Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12493MMPNP	HYDROMORPHONEP hydromorphone hydrochloride 2 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	2	10	1	$30.29	$31.60	$31.60
	Available brands
	Dilaudida
	HYDROMORPHONE JUNOa
	Hydromorphone-hamelna
	MEDSURGE HYDROMORPHONE 2 mg/1 mLa

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
12531MMPNP	HYDROMORPHONEP hydromorphone hydrochloride 10 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	2	10	1	$34.35	$31.60	$31.60
	Available brands
	Dilaudid-HPa
	HYDROMORPHONE JUNO-HPa
	Hydromorphone-hameln-HPa
	MEDSURGE HYDROMORPHONE HP 10 mg/1 mLa

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

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
13796DMPNP	HYDROMORPHONE hydromorphone hydrochloride 1 mg/mL oral liquid, 473 mL (PI, CMI)	1	473	0	$434.76	$31.60	$31.60
	Available brands
	Hydromorphone hydrochloride oral solution, USP (Medsurge)a

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

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
13799GDP	HYDROMORPHONE hydromorphone hydrochloride 1 mg/mL oral liquid, 473 mL (PI, CMI)	1	473	0	$434.76	$31.60	$31.60
	Available brands
	Hydromorphone hydrochloride oral solution, USP (Medsurge)a

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
13806PMPNP	HYDROMORPHONEP hydromorphone hydrochloride 1 mg/mL oral liquid, 473 mL (PI, CMI)	1	473	1	$434.76	$31.60	$31.60
	Available brands
	Hydromorphone hydrochloride oral solution, USP (Medsurge)a

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

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
14076WMPNP	HYDROMORPHONE hydromorphone hydrochloride 1 mg/mL oral liquid, 500 mL (PI, CMI)	1	500	0	$434.76	$31.60	$31.60
	Available brands
	pms-HYDROmorphone

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

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
14080CDP	HYDROMORPHONE hydromorphone hydrochloride 1 mg/mL oral liquid, 500 mL (PI, CMI)	1	500	0	$434.76	$31.60	$31.60
	Available brands
	pms-HYDROmorphone

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required (STREAMLINED)

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
14084GMPNP	HYDROMORPHONEP hydromorphone hydrochloride 1 mg/mL oral liquid, 500 mL (PI, CMI)	1	500	1	$434.76	$31.60	$31.60
	Available brands
	pms-HYDROmorphone

Source	General Schedule
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

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
8420EMPNP	HYDROMORPHONE hydromorphone hydrochloride 2 mg/mL injection, 5 x 1 mL ampoules (PI, CMI)	1	5	0	$24.23	$25.63	$29.08
	Available brands
	Dilaudida
	HYDROMORPHONE JUNOa
	Hydromorphone-hamelna
	MEDSURGE HYDROMORPHONE 2 mg/1 mLa