RIVASTIGMINE

RIVASTIGMINE (10538P)

rivastigmine 13.3 mg/24 hours patch, 30
10538P
Body System:
Manner of administration:Transdermal
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 13938)

Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Continuing
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $83.29 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Exelon Patch 15

RIVASTIGMINE (10541T)

rivastigmine 13.3 mg/24 hours patch, 30
10541T
Body System:
Manner of administration:Transdermal
General Schedule
Authority Required

Restriction

Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial

Restriction

Indication: Mild to moderately severe Alzheimer disease
Treatment phase: Initial
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $83.29 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Exelon Patch 15