National Health Act 1953 - Determinations under sections 85, 85A and 88 (No. PB 47 of 2006)

Administered by Department of Health, Disability and Ageing

Legislation au F2006L03686 Not in force Legislative Instrument

Legislation content

Determinations under sections 85,
85A and 88 (No. PB 47 of 2006)

as amended

made under the

National Health Act 1953

This compilation was prepared on 1 February 2007
taking into account amendments up to No. PB 6 of 2007

Prepared by the Office of Legislative Drafting and Publishing,
Attorney-General’s Department, Canberra

Pharmaceutical Benefits

Determinations under sections 85, 85A and 88

No. PB 47 of 2006 [see Note 1]

 

  1. These Determinations commence on 1 December 2006.

2. The Determinations (No. PB 40 of 2006) under sections 85, 85A and 88 of the National Health Act 1953 made on 21 September 2006 with effect from 1 October 2006 are repealed.

3. In these Determinations:

“Act” means the National Health Act 1953;

 “base-priced drug” means —

(a) in relation to cimetidine hydrochloride or ranitidine hydrochloride (tablet, effervescent, equivalent to 150 mg ranitidine or syrup equivalent to 150 mg ranitidine per 10 mL, 300 mL): cimetidine or famotidine or nizatidine or ranitidine hydrochloride (tablet equivalent to 150 mg ranitidine or tablet equivalent to 300 mg ranitidine); or

(b) in relation to amlodipine besylate or lercanidipine hydrochloride or nifedipine (tablet 20 mg (controlled release)): felodipine or nifedipine (tablet 10 mg or tablet 20 mg or tablet 30 mg (controlled release) or tablet 60 mg (controlled release)); or

(c) in relation to ramipril (pack containing 7 tablets 2.5 mg, 21 tablets 5 mg and 10 capsules 10 mg): captopril or enalapril maleate or fosinopril sodium or lisinopril or perindopril arginine or perindopril erbumine or quinapril hydrochloride or ramipril  (tablet 1.25 mg or tablet 2.5 mg or tablet 5 mg or capsule 10 mg) or trandolapril;

“CFC” means chlorofluorocarbon;

“CFU” means colony forming unit;

“electronic communication” has the meaning given by subsection 5(1) of the Electronic Transactions Act 1999;

“g” means gram;

“I.M.” means intramuscular;

“I.U.” means international unit;

“I.V.” means intravenous;

“kg” means kilogram;

“L” means litre;

“m” means metre;

“Medicare Australia CEO” means the Chief Executive Officer of Medicare Australia;

“mg” means milligram;

“mL” means millilitre;

“mm” means millimetre;

“mmol” means millimole;

“palliative care patient”, in relation to a purpose specified in Part 2 of the Second Schedule to these Determinations, means a patient with an active, progressive, far-advanced disease, and for whom the prognosis is limited and the focus of care is the quality of life;

“PBS” means Pharmaceutical Benefits Scheme;

“Regulations” means the National Health (Pharmaceutical Benefits) Regulations 1960 made under the Act.

4. For the purposes of subsection 85(3) of the Act, where the strength, type of unit, size of unit or other particulars of form are specified in the column headed “Form” in the First or Second Schedule to these Determinations in relation to a drug or medicinal preparation referred to in subsection 85(2) of the Act the name of which is specified in that Schedule, those particulars refer to the form or forms of the drug or medicinal preparation that is or are allowable for the purposes of Part VII of the Act to the effect that the drug or medicinal preparation in that form or in each of those forms is a pharmaceutical benefit when prescribed by a medical practitioner.

4A. For the purposes of subsection 85(3) of the Act, where a form is specified in the column headed “Form” in the Fourth Schedule to these Determinations, that particular refers to the form of a medicinal preparation, which is composed of one or more of the drugs or medicinal preparations specified in Schedule 4 to the Declaration under subsection 85(2) of the Act with or without the addition of one or more of the substances specified in Schedule 5 to that Declaration, that is allowable for the purposes of Part VII of the Act to the effect that the medicinal preparation in that form is a pharmaceutical benefit when prescribed by a medical practitioner.

5. For the purposes of subsection 88(1A) of the Act, where the strength, type of unit, size of unit or other particulars of form are specified in the column headed “Form” in the Third Schedule to these Determinations in relation to a drug or medicinal preparation referred to in subsection 85(2) of the Act the name of which is specified in that Schedule, those particulars refer to the form or forms of the drug or medicinal preparation that is or are allowable for the purposes of Part VII of the Act to the effect that the drug or medicinal preparation in that form or in each of those forms is a pharmaceutical benefit referred to in subsection 88(1A) of the Act for the supply of which a participating dental practitioner is authorised to write a prescription.

6. The purposes set out in the column headed “Purposes” in Part 2 of the First or Second Schedule to these Determinations are the only purposes for which a medical practitioner may prescribe the maximum quantities and numbers of repeats specified in that Part in relation to those pharmaceutical benefits specified in that same Part.

7. The purposes set out in the column headed “Purposes” in Part 2 of the Third Schedule to these Determinations are the only purposes for which a participating dental practitioner may prescribe the maximum quantities specified in that Part in relation to those pharmaceutical benefits specified in that same Part.

8. For the purposes of subsection 85A(2)(c) of the Act, the manner of administration, if any, set out in the column headed “Manner of administration” in relation to a pharmaceutical benefit, the name of which is specified in:

(a) the First or Second Schedule to these Determinations, is the only manner in which a medical practitioner may, in a prescription, direct the pharmaceutical benefit to be administered; or

(b) the Third Schedule to these Determinations, is the only manner in which a participating dental practitioner may, in a prescription, direct the pharmaceutical benefit to be administered.

9. For the purposes of subsection 85A(2)(a) of the Act, the maximum quantity or number of units of a pharmaceutical benefit that may, in one prescription, be directed to be supplied on any one occasion is:

(a) where the name of the pharmaceutical benefit is specified —

(i) in Part 1 of the First Schedule to these Determinations — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical benefit; or

(ii) in Part 2 of the First Schedule to these Determinations and the pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical benefit; or

(iii) in Part 1 of the Second Schedule to these Determinations — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical benefit; or

(iv) in Part 2 of the Second Schedule to these Determinations and the pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical benefit; or

(v) in Part 1 of the Third Schedule to these Determinations — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical benefit; or

(vi) in Part 2 of the Third Schedule to these Determinations and the pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum quantity” in relation to the pharmaceutical benefit; or

(b) in any other case — the quantity or number, if any, specified in the column headed “Maximum quantity” in the Fourth Schedule to these Determinations in relation to the form of the pharmaceutical benefit.

10. For the purposes of subsection 85A(2)(b) of the Act, the maximum number of occasions, if any, on which the supply of a pharmaceutical benefit may, in one prescription, be directed by a medical practitioner to be repeated is:

(a) where the name of the pharmaceutical benefit is specified —

(i) in Part 1 of the First Schedule to these Determinations — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or


(ii) in Part 2 of the First Schedule to these Determinations and the pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or

(iii) in Part 1 of the Second Schedule to these Determinations — the quantity or number, if any, specified in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or

(iv) in Part 2 of the Second Schedule to these Determinations and the pharmaceutical benefit is prescribed in accordance with the provisions of the column headed “Purposes” — the quantity or number, if any, in that Part of the Schedule in the column headed “Maximum number of repeats” in relation to the pharmaceutical benefit; or

(b) in any other case — the number, if any, specified in the column headed “Maximum number of repeats” in the Fourth Schedule to these Determinations in relation to the form of the pharmaceutical benefit.

11. The following purposes are specified in relation to each pharmaceutical benefit the name of which is specified in Part 2 of the First or Second Schedule to these Determinations:

(a) where a class of persons is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for the treatment of a person included in that class of persons;

(b) where a disease or condition is specified in the column headed “Purposes” —

(i) if subsubparagraph (ii) does not apply — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in relation to any person; or

(ii)      if the disease or condition is specified in relation to a specified class of persons — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in a person included in that class of persons;

(c) where a purpose is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for that purpose;

(d) where it is specified in the column headed “Purposes” that compliance with authority procedures set out in subparagraph 11(d) is required — that a medical practitioner has submitted to the Medicare Australia CEO a prescription for the supply of the pharmaceutical benefit:

(i) by preparing and signing the prescription:

(A) in a form approved by the Secretary and completed by the medical practitioner in ink in his or her own handwriting; or

(B) in a form, prepared by means of a computer, that is in accordance with the form approved by the Secretary under subsubsubparagraph (A); or

(C) in a form, prepared by means of a computer, approved in writing for the purpose by the Secretary and in the format approved in writing by the Secretary; or

(D) by a method approved in writing by the Secretary; or

(ii)      by submitting the prescription by giving the Medicare Australia CEO by telephone, details of the prescription which has been prepared and signed by the medical practitioner in accordance with subsubparagraph (i); or

(iii)    where the medical practitioner has attempted to obtain an authorisation by submitting details of the prescription to the Medicare Australia CEO in accordance with subsubparagraph (ii) but has been unable to do so because of a failure or other form of unavailability in the telephone system established by the Medicare Australia CEO for the provision of such authorisations, by submitting the prescription in accordance with the instructions stipulated in an emergency telephone message provided to the medical practitioner by the Medicare Australia CEO; or

(iv)     by submitting the prescription by giving the Medicare Australia CEO, by means of an electronic communication of a kind approved in writing by the Medicare Australia CEO, details of the prescription which has been prepared and signed by the medical practitioner in accordance with subsubparagraph (i).

11A. For the purposes of subsubparagraph 11(d)(i), a prescription that has been prepared and signed by the medical practitioner in accordance with that subparagraph is taken to have been submitted by him or her if it is submitted by one of his or her employees.

12. Subject to paragraph 12B, the authorisation of a prescription submitted under subparagraph 11(d) may be made:

(a) if the prescription was submitted in accordance with subsubparagraph 11(d)(i) — by the Medicare Australia CEO signing his or her authorisation of the prescription on it and:

(i) if the Medicare Australia CEO requires the medical practitioner to alter the prescription — by returning it to the medical practitioner for alteration before the medical practitioner gives it to the person in respect of whom it was prepared; or

(ii) in any other case:

(A) by returning it to the medical practitioner; or

(B) by sending it to the person in respect of whom it was prepared; or

(b) if the prescription was submitted in accordance with subsubparagraph 11(d)(ii) — orally, at the time the Medicare Australia CEO is given details of the prescription; or

(c) if the prescription was submitted in accordance with subsubparagraph 11(d)(iv) — by the Medicare Australia CEO sending his or her authorisation, by electronic communication, to the medical practitioner.

12A. If the Medicare Australia CEO authorises a prescription in accordance with subparagraph 12(b) or (c):

(a) the Medicare Australia CEO must tell the medical practitioner, orally or by electronic communication, the number that has been allotted to the authorised prescription; and

(b) the medical practitioner must:

(i) mark that number on the prescription; and

(ii) retain a copy of the prescription for 1 year from the date on which the prescription was authorised.


12B. Notwithstanding paragraph 12, if the prescription was submitted in accordance with subsubparagraph 11(d)(iii), authorisation shall be deemed to have been granted upon completion by the medical practitioner of the prescription in accordance with the instructions stipulated in the emergency telephone message provided to the medical practitioner by the Medicare Australia CEO.

12C. Where a prescription is authorised, or deemed to be authorised, in accordance with paragraph 12, and an authorisation is also granted in accordance with subregulation 13(5) of the Regulations increasing the maximum quantity or number of units of the pharmaceutical benefit that may, in the prescription, be directed to be supplied on any one occasion, or the maximum number of occasions on which the supply of the pharmaceutical benefit may, in the prescription, be directed to be repeated, the authorisation in accordance with paragraph 12 is taken to be for the prescription of the increased quantity, number, or occasions, as the case may be.

13. The following purposes are specified in relation to each pharmaceutical benefit the name of which is specified in Part 2 of the Third Schedule to these Determinations:

(a) where a class of persons is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for the treatment of a person included in that class of persons;

(b) where a disease or condition is specified in the column headed “Purposes” —

(i) if subsubparagraph (ii) does not apply — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in relation to any person; or

(ii) if the disease or condition is specified in relation to a specified class of persons — that the pharmaceutical benefit is to be supplied for the treatment of that disease or condition in a person included in that class of persons;

(c) where a purpose is specified in the column headed “Purposes” — that the pharmaceutical benefit is to be supplied for that purpose.

14. For the purposes of subsection 85(6) of the Act, the name of the manufacturer or the names of manufacturers denoted in accordance with the following table by letters appearing in the column headed “Brand” in the First, Second or Third Schedule to these Determinations in relation to a drug or medicinal preparation the name of which is specified in that Schedule is or are the brand or brands under which the drug or medicinal preparation may be supplied under Part VII of the Act as a pharmaceutical benefit:

 

Letters

Manufacturer's Name

Letters

Manufacturer's Name

AB

Abbott Australasia Pty Ltd

AE

AFT Pharmaceuticals Pty Limited

AF

Alphapharm Pty Limited

AG

Allergan Australia Pty Ltd

AH

Altana Pharma Pty Ltd

AL

Alphapharm Medical A Division of Alphapharm Pty Limited

AN

Amgen Australia Pty Ltd

AP

AstraZeneca Pty Ltd

AQ

Alcon Laboratories (Australia) Pty Ltd

AS

Aspen Pharmacare Australia Pty Ltd

AV

Aventis Pharma Pty Limited

AW

Arrow Pharmaceuticals Pty Limited

AX

Sanofi Pasteur Pty Limited

BC

Bristol Laboratories A Division of Bristol-Myers Squibb Australia Pty Ltd

BD

Biogen Idec Australia Pty Ltd

BF

Bellwether Pharma Limited

BG

Biochemie Australia A Division of Sandoz Pty Ltd

BN

Bayer Australia Limited

BP

British Pharmaceuticals

BQ

Bristol-Myers Squibb Pharmaceuticals A Division of Bristol-Myers Squibb Australia Pty Ltd

BR

B. Braun Australia Pty Ltd

BU

Bausch & Lomb Surgical A Division of Bausch & Lomb (Australia) Pty Ltd

BX

Baxter Healthcare Pty Limited

BY

Boehringer Ingelheim Pty Limited

CF

CNS Pharma Pty Ltd

CH

Chem mart Pty Limited

CO

Chemists' Own Pty Ltd A member of Sigma Group of Companies

CS

CSL Limited

CX

Contact Lens Centre Australia Pty Ltd

DK

Dakota Pharmaceuticals A Division of Sanofi-Synthelabo Australia Pty Limited

DN

Digiland Pty Ltd

DR

DiaCare International Pty Ltd

DT

DermaTech Laboratories Pty Ltd

EO

Ego Pharmaceuticals Pty Ltd

EP

EpiPharm Pty Ltd

ES

EBOS Group Pty Ltd

EX

Essex Laboratories

FA

F.H. Faulding & Co. Limited

FB

Pierre Fabre Medicament Australia Pty Limited

FL

C. B. Fleet Co. (Aust.) Pty Ltd

FM

Fawns and McAllan Pty Ltd A member of Sigma Group of Companies

FP

Ferring Pharmaceuticals Pty Ltd

FR

Charles E. Frosst Division of Merck Sharp & Dohme (Australia) Pty Ltd

GC

GlaxoSmithKline Consumer Healthcare

GD

General Diabetes Services

GH

Goldshield Healthcare (Australia) Pty Ltd

GK

GlaxoSmithKline Australia Pty Ltd

GM

Genepharm Pty Ltd

GN

Genepharm Australasia Limited

GP

GP Laboratories A Division of Pfizer Pty Limited

GX

GenRx Pty Ltd

HA

Hamilton Laboratories Pty Ltd

HP

Hoechst Division of Aventis Pharma Pty Limited

HX

Hexal Australia Pty Ltd

IQ

Ioquin A Division of Alcon Laboratories (Australia) Pty Ltd

IT

InterPharma Pty Ltd

IZ

Intensive Care Products Pty Ltd

JC

Janssen-Cilag Pty Ltd

JT

Johnson & Johnson Pacific Pty Limited

KN

Knoll A Division of Abbott Australasia Pty Ltd

KR

Kenral Division of Pharmacia Australia Pty Limited

KY

Key Pharmaceuticals Pty Ltd

LB

Life Bioscience Pty Ltd

LF

Laboratoires Fournier S.A.

LM

Link Medical Products Pty Ltd

LN

Lennon Healthcare A Division of Aspen Pharmacare Australia Pty Ltd

LU

Lundbeck Australia Pty Ltd

LY

Eli Lilly Australia Pty Limited

MD

Macarthur Research Division of Roche Products Pty Ltd

ME

Menley & James Division of GlaxoSmithKline Australia Pty Ltd

MF

Mundipharma Pty Ltd

MK

Merck Sharp & Dohme (Australia) Pty Ltd

ML

Marion Division of Aventis Pharma Pty Limited

MM

3M Pharmaceuticals Australia Pty Ltd

MQ

Merck Pharmaceuticals

MS

Abbott Diagnostics Division (MediSense Products)

MX

Mayne Pharma Pty Ltd

NA

National Diagnostic Products (Aust) Pty Limited

NE

Norgine Pty Limited

NF

FlexPen Products of Novo Nordisk Pharmaceuticals Pty Ltd

NI

InnoLet Products of Novo Nordisk Pharmaceuticals Pty Ltd

NL

NovoLet Products of Novo Nordisk Pharmaceuticals Pty Ltd

NM

Novartis Medicines A Division of Novartis Pharmaceuticals Australia Pty Ltd

NO

Novo Nordisk Pharmaceuticals Pty Ltd

NT

Nestlé Australia Ltd

NU

Nutricia Australia Pty Limited

NV

Novartis Pharmaceuticals Australia Pty Ltd

OA

Orphan Australia Pty Ltd

OR

Organon (Australia) Pty Limited

PC

Pfizer Consumer Healthcare Pty Ltd

PD

Parke Davis Pty Ltd

PE

Pacific EyeCare A Division of Allergan Australia Pty Ltd

PF

Pfizer Pty Limited

PH

Pharmacia Australia Pty Limited

PK

Pharmatel Fresenius Kabi Pty Ltd

PL

Pharmalab

PM

PMC Pharma A Division of AstraZeneca Pty Ltd

PP

Petrus Pharmaceuticals Pty Ltd

PU

Pharmacia & Upjohn Pty Limited

PX

Point of Care Diagnostics Australia Pty Ltd

QM

Qualimed Division of Aventis Pharma Pty Limited

RA

Ranbaxy Australia Pty Limited

RC

Reckitt Benckiser (Australia) Pty Limited

RD

Roche Diagnostics Australia Pty Ltd

RE

Real-RL Division of GlaxoSmithKline Australia Pty Ltd

RO

Roche Products Pty Ltd

SB

Scientific Hospital Supplies Australia Products

SC

Schering Pty Ltd Australian Subsidiary of Schering AG, Berlin

SE

Servier Laboratories (Aust.) Pty Ltd

SG

Serono Australia Pty Ltd

SH

Schering-Plough Pty Ltd

SI

Sigma Pharmaceuticals Pty Ltd

SJ

Sharpe Laboratories Pty Ltd

SL

SBPA A Division of Sandoz Pty Ltd

SM

Solvay Pharmaceuticals Division of Solvay Biosciences Pty Ltd

SN

Smith & Nephew Healthcare

SU

Sauter Laboratories (Aust.) Pty Ltd

SW

Sanofi-Synthelabo Australia Pty Limited

SY

Schering AG

SZ

Sandoz Pty Ltd

TM

Technipro Marketing Pty Ltd

TW

Terry White Chemists

UC

UCB Pharma A Division of UCB Australia Pty Ltd

VF

Vitaflo Australia Pty Ltd

VT

Valeant Pharmaceuticals Australasia Pty Ltd

WA

Winthrop Pharmaceuticals Division of Sanofi-Aventis Australia Pty Limited

WF

MedWatchDog Pty Limited

WT

Wyeth Consumer Healthcare Pty Ltd

WW

Wm R. Warner

WX

Wyeth Australia Pty Limited

WY

Wyeth Pharmaceuticals Division of Wyeth Australia Pty Limited

 

 

Abciximab

I.V. injection 10 mg in 5 mL vial

Injection

3

..

LY

Acamprosate Calcium

Tablet 333 mg (enteric coated)

Oral

180

1

AF

Acarbose

Tablet 50 mg

Oral

90

5

BN

 

Tablet 100 mg

Oral

90

5

BN

Acetazolamide

Tablet 250 mg

Oral

100

3

SI

Acetylcysteine Sodium

Inhalation solution equivalent to 200 mg acetylcysteine per mL, 5 mL

Inhalation

30

3

BQ

Aciclovir

Tablet 200 mg

Oral

50

..

AF, GK, GM, GX, HX

 

Tablet 800 mg

Oral

35

..

AF, GK, GM, GX, HX

 

Eye ointment 30 mg per g, 4.5 g

Application to the eye

1

..

GK

Acitretin

Capsule 10 mg

Oral

100

2

RO

 

Capsule 25 mg

Oral

100

2

RO

Adalimumab

Injection 40 mg in 0.8 mL pre-filled syringe

Injection

2

3

AB

Adrenaline

I.M. injection 150 micrograms in 0.3 mL single dose syringe auto-injector

Injection

1

..

CS

 

I.M. injection 300 micrograms in 0.3 mL single dose syringe auto-injector

Injection

1

..

CS

Adrenaline Acid Tartrate

Injection equivalent to adrenaline 1 in 1,000, 1 mL

Injection

5

1

AP

Albendazole

Tablet 200 mg

Oral

6

..

GK

 

Tablet 400 mg

Oral

60

2

GK

Alendronate Sodium

Tablet equivalent to 70 mg alendronic acid

Oral

4

5

AW, MK

 

Tablet equivalent to 40 mg alendronic acid

Oral

30

5

MK

Alendronate Sodium with Colecalciferol

Tablet equivalent to 70 mg alendronic acid with 70 micrograms colecalciferol

Oral

4

5

MK

"Alfaré"

Oral powder 400 g

Oral

8

5

NT

Allopurinol

Tablet 100 mg

Oral

200

2

AF, CH, FM, GX, HX, SI, TW

 

Tablet 300 mg

Oral

60

2

AF, CH, FM, GX, HX, SI, TW

Alprazolam

Tablet 250 micrograms

Oral

50

..

AF, AW, HX, PH

 

Tablet 500 micrograms

Oral

50

..

AF, AW, HX, PH

 

Tablet 1 mg

Oral

50

2

AF, AW, CH, GM, GX, HX, PH, TW

 

Tablet 2 mg

Oral

50

2

AF, AW, CH, GM, GX, HX, PH, TW

Aluminium Hydroxide - Dried with Magnesium Hydroxide

Tablet 200 mg-200 mg

Oral suspension 200 mg-200 mg per 5 mL, 500 mL

Oral

Oral

200

2

5

5

PC, WW

PC, WW

 

Aluminium Hydroxide - Dried with Magnesium Trisilicate and Magnesium Hydroxide

Oral suspension 250 mg-120 mg-120 mg per 5 mL, 500 mL

Oral

2

5

FM

Amantadine Hydrochloride

Capsule 100 mg

Oral

100

5

NV

Amiloride Hydrochloride

Tablet 5 mg

Oral

100

1

AF

Aminoglutethimide

Tablet 250 mg

Oral

100

5

NV

Amiodarone Hydrochloride

Tablet 100 mg

Oral

30

5

AF, AW, GX, HX, SW

 

Tablet 200 mg

Oral

30

5

AF, AW, CH, GX, HX, SW, TW

Amisulpride

Tablet 100 mg

Oral

30

5

SW

 

Tablet 200 mg

Oral

60

5

SW

 

Tablet 400 mg

Oral

60

5

SW

 

Oral solution 100 mg per mL, 60 mL

Oral

2

5

SW

Amitriptyline Hydrochloride

Tablet 10 mg

Oral

50

2

AF

 

Tablet 25 mg

Oral

50

2

AF

 

Tablet 50 mg

Oral

50

2

AF

Amlodipine Besylate

Tablet equivalent to 5 mg amlodipine

Oral

30

5

PF

 

Tablet equivalent to 10 mg amlodipine

Oral

30

5

PF

Amlodipine Besylate with Atorvastatin Calcium

Tablet equivalent to 5 mg amlodipine with 10 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 5 mg amlodipine with 20 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 5 mg amlodipine with 40 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 5 mg amlodipine with 80 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 10 mg amlodipine with 10 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 10 mg amlodipine with 20 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 10 mg amlodipine with 40 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 10 mg amlodipine with 80 mg atorvastatin

Oral

30

5

PF

Amoxycillin Trihydrate

Tablet, chewable, equivalent to 250 mg amoxycillin

Oral

20

1

GK

 

Tablet equivalent to 1 g amoxycillin

Oral

14

1

BG, GK, SZ

 

Capsule equivalent to 250 mg amoxycillin

Oral

20

1

AF, CH, CS, GK, GM, GX, HX, SI, TW

 

Capsule equivalent to 500 mg amoxycillin

Oral

20

1

AF, CH, CS, GK, GM, GX, HX, SI, TW

 

Sachet containing oral powder equivalent to 3 g amoxycillin

Oral

1

..

GK

Amoxycillin Trihydrate with Potassium Clavulanate

Tablet equivalent to 500 mg amoxycillin-125 mg clavulanic acid

Oral

10

1

AL, GK, HX, ME, SL, SZ

 

Tablet equivalent to 875 mg amoxycillin-125 mg clavulanic acid

Oral

10

1

AL, CH, GK, GX, HX, ME, SL, SZ, TW

Amoxycillin Trihydrate with Potassium Clavulanate and Water - Purified BP

Powder for oral suspension equivalent to 125 mg amoxycillin-31.25 mg clavulanic acid per 5 mL, 75 mL

Oral

1

1

AL, GK, HX, ME

 

Powder for oral suspension equivalent to 400 mg amoxycillin-57 mg clavulanic acid per 5 mL, 60 mL

Oral

1

1

AL, GK, HX, ME

Amoxycillin Trihydrate with Water - Purified BP

Powder for paediatric oral drops equivalent to 100 mg amoxycillin per mL, 20 mL

Oral

1

1

GK

 

Powder for oral suspension equivalent to 125 mg amoxycillin per 5 mL, 100 mL

Oral

1

1

AF, CH, CS, GK, GM, GX, HX, TW

 

Powder for oral suspension equivalent to 250 mg amoxycillin per 5 mL, 100 mL

Oral

1

1

AF, CH, GK, GM, GX, HX, SI, TW

 

Powder for oral suspension equivalent to 500 mg amoxycillin per 5 mL, 100 mL

Oral

1

1

SZ

Amphotericin

Lozenge 10 mg

Oral

20

1

BQ

 

Powder for injection 50 mg

Injection

1

..

BQ

Ampicillin Sodium

Powder for injection equivalent to 500 mg ampicillin

Injection

5

1

GM, LN

 

Powder for injection equivalent to 1 g ampicillin

Injection

5

1

AS, GM, LN

Ampicillin Trihydrate

Capsule equivalent to 250 mg ampicillin

Oral

24

1

AF

 

Capsule equivalent to 500 mg ampicillin

Oral

24

..

AF

Anakinra

Injection 100 mg in 0.67 mL single use pre-filled syringe

Injection

28

3

AN

Anastrozole

Tablet 1 mg

Oral

30

5

AP

Apraclonidine Hydrochloride

Eye drops equivalent to 5 mg apraclonidine per mL, 10 mL

Application to the eye

1

2

AQ

Aprepitant

Pack containing 1 capsule 125 mg and 2 capsules 80 mg

Oral

1

..

MK

Aripiprazole

Tablet 10 mg

Oral

30

5

BQ

 

Tablet 15 mg

Oral

30

5

BQ

 

Tablet 20 mg

Oral

30

5

BQ

 

Tablet 30 mg

Oral

30

5

BQ

Aspirin

Tablet 100 mg

Oral

112

1

FA, MX

 

Tablet, dispersible, 300 mg

Oral

96

1

RC

Atenolol

Tablet 50 mg

Oral

30

5

AF, AP, CH, GM, GX, SI, SZ, TW

Atorvastatin Calcium

Tablet equivalent to 10 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 20 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 40 mg atorvastatin

Oral

30

5

PF

 

Tablet equivalent to 80 mg atorvastatin

Oral

30

5

PF

Atovaquone

Oral suspension 750 mg per 5 mL, 210 mL

Oral

1

..

GK

Atropine Sulfate

Injection 600 micrograms in 1 mL ampoule

Injection

10

1

AP

 

Eye drops 10 mg per mL, 15 mL

Application to the eye

1

2

SI

Auranofin

Tablet 3 mg

Oral

60

5

GH

Azathioprine

Tablet 25 mg

Oral

100

2

GK, HX

 

Tablet 50 mg

Oral

100

2

AF, AW, GK, GM, GX, HX

Azithromycin Dihydrate

Tablet equivalent to 500 mg azithromycin

Oral

2

..

PF

Azithromycin Dihydrate with Water - Purified BP

Powder for oral suspension equivalent to 200 mg azithromycin per 5 mL, 15 mL

Oral

1

..

PF

Baclofen

Tablet 10 mg

Oral

100

5

AF, AW, CH, GM, GX, HX, NV, TW

 

Tablet 25 mg

Oral

100

5

AF, AW, CH, GM, GX, HX, NV, TW

Balsalazide Sodium

Capsule 750 mg

Oral

180

5

PK

"BCG Immunotherapeutic" (Bacillus Calmette-Guérin/ Connaught strain)

Single dose set comprising 1 vial powder for intravesical administration containing 6.6 to 19.2 x 108 CFU and 1 vial diluent 3 mL

Intravesical administration

3

1

AV

"BCG-Tice" (Bacillus Calmette-Guérin/ Tice strain)

Vial containing powder for intravesical administration approximately 5 x 108 CFU

Intravesical administration

3

1

OR

Beclomethasone Dipropionate

Pressurised inhalation 50 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

MM

 

Pressurised inhalation 100 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

MM

 

Pressurised inhalation in breath actuated device 50 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

MM

 

Pressurised inhalation in breath actuated device 100 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

MM

Benzathine Penicillin

Injection 900 mg in 2 mL cartridge-needle unit (for use with Tubex Injector)

Injection

1

..

AS

 

Powder for injection 900 mg

Injection

1

..

AS

Benzhexol Hydrochloride

Tablet 2 mg

Oral

200

2

SI

 

Tablet 5 mg

Oral

200

1

SI

Benztropine Mesylate

Tablet 2 mg

Oral

60

2

PL

 

Injection 2 mg in 2 mL ampoule

Injection

5

..

MK

Benzydamine Hydrochloride

Mouth and throat rinse 22.5 mg per 15 mL, 500 mL

Oral application

1

1

MM

Benzylpenicillin Sodium

Powder for injection equivalent to 600 mg benzylpenicillin

Injection

10

1

CS

 

Powder for injection equivalent to 3 g benzylpenicillin

Injection

10

..

CS

Betamethasone Acetate with Betamethasone Sodium Phosphate

Injection 3 mg-3.9 mg in 1 mL ampoule

Injection

5

..

SH

Betamethasone Dipropionate

Cream equivalent to 500 micrograms betamethasone per g, 15 g

Application

1

1

EX, SH

 

Ointment equivalent to 500 micrograms betamethasone per g, 15 g

Application

1

1

EX, SH

Betamethasone Valerate

Cream equivalent to 200 micrograms betamethasone per g, 100 g

Application

2

..

EX, FM, SH, SI

 

Cream equivalent to 500 micrograms betamethasone per g, 15 g

Application

1

1

FM, SI

 

Ointment equivalent to 200 micrograms betamethasone per g, 100 g

Application

2

..

EX, SH

 

Ointment equivalent to 500 micrograms betamethasone per g, 15 g

Application

1

1

FM, SI

Betaxolol Hydrochloride

Eye drops, suspension, equivalent to 2.5 mg betaxolol per mL, 5 mL

Application to the eye

1

5

AQ

 

Eye drops, solution, equivalent to 5 mg betaxolol per mL, 5 mL

Application to the eye

1

5

AQ, IQ

Bethanechol Chloride

Tablet 10 mg

Oral

100

2

HA

Bicalutamide

Tablet 50 mg

Oral

28

5

AP

Bifonazole

Cream 10 mg per g, 15 g

Application

2

3

BN

Bimatoprost

Eye drops 300 micrograms per mL, 3 mL

Application to the eye

1

5

AG

Biperiden Hydrochloride

Tablet 2 mg

Oral

200

2

AB

Bisacodyl

Tablet 5 mg

Oral

200

2

AE, AS

 

Suppositories 10 mg, 10

Rectal

3

5

BY, PP

 

Suppositories 10 mg, 12

Rectal

3

4

FL, PP

 

Enemas 10 mg in 5 mL, 25

Rectal

1

2

AS

Bisoprolol Fumarate

Tablet 2.5 mg

Oral

28

5

AL

 

Tablet 5 mg

Oral

28

5

AL

 

Tablet 10 mg

Oral

28

5

AL

Bivalirudin Trifluoroacetate

Powder for I.V. injection equivalent to 250 mg bivalirudin, vial

Injection

1

..

CS

Bleomycin Sulfate with any determined brand of Sodium Chloride Injection

Powder for injection 15,000 I.U. (with required solvent)

Injection

10

..

BQ, MX, SI

Brimonidine Tartrate

Eye drops 2 mg per mL, 5 mL

Application to the eye

1

5

AG, PE

Brimonidine Tartrate with Timolol Maleate

Eye drops 2 mg brimonidine tartrate with timolol maleate equivalent to 5 mg timolol per mL, 5 mL

Application to the eye

1

5

AG

Brinzolamide

Eye drops 10 mg per mL, 5 mL

Application to the eye

1

5

AQ, IQ

Bromocriptine Mesylate

Tablet equivalent to 2.5 mg bromocriptine

Oral

30

..

