English: 10MG Suppository 02241091 MAGIC BULLET DCM CITRIC ACID, MAGNESIUM OXIDE, SODIUM PICOSULFATE Powder 02254794 PICO-SALAX FEI DIOCTYL CALCIUM SULFOSUCCINATE 240MG Capsule 02245080 APO-DOCUSATE CALCIUM APX 00830275 DOCUSATE CALCIUM TAR 00842044 NOVO-DOCUSATE CALCIUM NOP 00664553 PMS-DOCUSATE CALCIUM PMS 00809055 RATIO-DOCUSATE CALCIUM RPH DIOCTYL SODIUM SULFOSUCCINATE 100MG Capsule 02245079 APO-DOCUSATE SODIUM APX 02106256 COLACE WPC 00794406 DOCUSATE SODIUM SDR 00830267 DOCUSATE SODIUM TRI 00716731 DOCUSATE SODIUM TAR 02246036 DOCUSATE SODIUM RPH 02239658 DOM-DOCUSATE SODIUM DPC 02020084 NOVO-DOCUSATE NOP 00703494 PMS-DOCUSATE SODIUM PMS 00870196 RATIO-DOCUSATE SODIUM RPH 00514888 SELAX ODN 01994344 SOFLAX PMS 200MG Capsule 02029529 SOFLAX PMS 250MG Capsule 02006596 SELAX ODN 10MG/ML Drop 02090163 COLACE WPC 00870218 DOCUSATE SODIUM RPH 00880140 PMS-SODIUM DOCUSATE PMS 02006723 SOFLAX PMS 4MG/ML Syrup 02086018 COLACE WPC 00703508 PMS-DOCUSATE SODIUM PMS 00870226 RATIO-DOCUSATE SODIUM RPH 02006758 SOFLAX SYRUP PMS 50MG/ML Syrup 00848417 PMS-DOCUSATE SODIUM PMS DIOCTYL SODIUM SULFOSUCCINATE, SENNA 50MG & 187MG Tablet 00026123 SENOKOT S PFR FIBER 469MG Tablet 00595829 NOVO-FIBRE NOP GLYCERINE Adult Suppository 00873462 GLYCERIN RPH * 01926039 GLYCERIN WLA 00812250 GLYCERINE WLA * 00884022 GLYCERINE RPH * Pediatric Suppository 02020815 GLYCERIN INFANT RPH 01926047 GLYCERIN INFANT & CHILD PFI LACTULOSE 667MG/ML Oral Liquid 02242814 APO-LACTULOSE APX 02247383 EURO-LAC EUR 667MG/ML Syrup 00703486 PMS-LACTULOSE PMS 00854409 RATIO-LACTULOSE RPH 00690686 RATIO-LACTULOSE RPH MACROGOL, POTASSIUM CHLORIDE, SODIUM BICARBONATE, SODIUM CHLORIDE, SODIUM SULFATE 60G & 750MG & 1.68G & 1.46G & 5.68G/L Powder 00677442 COLYTE ZYM 00652512 GOLYTELY BAX 00777838 PEGLYTE PMS MAGNESIUM HYDROXIDE 80MG/ML Liquid 02150646 MILK OF MAGNESIA PLAIN/SUGARFREE BCD 311MG Tablet 02150638 MILK OF MAGNESIA BCD MINERAL OIL 78% Jelly 00608734 LANSOYL GEL AXC 02186926 LANSOYL GEL SUGARFREE AXC Liquid 01935348 MINERAL OIL (HEAVY) 100% USP RWP 100% Liquid 01951718 NUJOL SCH PLANTAGO SEED 50% Powder 00599875 MUCILLIUM PMS POLYETHYLENE GLYCOL, POTASSIUM CHLORIDE, SODIUM BICARBONATE, SODIUM CHLORIDE, SODIUM SULFATE Oral Liquid 02147793 KLEAN-PREP RVX PSYLLIUM HYDROPHILIC MUCILLOID 680MG/G Powder 02174812 METAMUCIL ORIGINAL TEXTURE PGI 02174790 METAMUCIL SM TEXT ORANGE PGI 02174782 METAMUCIL SM TEXT ORANGE S/F PGI 02174804 METAMUCIL SM TEXT UNFLAV PGI SENNOSIDES 1.7MG/ML Liquid 02144379 SENNALAX PMS 02084651 SENNAPREP PMS 00367729 SENOKOT PFR 00367737 X-PREP PFR 8.6MG Tablet 02247389 EURO-SENNA EUR 00896411 PMS-SENNOSIDES PMS 01949292 RIVA-SENNA RIV 02089653 SANDOZ-SENNOSIDES SDZ 02237105 SENNA LAXATIVE SDR 02068109 SENNATAB PMS 00026158 