Prescription required for Retail Sales 

Material Number:
Active Ingredient:
Brand Reference:
 
Therapeutic Class (AHFS):
Strength:
DIN:
UPC:
Pack Size (Form):
()
 
Dosage Form:
Scored:
Colour:
Shape:
Markings:
 
Route of Administration:
Refrigeration Required:
No
 
Product Resources:
Product image 1Product image 2

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