Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12180CMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1700.52	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12186JMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1652.15	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12201EMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1700.52	$31.60	$31.60
	Available brands
	Ambrisentan Mylana
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
12212RMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1652.15	$31.60	$31.60
	Available brands
	Ambrisentan Mylana
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
5607DMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1652.15	$31.60	$31.60
	Available brands
	Ambrisentan Mylana
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Public
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
5608EMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1652.15	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
9648TMP	AMBRISENTAN ambrisentan 5 mg tablet, 30 (PI, CMI)	1	30	5	$1700.52	$31.60	$31.60
	Available brands
	Ambrisentan Mylana
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa

Source	S100 HSD Private
Body System	CARDIOVASCULAR SYSTEM > ANTIHYPERTENSIVES > OTHER ANTIHYPERTENSIVES

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
9649WMP	AMBRISENTAN ambrisentan 10 mg tablet, 30 (PI, CMI)	1	30	5	$1700.52	$31.60	$31.60
	Available brands
	Ambrisentan Viatrisa
	Cipla Ambrisentana
	PULMORISa
	Volibrisa