AF, NV

 

Capsule equivalent to 5 mg bromocriptine

Oral

60

5

AF, NV

 

Capsule equivalent to 10 mg bromocriptine

Oral

100

5

AF, NV

Budesonide

Nebuliser suspension 500 micrograms in 2 mL single dose units, 30

Inhalation

1

5

AP

 

Nebuliser suspension 1 mg in 2 mL single dose units, 30

Inhalation

1

5

AP

 

Powder for oral inhalation in breath actuated device 100 micrograms per dose, 200 doses

Inhalation by mouth

1

5

AP

 

Powder for oral inhalation in breath actuated device 200 micrograms per dose, 200 doses

Inhalation by mouth

1

5

AP

 

Powder for oral inhalation in breath actuated device 400 micrograms per dose, 200 doses

Inhalation by mouth

1

5

AP

Budesonide with Eformoterol Fumarate Dihydrate

Powder for oral inhalation in breath actuated device 100 micrograms-6 micrograms per dose, 120 doses

Inhalation by mouth

1

5

AP

 

Powder for oral inhalation in breath actuated device 200 micrograms-6 micrograms per dose, 120 doses

Inhalation by mouth

1

5

AP

 

Powder for oral inhalation in breath actuated devices 400 micrograms-12 micrograms per dose, 60 doses, 2

Inhalation by mouth

1

5

AP

Buprenorphine

Transdermal patch 5 mg

Transdermal

2

..

MF

 

Transdermal patch 10 mg

Transdermal

2

..

MF

 

Transdermal patch 20 mg

Transdermal

2

..

MF

Bupropion Hydrochloride

Tablet 150 mg (sustained release)

Oral

30

..

GK, HX, RE

Busulfan

Tablet 2 mg

Oral

100

..

GK

Cabergoline

Tablet 500 micrograms

Oral

2

..

PH

 

Tablet 1 mg

Oral

30

5

PU

 

Tablet 2 mg

Oral

30

5

PU

 

Tablet 4 mg

Oral

30

5

PU

Calcipotriol

Ointment 50 micrograms per g, 30 g

Application

1

1

CS

Calcitriol

Capsule 0.25 microgram

Oral

100

3

AF, AL, AW, GM, GX, HX, RO

Calcium Carbonate

Tablet, chewable, 1.25 g (equivalent to 500 mg calcium)

Oral

120

1

MM

 

Tablet 1.5 g (equivalent to 600 mg calcium)

Oral

120

1

WT

Calcium Citrate

Tablet equivalent to 250 mg calcium

Oral

120

1

KY

Calcium Folinate

Tablet equivalent to 15 mg folinic acid

Oral

10

..

MX

 

Injection equivalent to 50 mg folinic acid in 5 mL

Injection

5

5

IT, MX, PF

 

Injection equivalent to 100 mg folinic acid in 10 mL

Injection

10

1

IT, PF

 

Injection equivalent to 300 mg folinic acid in 30 mL

Injection

4

1

MX

Candesartan Cilexetil

Tablet 4 mg

Oral

30

5

AP

 

Tablet 8 mg

Oral

30

5

AP

 

Tablet 16 mg

Oral

30

5

AP

 

Tablet 32 mg

Oral

30

5

AP

Candesartan Cilexetil with Hydrochlorothiazide

Tablet 16 mg-12.5 mg

Oral

30

5

AP

Capecitabine

Tablet 150 mg

Oral

60

2

RO

 

Tablet 500 mg

Oral

120

2

RO

"Caprilon"

Oral powder 420 g

Oral

8

5

SB

Captopril

Tablet 12.5 mg

Oral

90

5

AF, BQ, CH, FM, GM, GX, HX, TW

 

Tablet 25 mg

Oral

90

5

AF, BQ, CH, FM, GM, GX, HX, TW

 

Tablet 50 mg

Oral

90

5

AF, BQ, CH, FM, GM, GX, HX, TW

 

Oral solution 5 mg per mL, 95 mL

Oral

1

5

BQ

Carbamazepine

Tablet 100 mg

Oral

200

2

BG, NV, SZ

 

Tablet 200 mg

Oral

200

2

AF, BG, NV, SZ

 

Tablet 200 mg (controlled release)

Oral

200

2

NV

 

Tablet 400 mg (controlled release)

Oral

200

2

NV

 

Oral suspension 100 mg per 5 mL, 300 mL

Oral

1

5

NV

Carbimazole

Tablet 5 mg

Oral

200

2

RO

"Carbohydrate Free Mixture"

Oral powder 225 g

Oral

24

5

SB

Carbomer 974

Ocular lubricating gel 3 mg per g, single dose units 0.5 g, 30

Application to the eye

3

5

AQ

Carbomer 980

Ocular lubricating gel 2 mg per g, 10 g

Application to the eye

1

5

BU, NM, NV

 

Eye drops 2 mg per g, single dose units 0.6 mL, 30

Application to the eye

3

5

NV

Carboplatin

Solution for I.V. injection 50 mg in 5 mL

Injection

2

..

IT, MX, PU

 

Solution for I.V. injection 150 mg in 15 mL

Injection

6

..

IT, MX, PU

 

Solution for I.V. injection 450 mg in 45 mL

Injection

2

..

IT, MX, PU

Carmellose Sodium

Eye drops 5 mg per mL, 15 mL

Application to the eye

1

5

AG

 

Eye drops 10 mg per mL, 15 mL

Application to the eye

1

5

AG

 

Eye drops 2.5 mg per mL, single dose units 0.6 mL, 24

Application to the eye

4

5

CX

 

Eye drops 5 mg per mL, single dose units 0.4 mL, 30

Application to the eye

3

5

AG

 

Eye drops 10 mg per mL, single dose units 0.4 mL, 30

Application to the eye

3

5

AG

 

Ocular lubricating gel 10 mg per mL, single dose units 0.6 mL, 28

Application to the eye

3

5

CX

Carmustine

Implants 7.7 mg, 8

Intracranial

1

..

OA

Carvedilol

Tablet 3.125 mg

Oral

30

..

GX, MD, RO

 

Tablet 6.25 mg

Oral

60

5

GX, MD, RO

 

Tablet 12.5 mg

Oral

60

5

GX, MD, RO

 

Tablet 25 mg

Oral

60

5

GX, MD, RO

Cefaclor Monohydrate

Tablet (sustained release) equivalent to 375 mg cefaclor

Oral

10

1

AF, AS, CH, GM, GX, LN, RA, TW

Cefaclor Monohydrate with Water - Purified BP

Powder for oral suspension equivalent to 125 mg cefaclor per 5 mL, 100 mL

Oral

1

1

AF, AS, AW, CH, GX, TW

 

Powder for oral suspension equivalent to 250 mg cefaclor per  5 mL, 75 mL

Oral

1

1

AF, AS, AW, CH, GX, TW

Cefepime Hydrochloride with any determined brand of Sodium Chloride Injection

Powder for injection equivalent to 1 g cefepime (with required solvent)

Injection

10

..

BQ

Powder for injection equivalent to 2 g cefepime (with required solvent)

Injection

10

..

BQ

Cefotaxime Sodium

Powder for injection equivalent to 1 g cefotaxime

Injection

10

..

MX, SZ

 

Powder for injection equivalent to 2 g cefotaxime

Injection

10

..

MX, SZ

Ceftriaxone Sodium

Powder for injection equivalent to 500 mg ceftriaxone

Injection

1

..

IZ

 

Powder for injection equivalent to 1 g ceftriaxone

Injection

5

..

IZ, MX, RO, SZ

 

Powder for injection equivalent to 2 g ceftriaxone

Injection

5

..

IZ, MX, RO, SZ

Cefuroxime Axetil

Tablet equivalent to 250 mg cefuroxime

Oral

14

1

GK

Celecoxib

Capsule 100 mg

Oral

60

3

PH

 

Capsule 200 mg

Oral

30

3

PH

Cephalexin

Capsule 250 mg (anhydrous)

Oral

20

1

AF, AS, CH, GM, GX, HX, LN, RA, TW

 

Capsule 500 mg (anhydrous)

Oral

20

1

AF, AS, CH, GM, GX, HX, LN, RA, TW

Cephalexin with Water - Purified BP

Granules for oral suspension 125 mg per 5 mL, 100 mL

Oral

1

1

AF, AS, CH, GM, GX, LN, TW

 

Granules for oral suspension 250 mg per 5 mL, 100 mL

Oral

1

1

AF, AS, CH, GM, GX, LN, TW

Cephalothin Sodium

Powder for injection equivalent to 1 g cephalothin

Injection

10

1

AS, MX

Cephazolin Sodium

Powder for injection equivalent to 500 mg cephazolin

Injection

10

..

MX

 

Powder for injection equivalent to 1 g cephazolin

Injection

10

..

AS, MX, SZ

Chlorambucil

Tablet 2 mg

Oral

100

2

GK

Chloramphenicol

Ear drops (aqueous) 5 mg per mL, 5 mL

Application to the ear

1

2

PF

 

Eye drops 5 mg per mL, 10 mL

Application to the eye

1

2

PF, SI

 

Eye ointment 10 mg per g, 4 g

Application to the eye

1

..

PF, SI

Chlorpromazine Hydrochloride

Tablet 10 mg

Oral

100

5

AV

 

Tablet 25 mg

Oral

100

5

AV

 

Tablet 100 mg

Oral

100

5

AV

 

Oral solution 25 mg per 5 mL, 100 mL

Oral

1

5

AV

 

Injection 50 mg in 2 mL ampoule

Injection

10

..

AV

Chlorthalidone

Tablet 25 mg

Oral

100

1

NV

Cholestyramine

Sachets containing 4.7 g oral powder (equivalent to 4 g cholestyramine), 50

Oral

2

5

BQ

 

Sachets containing 9.4 g oral powder (equivalent to 8 g cholestyramine), 50

Oral

1

5

BQ

Chorionic Gonadotrophin

Injection set containing 3 ampoules powder for injection 500 units and 3 ampoules solvent 1 mL

Injection

1

5

OR

 

Injection set containing 3 ampoules powder for injection 1,500 units and 3 ampoules solvent 1 mL

Injection

1

5

OR

Ciclesonide

Pressurised inhalation 80 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

AH

 

Pressurised inhalation 160 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

AH

Cimetidine

Tablet 200 mg

Oral

120

5

AF, GK

 

Tablet 400 mg

Oral

60

5

AF, GK, GX

 

Tablet 800 mg

Oral

30

5

AF, GX

Ciprofloxacin Hydrochloride

Tablet equivalent to 500 mg ciprofloxacin

Oral

14

..

AL, AW, BG, BN, GM, GN, GX, HX

 

Tablet equivalent to 750 mg ciprofloxacin

Oral

14

..

AL, AW, BN, GM, GN, GX, HX

 

Tablet equivalent to 250 mg ciprofloxacin

Oral

2

..

BN

Ciprofloxacin Hydrochloride

Ear drops equivalent to 3 mg ciprofloxacin per mL, 5 mL

Application to the ear

1

1

AQ

 

Eye drops equivalent to 3 mg ciprofloxacin per mL, 5 mL

Application to the eye

2

..

AQ, IQ

Cisplatin

I.V. injection 10 mg in 10 mL

Injection

1

..

PU

 

I.V. injection 50 mg in 50 mL

Injection

1

..

MX, PU

 

I.V. injection 100 mg in 100 mL

Injection

1

..

IT, MX

Citalopram Hydrobromide

Tablet equivalent to 10 mg citalopram

Oral

28

5

AF

 

Tablet equivalent to 20 mg citalopram

Oral

28

5

AF, AW, CH, GM, GX, LU, RE, SZ, TW

 

Tablet equivalent to 40 mg citalopram

Oral

28

5

AF, GX, SZ

Cladribine

Injection 10 mg in 5 mL vial

Injection

7

..

OA

 

Solution for I.V. infusion 10 mg in 10 mL single use vial

Injection

7

..

JC

Clarithromycin

Tablet 250 mg

Oral

14

1

AB, AF, AW, CH, GM, GX, HX, TW

Clindamycin Hydrochloride

Capsule equivalent to 150 mg clindamycin

Oral

25

..

KR, PH

Clomiphene Citrate

Tablet 50 mg

Oral

10

5

AV, AW, GX, HX, SG

Clomipramine Hydrochloride

Tablet 25 mg

Oral

50

2

AF, CH, GX, NV, TW

Clonazepam

Tablet 500 micrograms

Oral

200

2

AF, RO

 

Tablet 2 mg

Oral

200

2

AF, RO

 

Oral liquid 2.5 mg per mL, 10 mL

Oral

2

..

RO

 

Injection 1 mg in 2 mL (set containing solution 1 mg in 1 mL and 1 mL diluent)

Injection

5

..

RO

Clonidine Hydrochloride

Tablet 100 micrograms

Oral

100

5

BY

 

Tablet 150 micrograms

Oral

100

5

BY

Clopidogrel Hydrogen Sulfate

Tablet equivalent to 75 mg clopidogrel

Oral

28

5

BQ, SW

Clotrimazole

Lotion 10 mg per mL, 20 mL

Application

2

3

BN

Coal Tar - Prepared

Gel 10 mg per g, 100 mL

Application

1

2

EP

Codeine Phosphate

Tablet 30 mg

Oral

20

..

FM

Codeine Phosphate with Paracetamol

Tablet 30 mg-500 mg

Oral

20

..

AL, CO, DK, FM, GK, SW

Colchicine

Tablet 500 micrograms

Oral

100

2

AS, LN

Colestipol Hydrochloride

Oral powder, sachets 5 g, 120

Oral

1

5

PH

Copper Sulfate

Tablets, diagnostic compound, 36

 

2

3

BN

Cortisone Acetate

Tablet 5 mg

Oral

50

4

AS

 

Tablet 25 mg

Oral

60

4

AS

Cyclophosphamide

Tablet 50 mg

Oral

50

2

PH

Cyclophosphamide with any determined brand of Sodium Chloride Injection

 

Powder for injection 500 mg (anhydrous) (with required solvent)

Injection

2

..

BX

Powder for injection 1 g (anhydrous) (with required solvent)

Injection

1

..

BX

 

Powder for injection 2 g (anhydrous) (with required solvent)

Injection

1

..

BX

Cyclosporin

Capsule 10 mg

Oral

120

3

NV

 

Capsule 25 mg

Oral

60

3

HX, NV

 

Capsule 50 mg

Oral

60

3

HX, NV

 

Capsule 100 mg

Oral

60

3

HX, NV

 

Oral liquid 100 mg per mL, 50 mL

Oral

2

3

NV

Cyproheptadine Hydrochloride

Tablet 4 mg (anhydrous)

Oral

100

2

FR

Cyproterone Acetate

Tablet 50 mg

Oral

20

5

AF, GM, GX, HX, SC, SY

 

Tablet 100 mg

Oral

50

5

GM, GX, HX, SC, SY

Cytarabine

Injection 100 mg in 5 mL vial

Injection

10

1

PU

Dalteparin Sodium

Injection 2,500 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

Injection

10

1

PH

 

Injection 5,000 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

Injection

10

1

PH

 

Injection 7,500 I.U. (anti-Xa) in 0.75 mL single dose pre-filled syringe

Injection

10

1

PH

 

Injection 10,000 I.U. (anti-Xa) in 1 mL single dose pre-filled syringe

Injection

10

1

PH

Danazol

Capsule 100 mg

Oral

100

5

AF

 

Capsule 200 mg

Oral

100

5

AF

Dantrolene Sodium

Capsule 25 mg

Oral

100

2

PU

 

Capsule 50 mg

Oral

100

2

PU

Dapsone

Tablet 25 mg

Oral

100

1

LM

 

Tablet 100 mg

Oral

100

1

LM

Desmopressin Acetate

Intranasal solution 100 micrograms per mL, 2.5 mL dropper bottle

Nasal

5

5

FP

 

Tablet 200 micrograms

Oral

30

5

FP

 

Nasal spray (pump pack) 10 micrograms per actuation, 60 actuations, 6 mL

Nasal

1

5

FP

Dexamethasone

Tablet 500 micrograms

Oral

30

4

AS

 

Tablet 4 mg

Oral

30

4

AS

 

Eye drops 1 mg per mL, 5 mL

Application to the eye

1

2

AQ

Dexamethasone Sodium Metasulfobenzoate with Framycetin Sulfate and Gramicidin

Ear drops 500 micrograms (dexamethasone)-5 mg-50 micrograms per mL, 8 mL

Application to the ear

1

2

AV, QM

Dexamethasone Sodium Phosphate

Injection equivalent to 4 mg dexamethasone phosphate in 1 mL ampoule

Injection

5

..

MX

 

Injection equivalent to 8 mg dexamethasone phosphate in 2 mL vial

Injection

5

1

MX

 

Injection equivalent to 120 mg dexamethasone phosphate in 5 mL vial

Injection

1

..

MX

Dexamphetamine Sulfate

Tablet 5 mg

Oral

100

5

SI

"Dialamine"

Oral powder 200 g

Oral

10

5

SB

Diazepam

Tablet 2 mg

Oral

50

..

AF, AW, RO, SU

 

Tablet 5 mg

Oral

50

..

AF, AW, GM, RO, SU

 

Injection 10 mg in 2 mL ampoule

Injection

5

..

MX

Diclofenac Sodium

Tablet 25 mg (enteric coated)

Oral

100

3

AF, AW, BG, CH, GM, GX, HX, NV, TW

 

Tablet 50 mg (enteric coated)

Oral

50

3

AF, AW, CH, GM, GX, HX, NV, TW

 

Suppository 100 mg

Rectal

40

3

NV

Dicloxacillin Sodium

Capsule equivalent to 250 mg dicloxacillin

Oral

24

..

AF, BQ, SI

 

Capsule equivalent to 500 mg dicloxacillin

Oral

24

..

AF, BQ, SI

 

Powder for injection equivalent to 500 mg dicloxacillin

Injection

5

..

BQ

 

Powder for injection equivalent to 1 g dicloxacillin

Injection

5

1

BQ

"Digestelact"

Oral powder 900 g

Oral

3

1

SJ

Digoxin

Tablet 62.5 micrograms

Oral

200

1

FM, SI

 

Tablet 250 micrograms

Oral

100

1

FM, SI

 

Paediatric oral solution 50 micrograms per mL, 60 mL

Oral

2

3

SI

Dihydroergotamine Mesylate

Injection 1 mg in 1 mL ampoule

Injection

5

..

NV

Diltiazem Hydrochloride

Tablet 60 mg

Oral

90

5

AF, AV, CH, GM, GX, HP, HX, TW

 

Capsule 180 mg (controlled delivery)

Oral

30

5

AV, CH, GM, GX, HP, TW

 

Capsule 240 mg (controlled delivery)

Oral

30

5

AV, CH, GM, GX, HP, TW

 

Capsule 360 mg (controlled delivery)

Oral

30

5

AV, HP

Diphenoxylate Hydrochloride with Atropine Sulfate

Tablet 2.5 mg-25 micrograms

Oral

20

..

KR, PH

Diphtheria and Tetanus Vaccine - Adsorbed

Injection 0.5 mL ampoule

Injection

3

..

CS

Diphtheria and Tetanus Vaccine - Adsorbed (Diluted)

Injection 0.5 mL in pre-filled syringe. For immunisation of adults and children over the age of 8 years

Injection

3

..

CS

Dipivefrine Hydrochloride

Eye drops 1 mg per mL, 10 mL

Application to the eye

1

5

AG

Dipyridamole

Capsule 200 mg (sustained release)

Oral

60

5

BY

Dipyridamole with Aspirin

Capsule 200 mg (sustained release)-25 mg

Oral

60

5

BY

Disodium Etidronate

Tablet 200 mg

Oral

60

5

PU

Disodium Etidronate and Calcium Carbonate

Pack containing 28 tablets disodium etidronate 200 mg and 76 tablets calcium carbonate 1.25 g (equivalent to 500 mg calcium)

Oral

1

1

PU

Disodium Pamidronate

Concentrated injection 15 mg in 5 mL vial

Injection

4

..

MX

 

Injection set containing 4 vials powder for I.V. infusion 15 mg and 4 ampoules solvent 5 mL

Injection

1

..

NV

 

Concentrated injection 30 mg in 10 mL vial

Injection

2

..

MX

 

Injection set containing 2 vials powder for I.V. infusion 30 mg and 2 ampoules solvent 10 mL

Injection

1

..

NV

 

Concentrated injection 60 mg in 10 mL vial

Injection

1

..

MX

Disopyramide

Capsule 100 mg

Oral

100

5

AV

 

Capsule 150 mg

Oral

100

5

AV

Docetaxel

Injection set containing 1 single use vial concentrate for I.V. infusion 20 mg (anhydrous) in 0.5 mL and 1 single use vial solvent 1.5 mL

Injection

2

..

AV

 

Injection set containing 1 single use vial concentrate for I.V. infusion 80 mg (anhydrous) in 2 mL and 1 single use vial solvent 6 mL

Injection

1

..

AV

Docusate Sodium with Bisacodyl

Suppositories 100 mg-10 mg, 5

Rectal

6

5

FM

Dolasetron Mesylate

Tablet 200 mg

Oral

2

..

AV

 

I.V. injection 100 mg in 5 mL ampoule

Injection

1

..

AV

Domperidone

Tablet 10 mg

Oral

25

..

JC

Donepezil Hydrochloride

Tablet 5 mg

Oral

28

5

PF

 

Tablet 10 mg

Oral

28

5

PF

Dorzolamide Hydrochloride

Eye drops equivalent to 20 mg dorzolamide per mL, 5 mL

Application to the eye

1

5

MK

Dorzolamide Hydrochloride with Timolol Maleate

Eye drops equivalent to 20 mg dorzolamide-5 mg timolol per mL, 5 mL

Application to the eye

1

5

MK

Dothiepin Hydrochloride

Capsule 25 mg

Oral

50

2

AB, AF

 

Tablet 75 mg

Oral

30

2

AB, AF

Doxepin Hydrochloride

Tablet equivalent to 50 mg doxepin

Oral

50

2

AF

 

Capsule equivalent to 10 mg doxepin

Oral

50

2

AF, PF

 

Capsule equivalent to 25 mg doxepin

Oral

50

2

AF, PF

Doxorubicin Hydrochloride

Solution for I.V. injection or intravesical administration 10 mg in 5 mL single dose vial

Injection or intravesical administration

4

..

IT, MX, PH

 

Solution for I.V. injection or intravesical administration 20 mg in 10 mL single dose vial

Injection or intravesical administration

4

..

PH

 

Solution for I.V. injection or intravesical administration 50 mg in 25 mL single dose vial

Injection or intravesical administration

3

..

IT, MX, PH

 

Solution for I.V. injection or intravesical administration 100 mg in 50 mL single dose vial

Injection or intravesical administration

1

..

IT

 

Solution for I.V. injection or intravesical administration 200 mg in 100 mL single dose vial

Injection or intravesical administration

1

..

IT

Doxorubicin Hydrochloride - Pegylated Liposomal

Suspension for I.V. infusion 20 mg in 10 mL vial

Injection

1

..

SH

 

Suspension for I.V. infusion 50 mg in 25 mL vial

Injection

1

..

SH

Doxycycline Hydrochloride

Tablet equivalent to 50 mg doxycycline

Oral

25

5

AF, GM, PF

 

Capsule equivalent to 50 mg doxycycline (containing enteric coated pellets)

Oral

25

5

FA, MX

 

Tablet equivalent to 100 mg doxycycline

Oral

7

1

AF, GM, PF, SI

 

Capsule equivalent to 100 mg doxycycline (containing enteric coated pellets)

Oral

7

1

FA, MX

Doxycycline Monohydrate

Tablet equivalent to 50 mg doxycycline

Oral

25

5

AW, CH, GX, SZ, TW

 

Tablet equivalent to 100 mg doxycycline

Oral

7

1

CH, GX, SZ, TW

Drotrecogin Alfa (Activated)

Powder for I.V. infusion 5 mg, vial

Injection

1

..

LY

 

Powder for I.V. infusion 20 mg, vial

Injection

1

..

LY

"Duocal"

Oral powder 400 g

Oral

8

5

SB

Dydrogesterone

Tablet 10 mg

Oral

28

2

SM

"Easiphen"

Oral liquid 250 mL

Oral

90

5

SB

Efalizumab

Injection set containing 4 vials powder for injection 125 mg and 4 pre-filled syringes diluent 1.3 mL

Injection

1

3

SG

Eformoterol Fumarate Dihydrate

Capsule containing powder for oral inhalation 12 micrograms (for use in Foradile Aerolizer)

Inhalation by mouth

60

5

NV

 

Powder for oral inhalation in breath actuated device 6 micrograms per dose, 60 doses

Inhalation by mouth

1

5

AP

 

Powder for oral inhalation in breath actuated device 12 micrograms per dose, 60 doses

Inhalation by mouth

1

5

AP

"EleCare"

Oral powder 400 g

Oral

8

5

AB

Enalapril Maleate

Tablet 5 mg

Oral

30

5

AF, BF, CH, GM, GX, HX, MK, SI, TW

 

Tablet 10 mg

Oral

30

5

AF, BF, CH, FR, GM, GX, HX, MK, SI, TW

 

Tablet 20 mg

Oral

30

5

AF, BF, CH, FR, GM, GX, HX, MK, SI, TW

Enalapril Maleate with Hydrochlorothiazide

Tablet 20 mg-6 mg

Oral

30

5

MK

"Energivit"

Oral powder 400 g

Oral

8

5

SB

Enoxaparin Sodium

Injection 20 mg (2,000 I.U. anti-Xa) in 0.2 mL pre-filled syringe

Injection

10

1

AV

 

Injection 40 mg (4,000 I.U. anti-Xa) in 0.4 mL pre-filled syringe

Injection

10

1

AV

 

Injection 60 mg (6,000 I.U. anti-Xa) in 0.6 mL pre-filled syringe

Injection

10

1

AV

 

Injection 80 mg (8,000 I.U. anti-Xa) in 0.8 mL pre-filled syringe

Injection

10

1

AV

 

Injection 100 mg (10,000 I.U. anti-Xa) in 1 mL pre-filled syringe

Injection

10

1

AV

Entacapone

Tablet 200 mg

Oral

200

4

NV

Epirubicin Hydrochloride

Solution for injection 10 mg in 5 mL

Injection or intravesical administration

4

..

IT, PH

 

Solution for injection 20 mg in 10 mL

Injection or intravesical administration

4

..

PH

 

Solution for injection 50 mg in 25 mL

Injection or intravesical administration

3

..

IT, PH

 

Powder for injection 50 mg

Injection or intravesical administration

3

..

MX

 

Solution for injection 100 mg in 50 mL

Injection or intravesical administration

2

..

IT

 

Solution for injection 200 mg in 100 mL

Injection or intravesical administration

1

..

IT

Eplerenone

Tablet 25 mg

Oral

30

5

PF

 

Tablet 50 mg

Oral

30

5

PF

Eprosartan Mesylate

Tablet equivalent to 400 mg eprosartan

Oral

56

5

SM

 

Tablet equivalent to 600 mg eprosartan

Oral

28

5

SM

Eprosartan Mesylate with Hydrochlorothiazide

Tablet equivalent to 600 mg eprosartan with 12.5 mg hydrochlorothiazide

Oral

28

5

SM

Eptifibatide Acetate

Solution for I.V. injection equivalent to 20 mg eptifibatide in 10 mL vial

Injection

2

..

SH

 

Solution for I.V. infusion equivalent to 75 mg eptifibatide in 100 mL vial

Injection

3

..

SH

Erythromycin

Capsule 250 mg (containing enteric coated pellets)

Oral

25

1

FA, MX

Erythromycin Ethyl Succinate

Tablet equivalent to 400 mg erythromycin

Oral

25

1

AB, AF

Erythromycin Ethyl Succinate with Water - Purified BP

Powder for oral liquid equivalent to 200 mg erythromycin per 5 mL, 100 mL

Oral

1

1

AB, AF

 

Powder for oral liquid equivalent to 400 mg erythromycin per 5 mL, 100 mL

Oral

1

1

AB, AF

Erythromycin Lactobionate

Powder for I.V. infusion equivalent to 1 g erythromycin, vial

Injection

5

..

AB

Escitalopram Oxalate

Tablet equivalent to 10 mg escitalopram

Oral

28

5

CF, LU

 

Tablet equivalent to 20 mg escitalopram

Oral

28

5

CF, LU

 

Oral solution equivalent to 10 mg escitalopram per mL, 28 mL

Oral

1

5

LU

Esomeprazole Magnesium Trihydrate

Tablet (enteric coated), equivalent to 20 mg esomeprazole

Oral

30

1

AP

 

Tablet (enteric coated), equivalent to 40 mg esomeprazole

Oral

30

1

AP

Esomeprazole Magnesium Trihydrate and Clarithromycin and Amoxycillin Trihydrate

Pack containing 14 tablets (enteric coated) esomeprazole magnesium trihydrate equivalent to 20 mg esomeprazole, 14 tablets clarithromycin 500 mg and 28 capsules amoxycillin trihydrate equivalent to 500 mg amoxycillin

Oral

1

..

AP

Etanercept

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

Injection

2

2

WY

 

Injection set containing 4 vials powder for injection 50 mg and 4 pre-filled syringes solvent 1 mL

Injection

1

2

WY

Ethacrynic Acid

Tablet 25 mg

Oral

200

1

MK

Ethosuximide

Capsule 250 mg

Oral

200

2

PF

 

Oral solution 250 mg per 5 mL, 200 mL

Oral

1

5

PF

Etonogestrel

Subcutaneous implant 68 mg

Subcutaneous implantation

1

..

OR

Etoposide

Capsule 50 mg

Oral

20

..

BQ

 

Capsule 100 mg

Oral

10

..

BQ

 

Solution for I.V. infusion 100 mg in 5 mL vial

Injection

5

..

IT, MX

Etoposide Phosphate

Powder for I.V. infusion 113.6 mg, vial

Injection

5

..

BQ

 

Powder for I.V. infusion 1.136 g, vial

Injection

1

..

BQ

Everolimus

Tablet 0.25 mg

Oral

60

3

NV

 

Tablet 0.5 mg

Oral

60

3

NV

 

Tablet 0.75 mg

Oral

120

3

NV

Exemestane

Tablet 25 mg

Oral

30

5

PH

Ezetimibe

Tablet 10 mg

Oral

30

5

MK

Ezetimibe with Simvastatin

Tablet 10 mg-40 mg

Oral

30

5

MK

 

Tablet 10 mg-80 mg

Oral

30

5

MK

Famciclovir

Tablet 125 mg

Oral

40

1

NV

 

Tablet 250 mg

Oral

21

..

NV

 

Tablet 500 mg

Oral

30

..

NV

Famotidine

Tablet 20 mg

Oral

60

5

AF, AW, CH, GM, GX, HX, MK, TW

 

Tablet 40 mg

Oral

30

5

AF, AW, CH, GM, GX, HX, MK, TW

Felodipine

Tablet 2.5 mg (extended release)

Oral

30

5

AL, AP

 

Tablet 5 mg (extended release)

Oral

30

5

AL, AP

 

Tablet 10 mg (extended release)

Oral

30

5

AL, AP

Fenofibrate

Tablet 48 mg

Oral

60

5

LF

 

Tablet 145 mg

Oral

30

5

LF

Fentanyl

Transdermal patch 2.1 mg

Transdermal

5

..

JC

 

Transdermal patch 4.2 mg

Transdermal

5

..

JC

 

Transdermal patch 8.4 mg

Transdermal

5

..

JC

 

Transdermal patch 12.6 mg

Transdermal

5

..

JC

 

Transdermal patch 16.8 mg

Transdermal

5

..

JC

Ferrous Fumarate with Folic Acid

Tablet 310 mg (equivalent to 100 mg iron)-350 micrograms

Oral

60

1

AE

Ferrous Sulfate

Oral liquid 30 mg per mL, 250 mL

Oral

1

2

AE

Flecainide Acetate

Tablet 50 mg

Oral

60

5

MM

 

Tablet 100 mg

Oral

60

5

AF, MM

Flucloxacillin Magnesium with Water - Purified BP

Powder for oral suspension equivalent to 125 mg flucloxacillin per 5 mL, 100 mL

Oral

1

..

GK

 

Powder for oral suspension equivalent to 250 mg flucloxacillin per 5 mL, 100 mL

Oral

1

..

CS, GK

Flucloxacillin Sodium

Capsule equivalent to 250 mg flucloxacillin

Oral

24

..

AF, CS, GK, SI

 

Capsule equivalent to 500 mg flucloxacillin

Oral

24

..

AF, CS, GK, SI

 

Powder for injection equivalent to 500 mg flucloxacillin

Injection

5

..

CS, GM

 

Powder for injection equivalent to 1 g flucloxacillin

Injection

5

1

AS, CS, GM, MX

Fluconazole

Capsule 50 mg

Oral

28

5

AF, AW, HX, MX, PF, RA

 

Capsule 100 mg

Oral

28

5

AF, HX, MX, PF, RA

 

Capsule 200 mg

Oral

28

5

AF, AW, HX, MX, PF, RA

 

Solution for I.V. infusion 100 mg in 50 mL vial

Injection

7

..

PF

 

Solution for I.V. infusion 200 mg in 100 mL vial

Injection

7

..

PF

Fludrocortisone Acetate

Tablet 100 micrograms

Oral

200

1

BQ

Fluorometholone

Eye drops 1 mg per mL, 5 mL

Application to the eye

1

5

AG, AQ

Fluorometholone Acetate

Eye drops 1 mg per mL, 5 mL

Application to the eye

1

2

AQ

Fluorouracil

Injection 500 mg in 10 mL

Injection

10

..

IT, MX

 

Injection 1000 mg in 20 mL

Injection

5

..

IT

Fluoxetine Hydrochloride

Tablet, dispersible, equivalent to 20 mg fluoxetine

Oral

28

5

AL, LY

 

Capsule equivalent to 20 mg fluoxetine

Oral

28

5

AF, AL, BF, CH, GM, GX, HX, LY, SI, TW

Flupenthixol Decanoate

Oily I.M. injection 20 mg in 1 mL ampoule

Injection

5

..

LU

 

Oily I.M. injection 40 mg in 2 mL ampoule

Injection

5

..

LU

 

Oily I.M. injection 100 mg in 1 mL ampoule

Injection

5

..

LU

Fluphenazine Decanoate

Injection 12.5 mg in 0.5 mL ampoule

Injection

5

..

BQ

 

Injection 25 mg in 1 mL ampoule

Injection

5

..

BQ

 

Injection 50 mg in 2 mL ampoule

Injection

5

..

BQ

Flurbiprofen Sodium

Eye drops 300 micrograms per mL, single dose units 0.4 mL, 5

Application to the eye

1

..

