LACOSAMIDE

LACOSAMIDE (12634Y)

lacosamide 100 mg tablet, 56
12634Y
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17513)

Indication: Idiopathic generalised epilepsy with primary generalised tonic-clonic seizures
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 56 # of repeats: 5 DPMQ: $62.91 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat

LACOSAMIDE (13839J)

lacosamide 100 mg tablet, 56
13839J
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17516)

Indication: Idiopathic generalised epilepsy with primary generalised tonic-clonic seizures
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 112 # of repeats: 5 DPMQ: $112.04 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat

LACOSAMIDE (13867W)

lacosamide 100 mg tablet, 56
13867W
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17560)

Indication: Intractable focal onset seizures
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 112 # of repeats: 5 DPMQ: $112.04 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat

LACOSAMIDE (9335H)

lacosamide 100 mg tablet, 56
9335H
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17520)

Indication: Intractable focal onset seizures
Treatment phase: Initial treatment

Restriction (Streamlined authority code: 17455)

Indication: Intractable focal onset seizures
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: 56 # of repeats: 5 DPMQ: $62.91 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat