Pharmaceutical Schedule - effective 1 April 2003 (text extract)

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Contents

INTRODUCING PHARMAC ....................................... 5 PHARMAC and the Pharmaceutical Schedule ...... 6 Purpose of the Pharmaceutical Schedule ............ 8 Finding Information in the Pharmaceutical Schedule .................................. 8 Explaining drug entries ......................................... 9 Glossary ............................................................. 10 Units of Measure ................................................ 10 Abbreviations ...................................................... 10 Patient costs ...................................................... 11 Special Authority Applications ............................. 12 Community Exceptional Circumstances .............. 12 SECTION A: GENERAL RULES ............................... 1 3 INTRODUCTION ........................................................ 13 PART I ..................................................................... 13 INTERPRETATION AND DEFINITIONS ......................... 13 PART II .................................................................... 17 COMMUNITY PHARMACEUTICALS SUBSIDY ........... 17 PART III ................................................................... 18 PERIOD AND QUANTITY OF SUPPLY ....................... 18 3.1 Doctors’ and Midwives’ Prescriptions (other than oral contraceptives) ................. 18 3.2 Oral Contraceptives ...................................... 19 3.3 Dentists’ Prescriptions ................................. 20 3.4 Original Packs, and Certain Antibiotics ......... 20 PART IV ................................................................. 21 MISCELLANEOUS PROVISIONS .............................. 21 4.1 Bulk Supply Orders ....................................... 21 4.2 Practitioner’s Supply Orders ......................... 21 4.3 Wholesale Supply Orders .............................. 22 4.4 Retail Pharmacy and Hospital PharmacySpecialist Restriction ............................... 22 4.5 Amendment of Schedule .............................. 22 4.6 Conflict in Provisions .................................... 22 SECTION B: ALIMENTARY TRACT AND METABOLISM ANTACIDS AND ANTIFLATULENTS ........................... 23 Antacids and Reflux Barrier Agents ..................... 23 Phosphate Binding Agents .................................. 23 ANTIDIARRHOEALS ................................................. 23 Agents Which Reduce Motility ............................ 23 Rectal and Colonic Anti-inflammatories .............. 24 ANTIHAEMORRHOIDALS .......................................... 25 Corticosteroids ................................................... 25 Rectal Sclerosants ............................................. 25 Soothing Agents ................................................. 25 ANTISPASMODICS AND OTHER AGENTS ALTERING GUT MOTILITY .................................... 25 ANTIULCERANTS ................................................... Antisecretory and Cytoprotective ........................ Helicobacter Pylori Eradication ........................... H2 Antagonists ................................................... Proton Pump Inhibitors ....................................... Site Protective Agents ......................................... DIABETES .............................................................. Hyperglycaemic Agents ...................................... Insulin – Short-acting Preparations ..................... Insulin – Intermediate and Long-acting Preparations .................................................... Insulin – Rapid acting insulin analogues .............. Alpha glucosidase inhibitors ............................... Oral Hypoglycaemic Agents ................................ DIABETES MANAGEMENT ...................................... Glucose/Urine Testing ......................................... Glucose &/or Ketones/Urine Testing .................... Glucose/Blood Testing ........................................ Insulin Syringes and Needles .............................. LAXATIVES ............................................................. Bulk-forming Agents ........................................... Faecal Softeners ................................................. Osmotic Laxatives .............................................. Stimulant Laxatives ............................................ 26 26 26 27 28 28 29 29 29 29 30 30 31 31 31 31 32 32 33 33 34 34 34

DIGESTIVES INCLUDING ENZYMES ......................... 32

METABOLIC DISORDER AGENTS ............................ 35 Gaucher’s Disease ............................................. 35 MOUTH AND THROAT ............................................ Agents Used in Mouth Ulceration ........................ Oropharyngeal Anti-Infectives ............................. Other Oral Agents ............................................... Saliva Substitutes ............................................... VITAMINS ............................................................... Vitamin A ........................................................... Vitamin B Group ................................................. Vitamin C ........................................................... Vitamin D ........................................................... Vitamin E ........................................................... Vitamin K ........................................................... Multivitamin Preparations ................................... MINERALS ............................................................. Calcium ............................................................. Fluoride .............................................................. Iron .................................................................... Magnesium ........................................................ Zinc ................................................................... 35 35 35 36 36 36 36 36 37 37 38 38 38 38 38 38 38 38 38

BLOOD AND BLOOD FORMING ORGANS ANTIANAEMICS ...................................................... Hypoplastic and Haemolytic ............................... Iron Therapy ....................................................... Megaloblastic ..................................................... 39 39 40 40

DERMATOLOGICALS ANTIACNE PREPARATIONS ...................................... 63 ANTIBACTERIALS TOPICAL ..................................... 63 ANTIFUNGALS TOPICAL .......................................... 63 ANTIPRURITIC PREPARATIONS ................................ 65 CORTICOSTEROIDS - TOPICAL ................................ 66 Corticosteroids - Plain ........................................ 66 Corticosteroids - Combination ............................ 68 DISINFECTING AND CLEANSING AGENTS ................ 68 DUSTING POWDERS ............................................... 69 BARRIER CREAMS AND EMOLLIENTS ..................... 69 Barrier Creams ................................................... 69 Emollients ........................................................... 69 Other Dermatological Bases ................................ 70 MINOR SKIN INFECTIONS ........................................ 70 PARASITICIDAL PREPARATIONS .............................. 70 PSORIASIS AND ECZEMA PREPARATIONS .............. 71 SCALP PREPARATIONS ........................................... 73 SUNSCREENS ......................................................... 74 WART AND CORN PREPARATIONS .......................... 74 OTHER SKIN PREPARATIONS ................................... 75 Antineoplastics ................................................... 75 Topical Analgesia ................................................ 75 Wound Management Products ........................... 75 GENITO URINARY SYSTEM CONTRACEPTIVES – NON-HORMONAL ................... 76 Condoms ............................................................ 76 Spermicidal Agents ............................................. 76 Contraceptive Devices ........................................ 76 CONTRACEPTIVES – HORMONAL ............................ 77 Combined Oral Contraceptives ............................ 77 Progestogen-only Contraceptives ....................... 79 Emergency Contraceptives ................................. 79 ANTIANDROGEN ORAL CONTRACEPTIVES .............. 79 GYNAECOLOGICAL ANTI-INFECTIVES ...................... 80 IMPOTENCE TREATMENT ......................................... 80 MYOMETRIAL AND VAGINAL HORMONE PREPARATIONS ................................. 80 PREGNANCY TESTS - HCG URINE .......................... 81 URINARY AGENTS .................................................. 81 Alpha Adrenoceptor Blockers .............................. 81 Other urinary agents ........................................... 81 URINARY TRACT INFECTIONS .................................. 81 HORMONE PREPARATIONS - SYSTEMIC EXCLUDING CONTRACEPTIVE HORMONES ANABOLIC AGENTS ................................................ 82 CALCIUM HOMEOSTASIS ....................................... 82

ANTIFIBRINOLYTICS, HAEMOSTATICS AND LOCAL SCLEROSANTS ................................ 40 Vitamin K ............................................................ 41 ANTITHROMBOTIC AGENTS ..................................... 41 Antiplatelet Agents ............................................. 41 Heparin and Antagonist Preparations .................. 42 Oral Anticoagulants ............................................. 42 FLUIDS AND ELECTROLYTES ................................... 42 Intravenous Administration ................................. 42 Oral Administration ............................................. 43 LIPID MODIFYING AGENTS ...................................... 44 Fibrates .............................................................. 44 Other lipid modifying agents ................................ 44 Resins ................................................................ 44 HMG CoA Reductase Inhibitors (Statins) ............ 45 New Zealand Cardiovascular Guideline Group statement. ....................................................... 46 CARDIOVASCULAR SYSTEM CARDIOVASCULAR RISK CHARTS .......................... 50 ADRENERGIC NEURONE BLOCKERS ...................... 52 ALPHA ADRENOCEPTOR BLOCKERS ...................... 52 AGENTS AFFECTING THE RENIN-ANGIOTENSIN SYSTEM ............................................................. 52 ACE Inhibitors ..................................................... 52 ACE Inhibitors with Diuretics ............................... 54 Angiotensin II Antagonists ................................... 54 ANTIARRHYTHMICS ................................................ 55 ANTIHYPOTENSIVES ............................................... 56 BETA ADRENOCEPTOR BLOCKERS .......................... 56 CALCIUM CHANNEL BLOCKERS ............................. 58 Dihydropyridine Calcium Channel Blockers (DHP CCBs) ...................................... 58 Other Calcium Channel Blockers ......................... 59 CARDIAC GLYCOSIDES ........................................... 59 CENTRALLY ACTING AGENTS ................................. 59 DIURETICS .............................................................. 60 Loop Diuretics ..................................................... 60 Potassium Sparing Diuretics ............................... 60 Potassium Sparing Combination Diuretics ........... 60 Thiazide and Related Diuretics ............................ 60 NITRATES ................................................................ 61 SMOKING CESSATION ............................................. 61 SYMPATHOMIMETICS .............................................. 62 VASODILATORS ..................................................... 62

Alendronate for Osteoporosis .............................. 82 Alendronate for Pagets Disease .......................... 82 Other Treatments ................................................ 82 CORTICOSTEROIDS AND RELATED AGENTS FOR SYSTEMIC USE ........................................... 83 CORTICOSTEROIDS - INJECTABLES ......................... 84 SEX HORMONES NON CONTRACEPTIVE .................. 84 Androgen Agonists and Antagonists ................... 84 HORMONE REPLACEMENT THERAPY - SYSTEMIC .. 85 Oestrogens ......................................................... 85 Progestogens ..................................................... 86 Progestogen and oestrogen combined preparations ..................................... 86 OTHER OESTROGEN PREPARATIONS ....................... 87 OTHER PROGESTOGEN PREPARATIONS ................. 88 THYROID AND ANTITHYROID AGENTS .................... 88 TROPHIC HORMONES ............................................ 89 GnRH Analogues ................................................ 89 VASOPRESSIN AGONISTS ...................................... 90 OTHER ENDOCRINE AGENTS ................................. 90 INFECTIONS - AGENTS FOR SYSTEMIC USE ANTHELMINTICS ..................................................... 91 ANTIBACTERIALS .................................................... 91 Cephalosporins and Cephamycins ...................... 91 Macrolides .......................................................... 93 Penicillins ........................................................... 94 Tetracyclines ...................................................... 96 Other Antibiotics ................................................. 96 ANTIFUNGALS ........................................................ 98 ANTIMALARIALS ..................................................... 98 ANTITRICHOMONAL AGENTS .................................. 98 ANTITUBERCULOTICS AND ANTILEPROTICS ............ 99 ANTIVIRALS ............................................................ 99 Hepatitis B Treatment ......................................... 99 HERPES TREATMENT ........................................... First episode genital herpes .............................. Recurrent episodes of genital herpes ................ Acute herpes zoster .......................................... Herpes Treatment Guidelines ............................ ANTIRETROVIRALS .............................................. Non-nucleoside reverse transcriptase inhibitors Nucleoside reverse transcriptase inhibitors ....... Protease inhibitors ............................................ 101 101 101 101 101 106 107 107 108

ANTIRHEUMATOID AGENTS ................................. 112 CORTICOSTEROIDS - INJECTABLES ..................... 112 ENZYMES ............................................................. 113 HYPERURICAEMIA AND ANTIGOUT ...................... 113 MUSCLE RELAXANTS .......................................... 113 NERVOUS SYSTEM ANAESTHETICS ..................................................... 115 Local ................................................................ 115 ANALGESICS ........................................................ 115 Antipyretics and Non-Opioid Analgesics ............ 115 Antipyretics with Codeine ................................. 116 Opioid Analgesics ............................................. 116 ANTIDEPRESSANTS .............................................. 118 Cyclic and Related Agents ................................ 118 Monoamine-Oxidase Inhibitors (MAOIs) Non Selective ................................................. 119 Monoamine-Oxidase Type A Inhibitors ............... 119 Selective Serotonin Reuptake Inhibitors ............ 120 Other Antidepressants ...................................... 121 ANTIEPILEPSY DRUGS .......................................... 121 Agents for Control of Status Epilepticus ............ 121 Control of Epilepsy ............................................ 121 New antiepilepsy drugs ..................................... 122 ANTIMIGRAINE PREPARATIONS ............................. 123 Acute Migraine Treatment ................................. 123 Prophylaxis of Migraine ..................................... 124 ANTINAUSEA AND VERTIGO AGENTS .................... 124 ANTIPARKINSON AGENTS ..................................... 126 Dopamine Agonists and Related Agents ........... 126 Anticholinergics ................................................ 127 ANTIPSYCHOTICS ................................................. 127 General ............................................................. 127 Depot Injections ................................................ 129 ANXIOLYTICS ......................................................... 130 SEDATIVES AND HYPNOTICS ................................ 131 OTHER CNS AGENTS ............................................ 132 ONCOLOGY AGENTS AND IMMUNOSUPPRESSANTS CHEMOTHERAPEUTIC AGENTS ............................. 133 Alkylating Agents .............................................. 133 Antimetabolites ................................................. 133 Other Cytotoxic Agents ..................................... 134 Protein-tyrosine Kinase Inhibitors ..................... 134 ENDOCRINE THERAPY ........................................... 135 IMMUNOSUPPRESSANTS ..................................... 137 Cytotoxic Immunosuppressants ........................ 137 Immune Modulators .......................................... 137 Multiple Sclerosis Treatment ............................. 139 Other Immunosuppressants .............................. 141

URINARY TRACT INFECTIONS .............................. 108 MUSCULO-SKELETAL SYSTEM ANTICHOLINESTERASES ....................................... 109 ANTI-INFLAMMATORY NON STEROIDAL DRUGS (NSAIDS) ............................................. 109 NSAIDs Other ................................................... 111

RESPIRATORY SYSTEM AND ALLERGIES ANTIALLERGY PREPARATIONS .............................. 144 ANTIHISTAMINES ................................................... 144 ASTHMA PREVENTATIVE MEDICINES ................... 146 Inhaled corticosteroids - metered dose inhalers .......................................... 146 Inhaled corticosteroids - metered dose inhalers with spacers ..................... 146 Inhaled corticosteroids - breath activated devices ................................... 147 Inhaled corticosteroids - nebuliser solution .... 148 Nedocromil ..................................................... 148 Sodium cromoglycate .................................... 148 BRONCHODILATORS ............................................ 148 Inhaled beta-adrenoceptor agonists - metered dose inhalers .......................... 148 Inhaled beta-adrenoceptor agonists - breath activated devices ....................... 148 Inhaled beta-adrenoceptor agonists - long acting ........................................... 149 Inhaled beta-adrenoceptor agonists - nebuliser solutions ............................... 151 Inhaled anticholinergic agents - metered dose inhalers .......................... 151 Inhaled anticholinergic agents - nebuliser solutions ............................... 151 Inhaled beta-adrenoceptor agonist and anticholinergic agents - metered dose inhalers .......................................... 152 Inhaled beta-adrenoceptor agonist and anticholinergic agents nebuliser solution ................................... 152 Beta-adrenoceptor agonists long-acting tablets .................................. 152 Beta-adrenoceptor agonists - oral liquids ....... 152 Beta-adrenoceptor agonists - injection ........... 153 Theophylline derivatives ................................. 153 COUGH PREPARATIONS ....................................... 154 CYSTIC FIBROSIS ................................................. 154 NASAL PREPARATIONS ........................................ 154 Allergy Prophylactics ........................................ 154 RESPIRATORY DEVICES ....................................... 155 SENSORY ORGANS EAR PREPARATIONS ............................................. 156 EYE PREPARATIONS .............................................. 157 Anti-Infective Preparations ............................... 157 Corticosteroids and Other Anti-Inflammatory Preparations .................................................. 158 Glaucoma Preparations .................................... 159 Mydriatics and Cycloplegics ............................. 161 Preparations for Tear Deficiency ....................... 162 Other Eye Preparations ..................................... 162

VARIOUS AGENTS USED IN THE TREATMENT OF POISONINGS ................................................ 163 DETECTION OF SUBSTANCES IN URINE ................. 163 SECTION C: EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS ................... 164 Standard Formulae ........................................... 168 SECTION D: SPECIAL FOODS ............................... 172 NUTRIENT MODULES ........................................... 174 Carbohydrate ................................................. 174 Fat ................................................................. 174 Carbohydrate and Fat ..................................... 174 Protein .......................................................... 175 ORAL SUPPLEMENTS .......................................... 175 ORAL SUPPLEMENTS/COMPLETE DIET (NASOGASTRIC/GASTROSTOMY TUBE FEED) .. 176 Diabetic .......................................................... 177 Paediatric ....................................................... 177 Standard Products ......................................... 178 Added Fibre Products ..................................... 178 Specialised Complete Foods .......................... 178 FOOD THICKENERS ............................................... 179 GLUTEN FREE FOODS ........................................... 179 Bread and Bake Mixes ................................... 179 Pastas ........................................................... 180 FOODS FOR PKU AND OTHER INBORN ERRORS OF METABOLISM ............................. 180 Phenyl Free Bread Mixes ............................... 181 Phenyl Free Pastas ........................................ 181 Protein Supplements ...................................... 181 MULTI VITAMIN SUPPLEMENTS ............................. 182 INFANT FORMULAE ............................................... 182 Infant Formulae for Gastrointestinal and Other Malabsorptive Problems ................................ 182 SECTION E: PART I PRACTITIONER’S AND WHOLESALE SUPPLY ORDERS .................... 184 Pharmaceuticals that may be obtained on a Practitioner’s Supply Order ............................ 184 Pharmaceuticals that may be obtained on a Wholesale Supply Order ................................. 186 SECTION E PART II: REMOTE AREAS ................... 187 SECTION F: PHARMACEUTICALS EXEMPT FROM MONTHLY DISPENSING ..................... 189 SECTION G: SAFETY CAP MEDICINES ................ 191 INDEX .................................................................. 194 AUTHORITY TO SUBSTITUTE FORM ................... 215

Introducing PHARMAC

PHARMAC, the Pharmaceutical Management Agency, is a Crown entity established pursuant to the New Zealand Public Health and Disability Act 2000. The primary objective of PHARMAC is to secure for eligible people in need of pharmaceuticals, the best health outcomes that are reasonably achievable from pharmaceutical treatment and from within the amount of funding provided. The PHARMAC Board consists of up to six members appointed by the Minister of Health. All decisions relating to PHARMAC’s operation are made by or under the authority of the Board. In particular, Board members decide on the strategic direction of PHARMAC and may decide which community pharmaceuticals should be subsidised and at what levels, and determine national prices for some pharmaceuticals to be purchased by and used in DHB Hospitals, and whether or not special conditions are to be applied to such purchases.

Members of the PHARMAC Board

Richard Waddel Gregor Coster Liz Coutts Karen Guilliland Helmut Modlik David Moore Decisions taken by the PHARMAC Board members, or made under the authority of the Board, incorporate a balanced view of the needs of prescribers and patients. The aim is to achieve long-term gains and efficient ways of making pharmaceuticals available to the community and for DHB Hospitals to purchase them. The functions of PHARMAC are to perform the following, within the amount of funding provided to it in the Pharmaceutical Budget or to DHBs from their own budgets for the use of pharmaceuticals in their hospitals, as applicable, and in accordance with its annual plan and any directions given by the Minister (Section 65 of the Act): a) to maintain and manage a pharmaceutical schedule that applies consistently throughout New Zealand, including determining eligibility and criteria for the provision of subsidies; b) to manage incidental matters arising out of (a), including in exceptional circumstances providing for subsidies for the supply of pharmaceuticals not on the pharmaceutical schedule; c) to engage as it sees fit, but within its operational budget, in research to meet its objectives as set out in Section 47(a) of the Act; d) to promote the responsible use of pharmaceuticals; e) to manage the purchasing of any or all pharmaceuticals, whether used either in a hospital or outside it, on behalf of DHBs; f) any other functions given to PHARMAC by or under any enactment or authorised by the Minister.

Decision Criteria

PHARMAC updates the Pharmaceutical Schedule at regular intervals to notify prescribers, pharmacists, hospital managers and patients of changes to Community Pharmaceutical subsidies and the prices for Hospital Pharmaceuticals. In making decisions about amendments to the Pharmaceutical Schedule, PHARMAC is guided by its Operating Policies and Procedures, as amended or supplemented from time to time. PHARMAC takes into account the following criteria when making decisions about Community Pharmaceuticals: • the health needs of all eligible people within New Zealand (eligible defined by the Government’s then current rules of eligibility); • the particular health needs of Maori and Pacific peoples; • the availability and suitability of existing medicines, therapeutic medical devices and related products and related things; • the availability and suitability of existing medicines, therapeutical medical devices and related products and related things; • the clinical benefits and risks of pharmaceuticals; • the cost-effectiveness of meeting health needs by funding pharmaceuticals rather than using other publicly funded health and disability support services; • the budgetary impact (in terms of the pharmaceutical budget and the Government’s overall health budget) of any changes to the Pharmaceutical Schedule; • the direct cost to health service users; • the Government’s priorities for health funding, as set out in any objectives notified by the Crown to PHARMAC, or in PHARMAC’s Funding Agreement, or elsewhere; and • such other criteria as PHARMAC thinks fit. PHARMAC will carry out appropriate consultation when it intends to take any such “other criteria” into account. The Operating Policies and Procedures, including any supplements, also describe the way in which PHARMAC determines the level of subsidy or purchase price payable for each Community Pharmaceutical or Hospital Pharmaceutical, respectively. Copies of PHARMAC’s Operating Policies and Procedures and of any applicable supplements are available on the PHARMAC website (www.pharmac.govt.nz), or on request. The decision criteria for Hospital Pharmaceuticals are set out in the hospital supplement to the Operating Policies and Procedures and in the introductory part of Section H of the Pharmaceutical Schedule. 5

PHARMAC and the Pharmaceutical Schedule:

PHARMAC manages the national Pharmaceutical Schedule, which lists: • Pharmaceuticals available in the community and subsidised by the Government with funding from the Pharmaceutical Budget; and • some Pharmaceuticals purchased by DHBs for use in their hospitals, and includes those Hospital Pharmaceuticals for which national prices have been negotiated by PHARMAC. In the community approximately 3000 Pharmaceuticals are subsidised by the Government. Most are available to all eligible people within New Zealand on prescription by a medical doctor. Some are listed with guidelines or conditions such as ‘only if prescribed for a dialysis patient’ or ‘Special Authority – Retail Pharmacy’, to ensure that Pharmaceuticals are used by those people who are most likely to benefit from them. Pharmaceuticals provided to patients for use while in DHB hospitals are not covered by Sections A to G of the Pharmaceutical Schedule. Section H of the Pharmaceutical Schedule is not a comprehensive list of Pharmaceuticals that are used within the DHB Hospitals. Section H of the Pharmaceutical Schedule includes Pharmaceuticals that can be purchased at a national price by DHBs for use in their hospitals. These are referred to as National Contract Pharmaceuticals. Section H of the Pharmaceutical Schedule also identifies Pharmaceutical Cancer Treatments that DHBs have been directed to fund for use in their hospitals and/or in association with services provided in their hospitals, as well as new Pharmaceuticals used in hospitals, which have been or are being assessed by PHARMAC, the results of that analysis being available to DHB Hospitals via PHARMAC’s website. A list of Discretionary Community Supply Pharmaceuticals, in Section H of the Pharmaceutical Schedule, when published, will identify those products that currently are not subsidised from the Pharmaceutical Budget as Community Pharmaceuticals in Sections A to G of the Pharmaceutical Schedule but which DHBs can at their discretion fund for use in the community from their own budgets without specific Hospital Exceptional Circumstances approval.

The PHARMAC Team

The PHARMAC team has a wide range of expertise in health, medicine, economics, commerce, critical analysis, and policy development and implementation.

Chief Executive PTAC Secretary Therapeutic Group Manager Analyst Demand Side Manager Manager, Analysis and Assessment Stuart Bruce Manager, Communications and Relationships Mary Chesterfield Schedule Administrator Andrew Davies Tender Analyst Cristine Della Barca Manager, Hospital Pharmaceuticals Sean Dougherty Analyst Jan Edwards Finance Manager Ursula Egan Schedule Advisor Simon England Communications Advisor Helen Frost Receptionist

Wayne McNee Wendy Adams Raylene Andrews Jason Arnold Tracey Barron Matthew Brougham

Natalie Ganley John Geering Rachel Grocott

Therapeutic Group Manager IT Manager Hospital Pharmaceuticals Analyst Katie Harris Therapeutic Group Assistant Derek Kan Analyst Abby Laurenson Manager, Corporate Adam McRae Therapeutic Group Intern Peter Moodie Medical Director Jessica Nisbet Receptionist Jan Quin Project Manager Melanie Pemberton Executive Assistant Matthew Perkins Hospital Projects Advisor Sarah Schmitt Therapeutic Group Manager Martin Szuba Therapeutic Group Manager Jeanine van Kradenburg Demand Side Manager Rachel Wilson Manager, Demand Side

PHARMAC’s clinical advisors

Pharmacology and Therapeutics Advisory Committee (PTAC) PHARMAC works closely with the Pharmacology and Therapeutics Advisory Committee (PTAC), an expert medical committee which provides independent advice to PHARMAC on health needs and the clinical benefits of particular pharmaceuticals for use in the community and/or in DHB Hospitals. The committee members are all senior, practising clinicians. The chair of PTAC sits with the PHARMAC Board in an advisory capacity. PTAC helps decide which community pharmaceuticals are to be subsidised from public monies by making recommendations to PHARMAC. Part of the role of PTAC is to review whether Community Pharmaceuticals already listed on the Schedule should continue to receive Government funds. The resources freed up can be used to subsidise other community pharmaceuticals with a greater therapeutic worth. PHARMAC may obtain clinical advice from PTAC in relation to national purchasing strategies for Hospital Pharmaceuticals. There may be additional specialist hospital representatives on PTAC subcommittees, or additional PTAC subcommittees, where PHARMAC considers this necessary. PTAC members are: John Hedley MBChB, FRACP FACCP Member Thoracic, Cardiac and Gastroenterology , , Societies of Australia and New Zealand, Chairman Carl Burgess MD, MRCP (UK), FRACP pharmacologist , Jim Lello BHB, MBChB, DCH, FRNZCGP general practitioner , Coleen Lewis MBChB, general practitioner Peter Pillans MBChB, FCP FRACP pharmacologist , , Anthony Ruakere MBChB, Dip Obs, FRNZCGP general practitioner , Tom Thompson MBChB, FRACP physician , Paul Tomlinson MBChB, MD, MRCP FRACP BSc, paediatrician , , Contact PTAC C/- PTAC Secretary Pharmaceutical Management Agency PO Box 10 254, WELLINGTON

Purpose of the Pharmaceutical Schedule

The purpose of the Schedule is to list: • the Community Pharmaceuticals that are subsidised by the Government and to show the amount of the subsidy paid to contractors, as well as the manufacturer’s price (if it differs from the Subsidy) and any access conditions that may apply; and • some Hospital Pharmaceuticals that are purchased and used by DHB Hospitals, including those for which national prices have been negotiated by PHARMAC. The purpose of the Schedule is not to show the final cost to Government of subsidising each Community Pharmaceutical or to DHBs in purchasing each Hospital Pharmaceutical since that will depend on any rebate and other arrangements PHARMAC has with the supplier and, for some Hospital Pharmaceuticals, on any logistics arrangements put in place by individual DHB Hospitals.

