PRAMIPEXOLE

pramipexole dihydrochloride monohydrate 3 mg modified release tablet, 30

PRAMIPEXOLE (3421C)

pramipexole dihydrochloride monohydrate 3 mg modified release tablet, 30
3421C
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Parkinson disease
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $80.42 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
SIMIPEX XR
Sifrol ER