DOLUTEGRAVIR

dolutegravir 50 mg tablet, 30

DOLUTEGRAVIR (10283F)

dolutegravir 50 mg tablet, 30
10283F
Body System:
Manner of administration:Oral
S100 HSD Community Access
Authority Required (STREAMLINED)

Restriction  4512

Indication: HIV infection
Treatment phase: Initial

Restriction  4454

Indication: HIV infection
Treatment phase: Continuing
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $1,250.20 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Tivicay