DOXORUBICIN HYDROCHLORIDE (AS PEGYLATED LIPOSOMAL)

doxorubicin hydrochloride (as pegylated liposomal) 20 mg/10 mL injection, 10 mL vial

DOXORUBICIN HYDROCHLORIDE (AS PEGYLATED LIPOSOMAL) (5705G)

doxorubicin hydrochloride (as pegylated liposomal) 20 mg/10 mL injection, 10 mL vial
5705G
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction  6234

Indication: Kaposi sarcoma

Restriction  6274

Indication: Kaposi sarcoma
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: $553.68 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Caelyx
Liposomal Doxorubicin SUN