PROCHLORPERAZINE

PROCHLORPERAZINE (2369Q)

prochlorperazine mesilate 12.5 mg/mL injection, 10 x 1 mL ampoules
2369Q
Body System:
Manner of administration:Injection
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 0 DPMQ: $30.63 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Stemetil

PROCHLORPERAZINE (2893G)

prochlorperazine maleate 5 mg tablet, 25
2893G
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 25 # of repeats: 0 DPMQ: $16.70 Max safety net: $18.18 General Patient Charge: $20.97
Available brands
APO-Prochlorperazine
PROCHLORPERAZINE-WGR
ProCalm
Prochlorperazine GH
Prochlorperazine Viatris
Stemetil
*Additional charge for this brand is $2.79
 DPMQ: $19.49 Max safety net: $18.18 General Patient Charge: $23.76

PROCHLORPERAZINE (3477B)

prochlorperazine mesilate 12.5 mg/mL injection, 10 x 1 mL ampoules
3477B
Body System:
Manner of administration:Injection
Prescriber Bag
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 0 DPMQ: $30.63 Max safety net: $0.00 General Patient Charge: Nil
Available brands
Stemetil

PROCHLORPERAZINE (5205Y)

prochlorperazine maleate 5 mg tablet, 25
5205Y
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 25 # of repeats: 0 DPMQ: $16.70 Max safety net: $18.18 General Patient Charge: $20.97
Available brands
APO-Prochlorperazine
PROCHLORPERAZINE-WGR
ProCalm
Prochlorperazine GH
Prochlorperazine Viatris
Stemetil
*Additional charge for this brand is $2.79
 DPMQ: $19.49 Max safety net: $18.18 General Patient Charge: $23.76

PROCHLORPERAZINE (5206B)

prochlorperazine mesilate 12.5 mg/mL injection, 10 x 1 mL ampoules
5206B
Body System:
Manner of administration:Injection
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 10 # of repeats: 0 DPMQ: $30.63 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Stemetil