Finding Information in the Pharmaceutical Schedule

Community Pharmaceuticals

For Community Pharmaceuticals, the Schedule is organised in a way to help the reader find Community Pharmaceuticals, which may be used to treat similar conditions. To do this, Community Pharmaceuticals are first classified anatomically, originally based on the Anatomical Therapeutic Chemical (ATC) system, and then further classified under section headings structured for the New Zealand medical system. • Section A lists the General Rules in relation to Community Pharmaceuticals and related products. • Section B lists Community Pharmaceuticals and related products by anatomical classification, which are further divided into one or more therapeutic headings. Community Pharmaceuticals used to treat similar conditions are grouped together. • Section C lists the rules in relation to Extemporaneously Compounded Products (ECPs) and Community Pharmaceuticals that will be subsidised when extemporaneously compounded. • Section D lists the rules in relation to Special Foods and the Special Foods that are subsidised. • Section E Part I lists the Community Pharmaceuticals that are subsidised on a Practitioner’s Supply Order (PSO) and Wholesale Supply Order (WSO). • Section E Part II lists remote areas for the purpose of PSOs. • Section F lists the Community Pharmaceuticals that are exempt from monthly dispensing and related rules. • Section G lists the Community Pharmaceuticals eligible for reimbursement of safety Cap and related rules. The listings are displayed alphabetically (where practical) within each level of the classification system. Each anatomical section contains a series of therapeutic headings, some of which may contain a further classification level. Where a Community Pharmaceutical is used in more than one therapeutic area, they may be cross-referenced. The therapeutic headings in the Pharmaceutical Schedule do not necessarily correspond to the therapeutic groups and therapeutic subgroups, which PHARMAC establishes for the separate purpose of determining the level of subsidy to be paid for each Community Pharmaceutical. The index located at the back of the book in which Sections A–G of the Pharmaceutical Schedule are published can be used to find page numbers for generic chemical entities, or product brand names.

Hospital Pharmaceuticals

• Section H lists Pharmaceuticals that DHBs fund from their own budgets. The Hospital Pharmaceuticals are grouped into the following Parts in Section H: - Part I lists the rules in relation to Hospital Pharmaceuticals. - Part II lists Hospital Pharmaceuticals for which national contracts exist (National Contract Pharmaceuticals). These are listed alphabetically by generic chemical entity name and line item, the relevant Price negotiated by PHARMAC and, if applicable, an indication of whether it has Hospital Supply Status (HSS) and any associated Discretionary Variance (DV) Pharmaceuticals and DV Limit. - Part III lists Assessed Pharmaceuticals, which have been or are being assessed by PHARMAC and, where such assessment is available, PHARMAC’s findings regarding the use of the Assessed Pharmaceuticals in hospitals. DHB Hospitals are not obliged to act in accordance with those findings. - Part IV lists Discretionary Community Supply Pharmaceuticals, which are not Community Pharmaceuticals, but which a DHB Hospital can, in its discretion, fund for use in the community from its own budget. - Part V lists Pharmaceutical Cancer Treatments that DHBs have been directed to fund for use in their hospitals and/or in association with services provided in their hospitals. The index located at the back of the Section H supplement can be used to find page numbers for generic chemical entities, or product brand names, for Hospital Pharmaceuticals. 8

Explaining drug entries

The Pharmaceutical Schedule lists pharmaceuticals subsidised by the Government, the amount of that subsidy paid to contractors, the supplier’s price and the access conditions that may apply.

Example

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

Brand or manufacturer’s name Interchangeable Multisource Medicine Sole subsidised supply product

Practitioner’s Supply Order (or WSO for Wholesale Supply Order) Safety cap reimbursed

Fully subsidised product Original Pack - Subsidy is rounded up to a multiple of whole packs Subsidy paid on a product before mark-ups and GST

Conditions of and restricitions on prescribing (including Special Authority where it applies)

Quantity the Subsidy applies to Manufacturer’s Price if different from Subsidy

Glossary

Units of Measure

gram ............................................................ g kilogram ..................................................... kg international unit .......................................... iu microgram .................................................. µg

Abbreviations Ampoule ...................................................... Amp Capsule ........................................................ Cap Cream .......................................................... Crm Dispersible .................................................... Disp Effervescent ................................................... Eff Emulsion ...................................................... Emul Enteric Coated ................................................ EC Gelatinous ..................................................... Gel Granules ...................................................... Gran Injection ........................................................... Inj

BSO CBS

milligram .................................................... mg millilitre ....................................................... ml millimole ................................................ mmol unit ............................................................... u

Linctus ......................................................... Linc Liquid .............................................................. Liq Long Acting .................................................... LA Ointment ....................................................... Oint Sachet ......................................................... Sach Solution ........................................................ Soln Suppository ................................................. Supp Tablet ............................................................. Tab Tincture ........................................................ Tinc Trans Dermal Delivery System ..................... TDDS

Bulk Supply Order. Cost Brand Source. There is no set manufacturer’s price, and the Government subsidises the product at the price it is obtained by pharmacy. CE Compounded Extemporaneously. CPD Cost Per Dose. The Funder (as defined in Part I of the General Rules) cost of a standard dose, without mark-ups or fees and excluding GST. HSS hospital supply status, the status of being the brand of the relevant Hospital Pharmaceutical listed in Section H Part II as HSS, that DHBs are obliged to purchase subject to any DV Limit for that Hospital Pharmaceutical for the period of hospital supply, as awarded under an agreement between PHARMAC and the relevant pharmaceutical supplier. IMM Interchangeable Multi-source Medicine. The Ministry of Health publishes the list of products tested as being therapeutically equivalent, and which are therefore interchangeable by pharmacists. Such substitutions can only be made if the prescriber has provided the dispensing pharmacist with a signed authority to substitute. PSO Practitioner’s Supply Order. WSO Wholesale Supply Order. v Three months supply may be dispensed at one time if the exempted medicine is endorsed ‘certified exemption’ by the practitioner. Unit The smallest component of a pack on which the subsidy is based. For original pack (OP) products, the smallest unit is the pack itself in the size specified in the ‘per’ column. ‡ Safety cap required and subsidised for oral liquid formulations, including extemporaneously compounded preparations. Fully subsidised brand of a given medicine. Brands without the tick are not fully subsidised and may cost the patient a manufacturer’s surcharge. Sole Subsidised Supplier Only brand of this medicine subsidised. [HP1] Available from hospital pharmacies providing an outpatient dispensing service, and selected retail pharmacies in the Northern, Western Bay of Plenty, Wellington, Christchurch or South Canterbury regions that have an exclusive contract to dispense ‘Hospital Pharmacy’ [HP1] pharmaceuticals. [HP2] Available from any retail pharmacy in the Southern region. [HP3] Available from hospital pharmacies providing an outpatient dispensing service, and any retail pharmacy in the Northern, Midland, Central (including Nelson and Blenheim) and South Canterbury regions, and selected retail pharmacies in the Christchurch region that have an exclusive contract to dispense ‘Hospital Pharmacy’ [HP3] pharmaceuticals. [HP4] Available from hospital pharmacies and retail pharmacies with a Funder contract to dispense particular medicines. 10

Patient costs

Community Pharmaceutical costs met by the Government

Most of the cost of a subsidised prescription Community Pharmaceutical is met by the Government through the Pharmaceutical Budget. The Government pays a subsidy for the Community Pharmaceutical to Contractors, and a fee covering distribution and pharmacy dispensing services. The subsidy paid to Contractors does not necessarily represent the final cost to Government of subsidising a particular Community Pharmaceutical. The final cost will depend on the nature of PHARMAC’s contractual arrangements with the supplier. Fully subsidised medicines are identified with a in the product’s Schedule listing. CARBAMAZEPINE Tab 200 mg .................................... 14.53 Fully subsidised brand (19.14) Higher priced brand Community Pharmaceutical costs met by the patient Some Community Pharmaceutical costs are met by the patient. Generally a patient pays a prescription charge. In addition a patient will sometimes pay a manufacturer’s surcharge, after hours service fee and any special packaging fee. PRESCRIPTION CHARGE The only cost a patient should incur for a fully subsidised Community Pharmaceutical () is the standard government prescription charge, or the full cost of the Community Pharmaceutical, whichever is less. The Government prescription charge for a three month course of a particular Community Pharmaceutical ranges up to $15.00 and represents the patient’s contribution to the cost of the Community Pharmaceutical. The Government pays the rest of the cost. Maximum prescription charges vary by patient status as set out below. More information about prescription charges is contained in the pamphlet, Community Services Card, available from Work and Income.

Patient’s Health Card(s) No Card Maximum prescription charge Adult $15 Child 6 + $10 Child under 6 $0 Contraceptives $3 No other card $3 No other card $3 No other card $2 With HUHC only $2 With CSC $0

Community Services Card (CSC) High Use Health Card (HUHC) Prescription Subsidy Card

for families after first 20 prescriptions since previous February* * Except prescriptions with $0 charge

MANUFACTURER’S SURCHARGE Not all Community Pharmaceuticals are fully subsidised. Although PHARMAC endeavours to fully subsidise at least one Community Pharmaceutical in each therapeutic group, and has contracts with some suppliers to maintain the price of a particular product, manufacturers are able to set their own price to pharmacies. When these prices exceed the subsidy, the pharmacist may recoup the difference from the patient. To estimate the amount a patient will pay on top of the prescription charge, take the difference between the manufacturer’s price and the subsidy, and multiply this by 1.86. The 1.86 factor represents the pharmacy mark-up on the surcharge plus other costs such as GST. Pharmacies charge different mark-ups so this may vary.

Manufacturer’s surcharge to patient = (price - subsidy) x 1.86

For example, a Community Pharmaceutical with a supplier (ex-manufacturer) cost of $11.00 per pack with a $10.00 subsidy will cost the patient a surcharge of $1.86 on top of the prescription charge. The most a patient should pay is therefore $16.86 – being $15.00 maximum prescription charge, plus $1.86. Hospital Pharmaceutical costs The cost of purchasing Hospital Pharmaceuticals is met by the Funder (in particular, the relevant DHB) from its own budget. PHARMAC web site PHARMAC has set up an interactive Schedule on the Internet. It can be used to calculate the cost of a prescribed Community Pharmaceutical. This site at http://www.pharmac.govt.nz takes into account the quantity of Community Pharmaceutical prescribed as well as the patient’s age, whether the patient has a community services card, high use health card or prescription subsidy card, the fee for pharmacy services and prescription charges. Other information about PHARMAC is also available on our website. This includes copies of the Annual Review, Annual Report and Annual Plan, as well as information such as the Pharmaceutical Schedule, Pharmaceutical Schedule Updates, other publications and recent press releases. 11

Special Authority Applications

Special Authority is an application process in which a prescriber requests government subsidy on a Community Pharmaceutical for a particular person.

Subsidy

Once approved, the prescriber and the patient are provided a Special Authority number which must appear on the prescription. Specialists who make an application must communicate the valid authority number to the prescriber who will be writing the prescriptions. The authority number can provide access to subsidy, additional subsidy, or waive certain restrictions otherwise present on the Community Pharmaceutical. Some approvals are dependent on the availability of funding from the Pharmaceutical Budget.

Criteria

The criteria for approval of Special Authority applications are included below each Community Pharmaceutical listing. For some Special Authority Community Pharmaceuticals, not all indications that have been approved by Medsafe are subsidised. Criteria for each Special Authority Community Pharmaceutical are updated regularly, based on the decision criteria of PHARMAC. The appropriateness of the listing of a Community Pharmaceutical in the Special Authority category will also be regularly reviewed. Applications for inclusion of further Community Pharmaceuticals in the Special Authority category will generally be made by a pharmaceutical supplier.

Applications

Special Authority applications are administered by HealthPAC (Wanganui). All applications should be sent, in writing, to: HealthPAC, Private Bag 3015, WANGANUI Fax: (06) 345 1121 or free fax 0800 100 131 For inquiries, phone Niki Anderson, free phone 0800 CHEM NO (0800 243 666). Note:HealthPAC can only provide information on Special Authority applications to prescribers and pharmacists. Each application must include: The application must: • name and date of birth of the patient (codes • be signed by the practitioner for AIDS patients’ applications) • include the practitioner’s printed name and • diagnosis and brief clinical details address • name of the Community Pharmaceutical • show the practitioner’s Medical Council required, the form and strength of that registration number Pharmaceutical • provide evidence of the criteria as per Special • duration of the course of treatment Authority conditions for the Community • alternative therapies that have been tried. Pharmaceutical applied for.

Community Exceptional Circumstances

The purpose of the Community Exceptional Circumstances scheme is to provide funding from the Community Exceptional Circumstances budget for medication to be used in the community, in circumstances where the provision of a funded Community Pharmaceutical is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule (“Community Exceptional Circumstances”). In order to qualify for Community Exceptional Circumstances approval one of the following entry criteria must be met: a) the condition must be rare, or b) the reaction to alternative funded treatment must be unusual, or c) an unusual combination of circumstances must be present. Rare and unusual are considered to be in the order of less than 10 people nationally. Where one of the above Community Exceptional Circumstances entry criteria is met, the application may then be further examined under supplementary criteria, assessing suitability of the pharmaceutical, clinical benefit, the cost effectiveness of the treatment, and the patient’s ability to pay for the treatment. Where these documented criteria are met, a subsidy sufficient to fully fund the pharmaceutical will be made available to the specific patient on whose behalf the application was made. Community Exceptional Circumstances funding is only available where the criteria are met and is not available for financial reasons alone. Applications for Community Exceptional Circumstances should be made on the standard application form available from the address below. Applications for patients should be directed to: Exceptional Circumstances Panel Coordinator Phone: (09) 580 9173 or (09) 580 9174 Ministry of Health, Level 3, Unisys House 650 Great South Rd Fax: (09)580 9205, Email: ecpanel@ppc.govt.nz Penrose, Private Bag 92 522, AUCKLAND 12

SECTION A: GENERAL RULES

INTRODUCTION

Section A contains the restrictions and other general rules that apply to Subsidies on Community Pharmaceuticals. The amounts payable by the Funder to Contractors are currently determined by: • the quantities, forms, and strengths, of subsidised Community Pharmaceuticals dispensed under valid prescription by each Contractor; • the amount of the Subsidy on the Manufacturer’s Price payable for each unit of the Community Pharmaceuticals dispensed by each Contractor and; • the contractual arrangements between the Contractor and the Funder for the payment of the Contractor’s dispensing services. The Pharmaceutical Schedule shows the level of subsidy payable in respect of each Community Pharmaceutical so that the amount payable by the Government to Contractors, for each Community Pharmaceutical, can be calculated. The Pharmaceutical Schedule also shows the standard price (exclusive of GST) at which a Community Pharmaceutical is supplied ex-manufacturer to wholesalers if it differs from the subsidy. The manufacturer’s surcharge to patients can be estimated using the subsidy and the standard manufacturer’s price as set out in this Schedule. The cost to Government of subsidising each Community Pharmaceutical and the manufacturer’s prices may vary, in that suppliers may provide rebates to other stakeholders in the primary health care sector, including dispensers, wholesalers, and the Government. Rebates are not specified in the Pharmaceutical Schedule. This Schedule is dated the 1st day of April 2003 and is to be referred to as the Pharmaceutical Schedule Volume 10 Number 1, 2003. Distribution will be from 20th April 2003. This Schedule comes into force on the 1st day of April 2003.

PART I INTERPRETATION AND DEFINITIONS

1.1 In this Schedule, unless the context otherwise requires: “Access Exemption Criteria” means the criteria under which patients may receive greater than one month’s supply of a Community Pharmaceutical subsidised in one Lot. The specifics of these criteria are conveyed in Ministry of Health guidelines, which are issued from time to time. The criteria relate to: a) limited physical mobility; b) distance from a pharmacy; c) relocation of residence; d) extended travel. “Act” means the New Zealand Public Health and Disability Act 2000. “Advisory Committee” means the Pharmaceutical Services Advisory Committee convened by the Ministry of Health under the terms of the Advice Notice issued to Contractors pursuant to Section 88 of the Act. “Assessed Pharmaceuticals” means the list of Pharmaceuticals set out in Section H Part III of the Schedule, that have been or are being assessed by PHARMAC. “Bulk Supply Order” means a written order, on a form supplied by the Ministry of Health, or approved by HealthPAC, made by the licensee or manager of a Private Hospital or the matron or other person in charge of an institution approved by the Ministry of Health for the supply of such Community Pharmaceuticals as are expected to be required for the treatment of persons who are under the medical or dental supervision of such a Private Hospital or institution. “Class B Controlled Drug” means a Class B controlled drug within the meaning of the Misuse of Drugs Act 1975. “Community Exceptional Circumstances” means the policies and criteria administered by the Exceptional Circumstances Panel relating to funding from the Community Exceptional Circumstances budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule. “Community Pharmaceutical” means a Pharmaceutical listed in Sections A to G of the Pharmaceutical Schedule that is subsidised by the Funder from the Pharmaceutical Budget for use in the community. “Contractor” means a person who is entitled to receive a payment from the Crown or a DHB under a notice issued by the Crown or a DHB under Section 88 of the Act or under a contract with the Ministry of Health or a DHB for the supply of Community Pharmaceuticals. “Controlled Drug” means a controlled drug within the meaning of the Misuse of Drugs Act 1975 (other than a controlled drug specified in Part VI of the Third Schedule to that Act). “Cost, Brand, Source of Supply” means that the Community Pharmaceutical is eligible for Subsidy on the basis of the Contractor’s annotated purchase price, brand, and source of supply.

SECTION A: GENERAL RULES

“Dentist” means a person registered as a dentist under the Dental Act 1988 who holds a current annual practising certificate. “DHB” means an organisation established as a District Health Board by or under Section 19 of the Act. “DHB Hospital” means a DHB, including its hospital or associated provider unit that the DHB purchases Hospital Pharmaceuticals for. “Discretionary Community Supply Pharmaceutical” means the list of Pharmaceuticals set out in Section H Part IV of the Schedule, which may be funded by a DHB Hospital from its own budget for use in the community. “Doctor” means a medical Practitioner registered under the Medical Practitioners Act 1968 who holds a current annual practising certificate. “DV Limit” means, for a particular Hospital Pharmaceutical with HSS, the National DV Limit or the Individual DV Limit. “DV Pharmaceutical” means a discretionary variance Pharmaceutical, that does not have HSS and which: a) is either listed in Section H Part II of the Schedule as being a DV Pharmaceutical in association with the relevant Hospital Pharmaceutical with HSS; or b) is the same chemical entity, at the same strength, and in the same or a similar presentation or form, as the relevant Hospital Pharmaceutical with HSS, but which is not yet listed as being a DV Pharmaceutical. “Endorsements” – unless otherwise specified, endorsements should be either handwritten or computer generated by the doctor prescribing the medication. The endorsement can be written as “certified condition”, or state the condition of the patient, where that condition is specified for the Community Pharmaceutical in Section B of the Pharmaceutical Schedule. Where the doctor writes “certified condition” as the endorsement, he/she is making a declaration that the patient meets the criteria as set out in Section B of the Pharmaceutical Schedule. “Exceptional Circumstances Panel” means the panel of clinicians, appointed by the PHARMAC Board, that is responsible for administering policies in relation to Community Exceptional Circumstances. “Funder” means the body or bodies responsible, pursuant to the Act, for the funding of pharmaceuticals listed on the Schedule (which may be one or more DHBs and/or the Ministry of Health) and their successors. “GST” means goods and services tax under the Goods and Services Tax Act 1985. “Hospital Pharmaceuticals” means National Contract Pharmaceuticals, DV Pharmaceuticals, Discretionary Community Supply Pharmaceuticals, Assessed Pharmaceuticals and Pharmaceutical Cancer Treatments. “Hospital Pharmacy” means that the Community Pharmaceutical is not eligible for Subsidy unless it is supplied by a hospital or pharmacy contracted to the Funder to dispense as a hospital pharmacy to an Outpatient on the Prescription of a Doctor. “Hospital Pharmacy-Dermatologist” means that the Community Pharmaceutical is not eligible for Subsidy unless it is supplied by a hospital or pharmacy contracted to the Funder to dispense as a hospital pharmacy: a) to an Outpatient; and b) on a Prescription signed by a Specialist in dermatology “Hospital Pharmacy-Specialist” means that the Community Pharmaceutical is not eligible for Subsidy unless it is supplied by a hospital or pharmacy contracted to the Funder to dispense as a hospital pharmacy: a) to an Outpatient; and b) on a Prescription signed by a Specialist; or if the treatment of an Outpatient with the Community Pharmaceutical has been recommended by a Specialist, on the Prescription of a Practitioner endorsed with the words “recommended by [name of specialist and year of authorisation]” and signed by the Practitioner. “As recommended by a Specialist” to be interpreted as: a) follows a substantive consultation with an appropriate Specialist; b) the consultation to relate to the Patient for whom the Prescription is written; c) consultation to mean communication by referral, telephone, letter, facsimile or email; d) except in emergencies consultation to precede annotation of the Prescription; and e) both the specialist and the General Practitioner must keep a written record of the consultation. For the purposes of the definition it makes no difference whether or not the Specialist is employed by a hospital. “Hospital Pharmacy-Specialist Prescription” means that the Community Pharmaceutical is not eligible for Subsidy unless it is supplied by a hospital or pharmacy contracted to the Funder to dispense as a hospital pharmacy: a) to an Outpatient; and b) on a Prescription signed by a Specialist. “HSS” means hospital supply status, the status of being the brand of the relevant Hospital Pharmaceutical listed in Section H Part II as HSS, that DHBs are obliged to purchase subject to any DV Limit for that Hospital Pharmaceutical for the period of hospital supply, as awarded under an agreement between PHARMAC and the relevant pharmaceutical supplier.

SECTION A: GENERAL RULES

“In Combination” means that the Community Pharmaceutical is only subsidised when prescribed in combination with another subsidised pharmaceutical as specified in Section B or C of the Pharmaceutical Schedule. “Individual DV Limit” means, for a particular Hospital Pharmaceutical with HSS and a particular DHB Hospital, the discretionary variance limit, being the specified percentage of that DHB Hospital’s Total Market Volume up to which that DHB Hospital may purchase DV Pharmaceuticals of that Hospital Pharmaceutical. “Licensed Hospital” means a place or institution that is: a) a licensed hospital within the meaning of Part V of the Hospitals Act 1957; or b) recognised and approved as a hospital for the purposes of Part II of the Hospitals Act 1957. “Lot” means a quantity of a Community Pharmaceutical supplied in one dispensing. “Manufacturer’s Price” means the standard price at which a Community Pharmaceutical is supplied to wholesalers (excluding GST), as notified to PHARMAC by the supplier. “Maternity hospital” means that the Community Pharmaceutical is not eligible for Subsidy unless it is supplied pursuant to a Bulk Supply Order to a maternity hospital licensed under the Hospitals Act 1957. “Midwife” means a person registered as a midwife under the Nurses Act 1977 and subsequent amendments, and who holds a current annual practising certificate. “Month” means a period of 30 consecutive days. “Month restriction” means that no Subsidy is available: a) unless the Community Pharmaceutical is dispensed on the Prescription of a Practitioner; and b) for any quantity of that Community Pharmaceutical dispensed on the Prescription (whether or not dispensed as a repeat) in excess of a Monthly Lot. “Monthly Lot” means the quantity of a Community Pharmaceutical required for 30 consecutive days treatment. “National Contract Pharmaceutical” means a Hospital Pharmaceutical for which PHARMAC has negotiated a national contract and the Price. “National DV Limit” means, for a particular Hospital Pharmaceutical with HSS, the discretionary variance limit, being the specified percentage of the Total Market Volume up to which all DHB Hospitals may collectively purchase DV Pharmaceuticals of that Hospital Pharmaceutical. “Not In Combination” means that no Subsidy is available: a) unless the Community Pharmaceutical is dispensed on the Prescription of a Practitioner; and b) for any Prescription containing the Community Pharmaceutical in combination with other ingredients unless the particular combination of ingredients is separately specified in Section B or C of the Schedule, and then only to the extent specified. “Outpatient”, in relation to a Community Pharmaceutical, means a person who, as part of treatment at a hospital or other institution under the control of a DHB, is prescribed the Community Pharmaceutical for consumption or use in the person’s home. “PHARMAC” means the Pharmaceutical Management Agency established by Section 46 of the Act (PHARMAC). “Pharmaceutical” means a medicine, therapeutic medical device, or related product or related thing listed in Sections B to H of the Schedule. “Pharmaceutical Benefits” means the right of: a) a person; and b) any member under 16 years of age of that person’s family, to have made by the Government on his or her behalf, subject to any conditions for the time being specified in the Schedule, such payment in respect of any Community Pharmaceutical supplied to that person or family member under the order of a Practitioner in the course of his or her practice. “Pharmaceutical Budget” means the pharmaceutical budget set for PHARMAC by the Crown for the subsidised supply of Community Pharmaceuticals. “Pharmaceutical Cancer Treatments” means Pharmaceuticals listed in Part V of Section H of the Pharmaceutical Schedule, and their associated indications, that the Minister of Health has directed DHBs to fund, from their own budgets, for use in their hospitals, and/or in association with Outpatient services provided in their DHB Hospitals, in relation to the treatment of cancers. “Practitioner” means a Doctor, a Dentist, or a Midwife who holds a current annual practising certificate. “Practitioner’s Supply Order” means a written order made by a Practitioner on a form supplied by the Ministry of Health, or approved by HealthPAC, for the supply of Community Pharmaceuticals to the Practitioner, which the Practitioner requires to ensure medical supplies are available for emergency use, teaching and demonstration purposes, and for provision to certain patient groups where individual prescription is not practicable. “Prescription” means a quantity of a Community Pharmaceutical prescribed for a named person on a document signed by a Practitioner.

