADEFGVW Taro-Warfarin 02242684 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344076 SAS ADEFGVW Tab Orl 5mg Coumadin 01918354 BRI ADEFGVW Co. Apo-Warfarin 02242928 APX ADEFGVW Mylan-Warfarin 02244466 MYL ADEFGVW Novo-Warfarin 02265346 TEV ADEFGVW Taro-Warfarin 02242685 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344084 SAS ADEFGVW Tab Orl 6mg Coumadin 02240206 BRI ADEFGVW Co. Mylan-Warfarin 02287501 MYL ADEFGVW Taro-Warfarin 02242686 TAR ADEFGVW

October 2015 v.2 26

B01AA03 WARFARIN WARFARINE

Tab Orl 10mg Coumadin 01918362 BRI ADEFGVW Co. Apo-Warfarin 02242929 APX ADEFGVW Mylan-Warfarin 02244467 MYL ADEFGVW Taro-Warfarin 02242687 TAR ADEFGVW Warfarin (Disc/non disp Aug 1/16) 02344114 SAS ADEFGVW

B01AA07 ACENOCOUMAROL (NICOUMALONE)

ACENOCOUMAROL (NICOUMALONE)

Tab Orl 1mg Sintrom 00010383 PAL ADEFGVW Co. Tab Orl 4mg Sintrom 00010391 PAL ADEFGVW Co.

B01AB HEPARIN GROUP GROUPE DE L’HÉPARINE

B01AB01 HEPARIN HÉPARINE

Liq Inj 100IU/mL Heparin 00727520 LEO W Liq Liq Inj 10,000IU/mL Heparin (Disc/non disp July 2 /17) 00579718 LEO ADEFGV Liq

B01AB04 DALTEPARIN

DALTÉPARINE Liq Inj 2,50 0IU/0.2mL Fragmin (pre-filled syringe) 02132621 PFI W (SA) Liq Liq Inj 3 500UI/0,28mL Fragmin (pre-filled syringe) 02430789 PFI W (SA) Liq Liq Inj 5,000IU/0.2mL Fragmin (pre-filled syringe) 02132648 PFI W (SA) Liq Liq Inj 7,500IU/0.3mL Fragmin (pre-filled syringe) 02352648 PFI W (SA) Liq Liq Inj 10,000IU/0.4mL Fragmin (pre-filled syringe) 02352656 PFI W (SA) Liq Liq Inj 12,500IU/0.5mL Fragmin (pre-filled syringe) 02352664 PFI W (SA) Liq Liq Inj 15,000IU/0.6mL Fragmin (pre-filled syringe) 02352672 PFI W (SA) Liq Liq Inj 18,000IU/0.72mL Fragmin (pre-filled syringe) 02352680 PFI W (SA) Liq

October 2015 v.2 27

B01AB04 DALTEPARIN DALTÉPARINE

Liq Inj 10,000IU/mL Fragmin (ampoule) 02132664 PFI W (SA) Liq Liq Inj 2,500IU/mL Fragmin (single-dose vial) 02377454 PFI W (SA) Liq Liq Inj 25,000IU/mL Fragmin(multi-dose vial) 02231171 PFI W (SA) Liq

B01AB05 ENOXAPARIN

ÉNOXAPARINE

Liq Inj 30mg/0.3mL Lovenox (pre-filled syringe) 02012472 SAV W (SA) Liq Liq Inj 40mg/0.4mL Lovenox (pre-filled syringe) 02236883 SAV W (SA) Liq Liq Inj 60mg/0.6mL Lovenox (pre-filled syringe) 02378426 SAV W (SA) Liq Liq Inj 80mg/0.8mL Lovenox (pre-filled syringe) 02378434 SAV W (SA) Liq Liq Inj 100mg/mL Lovenox (pre-filled syringe) 02378442 SAV W (SA) Liq Liq Inj 300mg/3mL Lovenox 02236564 SAV W (SA) Liq Liq Inj 120mg/0.8mL Lovenox HP (pre-filled syringe) 02242692 SAV W (SA) Liq Liq Inj 150mg/mL Lovenox HP (pre-filled syringe) 02378469 SAV W (SA) Liq

B01AB06 NADROPARIN

NADROPARINE

Liq Inj 9500IU/mL Fraxiparin (pre-filled syringes) 02236913 APR W (SA) Liq Liq Inj 19000IU/mL Fraxiparin Forte (pre-filled syringes) 02240114 APR W (SA) Liq

B01AB10 TINZAPARIN

TINZAPARINE

Liq Inj 2500IU/0.25mL Innohep (pre-filled syringe) 02229755 LEO W (SA) Liq

October 2015 v.2 28

B01AB10 TINZAPARIN TINZAPARINE

Liq Inj 3500IU/0.35mL Innohep (pre-filled syringe) 02358158 LEO W (SA) Liq Liq Inj 4500IU/0.45mL Innohep (pre-filled syringe) 02358166 LEO W (SA) Liq Liq Inj 8000IU/0.4mL Innohep (pre-filled syringe) 02429462 LEO W (SA) Liq Liq Inj 10000IU/0.5mL Innohep (pre-filled syringe) 02231478 LEO W (SA) Liq Liq Inj 12000IU/0.6mL Innohep (pre-filled syringe) 02429470 LEO W (SA) Liq Liq Inj 14000IU/0.7mL Innohep (pre-filled syringe) 02358174 LEO W (SA) Liq Liq Inj 16000IU/0.8mL Innohep (pre-filled syringe) 02429489 LEO W (SA) Liq Liq Inj 18000IU/0.9mL Innohep (pre-filled syringe) 02358182 LEO W (SA) Liq Liq Inj 10000IU/mL Innohep 02167840 LEO W (SA) Liq Liq Inj 20000IU/mL Innohep 02229515 LEO W (SA) Liq

B01AC PLATELET AGGREGATION INHIBITORS EXCLUDING HEPARIN INHIBITEURS D’AGRÉGATION PLAQUETTAIRE, À L’EXCLUSION DE HÉPARINE

B01AC04 CLOPIDOGREL CLOPIDOGREL

Tab Orl 75mg Plavix 02238682 SAV W (SA) Co. Abbott-Clopidogrel 02412942 ABB W (SA) Act Clopidogrel 02303027 ATV W (SA) Apo-Clopidogrel 02252767 APX W (SA) Auro-Clopidogrel 02416387 ARO W (SA) Clopidogrel 02400553 SAS W (SA) Clopidogrel 02385813 SIV W (SA) Jamp-Clopidogrel 02415550 JPC W (SA) Mar-Clopidogrel 02422255 MAR W (SA) Mint-Clopidogrel 02408910 MNT W (SA) Mylan-Clopidogrel 02351536 MYL W (SA) pms-Clopidogrel 02348004 PMS W (SA) Ran-Clopidogrel 02379813 RAN W (SA) Sandoz Clopidogrel 02359316 SDZ W (SA) Teva-Clopidogrel 02293161 TEV W (SA)

October 2015 v.2 29

B01AC05 TICLOPIDINE TICLOPIDINE

Tab Orl 250mg Apo-Ticlopidine 02237701 APX ADEFVW Co. Mylan-Ticlopidine (Disc/non disp Jun 05/16) 02239744 MYL ADEFVW Teva-Ticlopidine 02236848 TEV ADEFVW Ticlopidine (Disc/non disp Aug 1/16) 02343045 SAS ADEFVW

B01AC07 DIPYRIDAMOLE

DIPYRIDAMOLE

Tab Orl 25mg Apo-Dipyridamole FC/FE 00895644 APX ADEFGVW Co. Tab Orl 50mg Apo-Dipyridamole FC/FE 00895652 APX ADEFGVW Co. Tab Orl 75mg Apo-Dipyridamole FC/FE 00895660 APX ADEFGVW Co.

B01AC09 EPOPROSTENOL

ÉPOPROSTÉNOL

Pws IV 0.5mg Caripul 02397447 ACT (SA) Pds. Pws IV 1.5mg Caripul 02397455 ACT (SA) Pds. Pws IV 0.5mg Flolan 02230845 GSK (SA) Pds. Pws IV 1.5mg Flolan 02230848 GSK (SA) Pds.

B01AC21 TREPROSTINIL

TREPROSTINIL

Liq SC 1mg/mL Remodulin 02246552 UTC (SA) Liq Liq SC 2.5mg/mL Remodulin 02246553 UTC (SA) Liq Liq SC 5mg/mL Remodulin 02246554 UTC (SA) Liq Liq SC 10mg/mL Remodulin 02246555 UTC (SA) Liq

B01AC22 PRASUGREL

PRASUGREL

Tab Orl 10mg Effient 02349124 LIL (SA) Co.

October 2015 v.2 30

B01AC24 TICAGRELOR TICAGRÉLOR

Tab Orl 90mg Brilinta 02368544 AZE (SA) Co.

B01AC30 COMBINATIONS

COMBINAISONS

DIPYRIDAMOLE / ACETYLSALICYLIC ACID DIPYRIDAMOLE / ACIDE ACÉTYLSALICYLIQUE

Cap Orl 200mg/25mg Aggrenox 02242119 BOE (SA) Caps

B01AE DIRECT THROMBIN INHIBITORS LES INHIBITEURS DIRECTS DE LA THROMBINE

B01AE07 DABIGATRAN DABIGATRAN

Cap Orl 110mg Pradaxa 02312441 BOE (SA) Caps Cap Orl 150mg Pradaxa 02358808 BOE (SA) Caps

B01AF DIRECT FACTOR XA INHIBITORS INHIBITEURS DU FACTEUR XA DIRECTE

B01AF01 RIVAROXABAN RIVAROXABAN

Tab Orl 10mg Xarelto 02316986 BAY (SA)

Co. Tab Orl 15mg Xarelto 02378604 BAY (SA) Co. Tab Orl 20mg Xarelto 02378612 BAY (SA)

Co. B01AF02 APIXABAN

APIXABAN

Tab Orl 2.5mg Eliquis 02377233 BRI (SA) Co. Tab Orl 5mg Eliquis 02397714 BRI (SA) Co.

October 2015 v.2 31

B02 ANTIHAEMORRHAGICS ANTIHÉMORRAGIQUES

B02A ANTIFIBRINOLYTICS ANTIFIBRINOLYTIQUES

B02AA AMINO ACIDS ACIDES AMINÉS

B02AA02 TRANEXAMIC ACID ACIDE TRANEXAMIQUE

Tab Orl 500mg Cyklokapron 02064405 PFI ADEFGVW Co. GD-Tranexamic Acid 02409097 GMD ADEFGVW Tranexamic Acid 02401231 STR ADEFGVW

B02AA03 AMINOMETHYLBENZOIC ACID

ACIDE AMINOMETHYLBENZOIQUE

Cap Orl 500mg Potaba (Disc/non disp Jun 18/17) 00611271 GLE ADEFGVW Caps Tab Orl 500mg Potaba (Disc/non disp Jul 31/16) 00550175 GLE ADEFGVW Co.

B02B VITAMIN K AND OTHER HEMOSTATICS VITAMINE K ET AUTRES PRODUITS HÉMOSTATIQUES

B02BA VITAMIN K VITAMINE K

B02BA01 PHYTOMENADIONE PHYTOMÉNADIONE

Liq IM 1mg/0.5mL Vitamin K 00781878 SDZ ADEFGVW Liq Liq IM 10mg/mL Vitamin K 00804312 SDZ ADEFGVW Liq

B03 ANTIANAEMIC PREPARATIONS PRÉPARATIONS ANTIANÉMIQUES

B03A IRON PREPARATIONS PRÉPARATIONS DE FER

B03AA IRON BIVALENT, ORAL PREPARATIONS FER BIVALENT, PRÉPARATIONS ORALES

B03AA02 FERROUS FUMARATE FUMARATE FERREUX

Sus Orl 60mg/mL Palafer 01923439 MVL AEFGVW Susp Cap Orl 300mg Palafer 01923420 MVL AEFGVW Caps Jamp-Fer 80024232 JPC AEFGVW Tab Orl 300mg Ferrous Fumarate 00031089 JPC AEFGVW Co.

October 2015 v.2 32

B03AA03 FERROUS GLUCONATE GLUCONATE FERREUX

Tab Orl 300mg Apo-Ferrous Gluconate 00545031 APX AEFGVW Co. Ferrous Gluconate 00031097 JPC AEFGVW Ferrous Gluconate 00582727 VTH AEFGVW Novo-Ferrogluc 80000435 TEV AEFGVW

B03AA07 FERROUS SULPHATE

SULFATE FERREUX

Dps Orl 75mg pms-Ferrous Sulfate 02222574 PMS AEFGVW Gttes Dps Orl 125mg/mL pms-Ferrous Sulfate 00816035 PMS AEFGVW Gttes ECT Orl 300mg Apo-Ferrous Sulfate-FC (Disc/non disp 01912518 APX AEFGVW Co.Ent Dec 12/16) Liq Orl 15mg Fer-In-Sol 00762954 MJO AEFGVW Liq Ferodan 02237385 ODN AEFGVW Jamp Ferrous Sulfate 80008309 JPC AEFGVW Liq Orl 30mg Jamp Ferrous Sulfate 80008295 JPC AEFGVW Liq SRT Orl 160mg Slow-Fe 00623520 NNC G Co.L.L. Syr Orl 150mg/5mL Fer-In-Sol 00017884 MJO AEFGVW Sir. Ferodan 00758469 ODN AEFGVW pms-Ferrous Sulfate 00792675 PMS AEFGVW Tab Orl 300mg Ferrous Sulfate 00031100 JPC AEFGVW Co. Ferrous Sulfate SC 00346918 PMT AEFGVW pms-Ferrous Sulfate 00586323 PMS AEFGVW

B03AC IRON TRIVALENT, PARENTERAL PREPARATIONS FER TRIVALENT, PRÉPARATIONS PARENTÉRALES

B03AC01 FERRIC OXIDE POLYMALTOSE COMPLEXES COMPLEXES D’OXYDE FERRIQUE POLYMALTOSE

Liq Inj 50mg/mL DexIron 02205963 LUI (SA) Liq

B03AC02 SACCHARATED IRON OXIDE

SACCHARURE D’OXYDE DE FER

Liq Inj 20mg/mL Venofer 02243716 LUI (SA) Liq

October 2015 v.2 33

B03AC07 FERRIC SODIUM GLUCONATE COMPLEX COMPLEXE DE GLUCONATE DE SODIUM FERRIQUE

Liq Inj 12.5mg/mL Ferrlecit 02243333 SAV (SA) Liq

B03AC99 FERUMOXYTOL FERUMOXYTOL

Liq Inj 30mg/mL Feraheme 02377217 TAK (SA) Liq

B03B VITAMIN B12 AND FOLIC ACID VITAMINE B12 ET ACIDE FOLIQUE

B03BA VITAMIN B12 (CYANOCOBALAMIN AND DERIVATIVES) VITAMINE B12 (CYANOCOBALAMINE ET DÉRIVÉS)

B03BA01 CYANOCOBALAMIN CYANOCOBALAMINE

Liq Inj 1000mcg/mL Vitamin B12 00521515 SDZ ADEFGVW Liq Cyanocobalamin 01987003 STR ADEFGVW Cyanocobalamin Injection USP 02413795 MYL ADEFGVW Jamp-Cyanocobalamin 02420147 JPC ADEFGVW

B03BB FOLIC ACID AND DERIVATIVES ACIDE FOLIQUE ET DÉRIVÉS

B03BB01 FOLIC ACID ACIDE FOLIQUE

Tab Orl 5mg Apo-Folic Acid 00426849 APX ADEFGVW Co. Euro-Folic 02285673 EUR ADEFGVW Jamp-Folic 02366061 JPC ADEFGVW

B03X OTHER ANTIANEMIC PREPARATIONS AUTRES PRÉPARATIONS ANTIANÉMIQUES

B03XA OTHER ANTIANEMIC PREPARATIONS AUTRES PRÉPARATIONS ANTIANÉMIQUES

B03XA01 EPOETIN ALFA ÉPOÉTINE ALFA

Liq Inj 1000IU/0.5mL Eprex 02231583 JAN W (SA) Liq Liq Inj 2000IU/0.5mL Eprex 02231584 JAN W (SA) Liq Liq Inj 3000IU/0.3mL Eprex 02231585 JAN W (SA) Liq Liq Inj 4000IU/0.4mL Eprex 02231586 JAN W (SA) Liq

October 2015 v.2 34

B03XA01 EPOETIN ALFA ÉPOÉTINE ALFA

Liq Inj 5000IU/0.5mL Eprex 02243400 JAN W (SA) Liq Liq Inj 6000IU/0.6mL Eprex 02243401 JAN W (SA) Liq Liq Inj 8000IU80.8mL Eprex 02243403 JAN W (SA) Liq Liq Inj 10000IU/mL Eprex 02231587 JAN W (SA) Liq Liq Inj 20000IU/0.5mL Eprex 02243239 JAN W (SA) Liq Liq Inj 30000IU0.75mL Eprex 02288680 JAN W (SA) Liq Liq Inj 40000IU/mL Eprex 02240722 JAN W (SA) Liq

B03XA02 DARBEPOETIN ALFA

DARBÉPOÉTINE ALFA

Liq Inj 10mcg/0.4mL Aranesp 02392313 AGA W (SA) Liq Liq Inj 20mcg/0.5mL Aranesp 02392321 AGA W (SA) Liq Liq Inj 30mcg/0.3mL Aranesp 02392348 AGA W (SA) Liq Liq Inj 40mcg/0.4mL Aranesp 02391740 AGA W (SA) Liq Liq Inj 50mcg/0.5mL Aranesp 02391759 AGA W (SA) Liq Liq Inj 60mcg/0.3mL Aranesp 02392356 AGA W (SA) Liq Liq Inj 80mcg/0.4mL Aranesp 02391767 AGA W (SA) Liq Liq Inj 100mcg/0.5mL Aranesp 02391775 AGA W (SA) Liq Liq Inj 130mcg/0.65mL Aranesp 02391783 AGA W (SA) Liq

October 2015 v.2 35

B03XA02 DARBEPOETIN ALFA DARBÉPOÉTINE ALFA

Liq Inj 150mcg/0.3mL Aranesp 02391791 AGA W (SA) Liq Liq Inj 200mcg/0.4mL Aranesp 02391805 AGA W (SA) Liq Liq Inj 300mcg/0.6mL Aranesp 02391821 AGA W (SA) Liq Liq Inj 500mcg/1mL Aranesp 02392364 AGA W (SA) Liq

B05 BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS PRODUITS DE REMPLACEMENT DU SANG ET SOLUTIONS POUR PERFUSION

B05C IRRIGATING SOLUTIONS SOLUTIONS POUR IRRIGATION

B05CA ANTIINFECTIVES ANTI-INFECTIEUX

B05CA10 COMBINATIONS COMBINAISONS

POLYMYXIN B / NEOMYCIN POLYMYXINE B / NÉOMYCINE

Liq Urh 200000IU/40mg Neosporin Irrigating Sol 00666157 GSK ADEFGVW Liq (Disc/Non Disp Jan 5/17)

C01 CARDIAC THERAPY CARDIOTHÉRAPIE

C01A CARDIAC GLYCOSIDES GLUCOSIDES CARDIOTONIQUES

C01AA DIGITALIS GLYCOSIDES GLUCOSIDES DIGITALIQUE

C01AA05 DIGOXIN DIGOXINE

Liq Orl 0.05mg/mL Toloxin 02242320 PDP ADEFGVW Liq Tab Orl 0.0625mg Toloxin 02335700 PDP ADEFGVW Co. Tab Orl 0.125mg Toloxin 02335719 PDP ADEFGVW Co. Tab Orl 0.25mg Toloxin 02335727 PDP ADEFGVW Co.

October 2015 v.2 36

C01B ANTIARRHYTHMICS, CLASS I AND III ANTIARHYTHMIQUES, CATÉGORIES I ET III

C01BA ANTIARRHYTHMICS, CLASS IA ANTIARHYTHMIQUES, CATÉGORIE IA

C01BA02 PROCAINAMIDE PROCAINAMIDE

SRT Orl 250mg Procan SR 00638692 ERF ADEFGVW Co.L.L. SRT Orl 500mg Procan SR (Disc/non disp Jun 5/17) 00638676 ERF ADEFGVW Co.L.L. SRT Orl 750mg Procan SR (Disc/non disp Jun 5/17) 00638684 ERF ADEFGVW Co.L.L.

C01BA03 DISOPYRAMIDE

DISOPYRAMIDE

Cap Orl 100mg Rythmodan 02224801 SAV ADEFGVW Caps

C01BB ANTIARRHYTHMICS, CLASS IB ANTIARHYTHMIQUES, CATÉGORIE IB

C01BB02 MEXILETINE MEXILÉTINE

Cap Orl 100mg Novo-Mexiletine 02230359 TEV ADEFGVW Caps Cap Orl 200mg Novo-Mexiletine 02230360 TEV ADEFGVW Caps

C01BC ANTIARRHYTHMICS, CLASS IC ANTIARHYTHMIQUES, CATÉGORIE IC

C01BC03 PROPAFENONE PROPAFÉNONE

Tab Orl 150mg Rythmol 00603708 BGP ADEFGVW Co. Apo-Propafenone 02243324 APX ADEFGVW Mylan-Propafenone 02245372 MYL ADEFGVW pms-Propafenone 02294559 PMS ADEFGVW Propafenone 02343053 SAS ADEFGVW Tab Orl 300mg Rythmol 00603716 BGP ADEFGVW Co. Apo-Propafenone 02243325 APX ADEFGVW Mylan-Propafenone 02245373 MYL ADEFGVW pms-Propafenone 02294575 PMS ADEFGVW Propafenone 02343061 SAS ADEFGVW

October 2015 v.2 37

C01BC04 FLECAINIDE FLÉCAÏNIDE

Tab Orl 50mg Flecainide 02275538 AAP ADEFGVW Co. Tab Orl 100mg Flecainide 02275546 AAP ADEFGVW Co.

C01BD ANTIARRHYTHMICS, CLASS III ANTIARHYTHMIQUES, CATÉGORIE III

C01BD01 AMIODARONE AMIODARONE

Tab Orl 100mg pms-Amiodarone 02292173 PMS ADEFGVW Co. Tab Orl 200mg Cordarone 02036282 PFI ADEFGVW Co. Amiodarone 02364336 SAS ADEFGVW Amiodarone 02385465 SIV ADEFGVW Apo-Amiodarone 02246194 APX ADEFGVW Mylan-Amiodarone 02240604 MYL ADEFGVW Phl-Amiodarone 02245781 PHL ADEFGVW pms-Amiodarone 02242472 PMS ADEFGVW Sandoz Amiodarone 02243836 SDZ ADEFGVW Teva-Amiodarone 02239835 TEV ADEFGVW

C01C CARDIAC STIMULANTS EXCLUDING CARDIAC GLYCOSIDES CARDIOTONIQUES À L’EXCLUSION DES GLYCOSIDES CARDIOTONIQUES

C01CA ADRENERGIC AND DOPAMINERGIC AGENTS AGENTS ADRÉNERGIQUES ET DOPAMINERGIQUES

C01CA17 MIDODRINE MIDODRINE

Tab Orl 2.5mg Midodrine 02278677 AAP ADEFGVW Co. Tab Orl 5mg Midodrine 02278685 AAP ADEFGVW Co.

C01CA24 EPINEPHRINE (CARDIAC STIMULANTS)

ÉPINEPHRINE (STIMULANTS CARDIAQUES)

Liq Inj 0.15mg Allerject 02382059 SAV ADEFGVW Liq Twinject 02268205 PAL ADEFGVW Liq Inj 0.3mg Allerject 02382067 SAV ADEFGVW Liq Twinject 02247310 PAL ADEFGVW Liq Inj 0.5mg EpiPen Jr 00578657 KNG ADEFGVW Liq

October 2015 v.2 38

C01CA24 EPINEPHRINE (CARDIAC STIMULANTS) ÉPINEPHRINE (STIMULANTS CARDIAQUES)

Liq Inj 1mg EpiPen 00509558 KNG ADEFGVW Liq Liq Inj 1mg Adrenalin 00155357 ERF ADEFGVW Liq

C01D VASODILATORS USED IN CARDIAC DISEASES VASODILATATEURS UTILISÉS POUR LES MALADIES CARDIAQUES

C01DA ORGANIC NITRATES NITRATES ORGANIQUES

C01DA02 NITROGLYCERIN (GLYCERYL TRINITRATE) NITROGLYCERINE (TRINITRATE DE GLYCERYLE)

Aem Slg 0.4mg Nitrolingual 02231441 SAV ADEFGVW Aém. Apo-Nitroglycerin 02393433 APX ADEFGVW Mylan-Nitro SL 02243588 MYL ADEFGVW Rho-Nitro 02238998 SDZ ADEFGVW Ont Top 2% Nitrol 01926454 PAL ADEFGVW Ont Pth Trd 0.2mg/hr Nitro-Dur 01911910 FRS ADEFVW Pth Minitran 02162806 VLN ADEFVW Mylan-Nitro Patch 02407442 MYL ADEFVW Trinipatch 02230732 PAL ADEFV Pth Trd 0.4mg/hr Nitro-Dur 01911902 FRS ADEFVW Pth Minitran 02163527 VLN ADEFVW Mylan-Nitro Patch 02407450 MYL ADEFVW Trinipatch 02230733 PAL ADEFV Pth Trd 0.6mg/hr Nitro-Dur 01911929 FRS ADEFVW Pth Minitran 02163535 VLN ADEFVW Mylan-Nitro Patch 02407469 MYL ADEFVW Trinipatch 02230734 PAL ADEFV Pth Trd 0.8mg/hr Nitro-Dur 02011271 FRS ADEFVW Pth Mylan-Nitro Patch 02407477 MYL ADEFVW Slt Slg 0.3mg Nitrostat 00037613 PFI ADEFGVW Co.S.L. Slt Slg 0.6mg Nitrostat 00037621 PFI ADEFGVW Co.S.L. Srd Trd 0.2mg Transderm-Nitro 00584223 NVR ADEFVW Srd Srd Trd 0.4mg Transderm-Nitro 00852384 NVR ADEFVW Srd

October 2015 v.2 39

C01DA02 NITROGLYCERIN (GLYCERYL TRINITRATE) NITROGLYCERINE (TRINITRATE DE GLYCERYLE)

Srd Trd 0.6mg Transderm-Nitro 02046156 NVR ADEFVW Srd

C01DA08 ISOSORBIDE DINITRATE

DINITRATE D’ISOSORBIDE

Slt Slg 5mg ISDN S/L 00670944 AAP ADEFGVW Co.S.L. Tab Orl 10mg ISDN 00441686 AAP ADEFGVW Co. Tab Orl 30mg ISDN 00441694 AAP ADEFGVW Co.

C01DA14 ISOSORBIDE MONONITRATE

MONONITRATE D’ISOSORBIDE

SRT Orl 60mg Imdur 02126559 AZE ADEFGVW Co.L.L. Apo-ISMN 02272830 APX ADEFGVW pms-ISMN 02301288 PMS ADEFGVW

C02 ANTIHYPERTENSIVES ANTIHYPERTENSEURS

C02A ANTIADRENERGIC AGENTS, CENTRALLY ACTING AGENTS ANTIADRÉNERGIQUES, AGISSANT CENTRALEMENT

C02AB METHYLDOPA MÉTHYLDOPA

C02AB02 METHYLDOPA (RACEMIC) MÉTHYLDOPA (RACEMIQUE)

Tab Orl 125mg Methyldopa 00360252 AAP ADEFGVW Co. Tab Orl 250mg Methyldopa 00360260 AAP ADEFGVW Co. Tab Orl 500mg Methyldopa 00426830 AAP ADEFGVW Co.

C02AC IMIDAZOLINE RECEPTOR AGONISTS AGONISTES DU RÉCEPTEUR IMIDAZOLINE

C02AC01 CLONIDINE CLONIDINE

Tab Orl 0.025mg Dixarit 00519251 BOE ADEFGVW Co. Novo-Clonidine 02304163 TEV ADEFGVW Tab Orl 0.1mg Catapres (Disc/non disp Aug 18/17) 00259527 BOE ADEFGVW Co. Novo-Clonidine 02046121 TEV ADEFGVW

October 2015 v.2 40

C02AC01 CLONIDINE CLONIDINE

Tab Orl 0.2mg Catapres (Disc/non disp Mar 30/17) 00291889 BOE ADEFGVW Co. Novo-Clonidine 02046148 TEV ADEFGVW

C02C ANTIADRENERGIC AGENTS, PERIPHERALLY ACTING AGENTS ANTIADRÉNERGIQUES, AGISSANT EN PÉRIPHÉRIE

C02CA ALPHA-ADRENOCEPTOR ANTAGONISTS ALPHABLOQUANT DE L’ADRÉNOCEPTEUR

C02CA01 PRAZOSIN PRAZOSINE

Tab Orl 1mg Apo-Prazo 00882801 APX ADEFGVW Co. Teva-Prazin 01934198 TEV ADEFGVW Tab Orl 2mg Apo-Prazo 00882828 APX ADEFGVW Co. Teva-Prazin 01934201 TEV ADEFGVW Tab Orl 5mg Apo-Prazo 00882836 APX ADEFGVW Co. Teva-Prazin 01934228 TEV ADEFGVW

C02CA04 DOXAZOSIN

DOXAZOSINE

Tab Orl 1mg Cardura-1 01958100 PFI ADEF18+V Co. Apo-Doxazosin 02240588 APX ADEF18+V Mylan-Doxazosin (Disc/non disp Sept 14/16) 02240498 MYL ADEF18+V pms-Doxazosin 02244527 PMS ADEF18+V Teva-Doxazosin 02242728 TEV ADEF18+V Tab Orl 2mg Cardura-2 01958097 PFI ADEF18+V Co. Apo-Doxazosin 02240589 APX ADEF18+V Mylan-Doxazosin (Disc/non disp Sept 14/16) 02240499 MYL ADEF18+V pms-Doxazosin 02244528 PMS ADEF18+V Teva-Doxazosin 02242729 TEV ADEF18+V Tab Orl 4mg Cardura-4 01958119 PFI ADEF18+V Co. Apo-Doxazosin 02240590 APX ADEF18+V Mylan-Doxazosin (Disc/non disp Sept 14/16) 02240500 MYL ADEF18+V pms-Doxazosin 02244529 PMS ADEF18+V Teva-Doxazosin 02242730 TEV ADEF18+V

C02D ARTERIOLAR SMOOTH MUSCLE, AGENTS ACTING ON MUSCLES LISSES ARTÉRIOLAIRES, AGENTS AGISSANT SUR LES

C02DB HYDRAZINOPHTHALAZINE DERIVATIVES DÉRIVÉS DU HYDRAZINOPHTHALAZINE

C02DB02 HYDRALAZINE HYDRALAZINE

Tab Orl 10mg Hydralazine 00441619 AAP ADEFGVW Co.

October 2015 v.2 41

C02DB02 HYDRALAZINE HYDRALAZINE

Tab Orl 25mg Hydralazine 00441627 AAP ADEFGVW Co. Tab Orl 50mg Hydralazine 00441635 AAP ADEFGVW Co.

C02DC PYRIMIDINE DERIVATIVES DÉRIVÉS DU PYRIMIDINE

C02DC01 MINOXIDIL MINOXIDIL

Tab Orl 2.5mg Loniten 00514497 PFI ADEFGVW Co. Tab Orl 10mg Loniten 00514500 PFI ADEFGVW Co.

C02K OTHER ANTIHYPERTENSIVES AUTRES ANTIHYPERTENSEURS

C02KX OTER ANTIHYPERTENSIVES AUTRES ANTIHYPERTENSEURS

C02KX01 BOSENTAN BOSENTAN

Tab Orl 62.5mg Tracleer 02244981 ACT (SA) Co. Act Bosentan 02386194 ATV (SA) Mylan-Bosentan 02383497 MYL (SA) pms-Bosentan 02383012 PMS (SA) Sandoz Bosentan 02386275 SDZ (SA) Teva-Bosentan (Disc/non disp Sept 1/17) 02398400 TEV (SA) Tab Orl 125mg Tracleer 02244982 ACT (SA) Co. Act Bosentan 02386208 ATV (SA) Mylan-Bosentan 02383500 MYL (SA) pms-Bosentan 02383020 PMS (SA) Sandoz Bosentan 02386283 SDZ (SA) Teva-Bosentan (Disc/non disp Sept 1/17) 02398419 TEV (SA)

C02KX02 AMBRISENTAN

AMBRISENTAN

Tab Orl 5mg Volibris 02307065 GSK (SA) Co. Tab Orl 10mg Volibris 02307073 GSK (SA) Co.

October 2015 v.2 42

C02KX05 RIOCIGUAT RIOCIGUAT

Tab Orl 0.5mg Adempas 02412764 BAY (SA) Co. Tab Orl 1mg Adempas 02412772 BAY (SA) Co. Tab Orl 1.5mg Adempas 02412799 BAY (SA) Co. Tab Orl 2mg Adempas 02412802 BAY (SA) Co. Tab Orl 2.5mg Adempas 02412810 BAY (SA) Co.

C03 DIURETICS DIURÉTIQUES

C03A LOW-CEILING DIURETICS, THIAZIDES DIURÉTIQUES DE PLAFOND BAS, THIAZIDES

C03AA THIAZIDES, PLAIN THIAZIDES, ORDINAIRE

C03AA03 HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE

Tab Orl 12.5mg Apo-Hydro 02327856 APX ADEFGVW Co. pms-Hydrochlorothiazide 02274086 PMS ADEFGVW Tab Orl 25mg Apo-Hydro 00326844 APX ADEFGVW Co. pms-Hydrochlorothiazide 02247386 PMS ADEFGVW Teva-Hydrochlorothiazide 00021474 TEV ADEFGVW Tab Orl 50mg Apo-Hydro 00312800 APX ADEFGVW Co. Hydrochlorothiazide 02360608 SAS ADEFGVW pms-Hydrochlorothiazide 02247387 PMS ADEFGVW Teva-Hydrazide 00021482 TEV ADEFGVW Tab Orl 100mg Apo-Hydro 00644552 APX ADEFGVW Co.

C03B LOW-CEILING DIURETICS, EXCLUDING THIAZIDES DIURÉTIQUES DE PLAFOND BAS, À L’EXCLUSION DES THIAZIDES

C03BA SULFONAMIDES, PLAIN SULFONAMIDES, ORDINAIRES

C03BA04 CHLORTHALIDONE CHLORTHALIDONE

Tab Orl 50mg Chlorthalidone 00360279 AAP ADEFGVW Co.

October 2015 v.2 43

C03BA08 METOLAZONE MÉTOLAZONE

Tab Orl 2.5mg Zaroxolyn 00888400 SAV ADEFGVW Co.

C03BA11 INDAPAMIDE

INDAPAMIDE

Tab Orl 1.25mg Lozide 02179709 SEV ADEFGVW Co. Apo-Indapamide 02245246 APX ADEFGVW Jamp-Indapamide 02373904 JPC ADEFGVW Mylan-Indapamide 02240067 MYL ADEFGVW pms-Indapamide 02239619 PMS ADEFGVW Tab Orl 2.5mg Lozide 00564966 SEV ADEFGVW Co. Apo-Indapamide 02223678 APX ADEFGVW Jamp-Indapamide 02373912 JPC ADEFGVW Mylan-Indapamide 02153483 MYL ADEFGVW Teva-Indapamide 02231184 TEV ADEFGVW pms-Indapamide 02239620 PMS ADEFGVW

C03C HIGH-CEILING DIURETICS DIURÉTIQUES À PLAFOND ÉLEVÉ

C03CA SULFONAMIDES, PLAIN SULFONAMIDES, ORDINAIRES

C03CA01 FUROSEMIDE FUROSÉMIDE

Liq Inj 10mg/mL Furosemide 00527033 SDZ VW Liq Furosemide 02382539 SDZ VW Liq Orl 10mg/mL Lasix 02224720 SAV ADEFGVW Liq Tab Orl 20mg Apo-Furosemide 00396788 APX ADEFGVW Co. Furosemide 02351420 SAS ADEFGVW pms-Furosemide 02247493 PMS ADEFGVW Teva-Furosemide 00337730 TEV ADEFGVW Tab Orl 40mg Furosemide 02351439 SAS ADEFGVW Co. pms-Furosemide 02247494 PMS ADEFGVW Tab Orl 80mg Apo-Furosemide 00707570 APX ADEFGVW Co. Furosemide 02351447 SAS ADEFGVW Teva-Furosemide 00765953 TEV ADEFGVW Tab Orl 500mg Lasix Special 02224755 SAV ADEFGVW Co.

October 2015 v.2 44

C03CA02 BUMETANIDE BUMÉTANIDE

Tab Orl 1mg Burinex 00728284 LEO ADEFVW Co. Tab Orl 5mg Burinex 00728276 LEO ADEFVW Co.

C03CC ARYLOXYACETIC ACID DERIVATIVES DÉRIVÉS DE L’ACIDE ARYLOXYACÉTIQUE

C03CC01 ETHACRYNIC ACID ACIDE ÉTHACRYNIQUE

Tab Orl 25mg Edecrin 02258528 VLN ADEFGVW Co.

C03D POTASSIUM-SPARING DRUGS MÉDICAMENTS D’ÉPARGNE DE POTASSIUM

C03DA ALDOSTERONE ANTAGONISTS ANTAGONISTES DE L’ALDOSTÉRONE

C03DA01 SPIRONOLACTONE SPIRONOLACTONE

Tab Orl 25mg Aldactone 00028606 PFI ADEFGVW Co. Teva-Spiroton 00613215 TEV ADEFGVW Tab Orl 100mg Aldactone 00285455 PFI ADEFGVW Co. Teva-Spiroton 00613223 TEV ADEFGVW

C03DA04 EPLERENONE

ÉPLÉRÉNONE

Tab Orl 25mg Inspra 02323052 PFI (SA) Co. Tab Orl 50mg Inspra 02323060 PFI (SA) Co.

C03DB OTHER POTASSIUM-SPARING AGENTS AUTRES MÉDICAMENTS D’ÉPARGNE DE POTASSIUM

C03DB01 AMILORIDE AMILORIDE

Tab Orl 5mg Midamor 02249510 AAP ADEFGVW Co.

October 2015 v.2 45

C03E DIURETICS AND POTASSIUM-SPARING AGENTS IN COMBINATION DIURÉTIQUES ET MÉDICAMENTS D’ÉPARGNE DE POTASSIUM EN COMBINAISON

C03EA LOW-CEILING DIURETICS AND POTASSIUM-SPARING AGENTS DIURÉTIQUES DE PLAFOND BAS ET MÉDICAMENTS D’ÉPARGNE DE POTASSIUM EN

COMBINAISON

C03EA01 HYDROCHLOROTHIAZIDE AND POTASSIUM-SPARING DRUGS HYDROCHLOROTHIAZIDE ET MÉDICAMENTS D’ÉPARGNE DE POTASSIUM

HYDROCHLOROTHIAZIDE / AMILORIDE HYDROCHLOROTHIAZIDE / AMILORIDE

Tab Orl 50mg/5mg Novamilor 01937219 TEV ADEFGVW Co. Apo-Amilzide 00784400 APX ADEFGVW Tab Orl 25mg/25mg Aldactazide-25 00180408 PFI ADEFGVW Co. Teva-Spirozine-25 00613231 TEV ADEFGVW Tab Orl 50mg/50mg Aldactazide-50 00594377 PFI ADEFGVW Co. Teva-Spirozine-50 00657182 TEV ADEFGVW

TRIAMTERENE / HYDROCHLOROTHIAZIDE TRIAMTÉRÈNE / HYDROCHLOROTHIAZIDE

Tab Orl 50mg/25mg Apo-Triazide 00441775 APX ADEFGVW Co. Teva-Triamterene/HCTZ 00532657 TEV ADEFGVW

C04 PERIPHERAL VASODILATORS VASODILATATEURS PÉRIPHÉRIQUES

C04A PERIPHERAL VASODILATORS VASODILATATEURS PÉRIPHÉRIQUES

C04AA 2-AMINO-1-PHENYLETHANOL DERIVATIVES DÉRIVÉS DU 2-AMINO-1 PHÉNYLÉTHANOL

C04AA02 BUPHENINE (HYLIDRIN) BUPHENINE (HYLIDRINE)

Tab Orl 6mg Arlidin 01926713 ERF ADEFGVW Co.

C04AD PURINE DERIVATIVES DÉRIVÉS DE LA PURINE

C04AD03 PENTOXIFYLLINE PENTOXIFYLLINE

SRT Orl 400mg Pentoxifylline SR 02230090 AAP ADEFGVW Co.L.L.

October 2015 v.2 46

C05 VASOPROTECTIVES VASOPROTECTEURS

C05A AGENTS FOR TREATMENT OF HEMORRHOIDS & ANAL FISSURES FOR TOPICAL USE AGENTS POUR LE TRAITEMENT DES HÉMORROÏDES ET FISSURES ANALES / USAGE TOPIQUE

C05AA CORTICOSTEROIDS CORTICOSTÉROÏDES

C05AA01 HYDROCORTISONE HYDROCORTISONE

HYDROCORTISONE / ZINC HYDROCORTISONE / ZINC

Aer Rt 1% / 1% Proctofoam HC 00363014 DUI ADEFGVW Aér. Ont Rt 0.5% / 0.5% Anusol-HC 00505773 JNJ ADEFGVW Ont Anodan HC 02128446 ODN ADEFGVW Ratio-Hemcort HC 00607789 RPH ADEFGVW Sandoz Anuzinc HC 02247691 SDZ ADEFGVW Jamp-Zinc-HC 02387239 JPC ADEFGVW Sup Rt 0.5% / 0.5% Anusol-HC 00476285 JNJ ADEFGVW Supp. Anodan HC 02236399 ODN ADEFGVW Ratio-Hemcort HC 00607797 RPH ADEFGVW Sab-Anuzinc HC 02242798 SDZ ADEFGVW

FRAMYCETIN / ESCULIN / DIBUCAINE / HYDROCORTISONE FRAMYCÉTINE / ESCULINE / DIBUCAINE / HYDROCORTISONE

Ont Rt 10mg/10mg/5mg/5mg Proctol Ointment 02247322 ODN ADEFGVW Ont. Proctosedyl 02223252 AXC ADEFGVW Sandoz Proctomyxin HC 02242527 SDZ ADEFGVW Sup Rt 10mg/10mg/5mg/5mg Proctol Suppositories 02247882 ODN ADEFGVW Supp. Proctosedyl 02223260 AXC ADEFGVW Sandoz Proctomyxin HC Supp 02242528 SDZ ADEFGVW

HYDROCORTISONE / PRAMOXINE / ZINC HYDROCORTISONE / PRAMOXINE / ZINC

Ont Rt 0.5% / 1% / 0.5% Anugesic-HC 00505781 JNJ ADEFGVW Ont Proctodan-HC Ointment 02234466 ODN ADEFGVW Sup Rt 10mg/20mg/10mg Anugesic-HC 00476242 JNJ ADEFGVW Supp. Proctodan-HC Suppositories 02240851 ODN ADEFGVW Sab-Anuzinc HC Plus 02242797 SDZ ADEFGVW

October 2015 v.2 47

C05B ANTIVARICOSE THERAPY TRAITEMENT ANTIVARICES

C05BA HEPARINS OR HEPARINOIDS FOR TOPICAL USE HÉPARINES OU HÉPARINOÏDS POUR USAGE TOPIQUE

C05BA04 PENTOSAN POLYSULFATE SODIUM POLYSULFATE DE PENTOSANE

Cap Orl 100mg Elmiron 02029448 JAN ADEFGVW Caps.

C07 BETA BLOCKING AGENTS BETA-BLOQUANTS

C07A BETA BLOCKING AGENTS, PLAIN BETA-BLOQUANTS, ORDINAIRES

C07AA BETA BLOCKING AGENTS, NON-SELECTIVE BETA-BLOQUANTS, NON SÉLECTIFS

C07AA03 PINDOLOL PINDOLOL

Tab Orl 5mg Visken 00417270 TRB ADEFGVW Co. Apo-Pindol 00755877 APX ADEFGVW pms-Pindolol (Disc/non disp Nov 17/16) 02231536 PMS ADEFGVW Sandoz Pindolol (Disc/non disp Apr 27/17) 02261782 SDZ ADEFGVW Teva-Pindol 00869007 TEV ADEFGVW Tab Orl 10mg Visken 00443174 TRB ADEFGVW Co. Apo-Pindol 00755885 APX ADEFGVW pms-Pindolol (Disc/non disp Nov 17/16) 02231537 PMS ADEFGVW Sandoz Pindolol (Disc/non disp Apr 27/17) 02261790 SDZ ADEFGVW Teva-Pindol 00869015 TEV ADEFGVW Tab Orl 15mg Visken 00417289 TRB ADEFGVW Co. Apo-Pindol 00755893 APX ADEFGVW pms-Pindolol (Disc/non disp Nov 17/16) 02231539 PMS ADEFGVW Sandoz Pindolol 02261804 SDZ ADEFGVW Teva-Pindol 00869023 TEV ADEFGVW

C07AA05 PROPRANOLOL

PROPRANOLOL

SRC Orl 60mg Inderal LA 02042231 PFI ADEFGVW Caps.L.L. SRC Orl 80mg Inderal LA 02042258 PFI ADEFGVW Caps.L.L. SRC Orl 120mg Inderal LA 02042266 PFI ADEFGVW Caps.L.L. SRC Orl 160mg Inderal LA 02042274 PFI ADEFGVW Caps.L.L.

October 2015 v.2 48

C07AA05 PROPRANOLOL PROPRANOLOL

Tab Orl 10mg Novo-Pranol 00496480 TEV ADEFGVW Co. Tab Orl 20mg Apo-Propranolol (Disc/non disp Oct 22/15) 00663719 APX ADEFGVW Co. Novo-Pranol 00740675 TEV ADEFGVW Tab Orl 40mg Novo-Pranol 00496499 TEV ADEFGVW Co. Tab Orl 80mg Novo-Pranol 00496502 TEV ADEFGVW Co. Tab Orl 120mg Apo-Propranolol (Disc/non disp May 6/17) 00504335 APX ADEFGVW Co.

C07AA06 TIMOLOL

TIMOLOL

Tab Orl 5mg Apo-Timol 00755842 APX ADEFGVW Co. Teva-Timol (Disc/non disp Oct 27/16) 01947796 TEV ADEFGVW Tab Orl 10mg Apo-Timol 00755850 APX ADEFGVW Co. Teva-Timol 01947818 TEV ADEFGVW Tab Orl 20mg Apo-Timol 00755869 APX ADEFGVW Co. Teva-Timol 01947826 TEV ADEFGVW

C07AA07 SOTALOL

SOTALOL

Tab Orl 80mg Apo-Sotalol 02210428 APX ADEFGVW Co. Jamp-Sotalol 02368617 JPC ADEFGVW Mylan-Sotalol 02229778 MYL ADEFGVW Novo-Sotalol 02231181 TEV ADEFGVW pms-Sotalol 02238326 PMS ADEFGVW ratio-Sotalol 02084228 TEV ADEFGVW Sandoz Sotalol 02257831 SDZ ADEFGVW Sotalol 02385988 SIV ADEFGVW Tab Orl 160mg Apo-Sotalol 02167794 APX ADEFGVW Co. Jamp-Sotalol 02368625 JPC ADEFGVW Mylan-Sotalol 02229779 MYL ADEFGVW Novo-Sotalol 02231182 TEV ADEFGVW pms-Sotalol 02238327 PMS ADEFGVW ratio-Sotalol 02084236 TEV ADEFGVW Sandoz Sotalol 02257858 SDZ ADEFGVW Sotalol 02385996 SIV ADEFGVW

October 2015 v.2 49

C07AA12 NADOLOL NADOLOL

Tab Orl 40mg Apo-Nadol 00782505 APX ADEFGVW Co. Tab Orl 80mg Apo-Nadol 00782467 APX ADEFGVW Co. Tab Orl 160mg Apo-Nadol 00782475 APX ADEFGVW Co.

C07AB BETA BLOCKING AGENTS, SELECTIVE BETA-BLOQUANTS, SÉLECTIFS

C07AB02 METOPROLOL MÉTOPROLOL

SRT Orl 100mg Lopresor SR 00658855 NVR ADEFGVW Co.L.L. Apo-Metoprolol SR 02285169 APX ADEFGVW Sandoz Metoprolol SR 02303396 SDZ ADEFGVW SRT Orl 200mg Lopresor SR 00534560 NVR ADEFGVW Co.L.L. Apo-Metoprolol SR 02285177 APX ADEFGVW Sandoz Metoprolol SR 02303418 SDZ ADEFGVW Tab Orl 25mg Apo-Metoprolol 02246010 APX ADEFGVW Co. Jamp-Metoprolol-L 02356813 JPC ADEFGVW Mylan-Metoprolol (type L) 02302055 MYL ADEFGVW pms-Metoprolol-L 02248855 PMS ADEFGVW Tab Orl 50mg Lopresor (coated) 00397423 NVR ADEFGVW Co. Apo-Metoprolol type “L” 00749354 APX ADEFGVW Apo-Metoprolol (uncoated) 00618632 APX ADEFGVW Jamp-Metoprolol-L 02356821 JPC ADEFGVW Metoprolol 02350394 SAS ADEFGVW Mylan-Metoprolol (type L) 02174545 MYL ADEFGVW pms-Metoprolol-L 02230803 PMS ADEFGVW Sandoz Metoprolol 02354187 SDZ ADEFGVW Teva-Metoprolol (coated) 00648035 TEV ADEFGVW Teva-Metoprolol (uncoated) 00842648 TEV ADEFGVW Tab Orl 100mg Lopresor (coated) 00397431 NVR ADEFGVW Co. Apo-Metoprolol type “L” 00751170 APX ADEFGVW Apo-Metoprolol (uncoated) 00618640 APX ADEFGVW Jamp-Metoprolol-L 02356848 JPC ADEFGVW Metoprolol 02350408 SAS ADEFGVW Mylan-Metoprolol (type L) 02174553 MYL ADEFGVW pms-Metoprolol-L 02230804 PMS ADEFGVW Sandoz Metoprolol 02354195 SDZ ADEFGVW Teva-Metoprolol (coated) 00648043 TEV ADEFGVW Teva-Metoprolol (uncoated) 00842656 TEV ADEFGVW

October 2015 v.2 50

C07AB03 ATENOLOL ATÉNOLOL

Tab Orl 25mg Atenolol 02247182 SIV ADEFGVW Co. Jamp-Atenolol 02367556 JPC ADEFGVW Mar-Atenolol 02371979 MAR ADEFGVW Mint-Atenolol 02368013 MNT ADEFGVW Mylan-Atenolol 02303647 MYL ADEFGVW pms-Atenolol 02246581 PMS ADEFGVW Ran-Atenolol 02373963 RAN ADEFGVW Teva-Atenolol 02266660 TEV ADEFGVW Tab Orl 50mg Tenormin 02039532 AZE ADEFGVW Co. Act Atenolol 02255545 ATV ADEFGVW Apo-Atenol 00773689 APX ADEFGVW Atenolol 02238316 SIV ADEFGVW Jamp-Atenolol 02367564 JPC ADEFGVW Mar-Atenolol 02371987 MAR ADEFGVW Mint-Atenolol 02368021 MNT ADEFGVW Mylan-Atenolol-50 02146894 MYL ADEFGVW Ran-Atenolol 02267985 RAN ADEFGVW ratio-Atenolol 02171791 TEV ADEFGVW Sandoz Atenolol 02231731 SDZ ADEFGVW Septa-Atenolol 02368641 SPT ADEFGVW pms-Atenolol 02237600 PMS ADEFGVW Tab Orl 100mg Tenormin 02039540 AZE ADEFGVW Co. Act Atenolol 02255553 ATV ADEFGVW Apo-Atenol 00773697 APX ADEFGVW Atenolol 02238318 SIV ADEFGVW Jamp-Atenolol 02367572 JPC ADEFGVW Mar-Atenolol 02371995 MAR ADEFGVW Mint-Atenolol 02368048 MNT ADEFGVW Mylan-Atenolol-100 02147432 MYL ADEFGVW pms-Atenolol 02237601 PMS ADEFGVW Ran-Atenolol 02267993 RAN ADEFGVW ratio-Atenolol 02171805 TEV ADEFGVW Sandoz Atenolol 02231733 SDZ ADEFGVW Septa-Atenolol 02368668 SPT ADEFGVW Teva-Atenolol (Disc/non disp Jul 24/17) 01912054 TEV ADEFGVW

C07AB04 ACEBUTOLOL

ACÉBUTOLOL

Tab Orl 100mg Sectral 01926543 SAV ADEFGVW Co. Acebutolol 02286246 SAS ADEFGVW Apo-Acebutolol 02147602 APX ADEFGVW Mylan-Acebutolol 02237721 MYL ADEFGVW Mylan-Acebutolol Type S 02237885 MYL ADEFGVW Teva-Acebutolol 02204517 TEV ADEFGVW

October 2015 v.2 51

C07AB04 ACEBUTOLOL ACÉBUTOLOL

Tab Orl 200mg Sectral 01926551 SAV ADEFGVW Co. Acebutolol 02286254 SAS ADEFGVW Apo-Acebutolol 02147610 APX ADEFGVW Mylan-Acebutolol 02237722 MYL ADEFGVW Mylan-Acebutolol Type S 02237886 MYL ADEFGVW Teva-Acebutolol 02204525 TEV ADEFGVW Tab Orl 400mg Sectral 01926578 SAV ADEFGVW Co. Acebutolol 02286262 SAS ADEFGVW Apo-Acebutolol 02147629 APX ADEFGVW Mylan-Acebutolol 02237723 MYL ADEFGVW Mylan-Acebutolol Type S 02237887 MYL ADEFGVW Teva-Acebutolol 02204533 TEV ADEFGVW

C07AB07 BISOPROLOL

BISOPROLOL

Tab Orl 5mg Apo-Bisoprolol 02256134 APX ADEFVW Co. Bisoprolol 02391589 SAS ADEFVW Bisoprolol 02383055 SIV ADEFVW Mylan-Bisoprolol 02384418 MYL ADEFVW pms-Bisoprolol 02302632 PMS ADEFVW Sandoz Bisoprolol 02247439 SDZ ADEFVW Teva-Bisoprolol 02267470 TEV ADEFVW Tab Orl 10mg Apo-Bisoprolol 02256177 APX ADEFVW Co. Bisoprolol 02391597 SAS ADEFVW Bisoprolol 02383063 SIV ADEFVW Mylan-Bisoprolol 02384426 MYL ADEFVW pms-Bisoprolol 02302640 PMS ADEFVW Sandoz Bisoprolol 02247440 SDZ ADEFVW Teva-Bisoprolol 02267489 TEV ADEFVW

C07AG ALPHA AND BETA BLOCKING AGENTS ALPHA-BLOQUANTS ET BETA-BLOQUANTS

C07AG01 LABETALOL LABÉTALOL

Tab Orl 100mg Trandate 02106272 PAL ADEFGVW Co. Tab Orl 200mg Trandate 02106280 PAL ADEFGVW Co.

October 2015 v.2 52

C07AG02 CARVEDILOL CARVÉDILOL

Tab Orl 3.125mg Apo-Carvedilol 02247933 APX (SA)

Co. Auro-Carvedilol 02418495 ARO (SA)

Carvedilol 02364913 SAS (SA)

Carvedilol 02248752 SIV (SA)

Jamp-Carvedilol 02368897 JPC (SA)

Mylan-Carvedilol 02347512 MYL (SA)

pms-Carvedilol 02245914 PMS (SA)

Ran-Carvedilol 02268027 RAN (SA)

ratio-Carvedilol 02252309 TEV (SA)

Zym-Carvedilol (Disc/non disp Jun 16/16) 02338068 ZYM (SA)





















Tab Orl 25mg Apo-Carvedilol 02247936 APX (SA)










October 2015 v.2 53

C07C BETA BLOCKING AGENTS AND OTHER DIURETICS BETA-BLOQUANTS ET AUTRES DIURÉTIQUES

C07CA BETA BLOCKING AGENTS, NON-SELECTIVE, OTHER DIURETICS BETA-BLOQUANTS, NON SÉLECTIFS, AUTRES DIURÉTIQUES

C07CA03 PINDOLOL AND OTHER DIURETICS PINDOLOL ET AUTRE DIURÉTIQUES

PINDOLOL / HYDROCHLOROTHIAZIDE PINDOLOL / HYDROCHLOROTHIAZIDE

Tab Orl 10mg/25mg Viskazide 00568627 TRB ADEFGVW Co. Tab Orl 10mg/50mg Viskazide 00568635 TRB ADEFGVW Co.

C07CB BETA BLOCKING AGENTS, SELECTIVE, AND OTHER DIURETICS BETA-BLOQUANTS, SÉLECTIFS, ET AUTRES DIURÉTIQUES

C07CB03 ATENOLOL AND OTHER DIURETICS ATÉNOLOL ET AU DIURÉTIQUES

ATENOLOL / CHLORTHALIDONE ATÉNOLOL / CHLORTHALIDONE

Tab Orl 50mg/25mg Tenoretic 02049961 AZE ADEFGVW Co. Apo-Atenidone 02248763 APX ADEFGVW

Teva-Atenolol/Chlorthalidone 02302918 TEV ADEFGVW

Tab Orl 100mg/25mg Tenoretic 02049988 AZE ADEFGVW Co. Apo-Atenidone 02248764 APX ADEFGVW

Teva-Atenolol/Chlorthalidone 02302926 TEV ADEFGVW

C08 CALCIUM CHANNEL BLOCKERS ANTAGONISTES DU CALCIUM

C08C SELECTIVE CALCIUM CHANNEL BLOCKERS WITH MAINLY VASCULAR EFFECTS ANTAGONISTES DU CALCIUM SÉLECTIFS AVEC PRINCIPALEMENT DES EFFETS VASCULAIRES

C08CA DIHYDROPYRIDINE DERIVATIVES DÉRIVÉS DU DIHYDROPYRIDINE

C08CA01 AMLODIPINE AMLODIPINE

Tab Orl 2.5mg Act Amlodipine 02297477 ATV ADEFVW Co. Amlodipine 02385783 SIV ADEFVW Jamp-Amlodipine 02357186 JPC ADEFVW Mar-Amlodipine 02371707 MAR ADEFVW pms-Amlodipine 02295148 PMS ADEFVW Ran-Amlodipine 02398877 RAN ADEFVW Sandoz Amlodipine 02330474 SDZ ADEFVW

October 2015 v.2 54

C08CA01 AMLODIPINE AMLODIPINE

Tab Orl 5mg Norvasc 00878928 PFI ADEFVW Co. Act Amlodipine 02297485 ATV ADEFVW Amlodipine 02429217 JPC ADEFVW Amlodipine 02331284 SAS ADEFVW Amlodipine 02385791 SIV ADEFVW Apo-Amlodipine 02273373 APX ADEFVW Auro-Amlodipine 02397072 ARO ADEFVW GD-Amlodipine 02280132 GMD ADEFVW Jamp-Amlodipine (new formulation) 02357194 JPC ADEFVW Mar-Amlodipine 02371715 MAR ADEFVW Mint-Amlodipine 02362651 MNT ADEFVW Mylan-Amlodipine 02272113 MYL ADEFVW pms-Amlodipine 02284065 PMS ADEFVW Ran-Amlodipine 02321858 RAN ADEFVW ratio-Amlodipine (Disc/non disp Sept 19/16) 02259605 RPH ADEFVW Sandoz Amlodipine 02284383 SDZ ADEFVW Septa-Amlodipine 02357712 SPT ADEFVW Teva-Amlodipine 02250497 TEV ADEFVW Tab Orl 10mg Norvasc 00878936 PFI ADEFVW Co. Act Amlodipine 02297493 ATV ADEFVW Amlodipine 02429225 JPC ADEFVW Amlodipine 02331292 SAS ADEFVW Amlodipine 02385805 SIV ADEFVW Apo-Amlodipine 02273381 APX ADEFVW Auro-Amlodipine 02397080 ARO ADEFVW GD-Amlodipine 02280140 GMD ADEFVW Jamp-Amlodipine (new formulation) 02357208 JPC ADEFVW Mar-Amlodipine 02371723 MAR ADEFVW Mint-Amlodipine 02362678 MNT ADEFVW Mylan-Amlodipine 02272121 MYL ADEFVW pms-Amlodipine 02284073 PMS ADEFVW Ran-Amlodipine 02321866 RAN ADEFVW ratio-Amlodipine (Disc/non disp Sept 19/16) 02259613 RPH ADEFVW Sandoz Amlodipine 02284391 SDZ ADEFVW Septa-Amlodipine 02357720 SPT ADEFVW Teva-Amlodipine 02250500 TEV ADEFVW

C08CA02 FELODIPINE

FÉLODIPINE

SRT Orl 2.5mg Plendil 02057778 AZE ADEFVW Co.L.L. SRT Orl 5mg Plendil 00851779 AZE ADEFVW Co.L.L. Sandoz Felodipine 02280264 SDZ ADEFVW SRT Orl 10mg Plendil 00851787 AZE ADEFVW Co.L.L. Sandoz Felodipine 02280272 SDZ ADEFVW

October 2015 v.2 55

C08CA05 NIFEDIPINE NIFÉDIPINE

Cap Orl 5mg Nifedipine 00725110 AAP ADEFGVW Caps Cap Orl 10mg Nifedipine 00755907 AAP ADEFGVW Caps ERT Orl 20mg Adalat XL 02237618 BAY ADEFGVW Co.L.P. ERT Orl 30mg Adalat XL 02155907 BAY ADEFGVW Co.L.P. Mylan-Nifedipine Extended Release 02349167 MYL ADEFGVW ERT Orl 60mg Adalat XL 02155990 BAY ADEFGVW Co.L.P. Mylan-Nifedipine Extended Release 02321149 MYL ADEFGVW

C08D SELECTIVE CALCIUM CHANNEL BLOCKERS WITH DIRECT CARDIAC EFFECTS ANTAGONISTES DU CALCIUM SÉLECTIFS AVEC EFFETS CARDIAQUES DIRECTS

C08DA PHENYLALKYLAMINE DERIVATIVES DÉRIVÉS DU PHÉNYLALKYLAMINE

C08DA01 VERAPAMIL VÉRAPAMIL

SRT Orl 120mg Isoptin SR 01907123 BGP ADEFGVW Co.L.L. Apo-Verapamil SR 02246893 APX ADEFGVW Mylan-Verapamil SR 02210347 MYL ADEFGVW SRT Orl 180mg Isoptin SR 01934317 BGP ADEFGVW Co.L.L. Apo-Verap SR 02246894 APX ADEFGVW Mylan-Verapamil 02210355 MYL ADEFGVW SRT Orl 240mg Isoptin SR 00742554 BGP ADEFGVW Co.L.L. Apo-Verap SR 02246895 APX ADEFGVW Mylan-Verapamil 02210363 MYL ADEFGVW Novo-Veramil SR (Disc/non disp Sept 29/16) 02211920 TEV ADEFGVW

pms-Verapamil SR 02237791 PMS ADEFGVW Tab Orl 80mg Apo-Verap 00782483 APX ADEFGVW Co. Mylan-Verapamil 02237921 MYL ADEFGVW Tab Orl 120mg Apo-Verap 00782491 APX ADEFGVW Co. Mylan-Verapamil 02237922 MYL ADEFGVW

October 2015 v.2 56

C08DB BENZOTHIAZEPINE DERIVATIVES DÉRIVÉS DU BENZOTHIAZÉPINE

C08DB01 DILTIAZEM DILTIAZEM

CDC Orl 120mg Cardizem CD 02097249 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370611 ATV ADEFGVW Apo-Diltiaz CD 02230997 APX ADEFGVW Diltiazem CD 02400421 SAS ADEFGVW pms-Diltiazem CD 02355752 PMS ADEFGVW Sandoz Diltiazem CD 02243338 SDZ ADEFGVW Teva-Diltazem CD 02242538 TEV ADEFGVW CDC Orl 180mg Cardizem CD 02097257 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370638 ATV ADEFGVW Apo-Diltiaz CD 02230998 APX ADEFGVW Diltiazem CD 02400448 SAS ADEFGVW pms-Diltiazem CD 02355760 PMS ADEFGVW Sandoz Diltiazem CD 02243339 SDZ ADEFGVW Teva-Diltazem CD 02242539 TEV ADEFGVW CDC Orl 240mg Cardizem CD 02097265 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370646 ATV ADEFGVW Apo-Diltiaz CD 02230999 APX ADEFGVW Diltiazem CD 02400456 SAS ADEFGVW pms-Diltiazem CD 02355779 PMS ADEFGVW Sandoz Diltiazem CD 02243340 SDZ ADEFGVW Teva-Diltazem CD 02242540 TEV ADEFGVW CDC Orl 300mg Cardizem CD 02097273 VLN ADEFGVW Caps.L.C. Act Diltiazem CD 02370654 ATV ADEFGVW Apo-Diltiaz CD 02229526 APX ADEFGVW Diltiazem CD 02400464 SAS ADEFGVW pms-Diltiazem CD 02355787 PMS ADEFGVW Sandoz Diltiazem CD 02243341 SDZ ADEFGVW Teva-Diltazem CD 02242541 TEV ADEFGVW ERC Orl 120mg Tiazac 02231150 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291037 APX ADEFVW Co Diltiazem T 02370441 COB ADEFVW Sandoz Diltiazem T 02245918 SDZ ADEFVW Teva-Diltiazem ER 02271605 TEV ADEFVW ERC Orl 180mg Tiazac 02231151 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291045 APX ADEFVW Co Diltiazem T 02370492 COB ADEFVW Sandoz Diltiazem T 02245919 SDZ ADEFVW Teva-Diltiazem ER 02271613 TEV ADEFVW

October 2015 v.2 57

C08DB01 DILTIAZEM DILTIAZEM

ERC Orl 240mg Tiazac 02231152 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291053 APX ADEFVW Co Diltiazem T 02370506 COB ADEFVW Sandoz Diltiazem T 02245920 SDZ ADEFVW Teva-Diltiazem ER 02271621 TEV ADEFVW ERC Orl 300mg Tiazac 02231154 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291061 APX ADEFVW Co Diltiazem T 02370514 COB ADEFVW Sandoz Diltiazem T 02245921 SDZ ADEFVW Teva-Diltiazem ER 02271648 TEV ADEFVW ERC Orl 360mg Tiazac 02231155 VLN ADEFVW Caps.L.P. Apo-Diltiaz TZ (Disc/non disp Dec 12/16) 02291088 APX ADEFVW Co Diltiazem T 02370522 COB ADEFVW Sandoz Diltiazem T 02245922 SDZ ADEFVW Teva-Diltiazem ER 02271656 TEV ADEFVW ERT Orl 120mg Tiazac XC 02256738 VLN ADEFGVW Co.L.P. ERT Orl 180mg Tiazac XC 02256746 VLN ADEFGVW Co.L.P. ERT Orl 240mg Tiazac XC 02256754 VLN ADEFGVW Co.L.P. ERT Orl 300mg Tiazac XC 02256762 VLN ADEFGVW Co.L.P. ERT Orl 360mg Tiazac XC 02256770 VLN ADEFGVW Co.L.P. Tab Orl 30mg Apo-Diltiaz 00771376 APX ADEFGVW Co. Teva-Diltiazem 00862924 TEV ADEFGVW Tab Orl 60mg Apo-Diltiaz 00771384 APX ADEFGVW Co. Teva-Diltiazem 00862932 TEV ADEFGVW

October 2015 v.2 58

C09 AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM AGENTS AGISSANT SUR LE SYSTÈME RÉNINE-ANGIOTENSINE

C09A ACE INHIBITORS, PLAIN INHIBITEUR DE L’ENZYME CONVERTISSANT L’ANGIOTENSINE, ORDINAIRE

C09AA ACE INHIBITORS, PLAIN INHIBITEUR DE L’ENZYME CONVERTISSANT L’ANGIOTENSINE, ORDINAIRE

C09AA01 CAPTOPRIL CAPTOPRIL

Tab Orl 12.5mg Apo-Capto 00893595 APX ADEFGVW Co. Mylan-Captopril (Disc/non disp. Jun 5/16) 02163551 MYL ADEFGVW Teva-Captoril 01942964 TEV ADEFGVW Tab Orl 25mg Apo-Capto 00893609 APX ADEFGVW Co. Mylan-Captopril (Disc/non disp. Jun 5/16) 02163578 MYL ADEFGVW Teva-Captoril 01942972 TEV ADEFGVW Tab Orl 50mg Apo-Capto 00893617 APX ADEFGVW Co. Mylan-Captopril (Disc/non disp. Jun 5/16) 02163586 MYL ADEFGVW Teva-Captoril 01942980 TEV ADEFGVW Tab Orl 100mg Apo-Capto 00893625 APX ADEFGVW Co. Mylan-Captopril (Disc/non disp. Jun 5/16) 02163594 MYL ADEFGVW Teva-Captoril 01942999 TEV ADEFGVW

C09AA02 ENALAPRIL

ÉNALAPRIL

Tab Orl 2.5mg Vasotec 00851795 FRS ADEFGVW Co. Act Enalapril 02291878 ATV ADEFGVW Apo-Enalapril 02020025 APX ADEFGVW

Enalapril 02400650 SAS ADEFGVW Mylan-Enalapril 02300036 MYL ADEFGVW pms-Enalapril 02300079 PMS ADEFGVW Ran-Enalapril 02352230 RAN ADEFGVW Sandoz Enalapril 02299933 SDZ ADEFGVW Teva-Enalapril (Disc/Non-Disp June 5/17) 02300680 TEV ADEFGVW Tab Orl 5mg Vasotec 00708879 FRS ADEFGVW Co. Act Enalapril 02291886 ATV ADEFGVW Apo-Enalapril 02019884 APX ADEFGVW Enalapril 02400669 SAS ADEFGVW Mylan-Enalapril 02300044 MYL ADEFGVW pms-Enalapril 02300087 PMS ADEFGVW Ran-Enalapril 02352249 RAN ADEFGVW Sandoz Enalapril 02299941 SDZ ADEFGVW Teva-Enalapril 02233005 TEV ADEFGVW

October 2015 v.2 59

C09AA02 ENALAPRIL ÉNALAPRIL

Tab Orl 10mg Vasotec 00670901 FRS ADEFGVW Co. Act Enalapril 02291894 ATV ADEFGVW Apo-Enalapril 02019892 APX ADEFGVW

Enalapril 02400677 SAS ADEFGVW Mylan-Enalapril 02300052 MYL ADEFGVW pms-Enalapril 02300095 PMS ADEFGVW Ran-Enalapril 02352257 RAN ADEFGVW Sandoz Enalapril 02299968 SDZ ADEFGVW Teva-Enalapril 02233006 TEV ADEFGVW Tab Orl 20mg Vasotec 00670928 FRS ADEFGVW Co. Act Enalapril 02291908 ATV ADEFGVW Apo-Enalapril 02019906 APX ADEFGVW Enalapril 02400685 SAS ADEFGVW Mylan-Enalapril 02300060 MYL ADEFGVW pms-Enalapril 02300109 PMS ADEFGVW Ran-Enalapril 02352265 RAN ADEFGVW Sandoz Enalapril 02299976 SDZ ADEFGVW Teva-Enalapril 02233007 TEV ADEFGVW

C09AA03 LISINOPRIL

LISINOPRIL

Tab Orl 5mg Prinivil 00839388 FRS ADEFGVW Co. Zestril 02049333 AZE ADEFGVW Act Lisinopril 02271443 ATV ADEFGVW Apo-Lisinopril 02217481 APX ADEFGVW Auro-Lisinopril 02394472 ARO ADEFGVW Jamp-Lisinopril 02361531 JPC ADEFGVW Lisinopril 02386232 SIV ADEFGVW Mylan-Lisinopril 02274833 MYL ADEFGVW pms-Lisinopril 02292203 PMS ADEFGVW Ran-Lisinopril 02294230 RAN ADEFGVW Sandoz Lisinopril 02289199 SDZ ADEFGVW Teva-Lisinopril P 02285061 TEV ADEFGVW Teva-Lisinopril Z 02285118 TEV ADEFGVW Tab Orl 10mg Prinivil 00839396 FRS ADEFGVW Co. Zestril 02049376 AZE ADEFGVW Act Lisinopril 02271451 ATV ADEFGVW Apo-Lisinopril 02217503 APX ADEFGVW Auro-Lisinopril 02394480 ARO ADEFGVW Jamp-Lisinopril 02361558 JPC ADEFGVW Lisinopril 02386240 SIV ADEFGVW Mylan-Lisinopril 02274841 MYL ADEFGVW pms-Lisinopril 02292211 PMS ADEFGVW Ran-Lisinopril 02294249 RAN ADEFGVW Sandoz Lisinopril 02289202 SDZ ADEFGVW Teva-Lisinopril P 02285088 TEV ADEFGVW Teva-Lisinopril Z 02285126 TEV ADEFGVW

October 2015 v.2 60

C09AA03 LISINOPRIL LISINOPRIL

Tab Orl 20mg Prinivil 00839418 FRS ADEFGVW Co. Zestril 02049384 AZE ADEFGVW Act Lisinopril 02271478 ATV ADEFGVW Apo-Lisinopril 02217511 APX ADEFGVW Auro-Lisinopril 02394499 ARO ADEFGVW Jamp-Lisinopril 02361566 JPC ADEFGVW Lisinopril 02386259 SIV ADEFGVW Mylan-Lisinopril 02274868 MYL ADEFGVW pms-Lisinopril 02292238 PMS ADEFGVW Ran-Lisinopril 02294257 RAN ADEFGVW Sandoz Lisinopril 02289229 SDZ ADEFGVW Teva-Lisinopril P 02285096 TEV ADEFGVW Teva-Lisinopril Z 02285134 TEV ADEFGVW

C09AA04 PERINDOPRIL

PERINDOPRIL

Tab Orl 2mg Coversyl 02123274 SEV ADEFGVW Co. Tab Orl 4mg Coversyl 02123282 SEV ADEFGVW Co. Tab Orl 8mg Coversyl 02246624 SEV ADEFGVW Co.

C09AA05 RAMIPRIL

RAMIPRIL

Cap Orl 1.25mg Altace 02221829 SAV ADEFGVW Caps Act Ramipril 02295482 ATV ADEFGVW Apo-Ramipril 02251515 APX ADEFGVW Auro-Ramipril 02387387 ARO ADEFGVW Jamp-Ramipril 02331101 JPC ADEFGVW Mar-Ramipril 02420457 MAR ADEFGVW Mylan-Ramipril 02301148 MYL ADEFGVW pms-Ramipril 02295369 PMS ADEFGVW Ran-Ramipril 02310503 RAN ADEFGVW ratio-Ramipril (Disc/non disp Sept 19/16) 02287692 RPH ADEFGVW

October 2015 v.2 61

C09AA05 RAMIPRIL RAMIPRIL

Cap Orl 2.5mg Altace 02221837 SAV ADEFGVW Caps Act Ramipril 02295490 ATV ADEFGVW Apo-Ramipril 02251531 APX ADEFGVW Auro-Ramipril 02387395 ARO ADEFGVW Jamp-Ramipril 02331128 JPC ADEFGVW Mar-Ramipril 02420465 MAR ADEFGVW Mint-Ramipril 02421305 MNT ADEFGVW Mylan-Ramipril 02301156 MYL ADEFGVW pms-Ramipril 02247917 PMS ADEFGVW Ramipril 02374846 SAS ADEFGVW Ramipril 02411563 SIV ADEFGVW Ran-Ramipril 02310511 RAN ADEFGVW ratio-Ramipril (Disc/non disp Sept 19/16) 02287706 RPH ADEFGVW Teva-Ramipril 02247945 TEV ADEFGVW Cap Orl 5mg Altace 02221845 SAV ADEFGVW Caps Act Ramipril 02295504 ATV ADEFGVW Apo-Ramipril 02251574 APX ADEFGVW Auro-Ramipril 02387409 ARO ADEFGVW Jamp-Ramipril 02331136 JPC ADEFGVW Mar-Ramipril 02420473 MAR ADEFGVW Mint-Ramipril 02421313 MNT ADEFGVW Mylan-Ramipril 02301164 MYL ADEFGVW pms-Ramipril 02247918 PMS ADEFGVW Ramipril 02374854 SAS ADEFGVW Ramipril 02411571 SIV ADEFGVW Ran-Ramipril 02310538 RAN ADEFGVW Teva-Ramipril 02247946 TEV ADEFGVW Cap Orl 10mg Altace 02221853 SAV ADEFGVW Caps Act Ramipril 02295512 ATV ADEFGVW Apo-Ramipril 02251582 APX ADEFGVW Auro-Ramipril 02387417 ARO ADEFGVW Jamp-Ramipril 02331144 JPC ADEFGVW Mar-Ramipril 02420481 MAR ADEFGVW Mint-Ramipril 02421321 MNT ADEFGVW Mylan-Ramipril 02301172 MYL ADEFGVW pms-Ramipril 02247919 PMS ADEFGVW Ramipril 02374862 SAS ADEFGVW Ramipril 02411598 SIV ADEFGVW Ran-Ramipril 02310546 RAN ADEFGVW Teva-Ramipril 02247947 TEV ADEFGVW Cap Orl 15mg Altace 02281112 SAV ADEFGVW Caps Apo-Ramipril 02325381 APX ADEFGVW Tab Orl 1.25mg Sandoz Ramipril 02291398 SDZ ADEFGVW Co.

October 2015 v.2 62

C09AA05 RAMIPRIL RAMIPRIL

Tab Orl 2.5mg Sandoz Ramipril 02291401 SDZ ADEFGVW Co. Tab Orl 5mg Sandoz Ramipril 02291428 SDZ ADEFGVW Co. Tab Orl 10mg Sandoz Ramipril 02291436 SDZ ADEFGVW Co.

C09AA06 QUINAPRIL

QUINAPRIL

Tab Orl 5mg Accupril 01947664 PFI ADEFGVW Co. Apo-Quinapril 02248499 APX ADEFGVW Tab Orl 10mg Accupril 01947672 PFI ADEFGVW Co. Apo-Quinapril 02248500 APX ADEFGVW Tab Orl 20mg Accupril 01947680 PFI ADEFGVW Co. Apo-Quinapril 02248501 APX ADEFGVW

Tab Orl 40mg Accupril 01947699 PFI ADEFGVW Co. Apo-Quinapril 02248502 APX ADEFGVW

C09AA07 BENAZEPRIL

BÉNAZÉPRIL

Tab Orl 5mg Lotensin 00885835 NVR ADEFGVW Co. Benazapril 02290332 AAP ADEFGVW Tab Orl 10mg Benazapril 02290340 AAP ADEFGVW Co. Tab Orl 20mg Lotensin 00885851 NVR ADEFGVW Co. Benazapril 02273918 AAP ADEFGVW

C09AA08 CILAZAPRIL

CILAZAPRIL

Tab Orl 1mg Apo-Cilazapril 02291134 APX ADEFGVW Co. Mylan-Cilazapril 02283778 MYL ADEFGVW Novo-Cilazapril 02266350 TEV ADEFGVW pms-Cilazapril 02280442 PMS ADEFGVW Tab Orl 2.5mg Inhibace 01911473 HLR ADEFGVW Co. Apo-Cilazapril 02291142 APX ADEFGVW Cilazapril 02350971 SAS ADEFGVW Co Cilazapril 02285215 COB ADEFGVW Mylan-Cilazapril 02283786 MYL ADEFGVW Novo-Cilazapril 02266369 TEV ADEFGVW pms-Cilazapril 02280450 PMS ADEFGVW

October 2015 v.2 63

C09AA08 CILAZAPRIL CILAZAPRIL

Tab Orl 5mg Inhibace 01911481 HLR ADEFGVW Co. Apo-Cilazapril 02291150 APX ADEFGVW Cilazapril (Disc/non dip Aug 1/16) 02350998 SAS ADEFGVW Co Cilazapril 02285223 COB ADEFGVW Mylan-Cilazapril 02283794 MYL ADEFGVW Novo-Cilazapril 02266377 TEV ADEFGVW pms-Cilazapril 02280469 PMS ADEFGVW

C09AA09 FOSINOPRIL

FOSINOPRIL

Tab Orl 10mg Apo-Fosinopril 02266008 APX ADEFGVW Co. Jamp-Fosinopril 02331004 JPC ADEFGVW Mylan-Fosinopril 02262401 MYL ADEFGVW Ran-Fosinopril 02294524 RAN ADEFGVW Teva-Fosinopril 02247802 TEV ADEFGVW Tab Orl 20mg Apo-Fosinopril 02266016 APX ADEFGVW Co. Jamp-Fosinopril 02331012 JPC ADEFGVW Mylan-Fosinopril 02262428 MYL ADEFGVW Ran-Fosinopril 02294532 RAN ADEFGVW Teva-Fosinopril 02247803 TEV ADEFGVW

C09AA10 TRANDOLAPRIL

TRANDOLAPRIL

Cap Orl 1mg Mavik 02231459 BGP ADEFGVW Caps Cap Orl 2mg Mavik 02231460 BGP ADEFGVW Caps Cap Orl 4mg Mavik 02239267 BGP ADEFGVW Caps

C09B ACE-INHIBITORS, COMBINATIONS INHIBITEUR DE L’ENZYME CONVERTISSANT L’ANGIOTENSINE, COMBINAISONS

C09BA ACE-INHIBITORS AND DIURETICS INHIBITEUR DE L’ENZYME CONVERTISSANT L’ANGIOTENSINE, ET DIURÉTIQUES

C09BA02 ENALAPRIL AND DIURETICS ÉNALAPRIL ET DIURÉTIQUES

ENALAPRIL / HYDROCHLOROTHIAZIDE ÉNALAPRIL / HYDROCHLOROTHIAZIDE

Tab Orl 5mg/12.5mg Novo-Enalapril/HCTZ 02300222 TEV ADEFGVW Co. Apo-Enalapril/HCTZ 02352923 APX ADEFGVW Tab Orl 10mg/25mg Vaseretic 00657298 FRS ADEFGVW Co. Teva-Enalapril/HCTZ (Disc/non disp Jul 14/17) 02300230 TEV ADEFGVW Apo-Enalapril/HCTZ 02352931 APX ADEFGVW

October 2015 v.2 64

C09BA03 LISINOPRIL AND DIURETICS LISINOPRIL ET DIURÉTIQUES

LISINOPRIL / HYDROCHLOROTHIAZIDE LISINOPRIL / HYDROCHLOROTHIAZIDE

Tab Orl 10mg/12.5mg Zestoretic 02103729 AZE ADEFGVW Co. Apo-Lisinopril/HCTZ (Disc/non disp Dec 12/16) 02261979 APX ADEFGVW Lisinopril HCTZ (Type Z) 02362945 SAS ADEFGVW Mylan-Lisinopril HCTZ 02297736 MYL ADEFGVW Sandoz Lisinopril HCT 02302365 SDZ ADEFGVW Teva-Lisinopril HCTZ (Type P) 02302136 TEV ADEFGVW Teva-Lisinopril HCTZ (Type Z) 02301768 TEV ADEFGVW Tab Orl 20mg/12.5mg Zestoretic 02045737 AZE ADEFGVW Co. Prinzide (Disc/non disp Oct 10/16) 00884413 FRS ADEFGVW Apo-Lisinopril/HCTZ (Disc/non disp Dec 12/16) 02261987 APX ADEFGVW Lisinopril HCTZ (Type Z) 02362953 SAS ADEFGVW Mylan-Lisinopril HCTZ 02297744 MYL ADEFGVW Sandoz Lisinopril HCT 02302373 SDZ ADEFGVW Teva-Lisinopril HCTZ (Type P) 02302144 TEV ADEFGVW Teva-Lisinopril HCTZ (Type Z) 02301776 TEV ADEFGVW Tab Orl 20mg/25mg Zestoretic 02045729 AZE ADEFGVW Co. Apo-Lisinopril/HCTZ (Disc/non disp Dec 12/16) 02261995 APX ADEFGVW Lisinopril HCTZ (Type Z) 02362961 SAS ADEFGVW Mylan-Lisinopril HCTZ 02297752 MYL ADEFGVW Sandoz Lisinopril HCT 02302381 SDZ ADEFGVW Teva-Lisinopril HCTZ (Type P) 02302152 TEV ADEFGVW Teva-Lisinopril HCTZ (Type Z) 02301784 TEV ADEFGVW

C09BA04 PERINDOPRIL AND DIURETICS

PERINDOPRIL ET DIURÉTIQUES

PERINDOPRIL / INDAPAMIDE PERINDOPRIL / INDAPAMIDE

Tab Orl 4mg/1.25mg Coversyl Plus 02246569 SEV ADEFGVW Co. Tab Orl 8mg/2.5mg Coversyl Plus HD 02321653 SEV ADEFGVW Co.

C09BA05 RAMIPRIL AND DIURETICS

RAMIPRIL ET DIURÉTIQUES

RAMIPRIL / HYDROCHLOROTHIAZIDE RAMIPRIL / HYDROCHLOROTHIAZIDE

Tab Orl 2.5mg/12.5mg Altace HCT 02283131 SAV ADEFGVW Co. pms–Ramipril-HCTZ 02342138 PMS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388332 TEV ADEFGVW

October 2015 v.2 65

C09BA05 RAMIPRIL AND DIURETICS RAMIPRIL ET DIURÉTIQUES

RAMIPRIL / HYDROCHLOROTHIAZIDE RAMIPRIL / HYDROCHLOROTHIAZIDE

Tab Orl 5mg/12.5mg Altace HCT 02283158 SAV ADEFGVW Co. pms–Ramipril-HCTZ 02342146 PMS ADEFGVW Ramipril-HCTZ 02412640 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388340 TEV ADEFGVW Tab Orl 5mg/25mg Altace HCT 02283174 SAV ADEFGVW Co. pms–Ramipril-HCTZ 02342162 PMS ADEFGVW Ramipril-HCTZ 02412667 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388367 TEV ADEFGVW Tab Orl 10mg/12.5mg Altace HCT 02283166 SAV ADEFGVW Co. pms–Ramipril-HCTZ 02342154 PMS ADEFGVW Ramipril-HCTZ 02412659 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 18/16) 02388359 TEV ADEFGVW Tab Orl 10mg/25mg Altace HCT 02283182 SAV ADEFGVW Co. pms–Ramipril-HCTZ 02342170 PMS ADEFGVW Ramipril-HCTZ 02412675 SNS ADEFGVW Teva-Ramipril/HCTZ (Disc/non disp Nov 19/16) 02388375 TEV ADEFGVW

C09BA06 QUINAPRIL AND DIURETICS

QUINAPRIL ET DIURÉTIQUES

QUINAPRIL / HYDROCHLOROTHIAZIDE QUINAPRIL / HYDROCHLOROTHIAZIDE

Tab Orl 10mg/12.5mg Accuretic 02237367 PFI ADEFGVW Co. Apo-Quinapril/HCTZ 02408767 APX ADEFGVW Tab Orl 20mg/12.5mg Accuretic 02237368 PFI ADEFGVW Co. Apo-Quinapril/HCTZ 02408775 APX ADEFGVW Tab Orl 20mg/25mg Accuretic 02237369 PFI ADEFGVW Co. Apo-Quinapril/HCTZ 02408783 APX ADEFGVW

C09BA08 CILAZAPRIL AND DIURETICS

CILAZAPRIL ET DIURÉTIQUES

CILAZAPRIL / HYDROCHLOROTHIAZIDE CILAZAPRIL / HYDROCHLOROTHIAZIDE

Tab Orl 5mg/12.5mg Inhibace Plus 02181479 HLR ADEFGVW Co. Apo-Cilazapril/HCTZ 02284987 APX ADEFGVW Novo-Cilazapril/HCTZ 02313731 TEV ADEFGVW

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C09C ANGIOTENSIN II ANTAGONISTS, PLAIN ANTAGONISTES DE L’ANGIOTENSINE II, ORDINAIRE

C09CA ANGIOTENSIN II ANTAGONISTS, PLAIN ANTAGONISTES DE L’ANGIOTENSINE II, ORDINAIRE

C09CA01 LOSARTAN LOSARTAN

Tab Orl 25mg Cozaar 02182815 FRS ADEFGVW Co. Act Losartan 02354829 ATV ADEFGVW Apo-Losartan 02379058 APX ADEFGVW Auro-Losartan 02403323 ARO ADEFGVW Jamp-Losartan 02398834 JPC ADEFGVW Losartan 02388863 SAS ADEFGVW Losartan 02388790 SIV ADEFGVW Mint-Losartan 02405733 MNT ADEFGVW Mylan-Losartan 02368277 MYL ADEFGVW pms-Losartan 02309750 PMS ADEFGVW Ran-Losartan (Disc/Non-Disp Jan 19/17) 02404451 RAN ADEFGVW Sandoz Losartan 02313332 SDZ ADEFGVW Teva-Losartan 02380838 TEV ADEFGVW Tab Orl 50mg Cozaar 02182874 FRS ADEFGVW Co. Act Losartan 02354837 ATV ADEFGVW Apo-Losartan 02353504 APX ADEFGVW Auro-Losartan 02403331 ARO ADEFGVW Jamp-Losartan 02398842 JPC ADEFGVW Losartan 02388871 SAS ADEFGVW Losartan 02388804 SIV ADEFGVW Mint-Losartan 02405741 MNT ADEFGVW Mylan-Losartan 02368285 MYL ADEFGVW pms-Losartan 02309769 PMS ADEFGVW Ran-Losartan (Disc/Non-Disp Jan 19/17) 02404478 RAN ADEFGVW Sandoz Losartan 02313340 SDZ ADEFGVW Teva-Losartan 02357968 TEV ADEFGVW Tab Orl 100mg Cozaar 02182882 FRS ADEFGVW Co. Act Losartan 02354845 ATV ADEFGVW Apo-Losartan 02353512 APX ADEFGVW Auro-Losartan 02403358 ARO ADEFGVW Jamp-Losartan 02398850 JPC ADEFGVW Losartan 02388898 SAS ADEFGVW Losartan 02388812 SIV ADEFGVW Mint-Losartan 02405768 MNT ADEFGVW Mylan-Losartan 02368293 MYL ADEFGVW pms-Losartan 02309777 PMS ADEFGVW Ran-Losartan (Disc/Non-Disp Jan 19/17) 02404486 RAN ADEFGVW Sandoz Losartan 02313359 SDZ ADEFGVW Teva-Losartan 02357976 TEV ADEFGVW

October 2015 v.2 67

C09CA02 EPROSARTAN ÉPROSARTAN

Tab Orl 400mg Teveten 02240432 BGP ADEFGVW Co. Tab Orl 600mg Teveten 02243942 BGP ADEFGVW Co.