AG

Flutamide

Tablet 250 mg

Oral

100

5

AF, SH

Fluticasone Propionate

Pressurised inhalation 50 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

GK

 

Pressurised inhalation 125 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

GK

 

Pressurised inhalation 250 micrograms per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

1

GK

 

Powder for oral inhalation in breath actuated device 100 micrograms per dose, 60 doses

Inhalation by mouth

1

5

GK

 

Powder for oral inhalation in breath actuated device 250 micrograms per dose, 60 doses

Inhalation by mouth

1

5

GK

 

Powder for oral inhalation in breath actuated device 500 micrograms per dose, 60 doses

Inhalation by mouth

1

1

GK

Fluticasone Propionate with Salmeterol Xinafoate

Pressurised inhalation 50 micrograms fluticasone propionate with salmeterol xinafoate equivalent to 25 micrograms salmeterol per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

GK

 

Pressurised inhalation 125 micrograms fluticasone propionate with salmeterol xinafoate equivalent to 25 micrograms salmeterol per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

GK

 

Pressurised inhalation 250 micrograms fluticasone propionate with salmeterol xinafoate equivalent to 25 micrograms salmeterol per dose, 120 doses (CFC-free formulation)

Inhalation by mouth

1

5

GK

 

Powder for oral inhalation in breath actuated device 100 micrograms fluticasone propionate with salmeterol xinafoate equivalent to 50 micrograms salmeterol per dose, 60 doses

Inhalation by mouth

1

5

GK

 

Powder for oral inhalation in breath actuated device 250 micrograms fluticasone propionate with salmeterol xinafoate equivalent to 50 micrograms salmeterol per dose, 60 doses

Inhalation by mouth

1

5

GK

 

Powder for oral inhalation in breath actuated device 500 micrograms fluticasone propionate with salmeterol xinafoate equivalent to 50 micrograms salmeterol per dose, 60 doses

Inhalation by mouth

1

5

GK

Fluvastatin Sodium

Capsule equivalent to 20 mg fluvastatin

Oral

28

5

NM, NV

 

Capsule equivalent to 40 mg fluvastatin

Oral

28

5

NM, NV

Fluvoxamine Maleate

Tablet 50 mg

Oral

30

5

AL, AW, HX, SM

 

Tablet 100 mg

Oral

30

5

AF, AW, HX, SM

Folic Acid

Tablet 500 micrograms

Oral

200

..

AF

 

Tablet 5 mg

Oral

200

1

AF

Follitropin Alfa

Injection set containing 1 vial powder for injection 75 I.U. and 1 pre-filled syringe solvent 1 mL

Injection

5

5

SG

 

Injection set containing 10 vials powder for injection 75 I.U. and 10 pre-filled syringes solvent 1 mL

Injection

1

5

SG

 

Injection 300 I.U. in 0.5 mL multi-dose cartridge

Injection

3

5

SG

 

Injection set containing 1 vial powder for injection 450 I.U. and 1 pre-filled syringe solvent 1 mL

Injection

3

5

SG

 

Injection 450 I.U. in 0.75 mL multi-dose cartridge

Injection

3

5

SG

 

Injection 900 I.U. in 1.5 mL multi-dose cartridge

Injection

2

5

SG

 

Injection set containing 1 vial powder for injection 1,050 I.U. and 1 pre-filled syringe solvent 2 mL

Injection

1

5

SG

Follitropin Beta

Solution for injection 300 I.U. in 0.36 mL multi-dose cartridge

Injection

3

5

OR

 

Solution for injection 600 I.U. in 0.72 mL multi-dose cartridge

Injection

2

5

OR

 

Solution for injection 900 I.U. in 1.08 mL multi-dose cartridge

Injection

2

5

OR

Fondaparinux Sodium

Injection 2.5 mg in 0.5 mL single dose pre-filled syringe

Injection

7

..

GK

Fosinopril Sodium

Tablet 10 mg

Oral

30

5

AF, AW, BQ, GX

 

Tablet 20 mg

Oral

30

5

AF, AW, BQ, GX

Fosinopril Sodium with Hydrochlorothiazide

Tablet 10 mg-12.5 mg

Tablet 20 mg-12.5 mg

Oral

Oral

30

30

5

5

BQ

BQ

Fotemustine

Powder for injection 208 mg with solvent

Injection

1

4

SE

Framycetin Sulfate

Eye or ear drops 5 mg per mL, 8 mL

Application to the eye or ear

1

2

AV

Frusemide

Tablet 20 mg

Oral

100

1

AV, CH, FM, GM, GX, TW

 

Tablet 40 mg

Oral

100

1

AF, AV, CH, FM, GM, GX, HX, TW

 

Tablet 500 mg

Oral

50

3

FM

 

Oral solution 10 mg per mL, 30 mL

Oral

1

3

AV

 

Injection 20 mg in 2 mL

Injection

5

..

AV, HX

Gabapentin

Capsule 100 mg

Oral

100

5

AF, AW, MX, PF

 

Capsule 300 mg

Oral

100

5

AF, AL, AW, GM, GX, HX, MX, PF

 

Capsule 400 mg

Oral

100

5

AF, AL, AW, GM, GX, HX, MX, PF

 

Tablet 600 mg

Oral

100

5

PF

 

Tablet 800 mg

Oral

100

5

AF, AW, PF

Galantamine Hydrobromide

Capsule (prolonged release) equivalent to 8 mg galantamine

Oral

28

5

JC

 

Capsule (prolonged release) equivalent to 16 mg galantamine

Oral

28

5

JC

 

Capsule (prolonged release) equivalent to 24 mg galantamine

Oral

28

5

JC

Gefitinib

Tablet 250 mg

Oral

30

1

AP

Gelatin - Succinylated

I.V. infusion 20 g per 500 mL, 500 mL

Injection

3

..

BR

Gemcitabine Hydrochloride

Powder for I.V. infusion equivalent to 200 mg gemcitabine

Injection

4

2

LY

 

Powder for I.V. infusion equivalent to 1 g gemcitabine

Injection

2

2

LY

Gemfibrozil

Tablet 600 mg

Oral

60

5

AF, CH, GM, GX, HX, PF, SI, TW

Gentamicin Sulfate

Injection equivalent to 80 mg gentamicin in 2 mL ampoule

Injection

10

1

MX, PU

 

Eye drops equivalent to 3 mg gentamicin per mL, 5 mL

Application to the eye

1

2

AG

Gestrinone

Capsule 2.5 mg

Oral

8

5

AV

Glatiramer Acetate

Injection 20 mg in 1 mL single dose pre-filled syringe

Injection

28

5

AV

Glibenclamide

Tablet 5 mg

Oral

100

5

AF, AV

Gliclazide

Tablet 30 mg (modified release)

Oral

100

5

SE

 

Tablet 80 mg

Oral

100

5

AF, AW, CH, GX, HX, SE, TW

Glimepiride

Tablet 1 mg

Oral

30

5

AF, AV, AW, ML, SZ

 

Tablet 2 mg

Oral

30

5

AF, AV, AW, ML, SZ

 

 

Tablet 3 mg

Oral

30

5

AF, AV, AW, ML, SZ

 

Tablet 4 mg

Oral

30

5

AF, AV, AW, ML, SZ

Glipizide

Tablet 5 mg

Oral

100

5

AF, PH

Glucagon Hydrochloride

Injection set containing 1 mg (1 I.U.) and 1 mL solvent in disposable syringe

Injection

1

1

NO

Glucose

I.V. infusion 278 mmol (anhydrous) per L, 1 L

Injection

5

1

BX

Glucose and Ketone Indicator—Urine

Reagent strips, 50 (Keto-Diabur-Test 5000)

 

2

2

RD

 

Reagent strips, 50 (Keto-Diastix)

 

2

2

BN

Glucose with Sodium Chloride, Potassium Chloride and Sodium Acid Citrate

Oral rehydration salts 3.56 g-470 mg-300 mg-530 mg per sachet, 10

Oral

1

..

AS, AV, CH, GM, TW

Glucose Indicator—Blood

Electrode strips, 50 (Advantage II)

 

2

5

RD

 

Electrode strips, 50 (Ascensia Elite)

 

2

5

BN

 

Electrode strips, 50 (Freestyle Papillon)

 

2

5

MS

 

Electrode strips, 50 (Glucocard 01 Sensor)

 

2

5

DR

 

Electrode strips, 50 (GlucoCare)

 

2

5

DR

 

Electrode strips, 50 (GlucoCare Super Sensor)

 

2

5

DR

 

Electrode strips, 50 (GlucoMen Sensor)

 

2

5

GD

 

Electrode strips, 50 (MWD Pen Sensor Strips)

 

2

5

WF

 

Electrode strips, 50 (Omnitest EZ)

 

2

5

BR

 

Electrode strips, 50 (Omnitest Plus)

 

2

5

BR

 

Electrode strips, 50 (Touch-In Plus)

 

2

5

DN

 

Electrode strips, 50 (TrueTrack)

 

2

5

DR

 

Discs containing electrode sensors, 10 sensors per disc, 5

 

2

5

BN

 

Electrode strips, 100 (Optium glucose)

 

1

5

MS

 

Electrode strips, 100 (Precision Plus)

 

1

5

MS

 

Electrode strips, 100 (SofTact)

 

1

5

MS

 

Electrode strips, 100 (TrueSense)

 

1

5

MS

 

Reagent strips, 50 (Accu-Chek Active)

 

2

5

RD

 

Reagent strips, 50 (Accu-Chek Go)

 

2

5

RD

 

Reagent strips, 51 (Accu-Chek Integra)

 

2

5

RD

 

Reagent strips, 50 (Betachek)

 

2

5

NA

 

Reagent strips, 50 (CareSens)

 

2

5

LB

 

Reagent strips, 50 (Glucoflex-R)

 

2

5

NA

 

Reagent strips, 50 (Glucostix)

 

2

5

BN

 

Reagent strips, 50 (SensoCard)

 

2

5

PX

Glucose Indicator—Urine

Reagent strips, 50 (Clinistix)

 

2

2

BN

 

Reagent strips, 50 (Diastix)

 

2

2

BN

Glycerol

Suppositories 700 mg, 12

Rectal

3

5

PP

 

Suppositories 1.4 g, 12

Rectal

3

5

PP

 

Suppositories 2.8 g, 12

Rectal

3

5

PP

Glyceryl Trinitrate

Tablets 600 micrograms, 100

Oral

1

5

FM, SI

 

Buccal/sublingual spray (pump pack) 400 micrograms per dose, 200 doses

Buccal/ sublingual

1

5

AV

 

Transdermal patch 18 mg

Transdermal

30

5

MM

 

Transdermal patch 25 mg

Transdermal

30

5

NV

 

Transdermal patch 40 mg

Transdermal

30

5

SH

 

Transdermal patch 36 mg

Transdermal

30

5

MM

 

Transdermal patch 50 mg

Transdermal

30

5

NV

 

Transdermal patch 80 mg

Transdermal

30

5

SH

 

Transdermal patch 54 mg

Transdermal

30

5

MM

 

Transdermal patch 120 mg

Transdermal

30

5

SH

Goserelin Acetate

Subcutaneous implant equivalent to 3.6 mg goserelin in pre-filled injection syringe

Subcutaneous implantation

1

5

AP

 

Subcutaneous implant (long acting) equivalent to 10.8 mg goserelin in pre-filled injection syringe

Subcutaneous implantation

1

1

AP

Granisetron Hydrochloride

Tablet equivalent to 2 mg granisetron

Oral

2

..

MX

 

Concentrated injection equivalent to 3 mg granisetron in 3 mL ampoule

Injection

1

..

MX

Griseofulvin

Tablet 125 mg

Oral

100

2

SI

 

Tablet 500 mg

Oral

28

2

SI

Haloperidol

Tablet 500 micrograms

Oral

100

5

SI

 

Tablet 1.5 mg

Oral

100

5

SI

 

Tablet 5 mg

Oral

50

5

SI

 

Oral solution 2 mg per mL, 100 mL

Oral

1

5

SI

 

Injection 5 mg in 1 mL ampoule

Injection

10

..

SI

Haloperidol Decanoate

I.M. injection equivalent to 50 mg haloperidol in 1 mL ampoule

Injection

5

..

JC

 

I.M. injection equivalent to 150 mg haloperidol in 3 mL ampoule

Injection

5

..

JC

"HCU express"

Sachets containing oral powder 25 g, 30

Oral

4

5

VF

"HCU gel"

Sachets containing oral powder 20 g, 30

Oral

4

5

VF

Heparin Sodium

Injection 5,000 units in 0.2 mL ampoule

Injection

5

5

MX

 

Injection (preservative-free) 5,000 I.U. in 5 mL ampoule

Injection

50

5

PU

 

Injection 35,000 units in 35 mL vial

Injection

12

5

MX

Hexamine Hippurate

Tablet 1 g

Oral

100

5

MM

Homatropine Hydrobromide

Eye drops 20 mg per mL, 15 mL

Application to the eye

1

2

AQ

Hydralazine Hydrochloride

Tablet 25 mg

Oral

200

2

AF

 

Tablet 50 mg

Oral

200

2

AF

Hydrochlorothiazide

Tablet 25 mg

Oral

100

1

PL

Hydrochlorothiazide with Amiloride Hydrochloride

Tablet 50 mg-5 mg

Oral

100

1

AF, MK

Hydrochlorothiazide with Triamterene

Tablet 25 mg-50 mg

Oral

100

1

AF

Hydrocortisone

Tablet 4 mg

Oral

50

4

AF

 

Tablet 20 mg

Oral

60

4

AF

 

Cream 10 mg per g, 50 g

Application

1

1

EO

Hydrocortisone Acetate

Eye ointment 5 mg per g, 5 g

Application to the eye

1

..

SI

 

Eye ointment 10 mg per g, 5 g

Application to the eye

1

..

SI

 

Cream 10 mg per g, 30 g

Application

1

1

FM, SI

 

Cream 10 mg per g, 50 g

Application

1

1

DT, FM, SI

 

Ointment 10 mg per g, 30 g

Application

1

1

FM, SI

 

Ointment 10 mg per g, 50 g

Application

1

1

FM, SI

 

Rectal foam 90 mg per applicatorful, 14 applications, aerosol 21.1 g

Rectal

2

3

GC

Hydrocortisone Sodium Succinate

Injection equivalent to 100 mg hydrocortisone with 2 mL solvent

Injection

2

..

PH

 

Injection equivalent to 250 mg hydrocortisone with 2 mL solvent

Injection

1

..

PH

Hydromorphone Hydrochloride

Tablet 2 mg

Oral

20

..

AB

 

Tablet 4 mg

Oral

20

..

AB

 

Tablet 8 mg

Oral

20

..

AB

 

Oral liquid 1 mg per mL, 473 mL

Oral

1

..

AB

 

Injection 2 mg in 1 mL ampoule

Injection

5

..

AB

 

Injection 10 mg in 1 mL ampoule

Injection

5

..

AB

 

Injection 50 mg in 5 mL ampoule

Injection

5

..

AB

 

Injection 500 mg in 50 mL vial

Injection

1

..

AB

Hydroxocobalamin

Injection 1 mg in 1 mL ampoule

Injection

2

..

MX

 

Injection 1 mg in 1 mL

Injection

3

..

MX

Hydroxychloroquine Sulfate

Tablet 200 mg

Oral

100

1

SW

Hydroxyurea

Capsule 500 mg

Oral

100

..

BQ

Hypromellose

Eye drops 3 mg per mL, 15 mL

Application to the eye

1

5

NM, NV

 

Eye drops 5 mg per mL, 15 mL

Application to the eye

1

5

AQ, SI

Hypromellose with Carbomer 980

Ocular lubricating gel 3 mg-2 mg per g, 10 g

Application to the eye

1

5

NM, NV

Hypromellose 2900 with Dextran 70

Eye drops 3 mg-1 mg per mL, single dose units 0.4 mL, 28

Application to the eye

3

5

AQ

Hypromellose 4500 with Dextran 70

Eye drops 3 mg-1 mg per mL, 15 mL

Application to the eye

1

5

AQ, IQ

Ibuprofen

Tablet 200 mg

Oral

100

3

AF

 

Tablet 400 mg

Oral

30

..

AB

Idarubicin Hydrochloride

Capsule 5 mg

Oral

3

..

PH

 

Capsule 10 mg

Oral

3

..

PH

 

Solution for I.V. injection 5 mg in 5 mL single use vial

Injection

3

..

PH

 

Solution for I.V. injection 10 mg in 10 mL single use vial

Injection

6

..

PH

Ifosfamide

Powder for I.V. injection 1 g in single dose vial

Injection

5

5

BX

 

Powder for I.V. injection 2 g in single dose vial

Injection

5

5

BX

Imipramine Hydrochloride

Tablet 10 mg

Oral

50

2

LN, NV

 

Tablet 25 mg

Oral

50

2

LN, NV

Imiquimod

Cream 50 mg per g, 250 mg single use sachets, 12

Application

1

1

MM

Indapamide Hemihydrate

Tablet 1.5 mg (sustained release)

Oral

90

1

SE

 

Tablet 2.5 mg

Oral

90

1

AF, CH, GM, GX, HX, SE, SI, TW

Indomethacin

Capsule 25 mg

Oral

100

3

AF, MK

 

Suppository 100 mg

Rectal

40

3

MK

Influenza Vaccine (Split Virion) - Inactivated

Injection containing antigens representative of the following types:
A/New Caledonia/20/99 (H1N1)-like strain 15 micrograms haemagglutinin;
A/Wisconsin/67/2005 (H3N2)-like strain 15 micrograms haemagglutinin;
B/Malaysia/2506/2004-like strain 15 micrograms haemagglutinin;
0.5 mL pre-filled syringe

Injection

1

..

AX, CS, GK, SM

Insect Allergen Extract—Honey Bee Venom

Injection set containing 550 micrograms vial with 9 mL vial solvent and 3 vials diluent 1.8 mL

Injection

1

..

ES

Insect Allergen Extract—Paper Wasp Venom

Injection set containing 550 micrograms vial with 9 mL vial solvent and 3 vials diluent 1.8 mL

Injection

1

..

ES

Insect Allergen Extract—Yellow Jacket Venom

Injection set containing 550 micrograms vial with 9 mL vial solvent and 3 vials diluent 1.8 mL

Injection

1

..

ES

Insulin - Isophane

Injection (bovine) 100 units per mL, 10 mL vial

Injection

5

2

AS

 

Injection (human) 100 units per mL, 10 mL vial

Injection

5

2

LY, NO

 

Injections (human), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

LY, NI, NL, NO

Insulin - Neutral

Injection (bovine) 100 units per mL, 10 mL vial

Injection

5

2

AS

 

Injection (human) 100 units per mL, 10 mL vial

Injection

5

2

LY, NO

 

Injections (human), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

LY, NO

Insulin - Neutral with Insulin - Isophane

Injection (human) 30 units-70 units per mL, 10 mL vial

Injection

5

2

LY, NO

 

Injection (human) 50 units-50 units per mL, 10 mL vial

Injection

5

2

NO

 

Injections (human), cartridges, 20 units-80 units per mL, 3 mL, 5

Injection

5

1

NO

 

Injections (human), cartridges, 30 units-70 units per mL, 3 mL, 5

Injection

5

1

LY, NI, NO

 

Injections (human), cartridges, 50 units-50 units per mL, 3 mL, 5

Injection

5

1

NO

Insulin Aspart

Injection (human analogue) 100 units per mL, 10 mL vial

Injection

5

2

NO

 

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

NF, NO

Insulin Aspart with Insulin Aspart Protamine Suspension

Injections (human analogue), cartridges, 30 units-70 units per mL, 3 mL, 5

Injection

5

1

NF, NO

Insulin Detemir

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

NF

Insulin Glargine

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

AV

Insulin Lispro

Injection (human analogue) 100 units per mL, 10 mL vial

Injection

5

2

LY

 

Injections (human analogue), cartridges, 100 units per mL, 3 mL, 5

Injection

5

1

LY

Insulin Lispro with Insulin Lispro Protamine Suspension

Injections (human analogue), cartridges, 25 units-75 units per mL, 3 mL, 5

Injection

5

1

LY

 

Injections (human analogue), cartridges, 50 units-50 units per mL, 3 mL, 5

Injection

5

1

LY

Interferon Alfa-2a

Injection 3,000,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

15

4

RO

 

Injection 4,500,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

5

4

RO

 

Injection 6,000,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

5

4

RO

 

Injection 9,000,000 I.U. in 0.5 mL single dose pre-filled syringe

Injection

5

4

RO

Interferon Alfa-2b

Solution for injection 18,000,000 I.U. in 1.2 mL multi-dose injection pen

Injection

3

4

SH

 

Solution for injection 30,000,000 I.U. in 1.2 mL multi-dose injection pen

Injection

3

5

SH

Interferon Beta-1a

Injection set comprising 1 vial powder for injection 30 micrograms (6,000,000 I.U.) with diluent

Injection

4

5

BD

 

Injection 30 micrograms (6,000,000 I.U.) in 0.5 mL single dose pre-filled syringe

Injection

4

5

BD

 

Injection 44 micrograms (12,000,000 I.U.) in 0.5 mL single dose pre-filled syringe

Injection

12

5

SG

Interferon Beta-1b

Injection set comprising 1 vial powder for injection 8,000,000 I.U. (250 micrograms) and solvent

Injection

15

5

SC

Ipratropium Bromide

Pressurised inhalation 21 micrograms per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

2

5

BY

 

Nebuliser solution 250 micrograms (anhydrous) in 1 mL single dose units, 30

Inhalation

2

5

AF, AW, BY, CH, GM, GX, PU, TW

 

Nebuliser solution 500 micrograms (anhydrous) in 1 mL single dose units, 30

Inhalation

2

5

AF, AW, BY, CH, GM, GX, PU, TW

 

Nebuliser solution 250 micrograms (anhydrous) per mL, 20 mL

Inhalation

2

2

BY

Irbesartan

Tablet 75 mg

Oral

30

5

BQ, SW

 

Tablet 150 mg

Oral

30

5

BQ, SW

 

Tablet 300 mg

Oral

30

5

BQ, SW

Irbesartan with Hydrochlorothiazide

Tablet 150 mg-12.5 mg

Tablet 300 mg-12.5 mg

Oral

Oral

30

30

5

5

BQ, SW

BQ, SW

Irinotecan Hydrochloride Trihydrate

I.V. injection 40 mg in 2 mL vial

I.V. injection 100 mg in 5 mL vial

Injection

Injection

1

2

3

3

MX, PU

MX, PU

Iron Polymaltose Complex

Injection 100 mg (iron) in 2 mL ampoule

Injection

5

..

BX, SI

Iron Sucrose

Concentrate for solution for infusion 2.7 g (equivalent to 100 mg iron (III)) in 5 mL ampoule

Injection

5

..

BX

Isoniazid

Tablet 100 mg

Oral

100

2

FM

Isosorbide Dinitrate

Tablet 10 mg

Oral

200

2

AF, SI

 

Tablet 5 mg (sublingual)

Oral

200

2

SI

Isosorbide Mononitrate

Tablet 60 mg (sustained release)

Oral

30

5

AF, AP, CH, GM, GX, HX, PM, TW

 

Tablet 120 mg (sustained release)

Oral

30

5

AP, PM

Isotretinoin

Capsule 10 mg

Oral

60

3

GM, GX, RO

 

Capsule 20 mg

Oral

60

3

CH, GM, GX, HX, RO, TW

Itraconazole

Capsule 100 mg

Oral

60

5

JC

Ivermectin

Tablet 3 mg

Oral

4

..

MK

"Karicare De-Lact"

Oral powder 900 g

Oral

5

..

NU

Ketoconazole

Tablet 200 mg

Oral

10

..

JC

 

Cream 20 mg per g, 30 g

Application

1

2

JC

 

Shampoo 10 mg per g, 100 mL

Application

1

1

JC

 

Shampoo 20 mg per g, 60 mL

Application

1

1

JC

"Ketonex-1"

Oral powder 350 g

Oral

8

5

AB

"Ketonex-2"

Oral powder 325 g

Oral

10

5

AB

Ketoprofen

Capsule 200 mg (sustained release)

Oral

28

3

AV, HP

 

Suppository 100 mg

Rectal

40

3

AV

"Kindergen"

Oral powder 400 g

Oral

16

5

SB

Labetalol Hydrochloride

Tablet 100 mg

Oral

100

5

AF, SI

 

Tablet 200 mg

Oral

100

5

AF, SI

Lactulose

Solution BP 3.34 g per 5 mL, 500 mL

Oral

1

5

AF, AW, GM, GX, HX, SM

Lamotrigine

Tablet 5 mg

Oral

56

5

AF, AW, GK, HX, ME

 

Tablet 25 mg

Oral

56

5

AF, AW, GK, GM, GX, HX, ME, RA

 

Tablet 50 mg

Oral

56

5

AF, AW, GK, GM, GX, HX, ME, RA

 

Tablet 100 mg

Oral

56

5

AF, AW, GK, GM, GX, HX, ME, RA

 

Tablet 200 mg

Oral

56

5

AF, AW, GK, GM, GX, HX, ME, RA

Lansoprazole

Capsule 30 mg

Oral

30

1

WY

 

Sachet containing granules for oral suspension, 30 mg per sachet

Oral

28

1

WY

 

Capsule 15 mg

Oral

30

5

WY

Latanoprost

Eye drops 50 micrograms per mL, 2.5 mL

Application to the eye

1

5

PU

Latanoprost with Timolol Maleate

Eye drops 50 micrograms latanoprost with timolol maleate equivalent to 5 mg timolol per mL, 2.5 mL

Application to the eye

1

5

PF

Leflunomide

Pack containing 3 tablets leflunomide 100 mg and 30 tablets leflunomide 20 mg

Oral

1

..

AV

 

Tablet 10 mg

Oral

30

5

AV, HP

 

Tablet 20 mg

Oral

30

5

AV, HP

Lercanidipine Hydrochloride

Tablet 10 mg

Oral

30

5

SM

 

Tablet 20 mg

Oral

30

5

SM

Letrozole

Tablet 2.5 mg

Oral

30

5

NV

Leuprorelin Acetate

I.M. injection (modified release), powder for injection 7.5 mg with diluent in pre-filled dual-chamber syringe

Injection

1

5

AB

 

Suspension for subcutaneous injection (modified release), 7.5 mg injection set

Injection

1

5

MX

 

I.M. injection (modified release), powder for injection 22.5 mg with diluent in pre-filled dual-chamber syringe

Injection

1

1

AB

 

Suspension for subcutaneous injection (modified release), 22.5 mg injection set

Injection

1

1

MX

 

I.M. injection (modified release), powder for injection 30 mg with diluent in pre-filled dual-chamber syringe

Injection

1

1

AB

 

Suspension for subcutaneous injection (modified release), 30 mg injection set

Injection

1

1

MX

 

Suspension for subcutaneous injection (modified release), 45 mg injection set

Injection

1

..

MX

Levetiracetam

Tablet 250 mg

Oral

60

5

UC

 

Tablet 500 mg

Oral

60

5

UC

 

Tablet 1 g

Oral

60

5

UC

Levobunolol Hydrochloride

Eye drops 2.5 mg per mL, 5 mL

Application to the eye

1

5

AG

Levodopa with Benserazide Hydrochloride

Dispersible tablet 50 mg-12.5 mg (benserazide)

Oral

100

5

RO

 

Dispersible tablet 100 mg-25 mg (benserazide)

Oral

100

5

RO

 

Tablet 100 mg-25 mg (benserazide)

Oral

100

5

RO

 

Tablet 200 mg-50 mg (benserazide)

Oral

100

5

RO

 

Capsule 50 mg-12.5 mg (benserazide)

Oral

100

5

RO

 

Capsule 100 mg-25 mg (benserazide)

Oral

100

5

RO

 

Capsule 100 mg-25 mg (benserazide) (sustained release)

Oral

100

5

RO

 

Capsule 200 mg-50 mg (benserazide)

Oral

100

5

RO

Levodopa with Carbidopa

Tablet 200 mg-50 mg (anhydrous) (modified release)

Oral

100

5

MK

 

Tablet 100 mg-25 mg (anhydrous)

Oral

100

5

AF, MK

 

Tablet 250 mg-25 mg (anhydrous)

Oral

100

5

HX, MK

Levodopa with Carbidopa and Entacapone

Tablet 50 mg-12.5 mg-200 mg

Tablet 100 mg-25 mg-200 mg

Oral

Oral

200

200

4

4

NV

NV

 

Tablet 150 mg-37.5 mg-200 mg

Oral

200

4

NV

Levonorgestrel

Tablets 30 micrograms, 28

Oral

4

2

SC, WY

 

Intrauterine drug delivery system 52 mg

Intrauterine

1

..

SC

Levonorgestrel with Ethinyloestradiol

Pack containing 21 tablets 125 micrograms-50 micrograms and 7 inert tablets

Oral

4

2

SC

 

Tablets 150 micrograms-30 micrograms, 21

Oral

4

2

SC

 

Pack containing 21 tablets 150 micrograms-30 micrograms and 7 inert tablets

Oral

4

2

SC, SY, WX, WY

 

Pack containing 6 tablets 50 micrograms-30 micrograms, 5 tablets 75 micrograms-40 micrograms, 10 tablets 125 micrograms-30 micrograms and 7 inert tablets

Oral

4

2

SC, SY, WX, WY

Lignocaine Hydrochloride

Injection 100 mg in 5 mL

Injection

5

..

PF

 

Infusion 500 mg in 5 mL ampoule

Injection

10

..

AP

Lincomycin Hydrochloride

Injection equivalent to 600 mg lincomycin in 2 mL vial

Injection

5

..

PH

Liothyronine Sodium

Tablet 20 micrograms

Oral

100

2

SI

Lisinopril

Tablet 5 mg

Oral

30

5

AF, AP, AW, BF, CH, GM, GX, HX, MK, TW

 

Tablet 10 mg

Oral

30

5

AF, AP, AW, BF, CH, GM, GX, HX, MK, TW

 

Tablet 20 mg

Oral

30

5

AF, AP, AW, BF, CH, GM, GX, HX, MK, TW

Lithium Carbonate

Tablet 250 mg

Oral

200

2

AS

 

Tablet 450 mg (slow release)

Oral

200

2

GK

"Locasol"

Low calcium compound powder 400 g

Oral

8

5

NU

Loperamide Hydrochloride

Capsule 2 mg

Oral

12

..

AS, JC

"Lophlex"

Sachets containing oral powder 27.8 g, 30

Oral

3

5

SB

"Lophlex LQ"

Oral liquid 125 mL, 30

Oral

3

5

SB

Lumiracoxib

Tablet 200 mg

Oral

30

3

NV

Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride

Sachets containing powder for oral solution 13.125 g-350.7 mg-178.5 mg-46.6 mg, 30

Oral

1

5

NE

"Mapleflex"

Sachets containing oral powder 29 g, 30

Oral

4

5

SB

Medroxyprogesterone Acetate

Tablet 500 mg

Oral

30

2

PH

 

Tablet 100 mg

Oral

100

2

PH

 

Tablet 200 mg

Oral

60

2

PH

 

Tablet 250 mg

Oral

60

2

PH

 

Tablet 5 mg

Oral

56

2

KR, PH

 

Tablet 10 mg

Oral

30

2

HX, KR, PH

 

Injection 50 mg in 1 mL vial

Injection

1

1

PH

 

Injection 150 mg in 1 mL vial

Injection

1

1

KR, PH

Mefenamic Acid

Capsule 250 mg

Oral

50

2

PD

Megestrol Acetate

Tablet 160 mg

Oral

30

2

BQ

Meloxicam

Tablet 7.5 mg

Oral

30

3

AW, BY

 

Tablet 15 mg

Oral

30

3

AW, BY

 

Capsule 7.5 mg

Oral

30

3

BY

 

Capsule 15 mg

Oral

30

3

BY

Melphalan

Tablet 2 mg

Oral

25

1

GK

Mercaptopurine

Tablet 50 mg

Oral

100

2

GK

Mesalazine

Tablet 250 mg

Oral

100

5

GK

 

Tablet 500 mg (enteric coated)

Oral

100

5

OA

 

Sachet containing granules, 500 mg per sachet

Oral

100

5

OA

 

Sachet containing granules, 1 g per sachet

Oral

100

2

OA

 

Suppositories 1 g, 28

Rectal

1

..

FP

 

Enemas 1 g in 100 mL, 7

Rectal

4

..

FP

 

Enemas 2 g in 60 mL, 7

Rectal

4

..

OA

 

Enemas 4 g in 60 mL, 7

Rectal

4

..

OA

 

Rectal foam 1 g per applicatorful, 14 applications, aerosol 80 g

Rectal

4

..

OA

Mesna

Solution for I.V. injection 400 mg in 4 mL ampoule

Injection

15

5

BX

 

Solution for I.V. injection 1 g in 10 mL ampoule

Injection

15

5

BX

"Metabolic Mineral Mixture"

Oral powder 250 g

Oral

1

5

SB

Metformin Hydrochloride

Tablet 500 mg

Oral

100

5

AF, AL, AW, BF, CH, GM, GN, GX, HX, MQ, TW

 

Tablet 500 mg (extended release)

Oral

90

5

AL

 

Tablet 850 mg

Oral

60

5

AF, AL, AW, BF, CH, GM, GN, GX, HX, MQ, TW

 

Tablet 1 g

Oral

90

5

AF, AL, AW

Metformin Hydrochloride with Glibenclamide

Tablet 250 mg-1.25 mg

Tablet 500 mg-2.5 mg

Oral

Oral

90

90

5

5

AL

AL

 

Tablet 500 mg-5 mg

Oral

90

5

AL

Methadone Hydrochloride

Tablet 10 mg

Oral

20

..

GK

 

Injection 10 mg in 1 mL ampoule

Injection

5

..

GK

Methotrexate

Tablet 2.5 mg

Oral

30

5

MX, PH

 

Tablet 10 mg

Oral

50

2

PH

 

Injection 5 mg in 2 mL vial

Injection

5

..

MX

 

Injection 50 mg in 2 mL vial

Injection

5

..

MX, PU

 

Solution concentrate for I.V. infusion 500 mg in 5 mL vial

Injection

1

..

IT

 

Solution concentrate for I.V. infusion 500 mg in 20 mL vial

Injection

1

..