SECTION A: GENERAL RULES

“Private Hospital” means a licensed hospital other than one owned or operated by a DHB. “Retail Pharmacy-Specialist” means that the Community Pharmaceutical is only eligible for Subsidy if it is supplied on a Prescription or Practitioner’s Supply Order signed by a Specialist, or, in the case of treatment recommended by a Specialist, a Prescription or Practitioner’s Supply Order and endorsed with the words “recommended by [name of Specialist and year of authorisation]” and signed by the Practitioner. “As recommended by a Specialist” to be interpreted as: a) follows a substantive consultation with an appropriate Specialist; b) the consultation to relate to the Patient for whom the Prescription is written; c) consultation to mean communication by referral, telephone, letter, facsimile or email; d) except in emergencies consultation to precede annotation of the Prescription; and e) both the Specialist and the General Practitioner must keep a written record of consultation. “Retail Pharmacy-Specialist Prescription” means that the Community Pharmaceutical is only eligible for Subsidy if it is supplied on a Prescription, or Practitioner’s Supply Order, signed by a Specialist. “Schedule” means this Pharmaceutical Schedule and all its sections and appendices. “Section B” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for Subsidies included in the Schedule. “Section C” of this Pharmaceutical Schedule means the list of community extemporaneously compounded preparations and galenicals eligible for Subsidies included in the Schedule. “Section D” of this Pharmaceutical Schedule means the list of community special foods eligible for Subsidies included in the Schedule. “Section E Part I” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for Subsidies and available on a Practitioner’s Supply Order or a Wholesale Supply Order included in the Schedule. “Section E Part II” of this Pharmaceutical Schedule means the list of remote areas for the purpose of community Practitioner’s Supply Orders included in the Schedule. “Section F” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for exemption from monthly dispensing included in this Schedule. “Section G” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for reimbursement of safety caps. “Section H” of this Pharmaceutical Schedule means the general rules for Hospital Pharmaceuticals and the lists of National Contract Pharmaceuticals and any associated DV Pharmaceuticals, of Discretionary Community Supply Pharmaceuticals, of Assessed Pharmaceuticals and of Pharmaceutical Cancer Treatments included in Section H of the Schedule. “Section H Part I” of this Pharmaceutical Schedule means the general rules for Hospital Pharmaceuticals. “Section H Part II” of this Pharmaceutical Schedule means the list of National Contract Pharmaceuticals, the relevant Price, an indication of whether the Pharmaceutical has HSS and any associated DV Pharmaceuticals and DV Limit. “Section H Part III” of this Pharmaceutical Schedule means the list of Assessed Pharmaceuticals. “Section H Part IV” of this Pharmaceutical Schedule means the list of Discretionary Community Supply Pharmaceuticals. “Section H Part V” of the Pharmaceutical Schedule means the list of Pharmaceutical Cancer Treatments. “Special Authority” means that the Community Pharmaceutical is only eligible for Subsidy or additional Subsidy for a particular person if an application meeting the criteria specified in the Schedule has been approved, and the valid Special Authority number is present on the prescription. “Specialist”, in relation to a Prescription, a doctor who holds a current annual practising certificate and who satisfies the criteria set out in paragraphs (a) or (b) or (c) or (d) below: a) i) the doctor’s name appears in the Vocational Register of medical practitioners in accordance with Section 21 and 22 of the Medical Practitioners Act 1995 and who has written the Prescription in the course of practising in that area of medicine; and ii) the doctor’s vocational branch or sub-branch is one of those listed below: – anaesthetics, cardiothoracic surgery, dermatology, diagnostic radiology, emergency medicine, general surgery, internal medicine, neurosurgery, obstetrics and gynaecology, occupational medicine, ophthalmology, otolaryngology head and neck surgery, orthopaedic surgery, paediatric surgery, paediatrics, pathology, plastic and reconstructive surgery, psychological medicine or psychiatry, public health medicine, radiation oncology, rehabilitation medicine, urology and venereology; b) the doctor is recognised by the Ministry of Health as a specialist for the purposes of this Schedule and receives remuneration from a DHB at a level which that DHB considers appropriate for specialists and who has written that Prescription in the course of practising in that area of medicine;

SECTION A: GENERAL RULES

c) the doctor is recognised by the Ministry of Health as a specialist in relation to a particular area of medicine for the purpose of writing Prescriptions and who has written the Prescription in the course of practising in that area of medicine; d) the doctor writes the Prescription on DHB stationery and is appropriately authorised by the relevant DHB to do so. “Subsidy” means the maximum amount that the Government will pay Contractors for a Community Pharmaceutical dispensed to a person eligible for Pharmaceutical Benefits and is different from the cost to Government of subsidising that Community Pharmaceutical . “Supply Order” means a Bulk Supply Order, a Practitioner’s Supply Order or a Wholesale Supply Order. “Wholesale Supply Order” means a written order by a Practitioner, on a form supplied by the Ministry of Health for the supply of certain Community Pharmaceuticals as listed in Section B and Section E Part I of the Schedule. 1.2 In addition to the above interpretations and definitions, unless the content requires otherwise, a reference in the Schedule to: a) the singular includes the plural; and b) any legislation includes a modification and re-enactment of, legislation enacted in substitution for, and a regulation, Order in Council, and other instrument from time to time issued or made under that legislation, where that legislation, regulation, Order in Council or other instrument has an effect on the prescribing, dispensing or subsidising of Community Pharmaceuticals.

PART II COMMUNITY PHARMACEUTICALS SUBSIDY

2.1 Community Pharmaceuticals eligible for Subsidy include every medicine, therapeutic medical device or related product, or related thing listed in Sections B to G of the Schedule, and every preparation (having an inert base) of any of them, is hereby declared to be a Community Pharmaceutical for the purposes of the Schedule, subject to: 2.1.1 clauses 2.2 and 2.3 of the Schedule; and 2.1.2 clauses 3.1 to 4.4 of the Schedule; and 2.1.3 the conditions (if any) specified in Sections B to G of the Schedule; 2.2 The following medicines, therapeutic medical devices, or related products or related things are not eligible for Subsidy: 2.2.1 substances, or combinations of substances, ordered for any purpose other than: a) treatment of a patient’s medical or dental condition; or b) pregnancy tests; or c) the prevention of sexually transmitted disease; or d) contraception. 2.2.2 substances and combinations of substances packed under pressure in aerosol cans or other similar devices, unless it is specified in Sections B to G of the Schedule that they may be so packed; 2.2.3 electrode jellies; 2.2.4 eye drops packed in single-dose units, unless it is specified in Sections B to G of the Schedule that they may be so packed; 2.2.5 insect repellents and similar preparations; 2.2.6 oral preparations in long-acting form, unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.7 substances or combinations of substances in lozenge or similar form, unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.8 machine-spread plasters; 2.2.9 preparations prescribed as foods, unless they are specified in Section D of the Schedule; 2.2.10 substances, combinations of substances, or articles, in the form of proprietary medicines or proprietary articles, unless they are deemed or declared to be Pharmaceuticals elsewhere in the Schedule; 2.2.11 shampoos, other than extemporaneously prepared medicated shampoos, or shampoos specified in Sections B to G of the Schedule intended for the treatment of a patient’s medical condition; 2.2.12 toilet preparations; 2.2.13 tooth pastes and powders; 2.2.14 lubricating jellies and catheter lubricants; 2.2.15 sterile diluents for nebulising solutions;

SECTION A: GENERAL RULES

2.2.16 substances in a form intended to enable delivery by transdermal diffusion or osmosis or by the insertion of any solid object or substance into the eye cavity, unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.17 substances in a form intended for intravenous delivery (other than by injection), unless it is specified in Sections B to G of the Schedule that they may be in such a form; 2.2.18 substances packed in pre-loaded syringes known as Min-I-Jets, unless it is specified in Sections B to G of the Schedule that they may be so packed; 2.2.19 Community Pharmaceuticals prescribed as cough mixtures, unless they are specified in Sections B to G of the Schedule otherwise than in combination with other ingredients; 2.2.20 vitamin preparations in capsule form, unless they are specified in Sections B to G of the Schedule; 2.2.21 substances prescribed for use as irrigating solutions, unless it is specified in Sections B to G of the Schedule that they may be prescribed for such use. 2.3 No claim by a Contractor for payment in respect of the supply of Community Pharmaceuticals will be allowed unless the Community Pharmaceuticals so supplied: 2.3.1 comply with the appropriate standards prescribed by regulations for the time being in force under the Medicines Act 1981; or 2.3.2 in the absence of any such standards, comply with the appropriate standards for the time being prescribed by the British Pharmacopoeia; or 2.3.3 in the absence of the standards prescribed in clauses 2.3.1 and 2.3.2, comply with the appropriate standards for the time being prescribed by the British Pharmaceutical Codex; or 2.3.4 in the absence of the standards prescribed in clauses 2.3.1, 2.3.2 and 2.3.3, are of a grade and quality not lower than those usually applicable to Community Pharmaceuticals intended to be used for medical purposes.

PART III PERIOD AND QUANTITY OF SUPPLY

3.1 Doctors’ and Midwives’ Prescriptions (other than oral contraceptives) The following provisions apply to all Prescriptions, other than those for an oral contraceptive, written by a Doctor or Midwife: 3.1.1 For a Community Pharmaceutical other than a Class B Controlled Drug, only a quantity sufficient to provide treatment for a period not exceeding three Months will be subsidised. 3.1.2 For methylphenidate hydrochloride and dexamphetamine sulphate, only a quantity sufficient to provide treatment for a period not exceeding one Month will be subsidised. 3.1.3 For a Class B Controlled Drug other than methylphenidate hydrochloride and dexamphetamine sulphate, only a quantity: a) sufficient to provide treatment for a period not exceeding 10 days; and b) which has been dispensed pursuant to a Prescription sufficient to provide treatment for a period not exceeding one Month, will be subsidised. 3.1.4 Where a Doctor or Midwife has prescribed a quantity of a Community Pharmaceutical sufficient to provide treatment for more than one Month, the Community Pharmaceutical will be subsidised only if it is dispensed in Monthly Lots, unless: a) the eligible person or his/her nominated representative endorses the back of the Prescription form with a statement identifying which Access Exemption Criterion (Criteria) applies and signs that statement to this effect; or b) both: i) the Practitioner endorses the Prescription with the words “certified exemption” written in the Practitioner’s own handwriting or signed or initialled by the Practitioner; and ii) every Community Pharmaceutical endorsed as “certified exemption” is listed in Section F of the Pharmaceutical Schedule. c) the Community Pharmaceutical is a contraceptive other than an oral contraceptive. 3.1.5 A Community Pharmaceutical is only eligible for Subsidy if the Prescription under which it has been dispensed was presented to the Contractor: a) for a Class B Controlled Drug, within eight days of the date on which the Prescription was written; or b) for any other Community Pharmaceutical, within three Months of the date on which the Prescription was written. 3.1.6 No subsidy will be paid for any Prescription, or part thereof, that is not fulfilled within: a) in the case of a Prescription for a total supply of from one to three Months, three Months from the date the Community Pharmaceutical was first dispensed; or

SECTION A: GENERAL RULES

b) in any other case, one Month from the date the Community Pharmaceutical was first dispensed. Only that part of any Prescription that is dispensed within the time frames specified above is eligible for Subsidy . 3.1.7 Subject to clause 3.1.8, a Community Pharmaceutical, other than an antibiotic, antidepressant, antipsychotic, or a Class B Controlled Drug which has been: a) prescribed in a quantity sufficient for use for one Month or more, but dispensed by the Contractor in smaller quantities will only be subsidised as if the Community Pharmaceutical had been dispensed in Monthly Lots; or b) prescribed in a quantity sufficient for use for less than one Month, but dispensed by the Contractor in quantities smaller than the quantity prescribed, will only be subsidised as if the Community Pharmaceutical had been dispensed in one Lot; or c) prescribed in multiple Prescriptions for treatment of a condition for a period of less than one Month and for continuous periods that when added together are more than one Month, will only be subsidised as if it had been dispensed as a Monthly Lot. 3.1.8 If a Community Pharmaceutical: a) is stable for a limited period only, and the Doctor or Midwife has endorsed the Prescription with the words “unstable medicine” and has specified the maximum quantity that may be dispensed at any one time; or b) is stable for a limited period only, and the Contractor has endorsed the Prescription with the words “unstable medicine” and has specified the maximum quantity that should be dispensed at any one time in all the circumstances of the particular case; or c) is prescribed for a patient who, in the opinion of the prescribing Doctor or Midwife, needs close control over access to Community Pharmaceuticals of that kind, and therefore endorsed the Prescription with the words “close control” and has specified the maximum quantity that may be dispensed at any one time, the actual quantity dispensed will be subsidised in accordance with any such specification. 3.2 Oral Contraceptives The following provisions apply to all Prescriptions written by a Doctor or Midwife for an oral contraceptive: 3.2.1 The prescribing Doctor or Midwife must specify on the Prescription the period of treatment for which the Community Pharmaceutical is to be supplied. This period must not exceed: a) three Months if prescribed by a Midwife; or b) six Months if prescribed by a Doctor. 3.2.2 Where the period of treatment specified in the Prescription does not exceed three Months, the Community Pharmaceutical is to be dispensed: a) in Lots as specified in the Prescription; or b) where no Lots are specified, in one Lot sufficient to provide treatment for the period prescribed. 3.2.3 Subject to clause 3.2.4, where the period of treatment specified in the Prescription exceeds three Months, the Community Pharmaceutical will be subsidised only if it is dispensed: a) in the number of Lots as specified in the Prescription, provided that: i) more than two Lots are specified, and ii) none of those Lots exceeds three Months’ supply; or b) in two Lots with a maximum of three Months’ supply for each Lot, in any other case. 3.2.4 Where the period of treatment exceeds three Months, the Contractor may dispense the Community Pharmaceutical in Lots greater than three Months’ supply to a maximum of the total quantity prescribed if the eligible person or his/ her nominated representative endorses the back of the Prescription form with a statement identifying which Access Exemption Criteria apply and signs that statement to this effect. 3.2.5 An oral contraceptive is only eligible for Subsidy if the Prescription under which it has been dispensed was presented to the Contractor within three Months of the date on which it was written. 3.2.6 An oral contraceptive prescribed by a Midwife is only eligible for Subsidy if the Prescription under which it has been dispensed has been written within the period of post natal care of the eligible person. 3.2.7 Where a Prescription specifies a period of treatment which exceeds three Months, and a repeat on the Prescription remains unfulfilled: a) after four Months from the date the Community Pharmaceutical was first dispensed, where the first Lot was sufficient to provide treatment for three Months; or b) after six Months from the date the Community Pharmaceutical was first dispensed, where the first Lot was not sufficient to provide treatment for three Months; only the actual quantity supplied by the Contractor within the time limits specified above will be eligible for Subsidy.

SECTION A: GENERAL RULES

3.3 Dentists’ Prescriptions The following provisions apply to every Prescription written by a Dentist: 3.3.1 The maximum quantity of a Community Pharmaceutical that will be subsidised is as follows: a) where the Community Pharmaceutical is a Controlled Drug, only such quantity as is necessary to provide treatment for a period not exceeding five days; and b) in any other case, only such quantity as is necessary to provide treatment for a period not exceeding five days and, where the Prescription specifies a repeat, one further period not exceeding five days. 3.3.2 Notwithstanding clause 3.3.1, if, in the opinion of the Dentist, an eligible person needs extended treatment with sodium fluoride for up to three Months, the Community Pharmaceutical will be subsidised for that extended period. A Prescription for any such extended supply of sodium fluoride will be subsidised only if it is dispensed in Monthly Lots, unless the eligible person or his/her nominated representative endorses the back of the Prescription form with a statement identifying which Access Exemption Criterion (Criteria) applies and signs that statement to this effect. 3.3.3 A Community Pharmaceutical is only eligible for Subsidy if the Prescription under which it has been dispensed has been presented to the Contractor: a) for a Class B Controlled Drug, within eight days of the date on which the Prescription was written; or b) for any other Community Pharmaceutical, within three Months of the date on which the Prescription was written. 3.3.4 No Subsidy will be paid for any Prescription, or part thereof, that is not fulfilled within: a) one Month from the date the Community Pharmaceutical was first dispensed; or b) in the case of sodium fluoride, three Months from the date the Community Pharmaceutical was first dispensed. Only that part of any Prescription that is dispensed within the time frames specified above is eligible for Subsidy. 3.4 Original Packs, and Certain Antibiotics 3.4.1 Notwithstanding clauses 3.1 and 3.3 of the Schedule, if a Practitioner prescribes or orders a Community Pharmaceutical that is identified as an Original Pack (OP) on the Pharmaceutical Schedule and is packed in a container from which it is not practicable to dispense lesser amounts, every reference in those clauses to an amount or quantity eligible for Subsidy, is deemed to be a reference: a) where an amount by weight or volume of the Community Pharmaceutical is specified in the Prescription, to the smallest container of the Community Pharmaceutical, or the smallest number of containers of the Community Pharmaceutical, sufficient to provide that amount; and b) in every other case, to the amount contained in the smallest container of the Community Pharmaceutical that is manufactured in, or imported into, New Zealand. 3.4.2 If a Community Pharmaceutical is the liquid oral form of an antibiotic to which a diluent must be added by the Contractor at the time of dispensing and it is prescribed or ordered by a Practitioner in an amount that does not coincide with the amount contained in one or more standard packs of that Community Pharmaceutical, Subsidy will only be made for the amount prescribed or ordered by the Practitioner in accordance with either clause 3.1 or clause 3.3 of the Schedule, unless the Contractor satisfies the Funder that he or she has not been able to dispense the balance of the pack or packs from which the Community Pharmaceutical has been dispensed. In such cases all of that pack or those packs is eligible for Subsidy.

SECTION A: GENERAL RULES

PART IV MISCELLANEOUS PROVISIONS

4.1 Bulk Supply Orders The following provisions apply to the supply of Community Pharmaceuticals under Bulk Supply Orders: 4.1.1 No Community Pharmaceutical supplied under a Bulk Supply Order will be subsidised if it is specifically restricted in Section B, C or D of the Schedule. 4.1.2 The person who placed the Bulk Supply Order may be called upon by the Ministry of Health to justify the amount ordered. 4.1.3 Class B Controlled Drugs will be subsidised only if supplied under Bulk Supply Orders placed by a Private Hospital. 4.1.4 Any order for a Class B Controlled Drug or for buprenorphine hydrochloride must be written on a Special Bulk Supply Order Controlled Drug Form supplied by the Ministry of Health. 4.1.5 Community Pharmaceuticals listed in Part I of the First Schedule to the Medicines Regulations 1984 will be subsidised only if supplied under a Bulk Supply Order placed by a Private Hospital and: a) that Private Hospital employs a registered general nurse, within the meaning of the Nurses Act 1977; and b) the Bulk Supply Order is supported by a written requisition signed by a Practitioner. 4.1.6 No Subsidy will be paid for any quantity of a Community Pharmaceutical supplied under a Bulk Supply Order in excess of what is a reasonable monthly allocation for the particular Private Hospital or institution, after taking into account stock on hand. 4.1.7 The Ministry of Health may, at any time, by public notification, declare that any Private Hospital, or other approved institution within its particular region, is not entitled to obtain supplies of Community Pharmaceuticals under Bulk Supply Orders with effect from the date specified in that declaration. Any such notice may in like manner be revoked by the Ministry of Health at any time. 4.2 Practitioner’s Supply Orders The following provisions apply to the supply of Community Pharmaceuticals to Practitioners under a Practitioner’s Supply Order: 4.2.1 Subject to clause 4.2.3, a Practitioner may only order under a Practitioner’s Supply Order those Community Pharmaceuticals listed in Section E Part I and only in such quantities as set out in Section E Part I that the Practitioner requires to ensure medical supplies are available for emergency use, teaching and demonstration purposes, and for provision to certain patient groups where individual prescription is not practicable. 4.2.2 Any order for a Class B Controlled Drug or for buprenorphine hydrochloride must be written on a Special Practitioner’s Supply Order Controlled Drug Form supplied by the Ministry of Health. 4.2.3 A Practitioner may order such Community Pharmaceuticals as he or she expects to be required for personal administration to patients under the Practitioner’s care if: a) the Practitioner’s normal practice is in the Hauraki Gulf Ward of Auckland City, the Strath Taieri Ward of Dunedin City, or in the specified districts of those wards listed in Section E Part II of the Schedule, or if the Practitioner is a locum for a Practitioner whose normal practice is in such a ward or district; and b) the quantities ordered are reasonable for up to one Month’s supply under the conditions normally existing in the practice. c) no Subsidy is available under Clause 4.2.3 for any Community Pharmaceutical specifically restricted in Section B and C of the Schedule and the Practitioner may be called on by the Ministry of Health to justify the amounts of Community Pharmaceuticals ordered. 4.2.4 No Community Pharmaceutical ordered under a Practitioner’s Supply order will be eligible for Subsidy unless the Practitioner’s Supply Order is made on a form supplied for that purpose by the Ministry of Health, or approved by HealthPAC’s and which: a) is personally signed and dated by the Practitioner; and b) sets out the Practitioner’s address; and c) sets out the Community Pharmaceuticals and quantities.

SECTION A: GENERAL RULES

4.2.5

The Ministry of Health may, at any time, on the recommendation of an Advisory Committee appointed by the Ministry of Health for that purpose, by public notification, declare that a Practitioner specified in such a notice is not entitled to obtain supplies of Community Pharmaceuticals under Practitioner’s Supply Orders until such time as the Ministry of Health notifies otherwise.

4.3 Wholesale Supply Orders The following provisions apply to the supply of Community Pharmaceuticals to Practitioners under Wholesale Supply Orders: 4.3.1 Notwithstanding anything contained in the Schedule, but subject nevertheless to subclause 4.3.3 of this clause, a Practitioner may obtain from a wholesaler or distributor, pursuant to a Wholesale Supply Order made on a form supplied by the Ministry of Health, any Community Pharmaceutical specified in Section B and Section E Part I of the Schedule as being available on a Wholesale Supply Order. 4.3.2 Subject to clause 4.3.3, Community Pharmaceuticals supplied to Practitioners under Wholesale Supply Orders will be subsidised at a rate not exceeding the Manufacturer’s Price for each such Community Pharmaceutical as set out in Section B and Section E Part I of the Schedule. 4.3.3 No subsidy will be paid for any quantity of a Community Pharmaceutical supplied to a Practitioner under a Wholesale Supply Order in excess of what is a reasonable monthly allocation for that particular Practitioner, after taking into account stock on hand. 4.3.4 The Ministry of Health may, at any time, on the recommendation of an Advisory Committee appointed by the Ministry of Health for that purpose, by public notification, declare that a Practitioner specified in such a notice is not entitled to obtain supplies of Community Pharmaceuticals under Wholesale Supply Orders until such time as the Ministry of Health notifies otherwise. 4.4 Retail Pharmacy and Hospital Pharmacy-Specialist Restriction The following provisions apply to Prescriptions for Community Pharmaceuticals eligible to be subsidised as “Retail Pharmacy-Specialist” and “Hospital Pharmacy-Specialist”: 4.4.1 Record Keeping It is expected that a record will be kept by both the General Practitioner and the Specialist of the fact of consultation and enough of the clinical details to justify the recommendation. This means referral by telephone will need to be followed up by written consultation. 4.4.2 Expiry The recommendation expires at the end of two years and can be renewed by a further consultation. 4.4.3 The circulation by Specialists of the circumstances under which they are prepared to recommend a particular Community Pharmaceutical is acceptable as a guide. It must however be followed up by the procedure in subclauses 4.4.1 and 4.4.2, for the individual Patient. 4.4.4 The use of preprinted forms and named lists of Specialists (as circulated by some pharmaceutical companies) is regarded as inappropriate. 4.4.5 The Rules for Retail Pharmacy-Specialist and Hospital Pharmacy-Specialist will be audited as part of HealthPAC’s routine auditing procedures. 4.5 Amendment of Schedule PHARMAC may amend the terms of the Schedule from time to time by notice in writing given in such manner as PHARMAC thinks fit, and in accordance with such protocols as agreed with the Pharmacy Guild of New Zealand (Inc) from time to time. 4.6 Conflict in Provisions If any rules in Sections B–G of this Schedule conflict with the rules in Section A, the rules in Sections B–G apply.

SECTION B: ALIMENTARY TRACT AND METABOLISM

Antacids and Antiflatulents Antidiarrhoeals

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTACIDS AND ANTIFLATULENTS Antacids and Reflux Barrier Agents

ALGINIC ACID Tab 500 mg with magnesium trisil 25 mg, aluminium hydroxide gel, dried 100 mg, and sodium bicarbonate 170 mg - peppermint flavour ....... 1.80 (7.81) Sodium alginate 225 mg and magnesium alginate 87.5 mg per sachet ........................................................ 4.50 CALCIUM CARBONATE Tab 420 mg and aminoacetic acid 180 mg with or without dimethicone 21 mg .................................................................... 30.00 (35.10) (57.20) POLYSILOXANE Tab aluminium hydroxide 250 mg with magnesium trisil 120 mg, magnesium hydroxide 120 mg and polysiloxane 10 mg .............. 15.00 (18.70) SIMETHICONE Tab aluminium hydroxide 200 mg with magnesium hydroxide 200 mg and activated simethicone 20 mg ...................................... 4.50 (12.45) Oral liq aluminium hydroxide 200 mg with magnesium hydroxide 200 mg and activated simethicone 20 mg per 5 ml ......................... 1.50 (4.05) SODIUM ALGINATE Oral liq 500 mg with sodium bicarbonate 267 mg per 10 ml (aniseed) .... 1.50 (7.07)

60 Gaviscon 30 Gaviscon Infant

1,000 Titralac Titralac-Sil

500 Gastrogel

300 Mylanta 500 ml Mylanta P 500 ml Gaviscon

Phosphate Binding Agents

ALUMINIUM HYDROXIDE Tab 600 mg .................................................................................. 12.56 100 Alu-Tab

ANTIDIARRHOEALS Agents Which Reduce Motility

CODEINE PHOSPHATE Tab 15 mg ...................................................................................... 7.60 (8.20) Tab 30 mg .................................................................................... 10.60 (12.70) Tab 60 mg .................................................................................... 20.10 (23.75) DIPHENOXYLATE HYDROCHLORIDE WITH ATROPINE SULPHATE Tab 2.5 mg with atropine sulphate 25 µg ......................................... 6.00 100 PSM 100 PSM 100 PSM 100 Diastop

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Antidiarrhoeals

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer LOPERAMIDE HYDROCHLORIDE - Available on a PSO Cap 2 mg ....................................................................................... 7.50 250 Dicap

Rectal and Colonic Anti-inflammatories

BUDESONIDE - Special Authority Cap 3 mg ................................................................................... 153.57 Special Authority - Retail pharmacy 100 Entocort CIR

a) For patients with mild to moderate ileal, ileocaecal or proximal Crohn’s disease who: - also suffer from diabetes or - have Cushingoid habitus, osteoporosis where there is significant risk of fracture or severe acne following treatment with conventional corticosteroid therapy. b) Applications to be made by a gastroenterologist, general surgeon or general physician. c) Approvals are valid for a maximum of three months. d) Approvals are granted for a maximum of six months treatment with Entocort CIR (which can either be consecutive or intermittent) for any one patient per year. NOTE: The rationale for this restriction is that clinical trials for Entocort CIR use beyond three months demonstrated no improvement in relapse rate.

HYDROCORTISONE ACETATE Rectal foam 10%, CFC-Free ........................................................... 19.06 MESALAZINE Tab 400 mg - Retail pharmacy-specialist ......................................... 68.40 Tab long-acting 500 mg - Retail pharmacy-specialist ....................... 85.50 Enema 1 g per 100 ml - Retail pharmacy-specialist ............................ 8.13 Suppos 500 mg ........................................................................... 27.95 OLSALAZINE - Retail pharmacy-specialist Cap 250 mg ................................................................................. 31.51 Tab 500 mg .................................................................................. 59.86 SODIUM CROMOGLYCATE - Hospital pharmacy [HP3]-specialist Cap 100 mg ................................................................................. 81.10 SULPHASALAZINE Tab 500 mg .................................................................................... 8.86 Tab EC 500 mg ............................................................................... 9.94 Enema 3 g per 100 ml - Retail pharmacy-specialist .......................... 37.40 (43.00) 21.1 g OP 100 100 1 OP 1 20 100 100 100 100 100 7 Colifoam Asacol Pentasa Asacol Pentasa Asacol Dipentum Dipentum Nalcrom Salazopyrin Salazopyrin EN Salazopyrin

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

ALIMENTARY TRACT AND METABOLISM

Antihaemorrhoidals Antispasmodics and Other Agents Altering Gut Motility

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIHAEMORRHOIDALS Corticosteroids

HYDROCORTISONE WITH CINCHOCAINE Oint 5 mg with cinchocaine hydrochloride 5 mg per g ..................... 8.51 Suppos 5 mg with cinchocaine hydrochloride 5 mg per g ................ 3.77 30 g OP 12 Proctosedyl Proctosedyl

Rectal Sclerosants

OILY PHENOL Inj 5%, 5 ml ................................................................................. 71.71 5 Baxter

Soothing Agents

ZINC OXIDE Oint zinc oxide with balsam peru ..................................................... 4.50 (6.50) Suppos zinc oxide with balsam peru ................................................ 4.47 (6.35) ATROPINE SULPHATE Inj 400 µg, 1 ml - Available on a PSO ............................................. 29.95 Inj 600 µg, 1 ml - Available on a PSO ............................................. 24.00 Inj 1200 µg 1 ml- Available on a PSO ............................................. 29.95 CISAPRIDE - Special Authority - Retail pharmacy Tab 5 mg ........................................................................................ 7.50 (8.62) Tab 10 mg .................................................................................... 20.00 (23.00) Oral liq 1 mg per ml ......................................................................... 9.63 (11.07) 50 g OP Anusol 12 Anusol

ANTISPASMODICS AND OTHER AGENTS ALTERING GUT MOTILITY

50 50 50 30 Prepulsid 50 Prepulsid 100 ml OP Prepulsid AstraZeneca AstraZeneca AstraZeneca

Special Authority - Retail pharmacy a) Subsidy available for the treatment of: i) adults with - severe reflux oesophagitis where other treatment, including acid suppression with proton pump inhibitors, has failed; or - gastroparesis; or ii) patients with malignancy of GI tract causing gastroparesis (or gastric outlet obstruction); or iii) children (not including infants from 0 to 3 months of age who were born prematurely) with severe gastrooesophageal reflux; who are not predisposed to heart arrhythmias, do not have a pre-existing QT-prolongation or hepatic failure, and are not using other medications which either inhibit the cytochrome P450 3A4 enzyme system or prolong the QT interval. Refer to the data sheet for details of specific drug interactions. b) Doses must not exceed: 40 mg per day for an adult; 20 mg per day for children between 25 and 50 kg; and 0.8 mg/kg/day for children up to 25 kg. c) Applications and reapplications may be made by any medical practitioner and must specify that the diagnosis has been made or confirmed by the relevant specialist, general physician, general surgeon, or paediatrician. Reapplication criteria are the same as the original application criteria. d) Approvals are valid for 1 year.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Antispasmodics and Other Agents Altering Gut Motility Antiulcerants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer DICYCLOMINE HYDROCHLORIDE Tab 10 mg - Available on a PSO ....................................................... 4.95 Tab long-acting 40 mg ................................................................. 13.00 (Merbentyl Dospan tab long-acting 40 mg to be delisted 1 September 2003) DOMPERIDONE - Special Authority available Tab 10 mg ...................................................................................... 3.90 (7.99) 100 100 Merbentyl Merbentyl Dospan

100 Motilium

Additional subsidy by Special Authority: a) Approval to fully fund domperidone is available for the control of nausea and vomiting in the treatment of terminal care patients; b) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed the manufacturer’s price identified in the Pharmaceutical Schedule. c) Approvals valid for 6 months; d) Dispensed by retail pharmacy.

HYOSCINE N-BUTYLBROMIDE Tab 10 mg ...................................................................................... 6.83 (10.85) Inj 20 mg, 1 ml - Available on a PSO ................................................. 6.15 MEBEVERINE HYDROCHLORIDE - Retail pharmacy-specialist Tab 135 mg .................................................................................. 10.72 (12.00) METOCLOPRAMIDE HYDROCHLORIDE Tab 10 mg ...................................................................................... 3.00 (5.00) ‡ Oral liq 5 mg per 5 ml ...................................................................... 2.74 (4.40) Inj 5 mg per ml, 2 ml - Available on a PSO .................................... 26.50 100 5 90 Colofac 100 100 ml 50 Maxolon AstraZeneca Metamide Maxolon Buscopan Buscopan

ANTIULCERANTS Antisecretory and Cytoprotective

MISOPROSTOL - Retail pharmacy-specialist Tab 200 µg .................................................................................. 52.70 120 Cytotec

Helicobacter Pylori Eradication

OMEPRAZOLE, AMOXYCILLIN AND CLARITHROMYCIN Omeprazole cap 20 mg x 14, amoxycillin cap 500 mg x 28, clarithromycin tab 500 mg x 14 ........................................ 58.00 OMEPRAZOLE, AMOXYCILLIN AND METRONIDAZOLE Omeprazole cap 40 mg x 7, amoxycillin cap 500 mg x 21, metronidazole tab 400 mg x 21 ................................................ 58.00 Klacid Hp7 Losec Hp7 OAC Helicosec

1 OP

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

ALIMENTARY TRACT AND METABOLISM

Antiulcerants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

H2 Antagonists

CIMETIDINE

a) Only on a prescription. b) Not as an effervescent or dispersible tab.

Tab 200 mg ................................................................................... 5.00 Tab 400 mg ................................................................................. 10.00 (19.66) Tab 800 mg ................................................................................. 20.00 (65.53) FAMOTIDINE - Only on a prescription. Tab 20 mg ...................................................................................... 3.38 (4.50) (32.76) Tab 40 mg ...................................................................................... 3.38 (4.50) (32.76) RANITIDINE HYDROCHLORIDE - Only on a prescription. Tab 150 mg .................................................................................... 3.50 Tab 300 mg .................................................................................... 3.50 Inj 25 mg per ml, 2ml ...................................................................... 8.75 Oral liq 150 mg per 10 ml - Subsidy by endorsement ....................... 20.04 60 30 5 300 ml 100 100 100 Apo-Cimetidine Apo-CimetidineIMM CytineIMM Apo-CimetidineIMM Cytine IMM Apo-Famotidine IMM Famox IMM Pepzan IMM Pepcidine IMM Apo-Famotidine IMM Famox IMM Pepzan IMM PepcidineIMM Apo-RanitidineIMM Zantac IMM Apo-RanitidineIMM Zantac IMM Zantac Zantac

Subsidy by endorsement: Oral liquid is subsidised only for patients: - with oesophageal stricture, or - in terminal care, or - who are either too young or too old to swallow conventional tablets and the prescription is endorsed accordingly. Note: the cost of treatment with ranitidine oral liquid is more than 10 times higher than that of ranitidine tablets. Following the derestriction of access PHARMAC will be monitoring expenditure on ranitidine oral liquid more closely and may, subject to consultation and PHARMAC Board approval, restrict access again if the expenditure was to grow substantially.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Antiulcerants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Proton Pump Inhibitors

LANSOPRAZOLE Cap 30 mg ................................................................................... 12.91 (56.40) OMEPRAZOLE Cap 10 mg ................................................................................... Cap 20 mg ................................................................................... Cap 40 mg ................................................................................... Inj 40 mg ..................................................................................... 17.37 24.81 44.66 19.23 30 Zoton 30 30 30 1 30 Somac 30 Somac Losec Losec Losec Losec

PANTOPRAZOLE Tab 20 mg .................................................................................... 11.13 (22.00) Tab 40 mg .................................................................................... 14.17 (28.00)

Site Protective Agents

SUCRALFATE Tab 1 g ......................................................................................... 35.50 (48.28) TRIPOTASSIUM DICITRATOBISMUTHATE Tab 120 mg ................................................................................. 38.00 120 Carafate 112 De-nol

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

ALIMENTARY TRACT AND METABOLISM

Diabetes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

DIABETES Hyperglycaemic Agents

GLUCAGON HYDROCHLORIDE - Available on PSO Inj 1 mg syringe kit ........................................................................ 27.00 1 Glucagen Hypokit

Insulin – Short-acting Preparations

INSULIN NEUTRAL v Inj human 100 u per ml, 3 ml ......................................................... 42.66

5 10 ml OP

Inj human 100 u per ml ................................................................. 25.26

Actrapid Penfill Humulin R Actrapid Humulin R Actrapid Velosulin

INSULIN ANIMAL - Special Authority v Inj animal 100 u per ml, 10 ml ....................................................... 25.26

10 ml OP

Special Authority - Retail pharmacy: - Specialist must make application

Insulin – Intermediate and Long-acting Preparations

INSULIN ISOPHANE v Inj human 100 u per ml, 3 ml ......................................................... 29.86

5 10 ml OP

Inj human inj 100 u per ml ............................................................. 17.68

Humulin N Protaphane Penfill Humulin N Protaphane Humulin 70/30 Humulin 80/20 PenMix 10 PenMix 20 PenMix 30 PenMix 40 PenMix 50 Humulin 70/30 Humulin 80/20 Mixtard 30 Mixtard 50 Humulin L Monotard Humulin U Ultratard Insulatard Protaphane Mixtard 30

INSULIN ISOPHANE WITH INSULIN NEUTRAL v Inj human with neutral insulin 100 u per ml, 3 ml ............................ 42.66

Inj human with neutral insulin 100 u per ml .................................... 25.26

10 ml OP

INSULIN ZINC SUSPENSION v Inj human 100 u per ml ................................................................. 25.26

10 ml OP 10 ml OP

Inj crystalline human 100 u per ml ................................................. 25.26

INSULIN ANIMAL - Special Authority v Inj animal 100 u per ml, 10 ml ....................................................... 25.26

10 ml OP

Special Authority - Retail pharmacy: - Specialist must make application

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Diabetes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Insulin – Rapid acting insulin analogues

INSULIN ASPART - Special Authority available v Inj 100 u per ml, 3 ml ................................................................... 59.52 v Inj 100 u per ml, 10 ml ................................................................. 34.92 INSULIN LISPRO - Special Authority available Inj 100 u per ml, 3 ml .................................................................... 59.52 v Inj 100 u per ml, 10 ml .................................................................. 34.92

5 1 5 10 ml OP

NovoRapid Penfill NovoRapid Humalog Humalog

Rapid acting insulin analogues are subsidised when: 1) prescribed on the same prescription as insulin isophane; or 2) prescribed with insulin isophane but are on a different prescription and the prescription is endorsed accordingly; or 3) A Special Authority has been approved. For 1, 2 and 3 first prescription to be written by a specialist (diabetologist, general physician or paediatrician). Subsequent prescriptions can be written by any medical practitioner. Special Authority (for use other than use with insulin isophane) - Retail Pharmacy Subsidised for: a) use alone (monotherapy) where the patient is unable to use any other insulins including those on insulin pump treatment; b) use with insulin other than insulin isophane (including ready-mixed preparations), where a reasonable trial of insulin isophane has been undertaken and it is not effective or not well tolerated; - application and first prescription to be made/written by a specialist (diabetologist, general physician or paediatrician); - subsequent prescriptions can be written by any medical practitioner; - approvals valid for patient’s lifetime. Note: “Reasonable trial”, “unable to use”, “not effective”, and “not well tolerated” are not defined in the Pharmaceutical Schedule and we ask clinicians to use their clinical judgement in interpreting these terms.

Alpha glucosidase inhibitors

ACARBOSE - Special Authority Tab 50 mg .................................................................................... 22.00 Tab 100 mg .................................................................................. 31.00 90 90 Glucobay Glucobay

Special Authority-retail pharmacy a) Subsidised for patients who - require but are not able to tolerate metformin therapy; or - require metformin but in whom metformin is contraindicated; or - have not responded to or tolerated the maximum dose of metformin appropriate for that patient. b) Applications must be made by a specialist (as defined in the Pharmaceutical Schedule). c) Prescriptions may be written by any medical practitioner. d) Approvals valid for 2 years.

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

ALIMENTARY TRACT AND METABOLISM

Diabetes Diabetes Management

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Oral Hypoglycaemic Agents

GLIBENCLAMIDE Tab 2.5 mg ..................................................................................... 1.98 Tab 5 mg ........................................................................................ 2.10 GLICLAZIDE Tab 80 mg .................................................................................... 39.08 (78.80) (Diamicron tab 80 mg to be delisted 1 May 2003) GLIPIZIDE Tab 5 mg ....................................................................................... 3.65 METFORMIN HYDROCHLORIDE Tab 500 mg .................................................................................. 13.89 Tab 850 mg .................................................................................. 11.65 TOLBUTAMIDE Tab 500 mg .................................................................................... 6.78 100 100 500 Gliben Gliben Apo-Gliclazide Diamicron

100 500 250 100

Minidiab Metomin Metomin Diatol

DIABETES MANAGEMENT Glucose/Urine Testing

COPPER - Not on a bulk supply order Tab, diagnostic ............................................................................... 3.35 (7.80) 24 OP Clinitest

GLUCOSE OXIDASE - Not on a bulk supply order Urine diagnostic test with peroxidase ............................................... 8.26 100 strip OP (9.09) Urine diagnostic test with peroxidase ............................................... 8.21 100 strip OP (9.66) Urine diagnostic test ....................................................................... 4.11 50 strip OP (7.00)

Clinistix Diastix Diabur 5000

Glucose &/or Ketones/Urine Testing

GLUCOSE OXIDASE - Not on a bulk supply order Urine diagnostic test with peroxidase, sodium nitroprusside and aminoacetic acid ................................................................... 4.53 50 stick OP (8.00) Urine diagnostic test with peroxidase, potassium iodide, sodium nitroprusside and aminoacetic acid ................................... 9.06 100 strip OP (11.47) SODIUM NITROPRUSSIDE - Not on a bulk supply order Urine diagnostic strips, buffered ..................................................... 3.39 50 strip OP (6.00) Urine diagnostic strips, buffered ..................................................... 6.79 100 strip OP (8.43)

Keto-Diabur 5000

Keto-Diastix

Ketur-Test Ketostix

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Diabetes Management Digestives Including Enzymes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Glucose/Blood Testing

GLUCOSE OXIDASE Blood diagnostic test with peroxidase ............................................. 26.95 (27.85) 50 test OP Ascensia Glucodisc Advantage II Glucocard Glucometer Esprit Accutrend BM-Test 1-44 Glucometer Elite Precision Plus

(29.90) (36.11) Blood diagnostic test with peroxidase ........................................... 53.90 (55.70) (Glucometer Esprit and Glucometer Elite to be delisted 1 July 2003)

100 test OP

Insulin Syringes and Needles

Subsidy is available for disposable insulin syringes, needles, and pen needles if prescribed on the same form as the one used for the supply of insulin or when prescribed for an insulin patient and the prescription is endorsed accordingly. Disposable supplies

INSULIN SYRINGES, disposable with attached needle

a) Maximum of 50 plastic syringes with attached needles per prescription.

v v v v v v

Syringe 0.3 ml with 29 g x 12.7 mm needle ............................... Syringe 0.3 ml with 30 g x 8 mm needle .................................... Syringe 0.5 ml with 29 g x 12.7 mm needle ............................... Syringe 0.5 ml with 30 g x 8 mm needle .................................... Syringe 1 ml with 29 g x 12.7 mm needle .................................. Syringe 1 ml with 30 g x 8 mm needle ........................................

19.90 19.90 19.90 19.90 19.90 19.90

100 100 100 100 100 100

B-D Ultra Fine B-D Ultra Fine II B-D Ultra Fine B-D Ultra Fine II B-D Ultra Fine B-D Ultra Fine II

INSULIN PEN NEEDLES

a) Maximum 30 pen needles per prescription.

v v

29 g x 12.7 mm ......................................................................... 4.91 31 g x 8 mm ............................................................................. 4.91

30 30

B-D Micro-Fine B-D Micro-Fine

DIGESTIVES INCLUDING ENZYMES

PANCREATIC ENZYME Tab EC 1,900 BP u lipase, 1,700 BP u amylase, 110 BP u protease ........... Tab EC 5,600 BP u lipase, 5,000 BP u amylase, 330 BP u protease ........... Cap 8,000 BP u lipase, 9,000 BP u amylase, 430 BP u protease ......... Tab EC 7,400 FIP u lipase, 7,000 FIP u amylase, 420 FIP u protease - Retail pharmacy-specialist ............................. Cap 8,000 USP u lipase, 30,000 USP u amylase, 30,000 USP u protease - Retail pharmacy-specialist ..................... Cap EC 10,000 BP u lipase, 9,000 BP u amylase and 210 BP u protease - Retail pharmacy-specialist .................. Cap EC 25,000 BP u lipase, 18,000 BP u amylase, 1,000 BP u protease - Retail pharmacy-specialist .......................... Cap EC 5,000 BP u lipase, 3,000 BP u amylase, 350 BP u protease - Retail pharmacy-specialist ............................. Cap EC 25,000 BP u lipase, 22,500 BP u amylase, 1,250 BP u protease - Retail pharmacy-specialist ...................... 32.46 58.44 67.26 17.97 (23.86) 85.00 34.93 94.38 50.00 94.40 300 300 300 100 Combizym 250 100 100 250 100 Cotazym ECS Creon 10000 Creon Forte Pancrease Panzytrat Pancrex V Pancrex V Forte Pancrex V

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

ALIMENTARY TRACT AND METABOLISM

Digestives Including Enzymes Laxatives

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer URSODEOXYCHOLIC ACID - Special Authority Cap 300 mg ............................................................................... 298.54 Special Authority - Retail pharmacy 100 Actigall

a) For the treatment of primary biliary cirrhosis as confirmed by antimitochondrial antibody titre (AMA) > 1:80, raised cholestatic liver enzymes +/- raised serum IgM. If AMA is negative a typical biopsy result is considered diagnostic. Please note that liver biopsy is not usually required for diagnosis but is helpful to stage the disease. b) Exclusion/Exit criteria: - Actigall is not an appropriate therapy for patients requiring a liver transplant (bilirubin > 170 µmol/l; decompensated cirrhosis). These patients should be referred to an appropriate transplant centre. - Treatment failure – doubling of serum bilirubin levels, absence of a significant decrease in ALP or ALT and AST, development of varices, ascites or encephalopathy, marked worsening of pruritus or fatigue, histological progression by two stages, or to cirrhosis, need for transplantation. c) Applications to be made by a gastroenterologist. d) Prescriptions to be written by a gastroenterologist. e) Initial approvals valid for six months. f) Re-approvals valid for two years.

LAXATIVES Bulk-forming Agents

MUCILAGINOUS LAXATIVES - Only on a prescription Sugar Free ...................................................................................... 4.84 (10.60) Dry ............................................................................................ 5.28 (8.18) Dry ............................................................................................ 5.72 Dry ............................................................................................ 7.92 (11.75) Dry - original flavour, regular texture only ......................................... 5.91 (12.38) Dry ............................................................................................ 8.80 (14.90) (Konsyl D to be delisted 1 August 2003) MUCILAGINOUS LAXATIVES WITH STIMULANTS Dry ............................................................................................ 4.40 (9.52) Dry ............................................................................................ 3.52 (7.50) Dry ............................................................................................ 8.80 (14.90) 275 g OP Mucilax 300 g OP 325 g OP 450 g OP 336 g OP MetamucilIMM 500 g OP Normacol Mucilax IMM Konsyl D Isogel

250 g OP Granocol 200 g OP Normacol Plus 500 g OP Normacol Plus

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Laxatives

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Faecal Softeners

DOCUSATE SODIUM - Only on a prescription Tab 50 mg ..................................................................................... Tab 120 mg ................................................................................... Oral drops 10% .............................................................................. Enema conc 18% ........................................................................... 4.25 4.80 3.95 5.40 100 100 30 ml OP 100 ml OP 5 200 Coloxyl Coloxyl Coloxyl Coloxyl Coloxyl Laxsol

DOCUSATE SODIUM WITH BISACODYL Suppos 100 mg with bisacodyl 10 mg ........................................... 2.95 DOCUSATE SODIUM WITH SENNOSIDES Tab 50 mg with total sennosides 8 mg .............................................. 7.98

Osmotic Laxatives

GLYCEROL - Only on a prescription Suppos 2.55 g ............................................................................... 3.12 Suppos 3.6 g ................................................................................. 5.15 (6.00) LACTULOSE - Only on a prescription Oral liq 10 g per 15 ml ..................................................................... 3.88 MAGNESIUM HYDROXIDE Tab - Only when prescribed for a dialysis patient ............................. 10.15 SODIUM ACID PHOSPHATE - Only on a prescription Enema 16% with sodium phosphate 8% ........................................... 2.50 12 20 PSM 500 ml 72 1 Lactulose (Pacific) Phillips Milk of Magnesia Fleet Phosphate Enema Microlax Fleet Glycerin Suppositories

SODIUM CITRATE WITH SODIUM LAURYL SULPHOACETATE - Only on a prescription Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml ............. 8.21 12

Stimulant Laxatives

BISACODYL - Only on a prescription Tab 5 mg ........................................................................................ 8.82 Suppos 5 mg ................................................................................. 2.35 (3.00) Suppos 10 mg ............................................................................... 3.96 DANTHRON WITH POLOXAMER - Only on a prescription 200 6 12 Dulcolax Dulcolax Fleet

Note:Danthron with poloxamer is only approved for the prevention or treatment of constipation in the terminally ill. Studies in rats have associated use of danthron with tumours.

Oral liq 25 mg with poloxamer 200 mg per 5 ml ................................ 5.00 Oral liq 75 mg with poloxamer 1g per 5 ml ....................................... 7.50 SENNA - Only on a prescription Tab, standardised ........................................................................... 2.17 (5.49) 300 ml 300 ml 100 Senokot Conthram Conthram Forte

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

ALIMENTARY TRACT AND METABOLISM

Metabolic Disorder Agents Mouth and Throat

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

METABOLIC DISORDER AGENTS Gaucher’s Disease

IMIGLUCERASE - Special Authority - Hospital pharmacy [HP4] Inj 40 iu per ml, 200 iu vial ....................................................... 1,606.00 1 Cerezyme

Special Authority approved by the Gaucher treatment panel. a) Subject to a budgetary cap. Applications will be considered and approved subject to funding availability. Application details may be obtained from: The Coordinator, Gaucher Treatment Panel Phone: 09 580 9176 Level 3, Unisys House Facsimile: 09 580 9205 650 Great South Road, Penrose Email: murray@ppc.govt.nz Private Bag 92522, Auckland

MOUTH AND THROAT Agents Used in Mouth Ulceration

BENZYDAMINE HYDROCHLORIDE - Retail pharmacy-specialist prescription Soln 0.15% .................................................................................... 9.00 (14.20) CHLORHEXIDINE Mouthwash 0.2% ........................................................................... 2.75 CHOLINE SALICYLATE WITH CETALKONIUM CHLORIDE Adhesive gel 8.7% with cetalkonium chloride 0.01% ........................ 2.06 (3.86) SODIUM CARBOXYMETHYLCELLULOSE With pectin and gelatin paste ........................................................... 1.52 (3.60) With pectin and gelatin paste ........................................................... 4.55 (7.90) With pectin and gelatin paste ......................................................... 17.20 With pectin and gelatin paste ......................................................... 21.81 (25.90) With pectin and gelatin powder ....................................................... 8.48 (10.95) TRIAMCINOLONE ACETONIDE 0.1% in Dental Paste USP ................................................................ 4.66 500 ml Difflam 200 ml OP 15 g OP Bonjela 5 g OP Orabase 15 g OP 56 g OP 80 g OP 28 g OP Stomahesive 5 g OP Oracort Orabase Stomahesive Orabase Orion

Oropharyngeal Anti-Infectives

AMPHOTERICIN B Lozenges 10 mg ............................................................................. 4.51 (5.86) MICONAZOLE Oral gel 20 mg per g ...................................................................... 8.95 20 Fungilin 40 g OP Daktarin

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Mouth and Throat Vitamins

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer NYSTATIN Oral liq 100,000 u per ml ................................................................ 4.28 Pastilles 100,000 u ........................................................................ 6.30 (8.20) 24 ml OP 28 OP Mycostatin Mycostatin

Other Oral Agents

ALLOPURINOL Mouthwash 500 mg per 500 ml ..................................................... CE 500 ml

a) maximum 500 ml per prescription (refer page 168)

FOLINIC ACID - Hospital pharmacy [HP3]-specialist Mouthwash 15 mg per 500 ml ....................................................... CE 500 ml

a) maximum 500 ml per prescription (refer page 168)

HYDROGEN PEROXIDE Soln 10 vol ..................................................................................... 0.75 (1.40) 100 ml PSM

a) maximum 200 ml per prescription

PILOCARPINE Oral liq (refer page 168) ................................................................ CE SODIUM FLUORIDE Tab 1.1 mg ..................................................................................... 3.00 THYMOL GLYCERIN Compound, BPC ............................................................................ 7.30 (8.90) 500 ml 100 500 ml PSM PSM

Saliva Substitutes

SALIVA SUBSTITUTE Oral liq ......................................................................................... CE 500 ml

a) maximum 500 ml per prescription (refer page 168)

VITAMINS Vitamin A

VITAMIN A WITH VITAMIN D Cap 4500 iu with Vitamin D 450 iu ................................................. 14.46 (17.90) VITAMIN A WITH VITAMINS D AND C Soln 1000 u with Vitamin D 400 u and ascorbic acid 30 mg per 10 drops ............................................................... 4.38 (4.55) 500 Halibut-liver Oil

10 ml OP Vitadol C

Vitamin B Group

HYDROXOCOBALAMIN Inj 1 mg per ml, 1 ml ...................................................................... 2.80 (8.40) 3 Neo-Cytamen

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

ALIMENTARY TRACT AND METABOLISM

Vitamins

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer PYRIDOXINE HYDROCHLORIDE

a) Only on a prescription not exceeding a strength of 100 mg per dose.

Tab 25 mg ...................................................................................... 3.06 (4.66) Tab 50 mg .................................................................................... 12.59 (17.63) Tab 100 mg .................................................................................... 5.38 (11.35) THIAMINE HYDROCHLORIDE – only on a prescription Tab 10 mg ...................................................................................... 3.36 (4.59) Tab 25 mg ...................................................................................... 3.85 (5.21) Tab 50 mg ...................................................................................... 4.18 (5.62) VITAMIN B COMPLEX Tab, strong, BPC .......................................................................... 12.10 90 500 Apo-Pyridoxine 100 Apo-Pyridoxine 100 Apo-Thiamine 100 Apo-Thiamine 100 Apo-Thiamine 500 Apo-B-Complex Healtheries Apo-Pyridoxine

Vitamin C

ASCORBIC ACID

Only on a prescription not exceeding a strength of 100 mg per dose

Tab 50 mg ..................................................................................... 2.60 (3.25) Tab 100 mg .................................................................................. 13.00 (17.25) ASCORBIC ACID AND SODIUM ASCORBATE 100 Apo-Ascorbic Acid 500 Apo-Ascorbic Acid

Only on a prescription not exceeding a strength of 100 mg per dose

Tab 100 mg .................................................................................... 2.60 100 Healtheries Vitamin C

Vitamin D

ALFACALCIDOL - Retail pharmacy-specialist Cap 0.25 µg ................................................................................ 26.32 Cap 1 µg ..................................................................................... 87.98 Oral drops 2 µg per ml .................................................................. 60.68 CALCIFEROL Tab 1.25 mg (50,000 iu) ............................................................... 12.65 a) Maximum 12 tablets per prescription CALCITRIOL - Retail pharmacy-specialist Cap 0.25 µg ................................................................................ 52.63 Cap 0.5 µg .................................................................................. 87.98 Oral liq 1 µg per ml ...................................................................... 39.40 100 100 20 ml OP 12 One-Alpha One-Alpha One-Alpha PSM

100 100 10 ml OP

Rocaltrol Rocaltrol Rocaltrol solution

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

ALIMENTARY TRACT AND METABOLISM

Vitamins Minerals

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Vitamin E

ALPHA TOCOPHERYL ACETATE - Special Authority Water solubilised soln 156 iu/ml, with calibrated dropper ............... 13.50 50 ml OP Micelle E

Special Authority - Hospital pharmacy [HP3] a) Cystic fibrosis patients; or b) Infants and children with liver disease or short gut syndrome who require vitamin supplementation c) Specialist must make application - paediatricians, respiratory physicians.

Vitamin K

Refer to BLOOD, Antifibrinolytics, page 40

Multivitamin Preparations

VITAMINS Tab (BPC cap strength) ................................................................. 15.60 1000 Healtheries Multi-vitamin tablets

MINERALS Calcium

CALCIUM CARBONATE Tab 1.25 g ..................................................................................... 4.50 Tab 1.5 g ....................................................................................... 3.20 CALCIUM CHLORIDE Inj 10%, 10 ml .............................................................................. 10.45 CALCIUM GLUCONATE Inj 10%, 10 ml .............................................................................. 99.50 CALCIUM LACTATE-GLUCONATE Tab 1 g ......................................................................................... 10.52 100 60 5 50 30 Osteo~500 Osteo~600 Baxter Baxter Calcium-Sandoz 1000

Fluoride

SODIUM FLUORIDE Tab 1.1 mg ..................................................................................... 3.00 100 PSM

Iron

Refer to BLOOD, Iron Therapy, page 40

Magnesium

MAGNESIUM HYDROXIDE

a) Not subsidised as a laxative

Oral liq (Refer page 168) ............................................................... CE MAGNESIUM SULPHATE Inj 49.3% ................................................................................... 161.40 50 Baxter

Zinc

ZINC SULPHATE Cap 220 mg ................................................................................... 5.56 (8.82) 100 Zincaps

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

BLOOD AND BLOOD FORMING ORGANS

Antianaemics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIANAEMICS Hypoplastic and Haemolytic

ERYTHROPOIETIN ALPHA - Special Authority Inj human recombinant 1,000 u, pre-filled syringe .......................... 76.02 (162.90) Inj human recombinant 2,000 u pre-filled syringe ......................... 152.04 (325.80) Inj human recombinant 3,000 u pre-filled syringe ......................... 228.06 (455.34) Inj human recombinant 4,000 u pre-filled syringe ......................... 304.08 (572.40) Inj human recombinant 10,000 u pre-filled syringe ....................... 760.20 (1322.82) 6 Eprex 6 Eprex 6 Eprex 6 Eprex 6 Eprex

Special Authority - Hospital pharmacy [HP3] a) Erythropoietin alpha is indicated in the treatment of anaemia associated with chronic renal failure. b) Erythropoietin alpha is to be given only to patients with the anaemia of end-stage renal failure (other treatable causes of anaemia being excluded) who have been on haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) for at least three months, who are not under evaluation for, or awaiting, a live donor kidney transplant and who meet one or more of the following criteria: 1. Anephric patients 2. Patients who are dependent on regular blood transfusion (1 unit each 4–8 weeks) to maintain haemoglobin > 60 g per litre 3. Patients as in 2 who cannot be transfused because of severe transfusion reactions 4. Transfusion induced haemosiderosis (clinical manifestations, serum ferritin >1,500 ug per ltr) 5. Patients with haemoglobin < 70 g per litre (mean of at least 4 haemoglobin concentrations over 4 months) 6. Patients with haemoglobin < 90 g per litre who have heart failure (low cardiac output, LV ejection fraction < 40%) or persistent angina. c) Specialist must make application – renal physicians.

ERYTHROPOIETIN BETA- Special Authority Inj 1,000 u, pre-filled syringe ......................................................... 76.02 Inj 2,000 u pre-filled syringe ........................................................ 152.04 Inj 3,000 u pre-filled syringe ........................................................ 228.06 Inj 4,000 u pre-filled syringe ........................................................ 304.08 Inj 5,000 u pre-filled syringe ........................................................ 380.10 Inj 6,000 u pre-filled syringe ........................................................ 456.12 Inj 10,000 u pre-filled syringe ...................................................... 760.20 6 6 6 6 6 6 6 Recormon Recormon Recormon Recormon Recormon Recormon Recormon

Special Authority - Hospital pharmacy [HP3] a) Erythropoietin beta is indicated in the treatment of anaemia associated with chronic renal failure (CRF) where no cause for anaemia other than CRF is detected and there is adequate monitoring of iron stores and iron replacement therapy. b) Erythropoietin beta is to be given only to patients in chronic renal failure with haemoglobin ≤ 100 g/l; and i) glomerular filtration rate ≤ 30 ml/min in non diabetic patients; or ii) glomerular filtration rate ≤ 45 ml/min in diabetic patients iii) haemodialysis or peritoneal dialysis patients. c) Specialist must make application – renal physicians continued…

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

BLOOD AND BLOOD FORMING ORGANS

Antianaemics Antifibrinolytics, Haemostatics and Local Sclerosants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

continued… Note. The Cockroft-Gault Formula may be used to estimate glomerular filtration rate (GFR) in persons 18 years and over: (140 – age) x Ideal Body Weight (kg) (ml/min) GFR (male) = 814 x serum creatinine (mmol/l) GFR (female) = Estimated GFR (male) x 0.85

Iron Therapy

FERROUS GLUCONATE ‡ Oral liq 300 mg per 5 ml .................................................................. 5.90 FERROUS GLUCONATE WITH ASCORBIC ACID Tab 170 mg with ascorbic acid 40 mg ........................................... 12.04 FERROUS SULPHATE Tab long-acting 325 mg ................................................................... 5.06 (13.55) FERROUS SULPHATE WITH FOLIC ACID Tab long-acting 325 mg with folic acid 350 µg ................................ 9.02 (16.20) IRON POLYMALTOSE Inj 50 mg per ml, 2 ml ................................................................... 38.97 100 ml 500 Fergon Healtheries Iron with Vitamin C

150 Ferro-Gradumet 150 Ferrograd-Folic 5 Ferrum H

Megaloblastic

FOLIC ACID Tab 0.8 mg .................................................................................... 15.00 Tab 5 mg ......................................................................................... 6.62 Oral liq 50 µg per ml - Retail pharmacy-specialist ......................... 20.05 1,000 500 25 ml OP Apo-Folic Acid Apo-Folic Acid Biomed

Oral liq is: a) Retail pharmacy-specialist; and b) Prescriptions must be written by a paediatrician or paediatric cardiologist; or c) On the recommendation of a paediatrician or paediatric cardiologist.

Inj 15 mg per ml, 1 ml ................................................................... 11.00 (23.75) HYDROXOCOBALAMIN Inj 1 mg per ml, 1 ml ....................................................................... 2.80 (8.40) 5 Abbott 3 Neo-Cytamen

ANTIFIBRINOLYTICS, HAEMOSTATICS AND LOCAL SCLEROSANTS

APROTININ - Hospital pharmacy [HP3]-specialist Inj 10,000 µg per ml 50 ml ............................................................ 63.60 1 Trasylol

fully subsidised [HP1], [HP2], [ HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

BLOOD AND BLOOD FORMING ORGANS

Antifibrinolytics, Haemostatics and Local Sclerosants Antithrombotic Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer SODIUM TETRADECYL SULPHATE Inj 0.5% 2 ml ................................................................................. 23.20 (39.58) Inj 1% 2 ml .................................................................................... 25.00 (42.59) Inj 3% 2 ml .................................................................................... 28.50 (48.62) TRANEXAMIC ACID Tab 500 mg ................................................................................... 49.14

5 Fibro-vein 5 Fibro-vein 5 Fibro-vein 100 Cyklokapron

Vitamin K

MENADIONE SODIUM BISULPHITE Tab 10 mg ....................................................................................... 4.75 PHYTOMENADIONE Tab 10 mg ....................................................................................... 5.60 Inj 2 mg per 0.2 ml - Available on a PSO .......................................... 8.00 Inj 10 mg per ml, 1 ml - Available on a PSO ..................................... 9.21 100 10 5 5 K-Thrombin Konakion KonakionMM KonakionMM

ANTITHROMBOTIC AGENTS Antiplatelet Agents

ASPIRIN Tab 300 mg - Available on a PSO ................................................... 26.50 Tab, soluble 300 mg ...................................................................... 30.53 (30.69) (103.68) (118.08) DIPYRIDAMOLE Tab 25 mg - Special Authority available ............................................ 0.21 (9.95) Tab long-acting 150 mg - Special Authority available ...................... 11.95 Cap long-acting 150 mg - Special Authority available ...................... 11.95 (22.39) (Persantin PL tab long-acting 150 mg to be delisted 1 July 2003) 1000 1152 PSM SolprinIMM Disprin IMM Aspro ClearIMM 100 60 60 Persantin Pytazen SRIMM Persantin PL IMM

Additional Subsidy by Special Authority: a) Approval to fully fund dipyridamole tablets, long-acting tablets and capsules is available in the following circumstances: - Patients with prosthetic heart valves – as an adjunct to oral anticoagulation for prophylaxis of thromboembolism (applications only from cardiothoracic surgeons, cardiologists and general physicians); - Patients after coronary artery vein bypass graft – as an adjunct to aspirin or as monotherapy for patients who are aspirin intolerant as defined below (applications only from cardiothoracic surgeons, cardiologists and general physicians); or - Patients who continue to have transient ischaemic episodes despite aspirin therapy or have transient ischaemic episodes and are aspirin intolerant as defined below (applications only from neurologists, neurosurgeons, cardiologists, vascular surgeons and general physicians); b) Approvals are valid indefinitely; c) Aspirin intolerant patients are defined as those with aspirin induced asthma, urticaria, or anaphylaxis, or those with significant aspirin induced bleeding, excluding bruising; d) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed the manufacturer’s price identified in the Pharmaceutical Schedule.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

BLOOD AND BLOOD FORMING ORGANS

Antithrombotic Agents Fluids and Electrolytes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Heparin and Antagonist Preparations

HEPARINISED SALINE Inj 10 iu per ml, 5 ml ...................................................................... 20.00 Inj 100 iu per ml, 5 ml .................................................................... 96.50 HEPARIN SODIUM Inj 1,000 iu per ml, 5 ml ................................................................. 66.80 (79.65) Inj 1,000 iu per ml, 35 ml ................................................................. 7.25 Inj 5,000 iu per ml, 1 ml ................................................................... 9.60 Inj 5,000 iu per ml, 5 ml ............................................................... 138.65 (153.35) Inj 25,000 iu per ml, 0.2 ml - Hospital pharmacy [HP3]-specialist .... 7.50 Inj 25,000 iu per ml, 5 ml - Hospital pharmacy [HP3]-specialist ... 117.28 (143.18) PROTAMINE SULPHATE Inj 10 mg per ml, 5 ml ................................................................... 22.40 (39.70) 50 50 50 AstraZeneca Baxter Baxter Multiparin Monoparin Baxter Baxter Baxter Multiparin Baxter Monoparin Multiparin 10 Artex

1 5 50 5 10

Oral Anticoagulants

WARFARIN SODIUM v Tab 1 mg ......................................................................................... 3.46 v Tab 1 mg ......................................................................................... 5.69 v Tab 2 mg ......................................................................................... 4.31 v Tab 3 mg ......................................................................................... 8.00 v Tab 5 mg ......................................................................................... 5.93 v Tab 5 mg ......................................................................................... 9.64 Note: Marevan and Coumadin are not interchangeable. 50 100 50 100 50 100 Coumadin Marevan Coumadin Marevan Coumadin Marevan

FLUIDS AND ELECTROLYTES Intravenous Administration

DEXTROSE - Available on a PSO Inj 50% 10 ml .................................................................................. 5.28 (8.25) POTASSIUM CHLORIDE Inj 75 mg per ml, 10 ml ................................................................. 26.00 Inj 150 mg per ml, 10 ml ............................................................... 26.00 SODIUM BICARBONATE Inj 8.4%, 10 ml ............................................................................ 100.60 Inj 8.4%, 100 ml ............................................................................ 10.80 5 Baxter 50 50 50 1 AstraZeneca AstraZeneca Baxter Baxter

fully subsidised [HP1], [HP2], [ HP3], [HP4] refer page 10

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BLOOD AND BLOOD FORMING ORGANS

Fluids and Electrolytes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer SODIUM CHLORIDE a) Only if prescribed on a prescription for renal dialysis, maternity or post-natal care in the home of the patient or on a PSO for emergency use. (500 ml and 1,000 ml pack size) Inf 0.9% - Available on a PSO ........................................................... 3.06 500 ml Baxter Inf 0.9% - Available on a PSO ........................................................... 4.06 1,000 ml Baxter Inj 0.9%, 5 ml - Available on a PSO ................................................ 16.00 Inj 0.9%, 10 ml - Available on a PSO .............................................. 21.55 Inj 0.9%, 20 ml .............................................................................. 23.58 Inj 20%, 10 ml ............................................................................. 149.88 TOTAL PARENTERAL NUTRITION (TPN) - Special Authority ................ CBS 50 50 30 50 Pharmacia Pharmacia Pharmacia Baxter

Special Authority - Hospital pharmacy [HP1] a) Approved where application has specialist support and also underlying condition is serious. Also require: - quantity used by patient on a weekly volume intraveneously - amount of nutrition patient is able to receive orally - exact formula of TPN - who has paid for TPN so far - complete medical history of patient including details of previous therapies - place of manufacture. b) Specialist must make application.

WATER

a) On a prescription or Practitioner’s Supply Order only when on the same form as an injection listed in the Pharmaceutical Schedule requiring a solvent or diluent, or b) On a bulk supply order, or c) When used in the extemporaneous compounding of eye drops.

Purified for inj 2 ml ........................................................................ 21.90 Purified for inj 5 ml ........................................................................ 15.00 Purified for inj 10 ml ...................................................................... 20.00 Purified for inj 20 ml ...................................................................... 21.00 50 50 50 30 Baxter Pharmacia Pharmacia Pharmacia

Oral Administration

CALCIUM POLYSTYRENE SULPHONATE - Retail pharmacy-specialist Powder ........................................................................................ 141.54 COMPOUND ELECTROLYTES Powder for soln for oral use 5 g - Available on a PSO ....................... 5.52 (8.99) 300 g 10 Calcium Resonium Gastrolyte (Natural) Gastrolyte (Fruit) Gastrolyte (Orange) Plasma-Lyte Oral Pedialyte Pedialyte Fruit

DEXTROSE WITH ELECTROLYTES Soln with electrolytes ....................................................................... 3.44 500 ml OP (3.89) Soln with electrolytes ....................................................................... 6.66 946 ml OP (7.39)

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

BLOOD AND BLOOD FORMING ORGANS

Fluids and Electrolytes Lipid Modifying Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer POTASSIUM BICARBONATE - Retail pharmacy-specialist Tab 315 mg with sodium acid phosphate 1.937 g and sodium bicarbonate 350 mg, effervescent .................................. 75.00 POTASSIUM CHLORIDE Tab 548 mg (14 m eq) with chloride 285 mg (8 m eq) eff ................ 5.26 (11.85) Tab long-acting 600 mg ................................................................. 12.31 (15.39) SODIUM POLYSTYRENE SULPHONATE - Retail pharmacy-specialist Powder .......................................................................................... 89.10

100 60 500

Phosphate-Sandoz

Chlorvescent K-SR Slow K Resonium-A

450 g

LIPID MODIFYING AGENTS Fibrates

BEZAFIBRATE Tab 200 mg ..................................................................................... 7.80 Tab long-acting 400 mg 8.00 GEMFIBROZIL Cap 300 mg ..................................................................................... 9.58 (Gemizol cap 300 mg to be delisted 1 August 2003) 90 30 100 Fibalip Bezalip Retard Gemizol

Other lipid modifying agents

ACIPIMOX - Retail pharmacy-specialist Cap 250 mg ................................................................................... 18.75 NICOTINIC ACID Tab 25 mg ..................................................................................... 13.27 Tab 50 mg ....................................................................................... 4.79 Tab 100 mg ..................................................................................... 6.97 Tab 500 mg ................................................................................... 16.15 30 500 100 100 100 Olbetam Apo-Nicotinic Apo-Nicotinic Apo-Nicotinic Apo-Nicotinic Acid Acid Acid Acid

Resins

CHOLESTYRAMINE WITH ASPARTAME Sachets 4 g with aspartame ........................................................... 23.10 (33.00) COLESTIPOL HYDROCHLORIDE Sachets 5 g ................................................................................... 11.55 60 Questran Light 30 Colestid

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BLOOD AND BLOOD FORMING ORGANS

Lipid Modifying Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

HMG CoA Reductase Inhibitors (Statins)

ATORVASTATIN - Special Authority Tab 10 mg ..................................................................................... 24.91 Tab 20 mg ..................................................................................... 36.30 Tab 40 mg ..................................................................................... 50.35 30 30 30 Lipitor Lipitor Lipitor

Special Authority - Retail pharmacy a) Applications can be made by a general practitioner or relevant specialist. b) Approvals will be granted if the patient fulfills at least one of the criteria outlined in (h) or (i). c) Prescriptions for all patients can be written either by the general practitioner or the relevant specialist. d) All information requested on the application must be supplied. e) Prescribers are required to certify on the Special Authority application that the patient has been offered 3–6 months of counselling and an opportunity to modify lifestyle in the direction which current knowledge suggests would further reduce their risks of cardiovascular morbidity and mortality. f) Attach the results of at least two laboratory tests completed within 12 months of the Special Authority application. At least one of these tests must be fasting (with the exception of patients with IDDM). If a computerised record of cholesterol levels is used, it must be signed by the prescriber. g) Approvals are valid indefinitely. h) General practitioners or relevant specialists may make applications for patients who are in the following risk groups: NHF A1: Patients with proven cardiovascular disease A1:1 – Patients with clinically proven ischaemic heart disease total cholesterol > 5.5 A1:2 – Patients post coronary artery bypass graft (CABG) or angioplasty total cholesterol > 4.5 Patients post heart transplant, regardless of cholesterol level. NHF B: Patients with > 20% 5-year cardiovascular disease risk total cholesterol > 9.0 NHF C: 15-20% 5-year cardiovascular disease risk total cholesterol > 9.0 NHF D: 10-15% 5-year cardiovascular disease risk total cholesterol > 9.0 NHF E: Patients with < 10% 5-year cardiovascular disease risk total cholesterol > 9.0 i) Relevant specialists may make applications for patients in the following risk groups: NHF A1: A1:3 – Patients with proven ischaemic stroke or unequivocal history total cholesterol > 6.0 of transient ischaemic attack due to atherosclerosis A1:4 – Patients with unequivocal history of intermittent claudication total cholesterol > 6.0 NHF A2: Patients with Genetic Lipid Disorders: total cholesterol > 6.0 Familial Hypercholesterolaemia, Familial Defective Apo B, Familial Combined, Dyslipidaemia, Combined Dyslipidaemia (Type III) NHF A3: Patients with insulin and non-insulin dependant diabetes, and established total cholesterol > 6.0 nephropathy (albumin excretion greater than 300 mg/day) j) Risk Groups sourced from the 1996 NHF Guidelines for the assessment and management of dyslipidaemia, NZ MED J 1996; 109: 224–32. Note: Patients with a total cholesterol level greater than 9 mmol/l should have their initial assessment undertaken by a specialist.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

BLOOD AND BLOOD FORMING ORGANS

Lipid Modifying Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer SIMVASTATIN - See prescribing guideline below Tab 5 mg ......................................................................................... 9.30 Tab 10 mg ..................................................................................... 11.10 Tab 20 mg ..................................................................................... 13.50 Tab 40 mg ..................................................................................... 24.00 30 30 30 30 Zocor Lipex Lipex Lipex

Prescribing Guideline Treatment with HMG CoA Reductase Inhibitors (statins) is recommended for patients with dyslipidaemia and an absolute 5 year cardiovascular risk of 15% or greater. For New Zealand Cardiovascular Group statement refer pages 46–49. For Cardiovascular Risk Charts, refer pages 50–51.

New Zealand Cardiovascular Guideline Group statement.

“The 1996 Heart Foundation guidelines for the Assessment and Management of Dyslipidaemia are currently being revised. An evidence-based guideline on the Assessment and Management of Cardiovascular Risk will be developed in 2002. The Cardiovascular Guideline Group has written an interim consensus statement for the management of dyslipidaemia. The Heart Foundation cardiovascular risk tables should be used to determine risk. Certain groups are classified to be at very high risk (>20%) and should be treated as such: • Patients who have had a previous cardiovascular event (angina, MI, angioplasty, coronary artery bypass grafts, TIA, ischaemic stroke and peripheral vascular disease) • Patients with genetic lipid disorders • Patients with diabetes and associated microalbuminuria, proteinuria, renal disease or other cardiovascular risk factors.” Management of cardiovascular risk – an interim consensus statement for the management of dyslipidaemia. The National Heart Foundation, New Zealand Guidelines Group and Stroke Foundation have established a cardiovascular guideline group to provide interim recommendations for the management of dyslipidaemia until a more comprehensive guideline for the management of cardiovascular risk is completed in December 2002. Defining Risk The benefit of improving a patient’s lipid profile depends primarily on the patient’s absolute risk of cardiovascular disease. Each patient’s absolute risk is determined by the synergistic effect of all risk factors. STEP 1 – Who should have their lipids measured? 1) It is desirable for all adults to know their cardiovascular risk. Lipid measurements should be part of an overall CVD risk assessment. 2) It is strongly recommended that those with: • a personal history of CVD – coronary heart disease, cerebrovascular disease or peripheral vascular disease • possible genetic lipid disorders • diabetes mellitus and impaired glucose tolerance • other CVD risk factors should have their lipids measured 3) Lipid measurements in children is recommended only when there is a strong family history of a genetic lipid disorder continued…

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BLOOD AND BLOOD FORMING ORGANS

Lipid Modifying Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Which lipids should be measured? • Total cholesterol • LDL cholesterol (fasting) • HDL cholesterol • Triglycerides (fasting) A single lipid profile may be suitable to classify level of risk. However it is essential to establish an accurate baseline if intensive dietary or drug treatment is considered. This requires a minimum of two tests within 1–2 weeks, one of these tests should be fasting. STEP 2 – Assessment of Risk Certain groups are classified clinically to be at very high risk (>20% over 5 years) without the use of the risk factor charts: • Patients who have had a previous cardiovascular event (angina, MI, angioplasty, coronary artery bypass grafts, TIA, ischaemic stroke or peripheral vascular disease) • Patients with genetic lipid disorders • Patients with diabetes and associated microalbuminuria, proteinuria, renal disease or other cardiovascular risk factors. The Heart Foundation cardiovascular risk factor tables should be used to assess risk in all other patients. Certain factors confer additional risk and move the patient up one risk category: • A strong family history of clinically proven coronary heart disease or ischaemic stroke in a first degree relative (males < 55 years, females < 65 years) • Maori or Pacific peoples STEP 3 – Management of cardiovascular risk • In high (15–20% risk over 5 years) and very high risk patients (>20% risk over 5 years) the aim is to reduce the patient’s level of risk to less than 15% over five years taking into account the reduction of all modifiable risk factors. • The minimal goal of treatment should be to reduce risk by at least one risk category/colour STEP 4 – Treatment of dyslipidaemia Optimum levels • Total cholesterol • LDL cholesterol • HDL cholesterol • TC: HDL ratio • Triglycerides

< 4 mmol/l < 2.5 mmol/l > 1 mmol/l < 4.5 < 2 mmol/l

The effort put into achieving these optimum levels should be related to the pre-treatment level of risk. The higher the level of risk the greater the effort made to achieve these targets. Recognise secondary causes of lipid abnormalies • These are: Diabetes, obesity, insulin resistance, medication, liver disorders, thyroid disorders, and renal disease. • A rise in cholesterol is to be expected in pregnancy. A cholesterol level should not be measured at this time. continued …

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

BLOOD AND BLOOD FORMING ORGANS

Lipid Modifying Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Lifestyle interventions • Individualised dietary counselling and other lifestyle changes are integral to treatment. Dietary therapy is additive to drug therapy and may further reduce cardiovascular risk. A cardioprotective dietary pattern not only reduces LDL-cholesterol, it improves the lipid profile, lowers blood pressure, improves glycaemic control and reduces the risk of clotting. • Patients classified clinically at very high risk (>20% over five years) should begin statin treatment concurrently with intensive dietary treatment. • All other patients should try lifestyle interventions for 6–12 weeks prior to consideration of drug treatment. • Increasing physical activity and smoking cessation, if relevant, should be part of the treatment plan. Pharmacological treatment • Priority for drug treatment is given to those at higher absolute risk because treatment in this group gives greater benefit and is more cost effective. The treatment of choice needs to be based on the complete lipid profile, including total, LDL and HDL cholesterol and triglycerides. • Statins are appropriate if the main abnormality is a raised total cholesterol or LDL cholesterol • Fibrates are appropriate if low HDL and high triglycerides are a prominent feature • Hypertension and diabetes should be well controlled At what threshold should we initiate drug treatment? After an acute CVD event • Patients presenting with an acute CVD event (MI or ischaemic stroke) with total cholesterol >4.0 mmol/l or LDL cholesterol >2.5 mmol/l should begin treatment with a statin or other appropriate medication concurrently with intensive dietary treatment. Patients classified clinically to be at very high risk (>20%) defined in Step 2 • Patients at very high risk (>20% risk over 5 years) classified clinically with a total cholesterol >4.0 mmol/l or LDL cholesterol >2.5 mmol/l should be considered for treatment with a statin or other appropriate medication begun concurrently with intensive dietary treatment. Patients at high (15–20%) and very high risk (>20%) using risk tables • Patients at high risk (>15% over 5 years) or very high (>20% over 5 years) whose risk has been assessed using the risk tables and with a total cholesterol >5.5 mmol/l or LDL cholesterol >4.0 mmol/l should receive 6– 12 weeks of dietary intervention prior to being considered for treatment with a statin, or other appropriate medication. Dietary intervention should be continued indefinitely. Patients at moderate risk (10–15%) • Clinical judgement is required for patients at moderate risk (10–15% risk over 5 years). In general these patients should be treated with lifestyle intervention and dietary advice. Patients with diabetes • Patients with diabetes who have high triglycerides and low HDL as part of the metabolic syndrome should be considered for treatments known to improve this lipid profile – diet, physical activity, fish oils and drug treatment including fibrates. • Patients with diabetes at very high risk (>20% over 5 years) with an elevated total cholesterol or LDL cholesterol should be considered for statin therapy. continued…

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BLOOD AND BLOOD FORMING ORGANS

Lipid Modifying Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Older people • There should be no restriction on access to drug treatment for older people with dyslipidaemias. See thresholds for drug treatment. Duration of treatment • Lifelong use of a cardioprotective diet and/or medication is required. This statement is to be regarded as a practical guide to aid decision-making and not as a strict protocol. It is intended to inform, not replace, clinical judgement, which must ultimately determine the appropriate treatment for each individual. References are available from: http://www.nzgg.org.nz/working_groups/cardiovascular.cfm The risk tables can be downloaded from: http://www.nzgg.org.nz/library/gl_complete/bloodpressure/table1.cfm Members of the Cardiovascular Guideline Group advising on the management of cardiovascular risk are: Associate Professor Bruce Arroll Dr Michael Crooke Mr Euan Grigor Professor Rod Jackson Professor Jim Mann (Chair) Dr Stewart Mann Associate Professor Richard Milne Dr Ate Moala Dr Diana North Dr Tania Riddell Mr David Roberts Professor Russell Scott Professor Harvey White

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

CARDIOVASCULAR DISEASE: BASELINE RISK AND TREATMENT BENEFITS

Risk level women

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Notes: • If BP consistently >170/100 antihypertensive medication may be required irrespective of other risk factors. • If total cholesterol, or total cholesterol : HDL ratio > 8, the person is classified at least as high risk. • For age > 75 the absolute risk of CVD is > 15% in nearly all individuals. • Other important CVD risk factors not included in the risk tables are family history of CVD, physical inactivity, obesity and left ventricular hypertrophy. The presence of these factors should influence treatment decisions for patients at borderline treatment levels.

