MONTELUKAST

MONTELUKAST (14526M)

montelukast 4 mg chewable tablet, 28
14526M
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15642)

Indication: Asthma
Treatment phase: First-line prevention
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: 5 DPMQ: $23.02 Max safety net: $24.56 General Patient Charge: $25.00
Available brands
APX-MONTELUKAST
MONTELAIR 4
MONTELUKAST-WGR
Montelukast Lupin
Montelukast Sandoz 4
Montelukast Viatris

MONTELUKAST (14553Y)

montelukast 5 mg chewable tablet, 28
14553Y
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 15643)

Indication: Asthma
Treatment phase: First-line prevention

Restriction (Streamlined authority code: 15644)

Indication: Asthma
Treatment phase: Prevention of condition
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: 5 DPMQ: $22.84 Max safety net: $24.38 General Patient Charge: $25.00
Available brands
APX-MONTELUKAST
MONTELAIR 5
MONTELUKAST-WGR
Montelukast Lupin
Montelukast Sandoz 5
Montelukast Viatris

MONTELUKAST (8627C)

montelukast 4 mg chewable tablet, 28
8627C
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 6666)

Indication: Asthma
Treatment phase: First-line prevention
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: $18.69 Max safety net: $20.23 General Patient Charge: $23.02
Available brands
APX-MONTELUKAST
MONTELAIR 4
MONTELUKAST-WGR
Montelukast Lupin
Montelukast Sandoz 4
Montelukast Viatris

MONTELUKAST (8628D)

montelukast 5 mg chewable tablet, 28
8628D
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 6674)

Indication: Asthma
Treatment phase: First-line prevention

Restriction (Streamlined authority code: 7781)

Indication: Asthma
Treatment phase: Prevention of condition
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: $18.60 Max safety net: $20.14 General Patient Charge: $22.93
Available brands
APX-MONTELUKAST
MONTELAIR 5
MONTELUKAST-WGR
Montelukast Lupin
Montelukast Sandoz 5
Montelukast Viatris