MX

 

Solution concentrate for I.V. infusion 1000 mg in 10 mL vial

Injection

1

..

IT, MX

 

Solution concentrate for I.V. infusion 5000 mg in 50 mL vial

Injection

1

..

IT

Methyldopa

Tablet 250 mg

Oral

100

5

AF, MK

Methylphenidate Hydrochloride

Tablet 10 mg

Oral

100

5

AF, NV

Methylprednisolone Aceponate

Cream 1 mg per g, 15 g

Application

1

..

CS

 

Ointment 1 mg per g, 15 g

Application

1

..

CS

 

Fatty ointment 1 mg per g, 15 g

Application

1

..

CS

 

Lotion 1 mg per g, 20 g

Application

1

..

CS

Methylprednisolone Acetate

Injection 40 mg in 1 mL vial

Injection

5

..

KR, PH

Methylprednisolone Sodium Succinate

Powder for injection equivalent to 40 mg methylprednisolone with diluent

Injection

5

..

PF

 

Powder for injection equivalent to 1 g methylprednisolone with diluent

Injection

1

..

PF

Methysergide Maleate

Tablet equivalent to 1 mg methysergide

Oral

100

2

NV

Metoclopramide Hydrochloride

Tablet 10 mg

Oral

25

..

AF, VT

 

Oral solution 5 mg per 5 mL, 100 mL

Oral

1

..

VT

 

Injection 10 mg in 2 mL ampoule

Injection

10

..

VT

Metoprolol Succinate

Pack containing 15 tablets 23.75 mg (controlled release), 15 tablets 47.5 mg (controlled release) and 15 tablets 95 mg (controlled release)

Oral

1

..

AP

 

Tablet 23.75 mg (controlled release)

Oral

15

..

AP

 

Tablet 47.5 mg (controlled release)

Oral

30

5

AP

 

Tablet 95 mg (controlled release)

Oral

30

5

AP

 

Tablet 190 mg (controlled release)

Oral

30

5

AP

Metoprolol Tartrate

Tablet 50 mg

Oral

100

5

AF, AP, AW, CH, GM, GX, HX, NV, TW

 

Tablet 100 mg

Oral

60

5

AF, AP, AW, CH, GM, GX, HX, NV, TW

Metronidazole

Tablet 200 mg

Oral

21

1

AF, AV, HP

 

Tablet 400 mg

Oral

5

2

AF

 

I.V. infusion 500 mg in 100 mL

Injection

5

1

BX

 

Suppositories 500 mg, 10

Rectal

1

..

AV

Metronidazole Benzoate

Oral suspension 320 mg per 5 mL, 100 mL

Oral

1

..

AV

Mexiletine Hydrochloride

Capsule 50 mg

Oral

100

5

BY

 

Capsule 200 mg

Oral

100

5

BY

Mianserin Hydrochloride

Tablet 10 mg

Oral

50

5

AF, OR

 

Tablet 20 mg

Oral

50

5

AF, OR

Miconazole

Tincture 20 mg per mL, 30 mL

Application

1

2

JC

Miconazole Nitrate

Cream 20 mg per g, 15 g

Application

2

3

JC

 

Cream 20 mg per g, 30 g

Application

1

2

JC

 

Cream 20 mg per g, 70 g

Application

1

1

JC

 

Powder 20 mg per g, 30 g

Application

1

2

JC

 

Lotion 20 mg per mL, 30 g

Application

1

2

JC

"Minaphlex"

Sachets containing oral powder 29 g, 30

Oral

4

5

SB

Minocycline Hydrochloride

Tablet equivalent to 50 mg minocycline

Oral

60

5

AF, SI

 

Capsule equivalent to 100 mg minocycline

Oral

11

..

AF

Minoxidil

Tablet 10 mg

Oral

100

5

PH

Mirtazapine

Tablet 15 mg (orally disintegrating)

Oral

30

5

BP

 

Tablet 30 mg

Oral

30

5

AF, AW, BP, GM, OR

 

Tablet 30 mg (orally disintegrating)

Oral

30

5

BP

 

Tablet 45 mg

Oral

30

5

AW, BP

 

Tablet 45 mg (orally disintegrating)

Oral

30

5

BP

Misoprostol

Tablet 200 micrograms

Oral

120

2

PH

Mitozantrone Hydrochloride

Injection equivalent to 10 mg mitozantrone in 5 mL vial

Injection

1

..

PU

 

Injection equivalent to 20 mg mitozantrone in 10 mL vial

Injection

1

..

BX, MX, PU, SI

 

Injection equivalent to 25 mg mitozantrone in 12.5 mL vial

Injection

1

..

BX, PU, SI

Moclobemide

Tablet 150 mg

Oral

60

5

AF, AL, CH, GM, GX, HX, RO, TW

 

Tablet 300 mg

Oral

60

5

AF, AL, CH, GM, GX, HX, RO, SI, TW

Modafinil

Tablet 100 mg

Oral

120

5

CS

Mometasone Furoate

Cream 1 mg per g, 15 g

Application

1

..

EX, SH

 

Ointment 1 mg per g, 15 g

Application

1

..

EX, SH

 

Lotion 1 mg per g, 30 mL

Application

1

..

EX, SH

"Monogen"

Oral powder 400 g

Oral

8

5

SB

Montelukast Sodium

Tablet, chewable, equivalent to 4 mg montelukast

Oral

28

5

MK

 

Tablet, chewable, equivalent to 5 mg montelukast

Oral

28

5

MK

Morphine Hydrochloride

Oral solution 2 mg per mL, 200 mL

Oral

1

..

MF

 

Oral solution 5 mg per mL, 200 mL

Oral

1

..

MF

 

Oral solution 10 mg per mL, 200 mL

Oral

1

..

MF

Morphine Sulfate

Tablet 10 mg

Oral

20

..

MF

 

Tablet 20 mg

Oral

20

..

MF

 

Tablet 30 mg

Oral

20

..

FM

 

Tablet 5 mg (controlled release)

Oral

20

..

MF

 

Tablet 10 mg (controlled release)

Oral

20

..

MF

 

Tablet 15 mg (controlled release)

Oral

20

..

MF

 

Tablet 30 mg (controlled release)

Oral

20

..

MF

 

Tablet 60 mg (controlled release)

Oral

20

..

MF

 

Tablet 100 mg (controlled release)

Oral

20

..

MF

 

Tablet 200 mg (controlled release)

Oral

20

..

MF

 

Capsule 10 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 20 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 30 mg (controlled release)

Oral

10

..

MF

 

Capsule 50 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 60 mg (controlled release)

Oral

10

..

MF

 

Capsule 90 mg (controlled release)

Oral

10

..

MF

 

Capsule 100 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 120 mg (controlled release)

Oral

10

..

MF

 

Sachet containing controlled release granules for oral suspension, 20 mg per sachet

Oral

20

..

MF

 

Sachet containing controlled release granules for oral suspension, 30 mg per sachet

Oral

20

..

MF

 

Sachet containing controlled release granules for oral suspension, 60 mg per sachet

Oral

20

..

MF

 

Sachet containing controlled release granules for oral suspension, 100 mg per sachet

Oral

20

..

MF

 

Sachet containing controlled release granules for oral suspension, 200 mg per sachet

Oral

20

..

MF

 

Injection 10 mg in 1 mL ampoule

Injection

5

..

MX

 

Injection 15 mg in 1 mL ampoule

Injection

5

..

MX

 

Injection 30 mg in 1 mL ampoule

Injection

5

..

MX

Morphine Tartrate

Injection 120 mg in 1.5 mL ampoule

Injection

5

..

MX

Moxonidine

Tablet 200 micrograms

Oral

30

5

SM

 

Tablet 400 micrograms

Oral

30

5

SM

"MSUD AID III"

Oral powder 500 g

Oral

4

5

SB

"MSUD Analog"

Oral powder 400 g

Oral

8

5

SB

"MSUD Express"

Sachets containing oral powder 25 g, 30

Oral

4

5

VF

"MSUD Maxamaid"

Oral powder 500 g

Oral

8

5

SB

"MSUD Maxamum"

Oral powder 500 g

Oral

8

5

SB

"MSUD-gel"

Sachets containing oral powder 20 g, 30

Oral

4

5

VF

Mycophenolate Mofetil

Capsule 250 mg

Oral

300

3

RO

 

Tablet 500 mg

Oral

150

3

RO

Mycophenolate Mofetil with Water - Purified BP

Powder for oral suspension 1 g per 5 mL, 165 mL

Oral

1

3

RO

Mycophenolate Sodium

Tablet (enteric coated) equivalent to 180 mg mycophenolic acid

Oral

120

3

NV

 

Tablet (enteric coated) equivalent to 360 mg mycophenolic acid

Oral

120

3

NV

Nafarelin Acetate

Nasal spray (pump pack) equivalent to 200 micrograms nafarelin per dose, 60 doses

Nasal

1

5

PH

Naloxone Hydrochloride

Injection 800 micrograms in 2 mL disposable injection set

Injection

1

..

CS

 

Injection 2 mg in 5 mL disposable injection set

Injection

1

..

CS

Naltrexone Hydrochloride

Tablet 50 mg

Oral

30

1

BQ

Nandrolone Decanoate

Injection 50 mg in 1 mL disposable syringe

Injection

1

7

OR

Naproxen

Tablet 250 mg

Oral

100

3

AF, RO

 

Tablet 500 mg

Oral

50

3

AF, RO

 

Tablet 750 mg (sustained release)

Oral

28

3

MD, RO

 

Tablet 1 g (sustained release)

Oral

28

3

MD, RO

 

Oral suspension 125 mg per 5 mL, 474 mL

Oral

1

3

RO

Naproxen Sodium

Tablet 550 mg

Oral

50

3

MD, RO

Naratriptan Hydrochloride

Tablet equivalent to 2.5 mg naratriptan

Oral

4

5

GK

Nedocromil Sodium

Pressurised inhalation 2 mg per dose, 112 doses (CFC-free formulation)

Inhalation by mouth

1

5

AV

"Neocate"

Oral powder 400 g

Oral

8

5

SB

"Neocate Advance"

Oral powder 400 g

Oral

8

5

SB

Neomycin Sulfate

Tablet 500 mg

Oral

25

1

AF

Neomycin Undecenoate with Bacitracin Zinc

Ear ointment 12 mg (3.5 mg neomycin)-400 units per g, 10 g

Application to the ear

1

..

HA

Nicorandil

Tablets 10 mg, 60

Oral

1

5

AV

 

Tablets 20 mg, 60

Oral

1

5

AV

Nifedipine

Tablet 10 mg

Oral

60

5

AF, AW, BN

 

Tablet 20 mg

Oral

60

5

AF, AW, BN, CH, GM, GX, HX, TW

 

Tablet 20 mg (controlled release)

Oral

30

5

BN

 

Tablet 30 mg (controlled release)

Oral

30

5

AF, AW, BN

 

Tablet 60 mg (controlled release)

Oral

30

5

AF, AW, BN

Nilutamide

Tablet 150 mg

Oral

30

5

AV

Nitrazepam

Tablet 5 mg

Oral

25

..

AF, VT

Nitrofurantoin

Capsule 50 mg

Oral

30

1

PU

 

Capsule 100 mg

Oral

30

1

PU

Nizatidine

Capsule 150 mg

Oral

60

5

AF, AS, LN

 

Capsule 300 mg

Oral

30

5

AF, AS, LN

Norethisterone

Tablets 350 micrograms, 28

Oral

4

2

JC, KR, PH

 

Tablet 5 mg

Oral

30

2

SC

Norethisterone with Ethinyloestradiol

Tablets 500 micrograms-35 micrograms, 21

Oral

4

2

PH

 

Pack containing 21 tablets 500 micrograms-35 micrograms and 7 inert tablets

Oral

4

2

KR, PH

 

Tablets 1 mg-35 micrograms, 21

Oral

4

2

PH

 

Pack containing 21 tablets 1 mg-35 micrograms and 7 inert tablets

Oral

4

2

KR, PH

 

Pack containing 12 tablets 500 micrograms-35 micrograms, 9 tablets 1 mg-35 micrograms and 7 inert tablets

Oral

4

2

KR, PH

Norethisterone with Mestranol

Tablets 1 mg-50 micrograms, 21

Oral

4

2

PH

 

Pack containing 21 tablets 1 mg-50 micrograms and 7 inert tablets

Oral

4

2

PH

Norfloxacin

Tablet 400 mg

Oral

14

1

AF, AW, CH, GM, GX, HX, MK, TW

Nortriptyline Hydrochloride

Tablet equivalent to 10 mg nortriptyline

Oral

50

2

AS

 

Tablet equivalent to 25 mg nortriptyline

Oral

50

2

AS

Nystatin

Tablet 500,000 units

Oral

50

..

SI

 

Capsule 500,000 units

Oral

50

..

SI

 

Oral suspension 100,000 units per mL, 24 mL

Oral

1

1

BQ, SI

 

Cream 100,000 units per g, 15 g

Application

2

3

BQ

Oestradiol

Tablet 2 mg

Oral

56

2

SM

 

Transdermal patches 390 micrograms, 8

Transdermal

1

5

NV

 

Transdermal patches 2 mg, 4

Transdermal

1

5

MM, SC

 

Transdermal patches 2 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 585 micrograms, 8

Transdermal

1

5

NV

 

Transdermal patches 3.28 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 3.8 mg, 4

Transdermal

1

5

MM, SC

 

Transdermal patches 4 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 780 micrograms, 8

Transdermal

1

5

NV

 

Transdermal patches 4.33 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 5.7 mg, 4

Transdermal

1

5

SC

 

Transdermal patches 1.17 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 6.57 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 7.6 mg, 4

Transdermal

1

5

MM, SC

 

Transdermal patches 8 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 1.56 mg, 8

Transdermal

1

5

NV

 

Transdermal patches 8.66 mg, 8

Transdermal

1

5

NV

 

Vaginal tablets 25 micrograms, 15

Vaginal

1

2

NO

Oestradiol and Oestradiol with Dydrogesterone

Pack containing 14 tablets oestradiol 2 mg and 14 tablets oestradiol 2 mg with dydrogesterone 10 mg

Oral

1

5

SM

Oestradiol and Oestradiol with Norethisterone Acetate

Pack containing 12 tablets oestradiol 2 mg, 10 tablets oestradiol 2 mg with norethisterone acetate 1 mg and 6 tablets oestradiol 1 mg

Oral

1

5

NO

 

Pack containing 4 transdermal patches oestradiol 4 mg and 4 transdermal patches oestradiol 10 mg with norethisterone acetate 30 mg

Transdermal

1

5

NV

Oestradiol Hemihydrate

Nasal spray 150 micrograms per actuation, 60 actuations, 4.2 mL

Nasal

1

5

SE

 

Transdermal gel equivalent to 1 mg oestradiol in 1 g sachet, 28

Transdermal

1

5

OR

 

Transdermal patches equivalent to 750 micrograms oestradiol, 8

Transdermal

1

5

NV

 

Transdermal patches equivalent to 1.5 mg oestradiol, 8

Transdermal

1

5

NV

 

Transdermal patches equivalent to 3 mg oestradiol, 8

Transdermal

1

5

NV

Oestradiol Hemihydrate and Oestradiol Hemihydrate with Norethisterone Acetate

Pack containing 4 transdermal patches equivalent to 4.33 mg oestradiol and 4 transdermal patches equivalent to 620 micrograms oestradiol with 2.7 mg norethisterone acetate

Transdermal

1

5

NV

 

Pack containing 4 transdermal patches equivalent to 4.33 mg oestradiol and 4 transdermal patches equivalent to 510 micrograms oestradiol with 4.8 mg norethisterone acetate

Transdermal

1

5

NV

Oestradiol Hemihydrate with Norethisterone Acetate

Tablets equivalent to 1 mg oestradiol with 500 micrograms norethisterone acetate, 28

Oral

1

5

NO

 

Tablets equivalent to 2 mg oestradiol with 1 mg norethisterone acetate, 28

Oral

1

5

NO

 

Transdermal patches equivalent to 620 micrograms oestradiol with 2.7 mg norethisterone acetate, 8

Transdermal

1

5

NV

 

Transdermal patches equivalent to 510 micrograms oestradiol with 4.8 mg norethisterone acetate, 8

Transdermal

1

5

NV

Oestradiol Valerate

Tablet 1 mg

Oral

56

2

SC

 

Tablet 2 mg

Oral

56

2

SC

Oestriol

Pessaries 500 micrograms, 15

Vaginal

1

2

OR

 

Vaginal cream 1 mg per g, 15 g

Application

1

1

OR

Oestrogens—Conjugated

Tablet 300 micrograms

Oral

56

2

WY

 

Tablet 625 micrograms

Oral

56

2

WY

Oestrogens—Conjugated with Medroxyprogesterone Acetate

Tablets 625 micrograms-2.5 mg, 28

Oral

1

5

WY

 

Tablets 625 micrograms-5 mg, 28

Oral

1

5

WY

Ofloxacin

Eye drops 3 mg per mL, 5 mL

Application to the eye

2

..

AG

Olanzapine

Tablet 2.5 mg

Oral

30

5

LY

 

Tablet 5 mg

Oral

30

5

LY

 

Tablet 7.5 mg

Oral

30

5

LY

 

Tablet 10 mg

Oral

30

5

LY

 

Wafer 5 mg

Oral

28

5

LY

 

Wafer 10 mg

Oral

28

5

LY

Olsalazine Sodium

Capsule 250 mg

Oral

100

5

UC

 

Tablet 500 mg

Oral

100

5

UC

Omeprazole

Tablet 20 mg

Oral

30

1

HX, SL

 

Capsule 20 mg

Oral

30

1

SZ

Omeprazole and Clarithromycin and Amoxycillin Trihydrate

Pack containing 14 capsules omeprazole 20 mg, 14 tablets clarithromycin 500 mg and 28 capsules amoxycillin trihydrate equivalent to 500 mg amoxycillin

Oral

1

..

AB

Omeprazole Magnesium

Tablet equivalent to 20 mg omeprazole

Oral

30

1

AL, AP, PM

 

Tablet equivalent to 10 mg omeprazole

Oral

30

5

AP

Ondansetron

Wafer 4 mg

Oral

4

..

GK, HX, RE

 

Wafer 8 mg

Oral

4

..

GK, HX, RE

Ondansetron Hydrochloride Dihydrate

Tablet equivalent to 4 mg ondansetron

Oral

4

..

AW, GK, HX, RE

 

Tablet equivalent to 8 mg ondansetron

Oral

4

..

AW, GK, HX, RE

 

Syrup equivalent to 4 mg ondansetron per 5 mL, 50 mL

Oral

1

1

GK

 

I.V. injection equivalent to 4 mg ondansetron in 2 mL ampoule

Injection

1

..

GK, HX, RE

 

I.V. injection equivalent to 8 mg ondansetron in 4 mL ampoule

Injection

1

..

GK, HX, RE

Oxaliplatin

Solution concentrate for I.V. infusion 50 mg in 10 mL

Injection

1

2

SW

 

Powder for I.V. infusion 50 mg

Injection

1

2

IT, MX, SW

 

Solution concentrate for I.V. infusion 100 mg in 20 mL

Injection

1

2

SW

 

Powder for I.V. infusion 100 mg

Injection

1

2

IT, MX, SW

Oxandrolone

Tablet 2.5 mg

Oral

100

1

CS

Oxazepam

Tablet 15 mg

Oral

25

..

AF, SI

 

Tablet 30 mg

Oral

25

..

AF, FM, SI

Oxcarbazepine

Tablet 150 mg

Oral

100

5

NV

 

Tablet 300 mg

Oral

100

5

NV

 

Tablet 600 mg

Oral

100

5

NV

 

Oral suspension 60 mg per mL, 250 mL

Oral

2

5

NV

Oxprenolol Hydrochloride

Tablet 20 mg

Oral

100

5

AF

 

Tablet 40 mg

Oral

100

5

AF

Oxybutynin Hydrochloride

Tablet 5 mg

Oral

100

5

AV

Oxycodone Hydrochloride

Tablet 5 mg

Oral

20

..

SI

 

Capsule 5 mg

Oral

20

..

MF

 

Capsule 10 mg

Oral

20

..

MF

 

Capsule 20 mg

Oral

20

..

MF

 

Oral solution 5 mg per 5 mL, 250 mL

Oral

1

..

MF

 

Tablet 5 mg (controlled release)

Oral

20

..

MF

 

Tablet 10 mg (controlled release)

Oral

20

..

MF

 

Tablet 20 mg (controlled release)

Oral

20

..

MF

 

Tablet 40 mg (controlled release)

Oral

20

..

MF

 

Tablet 80 mg (controlled release)

Oral

20

..

MF

Oxycodone Pectinate

Suppository equivalent to 30 mg oxycodone

Rectal

12

..

PL

Paclitaxel

Solution concentrate for I.V. infusion 30 mg in 5 mL vial

Injection

5

..

BQ, IT, MX

 

Solution concentrate for I.V. infusion 100 mg in 16.7 mL vial

Injection

2

..

BQ, IT, MX

 

Solution concentrate for I.V. infusion 150 mg in 25 mL vial

Injection

2

..

BQ, IT, MX

 

Solution concentrate for I.V. infusion 300 mg in 50 mL vial

Injection

1

..

BQ, IT, MX

Pancreatic Extract

Capsule (containing enteric coated minimicrospheres) providing not less than 5,000 BP units of lipase activity

Oral

500

10

SM

 

Capsule (containing enteric coated minimicrospheres) providing not less than 10,000 BP units of lipase activity

Oral

500

10

SM

 

Capsule (containing enteric coated minimicrospheres) providing not less than 25,000 BP units of lipase activity

Oral

200

10

SM

Pancrelipase

Capsule (containing enteric coated microspheres) providing not less than 10,000 BP units of lipase activity

Oral

500

10

OR

 

Capsule (containing enteric coated microtablets) providing not less than 25,000 BP units of lipase activity

Oral

200

10

TM

Pantoprazole Sodium Sesquihydrate

Tablet (enteric coated), equivalent to 40 mg pantoprazole

Oral

30

2

PH

 

Tablet (enteric coated), equivalent to 20 mg pantoprazole

Oral

30

5

PH

Paracetamol

Tablet 500 mg

Oral

100

1

AW, CH, FM, GM, HX, JT, PC, SW, TW

 

Tablet 665 mg (modified release)

Oral

192

5

GC, ME

 

Oral liquid 120 mg per 5 mL, 100 mL

Oral

1

2

SW

 

Oral liquid 240 mg per 5 mL, 200 mL

Oral

1

2

SW

Paraffin - Soft White with Paraffin - Liquid

Eye ointment, compound, 3.5 g

Application to the eye

2

5

AQ, IQ

 

Pack containing 2 tubes eye ointment, compound, 3.5 g

Application to the eye

1

5

AG, IQ, PE

Paroxetine Hydrochloride

Tablet equivalent to 20 mg paroxetine

Oral

30

5

AF, AW, CH, GK, GM, GX, SZ, TW

Pemetrexed Disodium Heptahydrate

Powder for I.V. infusion equivalent to 500 mg pemetrexed, vial

Injection

2

2

LY

Penicillamine

Tablet 125 mg

Oral

100

1

AL

 

Tablet 250 mg

Oral

100

1

AL

"Pepti-Junior"

Oral powder 450 g

Oral

8

5

NU

Pergolide Mesylate

Tablet equivalent to 50 micrograms pergolide

Oral

100

..

AS

 

Tablet equivalent to 250 micrograms pergolide

Oral

100

5

AS

 

Tablet equivalent to 1 mg pergolide

Oral

100

5

AS

Perhexiline Maleate

Tablet 100 mg

Oral

100

5

SI

Pericyazine

Tablet 2.5 mg

Oral

100

5

AV

 

Tablet 10 mg

Oral

100

5

AV

Perindopril Arginine

Tablet 2.5 mg

Oral

30

5

SE

 

Tablet 5 mg

Oral

30

5

SE

 

Tablet 10 mg

Oral

30

5

SE

Perindopril Erbumine

Tablet 2 mg

Oral

30

5

CH, GX, TW

 

Tablet 4 mg

Oral

30

5

CH, GX, TW

 

Tablet 8 mg

Oral

30

5

CH, GX, TW

Perindopril Erbumine with Indapamide Hemihydrate

Tablet 4 mg-1.25 mg

Oral

30

5

SE

Permethrin

Cream 50 mg per g, 30 g

Application

1

1

PC

Pethidine Hydrochloride

Injection 100 mg in 2 mL ampoule

Injection

5

..

MX

Phenelzine Sulfate

Tablet equivalent to 15 mg phenelzine

Oral

100

1

LM

"Phenex-1"

Oral powder 350 g

Oral

8

5

AB

"Phenex-2"

Oral powder 325 g

Oral

10

5

AB

 

Oral powder 400 g

Oral

8

5

AB

Phenobarbitone

Tablet 30 mg

Oral

200

4

SI

Phenobarbitone Sodium

Injection 200 mg in 1 mL ampoule

Injection

5

..

FM

Phenoxybenzamine Hydrochloride

Capsule 10 mg

Oral

100

5

GH

Phenoxymethylpenicillin Benzathine

Oral suspension equivalent to 125 mg phenoxymethylpenicillin per 5 mL, 100 mL

Oral

2

..

FM, SI

 

Oral suspension equivalent to 250 mg phenoxymethylpenicillin per 5 mL, 100 mL

Oral

2

..

FM, SI

Phenoxymethylpenicillin Potassium

Tablet equivalent to 250 mg phenoxymethylpenicillin

Oral

50

..

SI

 

Tablet equivalent to 500 mg phenoxymethylpenicillin

Oral

50

..

SI

 

Capsule equivalent to 250 mg phenoxymethylpenicillin

Oral

50

..

CS, FM, GM, HX

 

Capsule equivalent to 500 mg phenoxymethylpenicillin

Oral

50

..

CS, FM, GM, HX

Phenytoin

Tablet 50 mg

Oral

200

2

PF

 

Oral suspension 30 mg per 5 mL, 500 mL

Oral

1

3

PF

Phenytoin Sodium

Capsule 30 mg

Oral

200

2

PF

 

Capsule 100 mg

Oral

200

2

PF

"Phlexy-10"

Capsules 500 mg, 200

Oral

16

5

SB

 

Tablets 1 g, 75

Oral

24

5

SB

 

Bars 42 g, 20

Oral

10

5

SB

"Phlexy-10 Drink Mix"

Sachets containing oral powder 20 g, 30

Oral

7

5

SB

Pilocarpine Hydrochloride

Eye drops 5 mg per mL, 15 mL

Application to the eye

1

5

AG, PE

 

Eye drops 10 mg per mL, 15 mL

Application to the eye

1

5

AG, AQ, PE

 

Eye drops 20 mg per mL, 15 mL

Application to the eye

1

5

AG, AQ, PE

 

Eye drops 40 mg per mL, 15 mL

Application to the eye

1

5

AG, AQ, PE

 

Eye drops 60 mg per mL, 15 mL

Application to the eye

1

5

AG, PE

Pimecrolimus

Cream 10 mg per g, 15 g

Application

1

1

NV

Pindolol

Tablet 5 mg

Oral

100

5

AF, NV

 

Tablet 15 mg

Oral

50

5

AF, NV

Pioglitazone Hydrochloride

Tablet equivalent to 15 mg pioglitazone

Oral

28

5

LY

 

Tablet equivalent to 30 mg pioglitazone

Oral

28

5

LY

 

Tablet equivalent to 45 mg pioglitazone

Oral

28

5

LY

Piperazine Oestrone Sulfate

Tablet 730 micrograms

Oral

56

2

KR, PH

 

Tablet 1.46 mg

Oral

56

2

KR, PH

Piroxicam

Dispersible tablet 10 mg

Oral

50

3

AF, GX, HX, PF

 

Dispersible tablet 20 mg

Oral

25

3

AF, CH, GX, HX, PF, TW

 

Capsule 10 mg

Oral

50

3

AF, CH, GX, PF, TW

 

Capsule 20 mg

Oral

25

3

AF, CH, GX, PF, TW

Pizotifen Malate

Tablet equivalent to 500 micrograms pizotifen

Oral

100

2

NV

"PK AID II"

Oral powder 250 g

Oral

8

5

SB

"PKU Express Liquid"

Oral liquid 130 mL, 30

Oral

4

5

VF

"PKU-gel"

Sachets containing oral powder 20 g, 30

Oral

4

5

VF

"PKU-Express"

Sachets containing oral powder 25 g, 30

Oral

4

5

VF

Pneumococcal Vaccine - Polyvalent

Injection 0.5 mL vial (23 valent)

Injection

1

..

CS

Polyethylene Glycol 400 with Propylene Glycol

Eye drops 4 mg-3 mg per mL, 15 mL

Application to the eye

1

5

AQ

Polygeline

I.V. infusion 17.5 g per 500 mL with electrolytes, 500 mL

Injection

3

..

AE

Polyvinyl Alcohol

Eye drops 14 mg per mL, 15 mL

Application to the eye

1

5

AG, PE

 

Eye drops 14 mg per mL, 15 mL (contains sodium chlorite/hydrogen peroxide as preservative)

Application to the eye

1

5

AE

 

Eye drops 30 mg per mL, 15 mL

Application to the eye

1

5

AG, PE

 

Eye drops 30 mg per mL, 15 mL (contains sodium chlorite/hydrogen peroxide as preservative)

Application to the eye

1

5

AE

Potassium Chloride

Tablet 600 mg (sustained release)

Oral

200

1

AS, NM, NV

Potassium Chloride with Potassium Bicarbonate

Tablet, effervescent, 14 mmol K+ and 8 mmol Cl-

Oral

60

1

AS, LN

Pravastatin Sodium

Tablet 10 mg

Oral

30

5

AF, AW, BQ, CH, GM, GX, RE, SZ, TW

 

Tablet 20 mg

Oral

30

5

AF, AW, BQ, CH, GM, GX, RE, SZ, TW

 

Tablet 40 mg

Oral

30

5

AF, AW, BQ, CH, GM, GX, RE, SZ, TW

 

Tablet 80 mg

Oral

30

5

AW, BQ

Prazosin Hydrochloride

Tablet equivalent to 1 mg prazosin

Oral

100

5

AF, CH, GX, PF, TW

 

Tablet equivalent to 2 mg prazosin

Oral

100

5

AF, CH, GX, PF, TW

 

Tablet equivalent to 5 mg prazosin

Oral

100

5

AF, CH, GX, PF, TW

Prednisolone

Tablet 1 mg

Oral

100

4

AS, LN

 

Tablet 5 mg

Oral

60

4

AS, FM

 

Tablet 25 mg

Oral

30

4

AS, FM

Prednisolone Acetate with Phenylephrine Hydrochloride

Eye drops 10 mg-1.2 mg per mL, 10 mL

Application to the eye

1

2

AG

Prednisolone Sodium Phosphate

Oral solution equivalent to 5 mg prednisolone per mL, 30 mL

Oral

1

5

AS, LN

 

Enema, retention, equivalent to 20 mg prednisolone in 100 mL

Rectal

28

3

SI

 

Suppositories equivalent to 5 mg prednisolone, 10

Rectal

3

3

SI

Prednisone

Tablet 1 mg

Oral

100

4

AS, LN

 

Tablet 5 mg

Oral

60

4

AS, FM

 

Tablet 25 mg

Oral

30

4

AS, FM

Primidone

Tablet 250 mg

Oral

200

2

LM

"Pro-Phree"

Oral powder 400 g

Oral

8

5

AB

Probenecid

Tablet 500 mg

Oral

100

5

PL

Procaine Penicillin

Injection 1.5 g in disposable syringe

Injection

5

..

SI

Prochlorperazine

Suppositories 3 mg, equivalent to 5 mg prochlorperazine maleate, 5

Rectal

1

2

AV

 

Suppositories 15 mg, equivalent to 25 mg prochlorperazine maleate, 5

Rectal

1

2

AV

Prochlorperazine Maleate

Tablet 5 mg

Oral

25

..

AV, HP

Prochlorperazine Mesylate

Injection 12.5 mg in 1 mL ampoule

Injection

10

..

AV

Promethazine Hydrochloride

Injection 50 mg in 2 mL ampoule

Injection

10

..

MX

Propantheline Bromide

Tablet 15 mg

Oral

200

5

SI

Propranolol Hydrochloride

Tablet 10 mg

Oral

100

5

AF, AP

 

Tablet 40 mg

Oral

100

5

AF, AP

 

Tablet 160 mg

Oral

50

5

AF

Propylthiouracil

Tablet 50 mg

Oral

200

2

PL

Pyrantel Embonate

Tablet equivalent to 125 mg pyrantel

Oral

6

..

AF

 

Tablet equivalent to 250 mg pyrantel

Oral

6

..

AF

Pyridostigmine Bromide

Tablet 10 mg

Oral

100

5

VT

 

Tablet 60 mg

Oral

150

5

VT

 

Tablet 180 mg (modified release)

Oral

100

5

VT

Pyrimethamine

Tablet 25 mg

Oral

50

..

GK

Quetiapine Fumarate

Tablet equivalent to 25 mg quetiapine

Oral

60

5

AP

 

Tablet equivalent to 100 mg quetiapine

Oral

90

5

AP

 

Tablet equivalent to 200 mg quetiapine

Oral

60

5

AP

 

Tablet equivalent to 300 mg quetiapine

Oral

60

5

AP

Quinagolide Hydrochloride

Pack containing 3 tablets equivalent to 25 micrograms quinagolide and 3 tablets equivalent to 50 micrograms quinagolide

Oral

1

..