C09CA03 VALSARTAN

VALSARTAN

Tab Orl 40mg Diovan 02270528 NVR ADEFGVW Co. Act Valsartan 02337487 ATV ADEFGVW Apo-Valsartan 02371510 APX ADEFGVW Auro-Valsartan 02414201 ARO ADEFGVW Mylan- Valsartan 02383527 MYL ADEFGVW pms-Valsartan 02312999 PMS ADEFGVW Ran-Valsartan 02363062 RAN ADEFGVW Sandoz Valsartan 02356740 SDZ ADEFGVW Teva-Valsartan 02356643 TEV ADEFGVW Valsartan 02366940 SAS ADEFGVW Valsartan 02384523 SIV ADEFGVW Tab Orl 80mg Diovan 02244781 NVR ADEFGVW Co. Act Valsartan 02337495 ATV ADEFGVW Apo-Valsartan 02371529 APX ADEFGVW Auro-Valsartan 02414228 ARO ADEFGVW Mylan-Valsartan 02383535 MYL ADEFGVW pms-Valsartan 02313006 PMS ADEFGVW Ran-Valsartan 02363100 RAN ADEFGVW Sandoz Valsartan 02356759 SDZ ADEFGVW Teva-Valsartan 02356651 TEV ADEFGVW Valsartan 02366959 SAS ADEFGVW Valsartan 02384531 SIV ADEFGVW Tab Orl 160mg Diovan 02244782 NVR ADEFGVW Co. Act Valsartan 02337509 ATV ADEFGVW Apo-Valsartan 02371537 APX ADEFGVW Auro-Valsartan 02414236 ARO ADEFGVW Mylan- Valsartan 02383543 MYL ADEFGVW pms-Valsartan 02313014 PMS ADEFGVW Ran-Valsartan 02363119 RAN ADEFGVW Sandoz Valsartan 02356767 SDZ ADEFGVW Teva-Valsartan 02356678 TEV ADEFGVW Valsartan 02366967 SAS ADEFGVW Valsartan 02384558 SIV ADEFGVW

October 2015 v.2 68

C09CA03 VALSARTAN VALSARTAN

Tab Orl 320mg Diovan 02289504 NVR ADEFGVW Co. Act Valsartan 02337517 ATV ADEFGVW Apo-Valsartan 02371545 APX ADEFGVW Mylan- Valsartan 02383551 MYL ADEFGVW pms-Valsartan 02344564 PMS ADEFGVW Sandoz Valsartan 02356775 SDZ ADEFGVW Teva-Valsartan 02356686 TEV ADEFGVW Valsartan 02366975 SAS ADEFGVW Valsartan 02384566 SIV ADEFGVW

C09CA04 IRBESARTAN

IRBESARTAN

Tab Orl 75mg Avapro 02237923 SAV ADEFGVW Co. Act Irbesartan 02328070 ATV ADEFGVW Apo-Irbesartan 02386968 APX ADEFGVW Auro-Irbesartan 02406098 ARO ADEFGVW Irbesartan 02372347 SAS ADEFGVW Irbesartan 02385287 SIV ADEFGVW Jamp-Irbesartan 02418193 JPC ADEFGVW Mint-Irbesartan 02422980 MNT ADEFGVW Mylan-Irbesartan 02347296 MYL ADEFGVW pms-Irbesartan 02317060 PMS ADEFGVW Ran-Irbesartan 02406810 RAN ADEFGVW ratio-Irbesartan 02316390 TEV ADEFGVW Sandoz Irbesartan 02328461 SDZ ADEFGVW Teva-Irbesartan (Disc/non disp Oct 3/16) 02315971 TEV ADEFGVW Tab Orl 150mg Avapro 02237924 SAV ADEFGVW Co. Act Irbesartan 02328089 ATV ADEFGVW Apo-Irbesartan 02386976 APX ADEFGVW Auro-Irbesartan 02406101 ARO ADEFGVW Irbesartan 02372371 SAS ADEFGVW Irbesartan 02385295 SIV ADEFGVW Jamp-Irbesartan 02418207 JPC ADEFGVW Mint-Irbesartan 02422999 MNT ADEFGVW Mylan-Irbesartan 02347318 MYL ADEFGVW pms-Irbesartan 02317079 PMS ADEFGVW Ran-Irbesartan 02406829 RAN ADEFGVW ratio-Irbesartan 02316404 TEV ADEFGVW Sandoz Irbesartan 02328488 SDZ ADEFGVW Teva-Irbesartan 02315998 TEV ADEFGVW

October 2015 v.2 69

C09CA04 IRBESARTAN IRBESARTAN

Tab Orl 300mg Avapro 02237925 SAV ADEFGVW Co. Apo-Irbesartan 02386984 APX ADEFGVW Auro-Irbesartan 02406128 ARO ADEFGVW Co Irbesartan 02328100 COB ADEFGVW Irbesartan 02372398 SAS ADEFGVW Irbesartan 02385309 SIV ADEFGVW Jamp-Irbesartan 02418215 JPC ADEFGVW Mint-Irbesartan 02423006 MNT ADEFGVW Mylan-Irbesartan 02347326 MYL ADEFGVW pms-Irbesartan 02317087 PMS ADEFGVW Ran-Irbesartan 02406837 RAN ADEFGVW ratio-Irbesartan 02316412 TEV ADEFGVW Sandoz Irbesartan 02328496 SDZ ADEFGVW Teva-Irbesartan (Disc/non disp Sept 25/16) 02316005 TEV ADEFGVW

C09CA06 CANDESARTAN

CANDÉSARTAN

Tab Orl 4mg Atacand 02239090 AZE ADEFGVW Co. Apo-Candesartan 02365340 APX ADEFGVW Candesartan 02388901 SAS ADEFGVW Candesartan 02388693 SIV ADEFGVW Candesartan Cilexetil 02379260 AHI ADEFGVW Co Candesartan 02376520 COB ADEFGVW Jamp-Candesartan 02386496 JPC ADEFGVW Mylan-Candesartan 02379120 MYL ADEFGVW pms-Candesartan 02391171 PMS ADEFGVW Ran-Candesartan 02380684 RAN ADEFGVW Sandoz Candesartan 02326957 SDZ ADEFGVW Tab Orl 8mg Atacand 02239091 AZE ADEFGVW Co. Apo-Candesartan 02365359 APX ADEFGVW Candesartan 02388928 SAS ADEFGVW Candesartan 02388707 SIV ADEFGVW Candesartan Cilexetil 02379279 AHI ADEFGVW Co Candesartan 02376539 COB ADEFGVW Jamp-Candesartan 02386518 JPC ADEFGVW Mylan-Candesartan 02379139 MYL ADEFGVW pms-Candesartan 02391198 PMS ADEFGVW Ran-Candesartan 02380692 RAN ADEFGVW Sandoz Candesartan 02326965 SDZ ADEFGVW Teva-Candesartan 02366312 TEV ADEFGVW

October 2015 v.2 70

C09CA06 CANDESARTAN CANDÉSARTAN

Tab Orl 16mg Atacand 02239092 AZE ADEFGVW Co. Apo-Candesartan 02365367 APX ADEFGVW Candesartan 02388936 SAS ADEFGVW Candesartan 02388715 SIV ADEFGVW Candesartan Cilexetil 02379287 AHI ADEFGVW Co Candesartan 02376547 COB ADEFGVW Jamp-Candesartan 02386526 JPC ADEFGVW Mylan-Candesartan 02379147 MYL ADEFGVW pms-Candesartan 02391201 PMS ADEFGVW Ran-Candesartan 02380706 RAN ADEFGVW Sandoz Candesartan 02326973 SDZ ADEFGVW Teva-Candesartan 02366320 TEV ADEFGVW Tab Orl 32mg Atacand 02311658 AZE ADEFGVW Co. Apo-Candesartan 02399105 APX ADEFGVW Candesartan 02435845 SAS ADEFGVW Candesartan Cilexetil 02379295 AHI ADEFGVW Co Candesartan 02376555 COB ADEFGVW Jamp-Candesartan 02386534 JPC ADEFGVW Mylan-Candesartan 02379155 MYL ADEFGVW pms-Candesartan 02391228 PMS ADEFGVW Ran-Candesartan 02380714 RAN ADEFGVW Sandoz Candesartan 02392267 SDZ ADEFGVW Sandoz Candesartan 02417340 SDZ ADEFGVW Teva-Candesartan 02366339 TEV ADEFGVW

C09CA07 TELMISARTAN

TELMISARTAN

Tab Orl 40mg Micardis 02240769 BOE ADEFGVW Co. Act Telmisartan 02393247 ATV ADEFGVW Apo-Telmisartan 02420082 APX ADEFGVW Mylan-Telmisartan 02376717 MYL ADEFGVW pms-Telmisartan (Disc/Non-Disp Feb 25/17) 02391236 PMS ADEFGVW Sandoz Telmisartan 02375958 SDZ ADEFGVW Telmisartan 02407485 AHI ADEFGVW Telmisartan 02432897 PMS ADEFGVW Telmisartan 02388944 SAS ADEFGVW Telmisartan 02390345 SIV ADEFGVW Teva-Telmisartan 02320177 TEV ADEFGVW

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C09CA07 TELMISARTAN TELMISARTAN

Tab Orl 80mg Micardis 02240770 BOE ADEFGVW Co. Act Telmisartan 02393255 ATV ADEFGVW Apo-Telmisartan 02420090 APX ADEFGVW Mylan-Telmisartan 02376725 MYL ADEFGVW pms-Telmisartan(Disc/Non-Disp Feb 25/17) 02391244 PMS ADEFGVW Sandoz Telmisartan 02375966 SDZ ADEFGVW Telmisartan 02407493 AHI ADEFGVW Telmisartan 02432900 PMS ADEFGVW Telmisartan 02388952 SAS ADEFGVW Telmisartan 02390353 SIV ADEFGVW Teva-Telmisartan 02320185 TEV ADEFGVW

C09CA08 OLMESARTAN MEDOXOMIL

OLMÉSARTAN MÉDOXOMIL

Tab Orl 20mg Olmetec 02318660 FRS ADEFGVW Co. Tab Orl 40mg Olmetec 02318679 FRS ADEFGVW Co.

C09D ANGIOTENSIN II ANTAGONISTS, COMBINATIONS ANTAGONISTES DE L’ANGIOTENSINE II, EN COMBINAISON

C09DA ANGIOTENSIN II ANTAGONISTS AND DIURETICS ANTAGONISTES DE L’ANGIOTENSINE II ET DIURÉTIQUES

C09DA01 LOSARTAN AND DIURETICS LOSARTAN ET DIURÉTIQUES

LOSARTAN / HYDROCHLOROTHIAZIDE LOSARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 50mg/12.5mg Hyzaar 02230047 FRS ADEFGVW Co. Act Losartan/HCT 02388251 ATV ADEFGVW Apo-Losartan HCTZ 02371235 APX ADEFGVW Jamp-Losartan HCTZ 02408244 JPC ADEFGVW Losartan HCT 02388960 SIV ADEFGVW Losartan/HCTZ 02427648 SAS ADEFGVW Mint-Losartan/HCTZ 02389657 MNT ADEFGVW Mylan-Losartan HCTZ 02378078 MYL ADEFGVW pms-Losartan-HCTZ 02392224 PMS ADEFGVW Sandoz Losartan HCT 02313375 SDZ ADEFGVW Teva-Losartan HCTZ 02358263 TEV ADEFGVW

October 2015 v.2 72

C09DA01 LOSARTAN AND DIURETICS LOSARTAN ET DIURÉTIQUES

LOSARTAN / HYDROCHLOROTHIAZIDE LOSARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 100mg/12.5mg Hyzaar 02297841 FRS ADEFGVW Co. Act Losartan/HCT 02388278 ATV ADEFGVW Apo-Losartan HCTZ 02371243 APX ADEFGVW Losartan HCT 02388979 SIV ADEFGVW Losartan/HCTZ 02427656 SAS ADEFGVW Mint-Losartan/HCTZ 02389665 MNT ADEFGVW Mylan-Losartan HCTZ 02378086 MYL ADEFGVW pms-Losartan-HCTZ 02392232 PMS ADEFGVW Sandoz Losartan HCT 02362449 SDZ ADEFGVW Teva-Losartan HCTZ 02377144 TEV ADEFGVW Tab Orl 100mg/25mg Hyzaar DS 02241007 FRS ADEFGVW Co. Act Losartan/HCT 02388286 ATV ADEFGVW Apo-Losartan HCTZ 02371251 APX ADEFGVW Jamp-Losartan HCTZ 02408252 JPC ADEFGVW Losartan HCT 02388987 SIV ADEFGVW Losartan/HCTZ 02427664 SAS ADEFGVW Mint-Losartan/HCTZ DS 02389673 MNT ADEFGVW Mylan-Losartan HCTZ 02378094 MYL ADEFGVW pms-Losartan-HCTZ 02392240 PMS ADEFGVW Sandoz Losartan HCT 02313383 SDZ ADEFGVW Teva-Losartan HCTZ 02377152 TEV ADEFGVW

C09DA02 EPROSARTAN AND DIURETICS

ÉPROSARTAN ET DIURÉTIQUES

EPROSARTAN / HYDROCHLOROTHIAZIDE ÉPROSARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 600mg/12.5mg Teveten Plus 02253631 BGP ADEFGVW Co.

C09DA03 VALSARTAN AND DIURETICS

VALSARTAN ET DIURÉTIQUES

VALSARTAN / HYDROCHLOROTHIAZIDE VALSARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 80mg/12.5mg Diovan HCT 02241900 NVR ADEFGVW Co. Apo-Valsartan/HCTZ 02382547 APX ADEFGVW Auro-Valsartan HCT 02408112 ARO ADEFGVW Mylan-Valsartan HCTZ 02373734 MYL ADEFGVW Sandoz Valsartan HCT 02356694 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02356996 TEV ADEFGVW Valsartan/HCTZ 02367009 SAS ADEFGVW Valsartan HCT 02384736 SIV ADEFGVW

October 2015 v.2 73

C09DA03 VALSARTAN AND DIURETICS VALSARTAN ET DIURÉTIQUES

VALSARTAN / HYDROCHLOROTHIAZIDE VALSARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 160mg/12.5mg Diovan HCT 02241901 NVR ADEFGVW Co. Apo-Valsartan/HCTZ 02382555 APX ADEFGVW Auro-Valsartan HCT 02408120 ARO ADEFGVW Mylan-Valsartan HCTZ 02373742 MYL ADEFGVW Sandoz Valsartan HCT 02356708 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357003 TEV ADEFGVW Valsartan/HCTZ 02367017 SAS ADEFGVW Valsartan HCT 02384744 SIV ADEFGVW Tab Orl 160mg/25mg Diovan HCT 02246955 NVR ADEFGVW Co. Apo-Valsartan/HCTZ 02382563 APX ADEFGVW Auro-Valsartan HCT 02408139 ARO ADEFGVW Mylan-Valsartan HCTZ 02373750 MYL ADEFGVW Sandoz Valsartan HCT 02356716 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357011 TEV ADEFGVW Valsartan/HCTZ 02367025 SAS ADEFGVW Valsartan HCT 02384752 SIV ADEFGVW Tab Orl 320mg/12.5mg Diovan HCT 02308908 NVR ADEFGVW Co. Apo-Valsartan/HCTZ 02382571 APX ADEFGVW Auro-Valsartan HCT 02408147 ARO ADEFGVW Mylan-Valsartan HCTZ 02373769 MYL ADEFGVW Sandoz Valsartan HCT 02356724 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357038 TEV ADEFGVW Valsartan/HCTZ 02367033 SAS ADEFGVW Tab Orl 320mg/25mg Diovan HCT 02308916 NVR ADEFGVW Co. Apo-Valsartan/HCTZ 02382598 APX ADEFGVW Auro-Valsartan HCT 02408155 ARO ADEFGVW Mylan-Valsartan HCTZ 02373777 MYL ADEFGVW Sandoz Valsartan HCT 02356732 SDZ ADEFGVW Teva-Valsartan/ HCTZ 02357046 TEV ADEFGVW Valsartan/HCTZ 02367041 SAS ADEFGVW

October 2015 v.2 74

C09DA04 IRBESARTAN AND DIURETICS IRBESARTAN ET DIURÉTIQUES

IRBESARTAN / HYDROCHLOROTHIAZIDE IRBESARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 150mg/12.5mg Avalide 02241818 SAV ADEFGVW Co. Act Irbesartan HCT 02357399 ATV ADEFGVW Apo-Irbesartan/HCTZ 02387646 APX ADEFGVW Irbesartan/HCTZ 02372886 SAS ADEFGVW Irbesartan HCT 02385317 SIV ADEFGVW Jamp-Irbesartan/Hydrochlorothiazide 02418223 JPC ADEFGVW Mint-Irbesartan/HCTZ 02392992 MNT ADEFGVW pms-Irbesartan HCTZ 02328518 PMS ADEFGVW Ran-Irbesartan HCTZ 02363208 RAN ADEFGVW ratio-Irbesartan HCTZ 02330512 TEV ADEFGVW Sandoz Irbesartan HCT 02337428 SDZ ADEFGVW Teva-Irbesartan HCTZ 02316013 TEV ADEFGVW Tab Orl 300mg/12.5mg Avalide 02241819 SAV ADEFGVW Co. Act Irbesartan HCT 02357402 ATV ADEFGVW Apo-Irbesartan/HCTZ 02387654 APX ADEFGVW Irbesartan/HCTZ 02372894 SAS ADEFGVW Irbesartan HCT 02385325 SIV ADEFGVW Jamp-Irbesartan/Hydrochlorothiazide 02418231 JPC ADEFGVW Mint-Irbesartan/HCTZ 02393018 MNT ADEFGVW pms-Irbesartan HCTZ 02328526 PMS ADEFGVW Ran-Irbesartan HCTZ 02363216 RAN ADEFGVW ratio-Irbesartan HCTZ 02330520 TEV ADEFGVW Sandoz Irbesartan HCT 02337436 SDZ ADEFGVW Teva-Irbesartan HCTZ 02316021 TEV ADEFGVW Tab Orl 300mg/25mg Act Irbesartan HCT 02357410 ATV ADEFGVW Co. Apo-Irbesartan/HCTZ 02387662 APX ADEFGVW Irbesartan/HCTZ 02372908 SAS ADEFGVW Irbesartan HCT 02385333 SIV ADEFGVW Jamp-Irbesartan/Hydrochlorothiazide 02418258 JPC ADEFGVW Mint-Irbesartan/HCTZ 02393026 MNT ADEFGVW pms-Irbesartan HCTZ 02328534 PMS ADEFGVW Ran-Irbesartan HCTZ 02363224 RAN ADEFGVW ratio-Irbesartan HCTZ 02330539 TEV ADEFGVW Sandoz Irbesartan HCT 02337444 SDZ ADEFGVW Teva-Irbesartan HCTZ 02316048 TEV ADEFGVW

October 2015 v.2 75

C09DA06 CANDESARTAN AND DIURETICS CANDÉSARTAN ET DIURÉTIQUES

CANDESARTAN / HYDROCHLOROTHIAZIDE CANDÉSARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 16mg/12.5mg Atacand Plus 02244021 AZE ADEFGVW Co. Act Candesartan/HCT 02388650 ATV ADEFGVW Apo-Candesartan/HCTZ 02367866 APX ADEFGVW Candesartan HCT 02394812 SIV ADEFGVW Candesartan/HCTZ 02394804 SAS ADEFGVW Mylan-Candesartan HCTZ 02374897 MYL ADEFGVW pms-Candesartan-HCTZ 02391295 PMS ADEFGVW Sandoz Candesartan Plus 02327902 SDZ ADEFGVW Teva-Candesartan/HCTZ 02395541 TEV ADEFGVW Tab Orl 32mg/12.5mg Atacand Plus 02332922 AZE ADEFGVW Co. Apo-Candesartan/HCTZ 02395126 APX ADEFGVW Sandoz Candesartan Plus 02420732 SDZ ADEFGVW Teva-Candesartan/HCTZ 02395568 TEV ADEFGVW Tab Orl 32mg/25mg Atacand Plus 02332957 AZE ADEFGVW Co. Apo-Candesartan/HCTZ 02395134 APX ADEFGVW Sandoz Candesartan Plus 02420740 SDZ ADEFGVW

C09DA07 TELMISARTAN AND DIURETICS

TELMISARTAN ET DIURÉTIQUES

TELMISARTAN / HYDROCHLOROTHIAZIDE TELMISARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 80mg/12.5mg Micardis Plus 02244344 BOE ADEFGVW Co. Act Telmisartan/HCT 02393263 ATV ADEFGVW Mylan-telmisartan HCTZ 02373564 MYL ADEFGVW pms-Telmisartan/HCTZ 02401665 PMS ADEFGVW Sandoz Telmisartan HCT 02393557 SDZ ADEFGVW Telmisartan/HCTZ 02395355 SAS ADEFGVW Telmisartan HCTZ 02390302 SIV ADEFGVW Telmisartan-HCTZ 02433214 PMS ADEFGVW Teva-telmisartan HCTZ 02330288 TEV ADEFGVW Tab Orl 80mg/25mg Micardis Plus 02318709 BOE ADEFGVW Co. Act Telmisartan/HCT 02393271 ATV ADEFGVW Mylan-telmisartan HCTZ 02373572 MYL ADEFGVW pms-Telmisartan/HCTZ 02401673 PMS ADEFGVW Sandoz Telmisartan HCT 02393565 SDZ ADEFGVW Telmisartan/HCTZ 02395363 SAS ADEFGVW Telmisartan HCTZ 02390310 SIV ADEFGVW Telmisartan-HCTZ 02433222 PMS ADEFGVW Teva-telmisartan HCTZ 02379252 TEV ADEFGVW

October 2015 v.2 76

C09DA08 OLMESARTAN AND DIURETICS OLMÉSARTAN ET DIURÉTIQUES

OLMESARTAN / HYDROCHLOROTHIAZIDE OLMÉSARTAN / HYDROCHLOROTHIAZIDE

Tab Orl 20mg/12.5mg Olmetec Plus 02319616 FRS ADEFGVW Co. Tab Orl 40mg/12.5mg Olmetec Plus 02319624 FRS ADEFGVW Co. Tab Orl 40mg/25mg Olmetec Plus 02319632 FRS ADEFGVW Co.

C09DB ANGIOTENSIN II ANTAGONISTS AND CALCIUM CHANNEL BLOCKERS ANTAGONISTES DE L’ANGIOTENSINE II ET ANTAGONISTES DU CALCIUM

C09DB04 TELMISARTAN AND AMLODIPINE TELMISARTAN ET AMLODIPINE

Tab Orl 40mg/5mg Twynsta 02371022 BOE ADEFGVW Co. Tab Orl 40mg/10mg Twynsta 02371030 BOE ADEFGVW Co. Tab Orl 80mg/5mg Twynsta 02371049 BOE ADEFGVW Co. Tab Orl 80mg/10mg Twynsta 02371057 BOE ADEFGVW Co.

C10 LIPID MODIFYING AGENTS AGENTS RÉDUISANT LES LIPIDES SÉRIQUES

C10A LIPID MODIFYING AGENTS, PLAIN AGENTS RÉDUISANT LES LIPIDES SÉRIQUES, ORDINAIRES

C10AA HMG COA REDUCTASE INHIBITORS INHIBITEURS DU HMG COA-REDUCTASE

C10AA01 SIMVASTATIN SIMVASTATINE

Tab Orl 5mg Zocor 00884324 FRS ADEFGVW Co. Act Simvastatin 02248103 ATV ADEFGVW Apo-Simvastatin 02247011 APX ADEFGVW Auro-Simvastatin 02405148 ARO ADEFGVW Jamp-Simvastatin 02375591 JPC ADEFGVW Mar-Simvastatin 02375036 MAR ADEFGVW Mint-Simvastatin 02372932 MNT ADEFGVW Mylan-Simvastatin 02246582 MYL ADEFGVW pms-Simvastatin 02269252 PMS ADEFGVW Ran-Simvastatin 02329131 RAN ADEFGVW Simvastatin 02284723 SAS ADEFGVW Simvastatin 02386291 SIV ADEFGVW Teva-Simvastatin 02250144 TEV ADEFGVW

October 2015 v.2 77


Tab Orl 10mg Zocor 00884332 FRS ADEFGVW Co. Act Simvastatin 02248104 ATV ADEFGVW Apo-Simvastatin 02247012 APX ADEFGVW Auro-Simvastatin 02405156 ARO ADEFGVW Jamp-Simvastatin 02375605 JPC ADEFGVW Mar-Simvastatin 02375044 MAR ADEFGVW Mint-Simvastatin 02372940 MNT ADEFGVW Mylan-Simvastatin 02246583 MYL ADEFGVW pms-Simvastatin 02269260 PMS ADEFGVW Ran-Simvastatin 02329158 RAN ADEFGVW Simvastatin 02284731 SAS ADEFGVW Simvastatin 02386305 SIV ADEFGVW Teva-Simvastatin 02250152 TEV ADEFGVW Tab Orl 20mg Zocor 00884340 FRS ADEFGVW Co. Act Simvastatin 02248105 ATV ADEFGVW Apo-Simvastatin 02247013 APX ADEFGVW Auro-Simvastatin 02405164 ARO ADEFGVW Jamp-Simvastatin 02375613 JPC ADEFGVW Mar-Simvastatin 02375052 MAR ADEFGVW Mint-Simvastatin 02372959 MNT ADEFGVW Mylan-Simvastatin 02246737 MYL ADEFGVW pms-Simvastatin 02269279 PMS ADEFGVW Ran-Simvastatin 02329166 RAN ADEFGVW Simvastatin 02284758 SAS ADEFGVW Simvastatin 02386313 SIV ADEFGVW Teva-Simvastatin 02250160 TEV ADEFGVW Tab Orl 40mg Zocor 00884359 FRS ADEFGVW Co. Act Simvastatin 02248106 ATV ADEFGVW Apo-Simvastatin 02247014 APX ADEFGVW Auro-Simvastatin 02405172 ARO ADEFGVW Jamp-Simvastatin 02375621 JPC ADEFGVW Mar-Simvastatin 02375060 MAR ADEFGVW Mint-Simvastatin 02372967 MNT ADEFGVW Mylan-Simvastatin 02246584 MYL ADEFGVW pms-Simvastatin 02269287 PMS ADEFGVW Ran-Simvastatin 02329174 RAN ADEFGVW Simvastatin 02284766 SAS ADEFGVW Simvastatin 02386321 SIV ADEFGVW Teva-Simvastatin 02250179 TEV ADEFGVW

October 2015 v.2 78


Tab Orl 80mg Zocor (Disc/non disp May 06/16) 02240332 FRS ADEFGVW Co. Act Simvastatin 02248107 ATV ADEFGVW Apo-Simvastatin 02247015 APX ADEFGVW Auro-Simvastatin 02405180 ARO ADEFGVW Jamp-Simvastatin 02375648 JPC ADEFGVW Mar-Simvastatin 02375079 MAR ADEFGVW Mint-Simvastatin 02372975 MNT ADEFGVW Mylan-Simvastatin 02246585 MYL ADEFGVW pms-Simvastatin 02269295 PMS ADEFGVW Ran-Simvastatin 02329182 RAN ADEFGVW Simvastatin 02284774 SAS ADEFGVW Simvastatin 02386348 SIV ADEFGVW Teva-Simvastatin 02250187 TEV ADEFGVW

C10AA02 LOVASTATIN

LOVASTATINE

Tab Orl 20mg Mevacor (Disc/non disp. Jun 06/16) 00795860 FRS ADEFGVW Co. Act Lovastatin 02248572 ATV ADEFGVW Apo-Lovastatin 02220172 APX ADEFGVW Lovastatin 02353229 SAS ADEFGVW Mylan-Lovastatin 02243127 MYL ADEFGVW pms-Lovastatin 02246013 PMS ADEFGVW Sandoz Lovastatin (Disc/non disp Nov 15/15) 02247056 SDZ ADEFGVW Teva-Lovastatin 02246542 TEV ADEFGVW Tab Orl 40mg Mevacor (Disc/non disp. Jun 06/16) 00795852 FRS ADEFGVW Co. Act Lovastatin 02248573 ATV ADEFGVW Apo-Lovastatin 02220180 APX ADEFGVW Lovastatin 02353237 SAS ADEFGVW Mylan-Lovastatin 02243129 MYL ADEFGVW pms-Lovastatin 02246014 PMS ADEFGVW Sandoz Lovastatin (Disc/non disp Nov 15/15) 02247057 SDZ ADEFGVW Teva-Lovastatin 02246543 TEV ADEFGVW

C10AA03 PRAVASTATIN

PRAVASTATINE

Tab Orl 10mg Apo-Pravastatin 02243506 APX ADEFGVW Co. Co Pravastatin 02248182 COB ADEFGVW Jamp-Pravastatin 02330954 JPC ADEFGVW Mint-Pravastatin 02317451 MNT ADEFGVW Mylan-Pravastatin 02257092 MYL ADEFGVW pms-Pravastatin 02247655 PMS ADEFGVW Pravastatin 02356546 SAS ADEFGVW Pravastatin 02389703 SIV ADEFGVW Ran-Pravastatin 02284421 RAN ADEFGVW Sandoz Pravastatin (Disc/non disp Dec 31/16) 02247856 SDZ ADEFGVW Teva-Pravastatin 02247008 TEV ADEFGVW

October 2015 v.2 79

C10AA03 PRAVASTATIN PRAVASTATINE

Tab Orl 20mg Pravachol 00893757 BRI ADEFGVW Co. Apo-Pravastatin 02243507 APX ADEFGVW Co Pravastatin 02248183 COB ADEFGVW Jamp-Pravastatin 02330962 JPC ADEFGVW Mint-Pravastatin 02317478 MNT ADEFGVW Mylan-Pravastatin 02257106 MYL ADEFGVW pms-Pravastatin 02247656 PMS ADEFGVW Pravastatin 02356554 SAS ADEFGVW Pravastatin 02389738 SIV ADEFGVW Ran-Pravastatin 02284448 RAN ADEFGVW Sandoz Pravastatin (Disc/non disp Dec 31/16) 02247857 SDZ ADEFGVW Teva-Pravastatin 02247009 TEV ADEFGVW Tab Orl 40mg Pravachol 02222051 BRI ADEFGVW Co. Apo-Pravastatin 02243508 APX ADEFGVW Co Pravastatin 02248184 COB ADEFGVW Jamp-Pravastatin 02330970 JPC ADEFGVW Mint-Pravastatin 02317486 MNT ADEFGVW Mylan-Pravastatin 02257114 MYL ADEFGVW pms-Pravastatin 02247657 PMS ADEFGVW Pravastatin 02356562 SAS ADEFGVW Pravastatin 02389746 SIV ADEFGVW Ran-Pravastatin 02284456 RAN ADEFGVW Sandoz Pravastatin 02247858 SDZ ADEFGVW Teva-Pravastatin 02247010 TEV ADEFGVW

C10AA04 FLUVASTATIN

FLUVASTATINE

Cap Orl 20mg Lescol 02061562 NVR ADEFGVW Caps Sandoz Fluvastatin 02400235 SDZ ADEFGVW Teva-Fluvastatin 02299224 TEV ADEFGVW Cap Orl 40mg Lescol 02061570 NVR ADEFGVW Caps Sandoz Fluvastatin 02400243 SDZ ADEFGVW Teva-Fluvastatin 02299232 TEV ADEFGVW SRT Orl 80mg Lescol XL 02250527 NVR ADEFGVW Co.L.L

October 2015 v.2 80

C10AA05 ATORVASTATIN ATORVASTATINE

Tab Orl 10mg Lipitor 02230711 PFI ADEFGVW Co. Act Atorvastatin 02310899 ATV ADEFGVW Apo-Atorvastatin 02295261 APX ADEFGVW Atorvastatin 02348705 SAS ADEFGVW Atorvastatin 02411350 SIV ADEFGVW Auro-Atorvastatin 02407256 ARO ADEFGVW GD-Atorvastatin 02288346 GMD ADEFGVW Jamp-Atorvastatin 02391058 JPC ADEFGVW Mylan-Atorvastatin 02392933 MYL ADEFGVW Novo-Atorvastatin 02302675 TEV ADEFGVW pms-Atorvastatin 02399377 PMS ADEFGVW Ran-Atorvastatin 02313707 RAN ADEFGVW ratio-Atorvastatin 02350297 TEV ADEFGVW Reddy-Atorvastatin 02417936 RCH ADEFGVW Sandoz Atorvastatin 02324946 SDZ ADEFGVW Tab Orl 20mg Lipitor 02230713 PFI ADEFGVW Co. Act Atorvastatin 02310902 ATV ADEFGVW Apo-Atorvastatin 02295288 APX ADEFGVW Atorvastatin 02348713 SAS ADEFGVW Atorvastatin 02411369 SIV ADEFGVW Auro-Atorvastatin 02407264 ARO ADEFGVW GD-Atorvastatin 02288354 GMD ADEFGVW Jamp-Atorvastatin 02391066 JPC ADEFGVW Mylan-Atorvastatin 02392941 MYL ADEFGVW Novo-Atorvastatin 02302683 TEV ADEFGVW pms-Atorvastatin 02399385 PMS ADEFGVW Ran-Atorvastatin 02313715 RAN ADEFGVW ratio-Atorvastatin 02350319 TEV ADEFGVW Reddy-Atorvastatin 02417944 RCH ADEFGVW Sandoz Atorvastatin 02324954 SDZ ADEFGVW Tab Orl 40mg Lipitor 02230714 PFI ADEFGVW Co. Act Atorvastatin 02310910 ATV ADEFGVW Apo-Atorvastatin 02295296 APX ADEFGVW Atorvastatin 02348721 SAS ADEFGVW Atorvastatin 02411377 SIV ADEFGVW Auro-Atorvastatin 02407272 ARO ADEFGVW GD-Atorvastatin 02288362 GMD ADEFGVW Jamp-Atorvastatin 02391074 JPC ADEFGVW Mylan-Atorvastatin 02392968 MYL ADEFGVW Novo-Atorvastatin 02302691 TEV ADEFGVW pms-Atorvastatin 02399393 PMS ADEFGVW Ran-Atorvastatin 02313723 RAN ADEFGVW ratio-Atorvastatin 02350327 TEV ADEFGVW Reddy-Atorvastatin 02417952 RCH ADEFGVW Sandoz Atorvastatin 02324962 SDZ ADEFGVW

October 2015 v.2 81

C10AA05 ATORVASTATIN ATORVASTATINE

Tab Orl 80mg Lipitor 02243097 PFI ADEFGVW Co. Apo-Atorvastatin 02295318 APX ADEFGVW Act Atorvastatin 02310929 ATV ADEFGVW Atorvastatin 02348748 SAS ADEFGVW Atorvastatin 02411385 SIV ADEFGVW Auro-Atorvastatin 02407280 ARO ADEFGVW GD-Atorvastatin 02288370 GMD ADEFGVW Jamp-Atorvastatin 02391082 JPC ADEFGVW Mylan-Atorvastatin 02392976 MYL ADEFGVW Novo-Atorvastatin 02302713 TEV ADEFGVW pms-Atorvastatin 02399407 PMS ADEFGVW Ran-Atorvastatin 02313758 RAN ADEFGVW ratio-Atorvastatin 02350335 TEV ADEFGVW Reddy-Atorvastatin 02417960 RCH ADEFGVW Sandoz Atorvastatin 02324970 SDZ ADEFGVW

C10AA07 ROSUVASTATIN

ROSUVASTATINE

Tab Orl 5mg Crestor 02265540 AZE ADEFGVW Co. Act Rosuvastatin 02339765 ATV ADEFGVW Apo-Rosuvastatin 02337975 APX ADEFGVW Jamp-Rosuvastatin 02391252 JPC ADEFGVW Mar-Rosuvastatin 02413051 MAR ADEFGVW Mint-Rosuvastatin 02397781 MNT ADEFGVW Mylan-Rosuvastatin 02381265 MYL ADEFGVW pms-Rosuvastatin 02378523 PMS ADEFGVW Ran-Rosuvastatin 02382644 RAN ADEFGVW Rosuvastatin 02405628 SAS ADEFGVW Rosuvastatin 02411628 SIV ADEFGVW Sandoz Rosuvastatin 02338726 SDZ ADEFGVW Teva-Rosuvastatin 02354608 TEV ADEFGVW Tab Orl 10mg Crestor 02247162 AZE ADEFGVW Co. Act Rosuvastatin 02339773 ATV ADEFGVW Apo-Rosuvastatin 02337983 APX ADEFGVW Jamp-Rosuvastatin 02391260 JPC ADEFGVW Mar-Rosuvastatin 02413078 MAR ADEFGVW Mint-Rosuvastatin 02397803 MNT ADEFGVW Mylan-Rosuvastatin 02381273 MYL ADEFGVW pms-Rosuvastatin 02378531 PMS ADEFGVW Ran-Rosuvastatin 02382652 RAN ADEFGVW Rosuvastatin 02405636 SAS ADEFGVW Rosuvastatin 02411636 SIV ADEFGVW Sandoz Rosuvastatin 02338734 SDZ ADEFGVW Teva-Rosuvastatin 02354616 TEV ADEFGVW

October 2015 v.2 82

C10AA07 ROSUVASTATIN ROSUVASTATINE

Tab Orl 20mg Crestor 02247163 AZE ADEFGVW Co. Act Rosuvastatin 02339781 ATV ADEFGVW Apo-Rosuvastatin 02337991 APX ADEFGVW Jamp-Rosuvastatin 02391279 JPC ADEFGVW Mar-Rosuvastatin 02413086 MAR ADEFGVW Mint-Rosuvastatin 02397811 MNT ADEFGVW Mylan-Rosuvastatin 02381281 MYL ADEFGVW pms-Rosuvastatin 02378558 PMS ADEFGVW Ran-Rosuvastatin 02382660 RAN ADEFGVW Rosuvastatin 02405644 SAS ADEFGVW Rosuvastatin 02411644 SIV ADEFGVW Sandoz Rosuvastatin 02338742 SDZ ADEFGVW Teva-Rosuvastatin 02354624 TEV ADEFGVW Tab Orl 40mg Crestor 02247164 AZE ADEFGVW Co. Act Rosuvastatin 02339803 ATV ADEFGVW Apo-Rosuvastatin 02338009 APX ADEFGVW Jamp-Rosuvastatin 02391287 JPC ADEFGVW Mar-Rosuvastatin 02413108 MAR ADEFGVW Mint-Rosuvastatin 02397838 MNT ADEFGVW Mylan-Rosuvastatin 02381303 MYL ADEFGVW pms-Rosuvastatin 02378566 PMS ADEFGVW Ran-Rosuvastatin 02382679 RAN ADEFGVW Rosuvastatin 02405652 SAS ADEFGVW Rosuvastatin 02411652 SIV ADEFGVW Sandoz Rosuvastatin 02338750 SDZ ADEFGVW Teva-Rosuvastatin 02354632 TEV ADEFGVW

C10AB FIBRATES FIBRATES

C10AB04 GEMFIBROZIL GEMFIBROZIL

Tab Orl 300mg Apo-Gemfibrozil 01979574 APX ADEFGVW Co. Mylan-Gemfibrozil 02185407 MYL ADEFGVW Teva-Gemfibrozil 02241704 TEV ADEFGVW pms-Gemfibrozil 02239951 PMS ADEFGVW Tab Orl 600mg Apo-Gemfibrozil 01979582 APX ADEFGVW Co. Mylan-Gemfibrozil 02230476 MYL ADEFGVW Teva-Gemfibrozil 02142074 TEV ADEFGVW pms-Gemfibrozil (Disc/non disp Jan 31/16) 02230183 PMS ADEFGVW

C10AB05 FENOFIBRATE

FÉNOFIBRATE

Cap Orl 100mg Apo-Fenofibrate 02225980 APX ADEFGVW Caps

October 2015 v.2 83

C10AB05 FENOFIBRATE FÉNOFIBRATE

Cap Orl 200mg Lipidil Micro (Disc/non disp May 31/17) 02146959 ABB ADEFGVW Caps Apo-Feno-Micro 02239864 APX ADEFGVW Fenofibrate Micro(Disc/non disp Feb 27/17) 02286092 SAS ADEFGVW Mylan-Fenofibrate Micro 02240210 MYL ADEFGVW Novo-Fenofibrate Micro 02243552 TEV ADEFGVW pms-Fenofibrate Micro (Disc/non disp Apr 1/16) 02273551 PMS ADEFGVW ratio-Fenofibrate MC 02250039 TEV ADEFGVW Tab Orl 100mg Lipidil Supra (Disc/non disp Jan 29/16) 02241601 ABB ADEFGVW Co. Apo-Feno-Super 02246859 APX ADEFGVW Fenofibrate S 02356570 SAS ADEFGVW Sandoz Fenofibrate S 02288044 SDZ ADEFGVW Teva-Fenofibrate-S 02289083 TEV ADEFGVW Tab Orl 160mg Lipidil Supra 02241602 ABB ADEFGVW Co. Apo-Feno-Super 02246860 APX ADEFGVW Fenofibrate S 02356589 SAS ADEFGVW Sandoz Fenofibrate S 02288052 SDZ ADEFGVW Teva-Fenofibrate-S 02289091 TEV ADEFGVW

C10AC BILE ACID SEQUESTRANTS SEQUESTRANTS DE L’ACIDE BILIAIRE

C10AC01 CHOLESTYRAMINE CHOLESTYRAMINE

Pws Orl 4g Packets/sachets Olestyr 00890960 PDP ADEFGVW Pds. Pws Orl 4g Packets/sachets Olestyr 02210320 PDP ADEFGVW Pds.

C10AC02 COLESTIPOL

COLESTIPOL

Tab Orl 1g Colestid 02132680 PFI ADEFGVW Co. Pws Orl 5g Colestid 00642975 PFI ADEFGVW Pds. Pws Orl 7.5g Colestid (Orange) 02132699 PFI ADEFGVW Pds.

C10AC04 COLESEVELAM HYDROCHLORIDE

COLÉSÉVÉLAM, CHLORHYDRATE DE

Tab Orl 625mg Lodalis 02373955 VLN ADEFGVW Co.

October 2015 v.2 84

C10AX OTHER LIPID MODIFYING AGENTS AUTRE AGENTS RÉDUISANT LES LIPIDES SÉRIQUES

C10AX09 EZETIMIBE ÉZÉTIMIBE

Tab Orl 10mg Ezetrol 02247521 FRS (SA) Co. Act Ezetimibe 02414716 ATV (SA) Apo-Ezetimibe 02427826 APX (SA) Ezetimibe 02431300 SAS (SA) Ezetimibe 02429659 SIV (SA) Jamp- Ezetimibe 02423235 JPC (SA) Mar- Ezetimibe 02422662 MAR (SA) Mint- Ezetimibe 02423243 MNT (SA) Mylan- Ezetimibe 02378035 MYL (SA) pms- Ezetimibe 02416409 PMS (SA) Ran- Ezetimibe 02419548 RAN (SA) Sandoz- Ezetimibe 02416778 SDZ (SA) Teva- Ezetimibe 02354101 TEV (SA)

C10B LIPID MODIFYING AGENTS, COMBINATIONS AGENTS RÉDUISANT LES LIPIDES SÉRIQUES, EN COMBINAISON

C10BX HMG COA REDUCTASE INHIBITORS, OTHER COMBINATIONS INHIBITEURS DE LA HMG COA RÉDUCTASE, AUTRES COMBINAISONS

C10BX03 ATORVASTATIN AND AMLODIPINE ATORVASTATINE ET AMLODIPINE

Tab Orl 5mg/10mg Caduet 02273233 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411253 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362759 GMD ADEFGVW pms-Amlodipine/Atorvastatin 02404222 PMS ADEFGVW Tab Orl 5mg/20mg Caduet 02273241 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411261 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362767 GMD ADEFGVW pms-Amlodipine/Atorvastatin 02404230 PMS ADEFGVW Tab Orl 5mg/40mg Caduet 02273268 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411288 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362775 GMD ADEFGVW Tab Orl 5mg/80mg Caduet 02273276 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411296 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362783 GMD ADEFGVW Tab Orl 10mg/10mg Caduet 02273284 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411318 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362791 GMD ADEFGVW pms-Amlodipine/Atorvastatin 02404249 PMS ADEFGVW

October 2015 v.2 85

C10BX03 ATORVASTATIN AND AMLODIPINE ATORVASTATINE ET AMLODIPINE

Tab Orl 10mg/20mg Caduet 02273292 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411326 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362805 GMD ADEFGVW pms-Amlodipine/Atorvastatin 02404257 PMS ADEFGVW Tab Orl 10mg/40mg Caduet 02273306 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411334 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362813 GMD ADEFGVW Tab Orl 10mg/80mg Caduet 02273314 PFI ADEFGVW Co. Apo-Amlodipine-Atorvastatin 02411342 APX ADEFGVW GD-Amlodipine/Atorvastatin 02362821 GMD ADEFGVW

D01 ANTIFUNGALS FOR DERMATOLOGICAL USE ANTIFONGIQUES À USAGE DERMATOLOGIQUE

D01A ANTIFUNGALS FOR TOPICAL USE ANTIFONGIQUES POUR USAGE TOPIQUE

D01AA ANTIBIOTICS ANTIBIOTIQUES

D01AA01 NYSTATIN NYSTATINE

Crm Top 100000IU Nyaderm 00716871 TAR ADEFGVW Cr. Ratio-Nystatin 02194236 RPH ADEFGVW Ont Top 100000IU Ratio-Nystatin 02194228 RPH ADEFGVW Ont

D01AC IMIDAZOLE AND TRIAZOLE DERIVATIVES DÉRIVÉS DE L’IMIDAZOLE ET TRIAZOLE

D01AC01 CLOTRIMAZOLE CLOTRIMAZOLE

Crm Top 1% Canesten 02150867 YNO ADEFGVW Cr. Clotrimaderm 00812382 TAR ADEFGVW

D01AC02 MICONAZOLE

MICONAZOLE

Crm Top 2% Micatin 02085852 WLS ADEFGVW Cr. Monistat Derm 02126567 JNJ ADEFGVW

D01AC08 KETOCONAZOLE

KÉTOCONAZOLE

Crm Top 2% Ketoderm 02245662 TPH ADEFGVW Cr.

October 2015 v.2 86

D01AC20 COMBINATION, TOPICAL ANTIFUNGALS (IMIDAZOLE DERVATIVES) COMBINAISON, ANTIFONGIQUES TOPIQUES (DÉRIVÉS DE L’IMIDAZOLE)

CLOTRIMAZOLE / BETAMETHASONE CLOTRIMAZOLE / BÉTAMÉTHASONE

Crm Top 1%/0.05% Lotriderm 00611174 FRS ADEFGVW Cr.

D01AE OTHER ANTIFUNGALS FOR TOPICAL USE AUTRES ANTIFONGIQUES POUR USAGE TOPIQUE

D01AE14 CICLOPIROX CICLOPIROX

Crm Top 1% Loprox 02221802 VLN ADEFGVW Cr. Lot Top 1% Loprox 02221810 VLN ADEFGVW Lot

D01AE15 TERBINAFINE

TERBINAFINE

Crm Top 1% Lamisil 02031094 NVR ADEFGVW Cr.

D01B ANTIFUNGALS, SYSTEMIC PREPARATIONS ANTIFONGIQUES, PREPARATIONS SYSTEMIQUES

D01BA ANTIFUNGALS FOR SYSTEMIC USE ANTIFONGIQUES POUR USAGE SYSTEMIQUE

D01BA02 TERBINAFINE TERBINAFINE

Tab Orl 250mg Lamisil 02031116 NVR (SA) Co. Act Terbinafine 02254727 ATV (SA) Apo-Terbinafine 02239893 APX (SA) Auro-Terbinafine 02320134 ARO (SA) GD-Terbinafine (Disc/non disp Nov 30/15) 02352818 GMD (SA) Jamp-Terbinafine 02357070 JPC (SA) Mylan-Terbinafine (Disc/non disp Sept 14/17) 02242503 MYL (SA) pms-Terbinafine 02294273 PMS (SA) Sandoz Terbinafine (Disc/non disp Dec 31/16) 02262177 SDZ (SA) Terbinafine 02353121 SAS (SA) Terbinafine 02385279 SIV (SA) Teva-Terbinafine 02240346 TEV (SA)

October 2015 v.2 87

D05 ANTIPSORIATICS TRAITEMENT DU PSORIASIS

D05A ANTIPSORIATICS FOR TOPICAL USE TRAITEMENT DU PSORIASIS, POUR USAGE TOPIQUE

D05AA TARS GOUDRONS

D05AA99 TARS GOUDRONS

Liq Top 20% Odans LCD 00358495 ODN ADEFGV Liq

D05AX OTHER ANTISPORIATICS FOR TOPICAL USE AUTRES TRAITEMENTS DU PSORIASIS POUR USAGE TOPIQUE

D05AX02 CALCIPOTRIOL CALCIPOTRIOL

Crm Top 50mcg Dovonex 02150956 LEO ADEFV Cr. Ont Top 50mcg Dovonex 01976133 LEO ADEFV Ont Liq Top 50mcg Dovonex Scalp Solution 02194341 LEO ADEFV Liq

D05B ANTIPSORIATICS FOR SYSTEMIC USE TRAITEMENT DU PSORIASIS, POUR USAGE SYSTÉMIQUE

D05BA PSORALENS FOR SYSTEMIC USE PSORALENES, POUR USAGE SYSTÉMIQUE

D05BA02 METHOXSALEN MÉTHOXSALENE

Cap Orl 10mg Oxsoralen (Disc/non disp Aug 5/17) 01946374 VLN ADEFGVW Caps

D05BB RETINOIDS FOR TREATMENT OF PSORIASIS RÉTINOÏDES POUR LE TRAITEMENT DU PSORIASIS

D05BB02 ACITRETIN ACITRÉTINE

Cap Orl 10mg Soriatane 02070847 TRB ADEFGVW Caps Cap Orl 25mg Soriatane 02070863 TRB ADEFGVW Caps

October 2015 v.2 88

D06 ANTIBIOTICS AND CHEMOTHERAPEUTICS FOR DERMATOLOGICAL USE ANTIBIOTIQUES ET AGENTS CHIMIOTHÉRAPEUTIQUES ET DERMATOLOGIQUES

D06A ANTIBIOTICS FOR TOPICAL USE ANTIBIOTIQUES POUR USAGE TOPIQUE

D05AX OTHER ANTIBIOTICS FOR TOPICAL USE AUTRES ANTIBIOTIQUES POUR USAGE TOPIQUE

D06AX01 FUSIDIC ACID ACIDE FUSIDIQUE

Ont Top 2% Fucidin 00586676 LEO ADEFGVW Ont Crm Top 2% Fucidin 00586668 LEO ADEFGVW Cr.

D06AX07 GENTAMICIN

GENTAMICINE

Crm Top 0.1% ratio-Gentamicin Sulfate 00805386 RPH ADEFGVW Cr. Ont Top 0.1% ratio-Gentamicin Sulfate 00805025 RPH ADEFGVW Ont

D06AX09 MUPIROCIN

MUPIROCINE

Crm Top 2% Bactroban 02239757 GCH ADEFGVW Cr. Ont Top 2% Bactroban 01916947 GCH ADEFGVW Ont Taro-Mupirocin 02279983 TAR ADEFGVW

D06B CHEMOTHERAPEUTICS FOR TOPICAL USE AGENTS CHIMIOTHÉRAPEUTIQUES POUR USAGE TOPIQUE

D06BA SULFONAMIDES SULFONAMIDES

D06BA01 SILVER SULFADIAZINE SULFADIAZINE D’ARGENT

Crm Top 1% Flamazine 00323098 SNE ADEFGVW Cr.

D06BB ANTIVIRALS ANTIVIRAUX

D06BB03 ACYCLOVIR ACYCLOVIR

Ont Top 5% Zovirax 00569771 VLN ADEFGVW Ont

October 2015 v.2 89

D06BB04 PODOPHYLLOTOXIN PODOPHYLLOTOXINE

Liq Top 250mg/mL Podofilm 00598208 PAL ADEFGV Liq

D06BB10 IMIQUIMOD

IMIQUIMOD

Crm Top 5% Aldara 02239505 VLN (SA) Cr. Apo-Imiquimod 02407825 APX (SA)

D06BX OTHER CHEMOTHERAPEUTICS AUTRES AGENTS DE CHIMOTHÉRAPIE

D06BX01 METRONIDAZOLE MÉTRONIDAZOLE

Crm Top 0.75% Metrocream 02226839 GAC ADEFV Cr. Crm Top 1% Noritate 02156091 VLN ADEFV Cr. Rosasol cream (Disc/non disp Mar 3/16) 02242919 GSK ADEFV Gel Top 1% Metrogel 02297809 GAC ADEFGVW Gel Lot Top 0.75% Metrolotion 02248206 GAC ADEFGVW Lot

D07 CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS CORTICOSTÉROÏDES, PRÉPARATIONS DERMATOLOGIQUES

D07A CORTICOSTEROIDS, PLAIN CORTICOSTÉROÏDES, ORDINAIRES

D07AA CORTICOSTEROIDS, WEAK (GROUP I) CORTICOSTÉROÏDES, FAIBLES (GROUPE I)

D07AA02 HYDROCORTISONE HYDROCORTISONE

Crm Top 0.5% Cortate 80021088 SCO AEFGVW Cr. Hyderm 00716820 TAR AEFGVW Hydrosone 00564281 ROG AEFGVW Crm Top 1% Emo-Cort 00192597 STI ADEFGVW Cr. Hyderm 00716839 TAR ADEFGVW Prevex HC (Disc/non disp Dec 24/16) 00804533 GSK ADEFGVW Crm Top 2.5% Emo-Cort 00595799 STI ADEFGVW Cr. Lot Top 1% Emo-Cort 00192600 STI ADEFGVW Lot Jamp-Hydrocortisone 80057191 JPC ADEFGVW Sarna HC (Disc/non disp Dec 24/16) 00578541 GSK ADEFGVW

October 2015 v.2 90

D07AA02 HYDROCORTISONE HYDROCORTISONE

Lot Top 2.5% Emo-Cort 00595802 STI ADEFGVW Lot Sarna HC (Disc/non disp. Jun 6/16) 00856711 GSK ADEFGVW Ont Top 1% Cortoderm 00716693 TAR ADEFGVW Ont Crm Top 0.2% Hydroval 02242984 TPH ADEFGVW Cr. Ont Top 0.2% Hydroval 02242985 TPH ADEFGVW Ont

D07AB CORTICOSTEROIDS, MODERATELY POTENT (GROUP II) CORTICOSTÉROÏDES, MOYENNEMENT PUISSANT (GROUPE II)

D07AB01 CLOBETASONE CLOBÉTASONE

Crm Top 0.05% Spectro Eczemacare 02214415 GCH AEFGVW Cr.

D07AB08 DESONIDE

DÉSONIDE

Crm Top 0.05% pdp-Desonide 02229315 PDP ADEFGVW Cr. Ont Top 0.05% pdp-Desonide 02229323 PDP ADEFGVW Ont

D07AB09 TRIAMCINOLONE

TRIAMCINOLONE

Crm Top 0.1% Aristocort R 02194058 VLN ADEFGVW Cr. Crm Top 0.5% Aristocort C 02194066 VLN ADEFGVW Cr. Ont Top 0.1% Aristocort R 02194031 VLN ADEFGVW Ont

D07AC CORTICOSTEROIDS, POTENT (GROUP III) CORTICOSTÉROÏDES, PUISSANT (GROUPE III)

D07AC01 BETAMETHASONE BÉTAMÉTHASONE

BETAMETHASONE DIPROPIONATE DIPROPIONATE DE BÉTAMÉTHASONE

Crm Top 0.05% Diprosone 00323071 FRS ADEFGVW Cr. ratio-Topisone 00804991 RPH ADEFGVW

October 2015 v.2 91

D07AC01 BETAMETHASONE BÉTAMÉTHASONE

BETAMETHASONE DIPROPIONATE DIPROPIONATE DE BÉTAMÉTHASONE

Lot Top 0.05% Diprosone 00417246 FRS ADEFGVW Lot ratio-Topisone 00809187 RPH ADEFGVW Ont Top 0.05% Diprosone 00344923 FRS ADEFGVW Ont ratio-Topisone 00805009 RPH ADEFGVW Crm Top 0.05% Diprolene Glycol 00688622 FRS ADEFGVW Cr. ratio-Topilene Glycol 00849650 RPH ADEFGVW Lot Top 0.05% Diprolene Glycol 00862975 FRS ADEFGVW Lot ratio-Topilene Glycol 01927914 RPH ADEFGVW Ont Top 0.05% Diprolene Glycol 00629367 FRS ADEFGVW Ont ratio-Topilene Glycol 00849669 RPH ADEFGVW

BETAMETHASONE VALERATE VALÉRATE DE BÉTAMÉTHASONE

Crm Top 0.05% Betaderm 00716618 TAR ADEFGVW Cr. Celestoderm V/2 02357860 VLN ADEFGVW ratio-Ectosone Mild 00535427 RPH ADEFGVW Crm Top 0.1% Betaderm 00716626 TAR ADEFGVW Cr. Celestoderm V 02357844 VLN ADEFGVW ratio-Ectosone 00535435 RPH ADEFGVW Prevex B 00804541 GSK ADEFGVW Lot Top 0.05% ratio-Ectosone Mild 00653209 RPH ADEFGVW Lot Lot Top 0.1% Betaderm 00716634 TAR ADEFGVW Lot Valisone 00027944 VLN ADEFGVW ratio-Ectosone 00750050 RPH ADEFGVW ratio-Ectosone Scalp 00653217 RPH ADEFGVW Ont Top 0.05% Betaderm 00716642 TAR ADEFGVW Ont Celestoderm V/2 02357879 VLN ADEFGVW Ont Top 0.1% Betaderm 00716650 TAR ADEFGVW Ont Celestoderm V 02357852 VLN ADEFGVW

D07AC03 DESOXIMETASONE

DÉSOXIMÉTASONE

Crm Top 0.05% Topicort Mild 02221918 VLN ADEFGVW Cr. Crm Top 0.25% Topicort 02221896 VLN ADEFGVW Cr.

October 2015 v.2 92

D07AC03 DESOXIMETASONE DÉSOXIMÉTASONE

Gel Top 0.05% Topicort 02221926 VLN ADEFGVW Gel Ont Top 0.25% Topicort 02221934 VLN ADEFGVW Ont

D07AC04 FLUOCINOLONE

FLUOCINOLONE

Liq Top 0.01% Derma-Smoothe 00873292 HLZ ADEFGV Liq

D07AC06 DIFLUCORTOLONE

DIFLUCORTOLONE

Crm Top 0.1% Nerisone (Disc/non disp Mar 3/16) 00587826 GSK ADEFGVW Cr. Nerisone Oily 00587818 GSK ADEFGVW

D07AC08 FLUOCINONIDE

FLUOCINONIDE

Crm Top 0.05% Lidex 02161923 VLN ADEFGVW Cr. Lidemol 02163152 VLN ADEFGVW Lyderm 00716863 TPH ADEFGVW Gel Top 0.05% Lidex Gel 02161974 VLN ADEFGVW Gel Lyderm 02236997 TPH ADEFGVW Ont Top 0.05% Lidex 02161966 VLN ADEFGVW Ont Lyderm 02236996 TPH ADEFGVW

D07AC11 AMCINONIDE

AMCINONIDE

Crm Top 0.1% Cyclocort 02192284 GSK ADEFGVW Cr. ratio-Amcinonide 02247098 TEV ADEFGVW Taro-Amcinonide 02246714 TAR ADEFGVW Lot Top 0.1% Cyclocort 02192276 GSK ADEFGVW Lot ratio-Amcinonide 02247097 TEV ADEFGVW Ont Top 0.1% Cyclocort 02192268 GSK ADEFGVW Ont ratio-Amcinonide 02247096 TEV ADEFGVW

D07AC13 MOMETASONE

MOMÉTASONE

Crm Top 0.1% Elocom 00851744 FRS ADEFGVW Cr. Taro-Mometasone 02367157 TAR ADEFGVW Lot Top 0.1% Elocom 00871095 FRS ADEFGVW Lot Taro-Mometasone 02266385 TAR ADEFGVW

October 2015 v.2 93

D07AC13 MOMETASONE MOMÉTASONE

Ont Top 0.1% Elocom 00851736 FRS ADEFGVW Ont ratio-Mometasone 02248130 TEV ADEFGVW

D07AD CORTICOSTEROIDS, VERY POTENT (GROUP IV) CORTICOSTÉROÏDES, TRÈS PUISSANT (GROUPE IV)

D07AD01 CLOBETASOL CLOBÉTASOL

Crm Top 0.05% Dermovate 02213265 TPH ADEFGVW Cr. Mylan-Clobetasol 02024187 MYL ADEFGVW Novo-Clobetasol 02093162 TEV ADEFGVW pms-Clobetasol 02309521 PMS ADEFGVW ratio-Clobetasol 01910272 TEV ADEFGVW Taro-Clobetasol Cream 02245523 TAR ADEFGVW Lot Top 0.05% Dermovate 02213281 TPH ADEFGVW Lot Mylan-Clobetasol Propionate 02216213 MYL ADEFGVW ratio-Clobetasol 01910299 TEV ADEFGVW Taro-Clobetasol Topical Sol’n 02245522 TAR ADEFGVW Ont Top 0.05% Dermovate 02213273 TPH ADEFGVW Ont Mylan-Clobetasol 02026767 MYL ADEFGVW Novo-Clobetasol 02126192 TEV ADEFGVW pms-Clobetasol 02309548 PMS ADEFGVW ratio-Clobetasol 01910280 TEV ADEFGVW Taro-Clobetasol Ointment 02245524 TAR ADEFGVW

D07C CORTICOSTEROIDS, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, EN COMBINAISON AVEC DES ANTIBIOTIQUES

D07CA CORTICOSTEROIDS, WEAK, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, FAIBLES, EN COMBINAISON AVEC DES ANTIBIOTIQUES

D07CA02 HYDROCORTISONE AND ANTIBIOTICS HYDROCORTISONE ET ANTIBIOTIQUES

IODOCHLORHYDROXYQUINE / HYDROCORTISONE IODOCHLORHYDROXYQUINE / HYDROCORTISONE

Crm Top 3% / 1% Vioform HC 00074500 PAL ADEFGVW Cr.

POLYMYXIN B SULFATE / BACITRACIN ZINC / HYDROCORTISONE / NEOMYCIN POLYMYXINE B (SULFATE DE) / BACITRACINE / HYDROCORTISONE / NÉOMYCINE

Ont Top 5000IU/400IU/10mg/5mg Cortisporin (Disc/non 00666246 GSK ADEFGVW Ont disp Nov 3/16)

FUSIDIC ACID / HYDROCORTISONE ACIDE FUSIDIQUE / HYDROCORTISONE

Crm Top 2% / 1% Fucidin H 02238578 LEO ADEFGVW Cr.

October 2015 v.2 94

D07CB CORTICOSTEROIDS, MODERATELY POTENT, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, MOYENNEMENT PUISSANTS, EN COMBINAISON AVEC DES

ANTIBIOTIQUES

D07CB01 TRIAMCINOLONE AND ANTIBIOTICS TRIAMCINOLONE ET ANTIBIOTIQUES

TRIAMCINOLONE / NEOMYCIN / NYSTATIN / GRAMICIDIN TRIAMCINOLONE / NÉOMYCINE / NYSTATINE / GRAMICIDINE

Crm Top 100000IU/2.5mg/1mg/0.25mg Viaderm K-C 00717002 TAR ADEFGVW Cr. Ont Top 100000IU/2.5mg/1mg/0.25mg Viaderm K-C 00717029 TAR ADEFGVW Ont

D07CB05 FLUMETASONE AND ANTIBIOTICS

FLUMETASONE ET ANTIBIOTIQUES

CLIOQUINO / FLUMETHASONE CLIOQUINO / FLUMÉTHASONE

Crm Top 3% / 0.02% Locacorten-Vioform 00074462 PAL ADEFGVW Cr.

D07CC CORTICOSTEROIDS, POTENT, COMBINATIONS WITH ANTIBIOTICS CORTICOSTÉROÏDES, PUISSANT, EN COMBINAISON AVEC DES ANTIBIOTIQUES

D07CC01 BETAMETHASONE AND ANTIBIOTICS BÉTAMETHASONE ET ANTIBIOTIQUES

BETAMETHASONE / GENTAMICIN BÉTAMETHASONE / GENTAMICINE

Ont Top 0.1% / 0.1% Valisone G 00232351 VLN ADEFGVW Ont Crm Top 0.1% / 0.1% Valisone G 00177016 VLN ADEFGVW Cr.

D07X CORTICOSTEROIDS, OTHER COMBINATIONS CORTICOSTÉROÏDES, AUTRES COMBINAISONS

D07XA CORTICOSTEROIDS, WEAK, OTHER COMBINATIONS CORTICOSTÉROÏDES, FAIBLES, AUTRES COMBINAISONS

D07XA01 HYDROCORTISONE, OTHER COMBINATIONS HYDROCORTISONE, AUTRES COMBINAISONS

HYDROCORTISONE / PRAMOXINE HYDROCORTISONE / PRAMOXINE

Crm Top 1% / 1% Pramox HC 00770957 DPT ADEFGVW Cr.

HYDROCORTISONE / UREA HYDROCORTISONE / URÉA

Crm Top 10% / 1% Uremol HC (Disc/non disp Jun 23/16) 00503134 GSK ADEFGVW Cr.

October 2015 v.2 95

D07XA01 HYDROCORTISONE, OTHER COMBINATIONS HYDROCORTISONE, AUTRES COMBINAISONS

HYDROCORTISONE / UREA HYDROCORTISONE / URÉA

Lot Top 10% / 1% Uremol HC (Disc/non disp Jun 23/16) 00560022 GSK ADEFGVW Lot

D07XC CORTICOSTEROIDS, POTENT, OTHER COMBINATIONS CORTICOSTÉROÏDES, PUISSANTS, AUTRES COMBINAISONS

D07XC01 BETAMETHASONE, OTHER COMBINATIONS BÉTAMÉTHASONE, AUTRES COMBINAISONS

BETAMETHASONE / SALICYLIC ACID BÉTAMÉTHASONE / ACIDE SALICYLIQUE

Lot Top 20mg/0.5mg Diprosalic 00578428 FRS ADEFGVW Lot ratio-Topisalic 02245688 TEV ADEFGVW Ont Top 30mg/0.5mg Diprosalic 00578436 FRS ADEFGVW Ont

BETAMETHASONE / CALCIPOTRIOL BÉTAMÉTHASONE / CALCIPOTRIOL

Gel Top 0.5mg/50mcg Dovobet 02319012 LEO ADEFGVW Gel

D08 ANTISEPTICS AND DISINFECTANTS ANTISEPTIQUES ET AGENTS STÉRILISANTS

D08A ANTISEPTICS AND DISINFECTANTS ANTISEPTIQUES ET AGENTS STÉRILISANTS

D08AJ QUATERNARY AMMONIUM COMPOUNDS COMPOSÉS D’AMMONIUM QUATERNAIRE

D08AJ58 BENZETHONIUM CHLORIDE, COMBINATIONS COMBINATION DE BENZETHONIUM CHLORIDE

ALUMINUM ACETATE / BENZETHONIUM CHLORIDE ACÉTATE D’ALUMINIUM / CHLORURE DE BENZÉTHONIUM

Pwr Top 0.35% Buro Sol 00579947 TCD ADEFGVW Pds.

D09 MEDICATED DRESSINGS PANSEMENTS MÉDICAMENTEUX

D09A MEDICATED DRESSINGS PANSEMENTS MÉDICAMENTEUX

D09AA MEDICATED DRESSINGS WITH ANTIINFECTIVES PANSEMENTS MÉDICAMENTEUX ET ANTI-INFECTIEUX

D09AA01 FRAMYCETIN FRAMYCÉTINE

Dre Top 1% Sofra-Tulle (10cm x 30cm) 01987682 ERF ADEFGVW Dre Sofra-Tulle (10cm x 10cm) 01988840 ERF ADEFGVW

October 2015 v.2 96

D10 ANTI-ACNE PREPARATIONS PRÉPARATIONS CONTRE L’ACNÉ

D10A ANTI-ACNE PREPARATIONS FOR TOPICAL USE PRÉPARATIONS TOPIQUES CONTRE L’ACNÉ

D10AA CORTICOSTEROIDS, COMBINATIONS FOR TREATMENT OF ACNE CORTICOSTÉROÏDES, COMBINAISON CONTRE L’ACNÉ

D10AA02 METHYLPREDNISONE, COMBINATION METHYLPREDNISONE, COMBINAISON

ALUMINUM CHLORHYDROXIDE / SULPHUR / METHYLPREDNISOLONE / NEOMYCIN ALUMINUM (CHLORHYDROXIDE D’) / SOUFRE / MÉTHYLPREDNISOLONE / NÉOMYCINE

Lot Top 100mg/50mg/2.5mg/2.5mg Neo-Medrol Acne 00195057 PFI EDFGW Lot

D10AB PREPARATIONS CONTAINING SULPHUR PRÉPARATIONS CONTENANT DU SOUFRE

D10AB02 SULPHUR SOUFRE

SULFACETAMIDE SODIUM / SULPHUR SULFACÉTAMIDE SODIQUE / SOUFRE

Lot Top 10% / 5% Sulfacet R 02220407 VLN ADEFGVW Lot

D10AD RETINOIDS FOR TOPICAL USE IN ACNE RÉTINOÏDES POUR USAGE TOPIQUE CONTRE L’ACNÉ

D10AD01 TRETINOIN TRÉTINOINE

Crm Top 0.01% Stieva-A 00657204 GSK DEFG Cr. Crm Top 0.025% Stieva-A 00578576 GSK DEFG Cr. Crm Top 0.05% Retin-A 00443794 VLN DEFG Cr. Stieva-A 00518182 GSK DEFG Crm Top 0.1% Stieva-A Forte 00662348 GSK DEFG Cr. Gel Top 0.01% Vitamin A Acid 01926462 VLN DEFG Gel Gel Top 0.025% Vitamin A Acid 01926470 VLN DEFG Gel Gel Top 0.05% Vitamin A Acid 01926489 VLN DEFG Gel

October 2015 v.2 97

D10AE PEROXIDES PEROXIDES

D10AE01 BENZOYL PEROXIDE PEROXYDE DE BENZOYLE

BENZOYL PEROXIDE / POLYOXYETHYLENE LAURYL ETHER PEROXYDE DE BENZOYLE / LAURYL ETHER DE POLYOXYÉTHYLÈNE

Gel Top 10% / 6% Panoxyl (Disc/non disp Oct 1/16) 00263699 GSK ADEFGVW Gel Gel Top 20% / 6% Panoxyl (Disc/non disp Apr 1/16) 00373036 GSK ADEFGVW Gel

D10AF ANTIINFECTIVES FOR TREATMENT OF ACNE ANTI-INFECTIEUX POUR LE TRAITEMENT DE L’ACNÉE

D10AF01 CLINDAMYCIN CLINDAMYCINE

Liq Top 1% Dalacin T 00582301 PFI ADEFGV Liq Taro-Clindamycin 02266938 TAR ADEFGV

D10AF52 ERYTHROMYCIN COMBINATIONS

ÉRYTHROMYCINE, EN COMBINAISON

ERYTHROMYCIN BASE / TRETINOIN ÉRYTHROMYCINE BASE / TRÉTINOÏNE

Gel Top 4% / 0.025% Stievamycin 01905112 GSK DEFG Gel Gel Top 4% / 0.01% Stievamycin Mild 02015994 GSK DEFG Gel (Disc/non disp Aug 24/17)

D10AX OTHER ANTI ACNE PREPARATIONS FOR TOPICAL USE AUTRES PRÉPARATIONS CONTRE L’ACNÉ POUR USAGE TOPIQUE

D10AX03 AZELAIC ACID ACIDE AZÉLAÏQUE

Gel Top 15% Finacea 02270811 BAY ADEFGVW Gel

D10B ANTI ACNE PREPARATIONS FOR SYSTEMIC USE PRÉPARATIONS CONTRE L’ACNÉ POUR USAGE SYSTÉMIQUE

D10BA RETINOIDS FOR TREATMENT OF ACNE RÉTINOÏDES POUR LE TRAITEMENT DE L’ACNÉ

D10BA01 ISOTRETINOIN ISOTRÉTINOINE

Cap Orl 10mg Accutane Roche 00582344 HLR DEFG Caps Clarus 02257955 MYL DEFG Epuris 02396971 CIP EFG

October 2015 v.2 98

D10BA01 ISOTRETINOIN ISOTRÉTINOINE

Cap Orl 20mg Epuris 02396998 CIP EFG Caps Cap Orl 30mg Epuris 02397005 CIP EFG Caps Cap Orl 40mg Accutane Roche 00582352 HLR DEFG Caps Clarus 02257963 MYL DEFG Epuris 02397013 CIP EFG

D11 OTHER DERMATOLOGICAL PREPARATIONS AUTRES PRÉPARATIONS DERMATOLOGIQUES

D11A OTHER DERMATOLOGICAL PREPARATIONS AUTRES PRÉPARATIONS DERMATOLOGIQUES

D11AH AGENTS FOR DERMATITIS, EXCLUDING CORTICOSTEROIDS AUTRES PREPARATIONS DERMATOLOGIQUES

D11AH01 TACROLIMUS TACROLIMUS

Ont Top 0.03% Protopic 02244149 ASL (SA) Ont Ont Top 0.1% Protopic 02244148 ASL (SA) Ont

G01 GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS ANTI-INFECTIEUX ET ANTISEPTIQUES GYNÉCOLOGIQUES

G01A ANTIINFECTIVES AND ANTISEPTICS, EXCLUDING COMBINATIONS WITH CORTICOSTEROIDS ANTI-INFECTIEUX ET ANTISEPTIQUES, SAUF LES ASSOCIATIONS AVEC DES CORTICOSTÉROÏDES

G01AA ANTIBIOTICS ANTIBIOTIQUES

G01AA01 NYSTATIN NYSTATINE

Crm Vag 25000IU Nyaderm 00716901 TAR ADEFGVW Cr. Crm Vag 100000IU Ratio-Nystatin 02194163 RPH ADEFGVW Cr.

G01AA51 NYSTATIN, COMBINATIONS

COMBINATION NYSTATINE

NYSTATIN / METRONIDAZOLE NYSTATINE / MÉTRONIDAZOLE

Sup Vag 100000IU/500mg Flagystatin 01926829 SAV ADEFGVW Supp.

October 2015 v.2 99

G01AA51 NYSTATIN, COMBINATIONS COMBINATION NYSTATINE

NYSTATIN / METRONIDAZOLE NYSTATINE / MÉTRONIDAZOLE

Crm Vag 100000IU/500mg Flagystatin 01926845 SAV ADEFGVW Cr.

G01AC QUINOLINE DERIVATIVES DÉRIVÉS DE LA QUINOLEINE

G01AC01 DIIODOHYDROXYQUINOLINE QUINOLEINE DIIODOHYDROXYLE

Tab Orl 650mg Diodoquin (Disc/non disp Jul 30/16) 01997750 GLE ADEFGVW Co.

G01AF IMIDAZOLE DERIVATIVES DÉRIVÉS DE L’IMIDAZOLE

G01AF01 METRONIDAZOLE MÉTRONIDAZOLE

Crm Vag 10% Flagyl 01926861 AVE ADEFGVW Cr.

G01AF02 CLOTRIMAZOLE

CLOTRIMAZOLE

Crm Vag 1% Canesten 02150891 YNO ADEFGVW Cr. Crm Vag 2% Canesten 3 02150905 YNO ADEFGVW Cr. Crm Vag 500mg/1% Canesten 1 Comfortab 02264102 YNO ADEFGVW Cr. Canesten 3 Comfortab Combi-Pak 02264099 YNO ADEFGVW

G01AF04 MICONAZOLE

MICONAZOLE Crm Vag 2% Monistat 7 02084309 JNJ ADEFGVW Cr. Micozole Vaginal 2% 02231106 TAR ADEFGVW Crm Vag 1200mg / 2% Monistat 3 Dual Pak 02126249 JNJ ADEFGVW Cr. Sup Vag 400mg Monistat-3 02126605 JNJ ADEFGVW Supp.

G01AG TRIAZOLE DERIVATIVES DÉRIVÉS DU TRIAZOLE

G01AG02 TERCONAZOLE TERCONAZOLE

Crm Vag 0.4% Terazol 7 00894729 JAN ADEFGVW Cr. Taro-Terconazole 02247651 TAR ADEFGVW

October 2015 v.2 100

G02 OTHER GYNECOLOGICALS AUTRES AGENTS GYNÉCOLOGIQUES

G02B CONTRACEPTIVES FOR TOPICAL USE CONTRACEPTIFS TOPIQUES

G02BA INTRAUTERINE CONTRACEPTIVES CONTRACEPTIFS INTRA-UTÉRINS

G02BA03 PLASTIC IUD WITH PROGESTERONE AND LEVONORGESTREL DIU EN PLASTIQUE AVEC LA PROGESTÉRONE ET DE LÉVONORGESTREL

Ins Vag 13.5mg Jaydess 02408295 BAY DEFG Ins Ins Vag 52mg Mirena 02243005 BAY DEFG Ins

G02BB INTRAVAGINAL CONTRACEPTIVES CONTRACEPTIFS INTRAVAGINAUX

G02BB01 ETHINYL ESTRADIOL AND ETONOGESTREL ÉTHINYLOESTRADIOL ET ÉTONOGESTREL

Ins Vag 2.6mg/11.4mg Nuvaring 02253186 FRS (SA) Ins

G02C OTHER GYNECOLOGICALS AUTRES AGENTS GYNÉCOLOGIQUES

G02CB PROLACTINE INHIBITORS INHIBITEURS DE LA PROLACTINE

G02CB01 BROMOCRIPTINE BROMOCRIPTINE

Tab Orl 2.5mg Bromocriptine 02087324 AAP ADEFGVW Co. Cap Orl 5mg Bromocriptine 02230454 AAP ADEFGVW Caps

G02CB03 CABERGOLINE

CABERGOLINE

Tab Orl 0.5mg Dostinex 02242471 PAL (SA) Co. Co Cabergoline 02301407 COB (SA)

G02CB04 QUINAGOLIDE

QUINAGOLIDE

Tab Orl 0.075mg Norprolac 02223767 FEI (SA) Co. Tab Orl 0.15mg Norprolac 02223775 FEI (SA) Co.


G03 SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM HORMONES SEXUELLES ET MODULATEURS DE L’APPAREIL GÉNITAL

G03A HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE CONTRACEPTIFS HORMONAUX, SYSTÉMIQUES

G03AA PROGESTOGENS AND ESTROGENS, FIXED COMBINATIONS PROGESTOGÈNES ET OESTROGÈNES, COMBINAISONS FIXES

G03AA01 ETYNODIOL AND ETHINYL ESTRADIOL ÉTYNODIOL ET ÉTHINYLOESTRADIOL

Tab Orl 0.03mg/2mg Demulen 30 (21) 00469327 PFI DEFGV Co. Demulen 30 (28) 00471526 PFI DEFGV

G03AA05 NORETHISTERONE AND ETHINYL ESTRADIOL

NORÉTHISTERONE ET ÉTHINYLOESTRADIOL

Tab Orl 0.020mg/1mg Minestrin 1/20 (21) 00315966 WNC DEFGV Co. Minestrin 1/20 (28) 00343838 WNC DEFGV Tab Orl 1.5mg/0.03mg Loestrin 1.5/30 (21) 00297143 WNC DEFGV Co. Loestrin 1.5/30 (28) 00353027 WNC DEFGV Tab Orl 0.5mg/0.035mg Brevicon (21) 02187086 PFI DEFGV Co. Brevicon (28) 02187094 PFI DEFGV Ortho 0.5/35 (21) 00317047 JAN DEFGV Ortho 0.5/35 (28) 00340731 JAN DEFGV Tab Orl 1mg/0.035mg Brevicon 1/35 (21) 02189054 PFI DEFGV Co. Brevicon 1/35 (28) 02189062 PFI DEFGV Ortho 1/35 (21) 00372846 JAN DEFGV Ortho 1/35 (28) 00372838 JAN DEFGV Select 1/35 (21) 02197502 PFI DEFGV Select 1/35 (28) 02199297 PFI DEFGV

G03AA07 LEVONORGESTREL AND ETHINYL ESTRADIOL

LÉVONORGESTREL ET ÉTHINYLOESTRADIOL

Tab Orl 0.15mg/0.03mg Min-Ovral (21) 02042320 PFI DEFGV Co. Min-Ovral (28) 02042339 PFI DEFGV Ovima (21) 02387085 APX DEFGV Ovima (28) 02387093 APX DEFGV Portia (21) 02295946 TEV DEFGV Portia (28) 02295954 TEV DEFGV Tab Orl 0.1mg/0.02mg Alesse (21) 02236974 PFI DEFGV Co. Alesse (28) 02236975 PFI DEFGV Alysena (21) 02387875 APX DEFGV Alysena (28) 02387883 APX DEFGV Aviane (21) 02298538 TEV DEFGV Aviane (28) 02298546 TEV DEFGV Esme (21) 02388138 MYL DEFGV Esme (28) 02388146 MYL DEFGV Lutera (21) 02401185 COB DEFGV Lutera (28) 02401207 COB DEFGV


G03AA09 DESOGESTREL AND ETHINYL ESTRADIOL DÉSOGESTREL ET ÉTHINYLOESTRADIOL

Tab Orl 0.15mg/0.03mg Marvelon (21) 02042487 FRS DEFGV Co. Marvelon (28) 02042479 FRS DEFGV Apri (21) 02317192 TEV DEFGV Apri (28) 02317206 TEV DEFGV Freya (21) 02396491 TEV DEFGV Freya (28) 02396610 TEV DEFGV Mirvala (21) 02410249 APX DEFGV Mirvala (28) 02410257 APX DEFGV Reclipsen (21) 02420813 ATV DEFGV Reclipsen (28) 02417464 ATV DEFGV Tab Orl 0.15mg/0.03mg Linessa (21) 02272903 APR DEFGV Co. Linessa (28) 02257238 APR DEFGV Tab Orl 0.15mg/0.03mg Ortho-cept 02042533 JAN DEFGV Co. (Disc/non disp Mar 26/17)

G03AA11 NORGESTIMATE AND ETHINYLESTRADIOL

NORGESTIMATE ET ÉTHINYLOESTRADIOL

Tab Orl 0.25mg/0.035mg Cyclen (21) 01968440 JAN DEFGV Co. Cyclen (28) 01992872 JAN DEFGV

G03AA12 DROSPIRENONE AND ETHINYLESTRADIOL

DROSPIRÉNONE ET ÉTHINYLOESTRADIOL

Tab Orl 3mg/0.03mg Yasmin (21) 02261723 BAY DEFGV Co. Yasmin (28) 02261731 BAY DEFGV Zamine (21) 02410788 APX DEFGV Zamine (28) 02410796 APX DEFGV Zarah (21) 02385058 COB DEFGV Zarah (28) 02385066 COB DEFGV

G03AB PROGESTOGENS AND ESTROGENS, SEQUENTIAL PREPARATIONS PROGESTOGÈNES ET OESTROGÈNES, PRÉPARATION SÉQUENTIELLE

G03AB03 LEVONORGESTREL AND ETHINYLESTRADIOL LÉVONORGESTREL ET ÉTHINYLOESTRADIOL

Tab Orl 0.05mg/0.075mg/0.125mg/0.03mg/0.040mg/0.03mg Triquilar (21) 00707600 BAY DEFGV Co. Triquilar (28) 00707503 BAY DEFGV

G03AB04 NORETHISTERONE AND ETHINYLESTRADIOL

NORÉTHISTERONE ET ÉTHINYLOESTRADIOL

Tab Orl 1mg/0.5mg/0.035mg Synphasic (21) 02187108 PFI DEFGV Co. Synphasic (28) 02187116 PFI DEFGV Tab Orl 1mg/0.75mg/0.5mg/0.035mg Ortho 7/7/7 (21) 00602957 JAN DEFGV Co. Ortho 7/7/7 (28) 00602965 JAN DEFGV


G03AB11 NORGESTIMATE AND ETHINYLESTRADIOL NORGÉSTIMATE ET ÉTHINYLOESTRADIOL

Tab Orl 0.215mg/0.18mg/0.025mg/0.025mg Tri-Cyclen LO (21) 02258560 JAN DEFGV Co. Tri-Cyclen LO (28) 02258587 JAN DEFGV Tricira LO (21) 02401967 APX DEFGV Tricira LO (28) 02401975 APX DEFGV Tab Orl 0.25mg/0.215mg/0.18mg/0.035mg Tri-Cyclen (21) 02028700 JAN DEFGV Co. Tri-Cyclen (28) 02029421 JAN DEFGV

G03AC PROGESTOGENS PROGESTOGÈNES

G03AC01 NORGESTIMATE NORGÉSTIMATE

Tab Orl 0.35mg Micronor (28) 00037605 JAN DEFGV Co. Movisse 02410303 MYL DEFGV

G03AC06 MEDROXYPROGESTERONE

MÉDROXYPROGESTÉRONE

Sus Inj 50mg/mL Depo-Provera 00030848 PFI W Susp Sus Inj 150mg/mL Depo-Provera 00585092 PFI DEFGV Susp Medroxyprogesterone Acetate 02322250 SDZ DEFGV

G03AD EMERGENCY CONTRACEPTIVES CONTRACEPTIFS D’URGENCE

G03AD01 LEVONORGESTREL (EMERGENCY CONTRACEPTIVE) LÉVONORGESTREL (CONTRACEPTIF D’URGENCE)

Tab Orl 0.75mg Plan B 02241674 PAL DEFG Co. Next Choice 02364905 COB DEFG

G03B ANDROGENS ANDROGÈNES

G03BA 3-OXOANDROSTEN (4) DERIVATIVES DÉRIVÉS DU 3-OXOANDROSTENE (4)

G03BA03 TESTOSTERONE TESTOSTÉRONE

Cap Orl 40mg Andriol 00782327 FRS (SA) Caps pms-Testosterone 02322498 PMS (SA) Tarp-Testosterone 02421186 TAR (SA) Gel Top 25mg AndroGel Packets 02245345 BGP (SA) Gel Gel Top 50mg AndroGel Packets 02245346 BGP (SA) Gel


G03BA03 TESTOSTERONE TESTOSTÉRONE

Gel Top 1% Testim 02280248 PAL (SA) Gel Liq Inj 100mg/mL Depo-Testosterone 00030783 PFI ADEFGVW Liq Sandoz Testosterone 02246063 SDZ ADEFGVW Liq Inj 200mg/mL Delatestryl 00029246 VLN ADEFGVW Liq Pad Trd 2.5mg Androderm 02239653 ASP (SA) Gaze Pad Trd 5mg Androderm 02245972 ASP (SA) Gaze

G03C ESTROGENS OESTROGÈNES

G03CA NATURAL AND SEMISYNTHETIC ESTROGENS, PLAIN OESTROGÈNES NATURELS ET SEMI-SYNTHÉTIQUES, ORDINAIRES

G03CA03 ESTRADIOL ESTRADIOL

Tab Vag 10mcg Vagifem 10 02325462 NNO ADEFGVW Co. Gel Trd 0.06% Estrogel 02238704 FRS ADEFV Gel Ins Vag 2mg Estring 02168898 PAL ADEFV Ins Pth Trd 25mcg Climara 25 02247499 BAY ADEFVW Pth Pth Trd 50mcg Climara 50 02231509 BAY ADEFV Pth Pth Trd 75mcg Climara 75 02247500 BAY ADEFVW Pth Pth Trd 100mcg Climara 100 02231510 BAY ADEFV Pth Pth Trd 0.39mg Estradot 02245676 NVR (SA) Pth Pth Trd 0.585mg Estradot 02243999 NVR (SA) Pth


G03CA03 ESTRADIOL ESTRADIOL

Pth Trd 50mcg Estradot 02244000 NVR (SA) Pth Sandoz Estradiol Derm Srd 02246967 SDZ (SA) Pth Trd 75mcg Estradot 02244001 NVR (SA) Pth Sandoz Estradiol Derm Srd 02246968 SDZ (SA) Pth Trd 100mcg Estradot 02244002 NVR (SA) Pth Sandoz Estradiol Derm Srd 02246969 SDZ (SA) Tab Orl 0.5mg Estrace 02225190 TML ADEFGVW Co. Tab Orl 1mg Estrace 02148587 TML ADEFGVW Co. Tab Orl 2mg Estrace 02148595 TML ADEFGVW Co.

G03CA57 CONJUGATED ESTROGENS

OESTROGÈNES CONJUGUÉS

Crm Vag 0.625mg Premarin 02043440 PFI ADEFGVW Cr. Tab Orl 0.3mg Premarin 02414678 PFI ADEFGVW Co. Tab Orl 0.625mg Premarin 02414686 PFI ADEFGVW Co. Tab Orl 1.25mg Premarin 02414694 PFI ADEFGVW Co.

G03D PROGESTOGENS PROGESTOGÈNES

G03DA PREGNEN (4) DERIVATIVES DÉRIVÉS DU PREGNEN (4)

G03DA02 MEDROXYPROGESTERONE MÉDROXYPROGESTÉRONE

Tab Orl 2.5mg Provera 00708917 PFI ADEFGVW Co. Apo-Medroxy 02244726 APX ADEFGVW Teva-Medrone 02221284 TEV ADEFGVW Tab Orl 5mg Provera 00030937 PFI ADEFGVW Co. Apo-Medroxy 02244727 APX ADEFGVW Teva-Medrone 02221292 TEV ADEFGVW


G03DA02 MEDROXYPROGESTERONE MÉDROXYPROGESTÉRONE

Tab Orl 10mg Provera 00729973 PFI ADEFGVW Co. Apo-Medroxy 02277298 APX ADEFGVW Teva-Medrone 02221306 TEV ADEFGVW Tab Orl 100mg Apo-Medroxy 02267640 APX ADEFGVW Co.

G03DB PREGNADIEN DERIVATIVES DÉRIVATIFS DE LA PREGNADIENE

G03DB08 DIENOGEST DIENOGEST

Tab Orl 2mg Visanne 02374900 BAY (SA) Co.

G03FA PROGESTOGENS AND ESTROGENS IN COMBINATION PROGESTOGÈNES EN COMBINAISON

G03FA01 NORETHINDRONE AND ESTROGEN NORÉTHINDRONE ET ESTRADIOL

Pad Trd 140mcg/50mcg Estalis 02241835 NVR (SA) Gaze Pad Trd 250mcg/50mcg Estalis 02241837 NVR (SA) Gaze

G03H ANTIANDROGENS ANTIANDROGÈNES

G03HA ANTIANDROGENS, PLAIN ANTIANDROGÈNES, ORDINAIRES

G03HA01 CYPROTERONE CYPROTÉRONE

Tab Orl 50mg Androcur 00704431 PMS ADEFVW Co. Cyproterone 02245898 AAP ADEFVW Med-Cyproterone 02390760 GMP ADEFVW

G03X OTHER SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM AUTRES HORMONES SEXUELLES ET MODULATEURS DE L’APPAREIL GÉNITAL

G03XA ANTIGONADOTROPHINS AND SIMILAR AGENTS ANTIGONADOTROPHINES ET AGENTS SIMILAIRES

G03XA01 DANAZOL DANAZOL

Cap Orl 100mg Cyclomen 02018152 SAV ADEFVW Caps Cap Orl 200mg Cyclomen 02018160 SAV ADEFVW Caps


G03XC OTHER SEX HORMONES AUTRES HORMONES SEXUELS

G03XC01 RALOXIFENE RALOXIFÈNE

Tab Orl 60mg Evista 02239028 LIL (SA) Co. Act Raloxifene 02358840 ATV (SA) Apo-Raloxifene 02279215 APX (SA) pms-Raloxifene 02358921 PMS (SA) Teva-Raloxifene 02312298 TEV (SA)

G04 UROLOGICALS MÉDICAMENTS UROLOGIQUES

G04B UROLOGICALS MÉDICAMENTS UROLOGIQUES

G04BD DRUGS FOR URINARY FREQUENCY AND INCONTINENCE MÉDICAMENTS POUR LA FRÉQUENCE URINAIRE ET INCONTINENCE

G04BD04 OXYBUTYNIN OXYBUTYNINE

ERT Orl 5mg Ditropan XL 02243960 JAN (SA) Co.L.P. ERT Orl 10mg Ditropan XL 02243961 JAN (SA) Co.L.P. Syr Orl 1mg pms-Oxybutynin 02223376 PMS ADEFGVW Sir. Tab Orl 2.5mg pms-Oxybutynin 02240549 PMS ADEFGVW Co. Tab Orl 5mg Apo-Oxybutynin 02163543 APX ADEFGVW Co. Mylan-Oxybutynin 02230800 MYL ADEFGVW Novo-Oxybutynin 02230394 TEV ADEFGVW Oxybutynin 02350238 SAS ADEFGVW pms-Oxybutynin 02240550 PMS ADEFGVW

G04BD07 TOLTERODINE

TOLTÉRODINE

SRC Orl 2mg Detrol LA 02244612 PFI (SA) Caps.L.L. SRC Orl 4mg Detrol LA 02244613 PFI (SA) Caps.L.L. Tab Orl 1mg Detrol 02239064 PFI (SA) Co. Tab Orl 2mg Detrol 02239065 PFI (SA) Co.


G04BD08 SOLIFENACIN SOLIFÉNCINE

Tab Orl 5mg Vesicare 02277263 ASL (SA)

Co. Teva-Solifenacin 02397900 TEV (SA)

Tab Orl 10mg Vesicare 02277271 ASL (SA)

Co. Teva-Solifenacin 02397919 TEV (SA)

G04BD09 TROSPIUM

TROSPIUM

Tab Orl 20mg Trosec 02275066 SNV (SA)

Co.

G04BD10 DARIFENACIN DARIFÉNACINE

ERT Orl 7.5mg Enablex 02273217 MRS (SA)

Co.L.P. ERT Orl 15mg Enablex 02273225 MRS (SA)

Co.L.P. G04BD11 FESOTERODINE

FÉSOTÉRODINE

ERT Orl 4mg Toviaz 02380021 PFI (SA)

Co.L.P. ERT Orl 8mg Toviaz 02380048 PFI (SA)

Co.L.P.

G04BD12 MIRABEGRON MIRABEGRON

ERT Orl 25mg Myrbetriq 02402874 ASL (SA)

Co.L.P. ERT Orl 50mg Myrbetriq 02402882 ASL (SA)

Co.L.P. G04BE DRUGS USED IN ERECTILE DYSFUNCTION MÉDICAMENT POUR LE TRAITEMENT DU DYSFONCTIONNEMENT ÉRECTILE

G04BE03 SILDENAFIL SILDÉNAFIL

Tab Orl 20mg Revatio 02279401 PFI (SA) Co. Apo-Sildenafil R 02418118 APX (SA) ratio-Sildenafil R 02319500 TEV (SA)


G04BX OTHER UROLOGICAL AUTRES MÉDICAMENTS UROLOGIQUES

G04BX13 DIMETHYL SULFOXIDE SULFOXYDE DE DIMÉTHYLE

Liq ITV 500mg/g Rimso-50 00493392 BCH ADEFGVW Liq

G04C DRUGS USED IN BENIGN PROSTATIC HYPERTROPHY MÉDICAMENTS UTILISÉS POUR LE TRAITEMENT DE L’HYPERTROPHIE BÉNIGNE DE LA PROSTATE

G04CA ALPHA-ADRENORECEPTOR ANTAGONISTS ANTAGONISTES DE L’ALPHA-ADRÉNORÉCEPTEUR

G04CA02 TAMSULOSIN TAMSULOSINE

ERT Orl 0.4mg Flomax CR 02270102 BOE ADEFVW Co.L.P. Apo-Tamsulosin CR 02362406 APX ADEFVW Sandoz Tamsulosin CR 02340208 SDZ ADEFVW Tamsulosin CR 02427117 SAS ADEFVW Tamsulosin CR 02429667 SIV ADEFVW Teva-Tamsulosin CR 02368242 TEV ADEFVW SRC Orl 0.4mg Mylan-Tamsulosin 02298570 MYL ADEFVW Caps.L.L. ratio-Tamsulosin 02294265 TEV ADEFVW Sandoz Tamsulosin 02295121 SDZ ADEFVW Sandoz Tamsulosin 02319217 SDZ ADEFVW Teva-Tamsulosin 02281392 TEV ADEFVW

G04CA03 TERAZOSIN

TÉRAZOSINE

Tab Orl 1mg Hytrin 00818658 BGP ADEF18+VW Co. Apo-Terazosin 02234502 APX ADEF18+VW Mylan-Terazosin 02396289 MYL ADEF18+VW pms-Terazosin 02243518 PMS ADEF18+VW ratio-Terazosin (Disc/non disp Sept 19/16) 02218941 RPH ADEF18+VW Terazosin 02350475 SAS ADEF18+VW Teva-Terazosin 02230805 TEV ADEF18+VW Tab Orl 2mg Hytrin 00818682 BGP ADEF18+VW Co. Apo-Terazosin 02234503 APX ADEF18+VW Mylan-Terazosin 02396297 MYL ADEF18+VW pms-Terazosin 02243519 PMS ADEF18+VW ratio-Terazosin (Disc/non disp Sept 19/16) 02218968 RPH ADEF18+VW Terazosin 02350483 SAS ADEF18+VW Teva-Terazosin 02230806 TEV ADEF18+VW


G04CA03 TERAZOSIN TÉRAZOSINE

Tab Orl 5mg Hytrin 00818666 BGP ADEF18+VW Co. Apo-Terazosin 02234504 APX ADEF18+VW Mylan-Terazosin 02396300 MYL ADEF18+VW pms-Terazosin 02243520 PMS ADEF18+VW ratio-Terazosin (Disc/non disp Sept 19/16) 02218976 RPH ADEF18+VW Terazosin 02350491 SAS ADEF18+VW Teva-Terazosin 02230807 TEV ADEF18+VW Tab Orl 10mg Hytrin 00818674 BGP ADEF18+VW Co. Apo-Terazosin 02234505 APX ADEF18+VW Mylan-Terazosin 02396319 MYL ADEF18+VW pms-Terazosin 02243521 PMS ADEF18+VW ratio-Terazosin (Disc/non disp Sept 19/16) 02218984 RPH ADEF18+VW Terazosin 02350505 SAS ADEF18+VW Teva-Terazosin 02230808 TEV ADEF18+VW

G04CB TESTOSTERONE-5-ALPHA REDUCTASE INHIBITORS INHIBITEURS DE LA TESTOSTÉRONE-5-ALPHA RÉDUCTASE

G04CB01 FINASTERIDE FINASTÉRIDE

Tab Orl 5mg Proscar 02010909 FRS ADEFGVW Co. Act Finasteride 02354462 ATV ADEFGVW Apo-Finasteride 02365383 APX ADEFGVW Auro-Finasteride 02405814 ARO ADEFGVW Finasteride 02355043 AHI ADEFGVW Jamp-Finasteride 02357224 JPC ADEFGVW Mint-Finasteride 02389878 MNT ADEFGVW Mylan-Finasteride 02356058 MYL ADEFGVW pms-Finasteride 02310112 PMS ADEFGVW Ran-Finasteride 02371820 RAN ADEFGVW ratio-Finasteride (Disc/non disp Jul 8/17) 02306905 TEV ADEFGVW Sandoz Finasteride 02322579 SDZ ADEFGVW Teva-Finasteride 02348500 TEV ADEFGVW

G04CB02 DUTASTERIDE

DUTASTÉRIDE

Cap Orl 0.5mg Avodart 02247813 GSK ADEFGVW Caps Act Dutasteride 02412691 ATV ADEFGVW Apo-Dutasteride 02404206 APX ADEFGVW Dutasteride 02429012 SIV ADEFGVW Med-Dutasteride 02416298 GMP ADEFGVW Mint-Dutasteride 02428873 MNT ADEFGVW pms-Dutasteride 02393220 PMS ADEFGVW Sandoz Dutasteride 02424444 SDZ ADEFGVW Teva-Dutasteride 02408287 TEV ADEFGVW


H01 PITUITARY AND HYPOTHALAMIC HORMONES AND ANALOGUES HORMONES HYPOPHYSAIRES ET HYPOTHALAMIQUES

H01A ANTERIOR PITUITARY LOBE HORMONES AND ANALOGUES HORMONES DU LOBE ANTEHYPOPHYSAIRE

H01AC SOMATROPIN AND SOMATROPIN AGONISTS SOMATROPINE ET AGONISTES DE LA SOMATROPINE

H01AC01 SOMATROPIN SOMATROPINE

Pwd SC 5.3mg Genotropin GoQuick 02401703 PFI T (SA) Pws. Pwd SC 12mg Genotropin GoQuick 02401711 PFI T (SA) Pws. Pwd SC 0.6mg Genotropin MiniQuick 02401762 PFI T (SA) Pws. Pwd SC 0.8mg Genotropin MiniQuick 02401770 PFI T (SA) Pws. Pwd SC 1mg Genotropin MiniQuick 02401789 PFI T (SA) Pws. Pwd SC 1.2mg Genotropin MiniQuick 02401797 PFI T (SA) Pws. Pwd SC 1.4mg Genotropin MiniQuick 02401800 PFI T (SA) Pws. Pwd SC 1.6mg Genotropin MiniQuick 02401819 PFI T (SA) Pws. Pwd SC 1.8mg Genotropin MiniQuick 02401827 PFI T (SA) Pws. Pwd SC 2mg Genotropin MiniQuick 02401835 PFI T (SA) Pws. Ctg Inj 6mg Humatrope 02243077 LIL T (SA) Cart Ctg Inj 12mg Humatrope 02243078 LIL T (SA) Cart Ctg Inj 24mg Humatrope 02243079 LIL T (SA) Cart Liq Inj 5mg/1.5mL Omnitrope 02325063 SDZ T (SA) Liq


H01AC01 SOMATROPIN SOMATROPINE

Liq Inj 10mg/1.5mL Omnitrope 02325071 SDZ T (SA) Liq Liq Inj 5mg/2mL Nutropin AQ NuSpin 02399091 HLR T (SA) Liq Liq Inj 10mg/2mL Nutropin AQ NuSpin 02376393 HLR T (SA) Liq Liq Inj 20mg/2mL Nutropin AQ NuSpin 02399083 HLR T (SA) Liq Liq Inj 10mg/2mL Nutropin AQ Pen 02249002 HLR T (SA) Liq Liq Inj 6mg Saizen 02350122 EMD T (SA) Liq Liq Inj 12mg Saizen 02350130 EMD T (SA) Liq Liq Inj 20mg Saizen 02350149 EMD T (SA) Liq Pws Inj 1mg Humatrope 00745626 LIL T (SA) Pds. Nutropin (Disc/non disp Dec 02/15) 02216191 HLR T (SA) Pws Inj 3.33mg Saizen 02215136 EMD T (SA) Pds. Pws Inj 5mg Saizen 02237971 EMD T (SA) Pds. Pws Inj 8.8mg Saizen 02272083 EMD T (SA) Pds.

H01B POSTERIOR PITUITARY LOBE HORMONES HORMONES DU LOBE POSTHYPOPHYSAIRE

H01BA VASOPRESSIN AND ANALOGUES VASOPRESSINE ET ANALOGUES

H01BA02 DESMOPRESSIN DESMOPRESSINE

Aem Nas 10mcg DDAVP Intranasal 00836362 FEI (SA) Aém. Desmopressin 02242465 AAP (SA) Liq Inj 4mcg/mL DDAVP 00873993 FEI ADEFGVW Liq


H01BA02 DESMOPRESSIN DESMOPRESSINE

Liq Nas 10mcg DDAVP 00402516 FEI (SA) Liq ODT Slg 60mg DDAVP Melt 02284995 FEI DEFG-18 (SA) Co.D.O. ODT Slg 120mg DDAVP Melt 02285002 FEI DEFG-18 (SA) Co.D.O. ODT Slg 240mg DDAVP Melt 02285010 FEI DEFG-18 (SA) Co.D.O. Tab Orl 0.1mg DDAVP 00824305 FEI DEFG-18 (SA) Co. Apo-Desmopressin 02284030 APX DEFG-18 (SA) Novo-Desmopressin 02287730 TEV DEFG-18 (SA) pms-Desmopressin 02304368 PMS DEFG-18 (SA) Tab Orl 0.2mg DDAVP 00824143 FEI DEFG-18 (SA) Co. Apo-Desmopressin 02284049 APX DEFG-18 (SA) Novo-Desmopressin 02287749 TEV DEFG-18 (SA) pms-Desmopressin 02304376 PMS DEFG-18 (SA)

H01C HYPOTHALAMIC HORMONES HORMONES HYPOTHALAMIQUES

H01CA GONADOTROPIN-RELEASING HORMONES HORMONES DE LIBÉRATION DES GONADOTROPHINES HYPOPHYSAIRES

H01CA02 NAFARELIN NAFARÉLINE

Liq Nas 2mg/mL Synarel 02188783 PFI (SA) Liq

H01CB SOMATOSTATIN AND ANALOGUES SOMATOSTATINE ET ANALOGUES

H01CB02 OCTREOTIDE OCTRÉOTIDE

Liq Inj 0.05mg/mL Sandostatin 00839191 NVR ADEFGVW Liq Ocphyl 02413191 PDP ADEFGVW Octreotide Acetate Omega 02248639 OMG ADEFGVW Liq Inj 0.1mg/mL Sandostatin 00839205 NVR ADEFGVW Liq Ocphyl 02413205 PDP ADEFGVW Octreotide Acetate Omega 02248640 OMG ADEFGVW Liq Inj 0.2mg/mL Sandostatin 02049392 NVR ADEFGVW Liq Octreotide Acetate Omega 02248642 OMG ADEFGVW


H01CB02 OCTREOTIDE OCTRÉOTIDE

Liq Inj 0.5mg/mL Sandostatin 00839213 NVR ADEFGVW Liq Ocphyl 02413213 PDP ADEFGVW Octreotide Acetate Omega 02248641 OMG ADEFGVW Pws Inj 10mg Sandostatin LAR 02239323 NVR ADEFGVW Pds. Pws Inj 20mg Sandostatin LAR 02239324 NVR ADEFGVW Pds. Pws Inj 30mg Sandostatin LAR 02239325 NVR ADEFGVW Pds.

H01CB03 LANREOTIDE

LANRÉOTIDE

Liq SC 60mg/0.3mL Somatuline Autogel (pre-filled Syringe) 02283395 EMD (SA) Liq Liq SC 90mg/0.3mL Somatuline Autogel (pre-filled Syringe) 02283409 EMD (SA) Liq Liq SC 120mg/0.5mL Somatuline Autogel (pre-filled Syringe) 02283417 EMD (SA) Liq

H02 CORTICOSTEROIDS FOR SYSTEMIC USE CORTICOSTÉROÏDES SYSTÉMIQUES

H02A CORTICOSTEROIDS FOR SYSTEMIC USE, PLAIN CORTICOSTÉROÏDES SYSTÉMIQUES, ORDINAIRES

H02AA MINERALOCORTICOIDS MINÉRALOCORTICOÏDES

H02AA02 FLUDROCORTISONE FLUDROCORTISONE

Tab Orl 0.1mg Florinef 02086026 PAL ADEFGVW Co.

H02AB GLUCOCORTICOIDS GLUCOCORTICOÏDES

H02AB01 BETAMETHASONE BÉTAMÉTHASONE

Sus IA 3mg/3mg Celestone Soluspan (Disc/non disp Dec 00028096 FRS ADEFGVW Susp 15/16)


H02AB02 DEXAMETHASONE DEXAMÉTHASONE

Tab Orl 0.5mg Apo-Dexamethasone 02261081 APX ADEFGVW Co. pms-Dexamethasone 01964976 PMS ADEFGVW ratio-Dexamethasone 02240684 RPH ADEFGVW Tab Orl 2mg pms-Dexamethasone 02279363 PMS ADEFGVW Co. Tab Orl 4mg Dexasone 00489158 VLN ADEFGVW Co. Apo-Dexamethasone 02250055 APX ADEFGVW pms-Dexamethasone 01964070 PMS ADEFGVW ratio-Dexamethasone 02240687 RPH ADEFGVW Liq Inj 4mg/mL Dexamethasone-Omega 02204266 OMG ADEFGVW Liq Dexamethasone sodium phosphate 00664227 SDZ ADEFGVW Dexamethasone sodium phosphate 01977547 STR ADEFGVW

H02AB04 METHYLPREDNISOLONE

MÉTHYLPREDNISOLONE

Tab Orl 4mg Medrol 00030988 PFI ADEFGVW Co. Tab Orl 16mg Medrol 00036129 PFI ADEFGVW Co. Sus IA 20mg/mL Depo-Medrol 01934325 PFI ADEFGVW Susp Sus IA 80mg/mL Depo-Medrol 00030767 PFI ADEFGVW Susp Depo-Medrol 01934341 PFI ADEFGVW Sus IBU 40mg/mL Depo-Medrol 00030759 PFI ADEFGVW Susp Depo-Medrol 01934333 PFI ADEFGVW Pws Inj 125mg Solu-Medrol 02367955 PFI W Pds. Pws Inj 500mg Solu-Medrol 02367963 PFI W Pds.

H02AB06 PREDNISOLONE

PREDNISOLONE

Liq Orl 5mg/5mL Pediapred 02230619 SAV ADEFGVW Liq pms-Prednisolone 02245532 PMS ADEFGVW


H02AB07 PREDNISONE PREDNISONE

Tab Orl 1mg Winpred 00271373 AAP ADEFGRVW Co. Apo-Prednisone (Disc/non disp Jan 9/16) 00598194 APX ADEFGRVW

Tab Orl 5mg Apo-Prednisone 00312770 APX ABDEFGRVW Co. Novo-Prednisone 00021695 TEV ABDEFGRVW Tab Orl 50mg Apo-Prednisone 00550957 APX ADEFGRVW Co. Novo-Prednisone 00232378 TEV ADEFGRVW

H02AB09 HYDROCORTISONE

HYDROCORTISONE

Tab Orl 10mg Cortef 00030910 PFI ADEFGVW Co. Tab Orl 20mg Cortef 00030929 PFI ADEFGVW Co. Pws Inj 100mg Solu-Cortef 00030600 PFI ADEFGVW Pds.

H02AB10 CORTISONE

CORTISONE

Tab Orl 25mg Cortisone 00280437 VLN ADEFGVW Co.

H02B CORTICOSTEROIDS FOR SYSTEMIC USE, COMBINATIONS CORTICOSTÉROÏDES SYSTÉMIQUES, EN COMBINAISON

H02BX CORTICOSTEROIDS FOR SYSTEMIC USE, COMBINATIONS CORTICOSTÉROÏDES SYSTEMIQUES, EN COMBINAISON

H02BX01 METHYLPREDNISOLONE, COMBINATIONS MÉTHYLPREDNISOLONE, EN COMBINAISON

METHYLPREDNISOLONE / LIDOCAINE MÉTHYLPREDNISOLONE / LIDOCAÏNE

Sus IA 40mg/10mg Depo-Medrol 00260428 PFI ADEFGVW Susp

H03 THYROID THERAPY TRAITEMENT DE LA THYROÏDE

H03A THYROID PREPARATIONS PRÉPARATIONS POUR LA THYROÏDE

H03AA THYROID HORMONES HORMONES POUR LA THYROÏDE

H03AA01 LEVOTHYROXINE SODIUM LÉVOTHYROXINE SODIQUE

Tab Orl 0.025mg Synthroid 02172062 BGP ADEFGVW Co.


H03AA01 LEVOTHYROXINE SODIUM LÉVOTHYROXINE SODIQUE

Tab Orl 0.05mg Synthroid 02172070 BGP ADEFGVW Co. Eltroxin 02213192 APR ADEFGVW Tab Orl 0.075mg Synthroid 02172089 BGP ADEFGVW Co. Tab Orl 0.088mg Synthroid 02172097 BGP ADEFGVW Co. Tab Orl 0.1mg Synthroid 02172100 BGP ADEFGVW Co. Eltroxin 02213206 APR ADEFGVW Tab Orl 0.112mg Synthroid 02171228 BGP ADEFGVW Co. Tab Orl 0.125mg Synthroid 02172119 BGP ADEFGVW Co. Tab Orl 0.137mg Synthroid 02233852 BGP ADEFGVW Co. Tab Orl 0.15mg Synthroid 02172127 BGP ADEFGVW Co. Eltroxin 02213214 APR ADEFGVW Tab Orl 0.175mg Synthroid 02172135 BGP ADEFGVW Co. Tab Orl 0.2mg Synthroid 02172143 BGP ADEFGVW Co. Eltroxin 02213222 APR ADEFGVW Tab Orl 0.3mg Synthroid 02172151 BGP ADEFGVW Co. Eltroxin 02213230 APR ADEFGVW

H03AA02 LIOTHYRONINE SODIUM

LIOTHYRONINE SODIQUE Tab Orl 5mcg Cytomel 01919458 PFI ADEFGVW Co. Tab Orl 25mcg Cytomel 01919466 PFI ADEFGVW Co.

H03AA05 THYROID GLAND PREPARATIONS

PRÉPARATIONS POUR LA GLANDE THYROÏDE

DESICCATED THYROID EXTRAIT THYROÏDIEN LYOPHILISÉ

Tab Orl 30mg Thyroid 00023949 ERF ADEFGVW Co.


H03AA05 THYROID GLAND PREPARATIONS PRÉPARATIONS POUR LA GLANDE THYROÏDE

DESICCATED THYROID EXTRAIT THYROÏDIEN LYOPHILISÉ

Tab Orl 60mg Thyroid 00023957 ERF ADEFGVW Co. Tab Orl 125mg Thyroid 00023965 ERF ADEFGVW Co.

H03B ANTITHYROID PREPARATIONS PRÉPARATIONS ANTI-THYROÏDIENNES

H03BA THIOURACILS THIOURACILES

H03BA02 PROPYLTHIOURACIL PROPYLTHIOURACILE

Tab Orl 50mg Propyl-Thyracil 00010200 PAL ADEFGVW Co. Tab Orl 100mg Propyl-Thyracil 00010219 PAL ADEFGVW Co.

H03BB SULPHUR-CONTAINING IMIDAZOLE DERIVATIVES DÉRIVÉS DE L’IMIDAZOLE CONTENANT DU SOUFRE

H03BB02 THIAMAZOLE THIAMAZOLE

Tab Orl 5mg Tapazole 00015741 PAL ADEFGVW Co. Tab Orl 10mg Tapazole 02296039 PAL ADEFGVW Co.

H04 PANCREATIC HORMONES HORMONES PANCRÉATIQUES

H04A GLYCOGENOLYTIC HORMONES HORMONES GLYCOGÉNOLYTIQUES

H04AA GLYCOGENOLYTIC HORMONES HORMONES GLYCOGENOLYTIQUES

H04AA01 GLUCAGON GLUCAGON

Pws Inj 1mg Glucagen 02333619 NNO ADEFGVW Pds. Glucagen Hypokit 02333627 NNO ADEFGVW Glucagon 02243297 LIL ADEFGVW


H05 CALCIUM HOMEOSTASIS HOMÉOSTASIE DU CALCIUM

H05B ANTI-PARATHYROID AGENTS AGENTS ANTI-PARATHYROÏDES

H05BA CALCITONIN PREPARATIONS PRÉPARATIONS DU CALCITONINE

H05BA01 CALCITONIN (SALMON SYNTHETIC) CALCITONINE (SAUMON, SYNTHETIQUE)

Liq Inj 100U/mL Caltine (Disc/non disp Jul 25/16) 02007134 FEI ADEFGVW Liq Liq Inj 200U/mL Calcimar 01926691 SAV ADEFGVW Liq

J01 ANTIBACTERIALS FOR SYSTEMIC USE ANTIBACTÉRIENS POUR USAGE SYSTÉMIQUE

J01A TETRACYCLINES TÉTRACYCLINES

J01AA TETRACYCLINES TÉTRACYCLINES

J01AA02 DOXYCYCLINE DOXYCYCLINE

Cap Orl 100mg Vibramycin 00024368 PFI ABDEFGVW Caps Apo-Doxy 00740713 APX ABDEFGVW Doxycycline 02351234 SAS ABDEFGVW Teva-Doxycycline 00725250 TEV ABDEFGVW Tab Orl 100mg Apo-Doxy 00874256 APX ABDEFGVW Co. Doxycycline 02351242 SAS ABDEFGVW Teva-Doxycycline 02158574 TEV ABDEFGVW

J01AA07 TETRACYCLINE

TÉTRACYCLINE

Cap Orl 250mg Tetra 00580929 AAP ADEFGVW Caps

J01AA08 MINOCYCLINE

MINOCYCLINE

Cap Orl 50mg Apo-Minocycline 02084090 APX ABDEFGVW Caps Minocycline 02287226 SAS ABDEFGVW Mylan-Minocycline 02230735 MYL ABDEFGVW Teva-Minocycline 02108143 TEV ABDEFGVW pms-Minocycline 02294419 PMS ABDEFGVW Sandoz Minocycline 02237313 SDZ ABDEFGVW


J01AA08 MINOCYCLINE MINOCYCLINE

Cap Orl 100mg Apo-Minocycline 02084104 APX ABDEFGVW Caps Minocycline 02239982 IVX ABDEFGVW Minocycline 02287234 SAS ABDEFGVW Mylan-Minocycline 02230736 MYL ABDEFGVW Teva-Minocycline 02108151 TEV ABDEFGVW pms-Minocycline 02294427 PMS ABDEFGVW Sandoz Minocycline 02237314 SDZ ABDEFGVW

J01C BETA LACTAM ANTIBACTERIALS, PENICILLINS ANTIBACTÉRIEN BETA-LACTAME, PÉNICILLINES

J01CA PENICILLIN WITH EXTENDED SPECTRUMS PÉNICILLINE AVEC SPECTRUMS ÉTENDUS

J01CA01 AMPICILLIN AMPICILLINE

Cap Orl 250mg Teva-Ampicillin 00020877 TEV ADEFGVW Caps Cap Orl 500mg Teva-Ampicillin 00020885 TEV ADEFGVW Caps Pws Inj 500mg Teva-Ampicillin 00872652 TEV ADEFGW Pds. Pws Inj 1g Teva-Ampicillin 01933345 TEV ADEFGW Pds. Pws Inj 2g Ampicillin Sodium 01933353 TEV ADEFGW Pds.

J01CA04 AMOXICILLIN

AMOXICILLINE

Cap Orl 250mg Amoxicillin 02241826 NUM ABDEFGVW Caps Amoxicillin 02352710 SAS ABDEFGVW Amoxicillin 02401495 SIV ABDEFGVW Apo-Amoxi 00628115 APX ABDEFGVW Auro-Amoxicillin 02388073 ARO ABDEFGVW Mylan-Amoxicillin 02238171 MYL ABDEFGVW Novamoxin 00406724 TEV ABDEFGVW pms-Amoxicillin 02230243 PMS ABDEFGVW Cap Orl 500mg Amoxicillin 02241827 NUM ABDEFGVW Caps Amoxicillin 02352729 SAS ABDEFGVW Amoxicillin 02401509 SIV ABDEFGVW Apo-Amoxi 00628123 APX ABDEFGVW Auro-Amoxicillin 02388081 ARO ABDEFGVW Mylan-Amoxicillin 02238172 MYL ABDEFGVW Novamoxin 00406716 TEV ABDEFGVW pms-Amoxicillin 02230244 PMS ABDEFGVW


J01CA04 AMOXICILLIN AMOXICILLINE

Pws Orl 25mg Amoxicillin 02352745 SAS ABDEFGVW Pds. Amoxicillin (sugar-reduced) 02352761 SAS ABDEFGVW Apo-Amoxi 00628131 APX ABDEFGVW Novamoxin 00452149 TEV ABDEFGVW Novamoxin 125 (sugar-reduced) 01934171 TEV ABDEFGVW pms-Amoxicillin 02230245 PMS ABDEFGVW Pws Orl 50mg Amoxicillin 02352753 SAS ABDEFGVW Pds. Amoxicillin 02401541 SIV ABDEFGVW Amoxicillin (sugar-reduced) 02352788 SAS ABDEFGVW Apo-Amoxi 00628158 APX ABDEFGVW Novamoxin 00452130 TEV ABDEFGVW Novamoxin 125 (sugar-reduced) 01934163 TEV ABDEFGVW pms-Amoxicillin 02230246 PMS ABDEFGVW TabC Orl 125mg Novamoxin chew 02036347 TEV ABDEFGVW Co.C. TabC Orl 250mg Novamoxin chew 02036355 TEV ABDEFGVW Co.C.

J01CA12 PIPERACILLIN

PIPÉRACILLINE

Pws Inj 3g Piperacillin 02246641 HOS ADEFGW Pds.

J01CE BETA-LACTAMASE SENSITIVE PENICILLINS PÉNICILLINES SENSIBLES AUX BETA-LACTAMASES

J01CE01 BENZYLPENICILLIN (PENICILLIN G) BENZYLPÉNICILLINE (PÉNICILLINE G)

Liq Inj 1000000U Penicillin G Sodium 01930672 TEV ADEFGW Liq Liq Inj 5000000U Penicillin G Sodium 00883751 TEV ADEFGW Liq Liq Inj 10000000U Penicillin G Sodium 01930680 TEV ADEFGW Liq Pws Inj 1000000U Crystapen (Disc/non disp Nov 24/16) 02060086 BCH W Pds. Pws Inj 10000000U Crystapen (Disc/non disp Nov 24/16) 02060108 BCH W Pds.


J01CE02 PHENOXYMETHYLPENICILLIN (PENICILLIN V) PHENOXYMETHYLPÉNICILLINE (PÉNICILLINE V)

Pws Orl 25mg Apo-Pen VK 00642223 APX ADEFGVW Pds. Pws Orl 60mg Apo-Pen VK 00642231 APX ADEFGVW Pds. Tab Orl 300mg Pen VK 00642215 AAP ADEFGVW Co.

J01CE08 BENZATHINE BENZYLPENICILLIN (PENICILLIN G BENZATHINE)

BENZATHINE BENZYLPÉNICILLINE (PÉNICILLINE G BENZATHINE)

Sus Inj 1200000unit/2mL Bicillin L-A 02291924 KNG ADEFGVW Susp

J01CF BETA-LACTAMASE RESISTANT PENICILLINS PÉNICILLINES RÉSISTANT AUX BETA-LACTAMASE

J01CF02 CLOXACILLIN CLOXACILLINE

Cap Orl 250mg Novo-Cloxin 00337765 TEV ABDEFGVW Caps Cap Orl 500mg Novo-Cloxin 00337773 TEV ABDEFGVW Caps Pws Inj 500mg Cloxacillin Sodium 01912429 TEV ADEFGW Pds. Pws Inj 1g Cloxacillin Sodium 01975447 TEV ADEFGW Pds. Pws Inj 2g Cloxacillin Sodium 01912410 TEV ADEFGW Pds. Cloxacillin 02367424 STR W Pws Orl 25mg Novo-Cloxin 00337757 TEV ABDEFGVW Pds.

J01CR COMBINATIONS PENICILLINS INCLUDING BETA LACTAMASE INHIBITORS COMBINAISON DE PÉNICILLINES, Y COMPRIS LES INHIBITEURS DE BETA-LACTAMASE

J01CR02 AMOXICILLIN AND ENZYME INHIBITOR AMOXICILLINE ET INHIBITEURS D’ENZYMES

AMOXICILLIN / CLAVULANIC ACID AMOXICILLINE / ACIDE CLAVULANIQUE

Pws Orl 25mg/6.25mg Clavulin 01916882 GSK ABDEFGVW Pds. Apo-Amoxi Clav 02243986 APX ABDEFGVW Ratio-Aclavulanate 125 F (Disc/non disp Sept 1/17) 02244646 TEV ABDEFGVW


J01CR02 AMOXICILLIN AND ENZYME INHIBITOR AMOXICILLINE ET INHIBITEURS D’ENZYMES

AMOXICILLIN / CLAVULANIC ACID AMOXICILLINE / ACIDE CLAVULANIQUE

Pws Orl 50mg/12.5mg Clavulin-250 F 01916874 GSK ABDEFGVW Pds. Apo-Amoxi Clav 02243987 APX ABDEFGVW Ratio-Aclavulanate 250 F (Disc/non disp Sept 1/17) 02244647 TEV ABDEFGVW Pws Orl 200mg/28.5mg/5mL Clavulin 200 02238831 GSK ABDEFGVW Pds. Pws Orl 400mg/57mg/5mL Clavulin 400 02238830 GSK ABDEFGVW Pds. Apo-Amoxi Clav 02288559 APX ABDEFGVW Tab Orl 250mg/125mg Apo-Amoxi Clav 02243350 APX ABDEFGVW Co. Tab Orl 500mg/125mg Clavulin-500 F 01916858 GSK ABDEFGVW Co. Apo-Amoxi Clav 02243351 APX ABDEFGVW ratio-Aclavulanate 02243771 TEV ABDEFGVW Tab Orl 875mg/125mg Clavulin 02238829 GSK ABDEFGVW Co. Apo-Amoxi Clav 02245623 APX ABDEFGVW ratio-Aclavulanate 02247021 TEV ABDEFGVW Novo-Clavamoxin 02248138 TEV ABDEFGVW

J01CR03 TICARICILLIN AND ENZYME INHIBITOR

TICARICILLINE ET INHIBITEURS D’ENZYMES

TICARICILLIN / POTASSIUM CLAVULANATE TICARICILLINE / CLAVULANATE DE POTASSIUM

Pws Inj 3g Timentin (Disc/non disp Mar 23/17) 01916939 GSK W Pds.

J01CR05 PIPERACILLIN AND ENZYME INHIBITOR

PIPÉRACILLINE ET INHIBITEURS D’ENZYMES

PIPERACILLIN / TAZOBACTAM PIPÉRACILLINE / TAZOBACTAM

Pws Inj 2g/0.25g Tazocin (Disc/non disp Apr 24/17) 02170817 PFI ABDEFGW Pds. Piperacillin & Tazobactam 02308444 APX ABDEFGW Piperacillin & Tazobactam 02299623 SDZ ABDEFGW Pws Inj 3g/0.375g Tazocin (Disc/non disp Feb 26/17) 02170795 PFI ABDEFGW Pds. Piperacillin & Tazobactam 02308452 APX ABDEFGW Piperacillin & Tazobactam 02299631 SDZ ABDEFGW Piperacillin/Tazobactam 02370166 TEV ABDEFGW Pws Inj 4g/0.5g Tazocin (Disc/non disp Apr 24/17) 02170809 PFI ABDEFGW Pds. Piperacillin & Tazobactam 02308460 APX ABDEFGW Piperacillin & Tazobactam 02299658 SDZ ABDEFGW Piperacillin/Tazobactam 02370174 TEV ABDEFGW Piperacillin and Tazobactam 02391546 MYL ABDEFGW


J01D OTHER BETA LACTAM ANTIBACTERIALS AUTRES ANTIBACTERIEN BETA-LACTAM J01DB FIRST GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE PREMIÈRE GÉNÉRATION

J01DB01 CEPHALEXIN CÉPHALEXINE

Cap Orl 250mg Novo-Lexin 00342084 TEV ABDEFGVW Caps Cap Orl 500mg Novo-Lexin 00342114 TEV ABDEFGVW Caps Pws Orl 25mg Novo-Lexin 00342106 TEV ABDEFGVW Pds. Pws Orl 50mg Novo-Lexin 00342092 TEV ABDEFGVW Pds. Tab Orl 250mg Apo-Cephalex 00768723 APX ABDEFGVW Co. Novo-Lexin 00583413 TEV ABDEFGVW Tab Orl 500mg Apo-Cephalex 00768715 APX ABDEFGVW Co. Novo-Lexin 00583421 TEV ABDEFGVW

J01DB04 CEFAZOLIN

CÉFAZOLINE

Pws Inj 500mg Cefazolin Sodium 02108119 TEV ABDEFGVW Pds. Cefazolin Sodium 02308932 SDZ ABDEFGVW Pws Inj 1g Cefazolin 02297205 HOS ABDEFGVW Pds. Cefazolin Sodium 02108127 TEV ABDEFGVW Cefazolin Sodium 02308959 SDZ ABDEFGVW

J01DB05 CEFADROXIL

CÉFADROXIL

Cap Orl 500mg Apo-Cefadroxil 02240774 APX ADEFGVW Caps Teva-Cefadroxil 02235134 TEV ADEFGVW

J01DC SECOND GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE DEUXIÈME GÉNÉRATION

J01DC01 CEFOXITIN CÉFOXITINE

Pws Inj 1g Cefoxitin for Injection 02291711 APX W Pds. Cefoxitin Sodium 02128187 TEV W Pws Inj 2g Cefoxitin for Injection 02291738 APX W Pds. Cefoxitin Sodium 02128195 TEV W Pws Inj 10g Cefoxitin 02240773 TEV W Pds.


J01DC02 CEFUROXIME CÉFUROXIME

Liq Orl 125mg/mL Ceftin 02212307 GSK ABDEFGVW Liq Pws Inj 750mg Cefuroxime 02241638 FKB ADEFGVW Pds. Pws Inj 1.5g Cefuroxime 02241639 FKB ADEFGVW Pds. Tab Orl 250mg Ceftin 02212277 GSK ABDEFGVW Co. Apo-Cefuroxime 02244393 APX ABDEFGVW Auro-Cefuroxime 02344823 ARO ABDEFGVW ratio-Cefuroxime 02242656 TEV ABDEFGVW Tab Orl 500mg Ceftin 02212285 GSK ABDEFGVW Co. Apo-Cefuroxime 02244394 APX ABDEFGVW Auro-Cefuroxime 02344831 ARO ABDEFGVW ratio-Cefuroxime 02242657 TEV ABDEFGVW

J01DC04 CEFACLOR

CÉFACLOR

Cap Orl 250mg Ceclor 00465186 PDP ABDEFGVW Caps Cap Orl 500mg Ceclor 00465194 PDP ABDEFGVW Caps Pws Orl 25mg Ceclor 00465208 PDP ABDEFGVW Pds. Pws Orl 50mg Ceclor 00465216 PDP ABDEFGVW Pds. Pws Orl 75mg Ceclor B.I.D. 00832804 PDP ABDEFGVW Pds.

J01DC10 CEFPROZIL

CEFPROZIL

Tab Orl 250mg Cefzil 02163659 BRI ADEFGVW Co. Apo-Cefprozil 02292998 APX ADEFGVW Auro-Cefprozil 02347245 ARO ADEFGVW Ran-Cefprozil 02293528 RAN ADEFGVW Sandoz Cefprozil 02302179 SDZ ADEFGVW Tab Orl 500mg Cefzil 02163667 BRI ADEFGVW Co. Apo-Cefprozil 02293005 APX ADEFGVW Auro-Cefprozil 02347253 ARO ADEFGVW Ran-Cefprozil 02293536 RAN ADEFGVW Sandoz Cefprozil 02302187 SDZ ADEFGVW


J01DC10 CEFPROZIL CEFPROZIL

Pws Orl 25mg Cefzil 02163675 BRI ADEFGVW Pds. Apo-Cefprozil 02293943 APX ADEFGVW Auro-Cefprozil (Disc/non disp Nov 3/16) 02347261 ARO ADEFGVW Ran-Cefprozil 02329204 RAN ADEFGVW Pws Orl 50mg Cefzil 02163683 BRI ADEFGVW Pds. Apo-Cefprozil 02293951 APX ADEFGVW Auro-Cefprozil (Disc/non disp Nov 3/16) 02347288 ARO ADEFGVW Ran-Cefprozil 02293579 RAN ADEFGVW

J01DD THIRD GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE TROISIÈME GÉNÉRATION

J01DD01 CEFOTAXIME CÉFOTAXIME

Pws Inj 1g Claforan 02225093 SAV ADEFGVW Pds. Cefotaxime Sodium 02434091 STR ADEFGVW Pws Inj 2g Claforan 02225107 SAV ADEFGVW Pds. Cefotaxime Sodium 02434105 STR ADEFGVW

J01DD02 CEFTAZIDIME

CEFTAZIDIME Pws Inj 1g Fortaz 02212218 GSK ABDEFGVW Pds. Ceftazidime 00886971 FKB ABDEFGVW Pws Inj 2g Fortaz 02212226 GSK ABDEFGVW Pds. Ceftazidime 00886955 FKB ABDEFGVW

J01DD04 CEFTRIAXONE

CEFTRIAXONE Pws Inj 250mg Ceftriaxone 02292866 APX ADEFGVW Pds. Ceftriaxone Sodium 02325594 STR ADEFGVW Pws Inj 1g Ceftriaxone 02292270 SDZ ADEFGVW Pds. Ceftriaxone 02292874 APX ADEFGVW Ceftriaxone Sodium 02325616 STR ADEFGVW Ceftriaxone Sodium 02287633 TEV ADEFGVW Pws Inj 2g Ceftriaxone 02292289 SDZ ADEFGVW Pds. Ceftriaxone 02292882 APX ADEFGVW Ceftriaxone Sodium 02325624 STR ADEFGVW

J01DD08 CEFIXIME

CÉFIXIME Pws Orl 20mg Suprax 00868965 SAV ABDEFGVW Pds. Tab Orl 400mg Suprax 00868981 SAV ABDEFGVW Co. Auro-Cefixime 02432773 ARO ABDEFGVW


J01DE FOURTH GENERATION CEPHALOSPORINS CÉPHALOSPORINES DE QUATRIÈME GÉNÉRATION

J01DE01 CEFEPIME CÉFEPIME

Pws Inj 1g Maxipime (Disc/Non-Disp Jan 28/17) 02163632 BRI W Pds. Pws Inj 2g Maxipime (Disc/Non-Disp Jan 28/17) 02163640 BRI W Pds. Cefepime 02319039 APX W

J01DH CARBAPENEMS CARBAPENEMS

J01DH02 MEROPENEM MÉROPÉNEM

Pws Inj 500mg Merrem 02218488 AZE W Pds. Pws Inj 1g Merrem 02218496 AZE W Pds. Meropenem 02436507 STR W

J01DH03 ERTAPENEM

ERTAPÉNEM

Pws Inj 1g Invanz 02247437 FRS W Pds.

J01DH51 IMIPENEM AND ENZYME INHIBITOR

IMIPENEM ET INHIBITEURS D’ENZYMES

IMIPENEM / CILASTATIN IMIPÉNEM / CILASTATINE

Pws Inj 250mg Ran-Imipenem-Cilastatin 02351692 RAN W Pds. Pws Inj 500mg Primaxin 00717282 FRS W Pds. Ran-Imipenem-Cilastatin 02351706 RAN W

J01E SULFONAMIDES AND TRIMETHOPRIM SULFONAMIDES ET TRIMÉTHOPRIME

J01EA TRIMETHOPRIM AND DERIVATIVES TRIMÉTHOPRIME ET DÉRIVÉS

J01EA01 TRIMETHOPRIM TRIMÉTHOPRIME

Tab Orl 100mg Trimethoprim 02243116 AAP ADEFGVW Co. Tab Orl 200mg Trimethoprim 02243117 AAP ADEFGVW Co.


J01EE COMBINATIONS OF SULFONAMIDES AND TRIMETHOPRIM, INCLUDING DERIVATIVES COMBINAISON DE SULFONAMIDES ET DE TRIMÉTHOPRIME, INCLUANT LES DÉRIVÉS

J01EE01 SULFAMETHOXASOLE AND TRIMETHOPRIM SULFAMÉTHOXASOLE ET TRIMÉTHOPRIME

Sus Orl 8mg/40mg Teva-Trimel 00726540 TEV ABDEFGVW Susp Tab Orl 20mg/100mg Apo-Sulfatrim 00445266 APX ABDEFGVW Co. Tab Orl 80mg/400mg Apo-Sulfatrim 00445274 APX ABDEFGVW Co. Teva-Trimel 00510637 TEV ABDEFGVW Tab Orl 160mg/800mg Apo-Sulfatrim DS 00445282 APX ABDEFGVW Co. Teva-Trimel DS 00510645 TEV ABDEFGVW

J01F MACROLIDES, LINCOSAMIDES AND STREPTOGRAMINS MACROLIDES, LINCOSAMIDES ET STREPTOGRAMINES

J01FA MACROLIDES MACROLIDES

J01FA01 ERYTHROMYCIN ÉRYTHROMYCINE

ECC Orl 250mg Eryc 00607142 PFI ABDEFGVW Caps.Ent Erythro E-C (Disc/non disp Nov 7/16) 00726672 AAP ABDEFGVW ECC Orl 333mg Eryc 00873454 PFI ABDEFGVW Caps.Ent Erythro E-C (Disc/non disp Nov 7/16) 01925938 AAP ABDEFGVW Tab Orl 250mg Erythro 00682020 AAP ABDEFGVW Co. Liq Orl 250mg/5mL Novo-Rythro Estolate 00262595 TEV ABDEFGVW Liq Pws Orl 40mg Novo-Rythro 00605859 TEV ABDEFGVW Pds. Pws Orl 80mg Novo-Rythro 00652318 TEV ABDEFGVW Pds. Tab Orl 600mg Erythro-ES 00637416 AAP ABDEFGVW Co. Tab Orl 250mg Erythro-S 00545678 AAP ABDEFGVW Co. Tab Orl 500mg Erythro-S 00688568 AAP ABDEFGVW Co.


J01FA02 SPIRAMYCIN SPIRAMYCINE

Cap Orl 750000IU Rovamycine 250 01927825 ODN ADEFGVW Caps Cap Orl 1500000IU Rovamycine 500 01927817 ODN ADEFGVW Caps

J01FA09 CLARITHROMYCIN

CLARITHROMYCINE

ERT Orl 500mg Biaxin XL 02244756 ABB ABDEFGVW Co.L.P. Act Clarithromycin XL 02403196 ATV ABDEFGVW Apo-Clarithromycin XL 02413345 APX ABDEFGVW Pws Orl 125mg/5mL Biaxin 02146908 ABB ABDEFGVW Pds. Accel-Clarithromycin 02390442 ACC ABDEFGVW Clarithromycin 02408988 SAS ABDEFGVW Pws Orl 250mg/5mL Biaxin 02244641 ABB ABDEFGVW Pds. Accel-Clarithromycin 02390450 ACC ABDEFGVW Clarithromycin 02408996 SAS ABDEFGVW Tab Orl 250mg Biaxin BID 01984853 ABB ABDEFGVW Co. Apo-Clarithromycin 02274744 APX ABDEFGVW Mylan-Clarithromycin 02248856 MYL ABDEFGVW pms-Clarithromycin 02247573 PMS ABDEFGVW Ran-Clarithromycin 02361426 RAN ABDEFGVW Sandoz Clarithromycin 02266539 SDZ ABDEFGVW Teva-Clarithromycin 02248804 TEV ABDEFGVW Tab Orl 500mg Biaxin BID 02126710 ABB ABDEFGVW Co. Apo-Clarithromycin 02274752 APX ABDEFGVW Mylan-Clarithromycin 02248857 MYL ABDEFGVW pms-Clarithromycin 02247574 PMS ABDEFGVW Ran-Clarithromycin 02361434 RAN ABDEFGVW Sandoz Clarithromycin 02266547 SDZ ABDEFGVW Teva-Clarithromycin 02248805 TEV ABDEFGVW

J01FA10 AZITHROMYCIN

AZITHROMYCINE

Pws Inj 500mg Zithromax 02239952 PFI ADEFGVW Pds. Azithromycin 02385473 MYL ADEFGVW Pws Orl 100mg/5mL Zithromax 02223716 PFI ABDEFGVW Pds. Azithromycin 02274388 PMS ABDEFGVW GD-Azithromycin 02274566 GMD ABDEFGVW Novo-Azithromycin pediatric 02315157 TEV ABDEFGVW Phl-Azithromycin 02282380 PHL ABDEFGVW pms-Azithromycin 02418452 PMS ABDEFGVW Sandoz Azithromycin 02332388 SDZ ABDEFGVW


J01FA10 AZITHROMYCIN AZITHROMYCINE

Pws Orl 200mg/5mL Zithromax 02223724 PFI ABDEFGVW Pds. Azithromycin 02274396 PMS ABDEFGVW GD-Azithromycin 02274574 GMD ABDEFGVW Novo-Azithromycin pediatric 02315165 TEV ABDEFGVW Phl-Azithromycin 02282410 PHL ABDEFGVW pms-Azithromycin 02418460 PMS ABDEFGVW Sandoz Azithromycin 02332396 SDZ ABDEFGVW Tab Orl 250mg Zithromax 02212021 PFI ABDEFGVW Co. Act Azithromycin 02255340 ATV ABDEFGVW Apo-Azithromycin 02247423 APX ABDEFGVW Apo-Azithromycin Z 02415542 APX ABDEFGVW Azithromycin 02330881 SAS ABDEFGVW GD-Azithromycin 02274531 GMD ABDEFGVW Mylan-Azithromycin 02278359 MYL ABDEFGVW Novo-Azithromycin 02267845 TEV ABDEFGVW pms-Azithromycin 02261634 PMS ABDEFGVW ratio-Azithromycin (Disc/non disp Sept 19/16) 02275287 RPH ABDEFGVW Sandoz Azithromycin 02265826 SDZ ABDEFGVW Tab Orl 600mg Zithromax (Disc/non disp Feb 4/16) 02231143 PFI W (SA) Co. Act Azithromycin 02256088 ATV W (SA) Azithromycin (Disc/non disp Aug 1/16) 02330911 SAS W (SA) pms-Azithromycin 02261642 PMS W (SA)

J01FF LINCOSAMIDES LINCOSAMIDES

J01FF01 CLINDAMYCIN CLINDAMYCINE

Cap Orl 150mg Dalacin C 00030570 PFI ABDEFGVW Caps Apo-Clindamycin 02245232 APX ABDEFGVW Mylan-Clindamycin 02258331 MYL ABDEFGVW Teva-Clindamycin 02241709 TEV ABDEFGVW Cap Orl 300mg Dalacin C 02182866 PFI ABDEFGVW Caps Apo-Clindamycin 02245233 APX ABDEFGVW Mylan-Clindamycin 02258358 MYL ABDEFGVW Teva-Clindamycin 02241710 TEV ABDEFGVW Liq Inj 150mg/mL Dalacin C Phosphate 00260436 PFI ADEFGW Liq Clindamycin (bulk vials) 02230535 SDZ ADEFGW Clindamycin (2mL, 4mL, 6mL vials) 02230540 SDZ ADEFGW Pws Orl 75mg/5mL Dalacin C 00225851 PFI ABDEFGVW Pds.


J01G AMINOGLYCOSIDE ANTIBACTERIALS ANTIBACTÉRIENS AMINOGLYCOSIDES

J01GB OTHER AMINOGLYCOSIDES AUTRES AMINOGLYCOSIDES

J01GB01 TOBRAMYCIN TOBRAMYCINE

Liq Inh 300mg/5mL Tobi 02239630 NVR (SA)

Liq Liq Inj 40mg/mL Tobramycin (PF) 02241210 SDZ ABDEFGVW Liq Liq Inj 40mg/mL Tobramycin 02241210 SDZ ABDEFGVW Liq Tobramycin 02382814 MYL ABDEFGVW

J01GB03 GENTAMICIN

GENTAMICINE

Liq Inj 40mg/mL Gentamicin 02242652 SDZ ADEFGVW Liq

J01GB06 AMIKACIN

AMIKACINE

Liq Inj 250mg/mL Amikacin 02242971 SDZ W Liq

J01M QUINOLONE ANTIBACTERIALS ANTIBACTÉRIENS QUINOLONES

J01MA FLUOROQUINOLONES FLUOROQUINOLONES

J01MA01 OFLOXACIN OFLOXACINE

Tab Orl 200mg Ofloxacin (Disc/non disp Aug 26/17) 02231529 AAP ADEFGVW Co. Tab Orl 300mg Ofloxacin (Disc/non disp Aug 26/17) 02231531 AAP ADEFGVW Co. Tab Orl 400mg Ofloxacin (Disc/non disp Aug 26/17) 02231532 AAP ADEFGVW Co.

J01MA02 CIPROFLOXACIN

CIPROFLOXACINE

ERT Orl 1000mg Cipro XL 02251787 BAY (SA)

Co.L.P. Liq Inj 2mg/mL Ciprofloxacin I.V. 02267462 TEV W Liq


J01MA02 CIPROFLOXACIN CIPROFLOXACINE

Liq Orl 10g/100mL Cipro Oral Suspension 02237514 BAY (SA)

Liq Tab Orl 250mg Cipro 02155958 BAY BW (SA)

Co. Act Ciprofloxacin 02247339 ATV BW (SA)

Apo-Ciproflox 02229521 APX BW (SA)

Auro-Ciprofloxacin 02381907 ARO BW (SA)

Ciprofloxacin 02353318 SAS BW (SA)

Ciprofloxacin 02386119 SIV BW (SA)

Jamp-Ciprofloxacin 02380358 JPC BW (SA)

Mar-Ciprofloxacin 02379686 MAR BW (SA)

Mint-Ciprofloxacin 02317427 MNT BW (SA)

Mint-Ciproflox 02423553 MNT BW (SA)

Mylan-Ciprofloxacin 02245647 MYL BW (SA)

Teva-Ciprofloxacin 02161737 TEV BW (SA)

pms-Ciprofloxacin 02248437 PMS BW (SA)

Ran-Ciproflox 02303728 RAN BW (SA)

ratio-Ciprofloxacin (Disc/non disp Nov 29/15) 02246825 TEV BW (SA)

Sandoz Ciprofloxacin 02248756 SDZ BW (SA)

Septa-Ciprofloxacin 02379627 SPT BW (SA)

Tab Orl 500mg Cipro 02155966 BAY BW (SA)





Ciprofloxacin 02386127 SIV BW (SA)




Mint-Ciproflox 02423561 MNT BW (SA)


Teva-Ciprofloxacin 02161745 TEV BW (SA)






J01MA02 CIPROFLOXACIN CIPROFLOXACINE

Tab Orl 750mg Cipro 02155974 BAY BW (SA)









Novo-Ciprofloxacin 02161753 TEV BW (SA)



ratio-Ciprofloxacin (Disc/non disp Nov 29/15) 02246827 TEV BW (SA)



J01MA06 NORFLOXACIN

NORFLOXACINE

Tab Orl 400mg Apo-Norflox 02229524 APX ADEFVW Co. Co Norfloxacin 02269627 COB ADEFVW Teva-Norfloxacin 02237682 TEV ADEFVW

pms-Norfloxacin (Disc/non disp Oct 29/15) 02246596 PMS ADEFVW

J01MA12 LEVOFLOXACIN LÉVOFLOXACINE

Liq Inj 5mg/mL Levaquin (Disc/non disp Mar 19/16) 02236839 JAN W Liq Levofloxacin 02314932 HOS W Tab Orl 250mg Levaquin (Disc/non disp Oct 27/16) 02236841 JAN VW (SA)

Co. Act Levofloxacin 02315424 ATV VW (SA)

Apo-Levofloxacin 02284707 APX VW (SA)

Mylan-Levofloxacin 02313979 MYL VW (SA)

Teva-Levofloxacin 02248262 TEV VW (SA)

pms-Levofloxacin 02284677 PMS VW (SA)

Sandoz Levofloxacin 02298635 SDZ VW (SA)

Tab Orl 500mg Levaquin (Disc/non disp Apr 1/17) 02236842 JAN VW (SA)

Co. Act Levofloxacin 02315432 ATV VW (SA)

Apo-Levofloxacin 02284715 APX VW (SA)

Mylan-Levofloxacin 02313987 MYL VW (SA)

Teva-Levofloxacin 02248263 TEV VW (SA)

pms-Levofloxacin 02284685 PMS VW (SA)

Sandoz Levofloxacin 02298643 SDZ VW (SA)


J01MA12 LEVOFLOXACIN LÉVOFLOXACINE

Tab Orl 750mg Levaquin (Disc/non disp Apr 1/17) 02246804 JAN W Co. Act Levofloxacin 02315440 ATV W Apo-Levofloxacin 02325942 APX W Teva-Levofloxacin 02285649 TEV W pms-Levofloxacin 02305585 PMS W Sandoz Levofloxacin 02298651 SDZ W

J01MA14 MOXIFLOXACIN

MOXIFLOXACINE

Liq Inj 400mg/250mL Avelox I.V. 02246414 BAY W Liq Tab Orl 400mg Avelox 02242965 BAY VW (SA)

Co.

J01X OTHER ANTIBACTERIALS AUTRES ANTIBACTÉRIENS

J01XA GLYCOPEPTIDE ANTIBACTERIALS ANTIBACTÉRIENS GLYCOPEPTIDES

J01XA01 VANCOMYCIN VANCOMYCINE

Cap Orl 125mg Vancocin 00800430 MRS ADEFGVW Caps Jamp-Vancomycin 02407744 JPC ADEFGVW Vancomycin Hydrochloride 02377470 FKB ADEFGVW Cap Orl 250mg Vancocin 00788716 MRS ADEFGVW Caps Jamp-Vancomycin 02407752 JPC ADEFGVW Vancomycin Hydrochloride 02377489 FKB ADEFGVW Pws Inj 500mg pms-Vancomycin(Disc/non disp Mar 23/17) 02241820 PMS ABDEFGVW Pds. Sterile Vancomycin 02230191 HOS ABDEFGVW Sterile Vancomycin HCL 02139375 FKB ABDEFGVW Val-Vancomycin 02342855 VLN ABDEFGVW Vancomycin 02394626 SDZ ABDEFGVW Vancomycin 02407914 MYL ABDEFGVW Pws Inj 1g pms-Vancomycin(Disc/non disp Mar 23/17) 02241821 PMS ABDEFGVW Pds. Val-Vancomycin 02342863 VLN ABDEFGVW Vancomycin 02394634 SDZ ABDEFGVW Vancomycin HCL 02139383 FKB ABDEFGVW Vancomycin 02407922 MYL ABDEFGVW


J01XD IMIDAZOLE DERIVATIVES DÉRIVÉS DE L’IMIDAZOLE

J01XD01 METRONIDAZOLE MÉTRONIDAZOLE

Liq Inj 5mg/mL Metronidazole 00649074 HOS W Liq Metronidazole 00870420 BAX W Tab Orl 250mg Metronidazole 00545066 AAP ADEFGVW Co.

J01XE NITROFURAN DERIVATIVES DÉRIVÉS DU NITROFURANE

J01XE01 NITROFURANTOIN NITROFURANTOÏNE

Cap Orl 50mg Teva-Furantoin 02231015 TEV ADEFGVW Caps Cap Orl 100mg Macrobid 02063662 WNC ADEFGVW Caps Tab Orl 50mg Nitrofurantoin 00319511 AAP ADEFGVW Co. Tab Orl 100mg Nitrofurantoin 00312738 AAP ADEFGVW Co.

J01XX OTHER ANTIBACTERIALS AUTRES ANTIBACTÉRIENS

J01XX01 FOSFOMYCIN FOSFOMYCINE

Pws Orl 3g Monurol 02240335 PAL (SA) Pds.

J01XX05 METHENAMINE

MÉTHÉNAMINE

Tab Orl 500mg Mandelamine 00499013 ERF ADEFGVW Co.

J01XX08 LINEZOLID

LINÉZOLIDE

Tab Orl 600mg Zyvoxam 02243684 PFI (SA) Co. Apo-Linezolid 02426552 APX (SA) Sandoz Linezolid 02422689 SDZ (SA)


J02 ANTIMYCOTICS FOR SYSTEMIC USE ANTIMYCOTIQUES POUR USAGE SYSTÉMIQUE

J02A ANTIMYCOTICS FOR SYSTEMIC USE ANTIMYCOTIQUES POUR USAGE SYSTÉMIQUE

J02AA ANTIBIOTICS ANTIBIOTIQUES

J02AA01 AMPHOTERICIN B AMPHOTÉRICINE B

Pws Inj 50mg Fungizone IV 00029149 BRI W Pds.

J02AB IMIDAZOLE DERIVATIVES DÉRIVÉS DE L’IMIDAZOLE

J02AB02 KETOCONAZOLE KÉTOCONAZOLE

Tab Orl 200mg Apo-Ketoconazole 02237235 APX ADEFGVW Co. Novo-Ketoconazole 02231061 TEV ADEFGVW

J02AC TRIAZOLE DERIVATIVES DÉRIVÉS DE TRIAZOLE

J02AC01 FLUCONAZOLE FLUCONAZOLE

Cap Orl 150mg Diflucan 02141442 CHC ADEFGVW Caps Apo-Fluconazole 02241895 APX ADEFGVW Jamp-Fluconazole 02432471 JPC ADEFGVW pms-Fluconazole 02282348 PMS ADEFGVW Liq Inj 2mg/mL Diflucan 00891835 PFI W Liq Tab Orl 50mg Act Fluconazole 02281260 ATV ADEFGVW Co. Apo-Fluconazole 02237370 APX ADEFGVW Mylan-Fluconazole 02245292 MYL ADEFGVW Novo-Fluconazole 02236978 TEV ADEFGVW pms-Fluconazole 02245643 PMS ADEFGVW Tab Orl 100mg Act Fluconazole 02281279 ATV ADEFGVW Co. Apo-Fluconazole 02237371 APX ADEFGVW Mylan-Fluconazole 02245293 MYL ADEFGVW Novo-Fluconazole 02236979 TEV ADEFGVW pms-Fluconazole 02245644 PMS ADEFGVW

J02AC02 ITRACONAZOLE

ITRACONAZOLE

Cap Orl 100mg Sporanox 02047454 JAN (SA) Caps


J02AC03 VORICONAZOLE VORICONAZOLE

Tab Orl 50mg Vfend 02256460 PFI (SA) Co. Apo-Voriconazole 02409674 APX (SA) Sandoz Voriconazole 02399245 SDZ (SA) Teva-Voriconazole 02396866 TEV (SA) Tab Orl 200mg Vfend 02256479 PFI (SA) Co. Apo-Voriconazole 02409682 APX (SA) Sandoz Voriconazole 02399253 SDZ (SA) Teva-Voriconazole 02396874 TEV (SA)

J02AX ANTIMYCOTICS FOR SYSTEMIC USE ANTIMYCOTIQUES POUR USAGE SYSTÉMIQUE

J02AX04 CASPOFUNGIN CASPOFUNGIN

Pwd Inj 50mg Cancidas IV 02244265 FRS W Pws.

J04 ANTIMYCOBACTERIALS ANTIFONGIQUES BACTÉRIENS

J04A DRUGS FOR TREATMENT OF TUBERCULOSIS MÉDICAMENTS POUR LE TRAITEMENT DE LA TUBERCULOSE

J04AB ANTIBIOTICS ANTIBIOTIQUES

J04AB02 RIFAMPICIN RIFAMPICINE

Cap Orl 150mg Rifadin 02091887 SAV ADEFGPVW Caps Rofact 00393444 VLN ADEFGPVW Cap Orl 300mg Rifadin 02092808 SAV ADEFGPVW Caps Rofact 00343617 VLN ADEFGPVW

J04AB04 RIFABUTIN

RIFABUTINE

Cap Orl 150mg Mycobutin 02063786 PFI (SA) Caps

J04AC HYDRAZIDES HYDRAZIDES

J04AC01 ISONIAZID ISONIAZIDE

Tab Orl 300mg pdp-Isoniazid 00577804 PDP P Co. Syr Orl 10mg/mL pdp-Isoniazid 00577812 PDP P Sir.

http://www.whocc.no/atc_ddd_index/?code=J02AX


J04AK OTHER DRUGS FOR TREATMENT OF TUBERCULOSIS AUTRE MÉDICAMENTS POUR LE TRAITEMENT DE LA TUBERCULOSE

J04AK01 PYRAZINAMIDE PYRAZINAMIDE

Tab Orl 500mg pdp-Pyrazinamde 00618810 PDP P Co.

J04AK02 ETHAMBUTOL

ÉTHAMBUTOL

Tab Orl 100mg Etibi 00247960 VLN P Co. Tab Orl 400mg Etibi 00247979 VLN P Co.

J04AM COMBINATIONS OF DRUGS FOR TREATMENT OF TUBERCULOSIS COMBINAISON DE MÉDICAMENTS POUR LE TRAITEMENT DE LA TUBERCULOSE

J04AM02 RIFAMPICIN AND ISONIAZID RIFAMPICINE ET ISONIAZIDE

RIFAMPIN / ISONIAZID / PYRAZINAMIDE RIFAMPINE / ISONIAZIDE / PYRAZINAMIDE

Tab Orl 120mg/50mg/300mg Rifater 02148625 SAV P Co.

J04B DRUGS FOR TREATMENT OF LEPRA MÉDICAMENTS POUR LE TRAITEMENT DE LA LÈPRE

J04BA DRUGS FOR TREATMENT OF LEPRA MÉDICAMENTS POUR LE TRAITEMENT DE LA LEPRE

J04BA02 DAPSONE DAPSONE

Tab Orl 100mg Dapsone 02041510 JCB ADEFGVW Co.

J05 ANTIVIRALS FOR SYSTEMIC USE ANTIVIRAUX SYSTÉMIQUES

J05A DIRECT ACTING ANTIVIRALS AGENTS AGISSANT DIRECTEMENT SUR LE VIRUS

J05AB NUCLEOSIDES AND NUCLEOTIDES EXCLUDING REVERSE TRANSCRIPTASE INHIBITORS NUCLÉOSIDES ET NUCLÉOTIDES, À L’EXCLUSION DES INHIBITEURS LA TRANSCRIPTASE INVERSÉE

J05AB01 ACYCLOVIR ACYCLOVIR

Tab Orl 200mg Zovirax 00634506 GSK ADEFGVW Co. Acyclovir (Disc/non dips Aug 1/16) 02286556 SAS ADEFGVW Apo-Acyclovir 02207621 APX ADEFGVW Mylan-Acyclovir 02242784 MYL ADEFGVW ratio-Acyclovir 02078627 TEV ADEFGVW Teva-Acyclovir 02285959 TEV ADEFGVW


J05AB01 ACYCLOVIR ACYCLOVIR

Tab Orl 400mg Zovirax (Disc/non disp Feb 20/16) 01911627 GSK ADEFGVW Co. Acyclovir 02286564 SAS ADEFGVW Apo-Acyclovir 02207648 APX ADEFGVW Mylan-Acyclovir 02242463 MYL ADEFGVW ratio-Acyclovir (Disc/non disp Nov.29/15) 02078635 TEV ADEFGVW Teva-Acyclovir 02285967 TEV ADEFGVW Tab Orl 800mg Acyclovir (Disc/non disp Aug 1/16) 02286572 SAS ADEFGVW Co. Apo-Acyclovir 02207656 APX ADEFGVW Mylan-Acyclovir 02242464 MYL ADEFGVW Teva-Acyclovir 02285975 TEV ADEFGVW Liq Inj 25mg/mL Acyclovir Sodium 02236916 HOS ADEFGW Liq Liq Inj 50mg/mL Acyclovir Sodium 02236926 FKB ADEFGW Liq

J05AB04 RIBAVIRIN

RIBAVIRINE

Tab Orl 400mg Ibavyr 02425890 PDP (SA) Co. Tab Orl 600mg Ibavyr 02425904 PDP (SA) Co.

J05AB06 GANCICLOVIR

GANCICLOVIR

Pws Inj 500mg Cytovene 02162695 HLR ADEFGVW Pds.

J05AB09 FAMCICLOVIR

FAMCICLOVIR

Tab Orl 125mg Famvir 02229110 NVR ADEFGVW Co. Act Famciclovir 02305682 ATV ADEFGVW Apo-Famciclovir 02292025 APX ADEFGVW pms-Famciclovir 02278081 PMS ADEFGVW Sandoz Famciclovir 02278634 SDZ ADEFGVW Tab Orl 250mg Famvir 02229129 NVR ADEFGVW Co. Act Famciclovir 02305690 ATV ADEFGVW Apo-Famciclovir 02292041 APX ADEFGVW pms-Famciclovir 02278103 PMS ADEFGVW Sandoz Famciclovir 02278642 SDZ ADEFGVW


J05AB09 FAMCICLOVIR FAMCICLOVIR

Tab Orl 500mg Famvir 02177102 NVR ADEFGVW Co. Act Famciclovir 02305704 ATV ADEFGVW Apo-Famciclovir 02292068 APX ADEFGVW pms-Famciclovir 02278111 PMS ADEFGVW Sandoz Famciclovir 02278650 SDZ ADEFGVW

J05AB11 VALACYCLOVIR

VALACYCLOVIR

Tab Orl 500mg Valtrex 02219492 GSK ADEFGVW Co. Apo-Valacyclovir (Disc/non disp Jun 01/16) 02295822 APX ADEFGVW Auro-Valacyclovir (Disc/non disp Jun 20/16) 02405040 ARO ADEFGVW Co Valacyclovir (Disc/non disp Jun 1/16) 02331748 COB ADEFGVW Mylan-Valacyclovir (Disc/non disp May 16/16) 02351579 MYL ADEFGVW pms-Valacyclovir (Disc/non disp Jun 1/16) 02298457 PMS ADEFGVW Teva-Valacyclovir (Disc/non disp May 31/16) 02357534 TEV ADEFGVW

J05AB14 VALGANCICLOVIR

VALGANCYCLOVIR

Pws Orl 50mg/mL Valcyte 02306085 HLR (SA) Pds. Tab Orl 450mg Valcyte 02245777 HLR (SA) Co. Apo-Valganciclovir 02393824 APX (SA) Teva-Valganciclovir 02413825 TEV (SA)

J05AE PROTEASE INHIBITORS INHIBITEURS DE PROTÉASE

J05AE01 SAQUINAVIR SAQUINAVIR

Cap Orl 200mg Invirase 02216965 HLR DU Caps Tab Orl 500mg Invirase 02279320 HLR DU Co.

J05AE02 INDINAVIR

INDINAVIR

Cap Orl 200mg Crixivan (Disc/non disp Sep 19/16) 02229161 FRS DU Caps Cap Orl 400mg Crixivan 02229196 FRS DU Caps

J05AE03 RITONAVIR

RITONAVIR

Tab Orl 100mg Norvir 02357593 ABV DU Co.


J05AE04 NELFINAVIR NELFINAVIR

Tab Orl 250mg Viracept 02238617 VIV DU Co. Tab Orl 625mg Viracept 02248761 VIV DU Co.

J05AE07 FOSAMPRENAVIR

FOSAMPRÉNAVIR

Sus Orl 50mg/mL Telzir 02261553 VIV DU Susp Tab Orl 700mg Telzir 02261545 VIV DU Co.

J05AE08 ATAZANAVIR

ATAZANAVIR

Cap Orl 150mg Reyataz 02248610 BRI DU Caps Cap Orl 200mg Reyataz 02248611 BRI DU Caps Cap Orl 300mg Reyataz 02294176 BRI DU Caps

J05AE09 TIPRANAVIR

TIPRANAVIR

Cap Orl 250mg Aptivus 02273322 BOE (SA) Caps

J05AE10 DARUNAVIR

DARUNAVIR

Tab Orl 75mg Prezista 02338432 JAN DU Co. Tab Orl 150mg Prezista 02369753 JAN DU Co. Tab Orl 400mg Prezista (Disc/non disp Mar 26/17) 02324016 JAN DU Co. Tab Orl 600mg Prezista 02324024 JAN DU Co. Tab Orl 800mg Prezista 02393050 JAN DU Co.


J05AE11 TELAPREVIR TÉLAPRÉVIR

Tab Orl 375mg Incivek (Disc/non disp Jan 1/17) 02371553 VTX (SA) Co.

J05AE12 BOCEPREVIR

BOCÉPRÉVIR

Cap Orl 200mg Victrelis (Disc/non disp Mar 31/18) 02370816 FRS (SA) Caps

J05AE14 SIMEPREVIR

SIMÉPRÉVIR

Cap Orl 150mg Galexos 02416441 JAN (SA) Caps

J05AE30 COMBINATIONS OF PROTEASE INHIBITORS

COMBINAISONS D’INHIBITEURS DE PROTÉASE

LOPINAVIR / RITONAVIR LOPINAVIR / RITONAVIR

Liq Orl 80mg/20mg/mL Kaletra Oral Solution 02243644 ABV DU Liq Tab Orl 100mg/25mg Kaletra 02312301 ABV DU Co. Tab Orl 200mg/50mg Kaletra Tab 02285533 ABB DU Co.

J05AF NUCLEOSIDE AND NUCLEOTIDE REVERSE TRANSCRIPTASE INHIBITORS INHIBITEURS NUCLÉOSIDIQUES ET NUCLÉOTIDIQUES DE LA TRANSCRIPTASE

J05AF01 ZIDOVUDINE ZIDOVUDINE

Cap Orl 100mg Retrovir 01902660 VIV DU Caps Apo-Zidovudine 01946323 APX DU Liq Inj 10mg/mL Retrovir 01902644 VIV DU Liq Syr Orl 50mg/5mL Retrovir 01902652 VIV DU Sir.

J05AF02 DIDANOSINE

DIDANOSINE

ECC Orl 125mg Videx EC 02244596 BRI DU Caps.Ent. ECC Orl 200mg Videx EC 02244597 BRI DU Caps.Ent


J05AF02 DIDANOSINE DIDANOSINE

ECC Orl 250mg Videx EC 02244598 BRI DU Caps.Ent ECC Orl 400mg Videx EC 02244599 BRI DU Caps.Ent

J05AF04 STAVUDINE

STAVUDINE

Cap Orl 15mg Zerit 02216086 BRI DU Caps Cap Orl 20mg Zerit 02216094 BRI DU Caps Cap Orl 30mg Zerit 02216108 BRI DU Caps Cap Orl 40mg Zerit 02216116 BRI DU Caps

J05AF05 LAMIVUDINE

LAMIVUDINE

Liq Orl 5mg/mL Heptovir 02239194 GSK ADEFGVW Liq Liq Orl 10mg/mL 3TC 02192691 VIV DU Liq Tab Orl 100mg Heptovir 02239193 GSK ADEFGVW Co. Apo-Lamivudine HBV 02393239 APX ADEFGVW Tab Orl 150mg 3TC 02192683 VIV DU Co. Apo-Lamivudine 02369052 APX DU Tab Orl 300mg 3TC 02247825 VIV DU Co. Apo-Lamivudine 02369060 APX DU

J05AF06 ABACAVIR

ABACAVIR

Liq Orl 20mg/mL Ziagen 02240358 VIV DU Liq Tab Orl 300mg Ziagen 02240357 VIV DU Co.


J05AF07 TENOFOVIR TÉNOFOVIR

Tab Orl 300mg Viread 02247128 GIL (SA) Co.

J05AF08 ADEFOVIR DIPIVOXIL

ADÉFOVIR DIPIVOXIL

Tab Orl 10mg Hepsera 02247823 GIL (SA) Co. Apo-Adefovir 02420333 APX (SA)

J05AF10 ENTECAVIR

ENTÉCAVIR

Tab Orl 0.5mg Baraclude 02282224 BRI (SA) Co. Apo-Entecavir 02396955 APX (SA) Pms-Entecavir 02430576 PMS (SA)

J05AG NON-NUCLEOSIDES REVERSE TRANSCRIPTASE INHIBITORS INHIBITEURS NON NUCLÉOSIDIQUES DE LA TRANSCRIPTASE INVERSÉE

J05AG01 NEVIRAPINE NÉVIRAPINE

ERT Orl 400mg Viramune XR 02367289 BOE DU Co.L.P. Tab Orl 200mg Viramune 02238748 BOE DU Co. Auro-Nevirapine 02318601 ARO DU Mylan-Nevirapine 02387727 MYL DU pms-Nevirapine 02405776 PMS DU Teva-Nevirapine 02352893 TEV DU

J05AG03 EFAVIRENZ

ÉFAVIRENZ

Cap Orl 50mg Sustiva 02239886 BRI DU Caps Cap Orl 200mg Sustiva 02239888 BRI DU Caps Tab Orl 600mg Sustiva 02246045 BRI DU Co. Auro-Efavirenz 02418428 ARO DU Mylan-Efavirenz 02381524 MYL DU Teva-Efavirenz 02389762 TEV DU

J05AG04 ETRAVIRINE

ÉTRAVIRINE

Tab Orl 100mg Intelence 02306778 JAN (SA) Co. Tab Orl 200mg Intelence 02375931 JAN (SA) Co.


J05AG05 RILPIVIRINE RILPIVIRINE

Tab Orl 25mg Edurant 02370603 JAN DU Co.

J05AH NEURAMINIDASE INHIBITORS INHIBITEURS DE LA NEURAMINIDASE

J05AH01 ZANAMIVIR ZANAMIVIR

Pwr Inh 5mg Relenza 02240863 GSK (SA) Pd.

J05AH02 OSELTAMIVIR

OSELTAMIVIR

Cap Orl 30mg Tamiflu 02304848 HLR (SA) Caps Cap Orl 45mg Tamiflu 02304856 HLR (SA) Caps Cap Orl 75mg Tamiflu 02241472 HLR (SA) Caps

J05AR ANTIVIRALS FOR TREATMENT OF HIV INFECTIONS, COMBINATIONS ANTIVIRAUX POUR LE TRAITEMENT DES INFECTIONS AU VIH, COMBINAISONS

J05AR01 LAMIVUDINE AND ZIDOVUDINE LAMIVUDINE ET ZIDOVUDINE

Tab Orl 300mg/150mg Combivir 02239213 VIV DU Co. Apo-Lamivudine/Zidovudine 02375540 APX DU Teva-Lamivudine/Zidovudine 02387247 TEV DU

J05AR02 LAMIVUDINE AND ABACAVIR

LAMIVUDINE ET ABACAVIR

Tab Orl 600mg/300mg Kivexa 02269341 VIV DU Co.

J05AR03 TENOFOVIR DISOPROXIL AND EMTRICITABINE

TÉNOFOVIR DISOPROXIL ET EMTRICITABINE

Tab Orl 300mg/200mg Truvada 02274906 GIL DU Co.

J05AR04 ZIDOVUDINE, LAMIVUDINE AND ABACAVIR

ZIDOVUDINE, LAMIVUDINE ET ABACAVIR

Tab Orl 300mg/150mg/300mg Trizivir 02244757 VIV DU Co.


J05AR06 EMTRICITABINE, TENOFOVIR DISOPROXIL AND EFAVIRENZ EMTRICITABINE, TÉNOFOVIR DISOPROXIL ET ÉFAVIRENZ

Tab Orl 600mg/300mg/200mg Atripla 02300699 GIL DU Co.

J05AR08 EMTRICITABINE, TENOFOVIR DISOPROXIL AND RILPIVIRINE

EMTRICITABINE, TÉNOFOVIR DISOPROXIL ET RILPIVIRINE

Tab Orl 25mg/200mg/300mg Complera 02374129 GIL DU Co.

J05AR09 EMTRICITABINE, TENOFOVIR DISOPROXIL, ELVITEGRAVIR AND COBICSTAT

EMTRICITABINE, TÉNOFOVIR DISOPROXIL, ELVITEGRAVIR ET COBICISTAT

Tab Orl 150mg/150mg/200mg/300mg Stribild 02397137 GIL (SA) Co.

J05AR13 LAMIVUDINE, ABACAVIR AND DOLUTEGRAVIR

LAMIVUDINE, ABACAVIR ET DOLUTÉGRAVIR

Tab Orl 300mg/600mg0mg Triumeq 02430932 VIV DU Co.

J05AX OTHER ANTIVIRALS AUTRES ANTIVIRAUX

J05AX08 RALTEGRAVIR RALTÉGRAVIR

Tab Orl 400mg Isentress 02301881 FRS DU Co.

J05AX09 MARAVIROC

MARAVIROC

Tab Orl 150mg Celsentri 02299844 VIV (SA) Co. Tab Orl 300mg Celsentri 02299852 VIV (SA) Co.

J05AX12 DOLUTEGRAVIR

DOLUTÉGRAVIR

Tab Orl 50mg Tivicay 02414945 VIV DU Co.

J05AX15 SOFOSBUVIR

SOFOSBUVIR

Tab Orl 400mg Sovaldi 02418355 GIL (SA) Co.


J05AX65 SOFOSBUVIR AND LEDIPASVIR SOFOSBUVIR ET LÉDIPASVIR

Tab Orl 400mg/90mg Harvoni 02432226 GIL (SA) Co.

J05AX66 DASABUVIR, OMBITASVIR, PARITAPREVIR AND RITONAVIR

DASABUVIR, OMBITASVIR, PARITAPRÉVIR ET RITONAVIR

Tab Orl 250mg + 12.5mg/75mg/50mg Holkira Pak 02436027 ABV (SA) Co.

