INFLIXIMAB

infliximab 100 mg injection, 1 vial

INFLIXIMAB (5754W)

infliximab 100 mg injection, 1 vial
5754W
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required

Restriction

Indication: Severe Crohn disease
Treatment phase: Initial 1 (new patient)

Restriction

Indication: Severe Crohn disease
Treatment phase: Initial 2 (change or recommencement of treatment after a break in targeted therapy of less than 12 months)

Restriction

Indication: Severe Crohn disease
Treatment phase: Initial 3 (recommencement of treatment after a break in targeted therapy of more than 12 months)

Restriction

Indication: Severe Crohn disease
Treatment phase: Continuing treatment

Restriction

Indication: Severe Crohn disease
Treatment phase: Balance of supply
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $186.16 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Inflectra
Ixifi
Remicade
Remsima
Renflexis