Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9500BMP	MYCOPHENOLATE mycophenolate mofetil 1 g/5 mL powder for oral liquid, 165 mL (PI, CMI)	2	2	5	$489.02	$31.60	$31.60
	Available brands
	CellCepta
	Pharmacor Mycophenolatea

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9501CMP	MYCOPHENOLATE mycophenolate mofetil 250 mg capsule, 100 (PI, CMI)	6	600	5	$152.88	$31.60	$31.60
	Available brands
	APO-Mycophenolatea
	CellCepta
	Mycophenolate Sandoza
	Pharmacor Mycophenolate 250a

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9502DMP	MYCOPHENOLATE mycophenolate mofetil 500 mg tablet, 50 (PI, CMI)	6	300	5	$152.76	$31.60	$31.60
	Available brands
	ARX-MYCOPHENOLATEa
	CellCepta
	Ceptolatea
	MycoCepta
	Mycophenolate APOTEXa
	Mycophenolate GHa
	Mycophenolate Sandoza
	Noumed Mycophenolatea
	Pharmacor Mycophenolate 500a