FLUCONAZOLE

FLUCONAZOLE (1472L)

fluconazole 100 mg capsule, 28
1472L
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15984)

Indication: Cryptococcal meningitis

Restriction (Streamlined authority code: 15975)

Indication: Cryptococcal meningitis

Restriction (Streamlined authority code: 6023)

Indication: Oropharyngeal candidiasis

Restriction (Streamlined authority code: 6030)

Indication: Oropharyngeal candidiasis

Restriction (Streamlined authority code: 5989)

Indication: Oesophageal candidiasis

Restriction (Streamlined authority code: 16034)

Indication: Fungal infection
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: $24.06 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Dizole 100
Fluconazole Sandoz
Ozole
Diflucan
*Additional charge for this brand is $10.76
 DPMQ: $34.82 Max safety net: $25.00 General Patient Charge: $35.76