CLONAZEPAM

CLONAZEPAM (1808E)

clonazepam 2.5 mg/mL (0.1 mg/drop) oral liquid, 10 mL
1808E
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Epilepsy
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 0 DPMQ: $21.32 Max safety net: $22.80 General Patient Charge: $25.00
Available brands
Rivotril

CLONAZEPAM (3478C)

clonazepam 2.5 mg/mL (0.1 mg/drop) oral liquid, 10 mL
3478C
Body System:
Manner of administration:Oral
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: 1 # of repeats: 0 DPMQ: $17.55 Max safety net: $0.00 General Patient Charge: Nil
Available brands
Rivotril

CLONAZEPAM (5339B)

clonazepam 2.5 mg/mL (0.1 mg/drop) oral liquid, 10 mL
5339B
Body System:
Manner of administration:Oral
Palliative Care
Restricted Benefit

Restriction

Indication: For use in patients receiving palliative care
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 3 DPMQ: $21.32 Max safety net: $22.80 General Patient Charge: $25.00
Available brands
Rivotril