DESVENLAFAXINE

desvenlafaxine 50 mg modified release tablet, 28
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Major depressive disorders
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 28 # of repeats: 5 DPMQ: $21.09 Max safety net: $22.63 General Patient Charge: $25.00
Available brands
APO-Desvenlafaxine MR
Desvenlafaxine GH XR
desvenlafaxine 100 mg modified release tablet, 28
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Major depressive disorders
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 28 # of repeats: 5 DPMQ: $22.62 Max safety net: $24.16 General Patient Charge: $25.00
Available brands
APO-Desvenlafaxine MR
Desvenlafaxine GH XR
desvenlafaxine 100 mg modified release tablet, 28
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Major depressive disorders
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 56 # of repeats: 2 DPMQ: $30.88 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Desvenlafaxine MR
Desvenlafaxine GH XR
desvenlafaxine 50 mg modified release tablet, 28
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Major depressive disorders
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 56 # of repeats: 2 DPMQ: $27.82 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Desvenlafaxine MR
Desvenlafaxine GH XR