LACOSAMIDE

LACOSAMIDE (12658F)

lacosamide 200 mg tablet, 56
12658F
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: $111.96 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat

LACOSAMIDE (13949E)

lacosamide 200 mg tablet, 56
13949E
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: $214.94 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat

LACOSAMIDE (13951G)

lacosamide 200 mg tablet, 56
13951G
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: $214.94 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat

LACOSAMIDE (9338L)

lacosamide 200 mg tablet, 56
9338L
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: $111.96 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
LACOMED
Lacosam
Lacosamide ARX
Lacosamide Lupin
Lacosamide Sandoz
Vimcosa
Vimpat