SENOKOT PFR 12MG Tablet 00896403 PMS-SENNOSIDES PMS 02089645 SANDOZ-SENNOSIDES SDZ SODIUM CITRATE, SODIUM LAURYL SULFOACETATE, SORBITOL 90MG & 9MG & 625MG Enema 02063905 MICROLAX PMS SODIUM PHOSPHATE DIBASIC, SODIUM PHOSPHATE MONOBASIC 180MG & 480MG/ML Oral Liquid 02206218 PHOSPHO SODA FLEET LAXATIVE JAJ 02230399 PMS-PHOSPHATES SOLUTION PMS 60MG & 160MG/ML PED Rectal Liquid 00108065 FLEET ENEMA PEDIATRIC JAJ 60MG & 160MG/ML Rectal Liquid 02096900 ENEMOL DPC 00009911 FLEET ENEMA FRS 56:14.00 CHOLELITHOLYTIC AGENTS URSODIOL 250MG Tablet 02273497 PMS-URSODIOL PMS * 02238984 URSO AXC 500MG Tablet 02273500 PMS-URSODIOL PMS 02245894 URSO DS AXC 56:16.00 DIGESTANTS LACTASE 3,550U Capsule 02016478 LACTRASE RIV Oral Liquid 00903981 LACTAID MCL 50000U Oral Liquid 99003325 DAIRY-FREE KIN 3,000U Tablet 02200384 DAIRY DIGESTIVE PER 02239139 DAIRY DIGESTIVE SDR 02017512 DAIRY FREE KIN 01951637 DAIRYAID TAN 02230653 LACTAID JNO 4,500U Tablet 02239140 DAIRY DIGESTIVE EXTRA STRENGTH SDR 02224909 DAIRY FREE EXTRA STRENGTH KIN 02230113 DAIRYAID EXTRA STRENGTH TAN 02230654 LACTAID EXTRA STRENGTH JNO LIPASE, AMYLASE, PROTEASE 5,000U & 16,600U & 18,750U Capsule 02239007 CREON 5 MINIMICROSPHERES SPH 8,000U & 30,000U & 30,000U Capsule 00263818 COTAZYM ORG 20,000U & 66,400U & 75,000U Capsule 02239008 CREON 20 MINIMICROSPHERES SPH 4,000U & 11,000U & 11,000U Capsule (Enteric Coated Particles) 02181215 COTAZYM ECS4 ORG 4,000U & 12,000U & 12,000U Capsule (Enteric Coated Particles) 00789445 PANCREASE MT 4 JNO 4,500U & 20,000U & 25,000U Capsule (Enteric Coated Particles) 02203324 ULTRASE MS 4 AXC 8,000U & 30,000U & 30,000U Capsule (Enteric Coated Particles) 00502790 COTAZYM ECS 8 ORG 10,000U & 30,000U & 30,000U Capsule (Enteric Coated Particles) 00789437 PANCREASE MT 10 JNO 10,000U & 33,200U & 37,500U Capsule (Enteric Coated Particles) 02200104 CREON 10 MINIMICROSPHERES SPH 12,000U & 39,000U & 39,000U Capsule (Enteric Coated Particles) 02045834 ULTRASE MT 12 AXC 16,000U & 48,000U & 48,000U Capsule (Enteric Coated Particles) 00789429 PANCREASE MT 16 JNO 20,000U & 55,000U & 55,000U Capsule (Enteric Coated Particles) 00821373 COTAZYM ECS 20 ORG 20,000U & 65,000 & 65,000U Capsule (Enteric Coated Particles) 02045869 ULTRASE MT 20 AXC 25,000U & 74,000U & 62,500U Capsule (Enteric Coated Particles) 01985205 CREON 25 MINIMICROSPHERES SPH 4,500U & 20,000U & 25,000U Long Acting Capsule 02242374 PANCREASE LA JNO 24,000U & 100,000U & 100,000U/G Powder 02230020 VIOKASE AXC 8,000U & 30,000U & 30,000U Tablet 02230019 VIOKASE AXC 16,000U & 60,000U & 60,000U Tablet 02241933 VIOKASE AXC 56:20.00 EMETICS IPECAC Syrup 00378801 IPECAC XEN 00721328 PMS-IPECAC PMS 56:22.08 ANTIHISTAMINES DIMENHYDRINATE 50MG/ML Injection 00392537 DIMENHYDRINATE SDZ 