L01 ANTINEOPLASTIC AGENTS AGENTS ANTINÉOPLASIQUES

L01A ALKYLATING AGENTS AGENTS ALKYLANTS

L01AA NITROGEN MUSTARD ANALOGUES ANALOGUES, MOUTARDE AZOTÉE

L01AA01 CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE

Tab Orl 25mg Procytox 02241795 BAX ADEFGVW Co. Tab Orl 50mg Procytox 02241796 BAX ADEFGVW Co.

L01AA02 CHLORAMBUCIL

CHLORAMBUCIL

Tab Orl 2mg Leukeran 00004626 APR ADEFGVW Co.

L01AA03 MELPHALAN

MELPHALAN

Tab Orl 2mg Alkeran 00004715 APR ADEFGVW Co.

L01AB ALKYL SULPHONATES SULFONATES D’ALKYLE

L01AB01 BUSULFAN BUSULFAN

Tab Orl 2mg Myleran 00004618 APR ADEFGVW Co.

L01AD NITROSOUREAS NITROSURÉES

L01AD02 LOMUSTINE LOMUSTINE

Cap Orl 10mg CeeNU 00360430 BRI ADEFGVW Caps.


L01AD02 LOMUSTINE LOMUSTINE

Cap Orl 40mg CeeNU 00360422 BRI ADEFGVW Caps. Cap Orl 100mg CeeNU 00360414 BRI ADEFGVW Caps.

L01AX OTHER ALKYLATING AGENTS AUTRES AGENTS ALKYLANTS

L01AX03 TEMOZOLOMIDE TÉMOZOLOMIDE

Cap Orl 5mg Temodal 02241093 FRS (SA) Caps Cap Orl 20mg Temodal 02241094 FRS (SA) Caps Co Temozolomide 02395274 COB (SA) Cap Orl 100mg Temodal 02241095 FRS (SA) Caps Co Temozolomide 02395282 COB (SA) Cap Orl 140mg Temodal 02312794 FRS (SA) Caps Co Temozolomide 02395290 COB (SA) Cap Orl 250mg Temodal 02241096 FRS (SA) Caps Co Temozolomide 02395312 COB (SA)

L01B ANTIMETABOLITES ANTIMÉTABOLITES

L01BA FOLIC ACID ANALOGUES ANALOGUES DE L’ACIDE FOLIQUE

L01BA01 METHOTREXATE MÉTHOTREXATE

Liq IM 7.5mg/0.75mL Metoject 02320029 MDX ADEFGVW Liq Liq IM 10mg/mL Metoject 02320037 MDX ADEFGVW Liq

Liq IM 15mg/1.5mL Metoject 02320045 MDX ADEFGVW Liq

Liq IM 20mg/2mL Metoject 02304767 MDX ADEFGVW Liq

Liq IM 25mg/2.5mL Metoject 02320053 MDX ADEFGVW Liq Liq Inj 10mg/mL Methotrexate Inj USP 02182947 HOS ADEFGVW Liq


L01BA01 METHOTREXATE MÉTHOTREXATE

Liq Inj 25mg/mL Methotrexate Inj USP 02099705 TEV ADEFGVW Liq Methotrexate Inj USP 02182777 HOS ADEFGVW Methotrexate Inj USP 02182955 HOS ADEFGVW Tab Orl 2.5mg Methotrexate 02170698 PFI ADEFGVW Co. Methotrexate 02182963 APX ADEFGVW Ratio-Methotrexate 02244798 TEV ADEFGVW Tab Orl 10mg Methotrexate 02182750 HOS ADEFGVW Co.

L01BB PURINE ANALOGUES ANALOGUES PURINE

L01BB02 MERCAPTOPURINE MERCAPTOPURINE

Tab Orl 50mg Purinethol 00004723 TEV ADEFGVW Co. Mercaptopurine 02415275 STR ADEFGVW

L01BB03 TIOGUANINE

TIOGUANINE

Tab Orl 40mg Lanvis 00282081 APR ADEFGVW Co.

L01BB05 FLUDARABINE

FLUDARABINE

Tab Orl 10mg Fludara 02246226 SAV (SA) Co.

L01BC PYRIMIDINE ANALOGUES ANALOGUES PYRIMIDIQUES

L01BC02 FLUOROURACIL FLUOROURACILE

Crm Top 5% Efudex 00330582 VLN ADEFGVW Cr.

L01BC06 CAPECITABINE

CAPÉCITABINE

Tab Orl 150mg Xeloda 02238453 HLR (SA) Co. Ach-Capecitabine 02426757 AHI (SA) Sandoz Capecitabine 02421917 SDZ (SA) Teva-Capecitabine 02400022 TEV (SA) Tab Orl 500mg Xeloda 02238454 HLR (SA) Co. Ach-Capecitabine 02426765 AHI (SA) Sandoz Capecitabine 02421925 SDZ (SA) Teva-Capecitabine 02400030 TEV (SA)


L01C PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS ALCALOIDES DE PLANTES ET AUTRES PRODUITS NATURELS

L01CB PODOPHYLLOTOXIN DERIVATIVES DÉRIVÉS DE LA PODOPHYLLOTOXINE

L01CB01 ETOPOSIDE ÉTOPOSIDE

Cap Orl 50mg Vepesid 00616192 BRI ADEFGVW Caps

L01X OTHER ANTINEOPLASTIC AGENTS AUTRES AGENTS ANTINÉOPLASIQUES

L01XB METHYLHYDRAZINES MÉTHYLHYDRAZINES

L01XB01 PROCARBAZINE PROCARBAZINE

Cap Orl 50mg Matulane 00012750 QGT ADEFGVW Caps

L01XC MONOCLONAL ANTIBODIES ANTICORPS MONOCLONAUX

L01XC02 RITUXIMAB RITUXIMAB

Liq IV 10mg/mL Rituxan 02241927 HLR (SA) Liq

L01XE PROTEIN KINASE INHIBITORS INHIBITEURS DE PROTÉINE KINASE

L01XE01 IMATINIB IMATINIB

Cap Orl 100mg Gleevec 02253275 NVR (SA) Caps Act Imatinib 02397285 ATV (SA) Apo-Imatinib 02355337 APX (SA) pms-Imatinib 02431114 PMS (SA) Teva-Imatinib 02399806 TEV (SA) Tab Orl 400mg Gleevec 02253283 NVR (SA) Co. Act Imatinib 02397293 ATV (SA) Apo-Imatinib 02355345 APX (SA) pms-Imatinib 02431122 PMS (SA) Teva-Imatinib 02399814 TEV (SA)

L01XE03 ERLOTINIB

ERLOTINIB Tab Orl 25mg Tarceva 02269007 HLR (SA) Co. Teva-Erlotinib 02377691 TEV (SA) Tab Orl 100mg Tarceva 02269015 HLR (SA) Co. Teva-Erlotinib 02377705 TEV (SA)


L01XE03 ERLOTINIB ERLOTINIB

Tab Orl 150mg Tarceva 02269023 HLR (SA) Co. Teva-Erlotinib 02377713 TEV (SA)

L01XE04 SUNITINIB

SUNITINIB

Cap Orl 12.5mg Sutent 02280795 PFI (SA) Caps Cap Orl 25mg Sutent 02280809 PFI (SA) Caps Cap Orl 50mg Sutent 02280817 PFI (SA) Caps

L01XE05 SORAFENIB

SORAFENIB

Tab Orl 200mg Nexavar 02284227 BAY (SA) Co.

L01XE06 DASATINIB

DASATINIB

Tab Orl 20mg Sprycel 02293129 BRI (SA) Co. Tab Orl 50mg Sprycel 02293137 BRI (SA) Co. Tab Orl 70mg Sprycel 02293145 BRI (SA) Co. Tab Orl 80mg Sprycel 02360810 BRI (SA) Co. Tab Orl 100mg Sprycel 02320193 BRI (SA) Co. Tab Orl 140mg Sprycel 02360829 BRI (SA) Co.

L01XE07 LAPATINIB

LAPATINIB

Tab Orl 250mg Tykerb 02326442 NVR (SA) Co.


L01XE08 NILOTINIB NILOTINIB

Cap Orl 150mg Tasigna 02368250 NVR (SA) Caps Cap Orl 200mg Tasigna 02315874 NVR (SA) Caps

L01XE11 PAZOPANIB

PAZOPANIB

Tab Orl 200mg Votrient 02352303 NVR (SA) Co.

L01XE13 AFATINIB

AFATINIB

Tab Orl 20mg Giotrif 02415666 BOE (SA) Co. Tab Orl 30mg Giotrif 02415674 BOE (SA) Co. Tab Orl 40mg Giotrif 02415682 BOE (SA) Co.

L01XE15 VEMURAFENIB

VÉMURAFENIB

Tab Orl 240mg Zelboraf 02380242 HLR (SA) Co.

L01XE16 CRIZOTINIB

CRIZOTINIB

Cap Orl 200mg Xalkori 02384256 PFI (SA) Caps Cap Orl 250mg Xalkori 02384264 PFI (SA) Caps

L01XE17 AXITINIB

AXITINIB

Tab Orl 1mg Inlyta 02389630 PFI (SA) Co. Tab Orl 5mg Inlyta 02389649 PFI (SA) Co.

L01XE18 RUXOLITINIB

RUXOLITINIB

Tab Orl 5mg Jakavi 02388006 NVR (SA) Co.


L01XE18 RUXOLITINIB RUXOLITINIB

Tab Orl 15mg Jakavi 02388014 NVR (SA) Co. Tab Orl 20mg Jakavi 02388022 NVR (SA) Co.

L01XE21 REGORAFENIB

RÉGORAFENIB

Tab Orl 150mg Stivarga 02403390 BAY (SA) Co.

L01XE23 DABRAFENIB

DABRAFÉNIB

Cap Orl 50mg Tafinlar 02409607 NVR (SA) Caps Cap Orl 75mg Tafinlar 02409615 NVR (SA) Caps

L01XE25 TRAMETINIB

TRAMÉTINIB

Tab Orl 0.5mg Mekinist 02409623 NVR (SA) Co. Tab Orl 2mg Mekinist 02409658 NVR (SA) Co.

L01XE27 IBRUTINIB

IBRUTINIB

Cap Orl 140mg Imbruvica 02434407 JAN (SA) Caps

L01XX OTHER ANTINEOPLASTIC AGENTS AUTRES AGENTS ANTINÉOPLASIQUES

L01XX05 HYDROXYCARBAMIDE (HYDROXYUREA) HYDROXYCARBAMIDE (HYDROXYURÉE)

Cap Orl 500mg Hydrea 00465283 BRI ADEFGVW Caps Hydroxyurea 02343096 SAS ADEFGVW Mylan-Hydroxyurea 02242920 MYL ADEFGVW

L01XX11 ESTRAMUSTINE

ESTRAMUSTINE

Cap Orl 140mg Emcyt 02063794 PFI ADEFGVW Caps


L01XX14 TRETINOIN TRÉTINOÏNE

Cap Orl 10mg Vesanoid 02145839 XPI (SA) Caps

L01XX35 ANAGRELIDE

ANAGRÉLIDE

Cap Orl 0.5mg Agrylin 02236859 SHB ADEFGVW Caps Mylan-Anagrelide(Disc/non disp Nov 12/16) 02253054 MYL ADEFGVW pms-Anagrelide 02274949 PMS ADEFGVW Sandoz Anagrelide 02260107 SDZ ADEFGVW

L01XX43 VISMODEGIB

VISMODEGIB

Cap Orl 150mg Erivedge 02409267 HLR (SA) Caps

L02 ENDOCRINE THERAPY TRAITEMENT ENDOCRINIEN

L02A HORMONES AND RELATED AGENTS HORMONES ET AGENTS APPARENTÉS

L02AB PROGESTOGENS PROGESTOGÉNES

L02AB01 MEGESTROL MÉGESTROL

Sus Orl 40mg/mL Megace OS 02168979 BRI ADEFGVW Susp Tab Orl 40mg Megestrol 02195917 AAP ADEFGVW Co. Tab Orl 160mg Megestrol 02195925 AAP ADEFGVW Co.

L02AE GONADOTROPHIN RELEASING HORMONE ANALOGUES ANALOGUES DE L’HORMONE LIBÉRANT DE LA GONADOTROPHINE

L02AE01 BUSERELIN BUSÉRÉLINE

Asp Nas 1mg Suprefact 02225158 SAV AVW (SA) Asp Imp Inj 6.3mg Suprefact Depot 02228955 SAV ADEFVW Imp Imp Inj 9.45mg Suprefact Depot 02240749 SAV ADEFVW Imp


L02AE02 LEUPRORELIN LEUPRORÉLINE

Liq Inj 5mg Lupron 00727695 ABB AVW (SA) Liq Pws Inj 3.75mg Lupron Depot 00884502 ABB ADEFVW Pds. Pws Inj 7.5mg Lupron Depot 00836273 ABB ADEFVW Pds. Pws Inj 11.25mg Lupron Depot 02239834 ABB ADEFVW Pds. Pws Inj 22.5mg Lupron Depot 02230248 ABB ADEFVW Pds. Pws Inj 30mg Lupron Depot 02239833 ABB ADEFVW Pds. Sus Inj 22.5mg Eligard 02248240 SAV ADEFVW Susp Sus Inj 45mg Eligard 02268892 SAV ADEFVW Susp

L02AE03 GOSERELIN

GOSÉRÉLINE

Imp Inj 3.6mg Zoladex 02049325 AZE ADEFVW Imp Imp Inj 10.8mg Zoladex LA 02225905 AZE ADEFVW Imp

L02AE04 TRIPTORELIN

TRIPTORÉLINE

Pws Inj 3.75mg Trelstar 02240000 ASP ADEFVW Pds. Pws Inj 11.25mg Trelstar 02243856 ASP ADEFVW Pds. Pws Inj 22.5mg Trelstar 02412322 ASP ADEFVW Pds.


L02B HORMONE ANTAGONISTS AND RELATED AGENTS ANTAGONISTES D’HORMONES ET AGENTS CONNEXES

L02BA ANTI-ESTROGENS ANTI-OESTROGÈNES

L02BA01 TAMOXIFEN TAMOXIFÈNE

Tab Orl 10mg Apo-Tamox 00812404 APX ADEFGVW Co. Mylan-Tamoxifen 02088428 MYL ADEFGVW Teva-Tamoxifen 00851965 TEV ADEFGVW Tab Orl 20mg Nolvadex-d 02048485 AZE ADEFGVW Co. Apo-Tamox 00812390 APX ADEFGVW Mylan-Tamoxifen 02089858 MYL ADEFGVW Teva-Tamoxifen 00851973 TEV ADEFGVW

L02BB ANTI-ANDROGENS ANTI-ANDROGÉNES

L02BB01 FLUTAMIDE FLUTAMIDE

Tab Orl 250mg Euflex (Disc/non disp Jun 1/17) 00637726 FRS ADEFVW Co. Apo-Flutamide 02238560 APX ADEFVW pms-Flutamide 02230104 PMS ADEFVW Teva-Flutamide (Disc/non disp Oct 27/16) 02230089 TEV ADEFVW

L02BB02 NILUTAMIDE

NILUTAMIDE

Tab Orl 50mg Anandron 02221861 SAV ADEFVW Co.

L02BB03 BICALUTAMIDE

BICALUTAMIDE

Tab Orl 50mg Casodex 02184478 AZE ADEFVW Co. Act Bicalutamide 02274337 ATV ADEFVW Apo-Bicalutamide 02296063 APX ADEFVW Bicalutamide 02325985 AHI ADEFVW Bicalutamide 02382423 SIV ADEFVW Jamp-Bicalutamide 02357216 JPC ADEFVW Mylan-Bicalutamide (Disc/non disp Sept 14/17) 02302403 MYL ADEFVW Teva-Bicalutamide 02270226 TEV ADEFVW pms-Bicalutamide 02275589 PMS ADEFVW Ran-Bicalutamide 02371324 RAN ADEFVW Sandoz Bicalutamide 02276089 SDZ ADEFVW

L02BB04 ENZALUTAMIDE

ENZALUTAMIDE

Cap Orl 40mg Xtandi 02407329 ASL (SA) Caps


L02BG AROMATASE INHIBITORS INHIBITEURS AROMATASES

L02BG03 ANASTROZOLE ANASTROZOLE

Tab Orl 1mg Arimidex 02224135 AZE ADEFVW Co. Act Anastrozole 02394898 ATV ADEFVW Anastrozole 02351218 AHI ADEFVW Apo-Anastrozole 02374420 APX ADEFVW Auro-Anastrozole 02404990 ARO ADEFVW Jamp-Anastrozole 02339080 JPC ADEFVW Mar-Anastrozole 02379562 MAR ADEFVW Med-Anastrozole 02379104 GMP ADEFVW Mint-Anastrozole 02393573 MNT ADEFVW Mylan-Anastrozole 02361418 MYL ADEFVW Nat-Anastrozole 02417855 NAT ADEFVW pms-Anastrozole 02320738 PMS ADEFVW Ran-Anastrozole 02328690 RAN ADEFVW Taro-Anastrozole 02365650 TAR ADEFVW Teva-Anastrozole (Disc/non disp Sept 19/16) 02313049 TEV ADEFVW Sandoz Anastrozole 02338467 SDZ ADEFVW Zinda-Anastrozole 02326035 MCK ADEFVW

L02BG04 LETROZOLE

LÉTROZOLE

Tab Orl 2.5mg Femara 02231384 NVR ADEFVW Co. Apo-Letrozole 02358514 APX ADEFVW Auro-Letrozole 02404400 ARO ADEFVW Jamp-Letrozole 02373009 JPC ADEFVW Letrozole 02348969 COB ADEFVW Letrozole tablets usp 02338459 AHI ADEFVW Mar-Letrozole 02373424 MAR ADEFVW Med-Letrozole 02322315 GMP ADEFVW Myl-Letrozole 02372169 MYL ADEFVW Nat-Letrozole 02421585 NAT ADEFVW pms-Letrozole 02309114 PMS ADEFVW Ran-Letrozole 02372282 RAN ADEFVW Sandoz Letrozole 02344815 SDZ ADEFVW Teva-Letrozole 02343657 TEV ADEFVW Zinda-Letrozole 02378213 MCK ADEFVW

L02BG06 EXEMESTANE

EXÉMESTANE

Tab Orl 25mg Aromasin 02242705 PFI ADEFVW Co. Act Exemestane 02390183 ATV ADEFVW Apo-Exemestane 02419726 APX ADEFVW Med-Exemestane 02407841 GMP ADEFVW Teva-Exemestane 02408473 TEV ADEFVW


L02BX OTHER HORMONE ANTAGONISTS AND RELATED AGENTS AUTRES ANTAGONISTES D’HORMONES ET AGENTS CONNEXES

L02BX02 DEGARELIX DEGARELIX

Pws Inj 80mg/vial Firmagon 02337029 FEI ADEF+18VW Pds. Pws Inj 120mg/vial Firmagon 02337037 FEI ADEF+18VW Pds.

L02BX03 ABIRATERONE

ABIRATERONE

Tab Orl 250mg Zytiga 02371065 JAN (SA) Co.

L03 IMMUNOSTIMULANTS IMMUNOSTIMULANTS

L03A IMMUNOSTIMULANTS IMMUNOSTIMULANTS

L03AA COLONY STIMULATING FACTORS FACTEURS DE CROISSANCE DES GLOBULES BLANCS

L03AA02 FILGRASTIM FILGRASTIM

Liq Inj 300mcg/mL Neupogen 01968017 AGA W (SA) Liq Neupogen (1.6 mL size only) 00999001 AGA W (SA)

L03AA13 PEGFILGRASTIM

PEGFILGRASTIM Liq Inj 6mg Neulasta pre-filled syringe 02249790 AGA (SA) Liq

L03AB INTERFERONS INTERFÉRONS

L03AB05 INTERFERON ALFA-2B INTERFÉRON ALFA-2B

Liq Inj 6000000IU/mL Intron A 02238674 SCH ADEFGVW Liq Liq Inj 10000000IU/mL Intron A 02223406 SCH ADEFGVW Liq Intron A 02238675 SCH ADEFGVW Liq Inj 15000000IU/mL Intron A 02240693 SCH ADEFGVW Liq Liq Inj 25000000IU/mL Intron A 02240694 FRS ADEFGVW Liq Liq Inj 50000000IU/mL Intron A 02240695 SCH ADEFGVW Liq


L03AB07 INTERFERON BETA-1A INTERFÉRON BÊTA-1A

Liq Inj 22mcg/0.5mL Rebif 02237319 EMD H (SA)

Liq

Liq Inj 44mcg/0.5mL Rebif 02237320 EMD H (SA)

Liq

Liq Inj 66mcg/1.5mL Rebif Cartridge 02318253 EMD H (SA)

Liq

Liq Inj 132mcg/1.5mL Rebif Cartridge 02318261 EMD H (SA)

Liq Liq Inj 30mcg/0.5mL Avonex PS 02269201 BIG H (SA)

Liq L03AB08 INTERFERON BETA-1B

INTERFÉRON BÊTA-1B

Liq Inj 0.3mg Betaseron 02169649 BAY H (SA)

Liq Extavia 02337819 NVR H (SA)

L03AB11 PEGINTERFERON ALFA-2A

PEGINTERFÉRON ALFA-2A

Liq SC 180mcg/0.5mL Pegasys pre-filled syringe 02248077 HLR (SA) Liq Pegasys ProClick (Autoinjector) 02248077 HLR (SA)

L03AB60 PEGINTERFERON ALFA-2B, COMBINATIONS

PEGINTERFÉRON ALFA-2B, COMBINAISONS

PEGINTERFERON ALFA-2B / RIBAVIRIN PEGINTERFÉRON ALFA-2B / RIBAVIRINE

Kit SC 50mcg/0.5mL + 200mg Pegetron Clearclick 02254573 SCH (SA) Tro Pegetron (Disc/non disp Apr 29/17) 02246026 SCH (SA) Kit SC 80mcg/0.5mL + 200mg Pegetron Clearclick 02254581 SCH (SA) Tro Kit SC 100mcg/0.5mL + 200mg Pegetron Clearclick 02254603 SCH (SA) Tro Kit SC 120mcg/0.5mL + 200mg Pegetron Clearclick 02254638 SCH (SA) Tro Kit SC 150mcg/0.5mL + 200mg Pegetron 02246030 SCH (SA) Tro Pegetron Clearclick 02254646 SCH (SA)

PEGINTERFERON ALFA-2B / RIBAVIRIN / BOCEPREVIR PEGINTERFÉRON ALFA-2B / RIBAVIRINE / BOCÉPRÉVIR

Kit Inj 80mcg/0.5mg + 200mg + 200mg Victrelis Triple 02371448 FRS (SA) Tro (Disc/non disp Mar 31/18)


L03AB60 PEGINTERFERON ALFA-2B, COMBINATIONS PEGINTERFÉRON ALFA-2B, COMBINAISONS

PEGINTERFERON ALFA-2B / RIBAVIRIN / BOCEPREVIR PEGINTERFÉRON ALFA-2B / RIBAVIRINE / BOCÉPRÉVIR

Kit Inj 100mcg/0.5mg + 200mg +200mg Victrelis Triple 02371456 FRS (SA) Tro (Disc/non disp Mar 31/18) Kit Inj 120mcg/0.5mg + 200mg + 200mg Victrelis Triple 02371464 FRS (SA) Tro (Disc/non disp Mar 31/18) Kit Inj 150mcg/0.5mg + 200mg + 200mg Victrelis Triple 02371472 FRS (SA) Tro (Disc/non disp Mar 31/18)

L03AB61 PEGINTERFERON ALFA-2A, COMBINATIONS

PEGINTERFÉRON ALFA-2A, COMBINAISONS

PEGINTERFERON ALFA-2A / RIBAVIRIN PEGINTERFÉRON ALFA-2A / RIBAVIRINE

Kit SC 180mcg/0.5mL + 200mg Pegasys RBV 02253429 HLR (SA) Tro Pegasys RBV (ProClick Autoinjector) 02253429 HLR (SA)

L03AX OTHER IMMUNOSTIMULANTS

AUTRES IMMUNOSTIMULANTS

L03AX13 GLATIRAMER ACETATE GLATIRAMÈRE ACÉTATE

Liq Inj 20mg/mL Copaxone 02245619 SAV H (SA)

Liq L03AX16 PLERIXAFOR

PLÉRIXAFOR

Liq Inj 24mg/1.2mL Mozobil 02377225 SAV (SA) Liq

L04 IMMUNOSUPPRESSANTS AGENTS IMMUNOSUPPRESSEURS

L04A IMMUNOSUPPRESSANTS AGENTS IMMUNOSUPPRESSEURS

L04AA SELECTIVE IMMUNOSUPPRESSANTS IMMUNOSUPPRESSEURS SÉLECTIFS

L04AA06 MYCOPHENOLIC ACID ACIDE MYCOPHÉNOLIQUE

Cap Orl 250mg Cellcept 02192748 HLR ADEFGRV Caps Apo-Mycophenolate 02352559 APX ADEFGRV Jamp-Mycophenolate 02386399 JPC ADEFGRV Mycophenolate Mofetil 02383780 AHI ADEFGRV Mylan-Mycophenolate 02371154 MYL ADEFGRV Novo-Mycophenolate 02364883 TEV ADEFGRV Sandoz Mycophenolate 02320630 SDZ ADEFGRV


L04AA06 MYCOPHENOLIC ACID ACIDE MYCOPHÉNOLIQUE

Tab Orl 500mg Cellcept 02237484 HLR ADEFGRV Co. Apo-Mycophenolate 02348675 APX ADEFGRV Co Mycophenolate (Disc/non disp Jan 31/16) 02379996 COB ADEFGRV Jamp-Mycophenolate 02380382 JPC ADEFGRV Mycophenolate Mofetil 02378574 AHI ADEFGRV Mylan-Mycophenolate 02370549 MYL ADEFGRV Novo-Mycophenolate 02352567 TEV ADEFGRV Sandoz Mycophenolate 02313855 SDZ ADEFGRV ECT Orl 180mg Myfortic 02264560 NVR ADEFGRV Co.Ent Apo-Mycophenolic Acid 02372738 APX ADEFGRV ECT Orl 360mg Myfortic 02264579 NVR ADEFGRV Co.Ent Apo-Mycophenolic Acid 02372746 APX ADEFGRV

L04AA10 SIROLIMUS

SIROLIMUS

Liq Orl 1mg/mL Rapamune 02243237 PFI ADEFGRV Liq Tab Orl 1mg Rapamune 02247111 PFI ADEFGRV Co.

L04AA13 LEFLUNOMIDE

LÉFLUNOMIDE

Tab Orl 10mg Arava 02241888 SAV ADEFGVW Co. Apo-Leflunomide 02256495 APX ADEFGVW Leflunomide 02351668 SAS ADEFGVW Mylan-Leflunomide 02319225 MYL ADEFGVW Novo-Leflunomide 02261251 TEV ADEFGVW pms-Leflunomide 02288265 PMS ADEFGVW Sandoz Leflunomide 02283964 SDZ ADEFGVW Tab Orl 20mg Arava 02241889 SAV ADEFGVW Co. Apo-Leflunomide 02256509 APX ADEFGVW Leflunomide 02351676 SAS ADEFGVW Mylan-Leflunomide 02319233 MYL ADEFGVW Novo-Leflunomide 02261278 TEV ADEFGVW pms-Leflunomide 02288273 PMS ADEFGVW Sandoz Leflunomide 02283972 SDZ ADEFGVW

L04AA18 EVEROLIMUS

ÉVÉROLIMUS

Tab Orl 2.5mg Afinitor 02369257 NVR (SA) Co. Tab Orl 5mg Afinitor 02339501 NVR (SA) Co.


L04AA18 EVEROLIMUS ÉVÉROLIMUS

Tab Orl 10mg Afinitor 02339528 NVR (SA) Co.

L04AA23 NATALIZUMAB

NATALIZUMAB

Liq IV 300mg/15mL Tysabri 02286386 BIG (SA) Liq

L04AA24 ABATACEPT

ABATACEPT

Liq SC 125mg Orencia 02402475 BRI (SA) Liq Pws IV 250mg Orencia 02282097 BRI (SA) Pds.

L04AA25 ECULIZUMAB

ÉCULIZUMAB

Liq IV 10mg/mL Soliris 02322285 ALX (SA) Liq

L04AA27 FINGOLIMOD

FINGOLIMOD

Cap Orl 0.5mg Gilenya 02365480 NVR (SA) Caps

L04AA31 TERIFLUNOMIDE

TÉRIFLUNOMIDE

Tab Orl 14mg Aubagio 02416328 GZM (SA) Co.

L04AB TUMOR NECROSIS FACTOR ALPHA (TNF-A) INHIBITORS INHIBITEURS DU FACTEUR DE NÉCROSE TUMORALE ALPHA (TNF-A)

L04AB01 ETANERCEPT ÉTANERCEPT

Pws SC 25mg/mL Enbrel 02242903 AGA W (SA) Pds. Liq SC 50mg/mL Enbrel 02274728 AGA W (SA) Liq

L04AB02 INFLIXIMAB

INFLIXIMAB

Pws IV 100mg Remicade 02244016 JAN (SA) Pds.


L04AB04 ADALIMUMAB ADALIMUMAB

Liq SC 40mg/0.8mL Humira pre-filled syringe 02258595 ABV (SA) Liq

L04AB06 GOLIMUMAB

GOLIMUMAB

Liq SC 50mg/0.5mL Simponi autoInjector 02324784 JAN (SA) Liq Simponi pre-filled syringe 02324776 JAN (SA)

L04AC INTERLEUKIN INHIBITORS INHIBITEURS DES INTERLEUKINES

L04AC05 USTEKINUMAB USTEKINUMAB

Liq SC 45mg/0.5mL Stelara 02320673 JAN (SA) Liq Liq SC 90mg/mL Stelara 02320681 JAN (SA) Liq

L04AC07 TOCILIZUMAB

TOCILIZUMAB

Liq IV 80mg/4mL Actemra 02350092 HLR (SA) Liq Liq IV 200mg/10mL Actemra 02350106 HLR (SA) Liq Liq IV 400mg/20mL Actemra 02350114 HLR (SA) Liq

L04AD CALCINEURIN INHIBITORS INHIBITEURS DE LA CALCINEURINE

L04AD01 CYCLOSPORINE CYCLOSPORINE

Cap Orl 10mg Neoral 02237671 NVR AEFGRVW Caps Cap Orl 25mg Neoral 02150689 NVR AEFGRVW Caps Sandoz Cyclosporine 02247073 SDZ ADEFGRVW Cap Orl 50mg Neoral 02150662 NVR AEFGRVW Caps Sandoz Cyclosporine 02247074 SDZ ADEFGRVW Cap Orl 100mg Neoral 02150670 NVR AEFGRVW Caps Sandoz Cyclosporine 02242821 SDZ ADEFGRVW Liq Orl 100mg/mL Neoral 02150697 NVR AEFGRVW Liq Apo-Cyclosporine 02244324 APX ADEFGRVW


L04AD02 TACROLIMUS TACROLIMUS

Cap Orl 0.5mg Prograf 02243144 ASL ADEFGRV Caps Sandoz Tacrolimus 02416816 SDZ ADEFGRV Cap Orl 1mg Prograf 02175991 ASL ADEFGRV Caps Sandoz Tacrolimus 02416824 SDZ ADEFGRV Cap Orl 5mg Prograf 02175983 ASL ADEFGRV Caps Sandoz Tacrolimus 02416832 SDZ ADEFGRV ERC Orl 0.5mg Advagraf 02296462 ASL ADEFGRV Caps.L.P. ERC Orl 1mg Advagraf 02296470 ASL ADEFGRV Caps.L.P. ERC Orl 3mg Advagraf 02331667 ASL ADEFGRV Caps.L.P. ERC Orl 5mg Advagraf 02296489 ASL ADEFGRV Caps.L.P.

L04AX OTHER IMMUNOSUPPRESSANTS AUTRES AGENTS IMMUNOSUPPRESSEURS

L04AX01 AZATHIOPRINE AZATHIOPRINE

Tab Orl 50mg Imuran 00004596 APR ADEFGVW Co. Apo-Azathioprine 02242907 APX ADEFGVW Azathioprine 02343002 SAS ADEFGVW Mylan-Azathioprine 02231491 MYL ADEFGVW Teva-Azathioprine 02236819 TEV ADEFGVW

L04AX04 LENALIDOMIDE

LÉNALIDOMIDE

Cap Orl 5mg Revlimid 02304899 CEL (SA) Caps Cap Orl 10mg Revlimid 02304902 CEL (SA) Caps Cap Orl 15mg Revlimid 02317699 CEL (SA) Caps Cap Orl 25mg Revlimid 02317710 CEL (SA) Caps


L04AX05 PIRFENIDONE PIRFÉNIDONE

Cap Orl 267mg Esbriet 02393751 HLR (SA) Caps

L04AX06 POMALIDOMIDE

POMALIDOMIDE

Cap Orl 1mg Pomalyst 02419580 CEL (SA) Caps Cap Orl 2mg Pomalyst 02419599 CEL (SA) Caps Cap Orl 3mg Pomalyst 02419602 CEL (SA) Caps Cap Orl 4mg Pomalyst 02419610 CEL (SA) Caps

M01 ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS ANTI-INFLAMMATOIRES ET ANTIRHUMATISMAUX

M01A ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS ANTI-INFLAMMATOIRES ET ANTIRHUMATISMAUX, NON STÉROIDÏENS

M01AB ACETIC ACID DERIVATIVES AND RELATED SUBSTANCES ACIDE ACÉTIQUE ET SUBSTANCES APPARENTÉES

M01AB01 INDOMETHACIN INDOMÉTHACINE

Cap Orl 25mg Teva-Indomethacin 00337420 TEV ADEFGVW Caps Cap Orl 50mg Teva-Indomethacin 00337439 TEV ADEFGVW Caps Sup Rt 50mg Sab-Indomethacin 02231799 SDZ ADEFGVW Supp. Sup Rt 100mg Ratio-Indomethacin 01934139 TEV ADEFGVW Supp. Sab-Indomethacin 02231800 SDZ ADEFGVW

M01AB02 SULINDAC

SULINDAC

Tab Orl 150mg Apo-Sulin (Disc/non disp Oct 9/16) 00778354 APX ADEFGVW Co. Teva-Sundac 00745588 TEV ADEFGVW Tab Orl 200mg Apo-Sulin (Disc/non disp Oct 9/16) 00778362 APX ADEFGVW Co. Teva-Sundac 00745596 TEV ADEFGVW


M01AB05 DICLOFENAC DICLOFÉNAC

ECT Orl 25mg Teva-Difenac 00808539 TEV ADEFGVW Co.Ent Apo-Diclo 00839175 APX ADEFGVW pms-Diclofenac 02302616 PMS ADEFGVW Sandoz Diclofenac 02261952 SDZ ADEFGVW ECT Orl 50mg Voltaren 00514012 NVR ADEFGVW Co.Ent Apo-Diclo 00839183 APX ADEFGVW Diclofenac EC 02352397 SAS ADEFGVW pms-Diclofenac 02302624 PMS ADEFGVW Sandoz Diclofenac 02261960 SDZ ADEFGVW Teva-Difenac 00808547 TEV ADEFGVW SRT Orl 75mg Voltaren SR 00782459 NVR ADEFGVW Co.L.L. Apo-Diclo SR 02162814 APX ADEFGVW Diclofenac SR 02352400 SAS ADEFGVW pms-Diclofenac SR 02231504 PMS ADEFGVW Sandoz Diclofenac SR 02261901 SDZ ADEFGVW Teva-Difenac SR 02158582 TEV ADEFGVW SRT Orl 100mg Voltaren SR 00590827 NVR ADEFGVW Co.L.L. Apo-Diclo SR 02091194 APX ADEFGVW pms-Diclofenac SR 02231505 PMS ADEFGVW Sandoz Diclofenac SR 02261944 SDZ ADEFGVW Teva-Difenac SR 02048698 TEV ADEFGVW Sup Rt 50mg Voltaren 00632724 NVR ADEFGVW Supp. Pms-Difenac 02231506 PMS ADEFGVW Sandoz Diclofenac 02261928 SDZ ADEFGVW Sup Rt 100mg Voltaren 00632732 NVR ADEFGVW Supp. Pms-Difenac 02231508 PMS ADEFGVW Sandoz Diclofenac 02261936 SDZ ADEFGVW

M01AB15 KETOROLAC

KÉTOROLAC

Liq Inj 10mg Toradol 02162644 HLR W Liq Tab Orl 10mg Toradol 02162660 HLR W Co. Ketorolac 02229080 AAP W

M01AB55 DICLOFENAC COMBINATIONS

DICLOFÉNAC, EN COMBINAISON

DICLOFENAC / MISOPROSTOL DICLOFÉNAC / MISOPROSTOL

Tab Orl 50mg/200mcg Arthrotec 01917056 PFI ADEFGVW Co. Act Diclo-Miso 02397145 ATV ADEFGVW GD-Diclofenac/Misoprostol 02341689 GMD ADEFGVW


M01AB55 DICLOFENAC COMBINATIONS DICLOFÉNAC, EN COMBINAISON

DICLOFENAC / MISOPROSTOL DICLOFÉNAC / MISOPROSTOL

Tab Orl 75mg/200mcg Arthrotec 02229837 PFI ADEFGVW Co. Act Diclo-Miso 02397153 ATV ADEFGVW GD-Diclofenac/Misoprostol 02341697 GMD ADEFGVW

M01AC OXICAMS OXICAMS

M01AC01 PIROXICAM PIROXICAM

Cap Orl 10mg Apo-Piroxicam 00642886 APX ADEFGVW Caps Novo-Pirocam 00695718 TEV ADEFGVW Cap Orl 20mg Apo-Piroxicam 00642894 APX ADEFGVW Caps Novo-Pirocam 00695696 TEV ADEFGVW Sup Rt 20mg pms-Piroxicam (Disc/non disp Jul 4/16) 02154463 PMS ADEFGVW Supp.

M01AC06 MELOXICAM

MELOXICAM

Tab Orl 7.5mg Mobicox 02242785 BOE ADEFGVW Co. Act Meloxicam 02250012 ATV ADEFGVW Apo-Meloxicam 02248973 APX ADEFGVW Auro-Meloxicam 02390884 ARO ADEFGVW Meloxicam 02353148 SAS ADEFGVW Mylan-Meloxicam 02255987 MYL ADEFGVW Phl-Meloxicam 02248607 PHL ADEFGVW pms-Meloxicam 02248267 PMS ADEFGVW Teva-Meloxicam 02258315 TEV ADEFGVW Tab Orl 15mg Mobicox 02242786 BOE ADEFGVW Co. Act Meloxicam 02250020 ATV ADEFGVW Apo-Meloxicam 02248974 APX ADEFGVW Auro-Meloxicam 02390892 ARO ADEFGVW Meloxicam 02353156 SAS ADEFGVW Mylan-Meloxicam 02255995 MYL ADEFGVW Phl-Meloxicam 02248608 PHL ADEFGVW pms-Meloxicam 02248268 PMS ADEFGVW Teva-Meloxicam 02258323 TEV ADEFGVW

M01AE PROPIONIC ACID DERIVATIVES DÉRIVÉS DE L’ACIDE PROPIONIQUE

M01AE01 IBUPROFEN IBUPROFÈNE

Tab Orl 300mg Apo-Ibuprofen 00441651 APX AEFGVW Co.


M01AE01 IBUPROFEN IBUPROFÈNE

Tab Orl 400mg Motrin IB 02242658 JNJ AEFGVW Co. Apo-Ibuprofen 00506052 APX AEFGVW Jamp-Ibuprofen 02401290 JPC AEFGVW Novo-Profen 00629340 TEV AEFGVW pms-Ibuprofen 00836133 PMS AEFGVW Tab Orl 600mg Apo-Ibuprofen 00585114 APX ADEFGVW Co. Novo-Profen 00629359 TEV ADEFGVW

M01AE02 NAPROXEN

NAPROXÈNE

ECT Orl 250mg Naprosyn E (Disc/non disp Feb 5/16) 02162792 HLR ADEFGVW Co.Ent Apo-Naproxen EC 02246699 APX ADEFGVW Naproxen EC 02350785 SAS ADEFGVW Teva-Naprox EC 02243312 TEV ADEFGVW ECT Orl 375mg Naprosyn E 02162415 HLR ADEFGVW Co.Ent Apo-Naproxen EC 02246700 APX ADEFGVW Naproxen EC 02350793 SAS ADEFGVW Mylan-Naproxen EC 02243432 MYL ADEFGVW pms-Naproxen EC 02294702 PMS ADEFGVW Teva-Naprox EC 02243313 TEV ADEFGVW ECT Orl 500mg Naprosyn E 02162423 HLR ADEFGVW Co.Ent Apo-Naproxen EC 02246701 APX ADEFGVW Mylan-Naproxen EC 02241024 MYL ADEFGVW Naproxen EC 02350807 SAS ADEFGVW pms-Naproxen EC 02294710 PMS ADEFGVW Teva-Naprox EC 02243314 TEV ADEFGVW Sup Rt 500mg pms-Naproxen 02017237 PMS ADEFGVW Supp. Sus Orl 25mg/mL Pediapharm Naproxen 02162431 PED ADEFGVW Susp Tab Orl 125mg Apo-Naproxen 00522678 APX ADEFGVW Co. Tab Orl 250mg Apo-Naproxen 00522651 APX ADEFGVW Co. Naproxen 02350750 SAS ADEFGVW Teva-Naproxen 00565350 TEV ADEFGVW Tab Orl 275mg Anaprox 02162725 HLR ADEFGVW Co. Apo-Napro-Na 00784354 APX ADEFGVW Naproxen Sodium 02351013 SAS ADEFGVW Teva-Naproxen Sodium 00778389 TEV ADEFGVW


M01AE02 NAPROXEN NAPROXÈNE

Tab Orl 375mg Apo-Naproxen 00600806 APX ADEFGVW Co. Naproxen 02350769 SAS ADEFGVW Teva-Naproxen 00627097 TEV ADEFGVW Tab Orl 500mg Apo-Naproxen 00589861 APX ADEFGVW Co. Naproxen 02350777 SAS ADEFGVW Teva-Naproxen 00592277 TEV ADEFGVW Tab Orl 550mg Anaprox DS 02162717 HLR ADEFGVW Co. Apo-Napro-Na DS 01940309 APX ADEFGVW Naproxen Sodium DS 02351021 SAS ADEFGVW Teva-Naproxen Sodium DS 02026600 TEV ADEFGVW

M01AE03 KETOPROFEN

KÉTOPROFÈNE

Cap Orl 50mg Keto 00790427 AAP ADEFGVW Caps ECT Orl 50mg Keto-E 00790435 AAP ADEFGVW Co.Ent ECT Orl 100mg Keto-E 00842664 AAP ADEFGVW Co.Ent SRT Orl 200mg Keto SR 02172577 AAP ADEFGVW Co.L.L. Sup Rt 100mg pms-Ketoprofen 02015951 PMS ADEFGW Supp.

M01AE09 FLURBIPROFEN

FLURBIPROFÈNE

Tab Orl 50mg Apo-Flurbiprofen 01912046 APX ADEFGVW Co. Novo-Flurprofen 02100509 TEV ADEFGVW Tab Orl 100mg Apo-Flurbiprofen 01912038 APX ADEFGVW Co. Novo-Flurprofen 02100517 TEV ADEFGVW

M01AE11 TIAPROFENIC ACID

ACIDE TIAPROFÉNIQUE

Tab Orl 200mg Teva-Tiaprofenic 02179679 TEV ADEFGVW Co. Tab Orl 300mg Teva-Tiaprofenic 02179687 TEV ADEFGVW Co.


M01AG FENEMATES FENEMATES

M01AG01 MEFENAMIC ACID ACIDE MÉFÉNAMIQUE

Cap Orl 250mg Mefenamic 02229452 AAP ADEFGVW Caps

M01AH COXIBS COXIBS

M01AH01 CELECOXIB CÉLÉCOXIB

Cap Orl 100mg Celebrex 02239941 PFI W (SA)

Caps Apo-Celecoxib 02418932 APX W (SA)

Celecoxib 02429675 SIV W (SA)

Celecoxib 02436299 SAS W (SA)

Act-Celecoxib 02420155 ATV W (SA)

GD-Celecoxib 02291975 GMD W (SA)

Jamp-Celecoxib 02424533 JPC W (SA)

Mar-Celecoxib 02420058 MAR W (SA)

Mint-Celecoxib 02412497 MNT W (SA)

Mylan-Celecoxib 02423278 MYL W (SA)

pms-Celecoxib 02355442 PMS W (SA)

Ran-Celecoxib 02412373 RAN W (SA)

Sandoz Celecoxib 02321246 SDZ W (SA)

SDZ Celecoxib 02442639 SDZ W (SA)

Teva-Celecoxib 02288915 TEV W (SA)

Cap Orl 200mg Celebrex 02239942 PFI W (SA)

Caps Apo-Celecoxib 02418940 APX W (SA)

Celecoxib 02429683 SIV W (SA)

Celecoxib 02436302 SAS W (SA)

Act-Celecoxib 02420163 ATV W (SA)

GD-Celecoxib 02291983 GMD W (SA)

Jamp-Celecoxib 02424541 JPC W (SA)

Mar-Celecoxib 02420066 MAR W (SA)

Mint-Celecoxib 02412500 MNT W (SA)

Mylan-Celecoxib 02399881 MYL W (SA)

pms-Celecoxib 02355450 PMS W (SA)

Ran-Celecoxib 02412381 RAN W (SA)

Sandoz Celecoxib 02321254 SDZ W (SA)

SDZ Celecoxib 02442647 SDZ W (SA)

Teva-Celecoxib 02288923 TEV W (SA)

M01AX OTHER ANTIINFLAMMATORY AND ANTIRHEUMATIC AGENTS, NON STEROIDS AUTRES AGENTS ANTI-INFLAMMATOIRES ET ANTIRHUMATISMAUX, NON STÉROIDÏENS

M01AX01 NABUMETONE NABUMÉTONE

Tab Orl 500mg Apo-Nabumetone 02238639 APX ADEFGVW Co. Novo-Nabumetone 02240867 TEV ADEFGVW


M01AX01 NABUMETONE NABUMÉTONE

Tab Orl 750mg Novo-Nabumetone 02240868 TEV ADEFGVW Co.

M01C SPECIFIC ANTIRHEUMATIC AGENTS AGENTS ANTIRHUMATISMAUX SPÉCIFIQUES

M01CB GOLD PREPARATIONS PRÉPARATIONS D’OR

M01CB01 SODIUM AUROTHIOMALATE AUROTHIOMALATE SODIQUE

Liq Inj 10mg/mL Myochrysine 01927620 SAV ADEFGVW Liq Sodium Aurothiomalate 02245456 SDZ ADEFGVW Liq Inj 25mg/mL Myochrysine 01927612 SAV ADEFGVW Liq Sodium Aurothiomalate 02245457 SDZ ADEFGVW Liq Inj 50mg/mL Myochrysine 01927604 SAV ADEFGVW Liq Sodium Aurothiomalate 02245458 SDZ ADEFGVW

M01CB03 AURANOFIN

AURANOFINE

Cap Orl 3mg Ridaura 01916823 XPI ADEFGVW Caps

M01CC PENICILLAMINE AND SIMILAR AGENTS PÉNICILLAMINE ET AGENTS SEMBLABLES

M01CC01 PENICILLAMINE PÉNICILLAMINE

Cap Orl 250mg Cuprimine 00016055 VLN ADEFGVW Caps

M03 MUSCLE RELAXANTS MYORELAXANTS

M03A PERIPHERALLY ACTING AGENTS, MUSCLE RELAXANTS MYORELAXANTS À L’ACTION PÉRIPHÉRIQUE

M03AX OTHER MUSCLE RELAXANTS, PERIPHERALLY ACTING AUTRES MYORELAXANTS À L’ACTION PÉRIPHÉRIQUE

M03AX01 BOTULINUM TOXIN BOTULINUM TOXINE

Pws IM 50 Unit Botox 00903741 ALL (SA) Pds. Pws IM 50Unit Xeomin 02371081 MRZ (SA) Pds. Pws IM 100Unit Botox 01981501 ALL (SA) Pds.


M03AX01 BOTULINUM TOXIN BOTULINUM TOXINE

Pws IM 100Unit Xeomin 02324032 MRZ (SA) Pds. Pws IM 200Unit Botox 00999505 ALL (SA) Pds.

M03B MUSCLE RELAXANTS, CENTRALLY ACTING AGENTS MYORELAXANTS, AGENTS AGISSANT CENTRALEMENT

M03BA CARBAMIC ACID ESTERS ESTERS DE L’ACIDE CARBAMIQUE

M03BA03 METHOCARBAMOL MÉTHOCARBAMOL

Tab Orl 500mg Robaxin 01930990 WCH AEFGVW Co. Tab Orl 750mg Robaxin 01932187 WCH AEFGVW Co.

M03BA53 METHOCARBAMOL, COMBINATIONS EXCLUDING PSYCHOLEPTICS

MÉTHOCARBAMOL, EN COMBINAISON, A L’EXCLUSION DES PSYCHOLEPTIQUES

METHOCARBAMOL / ACETYLSALICYLIC ACID / CODEINE PHOSPHATE MÉTHOCARBAMOL / ACIDE ACETYLSALICYLIC / PHOSPHATE DE CODÉINE

Tab Orl 400mg/325mg/16.2mg Robaxisal C-1/4 01934783 WCH W Co. Tab Orl 400mg/325mg/32.4mg Robaxisal C-1/2 01934791 WCH W Co.

M03BC ETHERS, CHEMICALLY CLOSE TO ANTIHISTAMINES ÉTHERS, CHIMIQUEMENT PRÈS DES ANTIHISTAMINES

M03BC01 ORPHENADRINE ORPHÉNADRINE

SRT Orl 100mg Sandoz Orphenadrine Citrate 02243559 SDZ AEFGVW Co.L.L.

M03BX OTHER CENTRALLY ACTING AGENTS

AUTRES AGENTS AGISSANT CENTRALEMENT

M03BX01 BACLOFEN BACLOFÈNE

Tab Orl 10mg Lioresal 00455881 NVR ADEFGVW Co. Apo-Baclofen 02139332 APX ADEFGVW Baclofen 02287021 SAS ADEFGVW Mylan-Baclofen 02088398 MYL ADEFGVW Phl-Baclofen 02236963 PHL ADEFGVW pms-Baclofen 02063735 PMS ADEFGVW ratio-Baclofen 02236507 TEV ADEFGVW


M03BX01 BACLOFEN BACLOFÈNE

Tab Orl 20mg Lioresal D.S. 00636576 NVR ADEFGVW Co. Apo-Baclofen 02139391 APX ADEFGVW Baclofen 02287048 SAS ADEFGVW Mylan-Baclofen 02088401 MYL ADEFGVW Phl-Baclofen 02236964 PHL ADEFGVW pms-Baclofen 02063743 PMS ADEFGVW ratio-Baclofen 02236508 TEV ADEFGVW

M03BX02 TIZANIDINE

TIZANIDINE

Tab Orl 4mg Zanaflex 02239170 PAL (SA) Co. Mylan-Tizanidine (Disc/non disp Nov 12/16) 02272059 MYL (SA) Pal-Tizanidine 02239170 PAL (SA) Tizanidine 02259893 AAP (SA)

M03BX08 CYCLOBENZAPRINE

CYCLOBENZAPRINE

Tab Orl 10mg Apo-Cycloprine 02177145 APX ADEFGVW Co. Auro-Cyclobenzaprine 02348853 ARO ADEFGVW Cyclobenzaprine 02287064 SAS ADEFGVW Jamp-Cyclobenzaprine 02357127 JPC ADEFGVW Mylan-Cyclobenzaprine 02231353 MYL ADEFGVW Novo-Cycloprine 02080052 TEV ADEFGVW pms-Cyclobenzaprine 02212048 PMS ADEFGVW

M03C MUSCLE RELAXANTS, DIRECTLY ACTING AGENTS MYORELAXANTS, AGENTS AGISSANT DIRECTEMENT

M03CA DANTROLENE AND DERIVATIVES DANTROLENE ET DÉRIVÉS

M03CA01 DANTROLENE DANTROLÈNE

Cap Orl 25mg Dantrium 01997602 MTP ADEFGVW Caps Cap Orl 100mg Dantrium 01997653 MTP ADEFGVW Caps


M04 ANTIGOUT PREPARATIONS PRÉPARATIONS ANTI-GOUTTE

M04A ANTIGOUT PREPARATIONS PRÉPARATIONS ANTI-GOUTTE

M04AA PREPARATIONS INHIBITING URIC ACID PRODUCTION PRÉPARATIONS INHIBANT LA PRODUCTION D’ACIDE URIQUE

M04AA01 ALLOPURINOL ALLOPURINOL

Tab Orl 100mg Zyloprim 00402818 AAP ADEFGVW Co. Apo-Allopurinol 02402769 APX ADEFGVW Mar-Allopurinol 02396327 MAR ADEFGVW Tab Orl 200mg Zyloprim 00479799 AAP ADEFGVW Co. Apo-Allopurinol 02402777 APX ADEFGVW Mar-Allopurinol 02396335 MAR ADEFGVW Tab Orl 300mg Zyloprim 00402796 AAP ADEFGVW Co. Apo-Allopurinol 02402785 APX ADEFGVW Mar-Allopurinol 02396343 MAR ADEFGVW

M04AA03 FEBUXOSTAT

FÉBUXOSTAT

Tab Orl 80mg Uloric 02357380 TAK (SA) Tab

M04AB PREPARATIONS INCREASING URIC ACID EXCRETION PRÉPARATIONS AUGMENTANT L’EXCRÉTION D’ACIDE URIQUE

M04AB02 SULFINPYRAZONE SULFINPYRAZONE

Tab Orl 200mg Sulfinpyrazone 00441767 AAP ADEFGVW Co.

M04AC PREPARATION WITH NO EFFECT ON URIC ACID METABOLISM PRÉPARATION SANS EFFET SUR LE MÉTABOLISME DE L’ACIDE URIQUE

M04AC01 COLCHICINE COLCHICINE

Tab Orl 0.6mg Colchicine 00287873 EUR ADEFGVW Co. Colchicine 00572349 ODN ADEFGVW Jamp-Colchicine 02373823 JPC ADEFGVW


M05 DRUGS FOR TREATMENT OF BONE DISEASES MÉDICAMENTS POUR LE TRAITEMENT DES MALADIES OSSEUSES

M05B DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION MÉDICAMENTS AGISSANT SUR LA STRUCTURE OSSEUSE ET LA MINÉRALISATION

M05BA BISPHOSPHONATES BISPHOSPHONATES

M05BA01 ETIDRONIC ACID ACIDE ÉTIDRONIQUE

Tab Orl 200mg Didronel 01997629 PGA (SA) Co. Act Etidronate 02248686 ATV (SA) Mylan-Etidronate 02245330 MYL (SA)

M05BA02 CLODRONIC ACID

ACIDE CLODRONIQUE

Cap Orl 400mg Bonefos 01984845 BAY ADEFGVW Caps Clasteon 02245828 SNV ADEFGVW

M05BA04 ALENDRONIC ACID

ACIDE ALENDRONIQUE

Tab Orl 10mg Alendronate Sodium 02381486 AHI ADEFGVW Co. Apo-Alendronate 02248728 APX ADEFGVW Auro-Alendronate 02388545 ARO ADEFGVW Mint-Alendronate 02394863 MNT ADEFGVW Mylan-Alendronate 02270129 MYL ADEFGVW Ran-Alendronate 02384701 RAN ADEFGVW Sandoz Alendronate 02288087 SDZ ADEFGVW Teva-Alendronate 02247373 TEV ADEFGVW Tab Orl 40mg Co Alendronate 02258102 COB W (SA) Co. Tab Orl 70mg Fosamax 02245329 FRS ADEFGVW Co. Alendronate 02352966 SAS ADEFGVW Alendronate FC 02299712 SIV ADEFGVW Alendronate Sodium 02381494 AHI ADEFGVW Apo-Alendronate 02248730 APX ADEFGVW Auro-Alendronate 02388553 ARO ADEFGVW Co Alendronate 02258110 COB ADEFGVW Jamp-Alendronate 02385031 JPC ADEFGVW Mint-Alendronate 02394871 MNT ADEFGVW Mylan-Alendronate 02286335 MYL ADEFGVW pms-Alendronate FC 02284006 PMS ADEFGVW Ran-Alendronate 02384728 RAN ADEFGVW Sandoz Alendronate 02288109 SDZ ADEFGVW Teva-Alendronate 02261715 TEV ADEFGVW


M05BA07 RISEDRONIC ACID ACIDE RISEDRONIC

Tab Orl 5mg Actonel 02242518 WNC ADEFGVW Co. Teva-Risedronate 02298376 TEV ADEFGVW Tab Orl 30mg Actonel 02239146 WNC (SA) Co. Teva-Risedronate 02298384 TEV (SA) Tab Orl 35mg Actonel 02246896 WNC ADEFGVW Co. Apo-Risedronate 02353687 APX ADEFGVW Auro-Risedronate 02406306 ARO ADEFGVW Jamp-Risedronate 02368552 JPC ADEFGVW Mylan-Risedronate 02357984 MYL ADEFGVW pms-Risedronate 02302209 PMS ADEFGVW ratio-Risedronate 02319861 RPH ADEFGVW Risedronate 02370255 SAS ADEFGVW Risedronate 02411407 SIV ADEFGVW Sandoz Risedronate 02327295 SDZ ADEFGVW Teva-Risedronate 02298392 TV ADEFGVW

M05BA08 ZOLEDRONIC ACID

ACIDE ZOLÉDRONIQUE

Liq IV 5mg/100mL Aclasta 02269198 NVR (SA) Liq Taro-Zoledronic Acid 02415100 TAR (SA) Zoledronic Acid 02422433 RCH (SA) Zoledronic Acid 02408082 TEV (SA)

M05BB BISPHOSPHONATES, COMBINATIONS BISPHOSPHONATES EN COMBINAISON

M05BB01 ETIDRONIC ACID AND CALCIUM, SEQUENTIAL ACIDE ETIDRONIQUE ET CALCIUM, SEQUENTIELLE

Tab Orl 400mg, 500mg Didrocal (Disc/non disp Oct 31/15) 02176017 WNC (SA) Co. Act Etidrocal (Kit) 02263866 ATV (SA) Etidrocal (Disc/non disp Feb 27/17) 02353210 SAS (SA) Mylan-Eti-Cal Carepac (Kit) (Disc/non disp Jun 5/16) 02247323 MYL (SA) Novo-EtidronateCAL (Kit) (Disc/non disp Dec 11/15) 02324199 TEV (SA)

M05BB03 ALENDRONIC ACID AND COLECALCIFEROL

ACIDE ALENDRONIQUE ET COLÉCALCIFÉROL

Tab Orl 70mg/5600IU Fosavance 02314940 FRS ADEFGVW Co. Teva-Alendronate/Cholecalciferol 02403641 TEV ADEFGVW Sandoz Alendronate/Cholecalciferol 02429160 SDZ ADEFGVW

M05BX OTHER DRUGS AFFECTING MINERALIZATION AUTRES MÉDICAMENTS AGISSANT SUR LA MINÉRALISATION

M05BX04 DENOSUMAB DENOSUMAB

Liq SC 60mg/mL Prolia 02343541 AGA (SA) Liq


M05BX04 DENOSUMAB DENOSUMAB

Liq SC 120mg/1.7mL Xgeva 02368153 AGA (SA) Liq

N01 ANAESTHETICS ANESTHÉSIQUES

N01B LOCAL ANAESTHETICS ANESTHÉSIQUES LOCAUX

N01BX OTHER LOCAL ANAESTHETICS AUTRES ANESTHÉSIQUES LOCAUX

N01BX04 CAPSAICIN CAPSAÏCINE

Crm Top 0.025% Zostrix 00740306 MDS AEFGVW Cr. Capsaicin 02157101 VLN AEFGVW Crm Top 0.075% Zostrix H.P. 02004240 MDS AEFGVW Cr. Capsaicin Crm 02157128 VLN AEFGVW

N02 ANALGESICS ANALGÉSIQUES

N02A OPIOIDS OPIOÏDES

N02AA NATURAL OPIUM ALKALOIDS ALKALOÏDES D’OPIUM NATUREL

N02AA01 MORPHINE MORPHINE

SRT Orl 30mg M.O.S.SR 00776181 VLN ADEFGVW Co.L.L. SRT Orl 60mg M.O.S.SR (Disc/non disp May 31/17) 00776203 VLN ADEFGVW Co.L.L. Syr Orl 1mg/mL ratio-Morphine 00607762 RPH ADEFGVW Sir. Syr Orl 5mg/mL ratio-Morphine 00607770 RPH ADEFGVW Sir. Syr Orl 10mg/mL ratio-Morphine 00690783 RPH ADEFGVW Sir. Syr Orl 20mg/mL ratio-Morphine 00690791 RPH ADEFGVW Sir. Dps Orl 20mg/mL Statex 00621935 PAL ADEFGVW Gtts



Dps Orl 50mg/mL Statex 00705799 PAL ADEFGVW Gtts Liq Inj 10mg/mL Morphine Sulfate 00392588 SDZ ADEFGVW Liq Liq Inj 15mg/mL Morphine Sulfate 00392561 SDZ ADEFGVW Liq Liq Inj 25mg/mL Morphine HP 25 00676411 SDZ ADEFGVW Liq Liq Inj 50mg/mL Morphine HP 50 00617288 SDZ ADEFGVW Liq SRC Orl 10mg Kadian 02242163 ABB ADEFGVW Caps.L.L. M-Eslon 02019930 SAV ADEFGVW SRC Orl 15mg M-Eslon 15 02177749 SAV ADEFGVW Caps.L.L. SRC Orl 20mg Kadian 02184435 BGP ADEFGVW Caps.L.L. SRC Orl 30mg M-Eslon 02019949 SAV ADEFGVW Caps.L.L. SRC Orl 50mg Kadian 02184443 BGP ADEFGVW Caps.L.L. SRC Orl 60mg M-Eslon 02019957 SAV ADEFGVW Caps.L.L. SRC Orl 100mg Kadian 02184451 BGP ADEFGVW Caps.L.L. M-Eslon 02019965 SAV ADEFGVW SRC Orl 200mg Kadian 02177757 BGP ADEFGVW Caps.L.L. SRT Orl 15mg MS Contin 02015439 PFR ADEFGVW Co.L.L. Morphine SR 02350815 SAS ADEFGVW Sandoz Morphine SR 02244790 SDZ ADEFGVW Teva-Morphine SR 02302764 TEV ADEFGVW SRT Orl 30mg MS Contin 02014297 PFR ADEFGVW Co.L.L. Morphine SR 02350890 SAS ADEFGVW Sandoz Morphine SR 02244791 SDZ ADEFGVW Teva-Morphine SR 02302772 TEV ADEFGVW



SRT Orl 60mg MS Contin 02014300 PFR ADEFGVW Co.L.L. Morphine SR 02350912 SAS ADEFGVW Sandoz Morphine SR 02244792 SDZ ADEFGVW Teva-Morphine SR 02302780 TEV ADEFGVW SRT Orl 100mg MS Contin 02014319 PFR ADEFGVW Co.L.L. Teva-Morphine SR 02302799 TEV ADEFGVW SRT Orl 200mg MS Contin 02014327 PFR ADEFGVW Co.L.L. Teva-Morphine SR 02302802 TEV ADEFGVW Sup Rt 5mg Statex 00632228 PAL ADEFGVW Supp. Sup Rt 10mg Statex 00632201 PAL ADEFGVW Supp. Sup Rt 20mg Statex 00596965 PAL ADEFGVW Supp. Sup Rt 30mg Statex 00639389 PAL ADEFGVW Supp. Syr Orl 1mg/mL Statex 00591467 PAL ADEFGVW Sir. Syr Orl 5mg/mL Statex 00591475 PAL ADEFGVW Sir. Tab Orl 5mg MS IR 02014203 PFR ADEFGVW Co. Statex 00594652 PAL ADEFGVW Tab Orl 10mg MS IR 02014211 PFR ADEFGVW Co. Statex 00594644 PAL ADEFGVW Tab Orl 20mg MS IR 02014238 PFR ADEFGVW Co. Tab Orl 25mg Statex 00594636 PAL ADEFGVW Co. Tab Orl 30mg MS IR 02014254 PFR ADEFGVW Co. Tab Orl 50mg Statex 00675962 PAL ADEFGVW Co.


N02AA03 HYDROMORPHONE HYDROMORPHONE

Liq Inj 2mg/mL Dilaudid 00627100 PFR ADEFGVW Liq Hydromorphone Hydrochloride 02145901 SDZ ADEFGVW Liq Inj 10mg/mL Dilaudid HP 00622133 PFR ADEFGVW Liq Hydromorphone HP 10 02145928 SDZ ADEFGVW Liq Inj 20mg/mL Hydromorphone HP 20 02145936 SDZ ADEFGVW Liq Liq Inj 50mg/mL Hydromorphone HP 50 02146126 SDZ ADEFGVW Liq Cap Orl 4.5mg Hydromorph Contin 02359502 PFR ADEFGVW Caps. Cap Orl 9mg Hydromorph Contin 02359510 PFR ADEFGVW Caps. SRC Orl 3mg Hydromorph Contin 02125323 PFR ADEFGVW Caps.L.L. SRC Orl 6mg Hydromorph Contin 02125331 PFR ADEFGVW Caps.L.L. SRC Orl 12mg Hydromorph Contin 02125366 PFR ADEFGVW Caps.L.L. SRC Orl 18mg Hydromorph Contin 02243562 PFR ADEFGVW Caps.L.L. SRC Orl 24mg Hydromorph Contin 02125382 PFR ADEFGVW Caps.L.L. SRC Orl 30mg Hydromorph Contin 02125390 PFR ADEFGVW Caps.L.L. Syr Orl 1mg/mL Dilaudid 00786535 PFR ADEFGVW Sir. Pms-Hydromorphone 01916386 PMS ADEFGVW Tab Orl 1mg Dilaudid 00705438 PFR ADEFGVW Co. Apo-Hydromorphone 02364115 APX ADEFGVW pms-Hydromorphone 00885444 PMS ADEFGVW Teva-Hydromorphone 02319403 TEV ADEFGVW Tab Orl 2mg Dilaudid 00125083 PFR ADEFGVW Co. Apo-Hydromorphone 02364123 APX ADEFGVW pms-Hydromorphone 00885436 PMS ADEFGVW Teva-Hydromorphone 02319411 TEV ADEFGVW


N02AA03 HYDROMORPHONE HYDROMORPHONE

Tab Orl 4mg Dilaudid 00125121 PFR ADEFGVW Co. Apo-Hydromorphone 02364131 APX ADEFGVW pms-Hydromorphone 00885401 PMS ADEFGVW Teva-Hydromorphone 02319438 TEV ADEFGVW Tab Orl 8mg Dilaudid 00786543 PFR ADEFGVW Co. Apo-Hydromorphone 02364158 APX ADEFGVW pms-Hydromorphone 00885428 PMS ADEFGVW Teva-Hydromorphone 02319446 TEV ADEFGVW

N02AA05 OXYCODONE

OXYCODONE

ERT Orl 10mg Oxyneo 02372525 PFR W Co.L.P. ERT Orl 15mg Oxyneo 02372533 PFR W Co.L.P. ERT Orl 20mg Oxyneo 02372797 PFR W Co.L.P. ERT Orl 30mg Oxyneo 02372541 PFR W Co.L.P. ERT Orl 40mg Oxyneo 02372568 PFR W Co.L.P. ERT Orl 60mg Oxyneo 02372576 PFR W Co.L.P. ERT Orl 80mg Oxyneo 02372584 PFR W Co.L.P. Sup Rt 10mg Supeudol 00392480 SDZ ADEFGVW Supp. Tab Orl 5mg Oxy-IR 02231934 PFR W (SA) Co. Supeudol 00789739 SDZ W (SA) pms-Oxycodone IR 02319977 PMS W (SA) Tab Orl 10mg Oxy-IR 02240131 PFR W (SA) Co. Supeudol 00443948 SDZ W (SA) pms-Oxycodone IR 02319985 PMS W (SA) Tab Orl 20mg Oxy-IR 02240132 PFR W (SA) Co. Supeudol 02262983 SDZ W (SA) pms-Oxycodone IR 02319993 PMS W (SA)


N02AA59 CODEINE, COMBINATIONS, EXCLUDING PSYCHOLEPTICS CODÉINE, EN COMBINAISON, À L’EXCLUSION DES PSYCHOLEPTIQUES

ACETAMINOPHEN / CAFFEINE / CODEINE ACÉTAMINOPHÈNE / CAFÉINE / CODÉINE

Tab Orl 300mg/30mg/15mg Tylenol No.3 02163926 JAN ADEFGVW Co. ratio-Lenoltec #3 00653276 RPH ADEFGVW Tab Orl 300mg/30mg/30mg Atasol-30 00293512 CHU ADEFGVW Co.

ACETAMINOPHEN / CODEINE ACÉTAMINOPHÈNE / CODÉINE

Tab Orl 300mg/30mg ratio-Emtec-30 00608882 RPH ADEFGVW Co. Tab Orl 300mg/60mg Tylenol No.4 02163918 JAN ADEFGVW Co. ratio-Lenoltec #4 00621463 RPH ADEFGVW

ACETYLSALICYLIC ACID / CAFFEINE / CODEINE ACIDE ACÉTYLSALICYLIQUE / CAFÉINE / CODÉINE

Tab Orl 375mg/30mg/30mg 292 02238645 PDP ADEFGVW Co.

N02AB PHENYLPIPERIDINE DERIVATIVES DÉRIVÉS DU PHENYLPIPERDINE

N02AB02 PETHIDINE (MEPERIDINE) PÉTHIDINE (MÉPÉRIDINE)

Tab Orl 50mg Demerol 02138018 SAV W Co.

N02AB03 FENTANYL

FENTANYL

Pth Trd 12mcg Duragesic Mat 02334186 JAN W (SA) Pth Co Fentanyl 02386844 COB W (SA) Mylan-Fentanyl Matrix 02396696 MYL W (SA) pms-Fentanyl MTX 02341379 PMS W (SA) Ran-Fentanyl Matrix 02330105 RAN W (SA) Sandoz Fentanyl patch 02327112 SDZ W (SA) Teva-Fentanyl 02311925 TEV W (SA) Pth Trd 25mcg Duragesic Mat 02275813 JAN W (SA) Pth Apo-Fentanyl 02314630 APX W (SA) Co Fentanyl 02386852 COB W (SA) Mylan-Fentanyl Matrix 02396718 MYL W (SA) pms-Fentanyl MTX 02341387 PMS W (SA) Ran-Fentanyl Matrix 02330113 RAN W (SA) Sandoz Fentanyl 02327120 SDZ W (SA) Teva-Fentanyl 02282941 TEV W (SA)


N02AB03 FENTANYL FENTANYL

Pth Trd 37mcg Sandoz Fentanyl 02327139 SDZ W Pth Pth Trd 50mcg Duragesic Mat 02275821 JAN W (SA) Pth Apo-Fentanyl 02314649 APX W (SA) Co Fentanyl 02386879 COB W (SA) Mylan-Fentanyl Matrix 02396726 MYL W (SA) pms-Fentanyl MTX 02341395 PMS W (SA) Ran-Fentanyl Matrix 02330121 RAN W (SA) Sandoz Fentanyl 02327147 SDZ W (SA) Teva-Fentanyl 02282968 TEV W (SA) Pth Trd 75mcg Duragesic Mat 02275848 JAN W (SA) Pth Apo-Fentanyl 02314657 APX W (SA) Co Fentanyl 02386887 COB W (SA) Mylan-Fentanyl Matrix 02396734 MYL W (SA) pms-Fentanyl MTX 02341409 PMS W (SA) Ran-Fentanyl Matrix 02330148 RAN W (SA) Sandoz Fentanyl 02327155 SDZ W (SA) Teva-Fentanyl 02282976 TEV W (SA) Pth Trd 100mcg Duragesic Mat 02275856 JAN W (SA) Pth Apo-Fentanyl 02314665 APX W (SA) Co Fentanyl 02386895 COB W (SA) Mylan-Fentanyl Matrix 02396742 MYL W (SA) pms-Fentanyl MTX 02341417 PMS W (SA) Ran-Fentanyl Matrix 02330156 RAN W (SA) Sandoz Fentanyl 02327163 SDZ W (SA) Teva-Fentanyl 02282984 TEV W (SA)

N02AD BENZOMORPHAN DERIVATIVES DÉRIVÉS DU BENZOMORPHANE

N02AD01 PENTAZOCINE PENTAZOCINE

Tab Orl 50mg Talwin 02137984 SAV W Co.


N02B OTHER ANALGESICS AND ANTIPYRETICS AUTRES ANALGÉSIQUES ET ANTIPYRÉTIQUES

N02BA SALICYLIC ACID AND DERIVATIVES ACIDE SALICYLIQUE ET DÉRIVÉS

N02BA01 ACETYLSALICYLIC ACID ACIDE ACÉTYLSALICYLIQUE

ECT Orl 81mg ASA daily low dose 02243101 PMS V Co.Ent ASA ECT (Disc/non disp Nov 01/17) 02244993 PMS V Equate daily low-dose EC 02243801 PMS V Exact Coated daily low dose ASA 02243896 PMS V Praxis ASA 02283700 PDP V Rexall Coated low dose ASA 02243802 PMS V ASA EC 02426811 SAS V ECT Orl 325mg Entrophen 00010332 PDP AEFGVW Co.Ent Novasen 00216666 TEV AEFGVW ASATAB EC 02352427 ODN AEFGVW Enteric Coated ASA 02010526 TAN AEFGVW pms-ASA EC 02284529 PMS AEFGVW ECT Orl 650mg Entrophen (Disc/non disp Mar 10/16) 00010340 PDP AEFGVW Co.Ent Novasen 00229296 TEV AEFGVW Jamp-ASA EC 00794244 JPC AEFGVW

N02BA11 DIFLUNISAL

DIFLUNISAL

Tab Orl 250mg Diflunisal (Disc/non disp Aug 26/17) 02039486 AAP ADEFGVW Co. Novo-Diflunisal 02048493 TEV ADEFGVW Tab Orl 500mg Diflunisal (Disc/non disp Aug 26/17) 02039494 AAP ADEFGVW Co.

N02BA51 ACETYLSALICYLIC ACID, COMBINATIONS EXCLUDING PSYCHOLEPTICS

ACIDE ACÉTYLSALICYLIQUE, EN COMBINAISON, À L’EXCLUSION DES PSYCHOLEPTIQUES

ACETYLSALICYLIC ACID / OXYCODONE ACIDE ACÉTYLSALICYLIQUE / OXYCODONE

Tab Orl 325mg/5mg ratio-Oxycodan 00608157 RPH ADEFGVW Co.

N02BA71 ACETYLSALICYLIC ACID COMBNATIONS WITH PSYCHOLEPTICS

ACIDE ACÉTYLSALICYLIQUE, EN COMBINAISON AVEC DES PSYCHOLEPTIQUES

BUTALBITAL / ACETYLSALICYLIC ACID / CAFFEINE BUTALBITAL / ACIDE ACÉTYLSALICYLIQUE / CAFÉINE

Cap Orl 50mg/330mg/40mg Fiorinal 00226327 NVR W Caps ratio-Tecnal 00608238 RPH W Tab Orl 50mg/330mg/40mg ratio-Tecnal 00608211 RPH W Co.


N02BA71 ACETYLSALICYLIC ACID COMBNATIONS WITH PSYCHOLEPTICS ACIDE ACÉTYLSALICYLIQUE, EN COMBINAISON AVEC DES PSYCHOLEPTIQUES

BUTALBITAL / ACETYLSALICYLIC ACID / CAFFEINE / CODEINE BUTALBITAL / ACIDE ACÉTYLSALICYLIQUE / CAFÉINE/ CODÉINE

Cap Orl 50mg/330mg/40mg/15mg Fiorinal C ¼ 00176192 NVR W Caps ratio-Tecnal C ¼ 00608203 RPH W Cap Orl 50mg/330mg/40mg/30mg Fiorinal C ½ 00176206 NVR W Caps ratio-Tecnal C ½ 00608181 RPH W

N02BE ANILIDES ANILIDES

N02BE01 PARACETAMOL (ACETAMINOPHEN) PARACETAMOL (ACÉTAMINOPHÉNE)

Sup Rt 120mg Abenol 01919385 PDP G Supp. Acet – 120 02230434 PDP G Sup Rt 325mg Abenol 01919393 PDP G Supp. Tab Orl 325mg Acetaminophen 01938088 JPC G Co. Apo-Acetaminophen 00544981 APX G Novo-Gesic 00389218 TEV G Tab Orl 500mg Acetaminophen 01939122 JPC G Co. Apo-Acetaminophen 00545007 APX G Apo-Acetaminophen 02229977 APX G Novo-Gesic 00482323 TEV G

N02BE51 PARACETAMOL (ACETAMINOPHEN), COMBINATIONS EXCLUDING PSYCHOLEPTICS PARACETAMOL (ACÉTAMINOPHÉNE), EN COMBINAISONS, À L’EXCLUSION DES PSYCHOLEPTIQUES

ACETAMINOPHEN / CAFFEINE / CODEINE ACÉTAMINOPHÈNE / CAFÉINE / CODÉINE

Tab Orl 300mg/30mg/15mg Atasol-15 00293504 CHU ADEFGVW Co. Tab Orl 300mg/15mg/15mg Tylenol No.2 02163934 JAN ADEFGVW Co. ratio-Lenoltec #2 00653241 RPH ADEFGVW

ACETAMINOPHEN / OXYCODONE ACÉTAMINOPHÈNE / OXYCODONE

Tab Orl 325mg/2.5mg Percocet Demi 01916491 BRI ADEFGVW Co. Tab Orl 325mg/5mg Endocet 01916548 BRI ADEFGVW Co. Percocet 01916475 BRI ADEFGVW Apo-Oxycodone/Acet 02324628 APX ADEFGVW Oxycodone/Acet 02361361 SAS ADEFGVW ratio-Oxycocet 00608165 RPH ADEFGVW Sandoz Oxycodone/Acetaminophen 02307898 SDZ ADEFGVW


N02BG OTHER ANALGESICS AND ANTIPYRETICS AUTRE ANALGÉSIQUES ET ANTIPYRÉTIQUES

N02BG04 FLOCTAFENINE FLOCTAFÉNINE

Tab Orl 200mg Floctafenine 02244680 AAP ADEFGVW Co. Tab Orl 400mg Floctafenine 02244681 AAP ADEFGVW Co.

N02C ANTIMIGRAINE PREPARATIONS PRÉPARATIONS ANTI-MIGRAINES

N02CA ERGOT ALKALOIDS ALKALOÏDES DE L’ERGOT

N02CA01 DIHYDROERGOTAMINE DIHYDROERGOTAMINE

Liq Inj 1mg/mL Dihydroergotamine 02241163 SDZ ADEFGVW Liq Dihydroergotamine 00027243 STR ADEFGVW Liq Nas 4mg/mL Migranal 02228947 STR ADEFGVW Liq

N02CA52 ERGOTAMINE, COMBINATIONS EXCLUDING PSYCHOLEPTICS

ERGOTAMINE, EN COMBINAISON, À L’EXCLUSION DES PSYCHOLEPTIQUES ERGOTAMINE / CAFFEINE ERGOTAMINE / CAFÉINE

Tab Orl 1mg/100mg Cafergot (Disc/non disp Feb 7/16) 00176095 NVR ADEFGVW Co.

N02CC SELECTIVE 5HT1-RECEPTOR AGONISTS AGONISTES DES RECEPTEURS 5HT1 SELECTIFS

N02CC01 SUMATRIPTAN SUMATRIPTAN

Liq SC 12mg/mL Imitrex 02212188 GSK (SA) Liq Taro-Sumatriptan 02361698 TAR (SA) Spr Nas 5mg Imitrex 02230418 GSK (SA) Spr Spr Nas 20mg Imitrex 02230420 GSK (SA) Spr Tab Orl 50mg Imitrex DF 02212153 GSK (SA) Co. Act Sumatriptan 02257890 ATV (SA) Apo-Sumatriptan 02268388 APX (SA) Mylan-Sumatriptan 02268914 MYL (SA) pms-Sumatriptan 02256436 PMs (SA) Sandoz Sumatriptan 02263025 SDZ (SA) Sumatriptan 02286521 SAS (SA) Sumatriptan DF 02385570 SIV (SA) Teva-Sumatriptan DF 02286823 TEV (SA)


N02CC01 SUMATRIPTAN SUMATRIPTAN

Tab Orl 100mg Imitrex DF 02212161 GSK (SA) Co. Act Sumatriptan 02257904 ATV (SA) Apo-Sumatriptan 02268396 APX (SA) Mylan-Sumatriptan 02268922 MYL (SA) pms-Sumatriptan 02256444 PMS (SA) Sandoz Sumatriptan 02263033 SDZ (SA) Sumatriptan 02286548 SAS (SA) Sumatriptan DF 02385589 SIV (SA) Teva-Sumatriptan 02239367 TEV (SA) Teva-Sumatriptan DF 02286831 TEV (SA)

N02CC02 NARATRIPTAN

NARATRIPTAN

Tab Orl 1mg Amerge 02237820 GSK (SA) Co. Teva-Naratriptan 02314290 TEV (SA) Tab Orl 2.5mg Amerge 02237821 GSK (SA) Co. Teva-Naratriptan 02314304 TEV (SA) Sandoz Naratriptan 02322323 SDZ (SA)

N02CC03 ZOLMITRIPTAN

ZOLMITRIPTAN

ODT Orl 2.5mg Zomig Rapimelt 02243045 AZE (SA) Co.D.O. Jamp-Zolmitriptan ODT 02428237 JPC (SA) Mylan-Zolmitriptan ODT 02387158 MYL (SA) pms-Zolmitriptan ODT 02324768 PMS (SA) Sandoz Zolmitriptan ODT 02362996 SDZ (SA) Teva-Zolmitriptan OD 02342545 TEV (SA) Spr Nas 2.5mg Zomig 02248992 AZE (SA) Spr Spr Nas 5mg Zomig Nasal 02248993 AZE (SA) Spr Tab Orl 2.5mg Zomig 02238660 AZE (SA) Co. Jamp-Zolmitriptan 02421623 JPC (SA) Mar-Zolmitriptan 02399458 MAR (SA) Mylan-Zolmitriptan 02369036 MYL (SA) pms-Zolmitriptan 02324229 PMS (SA) Sandoz Zolmitriptan 02362988 SDZ (SA) Teva-Zolmitriptan 02313960 TEV (SA)


N02CC04 RIZATRIPTAN RIZATRIPTAN

ODT Orl 5mg Maxalt RPD 02240518 FRS (SA) Co.D.O. Act Rizatriptan ODT 02374730 ATV (SA) Apo-Rizatriptan RPD 02393484 APX (SA) Mint-Rizatriptan ODT 02439573 MNT (SA) Mylan-Rizatriptan ODT 02379198 MYL (SA) pms-Rizatriptan RDT 02393360 PMS (SA) Sandoz Rizatriptan ODT 02351870 SDZ (SA) Teva-Rizatriptan ODT 02396661 TEV (SA) ODT Orl 10mg Maxalt RPD 02240519 FRS (SA) Co.D.O. Act Rizatriptan ODT 02374749 ATV (SA) Apo-Rizatriptan RPD 02393492 APX (SA) Mint-Rizatriptan ODT 02439581 MNT (SA) Mylan-Rizatriptan ODT 02379201 MYL (SA) pms-Rizatriptan RDT 02393379 PMS (SA) Sandoz Rizatriptan ODT 02351889 SDZ (SA) Teva-Rizatriptan ODT 02396688 TEV (SA) Tab Orl 5mg Apo-Rizatriptan 02393468 APX (SA) Co. Jamp-Rizatriptan 02380455 JPC (SA) Mar-Rizatriptan 02379651 MAR (SA) Tab Orl 10mg Maxalt 02240521 FRS (SA) Co. Act Rizatriptan 02381702 ATV (SA) Apo-Rizatriptan 02393476 APX (SA) Jamp-Rizatriptan 02380463 JPC (SA) Mar-Rizatriptan 02379678 MAR (SA)

N02CC05 ALMOTRIPTAN

ALMOTRIPTAN

Tab Orl 6.25mg Axert 02248128 JNJ (SA) Co. Apo-Almotriptan 02405792 APX (SA) Mylan-Almotriptan 02398435 MYL (SA) Tab Orl 12.5mg Axert 02248129 JNJ (SA) Co. Apo-Almotriptan 02405806 APX (SA) Mylan-Almotriptan 02398443 MYL (SA) Sandoz Almotriptan 02405334 SDZ (SA)

N02CX OTHER ANTIMIGRAINE PREPARATIONS AUTRES PRÉPARATIONS ANTI-MIGRAINE

N02CX01 PIZOTIFEN PIZOTIFÈNE

Tab Orl 0.5mg Sandomigran 00329320 PAL ADEFGVW Co. Tab Orl 1mg Sandomigran DS 00511552 PAL ADEFGVW Co.


N03 ANTIEPILEPTICS ANTIÉPILEPTIQUES

N03A ANTIEPILEPTICS ANTIÉPILEPTIQUES

N03AA BARBITURATES AND DERIVATIVES BARBITURIQUES ET DÉRIVÉS

N03AA02 PHENOBARBITAL PHÉNOBARBITAL

Elx Orl 5mg/mL Phenobarbital 00645575 PMS ADEFGVW Elx Tab Orl 15mg Phenobarbital 00178799 PDP ADEFGVW Co. Tab Orl 30mg Phenobarbital 00178802 PDP ADEFGVW Co. Tab Orl 60mg Phenobarbital 00178810 PDP ADEFGVW Co. Tab Orl 100mg Phenobarbital 00178829 PDP ADEFGVW Co.

N03AA03 PRIMIDONE

PRIMIDONE

Tab Orl 125mg Primidone 00399310 AAP ADEFGVW Co. Tab Orl 250mg Primidone 00396761 AAP ADEFGVW Co.

N03AB HYDANTOIN DERIVATIVES DÉRIVÉS DE L’HYDANTOÏNE

N03AB02 PHENYTOIN PHÉNYTOÏNE

Cap Orl 30mg Dilantin 00022772 PFI ADEFGVW Caps Cap Orl 100mg Dilantin 00022780 PFI ADEFGVW Caps Liq Orl 50mg/mL Phenytoin Sodium 00780626 SDZ V Liq Tab Orl 50mg Dilantin infatabs 00023698 PFI ADEFGVW Co. Sus Orl 30mg/5mL Dilantin 30 00023442 PFI ADEFGVW Susp


N03AB02 PHENYTOIN PHÉNYTOÏNE

Sus Orl 125mg/5mL Dilantin 125 00023450 PFI ADEFGVW Susp Taro-Phenytoin 02250896 TAR ADEFGVW

N03AD SUCCINIMIDE DERIVATIVES DÉRIVÉS DU SUCCINIMIDE

N03AD01 ETHOSUXIMIDE ÉTHOSUXIMIDE

Cap Orl 250mg Zarontin 00022799 ERF ADEFGVW Caps Syr Orl 50mg/mL Zarontin 00023485 ERF ADEFGVW Sir.

