MACITENTAN + TADALAFIL

MACITENTAN + TADALAFIL (14785E)

Macitentan 10 mg + tadalafil 40 mg tablet, 30
14785E
Body System:
Manner of administration:Oral
Public
S100 HSD Public
Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Continuing treatment of combination therapy (dual or triple therapy, excluding selexipag)

Restriction

Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Continuing treatment of combination therapy (triple therapy with selexipag)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $2,552.08 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Opsynvi

MACITENTAN + TADALAFIL (14828K)

Macitentan 10 mg + tadalafil 40 mg tablet, 30
14828K
Body System:
Manner of administration:Oral
Private
S100 HSD Private
Authority Required

Restriction

Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Continuing treatment of combination therapy (dual or triple therapy, excluding selexipag)

Restriction

Indication: Pulmonary arterial hypertension (PAH)
Treatment phase: Continuing treatment of combination therapy (triple therapy with selexipag)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $2,600.96 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Opsynvi