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Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43

Summary of Changes – November 2020Effective November 30, 2020

Drug Programs Policy and Strategy BranchDrugs and Devices DivisionMinistry of Health

Visit Formulary Downloads: Edition 43

http://www.health.gov.on.ca/en/pro/programs/drugs/edition_43.aspx

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Table of Contents New Multi-Source Products ............................................................................................. 3

New Off-Formulary Interchangeable (OFI) Products ....................................................... 9

Manufacturer Name Changes ....................................................................................... 11

Product Brand and Manufacturer Name Changes ........................................................ 12

Drug Benefit Price (DBP) Changes ............................................................................... 13

Discontinued Products .................................................................................................. 14

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New Multi-Source Products Where applicable, please consult the respective brand reference product’s drug profile on the ODB e-Formulary for the details of the Limited Use (LU) code and criteria, and/or any associated Therapeutic Notes (TN).

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02491311 Methotrexate

Subcutaneous 15mg/0.3mL Inj Sol-0.3mL

Pref Syr ACH 24.5700

(Interchangeable with Metoject Subcutaneous – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02485184 AG-Alendronate 70mg Tab ANG 2.1014

(Interchangeable with Fosamax – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02478145 AG-Atorvastatin 10mg Tab ANG 0.1743 02478153 AG-Atorvastatin 20mg Tab ANG 0.2179 02478161 AG-Atorvastatin 40mg Tab ANG 0.2342 02478188 AG-Atorvastatin 80mg Tab ANG 0.2342

(Interchangeable with Lipitor – GB)

New Multi-Source Products (Continued)

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DIN/PIN Product Name Strength Dosage Form Mfr DBP 02437570 AG-Celecoxib 100mg Cap ANG 0.1279 02437589 AG-Celecoxib 200mg Cap ANG 0.2558

(Interchangeable with Celebrex – LU)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02475308 AG-Duloxetine 30mg DR Cap ANG 0.4814 02475316 AG-Duloxetine 60mg DR Cap ANG 0.9769

(Interchangeable with Cymbalta – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02481316 AG-Metoprolol-L 50mg Tab ANG 0.0624 02481324 AG-Metoprolol-L 100mg Tab ANG 0.1361

(Interchangeable with Lopresor – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02478137 AG-Moxifloxacin 400mg Tab ANG 1.5230

(Interchangeable with Avelox – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02475545 AG-Paroxetine 20mg Tab ANG 0.3250 02475553 AG-Paroxetine 30mg Tab ANG 0.3453

(Interchangeable with Paxil – GB)

New Multi-Source Products (Continued)

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DIN/PIN Product Name Strength Dosage Form Mfr DBP 02480727 AG-Pregabalin 25mg Cap ANG 0.1481 02480735 AG-Pregabalin 50mg Cap ANG 0.2324 02480743 AG-Pregabalin 75mg Cap ANG 0.3007 02480751 AG-Pregabalin 150mg Cap ANG 0.4145

(Interchangeable with Lyrica – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02477572 AG-Ramipril 2.5mg Cap ANG 0.0817 02477580 AG-Ramipril 5mg Cap ANG 0.0817 02477599 AG-Ramipril 10mg Cap ANG 0.1034

(Interchangeable with Altace – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02480050 AG-Simvastatin 5mg Tab ANG 0.1023 02480069 AG-Simvastatin 10mg Tab ANG 0.2023 02480077 AG-Simvastatin 20mg Tab ANG 0.2501 02480085 AG-Simvastatin 40mg Tab ANG 0.2501 02480093 AG-Simvastatin 80mg Tab ANG 0.2501

(Interchangeable with Zocor – GB)

New Multi-Source Products (Continued)

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DIN/PIN Product Name Strength Dosage Form Mfr DBP 02495376 Jamp Diltiazem T 120mg ER Cap JPC 0.2133 02495384 Jamp Diltiazem T 180mg ER Cap JPC 0.2889 02495392 Jamp Diltiazem T 240mg ER Cap JPC 0.3832 02495406 Jamp Diltiazem T 300mg ER Cap JPC 0.4720 02495414 Jamp Diltiazem T 360mg ER Cap JPC 0.5778

