LEUPRORELIN (&) BICALUTAMIDE

leuprorelin acetate 22.5 mg modified release injection [1 syringe] (&) inert substance diluent [1 syringe] (&) bicalutamide 50 mg tablet [28], 1 pack
Manner of administration:Injection/oral
General Schedule
Restricted Benefit

Restriction

Indication: Carcinoma of the prostate
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: $977.04 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Bi ELIGARD CP