ABOBOTULINUM TOXIN A Ontario LU Codes and Criteria

Drug list

UNCLASSIFIED THERAPEUTIC AGENTS › OTHER MISCELLANEOUS THERAPEUTIC AGENTS

ABOBOTULINUM TOXIN A (Dysport Therapeutic)

300U/Vial500U/VialPd Inj-Vial Pk

Dysport Therapeutic should be administered personally by a neurologist, pediatrician, or a physician with equivalent post-graduate training and experience with neuromuscular disorders.

LU130

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To reduce the subjective symptoms and objective signs of cervical dystonia (spasmodic torticollis) in adults.

Complete Ontario criteria

To reduce the subjective symptoms and objective signs of cervical dystonia (spasmodic torticollis) in adults.

LU412

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For the management of focal spasticity, due to stroke or spinal cord injury in adults.

Complete Ontario criteria

For the management of focal spasticity, due to stroke or spinal cord injury in adults.

LU413

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For the treatment of focal spasticity secondary to cerebral palsy in patients two years of age or older.

Complete Ontario criteria

For the treatment of focal spasticity secondary to cerebral palsy in patients two years of age or older.