The following amendments will take effect on August 17, 2009. The amended Manitoba Specified Drug Regulation and Drug Interchangeability Formulary Regulation will be available on the Manitoba Health website http://www.gov.mb.ca/health/mdbif on the effective date of August 17, 2009. Bulletin 61 is currently available for download: http://www.gov.mb.ca/health/mdbif/bulletin61.pdf Inside This Issue Part 1 Additions Page 1-2 Part 2 Additions Page 2-4 Part 3 Additions Page 5-6 New Interchangeable Categories Page 7-8 New Interchangeable Products Page 8-13 Product Deletions Page 13-14 Category Deletions Page 14 Interchangeable Product Price Changes Page 14-20 Discontinued Products Page 20-21 Manufacturer Updates Page 22 BULLETIN # 61 Manitoba Drug Benefits and Interchangeability Formulary Amendments
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The following amendments will take effect on August 17, 2009.
The amended Manitoba Specified Drug Regulation and Drug Interchangeability Formulary Regulation will beavailable on the Manitoba Health websitehttp://www.gov.mb.ca/health/mdbif on the effectivedate of August 17, 2009.
Bulletin 61 is currently available for download:http://www.gov.mb.ca/health/mdbif/bulletin61.pdf
(a) Step-down care following hospital separation in patients treated with parenteral antibiotics;(b) Treatment of gram-negative infections resistant to standard therapy;(c) Treatment of infections in persons allergic to alternative agents (eg. penicillins, cephalosporins and sulfonamides);(d) Treatment of bacterial prostatitis;(e) Treatment of respiratory infections in patients failing or likely to fail or intolerant of penicillins,cephalosporins and/or macrolides;(f) Treatment of diabetic foot infections.
02292378022923860229239402292408
Apo-Pramipexole pramipexole
0.25 mg0.5 mg
1 mg1.5 mg
Tablet APX
For the treatment of idiopathic Parkinson's Disease.
Part 2 Additions
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Bulletin #61Effective: August 17, 2009
0231542402315432 Co Levofloxacin levofloxacin 250 mg
500 mg Tablet COB
(a) Step-down care following hospital separation in patients treated with parenteral antibiotics;(b) Treatment of gram-negative infections resistant to standard therapy;(c) Treatment of infections in persons allergic to alternative agents (eg. penicillins, cephalosporins and sulfonamides);(d) Treatment of bacterial prostatitis;(e) Treatment of respiratory infections in patients failing or likely to fail or intolerant of penicillins,cephalosporins and/or macrolides;(f) Treatment of diabetic foot infections.
02297302022973100229732902297337
Co Pramipexole pramipexole
0.25 mg0.5 mg
1 mg1.5 mg
Tablet COB
For the treatment of idiopathic Parkinson's Disease.
(a) Step-down care following hospital separation in patients treated with parenteral antibiotics;(b) Treatment of gram-negative infections resistant to standard therapy;(c) Treatment of infections in persons allergic to alternative agents (eg. penicillins, cephalosporins and sulfonamides);(d) Treatment of bacterial prostatitis;(e) Treatment of respiratory infections in patients failing or likely to fail or intolerant of penicillins,cephalosporins and/or macrolides;(f) Treatment of diabetic foot infections.
For the treatment of otitis media in patients not responding to or intolerant of alternative antibiotics (eg. amoxicillin and erythromycin).
02314630023146490231465702314665
Novo-Fentanyl fentanyl
25 mcg50 mcg75 mcg
100 mcg
Patch NOP
For the treatment of pain in patients unable to tolerate oral analgesics or when there is failure to adequately control pain with oral analgesics or in patients in whom oral analgesics are deemedinappropiate.
(a) Step-down care following hospital separation in patients treated with parenteral antibiotics;(b) Treatment of gram-negative infections resistant to standard therapy;(c) Treatment of infections in persons allergic to alternative agents (eg. penicillins, cephalosporins and sulfonamides);(d) Treatment of bacterial prostatitis;(e) Treatment of respiratory infections in patients failing or likely to fail or intolerant of penicillins,cephalosporins and/or macrolides;(f) Treatment of diabetic foot infections.
(a) Step-down care following hospital separation in patients treated with parenteral antibiotics;(b) Treatment of gram-negative infections resistant to standard therapy;(c) Treatment of infections in persons allergic to alternative agents (eg. penicillins, cephalosporins and sulfonamides);(d) Treatment of bacterial prostatitis;(e) Treatment of respiratory infections in patients failing or likely to fail or intolerant of penicillins,cephalosporins and/or macrolides;(f) Treatment of diabetic foot infections.
(a) Step-down care following hospital separation in patients treated with parenteral antibiotics;(b) Treatment of gram-negative infections resistant to standard therapy;(c) Treatment of infections in persons allergic to alternative agents (eg. penicillins, cephalosporins and sulfonamides);(d) Treatment of bacterial prostatitis;(e) Treatment of respiratory infections in patients failing or likely to fail or intolerant of penicillins,cephalosporins and/or macrolides;(f) Treatment of diabetic foot infections.