00013579 GRAVOL HOR 3MG/ML Liquid 00230197 GRAVOL HOR 00757705 PMS-DIMENHYDRINATE PMS 25MG Suppository 00783595 GRAVOL HOR 50MG Suppository 00392553 DIMENHYDRINATE SIL 00013595 GRAVOL HOR 15MG Tablet 00511196 GRAVOL HOR 50MG Tablet 00363766 APO-DIMENHYDRINATE APX 00156655 DIMENHYDRINATE PRO 00013803 GRAVOL HOR 00399779 NAUSEATOL SIL 00586331 PMS-DIMENHYDRINATE PMS 00605786 TRAVEL AID VTH DOXYLAMINE SUCCINATE, PYRIDOXINE HCL 10MG & 10MG Tablet 00609129 DICLECTIN DUI MECLIZINE HCL 25MG Chewable Tablet 00220442 BONAMINE PFI 56:22.20 5-HT3 RECEPTOR ANTAGONISTS DOLASETRON MESYLATE 20MG/ML Injection 02231380 ANZEMET SAC 50MG Tablet 02231378 ANZEMET SAC 100MG Tablet 02231379 ANZEMET SAC GRANISETRON 1MG Tablet 02185881 KYTRIL HLR ONDANSETRON HCL DIHYDRATE 0.8MG/ML Liquid 02229639 ZOFRAN GSK 4MG Tablet 02264056 NOVO-ONDANSETRON NOP 02258188 PMS-ONDANSETRON PMS 02278529 RATIO-ONDANSETRON RPH 02274310 SANDOZ-ONDANSETRON SDZ 02213567 ZOFRAN GSK 02239372 ZOFRAN ODT GSK 8MG Tablet 02264064 NOVO-ONDANSETRON NOP 02258196 PMS-ONDANSETRON PMS 02278537 RATIO-ONDANSETRON RPH 02274329 SANDOZ-ONDANSETRON SDZ 02213575 ZOFRAN GSK 02239373 ZOFRAN ODT GSK 56:22.92 MISCELLANEOUS ANTIEMETICS DOMPERIDONE MALEATE 10MG Tablet 02103613 APO-DOMPERIDONE APX 02238315 DOM-DOMPERIDONE DPC 02236857 DOMPERIDONE PDL 02278669 GEN-DOMPERIDONE GEN 02157195 NOVO-DOMPERIDONE NOP 02231477 NU-DOMPERIDONE NXP 02236466 PMS-DOMPERIDONE PMS 02268078 RAN-DOMPERIDONE RBY 01912070 RATIO-DOMPERIDONE RPH NABILONE 0.5MG Capsule 02256193 CESAMET VAE 1MG Capsule 00548375 CESAMET VAE 56:28.12 HISTAMINE H2-ANTAGONISTS CIMETIDINE 200MG Tablet 00584215 APO-CIMETIDINE APX 02227436 GEN-CIMETIDINE GEN 00582409 NOVO-CIMETINE NOP 00865796 NU-CIMET NXP 02229717 PMS-CIMETIDINE PMS 300MG Tablet 00487872 APO-CIMETIDINE APX 00596477 CIMETIDINE PDL 02231287 DOM-CIMETIDINE DPC 02227444 GEN-CIMETIDINE GEN 00582417 NOVO-CIMETINE NOP 00865818 NU-CIMET NXP 02229718 PMS-CIMETIDINE PMS 400MG Tablet 00600059 APO-CIMETIDINE APX 00618691 CIMETIDINE PDL 02231288 DOM-CIMETIDINE DPC 02227452 GEN-CIMETIDINE GEN 00603678 NOVO-CIMETINE NOP 00865826 NU-CIMET NXP 02229719 PMS-CIMETIDINE PMS 600MG Tablet 00600067 APO-CIMETIDINE APX 00618705 CIMETIDINE PDL 02231290 DOM-CIMETIDINE DPC 02227460 GEN-CIMETIDINE GEN 00603686 NOVO-CIMETINE NOP 00865834 NU-CIMET NXP 02229720 PMS-CIMETIDINE PMS 800MG Tablet 00749494 APO-CIMETIDINE APX 02227479 GEN-CIMETIDINE GEN 00663727 NOVO-CIMETINE NOP 02229721 PMS-CIMETIDINE PMS FAMOTIDINE 20MG Tablet 01953842 APO-FAMOTIDINE APX 02241372 FAMOTIDINE PDL 02196018 GEN-FAMOTIDINE GEN 02022133 NOVO-FAMOTIDINE NOP 02024195 NU-FAMOTIDINE NXP 02238342 PENTA-FAMOTIDINE PEN 00710121 PEPCID FRS 02242327 RATIO-FAMOTIDINE RPH 02237148 ULCIDINE VAE 40MG Tablet 01953834 