Source	General Schedule
Body System	BLOOD AND BLOOD FORMING ORGANS > ANTITHROMBOTIC AGENTS > ANTITHROMBOTIC AGENTS

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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
13523RMPNP	DABIGATRAN dabigatran etexilate 110 mg capsule, 60 (PI, CMI)	2	120	5	$84.83	$31.60	$31.60
	Available brands
	ARX-Dabigatrana
	Dabigatran Sandoza
	PHARMACOR DABIGATRANa
	Pradaxaa * Additional charge for this brand is $17.86B	2	120	5	$102.69	$31.60	$49.46