EVEROLIMUS

EVEROLIMUS (13941R)

everolimus 1 mg tablet, 60
13941R
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: 4 Max qty units: 240 # of repeats: 3 DPMQ: $2,284.64 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Certican
Everocan

EVEROLIMUS (5737Y)

everolimus 1 mg tablet, 60
5737Y
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: 4 Max qty units: 240 # of repeats: 5 DPMQ: $2,121.68 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Certican
Everocan

EVEROLIMUS (9352F)

everolimus 1 mg tablet, 60
9352F
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: 2 Max qty units: 120 # of repeats: 3 DPMQ: $1,151.10 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Certican
Everocan

EVEROLIMUS (9582H)

everolimus 1 mg tablet, 60
9582H
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: 4 Max qty units: 240 # of repeats: 5 DPMQ: $2,170.56 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Certican
Everocan