(Interchangeable with Tiazac – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02497409 Jamp Oseltamivir 30mg Cap JPC 0.5243 02497425 Jamp Oseltamivir 75mg Cap JPC 1.0393

(Interchangeable with Tamiflu – LU)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02475197 Mint-Diclofenac 0.1% w/v Oph Sol (With

Preservative) MIN 1.2397/mL

(Interchangeable with Voltaren Ophtha – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02496380 Mint-Nadolol 40mg Tab MIN 0.2375 02496399 Mint-Nadolol 80mg Tab MIN 0.3410

(Interchangeable with Corgard – GB)

New Multi-Source Products (Continued)

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DIN/PIN Product Name Strength Dosage Form Mfr DBP 02493357 Riva Leucovorin 5mg Tab RIA 5.5164

(Interchangeable with Leucovorin Calcium – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02391589 Bisoprolol 5mg Tab SAI 0.0715 02391597 Bisoprolol 10mg Tab SAI 0.1044

(Interchangeable with Monocor – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02387956 Citalopram 20mg Tab SIV 0.1332 02387964 Citalopram 40mg Tab SIV 0.1332

(Interchangeable with Celexa – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02442957 Enalapril 2.5mg Tab SIV 0.1863 02442965 Enalapril 5mg Tab SIV 0.2203 02442973 Enalapril 10mg Tab SIV 0.2647 02442981 Enalapril 20mg Tab SIV 0.3195

(Interchangeable with Vasotec – GB)

New Multi-Source Products (Continued)

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DIN/PIN Product Name Strength Dosage Form Mfr DBP 02429659 Ezetimibe 10mg Tab SIV 0.1811

(Interchangeable with Ezetrol – LU)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02385341 Metformin FC 500mg Tab SIV 0.0247

(Interchangeable with Glucophage – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02385279 Terbinafine 250mg Tab SIV 0.7714

(Interchangeable with Lamisil – GB)

DIN/PIN Product Name Strength Dosage Form Mfr DBP 02495899 Calcitriol Capsules 0.25mcg Cap STR 0.2341 02495902 Calcitriol Capsules 0.5mcg Cap STR 0.3723

(Interchangeable with Rocaltrol – GB)

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New Off-Formulary Interchangeable (OFI) Products DIN/PIN Brand Name Strength Dosage Form Mfr DBP 02242504 Butorphanol Nasal

Spray 10mg/mL Nas-Sp-2.5mL

Pk (With Preservative)

AAP 61.1800

(Interchangeable with Stadol NS)

DIN/PIN Brand Name Strength Dosage Form Mfr DBP 02484757 AG-Moxifloxacin 0.5% w/v ANG 11.2700 Oph Sol-3mL Pk

(Preservative-Free) (Interchangeable with Vigamox)

DIN/PIN Brand Name Strength Dosage Form Mfr DBP 02475537 AG-Paroxetine 10mg Tab ANG 1.0430

(Interchangeable with Paxil)

DIN/PIN Brand Name Strength Dosage Form

Mfr DBP

02490463 Daptomycin for Injection

500mg/Vial Pd for Inj Sol-Vial Pk

DRR 184.0000/Vial

02490838 Daptomycin for Injection

500mg/Vial Pd for Inj Sol-Vial Pk

SDZ 162.3500/Vial

(Interchangeable with Cubicin DIN 02299909)

New Off-Formulary Interchangeable (OFI) Products (Continued)

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DIN/PIN Brand Name Strength Dosage Form Mfr DBP 02385368 Metformin FC 850mg Tab SIV 0.2090

(Interchangeable with Glucophage)

DIN/PIN Brand Name Strength Dosage Form Mfr DBP 02446111 Rizatriptan ODT 5mg ODT SIV 11.1150 02446138 Rizatriptan ODT 10mg ODT SIV 11.1150

(Interchangeable with Maxalt RPD)

