SPIRONOLACTONE

spironolactone 25 mg tablet, 100

SPIRONOLACTONE (13503Q)

spironolactone 25 mg tablet, 100
13503Q
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 5 DPMQ: $21.84 Max safety net: $23.38 General Patient Charge: $25.00
Available brands
Spironolactone Viatris 25
Aldactone
*Additional charge for this brand is $14.66
 DPMQ: $36.50 Max safety net: $23.38 General Patient Charge: $39.66
Spiractin 25
*Additional charge for this brand is $8.84
 DPMQ: $30.68 Max safety net: $23.38 General Patient Charge: $33.84