FP

 

Tablet equivalent to 75 micrograms quinagolide

Oral

30

5

FP

Quinapril Hydrochloride

Tablet equivalent to 5 mg quinapril

Oral

30

5

AF, AW, PF

 

Tablet equivalent to 10 mg quinapril

Oral

30

5

AF, AW, PF

 

Tablet equivalent to 20 mg quinapril

Oral

30

5

AF, AW, PF

Quinapril Hydrochloride with Hydrochlorothiazide

Tablet equivalent to 10 mg quinapril with 12.5 mg hydrochlorothiazide

Oral

30

5

PF

 

Tablet equivalent to 20 mg quinapril with 12.5 mg hydrochlorothiazide

Oral

30

5

PF

Quinine Bisulfate

Tablet 300 mg

Oral

50

2

AS

Quinine Sulfate

Tablet 300 mg

Oral

50

2

AS, LN

Rabeprazole Sodium

Tablet 20 mg (enteric coated)

Oral

30

2

JC

 

Tablet 10 mg (enteric coated)

Oral

28

5

JC

Raloxifene Hydrochloride

Tablet 60 mg

Oral

28

5

LY

Raltitrexed

Powder for I.V. infusion 2 mg in single use vial

Injection

3

2

AP

Ramipril

Tablet 1.25 mg

Oral

30

5

AV, ML, QM, WA

 

Tablet 2.5 mg

Oral

30

5

AV, ML, QM, WA

 

Tablet 5 mg

Oral

30

5

AV, ML, QM, WA

 

Capsule 10 mg

Oral

30

5

AV, ML, QM, WA

 

Pack containing 7 tablets 2.5 mg, 21 tablets 5 mg and 10 capsules 10 mg

Oral

1

..

AV

Ranitidine Hydrochloride

Tablet equivalent to 150 mg ranitidine

Oral

60

5

AF, CH, GK, GM, GX, HX, RA, SI, TW

 

Tablet, effervescent, equivalent to 150 mg ranitidine

Oral

60

5

GK

 

Tablet equivalent to 300 mg ranitidine

Oral

30

5

AF, CH, GK, GM, GX, HX, RA, SI, TW

 

Syrup equivalent to 150 mg ranitidine per 10 mL, 300 mL

Oral

2

5

GK

"RCF"

Oral liquid 384 mL

Oral

120

5

AB

Reboxetine Mesilate

Tablet equivalent to 4 mg reboxetine

Oral

60

5

PH

Reteplase

Pack containing 2 vials powder for injection 10 units, 2 single use pre-filled syringes with solvent, 2 reconstitution spikes and 2 needles

Injection

1

..

RO

Rifampicin

Capsule 150 mg

Oral

10

..

AF

 

Capsule 300 mg

Oral

10

..

AF

 

Syrup 100 mg per 5 mL, 60 mL

Oral

1

..

AV

Riluzole

Tablet 50 mg

Oral

56

5

AV

Risedronate Sodium

Tablet 5 mg

Oral

28

5

AV

 

Tablet 35 mg

Oral

4

5

AV

 

Tablet 30 mg

Oral

28

1

AV

Risedronate Sodium and Calcium Carbonate

Pack containing 4 tablets risedronate sodium 35 mg and 24 tablets calcium carbonate 1.25 g (equivalent to 500 mg calcium)

Oral

1

5

AV

Risperidone

Tablet 0.5 mg

Oral

60

2

JC

 

Tablet 0.5 mg (orally disintegrating)

Oral

56

2

JC

 

Tablet 1 mg

Oral

60

2

JC

 

Tablet 1 mg (orally disintegrating)

Oral

56

2

JC

 

Tablet 2 mg

Oral

60

5

JC

 

Tablet 2 mg (orally disintegrating)

Oral

56

5

JC

 

Tablet 3 mg

Oral

60

5

JC

 

Tablet 4 mg

Oral

60

5

JC

 

Oral solution 1 mg per mL, 30 mL

Oral

1

2

JC

 

Oral solution 1 mg per mL, 100 mL

Oral

1

5

JC

 

I.M. injection (modified release), set containing 1 vial powder for injection 25 mg and 1 pre-filled syringe diluent 2 mL

Injection

2

5

JC

 

I.M. injection (modified release), set containing 1 vial powder for injection 37.5 mg and 1 pre-filled syringe diluent 2 mL

Injection

2

5

JC

 

I.M. injection (modified release), set containing 1 vial powder for injection 50 mg and 1 pre-filled syringe diluent 2 mL

Injection

2

5

JC

Rituximab

Solution for I.V. infusion 100 mg in 10 mL vial

Injection

2

3

RO

 

Solution for I.V. infusion 500 mg in 50 mL vial

Injection

1

3

RO

Rivastigmine Hydrogen Tartrate

Capsule equivalent to 1.5 mg rivastigmine

Oral

56

5

NV

 

Capsule equivalent to 3 mg rivastigmine

Oral

56

5

NV

 

Capsule equivalent to 4.5 mg rivastigmine

Oral

56

5

NV

 

Capsule equivalent to 6 mg rivastigmine

Oral

56

5

NV

 

Oral solution equivalent to 2 mg rivastigmine per mL, 120 mL

Oral

1

5

NV

Rosiglitazone Maleate

Tablet equivalent to 4 mg rosiglitazone

Oral

28

5

GK

 

Tablet equivalent to 8 mg rosiglitazone

Oral

28

5

GK

Rosiglitazone Maleate with Metformin Hydrochloride

Tablet equivalent to 2 mg rosiglitazone with 500 mg metformin hydrochloride

Oral

56

5

GK

 

Tablet equivalent to 2 mg rosiglitazone with 1 g metformin hydrochloride

Oral

56

5

GK

 

Tablet equivalent to 4 mg rosiglitazone with 500 mg metformin hydrochloride

Oral

56

5

GK

 

Tablet equivalent to 4 mg rosiglitazone with 1 g metformin hydrochloride

Oral

56

5

GK

Rosuvastatin Calcium

Tablet equivalent to 5 mg rosuvastatin

Oral

30

5

AP

 

Tablet equivalent to 10 mg rosuvastatin

Oral

30

5

AP

 

Tablet equivalent to 20 mg rosuvastatin

Oral

30

5

AP

 

Tablet equivalent to 40 mg rosuvastatin

Oral

30

5

AP

Roxithromycin

Tablet for oral suspension 50 mg

Oral

10

1

AV

 

Tablet 150 mg

Oral

10

1

AF, AV, AW, HP, HX

 

Tablet 300 mg

Oral

5

1

AF, AV, AW, HP, HX

"S-26 LF"

Infant formula powder 900 g

Oral

5

..

WY

Salbutamol Sulfate

Oral solution equivalent to 2 mg salbutamol per 5 mL, 150 mL

Oral

2

5

GK

 

Capsule containing powder for oral inhalation equivalent to 200 micrograms salbutamol (for use in Ventolin Rotahaler)

Inhalation by mouth

200

5

GK

 

Pressurised inhalation equivalent to 100 micrograms salbutamol per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

2

5

AL, AW, GK, MM

 

Pressurised inhalation in breath actuated device equivalent to 100 micrograms salbutamol per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

2

5

MM

 

Nebuliser solution equivalent to 2.5 mg salbutamol in 2.5 mL single dose units, 30

Inhalation

2

5

AF, AW, CH, GK, GX, PU, TW

 

Nebuliser solution equivalent to 5 mg salbutamol in 2.5 mL single dose units, 30

Inhalation

2

5

AF, AW, CH, GK, GX, TW

 

Nebuliser solution equivalent to 5 mg salbutamol per mL, 30 mL

Inhalation

2

2

PU

Salcatonin

Injection 50 I.U. in 1 mL ampoule

Injection

30

5

NV

 

Injection 100 I.U. in 1 mL ampoule

Injection

15

5

NV

Salmeterol Xinafoate

Pressurised inhalation equivalent to 25 micrograms salmeterol per dose, 120 doses

Inhalation by mouth

1

5

GK

 

Powder for oral inhalation in breath actuated device equivalent to 50 micrograms salmeterol per dose, 60 doses

Inhalation by mouth

1

5

GK

Selegiline Hydrochloride

Tablet 5 mg

Oral

100

5

AF, GM

Sertraline Hydrochloride

Tablet equivalent to 50 mg sertraline

Oral

30

5

AF, AW, CH, GM, GX, PF, RA, SZ, TW

 

Tablet equivalent to 100 mg sertraline

Oral

30

5

AF, AW, CH, GM, GX, PF, RA, SZ, TW

Silver Sulfadiazine with Chlorhexidine Gluconate

Cream 10 mg-2 mg per g, 50 g

Application

1

..

SN

 

Cream 10 mg-2 mg per g, 100 g

Application

1

..

SN

Simvastatin

Tablet 5 mg

Oral

30

5

AF, BF, FR, HX, MK, RE

 

Tablet 10 mg

Oral

30

5

AF, AW, BF, CH, FR, GM, GN, GX, HX, MK, RE, TW

 

Tablet 20 mg

Oral

30

5

AF, AW, BF, CH, FR, GM, GN, GX, HX, MK, RE, TW

 

Tablet 40 mg

Oral

30

5

AF, AW, BF, CH, FR, GM, GN, GX, HX, MK, RE, TW

 

Tablet 80 mg

Oral

30

5

AF, AW, BF, CH, FR, GM, GN, GX, HX, MK, RE, TW

Sirolimus

Tablet 1 mg

Oral

100

3

WY

 

Tablet 2 mg

Oral

100

3

WY

 

Oral solution 1 mg per mL, 60 mL

Oral

1

3

WY

Sodium Acid Phosphate

Tablet, compound effervescent, equivalent to 500 mg phosphorus

Oral

100

5

NV

Sodium Alginate with Calcium Carbonate and Sodium Bicarbonate

Oral liquid 1 g-320 mg-534 mg in 20 mL, 500 mL

Oral

2

5

RC

Sodium Aurothiomalate

Injection 10 mg ampoule

Injection

10

..

AV

 

Injection 20 mg ampoule

Injection

10

1

AV

 

Injection 50 mg ampoule

Injection

10

1

AV

Sodium Chloride

Injection 9 mg per mL, 10 mL

Injection

5

1

PF

 

I.V. infusion 154 mmol per L, 1 L

Injection

5

1

BX

 

I.V. infusion 513 mmol per L, 1 L

Injection

2

1

BX

Sodium Chloride with Glucose

I.V. infusion 31 mmol-222 mmol (anhydrous) per L, 1 L

Injection

5

1

BX

 

I.V. infusion 19 mmol-104 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

1

BX

 

I.V. infusion 39 mmol-69 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

1

BX

Sodium Chloride with Potassium Chloride and Calcium Chloride

I.V. infusion containing approximately 148 mmol Na+, 4 mmol K+, 2 mmol Ca2+ and 156 mmol Cl- per L, 1 L

Injection

4

1

BX

Sodium Chloride with Sodium Acetate, Sodium Gluconate, Potassium Chloride and Magnesium Chloride

Electrolyte replacement solution 5.26 g-3.68 g-5.02 g- 370 mg-300 mg per L, 1 L

Injection

2

1

BX

Sodium Clodronate Tetrahydrate

Capsule equivalent to 400 mg sodium clodronate

Oral

100

2

SC

 

Tablet equivalent to 800 mg sodium clodronate

Oral

60

2

SC

Sodium Cromoglycate

Capsule containing powder for oral inhalation 20 mg (for use in Intal Spinhaler or Intal Halermatic)

Inhalation by mouth

100

5

GM

 

Solution for inhalation 20 mg in 2 mL ampoule

Inhalation

120

3

AV

 

Pressurised inhalation 1 mg per dose, 200 doses

Inhalation by mouth

1

5

AV

 

Pressurised inhalation 1 mg per dose, 200 doses (CFC-free formulation)

Inhalation by mouth

1

5

AV

 

Pressurised inhalation 5 mg per dose, 112 doses (CFC-free formulation)

Inhalation by mouth

1

5

AV

 

Eye drops 20 mg per mL, 10 mL

Application to the eye

1

5

AE, AV

Sodium Fusidate

Tablet 250 mg

Oral

36

1

CS

Sodium Lactate with Sodium Chloride, Potassium Chloride and Calcium Chloride

I.V. infusion containing approximately 131 mmol Na+, 5 mmol K+, 2 mmol Ca2+, 29 mmol HCO3- (as lactate) and 111 mmol Cl- per L, 1 L

Injection

5

1

BX

Sodium Valproate

Tablet, crushable, 100 mg

Oral

200

2

SW

 

Tablet 200 mg (enteric coated)

Oral

200

2

AF, SW

 

Tablet 500 mg (enteric coated)

Oral

200

2

AF, SW

 

Oral liquid 200 mg per 5 mL, 300 mL

Oral

2

2

SW

 

Oral solution 200 mg per 5 mL, 300 mL

Oral

2

2

SW

Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate

Enemas 3.125 g-450 mg-45 mg in 5 mL, 12

Rectal

2

2

PH

Sotalol Hydrochloride

Tablet 80 mg

Oral

60

5

AW, BQ, GX, HX

 

Tablet 160 mg

Oral

60

5

AF, AW, BQ, CH, GM, GX, HX, TW

Spironolactone

Tablet 25 mg

Oral

100

5

AF, PH

 

Tablet 100 mg

Oral

100

5

AF, PH

Sterculia with Frangula Bark

Granules 620 mg-80 mg per g, 500 g

Oral

1

1

NE

Sucralfate

Tablet equivalent to 1 g anhydrous sucralfate

Oral

120

2

AF, AS

Sulfacetamide Sodium

Eye drops 100 mg per mL, 15 mL

Application to the eye

1

2

AG

Sulfasalazine

Tablet 500 mg

Oral

200

5

PH

 

Tablet 500 mg (enteric coated)

Oral

200

5

KR, PH

Sulindac

Tablet 100 mg

Oral

100

3

AF

 

Tablet 200 mg

Oral

50

3

AF

Sulthiame

Tablet 50 mg

Oral

200

2

PL

 

Tablet 200 mg

Oral

200

2

PL

Sumatriptan

Nasal spray 20 mg in 0.1 mL single dose unit

Nasal

2

5

GK

Sumatriptan Succinate

Tablet equivalent to 50 mg sumatriptan

Oral

4

5

GK, ME

 

Tablet (fast disintegrating) equivalent to 50 mg sumatriptan

Oral

4

5

GK

Tacrolimus

Capsule 500 micrograms

Oral

100

3

JC

 

Capsule 1 mg

Oral

100

3

JC

 

Capsule 5 mg

Oral

50

3

JC

Tamoxifen Citrate

Tablet equivalent to 10 mg tamoxifen

Oral

60

5

AF, AP, GM

 

Tablet equivalent to 20 mg tamoxifen

Oral

60

5

AF, AP, CH, GM, GX, HX, SI, TW

Telmisartan

Tablet 40 mg

Oral

28

5

BY

 

Tablet 80 mg

Oral

28

5

BY

Telmisartan with Hydrochlorothiazide

Tablet 40 mg-12.5 mg

Tablet 80 mg-12.5 mg

Oral

Oral

28

28

5

5

BY

BY

Temazepam

Tablet 10 mg

Oral

25

..

AF, FM, SI

Temozolomide

Capsule 5 mg

Oral

15

2

SH

 

Capsule 20 mg

Oral

15

2

SH

 

Capsule 100 mg

Oral

15

2

SH

 

Capsule 250 mg

Oral

5

5

SH

Tenecteplase

Powder for injection 40 mg vial with solvent

Injection

1

..

BY

 

Powder for injection 50 mg vial with solvent

Injection

1

..

BY

Terbinafine Hydrochloride

Tablet equivalent to 250 mg terbinafine

Oral

42

1

AF, AW, GM, GX,  NV, SZ

Terbutaline Sulfate

Injection 500 micrograms in 1 mL ampoule

Injection

5

..

AP

 

Powder for oral inhalation in breath actuated device 500 micrograms per dose, 200 doses

Inhalation by mouth

1

5

AP

 

Nebuliser solution 5 mg in 2 mL single dose units, 30

Inhalation

2

5

AP

Testosterone

Subcutaneous implant 100 mg

Subcutaneous implantation

6

..

OR

 

Subcutaneous implant 200 mg

Subcutaneous implantation

3

..

OR

 

Transdermal gel 50 mg in 5 g sachet, 30

Transdermal

1

5

SC

 

Transdermal patches 12.2 mg, 60

Transdermal

1

5

MX

 

Transdermal patches 24.3 mg, 30

Transdermal

1

5

MX

Testosterone Enanthate

Injection 250 mg in 1 mL

Injection

3

3

SC

Testosterone Propionate with Testosterone Phenylpropionate and Testosterone Isocaproate

Injection 20 mg-40 mg-40 mg in 1 mL ampoule

Injection

3

3

OR

Testosterone Propionate with Testosterone Phenylpropionate, Testosterone Isocaproate and Testosterone Decanoate

Injection 30 mg-60 mg-60 mg-100 mg in 1 mL ampoule

Injection

3

3

OR

Testosterone Undecanoate

Capsule 40 mg

Oral

60

5

OR

 

I.M. injection 1,000 mg in 4 mL

Injection

1

1

SC

Tetrabenazine

Tablet 25 mg

Oral

112

5

OA

Tetracosactrin

Compound depot injection 1 mg in 1 mL ampoule

Injection

5

5

NV

Theophylline

Tablet 200 mg (sustained release)

Oral

100

5

MM

 

Tablet 250 mg (sustained release)

Oral

100

5

MM

 

Tablet 300 mg (sustained release)

Oral

100

5

MM

 

Oral solution 133.3 mg per 25 mL, 500 mL

Oral

1

5

MM

Thiamine Hydrochloride

Tablet 100 mg

Oral

100

2

AV

Thioguanine

Tablet 40 mg

Oral

25

1

GK

Thioridazine Hydrochloride

Tablet 10 mg

Oral

100

5

AF

 

Tablet 25 mg

Oral

100

5

AF

 

Tablet 50 mg

Oral

100

5

AF

 

Tablet 100 mg

Oral

100

5

AF

Thiotepa

Powder for injection 15 mg

Injection or intravesical administration

2

1

SI

Thyroxine Sodium

Tablet equivalent to 50 micrograms anhydrous thyroxine sodium

Oral

200

1

FM, SI

 

Tablet equivalent to 100 micrograms anhydrous thyroxine sodium

Oral

200

1

FM, SI

 

Tablet equivalent to 200 micrograms anhydrous thyroxine sodium

Oral

200

1

FM, SI

Tiagabine Hydrochloride

Tablet equivalent to 5 mg tiagabine

Oral

100

5

MX

 

Tablet equivalent to 10 mg tiagabine

Oral

100

5

MX

 

Tablet equivalent to 15 mg tiagabine

Oral

100

5

MX

Tiaprofenic Acid

Tablet 300 mg

Oral

60

3

AV

Ticarcillin Sodium with Potassium Clavulanate with any determined brand of Sodium Chloride Injection

Powder for injection equivalent to 3 g ticarcillin-100 mg clavulanic acid (with required solvent)

Injection

10

..

GK

Ticlopidine Hydrochloride

Tablet 250 mg

Oral

60

5

AF, HX, RO

Tiludronate Disodium

Tablet equivalent to 200 mg tiludronic acid

Oral

56

2

MX

Timolol Maleate

Eye gel equivalent to 1 mg timolol per g, 5 g

Application to the eye

1

5

NV

 

Eye drops equivalent to 2.5 mg timolol per mL, 5 mL

Application to the eye

1

5

FR, SI

 

Eye drops equivalent to 5 mg timolol per mL, 5 mL

Application to the eye

1

5

FR, SI

 

Eye drops (gellan gum solution) equivalent to 2.5 mg timolol per mL, 2.5 mL

Application to the eye

1

5

MK

 

Eye drops (gellan gum solution) equivalent to 5 mg timolol per mL, 2.5 mL

Application to the eye

1

5

MK

Tinidazole

Tablet 500 mg

Oral

4

..

GP, PF

Tiotropium Bromide Monohydrate

Capsule containing powder for oral inhalation equivalent to 18 micrograms tiotropium (for use in HandiHaler)

Inhalation by mouth

30

5

BY

Tirofiban Hydrochloride

Solution concentrate for I.V. infusion equivalent to 12.5 mg tirofiban in 50 mL vial

Injection

1

2

MK

Tobramycin

Eye drops 3 mg per mL, 5 mL

Application to the eye

1

2

AQ

 

Eye ointment 3 mg per g, 3.5 g

Application to the eye

1

..

AQ

Tobramycin Sulfate

Injection equivalent to 80 mg tobramycin in 2 mL (with preservative)

Injection

10

1

MX

 

Injection equivalent to 80 mg tobramycin in 2 mL (without preservative)

Injection

10

1

PU

Topiramate

Tablet 25 mg

Oral

60

5

JC

 

Tablet 50 mg

Oral

60

5

JC

 

Tablet 100 mg

Oral

60

5

JC

 

Tablet 200 mg

Oral

60

5

JC

 

Capsule 15 mg

Oral

60

5

JC

 

Capsule 25 mg

Oral

60

5

JC

 

Capsule 50 mg

Oral

60

5

JC

Topotecan Hydrochloride

Powder for I.V. infusion equivalent to 4 mg topotecan, vial

Injection

5

1

GK

Toremifene Citrate

Tablet equivalent to 60 mg toremifene

Oral

30

5

SH

Tramadol Hydrochloride

Capsule 50 mg

Oral

20

..

AF, AW, CH, CS, GX, TW

 

Tablet 50 mg (sustained release)

Oral

20

..

CS

 

Tablet 100 mg (sustained release)

Oral

20

..

AW, CS, HX

 

Tablet 150 mg (sustained release)

Oral

20

..

AW, CS, HX

 

Tablet 200 mg (sustained release)

Oral

20

..

AW, CS, HX

 

Oral drops 100 mg per mL, 10 mL

Oral

1

..

CS

 

Injection 100 mg in 2 mL ampoule

Injection

5

..

CS, HX

Trandolapril

Capsule 500 micrograms

Oral

28

5

AB, KN

 

Capsule 1 mg

Oral

28

5

AB, KN

 

Capsule 2 mg

Oral

28

5

AB, KN

 

Capsule 4 mg

Oral

28

5

AB

Tranexamic Acid

Tablet 500 mg

Oral

100

2

PH

Tranylcypromine Sulfate

Tablet equivalent to 10 mg tranylcypromine

Oral

50

2

GH

Travoprost

Eye drops 40 micrograms per mL, 2.5 mL

Application to the eye

1

5

AQ

Travoprost with Timolol Maleate

Eye drops 40 micrograms travoprost with timolol maleate equivalent to 5 mg timolol per mL, 2.5 mL

Application to the eye

1

5

AQ

Triamcinolone Acetonide

Injection 10 mg in 1 mL ampoule

Injection

5

..

BQ

 

Cream 200 micrograms per g, 100 g

Application

2

..

FM, SI

 

Ointment 200 micrograms per g, 100 g

Application

2

..

FM, SI

Triamcinolone Acetonide with Neomycin Sulfate, Gramicidin and Nystatin

Ear drops 1 mg-2.5 mg (neomycin)-250 micrograms-100,000 units per g, 7.5 mL

Application to the ear

1

2

BC, BQ

 

Ear ointment 1 mg-2.5 mg (neomycin)-250 micrograms-100,000 units per g, 5 g

Application to the ear

1

2

BC, BQ

Trifluoperazine Hydrochloride

Tablet equivalent to 1 mg trifluoperazine

Oral

100

5

GH

 

Tablet equivalent to 2 mg trifluoperazine

Oral

100

5

GH

 

Tablet equivalent to 5 mg trifluoperazine

Oral

100

5

GH

Triglycerides Oil - Medium Chain

500 mL

Oral

2

5

SB

Trimethoprim

Tablet 300 mg

Oral

7

1

AF, SI

Trimethoprim with Sulfamethoxazole

Tablet 80 mg-400 mg

Tablet 160 mg-800 mg

Oral

Oral

10

10

1

1

AF, SI

AF, CH, GX, RO, SI, TW

 

 

Paediatric oral suspension 40 mg-200 mg per 5 mL, 100 mL

Oral

1

1

AF, RO, SI

Tropisetron Hydrochloride

Capsule equivalent to 5 mg tropisetron

Oral

2

..

NV

 

I.V. injection equivalent to 5 mg tropisetron in 5 mL ampoule

Injection

1

..

NV

"TYR gel"

Sachets containing oral powder 20 g, 30

Oral

4

5

VF

"TYR Express"

Sachets containing oral powder 25 g, 30

Oral

4

5

VF

Ursodeoxycholic Acid

Capsule 250 mg

Oral

100

2

OA

Valaciclovir Hydrochloride

Tablet equivalent to 500 mg valaciclovir

Oral

20

..

GK

Vancomycin Hydrochloride

Capsule equivalent to 125 mg (125,000 I.U.) vancomycin activity

Oral

40

..

LY

 

Capsule equivalent to 250 mg (250,000 I.U.) vancomycin activity

Oral

40

..

LY

 

Powder for injection equivalent to 500 mg (500,000 I.U.) vancomycin activity

Injection

2

..

AS, MX

Venlafaxine Hydrochloride

Capsule (modified release) equivalent to 37.5 mg venlafaxine

Oral

28

..

WY

 

Capsule (modified release) equivalent to 75 mg venlafaxine

Oral

28

5

WY

 

Capsule (modified release) equivalent to 150 mg venlafaxine

Oral

28

5

WY

Verapamil Hydrochloride

Tablet 40 mg

Oral

100

5

AB, AF

 

Tablet 80 mg

Oral

100

5

AB, AF

 

Tablet 120 mg

Oral

100

5

AB

 

Tablet 160 mg

Oral

60

5

AB

 

Tablet 180 mg (sustained release)

Oral

30

5

AB, KN

 

Tablet 240 mg (sustained release)

Oral

30

5

AB, AF, KN

 

Capsule 160 mg (sustained release)

Oral

30

5

SI

 

Capsule 240 mg (sustained release)

Oral

30

5

SI

 

Injection 5 mg in 2 mL ampoule

Injection

5

..

AB

Vigabatrin

Tablet 500 mg

Oral

100

5

AV

 

Oral powder, sachet 500 mg

Oral

60

5

AV

Vinblastine Sulfate

Solution for I.V. injection 10 mg in 10 mL vial

Injection

5

..

MX

Vincristine Sulfate

I.V. injection 1 mg in 1 mL vial

Injection

10

..

MX, PU

Vinorelbine Tartrate

Capsule equivalent to 20 mg vinorelbine

Oral

20

2

FB

 

Capsule equivalent to 30 mg vinorelbine

Oral

16

2

FB

 

Solution for I.V. infusion equivalent to 10 mg vinorelbine in 1 mL

Injection

16

2

FB, IT, MX

 

Solution for I.V. infusion equivalent to 50 mg vinorelbine in 5 mL

Injection

4

2

FB, IT, MX

Warfarin Sodium

Tablet 1 mg

Oral

50

2

FM, SI

 

Tablet 2 mg

Oral

50

2

SI

 

Tablet 3 mg

Oral

50

2

FM

 

Tablet 5 mg

Oral

50

2

FM, SI

"XMET Analog"

Oral powder 400 g

Oral

8

5

SB

"XMET Maxamaid"

Oral powder 500 g

Oral

8

5

SB

"XMET Maxamum"

Oral powder 500 g

Oral

8

5

SB

"XMTVI Analog"

Oral powder 400 g

Oral

8

5

SB

"XMTVI Asadon"

Oral powder 200 g

Oral

5

5

SB

"XMTVI Maxamaid"

Oral powder 500 g

Oral

8

5

SB

"XMTVI Maxamum"

Oral powder 500 g

Oral

8

5

SB

"XP Analog"

Oral powder 400 g

Oral

8

5

SB

"XP Analog LCP"

Oral powder 400 g

Oral

8

5

SB

"XP Maxamaid"

Oral powder 500 g

Oral

8

5

SB

"XP Maxamum"

Sachets containing oral powder 50 g, 30

Oral

3

5

SB

 

Oral powder 500 g

Oral

8

5

SB

"XPhen, Tyr Analog"

Oral powder 400 g

Oral

8

5

SB

"XPhen, Tyr Maxamaid"

Oral powder 500 g

Oral

8

5

SB

"XPhen, Tyr Maxamum"

Oral powder 500 g

Oral

8

5

SB

"XPTM Tyrosidon"

Oral powder 500 g

Oral

4

5

SB

Zolmitriptan

Tablet 2.5 mg

Oral

4

5

AP

Zuclopenthixol Decanoate

Oily I.M. injection 200 mg in 1 mL ampoule

Injection

5

..

LU

 

Aciclovir

Tablet 200 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Oral

90

5

AF, CH, GK, GM, GX, HX, RA, TW

 

 

 

 

 

 

 

Tablet 800 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Patients with advanced human immunodeficiency virus disease (CD4 cell counts of less than 150 million per L)

Oral

120

5

AF, GK, GM, HX

 

 

 

 

 

 

Adalimumab

Injection 40 mg in 0.8 mL pre-filled syringe

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Commencement of adalimumab treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with adalimumab prior to 1 November 2004, who failed to qualify for PBS-subsidised therapy after 1 May 2004 due to an inability to receive concomitant methotrexate, and who have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab detailed below; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient;
the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

Injection

2

5

AB

 

 

 

 

 

 

 

 

Commencement of adalimumab treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with adalimumab prior to 1 March 2005, who failed to qualify for PBS-subsidised therapy after 1 May 2004 due to testing negative for rheumatoid factor, and who have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab detailed below; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient;
the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 

 

 

 

 

 

Continuing treatment within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and:
(a) who have demonstrated an adequate response to treatment with adalimumab; and
(b) whose most recent course of bDMARD treatment subsidised under the Pharmaceutical Benefits Scheme (PBS) in this bDMARD treatment cycle was with adalimumab; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle;
an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;


the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;
if the most recent course of adalimumab therapy was an initial 16 week course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;
a course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

 

 

 

 

 

Injection 40 mg in 0.8 mL pre-filled syringe

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:
(1) have severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and
(2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and
(3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with either methotrexate or sulfasalazine, at an adequate dose, for a minimum of 3 months; and
(4) have had the psoriatic component of their disease confirmed by a dermatologist or by biopsy at any time; and
(5) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and
where biological agent means adalimumab or etanercept or infliximab; and


where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);


if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;
if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;
if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;
the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;
a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

 

Injection

2

3

AB

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment, or recommencement of treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:
(1) have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and
(2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and
(3) have not failed treatment with adalimumab during the current Treatment Cycle; and
where biological agent means adalimumab or etanercept or infliximab; and
where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and


where the following conditions apply:
patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle;
patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with adalimumab within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if:
(i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with adalimumab, to their most recent course of PBS-subsidised adalimumab treatment; and
(ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and
(iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and
(iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;
the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form;
a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment at a dose that does not exceed 40 mg per fortnight

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment, or of a course which recommences treatment, with adalimumab within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

 

 

 

 

 

Injection 40 mg in 0.8 mL pre-filled syringe

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of adalimumab for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:
(1) have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and
(2) were receiving treatment with adalimumab prior to 16 March 2006; and
(3) have demonstrated a response to adalimumab treatment as specified in the criteria for continuing PBS-subsidised treatment with adalimumab; and
(4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and
where biological agent means adalimumab or etanercept or infliximab; and
where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgment form;
the course of treatment is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight;
patients are eligible for PBS-subsidised treatment under the above criteria once only
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

Injection

2

5

AB

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults:
(1) who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status; and
(2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with adalimumab; and
(3) who, at the time of application, demonstrate an adequate response to treatment with adalimumab; and
where biological agent means adalimumab or etanercept or infliximab; and
where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
an adequate response to treatment with adalimumab is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:


— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;
the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with adalimumab, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;
if the most recent course of adalimumab therapy was a 16-week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;
a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment at a dose that does not exceed 40 mg per fortnight
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total, at a dose that does not exceed 40 mg per fortnight

 

 

 

 

Adrenaline

I.M. injection 150 micrograms in 0.3 mL single dose syringe auto-injector

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient aged less than 17 years who has been assessed to be at significant risk of anaphylaxis by, or in consultation with, a clinical immunologist, allergist, paediatrician or respiratory physician, where a quantity of 2 adrenaline auto-injectors is necessary to ensure 1 is on hand at all times, and where the name of the specialist consulted is included in the authority application

Injection

2

..

CS

 

 

 

 

 

 

 

 

Initial supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient aged less than 17 years who has been discharged from hospital or an emergency department after treatment with adrenaline for acute allergic reaction with anaphylaxis, where a quantity of 2 adrenaline auto-injectors is necessary to ensure 1 is on hand at all times

 

 

 

 

 

 

Continuing supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient aged less than 17 years, where a quantity of 2 adrenaline auto-injectors is necessary to ensure 1 is on hand at all times, and where the patient has previously been issued with an authority prescription for this drug

 

 

 

 

 

I.M. injection 300 micrograms in 0.3 mL single dose syringe auto-injector

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient aged less than 17 years who has been assessed to be at significant risk of anaphylaxis by, or in consultation with, a clinical immunologist, allergist, paediatrician or respiratory physician, where a quantity of 2 adrenaline auto-injectors is necessary to ensure 1 is on hand at all times, and where the name of the specialist consulted is included in the authority application

Injection

2

..

CS

 

 

 

 

 

 

 

 

Initial supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient aged less than 17 years who has been discharged from hospital or an emergency department after treatment with adrenaline for acute allergic reaction with anaphylaxis, where a quantity of 2 adrenaline auto-injectors is necessary to ensure 1 is on hand at all times

 

 

 

 

 

 

Continuing supply for anticipated emergency treatment of acute allergic reactions with anaphylaxis in a patient aged less than 17 years, where a quantity of 2 adrenaline auto-injectors is necessary to ensure 1 is on hand at all times, and where the patient has previously been issued with an authority prescription for this drug

 

 

 

 

Albendazole

Tablet 200 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

6

1

GK

 

 

Treatment of tapeworm infestation

 

 

 

 

Amlodipine Besylate

Tablet equivalent to 5 mg amlodipine

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Oral

30

5

PF

 

 

Drug interactions occurring with all of the base-priced drugs

 

 

 

 

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

 

Tablet equivalent to 10 mg amlodipine

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Oral

30

5

PF

 

 

Drug interactions occurring with all of the base-priced drugs

 

 

 

 

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

Amoxycillin Trihydrate with Water - Purified BP

Powder for paediatric oral drops equivalent to 100 mg amoxycillin per mL, 20 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of infections suspected or proven to be due to a susceptible organism in patients who require a liquid formulation and in whom the syrup formulations are unsuitable

Oral

1

1

GK

Anakinra

Injection 100 mg in 0.67 mL single use pre-filled syringe

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Commencement of anakinra treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with anakinra prior to 1 July 2004 and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with anakinra detailed below; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and
where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly;
the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient;
the course of treatment is limited to a maximum of 24 weeks of treatment

Injection

28

5

AN

 

 

 

 

 

 

 

 

Commencement of anakinra treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with anakinra prior to 1 March 2005, who failed to qualify for PBS-subsidised therapy after 1 December 2004 due to testing negative for rheumatoid factor, and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with anakinra detailed below; and


where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and
where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly;
the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient;
the course of treatment is limited to a maximum of 24 weeks of treatment

 

 

 

 

 

 

Continuing treatment within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and:
(a) who have demonstrated an adequate response to treatment with anakinra; and
(b) whose most recent course of bDMARD treatment subsidised under the Pharmaceutical Benefits Scheme (PBS) in this bDMARD treatment cycle was with anakinra; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the patient receives concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly;
patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle;
if this treatment cycle is the patient's first bDMARD treatment cycle and the patient has failed to demonstrate a response to PBS-subsidised treatment with adalimumab, etanercept and infliximab commenced prior to 1 December 2004, the patient is eligible to continue PBS-subsidised therapy with anakinra in this first treatment cycle, despite having previously failed to respond to 3 bDMARDs;
an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:


— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;
the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with anakinra, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;
if the most recent course of anakinra therapy was an initial 16 week course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;
a course of treatment is limited to a maximum of 24 weeks of treatment
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who are receiving concomitant treatment with methotrexate at a dose of at least 7.5 mg weekly and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

Azithromycin Dihydrate

Tablet equivalent to 500 mg azithromycin

Trachoma

Oral

2

2

PF

Benzathine Penicillin

Injection 900 mg in 2 mL cartridge-needle unit (for use with Tubex Injector)

Syphilis

Injection

2

..

