Drug list
ANTI-INFECTIVE AGENTS › ANTIVIRALS

TENOFOVIR DISOPROXIL (Apo-Tenofovir · Auro-Tenofovir · Jamp-Tenofovir · Mint-Tenofovir · Mylan-Tenofovir Disoproxil · Nat-Tenofovir · PMS-Tenofovir · Tenofovir · Teva-Tenofovir · Viread)

300mgTab
LU517
QUICK SCAN

Confirmed chronic Hepatitis B infection in persons with

LU Authorization Period: 1 year
Complete Ontario criteria

Confirmed chronic Hepatitis B infection in persons with - HBV DNA greater than or equal to 1000 IU/mL AND - ALT levels greater than ULN OR - Evidence of fibrosis OR - Documented evidence of cirrhosis

LU518
QUICK SCAN

For patients with chronic Hepatitis B infection who have a contraindication, intolerance or inadequate response to one or more of the following: lamivudine, entecavir, adefovir or telbivudine.

LU Authorization Period: 1 year
Complete Ontario criteria

For patients with chronic Hepatitis B infection who have a contraindication, intolerance or inadequate response to one or more of the following: lamivudine, entecavir, adefovir or telbivudine.

LU519
QUICK SCAN

Patient is pregnant (2nd trimester or later) with HBV DNA greater than 1,000,000 IU/mL.

LU Authorization Period: 1 year
Complete Ontario criteria

Patient is pregnant (2nd trimester or later) with HBV DNA greater than 1,000,000 IU/mL.

LU520
QUICK SCAN

Patients with chronic Hepatitis B infection currently receiving treatment with tenofovir and requires treatment continuation.

LU Authorization Period: 1 year
Complete Ontario criteria

Patients with chronic Hepatitis B infection currently receiving treatment with tenofovir and requires treatment continuation.

LU521
QUICK SCAN

Patients with chronic Hepatitis B infection who are scheduled to undergo chemotherapy or significant immunosuppressive treatment.

LU Authorization Period: 1 year
Complete Ontario criteria

Patients with chronic Hepatitis B infection who are scheduled to undergo chemotherapy or significant immunosuppressive treatment.

LU522
QUICK SCAN

For HIV/AIDS.

LU Authorization Period: 1 year
Complete Ontario criteria

For HIV/AIDS.

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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