LACOSAMIDE
lacosamide 100 mg tablet, 56
LACOSAMIDE (13839J)
13839J
Body System:
Manner of administration:Oral
Restriction (Streamlined authority code: 17516)
Indication: Idiopathic generalised epilepsy with primary generalised tonic-clonic seizures
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 112 | # of repeats: 5 | DPMQ: $112.04 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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