VENLAFAXINE

VENLAFAXINE (14402B)

venlafaxine 150 mg modified release capsule, 28
14402B
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Major depressive disorders
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 56 # of repeats: 2 DPMQ: $22.40 Max safety net: $23.88 General Patient Charge: $25.00
Available brands
APO-Venlafaxine XR
BTC Venlafaxine XR
Elaxine SR 150
Enlafax-XR
Sandoz Venlafaxine XR
VENLAFAXINE XR-WGR
Venlafaxine generichealth XR
Efexor-XR
*Additional charge for this brand is $4.14
 DPMQ: $26.54 Max safety net: $23.88 General Patient Charge: $29.14

VENLAFAXINE (8302Y)

venlafaxine 150 mg modified release capsule, 28
8302Y
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Major depressive disorders
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 28 # of repeats: 5 DPMQ: $18.09 Max safety net: $19.57 General Patient Charge: $22.36
Available brands
APO-Venlafaxine XR
BTC Venlafaxine XR
Elaxine SR 150
Enlafax-XR
Sandoz Venlafaxine XR
VENLAFAXINE XR-WGR
Venlafaxine generichealth XR
Efexor-XR
*Additional charge for this brand is $2.07
 DPMQ: $20.16 Max safety net: $19.57 General Patient Charge: $24.43