02320312 Sandoz Methylphenidate SR methylphenidate HCl 20 mg Tablet SDZ
For treatment of attention deficit disorder and narcolepsy.
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Bulletin #61Effective: August 17, 2009
The following products will be considered for Pharmacare reimbursement upon an individual prescriber/patientrequest basis.
022953770229538502295393
Apo-Glimepiride glimepiride1 mg2 mg4 mg
Tablet APX
For patients poorly controlled on maximum doses of glyburide or gliclazide and metforminand diet (unless metformin is contraindicated because of renal/hepatic dysfunction orG.I. intolerance.)
02279215 Apo-Raloxifene raloxifene 60 mg Tablet APXFor the treatment of patients with:(a) Osteoporotic fractures;(b) Osteoporosis diagnosed with bone mineral density (BMD) measurements by any approved technology, e.g. a T score of < - 2.5; or(c) x-ray diagnosis of osteoporosis.
NOTE: Concurrent calcium and vitamin D supplementation is recommended.
0229984402299852 Celsentri maraviroc 150 mg
300 mg Tablet PFI
(a) For patients who have CCR5 tropic viruses, and (b) who have documented resistance to at least one agent from each of the three major classes of antiretroviral agents (nucleoside reverse transcriptase inhibitors, non-nucleoside reversetranscriptase inhibitors, protease inhibitors).
For the treatment of Rheumatoid Arthritis failing at least two (2) disease modifyingantirheumatic drugs (DMARDs).
02256452 Jamp-Loperamide loperamide 2 mg Tablet JPCFor the treatment of:(a) An ileostomy or a colostomy;(b) Bowel resection, including short bowel syndrome;(c) Inflammatory Bowel Diseases, i.e. Crohn's Disease, Ulcerative Colitis (this may include nonspecific colitis, microscopic colitis), and "diabetic gut" (neuropathy of the gut);(d) Cancer, including chemotherapy or radiation therapy;(e) HIV/AIDS;(f) Fecal incontinence.
(a) Treatment of severe refractory acne.(b) Hirsutism not responding to standard therapy.
02312298 Novo-Raloxifene raloxifene 60 mg Tablet NOP(a) Osteoporotic fractures OR(b) Osteoporosis diagnosed with bone mineral density measurements by any approved technology, i.e. a T score of < -2.5 OR(c) X-ray diagnosis of osteoporosis, i.e. NOT osteopenia PLUS(d) Concurrent calcium and Vitamin D therapy is recommended.
For the treatment of:(a) Patients unable to absorb oral medications due to Crohn's Disease or other absorption problems.(b) Ankylosing Spondylitis resistant to conventional treatment with acetaminophen and NSAID's.
022557070225572302255758
Risperdal Consta risperidone25 mg
37.5 mg50 mg
Injection JAN
For patients:(a) With a history of non-adherence, as evidenced by outcomes such as repeated hospitalizations, or(b) Who have tried one or more antipsychotic agents, and who continue to be inadequately controlled, orare experiencing significant side effects such as EPS.
02274906 Truvada emtricitabine/tenofovir 200/300 mg Tablet GILFor treatment as a dual nucleoside/nucleotide option for treatment of HIV patients where the virus is susceptible to both these agents and efavirenz is not indicated due to adverse effects or antiretroviral resistance.
02316986 Xarelto rivaroxaban 10 mg Tablet BAYFor the propholaxis of venous thromboembolism following total knee replacement or total hip replacement surgery, for up to two weeks, as an alternative to low molecular weight heparins.
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Bulletin #61Effective: August 17, 2009
The following new interchangeable categories and products were added:
Generic Name - Strength - FormDIN Trade Name Manufacturer
01950541Rhinaris-CS Anti-Allergic Nasal Mist(old name - Cromolyn Nasal Mist)
cromolyn sodium 2% Nasal Spray
The following products have been tranfserred to JHP Pharmaceuticals (JHP):01997602 Dantrium dantrolene sodium 25 mg Capsule01997653 Dantrium dantrolene sodium 100 mg Capsule01997572 Dantrium dantrolene sodium N/A IV
The following products have been tranfserred to Paladin Labs (PAL):02230732 Trinipatch nitroglycerin 0.2 mg Patch02230733 Trinipatch nitroglycerin 0.4 mg Patch02230734 Trinipatch nitroglycerin 0.6 mg Patch
The following products will be distributed by Takeda Canada (TAK):02242572 Actos pioglitazone 15 mg Tablet02242573 Actos pioglitazone 30 mg Tablet02242574 Actos pioglitazone 45 mg Tablet
The following products have been tranfserred to Tribute Pharma Canada (TPC):02083523 Bezalip SR bezafibrate 400 mg Tablet02070847 Soriatane acitretin 10 mg Capsule02070863 Soriatane acitretin 25 mg Capsule
The following product has been transferred to UCB Pharma (UCB):02063808 Dipentum olsalazine sodium 250 mg Tablet
The following product has been transferred to a Natural Health Product Number (NPN):80001408(old DIN - 00645923)