APO-FAMOTIDINE APX 02241373 FAMOTIDINE PDL 02196026 GEN-FAMOTIDINE GEN 02022141 NOVO-FAMOTIDINE NOP 02024209 NU-FAMOTIDINE NXP 02238343 PENTA-FAMOTIDINE PEN 00710113 PEPCID FRS 02242328 RATIO-FAMOTIDINE RPH 02237149 ULCIDINE VAE NIZATIDINE 150MG Capsule 02220156 APO-NIZATIDINE APX 00778338 AXID PHH 02185814 DOM-NIZATIDINE DPC 02246046 GEN-NIZATIDINE GEN 02239558 NIZATIDINE PDL 02240457 NOVO-NIZATIDINE NOP 02177714 PMS-NIZATIDINE PMS 300MG Capsule 02220164 APO-NIZATIDINE APX 00778346 AXID PHH 02246047 GEN-NIZATIDINE GEN 02238195 NIZATIDINE PHH 02239559 NIZATIDINE PDL 02240458 NOVO-NIZATIDINE NOP 02177722 PMS-NIZATIDINE PMS RANITIDINE HCL 15MG/ML Oral Solution 02280833 APO-RANITIDINE APX 02242940 NOVO-RANITIDINE NOP 02212374 ZANTAC GSK 150MG Tablet 00733059 APO-RANITIDINE APX 02265591 BCI-RANITIDINE BCI 02248570 CO-RANITIDINE COB 02207761 GEN-RANITIDINE GEN 02219077 MED-RANITIDINE MEC 00828564 NOVO-RANIDINE NOP 00865737 NU-RANIT NXP 02242453 PMS-RANITIDINE PMS 00740748 RANITIDINE PDL 00828823 RATIO-RANITIDINE RPH 02245782 RIVA-RANITIDINE PHH 02247814 RIVA-RANTIDINE RIV 02243229 SANDOZ-RANITIDINE SDZ 02212331 ZANTAC GSK 300MG Tablet 00733067 APO-RANITIDINE APX 02265605 BCI-RANITIDINE BCI 02248571 CO-RANITIDINE COB 02207788 GEN-RANITIDINE GEN 02219085 MED-RANITIDINE MEC 00828556 NOVO-RANIDINE NOP 00865745 NU-RANIT NXP 02242454 PMS-RANITIDINE PMS 00740756 RANITIDINE PDL 00828688 RATIO-RANITIDINE RPH 02245783 RIVA-RANITIDINE PHH 02247815 RIVA-RANITIDINE RIV 02243230 SANDOZ-RANITIDINE SDZ 02212358 ZANTAC GSK 56:28.28 PROSTAGLANDINS MISOPROSTOL 100MCG Tablet 02244022 APO-MISOPROSTOL APX 02240754 NOVO-MISOPROSTOL NOP 200MCG Tablet 02244023 APO-MISOPROSTOL APX 02248846 MISOPROSTOL PDL 02240755 NOVO-MISOPROSTOL NOP 02244125 PMS-MISOPROSTOL PMS 56:28.32 PROTECTANTS SUCRALFATE 200MG/ML Suspension 02103567 SULCRATE PLUS AXC 1G Tablet 02125250 APO-SUCRALFATE APX 02045702 NOVO-SUCRALATE NOP 02134829 NU-SUCRALFATE NXP 02238209 PMS-SUCRALFATE PMS 02130939 SUCRALFATE-1 PDL 02100622 SULCRATE AXC 56:28.36 PROTON-PUMP INHIBITORS AMOXICILLIN, CLARITHROMYCIN, LANSOPRAZOLE 500MG & 500MG & 30MG Kit 02238525 HP-PAC ABB LANSOPRAZOLE Limited use drug status (prior approval required) Coverage will be provided: - as part of multi-drug therapy (maximum 7-14 day coverage) for eradication of Helicobacter pylori in individuals with peptic ulcer disease (diagnosed by urea breath test, serology or endoscopically). Coverage will also be provided if the following prerequisites are met: - patient has tried at least 60 days of Apo-Omeprazole® (Generic) and - patient has tried at least 60 days of Rabeprazole sodium (Pariet®).
