Reminder to Pharmacists. Issuance of Bulletin #58

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1 Corporate and Provincial Program Support 300 Carlton, Winnipeg MB R3B 3M9 Reminder to Pharmacists Issuance of Bulletin #58 Bulletin #58, effective April 29, 2008, completes the initial transitional phase associated with the new generic submission criteria and is issued to balance access and inventory supply management by wholesalers, and manufacturers. To this end, this Bulletin contains product additions and/or line extensions for existing interchangeable categories as well as two Brand non-interchangeable products. In consideration of this transitional phase, the Manitoba Society of Pharmacists (MSP) has agreed to a one-time only exception to the 30 day notification period resulting in a 14 day notification period for Bulletin 58. Manitoba Health is committed to process improvements to further enhance the current listing process.

2 BULLETIN # 58 Manitoba Drug Benefits and Interchangeability Formulary Amendments The following amendments will take effect on April 29, The amended Manitoba Specified Drug Regulation and Drug Interchangeability Formulary Regulation will be available on the Manitoba Health website on the effective date of April 29, Bulletin 58 is currently available for download: Inside This Issue Part 1 Additions Page 1-2 Part 2 Additions Page 2-3 Part 3 Additions Page 3-5 New Interchangeable Products Page 5-10 Interchangeable Product Price Changes Page 10

3 Part 1 Additions Bulletin #58 DIN TRADE NAME GENERIC STRENGTH FORM MFR* Apo-Clozapine clozapine mg APX Co Venlafaxine XR venlafaxine HCl Capsule COB mg CTP citalopram 30 mg ORX Gen-Atenolol atenolol 2 GPM Gen-Clozapine clozapine 50 mg 200 mg GPM Gen-Metoprolol (Type L) metoprolol 2 GPM Novo-Morphine SR morphine sulfate 60 mg NOP pms-amiodarone amiodarone 100 mg PMS pms-bisoprolol bisoprolol fumarate PMS pms-clindamycin clindamycin 150 mg 300 mg Capsule PMS pms-doxycycline doxycycline 100 mg PMS pms-doxycycline doxycycline 100 mg Capsule PMS pms-enalapril enalapril pms-gliclazide gliclazide 80 mg PMS pms-lisinopril lisinopril PMS pms-paroxetine paroxetine 40 mg PMS pms-venlafaxine XR venlafaxine HCl mg Capsule PMS ratio-enalapril ratio-lisinopril P ratio-lisinopril Z ratio-ramipril enalapril lisinopril lisinopril ramipril Capsule PMS RPH RPH RPH RPH 1 of 10

4 ratio-tamsulosin tamsulosin 0.4 mg Capsule RPH ratio-venlafaxine XR venlafaxine HCl Capsule RPH mg Sandoz Brimonidine brimonidine 0.2% Ophthalmic SDZ Sandoz Enalapril Sandoz Lisinopril Sandoz Lisinopril HCT Sandoz Ramipril enalapril lisinopril lisinopril/ hydrochlorothiazide ramipril 2. 10/12. 20/12. 20/ Solution Capsule Sandoz Risperidone risperidone 0.2 SDZ Sandoz Tamsulosin tamsulosin 0.4 mg Capsule SDZ *Abbreviation of Manufacturers' Names SDZ SDZ SDZ SDZ Part 2 Additions Co Fluconazole fluconazole 50 mg 100 mg For the prophylaxis and treatment of: (a)oropharyngeal and esophageal candidiasis in immunocompromised patients; and (b)systemic fungal infections other than oropharyngeal candidiasis COB pms-minocycline minocycline 50 mg Capsule 100 mg (a)for treatment of acne unresponsive to tetracycline or erythromycin; (b)for rheumatoid arthritis patients who have failed two other second line agents. PMS 2 of 10

