BUDESONIDE + FORMOTEROL

budesonide 400 microgram/actuation + formoterol fumarate dihydrate 12 microgram/actuation powder for inhalation, 60 actuations

BUDESONIDE + FORMOTEROL (14398T)

budesonide 400 microgram/actuation + formoterol fumarate dihydrate 12 microgram/actuation powder for inhalation, 60 actuations
14398T
Body System:
Manner of administration:Inhalation By Mouth
General Schedule
Authority Required (STREAMLINED)

Restriction  15617

Indication: Asthma

Restriction  15548

Indication: Chronic obstructive pulmonary disease (COPD)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 4 # of repeats: 5 DPMQ: $108.72 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Bufomix Easyhaler 400/12
DuoResp Spiromax
Rilast TURBUHALER 400/12
Symbicort TURBUHALER 400/12
*Additional charge for this brand is $8.12
 DPMQ: $116.84 Max safety net: $25.00 General Patient Charge: $33.12