DOLUTEGRAVIR + RILPIVIRINE

dolutegravir 50 mg + rilpivirine 25 mg tablet, 30

DOLUTEGRAVIR + RILPIVIRINE (11540J)

dolutegravir 50 mg + rilpivirine 25 mg tablet, 30
11540J
Body System:
Manner of administration:Oral
S100 HSD Community Access
Authority Required (STREAMLINED)

Restriction  8214

Indication: HIV infection
Treatment phase: Initial treatment

Restriction  8226

Indication: HIV infection
Treatment phase: Continuing treatment
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: $1,649.50 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Juluca