Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
10875JMP	TACROLIMUS tacrolimus 750 microgram capsule, 100 (PI, CMI)	2	200	5	$179.58	$25.00	$25.00
	Available brands
	Tacrolimus Sandoz

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
10879NMP	TACROLIMUS tacrolimus 2 mg capsule, 100 (PI, CMI)	2	200	5	$496.96	$25.00	$25.00
	Available brands
	Tacrolimus Sandoz

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
11920JMP	TACROLIMUS tacrolimus 3 mg modified release capsule, 50 (PI, CMI)	2	100	3	$693.40	$25.00	$25.00
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6216EMP	TACROLIMUS tacrolimus 1 mg capsule, 100 (PI, CMI)	2	200	5	$223.04	$25.00	$25.00
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 1a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6217FMP	TACROLIMUS tacrolimus 5 mg capsule, 50 (PI, CMI)	2	100	5	$544.02	$25.00	$25.00
	Available brands
	Pharmacor Tacrolimus 5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6328CMP	TACROLIMUS tacrolimus 500 microgram capsule, 100 (PI, CMI)	2	200	5	$115.96	$25.00	$25.00
	Available brands
	Pacrolima
	Pharmacor Tacrolimus 0.5a
	Prografa
	Tacrografa
	Tacrolimus Sandoza

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9681MMP	TACROLIMUS tacrolimus 500 microgram modified release capsule, 30 (PI, CMI)	2	60	5	$87.92	$25.00	$25.00
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9682NMP	TACROLIMUS tacrolimus 1 mg modified release capsule, 60 (PI, CMI)	2	120	5	$137.38	$25.00	$25.00
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9683PMP	TACROLIMUS tacrolimus 5 mg modified release capsule, 30 (PI, CMI)	2	60	5	$789.34	$25.00	$25.00
	Available brands
	ADVAGRAF XLa
	Tacrolimus XR Sandoza