Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
3381YMPNP	OLANZAPINE olanzapine 5 mg orally disintegrating tablet, 28 (PI, CMI)	1	28	5	$18.20	$19.68	$23.13
	Available brands
	APO-Olanzapine ODTa
	OLANZAPINE ODT-WGRa
	Olanzapine Sandoz ODT 5a
	PRYZEX ODTa
	Zypine ODTa

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
3382BMPNP	OLANZAPINE olanzapine 10 mg orally disintegrating tablet, 28 (PI, CMI)	1	28	5	$20.61	$22.09	$25.54
	Available brands
	APO-Olanzapine ODTa
	OLANZAPINE ODT-WGRa
	Olanzapine Sandoz ODT 10a
	PRYZEX ODTa
	Zypine ODTa

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
3384DMPNP	OLANZAPINE olanzapine 15 mg orally disintegrating tablet, 28 (PI, CMI)	1	28	5	$24.03	$25.51	$28.96
	Available brands
	APO-Olanzapine ODTa
	OLANZAPINE ODT-WGRa
	Olanzapine Sandoz ODT 15a
	PRYZEX ODTa
	Zypine ODTa

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
3385EMPNP	OLANZAPINE olanzapine 20 mg orally disintegrating tablet, 28 (PI, CMI)	1	28	5	$27.43	$28.91	$31.60
	Available brands
	APO-Olanzapine ODTa
	OLANZAPINE ODT-WGRa
	Olanzapine Sandoz ODT 20a
	PRYZEX ODTa
	Zypine ODTa

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

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
8170BMPNP	OLANZAPINE olanzapine 2.5 mg tablet, 28 (PI, CMI)	1	28	5	$17.28	$18.76	$22.21
	Available brands
	APO-OLANZAPINEa
	Olanzapine RBXa
	Olanzapine Sandoza
	Ozin 2.5a
	PRYZEXa
	Zypinea
	Zyprexaa * Additional charge for this brand is $7.83B	1	28	5	$25.11	$18.76	$30.04

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

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
8185TMPNP	OLANZAPINE olanzapine 5 mg tablet, 28 (PI, CMI)	1	28	5	$18.20	$19.68	$23.13
	Available brands
	APO-OLANZAPINEa
	Olanzapine RBXa
	Olanzapine Sandoza
	Ozin 5a
	PRYZEXa
	Zypinea
	Zyprexaa * Additional charge for this brand is $10.17B	1	28	5	$28.37	$19.68	$33.30

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

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
8186WMPNP	OLANZAPINE olanzapine 7.5 mg tablet, 28 (PI, CMI)	1	28	5	$18.96	$20.44	$23.89
	Available brands
	APO-OLANZAPINEa
	Olanzapine RBXa
	Olanzapine Sandoza
	Ozin 7.5a
	PRYZEXa
	Zypinea
	Zyprexaa * Additional charge for this brand is $4.87B	1	28	5	$23.83	$20.44	$28.76

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

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
8187XMPNP	OLANZAPINE olanzapine 10 mg tablet, 28 (PI, CMI)	1	28	5	$20.61	$22.09	$25.54
	Available brands
	APO-OLANZAPINEa
	Olanzapine RBXa
	Olanzapine Sandoza
	Ozin 10a
	PRYZEXa
	Zypinea
	Zyprexaa * Additional charge for this brand is $4.92B	1	28	5	$25.53	$22.09	$30.46

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
8433WMPNP	OLANZAPINE olanzapine 5 mg wafer, 28 (PI, CMI)
	Available brands
	Zyprexa Zydisa * Additional charge for this brand is $10.17B	1	28	5	$28.37	$19.68	$33.30

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
8434XMPNP	OLANZAPINE olanzapine 10 mg wafer, 28 (PI, CMI)
	Available brands
	Zyprexa Zydisa * Additional charge for this brand is $9.95B	1	28	5	$30.56	$22.09	$35.49

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
8952EMPNP	OLANZAPINE olanzapine 15 mg wafer, 28 (PI, CMI)
	Available brands
	Zyprexa Zydisa * Additional charge for this brand is $11.65B	1	28	5	$35.68	$25.51	$40.61

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Note

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
8953FMPNP	OLANZAPINE olanzapine 20 mg wafer, 28 (PI, CMI)
	Available brands
	Zyprexa Zydisa * Additional charge for this brand is $11.65B	1	28	5	$39.08	$28.91	$43.25

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Caution

Note

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
9294EMPNP	OLANZAPINE olanzapine 210 mg modified release injection [1 vial] (&) inert substance diluent [3 mL vial], 1 pack (PI, CMI)	2	2	5	$323.50	$31.60	$31.60
	Available brands
	Zyprexa Relprevv

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Caution

Note

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
9295FMPNP	OLANZAPINE olanzapine 300 mg modified release injection [1 vial] (&) inert substance diluent [3 mL vial], 1 pack (PI, CMI)	2	2	5	$520.90	$31.60	$31.60
	Available brands
	Zyprexa Relprevv

Source	General Schedule
Body System	NERVOUS SYSTEM > PSYCHOLEPTICS > ANTIPSYCHOTICS

Caution

Note

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
9303PMPNP	OLANZAPINE olanzapine 405 mg modified release injection [1 vial] (&) inert substance diluent [3 mL vial], 1 pack (PI, CMI)	1	1	5	$347.15	$31.60	$31.60
	Available brands
	Zyprexa Relprevv