Drug list
UNCLASSIFIED THERAPEUTIC AGENTS

INCOBOTULINUMTOXINA (Xeomin)

100 LD50 Units200 Units/Vial50 LD50 UnitsPd for Inj-Vial PkPd for Inj-Vial Pk (Preservative-Free)
LU130
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To reduce the subjective symptoms and objective signs of cervical dystonia (spasmodic torticollis) in adults.

LU Authorization Period: 1 year
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.

LU Authorization Period: 1 year
Complete Ontario criteria

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

LU421
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For the treatment of blepharospasm associated with dystonia, including benign essential blepharospasm or VII nerve disorders in adults.

LU Authorization Period: 1 year
Complete Ontario criteria

For the treatment of blepharospasm associated with dystonia, including benign essential blepharospasm or VII nerve disorders in adults. Xeomin should be administered personally by a neurologist or a physician with equivalent post-graduate training and experience with neuromuscular disorders.

Clinical verification required

Quick summaries support scanning only. Confirm eligibility against the complete Ontario criteria and current Ontario e-Formulary before billing.

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