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Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 0011M HISTAL 4MG TAB (CAR/COL) CHLORPHENIRAMINE CHLORPHENIRAMINE HISTAL 1000'S A $29.06 $0.03 TABLET 84 TAB CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 0404 FIRST GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012AB ALLEGRA 120MG TAB (SFA/COL) FEXOFENADINE FEXOFENADINE ALLEGRA 10'S C $9.51 $0.95 TABLET 0 TAB SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012AB ALLEGRA 120MG TAB (SFA/COL) FEXOFENADIN (C) FEXOFENADINE ALLEGRA 10'S C $16.31 $1.63 TABLET IMMED SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09
40 0012AN MEQUILAN 5MG TAB (CAR/COL) MEQUITAZINE MEQUITAZINE MEQUILAN 112'S A $42.41 $0.38 TABLET 28 TAB CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012AQ ALLEGRA 180MG TAB (SFA/COL) FEXOFENADINE FEXOFENADINE ALLEGRA 10'S C $10.19 $1.02 TABLET 0 TAB SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012AQ ALLEGRA 180MG TAB (SFA/COL) FEXOFENADIN (C) FEXOFENADINE ALLEGRA 10'S C $24.19 $2.42 TABLET IMMED SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09
40 0012BA APO-CETIRIZINE 10MG TAB (APO/COL) CETIRIZINE APO-CETIRIZINE 100'S A $8.37 $0.08 TABLET 14 TAB APO APOTEX INC. COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012BB APO-LORATADINE 10MG TAB (APO/COL) LORATADINE APO-LORATADINE 100'S A $8.56 $0.09 TABLET 14 TAB APO APOTEX INC. COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012EA DESLORA-DENK 5MG TAB (EDK/COL) DESLORATADINE DESLORATADINE DESLORA-DENK 10'S C $3.13 $0.31 TABLET 0 TAB EDK DENK PHARMA GMBH & CO. KG. COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012EX CLARITYNE 10MG TAB (BSP/COL) LORATADINE LORATADINE CLARITYNE 30'S C $9.51 $0.32 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012Y ZYRTEC 10MG TAB (GSK/COL) CETIRIZINE CETIRIZINE ZYRTEC 20'S C $20.69 $1.03 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013AF ZYRTEC 10MG/ML DROPS (GSK/COL) CETIRIZINE CETIRIZINE ZYRTEC 10ML C $11.85 $11.85 DROPS 0 BOTT GSK GLAXOSMITHKLINE COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013E HISTAL 0.4MG/ML ELIX (CAR/COL) CHLORPHENIRAMI CHLORPHENIRAMINE HISTAL 2 LITRES A $34.79 $0.02 SYRUP 100 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 0404 FIRST GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013G ALLEGRA 6MG/ML SUSP (SFA/COL) FEXOFENADINE FEXOFENADINE ALLEGRA 150ML C $13.59 $0.09 SUSPENSION 0 ML SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013G ALLEGRA 6MG/ML SUSP (SFA/COL) FEXOFENAD (C) FEXOFENADINE ALLEGRA 150ML C $29.36 $0.20 SUSPENSION SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09
40 0013T ZYRTEC 1MG/ML SYR (GSK/COL) CETIRIZINE CETIRIZINE ZYRTEC 60ML C $11.20 $0.19 SYRUP 0 ML GSK GLAXOSMITHKLINE COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 00147 CHLORPHENIRAMINE 5MG/ML IV/IM INJ (STP/COL) CHLORPHENIRAMINE CHLORPHENIRAMINE 100X2ML B $173.97 $1.74 INJECTION 0 AMP STP STEROP LABORATORIES COL COLLINS LTD 0404 FIRST GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 IV/IM 0 ANTIHISTAMINICS
40 0071G APO-ZOLPIDEM 5MG TAB (APO/COL) ZOLPIDEM APO-ZOLPIDEM 30'S C $17.81 $0.59 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 0072K APO-ZOLPIDEM 10MG TAB (APO/COL) ZOLPIDEM APO-ZOLPIDEM 30'S C $19.98 $0.67 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
40 0081T FLUCONAZOLE 200MG INJ (BRA/COL) FLUCONAZOLE FLUCONAZOLE 100ML BQ $4.65 $4.65 INJECTION 0 VIAL BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 081408 AZOLES 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS