TOLVAPTAN
tolvaptan 15 mg tablet [28] (&) tolvaptan 45 mg tablet [28], 56
TOLVAPTAN (11600M)
11600M
Body System:
Manner of administration:Oral
Restriction 8288
Indication: Autosomal dominant polycystic kidney disease (ADPKD)
Treatment phase: Continuing treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 1 | # of repeats: 5 | DPMQ: $571.86 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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