TOLVAPTAN

TOLVAPTAN (11600M)

tolvaptan 15 mg tablet [28] (&) tolvaptan 45 mg tablet [28], 56
11600M
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 8288)

Indication: Autosomal dominant polycystic kidney disease (ADPKD)
Treatment phase: Continuing treatment
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: 5 DPMQ: $571.86 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Jinarc
Tolvaptan Lupin

TOLVAPTAN (11602P)

tolvaptan 15 mg tablet [28] (&) tolvaptan 45 mg tablet [28], 56
11602P
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Autosomal dominant polycystic kidney disease (ADPKD)
Treatment phase: Initial treatment
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: 5 DPMQ: $571.86 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Jinarc
Tolvaptan Lupin