PREGABALIN

PREGABALIN (2335X)

pregabalin 75 mg capsule, 56
2335X
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4172)

Indication: 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: 56 # of repeats: 5 DPMQ: $18.20 Max safety net: $19.68 General Patient Charge: $22.47
Available brands
APO-Pregabalin
BTC Pregabalin
Lyzalon
Neuroccord
PREGABALIN-DRLA
PREGABALIN-WGR
Prebalin
Pregabalin Lupin
Pregabalin Sandoz
Lyrica
*Additional charge for this brand is $5.19
 DPMQ: $23.39 Max safety net: $19.68 General Patient Charge: $27.66

PREGABALIN (2348N)

pregabalin 25 mg capsule, 56
2348N
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4172)

Indication: 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: 56 # of repeats: 5 DPMQ: $17.93 Max safety net: $19.41 General Patient Charge: $22.20
Available brands
APO-Pregabalin
BTC Pregabalin
Lyzalon
Neuroccord
PREGABALIN-DRLA
PREGABALIN-WGR
Prebalin
Pregabalin Lupin
Pregabalin Sandoz
Lyrica
*Additional charge for this brand is $2.00
 DPMQ: $19.93 Max safety net: $19.41 General Patient Charge: $24.20

PREGABALIN (2355Y)

pregabalin 150 mg capsule, 56
2355Y
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4172)

Indication: 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: 56 # of repeats: 5 DPMQ: $20.18 Max safety net: $21.66 General Patient Charge: $24.45
Available brands
APO-Pregabalin
BTC Pregabalin
Lyzalon
Neuroccord
PREGABALIN-DRLA
PREGABALIN-WGR
Prebalin
Pregabalin Lupin
Pregabalin Sandoz
Lyrica
*Additional charge for this brand is $6.70
 DPMQ: $26.88 Max safety net: $21.66 General Patient Charge: $31.15

PREGABALIN (2363J)

pregabalin 300 mg capsule, 56
2363J
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4172)

Indication: 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: 56 # of repeats: 5 DPMQ: $23.31 Max safety net: $24.79 General Patient Charge: $25.00
Available brands
APO-Pregabalin
BTC Pregabalin
Lyzalon
Neuroccord
PREGABALIN-DRLA
PREGABALIN-WGR
Prebalin
Pregabalin Lupin
Pregabalin Sandoz
Lyrica
*Additional charge for this brand is $1.65
 DPMQ: $24.96 Max safety net: $24.79 General Patient Charge: $26.65