Prescription required for Retail Sales LORAZEPAM SBL

Material Number:
66757
Active Ingredient:
LORAZEPAM
Brand Reference:
ATIVAN
 
Therapeutic Class (AHFS):
28:24.08
Strength:
1 MG
DIN:
02410753
UPC:
660933002320
Pack Size (Form):
100 TABLETS(BOTTLE)
 
Dosage Form:
Tablets
Scored:
N/A
Colour:
White to off-white
Shape:
round, flat-faced, bevelled edge tablet
Markings:
Engraved ‘1’ on one side
 
Route of Administration:
Oral
Refrigeration Required:
No
 
Product image 1Product image 2

not to scale
 
Packaging Information:
 
Length
Width
Height
Weight
Unit/Case
Unit
4.50 cm
4.50 cm
8.00 cm
0.054 kg
N/A
Case
18.00 cm
13.50 cm
8.00 cm
0.647 kg
12
Provincial Formulary Coverage:
X
X
X
X
X
I
I
I
NAB
NAB
 
Provincial Formulary Legend:
B
Benefit (Non-Interchangeable)
I
Interchangeable Only (Non-Benefit)
X
Interchangeable
BNL
Brand Not Listed
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