LOPINAVIR + RITONAVIR

LOPINAVIR + RITONAVIR (10272P)

lopinavir 200 mg + ritonavir 50 mg tablet, 120
10272P
Body System:
Manner of administration:Oral
S100 HSD Community Access
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4512)

Indication: HIV infection
Treatment phase: Initial

Restriction (Streamlined authority code: 4454)

Indication: HIV infection
Treatment phase: Continuing
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 240 # of repeats: 5 DPMQ: $909.04 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kaletra

LOPINAVIR + RITONAVIR (10327M)

lopinavir 400 mg/5 mL + ritonavir 100 mg/5 mL oral liquid, 60 mL
10327M
Body System:
Manner of administration:Oral
S100 HSD Community Access
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4512)

Indication: HIV infection
Treatment phase: Initial

Restriction (Streamlined authority code: 4454)

Indication: HIV infection
Treatment phase: Continuing
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 10 Max qty units: 10 # of repeats: 5 DPMQ: $856.58 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Kaletra