GABAPENTIN

GABAPENTIN (1835N)

gabapentin 400 mg capsule, 100
1835N
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17445)

Indication: Focal onset seizures
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 100 # of repeats: 5 DPMQ: $26.94 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APX-Gabapentin
GABAPENTIN-WGR
GAPENTIN
Gabacor
Gabapentin Sandoz
Nupentin 400
Neurontin
*Additional charge for this brand is $2.20
 DPMQ: $29.14 Max safety net: $25.00 General Patient Charge: $27.20

GABAPENTIN (4593R)

gabapentin 400 mg capsule, 100
4593R
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Refractory neuropathic pain
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 100 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
APX-Gabapentin DPMQ: $26.94 Max safety net: $7.70 General Patient Charge: $7.70
Gabacor DPMQ: $26.94 Max safety net: $7.70 General Patient Charge: $7.70
Neurontin DPMQ: $29.14 Max safety net: $7.70 General Patient Charge: $7.70
Gabapentin Sandoz DPMQ: $26.94 Max safety net: $7.70 General Patient Charge: $7.70
GABAPENTIN-WGR DPMQ: $26.94 Max safety net: $7.70 General Patient Charge: $7.70
Nupentin 400 DPMQ: $26.94 Max safety net: $7.70 General Patient Charge: $7.70