Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

Restricted Benefit

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
11520HMPNP	CLONAZEPAMP clonazepam 500 microgram tablet, 50 (PI, CMI)
	Available brands
	Rivotrila * Additional charge for this brand is $1.84B	2	100	3	$20.76	$20.23	$25.36

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Caution

Note

Authority Required

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
11559JMPNP	CLONAZEPAM clonazepam 500 microgram tablet, 50 (PI, CMI)
	Available brands
	Rivotrila * Additional charge for this brand is $3.68B	4	200	2	$29.38	$27.01	$33.68

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Restricted Benefit

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
12534QMPNP	CLONAZEPAMP clonazepam 1 mg/mL injection [5 x 1 mL ampoules] (&) inert substance diluent [5 x 1 mL ampoules], 1 pack (PI, CMI)	1	5	1	$22.71	$24.02	$27.31
	Available brands
	Rivotril

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Caution

Note

Authority Required

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
1805BMPNP	CLONAZEPAM clonazepam 500 microgram tablet, 100 (PI, CMI)	2	200	2	$25.68	$26.99	$30.00
	Available brands
	Paxam 0.5a

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Caution

Note

Authority Required

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
1806CMPNP	CLONAZEPAM clonazepam 2 mg tablet, 100 (PI, CMI)	2	200	2	$33.56	$30.00	$30.00
	Available brands
	Paxam 2

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

Restricted Benefit

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
1807DMPNP	CLONAZEPAM clonazepam 1 mg/mL injection [5 x 1 mL ampoules] (&) inert substance diluent [5 x 1 mL ampoules], 1 pack (PI, CMI)	1	5	0	$22.71	$24.02	$27.31
	Available brands
	Rivotril

Source	General Schedule
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Caution

Note

Authority Required

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
1808EMPNP	CLONAZEPAM clonazepam 2.5 mg/mL (0.1 mg/drop) oral liquid, 10 mL (PI, CMI)	2	2	0	$19.66	$20.97	$24.26
	Available brands
	Rivotril

Source	Prescriber Bag
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

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
3478CMPNP	CLONAZEPAM clonazepam 2.5 mg/mL (0.1 mg/drop) oral liquid, 10 mL (PI, CMI)	1	1	0	$15.90	$0.00	Nil
	Available brands
	Rivotril

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

Restricted Benefit

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
5337XMPNP	CLONAZEPAMP clonazepam 500 microgram tablet, 100 (PI, CMI)	1	100	3	$18.91	$20.22	$23.51
	Available brands
	Paxam 0.5a

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

Restricted Benefit

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
5338YMPNP	CLONAZEPAMP clonazepam 2 mg tablet, 100 (PI, CMI)	1	100	3	$22.85	$24.16	$27.45
	Available brands
	Paxam 2

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANTIEPILEPTICS > ANTIEPILEPTICS

Note

Restricted Benefit

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
5339BMPNP	CLONAZEPAMP clonazepam 2.5 mg/mL (0.1 mg/drop) oral liquid, 10 mL (PI, CMI)	2	2	3	$19.66	$20.97	$24.26
	Available brands
	Rivotril