VALACICLOVIR

valaciclovir 500 mg tablet, 42

VALACICLOVIR (8064K)

valaciclovir 500 mg tablet, 42
8064K
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 5962)

Indication: Herpes zoster

Restriction (Streamlined authority code: 5968)

Indication: Herpes zoster ophthalmicus
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 42 # of repeats: 0 DPMQ: $31.85 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APX-Valaciclovir
VALACICLOVIR-WGR
Vaclovir
Valaciclovir RBX
Valaciclovir Sandoz
Zelitrex
Valtrex
*Additional charge for this brand is $2.43
 DPMQ: $34.28 Max safety net: $25.00 General Patient Charge: $27.43