DABIGATRAN

dabigatran etexilate 110 mg capsule, 60

DABIGATRAN (9321N)

dabigatran etexilate 110 mg capsule, 60
9321N
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction  4402

Indication: Prevention of venous thromboembolism
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 60 # of repeats: 0 DPMQ: $43.27 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
ARX-Dabigatran
Dabigatran Sandoz
Dabigatran Viatris
PHARMACOR DABIGATRAN
Pradaxa
*Additional charge for this brand is $7.39
 DPMQ: $50.66 Max safety net: $25.00 General Patient Charge: $32.39