OCTREOTIDE

OCTREOTIDE (14201K)

octreotide 500 microgram/mL injection, 5 x 1 mL vials
14201K
Body System:
Manner of administration:Injection
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 9233)

Indication: Acromegaly

Restriction (Streamlined authority code: 9289)

Indication: Functional carcinoid tumour

Restriction (Streamlined authority code: 9232)

Indication: Vasoactive intestinal peptide secreting tumour (VIPoma)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 18 Max qty units: 90 # of repeats: 11 DPMQ: $1,919.22 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Octreotide Acetate Omega (Canada)

OCTREOTIDE (14218H)

octreotide 500 microgram/mL injection, 5 x 1 mL vials
14218H
Body System:
Manner of administration:Injection
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 8165)

Indication: Acromegaly

Restriction (Streamlined authority code: 6390)

Indication: Functional carcinoid tumour

Restriction (Streamlined authority code: 6369)

Indication: Vasoactive intestinal peptide secreting tumour (VIPoma)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 18 Max qty units: 90 # of repeats: 11 DPMQ: $1,870.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Octreotide Acetate Omega (Canada)