DAPAGLIFLOZIN + SITAGLIPTIN

DAPAGLIFLOZIN + SITAGLIPTIN (14638K)

Dapagliflozin 10 mg + sitagliptin 100 mg tablet, 28
14638K
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15269)

Indication: Diabetes mellitus type 2
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 28 # of repeats: 5 DPMQ: $67.13 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Sidapvia 10/100

DAPAGLIFLOZIN + SITAGLIPTIN (14645T)

Dapagliflozin 10 mg + sitagliptin 100 mg tablet, 28
14645T
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15270)

Indication: Diabetes mellitus type 2
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 56 # of repeats: 5 DPMQ: $120.80 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Sidapvia 10/100