French: 10MG Suppositoire 02241091 MAGIC BULLET DCM DIOCTYL (SULFOSUCCINATE SODIQUE DE) 100MG Capsule 02245079 APO-DOCUSATE SODIUM APX 02106256 COLACE WPC 00794406 DOCUSATE SODIUM SDR 00830267 DOCUSATE SODIUM TRI 00716731 DOCUSATE SODIUM TAR 02246036 DOCUSATE SODIUM RPH 02239658 DOM-DOCUSATE SODIUM DPC 02020084 NOVO-DOCUSATE NOP 00703494 PMS-DOCUSATE SODIUM PMS 00870196 RATIO-DOCUSATE SODIUM RPH 00514888 SELAX ODN 01994344 SOFLAX PMS 200MG Capsule 02029529 SOFLAX PMS 250MG Capsule 02006596 SELAX ODN 10MG/ML Gouttes 02090163 COLACE WPC 00870218 DOCUSATE SODIUM RPH 00880140 PMS-SODIUM DOCUSATE PMS 02006723 SOFLAX PMS 4MG/ML Sirop 02086018 COLACE WPC 00703508 PMS-DOCUSATE SODIUM PMS 00870226 RATIO-DOCUSATE SODIUM RPH 02006758 SOFLAX SIROP PMS 50MG/ML Sirop 00848417 PMS-DOCUSATE SODIUM PMS DIOCTYL (SULFOSUCCINATE SODIQUE DE), SÉNÉ 50MG & 187MG Comprimé 00026123 SENOKOT S PFR DIOCTYL SULFOSUCCINATE CALCIQUE 240MG Capsule 02245080 APO-DOCUSATE CALCIUM APX 00830275 DOCUSATE CALCIUM TAR 00842044 NOVO-DOCUSATE CALCIUM NOP 00664553 PMS-DUCOSATE CALCIUM PMS 00809055 RATIO-DOCUSATE CALCIUM RPH FIBRES 469MG Comprimé 00595829 NOVO-FIBRE NOP GLYCÉRINE Adult Suppositoire 00812250 GLYCERINE WLA * 00884022 GLYCERINE RPH * 00873462 GLYCERINE RPH * 01926039 GLYCERINE WLA Pediatric Suppositoire 02020815 GLYCERIN ENFANT RPH 01926047 GLYCERIN ENFANT ET PEDIATRIQUE PFI GRAINES DE PLANTAIN 50% Poudre 00599875 MUCILLIUM PMS HUILE MINÉRALE 78% Gel 00608734 LANSOYL GEL AXC 02186926 LANSOYL GEL SANS SUCRE AXC Liquide 01935348 MINERAL OIL (HEAVY) 100% USP RWP 100% Liquide 01951718 NUJOL SCH LACTULOSE 667MG/ML Liquide oral 02242814 APO-LACTULOSE APX 02247383 EURO-LAC EUR 667MG/ML Sirop 00703486 PMS-LACTULOSE PMS 00854409 RATIO-LACTULOSE RPH 00690686 RATIO-LACTULOSE RPH MACROGOL, POTASSIUM CHLORIDE, SODIUM BICARBONATE, SODIUM CHLORIDE, SODIUM SULFATE 60G & 750MG & 1.68G & 1.46G & 5.68G/L Poudre 00677442 COLYTE ZYM 00652512 GOLYTELY BAX 00777838 PEGLYTE PMS MAGNÉSIUM (HYDROXIDE DE) 311MG Comprimé 02150638 LAIT DE MAGNESIE BCD 80MG/ML Liquide 02150646 LAIT DE MAGNESIE BCD PHOSPHATE DIBASIQUE DE SODIUM, PHOSPHATE MONOBASIQUE DE SODIUM 60MG & 160MG/ML Liquide Rectale 02096900 ENEMOL DPC 00009911 FLEET LAVEMENT FRS 60MG & 160MG/ML PED Liquide Rectale 00108065 FLEET LAVEMENT PEDIATRIQUE JAJ 180MG & 480MG/ML Liquide oral 02206218 PHOSPHO SODA FLEET JAJ 02230399 PMS-PHOSPHATES SOLUTION PMS POLYÉTHYLÈNE GLYCOL, POTASSIUM (CHLORURE DE), SODIUM (BICARBONATE DE), SODIUM (CHLORURE DE), SODIUM (SULFATE DE) Liquide oral 02147793 KLEAN-PREP RVX PSYLLIUM (MUCILOÏDE HYDROPHILE DE) 680MG/G Poudre 02174790 METAMUCIL TEXT/LIS ORANGE PGI 02174782 METAMUCIL TEXT/LIS ORANGE S/F PGI 02174804 METAMUCIL TEXT/LIS SANS SAVEUR PGI 02174812 METAMUCIL TEXTURE ORIGINALE PGI SENNOSIDES 8.6MG Comprimé 02247389 EURO-SENNA EUR 00896411 PMS-SENNOSIDES PMS 01949292 RIVA-SENNA RIV 