Source	S100 HSD Community Access
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10266HMPNP	ZIDOVUDINE zidovudine 100 mg capsule, 100 (PI, CMI)	4	400	5	$548.37	$31.60	$31.60
	Available brands
	Retrovir

Source	S100 HSD Community Access
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10360GMPNP	ZIDOVUDINE zidovudine 250 mg capsule, 40 (PI, CMI)	6	240	5	$818.37	$31.60	$31.60
	Available brands
	Retrovir

Source	S100 HSD Community Access
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10361HMPNP	ZIDOVUDINE zidovudine 50 mg/5 mL oral liquid, 200 mL (PI, CMI)	15	15	5	$577.17	$31.60	$31.60
	Available brands
	Retrovir