# Based on a 20% reduction in total cholesterol, or a reduction in blood pressure of 10–15 mmHg systolic or 5–8 mmHg diastolic, which reduces the risk of cardiovascular disease by about one-third over five years.

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CARDIOVASCULAR DISEASE: BASELINE RISK AND TREATMENT BENEFITS

Risk level men

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

The 1996 Heart Foundation guidelines for the Assessment and Management of Dyslipidaemia are currently being revised. An evidence-based guideline on the Assessment and Management of Cardiovascular Risk will be developed in 2002. Patients defined clinically at very high risk (>20%) • Patients who have had a previous cardiovascular event (angina, MI, angioplasty, coronary artery bypass grafts, TIA, ischaemic stroke and peripheral vascular disease) • Patients with genetic lipid disorders • Patients with diabetes and associated microalbuminuria, proteinuria, renal disease or other cardiovascular risk factors. The Heart Foundation cardiovascular risk factors tables should be used to assess risk in all other patients. How to use the tables: • Identify the table relating to the person’s sex, diabetic status, smoking status and age (age shown is the mean for that category, e.g. age 60 = 55-65 years). • Within the table find the cell nearest to the person’s blood pressure and the total cholesterol:HDL ratio. • Compare cell with the risk level key and categorize risk for treatment decisions. Certain factors confer additional risk and move the patient up one risk category: • A strong family history of clinically proven coronary heart disease or ischaemic stroke in a first degree relative (males < 55 years, females < 65 years) • Maori or Pacific peoples

Data reproduced with kind permission of the National Heart Foundation.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

CARDIOVASCULAR SYSTEM

Adrenergic Neurone Blockers Alpha Adrenoceptor Blockers Agents Affecting the Renin-Angiotensin System

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ADRENERGIC NEURONE BLOCKERS

GUANETHIDINE SULPHATE Inj 10 mg per ml, 1 ml ................................................................... 12.80 (25.00) 5 Ismelin

ALPHA ADRENOCEPTOR BLOCKERS

DOXAZOSIN MESYLATE Tab 2 mg ....................................................................................... 17.59 Tab 4 mg ....................................................................................... 25.99 PHENOXYBENZAMINE HYDROCHLORIDE Cap 10 mg ..................................................................................... 26.05 PHENTOLAMINE MESYLATE Inj 10 mg per ml, 1 ml ................................................................... 17.97 (27.50) PRAZOSIN HYDROCHLORIDE Tab 0.5 mg ...................................................................................... 3.97 Tab 1 mg ......................................................................................... 2.99 Tab 2 mg ......................................................................................... 4.49 Tab 5 mg ......................................................................................... 7.49 TERAZOSIN HYDROCHLORIDE Tab 7 x 1 mg and 7 x 2 mg ............................................................... 0.74 Tab 2 mg ......................................................................................... 1.97 (4.66) Tab 5 mg ......................................................................................... 2.91 (5.60) 250 250 100 5 Regitine 100 100 100 100 14 OP 28 Hytrin BPH 28 Hytrin BPH Hyprosin Hyprosin Hyprosin Hyprosin Hytrin BPH Starter Pack Dosan Dosan Dibenyline

AGENTS AFFECTING THE RENIN-ANGIOTENSIN SYSTEM ACE Inhibitors

Perindopril and trandolapril will be funded to the level of the ex-manufacturer price listed in the Schedule for patients who were taking these ACE inhibitors for the treatment of congestive heart failure prior to 1 June 1998. The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are “certified condition” or an appropriate description of the patient such as “congestive heart failure”, “CHF”, “congestive cardiac failure” or “CCF”. Definition of Congestive Heart Failure At the request of some prescribers the PTAC Cardiovascular subcommittee has provided a definition of congestive heart failure for the purposes of the funding of the manufacturer’s surcharge: “Clinicians should use their clinical judgement. Existing patients would be eligible for the funding of the surcharge if the patient shows signs and symptoms of congestive heart failure, and requires or has in the past required concomitant treatment with a diuretic. The definition could also be considered to include patients post myocardial infarction with an ejection fraction of less than 40%.”

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

CARDIOVASCULAR SYSTEM

Agents Affecting the Renin-Angiotensin System

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer CAPTOPRIL Tab 12.5 mg .................................................................................. 10.96 Tab 25 mg ..................................................................................... 15.53 Tab 50 mg ..................................................................................... 28.04 ‡ Oral liq 5 mg per ml - (restricted to children under 12 years of age) ....... 44.38 CILAZAPRIL Tab 0.5 mg ...................................................................................... 2.20 Tab 2.5 mg ...................................................................................... 5.85 Tab 5 mg ......................................................................................... 9.20 ENALAPRIL Tab 5 mg ....................................................................................... 18.89 Tab 10 mg ..................................................................................... 25.75 Tab 20 mg ..................................................................................... 36.20 LISINOPRIL Tab 5 mg ......................................................................................... 4.91 Tab 10 mg ....................................................................................... 7.14 Tab 20 mg ..................................................................................... 10.10 PERINDOPRIL Tab 2 mg ......................................................................................... 3.00 (18.50) Tab 4 mg ......................................................................................... 4.05 (25.00) QUINAPRIL Tab 5 mg ......................................................................................... 3.14 Tab 10 mg ....................................................................................... 5.02 Tab 20 mg ....................................................................................... 9.55 TRANDOLAPRIL Cap 0.5 mg ...................................................................................... 1.87 (11.43) (12.57) Cap 1 mg ........................................................................................ 3.06 (18.67) (20.54) Cap 2 mg ........................................................................................ 4.43 (27.00) (29.70) (Gopten cap 0.5 mg to be delisted 1 September 2003) Captohexal Captohexal Captohexal Capoten Inhibace Inhibace Inhibace Enahexal Enahexal Enahexal PrinivilIMM PrinivilIMM PrinivilIMM

500 500 500 95 ml OP 30 30 30 500 500 500 30 30 30 30

Coversyl 30 Coversyl 30 30 30 28 Gopten IMM Odrik IMM 28 Gopten IMM Odrik IMM 28 Gopten IMM Odrik IMM Accupril Accupril Accupril

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

CARDIOVASCULAR SYSTEM

Agents Affecting the Renin-Angiotensin System

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ACE Inhibitors with Diuretics

CILAZAPRIL WITH HYDROCHLOROTHIAZIDE Tab 5 mg with hydrochlorothiazide 12.5 mg ..................................... 8.75 ENALAPRIL WITH HYDROCHLOROTHIAZIDE Tab 20 mg with hydrochlorothiazide 12.5 mg ................................... 3.32 (8.70) QUINAPRIL WITH HYDROCHLOROTHIAZIDE Tab 10 mg with hydrochlorothiazide 12.5 mg ................................... 5.62 Tab 20 mg with hydrochlorothiazide 12.5 mg ................................. 10.15 28 30 Co-Renitec 30 30 Accuretic 10 Accuretic 20 Inhibace Plus

Angiotensin II Antagonists

CANDESARTAN - Special Authority Tab 4 mg ....................................................................................... 22.19 Tab 8 mg ....................................................................................... 26.42 Tab 16 mg ..................................................................................... 32.23 28 28 28 Atacand Atacand Atacand

Special Authority - Retail Pharmacy a) Subsidy is available for patients with raised blood pressure who meet the following conditions: - use of beta blocker or diuretic by the patient is contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses; and - use of an ACE inhibitor by the patient is contraindicated; or not well tolerated; or insufficient to control blood pressure adequately at appropriate doses. b) Applications can be made by a relevant specialist or general practitioner. Subsequent prescriptions can be written by any medical practitioner. c) Approvals are valid for two years. d) Dispensed by retail pharmacy.

LOSARTAN - Special Authority Tab 12.5 mg .................................................................................. 26.04 Tab 50 mg ..................................................................................... 34.72 30 30 Cozaar Cozaar

Special Authority - Retail Pharmacy a) Patients with congestive heart failure who have been treated with and cannot tolerate two ACE inhibitors due to persistent cough that resolves on cessation and recurs on re-challenge with ACE inhibitor. b) Patients who have experienced angioedema on an ACE inhibitor at any time in the past or patients who have experienced angioedema (even if not using an ACE inhibitor) in the last 2 years. c) Applications can be made by a cardiologist and subsequent prescriptions can be written by any medical practitioner. d) Approvals are valid indefinitely. e) Dispensed by retail pharmacy.

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

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CARDIOVASCULAR SYSTEM

Antiarrhythmics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIARRHYTHMICS

AMIODARONE HYDROCHLORIDE - Retail pharmacy-specialist v Tab 100 mg ................................................................................... 18.65

30 30 10 250 250 60 ml 5 100 100 100

Tab 200 mg ................................................................................... 30.52 Inj 50 mg per ml, 3 ml ................................................................... 60.84

Aratac Cordarone-X Aratac Cordarone-X Cordarone-X Lanoxin PG Lanoxin Lanoxin Lanoxin

DIGOXIN Tab 62.5 µg - Available on a PSO ..................................................... 6.51 Tab 250 µg - Available on a PSO ...................................................... 9.96 ‡ Oral liq 50 µg per ml ........................................................................ 8.11 Inj 25 µg per ml, 2 ml .................................................................... 24.64 DISOPYRAMIDE PHOSPHATE v Cap 100 mg ................................................................................... 15.00 (21.70) v Cap 150 mg ................................................................................... 23.83 v Tab long-acting 250 mg ................................................................. 71.60 (86.64) FLECAINIDE ACETATE - Retail pharmacy-specialist v Tab 50 mg ..................................................................................... 42.82 v Tab 100 mg ................................................................................... 75.63 v Cap long-acting 100 mg ................................................................ 42.82 v Cap long-acting 200 mg ................................................................ 75.63 Inj 10 mg per ml 15 ml .................................................................. 49.02 LIGNOCAINE HYDROCHLORIDE - Only on a PSO Inj twin pack 100 mg per 5 ml .......................................................... 8.50 (15.30) MEXILETINE HYDROCHLORIDE v Cap 50 mg ..................................................................................... 22.52 v Cap 200 mg ................................................................................... 53.05 v Cap long-acting 360 mg ................................................................ 39.07 PROPAFENONE HYDROCHLORIDE - Retail pharmacy-specialist v Tab 150 mg ................................................................................... 40.90 v Tab 300 mg ................................................................................... 73.00 (Rytmonorm tab 300 mg to be delisted 1 October 2003)

Rythmodan Rythmodan Rythmodan Retard

60 60 30 30 5 2

Tambocor Tambocor Tambocor CR Tambocor CR Tambocor

Xylocard

a) Subsidised only on a PSO for patients with ventricular arrhythmia and PSO is endorsed accordingly.

100 100 50 50 50 Mexitil Mexitil Mexitil PL Rytmonorm Rytmonorm

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

CARDIOVASCULAR SYSTEM

Antihypotensives Beta Adrenoceptor Blockers

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIHYPOTENSIVES

MIDODRINE - Special Authority Tab 2.5 mg .................................................................................... 53.00 Tab 5 mg ....................................................................................... 79.00 100 100 Gutron Gutron

Special Authority - Hospital pharmacy [HP3] a) Subsidy is available for patients with disabling orthostatic hypotension who meet the following conditions: - have had a trial of fludrocortisone (unless contra-indicated) with unsatisfactory results; and - are using appropriate non pharmacological treatments such as support hose, increased salt intake, exercise, and elevation of head and trunk at night; and - in whom orthostatic hypotension is not due to drugs. b) Treatment should be started with small doses and titrated upwards as necessary. Hypertension should be avoided, and the usual target is a standing systolic blood pressure of 90 mmHg. c) Applications and reapplications by general physicians, neurologists and geriatricians. d) Prescriptions may be written by relevant specialists (as above) or general practitioners.

BETA ADRENOCEPTOR BLOCKERS

All oral Beta Adrenoceptor Blockers are exempted from monthly dispensing for patients with angina or arrhythmia. ACEBUTOLOL v Cap 100 mg ..................................................................................... 9.50 100 ACB v Cap 200 mg ................................................................................... 15.94 100 ACB v Tab 400 mg ................................................................................... 27.63 100 ACB ATENOLOL Tab 50 mg ..................................................................................... 10.36 v Tab 100 mg ................................................................................... 16.99

500 500 30 30 30

Loten Loten Dilatrend Dilatrend Dilatrend

CARVEDILOL - Special Authority Tab 6.25 mg .................................................................................. 28.00 Tab 12.5 mg .................................................................................. 36.00 Tab 25 mg ..................................................................................... 45.00

Special Authority - Retail pharmacy a) Approved where patients are already on an ACE inhibitor or Angiotensin II Antagonist with; 1. Symptomatic heart failure NYHA functional class II–III who have been treated with metoprolol and are intolerant to metoprolol or have demonstrated a sub-optimal response to metoprolol; or 2. Symptomatic heart failure NYHA functional class III–IV or left ventricular systolic dysfunction with an ejection fraction of less than 35% . b) Approvals valid indefinitely. c) Applications to be made by a general practitioner or relevant specialist. d) Prescriptions for all patients can be written by either a general practitioner or the relevant specialist. Note: Where possible treatment should be initiated by or on the recommendation of a specialist.

CELIPROLOL v Tab 200 mg ................................................................................... 21.49 LABETALOL v Tab 50 mg ....................................................................................... 7.87 v Tab 100 mg ..................................................................................... 9.63 v Tab 200 mg ................................................................................... 16.79 v Tab 400 mg ................................................................................... 31.31 Inj 5 mg per ml, 20 ml ................................................................... 59.06 (88.60) 180 100 100 100 100 5 Celol Hybloc Hybloc Hybloc Hybloc Trandate

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

CARDIOVASCULAR SYSTEM

Beta Adrenoceptor Blockers Beta Adrenoceptor Blockers with Diuretics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer All oral Beta Adrenoceptor Blockers are exempted from monthly dispensing for patients with angina or arrhythmia. METOPROLOL SUCCINATE v Tab long-acting 23.75 mg ................................................................ 3.61 30 Betaloc CR v Tab long-acting 47.5 mg .................................................................. 4.50 30 Betaloc CR v Tab long-acting 95 mg ..................................................................... 7.40 30 Betaloc CR v Tab long-acting 190 mg ................................................................. 12.50 30 Betaloc CR METOPROLOL TARTRATE v Tab 50 mg ..................................................................................... 15.00 (16.50) v Tab 100 mg ................................................................................... 21.80 v Tab long-acting 200 mg ................................................................. 24.32 Inj 1 mg per ml, 5 ml ..................................................................... 24.08 (27.22) NADOLOL v Tab 40 mg ..................................................................................... 16.63 v Tab 80 mg ..................................................................................... 24.66 OXPRENOLOL v Tab 40 mg ....................................................................................... 5.95 v Tab 80 mg ....................................................................................... 9.86 PINDOLOL v Tab 5 mg ......................................................................................... 4.90 v Tab 10 mg ....................................................................................... 9.35

100 60 30 5 Lopresor Lopresor Slow-Lopresor Betaloc 100 100 100 100 100 100 100 Apo-Nadolol Apo-Nadolol Captol 40 Captol 80 Pindol Apo-Pindolol Pindol Apo-Pindolol Pindol Cardinol Cardinol Cardinol LA Apo-Sotalol Pacific Apo-Sotalol Pacific Sotacor Apo-Timolol Hypermol

Tab 15 mg ..................................................................................... 13.75

PROPRANOLOL v Tab 10 mg ....................................................................................... 2.22 v Tab 40 mg ....................................................................................... 2.78 v Cap long-acting 160 mg ................................................................ 12.83 SOTALOL v Tab 80 mg ....................................................................................... 6.00

100 100 100 60 60 5 100

Tab 160 mg ................................................................................... 10.45 Inj 10 mg per ml, 4 ml ................................................................... 31.80

TIMOLOL v Tab 10 mg ..................................................................................... 11.22

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

CARDIOVASCULAR SYSTEM

Calcium Channel Blockers

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

CALCIUM CHANNEL BLOCKERS Dihydropyridine Calcium Channel Blockers (DHP CCBs)

AMLODIPINE - Special Authority available - see below Tab 5 mg ....................................................................................... 12.81 (22.82) Tab 10 mg ..................................................................................... 24.38 (34.85) FELODIPINE Tab long-acting 2.5 mg .................................................................... 8.58 Tab long-acting 5 mg 12.81 Tab long-acting 10 mg 24.38 NIFEDIPINE - Special Authority available Tab long-acting 10 mg ................................................................... 17.16 (17.72) Tab long-acting 20 mg ..................................................................... 6.95 Tab long-acting 30 mg ................................................................... 12.81 (19.90) Tab long-acting 60 mg ................................................................... 24.38 (29.50) 30 Norvasc 30 Norvasc 30 30 30 60 100 30 30 Adalat Oros Adalat 10 Nyefax Retard Adalat Oros Plendil ER Plendil ER Plendil ER

Additional subsidy by Special Authority – Retail pharmacy - for: - Nifedipine tab long-acting 30 mg x 30 (Adalat Oros) up to $19.90 - Nifedipine tab long-acting 60 mg x 30 (Adalat Oros) up to $29.50 - Amlodipine 5 mg x 30 (Norvasc) up to $19.90 - Amlodipine 10 mg x 30 (Norvasc) up to $29.50 Is available for patients who: a) have angina that is not controlled by other anginal medications (including felodipine); or b) were taking amlodipine or Adalat Oros for the treatment of angina prior to 1 June 1999; or c) are receiving maximal antihypertensive therapy, require a DHP CCB, and cannot tolerate felodipine. d) Applications can be made and prescriptions can be written by a relevant specialist or GP . e) Approvals are valid for two years. f) Dispensed by retail pharmacy.

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

CARDIOVASCULAR SYSTEM

Calcium Channel Blockers Cardiac Glycosides Centrally Acting Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Other Calcium Channel Blockers

DILTIAZEM HYDROCHLORIDE Tab 30 mg ....................................................................................... 4.50 Tab 60 mg ....................................................................................... 8.50 Cap long-acting 90 mg .................................................................... 7.65 Cap long-acting 120 mg (once per day) ........................................... 5.10 Cap long-acting 120 mg (twice per day) ........................................ 18.00 Tab long-acting 180 mg ................................................................... 7.65 Cap long-acting 180 mg .................................................................. 7.65 Tab long-acting 240 mg ................................................................. 10.20 Cap long-acting 240 mg ................................................................ 10.20 PERHEXILINE MALEATE - Special Authority Tab 100 mg ................................................................................... 39.85 (44.60) 100 100 60 30 100 30 30 30 30 100 Pexsig Dilzem Dilzem Dilzem SR Cardizem CD Dilzem SR Dilzem LA Cardizem CD Dilzem LA Cardizem CD

Special Authority - Hospital pharmacy [HP3] a) Approvals will only be given for patients who have refractory angina, and who are already on maximal anti-anginal therapy. b) Specialist must make application - cardiologists, general physicians. c) Prescriptions can be written either by a specialist or general practitioner.

VERAPAMIL HYDROCHLORIDE Tab 40 mg ....................................................................................... 5.00 Tab 80 mg ....................................................................................... 6.50 Tab 120 mg ................................................................................... 25.32 Tab long-acting 120 mg ................................................................. 16.38 Tab long-acting 240 mg ................................................................. 29.50 Inj 2.5 mg per ml, 2 ml - Available on a PSO ..................................... 7.55 100 100 100 250 250 5 Verpamil Verpamil Civicor Verpamil SR Verpamil SR Isoptin

CARDIAC GLYCOSIDES

CENTRALLY ACTING AGENTS

CLONIDINE Tab 150 µg .................................................................................... 29.33 TDDS 2.5 mg, 100 µg per day ....................................................... 19.30 TDDS 5 mg, 200 µg per day ......................................................... 28.80 TDDS 7.5 mg, 300 µg per day ....................................................... 37.10 100 4 4 4 5 Catapres Catapres-TTS-1 Catapres-TTS-2 Catapres-TTS-3 Catapres

a) All transdermal patches are only on a prescription.

Inj 150 µg per ml, 1 ml .................................................................. 13.00

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

CARDIOVASCULAR SYSTEM

Centrally Acting Agents Diuretics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer METHYLDOPA Tab 125 mg ..................................................................................... 6.39 Tab 250 mg ..................................................................................... 9.30 Tab 500 mg ................................................................................... 15.99 METHYLDOPA WITH HYDROCHLOROTHIAZIDE Tab 250 mg with hydrochlorothiazide 15 mg .................................. 24.80 Prodopa Prodopa Prodopa Hydromet

100 100 100 100

DIURETICS Loop Diuretics

BUMETANIDE Tab 1 mg ....................................................................................... 13.63 Inj 500 µg per ml, 4 ml .................................................................... 7.95 100 5 Burinex Burinex Diurin 40 Diurin Lasix Baxter Lasix Lasix

FRUSEMIDE Tab 40 mg - Available on a PSO ..................................................... 10.99 1,000 Tab 500 mg - Retail pharmacy-specialist ....................................... 11.20 100 ‡ Oral liq 10 mg per ml ....................................................................... 9.69 30 ml OP Inj 10 mg per ml, 2 ml - Available on a PSO ................................... 36.50 50 (44.00) Infusion 10 mg per ml, 25 ml - Retail pharmacy-specialist ............. 43.76 5 (Lasix inj 10 mg per ml, 2 ml to be delisted 1 June 2003)

Potassium Sparing Diuretics

AMILORIDE Tab 5 mg ....................................................................................... 11.00 ‡ Oral liq 1 mg per ml - Retail pharmacy-specialist ........................... 24.95 SPIRONOLACTONE Tab 25 mg ....................................................................................... 5.60 Tab 100 mg ................................................................................... 18.50 ‡ Oral liq 5 mg per ml - Retail pharmacy-specialist ........................... 25.50 100 25 ml OP 100 100 25 ml OP Midamor Biomed Spirotone Spirotone Biomed

Oral liquids (both Amiloride and Spironolactone): a) Retail pharmacy-specialist; and b) Prescriptions must be written by a paediatrician or paediatric cardiologist; or c) On the recommendation of a paediatrician or paediatric cardiologist.

Potassium Sparing Combination Diuretics

AMILORIDE WITH FRUSEMIDE Tab 5 mg with frusemide 40 mg ...................................................... 5.00 (7.33) AMILORIDE WITH HYDROCHLOROTHIAZIDE Tab 5 mg with hydrochlorothiazide 50 mg ...................................... 11.95 TRIAMTERENE WITH HYDROCHLOROTHIAZIDE Tab 50 mg with hydrochlorothiazide 25 mg ...................................... 3.60 30 Frumil 500 100 Amizide Triamizide

Thiazide and Related Diuretics

BENDROFLUAZIDE Tab 2.5 mg - Available on a PSO .................................................... 13.50 Tab 5 mg ....................................................................................... 21.50 500 500 Neo-Naclex Neo-Naclex

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

CARDIOVASCULAR SYSTEM

Diuretics Nitrates Smoking Cessation

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer CHLOROTHIAZIDE ‡ Oral liq 50 mg per ml - Retail pharmacy-specialist ......................... 21.50 25 ml OP Biomed

CHLORTHALIDONE Tab 25 mg ....................................................................................... 6.70 CYCLOPENTHIAZIDE Tab 0.5 mg ...................................................................................... 2.50 INDAPAMIDE Tab 2.5 mg ...................................................................................... 1.18 50 28 30 Hygroton Navidrex Naplin

NITRATES

GLYCERYL TRINITRATE v Tab 600 µg - Available on a PSO ...................................................... 3.27 100 v Aerosol spray, 400 µg per dose CFC-free ......................................... 6.99 200 dose OP v Oral pump spray 400 µg per dose .................................................... 6.99 200 dose OP v TDDS 5 mg .................................................................................... 17.50 30 v TDDS 10 mg .................................................................................. 23.27 30 ISOSORBIDE DINITRATE v Tab 10 mg ....................................................................................... 4.13 v Tab 30 mg ..................................................................................... 11.00 ISOSORBIDE MONONITRATE v Tab 20 mg ..................................................................................... 18.00 v Tab long-acting 40 mg ................................................................... 14.84 v Tab long-acting 60 mg ..................................................................... 1.95 100 100 100 30 30 Anginine Glytrin Nitrolingual Pumpspray Nitroderm TTS Nitroderm TTS Coronex Coronex Ismo 20 Corangin Duride

SMOKING CESSATION

NICOTINE Patch 5 mg ...................................................................................... 9.54 Patch 10 mg .................................................................................... 9.63 Patch 15 mg .................................................................................... 9.71 Gum 2 mg (Fruit, Mint) .................................................................. 13.02 Gum 4 mg (Fruit, Mint) ................................................................... 17.41 7 7 7 96 96 Nicotrol Nicotrol Nicotrol Nicotinell Nicotinell

Nicotine patches and gum are only available/subsidised on presentation of a Quitline Exchange Card

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

CARDIOVASCULAR SYSTEM

Sympathomimetics Vasodilators

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

SYMPATHOMIMETICS

ADRENALINE Inj 1 in 1,000, 1 ml - Available on a PSO .......................................... 4.95 Inj 1 in 10,000, 10 ml - Available on a PSO .................................. 125.00 ISOPRENALINE HYDROCHLORIDE Inj 200 µg per ml, 1 ml ................................................................. 36.80 (135.00) METARAMINOL TARTRATE Inj 10 mg per ml, 1 ml ................................................................... 21.00 5 50 25 Isuprel 5 Aramine Baxter Baxter

VASODILATORS

AMYL NITRITE Ampoule, 0.3 ml crushable ............................................................ 62.92 (73.40) HYDRALAZINE Inj 20 mg per ml, 1 ml ................................................................... 30.50 (42.00) OXYPENTIFYLLINE - Special Authority Tab 400 mg ................................................................................... 36.94 12 Baxter 5 Apresoline 50 Trental 400

Special Authority - Hospital pharmacy [HP3] Approvals granted for: a) Chronic post-thrombotic venous stasis ulcers of more than 4 months duration where other interventions have failed; or b) Sudden hearing loss – ENT specialist only.

