Drug list
ANTI-INFECTIVE AGENTS › ANTITUBERCULAR AGENTS

RIFABUTIN (Mycobutin)

150mgCap

For the prevention of Mycobacterium Avium Intracellular (MAI) in:

LU103
QUICK SCAN

Patients with a CD4+ cell count less than 200/mm3 with an AIDS-defining diagnosis;

LU Authorization Period: 1 year
Complete Ontario criteria

Patients with a CD4+ cell count less than 200/mm3 with an AIDS-defining diagnosis;

LU104
QUICK SCAN

Patients with a CD4+ cell count less than 100/mm3 without an AIDS-defining diagnosis.

LU Authorization Period: 1 year
Complete Ontario criteria

Patients with a CD4+ cell count less than 100/mm3 without an AIDS-defining diagnosis.

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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