OCTREOTIDE

octreotide 30 mg modified release injection [1 vial] (&) inert substance diluent [2 mL syringe], 1 pack

OCTREOTIDE (11512X)

octreotide 30 mg modified release injection [1 vial] (&) inert substance diluent [2 mL syringe], 1 pack
11512X
Body System:
Manner of administration:Injection
S100 HSD Community Access
Authority Required (STREAMLINED)

Restriction  8197

Indication: Acromegaly

Restriction  8208

Indication: Functional carcinoid tumour

Restriction  8198

Indication: Vasoactive intestinal peptide secreting tumour (VIPoma)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 5 DPMQ: $1,256.20 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Sandostatin LAR