TRIGLYCERIDES MEDIUM CHAIN FORMULA

triglycerides medium chain formula powder for oral liquid, 400 g

TRIGLYCERIDES MEDIUM CHAIN FORMULA (15380L)

triglycerides medium chain formula powder for oral liquid, 400 g
15380L
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Dietary management of conditions requiring a source of medium chain triglycerides

Restriction

Indication: Hyperlipoproteinaemia type 1

Restriction

Indication: Long chain fatty acid oxidation disorders

Restriction

Indication: Chylous ascites

Restriction

Indication: Chylothorax
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 8 Max qty units: 8 # of repeats: 5 DPMQ: $393.32 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Monogen