N03AE BENZODIAZEPINE DERIVATIVES DÉRIVÉS DU BENZODIAZÉPINES

N03AE01 CLONAZEPAM CLONAZÉPAM

Tab Orl 0.25mg pms-Clonazepam 02179660 PMS ADEFGVW Co. Tab Orl 0.5mg Rivotril 00382825 HLR ADEFGVW Co. Apo-Clonazepam 02177889 APX ADEFGVW Co Clonazepam 02270641 COB ADEFGVW Mylan-Clonazepam 02230950 MYL ADEFGVW Phl-Clonazepam 02236948 PHL ADEFGVW pms-Clonazepam R 02207818 PMS ADEFGVW Sandoz Clonazepam (Disc/non disp Apr 27/17) 02233960 SDZ ADEFGVW Teva-Clonazepam 02239024 TEV ADEFGVW Zym-Clonazepam (Disc/non disp Jun 16/16) 02345676 ZYM ADEFGVW Tab Orl 1mg Phl-Clonazepam 02145235 PHL ADEFGVW Co. pms-Clonazepam 02048728 PMS ADEFGVW Sandoz Clonazepam 02233982 SDZ ADEFGVW Zym-Clonazepam (Disc/non disp Jun 16/16) 02303329 ZYM ADEFGVW Tab Orl 2mg Rivotril 00382841 HLR ADEFGVW Co. Apo-Clonazepam 02177897 APX ADEFGVW Co Clonazepam 02270676 COB ADEFGVW Mylan-Clonazepam 02230951 MYL ADEFGVW Phl-Clonazepam 02145243 PHL ADEFGVW pms-Clonazepam 02048736 PMS ADEFGVW Sandoz Clonazepam (Disc/non disp Dec 31/16) 02233985 SDZ ADEFGVW Teva-Clonazepam 02239025 TEV ADEFGVW Zym-Clonazepam (Disc/non disp Jun 16/16) 02303337 ZYM ADEFGVW


N03AF CARBOXAMIDE DERIVATIVES DÉRIVÉS DU CARBOXAMIDE

N03AF01 CARBAMAZEPINE CARBAMAZÉPINE

SRT Orl 200mg Tegretol CR 00773611 NVR ADEFGVW Co.L.L. Mylan-Carbamazepine 02241882 MYL ADEFGVW pms-Carbamazepine 02231543 PMS ADEFGVW Taro-Carbamazepine CR 02237907 TAR ADEFGVW Sandoz Carbamazepine CR 02261839 SDZ ADEFGVW SRT Orl 400mg Tegretol CR 00755583 NVR ADEFGVW Co.L.L. Mylan-Carbamazepine 02241883 MYL ADEFGVW pms-Carbamazepine 02231544 PMS ADEFGVW Taro-Carbamazepine CR 02237908 TAR ADEFGVW Sandoz Carbamazepine CR 02261847 SDZ ADEFGVW Sus Orl 100mg/5mL Tegretol 02194333 NVR ADEFGVW Susp Taro-Carbamazepine 02367394 TAR ADEFGVW Tab Orl 200mg Tegretol 00010405 NVR ADEFGVW Co. Taro-Carbamazepine 02407515 TAR ADEFGVW Teva-Carbamazepine 00782718 TEV ADEFGVW TabC Orl 100mg Tegretol Chew 00369810 NVR ADEFGVW Co.C. pms-Carbamazepine 02231542 PMS ADEFGVW Sandoz Carbamazepine Chewtabs (Disc/non disp Apr 27/17) 02261855 SDZ ADEFGVW TabC Orl 200mg Tegretol Chew 00665088 NVR ADEFGVW Co.C. pms-Carbamazepine 02231540 PMS ADEFGVW

Sandoz Carbamazepine Chewtabs (Disc/non disp Dec 31/16) 02261863 SDZ ADEFGVW N03AF02 OXCARBAZEPINE

OXCARBAZÉPINE

Sus Orl 60mg/mL Trileptal 02244673 NVR (SA) Susp Tab Orl 150mg Trileptal 02242067 NVR (SA) Co. Oxcarbazepine 02284294 AAP (SA) Tab Orl 300mg Trileptal 02242068 NVR (SA) Co. Oxcarbazepine 02284308 AAP (SA) Tab Orl 600mg Trileptal 02242069 NVR (SA) Co. Oxcarbazepine 02284316 AAAP (SA)

N03AF03 RUFINAMIDE

RUFINAMIDE

Tab Orl 100mg Banzel 02369613 EIS (SA) Co.


N03AF03 RUFINAMIDE RUFINAMIDE

Tab Orl 200mg Banzel 02369621 EIS (SA) Co. Tab Orl 400mg Banzel 02369648 EIS (SA) Co.

N03AG FATTY ACID DERIVATIVES DÉRIVÉS DES ACIDES GRAS

N03AG01 VALPROIC ACID ACIDE VALPROÏQUE

ECT Orl 125mg Epival 00596418 BGP ADEFGVW Co.Ent Apo-Divalproex 02239698 APX ADEFGVW Divalproex 02400499 SAS ADEFGVW Novo-Divalproex 02239701 TEV ADEFGVW ECT Orl 250mg Epival 00596426 BGP ADEFGVW Co.Ent Apo-Divalproex 02239699 APX ADEFGVW Divalproex 02400502 SAS ADEFGVW Novo-Divalproex 02239702 TEV ADEFGVW ECT Orl 500mg Epival 00596434 BGP ADEFGVW Co.Ent Apo-Divalproex 02239700 APX ADEFGVW Divalproex 02400510 SAS ADEFGVW Novo-Divalproex 02239703 TEV ADEFGVW Cap Orl 250mg Depakene 00443840 BGP ADEFGVW Caps Apo-Valproic 02238048 APX ADEFGVW Novo-Valproic 02100630 TEV ADEFGVW pms-Valproic Acid 02230768 PMS ADEFGVW Sandoz Valproic (Disc/non disp Nov 15/15) 02239714 SDZ ADEFGVW ECC Orl 500mg pms-Valproic Acid 02229628 PMS ADEFGVW Caps.Ent Syr Orl 250mg/5mL Depakene 00443832 BGP ADEFGVW Sir. Apo-Valproic Acid 02238370 APX ADEFGVW pms-Valproic 02236807 PMS ADEFGVW

N03AG04 VIGABATRIN

VIGABATRIN

Pwr Orl 500mg Sabril (Sachet) 02068036 LBK (SA) Pd. Tab Orl 500mg Sabril 02065819 LBK (SA) Co.


N03AX OTHER ANTIEPILEPTICS AUTRE ANTIÉPILEPTIQUES

N03AX09 LAMOTRIGINE LAMOTRIGINE

Tab Orl 25mg Lamictal 02142082 GSK ADEFGVW Co. Apo-Lamotrigine 02245208 APX ADEFGVW Auro-Lamotrigine 02381354 ARO ADEFGVW Lamotrigine 02343010 SAS ADEFGVW Lamotrigine 02428202 SIV ADEFGVW Mylan-Lamotrigine 02265494 MYL ADEFGVW pms-Lamotrigine 02246897 PMS ADEFGVW Teva-Lamotrigine 02248232 TEV ADEFGVW Tab Orl 100mg Lamictal 02142104 GSK ADEFGVW Co. Apo-Lamotrigine 02245209 APX ADEFGVW Auro-Lamotrigine 02381362 ARO ADEFGVW Lamotrigine 02343029 SAS ADEFGVW Lamotrigine 02428210 SIV ADEFGVW Mylan-Lamotrigine 02265508 MYL ADEFGVW pms-Lamotrigine 02246898 PMS ADEFGVW Teva-Lamotrigine 02248233 TEV ADEFGVW Tab Orl 150mg Lamictal 02142112 GSK ADEFGVW Co. Apo-Lamotrigine 02245210 APX ADEFGVW Auro-Lamotrigine 02381370 ARO ADEFGVW Lamotrigine 02343037 SAS ADEFGVW Lamotrigine 02428229 SIV ADEFGVW Mylan-Lamotrigine 02265516 MYL ADEFGVW pms-Lamotrigine 02246899 PMS ADEFGVW Teva-Lamotrigine 02248234 TEV ADEFGVW TabC Orl 2mg Lamictal Chewtabs 02243803 GSK ADEFGVW Co.C TabC Orl 5mg Lamictal Chewtabs 02240115 GSK ADEFGVW Co.C

N03AX11 TOPIRAMATE

TOPIRAMATE

Cap Orl 15mg Topamax 02239907 JAN (SA) Caps Cap Orl 25mg Topamax 02239908 JAN (SA) Caps


N03AX11 TOPIRAMATE TOPIRAMATE

Tab Orl 25mg Topamax 02230893 JAN ADEFGVW Co. Abbott-Topiramate 02414600 BGP ADEFGVW Act Topiramate 02287765 ATV ADEFGVW Apo-Topiramate 02279614 APX ADEFGVW Auro-Topiramate 02345803 ARO ADEFGVW GD-Topiramate (Disc/non disp Nov 30/15) 02352850 GMD ADEFGVW Jamp-Topiramate 02435608 JPC ADEFGVW Mint-Topiramate 02315645 MNT ADEFGVW Mylan-Topiramate 02263351 MYL ADEFGVW Phl-Topiramate 02271184 PHL ADEFGVW pms-Topiramate 02262991 PMS ADEFGVW Ran-Topiramate 02396076 RAN ADEFGVW Sandoz Topiramate 02260050 SDZ ADEFGVW Sandoz Topiramate Tablets 02431807 SDZ ADEFGVW Teva-Topiramate 02248860 TEV ADEFGVW Topiramate 02356856 SAS ADEFGVW Topiramate 02389460 SIS ADEFGVW Topiramate 02395738 AHI ADEFGVW Zym-Topiramate (Disc/non disp Jun 16/16) 02325136 ZYM ADEFGVW Tab Orl 50mg pms-Topiramate 02312085 PMS ADEFGVW Co. Tab Orl 100mg Topamax 02230894 JAN ADEFGVW Co. Abbott-Topiramate 02414619 BGP ADEFGVW Act Topiramate 02287773 ATV ADEFGVW Apo-Topiramate 02279630 APX ADEFGVW Auro-Topiramate 02345838 ARO ADEFGVW GD-Topiramate (Disc/non disp Nov 30/15) 02352877 GMD ADEFGVW Jamp-Topiramate 02435616 JPC ADEFGVW Mint-Topiramate 02315653 MNT ADEFGVW Mylan-Topiramate 02263378 MYL ADEFGVW Phl-Topiramate 02271192 PHL ADEFGVW pms-Topiramate 02263009 PMS ADEFGVW Ran-Topiramate 02396084 RAN ADEFGVW Sandoz Topiramate 02260069 SDZ ADEFGVW Sandoz Topiramate Tablets 02431815 SDZ ADEFGVW Teva-Topiramate 02248861 TEV ADEFGVW Topiramate 02356864 SAS ADEFGVW Topiramate 02389487 SIS ADEFGVW Topiramate 02395746 AHI ADEFGVW Zym-Topiramate (Disc/non disp Jun 16/16) 02325144 ZYM ADEFGVW


N03AX11 TOPIRAMATE TOPIRAMATE

Tab Orl 200mg Topamax 02230896 JAN ADEFGVW Co. Abbott-Topiramate 02414627 BGP ADEFGVW Act Topiramate 02287781 ATV ADEFGVW Apo-Topiramate 02279649 APX ADEFGVW Auro-Topiramate 02345846 ARO ADEFGVW GD-Topiramate (Disc/non disp Nov 30/15) 02352885 GMD ADEFGVW Jamp-Topiramate 02435624 JPC ADEFGVW Mint-Topiramate 02315661 MNT ADEFGVW Mylan-Topiramate 02263386 MYL ADEFGVW Phl-Topiramate 02271206 PHL ADEFGVW pms-Topiramate 02263017 PMS ADEFGVW Ran-Topiramate 02396092 RAN ADEFGVW Sandoz Topiramate 02267837 SDZ ADEFGVW Sandoz Topiramate Tablets 02431823 SDZ ADEFGVW Teva-Topiramate 02248862 TEV ADEFGVW Topiramate 02356872 SAS ADEFGVW Topiramate 02395754 AHI ADEFGVW Zym-Topiramate (Disc/non disp Jun 16/16) 02325152 ZYM ADEFGVW

N03AX12 GABAPENTIN

GABAPENTINE

Cap Orl 100mg Neurontin 02084260 PFI ADEFGVW Caps Act Gabapentin 02256142 ATV ADEFGVW Apo-Gabapentin 02244304 APX ADEFGVW Auro-Gabapentin 02321203 ARO ADEFGVW Gabapentin 02353245 SAS ADEFGVW Gabapentin 02246314 SIV ADEFGVW GD-Gabapentin 02285819 GMD ADEFGVW Jamp-Gabapentin 02361469 JPC ADEFGVW Mar-Gabapentin 02391473 MAR ADEFGVW Mylan-Gabapentin 02248259 MYL ADEFGVW pms-Gabapentin 02243446 PMS ADEFGVW Ran-Gabapentin 02319055 RAN ADEFGVW Teva-Gabapentin 02244513 TEV ADEFGVW Cap Orl 300mg Neurontin 02084279 PFI ADEFGVW Caps Act Gabapentin 02256150 ATV ADEFGVW Apo-Gabapentin 02244305 APX ADEFGVW Auro-Gabapentin 02321211 ARO ADEFGVW Gabapentin 02353253 SAS ADEFGVW Gabapentin 02246315 SIV ADEFGVW GD-Gabapentin 02285827 GMD ADEFGVW Jamp-Gabapentin 02361485 JPC ADEFGVW Mar-Gabapentin 02391481 MAR ADEFGVW Mylan-Gabapentin 02248260 MYL ADEFGVW pms-Gabapentin 02243447 PMS ADEFGVW Ran-Gabapentin 02319063 RAN ADEFGVW Teva-Gabapentin 02244514 TEV ADEFGVW


N03AX12 GABAPENTIN GABAPENTINE

Cap Orl 400mg Neurontin 02084287 PFI ADEFGVW Caps Act Gabapentin 02256169 ATV ADEFGVW Apo-Gabapentin 02244306 APX ADEFGVW Auro-Gabapentin 02321238 ARO ADEFGVW Gabapentin 02353261 SAS ADEFGVW Gabapentin 02246316 SIV ADEFGVW GD-Gabapentin 02285835 GMD ADEFGVW Jamp-Gabapentin 02361493 JPC ADEFGVW Mar-Gabapentin 02391503 MAR ADEFGVW Mylan-Gabapentin 02248261 MYL ADEFGVW pms-Gabapentin 02243448 PMS ADEFGVW Ran-Gabapentin 02319071 RAN ADEFGVW Teva-Gabapentin 02244515 TEV ADEFGVW Tab Orl 600mg Neurontin 02239717 PFI ADEFGVW Co. Apo-Gabapentin 02293358 APX ADEFGVW Gabapentin 02392526 AHI ADEFGVW Gabapentin 02431289 SAS ADEFGVW Gabapentin 02388200 SIV ADEFGVW GD-Gabapentin 02285843 GMD ADEFGVW Jamp-Gabapentin 02402289 JPC ADEFGVW Mylan-Gabapentin 02397471 MYL ADEFGVW pms-Gabapentin 02255898 PMS ADEFGVW Teva-Gabapentin 02248457 TEV ADEFGVW Tab Orl 800mg Neurontin 02239718 PFI ADEFGVW Co. Apo-Gabapentin 02293366 APX ADEFGVW Gabapentin 02392534 AHI ADEFGVW Gabapentin 02431297 SAS ADEFGVW Gabapentin 02388219 SIV ADEFGVW GD-Gabapentin 02285851 GMD ADEFGVW Jamp-Gabapentin 02402297 JPC ADEFGVW Mylan-Gabapentin 02397498 MYL ADEFGVW pms-Gabapentin 02255901 PMS ADEFGVW Teva-Gabapentin 02247346 TEV ADEFGVW

N03AX14 LEVETIRACETAM

LÉVÉTIRACÉTAM

Tab Orl 250mg Keppra 02247027 UCB (SA) Co. Abbott-Levetiracetam 02414805 ABB (SA) Act Levetiracetam 02274183 ATV (SA) Apo-Levetiracetam 02285924 APX (SA) Auro-Levetiracetam 02375249 ARO (SA) Jamp-Levetiracetam 02403005 SIV (SA) Levetiracetam 02353342 SAS (SA) Levetiracetam 02399776 AHI (SA) pms-Levetiracetam 02296101 PMS (SA) Ran-Levetiracetam 02396106 RAN (SA)


N03AX14 LEVETIRACETAM LÉVÉTIRACÉTAM

Tab Orl 500mg Keppra 02247028 UCB (SA) Co. Abbott-Leveitracetam 02414791 ABB (SA) Act Levetiracetam 02274191 ATV (SA) Apo-Levetiracetam 02285932 APX (SA) Auro-Levetiracetam 02375257 ARO (SA) Jamp-Levetiracetam 02403021 SIV (SA) Levetiracetam 02399784 AHI (SA) Levetiracetam 02353350 SAS (SA) pms-Levetiracetam 02296128 PMS (SA) Ran-Levetiracetam 02396114 RAN (SA) Tab Orl 750mg Keppra 02247029 UCB (SA) Co. Abbott-Levetiracetam 02414783 ABB (SA) Act Levetiracetam 02274205 ATV (SA) Apo-Levetiracetam 02285940 APX (SA) Auro-Levetiracetam 02375265 ARO (SA) Jamp-Levetiracetam 02403048 SIV (SA) Levetiracetam 02353369 SAS (SA) Levetiracetam 02399792 AHI (SA) pms-Levetiracetam 02296136 PMS (SA) Ran-Levetiracetam 02396122 RAN (SA)

N03AX16 PREGABALIN

PRÉGABALINE

Cap Orl 25mg Lyrica 02268418 PFI W (SA) Caps Act Pregabalin 02402912 ATV W (SA) Apo-Pregabalin 02394235 APX W (SA) GD-Pregabalin 02360136 GMD W (SA) Mint-Pregabalin 02423804 MNT W (SA) Myl-Pregabalin 02408651 MYL W (SA) pms-Pregabalin 02359596 PMS W (SA) Pregabalin 02405539 SAS W (SA) Pregabalin 02411725 SIV W (SA) Pregabalin 02403692 SIV W (SA) Ran-Pregabalin 02392801 RAN W (SA) Sandoz Pregabalin 02390817 SDZ W (SA) Teva-Pregabalin 02361159 TEV W (SA) Mar-Pregabalin 02417529 MAR W (SA)


N03AX16 PREGABALIN PRÉGABALINE

Cap Orl 50mg Lyrica 02268426 PFI W (SA) Caps Act Pregabalin 02402920 ATV W (SA) Apo-Pregabalin 02394243 APX W (SA) GD-Pregabalin 02360144 GMD W (SA) Mint-Pregabalin 02423812 MNT W (SA) Myl-Pregabalin 02408678 MYL W (SA) pms-Pregabalin 02359618 PMS W (SA) Pregabalin 02405547 SAS W (SA) Pregabalin 02403706 SIV W (SA) Pregabalin 02411733 SIV W (SA) Ran-Pregabalin 02392828 RAN W (SA) Sandoz Pregabalin 02390825 SDZ W (SA) Teva-Pregabalin 02361175 TEV W (SA) Mar-Pregabalin 02417537 MAR W (SA) Cap Orl 75mg Lyrica 02268434 PFI W (SA) Caps Act Pregabalin 02402939 ATV W (SA) Apo-Pregabalin 02394251 APX W (SA) GD-Pregabalin 02360152 GMD W (SA) Mint-Pregabalin 02424185 MNT W (SA) Myl-Pregabalin 02408686 MYL W (SA) pms-Pregabalin 02359626 PMS W (SA) Pregabalin 02405555 SAS W (SA) Pregabalin 02403714 SIV W (SA) Pregabalin 02411741 SIV W (SA) Ran-Pregabalin 02392836 RAN W (SA) Sandoz Pregabalin 02390833 SDZ W (SA) Teva-Pregabalin 02361183 TEV W (SA) Mar-Pregabalin 02417545 MAR W (SA) Cap Orl 150mg Lyrica 02268450 PFI W (SA) Caps Act Pregabalin 02402955 ATV W (SA) Apo-Pregabalin 02394278 APX W (SA) GD-Pregabalin 02360179 GMD W (SA) Mint-Pregabalin 02424207 MNT W (SA) Myl-Pregabalin 02408694 MYL W (SA) pms-Pregabalin 02359634 PMS W (SA) Pregabalin 02405563 SAS W (SA) Pregabalin 02403722 SIV W (SA) Pregabalin 02411768 SIV W (SA) Ran-Pregabalin 02392844 RAN W (SA) Sandoz Pregabalin 02390841 SDZ W (SA) Teva-Pregabalin 02361205 TEV W (SA) Mar-Pregabalin 02417561 MAR W (SA)


N03AX16 PREGABALIN PRÉGABALINE

Cap Orl 225mg Lyrica 02268477 PFI W (SA) Caps Act Pregabalin 02402971 ATV W (SA) Apo-Pregabalin 02394286 APX W (SA) GD-Pregabalin 02360195 GMD W (SA) pms-Pregabalin 02398079 PMS W (SA) Ran-Pregabalin 02392852 RAN W (SA) Teva-Pregabalin 02361221 TEV W (SA) Cap Orl 300mg Lyrica 02268485 PFI W (SA) Caps Act Pregabalin 02402998 ATV W (SA) Apo-Pregabalin 02394294 APX W (SA) GD-Pregabalin 02360209 GMD W (SA) Myl-Pregabalin 02408708 MYL W (SA) pms-Pregabalin 02359642 PMS W (SA) Pregabalin 02405598 SAS W (SA) Pregabalin 02403730 SIV W (SA) Ran-Pregabalin 02392860 RAN W (SA) Sandoz Pregabalin 02390868 SDZ W (SA) Teva-Pregabalin 02361248 TEV W (SA)

N03AX18 LACOSAMIDE

LACOSAMIDE

Tab Orl 50mg Vimpat 02357615 UCB (SA) Co. Tab Orl 100mg Vimpat 02357623 UCB (SA) Co. Tab Orl 150mg Vimpat 02357631 UCB (SA) Co. Tab Orl 200mg Vimpat 02357658 UCB (SA) Co.

N03AX22 PERAMPANEL

PÉRAMPANEL

Tab Orl 2mg Fycompa 02404516 EIS (SA) Co. Tab Orl 4mg Fycompa 02404524 EIS (SA) Co. Tab Orl 6mg Fycompa 02404532 EIS (SA) Co. Tab Orl 8mg Fycompa 02404540 EIS (SA) Co.


N03AX22 PERAMPANEL PÉRAMPANEL

Tab Orl 10mg Fycompa 02404559 EIS (SA) Co. Tab Orl 12mg Fycompa 02404567 EIS (SA) Co.

N04 ANTI-PARKINSON DRUGS MÉDICAMENTS ANTI-PARKINSON

N04A ANTI-CHOLINERGIC AGENTS AGENTS ANTI-CHOLINERGIQUES

N04AA TERTIARY AMINES AMINES TERTIAIRES

N04AA01 TRIHEXYPHENIDYL TRIHEXYPHÉNIDYLE

Tab Orl 2mg Trihex 00545058 AAP ADEFGVW Co. Tab Orl 5mg Trihex 00545074 AAP ADEFGVW Co.

N04AA04 PROCYCLIDINE

PROCYCLIDINE Elx Orl 2.5mg/5mL pdp-Procyclidine 00587362 PDP ADEFGVW Elx. Tab Orl 2.5mg pdp-Procyclidine 00649392 PDP ADEFGVW Co. Tab Orl 5mg pdp-Procyclidine 00587354 PDP ADEFGVW Co.

N04AA05 PROFENAMINE (ETHOPROPAZINE)

PROFÉNAMINE (ÉTHOPROPAZINE) Tab Orl 50mg Parsitan 01927744 ERF ADEFGVW Co.

N04AC ETHERS OF TROPINE OR TROPINE DERIVATIVES ÉTHERS DE TROPINE OU DÉRIVÉS DU TROPINE

N04AC01 BENZATROPINE BENZYTROPINE

Liq Inj 1mg/mL Benztropine Omega 02238903 OMG ADEFGVW Liq Tab Orl 1mg pms-Benztropine 00706531 PMS ADEFGVW Co. Tab Orl 2mg Benztropine 00426857 PMS ADEFGVW Co.


N04B DOPAMINERGIC AGENTS AGENTS DOPAMINERGIQUES

N04BA DOPA AND DOPA DERIVATIVES DOPA ET DÉRIVÉS DU DOPA

N04BA02 LEVODOPA AND DECARBOXYLASE INHIBITOR LÉVODOPA ET INHIBITEUR DU DÉCARBOXYLASE

LEVODOPA / BENSERAZIDE LÉVODOPA / BENSÉRAZIDE

Cap Orl 50mg/12.5mg Prolopa 00522597 HLR ADEFGVW Caps Cap Orl 100mg/25mg Prolopa 00386464 HLR ADEFGVW Caps Cap Orl 200mg/50mg Prolopa 00386472 HLR ADEFGVW Caps

LEVODOPA / CARBIDOPA LÉVODOPA / CARBIDOPA

SRT Orl 100mg/25mg Sinemet CR 02028786 FRS ADEFVW Co.L.L. Apo-Levocarb CR 02272873 APX ADEFVW pms-Levocarb CR 02421488 PMS ADEFVW SRT Orl 200mg/50mg Sinemet CR 00870935 FRS ADEFVW Co.L.L. Apo-Levocarb CR 02245211 APX ADEFVW pms-Levocarb CR 02421496 PMS ADEFVW Tab Orl 100mg/10mg Sinemet 00355658 FRS ADEFVW Co. Apo-Levocarb 02195933 APX ADEFVW Teva-Levocarbidopa 02244494 TEV ADEFVW Tab Orl 100mg/25mg Sinemet 00513997 FRS ADEFVW Co. Apo-Levocarb 02195941 APX ADEFVW Teva-Levocarbidopa 02244495 TEV ADEFVW Tab Orl 250mg/25mg Sinemet 00328219 FRS ADEFVW Co. Apo-Levocarb 02195968 APX ADEFVW Teva-Levocarbidopa 02244496 TEV ADEFVW

N04BA03 LEVODOPA, CARBIDOPA, ENTACAPONE

LÉVODOPA, CARBIDOPA, ENTACAPONE

Tab Orl 50mg/12.5mg/200mg Stalevo 02305933 NVR (SA) Co. Tab Orl 75mg/18.75mg/200mg Stalevo 02337827 NVR (SA) Co. Tab Orl 100mg/25mg/200mg Stalevo 02305941 NVR (SA) Co.


N04BA03 LEVODOPA, CARBIDOPA, ENTACAPONE LÉVODOPA, CARBIDOPA, ENTACAPONE

Tab Orl 125mg/31.25mg/200mg Stalevo 02337835 NVR (SA) Co. Tab Orl 150mg/37.5mg/200mg Stalevo 02305968 NVR (SA) Co.

N04BB ADAMANTINE DERIVATIVES DÉRIVÉS DE L’ADAMANTINE

N04BB01 AMANTADINE AMANTADINE

Cap Orl 100mg pms-Amantadine Hydrochloride 01990403 PMS ADEFGVW Caps Syr Orl 10mg/mL pms-Amantadine 02022826 PMS ADEFGVW Sir.

N04BC DOPAMINE AGONISTS AGONISTES DE LA DOPAMINE

N04BC04 ROPINIROLE ROPINIROLE

Tab Orl 0.25mg Requip 02232565 GSK ADEFVW Co. Act Ropinirole 02316846 ATV ADEFVW Jamp-Ropinirole 02352338 JPC ADEFVW pms-Ropinirole 02326590 PMS ADEFVW Ran-Ropinirole 02314037 RAN ADEFVW Ropinirole 02353040 SAS ADEFVW Tab Orl 1mg Requip 02232567 GSK ADEFVW Co. Act Ropinirole 02316854 ATV ADEFVW Jamp-Ropinirole 02352346 JPC ADEFVW pms-Ropinirole 02326612 PMS ADEFVW Ran-Ropinirole 02314053 RAN ADEFVW Ropinirole 02353059 SAS ADEFVW Tab Orl 2mg Requip 02232568 GSK ADEFVW Co. Act Ropinirole 02316862 ATV ADEFVW Jamp-Ropinirole 02352354 JPC ADEFVW pms-Ropinirole 02326620 PMS ADEFVW Ran-Ropinirole 02314061 RAN ADEFVW Ropinirole (Disc/non dips Aug 1/16) 02353067 SAS ADEFVW Tab Orl 5mg Requip 02232569 GSK ADEFVW Co. Act Ropinirole 02316870 ATV ADEFVW Jamp-Ropinirole 02352362 JPC ADEFVW pms-Ropinirole 02326639 PMS ADEFVW Ran-Ropinirole 02314088 RAN ADEFVW Ropinirole 02353075 SAS ADEFVW


N04BC05 PRAMIPEXOLE PRAMIPEXOLE

Tab Orl 0.25mg Mirapex 02237145 BOE ADEFVW Co. Act Pramipexole 02297302 ATV ADEFVW Apo-Pramipexole 02292378 APX ADEFVW Mylan-Pramipexole 02376350 MYL ADEFVW pms-Pramipexole 02290111 PMS ADEFVW Pramipexole 02367602 SAS ADEFVW Pramipexole 02309122 SIV ADEFVW Sandoz Pramipexole 02315262 SDZ ADEFVW Teva-Pramipexole 02269309 TEV ADEFVW Tab Orl 0.5mg Mirapex 02241594 BOE ADEFVW Co. Act Pramipexole 02297310 ATV ADEFVW Apo-Pramipexole 02292386 APX ADEFVW Mylan-Pramipexole 02376369 MYL ADEFVW pms-Pramipexole 02290138 PMS ADEFVW Pramipexole 02367610 SAS ADEFVW Pramipexole 02309130 SIV ADEFVW Sandoz Pramipexole 02315270 SDZ ADEFVW Teva-Pramipexole 02269317 TEV ADEFVW Tab Orl 1mg Mirapex 02237146 BOE ADEFVW Co. Act Pramipexole 02297329 ATV ADEFVW Apo-Pramipexole 02292394 APX ADEFVW Mylan-Pramipexole 02376377 MYL ADEFVW pms-Pramipexole 02290146 PMS ADEFVW Pramipexole 02367629 SAS ADEFVW Pramipexole 02309149 SIV ADEFVW Sandoz Pramipexole 02315289 SDZ ADEFVW Teva-Pramipexole 02269325 TEV ADEFVW Tab Orl 1.5mg Mirapex 02237147 BOE ADEFVW Co. Act Pramipexole 02297337 ATV ADEFVW Apo-Pramipexole 02292408 APX ADEFVW Mylan-Pramipexole 02376385 MYL ADEFVW pms-Pramipexole 02290154 PMS ADEFVW Pramipexole 02309157 SIV ADEFVW Sandoz Pramipexole 02315297 SDZ ADEFVW Teva-Pramipexole 02269333 TEV ADEFVW

N04BD MONOAMINE OXIDASE TYPE B INHIBITORS OXIDASE DE MONOAMINE, INHIBITEURS DE TYPE B

N04BD01 SELEGILINE SÉLÉGILINE

Tab Orl 5mg Apo-Selegiline 02230641 APX ADEFVW Co. Mylan-Selegiline 02231036 MYL ADEFVW Novo-Selegiline 02068087 TEV ADEFVW


N04BX OTHER DOPAMINERGIC AGENTS AUTRES AGENTS DOPAMINERGIQUES

N04BX02 ENTACAPONE ENTACAPONE

Tab Orl 200mg Comtan 02243763 NVR ADEFGVW Co. Mylan-Entacapone 02390337 MYL ADEFGVW Sandoz Entacapone 02380005 SDZ ADEFGVW Teva-Entacapone 02375559 TEV ADEFGVW

N05 PSYCHOLEPTICS PSYCHOLEPTIQUES

N05A ANTIPSYCHOTICS ANTIPSYCHOTIQUES

N05AA PHENOTHIAZINE WITH ALIPHATIC SIDE CHAIN PHÉNOTHIAZINE AVEC CHAÎNE LATÉRALE ALIPHATIQUE

N05AA01 CHLORPROMAZINE CHLORPROMAZINE

Tab Orl 25mg Teva-Chlorpromazine 00232823 TEV ADEFGVW Co. Tab Orl 50mg Teva-Chlorpromazine 00232807 TEV ADEFGVW Co. Tab Orl 100mg Teva-Chlorpromazine 00232831 TEV ADEFGVW Co.

N05AA02 LEVOMEPROMAZINE (METHOTRIMEPRAZINE)

LÉVOMÉPROMAZINE (MÉTHOTRIMÉPRAZINE)

Liq Inj 25mg/mL Nozinan 01927698 SAV ADEFVW Liq Tab Orl 2mg Methoprazine 02238403 AAP ADEFGVW Co. Tab Orl 5mg Methoprazine 02238404 AAP ADEFGVW Co. Tab Orl 25mg Methoprazine 02238405 AAP ADEFGVW Co. Tab Orl 50mg Methoprazine 02238406 AAP ADEFGVW Co.

N05AB PHENOTHIAZINE WITH PIPERAZINE STRUCTURE PHÉNOTHIAZINE À STRUCTURE DE PIPÉRAZINE

N05AB02 FLUPHENAZINE FLUPHÉNAZINE

Liq Inj 100mg/mL Modecate conc 00755575 BRI ADEFGVW Liq


N05AB02 FLUPHENAZINE FLUPHÉNAZINE

Tab Orl 1mg Fluphenazine 00405345 AAP ADEFGVW Co. Tab Orl 2mg Fluphenazine 00410632 AAP ADEFGVW Co. Tab Orl 5mg Fluphenazine 00405361 AAP ADEFGVW Co.

N05AB03 PERPHENAZINE

PERPHÉNAZINE

Tab Orl 2mg Perphenazine 00335134 AAP ADEFGVW Co. Tab Orl 4mg Perphenazine 00335126 AAP ADEFGVW Co. Tab Orl 8mg Perphenazine 00335118 AAP ADEFGVW Co. Tab Orl 16mg Perphenazine 00335096 AAP ADEFGVW Co.

N05AB04 PROCHLORPERAZINE

PROCHLORPÉRAZINE

Sup Rt 10mg pms-Prochlorperazine 00753688 PMS ADEFGVW Supp Sandoz Prochlorperazine 00789720 SDZ ADEFGVW Tab Orl 5mg Prochlorazine 00886440 AAP ADEFGVW Co. Tab Orl 10mg Prochlorazine 00886432 AAP ADEFGVW Co.

N05AB06 TRIFLUOPERAZINE

TRIFLUOPÉRAZINE

Tab Orl 1mg Trifluoperazine 00345539 AAP ADEFGVW Co. Tab Orl 2mg Trifluoperazine 00312754 AAP ADEFGVW Co. Tab Orl 5mg Trifluoperazine 00312746 AAP ADEFGVW Co. Tab Orl 10mg Trifluoperazine 00326836 AAP ADEFGVW Co.


N05AC PHENOTHIAZINE WITH PIPERIDINE STRUCTURE PHÉNOTHIAZINES À STRUCTURE DE PIPÉRIDINE

N05AC01 PERICYAZINE PÉRICYAZINE

Cap Orl 5mg Neuleptil 01926780 ERF ADEFGVW Caps Cap Orl 10mg Neuleptil 01926772 ERF ADEFGVW Caps Cap Orl 20mg Neuleptil 01926764 ERF ADEFGVW Caps Dps Orl 10mg/mL Neuleptil 01926756 ERF ADEFGVW Gttes

N05AC04 PIPOTIAZINE

PIPOTIAZINE Liq Inj 25mg/mL Piportil L4 01926667 SAV ADEFGVW Liq Liq Inj 50mg/mL Piportil L4 01926675 SAV ADEFGVW Liq

N05AD BUTYROPHENONE DERIVATIVES DÉRIVÉS DU BUTYROPHÉNONE

N05AD01 HALOPERIDOL HALOPÉRIDOL

Tab Orl 0.5mg Apo-Haloperidol (Disc/non disp Dec 09/15) 00396796 APX ADEFGVW Co. Novo-Peridol 00363685 TEV ADEFGVW Tab Orl 1mg Apo-Haloperidol (Disc/non disp Feb 14/16) 00396818 APX ADEFGVW Co. Novo-Peridol 00363677 TEV ADEFGVW Tab Orl 2mg Novo-Peridol 00363669 TEV ADEFGVW Co. Tab Orl 5mg Novo-Peridol 00363650 TEV ADEFGVW Co. Tab Orl 10mg Apo-Haloperidol (Disc/non disp Feb 14/16) 00463698 APX ADEFGVW Co. Novo-Peridol 00713449 TEV ADEFGVW Liq Inj 5mg/mL Haloperidol 00808652 SDZ ADEFGVW Liq Liq Inj 50mg/mL Haloperidol LA 02130297 SDZ ADEFGVW Liq Liq Inj 100mg/mL Haloperidol LA 02130300 SDZ ADEFGVW Liq


N05AE INDOLE DERIVATIVES DÉRIVÉS DE L’INDOLE

N05AE04 ZIPRASIDONE ZIPRASIDONE

Cap Orl 20mg Zeldox 02298597 PFI ADEFGVW Caps Cap Orl 40mg Zeldox 02298600 PFI ADEFGVW Caps Cap Orl 60mg Zeldox 02298619 PFI ADEFGVW Caps Cap Orl 80mg Zeldox 02298627 PFI ADEFGVW Caps

N05AE05 LURASIDONE

LURASIDONE

Tab Orl 20mg Latuda 02422050 SNV (SA) Co. Tab Orl 40mg Latuda 02387751 SNV (SA) Co. Tab Orl 60mg Latuda 02413361 SNV (SA) Co. Tab Orl 80mg Latuda 02387778 SNV (SA) Co. Tab Orl 120mg Latuda 02387786 SNV (SA) Co.

N05AF THIOXANTHENE DERIVATIVES DÉRIVÉS DU THIOXANTHÉNE

N05AF01 FLUPENTHIXOL FLUPENTHIXOL

Tab Orl 0.5mg Fluanxol 02156008 VLH ADEFGVW Co. Tab Orl 3mg Fluanxol 02156016 VLH ADEFGVW Co. Liq Inj 20mg/mL Fluanxol Depot 02156032 VLH ADEFGVW Liq Liq Inj 100mg/mL Fluanxol Depot 02156040 VLH ADEFGVW Liq


N05AF04 THIOTHIXENE THIOTHIXÉNE

Cap Orl 2mg Navane (Disc/non disp Jun 5/17) 00024430 ERF ADEFGVW Caps Cap Orl 5mg Navane 00024449 ERF ADEFGVW Caps Cap Orl 10mg Navane (Disc/non disp Jun 5/17) 00024457 ERF ADEFGVW Caps

N05AF05 ZUCLOPENTHIXOL

ZUCLOPENTHIXOL

Tab Orl 10mg Clopixol 02230402 VLH (SA) Co. Tab Orl 25mg Clopixol 02230403 VLH (SA) Co. Liq Inj 200mg/mL Clopixol Depot 02230406 VLH ADEFGVW Liq

N05AG DIPHENYLBUTYLPIPERIDINE DERIVATIVES DÉRIVÉS DE LA DIPHÉNYLBUTYLPIPÉRIDINE

N05AG02 PIMOZIDE PIMOZIDE

Tab Orl 2mg Orap 00313815 AAP ADEFGVW Co. Pimozide 02245432 AAP ADEFGVW Tab Orl 4mg Orap 00313823 AAP ADEFGVW Co. Pimozide 02245433 AAP ADEFGVW

N05AH DIAZEPINES, OXAZEPINES, THIAZEPINES AND OXEPINES DIAZÉPINES, OXAZÉPINES, THIAZÉPINES ET OXÉPINNES

N05AH01 LOXAPINE LOXAPINE

Tab Orl 2.5mg Xylac 02242868 PDP ADEFGVW Co. Tab Orl 5mg Xylac 02230837 PDP ADEFGVW Co. Tab Orl 10mg Xylac 02230838 PDP ADEFGVW Co. Tab Orl 25mg Xylac 02230839 PDP ADEFGVW Co. Tab Orl 50mg Xylac 02230840 PDP ADEFGVW Co.


N05AH02 CLOZAPINE CLOZAPINE

Tab Orl 25mg Clozaril 00894737 NVR ADEFGVW Co. Apo-Clozapine 02248034 APX ADEFGVW Gen-Clozapine 02247243 MYL ADEFGVW Tab Orl 50mg Gen-Clozapine 02305003 MYL ADEFGVW Co. Tab Orl 100mg Clozaril 00894745 NVR ADEFGVW Co. Apo-Clozapine 02248035 APX ADEFGVW Gen-Clozapine 02247244 MYL ADEFGVW Tab Orl 200mg Gen-Clozapine 02305011 MYL ADEFGVW Co.

N05AH03 OLANZAPINE

OLANZAPINE

ODT Orl 5mg Zyprexa Zydis 02243086 LIL W (SA)

Co.D.O. Apo-Olanzapine ODT 02360616 APX W (SA)

Co Olanzapine ODT 02327562 COB W (SA)

Jamp-Olanzapine ODT 02406624 JPC W (SA)

Mar-Olanzapine ODT 02389088 MAR W (SA)

Mylan-Olanzapine ODT 02382709 MYL W (SA)

Olanzapine ODT 02343665 SIV W (SA)

Olanzapine ODT 02352974 SAS W (SA)

pms-Olanzapine ODT 02303191 PMS W (SA)

Ran-Olanzapine ODT 02414090 RAN W (SA)

Sandoz Olanzapine ODT 02327775 SDZ W (SA)

Teva-Olanzapine ODT 02321343 TEV W (SA)














N05AH03 OLANZAPINE OLANZAPINE
























Tab Orl 2.5mg Zyprexa 02229250 LIL W (SA)

Co. Apo-Olanzapine 02281791 APX W (SA)

Co Olanzapine 02325659 COB W (SA)

Mar-Olanzapine 02421232 MAR W (SA)

Mylan-Olanzapine 02337878 MYL W (SA)

Olanzapine 02372819 SAS W (SA)

Olanzapine 02385864 SIV W (SA)

pms-Olanzapine 02303116 PMS W (SA)

Ran-Olanzapine 02403064 RAN W (SA)

Sandoz Olanzapine 02310341 SDZ W (SA)

Teva-Olanzapine 02276712 TEV W (SA)

Tab Orl 5mg Zyprexa 02229269 LIL W (SA)












N05AH03 OLANZAPINE OLANZAPINE

Tab Orl 7.5mg Zyprexa 02229277 LIL W (SA)

































N05AH04 QUETIAPINE

QUÉTIAPINE

ERT Orl 50mg Seroquel XR 02300184 AZE ADEFGVW Co.L.P. Sandoz Quetiapine XR 02407671 SDZ ADEFGVW Teva-Quetiapine XR 02395444 TEV ADEFGVW ERT Orl 150mg Seroquel XR 02321513 AZE ADEFGVW Co.L.P. Sandoz Quetiapine XR 02407698 SDZ ADEFGVW Teva-Quetiapine XR 02395452 TEV ADEFGVW ERT Orl 200mg Seroquel XR 02300192 AZE ADEFGVW Co.L.P. Sandoz Quetiapine XR 02407701 SDZ ADEFGVW Teva-Quetiapine XR 02395460 TEV ADEFGVW


N05AH04 QUETIAPINE QUÉTIAPINE

ERT Orl 300mg Seroquel XR 02300206 AZE ADEFGVW Co.L.P. Sandoz Quetiapine XR 02407728 SDZ ADEFGVW Teva-Quetiapine XR 02395479 TEV ADEFGVW ERT Orl 400mg Seroquel XR 02300214 AZE ADEFGVW Co.L.P. Sandoz Quetiapine XR 02407736 SDZ ADEFGVW Teva-Quetiapine XR 02395487 TEV ADEFGVW Tab Orl 25mg Seroquel 02236951 AZE ADEFGVW Co. Abbott-Quetiapine 02412977 BGP ADEFGVW Act Quetiapine 02316080 ATV ADEFGVW Apo-Quetiapine 02313901 APX ADEFGVW Auro-Quetiapine 02390205 ARO ADEFGVW Jamp-Quetiapine 02330415 JPC ADEFGVW Mar-Quetiapine 02399822 MAR ADEFGVW Mylan-Quetiapine 02307804 MYL ADEFGVW Nat-Quetiapine 02439158 NAT ADEFGVW Phl-Quetiapine 02299054 PHL ADEFGVW pms-Quetiapine 02296551 PMS ADEFGVW Quetiapine 02317893 SIV ADEFGVW Quetiapine 02353164 SAS ADEFGVW Quetiapine 02387794 AHI ADEFGVW Ran-Quetiapine 02397099 RAN ADEFGVW Sandoz Quetiapine 02313995 SDZ ADEFGVW Teva-Quetiapine 02284235 TEV ADEFGVW Tab Orl 100mg Seroquel 02236952 AZE ADEFGVW Co. Abbott-Quetiapine 02412985 BGP ADEFGVW Act Quetiapine 02316099 ATV ADEFGVW Apo-Quetiapine 02313928 APX ADEFGVW Auro-Quetiapine 02390213 ARO ADEFGVW Jamp-Quetiapine 02330423 JPC ADEFGVW Mar-Quetiapine 02399830 MAR ADEFGVW Mylan-Quetiapine 02307812 MYL ADEFGVW Nat-Quetiapine 02439166 NAT ADEFGVW Phl-Quetiapine 02299062 PHL ADEFGVW pms-Quetiapine 02296578 PMS ADEFGVW Quetiapine 02317907 SIV ADEFGVW Quetiapine 02353172 SAS ADEFGVW Quetiapine 02387808 AHI ADEFGVW Ran-Quetiapine 02397102 RAN ADEFGVW Sandoz Quetiapine 02314002 SDZ ADEFGVW Teva-Quetiapine 02284243 TEV ADEFGVW Tab Orl 150mg Teva-Quetiapine 02284251 TEV AEFGVW Co.


N05AH04 QUETIAPINE QUÉTIAPINE

Tab Orl 200mg Seroquel 02236953 AZE ADEFGVW Co. Abbott-Quetiapine 02412993 BGP ADEFGVW Act Quetiapine 02316110 ATV ADEFGVW Apo-Quetiapine 02313936 APX ADEFGVW Auro-Quetiapine 02390248 ARO ADEFGVW Jamp-Quetiapine 02330458 JPC ADEFGVW Mar-Quetiapine 02399849 MAR ADEFGVW Mylan-Quetiapine 02307839 MYL ADEFGVW Nat-Quetiapine 02439182 NAT ADEFGVW Phl-Quetiapine 02299089 PHL ADEFGVW pms-Quetiapine 02296594 PMS ADEFGVW Quetiapine 02317923 SIV ADEFGVW Quetiapine 02353199 SAS ADEFGVW Quetiapine 02387824 AHI ADEFGVW Ran-Quetiapine 02397110 RAN ADEFGVW Sandoz Quetiapine 02314010 SDZ ADEFGVW Teva-Quetiapine 02284278 TEV ADEFGVW Tab Orl 300mg Seroquel 02244107 AZE ADEFGVW Co. Abbott-Quetaipine 02413000 BGP ADEFGVW Act Quetiapine 02316129 ATV ADEFGVW Apo-Quetiapine 02313944 APX ADEFGVW Auro-Quetiapine 02390256 ARO ADEFGVW Jamp-Quetiapine 02330466 JPC ADEFGVW Mar-Quetiapine 02399857 MAR ADEFGVW Mylan-Quetiapine 02307847 MYL ADEFGVW Nat-Quetiapine 02439190 NAT ADEFGVW Phl-Quetiapine 02299097 PHL ADEFGVW pms-Quetiapine 02296608 PMS ADEFGVW Quetiapine 02317931 SIV ADEFGVW Quetiapine 02353202 SAS ADEFGVW Quetiapine 02387832 AHI ADEFGVW Ran-Quetiapine 02397129 RAN ADEFGVW Sandoz Quetiapine 02314029 SDZ ADEFGVW Teva-Quetiapine 02284286 TEV ADEFGVW

N05AH05 ASENAPINE

ASÉNAPINE

Slt Orl 5mg Saphris (Sublingual) 02374803 FRS (SA) Co.S.L. Slt Orl 10mg Saphris (Sublingual) 02374811 FRS (SA) Co.S.L.


N05AN LITHIUM LITHIUM

N05AN01 LITHIUM LITHIUM

Cap Orl 150mg Carbolith 00461733 VLN ADEFGVW Caps Lithane 02013231 ERF ADEFGVW Apo-Lithium Carbonate 02242837 APX ADEFGVW pms-Lithium Carbonate 02216132 PMS ADEFGVW Cap Orl 300mg Carbolith 00236683 VLN ADEFGVW Caps Lithane 00406775 ERF ADEFGVW Apo-Lithium Carbonate 02242838 APX ADEFGVW pms-Lithium Carbonate 02216140 PMS ADEFGVW Cap Orl 600mg Carbolith 02011239 VLN ADEFGVW Caps SRT Orl 300mg Lithmax SR 02266695 AAP ADEFGVW Co.L.L. Liq Orl 8mmol/5mL pms-Lithium Citrate 02074834 PMS ADEFGVW Liq

N05AX OTHER ANTIPSYCHOTICS AUTRES ANTIPSYCHOTIQUES

N05AX08 RISPERIDONE RISPÉRIDONE

Liq Orl 1mg/mL Risperdal 02236950 JAN ADEFGVW Liq Apo-Risperidone 02280396 APX ADEFGVW pms-Risperidone 02279266 PMS ADEFGVW ODT Orl 0.5mg Risperdal M 02247704 JAN W (SA)

Co.D.O. Mylan-Risperidone ODT 02413485 MYL W (SA)

ODT Orl 1mg Risperdal M 02247705 JAN W (SA)


pms-Risperidone ODT 02291789 PMS W (SA)












Pws IM 12.5mg Risperdal Consta 02298465 JAN (SA) Pds. Pws IM 25mg Risperdal Consta 02255707 JAN (SA) Pds. Pws IM 37.5mg Risperdal Consta 02255723 JAN (SA) Pds. Pws IM 50mg Risperdal Consta 02255758 JAN (SA) Pds.

Tab Orl 0.25mg Risperdal 02240551 JAN ADEFGVW Co. Act Risperidone 02282585 ATV ADEFGVW Apo-Risperidone 02282119 APX ADEFGVW Jamp-Risperidone 02359529 JPC ADEFGVW Mar-Risperidone 02371766 MAR ADEFGVW Mint-Risperidone 02359790 MNT ADEFGVW Mylan-Risperidone 02282240 MYL ADEFGVW Phl-Risperidone 02258439 PHL ADEFGVW pms-Risperidone 02252007 PMS ADEFGVW Ran-Risperidone 02328305 RAN ADEFGVW Risperidone 02356880 SAS ADEFGVW Sandoz Risperidone 02303655 SDZ ADEFGVW Teva-Risperidone 02282690 TEV ADEFGVW Tab Orl 0.5mg Risperdal 02240552 JAN ADEFGVW Co. Act Risperidone 02282593 ATV ADEFGVW Apo-Risperidone 02282127 APX ADEFGVW Jamp-Risperidone 02359537 JPC ADEFGVW Mar-Risperidone 02371774 MAR ADEFGVW Mint-Risperidone 02359804 MNT ADEFGVW Mylan-Risperidone 02282259 MYL ADEFGVW Phl-Risperidone 02258447 PHL ADEFGVW pms-Risperidone 02252015 PMS ADEFGVW Ran-Risperidone 02328313 RAN ADEFGVW Risperidone 02356899 SAS ADEFGVW Sandoz Risperidone 02303663 SDZ ADEFGVW Teva-Risperidone 02264188 TEV ADEFGVW



Tab Orl 1mg Risperdal 02025280 JAN ADEFGVW Co. Act Risperidone 02282607 ATV ADEFGVW Apo-Risperidone 02282135 APX ADEFGVW Jamp-Risperidone 02359545 JPC ADEFGVW Mar-Risperidone 02371782 MAR ADEFGVW Mint-Risperidone 02359812 MNT ADEFGVW Mylan-Risperidone 02282267 MYL ADEFGVW Phl-Risperidone 02258455 PHL ADEFGVW pms-Risperidone 02252023 PMS ADEFGVW Ran-Risperidone 02328321 RAN ADEFGVW Risperidone 02356902 SAS ADEFGVW Sandoz Risperidone 02279800 SDZ ADEFGVW Teva-Risperidone 02264196 TEV ADEFGVW Tab Orl 2mg Risperdal 02025299 JAN ADEFGVW Co. Act Risperidone 02282615 ATV ADEFGVW Apo-Risperidone 02282143 APX ADEFGVW Jamp-Risperidone 02359553 JPC ADEFGVW Mar-Risperidone 02371790 MAR ADEFGVW Mint-Risperidone 02359820 MNT ADEFGVW Mylan-Risperidone 02282275 MYL ADEFGVW Phl-Risperidone 02258463 PHL ADEFGVW pms-Risperidone 02252031 PMS ADEFGVW Ran-Risperidone 02328348 RAN ADEFGVW Risperidone 02356910 SAS ADEFGVW Sandoz Risperidone 02279819 SDZ ADEFGVW Teva-Risperidone 02264218 TEV ADEFGVW Tab Orl 3mg Risperdal 02025302 JAN ADEFGVW Co. Act Risperidone 02282623 ATV ADEFGVW Apo-Risperidone 02282151 APX ADEFGVW Jamp-Risperidone 02359561 MPC ADEFGVW Mar-Risperidone 02371804 MAR ADEFGVW Mint-Risperidone 02359839 MNT ADEFGVW Mylan-Risperidone 02282283 MYL ADEFGVW Phl-Risperidone 02258471 PHL ADEFGVW pms-Risperidone 02252058 PMS ADEFGVW Ran-Risperidone 02328364 RAN ADEFGVW Risperidone 02356929 SAS ADEFGVW Sandoz Risperidone 02279827 SDZ ADEFGVW Teva-Risperidone 02264226 TEV ADEFGVW



Tab Orl 4mg Risperdal 02025310 JAN ADEFGVW Co. Act Risperidone 02282631 ATV ADEFGVW Apo-Risperidone 02282178 APX ADEFGVW Jamp-Risperidone 02359588 MPC ADEFGVW Mar-Risperidone 02371812 MAR ADEFGVW Mint-Risperidone 02359847 MNT ADEFGVW Mylan-Risperidone 02282291 MYL ADEFGVW Phl-Risperidone 02258498 PHL ADEFGVW pms-Risperidone 02252066 PMS ADEFGVW Ran-Risperidone 02328372 RAN ADEFGVW Risperidone 02356937 SAS ADEFGVW Sandoz Risperidone 02279835 SDZ ADEFGVW Teva-Risperidone 02264234 TEV ADEFGVW

N05AX12 ARIPIPRAZOLE

ARIPIPRAZOLE

Tab Orl 2mg Abilify 02322374 BRI (SA) Co. Tab Orl 5mg Abilify 02322382 BRI (SA) Co. Tab Orl 10mg Abilify 02322390 BRI (SA) Co.

Tab Orl 15mg Abilify 02322404 BRI (SA) Co. Tab Orl 20mg Abilify 02322412 BRI (SA) Co. Tab Orl 30mg Abilify 02322455 BRI (SA) Co. Pws IM 300mg Abilify Maintena 02420864 OTS (SA) Pds. Pws IM 400mg Abilify Maintena 02420872 OTS (SA) Pds.

N05AX13 PALIPERIDONE

PALIPÉRIDONE

Sus IM 50mg/0.5mL Invega Sustenna 02354217 JAN (SA) Susp Sus IM 75mg/0.75mL Invega Sustenna 02354225 JAN (SA) Susp


N05AX13 PALIPERIDONE PALIPÉRIDONE

Sus IM 100mg/mL Invega Sustenna 02354233 JAN (SA) Susp Sus IM 150mg/1.5mL Invega Sustenna 02354241 JAN (SA) Susp

N05B ANXIOLYTICS ANXIOLYTIQUES

N05BA BENZODIAZEPINE DERIVATIVES DÉRIVÉS DU BENZODIAZEPINE

N05BA01 DIAZEPAM DIAZÉPAM

Liq Inj 5mg/mL Diazepam 00399728 SDZ ADEFGVW Liq Diazepam 02386143 SDZ ADEFGVW Tab Orl 2mg Apo-Diazepam 00405329 APX ADEFGVW Co. pms-Diazepam 02247490 PMS ADEFGVW Tab Orl 5mg Valium 00013285 HLR ADEFGVW Co. Apo-Diazepam 00362158 APX ADEFGVW pms-Diazepam 02247491 PMS ADEFGVW Tab Orl 10mg Apo-Diazepam 00405337 APX ADEFGVW Co. pms-Diazepam 02247492 PMS ADEFGVW

N05BA02 CHLORDIAZEPOXIDE

CHLORDIAZÉPOXIDE

Cap Orl 5mg Chlordiazepoxide 00522724 AAP ADEFGVW Caps Cap Orl 10mg Chlordiazepoxide 00522988 AAP ADEFGVW Caps Cap Orl 25mg Chlordiazepoxide 00522996 AAP ADEFGVW Caps

N05BA04 OXAZEPAM

OXAZÉPAM

Tab Orl 10mg Apo-Oxazepam 00402680 APX ADEFGVW Co. Tab Orl 15mg Apo-Oxazepam 00402745 APX ADEFGVW Co. Tab Orl 30mg Apo-Oxazepam 00402737 APX ADEFGVW Co.


N05BA05 CLORAZEPATE DIPOTASSIUM CLORAZÉPATE DIPOTASSIQUE

Cap Orl 3.75mg Clorazepate 00860689 AAP ADEFGVW Caps Cap Orl 7.5mg Clorazepate 00860700 AAP ADEFGVW Caps Cap Orl 15mg Clorazepate 00860697 AAP ADEFGVW Caps

N05BA06 LORAZEPAM

LORAZÉPAM

Liq Inj 4mg/mL Lorazepam 02243278 SDZ ADEFVW Liq Slt Orl 0.5mg Ativan SL 02041456 PFI ADEFGVW Co.S.L. Apo-Lorazepam Sublingual 02410745 APX ADEFGVW Slt Orl 1mg Ativan SL 02041464 PFI ADEFGVW Co.S.L. Apo-Lorazepam Sublingual 02410753 APX ADEFGVW Slt Orl 2mg Ativan SL 02041472 PFI ADEFGVW Co.S.L. Apo-Lorazepam Sublingual 02410761 APX ADEFGVW Tab Orl 0.5mg Ativan 02041413 PFI ADEFGVW Co. Apo-Lorazepam 00655740 APX ADEFGVW Lorazepam 02351072 SAS ADEFGVW Novo-Lorazepam 00711101 TEV ADEFGVW pms-Lorazepam 00728187 PMS ADEFGVW Tab Orl 1mg Ativan 02041421 PFI ADEFGVW Co. Apo-Lorazepam 00655759 APX ADEFGVW Lorazepam 02351080 SAS ADEFGVW Novo-Lorazepam 00637742 TEV ADEFGVW pms-Lorazepam 00728195 PMS ADEFGVW Tab Orl 2mg Ativan 02041448 PFI ADEFGVW Co. Apo-Lorazepam 00655767 APX ADEFGVW Lorazepam 02351099 SAS ADEFGVW Novo-Lorazepam 00637750 TEV ADEFGVW pms-Lorazepam 00728209 PMS ADEFGVW

N05BA08 BROMAZEPAM

BROMAZÉPAM

Tab Orl 1.5mg Apo-Bromazepam 02177153 APX ADEFGVW Co. Tab Orl 3mg Lectopam 00518123 HLR ADEFGVW Co. Apo-Bromazepam 02177161 APX ADEFGVW Teva-Bromazepam 02230584 TEV ADEFGVW


N05BA08 BROMAZEPAM BROMAZÉPAM

Tab Orl 6mg Lectopam 00518131 HLR ADEFGVW Co. Apo-Bromazepam 02177188 APX ADEFGVW Teva-Bromazepam 02230585 TEV ADEFGVW

N05BA09 CLOBAZAM

CLOBAZAM

Tab Orl 10mg Frisium 02221799 LBK ADEFGV Co. Apo-Clobazam 02244638 APX ADEFGV Novo-Clobazam 02238334 TEV ADEFGV pms-Clobazam (Disc/non disp Apr 01/17) 02244474 PMS ADEFGV

N05BA12 ALPRAZOLAM

ALPRAZOLAM

Tab Orl 0.25mg Xanax 00548359 PFI ADEFGVW Co. Alprazolam 02349191 SAS ADEFGVW Apo-Alpraz 00865397 APX ADEFGVW Jamp-Alprazolam 02400111 JPC ADEFGVW Mylan-Alprazolam 02137534 MYL ADEFGVW Nat-Alprazolam 02417634 NAT ADEFGVW Teva-Alprazolam 01913484 TEV ADEFGVW Tab Orl 0.5mg Xanax 00548367 PFI ADEFGVW Co. Alprazolam 02349205 SAS ADEFGVW Apo-Alpraz 00865400 APX ADEFGVW Jamp-Alprazolam 02400138 JPC ADEFGVW Mylan-Alprazolam 02137542 MYL ADEFGVW Nat-Alprazolam 02417642 NAT ADEFGVW Teva-Alprazolam 01913492 TEV ADEFGVW

N05BB DIPHENYLMETHANE DERIVATIVES DÉRIVÉS DU DIPHENYLMETHANE

N05BB01 HYDROXYZINE HYDROXYZINE

Cap Orl 10mg Apo-Hydroxyzine 00646059 APX ADEFGVW Cap Novo-Hydroxyzine 00738824 TEV ADEFGVW Cap Orl 25mg Apo-Hydroxyzine 00646024 APX ADEFGVW Cap Novo-Hydroxyzine 00738832 TEV ADEFGVW Cap Orl 50mg Apo-Hydroxyzine 00646016 APX ADEFGVW Cap Novo-Hydroxyzine 00738840 TEV ADEFGVW Syr Orl 2mg/mL Atarax 00024694 ERF ADEFGVW Sir. pms-Hydroxyzine 00741817 PMS ADEFGVW


N05BE AZASPIRODECANEDIONE DERIVATIVES DÉRIVÉS DE L’AZASPIRODECANEDIONE

N05BE01 BUSPIRONE BUSPIRONE

Tab Orl 10mg Apo-Buspirone 02211076 APX ADEFGVW Co. Teva-Buspirone 02231492 TEV ADEFGVW pms-Buspirone 02230942 PMS ADEFGVW

N05C HYPNOTICS AND SEDATIVES HYPNOTIQUES ET SEDATIFS

N05CC ALDEHYDES AND DERIVATIVES ALDEHYDES ET DÉRIVÉS

N05CC01 CHLORAL HYDRATE CHLORAL (HYDRATE DE)

Syr Orl 100mg/mL Chloral Hydrate Syrup Odan 02247621 ODN ADEFGVW Sir. pms-Chloral Hydrate 00792659 PMS ADEFGVW

N05CD BENZODIAZEPINE DERIVATIVES DÉRIVÉS DU BENZODIAZEPINE

N05CD01 FLURAZEPAM FLURAZÉPAM

Cap Orl 15mg Flurazepam 00521698 AAP ADEFGVW Caps Cap Orl 30mg Flurazepam 00521701 AAP ADEFGVW Caps

N05CD02 NITRAZEPAM

NITRAZÉPAM

Tab Orl 5mg Mogadon 00511528 AAP ADEFGVW Co. Nitrazadon (Disc/non disp Jun 25/16) 02229654 VLN ADEFGVW Apo-Nitrazepam (Disc/non disp Apr 24/16) 02245230 APX ADEFGVW Sandoz Nitrazepam (Disc/non disp Jul 30/16) 02234003 SDZ ADEFGVW Tab Orl 10mg Mogadon 00511536 AAP ADEFGVW Co. Nitrazadon (Disc/non disp Jun 25/16) 02229655 VLN ADEFGVW Apo-Nitrazepam (Disc/non disp Apr 24/16) 02245231 APX ADEFGVW Sandoz Nitrazepam (Disc/non disp Jul 30/16) 02234007 SDZ ADEFGVW

N05CD05 TRIAZOLAM

TRIAZOLAM

Tab Orl 0.125mg Triazolam (Disc/non disp Nov 7/16) 00808563 AAP ADEFGVW Co. Tab Orl 0.25mg Triazolam 00808571 AAP ADEFGVW Co.


N05CD07 TEMAZEPAM TÉMAZÉPAM

Cap Orl 15mg Restoril 00604453 APR ADEFGVW Caps Apo-Temazepam 02225964 APX ADEFGVW Co Temazepam (Disc/Non-Disp Feb 19/17) 02244814 COB ADEFGVW Novo-Temazapam 02230095 TEV ADEFGVW Cap Orl 30mg Restoril 00604461 APR ADEFGVW Caps Apo-Temazepam 02225972 APX ADEFGVW Co Temazepam(Disc/Non-Disp June 2/17) 02244815 COB ADEFGVW Novo-Temazapam 02230102 TEV ADEFGVW

N05CD08 MIDAZOLAM

MIDAZOLAM

Liq Inj 1mg/mL Midazolam 02240285 SDZ ADEFVW Liq Midazolam 02242904 PPC ADEFVW Midazolam Injection 02382873 SDZ ADEFVW Liq Inj 5mg/mL Midazolam 02240286 SDZ ADEFVW Liq Midazolam 02242905 PPC ADEFVW Midazolam Injection 02382903 SDZ ADEFVW

N05CF BENZODIAZEPINE RELATED DRUGS MÉDICAMENTS LIÉS AU BENZODIAZÉPINE

N05CF01 ZOPICLONE ZOPICLONE

Tab Orl 5mg Imovane 02216167 SAV ADEFVW Co. Act Zopiclone 02271931 ATV ADEFVW Apo-Zopiclone 02245077 APX ADEFVW Jamp-Zopiclone 02406969 JPC ADEFVW Mar-Zopiclone 02386771 MAR ADEFVW Mint-Zopiclone 02391716 MNT ADEFVW Mylan-Zopiclone 02296616 MYL ADEFVW Novo-Zopiclone 02251450 TEV ADEFVW Phl-Zopiclone 02294052 PHL ADEFVW pms-Zopiclone 02243426 PMS ADEFVW Ran-Zopiclone 02267918 RAN ADEFVW ratio-Zopiclone 02246534 TEV ADEFVW Sandoz Zopiclone 02257572 SDZ ADEFVW Septa-Zopiclone 02386909 SPT ADEFVW Zopiclone 02344122 SAS ADEFVW Zopiclone 02385821 SIV ADEFVW


N05CF01 ZOPICLONE ZOPICLONE

Tab Orl 7.5mg Imovane 01926799 SAV ADEFVW Co. Rhovane 02008203 SAV ADEFVW Act Zopiclone 02271958 ATV ADEFVW Apo-Zopiclone 02218313 APX ADEFVW Jamp-Zopiclone 02356805 JPC ADEFVW Jamp-Zopiclone 02406977 JPC ADEFVW Mar-Zopiclone 02386798 MAR ADEFVW Mint-Zopiclone 02391724 MNT ADEFVW Mylan-Zopiclone 02238596 MYL ADEFVW Novo-Zopiclone 02251469 TEV ADEFVW Phl-Zopiclone 02294060 PHL ADEFVW pms-Zopiclone 02240606 PMS ADEFVW Ran-Zopiclone 02267926 RAN ADEFVW ratio-Zopiclone 02242481 TEV ADEFVW Sandoz Zopiclone 02257580 SDZ ADEFVW Septa-Zopiclone 02386917 SPT ADEFVW Zopiclone 02282445 SAS ADEFVW Zopiclone 02385848 SIV ADEFVW

N06 PSYCHOANALEPTICS PSYCHOANALEPTIQUES

N06A ANTIDEPRESSANTS ANTIDEPRESSIFS

N06AA NON-SELECTIVE MONOAMINE REUPTAKE INHIBITORS INHIBITEURS DE LA MONOAMINE NON SÉLECTIFS DU RECAPTAGE

N06AA01 DESIPRAMINE DÉSIPRAMINE

Tab Orl 10mg Desipramine 02216248 AAP ADEFGVW Co. Tab Orl 25mg Desipramine 02216256 AAP ADEFGVW Co. Tab Orl 50mg Desipramine 02216264 AAP ADEFGVW Co. Tab Orl 75mg Desipramine 02216272 AAP ADEFGVW Co. Tab Orl 100mg Desipramine 02216280 AAP ADEFGVW Co.

N06AA02 IMIPRAMINE

IMIPRAMINE

Tab Orl 10mg Imipramine 00360201 AAP ADEFGVW Co.


N06AA02 IMIPRAMINE IMIPRAMINE

Tab Orl 25mg Imipramine 00312797 AAP ADEFGVW Co. Tab Orl 50mg Imipramine 00326852 AAP ADEFGVW Co. Tab Orl 75mg Imipramine 00644579 AAP ADEFGVW Co.

N06AA04 CLOMIPRAMINE

CLOMIPRAMINE

Tab Orl 10mg Anafranil 00330566 APR ADEFGVW Co. Act Clomipramine (Disc/non disp Sept 1/17) 02244816 ATV ADEFGVW Apo-Clomipramine 02040786 APX ADEFGVW Tab Orl 25mg Anafranil 00324019 APR ADEFGVW Co. Act Clomipramine 02244817 ATV ADEFGVW Apo-Clomipramine 02040778 APX ADEFGVW Tab Orl 50mg Anafranil 00402591 APR ADEFGVW Co. Act Clomipramine 02244818 ATV ADEFGVW Apo-Clomipramine 02040751 APX ADEFGVW

N06AA06 TRIMIPRAMINE

TRIMIPRAMINE

Tab Orl 12.5mg Trimipramine 00740799 AAP ADEFGVW Co. Tab Orl 25mg Trimipramine 00740802 AAP ADEFGVW Co. Tab Orl 50mg Trimipramine 00740810 AAP ADEFGVW Co. Cap Orl 75mg Trimipramine 02070987 AAP ADEFGVW Cap Tab Orl 100mg Trimipramine 00740829 AAP ADEFGVW Co.

N06AA09 AMITRIPTYLINE

AMITRIPTYLINE

Tab Orl 10mg Elavil 00335053 AAP ADEFGVW Co. Amitriptyline 00370991 PDL ADEFGVW Apo-Amitriptyline 02403137 APX ADEFGVW


N06AA09 AMITRIPTYLINE AMITRIPTYLINE

Tab Orl 25mg Elavil 00335061 AAP ADEFGVW Co. Amitriptyline 00371009 PDL ADEFGVW Apo-Amitriptyline 02403145 APX ADEFGVW Tab Orl 50mg Elavil 00335088 AAP ADEFGVW Co. Apo-Amitriptyline 02403153 APX ADEFGVW Tab Orl 75mg Elavil 00754129 AAP ADEFGVW Co. Apo-Amitriptyline 02403161 APX ADEFGVW

N06AA10 NORTRIPTYLINE

NORTRIPTYLINE

Cap Orl 10mg Aventyl 00015229 AAP ADEFGVW Caps Apo-Nortriptyline (Disc/non disp Jul 17/2016) 02223511 APX ADEFGVW pms-Nortriptyline (Disc/non disp Aug 18/16) 02177692 PMS ADEFGVW Teva-Nortriptyline (Disc/non disp Jul 30/16) 02231781 TEV ADEFGVW Cap Orl 25mg Aventyl 00015237 AAP ADEFGVW Caps Apo-Nortriptyline (Disc/non disp Jul 17/2016) 02223538 APX ADEFGVW pms-Nortriptyline (Disc/non disp Aug 18/16) 02177706 PMS ADEFGVW Teva-Nortriptyline (Disc/non disp Jul 30/16) 02231782 TEV ADEFGVW

N06AA12 DOXEPIN

DOXÉPINE

Cap Orl 10mg Sinequan 00024325 ERF ADEFGVW Caps Doxepin 02049996 AAP ADEFGVW Cap Orl 25mg Sinequan 00024333 ERF ADEFGVW Caps Doxepin 02050005 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913425 TEV ADEFGVW Cap Orl 50mg Sinequan 00024341 ERF ADEFGVW Caps Doxepin 02050013 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913433 TEV ADEFGVW Cap Orl 75mg Sinequan (Disc/non disp Jun 5/17) 00400750 ERF ADEFGVW Caps Doxepin 02050021 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913441 TEV ADEFGVW Cap Orl 100mg Sinequan (Disc/non disp Jun 5/17) 00326925 ERF ADEFGVW Caps Doxepin 02050048 AAP ADEFGVW Novo-Doxepin (Disc/non disp Oct 18/15) 01913468 TEV ADEFGVW Cap Orl 150mg Novo-Doxepin (Disc/non disp Oct 18/15) 01913476 TEV ADEFGVW Caps


N06AA21 MAPROTILINE MAPROTILINE

Tab Orl 25mg Teva-Maprotiline 02158612 TEV ADEFGVW Co. Tab Orl 50mg Teva-Maprotiline 02158620 TEV ADEFGVW Co. Tab Orl 75mg Teva-Maprotiline 02158639 TEV ADEFGVW Co.

N06AB SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI’S) INHIBITEURS SPECIFIQUES DU RECAPTAGE DE LA SEROTONINE

N06AB03 FLUOXETINE FLUOXÉTINE

Cap Orl 10mg Prozac 02018985 LIL ADEFGVW Caps Act Fluoxetine 02242177 ATV ADEFGVW Apo-Fluoxetine 02216353 APX ADEFGVW Fluoxetine 02286068 SAS ADEFGVW Mylan-Fluoxetine 02237813 MYL ADEFGVW Phl-Fluoxetine 02223481 PHL ADEFGVW pms-Fluoxetine 02177579 PMS ADEFGVW Sandoz Fluoxetine 02243486 SDZ ADEFGVW Teva-Fluoxetine 02216582 TEV ADEFGVW Auro-Fluoxetine 02385627 ARO ADEFGVW Fluoxetine 02374447 SIV ADEFGVW Fluoxetine 02393441 AHI ADEFGVW Jamp-Fluoxetine 02401894 JPC ADEFGVW Mar-Fluoxetine 02392909 MAR ADEFGVW Mint-Fluoxetine 02380560 MNT ADEFGVW Ran-Fluoxetine 02405695 RAN ADEFGVW Zym-Fluoxetine (Disc/non disp Jun 16/16) 02302659 ZYM ADEFGVW Cap Orl 20mg Prozac 00636622 LIL ADEFGVW Caps Act Fluoxetine 02242178 ATV ADEFGVW Apo-Fluoxetine 02216361 APX ADEFGVW Auro-Fluoxetine 02385635 ARO ADEFGVW Fluoxetine 02286076 SAS ADEFGVW Fluoxetine 02374455 SIV ADEFGVW Fluoxetine 02383241 AHI ADEFGVW Jamp-Fluoxetine 02386402 JPC ADEFGVW Mar-Fluoxetine 02392917 MAR ADEFGVW Mint-Fluoxetine 02380579 MNT ADEFGVW Mylan-Fluoxetine 02237814 MYL ADEFGVW Phl-Fluoxetine 02223503 PHL ADEFGVW pms-Fluoxetine 02177587 PMS ADEFGVW Ran-Fluoxetine 02405709 RAN ADEFGVW Sandoz Fluoxetine 02243487 SDZ ADEFGVW Teva-Fluoxetine 02216590 TEV ADEFGVW Zym-Fluoxetine (Disc/non disp Jun 16/16) 02302667 ZYM ADEFGVW


N06AB04 CITALOPRAM CITALOPRAM

Tab Orl 10mg Abbott-Citalopram 02414570 ABB ADEFGVW Co. Citalopram 02430517 JPC ADEFGVW Citalopram 02387948 SIV ADEFGVW Jamp-Citalopram 02370085 JPC ADEFGVW Mar-Citalopram 02371871 MAR ADEFGVW Mint-Citalopram 02370077 MNT ADEFGVW Nat-Citalopram 02409003 NAT ADEFGVW pms-Citalopram 02270609 PMS ADEFGVW Teva-Citalopram 02312336 TEV ADEFGVW Tab Orl 20mg Celexa 02239607 VLH ADEFGVW Co. Abbott-Citalopram 02414589 ABB ADEFGVW Act Citalopram 02248050 ATV ADEFGVW Apo-Citalopram 02246056 APX ADEFGVW Auro-Citalopram 02275562 ARO ADEFGVW Citalopram 02430541 JPC ADEFGVW Citalopram 02353660 SAS ADEFGVW Citalopram 02387956 SIV ADEFGVW Jamp-Citalopram 02313405 JPC ADEFGVW Mar-Citalopram 02371898 MAR ADEFGVW Mint-Citalopram 02304686 MNT ADEFGVW Mylan-Citalopram 02246594 MYL ADEFGVW Nat-Citalopram 02409011 NAT ADEFGVW pms-Citalopram 02248010 PMS ADEFGVW Ran-Citalo 02285622 RAN ADEFGVW Sandoz Citalopram 02248170 SDZ ADEFGVW Septa-Citalopram 02355272 SPT ADEFGVW Teva-Citalopram 02293218 TEV ADEFGVW Tab Orl 30mg CTP 30 02296152 SNV ADEFGVW Co. Tab Orl 40mg Celexa 02239608 VLH ADEFGVW Co. Abbott-Citalopram 02414597 ABB ADEFGVW Act Citalopram 02248051 ATV ADEFGVW Apo-Citalopram 02246057 APX ADEFGVW Auro-Citalopram 02275570 ARO ADEFGVW Citalopram 02430568 JPC ADEFGVW Citalopram 02353679 SAS ADEFGVW Citalopram 02387964 SIV ADEFGVW Jamp-Citalopram 02313413 JPC ADEFGVW Mar-Citalopram 02371901 MAR ADEFGVW Mint-Citalopram 02304694 MNT ADEFGVW Mylan-Citalopram 02246595 MYL ADEFGVW Nat-Citalopram 02409038 NAT ADEFGVW pms-Citalopram 02248011 PMS ADEFGVW Ran-Citalo 02285630 RAN ADEFGVW Sandoz Citalopram 02248171 SDZ ADEFGVW Septa-Citalopram 02355280 SPT ADEFGVW Teva-Citalopram 02293226 TEV ADEFGVW


N06AB05 PAROXETINE PAROXÉTINE

Tab Orl 20mg Paxil 01940481 GSK ADEFGVW Co. Act Paroxetine 02262754 ATV ADEFGVW Apo-Paroxetine 02240908 APX ADEFGVW Auro-Paroxetine 02383284 ARO ADEFGVW Jamp-Paroxetine 02368870 JPC ADEFGVW Mar-Paroxetine 02411954 MAR ADEFGVW Mint-Paroxetine 02421380 MNT ADEFGVW Mylan-Paroxetine 02248013 MYL ADEFGVW Paroxetine 02282852 SAS ADEFGVW Paroxetine 02388235 SIV ADEFGVW pms-Paroxetine 02247751 PMS ADEFGVW Sandoz Paroxetine 02269430 SDZ ADEFGVW Sandoz Paroxetine Tablets 02431785 SDZ ADEFGVW Teva-Paroxetine 02248557 TEV ADEFGVW

Tab Orl 30mg Paxil 01940473 GSK ADEFGVW Co. Act Paroxetine 02262762 ATV ADEFGVW Apo-Paroxetine 02240909 APX ADEFGVW Auro-Paroxetine 02383292 ARO ADEFGVW Jamp-Paroxetine 02368889 JPC ADEFGVW Mar-Paroxetine 02411962 MAR ADEFGVW Mint-Paroxetine 02421399 MNT ADEFGVW Mylan-Paroxetine 02248014 MYL ADEFGVW Paroxetine 02282860 SAS ADEFGVW Paroxetine 02388243 SIV ADEFGVW pms-Paroxetine 02247752 PMS ADEFGVW Sandoz Paroxetine 02269449 SDZ ADEFGVW Sandoz Paroxetine Tablets 02431793 SDZ ADEFGVW Teva-Paroxetine 02248558 TEV ADEFGVW

Tab Orl 40mg pms-Paroxetine 02293749 PMS AEFGVW Co.

N06AB06 SERTRALINE

SERTRALINE Cap Orl 25mg Zoloft 02132702 PFI ADEFGVW Caps Act Sertraline 02287390 ATV ADEFGVW Apo-Sertraline 02238280 APX ADEFGVW Auro-Sertraline 02390906 ARO ADEFGVW GD-Sertraline 02273683 GMD ADEFGVW Jamp-Sertraline 02357143 JPC ADEFGVW Mar-Sertraline 02399415 MAR ADEFGVW Mint-Sertraline 02402378 MNT ADEFGVW Mylan-Sertraline 02242519 MYL ADEFGVW Phl-Sertraline 02245824 PHL ADEFGVW pms-Sertraline 02244838 PMS ADEFGVW Ran-Sertraline 02374552 RAN ADEFGVW Sandoz Sertraline 02245159 SDZ ADEFGVW Sertraline 02353520 SAS ADEFGVW Sertraline 02386070 SIV ADEFGVW Teva-Sertraline 02240485 TEV ADEFGVW


N06AB06 SERTRALINE SERTRALINE

Cap Orl 50mg Zoloft 01962817 PFI ADEFGVW Caps Act Sertraline 02287404 ATV ADEFGVW Apo-Sertraline 02238281 APX ADEFGVW Auro-Sertraline 02390914 ARO ADEFGVW GD-Sertraline 02273691 GMD ADEFGVW Jamp-Sertraline 02357151 JPC ADEFGVW Mar-Sertraline 02399423 MAR ADEFGVW Mint-Sertraline 02402394 MNT ADEFGVW Mylan-Sertraline 02242520 MYL ADEFGVW Phl-Sertraline 02245825 PHL ADEFGVW pms-Sertraline 02244839 PMS ADEFGVW Ran-Sertraline 02374560 RAN ADEFGVW Sandoz Sertraline 02245160 SDZ ADEFGVW Sertraline 02353539 SAS ADEFGVW Sertraline 02386089 SIV ADEFGVW Teva-Sertraline 02240484 TEV ADEFGVW Cap Orl 100mg Zoloft 01962779 PFI ADEFGVW Caps Act Sertraline 02287412 ATV ADEFGVW Apo-Sertraline 02238282 APX ADEFGVW Auro-Sertraline 02390922 ARO ADEFGVW GD-Sertraline 02273705 GMD ADEFGVW Jamp-Sertraline 02357178 JPC ADEFGVW Mar-Sertraline 02399431 MAR ADEFGVW Mint-Sertraline 02402408 MNT ADEFGVW Mylan-Sertraline 02242521 MYL ADEFGVW Phl-Sertraline 02245826 PHL ADEFGVW pms-Sertraline 02244840 PMS ADEFGVW Ran-Sertraline 02374579 RAN ADEFGVW Sandoz Sertraline 02245161 SDZ ADEFGVW Sertraline 02353547 SAS ADEFGVW Sertraline 02386097 SIV ADEFGVW Teva-Sertraline 02240481 TEV ADEFGVW

N06AB08 FLUVOXAMINE

FLUVOXAMINE

Tab Orl 50mg Luvox 01919342 BGP ADEFGVW Co. Act Fluvoxamine 02255529 ATV ADEFGVW Apo-Fluvoxamine 02231329 APX ADEFGVW Novo-Fluvoxamine 02239953 TEV ADEFGVW Ratio-Fluvoxamine 02218453 TEV ADEFGVW Tab Orl 100mg Luvox 01919369 BGP ADEFGVW Co. Act Fluvoxamine 02255537 ATV ADEFGVW Apo-Fluvoxamine 02231330 APX ADEFGVW Novo-Fluvoxamine 02239954 TEV ADEFGVW Ratio-Fluvoxamine (Disc/non disp Sept 29/16) 02218461 TEV ADEFGVW


N06AB10 ESCITALOPRAM ESCITALOPRAM

Tab Orl 10mg Cipralex 02263238 VLH ADEFGVW Co. Act Escitalopram 02313561 ATV ADEFGVW Apo-Escitalopram 02295016 APX ADEFGVW Auro-Escitalopram 02397358 ARO ADEFGVW Escitalopram 02430118 SAS ADEFGVW Escitalopram 02429039 SIV ADEFGVW Jamp-Escitalopram 02429780 JPC ADEFGVW Mar-Escitalopram 02423480 MAR ADEFGVW Mylan-Escitalopram 02309467 MYL ADEFGVW Nat-Escitalopram 02440296 NAT ADEFGVW Ran-Escitalopram 02385481 RAN ADEFGVW Sandoz Escitalopram 02364077 SDZ ADEFGVW Teva-Escitalopram 02318180 TEV ADEFGVW Tab Orl 20mg Cipralex 02263254 VLH ADEFGVW Co. Act Escitalopram 02313588 ATV ADEFGVW Apo-Escitalopram 02295024 APX ADEFGVW Auro-Escitalopram 02397374 ARO ADEFGVW Escitalopram 02430126 SAS ADEFGVW Escitalopram 02429047 SIV ADEFGVW Jamp-Escitalopram 02429799 JPC ADEFGVW Mar-Escitalopram 02423502 MAR ADEFGVW Mylan-Escitalopram 02309475 MYL ADEFGVW Nat-Escitalopram 02440318 NAT ADEFGVW Ran-Escitalopram 02385503 RAN ADEFGVW Sandoz Escitalopram 02364085 SDZ ADEFGVW Teva-Escitalopram 02318202 TEV ADEFGVW

N06AF MONOAMINE OXIDASE INHIBITORS, NON-SELECTIVE INHIBITEURS DE LA MONOAMINE OXYDASE, NON SELECTIFS

N06AF03 PHENELZINE PHÉNELZINE

Tab Orl 15mg Nardil 00476552 ERF ADEFGVW Co.

N06AF04 TRANYLCYPROMINE

TRANYLCYPROMINE

Tab Orl 10mg Parnate 01919598 GSK ADEFGVW Co.