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

DERMATOLOGICALS

Antiacne Preparations Antibacterials Topical Antifungals Topical

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIACNE PREPARATIONS

For systemic antibacterials, refer to INFECTIONS, Antibacterials, page 91 ISOTRETINOIN - Hospital pharmacy [HP3]-dermatologist Cap 10 mg ..................................................................................... 39.00 Cap 10 mg ..................................................................................... 42.00 Cap 20 mg ..................................................................................... 57.00 Cap 20 mg ..................................................................................... 66.00 Oratane Roaccutane Oratane Roaccutane

60 30 60 30

ANTIBACTERIALS TOPICAL

For systemic antibacterials, refer to INFECTIONS, Antibacterials, page 91 FRAMYCETIN SULPHATE WITH GRAMICIDIN a) Only on a prescription, b) Not in combination. Oint 1.5% with gramicidin 0.005% ................................................... 6.60 (10.12) FUSIDIC ACID a) Only on a prescription,

15 g OP Soframycin

b) Not in combination,

c) Maximum 15 g per prescription. Crm 2% ........................................................................................... 6.60 Oint 2% ............................................................................................ 6.60 Gel 2% ............................................................................................. 6.60 MUPIROCIN a) Only on a prescription, b) Not in combination. Oint 2% ............................................................................................ 6.60 (8.24) POLYNOXYLIN a) Only on a prescription, b) Not in combination. Gel .................................................................................................. 3.50 (6.46) 15 g OP 15 g OP 15 g OP Fucidin Fucidin Fucidin

15 g OP Bactroban

15 g OP Ponoxylan

SILVER SULPHADIAZINE a) Only on a PSO, b) Not in combination. Crm 1% with chlorhexidine digluconate 0.2% ................................... 8.45 50 g OP (11.30) Crm 1% with chlorhexidine digluconate 0.2% ................................. 10.80 100 g OP (14.64) Crm 1% with chlorhexidine digluconate 0.2% ................................. 32.40 500 g OP (45.88)

Silvazine Silvazine Silvazine

ANTIFUNGALS TOPICAL

For systemic antifungals, refer to INFECTIONS, Antifungals, page 98 AMOROLFINE - Not in combination Nail soln 5% .................................................................................. 37.86 (60.07) 5 ml OP Loceryl

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

DERMATOLOGICALS

Antifungals Topical

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer CICLOPIROXOLAMINE - Not in combination Crm 1% ........................................................................................... 1.00 20 g OP (10.59) Soln 1% ........................................................................................... 4.36 20 ml OP (9.99) Nail soln 8% .................................................................................. 37.81 3.5 ml OP CLOTRIMAZOLE - Not in combination Crm 1% ........................................................................................... 0.80 20 g OP Soln 1% ........................................................................................... 4.36 20 ml OP (7.35) ECONAZOLE NITRATE - Not in combination Crm 1% ........................................................................................... 1.00 15 g OP (5.77) Crm 1% ........................................................................................... 1.00 30 g OP (9.60) Foaming soln 1%, 10 ml sachets ..................................................... 9.89 3 (11.30) Soln 1% ........................................................................................... 4.36 10 ml OP (6.70) Soln 1% ........................................................................................... 4.36 30 ml OP (10.22) KETOCONAZOLE - Not in combination Crm 2% ........................................................................................... 1.00 (10.00) 15 g OP Nizoral Micreme Daktarin Daktarin

Batrafen Batrafen Batrafen Clocreme Canesten Ecreme Pevaryl Pevaryl Pevaryl Pevaryl Pevaryl

MICONAZOLE NITRATE - Not in combination Crm 2% ........................................................................................... 0.90 20 g OP Lotn 2% ........................................................................................... 4.36 30 ml OP (10.32) Tincture 2% ..................................................................................... 4.36 30 ml OP (12.46) NYSTATIN - Not in combination Crm 100,000 u per g ....................................................................... 1.00 (4.10) (4.64) Oint 100,000 u per g ........................................................................ 1.00 (4.10) (4.91) Paste 100,000 u per g, 30 g ............................................................. 1.00 (7.30) 15 g OP

Nilstat Mycostatin 15 g OP Nilstat Mycostatin 30 g OP Mycostatin

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

DERMATOLOGICALS

Antifungals Topical Antipruritic Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer TOLCICLATE - Not in combination Crm 1% ........................................................................................... 1.00 30 g OP (5.76) TOLNAFTATE - Not in combination Crm 1% ........................................................................................... 1.00 20 g OP (8.35) Soln 1% ........................................................................................... 4.36 10 ml OP (6.67)

Tolmicen

Tinaderm Tinaderm

ANTIPRURITIC PREPARATIONS

CALAMINE - Not in combination Crm, aqueous, BP .......................................................................... 17.10 (21.75) Lotn, BP ........................................................................................ 21.60 (24.50) CROTAMITON - Not in combination Crm 10% ......................................................................................... 4.26 (4.45) Lotn 10% ......................................................................................... 7.56 (7.70) MENTHOL Crystals ......................................................................................... 32.20 (32.80) (42.40) 500 g PSM 2,000 ml PSM 20 g OP Eurax 50 ml Eurax 100 g PSM David Craig

a) Only in combination with aqueous cream, 10% urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without phenol liquefied. (David Craig menthol crystals to be delisted 1 July 2003)

PHENOL Liquified ........................................................................................ 21.20 (29.70) (37.00) 500 ml PSM David Craig

(David Craig phenol liquified to be delisted 1 July 2003) (PSM phenol to be delisted 1 August 2003)

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

DERMATOLOGICALS

Corticosteroids Topical

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

CORTICOSTEROIDS - TOPICAL

For systemic corticosteroids, refer to CORTICOSTEROIDS AND RELATED AGENTS, page 83

Corticosteroids - Plain

BETAMETHASONE DIPROPIONATE Crm 0.05% ...................................................................................... 2.96 (6.10) Crm 0.05% ...................................................................................... 8.97 (16.20) Crm 0.05% in propylene glycol base ................................................ 4.33 (12.20) Oint 0.05% ....................................................................................... 2.96 (5.75) Oint 0.05% ....................................................................................... 8.97 (15.10) Oint 0.05% in propylene glycol base ................................................ 4.33 (12.20) BETAMETHASONE VALERATE Crm 0.1% ........................................................................................ 1.20 Crm 0.1% ........................................................................................ 4.00 Oint 0.1% ......................................................................................... 1.20 Oint 0.1% ......................................................................................... 4.00 Lotn 0.1% ...................................................................................... 10.05 CLOBETASOL PROPIONATE Crm 0.05% ...................................................................................... 1.20 Oint 0.05% ....................................................................................... 1.20 15 g OP Diprosone 50 g OP Diprosone 30 g OP 15 g OP 50 g OP Diprosone 30 g OP Diprosone OV 30 g OP 100 g OP 30 g OP 100 g OP 50 ml OP 30 g OP 30 g OP Beta Cream Beta Cream Beta Ointment Beta Ointment Betnovate Dermol Dermol Diprosone OV Diprosone

CLOBETASONE BUTYRATE Crm 0.05% ...................................................................................... 5.38 30 g OP (5.91) Crm 0.05% .................................................................................... 16.13 100 g OP (18.33) Oint 0.05% ....................................................................................... 5.38 30 g OP (5.91) Oint 0.05% ..................................................................................... 16.13 100 g OP (18.33) (Eumovate oint 0.05%, 30 g OP and 100 g OP to be delisted 1 May 2003) DIFLUCORTOLONE VALERATE Crm 0.1% ........................................................................................ 8.97 (12.04) Fatty Oint 0.1% ................................................................................ 8.97 (12.04) Oint 0.1% ......................................................................................... 8.97 (12.04) 50 g OP

Eumovate Eumovate Eumovate Eumovate

Nerisone 50 g OP Nerisone 50 g OP Nerisone

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

DERMATOLOGICALS

Corticosteroids Topical

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer FLUOCINOLONE ACETONIDE Crm 0.025% .................................................................................... 5.38 Oint 0.025% ..................................................................................... 5.38 HYDROCORTISONE - Only on a prescription Crm 1% ........................................................................................... 0.37 (5.25) Crm 1% ........................................................................................... 2.44 (2.86) 30 g OP 30 g OP 15 g OP 100 g Egocort Lemnis Fatty Cream HC Douglas PSM m-Hydrocortisone Synalar Synalar

Powder .......................................................................................... 46.20 25 g a) Up to 5%; b) In a dermatological base (not proprietary Topical Corticosteroid - Plain); (refer page 164) c) With or without other dermatological galenicals. HYDROCORTISONE WITH WOOL FAT AND MINERAL OIL - Only on the prescription of a doctor Lotn 1% with wool fat hydrous 3% and mineral oil ............................ 5.92 250 ml HYDROCORTISONE BUTYRATE Crm 0.1% ........................................................................................ 5.00 Crm 0.1% ...................................................................................... 15.00 Oint 0.1% ....................................................................................... 15.00 Lipocream 0.1% .............................................................................. 5.00 Lipocream 0.1% ............................................................................ 15.00 Milky emulsion 0.1% ........................................................................ 5.00 Milky emulsion 0.1% ...................................................................... 15.00 METHYLPREDNISOLONE ACEPONATE Crm 0.1% ........................................................................................ 4.95 Oint 0.1% ......................................................................................... 4.95 MOMETASONE FUROATE Crm 0.1% ........................................................................................ 4.95 Crm 0.1% ...................................................................................... 13.52 Oint 0.1% ......................................................................................... 4.95 Oint 0.1% ....................................................................................... 13.52 Lotn 0.1% ...................................................................................... 10.00 TRIAMCINOLONE ACETONIDE Crm 0.02% ...................................................................................... 6.45 (7.34) Oint 0.02% ....................................................................................... 6.45 (7.34) 30 g OP 100 g OP 100 g OP 30 g OP 100 g OP 30 g OP 100 g OP 15 g OP 15 g OP 15 g OP 45 g OP 15 g OP 45 g OP 50 ml OP 100 g OP

DP Lotn HC Locoid Locoid Locoid Locoid Lipocream Locoid Lipocream Locoid Crelo Locoid Crelo Advantan Advantan Elocon Elocon Elocon Elocon Elocon Aristocort

100 g OP Aristocort

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

DERMATOLOGICALS

Corticosteroids Topical Disinfecting and Cleansing Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Corticosteroids - Combination

BETAMETHASONE DIPROPIONATE WITH CLOTRIMAZOLE - Only on a prescription Crm 0.05% with clotrimazole 1% ...................................................... 4.90 15 g OP (7.95) BETAMETHASONE DIPROPIONATE WITH SALICYLIC ACID - Only on a prescription Oint 0.05% with salicylic acid 3% ..................................................... 8.10 30 g OP (10.95) Lotn 0.05% with salicylic acid 2% .................................................... 9.74 50 ml OP (13.80) BETAMETHASONE VALERATE WITH CLIOQUINOL - Only on a prescription Crm 0.1% with clioquinol 3% ........................................................... 4.90 Oint 0.1% with clioquinol 3% ............................................................ 4.90 BETAMETHASONE VALERATE WITH FUSIDIC ACID a) Only on a prescription; b) Maximum 15 g per prescription. Crm 0.1% with fusidic acid 2% ........................................................ 4.90 (6.98) 15 g OP 15 g OP

Lotricomb

Diprosalic Diprosalic Betnovate-C Betnovate-C

15 g OP Fucicort

DIFLUCORTOLONE VALERATE WITH CHLORQUINALDOL - Only on a prescription Crm 0.1% with chlorquinaldol 1% .................................................... 4.90 15 g OP (7.05) HYDROCORTISONE WITH MICONAZOLE - Only on a prescription Crm 1% with miconazole nitrate 2% ................................................. 1.32 15 g OP HYDROCORTISONE WITH NATAMYCIN AND NEOMYCIN - Only on a prescription Crm 1% with natamycin 1% and neomycin sulphate 0.5% ................ 4.90 15 g OP (6.09) Oint 1% with natamycin 1% and neomycin sulphate 0.5% ................ 4.90 15 g OP (6.09) HYDROCORTISONE BUTYRATE WITH CHLORQUINALDOL - Only on a prescription Crm 0.1% with chlorquinaldol 3% .................................................... 4.90 15 g OP (6.10)

Nerisone C Micreme H

Pimafucort Pimafucort

Locoid C

TRIAMCINOLONE ACETONIDE WITH GRAMICIDIN, NEOMYCIN AND NYSTATIN - Only on a prescription Crm 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 µg per g ............................................. 3.49 15 g OP Viaderm KC (6.09) Kenacomb Oint 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 µg per g ............................................. 3.49 15 g OP Viaderm KC (6.09) Kenacomb (Kenacomb crm and oint 1 mg to be delisted 1 May 2003)

DISINFECTING AND CLEANSING AGENTS

CHLORHEXIDINE GLUCONATE

a) Only if prescribed for a dialysis patient and the prescription is endorsed accordingly; and b) Maximum of 500 ml per month.

Soln 4% ........................................................................................... 9.34 Handrub 0.5% with ethanol 70% ...................................................... 5.70 SODIUM HYPOCHLORITE Soln .............................................................................................. 2.71

500 ml 500 ml 2,500 ml

Orion Microshield Handrub Janola

a) only if prescribed for a dialysis patient and the prescription is endorsed accordingly. 68

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10 “IMM” interchangeable multi-source medicines Sole Subsidised Supply

DERMATOLOGICALS

Dusting Powders Barrier Creams and Emollients

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

DUSTING POWDERS

DIPHEMANIL METHYLSULPHATE

a) Subsidised only if prescribed for an amputee with an artificial limb, or for a paraplegic patient; and b) On a prescription endorsed accordingly.

Powder 2% ...................................................................................... 6.81 (10.70) 50 g OP Prantal

BARRIER CREAMS AND EMOLLIENTS Barrier Creams

ZINC Cream BP ........................................................................................ 6.55 (8.90) Ointment BP .................................................................................... 6.55 (8.90) (PSM Zinc ointment BP to be delisted 1 September 2003) ZINC AND CASTOR OIL Ointment BP ..................................................................................... 6.20 500 g Sigma Cream 500 g PSM 500 g PSM

Emollients

AQUEOUS CREAM ................................................................................ 2.65 CETOMACROGOL Cream BP ........................................................................................ 2.80 (4.35) EMULSIFYING OINTMENT BP ............................................................... 4.09 500 g 500 g PSM IPW 500 g AFT AFT

GLYCEROL WITH PARAFFIN AND CETYL ALCOHOL - Only on the prescription of a doctor Lotn 5% with paraffin liq 5% and cetyl alcohol 2% ............................ 1.40 250 ml (7.72)

HYDROCORTISONE WITH WOOL FAT AND MINERAL OIL, refer to CORTICOSTEROIDS - PLAIN, page 67 OILY CREAM BP ................................................................................... 2.80 500 g (9.96) David Craig (14.00) PSM OIL IN WATER EMULSION Crm .............................................................................................. 2.80 500 g Lemnis Fatty Cream UREA Crm 10% ........................................................................................ 2.52 100 g OP Nutraplus

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

DERMATOLOGICALS

Barrier Creams and Emollients Minor Skin Infections Parasiticidal Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer WOOL FAT WITH MINERAL OIL - Only on the prescription of a doctor Lotn hydrous 3% with mineral oil ...................................................... 0.70 125 ml OP (5.01) Lotn hydrous 3% with mineral oil ..................................................... 1.12 200 ml OP (5.00) Lotn hydrous 3% with mineral oil ..................................................... 1.40 250 ml OP (2.18) (7.22) Lotn hydrous 3% with mineral oil ..................................................... 2.10 375 ml OP (9.38) Lotn hydrous 3% with mineral oil ..................................................... 5.60 1,000 ml (8.70) (18.43) (22.35)

BK Lotion Alpha-Keri Lotion DP Lotion Hydroderm Lotion BK Lotion Alpha-Keri Lotion DP Lotion Hydroderm Lotion Alpha-Keri Lotion BK Lotion

Other Dermatological Bases

PARAFFIN White soft ...................................................................................... 17.89 (39.50) 2,500 g IPW PSM

a) Only in combination with a dermatological galenical or as a diluent for a proprietary Topical Corticosteroid - Plain.

MINOR SKIN INFECTIONS

POVIDONE IODINE Antiseptic soln 10% ......................................................................... 6.42 (7.20) Alcohol skin preparation 10% ........................................................... 8.13 (14.20) Oint 10% - Only on a prescription, maximum 100 g per prescription ... 2.88 Oint 10% - Only on a prescription, maximum 100 g per prescription ... 6.87 (7.25) 500 ml Betadine IMM Biocil Viodine IMM Betadine Skin Prep Viodine Biocil Betadine IMM Betadine IMM

500 ml 25 g OP 100 g OP

PARASITICIDAL PREPARATIONS

GAMMA BENZENE HEXACHLORIDE Crm 1% ........................................................................................... 3.20 (4.00) MALATHION Liq 0.5% .......................................................................................... 4.50 Liq 0.5% ........................................................................................ 11.00 MALDISON Crm shampoo 1% ............................................................................ 2.86 (5.27) 50 g OP Benhex 50 ml OP 200 ml 40 g OP Prioderm Derbac-M Derbac-M

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

DERMATOLOGICALS

Parasiticidal Preparations Psoriasis and Eczema Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer PERMETHRIN Crm 5% ........................................................................................... 4.50 30 g OP (10.00) Lotn 5% ........................................................................................... 4.50 50 ml OP (7.00)

Lyderm Quellada-P

a) Should be strictly reserved for use as second line therapy in: - patients unable to tolerate the other medications, such as infants, young children and patients with allergies or eczema; - cases of scabies which are resistant to gamma benzene hexachloride and resistant to malathion. b) Verification of drug resistance is dependent on the persistence of the condition after treatment. In order to establish whether there is drug resistance, the following criteria should be fulfilled: - a definite diagnosis of scabies should be made; - it should be ascertained that the medication was administered properly; - the possibility of reinfestation should have been excluded.

PSORIASIS AND ECZEMA PREPARATIONS

ACITRETIN - Hospital pharmacy [HP3]-dermatologist Cap 10 mg ..................................................................................... 94.75 Cap 25 mg ................................................................................... 203.70 CALCIPOTRIOL Crm 50 µg per g ........................................................................... 23.62 Oint 50 µg per g ........................................................................... 23.62 Crm 50 µg per g ........................................................................... 65.87 Oint 50 µg per g ........................................................................... 65.87 Soln 50 µg per ml .......................................................................... 23.65 Soln 50 µg per ml .......................................................................... 39.52 100 100 30 g OP 30 g OP 100 g OP 100 g OP 30 ml OP 60 ml OP Neotigason Neotigason Daivonex Daivonex Daivonex Daivonex Daivonex Daivonex

COAL TAR Soln gel 7.5% .................................................................................. 7.75 100 g OP (8.71) (Psorigel to be delisted 1 June 2003) COAL TAR Soln BP ......................................................................................... 32.45 500 ml (39.35) (45.95)

Psorigel

David Craig PSM

a) Up to 10%; b) Only in combination with a dermatological base or proprietary Topical Corticosteroid - Plain; (refer page 164) c) With or without other dermatological galenicals.

COAL TAR WITH ALLANTOIN, MENTHOL, PHENOL AND SULPHUR Soln 5% with sulphur 0.5%, menthol 0.75%, phenol 0.5% and allantoin 2.5% crm ................................................................. 3.43 (3.95) Soln 5% with sulphur 0.5%, menthol 0.75%, phenol 0.5% and allantoin 2.5% crm ................................................................. 6.59 (7.62) COAL TAR WITH SALICYCLIC ACID AND SULPHUR Solution 12% with salicyclic acid 2% and sulphur 4% ointment ......... 7.95

30g OP Egopsoryl TA 75 g OP Egopsoryl TA 40 g OP Cocois

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

DERMATOLOGICALS

Psoriasis and Eczema Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer CYCLOSPORIN A - Special Authority Cap 25 mg ..................................................................................... 85.00 Cap 50 mg ................................................................................... 169.34 Cap 100 mg ................................................................................. 338.69 Oral liq 100 mg per ml ................................................................. 377.38 50 50 50 50 ml OP Neoral Neoral Neoral Neoral

DITHRANOL Crm 1% ......................................................................................... 27.50 METHOXSALEN - Retail pharmacy-specialist Cap 10 mg ..................................................................................... 11.66 POTASSIUM PERMANGANATE Crystals ........................................................................................... 0.89 (3.45) 50 g OP 25 25 g PSM Micanol Oxsoralen

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

DERMATOLOGICALS

Psoriasis and Eczema Preparations Scalp Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer SALICYLIC ACID Powder .......................................................................................... 29.52 (37.95) (38.40) 500 g David Craig PSM

a) Only in combination with a dermatological base or proprietary Topical Corticosteroid - Plain; (refer page 164) b) With or without other dermatological galenicals.

SULPHUR Precipitated ...................................................................................... 7.92 (9.25) 100 g PSM

a) Only in combination with a dermatological base or proprietary Topical Corticosteroid - Plain; (refer page 164) b) With or without other dermatological galenicals.

TAR WITH CADE OIL Bath emulsion 7.5% coal tar, 2.5% cade oil, 7.5% compound ........... 9.70 (20.15) 350 ml Polytar Emollient

TAR WITH TRIETHANOLAMINE LAURYL SULPHATE AND FLUORESCEIN - Only on the prescription of a doctor Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium ................................................................. 2.20 500 ml Pinetarsol

SCALP PREPARATIONS

BETAMETHASONE DIPROPIONATE Scalp lotn 0.05% ............................................................................ 12.29 100 ml OP (22.24) BETAMETHASONE VALERATE Scalp app 0.1% ............................................................................... 3.25 Scalp app 0.1% ............................................................................... 8.13 CLOBETASOL PROPIONATE Scalp app 0.05% ............................................................................. 2.50 FLUOCINOLONE ACETONIDE Gel 0.02% ........................................................................................ 5.23 (7.95) HYDROCORTISONE BUTYRATE Scalp lotn 0.1% ................................................................................ 7.16 Scalp lotn 0.1% .............................................................................. 17.90 KETOCONAZOLE Shampoo 2% ................................................................................... 5.25 Shampoo subsidised: a) Only on a prescription; b) Maximum 100 ml per prescription. 100 ml OP 250 ml OP 30 ml OP 30 g OP Synalar Gel 100 ml OP 250 ml OP 100 ml OP Locoid Locoid Sebizole

Diprosone Beta Scalp Beta Scalp Dermol

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

DERMATOLOGICALS

Sunscreens Wart and Corn Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

SUNSCREENS

SUNSCREENS, PROPRIETARY - Retail pharmacy-specialist Crm .............................................................................................. 1.74 50 g OP (6.00) Crm .............................................................................................. 3.39 100 g OP (5.89) Oint .............................................................................................. 5.00 14 g OP (15.00) Lotn .............................................................................................. 4.80 125 ml OP (7.68) (9.45) Lotn .............................................................................................. 4.80 300 ml OP (8.59)

Aquasun 30+ Hamilton Sunscreen R V Paque Le Tan SPF 15+ Aquasun 30+ Aquabloc 30+ Le Tan SPF 15+

WART AND CORN PREPARATIONS

FORMALDEHYDE Soln 37% ......................................................................................... 8.50 500 ml PSM

a) 10% solution subsidised for treatment of plantar’s warts; b) Solution is reusable for multiple treatments; c) Maximum 2,000 ml per dispensing; d) Maximum 6,000 ml per prescription; e) Not available on BSO or to rural doctors on PSO.

(PSM formaldehyde soln 37% to be delisted 1 August 2003) PODOPHYLLOTOXIN Soln 0.5 % ..................................................................................... 32.00 a) Only on a prescription; b) Maximum 3.5 ml per prescription. SALICYLIC ACID 3.5 ml OP Condyline

a) Maximum 20 g or 20 ml per prescription (refer page 168).

