EVEROLIMUS

EVEROLIMUS (5738B)

everolimus 250 microgram tablet, 60
5738B
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)

Restriction (Streamlined authority code: 5554)

Indication: Management of cardiac 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: 120 # of repeats: 5 DPMQ: $303.86 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Certican
Everocan

EVEROLIMUS (6459Y)

everolimus 250 microgram tablet, 60
6459Y
Body System:
Manner of administration:Oral
Private
S100 HSD Private
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 9691)

Indication: Management of renal allograft rejection
Treatment phase: Management (initiation, stabilisation and review of therapy)

Restriction (Streamlined authority code: 9693)

Indication: Management of cardiac 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: 120 # of repeats: 5 DPMQ: $324.90 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Certican
Everocan

EVEROLIMUS (8840G)

everolimus 250 microgram tablet, 60
8840G
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: 60 # of repeats: 3 DPMQ: $180.32 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Certican
Everocan