AS

 

Powder for injection 900 mg

Syphilis

Injection

2

..

AS

Bromocriptine Mesylate

Tablet equivalent to 2.5 mg bromocriptine

Acromegaly

Parkinson's disease

Oral

60

5

AF, NV

 

 

Pathological hyperprolactinaemia where surgery is not indicated

 

 

 

 

 

 

Pathological hyperprolactinaemia where surgery has already been used with incomplete resolution

 

 

 

 

 

 

Pathological hyperprolactinaemia where radiotherapy is not indicated

 

 

 

 

 

 

Pathological hyperprolactinaemia where radiotherapy has already been used with incomplete resolution

 

 

 

 

Buprenorphine

Transdermal patch 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

4

..

MF

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Transdermal patch 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

4

..

MF

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Transdermal patch 20 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

4

..

MF

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

Bupropion Hydrochloride

Tablet 150 mg (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Completion of treatment as short-term adjunctive therapy for nicotine dependence to facilitate the goal of achieving abstinence in patients who have indicated that they are ready to cease smoking and who have entered a comprehensive support and counselling program, and where the patient has previously been issued with an authority prescription for commencement of treatment with this drug

Oral

90

..

GK, HX, RE

 

 

 

 

 

 

Cabergoline

Tablet 500 micrograms

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

8

5

PH

 

 

Pathological hyperprolactinaemia where surgery is not indicated

 

 

 

 

 

 

Pathological hyperprolactinaemia where surgery has already been used with incomplete resolution

 

 

 

 

 

 

Pathological hyperprolactinaemia where radiotherapy is not indicated

 

 

 

 

 

 

Pathological hyperprolactinaemia where radiotherapy has already been used with incomplete resolution

 

 

 

 

Ceftriaxone Sodium

Powder for injection equivalent to 500 mg ceftriaxone

Infections where positive bacteriological evidence confirms that this antibiotic is an appropriate therapeutic agent

Septicaemia, suspected

Injection

5

..

IZ

 

 

Septicaemia, proven

 

 

 

 

Chorionic Gonadotrophin

Injection set containing 3 ampoules powder for injection 500 units and 3 ampoules solvent 1 mL

Cryptorchism not due to organic obstruction in boys over 12 months of age

Injection

2

1

OR

Ciprofloxacin Hydrochloride

Tablet equivalent to 250 mg ciprofloxacin

In compliance with authority procedures set out in subparagraph 11 (d):

Respiratory tract infection proven or suspected to be caused by Pseudomonas aeruginosa in severely immunocompromised patients

Oral

14

..

AL, AW, BG, BN, GX, HX

 

 

Bacterial gastroenteritis in severely immunocompromised patients

 

 

 

 

 

 

Treatment of infections proven to be due to Pseudomonas aeruginosa or other gram-negative bacteria resistant to all other oral antimicrobials

 

 

 

 

 

 

Treatment of joint and bone infections, epididymo-orchitis, prostatitis or perichondritis of the pinna, suspected or proven to be caused by gram-negative bacteria or gram-positive bacteria resistant to all other appropriate antimicrobials

 

 

 

 

Codeine Phosphate with Paracetamol

Tablet 30 mg-500 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment (for up to 6 months) of severe disabling pain not responding to non-narcotic analgesics, at a dose not exceeding 8 tablets per day

Oral

60

..

AL, CO, DK, FM, GK, SW

Cyproterone Acetate

Tablet 50 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Advanced carcinoma of the prostate

To reduce drive in sexual deviations in males

Oral

100

5

AF, GM, GX, HX, SC, SY

Dalteparin Sodium

Injection 2,500 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

Haemodialysis

Injection

20

3

PH

 

Injection 5,000 I.U. (anti-Xa) in 0.2 mL single dose pre-filled syringe

Haemodialysis

Injection

20

3

PH

 

Injection 7,500 I.U. (anti-Xa) in 0.75 mL single dose pre-filled syringe

Haemodialysis

Injection

20

3

PH

Desmopressin Acetate

Tablet 200 micrograms

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

90

5

FP

 

 

Cranial diabetes insipidus

 

 

 

 

 

 

 

Nasal spray (pump pack) 10 micrograms per actuation, 60 actuations, 6 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Cranial diabetes insipidus

Nasal

2

5

FP

Diazepam

Tablet 2 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Disabling spasticity

Oral

100

..

AF, AW, RO, SU

 

 

Malignant neoplasia (late stage)

 

 

 

 

 

 

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

 

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Disabling spasticity

Malignant neoplasia (late stage)

Oral

100

..

AF, AW, GM, RO, SU

 

 

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

 

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

"Digestelact"

Oral powder 900 g

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

3

10

SJ

 

 

Proven chronic lactose intolerance in children aged 1 year and over who are significantly malnourished, where the date of birth of the patient is included in the authority application, and where lactose intolerance has been proven either by the relief of symptoms on supervised withdrawal of lactose from the diet for 3 or 4 days and subsequent re-emergence of symptoms on rechallenge with lactose containing formulae or milk or food, or by the presence of not less than 0.5% reducing substance in stool exudate tested with copper sulfate diagnostic compound tablet

 

 

 

 

Doxycycline Hydrochloride

Tablet equivalent to 100 mg doxycycline

Pelvic inflammatory disease

Oral

28

..

AF, GM, PF, SI

 

Capsule equivalent to 100 mg doxycycline (containing enteric coated pellets)

Pelvic inflammatory disease

Oral

28

..

FA, MX

 

Tablet equivalent to 100 mg doxycycline

Urethritis

Oral

21

..

AF, GM, PF, SI

 

Capsule equivalent to 100 mg doxycycline (containing enteric coated pellets)

Urethritis

Oral

21

..

FA, MX

Doxycycline Monohydrate

Tablet equivalent to 100 mg doxycycline

Pelvic inflammatory disease

Oral

28

..

CH, GX, SZ, TW

 

Tablet equivalent to 100 mg doxycycline

Urethritis

Oral

21

..

CH, GX, SZ, TW

Efalizumab

Injection set containing 4 vials powder for injection 125 mg and 4 pre-filled syringes diluent 1.3 mL

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of efalizumab for continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin) by a dermatologist for adults 18 years and over who:

 


(a) have a documented history of severe chronic plaque psoriasis and were receiving treatment with efalizumab prior to 10 November 2005; and
(b) had a Psoriasis Area and Severity Index (PASI) score of greater than 15 prior to commencing treatment with efalizumab; and
(c) have signed a patient acknowledgement form indicating that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the relevant restriction for continuing PBS-subsidised treatment; and
(d) have demonstrated a response as specified in the criterion included in the relevant restriction for continuing PBS-subsidised treatment with efalizumab; and
where biological agent means efalizumab or etanercept; and
where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:


(i) a copy of the completed Psoriasis Area and Severity Index (PASI) calculation sheet and whole body area diagrams including the date of the assessment of the patient's condition at baseline (prior to initiation of efalizumab therapy) and the most recent PASI assessment; and
(ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and
(iii) a copy of the signed patient acknowledgement form;
the most recent PASI assessment is no more than 1 month old at the time of application;
the course of treatment is limited to a maximum of 24 weeks of treatment;
patients are eligible for PBS-subsidised treatment under the above criteria once only
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy, commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis, who were receiving non-PBS-subsidised treatment with efalizumab prior to 10 November 2005, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

1

5

SG

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:
(a) who have a documented history of severe chronic plaque psoriasis; and
(b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with efalizumab; and
(c) who have demonstrated an adequate response to their most recent course of treatment with efalizumab; and
where biological agent means efalizumab or etanercept; and
where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
an adequate response to efalizumab treatment is defined as a Psoriasis Area and Severity Index (PASI) score which is reduced by 75% or more, or is sustained at this level, after at least 12 weeks of efalizumab treatment, when compared with the baseline value for this Treatment Cycle established prior to biological agent treatment;
the PASI assessment is performed on the same affected body area assessed to establish the baseline pre-treatment PASI score;


patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:
(i) the assessment of response is conducted following at least 12 weeks of therapy, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course; and
(ii) the response assessment is submitted to the Medicare Australia CEO no later than 1 month from the date that course of treatment ceased;
the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes a copy of the completed Psoriasis Area and Severity Index (PASI) calculation sheet and whole body area diagrams along with the date of the assessment of the patient's condition;
a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment as systemic monotherapy, within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Commencement of a Biological Treatment Cycle with an initial PBS-subsidised course of efalizumab for continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin) by a dermatologist for adults 18 years and over:
(a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and were receiving treatment with efalizumab prior to 10 November 2005; and
(b) whose disease, prior to treatment with efalizumab, was classified as severe due to a plaque or plaques on the face, palm of a hand or sole of a foot, where either at least 2 of the 3 Psoriasis Area and Severity Index (PASI) symptom subscores for erythema, thickness and scaling were rated as severe or very severe, or the skin area affected was 30% or more of the face, palm of a hand or sole of a foot; and
(c) who have signed a patient acknowledgement form indicating that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not meet the predetermined response criterion for ongoing PBS-subsidised treatment, as outlined in the relevant restriction for continuing PBS-subsidised treatment; and
(d) who have demonstrated a response as specified in the criterion included in the relevant restriction for continuing PBS-subsidised treatment with efalizumab; and
where biological agent means efalizumab or etanercept; and


where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes the following:
(i) a copy of the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams including the date of the assessment of the patient's condition at baseline (prior to initiation of efalizumab therapy) and the most recent PASI assessment; and
(ii) details of previous phototherapy and systemic drug therapy (dosage where applicable, date of commencement and duration of therapy); and
(iii) a copy of the signed patient acknowledgement form;
the PASI assessment is performed on the same affected body area assessed to establish the baseline pre-treatment PASI score;
the most recent PASI assessment is no more than 1 month old at the time of application;


the course of treatment is limited to a maximum of 24 weeks of treatment;
patients are eligible for PBS-subsidised treatment under the above criteria once only
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of a course of initial PBS-subsidised treatment as systemic monotherapy, commencing a Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, who were receiving non-PBS-subsidised treatment with efalizumab prior to 10 November 2005, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Continuing treatment as systemic monotherapy (i.e. not in conjunction with acitretin, methotrexate or cyclosporin), within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over:
(a) who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot; and
(b) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle was with efalizumab; and
(c) who have demonstrated an adequate response to their most recent course of treatment with efalizumab; and


where biological agent means efalizumab or etanercept; and
where a Biological Treatment Cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for chronic plaque psoriasis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with a biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a biological agent up to 3 times (but with the same biological agent no more than twice), at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
an adequate response to efalizumab treatment is defined as the plaque or plaques assessed prior to biological agent treatment showing:
(i) a reduction in the Psoriasis Area and Severity Index (PASI) symptom subscores for all 3 of erythema, thickness and scaling, to slight or better, or sustained at this level, after at least 12 weeks of efalizumab treatment, as compared to the baseline values established prior to biological agent treatment; or
(ii) a reduction by 75% or more in the skin area affected, or sustained at this level, after at least 12 weeks of efalizumab treatment, as compared to the baseline value established prior to biological agent treatment;
the PASI assessment is performed on the same affected body area assessed to establish the baseline pre-treatment PASI score;
patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:


(i) the assessment of response is conducted following at least 12 weeks of therapy, in the case of a 16-week initial treatment course, or is conducted within 4 weeks prior to completion of the course, in the case of a 24-week treatment course; and
(ii) the response assessment is submitted to the Medicare Australia CEO no later than 1 month from the date that course of treatment ceased;
the application for authorisation includes a completed copy of the appropriate Severe Chronic Plaque Psoriasis PBS Authority Application - Supporting Information Form which includes a copy of the completed Psoriasis Area and Severity Index (PASI) calculation sheet and face, hand, foot area diagrams along with the date of the assessment of the patient's condition;
a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment as systemic monotherapy, within an ongoing Biological Treatment Cycle, by a dermatologist for adults 18 years and over who have a documented history of severe chronic plaque psoriasis of the face, or palm of a hand or sole of a foot, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

"EleCare"

Oral powder 400 g

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

8

5

AB

 

 

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

 

 

 

 

 

 

 

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

 

 

 

 

 

 

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

 

 

 

 

 

 

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

 

 

 

 

Enoxaparin Sodium

Injection 20 mg (2,000 I.U. anti-Xa) in 0.2 mL pre-filled syringe

Haemodialysis

Injection

20

3

AV

 

Injection 40 mg (4,000 I.U. anti-Xa) in 0.4 mL pre-filled syringe

Haemodialysis

Injection

20

3

AV

 

Injection 60 mg (6,000 I.U. anti-Xa) in 0.6 mL pre-filled syringe

Haemodialysis

Injection

20

3

AV

Escitalopram Oxalate

Oral solution equivalent to 10 mg escitalopram per mL, 28 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Major depressive disorders, where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

Oral

1

5

LU

 

 

 

 

 

 

 

 

Major depressive disorders, where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Major depressive disorders, where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Major depressive disorders, where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

 

 

Major depressive disorders, where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

Esomeprazole Magnesium Trihydrate

Tablet (enteric coated), equivalent to 20 mg esomeprazole

Maintenance of healed gastro-oesophageal reflux disease

Oral

30

5

AP

Etanercept

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment commencing a treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who have radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, and:
(a) who have not received any treatment with either etanercept or infliximab subsidised under the Pharmaceutical Benefits Scheme (PBS), or, where the patient has previously received PBS-subsidised treatment with either of these drugs, have not received PBS-subsidised treatment with etanercept or infliximab for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised treatment was approved; and
(b) who, where the patient has received non-PBS-subsidised treatment with etanercept or infliximab, have not received non-PBS-subsidised treatment with etanercept prior to 1 July 2004; and
(c) who have at least 2 of the following:
(i) low back pain and stiffness for 3 or more months that is relieved by exercise but not by rest; or
(ii) limitation of motion of the lumbar spine in the sagittal and the frontal planes as determined by a score of at least 1 on each of the lumbar flexion and lumbar side flexion measurements of the Bath Ankylosing Spondylitis Metrology Index (BASMI); or
(iii) limitation of chest expansion relative to normal values for age and gender; and


(d) who have failed to achieve an adequate response following treatment with at least 2 non-steroidal anti-inflammatory drugs (NSAIDs), in combination with an appropriate exercise program, for a total period of at least 3 months, unless:
(i) treatment with NSAIDs is contraindicated according to the relevant Therapeutic Goods Administration (TGA)-approved Product Information, in which case the patient is exempt from the NSAID component of the combined NSAID and exercise treatment regimen specified above; or
(ii) adverse events of a severity necessitating permanent treatment withdrawal develop during the relevant period of use of 2 NSAIDs, in which case the patient may be exempted from the NSAID component of the combined NSAID and exercise treatment regimen specified above; or
(iii) the patient is unable to complete the minimum exercise program, in which case the patient is exempt from completing the exercise component of the combined NSAID and exercise treatment regimen specified above; or
(iv) the patient has had a break in PBS-subsidised therapy with etanercept and infliximab of at least 5 years duration, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 NSAID, at an adequate dose, for a minimum of 3 consecutive months, instead of the combined NSAID and exercise regimen specified above; and
(e) who have signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with etanercept and with infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and


where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with etanercept or with infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with either etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with one or other drug up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment with etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and
where the following conditions apply:
failure to achieve an adequate response is demonstrated by:
(a) a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of at least 4 on a 0-10 scale, where the BASDAI score is determined at the completion of the 3 month NSAID and exercise trial, but prior to ceasing NSAID treatment, and is no more than 1 month old at the time of application; and
(b) an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 10 mg per L;
both ESR and CRP measurements are included in the authority application and are no more than 1 month old;
if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;
the authority application includes details of the NSAIDs trialled, their doses and duration of treatment;


if the NSAID dose is less than the maximum recommended dose in the relevant Therapeutic Goods Administration (TGA)-approved Product Information, the authority application includes the reasons why a higher dose cannot be used;
where the patient is exempted from the minimum 3 months of treatment with at least 2 NSAIDs because treatment with NSAIDs is contraindicated, the authority application includes evidence supporting the contraindication;
an appropriate minimum exercise program includes stretch and range of motion exercises 5 times per week, and either aerobic exercise of at least 20 minutes duration at least 3 times per week or a group exercise class at least once per week;
if a patient is unable to complete the minimum exercise program, the authority application includes the clinical reasons for this and details what, if any, exercise program has been followed;
the application for authorisation includes:
(a) a completed copy of the appropriate Tumour Necrosis Factor alfa antagonist PBS Authority Application - Supporting Information Form which includes the following:
(i) a copy of the radiological report confirming Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis; and
(ii) a copy of the completed BASDAI Assessment Form; and
(iii) a copy of the signed patient acknowledgment form; and
(iv) a copy of the exercise program self-certification form detailing the program followed and the dates over which it was followed; and
(b) confirmation by the prescribing doctor that, to the best of their knowledge, the patient has followed the exercise program detailed in the self-certification form;
a course of initial treatment commencing a treatment cycle is limited to a maximum of 6 weeks of treatment

Injection

3

..

WY

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment, or recommencement of treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who have radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis and who, in this treatment cycle, have received prior PBS-subsidised treatment with etanercept or with infliximab for this condition as 'new' patients and have not failed PBS-subsidised therapy with etanercept more than once; and
where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with etanercept or with infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with either etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with one or other drug up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment with etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and
where a 'new' patient is one who was not 'grandfathered' onto PBS-subsidised treatment with either etanercept or infliximab; and
where to be 'grandfathered' onto PBS-subsidised treatment with infliximab or with etanercept means to be commenced on PBS-subsidised treatment under the eligibility criteria specified for the initiation of PBS-subsidised treatment in patients who commenced non-PBS-subsidised treatment with infliximab prior to 1 March 2004 (where the patient is 'grandfathered' onto infliximab) or with etanercept prior to 1 July 2004 (where the patient is 'grandfathered' onto etanercept); and


where the following conditions apply:
patients who commenced PBS-subsidised treatment of ankylosing spondylitis with etanercept or infliximab prior to 1 August 2005 are deemed to have commenced their first treatment cycle with that therapy and any PBS-subsidised treatment with either drug received prior to 1 August 2005 is deemed to be treatment received as part of the patient's first treatment cycle;
the authority application includes a completed copy of the appropriate Tumour Necrosis Factor alfa antagonist PBS Authority Application - Supporting Information Form which includes a copy of the completed BASDAI Assessment Form;
the application is accompanied by the results of the patient's most recent course of PBS-subsidised etanercept or infliximab therapy, where:
(i) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course was ceased; and
(ii) if the most recent course of PBS-subsidised treatment is a 6 week course, the patient is assessed for response to that course no earlier than 4 weeks from the commencement of that course;
a course of initial treatment within an ongoing treatment cycle is limited to a maximum of 6 weeks of treatment

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment, or recommencement of treatment, with etanercept within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who have radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, who were 'grandfathered' onto PBS-subsidised treatment with etanercept or infliximab and who have not failed PBS-subsidised therapy with etanercept more than once; and


where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with etanercept or with infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with either etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with one or other drug up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment with etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and
where to be 'grandfathered' onto PBS-subsidised treatment with infliximab or with etanercept means to be commenced on PBS-subsidised treatment under the eligibility criteria specified for the initiation of PBS-subsidised treatment in patients who commenced non-PBS-subsidised treatment with infliximab prior to 1 March 2004 (where the patient is 'grandfathered' onto infliximab) or with etanercept prior to 1 July 2004 (where the patient is 'grandfathered' onto etanercept); and
where the following conditions apply:
patients who commenced PBS-subsidised treatment of ankylosing spondylitis with etanercept or infliximab prior to 1 August 2005 are deemed to have commenced their first treatment cycle with that therapy and any PBS-subsidised treatment with either drug received prior to 1 August 2005 is deemed to be treatment received as part of the patient's first treatment cycle;
the authority application includes a completed copy of the appropriate Tumour Necrosis Factor alfa antagonist PBS Authority Application - Supporting Information Form which includes a copy of the completed BASDAI Assessment Form;


the application is accompanied by the results of the patient's most recent course of PBS-subsidised etanercept or infliximab therapy, where:
(i) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course was ceased; and
(ii) if the most recent course of PBS-subsidised treatment is a 6 week course, the patient is assessed for response to that course no earlier than 4 weeks from the commencement of that course;
a course of initial treatment within an ongoing treatment cycle is limited to a maximum of 6 weeks of treatment

 

 

 

 

 

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who have received 6 weeks or more of treatment with etanercept subsidised under the Pharmaceutical Benefits Scheme (PBS) as 'new' patients, who have demonstrated a response to treatment with etanercept, and whose most recent course of PBS-subsidised therapy in this treatment cycle was with etanercept; and
where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with etanercept or with infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with either etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with one or other drug up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment with etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and


where a 'new' patient is one who was not 'grandfathered' onto PBS-subsidised treatment with either etanercept or infliximab; and
where to be 'grandfathered' onto PBS-subsidised treatment with infliximab or with etanercept means to be commenced on PBS-subsidised treatment under the eligiblity criteria specified for the initiation of PBS-subsidised treatment in patients who commenced non-PBS-subsidised treatment with infliximab prior to 1 March 2004 (where the patient is 'grandfathered' onto infliximab) or with etanercept prior to 1 July 2004 (where the patient is 'grandfathered' onto etanercept); and
where the following conditions apply:
patients who commenced PBS-subsidised treatment with etanercept or infliximab prior to 1 August 2005 are deemed to have commenced their first treatment cycle with that therapy and any PBS-subsidised treatment with either drug received prior to 1 August 2005 is deemed to be treatment received as part of the patient's first treatment cycle;
response is defined as an improvement from baseline of at least 2 in the patient's Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score and 1 of the following:
(a) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or
(b) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or
(c) an ESR or CRP measurement reduced by at least 20% from baseline;
all measurements provided are no more than 1 month old at the time of application;
the same acute phase reactant used to establish baseline at the commencement of an initial treatment course is measured for all subsequent continuing treatment applications for the patient;


patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:
(i) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and
(ii) if the course of therapy is a 6 week initial course, the assessment of response is made no earlier than 4 weeks from the commencement of that course;
the application for authorisation includes a completed copy of the appropriate Tumour Necrosis Factor alfa antagonist PBS Authority Application - Supporting Information Form which includes a copy of the completed BASDAI Assessment Form, including certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their continuing treatment assessment;
a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with etanercept as 'new' patients for a period of less than 24 weeks (other than a prescription for the first 4 weeks of continuing treatment immediately following an initial treatment course), and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total


In compliance with authority procedures set out in subsubparagraph
11 (d)(ii):

Continuing treatment, for up to 4 weeks, within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who have received 6 weeks of initial PBS-subsidised treatment with etanercept as 'new' patients immediately prior to this course of therapy and who, at the time of application, meet the criteria for continuing treatment with etanercept as specified above, and where a completed copy of the appropriate PBS Authority Application - Supporting Information Form (which includes a copy of the completed BASDAI Assessment Form) is submitted to the Medicare Australia CEO by facsimile

Injection

2

5

WY

 

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Commencement of a treatment cycle with an initial PBS-subsidised course of etanercept for continuing treatment, by a rheumatologist, of adults with active ankylosing spondylitis who have radiographically (plain X-ray) confirmed Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis, who were receiving treatment with etanercept prior to 1 July 2004; and
(a) who are receiving treatment with etanercept at the time of application; and
(b) who have not received prior PBS-subsidised treatment with infliximab; and
(c) whose Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score is less than or equal to 5 on a 0-10 scale; and


(d) who have:
(i) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or
(ii) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or
(iii) an ESR or CRP measurement reduced by at least 20% from pre-treatment baseline; and
(e) who have signed a patient acknowledgment form declaring that they understand and acknowledge that PBS-subsidised treatment with etanercept and with infliximab for ankylosing spondylitis will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and
where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with etanercept or with infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with either etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with one or other drug up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment with etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and
where the following conditions apply:
the BASDAI assessment and the ESR and CRP measurements are no more than 1 month old at the time of application;
the application for authorisation includes a completed copy of the appropriate Tumour Necrosis Factor alfa antagonist PBS Authority Application - Supporting Information Form which includes the following:

 


(i) a copy of the radiological report confirming Grade II bilateral sacroiliitis or Grade III unilateral sacroiliitis; and
(ii) a copy of the completed BASDAI Assessment Form; and
(iii) a copy of the signed patient acknowledgment form;
the course of treatment is limited to a maximum of 24 weeks of treatment;
patients are eligible for PBS-subsidised treatment under the above criteria once only
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of a course of initial PBS-subsidised treatment commencing a treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who were receiving non-PBS-subsidised treatment with etanercept prior to 1 July 2004 and at the time of the initial application for PBS-subsidised therapy and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with etanercept for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Continuing PBS-subsidised treatment within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who were 'grandfathered' onto PBS-subsidised treatment with etanercept or infliximab, who have received 6 weeks or more of PBS-subsidised treatment with etanercept, who have demonstrated a response to treatment with etanercept, and whose most recent course of PBS-subsidised therapy in this treatment cycle was with etanercept; and

 


where a treatment cycle is a period of treatment which commences when an eligible patient (one who has not received PBS-subsidised treatment with etanercept or with infliximab for ankylosing spondylitis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with either etanercept or infliximab, and which continues until the patient has tried and either failed, or ceased to respond to, PBS-subsidised courses of treatment with one or other drug up to 3 times (but with the same drug no more than twice), at which point the patient is no longer eligible for treatment with etanercept or infliximab for ankylosing spondylitis and the period of treatment ceases; and
where to be 'grandfathered' onto PBS-subsidised treatment with infliximab or with etanercept means to be commenced on PBS-subsidised treatment under the eligiblity criteria specified for the initiation of PBS-subsidised treatment in patients who commenced non-PBS-subsidised treatment with infliximab prior to 1 March 2004 (where the patient is 'grandfathered' onto infliximab) or with etanercept prior to 1 July 2004 (where the patient is 'grandfathered' onto etanercept); and
where the following conditions apply:
patients who commenced PBS-subsidised treatment with etanercept or infliximab prior to 1 August 2005 are deemed to have commenced their first treatment cycle with that therapy and any PBS-subsidised treatment with either drug received prior to 1 August 2005 is deemed to be treatment received as part of the patient's first treatment cycle;


response to treatment is defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score no more than 20% greater than the score included in the initial application for PBS-subsidised treatment, and:
(a) an erythrocyte sedimentation rate (ESR) measurement no greater than 25 mm per hour; or
(b) a C-reactive protein (CRP) measurement no greater than 10 mg per L; or
(c) an ESR or CRP measurement reduced by at least 20% from pre-treatment baseline;
all measurements provided are no more than 1 month old at the time of application;
the same acute phase reactant used to establish baseline at the commencement of an initial treatment course is measured for all subsequent continuing treatment applications for the patient;
patients will be deemed to have failed to respond to treatment with a course of PBS-subsidised therapy, despite demonstrating a response as defined above, unless:
(i) the response assessment is provided to the Medicare Australia CEO no later than 4 weeks from the date that course of treatment ceased; and
(ii) if the course of therapy is a 6 week initial course, the assessment of response is made no earlier than 4 weeks from the commencement of that course;
the application for authorisation includes a completed copy of the appropriate Tumour Necrosis Factor alfa antagonist PBS Authority Application - Supporting Information Form which includes a copy of the completed BASDAI Assessment Form including certification by the prescriber and the patient that the patient did not have access to their baseline BASDAI at the time of their continuing treatment assessment;
a course of continuing treatment within an ongoing treatment cycle is limited to a maximum of 24 weeks of treatment

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who were 'grandfathered' onto PBS-subsidised treatment with etanercept or infliximab and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing PBS-subsidised treatment with etanercept for a period of less than 24 weeks (other than a prescription for the first 4 weeks of continuing treatment immediately following an initial treatment course), and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(ii):

Continuing treatment, for up to 4 weeks, within an ongoing treatment cycle, by a rheumatologist, of adults with active ankylosing spondylitis who have received 6 weeks or more of initial PBS-subsidised treatment with etanercept as 'grandfathered' patients immediately prior to this course of therapy and who, at the time of application, meet the criteria for continuing treatment with etanercept as specified above, and where a completed copy of the appropriate Tumour Necrosis Factor alfa antagonist PBS Authority Application - Supporting Information Form (which includes a copy of the completed BASDAI Assessment Form) is submitted to the Medicare Australia CEO by facsimile

 

 

 

 

 

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:


(1) have severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and
(2) have not previously received PBS-subsidised treatment with a biological agent for this condition, or, where the patient has previously received PBS-subsidised treatment with a biological agent for this condition, have received no such treatment for a period of 5 years or more starting from the date the last application for PBS-subsidised therapy with a biological agent for this condition was approved; and
(3) have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly for a minimum period of 3 months and to sulfasalazine at a dose of at least 2 g per day for a minimum period of 3 months, unless the patient has had a break in PBS-subsidised biological agent treatment of at least 5 years, in which case the patient is required to achieve an adequate response to treatment with either methotrexate or sulfasalazine, at an adequate dose, for a minimum of 3 months; and
(4) have had the psoriatic component of their disease confirmed by a dermatologist or by biopsy at any time; and
(5) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and
where biological agent means adalimumab or etanercept or infliximab; and


where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
failure to achieve an adequate response to the treatment regimens specified at (3) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;
if treatment with any of the drugs mentioned at (3) above is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, the authority application includes details of the contraindication;
if intolerance to treatment with the regimens specified at (3) above develops during the relevant period of use and is of a severity necessitating permanent treatment withdrawal, the authority application includes details of the degree of this toxicity;


the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;
a course of initial treatment commencing a Treatment Cycle is limited to a maximum of 16 weeks of treatment

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment in a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

 

Injection

2

3

WY

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment, or recommencement of treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who:
(1) have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and
(2) have received prior PBS-subsidised treatment with a biological agent for this condition in this Treatment Cycle and who are eligible to receive further therapy with a biological agent within this Treatment Cycle; and
(3) have not failed treatment with etanercept during the current Treatment Cycle; and
where biological agent means adalimumab or etanercept or infliximab; and
where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
patients are eligible to receive further therapy with a biological agent within this Treatment Cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents within this Treatment Cycle;
patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this Treatment Cycle are eligible to recommence therapy with this drug within this same cycle if:
(i) they have demonstrated an adequate response, as specified in the criteria for continuing PBS-subsidised treatment with etanercept, to their most recent course of PBS-subsidised etanercept treatment; and
(ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and
(iii) the response was assessed following a minimum of 12 weeks of therapy, where the most recent course of PBS-subsidised treatment was a 16-week initial treatment course; and
(iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;
the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form;
a course of initial treatment within an ongoing Treatment Cycle is limited to a maximum of 16 weeks of treatment

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment, or of a course which recommences treatment, with etanercept within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

 

 

 

 

 

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Commencement of a Biological Treatment Cycle, with an initial PBS-subsidised course of etanercept for continuing treatment, by a rheumatologist or by an immunologist with expertise in the management of psoriatic arthritis, of adults who:
(1) have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months; and
(2) were receiving treatment with etanercept prior to 17 March 2005; and
(3) have demonstrated a response to etanercept treatment as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and
(4) have signed a patient acknowledgement form declaring that they understand and acknowledge that PBS-subsidised treatment with a biological agent will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and
where biological agent means adalimumab or etanercept or infliximab; and
where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form which includes a copy of the signed patient acknowledgement form;
the course of treatment is limited to a maximum of 24 weeks of treatment;
patients are eligible for PBS-subsidised treatment under the above criteria once only


In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of a course of initial PBS-subsidised treatment commencing a Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status within the last 12 months, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial PBS-subsidised treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

Injection

2

5

WY

 

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Continuing treatment within an ongoing Biological Treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults:
(1) who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status; and
(2) whose most recent course of PBS-subsidised treatment with a biological agent for this condition in the current Treatment Cycle was with etanercept; and
(3) who, at the time of application, demonstrate an adequate response to treatment with etanercept; and
where biological agent means adalimumab or etanercept or infliximab; and


where a Biological Treatment Cycle is a period of treatment with successive biological agents which commences when an eligible patient (one who has not received PBS-subsidised treatment with a biological agent for psoriatic arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 biological agent, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 biological agents, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
an adequate response to treatment with etanercept is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;
the authority application includes a completed copy of the appropriate Psoriatic Arthritis PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;