02089653 SANDOZ-SENNOSIDES SDZ 02237105 SENNA LAXATIF SDR 02068109 SENNATAB PMS 00026158 SENOKOT PFR 12MG Comprimé 00896403 PMS-SENNOSIDES PMS 02089645 SANDOZ-SENNOSIDES SDZ 1.7MG/ML Liquide 02144379 SENNALAX PMS 02084651 SENNAPREP PMS 00367729 SENOKOT PFR 00367737 X-PREP PFR SODIUM (CITRATE DE), SODIUM (LAURYLSULFOACÉTATE DE), SORBITOL 90MG & 9MG & 625MG Lavement 02063905 MICROLAX PMS 56:14.00 CHOLÉLITHOLYTIQUES URSODIOL 250MG Comprimé 02273497 PMS-URSODIOL PMS * 02238984 URSO AXC 500MG Comprimé 02273500 PMS-URSODIOL PMS 02245894 URSO DS AXC 56:16.00 DIGESTIFS LACTASE 3,550U Capsule 02016478 LACTRASE RIV 3,000U Comprimé 02200384 DAIRY DIGESTIF PER 02239139 DAIRY DIGESTIF SDR 02017512 DAIRY FREE KIN 01951637 DAIRYAID TAN 02230653 LACTAID JNO 4,500U Comprimé 02239140 DAIRY DIGESTIF EXTRA FORT SDR 02224909 DAIRY FREE EXTRA FORTE KIN 02230113 DAIRYAID EXTRA FORTE TAN 02230654 LACTAID EXTRA FORTE JNO Liquide oral 00903981 LACTAID MCL 50000U Liquide oral 99003325 DAIRY-FREE KIN LIPASE, AMYLASE, PROTÉASE 5,000U & 16,600U & 18,750U Capsule 02239007 CREON 5 MINIMICROSPHERES SPH 8,000U & 30,000U & 30,000U Capsule 00263818 COTAZYM ORG 20,000U & 66,400U & 75,000U Capsule 02239008 CREON 20 MINIMICROSPHERES SPH 4,000U & 11,000U & 11,000U Capsule (particules entérosolubles) 02181215 COTAZYM ECS 4 ORG 4,000U & 12,000U & 12,000U Capsule (particules entérosolubles) 00789445 PANCREASE MT 4 JNO 4,500U & 20,000U & 25,000U Capsule (particules entérosolubles) 02203324 ULTRASE MS 4 AXC 8,000U & 30,000U & 30,000U Capsule (particules entérosolubles) 00502790 COTAZYM ECS 8 ORG 10,000U & 30,000U & 30,000U Capsule (particules entérosolubles) 00789437 PANCREASE MT 10 JNO 10,000U & 33,200U & 37,500U Capsule (particules entérosolubles) 02200104 CREON 10 MINIMICROSPHERES SPH 12,000U & 39,000U & 39,000U Capsule (particules entérosolubles) 02045834 ULTRASE MT 12 AXC 16,000U & 48,000U & 48,000U Capsule (particules entérosolubles) 00789429 PANCREASE MT 16 JNO 20,000U & 55,000U & 55,000U Capsule (particules entérosolubles) 00821373 COTAZYM ECS 20 ORG 20,000U & 65,000 & 65,000U Capsule (particules entérosolubles) 02045869 ULTRASE MT 20 AXC 25,000U & 74,000U & 62,500U Capsule (particules entérosolubles) 01985205 CREON 25 MINIMICROSPHERES SPH 4,500U & 20,000U & 25,000U Capsule à action prolongée 02242374 PANCREASE LA JNO 8,000U & 30,000U & 30,000U Comprimé 02230019 VIOKASE AXC 16,000U & 60,000U & 60,000U Comprimé 02241933 VIOKASE AXC 24,000U & 100,000U & 100,000U/G Poudre 02230020 VIOKASE AXC 56:20.00 ÉMÉTIQUES IPÉCA Sirop 00378801 IPECA XEN 00721328 PMS-IPECAC PMS 56:22.08 ANTIHISTAMINIQUES DIMENHYDRINATE 15MG Comprimé 00511196 GRAVOL HOR 50MG Comprimé 00363766 APO-DIMENHYDRINATE APX 00156655 DIMENHYDRINATE PRO 00605786 DIMENHYDRINATE VTH 