N06AG MONOAMINE OXIDASE TYPE A INHIBITORS INHIBITEURS DE LA MONOAMINE OXYDASE DE TYPE A

N06AG02 MOCLOBEMIDE MOCLOBÉMIDE

Tab Orl 100mg Apo-Moclobemide 02232148 APX ADEFGVW Co. Teva-Moclobemide 02239746 TEV ADEFGVW


N06AG02 MOCLOBEMIDE MOCLOBÉMIDE

Tab Orl 150mg Manerix 00899356 MVL ADEFGVW Co. Apo-Moclobemide 02232150 APX ADEFGVW Teva-Moclobemide 02239747 TEV ADEFGVW Tab Orl 300mg Manerix 02166747 MVL ADEFGVW Co. Apo-Moclobemide 02240456 TEV ADEFGVW Teva-Moclobemide 02239748 APX ADEFGVW

N06AX OTHER ANTIDEPRESSANTS AUTRES ANTIDEPRESSIFS

N06AX02 TRYPTOPHAN TRYPTOPHANE

Cap Orl 500mg Tryptan 00718149 VLN ADEFGVW Caps Apo-Tryptophan 02248540 APX ADEFGVW Teva-Tryptophan 02240334 TEV ADEFGVW Tab Orl 250mg Tryptan 02239326 VLN ADEFGVW Co. Tab Orl 500mg Tryptan 02029456 VLN ADEFGVW Co. Apo-Tryptophan 02248538 APX ADEFGVW Ratio-Tryptophan 02240333 TEV ADEFGVW Tab Orl 750mg Tryptan 02239327 VLN ADEFGVW Co. Cap Orl 1000mg Tryptan 00654531 VLN ADEFGVW Caps Apo-Tryptophan 02248539 APX ADEFGVW Teva-Tryptophan 02237250 TEV ADEFGVW

N06AX05 TRAZODONE

TRAZODONE Tab Orl 50mg Apo-Trazodone 02147637 APX ADEFGVW Co. Mylan-Trazodone 02231683 MYL ADEFGVW Phl-Trazodone 02236941 PHL ADEFGVW pms-Trazodone 01937227 PMS ADEFGVW Teva-Trazodone 02144263 TEV ADEFGVW Trazodone 02348772 SAS ADEFGVW Tab Orl 100mg Apo-Trazodone 02147645 APX ADEFGVW Co. Mylan-Trazodone 02231684 MYL ADEFGVW Phl-Trazodone 02236942 PHL ADEFGVW pms-Trazodone 01937235 PMS ADEFGVW Teva-Trazodone 02144271 TEV ADEFGVW Trazodone 02348780 SAS ADEFGVW Tab Orl 150mg Apo-Trazodone 02147653 APX ADEFGVW Co. Teva-Trazodone 02144298 TEV ADEFGVW Trazodone 02348799 SAS ADEFGVW


N06AX11 MIRTAZAPINE MIRTAZAPINE

ODT Orl 15mg Remeron RD 02248542 FRS ADEFGVW Co.D.O. Auro-Mirtazapine OD 02299801 ARO ADEFGVW GD-Mirtazapine OD (Disc/non disp Nov 30/15) 02352826 GMD ADEFGVW Novo-Mirtazapine OD 02279894 TEV ADEFGVW ODT Orl 30mg Remeron RD 02248543 FRS ADEFGVW Co.D.O. Auro-Mirtazapine OD 02299828 ARO ADEFGVW GD-Mirtazapine OD (Disc/non disp Nov 30/15) 02352834 GMD ADEFGVW Novo-Mirtazapine OD 02279908 TEV ADEFGVW ODT Orl 45mg Remeron RD 02248544 FRS ADEFGVW Co.D.O. Auro-Mirtazapine OD 02299836 ARO ADEFGVW GD-Mirtazapine OD (Disc/non disp Nov 30/15) 02352842 GMD ADEFGVW

Novo-Mirtazapine OD 02279916 TEV ADEFGVW Tab Orl 15mg Apo-Mirtazapine 02286610 APX ADEFGVW Co. Auro-Mirtazapine 02411695 ARO ADEFGVW Mirtazapine (Disc/non disp Jun 25/16) 02281732 MEL ADEFGVW Mylan-Mirtazapine 02256096 MYL ADEFGVW pms-Mirtazapine 02273942 PMS ADEFGVW Sandoz Mirtazapine 02250594 SDZ ADEFGVW Zym-Mirtazapine (Disc/non disp Jun 16/16) 02325179 ZYM ADEFGVW Tab Orl 30mg Remeron 02243910 FRS ADEFGVW Co. Apo-Mirtazapine 02286629 APX ADEFGVW Auro-Mirtazapine 02411709 ARO ADEFGVW Mirtazapine (Disc/non disp Jun 25/16) 02252279 MEL ADEFGVW Mirtazapine 02370689 SAS ADEFGVW Mylan-Mirtazapine 02256118 MYL ADEFGVW Novo-Mirtazapine 02259354 TEV ADEFGVW pms-Mirtazapine 02248762 PMS ADEFGVW Sandoz Mirtazapine 02250608 SDZ ADEFGVW Zym-Mirtazapine (Disc/non disp Jun 16/16) 02325187 ZYM ADEFGVW

N06AX12 BUPROPION

BUPROPION

SRT Orl 100mg Bupropion SR 02391562 SAS ADEFGVW Co.L.L. pms-Bupropion 02325373 PMS ADEFGVW ratio-Bupropion SR 02285657 TEV ADEFGVW Sandoz Bupropion SR 02275074 SDZ ADEFGVW SRT Orl 150mg Wellbutrin SR 02237825 VLN ADEFGVW Co.L.L. Bupropion SR 02391570 SAS ADEFGVW pms-Bupropion 02313421 PMS ADEFGVW ratio-Bupropion SR 02285665 TEV ADEFGVW Sandoz Bupropion SR 02275082 SDZ ADEFGVW SRT Orl 150mg Wellbutrin XL 02275090 VLN ADEFGVW Co.L.L. Mylan-Bupropion XL 02382075 MYL ADEFGVW


N06AX12 BUPROPION BUPROPION

SRT Orl 150mg Zyban 02238441 VLN (SA) Co.L.L. SRT Orl 300mg Wellbutrin XL 02275104 VLN ADEFGVW Co.L.L. Mylan-Bupropion XL 02382083 MYL ADEFGVW

N06AX16 VENLAFAXINE

VENLAFAXINE

SRC Orl 37.5mg Effexor XR 02237279 PFI ADEFGVW Caps.L.L. Act Venlafaxine XR 02304317 ATV ADEFGVW Apo-Venlafaxine XR 02331683 APX ADEFGVW GD-Venlafaxine XR 02360020 GMD ADEFGVW Mylan-Venlafaxine XR 02310279 MYL ADEFGVW pms-Venlafaxine XR 02278545 PMS ADEFGVW Ran-Venlafaxine XR 02380072 RAN ADEFGVW Sandoz Venlafaxine XR 02310317 SDZ ADEFGVW Teva-Venlafaxine XR 02275023 TEV ADEFGVW Venlafaxine XR 02354713 SAS ADEFGVW Venlafaxine XR 02385929 SIV ADEFGVW SRC Orl 75mg Effexor XR 02237280 PFI ADEFGVW Caps.L.L. Act Venlafaxine XR 02304325 ATV ADEFGVW Apo-Venlafaxine XR 02331691 APX ADEFGVW GD-Venlafaxine XR 02360039 GMD ADEFGVW Mylan-Venlafaxine XR 02310287 MYL ADEFGVW pms-Venlafaxine XR 02278553 PMS ADEFGVW Ran-Venlafaxine XR 02380080 RAN ADEFGVW Sandoz Venlafaxine XR 02310325 SDZ ADEFGVW Teva-Venlafaxine XR 02275031 TEV ADEFGVW Venlafaxine XR 02354721 SAS ADEFGVW Venlafaxine XR 02385937 SIV ADEFGVW SRC Orl 150mg Effexor XR 02237282 PFI ADEFGVW Caps.L.L. Act Venlafaxine XR 02304333 ATV ADEFGVW Apo-Venlafaxine XR 02331705 APX ADEFGVW GD-Venlafaxine XR 02360047 GMD ADEFGVW Mylan-Venlafaxine XR 02310295 MYL ADEFGVW pms-Venlafaxine XR 02278561 PMS ADEFGVW Ran-Venlafaxine XR 02380099 RAN ADEFGVW Sandoz Venlafaxine XR 02310333 SDZ ADEFGVW Teva-Venlafaxine XR 02275058 TEV ADEFGVW Venlafaxine XR 02354748 SAS ADEFGVW Venlafaxine XR 02385945 SIV ADEFGVW

N06AX21 DULOXETINE

DULOXÉTINE

Cap Orl 30mg Cymbalta 02301482 LIL (SA) Caps


N06AX21 DULOXETINE DULOXÉTINE

Cap Orl 60mg Cymbalta 02301490 LIL (SA) Caps

N06B PSYCHOSTIMULANTS, AGENTS USED FOR ADHD AND NOOTROPICS PSYCHOSTIMULANTS, AGENTS UTILISÉS POUR ADHD ET NOOTROPIQUES

N06BA CENTRALLY ACTING SYMPATHOMIMETICS ADRENERGIQUES AGISSANT CENTRALEMENT

N06BA02 DEXAMPHETAMINE DEXAMPHÉTAMINE

Tab Orl 5mg Dexedrine 01924516 PAL DEF-18G Co. Apo-Dextroamphetamine 02443236 APX DEF-18G SRC Orl 10mg Dexedrine 01924559 PAL DEF-18G Caps.L.L. SRC Orl 15mg Dexedrine 01924567 PAL DEF-18G Caps.L.L.

N06BA04 METHYLPHENIDATE

MÉTHYLPHÉNIDATE

ERC Orl 10mg Biphentin 02277166 PFR (SA) Caps.L.P. ERC Orl 15mg Biphentin 02277131 PFR (SA) Caps.L.P. ERC Orl 20mg Biphentin 02277158 PFR (SA) Caps.L.P. ERC Orl 30mg Biphentin 02277174 PFR (SA) Caps.L.P. ERC Orl 40mg Biphentin 02277182 PFR (SA) Caps.L.P. ERC Orl 50mg Biphentin 02277190 PFR (SA) Caps.L.P. ERC Orl 60mg Biphentin 02277204 PFR (SA) Caps.L.P. ERC Orl 80mg Biphentin 02277212 PFR (SA) Caps.L.P. ERT Orl 18mg Concerta ER 02247732 JAN (SA) Co.L.P. pms-Methylphenidate ER 02413728 PMS (SA) Teva-Methylphenidate ER-C 02315068 TEV (SA)


N06BA04 METHYLPHENIDATE MÉTHYLPHÉNIDATE

ERT Orl 27mg Concerta ER 02250241 JAN (SA) Co.L.P. pms-Methylphenidate ER 02413736 PMS (SA) Teva-Methylphenidate ER-C 02315076 TEV (SA) ERT Orl 36mg Concerta ER 02247733 JAN (SA) Co.L.P. pms-Methylphenidate ER 02413744 PMS (SA) Teva-Methylphenidate ER-C 02315084 TEV (SA) ERT Orl 54mg Concerta ER 02247734 JAN (SA) Co.L.P. pms-Methylphenidate ER 02413752 PMS (SA) Teva-Methylphenidate ER-C 02315092 TEV (SA) SRT Orl 20mg Ritalin SR 00632775 NVR ADEFGVW Co.L.L. Apo-Methylphenidate SR 02266687 APX ADEFGVW Sandoz Methylphenidate SR 02320312 SDZ ADEFGVW Tab Orl 5mg Apo-Methylphenidate 02273950 APX ADEFGVW Co. pms-Methylphenidate 02234749 PMS ADEFGVW Tab Orl 10mg Ritalin 00005606 NVR ADEFGVW Co. Apo-Methylphenidate 02249324 APX ADEFGVW pms-Methylphenidate 00584991 PMS ADEFGVW Tab Orl 20mg Ritalin 00005614 NVR ADEFGVW Co. Apo-Methylphenidate 02249332 APX ADEFGVW pms-Methylphenidate 00585009 PMS ADEFGVW

N06BA07 MODAFINIL

MODAFINIL

Tab Orl 100mg Alertec 02239665 SHI (SA) Co. Apo-Modafinil 02285398 APX (SA)

N06BA12 LISDEXAMFETAMINE

LISDEXAMFÉTAMINE

Cap Orl 10mg Vyvanse 02439603 SHI (SA) Caps Cap Orl 20mg Vyvanse 02347156 SHI (SA) Caps Cap Orl 30mg Vyvanse 02322951 SHI (SA) Caps Cap Orl 40mg Vyvanse 02347164 SHI (SA) Caps Cap Orl 50mg Vyvanse 02322978 SHI (SA) Caps


N06BA12 LISDEXAMFETAMINE LISDEXAMFÉTAMINE

Cap Orl 60mg Vyvanse 02347172 SHI (SA) Caps

N06DA ANTICHOLINESTERASES ANTICHOLINESTÉRASES

N06DA02 DONEPEZIL DONÉPÉZIL

Tab Orl 5mg Aricept 02232043 PFI (SA) Co. Act Donepezil 02397595 ATV (SA) Apo-Donepezil 02362260 APX (SA) Auro-Donepezil 02400561 ARO (SA) Donepezil 02402645 AHI (SA) Donepezil 02420597 SIV (SA) Jamp-Donepezil 02404419 JPC (SA) Jamp-Donepezil 02416948 JPC (SA) Mar-Donepezil 02402092 MAR (SA) Mylan-Donepezil 02359472 MYL (SA) Nat-Donepezil 02439557 NAT (SA) pms-Donepezil 02322331 PMS (SA) Ran-Donepezil 02381508 RAN (SA) Sandoz Donepezil 02328666 SDZ (SA) Teva-Donepezil 02340607 TEV (SA) Tab Orl 10mg Aricept 02232044 PFI (SA) Co. Act Donepezil 02397609 ATV (SA) Apo-Donepezil 02362279 APX (SA) Auro-Donepezil 02400588 ARO (SA) Donepezil 02402653 AHI (SA) Donepezil 02420600 SIV (SA) Jamp-Donepezil 02404427 JPC (SA) Jamp-Donepezil 02416956 JPC (SA) Mar-Donepezil 02402106 MAR (SA) Mylan-Donepezil 02359480 MYL (SA) Nat-Donepezil 02439565 NAT (SA) pms-Donepezil 02322358 PMS (SA) Ran-Donepezil 02381516 RAN (SA) Sandoz Donepezil 02328682 SDZ (SA) Teva-Donepezil 02340615 TEV (SA)

N06DA03 RIVASTIGMINE

RIVASTIGMINE

Cap Orl 1.5mg Exelon 02242115 NVR (SA) Caps Apo-Rivastigmine 02336715 APX (SA) Mint-Rivastigmine 02406985 MNT (SA) Novo-Rivastigmine 02305984 NOP (SA) pms-Rivastigmine 02306034 PMS (SA) ratio-Rivastigmine 02311283 TEV (SA) Sandoz Rivastigmine 02324563 SDZ (SA)


N06DA03 RIVASTIGMINE RIVASTIGMINE

Cap Orl 3mg Exelon 02242116 NVR (SA) Caps Apo-Rivastigmine 02336723 APX (SA) Mint-Rivastigmine 02406993 MNT (SA) Novo-Rivastigmine 02305992 NOP (SA) pms-Rivastigmine 02306042 PMS (SA) ratio-Rivastigmine 02311291 TEV (SA) Sandoz Rivastigmine 02324571 SDZ (SA) Cap Orl 4.5mg Exelon 02242117 NVR (SA) Caps Apo-Rivastigmine 02336731 APX (SA) Mint-Rivastigmine 02407000 MNT (SA) Novo-Rivastigmine 02306018 NOP (SA) pms-Rivastigmine 02306050 PMS (SA) ratio-Rivastigmine 02311305 TEV (SA) Sandoz Rivastigmine 02324598 SDZ (SA) Cap Orl 6mg Exelon 02242118 NVR (SA) Caps Apo-Rivastigmine 02336758 APX (SA) Mint-Rivastigmine 02407019 MNT (SA) Novo-Rivastigmine 02306026 NOP (SA) ratio-Rivastigmine 02311313 TEV (SA) Sandoz Rivastigmine 02324601 SDZ (SA) Liq Orl 2mg Exelon 02245240 NVR (SA) Liq

N06DA04 GALANTAMINE

GALANTAMINE

ERC Orl 8mg Reminyl ER 02266717 JAN (SA) Caps.L.P. Mar-Galantamine ER 02420821 MAR (SA) Mylan-Galantamine ER 02339439 MYL (SA) pms-Galantamine ER 02398370 PMS (SA) Teva-Galantamine ER (Disc/non disp Sept 29/16) 02377950 TEV (SA) ERC Orl 16mg Reminyl ER 02266725 JAN (SA) Caps.L.P. Mar-Galantamine ER 02420848 MAR (SA) Mylan-Galantamine ER 02339447 MYL (SA) pms-Galantamine ER 02398389 PMS (SA) Teva-Galantamine ER (Disc/non disp Sept 29/16) 02377969 TEV (SA) ERC Orl 24mg Reminyl ER 02266733 JAN (SA) Caps.L.P. Mar-Galantamine ER 02420856 MAR (SA) Mylan-Galantamine ER 02339455 MYL (SA) pms-Galantamine ER 02398397 PMS (SA) Teva-Galantamine ER (Disc/non disp Sept 29/16) 02377977 TEV (SA)


N07 OTHER NERVOUS SYSTEM DRUGS AUTRES MÉDICAMENTS DU SYSTÈME NERVEUX

N07A PARASYMPATHOMIMETICS PARAADRENERGIQUES

N07AA ANTICHOLINESTERASES ANTICHOLINESTERASES

N07AA02 PYRIDOSTIGMINE PYRIDOSTIGMINE

SRT Orl 180mg Mestinon SR 00869953 VLN ADEFGVW Co.L.L. Tab Orl 60mg Mestinon 00869961 VLN ADEFGVW Co.

N07AB CHOLINE ESTERS ESTERS DE CHOLINE

N07AB02 BETHANECHOL BÉTHANÉCHOL

Tab Orl 10mg Duvoid 01947958 PAL ADEFGVW Co. Tab Orl 25mg Duvoid 01947931 PAL ADEFGVW Co. Tab Orl 50mg Duvoid 01947923 PAL ADEFGVW Co.

N07AB DRUGS USED IN ALCOHOL DEPENDENCE MÉDICAMENTS UTULISÉS EN CAS DE DÉPENDENCE AUX ALCOHOLE

N07AB03 ACAMPROSATE ACAMPROSATE

SRT Orl 333mg Campral 02293269 MYL (SA) Co.L.L.

N07AB04 NALTREXONE

NALTREXONE

Tab Orl 50mg Revia 02213826 TEV (SA) Co.

N07AX OTHER PARASYMPATHOMIMETICS AUTRES PARAADRENERGIQUES

N07AX01 PILOCARPINE PILOCARPINE

Tab Orl 5mg Salagen 02216345 PFI (SA) Co. Pilocarpine 02402483 STR (SA)


N07B DRUGS USED IN ADDICTIVE DISORDERS MÉDICAMENTS UTULISÉS EN CAS DE TROUBLES AUX DÉPENDENCES

N07BA DRUGS USED IN NICOTINE DEPENDENCE MEDICAMENTS UTULISES EN CAS DE DEPENDANCE A LA NICOTINE

N07BA03 VARENICLINE TARTRATE VARÉNICLINE, TARTRATE DE

Tab Orl 0.5mg Champix 02291177 PFI (SA) Co. Tab Orl 1mg Champix 02291185 PFI (SA) Co. Kit Orl 0.5mg, 1mg Champix Starter Kit 02298309 PFI (SA) Tro

N07BC DRUGS USED IN OPIOID DEPENDENCE MÉDICAMENTS UTULISÉS EN CAS DE DÉPENDENCE AUX OPIACÉS

N07BC02 METHADONE MÉTHADONE

Liq Orl 1mg/mL Metadol Liq Opioid Dependence / dépendance aux opiacés 00903823 PAL (SA) Pain Management/ gestion de la douleur 00903825 PAL (SA) Liq Orl 10mg/mL Metadol Liq Opioid Dependence / dépendance aux opiacés 00903824 PAL (SA) Pain Management/ gestion de la douleur 00903826 PAL (SA) Methadose Unflavored Opioid Dependence / dépendance aux opiacés 02394618 MAL (SA) Methadose Cherry flavored Opioid Dependence / dépendance aux opiacés 02394596 MAL (SA) Pws Orl Methadone Compounded Oral Solution Pds. Opioid Dependence / dépendance aux opiacés 00999734 (SA)

Pain Management/ gestion de la douleur 00999801 (SA)

Tab Orl 1mg Metadol 02247698 PAL (SA) Co. Tab Orl 5mg Metadol 02247699 PAL (SA) Co. Tab Orl 10mg Metadol 02247700 PAL (SA) Co. Tab Orl 25mg Metadol 02247701 PAL (SA) Co.


N07BC51 BUPRENORPHINE, COMBINATIONS BUPRÉNORPHINE, COMBINAISONS

BUPRENORPHINE / NALOXONE BUPRÉNORPHINE / NALOXONE

Slt Orl 2mg/0.5mg Suboxone 02295695 ICL (SA) Co.S.L. Mylan-Buprenorphine/Naloxone 02408090 MYL (SA) Teva-Buprenorphine/Naloxone 02424851 TEV (SA) Slt Orl 8mg/2mg Suboxone 02295709 ICL (SA) Co.S.L. Mylan-Buprenorphine/Naloxone 02408104 MYL (SA) Teva-Buprenorphine/Naloxone 02424878 TEV (SA)

N07C ANTIVERTIGO PREPARATIONS PRÉPARATIONS ANTIVERTIGINEUX

N07CA ANTIVERTIGO PREPARATIONS PRÉPARATIONS ANTIVERTIGINEUX

N07CA01 BETAHISTINE BÉTAHISTINE

Tab Orl 8mg Novo-Betahistine 02280183 NOP (SA) Co. Tab Orl 16mg Serc 02243878 BGP (SA) Co. Act Betahistine 02374757 ATV (SA) Novo-Betahistine 02280191 NOP (SA) Tab Orl 24mg Serc 02247998 BGP (SA) Co. Act Betahistine 02374765 ATV (SA) Novo-Betahistine 02280205 NOP (SA)

N07CA03 FLUNARIZINE

FLUNARIZINE Cap Orl 5mg Flunarizine 02246082 AAP DEF Caps

N07X OTHER NERVOUS SYSTEM DRUGS AUTRES MÉDICAMENTS DU SYSTEME NERVEUX

N07XX OTHER NERVOUS SYSTEM DRUGS AUTRES MÉDICAMENTS DU SYSTEME NERVEUX

N07XX02 RILUZOLE RILUZOLE

Tab Orl 50mg Rilutek 02242763 SAV (SA) Co. Apo-Riluzole 02352583 APX (SA) Mylan-Riluzole 02390299 MYL (SA)

N07XX06 TETRABENAZINE

TÉTRABENAZINE Tab Orl 25mg Nitoman 02199270 VLN ADEFGVW Co. Apo-Tetrabenazine 02407590 APX ADEFGVW pms-Tetrabenazine 02402424 PMS ADEFGVW


N07XX09 DIMETHYL FUMARATE FUMARATE DE DIMÉTHYLE

CDR Orl 120mg Tecfidera 02404508 BIG H (SA) Caps.L.R CDR Orl 240mg Tecfidera 02420201 BIG H (SA) Caps.L.R

P01 ANTIPROTOZOALS ANTIPROTOZOAIRES

P01A AGENTS AMOEBIASIS & OTHER PROTOZOAL DISEASES ANTIPROTOZOAIRES

P01AX OTHER AGENTS AMOEBIASIS & OTHER PROTOZOAL DISEASES AUTRES ANTIPROTOZOAIRES

P01AX06 ATOVAQUONE ATOVAQUONE

Sus Orl 750mg/5mL Mepron 02217422 GSK (SA) Susp

P01B ANTIMALARIALS ANTIPALUDIQUES

P01BA AMINOQUINOLINES AMINOQUINOLINES

P01BA01 CHLOROQUINE CHLOROQUINE

Tab Orl 250mg Teva-Chloroquine 00021261 TEV ADEFGVW Co.

P01BA02 HYDROXYCHLOROQUINE

HYDROXYCHLOROQUINE

Tab Orl 200mg Plaquenil 02017709 SAV ADEFGVW Co. Apo-Hydroxyquine 02246691 APX ADEFGVW Mylan-Hydroxychloroquine 02252600 MYL ADEFGVW

P01BA03 PRIMAQUINE

PRIMAQUINE

Tab Orl 15mg Primaquine 02017776 SAV ADEFGVW Co.

P01BC METHANOLQUINOLINES METHANOLQUINOLINES

P01BC01 QUININE QUININE

Cap Orl 200mg Apo-Quinine 02254514 APX ADEFGV Caps Novo-Quinine 00021008 TEV ADEFGVW Quinine Sulfate 00695440 ODN ADEFGV


P01BC01 QUININE QUININE

Cap Orl 300mg Apo-Quinine 02254522 APX ADEFGV Caps Novo-Quinine 00021016 TEV ADEFGVW Quinine Sulfate 00695459 ODN ADEFGV Tab Orl 300mg Quinine Sulfate 00695432 ODN ADEFGVW Co.

P01C AGENTS AGAINST LEISHMANIASIS AND TRYPANOSOMIASIS

AGENTS CONTRE LEISHMANIOSE ET TRYPANOSOMIASE

P01CX OTHER AGENTS AGAINST LEISHMANIASIS AND TRYPANOSOMIASIS AUTRE AGENTS CONTRE LEISHMANIOSE ET TRYPANOSOMIASE

P01CX01 PENTAMIDINE ISETIONATE PENTAMIDINE ISÉTIONATE

Pws Inj 300mg Pentamidine Isetionate 02183080 HOS ADEFGVW Pds.

P02 ANTHELMINTICS ANTHELMINTIQUES

P02C ANTINEMATODAL AGENTS AGENTS ANTINEMATODAUX

P02CA BENZIMIDAZOLE AGENTS AGENTS DU BENZIMIDAZOLE

P02CA01 MEBENDAZOLE MÉBENDAZOLE

Tab Orl 100mg Vermox 00556734 JAN ADEFGVW Co.

P02CC TETRAHYDROPIRIMIDINE DERIVATIVES DÉRIVÉS DU TETRAHYDROPIRIMIDINE

P02CC01 PYRANTEL PYRANTEL

Tab Orl 125mg Combantrin 01944363 JNJ EF-18G Co.

P03 ECTOPARASITICIDES, INCLUDING SCABICIDES, INSECTICIDES & REPELLANTS ECTOPARASITICIDES, Y COMPRIS LES SCABICIDES, LES INSECTICIDES ET REPULSIFS

P03A ECTOPARASITICIDES, INCLUDING SCABICIDES ECTOPARASITICIDES, Y COMPRIS LES SCABICIDES

P03AC PYRETHRINES, INCLUDING SYNTHETIC COMPOUNDS PYRETHRINES, Y COMPRIS LES COMPOSÉS SYNTHÉTIQUES

P03AC04 PERMETHRIN PERMÉTHRINE

Crm Top 1% Kwellada-P Crème Rinse 1% 02231480 MDI EFGV Cr. Nix Crème 00771368 INP EFGV


P03AC04 PERMETHRIN PERMÉTHRINE

Crm Top 5% Nix Dermal 02219905 GCH EFGV Cr. Lot Top 5% Kwellada-P 02231348 MDI EFGV Lot

P03AC51 PYRETHRUM, COMBINATIONS

PYRETHRUM, EN COMBINAISON

PYRETHRINS / PIPERONYL BUTOXIDE PYRÉTHRINES / BUTOXYDE DE PIPÉRONYLE

Shp Top 3% R & C Shampoo and Conditioner 02125447 MDI EFGV Shp

P03AX OTHER ECTOPARACITICIDES, INCLUDING SCABICIDES AUTRES ECTOPARASITICIDES, Y COMPRIS LES SCABICIDES

CROTAMITON CROTAMITON

Crm Top 10% Eurax 00623377 CLC EF-18G Cr.

ISOPROPYL MYRISTATE MYRISTATE D’ISOPROPYLE

Liq Top 50% Resultz 02279592 MDF EFGV Liq

R01 NASAL PREPARATIONS PRÉPARATIONS NASALES

R01A DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE DÉCONGESTIONNANTS ET AUTRES PRÉPARATIONS NASALES, UTILISATION TOP

R01AC ANTIALLERGIC AGENTS, EXCLUDING CORTICOSTEROIDS AGENTS ANTI-ALLERGIQUES, A L’EXCLUSION DES CORTICOSTÉROÏDES

R01AC01 CROMOGLICIC ACID ACIDE CROMOGLICIQUE

Aem Nas 2% Rhinaris-CS Anti-Allergic Nsl 01950541 PDP ADEFGVW Aém.

R01AD CORTICOSTEROIDS CORTICOSTÉROÏDES

R01AD01 BECLOMETHASONE BÉCLOMÉTHASONE

Aem Nas 50mcg Apo-Beclomethasone AQ 02238796 APX ABDEFGVW Aém. Mylan-Beclo AQ 02172712 MYL ABDEFGVW


R01AD05 BUDESONIDE BUDÉSONIDE

Aem Nas 100mcg Rhinocort 02035324 AZE ADEFVW Aém. Aem Nas 64mcg Rhinocort Aqua 02231923 AZE ADEFVW Aém. Mylan-Budesonide 02241003 MYL ADEFVW Aem Nas 100mcg Mylan-Budesonide 02230648 MYL ADEFGVW Aém.

R01AD08 FLUTICASONE

FLUTICASONE

Aem Nas 50mcg Flonase AQ 02213672 GSK ABDEFGVW Aém. Apo-Fluticasone 02294745 APX ABDEFGVW ratio-Fluticasone 02296071 TEV ABDEFGVW

R01AD09 MOMETASONE

MOMÉTASONE

Asp Nas 0.1% Nasonex Aqueous 02238465 FRS ADEFGVW Asp Apo-Mometasone 02403587 APX ADEFGVW

R01AX OTHER NASAL PREPARATIONS AUTRES PRÉPARATIONS NASALES

R01AX03 IPRATROPIUM BROMIDE BROMURE D’IPRATROPIUM

Spr Nas 0.03% Atrovent Nasal 02163705 BOE ADEFGVW Vap pms-Ipratropium 02239627 PMS ADEFGVW Spr Nas 0.06% Atrovent Nasal 02163713 BOE ADEFGVW Vap Ipravent 02246084 AAP ADEFGVW

R03 DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES

R03A ADRENERGICS, INHALANTS ADRENERGIQUES, INHALANTS

R03AC SELECTIVE BETA2-ADRENOCEPTOR AGONISTS AGONISTES DES RECEPTEURS ADRENERGIQUES BETA2 SELECTIFS

R03AC02 SALBUTAMOL SALBUTAMOL

Aem Inh 100mcg Airomir 02232570 VLN ABDEFGVW Aém. Ventolin 02241497 GSK ABDEFGVW Apo-Salvent CFC Free 02245669 APX ABDEFGVW Novo-Salbutamol 02326450 TEV ABDEFGVW Salbutamol HFA 02419858 SAS ABDEFGVW


R03AC02 SALBUTAMOL SALBUTAMOL

Liq Inh 1mg/mL Ventolin Nebules P.F. 02213419 GSK BDEF-18GVW Liq Med-Salbutamol 02237414 MED BDEF-18GVW pms-Salbutamol 02208229 PMS BDEF-18GVW ratio-Salbutamol unit/dose PF (Disc/Non-Disp Feb 10/17) 01986864 TEV BDEF-18GVW Teva-Salbutamol Sterinebs 01926934 TEV BDEF-18GVW Liq Inh 2mg/mL Ventolin Nebules PF 02213427 GSK D-18G Liq pms-Salbutamol 02208237 PMS D-18G

Teva-Salbutamol Sterinebs 02173360 TEV D-18G Liq Inh 5mg/mL Ventolin 02213486 GSK BDEF-18GVW Liq pms-Salbutamol (Disc/non disp Mar 23/17) 02069571 PMS BDEF-18GVW ratio-Salbutamol 00860808 TEV BDEF-18GVW Sandoz Salbutamol 02154412 SDZ BDEF-18GVW Pwr Inh 200mcg Ventolin Diskus 02243115 GSK ADEFGVW Pd.

R03AC03 TERBUTALINE

TERBUTALINE

Pwr Inh 0.5mg Bricanyl Turbuhaler 00786616 AZE ADEFGVW Pd.

R03AC12 SALMETEROL

SALMÉTÉROL

Pwr Inh 50mcg Serevent Diskus 02231129 GSK (SA) Pd. Serevent Diskhaler 02214261 GSK (SA)

R03AC13 FORMOTEROL

FORMOTÉROL

Pwr Inh 6mcg Oxeze 02237225 AZE (SA) Pd. Pwr Inh 12mcg Oxeze 02237224 AZE (SA) Pd. Cap Inh 12mcg Foradil 02230898 NVR (SA) Caps.

R03AC18 INDACATEROL

INDACATÉROL

Cap Inh 75mcg Onbrez Breezhaler 02376938 NVR (SA) Caps


R03AK ADRENERGICS AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES ADRÉNERGIQUES ET AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES

R03AK06 SALMETEROL AND OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES SALMÉTÉROL ET AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES

SALMETEROL / FLUTICASONE SALMÉTÉROL / FLUTICASONE

Pwr Inh 25mcg/125mcg Advair 125 02245126 GSK W (SA) Pd. Pwr Inh 25mcg/250mcg Advair 250 02245127 GSK W (SA) Pd. Pwr Inh 50mcg/100mcg Advair Diskus 02240835 GSK W (SA) Pd. Pwr Inh 50mcg/250mcg Advair Diskus 02240836 GSK W (SA) Pd. Pwr Inh 50mcg/500mcg Advair Diskus 02240837 GSK W (SA) Pd.

R03AK07 FORMOTEROL AND BUDESONIDE

FORMOTÉROL ET BUDÉSONIDE

Pwr Inh 100mcg/6mcg Symbicort MDI 02245385 AZE (SA) Pd. Pwr Inh 200mcg/6mcg Symbicort MDI 02245386 AZE (SA) Pd.

R03AK09 FORMOTEROL AND MOMETASONE

FORMOTÉROL ET MOMÉTASONE

Aem Inh 5mcg/50mcg Zenhale (Disc/non disp May 7/17) 02361744 FRS (SA) Aém. Aem Inh 5mcg/100mcg Zenhale 02361752 FRS (SA) Aém. Aem Inh 5mcg/200mcg Zenhale 02361760 FRS (SA) Aém.

R03AK10 VILANTEROL AND FLUTICASONE VILANTÉROL ET FLUTICASONE

Pwr Inh 25mcg/100mcg Breo Ellipta 02408872 GSK (SA) Pd.


R03AL ADRENERGICS IN COMBINATION WITH ANTICHOLINERGICS ADRÉNERGIQUES EN ASSOCIATION AVEC LES ANTICHOLINERGIQUES

R03AL03 VILANTEROL AND UMECLIDINIUM BROMIDE VILANTÉROL ET BROMURE D’UMÉCLIDINIUM

Pwr Inh 25mcg/62.5mcg Anoro Ellipta 02418401 GSK (SA) Pds.

R03AL04 INDACATEROL AND GLYCOPYRRONIUM BROMIDE

INDACATÉROL ET BROMURE DE GLYCOPYRRONIUM

Cap Inh 110mcg/50mcg Ultibro Breezhaler 02418282 NVR (SA) Caps.

R03B OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES, INHALANTS R03BA GLUCOCORTICOIDS GLUCOCORTICOÏDES

R03BA01 BECLOMETHASONE BÉCLOMÉTHASONE

Aem Inh 50mcg Qvar 02242029 VLN ADEFGVW Aém. Aem Inh 100mcg Qvar 02242030 VLN ADEFGVW Aém.

R03BA02 BUDESONIDE

BUDÉSONIDE

Pwr Inh 100mcg Pulmicort Turbuhaler 00852074 AZE ABDEFGVW Pd. Pwr Inh 200mcg Pulmicort Turbuhaler 00851752 AZE ABDEFGVW Pd. Pwr Inh 400mcg Pulmicort Turbuhaler 00851760 AZE ABDEFGVW Pd. Sus Inh 0.125mg/mL Pulmicort Nebuamp 02229099 AZE W Susp Sus Inh 0.25mg/mL Pulmicort Nebuamp 01978918 AZE ABDEFGVW Susp Sus Inh 0.5mg/mL Pulmicort Nebuamp 01978926 AZE ABDEFGVW Susp

R03BA05 FLUTICASONE

FLUTICASONE

Aem Inh 50mcg Flovent Metered Dose HFA 02244291 GSK ABDEFGVW Aém.


R03BA05 FLUTICASONE FLUTICASONE

Aem Inh 125mcg Flovent Metered Dose HFA 02244292 GSK ABDEFGVW Aém. Aem Inh 250mcg Flovent Metered Dose HFA 02244293 GSK ABDEFGVW Aém. Pwr Inh 50mcg Flovent Diskus 02237244 GSK ABDEFGVW Pd. Pwr Inh 100mcg Flovent Diskus 02237245 GSK ABDEFGVW Pd. Pwr Inh 250mcg Flovent Diskus 02237246 GSK ABDEFGVW Pd. Pwr Inh 500mcg Flovent Diskus 02237247 GSK ABDEFGVW Pd.

R03BA07 MOMETASONE

MOMÉTASONE

Pwr Inh 200mcg Asmanex Twisthaler 02243595 MSD ADEFGVW Pd. Pwr Inh 400mcg Asmanex Twisthaler 02243596 MSD ADEFGVW Pd.

R03BA08 CICLESONIDE

CICLÉSONIDE

Aem Inh 100mcg Alvesco 02285606 NYC ABDEFGVW Aém. Aem Inh 200mcg Alvesco 02285614 NYC ABDEFGVW Aém.

R03BB ANTICHOLINERGICS ANTICHOLINERGIQUES

R03BB01 IPRATROPIUM BROMIDE BROMURE D’IPRATROPIUM

Aem Inh 20mcg Atrovent HFA 02247686 BOE ABDEFGVW Aém. Liq Inh 250mcg/mL Apo-Ipravent 02126222 APX BEF-18GVW Liq Mylan-Ipratropium Soln 02239131 MYL BEF-18GVW Novo-Ipramide 02210479 TEV BEF-18GVW pms-Ipratropium 02231136 PMS BEF-18GVW


R03BB01 IPRATROPIUM BROMIDE BROMURE D’IPRATROPIUM

Liq Inh 250mcg/mL pms-Ipratropium (1mL nebules) 02231244 PMS BEF-18GVW Liq pms-Ipratropium (2mL nebules) 02231245 PMS BEF-18GVW ratio-Ipratropium UDV 02097168 TEV BEF-18GVW Teva-Ipratropium 02216221 TEV BEF-18GVW

R03BB04 TIOTROPIUM

TIOTROPIUM

Cap Inh 18mcg Spiriva 02246793 BOE (SA) Caps

R03BB05 ACLIDINUM BROMIDE

BROMURE D’ACLIDINUM

Pwr Inh 400mcg Tudorza Genuair 02409720 ALM (SA) Pd.

R03BB06 GLYCOPYRRONIUM BROMIDE

BROMURE DE GLYCOPYRRONIUM

Cap Inh 50mcg Seebri Breezhaler 02394936 NVR (SA) Caps

R03BC ANTIALLERGIC AGENTS, EXCLUDING CORTICOSTEROIDS AGENTS ANTIALLERGIQUES, A L’EXCLUSION DES CORTICOSTÉROÏDES

R03BC01 CROMOGLICIC ACID ACIDE CROMOGLICIQUE

Liq Inh 1% pms-Sodium Cromoglycate 02046113 PMS ABDEFGVW Liq

R03BX OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES, INHALANTS

R03BX99 HYPERTONIC SODIUM CHLORIDE CHLORURE DE SODIUM, HYPERTONIQUE

Liq Inh 7% Hyper-Sal 80029414 KEG BDEFG Liq

R03C ADRENERGICS FOR SYSTEMIC USE ADRENERGIQUES, PRÉPARATIONS SYSTEMIQUES

R03CB NON-SELECTIVE BETA-ADRENOCEPTOR AGONISTS AGONISTES DES RECEPTEURS ADRENERGIQUES BETA NON SELECTIFS

R03CB03 ORCIPRENALINE ORCIPRÉNALINE

Syr Orl 2mg/mL Orciprenaline 02236783 AAP ADEFGVW Sir.


R03CC SELECTIVE BETA2-ADRENOCEPTOR AGONISTS AGONISTES DES RECEPTEURS ADRENERGIQUES BETA2 SELECTIFS

R03CC02 SALBUTAMOL SALBUTAMOL

Tab Orl 2mg Apo-Salvent 02146843 APX ADEFGVW Co. Tab Orl 4mg Apo-Salvent 02146851 APX ADEFGVW Co.

R03D OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES AUTRES MÉDICAMENTS CONTRE LES BRONCHOPNEUMOPATHIES OBSTRUCTIVES

R03DA XANTHINES XANTHINES

R03DA02 CHOLINE THEOPHYLLINATE (OXTRIPHYLLINE) THÉOPHYLLINATE CHOLINE (OXTRIPHYLLINE)

Elx Orl 100mg/5mL Choledyl 00476366 ERF ADEFGVW Elx

R03DA04 THEOPHYLLINE

THÉOPHYLLINE

Liq Orl 80mg/15mL Theolair 01966219 VLN ADEFGVW Liq SRT Orl 100mg Apo-Theo LA 00692689 APX ADEFGVW Co.L.L. Teva-Theophylline 02230085 TEV ADEFGVW SRT Orl 200mg Apo-Theo LA 00692697 APX ADEFGVW Co.L.L. Teva-Theophylline SR 02230086 TEV ADEFGVW SRT Orl 300mg Apo-Theo LA 00692700 APX ADEFGVW Co.L.L. Teva-Theophylline SR 02230087 TEV ADEFGVW SRT Orl 400mg Theo ER 02360101 AAP ADEFGVW Co.L.L. Uniphyl 02014165 PFR ADEFGVW SRT Orl 600mg Theo ER 02360128 AAP ADEFGVW Co.L.L. Uniphyl 02014181 PFR ADEFGVW

R03DC LEUKOTRIENE RECEPTOR ANTAGONISTS ANTAGONISTES DES RECEPTEURS DU LEUCOTRIENE

R03DC01 ZAFIRLUKAST ZAFIRLUKAST

Tab Orl 20mg Accolate 02236606 AZE (SA) Co.


R03DC03 MONTELUKAST MONTÉLUKAST

Gra Orl 4mg Singulair 02247997 FRS (SA) Gra Sandoz Montelukast 02358611 SDZ (SA) TabC Orl 4mg Singulair 02243602 FRS (SA) Co.C. Apo-Montelukast 02377608 APX (SA) Auro-Montelukast Chewable 02422867 ARO (SA) Mar-Montelukast 02399865 MAR (SA) Mint-Montelukast 02408627 MNT (SA) Montelukast 02379317 SAS (SA) Montelukast 02382458 SIV (SA) Mylan-Montelukast 02380749 MYL (SA) pms-Montelukast 02354977 PMS (SA) Ran-Montelukast 02402793 RAN (SA) Sandoz Montelukast 02330385 SDZ (SA) Teva-Montelukast 02355507 TEV (SA) TabC Orl 5mg Singulair 02238216 FRS (SA) Co.C. Apo-Montelukast 02377616 APX (SA) Mar-Montelukast 02399873 MAR (SA) Mint-Montelukast 02408635 MNT (SA) Montelukast 02379325 SAS (SA) Montelukast 02382466 SIV (SA) Mylan-Montelukast 02380757 MYL (SA) pms-Montelukast 02354985 PMS (SA) Ran-Montelukast 02402807 RAN (SA) Sandoz Montelukast 02330393 SDZ (SA) Teva-Montelukast 02355515 TEV (SA) Tab Orl 10mg Singulair 02238217 FRS (SA) Co. Apo-Montelukast 02374609 APX (SA) Auro-Montelukast 02401274 ARO (SA) Jamp-Montelukast 02391422 JPC (SA) Mar-Montelukast 02399997 MAR (SA) Mint-Montelukast 02408643 MNT (SA) Montelukast 02379333 SAS (SA) Montelukast 02382474 SIV (SA) Montelukast Sodium 02379236 AHI (SA) Mylan-Montelukast 02368226 MYL (SA) pms-Montelukast 02373947 PMS (SA) Ran-Montelukast 02389517 RAN (SA) Sandoz Montelukast 02328593 SDZ (SA) Teva-Montelukast 02355523 TEV (SA)


R05 COUGH AND COLD PREPARATIONS PRÉPARATIONS CONTRE LA TOUX ET LE RHUME

R05C EXPECTORANTS, EXCLUDING COMBINATIONS WITH COUGH SUPPRESSANTS EXPECTORANTS, A L’EXCLUSION D’UNE COMBINAISON AVEC UN ANTITUSSIF

R05CA EXPECTORANTS EXPECTORANTS

R05CA03 GUAIFENESIN GUAIFÉNÉSINE

Syr Orl 100mg/5mL Balminil 00608920 ROG G Sir Balminil Expect Sans Sucrose 00609951 ROG G Robitussin 01931032 WCH G

R05CB MUCOLYTICS MUCOLYTIQUES

R05CB01 ACETYLCYSTEINE ACÉTYLCYSTÉINE

Liq Inh 200mg/mL Mucomyst 02091526 WLS ADEFGVW Liq Parvolex 02181460 BCH W Acetylcysteine 02243098 SDZ ADEFGVW

R05CB13 DORNASE ALFA

DORNASE ALPHA

Liq Inh 1mg/mL Pulmozyme 02046733 HLR (SA) Liq

R05D COUGH SUPPRESSANTS, EXCLUDING COMBINATIONS WITH EXPECTORANTS ANTITUSSIFS, A L’EXCLSION D’UNE COMBINAISON AVEC UN EXPECTORANT

R05DA OPIUM ALKALOIDS AND DERIVATIVES ALKALOIDES D’OPIUM ET DÉRIVÉS

R05DA04 CODEINE CODÉINE

Liq Inj 30mg/mL Codeine Phosphate 00544884 SDZ W Liq Syr Orl 5mg/mL Codeine Phosphate 00050024 ATL ADEFGVW Sir ratio-Codeine 00779474 RPH ADEFGVW Tab Orl 15mg Codeine 00779458 ROG ADEFGVW Co. ratio-Codeine 00593435 RPH ADEFGVW Tab Orl 30mg ratio-Codeine 00593451 RPH ADEFGVW Co. SRT Orl 50mg Codeine Contin 02230302 PFR W (SA) Co.L.L. SRT Orl 100mg Codeine Contin 02163748 PFR W (SA) Co.L.L.


R05DA04 CODEINE CODÉINE

SRT Orl 150mg Codeine Contin 02163780 PFR W (SA) Co.L.L. SRT Orl 200mg Codeine Contin 02163799 PFR W (SA) Co.L.L.

R05DA09 DEXTROMETHORPHAN

DEXTROMÉTHORPHANE

Liq Orl 15mg/mL Koffex Sugar Free Clear 01928791 ROG G Liq Sus Orl 30mg/5mL Delsym 02018403 NNC G Susp Syr Orl 3mg/mL Balminil DM 00436895 ROG G Sir Benylin DM 01944738 JNJ G Koffex DM 01928783 ROG G

R05F COUGH SUPPRESSANTS AND EXPECTORANTS, COMBINATIONS ANTITUSSIFS ET EXPECTORANTS, EN COMBINAISON

R05FA OPIUM DERIVATIVES AND EXPECTORANTS DÉRIVÉS DE L’OPIUM ET EXPECTORANTS

R05FA02 OPIUM DERIVATIVES AND EXPECTORANTS DÉRIVÉS DE L’OPIUM ET EXPECTORANTS

GUAIFENESIN / DEXTROMETHORPHAN GUAIFÉNÉSINE / DEXTROMÉTHORPHANE

Liq Orl 20mg/3mg Robitussin DM Exp 01931024 WCH G Liq

GUAIFENESIN / DEXTROMETHORPHAN / PSEUDOEPHEDRINE GUAIFÉNÉSINE / DEXTROMÉTHORPHANE / PSEUDOÉPHÉDRINE

Syr Orl 100mg/50mg/30mg Benylin DM-D-E 01944673 JNJ G Sir

R06 ANTIHISTAMINES FOR SYSTEMIC USE ANTIHISTAMINIQUES SYSTEMIQUES

R06A ANTIHISTAMINES FOR SYSTEMIC USE ANTIHISTAMINIQUES SYSTEMIQUES

R06AA AMINOALKYL ETHERS AMINOALKYLETHERS

R06AA02 DIPHENHYDRAMINE DIPHENHYDRAMINE

Elx Orl 12.5mg/5mL Benadryl 02019736 JNJ G Elx


R06AA02 DIPHENHYDRAMINE DIPHENHYDRAMINE

Tab Orl 25mg Benadryl 02017849 JNJ G Co. Diphenhydramine 02257548 JPC G Tab Orl 50mg Diphenhydramine 02257556 JPC G Co.

R06AA09 DOXYLAMINE

DOXYLAMINE

SRT Orl 10mg/10mg Diclectin 00609129 DUI DEFG Co.L.L.

R06AB SUBSTITUTED ALKYL AMINES AMINO-ALKYLES SUBSTITUTES

R06AB04 CHLORPHENAMINE CHLORPHÉNAMINE

Tab Orl 4mg Chlor-Tripolon 00738972 SCO G Co. Novo-Pheniram 00021288 TEV G

R06AE PIPERAZINE DERIVATIVES DÉRIVÉS DU PIPERAZINE

R06AE07 CETIRIZINE CÉTIRIZINE

Tab Orl 10mg Reactine 02223554 JNJ G Co. Apo-Cetirizine 02231603 APX G Extra Strength Allergy Relief 02315955 PMS G

R06AX OTHER ANTIHISTAMINES FOR SYSTEMIC USE DIVERS ANTIHISTAMINIQUES SYSTEMIQUES

R06AX13 LORATADINE LORATADINE

Tab Orl 10mg Claritin 00782696 SCO G Co. Apo-Loratadine 02243880 APX G

R06AX17 KETOTIFEN

KÉTOTIFÈNE

Syr Orl 1mg/5mL Zaditen 00600784 TEV DEFG Sir Tab Orl 1mg Zaditen 00577308 TEV DEFG Co.


R07 OTHER RESPIRATORY SYSTEM PRODUCTS AUTRES PRODUITS DU SYSTÈME RESPIRATOIRE

R07A OTHER RESPIRATORY SYSTEM PRODUCTS AUTRES PRODUITS DU SYSTÈME RESPIRATOIRE

R07AX OTHER RESPIRATORY SYSTEM PRODUCTS AUTRES PRODUITS DU SYSTÈME RESPIRATOIRE

R07AX02 IVACAFTOR IVACAFTOR

Tab Orl 150mg Kalydeco 02397412 VTX (SA) Co.

S01 OPHTHALMOLOGICALS AGENTS OPHTHALMOLOGIQUES

S01A ANTIINFECTIVES ANTIINFECTIEUX

S01AA ANTIBIOTICS ANTIBIOTIQUES

S01AA07 FRAMYCETIN FRAMYCÉTINE

Dps Oph 0.5% Soframycin 02224887 ERF ADEFGVW Gttes

S01AA11 GENTAMICIN

GENTAMICINE

Dps Oph 0.3% Garamycin (Disc/non disp Sept 2/16) 00512192 FRS ADEFGVW Gttes

S01AA12 TOBRAMYCIN

TOBRAMYCINE

Liq Oph 0.3% Tobrex 00513962 ALC ADEFGVW Liq pms-Tobramycin (Disc/non disp Jun 1/16) 02239577 PMS ADEFGVW Sandoz Tobramycin 02241755 SDZ ADEFGVW Ont Oph 0.3% Tobrex 00614254 ALC ADEFGVW Ont

S01AA17 ERYTHROMYCIN

ÉRYTHROMYCINE

Ont Oph 0.5% Erythromycin 02326663 SGQ ADEFGVW Ont pms-Erythromycin 01912755 PMS ADEFGVW

S01AA30 COMBINATIONS OF DIFFERENT ANTIBIOTICS

EN COMBINAISON AVEC DIFFERENTS ANTIBIOTIQUES

POLYMYXIN B SULFATE / BACITRACIN ZINC POLYMYXINE B (SULFATE DE) / BACITRACINE

Ont Oph 10000IU/500IU Polysporin 02239157 JNJ G Ont


S01AB SULFONAMIDES SULFONAMIDES

S01AB04 SULFACETAMIDE SULFACÉTAMIDE

Dps Oph 10% Sodium Sulamyd (Disc/non disp Dec 15/16) 00028053 SDZ ADEFGVW Gttes

S01AD ANTIVIRALS ANTIVIRAUX

S01AD02 TRIFLURIDINE TRIFLURIDINE

Liq Oph 1% Viroptic 00687456 VLN ADEFGVW Liq

S01AX OTHER ANTIINFECTIVES AUTRES ANTIINFECTIEUX

S01AX11 OFLOXACIN OFLOXACINE

Liq Oph 0.3% Ocuflox 02143291 ALL W (SA)

Liq Apo-Ofloxacin 02248398 APX W (SA)

Sandoz Ofloxacin (Disc/non disp Dec 31/16) 02247189 SDZ W (SA)

S01AX13 CIPROFLOXACIN

CIPROFLOXACINE

Liq Oph 0.3% Ciloxan 01945270 ALC W (SA)

Liq Sandoz Ciprofloxacin 02387131 SDZ W (SA)

Ont Oph 0.3% Ciloxan 02200864 ALC W (SA) Ont

S01AX20 OCRIPLASMIN

OCRIPLASMINE

Liq IVL 2.5mg/mL Jetrea 02410818 ALC (SA) Liq

S01B ANTIINFLAMMATORY AGENTS AGENTS ANTIINFLAMMATOIRES

S01BA CORTICOSTEROIDS, PLAIN CORTICOSTÉROÏDES, ORDINAIRES

S01BA01 DEXAMETHASONE DEXAMÉTHASONE

Dps Oph 0.1% Maxidex 00042560 ALC ADEFGVW Gttes Ont Oph 0.1% Maxidex 00042579 ALC ADEFGVW Ont


S01BA04 PREDNISOLONE PREDNISOLONE

Liq Oph 0.12% Pred Mild 00299405 ALL ADEFGVW Liq Sus Oph 1% Pred Forte 00301175 ALL ADEFGVW Susp ratio-Prednisolone 00700401 RPH ADEFGVW Sandoz Prednisolone 01916203 SDZ ADEFGVW

S01BA07 FLUOROMETHOLONE

FLUOROMÉTHOLONE

Dps Oph 0.1% FML 00247855 ALL ADEFGVW Gttes pms-Fluorometholone (Disc/non disp Jun 11/16) 02238568 PMS ADEFGVW Sandoz Fluorometholone 00432814 SDZ ADEFGVW Sus Oph 0.25% FML Forte 00707511 ALL ADEFGVW Susp Sus Oph 0.1% Flarex 00756784 ALC ADEFGVW Susp

S01BC ANTIINFLAMMATORY AGENTS, NON STEROIDS AGENTS ANTIINFLAMMATOIRES, NON STÉROÏDIENS

S01BC03 DICLOFENAC DICLOFÉNAC

Liq Oph 0.1% Voltaren 01940414 ALC ADEFGVW Liq Apo-Diclofenac 02441020 APX ADEFGVW

S01BC05 KETOROLAC

KÉTOROLAC Liq Oph 0.45% Acuvail 02369362 ALL ADEFGVW Liq Liq Oph 0.5% Acular 01968300 ALL ADEFGVW Liq Ketorolac 02245821 AAP ADEFGVW

S01C ANTIINFLAMMATORY AGENTS & ANTIINFECTIVES IN COMBINATION AGENTS ANTIINFLAMMATOIRES ET ANTIINFECTIEUX EN COMBINAISON

S01CA CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON

S01CA01 DEXAMETHASONE AND ANTIINFECTIVES DEXAMÉTHASONE ET ANTIINFECTIEUX

DEXAMETHASONE / NEOMYCIN / POLYMYXIN B DEXAMÉTHASONE / NÉOMYCINE / POLYMYXINE B

Sus Oph 1mg/3.5mg/6000IU Maxitrol 00042676 ALC ADEFGVW Susp Ont Oph 1mg / 3.5mg / 6000IU Maxitrol 00358177 ALC ADEFGVW Ont



DEXAMETHASONE / TOBRAMYCIN DEXAMÉTHASONE / TOBRAMYCINE

Ont Oph 0.3% / 0.1% Tobradex 00778915 ALC ADEFGVW Ont Sus Oph 0.3% / 0.1% Tobradex 00778907 ALC ADEFGVW Susp

S01CA02 PREDNISOLONE AND ANTIINFECTIVES

PREDNISOLONE ET ANTIINFECTIEUX

PREDNISOLONE / SULFACETAMIDE PREDNISOLONE / SULFACÉTAMIDE

Dps Oph 10% / 0.2% Blephamide 00807788 ALL ADEFGVW Gttes Ont Oph 10% / 0.2% Blephamide S.O.P. 00307246 ALL ADEFGVW Ont

S01E ANTIGLAUCOMA PREPARATIONS AND MIOTICS PRÉPARATIONS ANTIGLAUCOME ET MIOTIQUES

S01EA SYMPATHOMIMETICS IN GLAUCOMA THERAPY ADRENERGIQUES POUR LE TRAITEMENT DU GLAUCOME

S01EA03 APRACLONIDINE APRACLONIDINE

Liq Oph 0.5% Iopidine 02076306 ALC ADEFGVW Liq

S01EA05 BRIMONIDINE

BRIMONIDINE

Liq Oph 0.15% Alphagan P 02248151 ALL ADEFGVW Liq Brimonidine P 02301334 AAP ADEFGVW Liq Oph 0.2% Alphagan 02236876 ALL ADEFGVW Liq Apo-Brimonidine 02260077 APX ADEFGVW pms-Brimonidine 02246284 PMS ADEFGVW ratio-Brimonidine (Disc/non disp Sept 1/17) 02243026 TEV ADEFGVW Sandoz Brimonidine 02305429 SDZ ADEFGVW

S01EB PARASYMPATHOMIMETICS PARA-ADRENERGIQUES

S01EB01 PILOCARPINE PILOCARPINE

Dps Oph 1% Isopto Carpine 00000841 ALC ADEFGVW Gttes


S01EB01 PILOCARPINE PILOCARPINE

Dps Oph 2% Isopto Carpine 00000868 ALC ADEFGVW Gttes Dps Oph 4% Isopto Carpine 00000884 ALC ADEFGVW Gttes Dps Oph 6% Pilocarpine 02230239 IVX ADEFGVW Gttes

S01EC CARBONIC ANHYDRASE INHIBITORS INHIBITEURS DE L’ANHYDRASE CARBONIQUE

S01EC01 ACETAZOLAMIDE ACÉTAZOLAMIDE

Tab Orl 250mg Acetazolamide 00545015 AAP ADEFGVW Co.

S01EC03 DORZOLAMIDE

DORZOLAMIDE

Liq Oph 2% Trusopt 02216205 FRS ADEFGVW Liq Sandoz Dorzolamide 02316307 SDZ ADEFGVW

S01EC04 BRINZOLAMIDE

BRINZOLAMIDE

Liq Oph 1% Azopt 02238873 ALC ADEFGVW Liq

S01EC05 METHAZOLAMIDE

MÉTHAZOLAMIDE

Tab Orl 50mg Methazolamide 02245882 AAP ADEFGVW Co.

S01ED BETA BLOCKING AGENTS BETA-BLOQUANTS

S01ED01 TIMOLOL TIMOLOL

Dps Oph 0.25% Apo-Timop 00755826 APX ADEFGVW Gttes pms-Timolol 02083353 PMS ADEFGVW Sandoz Timolol Maleate 02166712 SDZ ADEFGVW Dps Oph 0.5% Timoptic Oph 00451207 FRS ADEFGVW Gttes Apo-Timop 00755834 APX ADEFGVW pms-Timolol 02083345 PMS ADEFGVW Sandoz Timolol Maleate 02166720 SDZ ADEFGVW Liq Oph 0.25% Timoptic-XE Oph 02171880 FRS ADEFGVW Liq Timolol Maleate-EX 02242275 SDZ ADEFGVW


S01ED01 TIMOLOL TIMOLOL

Liq Oph 0.5% Timoptic-XE Oph 02171899 FRS ADEFGVW Liq Timolol Maleate-EX 02242276 SDZ ADEFGVW Apo-Timop 02290812 APX ADEFGVW

S01ED02 BETAXOLOL

BÉTAXOLOL

Sus Oph 0.25% Betoptic S 01908448 ALC ADEFGVW Susp

S01ED03 LEVOBUNOLOL

LÉVOBUNOLOL

Liq Oph 0.25% ratio-Levobunolol (Disc/non disp Sept 29/16) 02031159 TEV ADEFGVW Liq Liq Oph 0.5% Betagan 00637661 ALL ADEFGVW Liq ratio-Levobunolol (Disc/non disp Sept 29/16) 02031167 TEV ADEFGVW Sandoz Levobunolol (Disc/non disp Dec 31/16) 02241716 SDZ ADEFGVW

S01ED51 TIMOLOL COMBINATIONS

TIMOLOL EN COMBINAISON

TIMOLOL / BRIMONIDINE TIMOLOL / BRIMONIDINE

Liq Oph 0.5%/0.2% Combigan 02248347 ALL ADEFGVW Liq

TIMOLOL / BRINZOLAMIDE TIMOLOL / BRINZOLAMIDE

Sus Oph 0.5%/1% Azarga 02331624 ALC ADEFGVW Susp

TIMOLOL / DORZOLAMIDE TIMOLOL / DORZOLAMIDE

Liq Oph 2%/0.5% Cosopt 02240113 FRS ADEFGVW Liq Act Dorzotimolol 02404389 ATV ADEFGVW Apo-Dorzo-Timop 02299615 APX ADEFGVW Sandoz Dorzolamide/Timolol 02344351 SDZ ADEFGVW Teva-Dorzotimol 02320525 TEV ADEFGVW

TIMOLOL / LATANOPROST TIMOLOL / LATANOPROST

Liq Oph 0.005%/0.5% Xalacom 02246619 PFI ADEFGVW Liq Apo-Latanoprost-Timop 02414155 APX ADEFGVW GD-Latanoprost/Timolol 02373068 GMD ADEFGVW Sandoz Latanoprost/Timolol 02394685 SDZ ADEFGVW

TIMOLOL / TRAVOPROST TIMOLOL / TRAVOPROST

Liq Oph 0.5%/0.004% Duo Trav 02278251 ALC ADEFGVW Liq


S01EE PROSTAGLANDIN ANALOGUES ANALOGUES DE LA PROSTAGLANDINE

S01EE01 LATANOPROST LATANOPROST

Liq Oph 0.005% Xalatan 02231493 PFI ADEFGVW Liq Apo-Latanoprost 02296527 APX ADEFGVW Act Latanoprost 02254786 ATV ADEFGVW GD-Latanoprost 02373041 GMD ADEFGVW Latanoprost 02375508 PMS ADEFGVW Sandoz Latanoprost 02367335 SDZ ADEFGVW pms-Latanoprost 02317125 PMS ADEFGVW

S01EE03 BIMATOPROST

BIMATOPROST

Liq Oph 0.01% Lumigan RC 02324997 ALL ADEFGVW Liq

S01EE04 TRAVOPROST

TRAVOPROST

Liq Oph 0.004% Travatan Z 02318008 ALC ADEFGVW Liq Apo-Travoprost Z 02415739 APX ADEFGVW Sandoz Travoprost 02413167 SDZ ADEFGVW Teva-Travoprost 02412063 TEV ADEFGVW

S01F MYDRIATICS AND CYCLOPLEGICS MYDRIATIQUES ET CYCLOPLEGIQUES

S01FA ANTICHOLINERGICS ANTICHOLINERGIQUES

S01FA01 ATROPINE ATROPINE

Dps Oph 1% Isopto Atropine 00035017 ALC ADEFGVW Gttes

S01FA04 CYCLOPENTOLATE

CYCLOPENTOLATE

Liq Oph 1% Cyclogyl 00252506 ALC ADEFGVW Liq

S01FA05 HOMATROPINE

HOMATROPINE

Liq Oph 2% Isopto Homatropine 00000779 ALC ADEFGVW Liq Liq Oph 5% Isopto Homatropine 00000787 ALC ADEFGVW Liq


S01FA06 TROPICAMIDE TROPICAMIDE

Liq Oph 0.5% Mydriacyl 00000981 ALC ADEFGVW Liq Liq Oph 1% Mydriacyl 00001007 ALC ADEFGVW Liq

S01G DECONGESTANTS AND ANTIALLERGICS DÉCONGESTIONNANTS ET ANTIALLERGIQUES

S01GX OTHER ANTIALLERGICS AUTRES ANTIALLERGIQUES

S01GX01 CROMOGLICIC ACID ACIDE CROMOGLICIQUE

Liq Oph 2% Cromolyn Ophthalmic Solution 02009277 PDP ADEFGVW Liq Opticrom 02230621 ALL ADEFGVW

S01GX08 KETOTIFEN

KÉTOTIFÈNE

Liq Oph 0.025% Zaditor 02242324 NVO ADEFGVW Liq

S01GX09 OLOPATADINE

OLOPATADINE

Liq Oph 0.2% Pataday 02362171 ALC ADEFGVW Liq

S01L OCULAR VASCULAR DISORDER AGENTS AGENTS POUR LES TROUBLES VASCULAIRES OCULAIRES

S01LA ANTINEOVASCULARISATION AGENTS AGENTS ANTINÉOVASCULAIRES

S01LA04 RANIBIZUMAB RANIBIZUMAB

Liq IVL 10mg/mL Lucentis 02296810 NVO (SA) Liq

S01LA05 AFLIBERCEPT

AFLIBERCEPT

Liq IVL 40mg/mL Eylea 02415992 BAY (SA) Liq


S01X OTHER OPTHALMOLOGICALS AUTRES OPTHALMOLOGIQUES

S01XA OTHER OPTHALMOLOGICALS AUTRES OPTHALMOLOGIQUES

S01XA03 SODIUM CHLORIDE, HYPERTONIC CHLORURE DE SODIUM, HYPERTONIQUE

Dps Oph 5% Muro 128 00750824 BSH AEFGVW Gttes Ont Oph 5% Muro 128 00750816 BSH AEFGVW Ont Odan-Sodium Chloride 80046696 ODN AEFGVW

S02 OTOLOGICALS AGENTS OTOLOGIQUES

S02A ANTIINFECTIVES ANTIINFECTIEUX

S02AA ANTIINFECTIVES ANTIINFECTIEUX

S02AA14 GENTAMICIN GENTAMICINE

Dps Ot 0.3% Garamycin (Disc/non disp Mar 3/16) 00512184 FRS ADEFGVW Gttes Sandoz Gentamicin 02229441 SDZ ADEFGVW

S02AA30 ANTIINFECTIVES, COMBINATIONS

ANTIINFECTIEUX, EN COMBINAISON

ALUMINUM ACETATE / BENZETHONIUM CHLORIDE ACÉTATE D’ALUMINIUM / CHLORURE DE BENZÉTHONIUM

Liq Ot 0.5%/0.03% Buro-Sol Otic (Disc/Non-Disp Jan 5/17) 00674222 TCD ADEFGVW Liq

S02C CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON


S02CA02 FLUMETASONE AND ANTIINFECTIVES FLUMETASONE ET ANTIINFECTIEUX

FLUMETASONE / CLIOQUINOL FLUMÉTASONE / CLIOQUINOL

Dps Ot 1%/0.02% Locacorten-Vioform 00074454 PAL ADEFGVW Gttes

S02CA06 DEXAMETHASONE AND CIPROFLOXACINE

DEXAMÉTHASONE ET CIPROFLOXACINE

Liq Ot 0.3%/0.1% Ciprodex 02252716 ALC (SA) Liq


S03 OPHTHALMOLOGICAL AND OTOLOGICAL PREPARATIONS PRÉPARATIONS OPHTHALMOLOGIQUES ET OTOLOGIQUES

S03C CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION CORTICOSTÉROÏDES ET ANTIINFECTIEUX EN COMBINAISON



DEXAMETHASONE / FRAMYCETIN / GRAMICIDIN DEXAMÉTHASONE / FRAMYCÉTINE / GRAMICIDINE

Dps Oph 5mg/0.5mg/0.05mg Sofracort E/E 02224623 SAV ADEFGV Gttes

S03CA06 BETAMETHASONE AND ANTIINFECTIVES

BÉTAMÉTHASONE ET ANTIINFECTIEUX

BETAMETHASONE / GENTAMICIN BÉTAMÉTHASONE / GENTAMICINE

Liq Oph 0.3%/0.1% Garasone (Disc/non disp Apr 01/16) 00682217 FRS ADEFGVW Liq Sandoz Pentasone 02244999 SDZ ADEFGVW

V01 ALLERGENS ALLERGENES

V01A ALLERGENS ALLERGENES

V01AA ALLERGEN EXTRACTS EXTRAITS D’ALLERGENES

V01AA02 GRASS POLLEN POLLEN DE GRAMINÉES

Slt Orl 100IR Oralair 02381885 STA (SA) Co.S.L. Slt Orl 300IR Oralair 02381893 STA (SA) Co.S.L.

V01AA20 VARIOUS ALLERGEN EXTRACTS

DIVERS EXTRAITS D’ALLERGENE

Liq Inj Allergy Sera 00999938 HJM EF-18G Liq


V03 ALL OTHER THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS THERAPEUTIQUES

V03A ALL OTHER THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS THERAPEUTIQUES

V03AC IRON CHELATING AGENTS AGENTS CHÉLATEURS DE FER

V03AC01 DEFEROXAMINE DÉFÉROXAMINE

Pws Inj 500mg Desferal 01981242 NVR ADEFGVW Pds. Deferoxamine Mesilate 02241600 HOS ADEFGVW pms-Deferoxamine (Disc/non disp Dec 20/15) 02242055 PMS ADEFGVW Pws Inj 2g Desferal 01981250 NVR ADEFGVW Pds. Deferoxamine Mesilate 02247022 HOS ADEFGVW pms-Deferoxamine (Disc/non disp Dec 20/15) 02243450 PMS ADEFGVW

V03AC03 DEFERASIROX

DÉFÉRASIROX

Tab Orl 125mg Exjade 02287420 NVR (SA) Co. Tab Orl 250mg Exjade 02287439 NVR (SA) Co. Tab Orl 500mg Exjade 02287447 NVR (SA) Co.

V03AE FOR TREATMENT OF HYPERKALEMIA AND HYPERPHOSPHATEMIA POUR LE TRAITEMENT DE HYPERKALEMIA ET HYPERPHOSPHATEMIA

V03AE01 POLYSTYRENE SULFONATE POLYSTYRÈNE SULFONATE

Pws Orl 100% Kayexalate 02026961 SAV ADEFGVW Pds. Solystat 00755338 PDP ADEFGVW Sus Orl 250mg/mL Solystat 00769541 PDP ADEFGVW Susp

V03AE02 SEVELAMER

SEVELAMER

Tab Orl 800mg Renagel 02244310 SAV (SA) Co.

V03AF DETOXIFYING AGENTS FOR ANTINEOPLASTIC TREATMENT AGENTS DÉTOXIFIANTS POUR TRAITEMENT ANTINÉOPLASIQUE

V03AF03 CALCIUM FOLINATE FOLINATE DE CALCIUM

Tab Orl 5mg Leucovorin Calcium 02170493 PFI ADEFGVW Co.


V03AG DRUGS FOR TREATMENT OF HYPERCALCEMIA MÉDICAMENTS POUR LE TRAITEMENT DE L’ HYPERCALCEMIE

V03AG99 DRUGS FOR TREATMENT OF HYPERCALCEMIA MÉDICAMENTS POUR LE TRAITEMENT DE L’ HYPERCALCEMIE

SODIUM ACID PHOSPHATE / SODIUM BICARBONATE / POTASSIUM PHOSPHATE ACIDE DE SODIUM / SODIUM (BICARBONATE DE) / POTASSIUM

Evt Orl 356mg/350mg/315mg Phosphate Novartis 80027202 NVR G Co.Eff.

V04 DIAGNOSTIC AGENTS AGENTS DIAGNOSTIQUES

V04C OTHER DIAGNOSTIC AGENTS AUTRES AGENTS DIAGNOSTIQUES

V04CJ TESTS FOR THYREOIDEA FUNCTION TESTS DE LA FONCTION THYROÏDIENNE

V04CJ01 THYROTROPIN THYROTROPINE

Pws IM 0.9mg Thyrogen 02246016 GZM (SA) Pds

V07 ALL OTHER NON-THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS NON THERAPEUTIQUES

V07A ALL OTHER NON-THERAPEUTIC PRODUCTS TOUS LES AUTRES PRODUITS NON THERAPEUTIQUES

V07AY OTHER NON-THERAPEUTIC AUXILLIARY PRODUCTS AUTRES PRODUITS AUXILIAIRES NON THERAPEUTIQUES

V07AY90 PLACEBO PLACEBO

Cap Orl 100mg Placebo 00501190 ODN AEFGVW Caps

October 2015 v.2 A - 1

APPENDIX I-A / ANNEXE I-A

ABBREVIATIONS OF DOSAGE FORMS / ABRÉVIATIONS DES FORMES POSOLOGIQUES

FORM CODE FORME

Metered-Dose Aerosol Aem/Aém. Aérosol-dose mesurée

Aerosol (with propellants) Aer/Aér. Aérosol (avec agents de propulsion)

Aerosol (without propellants) Asp Aérosol (sans agents de propulsion)

Capsule Cap/Caps Capsule

Chewable Tablets TabC/Co.C. Comprimés à croquer

Controlled Delivery Capsules CDC/Caps.L.C. Capsules à libération contrôlée

Cleanser Clr/Net Nettoyant

Cream Crm/Cr. Crème

Cartridge Ctg/Cart Cartouche

Douche Dch Douche

Delayed Action (Injectables) Dla Soluté injectable-retard

Delayed Release Capsule CDR/Caps.L.R. Capsule à liberation retardée

Drop Dps/Gttes Gouttes

Dressing Dre Pansement

Enteric Coated Capsule ECC/Caps.Ent. Capsule entérique

Each Ech/Ch Chacun

Enteric Coated Granule Ecg Granule entérique

Enteric Coated Tablet ECT/Co.Ent Comprimés entérique

Elixir Elx Élixir

Emulsion Eml/Émuls Émulsion

Enema Enm/Lav. Lavement

Extended Release ER À libération prolongée

Extended Release Capsules ERC/Caps.L.P. Capsules à libération prolongée

Extended Release Tablets ERT/Co.L.P. Comprimés à libération prolongée

Effervescent Granule Evg/Gev Granule effervescente

Effervescent Powder Ecp/Pev Poudre effervescente

Effervescent Tablet Evt/Co.Eff. Comprimé effervescent

Film Coated FC pelliculés

Gas Gas Gaz

Gel Gel Gelée

Granules Gran Granules

Immediate release IR Libération immédiate




FORM CODE FORME

Inhaler Inh Inhalateur

Instrument Ins Pièce à insérer

Insulin Ins Insuline

Kit Kit/Tro Trousse

Liniment Lin Liniment

Liquid Liq Liquide

Lente Suspension Lla/Susp. Suspension

Lotion Lot Lotion

Lozenge Loz Pastille

Miscellaneous Misc Divers

Mist, Aerosol Mst/Baer Bruine en aérosol

Mouthwash MWH/R.-B. rince-bouche

Nebules Neb Nébules

Orally Disintegrating Film ODF Film à désintégration orale

Orally Disintegrating Tablet ODT/Co.D.O. Comprimés à désintégration orale

Oral liquid O/L Liquide Oral

Ointment Ont Onguent, pommade

Pad Pad/Gaze Compresse

Package Pck Paquet

Paste Pst Pâte

Patch Pth Timbre cutané

Preservative Free PF Sans agent de conservation

Powder Pwr/Pd. Poudre

Powder For Solution Pws/Pds. Poudre pour solution

Rapid Dissolving RD Dissolution rapide

Rapid Disintegrating RPD Désintégration rapide

Shampoo Shp Shampooing

Semi-Lente Suspension SLA Suspension semi-lente

Slow release SR Libération lente

Sublingual Tablet Slt/Co.S.L. Comprimé sublingual

Spray Spr/Vap Vaporisateur




FORM CODE FORME

Sustained-Released Capsule SRC/Caps.L.L. Capsule à liberation lente

Packet Packet/Sachets Sachet/Paquet,

Sustained-Release Disc Srd Disque à action soutenue

Sustained-Release Syrup SRS Sirop à action soutenue

Sustained-Release Tablet SRT/Co.L.L. Comprimé à liberation lente

Suppository Sup/Supp. Suppositoire

Suspension Susp/Susp Suspension

Syrup Syr/Sir. Sirop

Tablet Tab/Co. Comprimé

Ultra-Lente Suspension Ula Suspension ultra-lente

Wafer Waf Gaufrette


APPENDIX I-B/ ANNEXE I-B

ABBREVIATIONS OF ROUTES / ABRÉVIATIONS DES VOIES D’ADMINISTRATION

ROUTE CODE VOIE

Buccal Buc Buccale, orale

Dental Den Dentaire

Intra Articular IA Intra-articulaire

Intrabursal IBU Intrabursique

Intracardiac ICD Intracardiaque

Intracavity ICV Intra-cavitaire

Intradermal ID Intradermique

Intramuscular IM Intramusculaire

Intervertebral IND Intervertébrale

Intrafollicular INF Intra-folliculaire

Inhalation Inh Inhalation

Injectable Inj Injectable

Instrument(s) Ins Instrument(s)

Intrathecal INT Intra-thécale

Intraocular IO Intraoculaire

Intraperitoneal IP Intrapéritonéale

Intrapleural IPL Intrapleurale

Intrapulmonary IPU Intrapulmonaire

Intravitreal IVL Intravitréenne

Irrigation IR Irrigation

Instillation ISL Instillation

Intravenous IV intraveineuse

Intraventicular IVR Intraventriculaire

Miscellaneous Mis Divers

Nasal Nas Nasale

Nil NIL Néant

Ophthalmic Oph Ophtalmique

Oral Orl Orale

Otic Ot Otique

Parenteral (Unspecified) Prt Parentérale (non spécifiée)

Retrobulbar RB Rétrobulbaire


APPENDIX I-B/ ANNEXE I-B

ABBREVIATIONS OF ROUTES / ABRÉVIATIONS DES VOIES D’ADMINISTRATION

ROUTE CODE VOIE

Rectal Rt Rectale

Sublingual Slg Sublinguale

Topical Top Topique

Transdermal Trd Transdermique

Vaginal Vag Vaginale


APPENDIX I-C/ ANNEXE I-C

ABBREVIATIONS OF UNITS / ABRÉVIATIONS DES UNITÉS DE MESURE

UNIT CODE UNITÉS

Ampoule Amp Ampoule

Billion B Milliard

Bottle Bottl Flacon, bouteille

Box Box Boîte

Capsule Cap Capsule

Cubic Centimetre CC Centimètre cube

Centimetre cm Centimètre

Disk Disk Disque

Fluid Ounce Fl oz Once liquide

Gallon Gal Gallon

Gram g Gramme

Grain Gr Grain

Kilogram kg Kilogramme

Kit Kit/Tro Trousse

Litre L Litre

Pound lb Livre

Lozenge Loz Pastille

Million M Million

Microgram mcg Microgramme

Milli-equivalent mEq Milli-équivalent

Milligram mg Milligramme

Drop dps/gttes Goutte

Millitre mL Millilitre

Millimole Mmol Millimole

Nil Nil Néant

Ounce oz Once

Package Pcg Paquet, emballage

Syringe SYR Seringue

Tablet Tab/Co. Comprimé

Tablespoon Tbs Cuillerée à soupe

Trace Trace Trace


APPENDIX I-C/ ANNEXE I-C

ABBREVIATIONS OF UNITS / ABRÉVIATIONS DES UNITÉS DE MESURE

UNIT CODE UNITÉS

Teaspoon Tsp Cuillerée à thé

Tube Tube Tube

International Unit IU Unité internationale

Vial Vial Fiole

By Weight w/w En poids


APPENDIX I-D / ANNEXE I-D

ABBREVIATIONS OF MANUFACTURER'S NAMES/ABRÉVIATIONS DES NOMS DE FABRICANTS

AAP AA Pharma Inc. ABB Abbott Laboratories, Ltd. AGA Amgen Canada Inc. AHI Accord Healthcare Inc. AJP Agila-Jamp Canada Inc. ALC Alcon Canada Inc. ALL Allergan Inc. APR Aspri Pharma Canada Inc. APX Apotex Inc. ARO Auro Pharma Inc. ASL Astellas Pharma Canada Inc. ASP Actavis Specialty Pharmaceuticals ATL Laboratoire Atlas Inc. ATV Actavis Pharma Company AVE Aventis Pharma Inc. AXC Aptalis AXS Axxess Pharma Inc. AZE AstraZeneca Canada Inc. BAX Baxter Corporation BAY Bayer Inc., HealthCare Division BCH Bioniche Inc. BGP BGP Pharma Inc. BIF Bioforce Canada Ltd/Ltee. BIG Biogen Idec Canada, Inc. BOE Boehringer Ingelheim (Canada) Ltd. BRI Bristol-Myers Squibb Canada Inc. BSH Baush & Lomb Canada Inc. CDX Canderm Pharma Inc. CHU Church and Dwight Canada Corp. CLC Columbia Laboratories Canada Inc. COB Cobalt Pharmaceuticals Company CYI Cytex Pharmaceuticals Inc. DCL D.C. Labs Limited DPT Dermtek Pharmaceuticals Ltd DUI Duchesnay EMD EMD Serono Canada Inc. ERF Erfa Canada Inc. EUR Europharm International Canada Inc. FEI Ferring Inc. FRS Merck Canada Inc. GAC Galderma Canada Inc. GCH GlaxoSmithKline Consumer Healthcare Inc. GIL Gilead Sciences Inc. GLE Glenwood Laboratories Canada Ltd. GMD GenMed, a division of Pfizer Canada Inc. GMP Generic Medical Partners GNC General Nutrition Canada Inc. GND Golden Neo-Life Diamite International Lt GSK GlaxoSmithKline HAL Hall Laboratories Ltd. HHC Holista Health Corporation HJM Medavie Blue Cross HLR Hoffmann-La Roche Ltd/Ltee. HOS Hospira Healthcare Corporation INP Insight Pharmaceuticals Corp. IVX Ivax Pharmaceuticals Canada Inc. JAM Jamieson Laboratories Ltd. JAN Janssen Inc. JCB Jacobus Pharmaceutical Company Inc. JNJ Johnson & Johnson Consumer Group JPC Jamp Pharma Corporation KNG King Pharmaceuticals Canada KRI Kripps Pharmacy Ltd

LBK Lundbeck Inc. LEO Leo Pharma Inc. LIL Eli Lilly Canada Inc. MAR Marcan Pharmaceuticals Inc MDI Medtech Products Inc. MDS Medicis Canada LTD./LTEE. MED Medican Pharma Inc. MEL Meliapharm Inc. MJO Mead Johnson Canada MLA Proctor & Gamble Healthcare MNT Mint Pharmaceuticals Inc. MRS Merus Labs Inc. MTP Methapharm Inc. MVL Meda Valeant Pharma Canada Inc. MYL Mylan Pharmaceuticals ULC NEO Neo Lab Inc. NGP Next Generation Pharma Inc. NNC Novartis Consumer Health Canada Inc. NNO Novo Nordisk Canada Inc. NOP Novopharm Ltd. NSE Nutri Souce Inc Les Aliments NUM 4349121 Canada Inc. NVO Novartis Ophthalmics NVR Novartis Pharmaceuticals Canada Inc. NYC Nycomed Canada Inc. ODN Odan Laboratories Ltd. OMG Omega Laboratories Limited PAL Paladin Labs Inc. PAT Pathogenesis Canada Ltd PDL Pro Doc Laboratories Ltd PDP PendoPharm, a Division of Pharmascience Inc. PFI Pfizer Canada Inc. PFR Purdue Pharma PHL Pharmel Inc (Div of PMS/Price D.Shipp) PMS Pharmascience Inc. PMT Pharmetics Inc. PPC Pharmaceutical Partners of Canada PVR Pharmavite Corporation QGT Sigma-Tau RAN Ranbaxy Pharmaceuticals Canada Inc. RHG Rheningold Food International Ltd. RIK 3M Pharmaceuticals ROG Rougier Pharma Inc, Div of Ratiopharm RPH Ratiopharm Inc. SAS Sanis Health Inc. SAV Sanofi-Aventis Canada Inc. SCH Schering-Plough Canada Inc. SCO Schering-Plough (Canada) Inc. SDZ Sandoz Canada Incorporated SEP Sepracor Pharmaceuticals Inc. SEV Servier Canada Inc. SHI Shire Canada Inc. SIV Sivem Pharmaceuticals SNE Smith & Nephew, Inc. SNS Sanofi-Synthelabo Canada Inc. SNV Sunovion Pharmaceuticals Canada Inc SPH Solvay Pharma Inc. SPT Septa Pharmaceuticals Inc. STR Sterimax Inc. SWS Swiss Herbal Remedies Ltd TAR Taro Pharmaceuticals Inc. TCD Trans Canaderm Inc.


APPENDIX I-D / ANNEXE I-D

ABBREVIATIONS OF MANUFACTURER'S NAMES/ABRÉVIATIONS DES NOMS DE FABRICANTS

TCH Technilab, Inc. TEV Teva Canada Limited TPH TaroPharma, Divison of Taro

Pharmaceuticals TRB Tribute Pharmaceuticals TRI Triton Pharma Inc. UCB UCB Canada Inc. VAL Valeo Pharma Inc. VIV ViiV Healthcare ULC VLH Lundbeck Canada Inc.

VLN Valeant Canada Ltd. VTH Vita Health Company (1985) Ltd WAM Wampole Brands WCH Wyeth Consumer Healthcare Inc. WLS Wellspring Pharmaceutical Cananda Corp. WNC Warner Chilcott Canada Co. XPI Xediton Pharmaceuticals Inc. YNO Bayer Inc. Consumer Care Division ZYM Zymcan Pharmaceuticals Inc.

October 2015 v.2 A - 10

APPENDIX II Extemporaneous Preparations Extemporaneous preparations are defined as a drug or mixture of drugs prepared or compounded in a pharmacy according to the order of a prescriber. To be eligible as a benefit, extemporaneous preparations must be in the list below or: 1. be specifically tailored to a physician's prescription and 2. contain one or more drugs presently considered a benefit and 3. not duplicate the formulation of a manufactured drug product and 4. not contain drugs in the exclusion list Claims for Extemporaneous Preparations listed below are to be submitted electronically using the PIN assigned to the product. Claims for Extemporaneous Preparations not listed below are to be submitted electronically using the DIN of at least one ingredient which is a program benefit. This claim must be identified by entering the appropriate CPhA version 3 code. Note: When there is a shortage or no supply of a commercially available product and the healthcare professional has determined a medical need for this product, the product may be compounded during the period of shortage or no supply only. (Health Products and Food Branch Inspectorate Policy on Manufacturing and Compounding Drug Products in Canada) Regular Benefits Product Name PIN Plans Anthralin Ointment 0.4% 00901113 ADEFGV Anthralin Soft Paste 0.05% 00902063 ADEFGV Anthralin Soft Paste 0.1% 00900907 ADEFGV Anthralin Soft Paste 0.2% 00900915 ADEFGV Anthralin Weak Ointment 0.2% 00901105 ADEFGV Disulfiram powder 00999087 ADEFG Hydrochlorothiazide powders and suspensions for oral use 00999106* ADEFGV Hydrocortisone powder for topical applications >0.5% 00990841* ADEFGV LCD (Coal Tar Solution) in compounds for topical applications 00358495* ADEFGV Meclizine Powder 00903076 ADEFGV Prednisone powders and suspension for oral use 00999108* ADEFGV Progesterone powder in compounds for topical application 00990876* ADEFGV Propylene Glycol Liquid in compounds for topical applications 00990884* ADEFGV Salicylic Acid in compounds for topical applications 00900788* ADEFGV Saturated Solution Potassium Iodide 00999105* ADEFGV Spironolactone powders and suspensions for oral use 00999107* ADEFGV Sulphur in compounds for topical applications 00900826* ADEFGV

* This PIN must be used to submit claims for any strength of this extemporaneous preparation.

October 2015 v.2 A - 11

APPENDIX III Special Authorization Certain drugs are only eligible for coverage under New Brunswick Drug Plans (NB Drug Plans) through special authorization. The criteria are developed by the Atlantic and Canadian Expert Advisory Committees. Drugs eligible for consideration through special authorization: • Drugs listed as special authorization benefits have specific criteria which must be met in order to be approved.

