TRANYLCYPROMINE

TRANYLCYPROMINE (14401Y)

tranylcypromine 10 mg tablet, 50
14401Y
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 100 # of repeats: 1 DPMQ: $90.44 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Parnate
TRANYLMED

TRANYLCYPROMINE (2444P)

tranylcypromine 10 mg tablet, 50
2444P
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: 50 # of repeats: 2 DPMQ: $52.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Parnate
TRANYLMED