5 mg Ran-Ciproflox ciprofloxacin 500 mg 750 mg (a)step down care following hospital separation in patients treated with parenteral antibiotics; (b)treatment of Pseudomonal infections or resistant gram negative infections; (c)treatment of resistant Gonococcal infections; (d)treatment of infections in persons allergic to alternative agents (eg. penicillins, cephalosporins and sulfonamides); (e)treatment of infections in immunocompromised patients; (f)treatment of diabetic foot infections and complications of orthopedic surgery; (g)treatment of chronic bacterial prostatitis. RAN Sandoz Cefprozil cefprozil 250 mg SDZ 500 mg (a)step down care following hospital separation in patients treated with intravenous cephalosporins; (b)treatment of patients with infections not responding to alternative antibiotics (eg. amoxicillin); (c)treatment of infections caused by organisms known to be resistant to alternative antibiotics (eg. amoxicillin); (d)treatment of patients known to be allergic or unresponsive to alternative antibiotics (eg. penicillin or sulfonamides) Sandoz Cefprozil cefprozil 12/5 ml Suspension SDZ 250 mg/5 ml (a)step down care following hospital separation in patients treated with intravenous cephalosporins; (b)treatment of patients with infections not responding to alternative antibiotics (eg. amoxicillin); (c)treatment of infections caused by organisms known to be resistant to alternative antibiotics (eg. amoxicillin); (d)treatment of patients known to be allergic or unresponsive to alternative antibiotics (eg. penicillin or sulfonamides). Part 3 Additions The following products will be considered for Pharmacare reimbursement upon an individual prescriber/patient request basis Co Pioglitazone pioglitazone 1 30 mg 4 1) For use as second line therapy for Type 2 diabetics who are not optimally controlled on maximal doses of metformin and either a sulfonylurea (glyburide, gliclazide) or repaglinide or with contraindications to these agents. 2) Type 2 diabetics on high doses of insulin (over 2 u/kg) and on maximally tolerated metformin who are not achieving optimal control. Note: Actos should be used as an add-on to pre-existing therapy and not a substitution. COB 3 of 10

6 pms-ismn isosorbide-5-mononitrate 60 mg PMS Prevention of angina in patients failing or not tolerating Isordil (isosorbide dinitrate), nitroglycerin patches, beta blockers (e.g. Propranolol, Atenolol), calcium channel blockers (e.g. Amlodipine, Nifedipine) or a combination of nitrate and CCB or B-blocker in patients with hypertension pms-levetiracetam levetiracetam 250 mg 500 mg 750 mg An add-on anticonvulsant or for control of pain where initiated by a pain clinic and where other similar agents have failed. PMS pms-naproxen EC naproxen mg Intolerable gastrointestinal side effects on at least 3 other NSAIDs and no evidence of decreased ulceration. PMS pms-pioglitazone pioglitazone 1 30 mg 4 1) For use as second line therapy for Type 2 diabetics who are not optimally controlled on maximal doses of metformin and either a sulfonylurea (glyburide, gliclazide) or repaglinide or with contraindications to these agents. 2) Type 2 diabetics on high doses of insulin (over 2 u/kg) and on maximally tolerated metformin who are not achieving optimal control. Note: Actos should be used as an add-on to pre-existing therapy and not a substitution. PMS ratio-omeprazole omeprazole RPH As per criteria for Losec (see Bulletin 50) ratio-pioglitazone pioglitazone 1 30 mg 4 1) For use as second line therapy for Type 2 diabetics who are not optimally controlled on maximal doses of metformin and either a sulfonylurea (glyburide, gliclazide) or repaglinide or with contraindications to these agents. 2) Type 2 diabetics on high doses of insulin (over 2 u/kg) and on maximally tolerated metformin who are not achieving optimal control. Note: Actos should be used as an add-on to pre-existing therapy and not a substitution. RPH 4 of 10

7 Sandoz Omperazole omeprazole Capsule SDZ As per criteria for Apo-Omeprazole (see Bulletin 50) Sandoz Pioglitazone pioglitazone 1 30 mg 4 1) For use as second line therapy for Type 2 diabetics who are not optimally controlled on maximal doses of metformin and either a sulfonylurea (glyburide, gliclazide) or repaglinide or with contraindications to these agents. 2) Type 2 diabetics on high doses of insulin (over 2 u/kg) and on maximally tolerated metformin who are not achieving optimal control. Note: Actos should be used as an add-on to pre-existing therapy and not a substitution. SDZ Sutent sunitinib mg Capsule For the treatment of metastatic renal cell carcinoma (MRCC) in patients with favourableto intermediate-risk disease. PFI Nexavar sorafenib 200 mg BAY For the treatment of locally advanced/metastatic Renal Cell (clear cell) Carcinoma (RCC) in patients who failed prior cytokine therapy or are considered unsuitable for such therapy. New Interchangeable Products The following products have been added to existing interchangeable drug categories: Bisoprolol Fumarate - - $ pms-bisoprolol PMS ** Bisoprolol Fumarate - - $ pms-bisoprolol PMS ** Brimonidine - 0.2% - Ophthalmic Solution Sandoz Brimonidine SDZ $ per ml ** Cefprozil mg - $ Sandoz Cefprozil SDZ of 10