These drugs are listed alphabetically by generic name in the following section. • Under exceptional circumstances, requests for drugs without specific criteria may be reviewed case-by-case and

assessed based on the published medical evidence. Drugs not eligible for consideration through special authorization: • New drugs not yet reviewed by the expert advisory committee • Drugs excluded as eligible benefits further to the expert advisory committee’s review and recommendation • Drugs not licensed or marketed in Canada (e.g. drugs obtained through Health Canada’s Special Access

Program) • Products specifically excluded as benefits as identified on the exclusion list (Formulary pages IV and V). Reimbursement of brand name products when generics exist When interchangeable generic products are available for a brand name drug, the New Brunswick Drug Plans (NB Drug Plans) will only reimburse pharmacies for the lowest cost generic product. Patients, who choose to receive a brand name product when a generic product exists, are responsible for paying any difference in price. The NB Drug Plans will consider requests for reimbursement of brand name drugs when a patient has had a hypersensitivity reaction (e.g. edema, respiratory distress, serum sickness, anaphylaxis) to a non-medicinal ingredient contained in the interchangeable generic product. Requests may be made by submitting a completed Special Authorization Request Form and providing details of the hypersensitivity reaction. Information on the safety and effectiveness of generic drugs is available on Health Canada’s website at http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/med-gen-eng.php.

http://www.gnb.ca/0212/pdf/special_auth/SA_fillable_online_form-e.pdf

http://www.gnb.ca/0212/pdf/special_auth/SA_fillable_online_form-e.pdf

http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/med-gen-eng.php

http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/med-gen-eng.php

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Special authorization requests must be submitted in writing by the prescriber and include the following information: Patient Identification • Name of patient • NB Medicare number • Date of birth Prescriber Identification • Name, address, telephone number and FAX number (if applicable) of prescriber Drug Requested • Drug name, strength and dosage form • Dosage schedule • Expected duration of therapy Reason for the Request • Diagnosis and/or indication for which the drug is being used • Information regarding previous drugs which have been used and the patient’s response to therapy where

appropriate • Any additional information that may assist in making a decision on the request for special authorization. Special authorization requests for patients of Plans A,B,D,E,F,G,R,V should be sent by mail or FAX to: Special Authorization Unit New Brunswick Drug Plans P.O. Box 690 Moncton, NB E1C 8M7 Local Fax: 506-867-4872 Toll Free Fax: 1-888-455-8322 NB Drug Plans Inquiry Line: 1-800-332-3691 Plan U (HIV - Infected Persons) special authorization requests should be sent by mail or FAX to: Special Authorization Unit – Plan U New Brunswick Prescription Drug Program P.O. Box 690 Moncton, NB E1C 8M7 Local fax: 506-867-4339 Toll Free Fax: 1-866-770-7746 Toll Free Telephone: 1-800-332-3691

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The New Brunswick Drug Plans Special Authorization Criteria

ABATACEPT (ORENCIA) 250mg vial for intravenous injection Juvenile Rheumatoid Arthritis • For the treatment of Juvenile Rheumatoid Arthritis:

- In children (age 6-17) with moderate to severe active polyarticular juvenile idiopathic arthritis/juvenile rheumatoid arthritis who are intolerant to, or who have not had an adequate response from etanercept.

- Initial treatment is limited to a maximum of 16 weeks. Retreatment is permitted for children who demonstrated an adequate initial treatment response and who are experiencing a disease flare.

Clinical Notes: • Intravenous infusion: initial IV infusion dose is administered at 0, 2, and 4 weeks then every 4 weeks thereafter. • Abatacept will not be reimbursed in combination with anti-TNF agents. Claim Note: • Must be prescribed by a rheumatologist. ABATACEPT (ORENCIA) 250mg vial for intravenous injection, and 125mg subcutaneous injection Rheumatoid Arthritis • For patients with moderate to severe active rheumatoid arthritis who:

- Have not responded to, or have had intolerable side-effects with, an adequate trial of combination therapy of at least two traditional DMARDs (disease modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated,

OR - Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional

DMARDs in sequence, one of which must have been methotrexate unless contraindicated Clinical Notes: • Intravenous infusion: initial IV infusion dose is administered at 0, 2, and 4 weeks then every 4 weeks thereafter. • Subcutaneous injection: a single IV loading dose of up to 1000 mg/dose followed by 125 mg subcutaneous

injection within a day, then once-weekly subcutaneous injections. • Abatacept will not be reimbursed in combination with anti-TNF agents.

Claim Note: • Must be prescribed by a rheumatologist. ABIRATERONE (ZYTIGA) 250mg tablet In combination with prednisone for the treatment of metastatic prostate cancer (castration-resistant prostate cancer) in patients who: • are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy,

OR • have received prior chemotherapy containing docetaxel after failure of androgen deprivation therapy. ACAMPROSATE CALCIUM (CAMPRAL) 333mg tablet For the maintenance of abstinence from alcohol in patients with alcohol dependence who have been abstinent for at least four days, and who have contraindications to naltrexone (e.g. currently receiving opioids, acute hepatitis or liver failure). Clinical Note: • Treatment with acamprosate should be part of a comprehensive management plan that includes counseling. ACLIDINUM BROMIDE (TUDORZA GENUAIR) 400mcg powder for inhalation Chronic Obstructive Pulmonary Disease • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of

short-acting bronchodilator therapy (i.e. salbutamol at a maximum dose of 8 puffs/day or ipratropium at maximum dose of 12 puffs/day).

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• Coverage can be provided without a trial of short-acting agent if there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1 /FVC ratio < 0.7) and significant symptoms (i.e. Medical Research Council (MRC) Dyspnea Scale score of 3-5).

• Combination therapy with aclidinum bromide AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC

ratio < 0.7), and significant symptoms (i.e. MRC score of 3-5) AND

- there is evidence of one or more moderate-to-severe exacerbations per year, on average, for 2 consecutive years requiring antibiotics and/or systemic (oral or intravenous) corticosteroids.

Clinical Note: • If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of

condition must be provided for consideration (i.e. MRC scale). Spirometry reports from any point in time will be accepted.

Medical Research Council (MRC) Dyspnea Scale

COPD Stage Symptoms

MODERATE – MRC 3 to 4 Shortness of breath from COPD causing the patient to stop after walking about 100 meters (or after a few minutes) on the level.

SEVERE – MRC 5 Shortness of breath from COPD resulting in the patient being too breathless to leave the house or breathless after undressing, or the presence of chronic respiratory failure or clinical signs of right heart failure.

ADALIMUMAB (HUMIRA) 40mg/0.8mL (50mg/mL) injection Ankylosing Spondylitis • For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index

(BASDAI) score ≥ 4 on 10 point scale) who: - Have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the

optimum dose for a minimum period of 3 months observation or in whom NSAIDs are contraindicated OR

- Have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD.

• Requests for renewal must include information showing the beneficial effects of the treatment, specifically:

- A decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score OR

- Patient and expert opinion of an adequate clinical response as indicated by a significant functional improvement (measured by outcomes such as HAQ or “ability to return to work”)

Clinical Notes: 1. *Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial disease do not

require a trial of NSAIDs alone. 2. Adalimumab will not be reimbursed in combination with other anti-TNF agents Claim Notes: • Must be prescribed by a rheumatologist or internist • Approval will be for a maximum of 6 months • Approvals will be for a maximum dose of 40mg every two weeks Crohn’s Disease • For moderately to severely active Crohn's disease in patients who are refractory or have contraindications to an

adequate course of 5-aminosalicylic acid and corticosteroids and other immunosuppressive therapy. Clinical Notes: 1. Eligible patients should receive an induction dose of 160mg followed by 80mg two weeks later. 2. Clinical response should be assessed four weeks after the first induction dose. Claim Notes: • Initial requests will be approved for a maximum of 12 weeks. • Ongoing coverage for maintenance therapy will only be reimbursed for responders and for a dose not exceeding

40mg every two weeks.

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Polyarticular Juvenile Idiopathic Arthritis (pJIA) • For the treatment of children (age 4-17) with moderately to severely active polyarticular juvenile idiopathic arthritis

(pJIA) who have had inadequate response to one or more disease modifying antirheumatic drugs (DMARDs). Claim Note: • Must be prescribed by a rheumatologist. Psoriatic Arthritis • For the treatment of active psoriatic arthritis in patients who:

- Have at least three active and tender joints, and - Have not responded to an adequate trial of two DMARDs or have an intolerance or contraindication to

DMARDs. Clinical Note: • Should not be used in combination with other tumor necrosis factor (TNF) antagonists. Claim Notes: • Must be prescribed by a rheumatologist. • The number of doses is limited to twenty-six 40 mg doses per year with no dose escalation permitted. Rheumatoid Arthritis • For patients with moderate to severe active rheumatoid arthritis who:



DMARDs in sequence, one of which must have been methotrexate unless contraindicated Clinical Note: • Should not be used in combination with other tumor necrosis factor (TNF) antagonists. Claim Notes: • Must be prescribed by a rheumatologist. • The number of doses is limited to twenty-six 40 mg doses per year with no dose escalation permitted. Plaque Psoriasis • Requests will be considered for treatment of patients with severe, debilitating chronic plaque psoriasis who meet

all of the following criteria: - Body surface area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or

genital region; - Failure to respond to, contraindications to or intolerance to methotrexate and cyclosporine; - Failure to respond to, intolerance to or unable to access phototherapy

Clinical Notes: 1. Continuation of therapy beyond 16 weeks will be based on response. Patients not responding adequately at

these time points should have treatment discontinued with no further treatment with the same agent recommended.

2. An adequate response is defined as either: - ≥75% reduction in the Psoriasis Area and Severity Index (PASI) score from when treatment started (PASI

75), OR

- ≥50% reduction in the PASI score (PASI 50) with a ≥5 point improvement in the Dermatology Life Quality Index (DLQI) from when treatment started,

OR - A quantitative reduction in BSA affected with qualitative consideration of specific regions such as face,

hands, feet, or genital region. 3. Concurrent use of >1 biologic will not be approved Claim Notes: • Initial approval limited to 16 weeks. • Must be prescribed by a dermatologist • Approval limited to a dose of 80 mg administered once followed by 40 mg after 1 week of initial dose, then 40 mg

every other week thereafter, up to a year (if response criteria met at 16 weeks).

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ADEFOVIR DIPIVOXIL (HEPSERA and generic brand) 10mg tablet For the treatment of Hepatitis B when used in combination with lamivudine, in patients who have failed lamivudine, as defined by an increase in HBV DNA of > 1 log 10 IU/mL above the nadir, measured on two separate occasions within an interval of at least one month, after the first three months of lamivudine therapy, and when lamivudine failure is not due to poor adherence to therapy.

AFATINIB DIMALEATE (GIOTRIF) 20mg, 30mg, 40mg tablets For the first-line treatment of patients with EGFR mutation positive advanced or metastatic adenocarcinoma of the lung who have an ECOG performance status 0 or 1. Renewal Criteria: Written confirmation that the patient has responded to treatment and in whom there is no evidence of disease progression. Clinical Note: • Patients who receive afatinib 1st line are not eligible for erlotinib for 2nd line, 3rd line, or maintenance therapy). Claim Notes: • Doses of more than 40 mg once daily will not be approved. • Approval duration: 6 months AFILBERCEPT (EYLEA) 40mg/mL solution for intravitreal injection 1. Neovascular (wet) age-related macular degeneration (AMD)

Initial Coverage: For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) where all of the following apply to the eye to be treated: • Best Corrected Visual Acuity (BCVA) is between 6/12 and 6/96 • The lesion size is less than or equal to 12 disc areas in greatest linear dimension • There is evidence of recent (< 3 months) presumed disease progression (blood vessel growth, as indicated

by fluorescein angiography, or optical coherence tomography (OCT) • Administration is to be done by a qualified ophthalmologist experienced in intravitreal injections. • The interval between doses should not be shorter than 1 month.

Continued Coverage: Treatment should be continued only in people who maintain adequate response to therapy. Clinical Notes: • Coverage will not be approved for patients:

- With permanent retinal damage as defined by the Royal College of Ophthalmology guidelines - Receiving concurrent treatment with verteporfin.

• Aflibercept should be permanently discontinued if any one of the following occurs: - Reduction in BCVA in the treated eye to less than 15 letters (absolute) on 2 consecutive visits in the

treated eye, attributed to AMD in the absence of other pathology - Reductions in BCVA of 30 letters or more compared to either baseline and/or best recorded level since

baseline as this may indicate either poor treatment effect, adverse events or both. - There is evidence of deterioration of the lesion morphology despite optimum treatment over 3

consecutive visits.

Claim Notes: • An initial claim of up to two vials of aflibercept (1 vial per eye treated) will be automatically reimbursed when

prescribed by an ophthalmologist. If additional medication is required, a request should be made through special authorization.

• Reimbursement will be limited to a maximum of 1 vial of aflibercept per eye treated every 30 days. Claims submitted for greater than 1 vial, or submitted within 30 days of a previous claim, will not be reimbursed.

• Please refer to Quantities for Claims Submissions for the correct unit of measure.

2. Diabetic macular edema (DME)

Initial coverage: For the treatment of visual impairment due to diabetic macular edema (DME) in patients who meet all of the following criteria:

http://www.gnb.ca/0212/pdf/quan-claim-sub/QuantitiesClaimsSubmissions.pdf

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• clinically significant centre-involving macular edema for whom laser photocoagulation is also indicated • hemoglobin A1c test in the past 6 months with a value of less than or equal to 11% • best corrected visual acuity of 20/32 to 20/400 • central retinal thickness greater than or equal to 250 micrometers

Renewal Criteria: • confirm that a hemoglobin A1c test in the past 6 months had a value of less than or equal to 11% • date of last visit and results of best corrected visual acuity at that visit • date of last OCT and central retinal thickness on that examination • if aflibercept is being administered monthly, please provide details on the rationale

Clinical Notes: • Treatment should be given monthly until maximum visual acuity is achieved (i.e. stable visual acuity for three

consecutive months while on aflibercept). Thereafter, visual acuity should be monitored monthly. • Treatment should be resumed when monitoring indicates a loss of visual acuity due to DME and continued

until stable visual acuity is reached again for three consecutive months.

Claim Notes: • Approval Period: 1 year • Please refer to Quantities for Claims Submissions for the correct unit of measure.

3. Central retinal vein occlusion (CRVO)

For the treatment of visual impairment due to macular edema secondary to central retinal vein occlusion (CRVO). Clinical Notes: • Treatment should be given monthly until maximum visual acuity is achieved (i.e. stable visual acuity for three

consecutive months while on aflibercept). Thereafter, visual acuity should be monitored monthly. • Treatment should be resumed when monitoring indicates a loss of visual acuity due to macular edema

secondary to central retinal vein occlusion and continued until stable visual acuity is reached again for three consecutive months.

Claim Notes: • Approval Period: 1 year • Please refer to Quantities for Claims Submissions for the correct unit of measure.

ALENDRONATE (generic brand) 40mg tablet

For the treatment of Paget’s disease. ALGLUCOSIDASE ALFA (MYOZYME) 50mg vial injection For the treatment of infantile-onset Pompe disease, as demonstrated by onset of symptoms and confirmed cardiomyopathy within the first 12 months of life. Monitoring of therapy The monitoring of markers of disease severity and response to treatment must include at least: 1. Weight, length and head circumference. 2. Need for ventilatory assistance, including supplementary oxygen, CPAP, BiPAP, or endotracheal intubation and

ventilation. 3. Left ventricular mass index (LVMI) as determined by echocardiography (not ECG alone). 4. Periodic consultation with cardiology. 5. Periodic consultation with respirology. Withdrawal of therapy 1. Patients to be considered for reimbursement of drug costs for alglucosidase alfa treatment must be willing to

participate in the long-term evaluation of the efficacy of treatment by periodic medical assessment. Failure to comply with recommended medical assessment and investigations may result in withdrawal of financial support of drug therapy.

2. The development of the need for continuing invasive ventilatory support after the initiation of ERT should be considered a treatment failure. Funding for ERT should not be continued for infants who fail to achieve ventilator-free status, or who deteriorate further, within 6 months after the initiation of ventilatory support.

3. Deterioration of cardiac function, as shown by failure of LV hypertrophy (as indicated by LV mass index) to regress by more than Z=1 unit, or persistent clinical or echocardiographic findings of cardiac systolic or diastolic failure without evidence of improvement, in spite of 24 weeks of ERT, should be considered a treatment failure and funding for ERT should be discontinued.



October 2015 v.2 A - 18

ALMOTRIPTAN (AXERT and generic brands) 6.25mg and 12.5mg tablets • For the treatment of migraine1 headache of moderate2 intensity when other therapies (e.g. NSAIDs,

acetaminophen, DHE spray) are not effective AND patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and naratriptan.

• For the treatment of migraine1 headache of severe2 or ultra severe2 intensity when patients have not responded to oral sumatriptan, zolmitriptan, rizatriptan and/or naratriptan.

Clinical Notes: 1. 1 As diagnosed based on current Canadian guidelines. 2. 2 Definitions:

- Moderate - pain is distracting causing need to slow down and limit activities; - Severe - pain affects ability to concentrate and very difficult to continue with daily activities; - Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping

Claim Notes: • Coverage limited to 6 doses / 30 days3

- patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a maximum of 12 doses / 30 days

• 3 Reimbursement will be available for a maximum quantity of triptan doses as outlined in criteria per 30 days regardless of the agent(s) used within the 30 day period.

• Special authorization for the products almotriptan 6.25mg and 12.5mg tablets, naratriptan 1mg and 2.5mg tablets, rizatriptan 5mg and 10mg tablets and wafers, sumatriptan 5mg and 20mg nasal spray and zolmitriptan 2.5mg tablets and orally dispersible tablets, 2.5mg and 5mg nasal spray will be considered as a set. Approvals will include all products in this list, however reimbursement will be available for a maximum quantity of one agent per month.

AMBRISENTAN (VOLIBRIS) 5mg and 10mg tablets For treatment of patients with pulmonary arterial hypertension (PAH), of at least World Health Organization (WHO) functional class III, which is associated with either idiopathic or connective tissue disease and who have failed to respond to or who have contraindications to, or who are not a candidate for sildenafil. Clinical Notes: 1. Diagnosis of PAH should be confirmed by cardiac catheterization 2. Ambrisentan will not be approved when used concurrently with other endothelin receptor antagonists,

epoprostenol, treprostinil or sildenafil. Claim Note: • The maximum dose of ambrisentan that will be reimbursed is 10mg daily APIXABAN (ELIQUIS) 2.5mg and 5mg tablets Atrial fibrillation For the prevention of stroke and systemic embolism in at-risk patients with non-valvular atrial fibrillation for whom: • Anticoagulation is inadequate following at least a two month trial on warfarin;

OR • Warfarin is contraindicated or not possible due to inability to regularly monitor through International Normalized

Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy, and at home). Clinical Notes: • The following patient groups are excluded from coverage for apixaban for atrial fibrillation:

- Patients with impaired renal function (creatinine clearance or estimated glomerular filtration rate <25 mL/min) - Patients 75 years of age or older without documented stable renal function - Patients with hemodynamically significant rheumatic valvular heart disease, especially mitral stenosis - Patients with prosthetic heart valves.

• At-risk patients with atrial fibrillation are defined as those with a CHADS2 score of ≥ 1. Prescribers may consider an antiplatelet regimen or oral anticoagulation for patients with a CHADS2 score of 1.

• Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e. adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period).

• Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that is maintained for at least 3 months.

• The usual recommended dose is 5mg twice daily; a reduced dose of apixaban 2.5mg twice daily is recommended for patients with at least two of the following: age > 80 years, body weight < 60kg, or serum creatinine > 133 micromole/litre.

October 2015 v.2 A - 19

• Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see apixaban product monograph).

• Patients starting apixaban should have ready access to appropriate medical services to manage a major bleeding event.

• There is currently no data to support that apixaban provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves. As a result, apixaban is not recommended in these populations.

Venous thromboembolic events (VTE) treatment For the treatment of VTE (deep vein thrombosis (DVT) or pulmonary embolism (PE)). Clinical Notes: 1. The recommended dose of apixaban for patients initiating DVT or PE treatment is 10mg twice daily for 7 days,

followed by 5 mg twice daily. 2. Drug plan coverage for apixaban is an alternative to heparin/warfarin for up to 6 months. When used for greater

than 6 months, apixaban 2.5mg twice daily is more costly than heparin/warfarin. As such, patients with an intended duration of therapy greater than 6 months should be considered for initiation on heparin/warfarin.

3. Since renal impairment can increase bleeding risk, it is important to monitor renal function regularly. Other factors that increase bleeding risks should also be assessed and monitored (see product monograph).

Claim Note: • Approval Period: Up to 6 months APIXABAN (ELIQUIS) 2.5mg tablet VTE prophylaxis • For the prevention of venous thromboembolic events (VTE) in patients who have undergone elective total knee

replacement (TKR) surgery. • For the prevention of VTE in patients who have undergone elective total hip replacement (THR) surgery.

Clinical Notes: 1. The total duration of therapy includes the period during which doses are administered post-operatively in an acute

care (hospital) setting, and the approval period is for the balance of the total duration after discharge. 2. The first dose is typically administered 12 to 24 hours after surgery, assuming adequate hemostasis has been

achieved. 3. The ADVANCE clinical trial program did not evaluate the efficacy or safety of sequential use of molecular weight

heparin followed by apixaban for the prophylaxis of VTE. Due to the current lack of evidence for sequential use, coverage is not intended for this practice.

4. Clinical judgment is warranted to assess the increased risk for VTE and/or adverse effects in patients with a history of previous VTE, myocardial infarction, transient ischemic attack or ischemic stroke; a history of intraocular or intracerebral bleeding; a history of gastrointestinal disease with gastrointestinal bleeding; moderate or severe renal insufficiency (estimated creatinine clearance <30 mL/min); severe liver disease; concurrent use of other anticoagulants; or age greater than 75 years.

5. Apixaban has not been studied in clinical trials in patients undergoing hip fracture surgery, and is not recommended in these patients.

Claim Notes: • Maximum reimbursement without Special Authorization will be limited to 14 days of therapy (28 tablets) for TKR or

30 days of therapy (60 tablets) for THR, within a 6 month period. • Subsequent reimbursement for prophylaxis within a 6 month period (i.e. second joint replacement procedure

within the 6 month period) will require Special Authorization. APREPITANT (EMEND) 80mg and 125mg capsules; Tri-Pack For the prevention of acute and delayed nausea and vomiting due to highly emetogenic cancer chemotherapy (e.g. cisplatin >70 mg/m2) in patients who have experienced emesis despite treatment with a combination of a 5-HT3 antagonist and dexamethasone in a previous cycle of highly emetogenic chemotherapy. Claim Note: • Prescription claims for up to a maximum of 2 Tri-packs, or 6 capsules will be automatically reimbursed every 28

days when the prescription is written by an oncologist or an oncology clinical associate/general practitioners-oncology. If additional medication is required within a 28 day period subsequent to the initial prescription, a request should be made through special authorization.

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ARIPIPRAZOLE (ABILIFY) 2mg, 5mg, 10mg, 15mg, 20mg and 30mg tablets For the treatment of schizophrenia and related psychotic disorders (not dementia related) in patients with a history of failure, intolerance, or contraindication to at least one less expensive antipsychotic agent. ARIPIPRAZOLE (ABILIFY MAINTENA) 300mg and 400mg vial For the treatment of schizophrenia in patients • for whom compliance with oral antipsychotics presents problems

OR • who are currently receiving a typical depot antipsychotic and experiencing significant side effects (e.g.

extrapyramidal symptoms or tardive dyskinesia) or lack of efficacy ASENAPINE (SAPHRIS) 5mg and 10mg sublingual tablets For the acute treatment of manic or mixed episodes associated with bipolar I disorder as either: • Monotherapy, after a trial of lithium or divalproex sodium has failed, and trials of less expensive atypical

antipsychotic agents have failed due to intolerance or lack of response

• Co-therapy with lithium or divalproex sodium, after trials of less expensive atypical antipsychotic agents have failed due to intolerance or lack of response.

ATOVAQUONE (MEPRON) 750mg/5mL suspension For the treatment of mild to moderate Pneumocystis Carinii pneumonia in patients who are intolerant to trimethoprim-sulfamethoxazole. AXITINIB (INLYTA) 1mg and 5mg tablets As a second-line treatment for patients with metastatic clear cell renal carcinoma, who, based on the mutual assessment of the treating physician and patient, are unable to tolerate ongoing use of an effective dose of everolimus or who have a contraindication to everolimus. AZITHROMYCIN (ZITHROMAX and generic brands) 600mg tablet For the prevention of disseminated Mycobacterium Avium Complex (MAC) in HIV positive patients who are severely immunocompromised with CD4 levels <0.1 x 109/L. BETAHISTINE (SERC and generic brands) 8mg, 16mg and 24mg tablets For the symptomatic treatment of the recurrent episodes of vertigo associated with Ménière’s disease. BOCEPREVIR (VICTRELIS) 200mg capsule BOCEPREVIR/RIBAVIRIN PLUS PEGINTERFERON ALFA-2B (VICTRELIS TRIPLE) 200mg / 200mg capsules plus 80mcg injection 200mg / 200mg capsules plus 100mcg injection 200mg / 200mg capsules plus 120mcg injection 200mg / 200mg capsules plus 150mcg injection For the treatment of chronic hepatitis C genotype 1 infection in patients with compensated liver disease, in combination with peginterferon alpha and ribavirin, if the following criteria are met: • Detectable levels of hepatitis C virus (HCV) RNA in the last six months • Fibrosis stage of F2, F3 or F4 or on the recommendation of an Internal Medicine Specialist Claim Note: • One course of treatment only (for up to 44 weeks duration) will be approved.

October 2015 v.2 A - 21

BOSENTAN (TRACLEER and generic brands) 62.5mg and 125mg tablets For treatment of pulmonary arterial hypertension (PAH) in patients with World Health Organization (WHO) functional class III or IV Clinical Notes: • Idiopathic pulmonary arterial hypertension (IPAH) in patients who do not demonstrate vasoreactivity on testing or

who demonstrate vasoreactivity on testing but fail a trial of, or are intolerant to, calcium channel blockers. • Pulmonary arterial hypertension associated with connective tissue disease or congenital heart disease or human

immunodeficiency virus (HIV) who do not respond adequately to conventional therapy. BUDESONIDE/FORMOTEROL (SYMBICORT) 100mcg/6mcg and 200mcg/6mcg metered dose inhalers Reversible Obstructive Airway Disease • For patients with reversible obstructive airways disease who are:

- Stabilized on an inhaled corticosteroid and a long-acting beta2-adrenergic agonist, OR

- Using optimal doses of inhaled corticosteroids but are still poorly controlled. Chronic Obstructive Pulmonary Disease • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of



• Combination therapy with a long-acting muscarinic antagonist (LAMA) AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC






COPD Stage Symptoms



BUPRENORPHINE / NALOXONE (SUBOXONE and generic brands) 2mg/0.5mg and 8mg/2mg sublingual tablets For the treatment of opioid dependence for patients in whom methadone is contraindicated (e.g. patients at high risk of, or with QT prolongation, or hypersensitivity to methadone). Clinical Note: • Commonly reported adverse effects associated with methadone therapy (e.g. sweating, constipation, insomnia,

etc.) will not be considered to be hypersensitivity. Claim Note: • Requests from New Brunswick physicians authorized to prescribe methadone or physicians with experience in the

treatment of opioid dependence will be considered.

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BUPROPION (ZYBAN) 150mg tablet For smoking cessation treatment in adults 18 years of age and older. Claim Notes: • A maximum of 168 tablets (12 weeks of treatment) will be reimbursed annually without special authorization. • A second 12 week course may be approved under special authorization for individuals who have demonstrated

some success with smoking cessation and require additional treatment. BUSERELIN ACETATE (SUPREFACT) 1mg/mL nasal solution 1. For the palliative treatment of stage D2 carcinoma of the prostate (Plans D and F). 2. For the hormonal management of endometriosis

Claim Notes: • Buserelin is a regular benefit for Plans A and V. • Approval period is limited to a maximum of 6 months. CABERGOLINE (DOSTINEX and generic brand) 0.5mg tablet For the treatment of patients with hyperprolactinemia who have failed or are intolerant to bromocriptine CANAGLIFLOZIN (INVOKANA) 100mg and 300mg tablets For the treatment of type 2 diabetes mellitus, in addition to metformin and a sulfonylurea, in patients with inadequate glycemic control on metformin and a sulfonylurea and for whom insulin is not an option.

CAPECITABINE (XELODA and generic brand) 150mg and 500mg tablets Colorectal Cancer • For single agent therapy of colorectal cancer in patients who are chemotherapy naive or patients who have

progressed 6 months after completion of adjuvant 5-FU/ leucovorin therapy. Coverage will be limited to: a) Metastatic colorectal cancer, with an ECOG performance status of 0-2*, when first line combination

chemotherapy (5-FU/ leucovorin/irinotecan) is declined or not tolerated. b) Stage III (Dukes’ C) colon cancer and ECOG status 0-1† as adjuvant therapy.

• As part of the CAPOX (capecitabine-oxaliplatin) regimen for the first-line and second-line treatment of Metastatic Colorectal Cancer (mCRC) for patients with an ECOG performance status of 0-2*.

Metastatic Breast Cancer • For treatment of metastatic breast cancer where patients have progressed after prior chemotherapy and who

have an ECOG performance status of 0-2*. Clinical Note: • *Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. Claim Note: • Prescriptions written by New Brunswick hematologists, oncologists or an oncology clinical associate/general

practitioners-oncology do not require special authorization. CARVEDILOL (generic brands) 3.125mg, 6.25mg, 12.5mg and 25mg tablets For the treatment of stable symptomatic heart failure in patients with a left ventricular ejection fraction (LVEF) less than or equal to 40%. Claim Note: • Prescriptions written by cardiologists or internists do not require special authorization. Subsequent refills ordered

by other practitioners will not require special authorization. CELECOXIB (CELEBREX and generic brands) 100mg and 200mg capsules 1. For the treatment of osteoarthritis and rheumatoid arthritis in patients who have at least one of the following risk

factors: • Past history of ulcers

October 2015 v.2 A - 23

• Concurrent warfarin therapy • Concurrent prednisone therapy • Failure or intolerance to at least two other NSAIDs (e.g. ibuprofen, diclofenac, naproxen)

Clinical Note: • Recommended maximum daily doses:

- 200mg for osteoarthritis - 400mg for rheumatoid arthritis

2. For patients who are at high risk of upper gastrointestinal (GI) complications and have had failure or intolerance to

at least two other NSAIDs. 3. For patients who have a documented history of ulcers proven radiographically and/or endoscopically.

Claim Note: • Celecoxib is a regular benefit for patients age 65 and over.

CHOLINESTERASE INHIBITORS (Donepezil, Galantamine, Rivastigmine)

- For the treatment of mild to moderate Alzheimer’s disease

To initiate therapy: Requests must be submitted on the appropriate NB Drug Plans special authorization form. http://www.gnb.ca/0212/alzheimers-e.asp

For a patient being started on a first cholinesterase inhibitor (ChEI):

Patients who meet all of the following reimbursement criteria will be approved for an initial 6 months of therapy: • a diagnosis of probable Alzheimer’s disease or possible Alzheimer’s disease with

vascular component or Lewy bodies; • a Mini Mental Score Exam (MMSE) score of 10 to 30; and • a Functional Assessment & Staging Test (FAST) score of 4 to 5

For a patient who has previously taken no more than one other ChEI and is switching:

Patients will be approved for an initial 6 months of therapy with a second ChEI when the following information is provided: • the reason for discontinuing the first ChEI

Requests to switch from one agent in the class to another will not be considered beyond the initial 6 month approval.

To continue therapy for 1 year period (once initial 6 month approval has been completed): Patients who meet the following monitoring criteria will be approved for 1 year periods of therapy:

• MMSE score of 10 to 30 (Note: MMSE score must be provided 6 months after starting a ChEI and then only annually thereafter.);

AND • FAST score of 4 to 5 (Note: FAST score must be provided 6 months after starting a ChEI and then only

annually thereafter.)

Note: Monitoring of target symptoms will no longer be required; however, physicians will be asked at the initial and subsequent reassessments if, in their opinion, the patient is benefiting from the drug.

CIPROFLOXACIN (CILOXAN and generic brand) 0.3% ophthalmic solution and 0.3% ophthalmic ointment For the treatment of corneal ulcers and bacterial conjunctivitis. Claim Note: • Prescriptions written by New Brunswick ophthalmologists and optometrists do not require special authorization.

http://www.gnb.ca/0212/alzheimers-e.asp

October 2015 v.2 A - 24

CIPROFLOXACIN (CIPRO and generic brands) 250mg, 500mg and 750mg tablets 500mg/5mL Oral Suspension For the treatment of: • Complicated urinary tract infections caused by resistant bacteria. • Skin, soft tissue, bone and joint infections caused by Gram negative bacteria. • Severe (“malignant”) otitis externa. • Infections with Pseudomonas aeruginosa (susceptible strains – resistance is now common). Claim Notes: • Prescriptions written by New Brunswick urologists, infectious disease specialists, medical oncologists,

hematologists, respiratory medicine specialists or medical microbiologists do not require special authorization. • Ciprofloxacin 250mg, 500mg, and 750mg tablets are regular benefit for Plan B.

CIPROFLOXACIN (CIPRO XL) 1000mg tablet For the treatment of complicated urinary tract infection and acute uncomplicated pyelonephritis when alternative agents are ineffective, not tolerated or contraindicated. Claim Note: • Prescriptions written by New Brunswick urologists, infectious disease specialists and medical microbiologists do

not require special authorization. CIPROFLOXACIN HCL / DEXAMETHASONE (CIPRODEX) 0.3% / 0.1% otic suspension • For the treatment of acute otitis media with otorrhea through tympanostomy tubes who require treatment. • For the treatment of acute otitis externa in the presence of a tympanostomy tube or known perforation of the

tympanic membrane. Claim Note: • Prescriptions written by certified New Brunswick otolaryngologists do not require special authorization. CLOPIDOGREL (PLAVIX and generic brands) 75mg tablet 1. Secondary prevention of vascular ischemic events (myocardial infarction, stroke) in patients with a history of

symptomatic atherosclerotic disease (including symptomatic peripheral artery disease) who have had treatment failure or are intolerant or allergic to ASA.

2. For the prevention of thrombosis post stent implantation for a period of up to 6 months for bare-metal stents (BMS) and 12 months for drug- eluting stents (DES).

3. For the prevention of vascular ischemic events in patients who have been hospitalized with acute coronary syndrome (i.e. unstable angina or non-ST segment elevation myocardial infarction) in combination with ASA for a period of three months. Longer term combination therapy may be considered for a period of 12 months post NSTE-ACS for patients: • with a second acute coronary syndrome within 12 months, or • with complex or extensive CAD (i.e. diffuse 3 vessel CAD not amenable to revascularization), or • who have had a previous stroke, transient ischemic attack or symptomatic PAD

Claim Note: • Prescriptions written by cardiologists do not require special authorization. CODEINE (CODEINE CONTIN) 50mg, 100mg, 150mg, and 200mg tablets (controlled release) For the treatment of mild to moderate cancer-related or chronic non-cancer pain. CRIZOTINIB (XALKORI) 200mg and 250mg capsules Second-line therapy for patients with anaplastic lymphoma kinase (ALK) -positive advanced non-small cell lung cancer (NSCLC) with an ECOG performance status of 0-2.

October 2015 v.2 A - 25

DABIGATRAN (PRADAXA) 110mg and 150mg capsules For the prevention of stroke and systemic embolism in at-risk patients with non-valvular atrial fibrillation for whom: • Anticoagulation is inadequate following at least a two month trial of warfarin; or • Warfarin is contraindicated or not possible due to inability to regularly monitor through International Normalized

Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy and at home). Clinical Notes: 1. The following patient groups are excluded from coverage for dabigatran for atrial fibrillation:

- Patients with impaired renal function (creatinine clearance or estimated glomerular filtration rate < 30 mL/min)

- Patients 75 years of age or older without documented stable renal function - Patients with hemodynamically significant rheumatic valvular heart disease, especially mitral stenosis - Patients with prosthetic heart valves

2. At-risk patients with atrial fibrillation are defined as those with a CHADS2 score of ≥ 1. 3. Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least

35% of the tests during the monitoring period (i.e. adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period).

4. Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see dabigatran Product Monograph).

5. Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that maintained for at least three months (i.e. 30-49 mL/min for 110 mg twice daily dosing or ≥ 50 mL/min for 150 mg twice daily dosing).

6. There is currently no data to support that dabigatran provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves, so dabigatran is not recommended in these populations.

7. Patients starting dabigatran should have ready access to appropriate medical services to manage a major bleeding event.

DABRAFENIB (TAFINLAR) 50mg and 75mg capsules • As monotherapy for the first line treatment of patients with BRAF V600 mutation-positive unresectable or

metastatic melanoma with ECOG performance status of 0 or 1. If brain metastases are present, patients should be asymptomatic or stable.

• As monotherapy for the second line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma for patients who have progressed after receiving chemotherapy treatment in the first line setting with ECOG performance status of 0 or 1. If brain metastases are present, patients should be asymptomatic or stable.

Clinical Notes: • Recommended Dose: 150 mg twice daily until disease progression or development of unacceptable toxicity

requiring discontinuation of dabrafenib. • Dabrafenib will not be reimbursed in patients who have progressed on a prior BRAF therapy. Claim Notes: • Initial approval duration: 6 months • Renewal approval duration: 6 months DALTEPARIN SODIUM (FRAGMIN) Pre-filled syringes, ampoule, single dose vial, and multidose vial See criteria under Low Molecular Weight Heparins. DARBEPOETIN (ARANESP) 10, 20, 30, 40, 50, 60, 80, 100, 130, 150, 200, 300 and 500mcg SingleJect® pre-filled Syringes

• For the treatment of anemia associated with chronic renal failure.

Claim Note: - Patients on dialysis (end-stage renal disease) receive darbepoetin through the dialysis units.

• For the treatment of transfusion dependent patients with hematologic malignancies whose transfusion

requirements are ≥ 2 units of packed red blood cells per month over 3 months. Clinical Note: - Approval of further 12 week cycles is dependent on evidence of satisfactory clinical response or reduced

treatment requirement to less than 2 units of PRBC monthly. Claim Note: - Initial approval for 12 weeks.

October 2015 v.2 A - 26

DARIFENACIN HYDROBROMIDE (ENABLEX) 7.5mg and 15mg extended release tablets For the treatment of overactive bladder with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: • Requests for the treatment of stress incontinence will not be considered. Claim Note: • If the patient has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize

this information and the claim for darifenacin will be automatically reimbursed without the need for a written special authorization request.

DASABUVIR PLUS OMBITASVIR, PARITAPREVIR AND RITONAVIR (HOLKIRA PAK) 250mg tablet + 12.5mg/75mg/50mg film-coated tablet For the treatment of chronic hepatitis C genotype 1 infection in adult patients.

Genotype 1 Patient Population Approval period

Treatment naïve and experienced genotype 1b, non-cirrhotic* 12 weeks

Treatment naïve and experienced genotype 1a, non-cirrhotic 12 weeks in combination with RBV

Treatment naïve and experienced genotype 1b, cirrhotic 12 weeks in combination with RBV

Treatment naïve and experienced (prior relapsers and prior partial responders) genotype 1a, cirrhotic 12 weeks in combination with RBV

Treatment experienced genotype 1a, with cirrhosis AND who have had a previous null response to PegIFN and RBV 24 weeks in combination with RBV

*Holkira Pak with ribavirin (RBV) is recommended in patients with an unknown genotype 1 subtype or with mixed genotype 1 infection. Patients must also meet all of the following criteria: 1. Prescribed by a hepatologist, gastroenterologist or an infectious disease specialist (or other physician

experienced in treating hepatitis C). 2. Lab-confirmed hepatitis C genotype 1, subtype 1a or 1b required. 3. Patient has a quantitative HCV RNA value within the last 6 months. 4. Fibrosis stage F2 or greater (Metavir scale or equivalent). Exclusion Criteria: • Patients currently being treated with another HCV antiviral agent. • Patients who have received a previous treatment course of Holkira Pak (re-treatment requests will not be

considered). • Decompensated patients. • Patients with a hepatitis C infection with a genotype other than 1a or 1b. • Patients who have received previous NS3/4A protease inhibitor-based regimens (i.e. boceprevir, telaprevir and

simeprevir based regimens). • Patients who have received previous sofosbuvir-based regimens (including ledispavir/sofosbuvir).

Clinical notes: 1. Treatment-experienced patients are patients who have previously been treated with peginterferon / ribavirin

(PegIFN/RBV) regimen, including regimens containing HCV protease inhibitors and did not receive adequate response.

2. Compensated cirrhosis is defined as cirrhosis with a Child Pugh Score = A (5-6). 3. HIV-HCV co-infected patients may be considered as per criteria listed above. 4. For patients who require RBV (ModeribaTM) as outlined above, it will be provided at no cost through AbbVie Care

when prescribed in combination with Holkira Pak. RBV will not be covered by New Brunswick Drug Plans. Please contact AbbVie Care for more information at 1-844-471-CARE (2273).

Claim notes: • Requests will be considered for individuals enrolled in Plans ADEFGV. • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here.

http://www2.gnb.ca/content/gnb/en/departments/health/MedicarePrescriptionDrugPlan/NBDrugPlan/ForHealthCareProfessionals/ClaimSubmissions.html

October 2015 v.2 A - 27

DASATINIB (SPRYCEL) 20mg, 50mg, 70mg, 80mg, 100mg and 140mg tablets Chronic Myeloid Leukemia (CML) For adult patients with chronic phase CML • with primary or acquired resistance to imatinib 600mg per day. Dosing recommendation: 100mg per day or 70mg

two times daily • who progress to accelerated phase on imatinib 600mg per day. Dosing recommendation: 140mg per day • who have blast crisis while on imatinib 600mg per day. Dosing recommendation: 140mg per day • who have intolerance to imatinib or have experienced grade 3 or higher toxicities to imatinib Renewal Criteria: • Request for renewal must specify how the patient has benefited from therapy and is expected to continue to do

so. Claim Notes: • Initial approval period: 1 year • Renewal period: 1 year Acute Lymphoblastic Leukemia (ALL) For adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia (ALL) whose disease is resistant to imatinib-containing chemotherapy (patient must have tried 600mg/day) or have experienced grade 3 non-hematologic toxicity, or grade 4 hematologic toxicity persisting for more than 7 days as a result of therapy with imatinib. Renewal Criteria: • Written confirmation that the patient has benefited from therapy and is expected to continue to do so. Claim Notes: • Initial approval period: 1 year • Renewal period: 1 year DEFERASIROX (EXJADE) 125mg, 250mg and 500mg dispersible tablets for suspension For patients who require iron chelation but in whom deferoxamine is contraindicated. DENOSUMAB (PROLIA) 60mg/mL pre-filled syringe • For the treatment of osteoporosis in postmenopausal women who would otherwise be eligible for coverage of oral

bisphosphonate therapy and who have clinically or radiographically-documented fracture due to osteoporosis AND

• Contraindication to oral bisphosphonates for one of the following reasons: - immune-mediated hypersensitivity reaction to oral bisphosphonates;

OR - abnormalities of the esophagus which delay esophageal emptying such as stricture or achalasia.

Clinical Note: • Please note that commonly reported adverse effects or intolerance to bisphosphonates will not be considered to

be hypersensitivity. DENOSUMAB (XGEVA) 120mg/1.7mL single use vial For the prevention of skeletal-related events (SREs) in patients with castrate-resistant prostate cancer (CRPC) with one or more documented bone metastases and an ECOG performance status of 0-2*. Clinical Note: • *Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. DESMOPRESSIN (DDAVP and generic brands) 0.1mg and 0.2mg tablets DESMOPRESSIN (DDAVP MELT) 60mcg, 120mcg and 240mcg tablets • For the management of diabetes insipidus. • For the treatment of patients 18 years and older with nocturnal enuresis. Claim Note: • Desmopressin oral formulations are a regular benefit for Plans DEFG-18.

October 2015 v.2 A - 28

DESMOPRESSIN (DDAVP and generic brand) 10mcg/metered dose nasal spray and 0.1mg/mL intranasal solution • For the treatment of patients with diabetes insipidus. Clinical Note: • The nasal formulations are no longer indicated for nocturnal enuresis due to the risk of hyponatremia. DIENOGEST (VISANNE) 2mg tablet For the management of pelvic pain associated with endometriosis in patients for whom one or more less costly hormonal options are either ineffective or cannot be used. Clinical Note: • Continuous combined oral contraceptives and medroxyprogesterone are examples of less costly hormonal

options. DIMETHYL FUMARATE (TECFIDERA) 120mg and 240mg delayed-release capsules For the treatment of relapsing-remitting multiple sclerosis (RRMS) in patients who meet the following criteria: • Two disabling attacks of MS in the previous two years, and • Ambulatory with or without aid (EDSS of less than or equal to 6.5) Clinical Note: • An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24 hours

in the absence of fever, and preceded by stability for at least one month. Claim Note: • Prescriptions written by New Brunswick neurologists do not require special authorization. DIPYRIDAMOLE EXTENDED RELEASE/ASA IMMEDIATE RELEASE (AGGRENOX) 200mg/25mg capsule For the secondary prevention of ischemic stroke/TIA in patients who have experienced a recurrent thrombotic event (stroke, symptoms of TIA) while taking ASA. DONEPEZIL (ARICEPT and generic brands) 5mg and 10mg tablets See criteria under Cholinesterase Inhibitors. DORNASE ALPHA RECOMBINANT (PULMOZYME) 1 mg/mL solution For cystic fibrosis (Plan B) patients with a FEV1<70% predicted with clinically significant decline in FEV1 not responsive to usual treatment. DULOXETINE (CYMBALTA) 30 mg and 60 mg capsules For the treatment of peripheral neuropathic pain in diabetic patients who have failed treatment with at least 2 other less costly agents used for the treatment of neuropathic pain. (i.e. tricyclic antidepressants and/or an anticonvulsants). Claim Note: • The maximum allowable dose is 60 mg/day. ECULIZUMAB (SOLIRIS) 10mg/mL vial For the treatment of paroxysmal nocturnal hemoglobinuria (PNH). Clinical Notes: 1. A Request for Coverage including the completed consent and specific special authorization forms must be

submitted and the patient must: a. Satisfy the Clinical Criteria for eculizumab (initial or continued coverage, as appropriate); b. Not meet any of the criteria specified in Contraindications to Coverage or Discontinuance of Coverage.

October 2015 v.2 A - 29

2. Please contact the NB Drug Plans at 1-800-332-3691 for a packet containing the Clinical Criteria and required forms.

Claim Note: • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. ELVITEGRAVIR/COBICISTAT/EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE (STRIBILD) 150mg/150mg/200mg/300mg tablet As a complete regimen for antiretroviral treatment naïve HIV-1 infected patients in whom efavirenz is not indicated. Claim Note: • Prescriptions written by NB Infectious Disease Specialists and Medical Microbiologists experienced in treating

patients with HIV/AIDS, do not require special authorization. ENOXAPARIN SODIUM (LOVENOX) Pre-filled syringes and multidose vials ENOXAPARIN SODIUM (LOVENOX HP) Pre-filled syringes See criteria under Low Molecular Weight Heparins. ENTECAVIR (BARACLUDE and generic brands) 0.5mg tablet For the treatment of chronic hepatitis B infection in patients with cirrhosis documented on radiologic or histologic grounds and a HBV DNA concentration above 2,000 lU/mL. ENZALUTAMIDE (XTANDI) 40mg capsule For treatment of patients with metastatic castration-resistant prostate cancer who: • are asymptomatic or mildly symptomatic after failure of androgen deprivation therapy and have not received prior

chemotherapy, OR

• have progressed on docetaxel-based chemotherapy and would be an alternative to abiraterone for patients in the post-docetaxel setting

Clinical Notes: • Patient must have no risk factors for seizures • When used as first line treatment, patient must have an ECOG performance status < 1 • When used as second line treatment , patient must have an ECOG performance status ≤2 • Will not be reimbursed in combination with abiraterone EPLERENONE (INSPRA) 25mg and 50mg tablets For the treatment of patients with New York Heart Association (NYHA) class II chronic heart failure with left ventricular systolic dysfunction (with ejection fraction ≤ 35%), as a complement to standard therapy. Clinical Note: • Patients must be on optimal therapy with an angiotensin-converting–enzyme (ACE) inhibitor, an angiotensin-

receptor blocker (ARB), or both and a beta-blocker (unless contraindicated) at the recommended dose or maximal tolerated dose.

EPOETIN ALFA (EPREX) 1000IU/0.5mL, 2000IU/0.5mL, 3000IU/0.3mL, 4000IU/0.4mL, 5000IU/.5mL, 6000IU/.6mL, 8000IU/.8mL, 10000IU/mL, 20000IU/mL, 30,000IU/0.75mL and 40000IU/mL vials and pre-filled syringes 1. Treatment of anemia associated with chronic renal failure.

Claim Note: - Patients on dialysis (end-stage renal disease) receive epoetin through the dialysis units.

2. Treatment of transfusion dependent anemia related to therapy with zidovudine in HIV-infected patients.

3. Treatment of transfusion dependent patients with hematologic malignancies whose transfusion requirements are ≥ 2 units of packed red blood cells per month over 3 months.


October 2015 v.2 A - 30

Clinical Note: • Approval of further 12 week cycles is dependent on evidence of satisfactory clinical response or reduced

treatment requirement to less than 2 units of PRBC monthly. Claim Note: • Initial approval for 12 weeks.

EPOPROSTENOL SODIUM (CARIPUL and FLOLAN) 0.5mg and 1.5mg vials for injection 1. For the treatment of World Health Organization (WHO) class III or IV idiopathic pulmonary arterial hypertension in

patients who do not demonstrate vasoreactivity on testing or who demonstrate vasoreactivity on testing but fail a trial of, or are intolerant to, calcium channel blockers.

2. For the treatment of WHO class III or IV pulmonary arterial hypertension associated with scleroderma in patients who do not respond adequately to conventional therapy.

ERLOTINIB (TARCEVA) 25mg, 100mg and 150mg tablets Non-small Cell Lung Cancer (NSCLC) For the treatment of patients with locally advanced or metastatic NSCLC after failure of at least one prior chemotherapy regimen and whose EGFR mutation status is positive or unknown. Renewal Criteria: • Written confirmation that the patient has responded to treatment and in whom there is no evidence of disease

progression. Claim Notes: • Initial approval period: 6 month trial • Renewal period: 6 months ESTRADIOL-17β (ESTRADOT and generic brand) 25 mcg, 37.5mcg, 50mcg, 75mcg and 100mcg transdermal patch For the treatment of menopausal symptoms in women for whom oral forms of HRT are not tolerated or indicated. ETANERCEPT (ENBREL) 25mg liquid injection 50mg/mL pre-filled syringe Ankylosing Spondylitis • For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index

(BASDAI) score ≥ 4 on 10 point scale) who: - have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the


- have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD.

• Requests for renewal must include information showing the beneficial effects of the treatment, specifically: - a decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score;

OR - patient and expert opinion of an adequate clinical response as indicated by a significant functional

improvement (measured by outcomes such as HAQ or “ability to return to work”) Clinical Notes: 1. * Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial, disease do not

require a trial of NSAIDs alone. 2. Etanercept will not be reimbursed in combination with other anti-TNF agents. Claim Notes: • Must be prescribed by a rheumatologist or internist • Approval will be for a maximum of 6 months • Approvals will be for a maximum dose of 50mg per week.

October 2015 v.2 A - 31

Juvenile Rheumatoid Arthritis • For the treatment of children (age 4-17) with moderately to severely active polyarticular juvenile rheumatoid

arthritis who have: - not responded to adequate treatment with one or more disease modifying antirheumatic drug (DMARD) for

at least 3 months, OR

- intolerance to DMARDs Claim Note: • Must be prescribed by a rheumatologist. Psoriatic Arthritis • For the treatment of patients with active psoriatic arthritis who have not responded to an adequate trial with two

disease modifying antirheumatic drugs (DMARDs) or who have an intolerance or contraindication to DMARDs. Claim Note: • Must be prescribed by a rheumatologist. Rheumatoid Arthritis • For patients with moderate to severe active rheumatoid arthritis who:



DMARDs in sequence, one of which must have been methotrexate unless contraindicated Claim Note: • Must be prescribed by a rheumatologist. Plaque Psoriasis • Requests will be considered for treatment of patients with severe, debilitating chronic plaque psoriasis who meet





2. An adequate response is defined as either: - ≥75% reduction in the Psoriasis Area and Severity Index (PASI) score from when treatment started (PASI 75),

OR - ≥50% reduction in the PASI score (PASI 50) with a ≥5 point improvement in the Dermatology Life Quality

Index (DLQI) from when treatment started, OR

- A quantitative reduction in BSA affected with qualitative consideration of specific regions such as face, hands, feet, or genital region.

3. Concurrent use of >1 biologic will not be approved Claim Notes: • Initial approval limited to 12 weeks. • Must be prescribed by a dermatologist • Approval limited to a dose of 50 mg twice weekly for an initial 12 weeks, then 50 mg weekly, thereafter up to a

year (if response criteria met at 12 weeks) ETIDRONATE (DIDRONEL and generic brands) 200mg tablet See criteria under Osteoporosis Drugs. ETIDRONATE AND CALCIUM (DIDROCAL and generic brands) 400mg/500mg tablet See criteria under Osteoporosis Drugs.

October 2015 v.2 A - 32

ETONOGESTREL / ETHINYL ESTRADIOL (NUVARING) 11.4mg/2.6mg vaginal ring

For conception control in women who are unable to take oral contraceptives. ETRAVIRINE (INTELENCE) 100mg and 200mg tablets For the treatment of HIV-1 infection in patients who are antiretroviral experienced and have virologic failure due to HIV-1 strains resistant to multiple antiretroviral agents, including other non-nucleoside reverse transcriptase inhibitors. EVEROLIMUS (AFINITOR) 2.5mg, 5mg and 10mg tablets 1. For the treatment of metastatic renal cell carcinoma (mRCC) with clear cell morphology, in patients previously

treated with a tyrosine kinase inhibitor. 2. In combination with exemestane, for the treatment of hormone-receptor positive, HER2 negative advanced breast

cancer, in postmenopausal women with ECOG performance status ≤ 2 after recurrence or progression following a non-steroidal aromatase inhibitor (NSAI), if the treating oncologist would consider using exemestane.

3. For the treatment of patients with progressive, unresectable, well or moderately differentiated, locally advanced or metastatic pancreatic neuroendocrine tumours (pNET) with good performance status (ECOG 0-2), until disease progression.

Claim Note: • Dosing for above indications: maximum 10mg daily EZETIMIBE (EZETROL and generic brands) 10mg tablets For the treatment of hypercholesterolemia • As adjunctive therapy with a statin, in patients who have not reached treatment goals on maximum tolerated statin

therapy alone, OR

• As monotherapy in patients who are intolerant to statins and, when appropriate, fibrates. FEBUXOSTAT (ULORIC) 80mg tablet For patients with symptomatic gout who have documented hypersensitivity to allopurinol. Hypersensitivity to allopurinol is a rare condition that is characterized by a major skin manifestation, fever, multi-organ involvement, lymphadenopathy and hematological abnormalities (eosinophilia, atypical lymphocytes). Clinical Note: • Intolerance or lack of response to allopurinol will not be covered by these criteria. FENTANYL (DURAGESIC MAT and generic brands) Transdermal system 12mcg/hr, 25mcg/hr, 50mcg/hr, 75mcg/hr and 100mcg/hr For the management of malignant or chronic non-malignant pain in adult patients; • who were previously receiving continuous opioid administration (i.e. not opioid naive),

OR • who are unable to take oral therapy. FERUMOXYTOL (FERAHEME) 30mg/mL (510mg/17mL) intravenous injection For the treatment of iron deficiency anemia in patients with chronic kidney disease who are predialysis or receiving home hemodialysis or peritoneal dialysis. Claim Notes: • Requests will be considered from a practitioner with a specialty in nephrology. • The maximum dose that will be reimbursed is 510mg. FESOTERODINE FUMARATE (TOVIAZ) 4mg and 8mg extended-release tablets For the treatment of overactive bladder with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have not tolerated a reasonable trial of immediate-release oxybutynin.

October 2015 v.2 A - 33

Clinical Note: • Requests for the treatment of stress incontinence will not be considered. Claim Note: • If the patient has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize

this information and the claim for fesoterodine will be automatically reimbursed without the need for a written special authorization request.

FIDAXOMICIN (DIFICID) 200mg tablet For the treatment of Clostridium Difficile Infection (CDI) where the patient: • has experienced a third or subsequent episode within 6 months of treatment with vancomyin for prior episode(s),

with no previous trial of fidaxomicin; OR

• has experienced treatment failure* with oral vancomycin for the current CDI episode; OR

• has had a documented allergy (immune-mediated reaction) to oral vancomycin; OR

• has experienced a severe adverse reaction or intolerance** to oral vancomycin treatment that resulted in the discontinuation of vancomycin therapy.

Re-treatment criteria: • Re-treatment with fidaxomicin will only be considered for an early relapse occurring within 30 days of the

completion of the most recent fidaxomicin course. • Relapse/recurrence occurring beyond 30 days after the completion of the most recent fidaxomicin course will

require a trial with vancomycin, unless there is a documented allergy, severe adverse reaction or intolerance to prior oral vancomycin use.

Clinical Notes: • *Treatment failure is defined as 7 days of vancomycin therapy without acceptable clinical improvement. • **Details of severe adverse reaction or intolerance must be provided and should be clinically related to oral

administration of vancomycin. Claim Note: • Requests will be approved for 200mg twice a day for 10 days. FILGRASTIM (NEUPOGEN - AMGEN) 300mcg/1mL and 480mcg/1.6mL injections CHEMOTHERAPY SUPPORT • Primary prophylaxis:

When given as an integral part of an aggressive chemotherapy regimen with curative intent, in order to maintain dose intensity in compressed interval or dose dense treatment, as specified in a chemotherapy protocol.

• Secondary prophylaxis: - For use in patients receiving myelosuppressive chemotherapy who have experienced an episode of febrile

neutropenia, neutropenic sepsis or profound neutropenia in a previous cycle of chemotherapy; or - For use in patients who have experienced a dose reduction or treatment delay longer than one week, due to

neutropenia.

• Dosing for Chemotherapy support: The manufacturer recommends an initial dose of 5mcg/kg/day. When dose scavenging techniques are not available, the following recommendations are suggested: - Patients ≤70 Kg use 1 mL vial (300mcg) DIN 01968017 - Patients > 70 Kg use 1.6 mL vial (480mcg) PIN 00999001

NON-MALIGNANT INDICATIONS • Treatment of congenital neutropenia, idiopathic neutropenia or cyclic neutropenia in patients with recurrent

clinical infections. • Drug-induced neutropenia (e.g. antiviral therapy in patients with HIV). • Refer to product monograph for dosing recommendations. STEM-CELL TRANSPLANTATION • Mobilization:

As an adjunct to progenitor cell transplantation, for mobilization of peripheral blood stem cells (PBSC). The recommended dosage is 10mcg/kg/day.

October 2015 v.2 A - 34

• Reconstitution/Engraftment:

Post bone marrow transplantation (BMT) or PBSC transplantation to speed hematopoietic reconstitution. The recommended dosage is 5mcg/kg/day.

UNACCEPTABLE USE • Treatment of febrile neutropenia or in the prevention of febrile neutropenia in the palliative setting. Claim Note: • Filgrastim must be prescribed or requested by a certified hematologist or medical oncologist. FINGOLIMOD (GILENYA) 0.5 mg capsule For the treatment of patients with Relapsing Remitting Multiple Sclerosis (RRMS) who meet all of the following criteria: • Failure to respond to full and adequate courses1 of at least one interferon OR glatiramer acetate; OR documented

intolerance2 to both therapies • Have experienced one or more clinically disabling relapses in the previous year • Demonstrate a significant increase in T2 lesion load compared with that from a previous MRI scan (i.e. 3 or more

new lesions) OR have at least one gadolinium enhancing lesion • Request is being made by and followed by a neurologist experienced in the management of RRMS • Patient has a recent Expanded Disability Status Scale (EDSS) score less than or equal to 5.5 (i.e. patients must

be able to ambulate at least 100 meters without assistance) Exclusion Criteria: • Combination therapy of fingolimod with other disease modifying therapies (e.g. Avonex, Betaseron, Copaxone,

Rebif, Extavia, Tysabri) will not be funded. • Combination therapy of fingolimid with Fampyra will not be funded. • Patients with EDSS > 5.5 will not be funded • Patients who have experienced a heart attack or stroke within the 6 months prior to the funding request will not be

considered. • Patients with a history of sick sinus syndrome, atrioventricular block, significant QT prolongation, bradycardia,

ischemic heart disease, or congestive heart failure will not be considered. • Patients younger than 18 years of age will not be considered. • Patients with needle phobia or those having a preference for an oral therapy over an injection and who do not

have one or more clinical contraindications to interferon or glatiramer therapy will not be funded. • Skin reactions at the site of the injection do NOT qualify as a contraindication to interferon or glatiramer therapy. Requirements for Initial Requests: • The patient’s physician must provide documentation setting out the details of the patient’s most recent

neurological examination within ninety (90) days of the submitted request. This must include a description of any recent attacks, the dates, and the neurological findings.

Renewal requests will be considered. • Date and details of the most recent neurological examination and EDSS scores must be provided (exam must

have occurred within that last 90 days); AND

• Patient must be stable or have experienced no more than 1 disabling attack/relapse in the past year; AND

• The recent Expanded Disability Status Scale (EDSS) score must be less than or equal to 5.5 (i.e. patients must be able to ambulate at least 100 meters without assistance)

Clinical Notes: 1. 1Failure to respond to full and adequate courses is defined as a trial of at least 6 months of interferon or glatiramer

therapy AND experienced at least one disabling relapse (attack) while on interferon or glatiramer therapy (MRI report does not need to be submitted with the request)

2. 2Intolerance is defined as documented serious adverse effects or contraindications that are incompatible with further use of that class of drug. (Note that skin reactions at the site of the injection do NOT qualify as a contraindication to interferon or glatiramer therapy.)

Claim Notes: • Dosage: 0.5 mg once daily • Initial approval period: 1 year • Renewal approval period: 2 years

October 2015 v.2 A - 35

FLUDARABINE (FLUDARA) 10mg tablet For the first-line treatment of chronic lymphocytic leukemia (CLL) in combination with rituximab (with or without cyclophosphamide). FORMOTEROL (FORADIL) 12 mcg dry powder for inhalation

Reversible obstructive airway disease: • For the treatment of patients, 12 years of age or older, with reversible obstructive airway disease who are using

optimal corticosteroid treatment, but are still poorly controlled. Chronic Obstructive Pulmonary Disease • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of



• Combination therapy with tiotropium AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC

ratio < 0.7), and significant symptoms i.e. MRC score of 3-5) AND





COPD Stage Symptoms



Claim Note: • Prescriptions written by certified New Brunswick respirologists do not require special authorization. Subsequent

refills ordered by other practitioners will not require special authorization. FORMOTEROL (OXEZE) 6 mcg and 12 mcg turbuhalers

Reversible obstructive airway disease: • For the treatment of patients, 12 years of age or older, with reversible obstructive airway disease who are using







October 2015 v.2 A - 36




COPD Stage Symptoms




refills ordered by other practitioners will not require special authorization. FOSFOMYCIN (MONUROL) 3g sachet For the treatment of uncomplicated urinary tract infections in adult female patients where: • The infecting organism is resistant to other oral agents,

OR • Other less costly agents are not tolerated. Clinical Note: • Fosfomycin is not indicated in the treatment of pyelonephritis or perinephric abscess. GALANTAMINE (REMINYL ER and generic brands) 8mg, 16mg, and 24mg capsules See criteria under Cholinesterase Inhibitors. GLATIRAMER ACETATE (COPAXONE) 20mg injection 1. For the treatment of patients with clinically definite multiple sclerosis (CDMS) including relapsing-remitting multiple

sclerosis or secondary progressive multiple sclerosis who meet the following criteria: • Two disabling attacks of MS in the previous two years,

AND • Ambulatory with or without aid (EDSS of less than or equal to 6.5)

2. For the treatment of patients who have experienced a clinically isolated syndrome (CIS) and are considered at

risk for developing CDMS. Clinical Note: • An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24 hours

in the absence of fever, and preceded by stability for at least one month. Claim Note: • Prescriptions written by New Brunswick neurologists do not require special authorization. GLYCOPYRRONIUM BROMIDE (SEEBRI BREEZHALER) 50mcg capsule Chronic Obstructive Pulmonary Disease • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of



• Combination therapy with glycopyrronium bromide AND a long-acting beta2-adrenergic agonist/inhaled corticosteroid (LABA/ICS) will only be considered if: - there is spirometric evidence of at least moderate to severe airflow obstruction (FEV1 < 60% and FEV1/FVC



October 2015 v.2 A - 37



Medical Research Council (MRC) Dyspnea Scale COPD Stage Symptoms



GOLIMUMAB (SIMPONI) 50mg/0.5mL autoinjector/pre-filled syringe 1. For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index

(BASDAI) score ≥ 4 on 10 point scale) who: • Have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the

optimum dose for a minimum 3 month observation period or in whom NSAIDs are contraindicated OR

• Have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum 3 month observation period and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD.

Renewal requests: • Requests for continuation of therapy must include information showing the clinical beneficial effects of the

treatment, specifically: - a decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score

OR - patient and expert opinion of an adequate clinical response as indicated by a significant functional

improvement (measured by outcomes such as HAQ or “ability to return to work”)

Clinical Notes: 1. Golimumab will not be reimbursed in combination with other anti-TNF agents. 2. * Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial disease do

not require a trial of NSAIDs alone.

Claim Notes: • Must be prescribed by a rheumatologist or internist. • Initial approval will be for 4 x 50 mg doses in a 4 month period. • Approvals for continuation of therapy will be for 12 x 50 mg doses annually with no dose escalation permitted.

2. For the treatment of moderate to severe psoriatic arthritis in patients who:

• Have at least three active and tender joints, AND

• Have not responded to an adequate trial of two DMARDs or have an intolerance or contraindication to DMARDs.

Renewal Requests: • Requests for continuation of therapy must include information demonstrating clinical beneficial effects of the

treatment.

Clinical Note: • Golimumab will not be reimbursed in combination with other anti-TNF agents.

Claim Notes: • Must be prescribed by a rheumatologist or internist • Initial approval will be for 4 x 50mg doses in a 4 month period. • Approvals for continuation of therapy will be for 12 x 50 mg doses annually with no dose escalation permitted.

October 2015 v.2 A - 38

3. For patients with moderate to severe active rheumatoid arthritis who:

• Have not responded to, or have had intolerable side-effects with, an adequate trial of combination therapy of at least two traditional DMARDs (disease modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated,

OR • Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional

DMARDs in sequence, one of which must have been methotrexate unless contraindicated. Renewal Requests: • Requests for continuation of therapy must include information demonstrating clinical beneficial effects of the

treatment. Clinical Note: • Golimumab will not be reimbursed in combination with anti-TNF agents. Claim Notes: • Must be prescribed by a rheumatologist. • Initial approval will be for 4 x 50 mg doses in a 4 month period. • Approvals for continuation of therapy will be for 12 x 50 mg doses annually with no dose escalation permitted.

GRANISETRON (KYTRIL and generic brand) 1mg tablet For the treatment of emesis in patients who are: • receiving moderately or severely emetogenic chemotherapy

OR • receiving intravenous chemotherapy or radiotherapy and who have not experienced adequate control with other

available antiemetics OR

• receiving any intravenous chemotherapy or radiotherapy and have experienced emesis with a prior cycle of chemotherapy with intolerable side effects to other antiemetics, including steroids and anti-dopaminergic agents.

Clinical Notes: 1. Only requests for the oral dosage forms are eligible for consideration. Usually a single oral dose pre-

chemotherapy is sufficient to control symptoms. 2. Some patients may require additional therapy up to 48 hours after the last dose of chemotherapy or last radiation

treatment. Benefit beyond 48 hours has not been established. 3. When used in combination with aprepitant, only a single oral dose pre-chemotherapy will be covered. Claim Note: • Prescription claims for up to a maximum of 12 tablets of ondansetron or 2 tablets of granisetron will be

automatically reimbursed every 28 days when the prescription is written by an oncologist or an oncology clinical associate/general practitioners-oncology. If additional medication is required within a 28 day period subsequent to the initial prescription, a request should be made through special authorization.

GRASS POLLEN ALLERGEN EXTRACT (ORALAIR) 100IR and 300IR sublingual tablets For the seasonal treatment of grass pollen allergic rhinitis in patients who have not adequately responded to, or tolerated, conventional pharmacotherapy. Clinical Notes: • Treatment with grass pollen allergen extract must be initiated by physicians with adequate training and

experience in the treatment of respiratory allergic diseases. • Treatment should be initiated four months before the onset of pollen season and should only be continued until

the end of the season • Treatment should not be taken for more than three consecutive years Hp-PAC (Containing LANSOPRAZOLE 30mg Cap, AMOXICILLIN 500mg Cap, CLARITHROMYCIN 500mg Tab) For the treatment of patients with H. pylori infection and active duodenal ulcer disease. Clinical Notes: 1. Treatment should be limited to a period of 7 days for first-line therapy. 2. In cases of H. pylori treatment failure or re-infection, second-line treatment should be limited to a period of 7-14

days provided at least 4 weeks have elapsed from first-line treatment. In addition, if treatment failure or re-infection occurs within a three month period of first-line treatment, a different antibiotic should be used.

October 2015 v.2 A - 39

IBRUTINIB (IMBRUVICA) 140mg capsule For the treatment of patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) who have received at least one prior therapy and are considered inappropriate for treatment or retreatment with a fludarabine-based regimen.

IMATINIB (GLEEVEC and generic brands) 100mg and 400mg tablets Requests from specialists in hematology/oncology will be considered for: 1. Patients who have documented evidence of Philadelphia chromosome positive (Ph+) chronic myeloid leukemia

(CML), with an ECOG performance status of 0-2*. 2. Patients with C-Kit positive (CD117), metastatic or locally advanced, inoperable gastrointestinal stromal tumours

(GIST), who have an ECOG performance status of 0-2*. 3. For the treatment of adult patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic

leukemia (Ph+ALL) when used as a single agent for induction and maintenance phase therapy. Clinical Note: • *Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. IMIQUIMOD (ALDARA and generic brand) 5% cream 1. For the treatment of external genital and external perianal/condyloma acuminata warts.

Claim Note: • Approval Period: 16 weeks

2. For the treatment of actinic keratosis in patients who have failed treatment with 5-Fluorouracil (5-FU) and

cryotherapy.


3. For the treatment of biopsy-confirmed primary superficial basal cell carcinoma:

• with a tumour diameter of ≤ 2 cm AND

• located on the trunk, neck or extremities (excluding hands and feet) AND

• where surgery or irradiation therapy is not medically indicated - recurrent lesions in previously irradiated area

OR - multiple lesions, too numerous to irradiate or remove surgically.

Clinical Note: • Surgical management should be considered first-line for superficial basal cell carcinoma in most patients,

especially for isolated lesions.


INCOBOTULINUMTOXIN-A (XEOMIN) 50 LD50 units/ vial and 100 unit vial for injection • For the treatment of blepharospasm in patients 18 years of age and older. • For the treatment of cervical dystonia (spasmodic torticollis) in patients 18 years of age or older. INDACATEROL MALEATE (ONBREZ BREEZHALER) 75mcg inhalation powder hard capsules Chronic Obstructive Pulmonary Disease • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of



October 2015 v.2 A - 40




Clinical Notes: • Dose not to exceed 75 mcg/day • If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding severity of






refills ordered by other practitioners will not require special authorization. INDACATEROL / GLYCOPYRROLATE (ULTIBRO BREEZEHALER) 110mcg / 50mcg powder for inhalation For the treatment of moderate to severe chronic obstructive pulmonary disease (COPD), as defined by spirometry, in patients with an inadequate response to a long-acting beta-2 agonist (LABA) or long-acting anticholinergic (LAAC). Clinical notes: • Moderate to severe COPD is defined by spirometry (post-bronchodilator) FEV1 < 60% predicted and FEV1/FVC

ratio of < 0.70. Spirometry reports from any point in time will be accepted. If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding COPD severity must be provided for consideration (i.e. Medical Research Council (MRC) Dyspnea Scale score of at least Grade 3). MRC Grade 3 is described as: walks slower than people of same age on the level because of shortness of breath (SOB) from COPD or has to stop for breath when walking at own pace on the level.

• Inadequate response is defined as persistent symptoms after at least 2 months of long-acting beta-2 agonist (LABA) or long-acting anticholinergic therapy (LAAC).

INFLIXIMAB (REMICADE) 100mg liquid injection Ankylosing Spondylitis • For the treatment of patients with moderate to severe ankylosing spondylitis (e.g. Bath AS Disease Activity Index

(BASDAI) score ≥ 4 on 10 point scale) who: - have axial symptoms* and who have failed to respond to the sequential use of at least 2 NSAIDs at the


- have peripheral symptoms and who have failed to respond to, or have contraindications to, the sequential use of at least 2 NSAIDs at the optimum dose for a minimum period of 3 months observation and have had an inadequate response to an optimal dose or maximal tolerated dose of a DMARD.

Renewal Requests: • Requests for renewal must include information showing the beneficial effects of the treatment, specifically:

- a decrease of at least 2 points on the BASDAI scale, compared with the pre-treatment score; OR

- patient and expert opinion of an adequate clinical response as indicated by a significant functional improvement (measured by outcomes such as HAQ or “ability to return to work”)

October 2015 v.2 A - 41

Clinical Notes: 1. Patients with recurrent uveitis (2 or more episodes within 12 months) as a complication to axial disease, do not

require a trial of NSAIDs alone 2. Infliximab will not be reimbursed in combination with other anti-TNF agents. Claim Notes: • Must be prescribed by a rheumatologist or internist • Approval will be for a maximum of 6 months • Approvals will be for a maximum of 5mg/kg at weeks 0, 2 and 6, then every 6 to 8 weeks thereafter. • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. Crohn’s Disease • For moderately to severely active Crohn's disease in patients who are refractory or have contraindications to an

adequate course of 5-aminosalicylic acid and corticosteroids and other immunosuppressive therapy. Initial approval will consist of 3 doses of 5 mg/kg given at weeks 0, 2 and 6.

Clinical Note: • Infliximab will not be reimbursed in combination with other anti-TNF agents. Claim Notes: • Ongoing coverage for maintenance therapy will only be reimbursed for responders and for a dose not exceeding

5mg/kg every 8 weeks. Coverage must be reassessed annually and is dependent on evidence of continued response.

• Must be prescribed by, or in consultation with, a gastroenterologist or physician with a specialty in gastroenterology.

• Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate transactions as outlined here.

Plaque Psoriasis • Requests will be considered for treatment of patients with severe, debilitating chronic plaque psoriasis who meet





2. An adequate response is defined as either: - ≥75% reduction in the Psoriasis Area and Severity Index (PASI) score from when treatment started (PASI 75),

OR - ≥50% reduction in the PASI score (PASI 50) with a ≥5 point improvement in the Dermatology Life Quality

Index (DLQI) from when treatment started, OR

- A quantitative reduction in BSA affected with qualitative consideration of specific regions such as face, hands, feet, or genital region.

3. Concurrent use of >1 biologic will not be approved Claim Notes: • Initial approval limited to 12 weeks. • Must be prescribed by a dermatologist • Approval limited to a dose of 5 mg/kg administered at 0, 2, and 6 weeks, then every 8 weeks up to a year (if

response criteria met at 12 weeks) • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. Rheumatoid Arthritis • For patients with moderate to severe active rheumatoid arthritis who:


OR




October 2015 v.2 A - 42

- Are not candidates for combination DMARD therapy must have had adequate trial of at least three traditional DMARDs in sequence, one of which must have been methotrexate unless contraindicated

Claim Note: • Must be prescribed by a rheumatologist. • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. INSULIN ASPART (NOVORAPID) 10mL vials and 5x3mL cartridges For patients with type I or II diabetes who have experienced frequent episodes of postprandial hypoglycemia; have unpredictable mealtimes; have insulin resistance; or who are using continuous subcutaneous insulin infusion. Claim Note: • Prescriptions written by New Brunswick endocrinologists and internists do not require special authorization.

Subsequent refills ordered by other practitioners will not require special authorization. INSULIN DETEMIR (LEVEMIR PENFILL) 100 U/mL cartridge For the treatment of patients who have been diagnosed with Type 1 or Type 2 diabetes requiring insulin and have previously taken insulin NPH and/or pre-mix daily at optimal dosing.

AND 1. Have experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management.

OR 2. Have documented severe or continuing systemic or local allergic reaction to existing insulin(s). Claim Note: • Requests should be submitted on the long-acting insulin analogue special authorization request form. INSULIN GLARGINE (LANTUS) 100U/mL vial, cartridge, and SoloSTAR For the treatment of patients who have been diagnosed with Type 1 or Type 2 diabetes requiring insulin and have previously taken insulin NPH and/or pre-mix daily at optimal dosing.

AND 1. Have experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management.

OR 2. Have documented severe or continuing systemic or local allergic reaction to existing insulin(s). Claim Note: • Requests should be submitted on the long-acting insulin analogue special authorization request form. INSULIN GLULISINE (APIDRA) 100IU/mL vials, cartridges and SoloSTAR pre-filled pens For patients with type I or II diabetes who have experienced frequent episodes of postprandial hypoglycemia; have unpredictable mealtimes; have insulin resistance; or who are using continuous subcutaneous insulin infusion. Claim Notes: • Prescriptions written by New Brunswick endocrinologists and internists do not require special authorization.

Subsequent refills ordered by other practitioners will not require special authorization. • Insulin glulisine is a regular benefit for Plans DEFG<18 years of age. INSULIN LISPRO (HUMALOG) 10mL vials, 1.5mL and 3mL cartridges, and KwikPen pre-filled pen For patients with type I or II diabetes who have experienced frequent episodes of postprandial hypoglycemia; have unpredictable mealtimes; have insulin resistance; or who are using continuous subcutaneous insulin infusion. Claim Note: • Prescriptions written by New Brunswick endocrinologists and internists do not require special authorization.

Subsequent refills ordered by other practitioners will not require special authorization.


October 2015 v.2 A - 43

INTERFERON BETA-1A (AVONEX PS) 30mcg/0.5mL injection INTERFERON BETA-1A (REBIF) 22mcg/0.5mL, 66mcg/1.5mL, 44mcg/0.5mL, 132mcg/1.5mL INTERFERON BETA-1B (BETASERON, EXTAVIA) 0.3mg injection 1. For the treatment of patients with clinically definite multiple sclerosis (CDMS) including relapsing-remitting multiple

sclerosis, secondary progressive multiple sclerosis or relapsing progressive multiple sclerosis who meet the following criteria: • Two disabling attacks of MS in the previous two years,

AND • Ambulatory with or without aid (EDSS of less than or equal to 6.5)

2. For the treatment of patients who have experienced a clinically isolated syndrome (CIS) and are considered at

risk for developing CDMS. Clinical Note: • An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24 hours

in the absence of fever, and preceded by stability for at least one month. Claim Note: • Prescriptions written by New Brunswick neurologists do not require special authorization. IRON DEXTRAN (DEXIRON) 50mg/mL injection For the treatment of iron deficiency anemia in patients who • are intolerant to oral iron replacement products,

OR • have not responded to adequate therapy with oral iron. IRON SUCROSE (VENOFER) 20mg/mL injection For the treatment of iron deficiency anemia in patients who • are intolerant to oral iron replacement products,

OR • have not responded to adequate therapy with oral iron. ITRACONAZOLE (SPORANOX) 100mg capsule 1. For the treatment of severe systemic fungal infections not responding to alternative therapy. 2. For the treatment of severe or resistant fungal infections in immunocompromised patients not responding to

alternative therapy. 3. For the treatment of skin infections (excluding onychomycosis) caused by dermatophyte fungi not responding to

alternative therapy. IVACAFTOR (KALYDECO) 150mg tablet For the treatment of cystic fibrosis in patients who meet the following criteria: • age 6 years and older; and • have documented G551D mutation in the Cystic Fibrosis Transmembrane conductance Regulator (CFTR) gene. Claim Note: • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. Initial renewal criteria: Renewal requests will be considered in patients with documented response to treatment (after at least 6 months of therapy) as evidenced by the following: In cases where the patient’s sweat chloride levels prior to commencing therapy were above 60mmol/litre: • the patient's sweat chloride level fell below 60mmol/litre; or • the patient's sweat chloride level is 30% lower than the level reported in a previous test;


October 2015 v.2 A - 44

In cases where the baseline sweat chloride levels prior to commencing therapy were below 60mmol/litre: • the patient's sweat chloride level is 30% lower than the level reported in a previous test; or • the patient demonstrates a sustained absolute improvement in FEV1 of at least 5% when compared to the FEV1

test conducted prior to the commencement of therapy. Subsequent renewal criteria: • The patient is continuing to benefit from therapy. Clinical Notes: • The patient’s sweat chloride level and FEV1 must be provided with each request. • A sweat chloride test must be performed within a few months of starting ivacaftor therapy to determine if sweat

chloride levels are reducing. - If the expected reduction occurs, a sweat chloride test must be performed again 6 months after starting

therapy to determine if the full reduction has been achieved. Thereafter, sweat chloride levels must be checked annually.

- If the expected reduction does not occur, a sweat chloride test should be performed again one week later. If the criteria are not met, funding will be discontinued.

Claim Notes: • Requests will be considered for individuals enrolled in Plans ADEFGV. • Approved dose: 150mg every 12 hours • Initial and renewal approval duration: 1 year LACOSAMIDE (VIMPAT) 50mg, 100mg, 150mg and 200mg tablets For the adjunctive treatment of refractory partial-onset seizures in patients who meet all of the following criteria: • are under the care of a physician experienced in the treatment of epilepsy,

AND • are currently receiving two or more antiepileptic drugs,

AND • in whom all other antiepileptic drugs are ineffective or not appropriate LACTULOSE (various brands) 667 mg/mL syrup For the treatment of hepatic encephalopathy in patients with liver disease. Clinical Note: • Please note requests for treatment of constipation will not be considered. LANREOTIDE ACETATE (SOMATULINE AUTOGEL) 60mg/0.3mL, 90mg/0.3mL, 120mg/0.5mL pre-filled syringes For the treatment of acromegaly. LANSOPRAZOLE (PREVACID and generic brands) 15mg and 30mg capsules See criteria under Proton Pump Inhibitors. LANSOPRAZOLE (PREVACID FASTAB) 15mg and 30mg delayed release tablets For patients who meet the special authorization criteria for a proton pump inhibitor and require administration through a feeding tube. LAPATINIB (TYKERB) 250mg tablet For use in combination with capecitabine, for the treatment of HER2-positive patients with advanced or metastatic breast cancer who have progressed on trastuzumab-based treatments (e.g. taxanes, anthracycline, trastuzumab) and who have an ECOG performance status of 0-2.

October 2015 v.2 A - 45

Renewal criteria: • Written confirmation that the patient has responded to treatment and that there is no evidence of disease

progression. Clinical Note: • Requests will not be considered for use in combination with trastuzumab for second-line HER2-positive metastatic

breast cancer or in the adjuvant setting Claim Notes: • Initial approval period: 6 months • Renewal period: 6 months LENALIDOMIDE (REVLIMID) 5mg, 10mg, 15mg and 25mg capsules 1. For the treatment of Myelodysplastic Syndrome (MDS) in patients with:

• Demonstrated diagnosis of MDS on bone marrow aspiration • Presence of 5-q deletion documented by appropriate genetic testing • International Prognostic Scoring System (IPSS) risk category low or intermediate-1† • Presence of symptomatic anemia (defined as transfusion dependent)* Renewal criteria: • For patients who were transfusion-dependent and have demonstrated a reduction in transfusion requirements

of at least 50%. • Renewal requests for all other patients will be considered on a case-by-case basis. Information describing the

results of serial CBC (pre- and post-lenalidomide) and any other objective evidence of response should be included.

Clinical Notes: • † calculator available on www.uptodate.com • *Requests for patients who are not transfusion-dependent will be considered on a case-by-case basis. The

physician should provide clinical evidence of symptomatic anemia affecting the patient’s quality of life and the rationale for why transfusions are not being used.

Claim Notes: • Initial approval period: 6 months • Renewal period: 1 year

2. For the treatment of multiple myeloma when used in combination with dexamethasone, in patients who:

• Are not candidates for autologous stem cell transplant; AND • Where the patient is either:

- Refractory to or has relapsed after the conclusion of initial or subsequent treatments and who is suitable for further chemotherapy;

OR - Has completed at least one full treatment regimen as initial therapy and is experiencing intolerance to their

current chemotherapy.

3. For the maintenance treatment of patients with newly diagnosed multiple myeloma, following autologous stem-cell transplantation (ASCT), who have stable disease or better, with no evidence of disease progression. Renewal criteria: • Written confirmation that there is no evidence of disease progression. Clinical Notes: • Recommended Dose: Initial dose of 10 mg daily. Dose adjustments (5-15 mg) may be necessary based on

individual patient characteristics/responses. • Lenalinomide may be continued until evidence of disease progression or development of unacceptable toxicity

requiring discontinuation of lenalidomide. Claim Notes: • Initial approval duration: 1 year • Renewal approval duration: 1 year

http://www.uptodate.com/

October 2015 v.2 A - 46

Clinical Note: • Due to its structural similarities to thalidomide, lenalidomide (Revlimid) is only available through a controlled

distribution program called RevAid® to minimize the risk of fetal exposure. Only prescribers and pharmacists registered with this program are able to prescribe and dispense lenalidomide (Revlimid). In addition, patients must be registered and meet all the conditions of the program in order to receive the product. For information, call 1-888-RevAid1 or log onto www.RevAid.ca.


transactions as outlined here. LEUPROLIDE (LUPRON) 5mg injection 1. For the palliative treatment of stage D2 carcinoma of the prostate (Plans D and F). 2. For the treatment of central precocious puberty. Claim Note: • Lupron 5mg injection is a regular benefit for Plans A and V. LEVETIRACETAM (KEPPRA and generic brands) 250mg, 500mg and 750mg tablets As an adjunctive therapy in the management of patients with epilepsy who are not satisfactorily controlled by conventional therapy. LEVOCARNITINE (CARNITOR) 100mg/mL oral liquid and 330mg tablet 1. For the treatment of patients with primary systemic carnitine deficiency. 2. For the treatment of patients with an inborn error of metabolism that results in secondary carnitine deficiency. LEVODOPA/CARBIDOPA / ENTACAPONE (STALEVO) 50/12.5/200 mg, 75/18.75/200 mg, 100/25/200 mg, 125/31.25/200 mg, and 150/37.5/200 mg tablets For the treatment of patients with Parkinson’s disease • who are currently receiving immediate-release levodopa/carbidopa and entacapone,

OR • who are not well controlled and are experiencing significant “wearing off” symptoms despite optimal therapy with

levodopa/decarboxylase. LEVOFLOXACIN (LEVAQUIN and generic brands) 250mg and 500mg tablets • For the completion of therapy instituted in the hospital setting for the treatment of nosocomial pneumonia,

community acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB). • For the treatment of severe pneumonia in nursing home patients (regular benefit for Plan V). • For the treatment1 of CAP in patients;

- with co-morbidity2 upon radiographic confirmation of pneumonia, OR

- who have failed first line therapies (macrolide, doxycycline, amoxicillin-clavulanate). • For the treatment1 of AECB in complicated patients3 who have failed treatment with one of the following

(amoxicillin, doxycycline, TMP-SMX, cefuroxime, macrolide, ketolide or amoxicillin-clavulanate). Clinical Notes: 1. 1 If treated with an antibiotic within the past 3 months choose an antibiotic from a different class. 2. 2 Co-morbidity includes chronic lung disease, malignancy, diabetes, liver, renal or congestive heart failure, use of

antibiotics or steroids in the past 3 months, suspected macroaspiration, hospitalization within last 3 months, HIV/AIDs, smoking, malnutrition or acute weight loss.

3. 3 Complicated AECB defined as increased cough and sputum, sputum purulence and increased dyspnea AND

• FEV1 < 50% predicted OR

• FEV1 50-65% and one of the following: - ≥ 4 exacerbations per year - Ischemic heart disease - Chronic oral steroid use - Antibiotic use in the past 3 months

http://www.revaid.ca/


October 2015 v.2 A - 47

Claim Notes: • Prescriptions written by New Brunswick infectious disease specialists, medical microbiologists, medical

oncologists, respirologists and internal medicine specialists will not require special authorization. • Levofloxacin is a regular benefit for Plan V. LINAGLIPTIN (TRAJENTA) 5mg tablets For patients with type 2 diabetes mellitus with inadequate glycemic control while on optimal doses of metformin and a sulfonylurea, and for whom NPH insulin is not an option, when added as a third agent. LINEZOLID (ZYVOXAM and generic brands) 600mg tablets • For treatment of proven vancomycin-resistant enterocci (VRE) infections. • For the treatment of proven methicillin-resistant Staphylococcus aureus (MRSA) / methicillin-resistant

Staphylococcus epidermidis (MRSE) infections in patients who are unresponsive to, or intolerant of, intravenous vancomycin or in whom intravenous vancomycin is not appropriate.

Claim Note: • The drug must be prescribed by, or in consultation with, an infectious disease specialist or medical microbiologist. LISDEXAMFETAMINE DIMESYLATE (VYVANSE) 10mg, 20mg, 30mg, 40mg, 50mg, 60mg capsules For treatment of Attention Deficit Hyperactivity Disorder (ADHD) in patients age 6 to 25 years who: • Demonstrate significant and problematic disruptive behaviour or who have problems with inattention that

interfere with learning; AND

• Have been tried on methylphenidate (immediate release or long-acting formulation) or dexamphetamine with unsatisfactory results.

Claim Notes: • Requests will be considered from specialists in pediatric psychiatry, pediatricians or general practitioners with

expertise in ADHD. • The maximum dose reimbursed is 60mg daily.

October 2015 v.2 A - 48

LOW MOLECULAR WEIGHT HEPARINS (Dalteparin, Enoxaparin, Nadroparin, Tinzaparin). 1. For the treatment of venous thromboembolism (VTE) and/or pulmonary embolism (PE) for a maximum of 30

days. 2. For the extended treatment of recurrent symptomatic venous thromboembolism (VTE) that has occurred while

patients are on therapeutic doses of warfarin. 3. For the prophylaxis of venous thromboembolism (VTE) up to 35 days following elective hip replacement or hip

fracture surgery. 4. For the prophylaxis of VTE up to 10 days following elective knee replacement surgery. 5. For the prophylaxis of venous thromboembolism (VTE) post abdominal or pelvic surgery for management of a

malignant tumor for up to 28 days (enoxaparin only). 6. For the treatment and secondary prevention of symptomatic venous thromboembolism (VTE) or pulmonary

embolism (PE) for a period of up to 6 months in patients with cancer for whom warfarin therapy is not an option. Claim Note: • An annual quantity limit of approximately 30 days of therapy is applied to all Low Molecular Weight Heparin DINs

listed in the table. If the DIN does not appear in the table or if an additional quantity is required, a request must be made through special authorization.

Product Name DIN Approximate 30 Day Treatment Quantity

Dalteparin (Fragmin)

• 2,500IU/0.2mL pre-filled syringe • 3,500IU/0.28mL pre-filled syringe • 5,000IU/0.2mL pre-filled syringe • 7,500IU/0.3mL pre-filled syringe • 10,000IU/0.4mL pre-filled syringe • 12,500IU/0.5mL pre-filled syringe • 15,000IU/0.6mL pre-filled syringe • 18,000IU/0.72mL pre-filled syringe • 25,000IU/mL multi-dose vial

02132621 02430789 02132648 02352648 02352656 02352664 02352672 02352680 02231171

0.2mL x 30 syringes = 6mL 0.28mL x 30 syringes = 8.4mL 0.2mL x 30 syringes = 6mL 0.3mL x 30 syringes = 9mL 0.4mL x 30 syringes = 12mL 0.5mL x 30 syringes = 15mL 0.6mL x 30 syringes = 18mL 0.72mL x 30 syringes = 24mL 3.8mL x 6 vials = 24mL

Enoxaparin Lovenox & Lovenox HP)

• 30mg/0.3mL pre-filled syringe • 40mg/0.4mL pre-filled syringe • 60mg/0.6mL pre-filled syringe • 80mg/0.8mL pre-filled syringe • 100mg/mL pre-filled syringe • 120mg/0.8mL pre-filled syringe (HP) • 150mg/mL pre-filled syringe (HP)

02012472 02236883 02378426 02378434 02378442 02242692 02378469

0.3mL x 30 syringes = 9mL 0.4mL x 30 syringes = 12mL 0.6mL x 30 syringes = 18mL 0.8mL x 30 syringes = 24mL 1mL x 30 syringes = 30mL 0.8mL x 30 syringes = 24mL 1mL x 30 syringes = 30mL

Nadroparin (Fraxiparin & Fraxiparin Forte)

• 2,850IU/0.3mL pre-filled syringe • 3.800IU/0.4mL pre-filled syringe • 5,700IU/0.6mL pre-filled syringe • 7,600IU/0.8mL pre-filled syringe • 9,500IU/mL pre-filled syringe • 11,400IU/0.6mL pre-filled syringe • 15,200IU/0.8mL pre-filled syringe • 19,000IU/mL pre-filled syringe

02236913

02240114

0.3mL x 30 syringes = 9mL 0.4mL x 30 syringes = 12mL 0.6mL x 30 syringes = 18mL 0.8mL x 30 syringes = 24mL 1mL x 30 syringes = 10mL 0.6mL x 30 syringes = 18mL 0.8mL x 30 syringes = 24mL 1.0mL x 30 syringes = 30mL

Tinzaparin (Innohep)

• 2,500IU/0.25mL pre-filled syringe • 3,500IU/0.35mL pre-filled syringe • 4,500IU/0.45mL pre-filled syringe • 8,000IU/0.4mL pre-filled syringe • 10,000IU/0.5mL pre-filled syringe • 12,000IU/0.6mL pre-filled syringe • 14,000IU/0.7mL pre-filled syringe • 16,000IU/0.8mL pre-filled syringe • 18,000IU/0.9mL pre-filled syringe

02229755 02358158 02358166 02429462 02231478 02429470 02358174 02429489 02358182

0.25mL x 30 syringes = 7.5mL 0.35mL x 30 syringes = 10.5mL 0.45mL x 30 syringes = 13.5mL 0.4mL x 30 syringes = 12mL 0.5mL x 30 syringes = 15mL 0.6mL x 30 syringes = 18mL 0.7mL x 30 syringes = 21mL 0.8mL x 30 syringes = 24mL 0.9mL x 30 syringes = 27mL

October 2015 v.2 A - 49

LURASIDONE (LATUDA) 20mg, 40mg, 60mg, 80mg, 120mg film-coated tablets For the treatment of schizophrenia and related psychotic disorders (not dementia related) in patients with a history of failure, intolerance, or contraindication to at least one less expensive antipsychotic agent. MARAVIROC (CELSENTRI) 150mg and 300mg tablets For the treatment of HIV-1 infection in patients who have CCR5 tropic viruses and who have documented resistance to at least one agent from each of the three major classes of antiretrovirals (i.e. nucleoside/tide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors.) Clinical Note: • Requests for HIV-1 treatment-naïve patients will not be considered. METFORMIN / SAXAGLIPTIN (KOMBOGLYZE) 500mg/2.5mg, 850mg/2.5mg, and 1000mg/2.5mg tablets For the treatment of type 2 diabetes mellitus in patients: • for whom insulin is not an option

AND • who are already stabilized on therapy with metformin, a sulfonylurea and saxagliptin, to replace the individual

components of saxagliptin and metformin. METHADONE Compounded Oral Solution Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of severe cancer-related or chronic non-malignant pain as an alternative to other opioids. 2. For the treatment of opioid dependence. All requests must meet requirements set out by the New Brunswick Drug Plans. Pharmacy Claims: Claims submitted by pharmacies must be billed using the applicable PIN.

Opioid dependence 00999734 Chronic pain 00999801

METHADONE HCL (METHADOSE) 10mg/mL dye-free, sugar-free, unflavored oral concentrate and cherry flavored oral concentrate Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of opioid dependence. All requests must meet requirements set out by the New Brunswick Drug Plans. Pharmacy Claims: Claims submitted by pharmacies must be billed using DIN 02394618 or DIN 02394596. METHADONE HCL (METADOL) 1 mg/mL oral solution and 10 mg/mL oral concentrate Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of severe cancer-related or chronic non-malignant pain as an alternative to other opioids. 2. For the treatment of opioid dependence. All requests must meet requirements set out by the New Brunswick Drug Plans. Pharmacy Claims: Claims submitted by pharmacies must be billed using the applicable PIN. 1mg/mL oral solution


10mg/mL oral concentrate


October 2015 v.2 A - 50

METHADONE HCL (METADOL) 1mg, 5mg, 10mg and 25mg tablets Requests from New Brunswick physicians authorized to prescribe methadone will be considered: 1. For the treatment of severe cancer-related or chronic non-malignant pain as an alternative to other opioids. Claim Note: • Requests will not be considered:

1. For the treatment of opioid dependence. 2. Preparations compounded using Metadol tablets will not be considered.

METHYLPHENIDATE (BIPHENTIN) 10mg, 15mg, 20mg, 30mg, 40mg, 50mg, 60mg and 80mg controlled release capsules For the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in children age 6 to 25 years who demonstrate significant symptoms and who have tried immediate release and slow release methylphenidate with unsatisfactory results. Claim Note: • Requests will be considered from specialists in pediatric psychiatry, pediatricians or general practitioners with

expertise in ADHD. METHYLPHENIDATE-ER (CONCERTA and generic brands) 18mg, 27mg, 36mg and 54mg extended-release tablets For the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in children aged 6 to 25 years who demonstrate significant symptoms and who have tried immediate release or slow release methylphenidate with unsatisfactory results. Claim Note: • Requests will be considered from specialists in pediatric psychiatry, pediatricians or general practitioners with

expertise in ADHD. MIRABEGRON (MYRBETRIQ) 25mg and 50mg extended-release tablets For the treatment of overactive bladder (OAB) with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have an intolerance or inadequate response to an adequate trial of immediate-release oxybutynin. Clinical Notes: • Requests for the treatment of stress incontinence will not be considered. • Not to be used in combination with other pharmacological treatments of OAB Claim Note: • If the patient has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize

this information and the claim for mirabegron will be automatically reimbursed without the need for a written special authorization request.

MODAFINIL (ALERTEC and generic brand) 100mg tablet For the treatment of narcolepsy confirmed by a sleep study. MOMETASONE FUROATE/FORMOTEROL FUMARATE DIHYDRATE (ZENHALE) 5mcg/50mcg, 5mcg/100mcg and 5mcg/200mcg per actuation metered-dose inhalers For patients with reversible obstructive airways disease who are: • Stabilized on an inhaled corticosteroid and a long-acting beta2-adrenergic agonist

OR • Using optimal doses of inhaled corticosteroids but are still poorly controlled. MONTELUKAST (SINGULAIR and generic brands) 4mg and 5mg chewable tablets 10mg tablet 4mg oral granules For the treatment of moderate to severe asthma in patients who: • Are not adequately controlled with moderate to high dose inhaled corticosteroids despite compliance with

treatment AND

• Require increasing amounts of short-acting beta2-adrenergic agonists.

October 2015 v.2 A - 51

MOXIFLOXACIN (AVELOX) 400mg tablet • For the completion of therapy instituted in the hospital setting for the treatment of nosocomial pneumonia,

community acquired pneumonia (CAP) or acute exacerbation of chronic bronchitis (AECB). • For the treatment of severe pneumonia in nursing home patients (regular benefit for Plan V). • For the treatment1 of CAP in patients;

- with co-morbidity2 upon radiographic confirmation of pneumonia, OR

- who have failed first line therapies (macrolide, doxycycline, amoxicillin-clavulanate). • For the treatment1 of AECB in complicated patients3 who have failed treatment with one of the following

(amoxicillin, doxycycline, TMP-SMX, cefuroxime, macrolide, ketolide or amoxicillin-clavulanate). Clinical Notes: 1. 1 If treated with an antibiotic within the past 3 months choose an antibiotic from a different class. 2. 2 Co-morbidity includes chronic lung disease, malignancy, diabetes, liver, renal or congestive heart failure, use of

antibiotics or steroids in the past 3 months, suspected macroaspiration, hospitalization within last 3 months, HIV/AIDs, smoking, malnutrition or acute weight loss.

3. 3 Complicated AECB defined as increased cough and sputum, sputum purulence and increased dyspnea AND

- FEV1 < 50% predicted OR

- FEV1 50-65% and one of the following: • ≥ 4 exacerbations per year • Ischemic heart disease • Chronic oral steroid use • Antibiotic use in the past 3 months

Claim Notes: • Prescriptions written by New Brunswick infectious disease specialists, medical microbiologists, medical

oncologists, respirologists and internal medicine specialists will not require special authorization. • Moxifloxacin is a regular benefit for Plan V. NABILONE (CESAMET and generic brands) 0.25mg, 0.5mg and 1mg capsules For the management of severe nausea and vomiting associated with cancer chemotherapy. NADROPARIN CALCIUM (FRAXIPARIN) Pre-filled syringes NADROPARIN CALCIUM (FRAXIPARIN FORTE) Pre-filled syringes See criteria under Low Molecular Weight Heparins. NAFARELIN ACETATE (SYNAREL) 2mg/mL nasal solution Approved for the hormonal management of endometriosis, including pain relief and reduction of endometriotic lesions. Clinical Note: • Requests will be considered for women age 18 and older. Claim Note: • Approval limits payment to a maximum of 6 months of therapy. NALTREXONE (REVIA) 50mg tablet • For the treatment of alcohol dependence, as an adjunct to a comprehensive program to support abstinence, and

reduce the risk of relapse. • For the maintenance of opioid-free state in individuals who were previously opioid-dependent but have

successfully completed detoxification. Treatment should not be attempted until the patient has remained opioid-free for 7 - 10 days. Requests will be considered only when used as an adjunct to psychosocial intervention. In the event that a patient participates in a program other than those offered by New Brunswick Addiction Services, details on the type of counselling/supportive program the patient will be involved in will be requested.

October 2015 v.2 A - 52

Continued coverage will require information on the outcome of therapy as well as patient's compliance with treatment programs. Claim Note: • Coverage will be approved initially for 12 weeks. NARATRIPTAN (AMERGE and generic brands) 1mg and 2.5mg tablets • For the treatment of migraine1 headache when:

- Migraines are moderate2 in severity and other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not effective,

OR - Migraine attacks are severe2 or ultra severe2

Clinical Notes: 1. 1As diagnosed based on current Canadian guidelines. 2. 2 Definitions:

• Moderate - pain is distracting causing need to slow down and limit activities; • Severe - pain affects ability to concentrate and very difficult to continue with daily activities; • Ultra severe - unable to speak or think clearly; not able to function; likely lying down or sleeping





NATALIZUMAB (TYSABRI) 300mg/15mL vial Initial Request: For the treatment of Relapsing-Remitting Multiple Sclerosis (RRMS) in patients who meet all the following criteria: • The patient’s physician is a neurologist experienced in the management of relapsing-remitting multiple sclerosis

(RRMS); AND

The patient; • Has a current EDSS less than or equal to 5.0;

AND • Has failed to respond to a full and adequate course (see note below) of at least ONE disease modifying therapy

OR has contraindications/intolerance to at least TWO disease modifying therapies; AND

• Has had ONE of the following types of relapses in the past year: - The occurrence of one relapse with partial recovery during the past year AND has at least ONE gadolinium-

enhancing lesion on brain MRI, OR significant increase in T2 lesion load compared to a previous MRI; OR

- The occurrence of two or more relapses with partial recovery during the past year; OR

- The occurrence of two or more relapses with complete recovery during the past year AND has at least ONE gadolinium-enhancing lesion on brain MRI, OR significant increase in T2 lesion load compared to a previous MRI.

Requirements for Initial Requests: • The patient’s physician provides documentation setting out the details of the patient’s most recent neurological

examination within ninety (90) days of the submitted request. This must include a description of any recent attacks, the dates, and the neurological findings.

• MRI reports do NOT need to be submitted with the initial request

October 2015 v.2 A - 53

Renewal Criteria: • Date and details of the most recent neurological examination and EDSS scores must be provided (exam must

have occurred within that last 90 days) AND

• Patients must be stable or have experienced no more than 1 disabling attack/relapse in the past year; AND

• Recent Expanded Disability Status Scale (EDSS) score less than or equal to 5.0 Clinical Notes: 1. Failure to respond to a full and adequate course: defined as a trial of at least 6 months of interferon or glatiramer

therapy AND experienced at least one disabling relapse (attack) while on interferon or glatiramer therapy. 2. Combination therapy of Natalizumab with other disease modifying therapies (e.g. Avonex, Betaseron, Copaxone,

Rebif, Extavia, Gilenya) will not be funded. Claim Note: • Approval Period: 1 year NILOTINIB (TASIGNA) 150mg capsule For the first-line treatment of adult patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase. NILOTINIB (TASIGNA) 200mg capsule For the treatment of chronic phase (CP) and accelerated phase (AP) Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML) in adult patients who: • are resistant or intolerant to imatinib,

OR • intolerant to dasatinib NORETHINDRONE ACETATE / ESTRADIOL-17β (ESTALIS) 140/50mcg and 250/50mcg transdermal patches For the treatment of menopausal symptoms in women for whom oral forms of HRT are not tolerated or indicated. OCRIPLASMIN (JETREA) 2.5mg/mL intravitreal injection For the treatment of symptomatic vitreomacular adhesion (VMA) if the following clinical criteria and conditions are met: • Diagnosis of VMA has been confirmed through optical coherence tomography. • Patients do not have any of the following: large diameter macular holes (greater than 400 micrometres), high

myopia (greater than 8 dioptre spherical correction or axial length greater than 28 millimetres), aphakia, history of retinal detachment, lens zonule instability, recent ocular surgery or intraocular injection (including laser therapy), proliferative diabetic retinopathy, ischemic retinopathies, retinal vein occlusions, exudative age-related macular degeneration, or vitreous hemorrhage.

Clinical Notes: • Ocriplasmin should be administered by an ophthalmologist experienced in intravitreal injections. • Treatment with ocriplasmin should be limited to a single injection per eye (i.e. retreatments are not covered). OFLOXACIN (OCUFLOX and generic brands) 0.3% ophthalmic solution For the treatment of bacterial conjunctivitis. Claim Note: • Prescriptions written by New Brunswick ophthalmologists and optometrists do not require special authorization. OLANZAPINE (ZYPREXA and generic brands) 2.5mg, 5mg, 7.5mg, 10mg and 15mg tablets OLANZAPINE (ZYPREXA ZYDIS and generic brands) 5mg, 10mg, 15mg and 20mg oral disintegrating tablets • For the acute and maintenance treatment of schizophrenia and related psychotic disorders. • For the acute treatment of manic or mixed episodes in bipolar l disorder in patients with intolerance or a history of

failure to one other atypical antipsychotic. • For maintenance treatment in patients with bipolar disorder who are currently stabilized on olanzapine.

October 2015 v.2 A - 54

Clinical Note: • Advice from a psychiatrist is suggested prior to starting therapy. Claim Note: • Prescriptions written by New Brunswick psychiatrists do not require special authorization. Subsequent refills

ordered by other practitioners will not require special authorization. ONABOTULINUMTOXINA (BOTOX) 50 Allergan units per vial (PIN 00903741) and 100 Allergan units per vial 1. For the treatment of equinus foot deformity in cerebral palsy in patients 2 years of age and older. 2. To reduce the subjective symptoms and objective signs of cervical dystonia (spasmodic torticollis) in adults. 3. For the treatment of blepharospasm, hemifacial spasm (VII nerve disorder) and strabismus in patients 12 years of

age and older. 4. For the treatment of upper and lower limb (at or below the knee) focal spasticity following stroke in adults. Initial

approval period for focal spasticity following stroke will be 6 months. Continued approval will require documented benefit of improved passive and/or active range of motion, muscle tone, or improved gait (in the case of lower limb spasticity).

Clinical Notes: • The following conditions are excluded from coverage:

- Chronic migraine - Chronic pain - Hyperhidrosis - Muscle contracture for support of perineal care.

ONABOTULINUMTOXINA (BOTOX) 200 Allergan units per vial (PIN 00999505) For the treatment of urinary incontinence due to neurogenic detrusor overactivity resulting from neurogenic bladder associated with multiple sclerosis (MS) or subcervical spinal cord injury (SCI) if the following conditions are met: • patient failed to respond to behavioural modification and anticholinergics and/or is intolerant to anticholinergics • subsequent treatments are provided at intervals no less than every 36 weeks Clinical Note: • Patients who fail to respond to initial treatment with onabotulinumtoxinA should not be retreated. ONDANSETRON (ZOFRAN and generic brands) 4mg and 8mg tablets 4mg/5mL oral solution For the treatment of emesis in patients who are: • receiving moderately or severely emetogenic chemotherapy






treatment. Benefit beyond 48 hours has not been established. 3. When used in combination with aprepitant, only a single oral dose pre-chemotherapy will be covered. Claim Note: • Prescription claims for up to a maximum of 12 tablets of ondansetron or 2 tablets of granisetron will be

automatically reimbursed every 28 days when the prescription is written by an oncologist or an oncology clinical associate/general practitioners-oncology. If additional medication is required within a 28 day period subsequent to the initial prescription, a request should be made through special authorization.

October 2015 v.2 A - 55

ONDANSETRON (ZOFRAN ODT and generic brand) 4mg and 8mg oral disintegrating tablets Requests will be considered for the treatment of emesis in patients who have difficulty swallowing oral tablets and are: • receiving moderately or severely emetogenic chemotherapy






treatment. Benefit beyond 48 hours has not been established. 3. When used in combination with aprepitant, only a single oral dose prechemotherapy will be covered. OSELTAMIVIR (TAMIFLU) 30mg, 45mg and 75mg capsules For beneficiaries residing in long-term care facilities* during an influenza outbreak situation and further to the recommendation of a Medical Officer of Health: • For treatment of long-term care residents with clinically suspected or lab confirmed influenza A or B. A clinically

suspected case is one in which the patient meets the criteria of influenza-like illness and there is confirmation of influenza A or B circulating within the facility or surrounding community.

• For prophylaxis of long-term care residents where the facility has an influenza A or B outbreak. Prophylaxis should be continued until the outbreak is over. An outbreak is declared over 7 days after the onset of the last case in the facility.

Clinical note: • *In these criteria, long-term care facility refers to a licensed nursing home and does not include special care

homes.

October 2015 v.2 A - 56

OSTEOPOROSIS DRUGS (etidronate and raloxifene) Requests for osteoporosis drugs for patients without documented fracture should reference the most recent (2010) version of the Canadian Association of Radiologist and Osteoporosis Canada (CAROC) table1, or the World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX) http://www.shef.ac.uk/FRAX/tool.jsp?lang=en when determining whether the patient meets criteria for high (>20%) 10-year fracture risk.

Fracture Risk Tables

Women

Age

(years)

10-YEAR RISK Low Risk

< 10% Moderate Risk

10% - 20% High Risk

> 20% LOWEST T-SCORE

femoral neck 50 > - 2.5 - 2.5 to - 3.8 < - 3.8 55 > - 2.5 - 2.5 to - 3.8 < - 3.8 60 > - 2.3 - 2.3 to - 3.7 < - 3.7 65 > - 1.9 - 1.9 to - 3.5 < - 3.5 70 > - 1.7 - 1.7 to - 3.2 < - 3.2 75 > - 1.2 - 1.2 to - 2.9 < - 2.9 80 > - 0.5 - 0.5 to - 2.6 < - 2.6 85 > +0.1 + 0.1 to - 2.2 < - 2.2

1Ref: Can Assoc Radiol J, 2011; 62(4): 243-50

Men

Age

(years)

10-YEAR RISK Low Risk

< 10% Moderate Risk

10% - 20% High Risk

> 20% LOWEST T-SCORE

femoral neck 50 > -2.5 - 2.5 to - 3.9 < - 3.9 55 > -2.5 - 2.5 to - 3.9 < - 3.9 60 > -2.5 - 2.5 to - 3.7 < - 3.7 65 > -2.4 - 2.4 to - 3.7 < - 3.7 70 > -2.3 - 2.3 to - 3.7 < - 3.7 75 > -2.3 - 2.3 to - 3.8 < - 3.8 80 > -2.1 - 2.1 to - 3.8 < - 3.8 85 > -2.0 - 2.0 to - 3.8 < - 3.8

ETIDRONATE (DIDRONEL and generic brands) 200mg tablets ETIDRONATE AND CALCIUM (DIDROCAL KIT and generic brands) 400mg/500mg tablets For the treatment of osteoporosis: • with documented fragility fracture when alendronate or risedronate are not tolerated or contraindicated;

OR • without documented fractures in patients at high 10-year fracture risk (see fracture risk tables) when alendronate

or risedronate are not tolerated or contraindicated. RALOXIFENE (EVISTA and generic brands) 60mg tablets For the treatment of postmenopausal osteoporosis • with documented fragility fracture when bisphosphonates are not tolerated or contraindicated;

OR • without documented fractures in patients at high 10-year fracture risk (see fracture risk tables) when

bisphosphonates are not tolerated or contraindicated. OXCARBAZEPINE (TRILEPTAL and generic brand) 150mg, 300mg and 600mg tablets 60mg/mL suspension For the treatment of epilepsy in patients who have had an inadequate response or are intolerant to at least 3 other antileptics including carbamazepine. OXYBUTYNIN (DITROPAN XL) 5mg and 10mg tablets For the treatment of overactive bladder with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: • Requests for the treatment of stress incontinence will not be considered. OXYCODONE (OXY IR and generic and SUPEUDOL) 5mg, 10mg and 20mg tablets (immediate release) For the treatment of moderate to severe cancer-related or chronic non-malignant pain.

http://www.shef.ac.uk/FRAX/tool.jsp?lang=en

October 2015 v.2 A - 57

PALIPERIDONE (INVEGA SUSTENNA) 50mg/0.5mL, 75mg/0.75mL, 100mg/mL and 150mg/1.5mL pre-filled syringes For the treatment of schizophrenia in patients: • for whom compliance with an oral antipsychotic presents problems,

OR • who are currently receiving a typical depot antipsychotic and experiencing significant side effects (EPS or TD)

or lack of efficacy. PANTOPRAZOLE SODIUM (PANTOLOC and generic brands) 20mg and 40mg tablets See criteria under Proton Pump Inhibitors. PAZOPANIB (VOTRIENT) 200mg tablet 1. As a first-line treatment for patients with advanced or metastatic clear cell renal carcinoma and good performance

status. 2. For the treatment of advanced or metastatic renal cell (clear cell) carcinoma (mRCC) in patients who are unable

to tolerate sunitinib and who have an ECOG performance status of 0 or 1. Renewal Criteria: • Written confirmation that the patient has benefited from therapy and is expected to continue to do so. Claim Notes: • Initial approval period: 1 year • Renewal period: 1 year PEGFILGRASTIM (NEULASTA) 6mg pre-filled syringe Requests will be considered for the following indications: Chemotherapy Support • Primary prophylaxis:

- For use in previously untreated patients receiving a moderate to severely myelosuppressive chemotherapy regimen (i.e. ≥ 40% incidence of febrile neutropenia). Febrile neutropenia is defined as a temperature ≥ 38.5°C or > 38.0°C three times in a 24 hour period and neutropenia with an absolute neutrophil count (ANC) < 0.5 x 109/L.

• Secondary prophylaxis: - For use in patients receiving myelosuppressive chemotherapy who have experienced an episode of febrile

neutropenia, neutropenic sepsis or profound neutropenia in a previous cycle of chemotherapy; or - For use in patients who have experienced a dose reduction or treatment delay longer than one week, due to

neutropenia. • Dosing for chemotherapy support:

- The recommended dosage of pegfilgrastim is a single subcutaneous injection of 6mg, administered once per cycle of chemotherapy. Pegfilgrastim

should be administered no sooner than 24 hours after the administration

of cytotoxic chemotherapy. Clinical Notes: 1. Pegfilgrastim is not indicated and requests will not be considered for the following:

- Myeloid malignancies - Pediatric patients with cancer receiving myelosuppressive chemotherapy - Non-malignant neutropenias - Stem-cell transplantation - Treatment of febrile neutropenia or in the prevention of febrile neutropenia in the palliative setting

2. Filgrastim (Neupogen®) dosing is 5 mcg/kg/day. For patients ≤ 60 kg who are prescribed filgrastim 300mcg for 9 or fewer days, the cost of filgrastim therapy is less than the cost of pegfilgrastim 6mg.

Claim Note: • Requests will be considered when prescribed by, or on the advice of, a hematologist or medical oncologist.

October 2015 v.2 A - 58

PEGINTERFERON ALFA-2A (PEGASYS) 180mcg/0.5mL pre-filled syringe and ProClick Autoinjector Requests will be considered for the treatment of: • Chronic hepatitis C (HCV RNA positive) for patients who cannot tolerate ribavirin.

- Initial coverage of 24 weeks will be approved for all patients. Coverage for an additional 24 weeks will be approved for patients with HCV genotype 1.

- A positive HCV RNA assay after 24 weeks of therapy is an indication to stop treatment. • HBeAg negative chronic hepatitis B patients with compensated liver disease, liver inflammation and evidence of

viral replication with demonstrated intolerance or failure to lamivudine therapy. - Maximum duration of coverage will be 48 weeks.

Claim Note: • Requests will be considered from internal medicine specialists. PEGINTERFERON ALFA-2A AND RIBAVIRIN (PEGASYS RBV) 180mcg injection and 200mg tablet (pre-filled syringe and ProClick Autoinjector) 1. For the treatment of peginterferon and ribavirin treatment-naïve chronic hepatitis C (HCV RNA positive) patients.

Clinical Note: • A positive HCV RNA assay after 24 weeks of therapy is an indication to stop treatment. Claim Notes: • Initial coverage of 24 weeks will be approved for all patients. Coverage for an additional 24 weeks will be

approved for patients with HCV genotypes other than 2 and 3. • Requests will be considered from internal medicine specialists

2. For the treatment of patients with chronic hepatitis C genotype 1 infection (HCV RNA positive) in combination with

boceprevir or telaprevir. Claim Notes: • Coverage will be approved for up to a total of 48 weeks in combination with boceprevir or telaprevir. • Requests will be considered from internal medicine specialists

PEGINTERFERON ALFA-2B AND RIBAVIRIN (PEGETRON and PEGETRON CLEARCLICK) 50mcg injection and 200mg capsule, 80mcg injection and 200mg capsule 100mcg injection and 200mg capsule, 120mcg injection and 200mg capsule 150mcg injection and 200mg capsule 1. For the treatment of peginterferon and ribavirin treatment-naïve chronic hepatitis C (HCV RNA positive) patients.

Clinical Note: • A positive HCV RNA assay after 24 weeks of therapy is an indication to stop treatment.

Claim Notes: • Initial coverage of 24 weeks will be approved for all patients. Coverage for an additional 24 weeks will be

approved for patients with HCV genotypes other than 2 and 3. • Requests will be considered from internal medicine specialists

2. For the treatment of patients with chronic hepatitis C genotype 1 infection (HCV RNA positive) in combination

with boceprevir or telaprevir.

Claim Notes: • Coverage will be approved for up to a total of 48 weeks in combination with boceprevir or telaprevir. • Requests will be considered from internal medicine specialists

PERAMPANEL (FYCOMPA) 2mg, 4mg, 6mg, 8mg, 10mg, 12mg tablets For the adjunctive treatment of refractory partial-onset seizures in patients who meet all of the following criteria: • are under the care of a physician experienced in the treatment of epilepsy,


AND • in whom less costly antiepileptic drugs* are ineffective or not appropriate.

October 2015 v.2 A - 59

Clinical Notes: • The combination of lacosamide (Vimpat) and perampanel (Fycompa) will not be reimbursed. • *Less costly antiepileptic drugs may include the following: carbamazepine, gabapentin, lamotrigine, phenytoin,

topiramate, vigabatrin. PILOCARPINE (SALAGEN and generic brand) 5mg tablet • For the treatment of the symptoms of xerostomia (dry mouth) due to salivary gland hypofunction caused by

radiotherapy for cancer of the head and neck. • For the treatment of the symptoms of xerostomia (dry mouth) and xerophthalmia (dry eyes) in patients with

Sjögren's syndrome. PIOGLITAZONE (ACTOS and generic brands) 15mg, 30mg and 45mg tablets For patients with type 2 diabetes who are not adequately controlled by diet, exercise and drug therapy. Drug therapy should include a trial of a sulfonylurea and metformin, alone and in combination, unless one of these agents is not tolerated or is contraindicated. PIRFENIDONE (ESBRIET) 267mg capsule Initial approval criteria: Adult patients who have a diagnosis of mild to moderate idiopathic pulmonary fibrosis (IPF)* confirmed by a respirologist and a high-resolution CT scan within the previous 24 months. *Mild-moderate IPF is defined as: a FVC between 50-80% predicted, and a Percent Carbon Monoxide Diffusing Capacity (%DLCO) between 30-90% predicted.

Initial renewal criteria: Patients must NOT demonstrate progression of disease defined as an absolute decline in percent predicted FVC of ≥10% from initiation of therapy until renewal (initial 6 month treatment period).If a patient has experienced progression as defined above, then the results should be validated with a confirmatory pulmonary function test conducted 4 weeks later. Second renewal (12 months after initiation of therapy): Patients must NOT demonstrate progression of disease defined as an absolute decline in percent predicted FVC of ≥10% since initiation of therapy (baseline). If a patient has experienced progression as defined above, then the results should be validated with a confirmatory pulmonary function test conducted 4 weeks later.

Claim Notes: • Initial approval period: 7 months (allow 4 weeks for repeat pulmonary function tests) • Renewal Approval period: 6 months • Second renewal approval period: 12 months PLERIXAFOR (MOZOBIL) 24mg/1.2mL solution for injection For use in combination with filgrastim to mobilize hematopoietic stem cells for subsequent autologous transplantation in patients with Non-Hodgkin’s lymphoma (NHL) or multiple myeloma (MM) if one of the following criteria are met: • A PBCD34+ count of < 10 cells/uL after 4 days of filgrastim;

OR • Less than 50% of the target CD34 yield is achieved on the 1st day of apheresis (after being mobilized with

filgrastim alone or following chemotherapy); OR

• If a patient has failed a previous stem cell mobilization with filgrastim alone or following chemotherapy.

Claim Note: • Reimbursement is limited to a maximum of 4 doses (0.24mg/kg given daily) for a single mobilization attempt and

to prescriptions written by an oncologist or hematologist. POMALIDOMIDE (POMALYST) 1mg, 2mg, 3mg and 4mg capsules For the treatment of patients with relapsed and/or refractory multiple myeloma who: • Have previously failed at least two treatments including both bortezomib and lenalidomide, and • Demonstrated disease progression on the last treatment.

October 2015 v.2 A - 60

Clinical Note: • Requests for pomalidomide will be considered in rare instances where bortezomib is contraindicated or when

patients are intolerant to it; however, in all cases patients should have failed lenalidomide which they may have received in the maintenance setting.


transactions as outlined here. PRASUGREL HYDROCHLORIDE (EFFIENT) 10mg tablet In combination with ASA for patients with: • ST-elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) who

have not received antiplatelet therapy prior to arrival in the catheterization lab. Treatment must be initiated in hospital.

OR • Acute coronary syndrome who failed on optimal clopidogrel and ASA therapy as defined by definite stent

thrombosis1, or recurrent STEMI, or NSTEMI or UA after prior revascularization via PCI. Clinical Notes: 1. Definite stent thrombosis, according to the Academic Research Consortium, is a total occlusion originating in or

within 5 mm of the stent or is a visible thrombus within the stent or is within 5 mm of the stent in the presence of an acute ischemic clinical syndrome within 48 hours. Definite stent thrombosis must be confirmed by angiography or by pathologic evidence of acute thrombosis.

2. As per the product monograph, prasugrel is contraindicated in patients with a known history of transient ischemic attack or stroke; those with active pathological bleeding such as gastrointestinal bleeding or intracranial hemorrhage; and those with severe hepatic impairment (Child-Pugh Class C).

3. As per the product monograph, prasugrel is not recommended in patients ≥ 75 years of age because of the increase risk of fatal and intracranial bleeding; or those with body weight < 60 kg because of increased risk of major bleeding due to an increase in exposure to the active metabolite of prasugrel.

Claim Notes: • Approval will be for a maximum of 12 months. • Prescriptions written by invasive (interventional) cardiologists do not require special authorization. PREGABALIN (LYRICA and generic brands) 25mg, 50mg, 75mg, 150mg, 225mg and 300mg capsules For the treatment of neuropathic pain (e.g. diabetic peripheral neuropathy, postherpetic neuralgia) in patients who have failed a trial of a tricyclic antidepressant (e.g. amitriptyline, desipramine, imipramine, nortriptyline).


October 2015 v.2 A - 61

PROTON PUMP INHIBITORS (Lansoprazole, Pantoprazole Sodium)

QUINAGOLIDE (NORPROLAC) 0.075mg, 0.15mg tablets For the treatment of patients with hyperprolactinemia who have failed or are intolerant to bromocriptine. RALOXIFENE (EVISTA and generic brands) 60mg tablet

See criteria under Osteoporosis Drugs. RANIBIZUMAB (LUCENTIS) 10mg/mL solution for intravitreal injection 1. Neovascular (wet) age-related macular degeneration (AMD)

Initial Coverage: For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD) where all of the following apply to the eye to be treated: • Best Corrected Visual Acuity (BCVA) is between 6/12 and 6/96 • The lesion size is less than or equal to 12 disc areas in greatest linear dimension • There is evidence of recent (< 3 months) presumed disease progression (blood vessel growth, as indicated by

fluorescein angiography, or optical coherence tomography (OCT) • Administration is to be done by a qualified ophthalmologist experienced in intravitreal injections. • The interval between doses should not be shorter than 1 month.

Continued Coverage: Treatment with ranibizumab should be continued only in people who maintain adequate response to therapy.

Lansoprazole 15mg & 30mg capsules and Pantoprazole Sodium 20mg & 40mg tablets

Requests for lansoprazole and pantoprazole sodium will be considered for patients in whom there has been a therapeutic failure with regular benefit PPIs (e.g. rabeprazole, omeprazole).

Approval Periods

Requests for lansoprazole and pantoprazole sodium, meeting criteria above, will be considered for the following maximum approval periods:

Indication and Diagnostic Information Maximum Approval Period

1 Symptomatic GERD or other reflux-associated indications (i.e. non-cardiac chest pain)

Considered for short-term (8-12 week) approval

2 Erosive/ulcerative esophagitis or Barrett’s esophagus Considered for long term approval

3 Zollinger-Ellison Syndrome

Considered for long-term approval

4 Gastric/duodenal ulcers in individuals who are H. pylori negative or having uninvestigated peptic ulcer disease (PUD)

Considered for up to 12 weeks

5 H. pylori positive patients with PUD H. pylori regimens containing lansoprazole or pantoprazole sodium will be reimbursed only under special authorization.

6 Gastro-duodenal protection (ulcer prophylaxis) for high risk patients (e.g. high risk NSAID users)

Considered for one year with reassessment

October 2015 v.2 A - 62

Clinical Notes: 1. Coverage will not be approved for patients:

- With permanent retinal damage as defined by the Royal College of Ophthalmology guidelines - Receiving concurrent treatment with verteporfin.

2. Ranibizumab should be permanently discontinued if any one of the following occurs: • Reduction in BCVA in the treated eye to less than 15 letters (absolute) on 2 consecutive visits in the

treated eye, attributed to AMD in the absence of other pathology • Reductions in BCVA of 30 letters or more compared to either baseline and/or best recorded level since

baseline as this may indicate either poor treatment effect, adverse events or both. • There is evidence of deterioration of the lesion morphology despite optimum treatment over 3 consecutive

visits. Claim Notes: • An initial claim of up to two vials of ranibizumab (one vial per eye treated) will be automatically reimbursed

when prescribed by an ophthalmologist. If additional medication is required, a request should be made through special authorization.

• The NBPDP will limit reimbursement to a maximum of 1 vial of ranibizumab per eye treated every 30 days. Claims submitted for greater than 1 vial, or submitted within 30 days of a previous claim will not be reimbursed.

• Please refer to Quantities for Claims Submissions for the correct unit of measure. 2. Diabetic macular edema (DME)

Initial coverage: For the treatment of visual impairment due to diabetic macular edema (DME) in patients who meet all of the following criteria: • clinically significant centre-involving macular edema for whom laser photocoagulation is also indicated • hemoglobin A1c test in the past 6 months with a value of less than or equal to 11% • best corrected visual acuity of 20/32 to 20/400 • central retinal thickness greater than or equal to 250 micrometers Renewal Criteria: • confirm that a hemoglobin A1c test in the past 6 months had a value of less than or equal to 11% • date of last visit and results of best corrected visual acuity at that visit • date of last OCT and central retinal thickness on that examination • if ranibizumab is being administered monthly, please provide details on the rationale Clinical Notes: • Treatment should be given monthly until maximum visual acuity is achieved (i.e. stable visual acuity for three

consecutive months while on ranibizumab). Thereafter, the patient's visual acuity should be monitored monthly. Treatment should be resumed when monitoring indicates a loss of visual acuity due to DME until stable visual acuity is reached again for three consecutive months.

Claim Notes: • Approval Period: 1 year • Please refer to Quantities for Claims Submissionsfor the correct unit of measure.

REGORAFENIB (STIVARGA) 150mg tablet For the treatment of patients with metastatic and/or unresectable gastrointestinal stromal tumors (GIST) who have had disease progression on, or intolerance to, imatinib and sunitinib, and who have an ECOG performance status of 0 or 1. Renewal Criteria: • Written confirmation that the patient continues to benefit from therapy. Clinical Note: • Recommended dose: 160mg once daily (3 weeks on, 1 week off).

Claim Notes: • Initial approval duration: 6 months • Renewal approval duration: 6 months REPAGLINIDE (GLUCONORM and generic brands) 0.5mg, 1mg and 2mg tablets For patients with type 2 diabetes who are not adequately controlled by diet and exercise and glyburide and/or metformin or who have frequent or severe hypoglycemic episodes despite dosage adjustment of glyburide.



October 2015 v.2 A - 63

RIBAVIRIN (IBAVYR) 400mg and 600mg tablets For use in combination with other drugs for the treatment of chronic hepatitis C. The applicable criteria for the combination regimen must be met. RIFABUTIN (MYCOBUTIN) 150mg tablet Requests will be considered for the prophylaxis of disseminated Mycobacterium avium complex (MAC) disease in the following patients: • HIV infected patients with an AIDS defining diagnosis and CD4+ cell count less than or equal to 200/mm3. • HIV positive patients without an AIDS defining diagnosis and CD4+ cell count less than or equal to 100/mm3. RILUZOLE (RILUTEK and generic brands) 50mg tablet For the treatment of amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s Disease, when initiated by a physician with expertise in the management of ALS in patients who have: • A probable or definite diagnosis of ALS as defined by the World Federation of Neurology criteria. • ALS symptoms for less than five years. • FVC > 60 % predicted upon initiation of therapy. • No tracheostomy for invasive ventilation Clinical Note: • Coverage cannot be renewed once the patient has a tracheostomy for the purpose of invasive ventilation. Claim Note: • Requests will be approved for a maximum of six months coverage. RIOCIGUAT (ADEMPAS) 0.5mg, 1mg, 1.5mg, 2mg, and 2.5mg film-coated tablets For the treatment of inoperable chronic thromboembolic pulmonary hypertension (CTEPH) World Health Organization [WHO] Group 4) or persistent or recurrent CTEPH after surgical treatment in adult patients (18 years of age or older) with WHO Functional Class II or III pulmonary hypertension. Clinical Note: • Requests will be considered from physicians with experience in the diagnosis and treatment of CTEPH. Claim Note: • Approval duration: 1 year RISEDRONATE (ACTONEL and generic brand) 30mg tablet For the treatment of Paget’s disease. RISPERIDONE (RISPERDAL M and generic brands) 0.5mg, 1mg, 2mg, 3mg and 4mg oral disintegrating tablets 1. For the treatment of schizophrenia and related psychotic disorders. 2. For use in severe dementia for the short-term symptomatic management of inappropriate behaviour due to

aggression and/or psychosis. 3. For the acute management of manic episodes associated with Bipolar 1 disorder. Clinical Note: • Requests will be considered for patients who have difficulty swallowing oral tablets. Claim Note: • Prescriptions written by New Brunswick psychiatrists do not require special authorization. Subsequent refills

ordered by other practitioners will not require special authorization.

October 2015 v.2 A - 64

RISPERIDONE (RISPERDAL CONSTA) Prolonged release suspension for injection 12.5mg, 25mg, 37.5mg and 50mg vials For the treatment of schizophrenia in patients: • for whom compliance with an oral antipsychotic presents problems,

OR • who are currently receiving a typical depot antipsychotic and experiencing significant side effects (EPS or TD) or

lack of efficacy RITUXIMAB (RITUXAN) 10mg/mL injection 1. Rheumatoid Arthritis

• For the treatment of adult patients with severe active rheumatoid arthritis who have failed to respond to an adequate trial with an anti-TNF agent.

Clinical Notes: • Rituximab will not be reimbursed concomitantly with anti-TNF agents. • Approval for re-treatment with rituximab will only be considered for patients who have achieved a response,

followed by a subsequent loss of effect and, after an interval of no less than six months from the previous dose.

2. Polyangiitis

• For the induction of remission in patients with severely active granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) who have severe intolerance or other contraindication to cyclophosphamide, or who have failed an adequate trial of cyclophosphamide.

RIVAROXABAN (XARELTO) 10mg film-coated tablet Venous thromboembolism prophylaxis (following total knee or total hip replacement surgery) • For the prophylaxis of venous thromboembolism as an alternative to low molecular weight heparins for total knee

replacement (usual duration up to 14 days) OR total hip replacement surgery (usual duration up to 35 days). Claim Notes: • The maximum dose of rivaroxaban that will be reimbursed is 10 mg daily for up to 30 days during a 6 month

period. • Subsequent requirements for prophylaxis within a 6 month period (i.e. second joint replacement procedure within

the 6 month period) will require Special Authorization. RIVAROXABAN (XARELTO) 15mg and 20mg film-coated tablets Atrial fibrillation For the prevention of stroke and systemic embolism in at-risk patients with non-valvular atrial fibrillation for whom: • Anticoagulation is inadequate following a at least a two month trial on warfarin; or • Warfarin is contraindicated or not possible due to inability to regularly monitor through International Normalized

Ratio (INR) testing (i.e. no access to INR testing services at a laboratory, clinic, pharmacy, and at home). Clinical Notes: • The following patient groups are excluded from coverage for rivaroxaban for atrial fibrillation:

- Patients with impaired renal function (creatinine clearance or estimated glomerular filtration rate <30 mL/min) - Patients 75 years of age or older without documented stable renal function - Patients with hemodynamically significant rheumatic valvular heart disease, especially mitral stenosis - Patients with prosthetic heart valves.

• At-risk patients with atrial fibrillation are defined as those with a CHADS2 score of ≥ 1. Although the ROCKET-AF trial included patients with higher CHADS2 scores (≥ 2), other landmark studies with the other newer oral anticoagulants demonstrated a therapeutic benefit in patients with a CHADS2 score of 1. Prescribers may consider an antiplatelet regimen or oral anticoagulation for patients with a CHADS2 score of 1.

• Inadequate anticoagulation is defined as INR testing results that are outside the desired INR range for at least 35% of the tests during the monitoring period (i.e., adequate anticoagulation is defined as INR test results that are within the desired INR range for at least 65% of the tests during the monitoring period).

• Since renal impairment can increase bleeding risk, renal function should be regularly monitored. Other factors that increase bleeding risk should also be assessed and monitored (see rivaroxaban product monograph).

• Documented stable renal function is defined as creatinine clearance or estimated glomerular filtration rate that is maintained for at least 3 months (i.e. 30-49 mL/min for 15 mg once daily dosing or ≥ 50 mL/min for 20 mg once daily dosing).

October 2015 v.2 A - 65

• There is currently no data to support that rivaroxaban provides adequate anticoagulation in patients with rheumatic valvular disease or those with prosthetic heart valves, rivaroxaban is not recommended in these populations.

• Patients starting rivaroxaban should have ready access to appropriate medical services to manage a major bleeding event.

Venous thromboembolic events (VTE) treatment For the treatment of VTE (deep vein thrombosis (DVT) or pulmonary embolism (PE)). Clinical Notes: • The recommended dose of rivaroxaban for patients initiating DVT or PE treatment is 15mg twice daily for 3

weeks, followed by 20mg once daily. • Drug plan coverage for rivaroxaban is an alternative to heparin/warfarin for up to 6 months. When used for

greater than 6 months, rivaroxaban is more costly than heparin/warfarin. As such, patients with an intended duration of therapy greater than 6 months should be considered for initiation on heparin/warfarin.

• Since renal impairment can increase bleeding risk, it is important to monitor renal function regularly. Other factors that increase bleeding risks should also be assessed and monitored (see product monograph).

Claim Note: • Approval Period: Up to 6 months RIVASTIGMINE (EXELON and generic brands) 1.5mg, 3mg, 4.5mg and 6mg capsules 2mg/mL oral liquid See criteria under Cholinesterase Inhibitors. RIZATRIPTAN (MAXALT and generic brands) 5mg and 10mg tablets RIZATRIPTAN (MAXALT RPD and generic brands) 5mg and 10mg oral disintegrating tablets • For the treatment of migraine1 headache when:



Clinical Notes: • 1As diagnosed based on current Canadian guidelines. • 2 Definitions:


Claim Notes: • A maximum of 72 tablets will be reimbursed annually without special authorization. If additional medication is

required within the year, a request should be made through special authorization. • Patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a

maximum of 12 doses / 30 days. RUFINAMIDE (BANZEL) 100mg, 200mg and 400mg tablets For the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome for patients who meet all of the following criteria: • are under the care of a physician experienced in treating Lennox-Gastaut syndrome-associated seizures,


AND • in whom less costly antiepileptic drugs are ineffective or not appropriate. RUXOLITINIB (JAKAVI) 5mg, 15mg, 20mg tablets For patients with intermediate to high risk symptomatic Myelofibrosis (MF) as assessed using the Dynamic International Prognostic Scoring System (DIPSS) Plus or patients with symptomatic splenomegaly. Patients should have ECOG performance status ≤3 and be either previously untreated or refractory to other treatment.

October 2015 v.2 A - 66

SALMETEROL/FLUTICASONE (ADVAIR) 50/100mcg, 50/250mcg and 50/500mcg discus 25/125mcg and 25/250mcg metered dose inhalers Reversible Obstructive Airway Disease • For patients with reversible obstructive airways disease who are:

- Stabilized on an inhaled corticosteroid and a long-acting beta2-adrenergic agonist, OR

- Using optimal doses of inhaled corticosteroids but are still poorly controlled.

Chronic Obstructive Pulmonary Disease • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of









COPD Stage Symptoms



SALMETEROL XINAFOATE (SEREVENT) 50mcg diskus and diskhaler Reversible Obstructive Airway Disease: • For the treatment of patients, 12 years of age or older, with reversible obstructive airway disease who are using









October 2015 v.2 A - 67


COPD Stage Symptoms




refills ordered by other practitioners will not require special authorization. SAXAGLIPTIN (ONGLYZA) 2.5mg and 5mg tablets For the treatment of type 2 diabetes mellitus, in addition to metformin and a sulfonylurea, in patients with inadequate glycemic control on metformin and a sulfonylurea and for whom insulin is not an option. SEVELAMER (RENAGEL) 800mg tablet Treatment of severe renal failure, where a calcium salt is contraindicated or not tolerated or when a phosphate binder is needed in association with a calcium salt, where a calcium salt alone does not produce optimal control of the hyperphosphatemia. Claim Note: • The prescription must be initiated by a nephrologist. SILDENAFIL CITRATE (REVATIO and generic brands) 20mg tablet • For the treatment of patients with World Health Organization (WHO) functional class III idiopathic pulmonary

arterial hypertension (IPAH) who do not demonstrate vasoreactivity on testing or who do demonstrate vasoreactivity on testing but fail a trial of calcium channel blockers.

• For the treatment of patients with World Health Organization (WHO) functional class III pulmonary arterial hypertension (PAH) associated with connective tissue diseases who do not respond to conventional therapy.

• Diagnosis of PAH should be confirmed by cardiac catheterization. Claim Note: • The maximum dose of sildenafil that will be reimbursed is 20mg three times daily. SIMEPREVIR (GALEXOS) 150mg capsule For the treatment of chronic hepatitis C genotype 1 infection in patients with compensated liver disease, in combination with peginterferon alpha and ribavirin, if the following criteria are met: • Detectable levels of hepatitis C virus (HCV) RNA in the last six months. • Fibrosis stage of F2, F3 or F4 (Metavir score or equivalent). Exclusion Criteria: • Patients with the NS3 Q80K polymorphism should not be treated with simeprevir. • Patients who have received a prior full therapeutic course of boceprevir or telaprevir in combination with

peginterferon alpha and ribavirin and did not receive an adequate response. • Decompensated liver disease. • Patients less than 18 years old. • Patients who have had prior organ transplant including liver transplant. • Simeprevir in combination with sofosbuvir. Clinical Notes: 1. Recommended dose is 150mg once daily in combination with peginterferon alpha and ribavirin.

October 2015 v.2 A - 68

2. Duration of treatment is to be determined using Response-Guided Therapy.

3. Discontinuation of treatment is recommended in patients with inadequate on-treatment virologic response since it

is unlikely that they will achieve a sustained virologic response and may develop treatment-emergent resistance.

HCV RNA Action

Treatment Week 4: ≥25 IU/mL Discontinue simeprevir, peginterferon alfa and ribavirin

Treatment Week 12: detectable Discontinue peginterferon alfa and ribavirin (treatment with simeprevir is complete at Week 12)

Treatment Week 24: detectable Discontinue peginterferon alfa and ribavirin

Please refer to the product monograph for full prescribing information.

Claim Notes: • Only one course of treatment (for up to 12 weeks duration) will be approved. • Renewals will not be considered. • Requests will be considered for individuals enrolled in Plans ADEFGV. • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. SITAGLIPTIN (JANUVIA) 25mg, 50mg and 100mg tablets SITAGLIPTIN / METFORMIN (JANUMET) 50mg/500mg, 50mg/850mg and 50mg/1000mg tablets SITAGLIPTIN / METFORMIN (JANUMET XR) 50mg/1000mg tablets extended release tablet For the treatment of Type 2 diabetes mellitus in patients for whom NPH insulin is not an option and: • Who have inadequate glycemic control while on optimal doses of metformin and a sulfonylurea when added as a

third agent; OR

• In combination with metformin when a sulfonylurea is not suitable due to contraindications or intolerance; OR

• As monotherapy when metformin and sulfonylurea are not suitable due to contraindications or intolerance SODIUM FERRIC GLUCONATE COMPLEX (FERRLECIT) 12.5mg/mL injection For the treatment of iron deficiency anemia in patients who • are intolerant to oral iron replacement products,

OR • have not responded to adequate therapy with oral iron.

Patient Group HCV RNA at Week 4

Triple Therapy Simeprevir,

Peginterferon alfa and Ribavirin

Dual Therapy Peginterferon alfa

and Ribavirin

Total Treatment Duration

Treatment-Naïve and Prior Relapsers

Undetectable First 12 weeks Additional 12 weeks 24 weeks

<25 IU/mL detectable First 12 weeks Additional 36 weeks 48 weeks

Prior Non-Responders (Including Partial and Null Responder)

Undetectable or <25 IU/mL

detectable First 12 weeks Additional 36 weeks 48 weeks


October 2015 v.2 A - 69

SOFOSBUVIR (SOVALDI) 400mg tablet For the treatment of adult patients 18 years of age or older with chronic hepatitis C infection with compensated liver disease (including compensated cirrhosis) as follows:

Approval Period and Regimen

Genotype 1: • Treatment-naive patients

12 weeks of sofosbuvir in combination with PegIFN/RBV

Genotype 2: • Treatment-naïve patients in whom interferon

(IFN) is medically contraindicated, or • Peginterferon / ribavirin (PegIFN/RBV)

treatment-experienced patients

12 weeks of sofosbuvir in combination with RBV

Genotype 3: • Treatment-naïve patients in whom IFN is

medically contraindicated, or • PegIFN/RBV treatment-experienced patients

24 weeks of sofosbuvir in combination with RBV

Patients must also meet ALL of the following: • Prescribed by a hepatologist, gastroenterologist, or an infectious disease specialist (or other physician

experienced in treating hepatitis C). • Lab-confirmed hepatitis C genotype 1, 2 or 3. • Patient has a quantitative HCV RNA value within the last 6 months. • Fibrosis stage F2 or greater (Metavir scale or equivalent). Exclusion Criteria: • Patients currently being treated with another HCV antiviral agent. • Patients who have previously received a treatment course of sofosbuvir (re-treatment requests will not be

considered). Clinical Notes: • Compensated cirrhosis is defined as cirrhosis with a Child Pugh Score = A (5-6). • Medical contraindication to interferon is defined as hypersensitivity to peginterferon or interferon alfa-2a or 2b,

polyethylene glycol or any component of the formulation resulting in discontinuation of therapy; or presence of significant clinical comorbidities which are deemed to have a high risk of worsening with interferon treatment. Details are required regarding a patient’s contraindications and/or risk of worsening significant comorbidities.

• Genotype 2 or 3 treatment-experienced patients are patients who have previously been treated with PegIFN/RBV and did not receive adequate response.

• HIV / HCV co-infected patients may be considered as per criteria listed above. Claim Notes: • Requests will be considered for individuals enrolled in Plans ADEFGV. • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. SOFOSBUVIR / LEDIPASVIR (HARVONI) 400mg / 90mg tablet For the treatment of chronic hepatitis C genotype 1 infection in adult patients. Genotype 1 Approval Period

Treatment naïve patients with no cirrhosis, viral load < 6 million IU/mL 8 weeks

Treatment naïve patients with no cirrhosis, viral load ≥ 6 million IU/mL or Treatment naïve patients with compensated cirrhosis or Treatment-experienced patients with no cirrhosis

12 weeks

Treatment-experienced patients with compensated cirrhosis 24 weeks


October 2015 v.2 A - 70

Patients must also meet all of the following criteria: 1. Prescribed by a hepatologist, gastroenterologist or an infectious disease specialist (or other physician

experienced in treating hepatitis C) 2. Lab-confirmed hepatitis C genotype 1 3. Patient has a quantitative HCV RNA value within the last 6 months 4. Fibrosis stage F2 or greater (Metavir scale or equivalent)

Exclusion Criteria: • Patients currently being treated with another HCV antiviral agent. • Patients who have previously received a treatment course of ledipasvir/sofosbuvir (re-treatment requests will not

be considered). Clinical notes: 1. For treatment naïve patients with no cirrhosis, viral load < 6 million IU/mL, evidence has shown that the SVR

rates with the 8-week and 12-week treatment regimens are similar. Treatment regimens of up to 12 weeks are recognized as a Health Canada approved treatment option. Patients with severe fibrosis/borderline cirrhosis (F3-4) or HIV/HCV co-infected patients may be considered for 12 weeks coverage.

2. Compensated cirrhosis is defined as cirrhosis with a Child Pugh Score = A (5-6) 3. Treatment-experienced patients are patients who have previously been treated with peginterferon / ribavirin

(PegIFN/RBV) regimen, including regimens containing HCV protease inhibitors and did not receive adequate response.

4. HIV-HCV co-infected patients may be considered as per criteria listed above.

Claim notes: • Requests will be considered for individuals enrolled in Plans ADEFGV. • Claims that exceed the maximum claim amount of $9,999.99 must be divided and submitted as separate

transactions as outlined here. SOLIFENACIN (VESICARE) 5mg and 10mg tablets For the treatment of overactive bladder with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: • Requests for the treatment of stress incontinence will not be considered. Claim Note: • If the patient has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize

this information and the claim for solifenacin will be automatically reimbursed without the need for a written special authorization request.

SOMATROPIN (GENOTROPIN) 0.6mg, 0.8mg, 1mg, 1.2mg, 1.4mg, 1.6mg, 1.8mg, 2mg MiniQuick® pre-filled syringes 5.3mg, 12mg GoQuick® pre-filled pens 1. Growth Hormone Deficiency in Children

For the treatment of growth hormone deficiency in children under the age of 18.

Claim Notes: • Must be prescribed by, or in consultation with, an endocrinologist. • Somatropin is a regular benefit for Plan T

2. Turner Syndrome

For the treatment of short stature associated with Turner Syndrome in patients whose epiphyses are not closed.

Claim Note: • Must be prescribed by, or in consultation with, an endocrinologist.

SOMATROPIN (HUMATROPE) 1mg, 6mg, 12mg and 24mg/vial injection 1. Growth Hormone Deficiency in Children


Claim Notes: • Must be prescribed by, or in consultation with, an endocrinologist. • Somatropin is a regular benefit for Plan T.


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2. Turner Syndrome For the treatment of short stature associated with Turner Syndrome in patients whose epiphyses are not closed.


SOMATROPIN (NUTROPIN AQ Pen Cartridge) 10mg/2mL pen cartridge SOMATROPIN (NUTROPIN AQ NuSpin) 5mg/2mL, 10mg/2mL, and 20mg/2mL cartridges SOMATROPIN (SAIZEN) 3.33mg, 5mg and 8.8mg/vial injections 6mg, 12mg and 20mg cartridges 1. Growth Hormone Deficiency in Children


Claim Notes: • Must be prescribed by, or in consultation with, an endocrinologist. • Somatropin is a regular benefit for Plan T.

2. Turner Syndrome

For the treatment of short stature associated with Turner Syndrome in patients whose epiphyses are not closed.


3. Chronic Renal Insufficiency

For the treatment of children with growth failure associated with chronic renal insufficiency, up to the time of renal transplantation, who meet the following criteria: • A glomerular filtration rate less than or equal to 1.25 mL/s/1.73m² (75 mL/min/1.73m²) • Evidence of growth impairment:

- Z score (HSDS) less than -1.88 (HSDS = height standard deviation score, a statistical comparison to the average of normal values for age and sex) or height-for-age at the 3rd percentile

OR - Height velocity-for-age SDS less than -1.88 or height velocity-for-age less than 3rd percentile, persisting

for greater than 3 months despite treatment of nutritional deficiencies and metabolic abnormalities.

Claim Note: • Somatropin must be prescribed by, or in consultation with, a specialist in pediatric nephrology.

SOMATROPIN (OMNITROPE) 3.33mg and 6.7mg/cartridges For the treatment of growth hormone deficiency in children under the age of 18. Claim Notes: • Must be prescribed by, or in consultation with, an endocrinologist. • Somatropin is a regular benefit for Plan T. SORAFENIB (NEXAVAR) 200mg tablet Metastatic Renal Cell Carcinoma (MRCC) As second-line therapy for patients with histologically confirmed metastatic clear cell renal cell carcinoma, who: • have disease progression after prior cytokine therapy (e.g. interferon; aldesleukin) within the previous 8 months;

AND • have a performance status of 0 or 1 on the basis of the Eastern Cooperative Oncology Group (ECOG) criteria†;

AND • have a favourable or intermediate risk status, according to the Memorial Sloan-Kettering Cancer Center (MSKCC)

prognostic score. Renewal criteria: • Written confirmation that the patient has benefited from therapy and is expected to continue to do so. Clinical Note: • † Patients who are asymptomatic and those who are symptomatic but completely ambulant.

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Claim Notes: • Initial approval period: 1 year. • Renewal period: 1 year. Advanced Hepatocellular Carcinoma (HCC) For patients with Child-Pugh Class A* who have: • A performance status of 0,1, or 2†

on the basis of the Eastern Cooperative Oncology Group (ECOG) criteria; AND

• Either progressed on trans-arterial chemoembolization (TACE) or not suitable for the TACE procedure. • Coverage may be renewed for patients with documentation of radiography and/or scan results indicating no

progression Clinical Notes: 1. Sorafenib will not be reimbursed if used with induction or adjuvant intent along with other curative-intent

treatments; for maintenance therapy after trans-arterial chemoembolization; or if patients have Child-Pugh B or Child-Pugh C cirrhosis.

2. *A Child-Pugh score of 5-6 is considered class A (well-compensated disease); 7-9 is class B (significant functional compromise); and 10-15 is class C (decompensated disease).

3. † Patients who are asymptomatic and those who are symptomatic and in bed less than 50% of the time. 4. The Memorial Sloan-Kettering Cancer Center (MSKCC) Prognostic Score categorizes patients into three risk

groups according to the number of pre-treatment risk factors present: Favourable = none; Intermediate = one or two; Poor = three or more. Pre-treatment risk factors: - Low Karnofsky performance status (<80%) - Lactate Dehydrogenase level greater than 1.5 times the upper limit of normal - Hemoglobin level below the lower limit of normal - High corrected serum calcium level (>10 mg/dL or 2.5 mmol/L) - Interval of less than 1 year between diagnosis and treatment

Claim Notes: • Initial approval period: 6 months • Approval period for renewal: 1 year SUMATRIPTAN (IMITREX AND IMITREX DF and generic brands) 50mg and 100mg tablets • For the treatment of migraine1 headache when:









SUMATRIPTAN (IMITREX NASAL SPRAY) 5mg and 20mg nasal sprays • For the treatment of migraine1 headache of moderate2 intensity when other therapies (e.g. NSAIDs,


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SUMATRIPTAN (IMITREX INJECTION and generic brand) 6mg injection • For the treatment of migraine1 headache of moderate2 intensity when other therapies (e.g. NSAIDs,

acetaminophen, DHE spray) are not effective AND oral and nasal triptans are not appropriate. • For the treatment of migraine1 headache of severe2 or ultra severe2 intensity when oral and nasal triptans are not

appropriate.






SUNITINIB (SUTENT) 12.5mg, 25mg and 50mg capsules 1. Pancreatic Neuroendocrine Tumors (pNET)

For the treatment of patients with progressive, unresectable, well or moderately differentiated, locally advanced or metastatic pancreatic neuroendocrine tumors (pNET) with an ECOG performance status of 0-2, until disease progression.

2. Gastrointestinal Stromal Tumour (GIST)

For the treatment of patients with c-KIT expressing (CD117+) unresectable or metastatic/recurrent gastrointestinal stromal tumour (GIST) who meet the criteria for imatinib and who have: • Early progression (within 6 months) while on imatinib; • Progression following treatment with optimum (escalated) doses of imatinib;

OR • Intolerance to imatinib

Clinical Notes: • Response to sunitinib therapy should be assessed at least every six months and therapy should be

discontinued when there is objective evidence of disease progression • Sunitinib will not be reimbursed concomitantly with imatinib Claim Note: • The dose reimbursed will be 50mg per day (4 weeks on, 2 weeks off)

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3. Metastatic Renal Cell Carcinoma (MRCC) For patients with histologically confirmed metastatic renal cell carcinoma (MRCC), who require: • First-line therapy for the treatment of MRCC, and the patient is either a favourable or intermediate risk

according to the Memorial Sloan-Kettering Cancer Center (MSKCC) prognostic score* OR

• Second-line therapy for the treatment of MRCC, provided that disease progression has occurred after prior cytokine therapy (e.g. interferon; aldesleukin).

Renewal criteria: • Written confirmation that the patient has benefited from therapy and is expected to continue to do so.

Clinical Notes: • The Memorial Sloan-Kettering Cancer Center (MSKCC) Prognostic Score categorizes patients into three risk

groups according to the number of pre-treatment risk factors present: Favourable = none; Intermediate = one or two; Poor = three or more. Pre-treatment risk factors: - Low Karnofsky performance status (<80%) - Lactate Dehydrogenase level greater than 1.5 times the upper limit of normal - Hemoglobin level below the lower limit of normal - High corrected serum calcium level (>10 mg/dL or 2.5 mmol/L) - Interval of less than 1 year between diagnosis and treatment Reference: Motzer RJ, Bacik J, Murphy BA et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol 2002;20;289-96.

Claim Notes: • The prescribed dosage is 50mg daily for four weeks, followed by two weeks off. This dosage is repeated in

six week cycles. • Initial approval period: 1 year • Renewal period: 1 year

TACROLIMUS (PROTOPIC) 0.03% ointment For children over 2 years of age with refractory atopic dermatitis. Claim Note: • Approvals will be given for up to twelve months at a time. TACROLIMUS (PROTOPIC) 0.1% ointment For the treatment of adults with moderate to severe atopic dermatitis who have failed or are intolerant to a site appropriate strength of corticosteroid therapy (i.e. low potency for the face versus intermediate to high potency for the trunk and extremities). TEMOZOLOMIDE (TEMODAL and generic brand) 5mg, 20mg, 100mg, 140mg and 250mg capsules For the treatment of newly diagnosed high grade glioma patients with a good performance status (Karnofsky performance status greater or equal to 60%) when used in combination with radiotherapy or as adjuvant therapy post-radiation up to a maximum of 6 cycles. TENOFOVIR (VIREAD) 300mg tablet • For the treatment of adult patients who have experienced adverse events or virologic failure with nucleoside

reverse transcriptase inhibitors. • For the treatment of chronic hepatitis B infection in patients with cirrhosis documented on radiologic or histologic

grounds and a HBV DNA concentration above 2000 lU/mL. TERBINAFINE HYDROCHLORIDE (LAMISIL and generic brands) 250mg tablet • Treatment of onychomycosis • Treatment of dermatophyte infection unresponsive to other treatments or unlikely to respond to other treatments

due to the site or severity of the infection. Claim Notes: • Approval limits payment for 6 weeks for the treatment of fingernail mycosis. • Approval limits payment for 12 weeks for the treatment of toenail mycosis.

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TERIFLUNOMIDE (AUBAGIO) 14mg film-coated tablet For the treatment of relapsing-remitting multiple sclerosis (RRMS) in patients who meet the following criteria: • Two disabling attacks of MS in the previous two years, and • Ambulatory with or without aid (EDSS of less than or equal to 6.5) Clinical Note: • An attack is defined as the appearance of new symptoms or worsening of old symptoms, lasting at least 24

hours in the absence of fever, and preceded by stability for at least one month. Claim Notes: • Requests will be considered for individuals enrolled in Plans ADEFGV. • Prescriptions written by New Brunswick neurologists do not require special authorization. TESTOSTERONE (ANDRODERM, ANDROGEL, TESTIM) 12.2mg and 24.3mg patches, 2.5g and 5g packets, 1% gel TESTOSTERONE UNDECANDOATE (ANDRIOL and generic brands) 40 mg capsule For the treatment of congenital and acquired primary or secondary hypogonadism in males with a specific diagnosis of: • Primary: cryptorchidism, Klinefelter’s, orchiectomy, and other established causes • Secondary: Pituitary-hypothalamic injury due to tumors, trauma, radiation Testosterone deficiency should be clearly demonstrated by clinical features and confirmed by two separate free testosterone measurements before initiating any replacement therapy Clinical Note: • Older males with non-specific symptoms of fatigue, malaise, or depression who have low testosterone levels do

not satisfy these criteria. THYROTROPIN ALPHA (THYROGEN) 0.9mg/mL injection

1. For on-going evaluation in patients who have documented evidence of thyroid cancer, have undergone

appropriate surgical and/or medical management, and require monitoring for recurrence and metastatic disease. This includes: • The patient has failed to respond to, or relapsed during:

- Primary use in patients with inability to raise an endogenous TSH level (≥ 25 mu/L) with thyroid hormone withdrawal.

- Primary use in patients with one of the following documented comorbidities in whom severe hypothyroidism could be life threatening: unstable angina recent myocardial infarction class III-IV congestive heart failure uncontrolled psychiatric illness other medical condition in which the clinical course could lead to a potential life threatening situation

- Secondary use in patients with previous thyroid hormone withdrawal resulting in a documented life threatening event.

2. As an adjunctive treatment as pre-therapeutic stimulation for radioiodine ablation of thyroid tissue remnants in patients maintained on thyroid hormone suppression therapy who have undergone near-total or total thyroidectomy for well-differentiated thyroid cancer without evidence of distant metastatic thyroid cancer.

TICAGRELOR (BRILINTA) 90mg tablet To be taken in combination with ASA 75mg -150mg dailya for patients with acute coronary syndrome (i.e. ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina (UA), as follows: STEMIb,c

• STEMI patients undergoing primary PCI

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NSTEMI or UAb,c

• Presence of high risk features irrespective of intent to perform revascularization: - High GRACE risk score (>140) - High TIMI risk score (5-7) - Second ACS within 12 months - Complex or extensive coronary artery disease e.g. diffuse three vessel disease - Definite documented cerebrovascular or peripheral vascular disease - Previous CABG

OR • Undergoing PCI + high risk angiographic anatomyd Clinical Notes: 1. a Co-administration of ticagrelor with high maintenance dose ASA (>150mg daily) is not recommended. 2. b In the PLATO study more patients on ticagrelor experienced non CABG related major bleeding than patients on

clopidogrel, however, there was no difference between the rate of overall major bleeding, between patients treated with ticagrelor and those treated with clopidogrel. As with all other antiplatelet treatments the benefit/risk ratio of antithrombotic effect vs. bleeding complications should be evaluated.

3. c Ticagrelor is contraindicated in patients with active pathological bleeding, in those with a history of intracranial hemorrhage and moderate to severe hepatic impairment.

4. d High risk angiographic anatomy is defined as any of the following: left main stenting, high risk bifurcation stenting (i.e., two-stent techniques), long stents ≥ 38 mm or overlapping stents, small stents ≤ 2.5 mm in patients with diabetes.

Claim Notes: • Approval will be for a maximum of 12 months. • Prescriptions written by invasive (interventional) cardiologists do not require special authorization. TINZAPARIN SODIUM (INNOHEP) 10,000IU/mL multidose vials and pre-filled syringes 20,000IU/mL multidose vials and pre-filled syringes See criteria under Low Molecular Weight Heparins TIOTROPIUM (SPIRIVA) 18mcg capsule for inhalation Chronic Obstructive Pulmonary Disease • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of









COPD Stage Symptoms



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TIPRANAVIR (APTIVUS) 250mg capsule For the treatment of adult patients with HIV-1 infection who are treatment experienced, have demonstrated failure to multiple protease inhibitors and in whom no other protease inhibitor is a treatment option. TIZANIDINE (ZANAFLEX and generic brands) 4mg tablet

For the treatment of spasticity caused by traumatic brain injury, multiple sclerosis (MS), spinal cord injury (SCI) or cerebral vascular accident (CVA) in patients in whom baclofen is contraindicated, ineffective or not tolerated. TOBRAMYCIN (TOBI) 300mg/5mL solution for inhalation For the treatment of cystic fibrosis patients who do not tolerate injectable tobramycin when used for inhalation. TOCILIZUMAB (ACTEMRA) 80mg, 200mg and 400mg single dose vials (20mg/mL) Rheumatoid Arthritis For patients with moderate to severe active rheumatoid arthritis who: • Have not responded to an adequate trial of combination therapy of at least two traditional DMARDs (disease-

modifying antirheumatic drugs). Combination DMARD therapy must include methotrexate unless contraindicated or not tolerated,

OR • Are not candidates for combination DMARD therapy, must have had adequate trial of at least three traditional

DMARDs in sequence, one of which must have been methotrexate unless contraindicated AND

• Have had an inadequate response to a tumour necrosis factor (TNF)-alpha antagonist. Clinical Notes: 1. Requests for continuation of therapy must include information demonstrating clinical response. 2. No dose escalation permitted above 8 mg/kg every 4 weeks or a maximum dose of 800 mg per infusion for

individuals whose body weight is more than 100 kg. 3. Will not be reimbursed in combination with other biologic agents. Claim Notes: • Must be prescribed by a rheumatologist. • Initial approval will be for 16 weeks at a dose of 4 mg/kg. Systemic Juvenile Idiopathic Arthritis (sJIA) For the treatment of active systemic juvenile idiopathic arthritis (sJIA), in patients 2 years of age or older, who have responded inadequately to non-steroidal anti-inflammatory drugs (NSAIDs) and systemic corticosteroids (with or without methotrexate) due to intolerance or lack of efficacy. Clinical Notes: 1. Coverage will be approved for a dose of 12 mg/kg for patients weighing less than 30kg or 8 mg/kg for patients

weighing greater than or equal to 30kg to a maximum of 800mg, administered every two weeks. 2. Continued coverage will be dependent on a positive patient response as determined by a pediatric

rheumatologist. Claim Notes: • Must be prescribed by, or in consultation with, a pediatric rheumatologist. • Initial approval period: 16 weeks • Renewal period: 1 year TOLTERODINE (DETROL) 1mg and 2mg tablets For the treatment of overactive bladder with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: • Requests for the treatment of stress incontinence will not be considered. Claim Note: • If the patient has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize

this information and the claim for tolterodine will be automatically reimbursed without the need for a written special authorization request.

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TOLTERODINE (DETROL LA) 2mg and 4mg capsules For the treatment of overactive bladder with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: • Requests for the treatment of stress incontinence will not be considered. TOPIRAMATE (TOPAMAX) 15mg and 25mg sprinkle capsules • For the treatment of refractory epilepsy not well controlled with conventional therapy. • To reduce the frequency of migraine headaches in adult patients who have failed an adequate trial of, or have

contraindications to, beta blockers AND tricyclics for prophylaxis. TRAMETINIB (MEKINIST) 0.5mg and 2mg tablets • As monotherapy for the first line treatment of patients with BRAF V600 mutation-positive unresectable or

metastatic melanoma with ECOG performance status of 0 or 1. If brain metastases are present, patients should be stable.

• As monotherapy for the second line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma for patients who have progressed after receiving chemotherapy treatment in the first line setting with ECOG performance status of 0 or 1. If brain metastases are present, patients should be stable.

Clinical Notes: • Recommended Dose: 2 mg once daily until disease progression or development of unacceptable toxicity requiring

discontinuation of trametinib. • Trametinib will not be reimbursed in patients who have progressed on a prior BRAF therapy. Claim Notes: • Initial approval duration: 6 months • Renewal approval duration: 6 months TREPROSTINIL (REMODULIN) 1mg/mL, 2.5mg/mL, 5mg/mL and 10mg/mL solution For the treatment of patients with primary pulmonary hypertension or pulmonary hypertension secondary to collagen vascular disease, with New York Heart Association class III or IV disease who have both: 1. failed to respond to non-prostanoid therapies

AND 2. who are not candidates for epoprostenol therapy because of:

• prior recurrent complications with central line access (e.g. infection, thrombosis) OR;

• inability to operate the complicated delivery system of epoprostenol OR;

• they reside in an area without ready access to medical care, which could complicate problems associated with an abrupt interruption of epoprostenol.

TRETINOIN (VESANOID) 10mg capsule For the induction of remission in acute promyelocytic leukemia (APL) in previously untreated patients as well as in those who have relapsed after, or were refractory to, standard chemotherapy. TROSPIUM (TROSEC) 20mg tablet For the treatment of overactive bladder with symptoms of urgency, urgency incontinence, and urinary frequency, in patients who have not tolerated a reasonable trial of immediate-release oxybutynin. Clinical Note: • Requests for the treatment of stress incontinence will not be considered. Claim Note: • If the patient has had a claim for oxybutynin in the previous 24 months, the adjudication system will recognize

this information and the claim for trospium will be automatically reimbursed without the need for a written special authorization request.

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URSODIOL (URSO and generic brand) 250mg tablet URSODIOL (URSO DS and generic brand) 500mg tablet For the management of cholestatic liver diseases, such as primary biliary cirrhosis. USTEKINUMAB (STELARA) 45 mg/0.5 mL and 90 mg/1 mL pre-filled syringes For patients with severe, debilitating chronic plaque psoriasis who meet all of the following criteria: • Body surface area (BSA) involvement of >10% and/or significant involvement of the face, hands, feet or genital

region; • Failure to respond to, contraindications to, or intolerant to methotrexate and cyclosporine; • Failure to respond to, intolerant to, or unable to access phototherapy Clinical Notes: 1. Continuation of therapy beyond 16 weeks will be based on response. Patients not responding adequately at

these time points should have treatment discontinued with no further treatment with the same agent recommended

2. An adequate response is defined as either: - ≥75% reduction in Psoriasis Area Severity Index (PASI) score from when treatment started, or - ≥50% reduction in PASI with a ≥5 point improvement in the Dermatology Life Quality Index (DLQI), or - A quantitative reduction in BSA affected with qualitative consideration of specific regions such as the face,

hands, feet or genital region. 3. Concurrent use of >1 biologic will not be approved 4. Approval limited to a dose of 90 mg administered initially at weeks 0, 4 and 16, then 90 mg every 12 weeks

thereafter, up to a year (if response criteria met at 16 weeks). Claim Notes: • Initial approval limited to 16 weeks. • Must be prescribed by a dermatologist VALGANCICLOVIR (VALCYTE and generic brand) 450mg tablet 50mg/mL oral suspension • For the treatment of cytomegalovirus (CMV) retinitis in HIV positive patients on the advice of an infectious

disease specialist. • For the prevention of cytomegalovirus (CMV) disease in solid organ transplant patients at high-risk (i.e. donor

CMV seropositive / recipient seronegative.) • For the treatment of cytomegalovirus (CMV) disease in solid organ transplant patients.

Claim Note: • Coverage will be for a maximum of 100 days post transplant. Requests from specific transplant centres for

longer durations will be considered based on their standard protocols. VARENICLINE (CHAMPIX) 0.5mg and 1mg tablets For smoking cessation treatment in adults 18 years of age and older. Claim Notes: • Maximum of 168 tablets (12 weeks of treatment) will be reimbursed annually. • Individuals who have already completed a full course of treatment with Zyban will not be eligible for

reimbursement of Champix within the same fiscal year. VEMURAFENIB (ZELBORAF) 240mg film-coated tablet • For the first line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma

who have an ECOG status performance of 0 or 1. • For the second line treatment of patients with BRAF V600 mutation-positive unresectable or metastatic

melanoma who have an ECOG performance status of 0 or 1 and did not receive vemurafenib as first line treatment.

Clinical Notes: • Recommended Dose: 960mg twice daily until disease progression or development of unacceptable toxicity

requiring discontinuation of vemurafenib. • Vemrurafenib will not be reimbursed in patients who have progressed on a prior BRAF therapy

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Claim Notes: • Initial approval duration: 6 months • Renewal approval duration: 6 months VIGABATRIN (SABRIL) 500mg tablet and 500mg sachet Requests will be considered for: • The adjunctive management of epilepsy which is not satisfactorily controlled by conventional therapy. • Initial monotherapy for the management of infantile spasms. Claim Note: • The maximum approved dose will be 4g/day

VILANTEROL TRIFENATATE / FLUTICASONE FUROATE (BREO ELLIPTA) 25mcg / 100mcg powder for inhalation Chronic Obstructive Pulmonary Disease: • For the treatment of chronic obstructive pulmonary disease (COPD) if symptoms persist after 2-3 months of











VILANTEROL / UMECLIDINUM BROMIDE (ANORO ELLIPTA) 25mcg/62.5mcg powder for inhalation For the treatment of moderate to severe chronic obstructive pulmonary disease (COPD), as defined by spirometry, in patients with an inadequate response to a long-acting beta-2 agonist (LABA) or long-acting anticholinergic (LAAC). Clinical Notes: • Moderate to severe COPD is defined by spirometry (post-bronchodilator) FEV1 < 60% predicted and FEV1/FVC

ratio of < 0.70. Spirometry reports from any point in time will be accepted. If spirometry cannot be obtained, reasons must be clearly explained and other evidence regarding COPD severity must be provided for consideration (i.e. Medical Research Council (MRC) Dyspnea Scale score of at least Grade 3). MRC Grade 3 is described as: walks slower than people of same age on the level because of shortness of breath (SOB) from COPD or has to stop for breath when walking at own pace on the level.

• Inadequate response is defined as persistent symptoms after at least 2 months of long-acting beta-2 agonist (LABA) or long-acting anticholinergic therapy (LAAC).

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VISMODEGIB (ERIVEDGE) 150mg capsule Initial Requests: • For patients with metastatic basal cell carcinoma (BCC) or with locally advanced BCC (including patients with

basal cell nevus syndrome, i.e. Gorlin syndrome) who have measurable metastatic disease or locally advanced disease, which is considered inoperable or inappropriate for surgery1 AND inappropriate for radiotherapy2

AND • Patient 18 years or age or older;

AND • Patient has ECOG ≤ 2 • Patient preference for oral therapy will not be considered Information Required Physicians must provide rationale for why surgery1 AND radiation2 cannot be considered • The request must include a surgical consultation report that provides a preoperative/surgical evaluation why

surgery is not appropriate for the patient; AND

• A consultation report as to why radiation therapy is not appropriate for the patient • Both of the above evaluations must come from a physician who is not the requesting physician • Confirmation that the patient has been discussed at a multi-disciplinary cancer conference or equivalent (e.g.

Regional Tumour Board). Renewal criteria: • The physician has confirmed that the patient has not experienced disease progression while on Erivedge

therapy. Clinical Notes: • 1Considered inoperable or inappropriate for surgery for one of the following reasons:

- Technically not possible to perform surgery due to size/location/invasiveness of BCC (either lesion too large or can be several small lesions making surgery not feasible)

- Recurrence of BCC after two or more surgical procedures and curative resection unlikely - Substantial deformity and/or morbidity anticipated from surgery

• 2Considered inappropriate for radiation for one of the following reasons: - Contraindication to radiation (e.g. Gorlin syndrome) - Prior radiation to lesion - Suboptimal outcomes expected due to size/location/invasiveness of BCC

• Dose: 150mg orally once daily taken until disease progression or unacceptable toxicity. Claim Notes: • Initial approval duration: 1 year • Renewal approval duration: 1 year VORICONAZOLE (VFEND and generic brands) 50mg and 200mg tablets • For the treatment of invasive aspergillosis. • For culture proven invasive candidiasis with documented resistance to fluconazole. Claim Notes: • Must be prescribed in consultation with a specialist in infectious diseases or medical microbiology. • Initial requests will be approved for a maximum of 3 months. ZAFIRLUKAST (ACCOLATE) 20mg tablet For the treatment of moderate to severe asthma in patients who: • Are not adequately controlled with moderate to high dose inhaled corticosteroids despite compliance with

treatment AND

• Require increasing amounts of short-acting beta2-adrenergic agonists. ZANAMIVIR (RELENZA) 5mg powder for inhalation For beneficiaries residing in long-term care facilities meeting the same criteria as for oseltamivir and for whom there is suspected or confirmed oseltamivir resistance, or for whom oseltamivir is contraindicated.

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ZOLEDRONIC ACID (ACLASTA and generic brands) 5mg/100mL solution for infusion Osteoporosis For the treatment of osteoporosis in postmenopausal women who were previously approved or would otherwise be eligible for coverage of oral bisphosphonates and who: • Have experienced further significant decline in bone mineral density (BMD) after 1 year of continuous oral

bisphosphonate therapy. OR

• Have experienced serious intolerance to oral bisphosphonates. OR

• Have a contraindication to oral bisphosphonates. Clinical Note: • Serious intolerance is defined as esophageal ulceration, erosion or stricture, or lower gastrointestinal symptoms

severe enough to cause discontinuation of oral bisphosphonates, or swallowing disorders that will increase the risk of esophageal ulceration from oral bisphosphonates.

Paget’s Disease For the treatment of Paget’s disease of bone. ZOLMITRIPTAN (ZOMIG and generic brands) 2.5mg tablet ZOLMITRIPTAN (ZOMIG RAPIMELT and generic brands) 2.5mg oral disintegrating tablets For the treatment of migraine1 headache when: • Migraines are moderate2 in severity and other therapies (e.g. NSAIDs, acetaminophen, DHE spray) are not

effective, OR

• Migraine attacks are severe2 or ultra severe2 Clinical Notes: • 1As diagnosed based on current Canadian guidelines. • 2 Definitions:


Claim Notes: • A maximum of 72 tablets will be reimbursed annually without special authorization. If additional medication is

required within the year, a request should be made through special authorization. • Patients with >3 migraines/month on average despite prophylactic therapy may be considered for up to a

maximum of 12 doses / 30 days. ZOLMITRIPTAN (ZOMIG NASAL SPRAY) 2.5mg and 5mg nasal sprays • For the treatment of migraine1 headache of moderate2 intensity when other therapies (e.g. NSAIDs,








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ZUCLOPENTHIXOL (CLOPIXOL) 10mg and 25mg tablets For the treatment of schizophrenia in patients with a history of failure, intolerance, or contraindication to at least one antipsychotic agent.

New Brunswick Drug Plans Formulary - gnb.ca · tuberculosis (TB) infection. Public Health : October...

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