00013803 GRAVOL HOR 00399779 NAUSEATOL SIL 00586331 PMS-DIMENHYDRINATE PMS 50MG/ML Injection 00392537 DIMENHYDRINATE SDZ 00013579 GRAVOL HOR 3MG/ML Liquide 00230197 GRAVOL HOR 00757705 PMS-DIMENHYDRINATE PMS 25MG Suppositoire 00783595 GRAVOL HOR 50MG Suppositoire 00392553 DIMENHYDRINATE SIL 00013595 GRAVOL HOR DOXYLAMINE (SUCCINATE DE), PYRIDOXINE (CHLORHYDRATE DE) 10MG & 10MG Comprimé 00609129 DICLECTIN DUI MÉCLIZINE (CHLORHYDRATE DE) 25MG Comprimé à croquer 00220442 BONAMINE PFI 56:22.20 ANTAGONOSTES DU RÉCEPTEUR 5-HT3 DOLASÉTRON (MÉSYLATE DE) 50MG Comprimé 02231378 ANZEMET SAC 100MG Comprimé 02231379 ANZEMET SAC 20MG/ML Injection 02231380 ANZEMET SAC GRANISETRON 1MG Comprimé 02185881 KYTRIL HLR ONDANSÉTRON (CHLROHYDRATE DIHYDRATÉ) 4MG Comprimé 02264056 NOVO-ONDANSETRON NOP 02258188 PMS-ONDANSETRON PMS 02278529 RATIO-ONDANSETRON RPH 02274310 SANDOZ-ONDANSETRON SDZ 02213567 ZOFRAN GSK 02239372 ZOFRAN ODT GSK 8MG Comprimé 02264064 NOVO-ONDANSETRON NOP 02258196 PMS-ONDANSETRON PMS 02278537 RATIO-ONDANSETRON RPH 02274329 SANDOZ-ONDANSETRON SDZ 02213575 ZOFRAN GSK 02239373 ZOFRAN ODT GSK 0.8MG/ML Liquide 02229639 ZOFRAN GSK 56:22.92 ANTIÉMÉTIQUES DIVERS DOMPÉRIDONE (MALÉATE DE) 10MG Comprimé 02103613 APO-DOMPERIDONE APX 02238315 DOM-DOMPERIDONE DPC 02236857 DOMPERIDONE PDL 02278669 GEN-DOMPERIDONE GEN 02157195 NOVO-DOMPERIDONE NOP 02231477 NU-DOMPERIDONE NXP 02236466 PMS-DOMPERIDONE PMS 02268078 RAN-DOMPERIDONE RBY 01912070 RATIO-DOMPERIDONE RPH NABILONE 0.5MG Capsule 02256193 CESAMET VAE 1MG Capsule 00548375 CESAMET VAE 56:28.12 ANTAGONISTES DY RÉCEPTEUR H2 DE L'HISTAMINE CIMÉTIDINE 200MG Comprimé 00584215 APO-CIMETIDINE APX 02227436 GEN-CIMETIDINE GEN 00582409 NOVO-CIMETINE NOP 00865796 NU-CIMET NXP 02229717 PMS-CIMETIDINE PMS 300MG Comprimé 00487872 APO-CIMETIDINE APX 00596477 CIMETIDINE PDL 02231287 DOM-CIMETIDINE DPC 02227444 GEN-CIMETIDINE GEN 00582417 NOVO-CIMETINE NOP 00865818 NU-CIMET NXP 02229718 PMS-CIMETIDINE PMS 400MG Comprimé 00600059 APO-CIMETIDINE APX 00618691 CIMETIDINE PDL 02231288 DOM-CIMETIDINE DPC 02227452 GEN-CIMETIDINE GEN 00603678 NOVO-CIMETINE NOP 00865826 NU-CIMET NXP 02229719 PMS-CIMETIDINE PMS 600MG Comprimé 00600067 APO-CIMETIDINE APX 00618705 CIMETIDINE PDL 02231290 DOM-CIMETIDINE DPC 02227460 GEN-CIMETIDINE GEN 00603686 NOVO-CIMETINE NOP 00865834 NU-CIMET NXP 02229720 PMS-CIMETIDINE PMS 800MG Comprimé 00749494 APO-CIMETIDINE APX 02227479 GEN-CIMETIDINE GEN 00663727 NOVO-CIMETINE NOP 02229721 PMS-CIMETIDINE PMS FAMOTIDINE 20MG Comprimé 01953842 APO-FAMOTIDINE APX 02241372 FAMOTIDINE PDL 02196018 GEN-FAMOTIDINE GEN 02022133 NOVO-FAMOTIDINE NOP 02024195 NU-FAMOTIDINE NXP 02238342 PENTA-FAMOTIDINE PEN 00710121 PEPCID FRS 02242327 RATIO-FAMOTIDINE RPH 02237148 ULCIDINE VAE 