Drugs available on Contract - [SPORANOX 100MG CAP (JAC) ITRACONAZOLE], []

Contract Number	42
Brand Code	5861D
Brand Name	SPORANOX 100MG CAP (JAC) ITRACONAZOLE
Active Ingredient	ITRACONAZOLE
Trade Name	SPORANOX
Package Size	60'S
Formulary Category	C
Pkg Price	186.88
Unit Price	3.11
Strength	100MG
Unit Description	CAP
Max. Reimbursable Quantity / Month	12
Package Description	BLIS
Manufacturer Code	JAC
Manufacturer Name	JANSSEN-CILAG
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor
Dentist Allowed	N
Therapeutic Code	081408
Therapeutic Desc	AZOLES
Status Description
Default Route	ORAL
Max Repeats	0
Therapeutic Head	AZOLES
Amend Date