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Manufacturer Name Changes DIN/PIN Brand Name Strength Dosage

Form Current Mfr

New Mfr

00330566 Anafranil 10mg Tab AAP APX 00324019 Anafranil 25mg Tab AAP APX 00402591 Anafranil 50mg Tab AAP APX 02285606 Alvesco 100mcg/Actuation Inh-120

Dose Pk AZC COV

02285614 Alvesco 200mcg/Actuation Inh-120 Dose Pk

AZC COV

02229110 Famvir 125mg Tab NOV APU 02229129 Famvir 250mg Tab NOV APU 02177102 Famvir 500mg Tab NOV APU 02468735 Akynzeo 300mg & 0.5mg Cap PFP ELV 02277166 Biphentin 10mg ER Cap PFP ELV 02277131 Biphentin 15mg ER Cap PFP ELV 02277158 Biphentin 20mg ER Cap PFP ELV 02277174 Biphentin 30mg ER Cap PFP ELV 02277182 Biphentin 40mg ER Cap PFP ELV 02277190 Biphentin 50mg ER Cap PFP ELV 02277204 Biphentin 60mg ER Cap PFP ELV 02277212 Biphentin 80mg ER Cap PFP ELV 02240113 Cosopt 2% & 0.5% Oph Sol PFP ELV 02258692 Cosopt

Preservative Free 2% & 0.5% Oph Sol-

0.2mL Pk PFP ELV

00451207 Timoptic 0.5% Oph Sol PFP ELV 02171899 Timoptic-XE 0.5% Oph Gellan

Sol PFP ELV

02216205 Trusopt 2% Oph Sol PFP ELV

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Product Brand and Manufacturer Name Changes DIN/PIN Current Brand

Name Current Mfr

New Brand Name

New Mfr

Strength Dosage Form

00782505 Nadolol AAP Apo-Nadolol APX 40mg Tab 00782467 Nadolol AAP Apo-Nadolol APX 80mg Tab 00782475 Nadolol AAP Apo-Nadolol APX 160mg Tab 02291967 Ondansetron AAP Apo-

Ondansetron APX 4mg/5mL O/L

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Drug Benefit Price (DBP) Changes DIN/PIN Brand Name Strength Dosage Form Mfr DBP 00782505 Apo-Nadolol 40mg Tab APX 0.2375 00782467 Apo-Nadolol 80mg Tab APX 0.3410 02431637 Calcitriol-

Odan 0.25mcg Cap ODN 0.2341

02431645 Calcitriol-Odan

0.5mcg Cap ODN 0.3723

02498316 Riximyo 10mg/mL Inj Sol-Vial SDZ 29.7000 02465493 Cubicin RF 500mg/10mL Pd for Inj-10mL Pk SUO 184.0000 02485710 Taro-

Calcitriol 0.25mcg Cap TAR 0.2341

02485729 Taro-Calcitriol

0.5mcg Cap TAR 0.3723

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Discontinued Products (Some products will remain on Formulary for six months to facilitate depletion of supply)

DIN/PIN Brand Name Strength Dosage Form Mfr 00271373 Winpred 1mg Tab AAP 01966219 Theolair Alcohol Free Oral Liquid 5.3mg/mL O/L GRA 01923420 Palafer 300mg Cap GSK 00564966 Lozide 2.5mg Tab SEV 00687456 Viroptic 1% Oph Sol THE 00511528 Mogadon 5mg Tab VAL 00511536 Mogadon 10mg Tab VAL 01946374 Oxsoralen 10mg Cap VAL 00869945 Prostigmin 15mg Tab VAL 00283991 Tebrazid 500mg Tab VAL 02237825 Wellbutrin SR 150mg Tab VAL

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Ontario Drug Benefit Formulary/Comparative Drug IndexNew Multi-Source ProductsNew Off-Formulary Interchangeable (OFI) Products

Manufacturer Name ChangesProduct Brand and Manufacturer Name ChangesDrug Benefit Price (DBP) ChangesDiscontinued Products