40MG Comprimé 01953834 APO-FAMOTIDINE APX 02241373 FAMOTIDINE PDL 02196026 GEN-FAMOTIDINE GEN 02022141 NOVO-FAMOTIDINE NOP 02024209 NU-FAMOTIDINE NXP 02238343 PENTA-FAMOTIDINE PEN 00710113 PEPCID FRS 02242328 RATIO-FAMOTIDINE RPH 02237149 ULCIDINE VAE NIZATIDINE 150MG Capsule 02220156 APO-NIZATIDINE APX 00778338 AXID PHH 02185814 DOM-NIZATIDINE DPC 02246046 GEN-NIZATIDINE GEN 02239558 NIZATIDINE PDL 02240457 NOVO-NIZATIDINE NOP 02177714 PMS-NIZATIDINE PMS 300MG Capsule 02220164 APO-NIZATIDINE APX 00778346 AXID PHH 02246047 GEN-NIZATIDINE GEN 02238195 NIZATIDINE PHH 02239559 NIZATIDINE PDL 02240458 NOVO-NIZATIDINE NOP 02177722 PMS-NIZATIDINE PMS RANITIDINE (CHLORHYDRATE DE) 150MG Comprimé 00733059 APO-RANITIDINE APX 02265591 BCI-RANITIDINE BCI 02248570 CO-RANITIDINE COB 02207761 GEN-RANITIDINE GEN 02219077 MED-RANITIDINE MEC 00828564 NOVO-RANIDINE NOP 00865737 NU-RANIT NXP 02242453 PMS-RANITIDINE PMS 00740748 RANITIDINE PDL 00828823 RATIO-RANITIDINE RPH 02245782 RIVA-RANITIDINE PHH 02247814 RIVA-RANTIDINE RIV 02243229 SANDOZ-RANITIDINE SDZ 02212331 ZANTAC GSK 300MG Comprimé 00733067 APO-RANITIDINE APX 02265605 BCI-RANITIDINE BCI 02248571 CO-RANITIDINE COB 02207788 GEN-RANITIDINE GEN 02219085 MED-RANITIDINE MEC 00828556 NOVO-RANIDINE NOP 00865745 NU-RANIT NXP 02242454 PMS-RANITIDINE PMS 00740756 RANITIDINE PDL 00828688 RATIO-RANITIDINE RPH 02245783 RIVA-RANITIDINE PHH 02247815 RIVA-RANITIDINE RIV 02243230 SANDOZ-RANITIDINE SDZ 02212358 ZANTAC GSK 15MG/ML Solution orale 02280833 APO-RANITIDINE APX 02242940 NOVO-RANITIDINE NOP 02212374 ZANTAC GSK 56:28.28 PROSTAGLANDINES MISOPROSTOL 100MCG Comprimé 02244022 APO-MISOPROSTOL APX 02240754 NOVO-MISOPROSTOL NOP 200MCG Comprimé 02244023 APO-MISOPROSTOL APX 02248846 MISOPROSTOL PDL 02240755 NOVO-MISOPROSTOL NOP 02244125 PMS-MISOPROSTOL PMS 56:28.32 PROTECTEURS SUCRALFATE 1G Comprimé 02125250 APO-SUCRALFATE APX 02045702 NOVO-SUCRALATE NOP 02134829 NU-SUCRALFATE NXP 02238209 PMS-SUCRALFATE PMS 02130939 SUCRALFATE-1 PDL 02100622 SULCRATE AXC 200MG/ML Suspension 02103567 SULCRATE PLUS AXC 56:28.36 INHIBITEURS DE LA POMPE à PROTONS AMOXICILLINE, CLARITHROMYCINE, LANSOPRAZOLE 500MG & 500MG & 30MG Trousse 02238525 HP-PAC ABB LANSOPRAZOLE Médicament à usage restreint (autorisation préalable nécessaire). Seront couverts: - en association avec d'autres produits, pour l'éradication de l'Hélicobacter pylori chez les personnes souffrant d'un ulcère peptique, (ulcère diagnostiqué par test respiratoire à l'urée, sérologie ou endoscopie) (traitement de 7-14 jours). Seront aussi couverts si les conditions préalables sont confirmées : - patient a essayé au minimum 60 jours d'Apo-Oméprazole ® (générique) et - patient a essayé au minimum 60 jours de Rabeprazole sodium (Pariet®).