GABAPENTIN

GABAPENTIN (4591P)

gabapentin 100 mg capsule, 100
4591P
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Refractory 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: 100 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
APX-Gabapentin DPMQ: $18.36 Max safety net: $7.70 General Patient Charge: $7.70
Gabacor DPMQ: $18.36 Max safety net: $7.70 General Patient Charge: $7.70
GAPENTIN DPMQ: $18.36 Max safety net: $7.70 General Patient Charge: $7.70
Neurontin DPMQ: $20.53 Max safety net: $7.70 General Patient Charge: $7.70
Nupentin 100 DPMQ: $18.36 Max safety net: $7.70 General Patient Charge: $7.70

GABAPENTIN (4592Q)

gabapentin 300 mg capsule, 100
4592Q
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Refractory 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: 100 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
APX-Gabapentin DPMQ: $23.72 Max safety net: $7.70 General Patient Charge: $7.70
Gabacor DPMQ: $23.72 Max safety net: $7.70 General Patient Charge: $7.70
GAPENTIN DPMQ: $23.72 Max safety net: $7.70 General Patient Charge: $7.70
Neurontin DPMQ: $25.84 Max safety net: $7.70 General Patient Charge: $7.70
Gabapentin Sandoz DPMQ: $23.72 Max safety net: $7.70 General Patient Charge: $7.70
GABAPENTIN-WGR DPMQ: $23.72 Max safety net: $7.70 General Patient Charge: $7.70
Nupentin 300 DPMQ: $23.72 Max safety net: $7.70 General Patient Charge: $7.70

GABAPENTIN (4593R)

gabapentin 400 mg capsule, 100
4593R
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Refractory 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: 100 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
APX-Gabapentin DPMQ: $27.12 Max safety net: $7.70 General Patient Charge: $7.70
Gabacor DPMQ: $27.12 Max safety net: $7.70 General Patient Charge: $7.70
GAPENTIN DPMQ: $27.12 Max safety net: $7.70 General Patient Charge: $7.70
Neurontin DPMQ: $29.25 Max safety net: $7.70 General Patient Charge: $7.70
Gabapentin Sandoz DPMQ: $27.12 Max safety net: $7.70 General Patient Charge: $7.70
GABAPENTIN-WGR DPMQ: $27.12 Max safety net: $7.70 General Patient Charge: $7.70
Nupentin 400 DPMQ: $27.12 Max safety net: $7.70 General Patient Charge: $7.70

GABAPENTIN (4594T)

gabapentin 600 mg tablet, 100
4594T
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Refractory 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: 100 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
GAPENTIN DPMQ: $34.34 Max safety net: $7.70 General Patient Charge: $7.70
Neurontin DPMQ: $36.48 Max safety net: $7.70 General Patient Charge: $7.70
APX-GABAPENTIN DPMQ: $34.34 Max safety net: $7.70 General Patient Charge: $7.70
Gabapentin APOTEX DPMQ: $34.34 Max safety net: $7.70 General Patient Charge: $7.70
Pharmacor Gabapentin 600 DPMQ: $34.34 Max safety net: $7.70 General Patient Charge: $7.70

GABAPENTIN (4595W)

gabapentin 800 mg tablet, 100
4595W
Body System:
Manner of administration:Oral
Repatriation Pharmaceutical Benefits
Authority Required

Restriction

Indication: Refractory 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: 100 # of repeats: 5 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Neurontin DPMQ: $41.35 Max safety net: $7.70 General Patient Charge: $7.70
Gabapentin APOTEX DPMQ: $41.35 Max safety net: $7.70 General Patient Charge: $7.70
Pharmacor Gabapentin 800 DPMQ: $41.35 Max safety net: $7.70 General Patient Charge: $7.70