RIZATRIPTAN

rizatriptan 10 mg orally disintegrating tablet, 2
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Migraine attack
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 4 # of repeats: 5 DPMQ: $22.40 Max safety net: $23.88 General Patient Charge: $25.00
Available brands
APO-RIZATRIPTAN ODT
RIXALT
RIZATRIPTAN ODT-WGR
Rizatriptan ODT Viatris
Rizatriptan-Au