 


if the most recent course of etanercept therapy was a 16 week initial treatment course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;
a course of continuing treatment within an ongoing Treatment Cycle is limited to a maximum of 24 weeks of treatment
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing Biological Treatment Cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of psoriatic arthritis, of adults who have a documented history of severe active psoriatic arthritis with a record of rheumatoid factor negative status, and who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment in a biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and:
(a) (i) who have not previously received treatment with a bDMARD for this condition subsidised under the Pharmaceutical Benefits Scheme (PBS); or
(ii) who, where the patient has previously received PBS-subsidised bDMARD treatment, have received no PBS-subsidised treatment with a bDMARD for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised bDMARD therapy was approved; and
(b) who have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide alone or with leflunomide in combination with methotrexate or with cyclosporin alone, unless:
(i) treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to that particular agent (or agents) only; or
(ii) the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and
(c) who have signed a patient acknowledgement form declaring that they understand and acknowledge that, within a single bDMARD treatment cycle, PBS-subsidised treatment with any bDMARD will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
failure to achieve an adequate response to the treatment regimens specified at (b) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;
where the patient is exempted from demonstrating an inadequate response to a treatment regimen specified at (b) above on the basis of contraindication or intolerance, the authority application includes details of the contraindication or intolerance, including the degree of toxicity;


the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;
a course of treatment is limited to a maximum of 16 weeks of treatment

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment in a bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

2

3

WY

 

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment or recommencement of treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who have received prior PBS-subsidised treatment with a bDMARD for this condition in this bDMARD treatment cycle and who are eligible to receive further bDMARD therapy within this treatment cycle; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle;
patients are eligible to commence therapy with etanercept within this bDMARD treatment cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this treatment cycle, and provided they also meet the conditions applying to recommencement of etanercept therapy specified below, if applicable;
patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this bDMARD treatment cycle are eligible to recommence therapy with this drug within this same cycle if:
(i) they have demonstrated an adequate response to their most recent course of PBS-subsidised etanercept treatment; and


(ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and
(iii) the response was assessed following a minimum of 12 weeks of therapy when the most recent course of PBS-subsidised treatment was an initial 16 week course; and
(iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;
an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form and, where this is required, evidence of the patient's response to their most recent course of etanercept therapy;
a course of treatment is limited to a maximum of 16 weeks of treatment


In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment, or of a course which recommences treatment, within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment, for up to 4 months, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, and who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against the predetermined response criteria does not support continuation of PBS-subsidised treatment; and


where the patient has failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, has failed to achieve an adequate response to methotrexate in combination with 2 other disease modifying anti-rheumatic drugs for a minimum of 3 months, and has subsequently failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide alone or leflunomide in combination with methotrexate or cyclosporin alone, unless treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to the above treatment regimens; and
where the following conditions apply:
failure to achieve an adequate response is demonstrated by an elevated erythrocyte sedimentation rate greater than 25 mm per hour or a C-reactive protein level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints or at least 4 active joints from the following list:
— elbow, wrist, knee or ankle (assessed as swollen and tender);
— shoulder, cervical spine or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
if the requirement to demonstrate an elevated erythrocyte sedimentation rate or C-reactive protein level cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;
the authority application includes sufficient information to determine the patient's eligibility according to the above criteria and the date of joint assessment;


where the patient is exempted from demonstrating an inadequate response to the treatment regimens specified above, the authority application includes details of the contraindication or intolerance, including the degree of toxicity

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Initial treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 4 months, and where approval of the application would enable the patient to complete a period of initial treatment of not more than 4 months of uninterrupted therapy

 

 

 

 

 

Injection set containing 4 vials powder for injection 50 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph      11 (d)(i):

Initial treatment in a biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and:
(a) (i) who have not previously received treatment with a bDMARD for this condition subsidised under the Pharmaceutical Benefits Scheme (PBS); or
(ii) who, where the patient has previously received PBS-subsidised bDMARD treatment, have received no PBS-subsidised treatment with a bDMARD for this condition for a period of 5 years or more starting from the date the last course of PBS-subsidised bDMARD therapy was approved; and


(b) who have failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, have failed to achieve an adequate response to methotrexate (at a dose of at least 7.5 mg weekly) in combination with 2 other non-biological disease modifying anti-rheumatic drugs (DMARDs) for a minimum of 3 months, and have failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide alone or with leflunomide in combination with methotrexate or with cyclosporin alone, unless:
(i) treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to that particular agent (or agents) only; or
(ii) the patient has had a break in PBS-subsidised bDMARD treatment of at least 5 years, in which case the patient is required to demonstrate failure to achieve an adequate response to treatment with at least 1 non-biological DMARD, at an adequate dose, for a minimum of 3 months; and
(c) who have signed a patient acknowledgement form declaring that they understand and acknowledge that, within a single bDMARD treatment cycle, PBS-subsidised treatment with any bDMARD will cease if they do not demonstrate the response to treatment required to support continuation of PBS-subsidised treatment at any assessment where a response must be demonstrated; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
failure to achieve an adequate response to the treatment regimens specified at (b) above is demonstrated by an elevated erythrocyte sedimentation rate (ESR) greater than 25 mm per hour or a C-reactive protein (CRP) level greater than 15 mg per L, and either a total active joint count of at least 20 active (swollen and tender) joints, or at least 4 active joints from the following list of major joints:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
if the requirement to demonstrate an elevated ESR or CRP cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;


where the patient is exempted from demonstrating an inadequate response to a treatment regimen specified at (b) above on the basis of contraindication or intolerance, the authority application includes details of the contraindication or intolerance, including the degree of toxicity;
the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form which includes details of the patient's ESR and CRP measurements, and an assessment of the patient's active joint count, conducted no earlier than 1 month prior to the date of application, and a copy of the signed patient acknowledgment form;
a course of treatment is limited to a maximum of 16 weeks of treatment
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment in a bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

Injection

1

3

WY

 

 

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment or recommencement of treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who have received prior PBS-subsidised treatment with a bDMARD for this condition in this bDMARD treatment cycle and who are eligible to receive further bDMARD therapy within this treatment cycle; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and
where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle;
patients are eligible to commence therapy with etanercept within this bDMARD treatment cycle provided they have not already tried, and either failed or ceased to respond to, PBS-subsidised treatment with 3 bDMARDs within this treatment cycle, and provided they also meet the conditions applying to recommencement of etanercept therapy specified below, if applicable;
patients who have previously commenced, and subsequently ceased, PBS-subsidised treatment with etanercept within this bDMARD treatment cycle are eligible to recommence therapy with this drug within this same cycle if:
(i) they have demonstrated an adequate response to their most recent course of PBS-subsidised etanercept treatment; and
(ii) the response was assessed, and the assessment was provided to the Medicare Australia CEO, no later than 4 weeks from the date that course ceased; and


(iii) the response was assessed following a minimum of 12 weeks of therapy when the most recent course of PBS-subsidised treatment was an initial 16 week course; and
(iv) response to treatment was determined using the same indices of disease severity used to establish baseline at the commencement of treatment;
an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form and, where this is required, evidence of the patient's response to their most recent course of etanercept therapy;
a course of treatment is limited to a maximum of 16 weeks of treatment

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuation of initial treatment, or of a course which recommences treatment, within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for initial treatment or recommencement of treatment with this drug for a period of less than 16 weeks, and where approval of the application would enable the patient to complete a course of 16 weeks of treatment in total

 

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial treatment, for up to 4 months, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, and who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against the predetermined response criteria does not support continuation of PBS-subsidised treatment; and


where the patient has failed to achieve an adequate response to methotrexate at a dose of at least 20 mg weekly, has failed to achieve an adequate response to methotrexate in combination with 2 other disease modifying anti-rheumatic drugs for a minimum of 3 months, and has subsequently failed to achieve an adequate response following a minimum of 3 months' treatment with leflunomide alone or leflunomide in combination with methotrexate or cyclosporin alone, unless treatment with any of the above-mentioned drugs is contraindicated according to the relevant Therapeutic Goods Administration-approved Product Information, or intolerance of a severity necessitating permanent treatment withdrawal develops during the relevant period of use, in which case the patient is exempted from demonstrating an inadequate response to the above treatment regimens; and
where the following conditions apply:
failure to achieve an adequate response is demonstrated by an elevated erythrocyte sedimentation rate greater than 25 mm per hour or a C-reactive protein level greater than 15 mg per L, and either an active joint count of at least 20 active (swollen and tender) joints or at least 4 active joints from the following list:
— elbow, wrist, knee or ankle (assessed as swollen and tender);
— shoulder, cervical spine or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
if the requirement to demonstrate an elevated erythrocyte sedimentation rate or C-reactive protein level cannot be met, the authority application includes the reasons why this criterion cannot be satisfied;
the authority application includes sufficient information to determine the patient's eligibility according to the above criteria and the date of joint assessment;


where the patient is exempted from demonstrating an inadequate response to the treatment regimens specified above, the authority application includes details of the contraindication or intolerance, including the degree of toxicity

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Initial treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who have previously been issued with an authority prescription for initial treatment with this drug for a period of less than 4 months, and where approval of the application would enable the patient to complete a period of initial treatment of not more than 4 months of uninterrupted therapy

 

 

 

 

 

Injection set containing 4 vials powder for injection 25 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph      11 (d)(i):

Commencement of etanercept treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with etanercept prior to 1 March 2005, who failed to qualify for PBS-subsidised therapy after 1 August 2003 due to testing negative for rheumatoid factor, and who have demonstrated a response to etanercept treatment as specified in the criteria for continuing PBS-subsidised treatment with etanercept detailed below; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient;
the course of treatment is limited to a maximum of 24 weeks of treatment

Injection

2

5

WY

 

 

 

 

 

 

 

 

Continuing treatment within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and:
(a) who have demonstrated an adequate response to treatment with etanercept; and
(b) whose most recent course of bDMARD treatment subsidised under the Pharmaceutical Benefits Scheme (PBS) in this bDMARD treatment cycle was with etanercept; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle;
an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;


the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;
if the most recent course of etanercept therapy was an initial 16 week course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;
a course of treatment is limited to a maximum of 24 weeks of treatment
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial PBS-subsidised supply for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who were receiving treatment with etanercept prior to 1 December 2002, who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against predetermined response criteria does not support continuation of PBS-subsidised treatment, and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and where the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient

 

 

 

 

 

 

Continuing PBS-subsidised treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who, at the time of application, demonstrate an adequate response to treatment with etanercept as manifested by an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and an active joint count of fewer than 10 active (swollen and tender) joints or a reduction in the active (swollen and tender) joint count by at least 50% from baseline or a reduction in the number of the following active joints, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as swollen and tender);


— shoulder, cervical spine or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); and
where the following conditions apply:
the authority application includes sufficient information to determine the patient's response to treatment with etanercept according to the above criteria and the date of assessment of the patient;
patients who have previously ceased treatment with etanercept due to failure to demonstrate an adequate response to treatment are not eligible to recommence treatment until a period of 12 months has elapsed since cessation of the previous treatment;
authority applications for re-treatment with etanercept following a break in PBS-subsidised treatment with the drug include the reason for and date of cessation of the previous treatment course

 

 

 

 

 

 

Injection set containing 4 vials powder for injection 50 mg and 4 pre-filled syringes solvent 1 mL

In compliance with authority procedures set out in subsubparagraph      11 (d)(i):

Commencement of etanercept treatment in a bDMARD treatment cycle with an initial supply subsidised under the Pharmaceutical Benefits Scheme (PBS) for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who were receiving treatment with etanercept prior to 1 March 2005, who failed to qualify for PBS-subsidised therapy after 1 August 2003 due to testing negative for rheumatoid factor, and who have demonstrated a response to etanercept treatment as specified in the criteria for continuing PBS-subsidised treatment with etanercept detailed below; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient;
the course of treatment is limited to a maximum of 24 weeks of treatment

Injection

1

5

WY

 

 

 

 

 

 

 

 

Continuing treatment within an ongoing biological disease modifying anti-rheumatic drug (bDMARD) treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis, and:
(a) who have demonstrated an adequate response to treatment with etanercept; and
(b) whose most recent course of bDMARD treatment subsidised under the Pharmaceutical Benefits Scheme (PBS) in this bDMARD treatment cycle was with etanercept; and
where bDMARD means a drug included in the following list of drugs:
adalimumab, anakinra, etanercept or infliximab; and


where a bDMARD treatment cycle is a period of treatment with successive bDMARDs which commences when an eligible patient (one who has not received PBS-subsidised treatment with a bDMARD for rheumatoid arthritis in at least the previous 5 years) receives an initial course of PBS-subsidised therapy with 1 bDMARD, and which continues until the patient has tried, and either failed or ceased to respond to, PBS-subsidised treatment with a maximum of 3 bDMARDs, at which point the patient is no longer eligible for treatment and the period of treatment ceases; and
where the following conditions apply:
patients who commenced PBS-subsidised bDMARD treatment prior to 1 December 2004 are deemed to have commenced their first bDMARD treatment cycle with that therapy and any PBS-subsidised treatment received prior to 1 December 2004 is deemed to be treatment received as part of the patient's first bDMARD treatment cycle;
an adequate response to treatment is defined as an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and either a reduction in the total active (swollen and tender) joint count by at least 50% from baseline, where baseline is at least 20 active joints, or a reduction in the number of the following major joints which are active, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as active if swollen and tender); or
— shoulder or hip (assessed as active if there is pain in passive movement and restriction of passive movement, and where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth);
the same indices of disease severity used to establish baseline at the commencement of treatment are used to determine response;

 


the authority application includes a completed copy of the appropriate Biological DMARD PBS Authority Application - Supporting Information Form, and a measurement of response to the most recent prior course of therapy with etanercept, where response is assessed, and this assessment is provided to the Medicare Australia CEO, no later than 4 weeks from the cessation of that treatment course;
if the most recent course of etanercept therapy was an initial 16 week course, the application for continuing treatment is accompanied by an assessment of response to a minimum of 12 weeks of treatment with that course;
a course of treatment is limited to a maximum of 24 weeks of treatment
 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i) or 11 (d)(ii):

Continuing treatment within an ongoing bDMARD treatment cycle, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of adults with severe active rheumatoid arthritis who, qualifying under the criteria specified above, have previously been issued with an authority prescription for continuing treatment with this drug for a period of less than 24 weeks, and where approval of the application would enable the patient to complete a course of 24 weeks of treatment in total

 

 

 

 

 

 

In compliance with authority procedures set out in subsubparagraph
11 (d)(i):

Initial PBS-subsidised supply for continuing treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who were receiving treatment with etanercept prior to 1 December 2002, who have signed a patient agreement form indicating that they understand and acknowledge that PBS-subsidised treatment will cease if their response to treatment as assessed against predetermined response criteria does not support continuation of PBS-subsidised treatment, and who have demonstrated a response as specified in the criteria for continuing PBS-subsidised treatment with etanercept; and where the authority application includes sufficient information to determine the patient's eligibility for treatment and the date of assessment of the patient

 

 

 

 

 

 

Continuing PBS-subsidised treatment, by a rheumatologist or by a clinical immunologist with expertise in the management of rheumatoid arthritis, of patients aged 18 years or older with a documented history of severe active polyarticular course juvenile chronic arthritis with onset prior to the age of 18 years, who, at the time of application, demonstrate an adequate response to treatment with etanercept as manifested by an erythrocyte sedimentation rate no greater than 25 mm per hour or a C-reactive protein level no greater than 15 mg per L or either marker reduced by at least 20% from baseline, and an active joint count of fewer than 10 active (swollen and tender) joints or a reduction in the active (swollen and tender) joint count by at least 50% from baseline or a reduction in the number of the following active joints, from at least 4, by at least 50%:
— elbow, wrist, knee or ankle (assessed as swollen and tender);


— shoulder, cervical spine or hip (assessed as pain in passive movement and restriction of passive movement, where pain and limitation of movement are due to active disease and not irreversible damage such as joint destruction or bony overgrowth); and
where the following conditions apply:
the authority application includes sufficient information to determine the patient's response to treatment with etanercept according to the above criteria and the date of assessment of the patient;
patients who have previously ceased treatment with etanercept due to failure to demonstrate an adequate response to treatment are not eligible to recommence treatment until a period of 12 months has elapsed since cessation of the previous treatment;
authority applications for re-treatment with etanercept following a break in PBS-subsidised treatment with the drug include the reason for and date of cessation of the previous treatment course

 

 

 

 

Famciclovir

Tablet 250 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

56

5

NV

 

 

Suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

 

 

 

 

 

Tablet 500 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

56

5

NV

 

 

Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes in immunocompromised patients, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

 

 

 

 

Fentanyl

Transdermal patch 2.1 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

10

..

JC

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Transdermal patch 4.2 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

10

..

JC

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Transdermal patch 8.4 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

10

..

JC

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Transdermal patch 12.6 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

10

..

JC

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Transdermal patch 16.8 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Transdermal

10

..

JC

 

 

Chronic severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

Granisetron Hydrochloride

Tablet equivalent to 2 mg granisetron

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

5

1

MX

 

 

 

 

 

 

 

Concentrated injection equivalent to 3 mg granisetron in 3 mL ampoule

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Injection

1

..

MX

Hydrocortisone Sodium Succinate

Injection equivalent to 100 mg hydrocortisone with 2 mL solvent

For use in a hospital

Injection

6

..

PH

 

Injection equivalent to 250 mg hydrocortisone with 2 mL solvent

For use in a hospital

Injection

6

..

PH

Hydromorphone Hydrochloride

Tablet 2 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

AB

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 4 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

AB

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 8 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

AB

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Oral liquid 1 mg per mL, 473 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Oral

2

..

AB

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

Ibuprofen

Tablet 400 mg

Chronic arthropathies (including osteoarthritis) with an inflammatory component

Oral

90

3

AB

 

 

Bone pain due to malignant disease

 

 

 

 

Interferon Alfa-2a

Injection 3,000,000 I.U. in 0.5 mL single dose pre-filled syringe

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

15

5

RO

 

 

 

 

 

 

 

Injection 4,500,000 I.U. in 0.5 mL single dose pre-filled syringe

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

5

5

RO

 

Injection 6,000,000 I.U. in 0.5 mL single dose pre-filled syringe

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

5

5

RO

 

 

 

 

 

 

 

Injection 9,000,000 I.U. in 0.5 mL single dose pre-filled syringe

In compliance with authority procedures set out in subparagraph 11 (d):

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

Injection

5

5

RO

 

 

 

 

 

 

Interferon Alfa-2b

Solution for injection 18,000,000 I.U. in 1.2 mL multi-dose injection pen

In compliance with authority procedures set out in subparagraph 11 (d):

Maintenance treatment of multiple myeloma once remission has been achieved with chemotherapy

Injection

3

5

SH

 

 

Low grade non-Hodgkin's lymphoma with clinical features suggestive of a poor prognosis, in combination with anthracycline-based chemotherapy

 

 

 

 

"Karicare De-Lact"

Oral powder 900 g

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

5

5

NU

 

 

Proven chronic lactose intolerance in patients up to the age of 12 months, where the date of birth of the patient is included in the authority application, and where lactose intolerance has been proven either by the relief of symptoms on supervised withdrawal of lactose from the diet for 3 or 4 days and subsequent re-emergence of symptoms on rechallenge with lactose containing formulae or milk or food, or by the presence of not less than 0.5% reducing substance in stool exudate tested with copper sulfate diagnostic compound tablet

 

 

 

 

Ketoconazole

Tablet 200 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

30

5

JC

 

 

Oral candidiasis in severely immunocompromised persons where topical therapy has failed

 

 

 

 

 

 

Systemic or deep mycoses where other forms of therapy have failed

 

 

 

 

Lansoprazole

Capsule 30 mg

Gastro-oesophageal reflux disease

Oral

30

5

WY

 

 

Scleroderma oesophagus

 

 

 

 

 

 

Sachet containing granules for oral suspension, 30 mg per sachet

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Oral

28

5

WY

 

Sachet containing granules for oral suspension, 30 mg per sachet

In compliance with authority procedures set out in subparagraph 11 (d):

Initial treatment of peptic ulcer, in patients unable to take a solid dose form of a proton pump inhibitor

Oral

28

1

WY

 

Sachet containing granules for oral suspension, 30 mg per sachet

In compliance with authority procedures set out in subparagraph 11 (d):

Gastro-oesophageal reflux disease, in patients unable to take a solid dose form of a proton pump inhibitor

Oral

28

5

WY

 

 

Scleroderma oesophagus, in patients unable to take a solid dose form of a proton pump inhibitor

 

 

 

 

Lercanidipine Hydrochloride

Tablet 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

30

5

SM

 

 

Adverse effects occurring with all of the base-priced drugs

 

 

 

 

 

 

Drug interactions occurring with all of the base-priced drugs

 

 

 

 

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

 

Tablet 20 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

30

5

SM

 

 

Adverse effects occurring with all of the base-priced drugs

 

 

 

 

 

 

Drug interactions occurring with all of the base-priced drugs

 

 

 

 

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

Levetiracetam

Tablet 250 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

UC

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Tablet 500 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

UC

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Tablet 1 g

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

UC

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

Medroxyprogesterone Acetate

Tablet 10 mg

Endometriosis

Oral

100

2

KR, PH

Methadone Hydrochloride

Tablet 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

GK

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Injection 10 mg in 1 mL ampoule

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Injection

10

..

GK

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Metronidazole

Tablet 400 mg

Treatment of anaerobic infections

Oral

21

1

AF, AV, HP

Morphine Hydrochloride

Oral solution 2 mg per mL, 200 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Oral

2

..

MF

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Oral solution 5 mg per mL, 200 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Oral

2

..

MF

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Oral solution 10 mg per mL, 200 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Oral

2

..

MF

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

Morphine Sulfate

Tablet 30 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

FM

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 5 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 10 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 15 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 30 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 60 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 100 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 10 mg (containing sustained release pellets)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

GK

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 20 mg (containing sustained release pellets)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

GK

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 30 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

20

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 50 mg (containing sustained release pellets)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

GK

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 60 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

20

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 90 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

20

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 100 mg (containing sustained release pellets)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

GK

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 120 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

20

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Sachet containing controlled release granules for oral suspension, 20 mg per sachet

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Oral

40

..

MF

 

 

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Sachet containing controlled release granules for oral suspension, 30 mg per sachet

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Oral

40

..

MF

 

 

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Sachet containing controlled release granules for oral suspension, 60 mg per sachet

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Oral

40

..

MF

 

 

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Sachet containing controlled release granules for oral suspension, 100 mg per sachet

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

Oral

40

..

MF

 

 

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

"Neocate"

Oral powder 400 g

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

8

5

SB

 

 

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

 

 

 

 

 

 

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

 

 

 

 

 

 

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

 

 

 

 

 

 

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

 

 

 

 

"Neocate Advance"

Oral powder 400 g

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

8

5

SB

 

 

Continuing treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children up to the age of 2 years, where the child has been assessed by a suitably qualified allergist or paediatrician, and where the date of birth of the patient is included in the authority application

 

 

 

 

 

 

Treatment for combined intolerance (not infant colic) to cows' milk protein, soy protein and protein hydrolysate formulae in children aged 2 years and over, where the child is assessed by a suitably qualified allergist or paediatrician at intervals not greater than 6 months, and where the date of birth of the patient is included in the authority application

 

 

 

 

 

 

Severe intestinal malabsorption including short bowel syndrome where protein hydrolysate formulae have failed

 

 

 

 

 

 

Severe intestinal malabsorption including short bowel syndrome where the patient has been receiving parenteral nutrition

 

 

 

 

Nifedipine

Tablet 20 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Oral

30

5

BN

 

 

Drug interactions occurring with all of the base-priced drugs

 

 

 

 

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

Nitrazepam

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

5

AF, VT

 

 

Myoclonic epilepsy

 

 

 

 

 

 

Malignant neoplasia (late stage)

 

 

 

 

 

 

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

 

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

Omeprazole

Tablet 20 mg

Gastro-oesophageal reflux disease

Oral

30

5

HX, SL

 

 

Scleroderma oesophagus

 

 

 

 

 

 

Zollinger-Ellison syndrome

 

 

 

 

 

Capsule 20 mg

Gastro-oesophageal reflux disease

Oral

30

5

SZ

 

 

Scleroderma oesophagus

 

 

 

 

 

 

Zollinger-Ellison syndrome

 

 

 

 

Omeprazole Magnesium

Tablet equivalent to 20 mg omeprazole

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Oral

30

5

AL, AP, PM

 

 

Zollinger-Ellison syndrome

 

 

 

 

Ondansetron

Wafer 4 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

GK, HX, RE

 

 

 

 

 

 

 

Wafer 8 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

GK, HX, RE

 

 

 

 

 

 

Ondansetron Hydrochloride Dihydrate

Tablet equivalent to 4 mg ondansetron

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

AW, GK, HX, RE

 

 

 

 

 

 

 

Tablet equivalent to 8 mg ondansetron

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Oral

10

1

AW, GK, HX, RE

 

 

 

 

 

 

 

I.V. injection equivalent to 4 mg ondansetron in 2 mL ampoule

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Injection

1

..

GK, HX, RE

 

I.V. injection equivalent to 8 mg ondansetron in 4 mL ampoule

In compliance with authority procedures set out in subparagraph 11 (d):

Management of nausea and vomiting associated with radiotherapy being used to treat malignancy

Injection

1

..

GK, HX, RE

Oxazepam

Tablet 15 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

5

AF, SI

 

 

Malignant neoplasia (late stage)

 

 

 

 

 

 

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

 

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

Tablet 30 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

5

AF, FM, SI

 

 

Malignant neoplasia (late stage)

 

 

 

 

 

 

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

 

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

Oxycodone Hydrochloride

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

SI

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

MF

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

 

Capsule 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

MF

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Capsule 20 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

40

..

MF

 

 

Severe disabling pain associated with proven malignant neoplasia

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Oral solution 5 mg per 5 mL, 250 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Oral

2

..

MF

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 5 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 10 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 20 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 40 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

Tablet 80 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Chronic severe disabling pain associated with proven malignant neoplasia

Oral

40

..

MF

 

 

 

 

 

 

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

Oxycodone Pectinate

Suppository equivalent to 30 mg oxycodone

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain associated with proven malignant neoplasia

Rectal

24

..

PL

 

 

Chronic severe disabling pain not responding to non-narcotic analgesics where the total duration of narcotic analgesic treatment is less than 12 months

 

 

 

 

 

 

Initial treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics in a patient who has been receiving narcotic analgesic treatment for this condition, where the patient's pain management has been reviewed through consultation by the patient with another medical practitioner no earlier than 3 months prior to the date of the authority application and the clinical need for continuing narcotic analgesic treatment has been confirmed, and where the full name of the medical practitioner consulted and the date of consultation are included in the authority application

 

 

 

 

 

 

Continuing treatment of chronic severe disabling pain not responding to non-narcotic analgesics where the patient has previously been issued with an authority prescription under the Pharmaceutical Benefits Scheme for treatment beyond 12 months of chronic severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

Pantoprazole Sodium Sesquihydrate

Tablet (enteric coated), equivalent to 40 mg pantoprazole

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Zollinger-Ellison syndrome

Oral

30

5

PH

Paracetamol

Tablet 500 mg

Chronic arthropathies

Oral

300

4

AW, CH, FM, GM, HX, JT, PC, SW, TW

Pemetrexed Disodium Heptahydrate

Powder for I.V. infusion equivalent to 500 mg pemetrexed, vial

In compliance with authority procedures set out in subparagraph 11 (d):

Locally advanced or metastatic non-small cell lung cancer, after prior platinum-based chemotherapy, where treatment with paclitaxel or docetaxel is contraindicated

Injection

2

2

LY

 

 

 

 

 

 

 

 

Locally advanced or metastatic non-small cell lung cancer, after prior platinum-based chemotherapy, where intolerance to treatment with either docetaxel or paclitaxel has developed

 

 

 

 

 

 

Locally advanced or metastatic non-small cell lung cancer, after prior platinum-based chemotherapy, where treatment with either docetaxel or paclitaxel has been unsuccessful

 

 

 

 

 

 

Locally advanced or metastatic non-small cell lung cancer, after prior platinum-based chemotherapy, where transfer to docetaxel or paclitaxel is likely to result in adverse clinical consequences

 

 

 

 

Phenoxymethylpenicillin Potassium

Tablet equivalent to 250 mg phenoxymethylpenicillin

Prophylaxis of recurrent streptococcal infections (including rheumatic fever)

Oral

50

5

SI

 

Capsule equivalent to 250 mg phenoxymethylpenicillin

Prophylaxis of recurrent streptococcal infections (including rheumatic fever)

Oral

50

5

CS, FM, GM, HX

Rabeprazole Sodium

Tablet 20 mg (enteric coated)

Gastro-oesophageal reflux disease

Scleroderma oesophagus

Oral

30

5

JC

Ramipril

Pack containing 7 tablets 2.5 mg, 21 tablets 5 mg and 10 capsules 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Oral

1

..

AV

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

Ranitidine Hydrochloride

Tablet, effervescent, equivalent to 150 mg ranitidine

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Oral

60

5

GK

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

 

Syrup equivalent to 150 mg ranitidine per 10 mL, 300 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Adverse effects occurring with all of the base-priced drugs

Drug interactions occurring with all of the base-priced drugs

Oral

2

5

GK

 

 

Drug interactions expected to occur with all of the base-priced drugs

 

 

 

 

 

 

Transfer to a base-priced drug would cause patient confusion resulting in problems with compliance

 

 

 

 

Rifampicin

Capsule 150 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

..

AF

 

 

Leprosy in adults

 

 

 

 

 

Capsule 300 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

..

AF

 

 

Leprosy in adults

 

 

 

 

Risperidone

Tablet 0.5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Schizophrenia

 

 

 

 

 

Tablet 0.5 mg (orally disintegrating)

In compliance with authority procedures set out in subparagraph 11 (d):

Schizophrenia

Oral

56

5

JC

 

Tablet 1 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Schizophrenia

 

 

 

 

 

 

Adjunctive therapy to mood stabilisers for up to 6 months, of an episode of acute mania associated with bipolar I disorder

 

 

 

 

 

 

Tablet 1 mg (orally disintegrating)

In compliance with authority procedures set out in subparagraph 11 (d):

Schizophrenia

Oral

56

5

JC

 

 

Adjunctive therapy to mood stabilisers for up to 6 months, of an episode of acute mania associated with bipolar I disorder

 

 

 

 

Rituximab

Solution for I.V. infusion 100 mg in 10 mL vial

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of previously untreated, CD20 positive, diffuse large B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

Injection

2

7

RO

 

 

 

 

 

 

 

 

Treatment of symptomatic patients with previously untreated, CD20 positive, Stage III or IV, follicular, B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

 

 

 

 

 

Solution for I.V. infusion 500 mg in 50 mL vial

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of previously untreated, CD20 positive, diffuse large B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

Injection

1

7

RO

 

 

 

 

 

 

 

 

Treatment of symptomatic patients with previously untreated, CD20 positive, Stage III or IV, follicular, B-cell non-Hodgkin's lymphoma, in combination with chemotherapy

 

 

 

 

"S-26 LF"

Infant formula powder 900 g

In compliance with authority procedures set out in subparagraph 11 (d):

Proven chronic lactose intolerance in patients up to the age of 12 months, where the date of birth of the patient is included in the authority application, and where lactose intolerance has been proven either by the relief of symptoms on supervised withdrawal of lactose from the diet for 3 or 4 days and subsequent re-emergence of symptoms on rechallenge with lactose containing formulae or milk or food, or by the presence of not less than 0.5% reducing substance in stool exudate tested with copper sulfate diagnostic compound tablet

Oral

5

5

WY

 

 

 

 

 

 

Sertraline Hydrochloride

Tablet equivalent to 50 mg sertraline

Obsessive-compulsive disorder

Panic disorder where other treatments have failed or are inappropriate

Oral

30

5

AF, AW, PF

 

Tablet equivalent to 100 mg sertraline

Obsessive-compulsive disorder

Panic disorder where other treatments have failed or are inappropriate

Oral

30

5

AF, AW, PF

Temazepam

Tablet 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

5

AF, FM, SI

 

 

Malignant neoplasia (late stage)

 

 

 

 

 

 

For use by patients who are receiving long-term nursing care on account of age, infirmity or other condition in hospitals, nursing homes or residential facilities and who have been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

 

 

For use by a patient who is receiving long-term nursing care and in respect of whom a Carer Allowance is payable as a disabled adult and who has been demonstrated, within the past 6 months, to be benzodiazepine dependent by an unsuccessful attempt at gradual withdrawal

 

 

 

 

Temozolomide

Capsule 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

5

5

SH

 

 

Recurrence of anaplastic astrocytoma following standard therapy

 

 

 

 

 

 

Recurrence of glioblastoma multiforme following standard therapy

 

 

 

 

 

 

Glioblastoma multiforme following radiotherapy

 

 

 

 

 

Capsule 20 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

5

5

SH

 

 

Recurrence of anaplastic astrocytoma following standard therapy

 

 

 

 

 

 

Recurrence of glioblastoma multiforme following standard therapy

 

 

 

 

 

 

Glioblastoma multiforme following radiotherapy

 

 

 

 

 

Capsule 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

5

5

SH

 

 

Recurrence of anaplastic astrocytoma following standard therapy

 

 

 

 

 

 

Recurrence of glioblastoma multiforme following standard therapy

 

 

 

 

 

 

Glioblastoma multiforme following radiotherapy

 

 

 

 

Topiramate

Tablet 25 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Tablet 50 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Tablet 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Tablet 200 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Capsule 15 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid form dose of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Capsule 25 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid form dose of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

 

Capsule 50 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

60

5

JC

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where adverse events have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions have occurred with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where drug interactions are expected to occur with other suitable drugs available under the Pharmaceutical Benefits Scheme

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid dose form of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme would cause patient confusion resulting in problems with compliance

 

 

 

 

 

 

Treatment of partial epileptic seizures, primary generalised tonic-clonic epileptic seizures and seizures of the Lennox-Gastaut syndrome, which are not controlled satisfactorily by other anti-epileptic drugs in patients unable to take a solid form dose of topiramate, and where transfer to another suitable drug available under the Pharmaceutical Benefits Scheme is likely to result in adverse clinical consequences

 

 

 

 

Tramadol Hydrochloride

Capsule 50 mg

For dosage titration in chronic pain where aspirin or paracetamol alone is inappropriate or has failed

Oral

20

2

AF, AW, CH, CS, GX, TW

 

Tablet 50 mg (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

CS

 

Tablet 100 mg (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

AW, CS, HX

 

Tablet 150 mg (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

AW, CS, HX

 

Tablet 200 mg (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

40

..

