SIROLIMUS

SIROLIMUS (14072P)

sirolimus 1 mg tablet, 100
14072P
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 3 DPMQ: $1,299.42 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune

SIROLIMUS (6436R)

sirolimus 1 mg tablet, 100
6436R
Body System:
Manner of administration:Oral
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 9914)

Indication: Management of renal allograft rejection
Treatment phase: Management (initiation, stabilisation and review of therapy)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 5 DPMQ: $1,223.92 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune

SIROLIMUS (8724E)

sirolimus 1 mg tablet, 100
8724E
Body System:
Manner of administration:Oral
General Schedule
No restrictions
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: 3 DPMQ: $654.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune

SIROLIMUS (9549N)

sirolimus 1 mg tablet, 100
9549N
Body System:
Manner of administration:Oral
Public
S100 HSD Public
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 5795)

Indication: Management of renal allograft rejection
Treatment phase: Management (initiation, stabilisation and review of therapy)
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 5 DPMQ: $1,175.04 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune