HYDROMORPHONE

HYDROMORPHONE (12493M)

hydromorphone hydrochloride 2 mg/mL injection, 5 x 1 mL ampoules
12493M
Body System:
Manner of administration:Injection
Palliative Care
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 11697)

Indication: Severe pain
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 10 # of repeats: 1 DPMQ: $31.42 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Dilaudid
HYDROMORPHONE JUNO
Hydromorphone-hameln
MEDSURGE HYDROMORPHONE 2 mg/1 mL

HYDROMORPHONE (12531M)

hydromorphone hydrochloride 10 mg/mL injection, 5 x 1 mL ampoules
12531M
Body System:
Manner of administration:Injection
Palliative Care
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 11697)

Indication: Severe pain
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 10 # of repeats: 1 DPMQ: $35.48 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Dilaudid-HP
HYDROMORPHONE JUNO-HP
Hydromorphone-hameln-HP
MEDSURGE HYDROMORPHONE HP 10 mg/1 mL

HYDROMORPHONE (8420E)

hydromorphone hydrochloride 2 mg/mL injection, 5 x 1 mL ampoules
8420E
Body System:
Manner of administration:Injection
General Schedule
Restricted Benefit

Restriction

Indication: Severe pain
Treatment phase: Initial PBS treatment after 1 June 2020 where patient has been treated with opioids for less than 12 months

Restriction

Indication: Severe pain
Treatment phase: Initial PBS treatment after 1 June 2020 where patient has been treated with opioids for more than 12 months

Restriction

Indication: Severe pain
Treatment phase: Continuing PBS treatment after 1 June 2020
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 5 # of repeats: 0 DPMQ: $25.35 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Dilaudid
HYDROMORPHONE JUNO
Hydromorphone-hameln
MEDSURGE HYDROMORPHONE 2 mg/1 mL

HYDROMORPHONE (8421F)

hydromorphone hydrochloride 10 mg/mL injection, 5 x 1 mL ampoules
8421F
Body System:
Manner of administration:Injection
General Schedule
Restricted Benefit

Restriction

Indication: Severe pain
Treatment phase: Initial PBS treatment after 1 June 2020 where patient has been treated with opioids for less than 12 months

Restriction

Indication: Severe pain
Treatment phase: Initial PBS treatment after 1 June 2020 where patient has been treated with opioids for more than 12 months

Restriction

Indication: Severe pain
Treatment phase: Continuing PBS treatment after 1 June 2020
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 5 # of repeats: 0 DPMQ: $27.38 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Dilaudid-HP
HYDROMORPHONE JUNO-HP
Hydromorphone-hameln-HP
MEDSURGE HYDROMORPHONE HP 10 mg/1 mL