AW, CS, HX

 

Oral drops 100 mg per mL, 10 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Severe disabling pain not responding to non-narcotic analgesics

Oral

2

..

CS

Valaciclovir Hydrochloride

Tablet equivalent to 500 mg valaciclovir

In compliance with authority procedures set out in subparagraph 11 (d):

Episodic treatment or suppressive therapy of moderate to severe recurrent genital herpes, where the diagnosis is confirmed microbiologically (by viral culture, antigen detection or nucleic acid amplification by polymerase chain reaction) but where commencement of treatment need not await confirmation of diagnosis

Oral

30

5

GK

 

 

 

 

 

 

 

Tablet equivalent to 500 mg valaciclovir

In compliance with authority procedures set out in subparagraph 11 (d):

Treatment of patients with herpes zoster within 72 hours of the onset of the rash

Oral

42

..

GK

 

 

 

 

 

 

 

 

Herpes zoster ophthalmicus

 

 

 

 

Vancomycin Hydrochloride

Powder for injection equivalent to 500 mg (500,000 I.U.) vancomycin activity

Endophthalmitis

Use initiated in a hospital for infections where vancomycin hydrochloride is an appropriate antibiotic

Injection

5

..

AS, MX

 

 

Benzydamine Hydrochloride

Mouth and throat rinse 22.5 mg per 15 mL, 500 mL

Oral application

1

..

MM

Bisacodyl

Tablet 5 mg

Oral

200

..

AE, AS

 

Suppositories 10 mg, 10

Rectal

3

..

BY, PP

 

Suppositories 10 mg, 12

Rectal

3

..

FL, PP

 

Enemas 10 mg in 5 mL, 25

Rectal

1

..

AS

Carmellose Sodium

Mouth spray 10 mg per mL, 25 mL

Oral application

1

..

HA

 

Mouth spray 10 mg per mL, 100 mL

Oral application

1

..

HA

Clonazepam

Tablet 500 micrograms

Oral

100

..

AF, RO

 

Tablet 2 mg

Oral

100

..

AF, RO

 

Oral liquid 2.5 mg per mL, 10 mL

Oral

2

..

RO

Diazepam

Tablet 2 mg

Oral

50

..

AF, AW, RO, SU

 

Tablet 5 mg

Oral

50

..

AF, AW, GM, RO, SU

Diclofenac Sodium

Tablet 25 mg (enteric coated)

Oral

100

..

AF, AW, BG, CH, GM, GX, HX, NV, TW

 

Tablet 50 mg (enteric coated)

Oral

50

..

AF, AW, CH, GM, GX, HX, NV, TW

 

Suppository 100 mg

Rectal

40

..

NV

Docusate Sodium with Bisacodyl

Suppositories 100 mg-10 mg, 5

Rectal

6

..

FM

Glycerol

Suppositories 700 mg, 12

Rectal

3

..

PP

 

Suppositories 1.4 g, 12

Rectal

3

..

PP

 

Suppositories 2.8 g, 12

Rectal

3

..

PP

Hyoscine Butylbromide

Injection 20 mg in 1 mL ampoule

Injection

5

..

BY

Ibuprofen

Tablet 200 mg

Oral

100

..

AF

 

Tablet 400 mg

Oral

90

..

AB

Indomethacin

Capsule 25 mg

Oral

100

..

AF, MK

 

Suppository 100 mg

Rectal

40

..

MK

Lactulose

Solution BP 3.34 g per 5 mL, 500 mL

Oral

1

..

AF, AW, GM, GX, HX, SM

Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride

Sachets containing powder for oral solution 13.125 g-350.7 mg-178.5 mg-46.6 mg, 30

Oral

1

..

NE

Methadone Hydrochloride

Oral liquid 25 mg per 5 mL, 200 mL

Oral

1

..

GK

Morphine Sulfate

Tablet 10 mg

Oral

20

..

MF

 

Tablet 20 mg

Oral

20

..

MF

 

Tablet 200 mg (controlled release)

Oral

20

..

MF

Naproxen

Tablet 250 mg

Oral

100

..

AF, RO

 

Tablet 500 mg

Oral

50

..

AF, RO

 

Tablet 750 mg (sustained release)

Oral

28

..

MD, RO

 

Tablet 1 g (sustained release)

Oral

28

..

MD, RO

 

Oral suspension 125 mg per 5 mL, 474 mL

Oral

1

..

RO

Naproxen Sodium

Tablet 550 mg

Oral

50

..

MD, RO

Nitrazepam

Tablet 5 mg

Oral

50

..

AF, VT

Oxazepam

Tablet 15 mg

Oral

50

..

AF, SI

 

Tablet 30 mg

Oral

50

..

AF, FM, SI

Paracetamol

Tablet 665 mg (modified release)

Oral

192

..

GC, ME

 

Suppositories 500 mg, 24

Rectal

1

..

GC

Promethazine Hydrochloride

Tablet 10 mg

Oral

50

..

AV

 

Tablet 25 mg

Oral

50

..

AV

 

Oral liquid 5 mg per 5 mL, 100 mL

Oral

1

..

AV

Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate

Enemas 3.125 g-450 mg-45 mg in 5 mL, 12

Rectal

2

..

PH

Sterculia with Frangula Bark

Granules 620 mg-80 mg per g, 500 g

Oral

1

..

NE

Sulindac

Tablet 100 mg

Oral

100

..

AF

 

Tablet 200 mg

Oral

50

..

AF

Temazepam

Tablet 10 mg

Oral

50

..

AF, FM, SI

 

Benzydamine Hydrochloride

Mouth and throat rinse 22.5 mg per 15 mL, 500 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where a painful mouth is a problem

Oral application

1

3

MM

 

 

Continuing supply for palliative care patients where a painful mouth is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Bisacodyl

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

200

3

AE, AS

 

 

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Suppositories 10 mg, 10

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

3

3

BY, PP

 

 

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Suppositories 10 mg, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

3

3

FL, PP

 

 

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Enemas 10 mg in 5 mL, 25

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

1

3

AS

 

 

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

 

Carmellose Sodium

Mouth spray 10 mg per mL, 25 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where dry mouth is a symptom

Oral application

1

3

HA

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where dry mouth is a symptom, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Mouth spray 10 mg per mL, 100 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where dry mouth is a symptom

Oral application

1

3

HA

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where dry mouth is a symptom, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Clonazepam

Tablet 500 micrograms

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

3

AF, RO

 

 

Initial supply, for up to 4 months, for palliative care patients for the prevention of epilepsy

 

 

 

 

 

 

Continuing supply for palliative care patients for the prevention of epilepsy, where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 2 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

3

AF, RO

 

 

Initial supply, for up to 4 months, for palliative care patients for the prevention of epilepsy

 

 

 

 

 

 

Continuing supply for palliative care patients for the prevention of epilepsy, where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Oral liquid 2.5 mg per mL, 10 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients for the prevention of epilepsy

Oral

2

3

RO

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients for the prevention of epilepsy, where consultation with a palliative care specialist or service has occurred

 

 

 

 

Diazepam

Tablet 2 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

Oral

50

3

AF, AW, RO, SU

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

Oral

50

3

AF, AW, GM, RO, SU

 

 

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Diclofenac Sodium

Tablet 25 mg (enteric coated)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

100

3

AF, AW, BG, CH, GM, GX, HX, NV, TW

 

 

 

 

 

 

 

Tablet 50 mg (enteric coated)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

50

3

AF, AW, CH, GM, GX, HX, NV, TW

 

 

 

 

 

 

 

 

 

 

 

 

 

Suppository 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

40

3

NV

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Docusate Sodium with Bisacodyl

Suppositories 100 mg-10 mg, 5

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Rectal

6

3

FM

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

 

Glycerol

Suppositories 700 mg, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

3

3

PP

 

 

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Suppositories 1.4 g, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

3

3

PP

 

 

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Suppositories 2.8 g, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

3

3

PP

 

 

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Hyoscine Butylbromide

Injection 20 mg in 1 mL ampoule

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where colicky pain is a symptom

Injection

5

3

BY

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where colicky pain is a symptom, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Ibuprofen

Tablet 200 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

3

AF

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 400 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

90

3

AB

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Indomethacin

Capsule 25 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

3

AF, MK

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Suppository 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

40

3

MK

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Lactulose

Solution BP 3.34 g per 5 mL, 500 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Oral

1

3

AF, AW, GM, GX, HX, SM

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Macrogol 3350 with Sodium Chloride, Sodium Bicarbonate and Potassium Chloride

Sachets containing powder for oral solution 13.125 g-350.7 mg-178.5 mg-46.6 mg, 30

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

Oral

1

3

NE

 

 

 

 

 

 

Methadone Hydrochloride

Oral liquid 25 mg per 5 mL, 200 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics

Oral

1

2

GK

 

 

 

 

 

 

 

 

Continuing supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Morphine Sulfate

Tablet 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

20

2

MF

 

 

Initial supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

 

Continuing supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 20 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

20

2

MF

 

 

Initial supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics

 

 

 

 

 

 

Continuing supply, for up to 3 months, for palliative care patients with severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 200 mg (controlled release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics

Oral

20

2

MF

 

 

 

 

 

 

 

 

Continuing supply, for up to 3 months, for palliative care patients with chronic severe disabling pain not responding to non-narcotic analgesics, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Naproxen

Tablet 250 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

3

AF, RO

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 500 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AF, RO

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 750 mg (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Oral

28

3

MD, RO

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 1 g (sustained release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

Oral

28

3

MD, RO

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Oral suspension 125 mg per 5 mL, 474 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent

Oral

1

3

RO

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem in patients unable to take a solid dose form of a non-steroidal anti-inflammatory agent, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Naproxen Sodium

Tablet 550 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

MD, RO

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Nitrazepam

Tablet 5 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AF, VT

 

 

Initial supply, for up to 4 months, for palliative care patients where insomnia is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where insomnia is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Oxazepam

Tablet 15 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AF, SI

 

 

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 30 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AF, FM, SI

 

 

Initial supply, for up to 4 months, for palliative care patients where anxiety is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where anxiety is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Paracetamol

Tablet 665 mg (modified release)

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated

Oral

192

3

GC, ME

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Suppositories 500 mg, 24

In compliance with authority procedures set out in subparagraph 11 (d):

Rectal

1

3

GC

 

 

Initial supply, for up to 4 months, for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated

 

 

 

 

 

 

Continuing supply for palliative care patients for analgesia or fever where alternative therapy cannot be tolerated, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Promethazine Hydrochloride

Tablet 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AV

 

 

Initial supply, for up to 4 months, for palliative care patients where nausea and/or vomiting is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where nausea and/or vomiting is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 25 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AV

 

 

Initial supply, for up to 4 months, for palliative care patients where nausea and/or vomiting is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where nausea and/or vomiting is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

 

 

Oral liquid 5 mg per 5 mL, 100 mL

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where nausea and/or vomiting is a problem

Oral

1

3

AV

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where nausea and/or vomiting is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Sorbitol with Sodium Citrate and Sodium Lauryl Sulfoacetate

Enemas 3.125 g-450 mg-45 mg in 5 mL, 12

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Rectal

2

3

PH

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Sterculia with Frangula Bark

Granules 620 mg-80 mg per g, 500 g

In compliance with authority procedures set out in subparagraph 11 (d):

Initial supply, for up to 4 months, for palliative care patients where constipation is a problem

Oral

1

3

NE

 

 

 

 

 

 

 

 

Continuing supply for palliative care patients where constipation is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

Sulindac

Tablet 100 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

100

3

AF

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Tablet 200 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AF

 

 

Initial supply, for up to 4 months, for palliative care patients where severe pain is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where severe pain is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

 

 

 

 

Temazepam

Tablet 10 mg

In compliance with authority procedures set out in subparagraph 11 (d):

Oral

50

3

AF, FM, SI

 

 

Initial supply, for up to 4 months, for palliative care patients where insomnia is a problem

 

 

 

 

 

 

Continuing supply for palliative care patients where insomnia is a problem, and where consultation with a palliative care specialist or service has occurred

 

 

 

 

 

Adrenaline Acid Tartrate

Injection equivalent to adrenaline 1 in 1,000, 1 mL

Injection

5

..

AP

Amoxycillin Trihydrate

Tablet, chewable, equivalent to 250 mg amoxycillin

Oral

20

..

GK

 

Capsule equivalent to 250 mg amoxycillin

Oral

20

..

AF, CH, CS, GK, GM, GX, HX, SI, TW

 

Capsule equivalent to 500 mg amoxycillin

Oral

20

..

AF, CH, CS, GK, GM, GX, HX, SI, TW

 

Sachet containing oral powder equivalent to 3 g amoxycillin

Oral

1

..

GK

Amoxycillin Trihydrate with Potassium Clavulanate

Tablet equivalent to 500 mg amoxycillin-125 mg clavulanic acid

Oral

10

..

AL, GK, HX, ME, SL, SZ

 

Tablet equivalent to 875 mg amoxycillin-125 mg clavulanic acid

Oral

10

..

AL, CH, GK, GX, HX, ME, SL, SZ, TW

Amoxycillin Trihydrate with Potassium Clavulanate and Water - Purified BP

Powder for oral suspension equivalent to 125 mg amoxycillin-31.25 mg clavulanic acid per 5 mL, 75 mL

Oral

1

..

AL, GK, HX, ME

 

Powder for oral suspension equivalent to 400 mg amoxycillin-57 mg clavulanic acid per 5 mL, 60 mL

Oral

1

..

AL, GK, HX, ME

Amoxycillin Trihydrate with Water - Purified BP

Powder for paediatric oral drops equivalent to 100 mg amoxycillin per mL, 20 mL

Oral

1

..

GK

 

Powder for oral suspension equivalent to 125 mg amoxycillin per 5 mL, 100 mL

Oral

1

..

AF, CH, CS, GK, GM, GX, HX, TW

 

Powder for oral suspension equivalent to 250 mg amoxycillin per 5 mL, 100 mL

Oral

1

..

AF, CH, GK, GM, GX, HX, SI, TW

 

Powder for oral suspension equivalent to 500 mg amoxycillin per 5 mL, 100 mL

Oral

1

..

SZ

Amphotericin

Lozenge 10 mg

Oral

20

..

BQ

Ampicillin Sodium

Powder for injection equivalent to 500 mg ampicillin

Injection

5

..

GM, LN

 

Powder for injection equivalent to 1 g ampicillin

Injection

5

..

AS, GM, LN

Ampicillin Trihydrate

Capsule equivalent to 250 mg ampicillin

Oral

24

..

AF

 

Capsule equivalent to 500 mg ampicillin

Oral

24

..

AF

Aspirin

Tablet, dispersible, 300 mg

Oral

96

..

RC

Atropine Sulfate

Injection 600 micrograms in 1 mL ampoule

Injection

10

..

AP

Benzathine Penicillin

Injection 900 mg in 2 mL cartridge-needle unit (for use with Tubex Injector)

Injection

1

..

AS

 

Powder for injection 900 mg

Injection

1

..

AS

Benztropine Mesylate

Injection 2 mg in 2 mL ampoule

Injection

5

..

MK

Benzydamine Hydrochloride

Mouth and throat rinse 22.5 mg per 15 mL, 500 mL

Oral application

1

..

MM

Benzylpenicillin Sodium

Powder for injection equivalent to 600 mg benzylpenicillin

Injection

10

..

CS

 

Powder for injection equivalent to 3 g benzylpenicillin

Injection

10

..

CS

Betamethasone Acetate with Betamethasone Sodium Phosphate

Injection 3 mg-3.9 mg in 1 mL ampoule

Injection

5

..

SH

Carbamazepine

Tablet 100 mg

Oral

200

..

BG, NV, SZ

 

Tablet 200 mg

Oral

200

..

AF, BG, NV, SZ

 

Tablet 200 mg (controlled release)

Oral

200

..

NV

 

Tablet 400 mg (controlled release)

Oral

200

..

NV

 

Oral suspension 100 mg per 5 mL, 300 mL

Oral

1

..

NV

Cefaclor Monohydrate

Tablet (sustained release) equivalent to 375 mg cefaclor

Oral

10

..

AF, AS, CH, GM, GX, LN, RA, TW

Cefaclor Monohydrate with Water - Purified BP

Powder for oral suspension equivalent to 125 mg cefaclor per 5 mL, 100 mL

Oral

1

..

AF, AS, AW, CH, GX, TW

 

Powder for oral suspension equivalent to 250 mg cefaclor per 5 mL, 75 mL

Oral

1

..

AF, AS, AW, CH, GX, TW

Cefotaxime Sodium

Powder for injection equivalent to 1 g cefotaxime

Injection

10

..

MX, SZ

 

Powder for injection equivalent to 2 g cefotaxime

Injection

10

..

MX, SZ

Cefuroxime Axetil

Tablet equivalent to 250 mg cefuroxime

Oral

14

..

GK

Cephalexin

Capsule 250 mg (anhydrous)

Oral

20

..

AF, AS, CH, GM, GX, HX, LN, RA, TW

 

Capsule 500 mg (anhydrous)

Oral

20

..

AF, AS, CH, GM, GX, HX, LN, RA, TW

Cephalexin with Water - Purified BP

Granules for oral suspension 125 mg per 5 mL, 100 mL

Oral

1

..

AF, AS, CH, GM, GX, LN, TW

 

Granules for oral suspension 250 mg per 5 mL, 100 mL

Oral

1

..

AF, AS, CH, GM, GX, LN, TW

Cephalothin Sodium

Powder for injection equivalent to 1 g cephalothin

Injection

10

..

AS, MX

Chloramphenicol

Eye drops 5 mg per mL, 10 mL

Application to the eye

1

..

PF, SI

Clindamycin Hydrochloride

Capsule equivalent to 150 mg clindamycin

Oral

25

..

KR, PH

Codeine Phosphate

Tablet 30 mg

Oral

20

..

FM

Codeine Phosphate with Paracetamol

Tablet 30 mg-500 mg

Oral

20

..

AL, CO, DK, FM, GK, SW

Diazepam

Tablet 2 mg

Oral

50

..

AF, AW, RO, SU

 

Tablet 5 mg

Oral

50

..

AF, AW, GM, RO, SU

 

Injection 10 mg in 2 mL ampoule

Injection

5

..

MX

Diclofenac Sodium

Tablet 25 mg (enteric coated)

Oral

100

..

AF, AW, BG, CH, GM, GX, HX, NV, TW

 

Tablet 50 mg (enteric coated)

Oral

50

..

AF, AW, CH, GM, GX, HX, NV, TW

 

Suppository 100 mg

Rectal

40

..

NV

Dicloxacillin Sodium

Capsule equivalent to 250 mg dicloxacillin

Oral

24

..

AF, BQ, SI

 

Capsule equivalent to 500 mg dicloxacillin

Oral

24

..

AF, BQ, SI

 

Powder for injection equivalent to 500 mg dicloxacillin

Injection

5

..

BQ

 

Powder for injection equivalent to 1 g dicloxacillin

Injection

5

..

BQ

Doxycycline Hydrochloride

Tablet equivalent to 100 mg doxycycline

Oral

7

..

AF, GM, PF, SI

 

Capsule equivalent to 100 mg doxycycline (containing enteric coated pellets)

Oral

7

..

FA, MX

Doxycycline Monohydrate

Tablet equivalent to 100 mg doxycycline

Oral

7

..

CH, GX, SZ, TW

Erythromycin

Capsule 250 mg (containing enteric coated pellets)

Oral

25

..

FA, MX

Erythromycin Ethyl Succinate

Tablet equivalent to 400 mg erythromycin

Oral

25

..

AB, AF

Erythromycin Ethyl Succinate with Water - Purified BP

Powder for oral liquid equivalent to 200 mg erythromycin per 5 mL, 100 mL

Oral

1

..

AB, AF

 

Powder for oral liquid equivalent to 400 mg erythromycin per 5 mL, 100 mL

Oral

1

..

AB, AF

Erythromycin Lactobionate

Powder for I.V. infusion equivalent to 1 g erythromycin, vial

Injection

5

..

AB

Flucloxacillin Magnesium with Water - Purified BP

Powder for oral suspension equivalent to 125 mg flucloxacillin per 5 mL, 100 mL

Oral

1

..

GK

 

Powder for oral suspension equivalent to 250 mg flucloxacillin per 5 mL, 100 mL

Oral

1

..

CS, GK

Flucloxacillin Sodium

Capsule equivalent to 250 mg flucloxacillin

Oral

24

..

AF, CS, GK, SI

 

Capsule equivalent to 500 mg flucloxacillin

Oral

24

..

AF, CS, GK, SI

 

Powder for injection equivalent to 500 mg flucloxacillin

Injection

5

..

CS, GM

 

Powder for injection equivalent to 1 g flucloxacillin

Injection

5

..

AS, CS, GM, MX

Glucagon Hydrochloride

Injection set containing 1 mg (1 I.U.) and 1 mL solvent in disposable syringe

Injection

1

..

NO

Glucose

I.V. infusion 278 mmol (anhydrous) per L, 1 L

Injection

5

..

BX

Glyceryl Trinitrate

Tablets 600 micrograms, 100

Oral

1

..

FM, SI

Hydrocortisone Acetate

Cream 10 mg per g, 30 g

Application

1

..

FM, SI

 

Cream 10 mg per g, 50 g

Application

1

..

DT, FM, SI

 

Ointment 10 mg per g, 30 g

Application

1

..

FM, SI

 

Ointment 10 mg per g, 50 g

Application

1

..

FM, SI

Hydrocortisone Sodium Succinate

Injection equivalent to 100 mg hydrocortisone with 2 mL solvent

Injection

6

..

PH

 

Injection equivalent to 250 mg hydrocortisone with 2 mL solvent

Injection

6

..

PH

Hydromorphone Hydrochloride

Tablet 2 mg

Oral

20

..

AB

 

Tablet 4 mg

Oral

20

..

AB

 

Tablet 8 mg

Oral

20

..

AB

 

Oral liquid 1 mg per mL, 473 mL

Oral

1

..

AB

 

Injection 2 mg in 1 mL ampoule

Injection

5

..

AB

 

Injection 10 mg in 1 mL ampoule

Injection

5

..

AB

 

Injection 50 mg in 5 mL ampoule

Injection

5

..

AB

Ibuprofen

Tablet 200 mg

Oral

100

..

AF

 

Tablet 400 mg

Oral

30

..

AB

Indomethacin

Capsule 25 mg

Oral

100

..

AF, MK

 

Suppository 100 mg

Rectal

40

..

MK

Ketoprofen

Capsule 200 mg (sustained release)

Oral

28

..

AV, HP

 

Suppository 100 mg

Rectal

40

..

AV

Lignocaine Hydrochloride

Injection 100 mg in 5 mL

Injection

5

..

PF

Lincomycin Hydrochloride

Injection equivalent to 600 mg lincomycin in 2 mL vial

Injection

5

..

PH

Methylprednisolone Acetate

Injection 40 mg in 1 mL vial

Injection

5

..

KR, PH

Metoclopramide Hydrochloride

Tablet 10 mg

Oral

25

..

AF, VT

 

Oral solution 5 mg per 5 mL, 100 mL

Oral

1

..

VT

 

Injection 10 mg in 2 mL ampoule

Injection

10

..

VT

Metronidazole

Tablet 200 mg

Oral

21

..

AF, AV, HP

 

Tablet 400 mg

Oral

5

..

AF

 

I.V. infusion 500 mg in 100 mL

Injection

5

..

BX

 

Suppositories 500 mg, 10

Rectal

1

..

AV

Metronidazole Benzoate

Oral suspension 320 mg per 5 mL, 100 mL

Oral

1

..

AV

Morphine Hydrochloride

Oral solution 2 mg per mL, 200 mL

Oral

1

..

MF

 

Oral solution 5 mg per mL, 200 mL

Oral

1

..

MF

 

Oral solution 10 mg per mL, 200 mL

Oral

1

..

MF

Morphine Sulfate

Tablet 30 mg

Oral

20

..

FM

 

Tablet 5 mg (controlled release)

Oral

20

..

MF

 

Tablet 10 mg (controlled release)

Oral

20

..

MF

 

Tablet 15 mg (controlled release)

Oral

20

..

MF

 

Tablet 30 mg (controlled release)

Oral

20

..

MF

 

Tablet 60 mg (controlled release)

Oral

20

..

MF

 

Tablet 100 mg (controlled release)

Oral

20

..

MF

 

Capsule 10 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 20 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 30 mg (controlled release)

Oral

10

..

MF

 

Capsule 50 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 60 mg (controlled release)

Oral

10

..

MF

 

Capsule 90 mg (controlled release)

Oral

10

..

MF

 

Capsule 100 mg (containing sustained release pellets)

Oral

20

..

GK

 

Capsule 120 mg (controlled release)

Oral

10

..

MF

 

Sachet containing controlled release granules for oral suspension, 20 mg per sachet

Oral

20

..

MF

 

Sachet containing controlled release granules for oral suspension, 30 mg per sachet

Oral

20

..

MF

 

Sachet containing controlled release granules for oral suspension, 60 mg per sachet

Oral

20

..

MF

 

Sachet containing controlled release granules for oral suspension, 100 mg per sachet

Oral

20

..

MF

 

Injection 10 mg in 1 mL ampoule

Injection

5

..

MX

 

Injection 15 mg in 1 mL ampoule

Injection

5

..

MX

 

Injection 30 mg in 1 mL ampoule

Injection

5

..

MX

Naloxone Hydrochloride

Injection 800 micrograms in 2 mL disposable injection set

Injection

1

..

CS

 

Injection 2 mg in 5 mL disposable injection set

Injection

1

..

CS

Naproxen

Tablet 250 mg

Oral

100

..

AF, RO

 

Tablet 500 mg

Oral

50

..

AF, RO

 

Tablet 750 mg (sustained release)

Oral

28

..

MD, RO

 

Tablet 1 g (sustained release)

Oral

28

..

MD, RO

Naproxen Sodium

Tablet 550 mg

Oral

50

..

MD, RO

Nitrazepam

Tablet 5 mg

Oral

25

..

AF, VT

Nystatin

Tablet 500,000 units

Oral

50

..

SI

 

Capsule 500,000 units

Oral

50

..

SI

 

Oral suspension 100,000 units per mL, 24 mL

Oral

1

..

BQ, SI

Oxazepam

Tablet 15 mg

Oral

25

..

AF, SI

 

Tablet 30 mg

Oral

25

..

AF, FM, SI

Oxycodone Hydrochloride

Tablet 5 mg

Oral

20

..

SI

 

Capsule 5 mg

Oral

20

..

MF

 

Capsule 10 mg

Oral

20

..

MF

 

Capsule 20 mg

Oral

20

..

MF

 

Oral solution 5 mg per 5 mL, 250 mL

Oral

1

..

MF

 

Tablet 5 mg (controlled release)

Oral

20

..

MF

 

Tablet 10 mg (controlled release)

Oral

20

..

MF

 

Tablet 20 mg (controlled release)

Oral

20

..

MF

 

Tablet 40 mg (controlled release)

Oral

20

..

MF

 

Tablet 80 mg (controlled release)

Oral

20

..

MF

Oxycodone Pectinate

Suppository equivalent to 30 mg oxycodone

Rectal

12

..

PL

Paracetamol

Tablet 500 mg

Oral

100

..

AW, CH, FM, GM, HX, JT, PC, SW, TW

 

Oral liquid 120 mg per 5 mL, 100 mL

Oral

1

..

SW

 

Oral liquid 240 mg per 5 mL, 200 mL

Oral

1

..

SW

Pethidine Hydrochloride

Injection 100 mg in 2 mL ampoule

Injection

5

..

MX

Phenoxymethylpenicillin Benzathine

Oral suspension equivalent to 125 mg phenoxymethylpenicillin per 5 mL, 100 mL

Oral

2

..

FM, SI

 

Oral suspension equivalent to 250 mg phenoxymethylpenicillin per 5 mL, 100 mL

Oral

2

..

FM, SI

Phenoxymethylpenicillin Potassium

Tablet equivalent to 250 mg phenoxymethylpenicillin

Oral

50

..

SI

 

Tablet equivalent to 500 mg phenoxymethylpenicillin

Oral

50

..

SI

 

Capsule equivalent to 250 mg phenoxymethylpenicillin

Oral

50

..

CS, FM, GM, HX

 

Capsule equivalent to 500 mg phenoxymethylpenicillin

Oral

50

..

CS, FM, GM, HX

Piroxicam

Dispersible tablet 10 mg

Oral

50

..

AF, GX, HX, PF

 

Dispersible tablet 20 mg

Oral

25

..

AF, CH, GX, HX, PF, TW

 

Capsule 10 mg

Oral

50

..

AF, CH, GX, PF, TW

 

Capsule 20 mg

Oral

25

..

AF, CH, GX, PF, TW

Procaine Penicillin

Injection 1.5 g in disposable syringe

Injection

5

..

SI

Prochlorperazine

Suppositories 3 mg, equivalent to 5 mg prochlorperazine maleate, 5

Rectal

1

..

AV

 

Suppositories 15 mg, equivalent to 25 mg prochlorperazine maleate, 5

Rectal

1

..

AV

Prochlorperazine Maleate

Tablet 5 mg

Oral

25

..

AV, HP

Prochlorperazine Mesylate

Injection 12.5 mg in 1 mL ampoule

Injection

10

..

AV

Promethazine Hydrochloride

Injection 50 mg in 2 mL ampoule

Injection

10

..

MX

Sodium Chloride

Injection 9 mg per mL, 10 mL

Injection

5

..

PF

 

I.V. infusion 154 mmol per L, 1 L

Injection

5

..

BX

 

I.V. infusion 513 mmol per L, 1 L

Injection

2

..

BX

Sodium Chloride with Glucose

I.V. infusion 31 mmol-222 mmol (anhydrous) per L, 1 L

Injection

5

..

BX

 

I.V. infusion 19 mmol-104 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

..

BX

 

I.V. infusion 39 mmol-69 mmol (anhydrous) per 500 mL, 500 mL

Injection

5

..

BX

Sulindac

Tablet 100 mg

Oral

100

..

AF

 

Tablet 200 mg

Oral

50

..

AF

Temazepam

Tablet 10 mg

Oral

25

..

AF, FM, SI

Ticarcillin Sodium with Potassium Clavulanate with any determined brand of Sodium Chloride Injection

Powder for injection equivalent to 3 g ticarcillin-100 mg clavulanic acid (with required solvent)

Injection

10

..

GK

Tramadol Hydrochloride

Capsule 50 mg

Oral

20

..

AF, AW, CH, CS, GX, TW

 

Tablet 50 mg (sustained release)

Oral

20

..

CS

 

Tablet 100 mg (sustained release)

Oral

20

..

AW, CS, HX

 

Tablet 150 mg (sustained release)

Oral

20

..

AW, CS, HX

 

Tablet 200 mg (sustained release)

Oral

20

..

AW, CS, HX

 

Oral drops 100 mg per mL, 10 mL

Oral

1

..

CS

 

Injection 100 mg in 2 mL ampoule

Injection

5

..

CS, HX

Triamcinolone Acetonide

Injection 10 mg in 1 mL ampoule

Injection

5

..

BQ

Trimethoprim with Sulfamethoxazole

Tablet 80 mg-400 mg

Tablet 160 mg-800 mg

Oral

Oral

10

10

..

..

AF, SI

AF, CH, GX, RO, SI, TW

 

 

Paediatric oral suspension 40 mg-200 mg per 5 mL, 100 mL

Oral

1

..

AF, RO, SI

Vancomycin Hydrochloride

Powder for injection equivalent to 500 mg (500,000 I.U.) vancomycin activity

Injection

2

..

AS, MX

 

Ibuprofen

Tablet 400 mg

Chronic arthropathies (including osteoarthritis) with an inflammatory component

Oral

90

..

AB

 

 

Bone pain due to malignant disease

 

 

 

 

Metronidazole

Tablet 400 mg

Treatment of anaerobic infections

Oral

21

..

AF, AV, HP

Paracetamol

Tablet 500 mg

Chronic arthropathies

Oral

300

..

AW, CH, FM, GM, HX, JT, PC, SW, TW

 

 

Creams 100 g 1

Dusting Powders 100 g 1

Ear Drops 15 mL 2

Eye Drops containing Cocaine Hydrochloride BP 15 mL ..

Eye Drops, Other 15 mL 5

Eye Lotions 200 mL 2

Inhalations 50 mL 1

Linctuses containing Codeine Phosphate BP 100 mL ..

Linctuses, Other 100 mL 2

Lotions 200 mL 2

Mixtures containing Codeine Phosphate BP 200 mL ..

Mixtures, Other 200 mL 4

Mixtures for Children containing Codeine Phosphate BP  100 mL ..

Mixtures for Children, Other 100 mL 4

Mouth Washes 200 mL 1

Nasal Instillations 15 mL 2

Ointments and Waxes 100 g 1

Paints 25 mL 1

Pastes containing Cocaine Hydrochloride BP 25 g ..

Pastes, Other 100 g 1

Powders for Internal Use 100 g 2

Solutions 200 mL 2

 

 

Notes to the Determinations under sections 85, 85A and 88 (No. PB 47 of 2006)

Note 1

The Determinations under sections 85, 85A and 88 (No. PB 47 of 2006) (in force under sections 85, 85A and 88 of the National Health Act 1953) as shown in this compilation is amended as indicated in the Tables below.

Table of Instruments

Title

Date of FRLI Registration

Date of
commencement

Application, saving or
transitional provisions

No. PB 47 of 2006

14 Nov 2006 (see F2006L03686)

1 Dec 2006

 

No. PB 1 of 2007

7 Dec 2006 (see F2006L03974)

1 Jan 2007

No. PB 6 of 2007

11 Jan 2007 (see F2007L00082)

1 Feb 2007

Table of Amendments

ad. = added or inserted      am. = amended      rep. = repealed      rs. = repealed and substituted

Provision affected

How affected

Para. 3...............

am. No. PB 6 of 2007

Para. 14..............

am. Nos. PB 1 and PB 6 of 2007

First Schedule

 

Part 1................

am. Nos. PB 1 and PB 6 of 2007

Part 2................

am. No. PB 6 of 2007

Third Schedule

 

Part 1................

am. Nos. PB 1 and PB 6 of 2007

 

Interactions

Authorises

All Versions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.