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: $18.60 Max safety net: $20.14 General Patient Charge: $22.93
Available brands
APO-Pregabalin
BTC Pregabalin
Lyzalon
Neuroccord
PREGABALIN-DRLA
PREGABALIN-WGR
Prebalin
Pregabalin Lupin
Pregabalin Sandoz
Lyrica
*Additional charge for this brand is $5.07
 DPMQ: $23.67 Max safety net: $20.14 General Patient Charge: $28.00

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: $18.33 Max safety net: $19.87 General Patient Charge: $22.66
Available brands
APO-Pregabalin
BTC Pregabalin
Lyzalon
Neuroccord
PREGABALIN-DRLA
PREGABALIN-WGR
Prebalin
Pregabalin Lupin
Pregabalin Sandoz
Lyrica
*Additional charge for this brand is $1.99
 DPMQ: $20.32 Max safety net: $19.87 General Patient Charge: $24.65

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: $20.56 Max safety net: $22.10 General Patient Charge: $24.89
Available brands
APO-Pregabalin
BTC Pregabalin
Lyzalon
Neuroccord
PREGABALIN-DRLA
PREGABALIN-WGR
Prebalin
Pregabalin Lupin
Pregabalin Sandoz
Lyrica
*Additional charge for this brand is $6.49
 DPMQ: $27.05 Max safety net: $22.10 General Patient Charge: $31.38

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: $23.59 Max safety net: $25.00 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 $1.61
 DPMQ: $25.20 Max safety net: $25.00 General Patient Charge: $26.61