GABAPENTIN

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
Neurontin DPMQ: $36.59 Max safety net: $7.70 General Patient Charge: $7.70
APX-GABAPENTIN DPMQ: $34.39 Max safety net: $7.70 General Patient Charge: $7.70
Gabapentin APOTEX DPMQ: $34.39 Max safety net: $7.70 General Patient Charge: $7.70
Pharmacor Gabapentin 600 DPMQ: $34.39 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: $41.62 Max safety net: $7.70 General Patient Charge: $7.70
Gabapentin APOTEX DPMQ: $41.62 Max safety net: $7.70 General Patient Charge: $7.70
Pharmacor Gabapentin 800 DPMQ: $41.62 Max safety net: $7.70 General Patient Charge: $7.70

GABAPENTIN (8389M)

gabapentin 800 mg tablet, 100
8389M
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 17445)

Indication: Focal onset seizures
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: $41.62 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
GAPENTIN
Gabapentin APOTEX
Neurontin
Pharmacor Gabapentin 800