LAROTRECTINIB

LAROTRECTINIB (13281B)

larotrectinib 20 mg/mL oral liquid, 2 x 50 mL
13281B
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Solid tumours (of any type) with confirmed neurotrophic tropomyosin receptor kinase (NTRK) gene fusion where treatment with this drug is/was initiated in a child
Treatment phase: Initial treatment

Restriction

Indication: Solid tumours (of certain specified types) with confirmed neurotrophic tropomyosin receptor kinase (NTRK) gene fusion
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: 2 DPMQ: $3,462.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vitrakvi

LAROTRECTINIB (13289K)

larotrectinib 20 mg/mL oral liquid, 2 x 50 mL
13289K
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Solid tumours with confirmed neurotrophic tropomyosin receptor kinase (NTRK) gene fusion
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: $3,462.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vitrakvi

LAROTRECTINIB (14230Y)

larotrectinib 20 mg/mL oral liquid, 2 x 50 mL
14230Y
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Solid tumours (of certain specified types) with confirmed neurotrophic tropomyosin receptor kinase (NTRK) gene fusion
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: 2 DPMQ: $3,462.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vitrakvi

LAROTRECTINIB (14256H)

larotrectinib 20 mg/mL oral liquid, 2 x 50 mL
14256H
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Solid tumours (of certain specified types) with confirmed neurotrophic tropomyosin receptor kinase (NTRK) gene fusion
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: $3,462.93 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vitrakvi