SIROLIMUS

SIROLIMUS (13886W)

sirolimus 2 mg tablet, 100
13886W
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: $2,513.06 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune

SIROLIMUS (6457W)

sirolimus 2 mg tablet, 100
6457W
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: $2,399.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune

SIROLIMUS (8833X)

sirolimus 2 mg tablet, 100
8833X
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: $1,271.03 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune

SIROLIMUS (9548M)

sirolimus 2 mg tablet, 100
9548M
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: $2,350.12 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Rapamune