TRIFLURIDINE + TIPIRACIL

TRIFLURIDINE + TIPIRACIL (11524M)

trifluridine 20 mg + tipiracil 8.19 mg tablet, 20
11524M
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 18518)

Indication: Metastatic colorectal cancer
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 8183)

Indication: Metastatic colorectal cancer
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 80 # of repeats: 2 DPMQ: $3,934.40 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lonsurf 20/8.19

TRIFLURIDINE + TIPIRACIL (12033H)

trifluridine 20 mg + tipiracil 8.19 mg tablet, 20
12033H
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 18515)

Indication: Metastatic (Stage IV) adenocarcinoma of the stomach or gastro-oesophageal junction
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 10310)

Indication: Metastatic (Stage IV) adenocarcinoma of the stomach or gastro-oesophageal junction
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 80 # of repeats: 2 DPMQ: $3,934.40 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lonsurf 20/8.19