8 Cefprozil mg - $ Sandoz Cefprozil SDZ Cefprozil - 12/5 ml - Suspension Sandoz Cefprozil SDZ $ per ml Cefprozil mg/5 ml - Suspension Sandoz Cefprozil SDZ $ per ml Ciprofloxacin mg - $ Ran-Ciproflox RAN Ciprofloxacin mg - $ Ran-Ciproflox RAN Ciprofloxacin mg - $ Ran-Ciproflox RAN Clindamycin mg - Capsule $ pms-clindamycin PMS ** Clindamycin mg - Capsule $ pms-clindamycin PMS ** Clozapine $ Apo-Clozapine APX ** Clozapine mg - $ Apo-Clozapine APX ** Doxycycline mg - Capsule $ pms-doxycycline PMS ** Doxycycline mg - $ pms-doxycycline PMS ** of 10

9 Enalapril $ pms-enalapril PMS ratio-enalapril RPH Sandoz Enalapril SDZ Enalapril - - $ pms-enalapril PMS ratio-enalapril RPH Sandoz Enalapril SDZ Enalapril - - $ pms-enalapril PMS ratio-enalapril RPH Sandoz Enalapril SDZ Enalapril - - $ pms-enalapril PMS ratio-enalapril RPH Sandoz Enalapril SDZ Fluconazole - 50 mg - $ Co Fluconazole COB ** Fluconzole mg - $ Co Fluconzole COB ** Gliclazide - 80 mg - $ pms-gliclazide PMS ** Isosorbide-5-Mononitrate - 60mg - $ pms-ismn PMS ** Levetiracetam mg - $ pms-levetiracetam PMS ** Levetiracetam mg - $ pms-levetiracetam PMS ** of 10

10 Levetiracetam mg - $ pms-levetiracetam PMS ** Lisinopril - - $ pms-lisinopril PMS ratio-lisinopril P RPH ratio-lisinopril Z RPH Sandoz Lisinopril SDZ Lisinopril - - $ pms-lisinopril PMS ratio-lisinoprol P RPH ratio-lisinoprol Z RPH Sandoz Lisinopril SDZ Lisinopril - - $ pms-lisinopril PMS ratio-lisinopril P RPH ratio-lisinopril Z RPH Sandoz Lisinopril SDZ Linsinopril/Hydrochlorothiazide - 10/12. - $ Sandoz Lisinopril HCT SDZ Linsinopril/Hydrochlorothiazide - 20/12. - $ Sandoz Lisinopril HCT SDZ Linsinopril/Hydrochlorothiazide - 20/2 - $ Sandoz Lisinopril HCT SDZ Minocycline - 50 mg - Capsule $ pms-minocycline PMS ** Minocycline mg - Capsule $ pms-minocycline PMS ** Morphine Sulfate - 60 mg - Sustained Release s $ Novo-Morphine SR NOP ** of 10

11 Naproxen Enteric Coated $ pms-naproxen EC PMS ** Naproxen mg - Enteric Coated $ pms-naproxen EC PMS ** Omeprazole - - Capsule $ ratio-omeprazole () RPH Sandoz Omeprazole SDZ Pioglitazone $ Co Pioglitazone COB pms-pioglitazone PMS ratio-pioglitazone RPH Sandoz Pioglitazone SDZ Pioglitazone - 30 mg - $ Co Pioglitazone COB pms-pioglitazone PMS ratio-pioglitazone RPH Sandoz Pioglitazone SDZ Pioglitazone $ Co Pioglitazone COB pms-pioglitazone PMS ratio-pioglitazone RPH Sandoz Pioglitazone SDZ Ramipril Capsule $ ratio-ramipril RPH Sandoz Ramipril (s) SDZ Ramipril Capsule $ ratio-ramipril RPH Sandoz Ramipril (s) SDZ Ramipril - - Capsule $ ratio-ramipril RPH Sandoz Ramipril (s) SDZ of 10

12 Ramipril - - Capsule $ ratio-ramipril RPH Sandoz Ramipril (s) SDZ Risperidone $ Sandoz Risperidone SDZ Tamsulosin mg - Capsule $ ratio-tamsulosin RPH Sandoz Tamsulosin SDZ Venlafaxine Capsule $ Co Venlafaxine XR COB pms-venlafaxine XR PMS ratio-venlafaxine XR RPH ** Venlafaxine -7 - Capsule $ Co Venlafaxine XR COB pms-venlafaxine XR PMS ratio-venlafaxine XR RPH ** Venlafaxine mg - Capsule $ Co Venlafaxine XR COB pms-venlafaxine XR PMS ratio-venlafaxine XR RPH ** ** The price change has resulted in a change to the lowest price in the category. Interchangeable Product Price Changes The following changes in prices have occurred: ($) ratio-oxycocet oxycocet 5/32 ** ratio-lenoltec No.2 acetaminophen with codeine 300/15/1 ** ratio-lenoltec No.3 acetaminophen with codeine 300/15/30 mg ** ratio-lenoltec No.4 acetaminophen with codeine 300/60 mg ** ** The price change has resulted in a change to the lowest price in the category. 10 of 10

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