Oint 20% ........................................................................................ CE Oint 40% ........................................................................................ CE Oint 60% ........................................................................................ CE Soln 20% ....................................................................................... CE Soln 40% ....................................................................................... CE 20 g 20 g 20 g 20 ml 20 ml

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

DERMATOLOGICALS

Other Skin Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

OTHER SKIN PREPARATIONS Antineoplastics

FLUOROURACIL SODIUM - Retail pharmacy-specialist Crm 5% ......................................................................................... 23.89 20 g OP Efudix

Topical Analgesia

ASPIRIN & CHLOROFORM Application (refer page 168) ........................................................... CE

Wound Management Products

HYDROGEN PEROXIDE Soln 20 vol .................................................................................... 12.52 (13.20) a) Maximum 500 ml per prescription. MAGNESIUM SULPHATE Paste .............................................................................................. 2.98 (4.10) 2,000ml PSM

80 g PSM

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

GENITO URINARY SYSTEM

Contraceptives – Non-hormonal

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

CONTRACEPTIVES – NON-HORMONAL Condoms

CONDOMS WITH SPERMICIDE - Available on a PSO .......................... 28.56 144 Durex Extra Confidence Lifestyles Spermicidal Shield Gold Durex Confidence Gold Knight Sagami Silver De Luxe Shield Blue Lifestyles Flared R3 Superfeucht Sagami Sustaining

CONDOMS WITHOUT SPERMICIDE - Available on a PSO .................... 18.50

144

(68.40) CONDOMS EXTRA STRENGTH - Available on a PSO ........................... 21.00 144

Spermicidal Agents

DI-ISOBUTYLPHENOXYPOLYETHOXY-ETHANOL - Available on a PSO Jelly 1% ........................................................................................... 5.81 (7.80) NONOXYNOL 9 - Available on a PSO Pessary ........................................................................................... 6.76 (Rendells Plus to be delisted 1 June 2003) APPLICATOR - when ordered with spermicide ...................................... 4.10 (4.34) 75 g OP Ortho-Gynol 12 OP each Ortho Rendells Plus

Contraceptive Devices

CERVICAL CAP - Only on a WSO .......................................................... 6.71 1 OP Dumas Vault Vimule Prentif Ortho All-flex Ortho Coil Nova-T Multiload Cu 375 Multiload Cu 375SL

(Dumas Vault, Vimule and Prentif cervical cap to be delisted 1 August 2003) DIAPHRAGM - Available on a PSO ...................................................... 42.90 INTRA-UTERINE DEVICE - Only on a WSO .......................................... 28.00 39.50 1 OP 1 OP

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

GENITO URINARY SYSTEM

Contraceptives – Hormonal

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

CONTRACEPTIVES – HORMONAL

Additional subsidy by Special Authority is available to reimburse the manufacturer’s price identified on the Pharmaceutical Schedule as at 1 November 1999. a) Additional subsidy to fund Mercilon, Marvelon, Minulet and Femodene is available for all new applications submitted after 1 November 1999 for women who are either: - on a Social Welfare benefit; or - have an income no greater than the benefit; AND - have tried at least one of the fully funded options and have been unable to tolerate it. b) The approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon, Marvelon, Minulet and Femodene. c) The additional subsidy will fund Mercilon, Marvelon, Minulet and Femodene up to the manufacturer’s price for each of these products as identified on the Schedule at 1 November 1999. d) Special Authorities approved before 1 November 1999 remain valid until the expiry date and can be renewed providing that women are still either: - on a Social Welfare benefit; or - have an income no greater than the benefit. e) The approval numbers of Special Authorities approved before 1 November 1999 are interchangeable for products within the combined oral contraceptives and progestogen-only contraceptives groups, except Loette, Melodene & Microgynon 20 ED. f) Approvals are valid for two years. g) Dispensed by retail pharmacy.

Combined Oral Contraceptives

Additional subsidy by Special Authority – refer above.

ETHINYLOESTRADIOL WITH DESOGESTREL - Available on a PSO Tab 20 µg with desogestrel 150 µg .................................................. 9.45 (13.80) Tab 20 µg with desogestrel 150 µg and 7 inert tab ........................... 9.45 (13.80) Tab 30 µg with desogestrel 150 µg .................................................. 9.45 (13.80) Tab 30 µg with desogestrel 150 µg and 7 inert tab ........................... 9.45 (13.80) ETHINYLOESTRADIOL WITH GESTODENE - Available on a PSO Tab 20 µg with gestodene 75 µg and 7 inert tab ............................... 3.15 (Special Authority does not apply) (6.00) Tab 30 µg with gestodene 75 µg ...................................................... 9.45 (15.00) Tab 30 µg with gestodene 75 µg and 7 inert tab .............................. 9.45 (14.49) (15.00) 63 Mercilon 21 84 Mercilon 28 63 Marvelon 21 84 Marvelon 28 28 Melodene 63 Femodene 21 84 Minulet 28 Femodene 28

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

GENITO URINARY SYSTEM

Contraceptives – Hormonal

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer ETHINYLOESTRADIOL WITH LEVONORGESTREL - Available on a PSO Tab 20 µg with levonorgestrel 100 µg and 7 inert tab (Special Authority does not apply) ............................................... 9.45 (16.50) Tab 30 µg with levonorgestrel 150 µg .............................................. 9.45 (15.00) Tab 30 µg with levonorgestrel 150 µg and 7 inert tab ....................... 9.45 (14.49) (15.00) Tab ethinyloestradiol 30 µg with levonorgestrel 50 µg (6) and tab ethinyloestradiol 40 µg with levonorgestrel 75 µg (5) and tab ethinyloestradiol 30 µg with levonorgestrel 125 µg (10) and 7 inert tab ............................................................................. 9.45 (14.49) Tab 50 µg with levonorgestrel 125 µg and 7 inert tab ...................... 9.45 Tab 50 µg with levonorgestrel 250 µg .............................................. 9.45 (13.80) Tab 50 µg with levonorgestrel 250 µg and 7 inert tab ....................... 9.45 (13.80) ETHINYLOESTRADIOL WITH NORETHISTERONE - Available on a PSO Tab 35 µg with norethisterone 500 µg .............................................. 9.45 (14.52) Tab 35 µg with norethisterone 500 µg and 7 inert tab ....................... 6.62 (14.52) Tab ethinyloestradiol 35 µg with norethisterone 500 µg (7 )and tab ethinyloestradiol 35 µg with norethisterone 1 mg (9) and tab ethinyloestradiol 35 µg with norethisterone 500 µg (5) and 7 inert tab ................................................................................... 9.45 (13.80) Tab 35 µg with norethisterone 1 mg ................................................. 9.45 (14.52) Tab 35 µg with norethisterone 1 mg and 7 inert tab .......................... 9.45 (14.52) (Brevinor 28 tab to be delisted 1 July 2003) ETHINYLOESTRADIOL WITH NORGESTREL - Available on a PSO Tab 50 µg with norgestrel 500 µg .................................................... 3.15 (4.73)

84 Loette Microgynon 20 ED 63 84 Microgynon 30 Levlen ED Monofeme Nordette 28 Microgynon 30 ED

84 63 84

Trifeme Triquilar ED Triphasil 28 Microgynon 50 ED Nordiol 21 Nordiol 28

63 84 Brevinor 21 Norimin Brevinor 28

84 Synphasic 28 63 Brevinor 1/21 84 Brevinor 1/28

21 Ovral

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

GENITO URINARY SYSTEM

Contraceptives – Hormonal Antiandrogen Oral Contraceptives

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer NORETHISTERONE WITH MESTRANOL - Available on a PSO Tab 1 mg with mestranol 50 µg ........................................................ 9.45 (13.80) Tab 1mg with mestranol 50 µg and 7 inert tab ................................. 9.45 (13.80) 63 Norinyl-1/21 84 Norinyl-1/28

Progestogen-only Contraceptives

Additional subsidy by Special Authority – refer page 77 (e). ETHYNODIOL DIACETATE - Available on a PSO Tab 500 µg ...................................................................................... 6.62 LEVONORGESTREL - Available on a PSO Tab 30 µg ........................................................................................ 8.70 (13.80) (14.50) MEDROXYPROGESTERONE ACETATE - Available on a PSO Inj 150 mg per ml, 1 ml syringe ........................................................ 8.47 Inj 150 mg per ml, 1 ml .................................................................... 8.47 NORETHISTERONE - Available on a PSO Tab 350 µg ...................................................................................... 9.10 84 84 Microval Microlut each each 84 Depo-Provera Depo-Provera Noriday 28 Femulen

Emergency Contraceptives

LEVONORGESTREL - Available on a PSO Tab 750 µg ...................................................................................... 8.50 a) Maximum of 4 tablets per prescription. 2 Postinor-2

ANTIANDROGEN ORAL CONTRACEPTIVES

CYPROTERONE ACETATE WITH ETHINYLOESTRADIOL Tab 2 mg with ethinyloestradiol 35 µg and 7 inert tabs ................... 9.45 84 Estelle 35

a) Prescribers may code prescriptions “contraceptive” (code “O”) when used as indicated for contraception. The period of supply and prescription charge will be as per other contraceptives, as follows: - $3.00 prescription charge (patient co-payment) will apply; - prescription may be written for up to six months supply; and - pharmacists may dispense up to three months supply. b) Prescriptions coded in any other way are subject to the non-contraceptive prescription charges, and the noncontraceptive period of supply. ie. Prescriptions may be written for up to three months supply, and dispensed monthly.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

GENITO URINARY SYSTEM

Gynaecological Anti-infectives Impotence Treatment

Myometrial and Vaginal Hormone Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

GYNAECOLOGICAL ANTI-INFECTIVES

ACETIC ACID WITH HYDROXYQUINOLINE AND RICINOLEIC ACID Jelly with acetic acid 0.94%, hydroxyquinoline sulphate 0.025% and ricinoleic acid 0.75% with applicator ...................................... 8.43 100 g OP (11.32) CLOTRIMAZOLE Pessaries 100 mg with applicator(s) ................................................ 1.93 6 Pessaries 500 mg with applicator ..................................................... 1.93 each Vaginal crm 1% with applicator(s) .................................................... 1.89 35 g OP Vaginal crm 2% with applicators ...................................................... 4.20 25 g OP ECONAZOLE NITRATE Pessaries 150 mg with applicators ................................................... 2.75 (9.71) Vaginal crm 1% with applicators ...................................................... 2.75 (8.97) MICONAZOLE NITRATE Vaginal crm 2% with applicator ........................................................ 2.75 Vaginal crm 2% with applicator ........................................................ 2.75 (4.38) NYSTATIN Vaginal crm 100,000 u per 5 g with applicator ................................. 4.40 (4.66) TIOCONAZOLE Vaginal oint 6.5% with applicator ...................................................... 2.75 (8.92) 3 Gyno-Pevaryl 40 g OP Gyno-Pevaryl 40 g OP 45 g OP Micreme Micozole 75 g OP Nilstat 4.6 g OP Gyno-Trosyd

Aci-Jel Clotrihexal Clotrihexal Clocreme Clotrimaderm 2%

IMPOTENCE TREATMENT

PAPAVERINE HYDROCHLORIDE Inj 12 mg per ml, 10 ml ................................................................. 68.00 5 Baxter

MYOMETRIAL AND VAGINAL HORMONE PREPARATIONS

ERGOMETRINE MALEATE Inj 500 µg per ml, 1 ml - Available on a PSO .................................. 11.60 (15.65) GEMEPROST - Special Authority Pessaries 1 mg ............................................................................ 258.14 5 Baxter 5 Cervagem

Special Authority - Hospital pharmacy [HP1] a) Termination of advanced pregnancy i.e. beyond 12 weeks. Only for Epsom Day Unit in Auckland. b) Specialist must make application.

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

GENITO URINARY SYSTEM

Myometrial and Vaginal Hormone Preparations Pregnancy Tests - HCG Urine Urinary Agents & Urinary Tract Infections

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer OESTRIOL Pessaries 500 µg ............................................................................. 7.25 Crm 1 mg per g with applicator ........................................................ 7.00 OXYTOCIN - Available on a PSO Inj 5 iu per ml, 1 ml .......................................................................... 4.00 (4.94) Inj 10 iu per ml, 1 ml ........................................................................ 5.00 (6.18) Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml ...................... 6.80 (8.40) 15 15 g OP 5 Syntocinon 5 Syntocinon 5 Syntometrine Ovestin Ovestin

PREGNANCY TESTS - HCG URINE

PREGNANCY TEST - HCG URINE - Only on a WSO

25 ............................................................................................ 29.50 25 tests MDS Quick Card

URINARY AGENTS Alpha Adrenoceptor Blockers

PHENOXYBENZAMINE HYDROCHLORIDE Cap 10 mg ..................................................................................... 26.05 TERAZOSIN HYDROCHLORIDE Tab 7 x 1 mg and 7 x 2 mg ............................................................... 0.74 Tab 2 mg ......................................................................................... 1.97 (4.66) Tab 5 mg ......................................................................................... 2.91 (5.60) 100 14 OP 28 Hytrin BPH 28 Hytrin BPH Dibenyline Hytrin BPH Starter Pack

Other urinary agents

OXYBUTYNIN Tab 5 mg ......................................................................................... 9.38 100 (12.94) Oral liq 5 mg per 5 ml .................................................................... 22.26 473 ml OP SODIUM CITRO-TARTRATE Grans effervescent 4 g sachets ........................................................ 3.20 (3.90) (4.33) 25 Citravescent Ural

Apo-Oxybutynin Apo-Oxybutynin

URINARY TRACT INFECTIONS

Refer also to INFECTIONS, Antibacterials, page 91 and INFECTIONS, Urinary Tract Infections, page 108.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Anabolic Agents Calcium Homeostasis

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANABOLIC AGENTS

NANDROLONE DECANOATE - Retail pharmacy-specialist Inj 50 mg per ml, 1 ml ............................................................... 21.15 1 Deca-Durabolin Orgaject

CALCIUM HOMEOSTASIS Alendronate for Osteoporosis

ALENDRONATE - Special Authority Tab 10 mg ..................................................................................... 51.30 Tab 70 mg ..................................................................................... 47.90 30 4 Fosamax Fosamax

Special Authority – Retail pharmacy a) Treatment of severe osteoporosis for patients meeting the following criteria: 1) history of one previous significant osteoporotic fracture demonstrated radiologically; and 2) documented bone mass density (BMD)≈ 3.0 standard deviations below the mean normal value in young adults (i.e. T-Score ≤ – 3.0). b) Application to be made by endocrinologist, rheumatologist, geriatrician, general physician, or gynaecologist. c) Approvals are valid indefinitely. d) Special Authority numbers for alendronate 10 mg and 70 mg can be interchangeable. Note: In line with the Australian guidelines for funding alendronate, a vertebral fracture is defined as a 20% or greater reduction in height of the anterior or mid portion of a vertebral body relative to the posterior height of that body, or a 20% or greater reduction in any of these heights compared to the vertebral body above or below the affected vertebral body.

Alendronate for Pagets Disease

ALENDRONATE - Special Authority Tab 40 mg ................................................................................... 133.00 30 Fosamax

Special Authority – Retail pharmacy a) Treatment of Paget’s disease for patients meeting one of the following criteria: - bone or articular pain - bone deformity - bone, articular or neurological complications - asymptomatic disease, but risk of complications due to site (base of skull, spine, long bones of lower limbs) - preparation for orthopaedic surgery. b) Relevant specialist must make application and reapplication. c) Approvals are valid for 6 months.

Other Treatments

CALCITONIN - Hospital pharmacy [HP3]-specialist Inj 100 iu per ml, 1 ml .................................................................. 100.00 ETIDRONATE DISODIUM - Retail pharmacy-specialist Tab 200 mg ................................................................................. 110.00 5 100 Miacalcic Etidrate

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Calcium Homeostasis Corticosteroids and Related Agents for Systemic Use

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer PAMIDRONATE DISODIUM - Special Authority Inj 3 mg per ml, 5 ml ..................................................................... 51.19 Inj 3 mg per ml, 10 ml .................................................................... 76.00 Inj 6 mg per ml, 10 ml .................................................................. 152.00 1 1 1 Baxter Baxter Pamisol Baxter Pamisol

Special Authority - Hospital pharmacy [HP3] a) Paget’s disease. b) Tumour-induced hypercalcaemia, only patients under hospice care. c) Tumour-induced osteolysis without hypercalcaemia, only patients under hospice care. d) Specialist must make application.

CORTICOSTEROIDS AND RELATED AGENTS FOR SYSTEMIC USE

BETAMETHASONE SODIUM PHOSPHATE WITH BETAMETHASONE ACETATE Inj 3.9 mg with betamethasone acetate 3 mg per ml, 1 ml .............. 19.20 (28.00) CORTISONE ACETATE v Tab 5 mg ......................................................................................... 8.09 (12.65) v Tab 25 mg ..................................................................................... 18.68 (25.00) DEXAMETHASONE - Retail pharmacy-specialist v Tab 1 mg - Available on a PSO ....................................................... 16.08 v Tab 4 mg - Available on a PSO ....................................................... 61.89 Oral liq 1 mg per ml ....................................................................... 38.00 5 Celestone Chronodose 100 Douglas 100 Douglas 100 100 25 ml OP Douglas Douglas Biomed

Oral liq prescriptions: a) Must be written by a paediatrician or paediatric cardiologist; or b) On the recommendation of a paediatrician or paediatric cardiologist.

DEXAMETHASONE SODIUM PHOSPHATE - Available on a PSO or BSO Inj 4 mg per ml, 1 ml ..................................................................... 22.60 Inj 4 mg per ml, 2 ml ..................................................................... 32.60 FLUDROCORTISONE ACETATE v Tab 100 µg ...................................................................................... 7.62 HYDROCORTISONE v Tab 5 mg ......................................................................................... 8.83 v Tab 20 mg ..................................................................................... 16.43 Inj 50 mg per ml, 2 ml - Only on a PSO ............................................ 3.72 METHYLPREDNISOLONE - Retail pharmacy-specialist v Tab 4 mg ....................................................................................... 48.57 v Tab 100 mg ................................................................................. 166.52 5 5 100 100 100 1 100 20 Baxter Baxter Florinef Douglas Douglas Solu-Cortef Medrol Medrol

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Corticosteroids and Related Agents for Systemic Use Corticosteriods - Injectables Sex Hormones Non Contraceptive

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer METHYLPREDNISOLONE SODIUM SUCCINATE - Retail pharmacy-specialist Inj 40 mg per ml, 1 ml .................................................................. 151.40 Inj 62.5 mg per ml, 2 ml ............................................................... 412.59 Inj 500 mg ..................................................................................... 39.16 Inj 1 g ............................................................................................ 70.95 PREDNISOLONE SODIUM PHOSPHATE - Available on a PSO Oral liq 5 mg per ml ......................................................................... 9.95 Solu-Medrol Solu-Medrol Solu-Medrol Solu-Medrol Redipred

25 25 1 1 30 ml OP

a) Restricted to children under 12 years of age.

PREDNISONE v Tab 1 mg ..................................................................................... 9.99 v Tab 2.5 mg ................................................................................ 11.41 v Tab 5 mg - Available on a PSO .................................................. 11.98 v Tab 20 mg ................................................................................. 35.41 TETRACOSACTRIN Inj 250 µg .................................................................................... 147.65 Inj 1 mg per ml, 1 ml ..................................................................... 22.40 500 500 500 500 10 1 Apo-Prednisone Apo-Prednisone Apo-Prednisone Apo-Prednisone Synacthen Synacthen Depot

CORTICOSTEROIDS - INJECTABLES

Refer to MUSCULO-SKELETAL, CORTICOSTEROIDS - INJECTABLES, page 112

SEX HORMONES NON CONTRACEPTIVE Androgen Agonists and Antagonists

CYPROTERONE ACETATE - Hospital pharmacy [HP3]-specialist prescription Tab 50 mg ..................................................................................... 84.75 Inj 100 mg per ml, 3 ml ............................................................... 196.82 SPIRONOLACTONE Tab 25 mg ....................................................................................... 5.60 Tab 100 mg ................................................................................... 18.50 TESTOSTERONE CYPIONATE - Retail pharmacy-specialist Inj long-acting 100 mg per ml, 10 ml ............................................. 61.41 TESTOSTERONE ENANTHATE - Retail pharmacy-specialist Inj long-acting 250 mg - prefilled syringe ....................................... 45.00 TESTOSTERONE ESTERS - Retail pharmacy-specialist Inj 250 mg per ml, 1 ml ................................................................. 12.98 TESTOSTERONE UNDECANOATE - Retail pharmacy-specialist Cap 40 mg ..................................................................................... 60.71 50 3 100 100 1 3 1 Siterone Androcur Depot Spirotone Spirotone Depo-Testosterone Primoteston Sustanon 250 Orgaject Panteston

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Hormone Replacement Therapy - Systemic

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

HORMONE REPLACEMENT THERAPY - SYSTEMIC

Additional subsidy by Special Authority (TDDS only): a) Approval for additional subsidy for transdermal delivery (TDDS) of HRT is available for patients who have either: - acute or significant liver disease – a declaration must be provided from a gastroenterologist or general physician stating that oral oestrogens are contraindicated due to liver disease; or - oestrogen induced hypertension requiring antihypertensive therapy – documented evidence must be provided that raised blood pressure levels or inability to control blood pressure adequately occurred post oral oestrogens; or - hypertriglyceridaemia – documented evidence must be provided that triglyceride levels increased to at least 2 x normal triglyceride levels post oral oestrogens; b) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed the level of the lowest priced TDDS product within the specified dose group; c) Applications to be written by general practitioner, obstetrician and gynaecologist, or general physician; d) Approvals valid for five years; e) Approvals for subsidy on Estraderm TTS25 remain valid until their expiry date; f) Dispensed by retail pharmacy.

Oestrogens

Low Dose OESTRADIOL TDDS 25 µg per day ........................................................................ 3.01 8 (10.86) Estraderm TTS 25 a) Only on a prescription; b) Maximum of 2 patches per week; c) Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the low dose oestrogens. OESTROGENS Conjugated, equine tab 300 µg ........................................................ 3.01 Medium/Low Dose OESTRADIOL Tab 1 mg ......................................................................................... 4.12 (6.50) 28 Premarin

28 OP Estrofem

OESTRADIOL VALERATE Tab 1 mg ......................................................................................... 4.12 28 (5.40) Progynova Medium Dose OESTRADIOL TDDS 50 µg per day ........................................................................ 4.12 8 (13.18) Estraderm TTS 50 a) Only on a prescription; b) Maximum of 2 patches per week; c) Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens. 4 TDDS 3.9 mg per day (releases 50 µg of oestradiol per day) ............ 4.12 (11.53) Climara 50 (11.73) Femtran 50 a) Only on a prescription; b) Maximum of 1 patch per week; c) Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens. ‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Hormone Replacement Therapy - Systemic

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer OESTROGENS Conjugated, equine tab 625 µg ........................................................ 4.12 Medium/High Dose OESTRADIOL Tab 2 mg ......................................................................................... 5.40 (7.00) OESTRADIOL VALERATE Tab 2 mg ......................................................................................... 5.40 28 Premarin

28 OP Estrofem 28 Progynova

High Dose OESTRADIOL TDDS 100 µg per day ...................................................................... 7.05 8 (16.14) Estraderm TTS 100 a) Only on a prescription; b) Maximum of 2 patches per week; c) Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the high dose oestrogens. TDDS 7.8 mg per day (releases 100 µg of oestradiol per day) .......... 7.05 4 (14.33) Climara100 (14.53) Femtran 100 a) Only on a prescription; b) Maximum of 1 patch per week; c) Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the high dose oestrogens. OESTROGENS Conjugated, equine tab 1.25 mg ...................................................... 7.05 28 Premarin

Progestogens

Low Dose MEDROXYPROGESTERONE ACETATE Tab 2.5 mg ...................................................................................... 4.13 (4.65) Medium Dose MEDROXYPROGESTERONE ACETATE Tab 5 mg ....................................................................................... 27.49 (30.93) High Dose MEDROXYPROGESTERONE ACETATE Tab 10 mg ..................................................................................... 15.14 (17.03)

30 Provera

100 Provera

30 Provera

Progestogen and oestrogen combined preparations

OESTRADIOL WITH LEVONORGESTREL Tab 2 mg with 75 µg levonorgestrel (12) and 2 mg oestradiol tab (16) ........ 5.40 28 Nuvelle

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

HORMONE PREPARATIONS - SYSTEMIC EXCLUDING CONTRACEPTIVE HORMONES

Hormone Replacement Therapy - Systemic Other Oestrogen Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer OESTRADIOL WITH NORETHISTERONE Tab 1 mg with 0.5 mg norethisterone acetate ................................... 5.40 28 OP (11.45) Kliovance Tab 2 mg with 1 mg norethisterone acetate ...................................... 5.40 28 OP (7.00) Cliane IMM (11.45) Kliogest IMM Tab 2 mg with 1 mg norethisterone acetate (10) and 2 mg oestradiol tab (12) and 1 mg oestradiol tab (6) ................... 5.40 28 OP (10.00) Trisequens TDDS 50 µg (10) and 1 mg norethisterone tab (12) ......................... 5.40 1 OP (17.75) Estrapak a) Only on a prescription; b) Maximum of 1 pack (10 patches and 12 tablets) per month; c) Additional subsidy by Special Authority available to fully fund to the level of the lowest priced TDDS brand within the medium dose oestrogens. (Estrapak TDDS 50 µg to be delisted 1 July 2003) OESTROGENS WITH MEDROXYPROGESTERONE Tab 625 µg conjugated equine with 2.5 mg medroxyprogesterone acetate tab (28) .................................... 5.40 (11.45) Tab 625 µg conjugated equine with 5 mg medroxyprogesterone acetate tab (28) .................................... 5.40 (11.45) Tab 625 µg conjugated equine (14), 625 µg conjugated equine 5 mg with medroxyprogesterone acetate tab (14) ......... 5.40 (10.45) Tab 625 µg conjugated equine (28) and 5 mg medroxyprogesterone acetate tab (28) ................................ 5.40 (11.00) Tab 625 µg conjugated equine (28) and 10 mg medroxyprogesterone acetate tab (14) .............................. 5.40 (10.00) OESTROGENS WITH NORGESTREL Tab 625 µg conjugated equine (28) and 150 µg norgestrel tab (12) ..... 5.40 (7.75) Tab 1.25 mg conjugated equine (28) and 150 µg norgestrel tab (12) .... 5.40 (7.75)

28 OP Premia 2.5 Continuous 28 OP Premia 5 Continuous 28 OP Premia 5 56 OP Menoprem Continuous 42 OP Menoprem 40 OP Prempak-C 40 OP Prempak-C

OTHER OESTROGEN PREPARATIONS

ETHINYLOESTRADIOL Tab 10 µg ...................................................................................... 16.52 (17.60) OESTRADIOL Implant 50 mg ............................................................................... 22.50 Implant 100 mg ............................................................................. 48.85 OESTRIOL Tab 2 mg ......................................................................................... 7.00 100 Paines and Byrne 1 1 30 Organon Organon Ovestin

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Other Progestogen Preparations Thyroid and Antithyroid Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

OTHER PROGESTOGEN PREPARATIONS

DYDROGESTERONE Tab 10 mg ..................................................................................... 27.50 (29.90) LEVONORGESTREL Levonorgestrel – releasing intauterine system 20 µg/24 hr Levonorgestrel .......................................................... 269.50 50 Duphaston

Mirena

Special Authority - Retail pharmacy a) Mirena is subsidised for use in patients with a clinical diagnosis of heavy menstrual bleeding who have failed to respond to or are unable to tolerate other appropriate pharmaceutical therapies as per the Heavy Menstrual Bleeding Guidelines together with evidence of either: i) a serum ferritin level below 16 mg/l (within the last 12 months); or ii) a Haemoglobin level of less than 120 g/l. For patients whose most recent insertion was before 1 October 2002, the criteria for application are: i) the patient had a clinical diagnosis of heavy menstrual bleeding; and ii) the patient demonstrated clinical improvement of heavy menstrual bleeding; and iii) the application must state the date of the previous insertion. b) Reapplications are to be made for subsequent insertions. The criteria for reapproval are: i) clinical improvement of heavy menstrual bleeding; or ii) removal or expulsion of a previous Mirena insertion for heavy menstrual bleeding within three months of that previous insertion. All reapplications must state the date of previous insertion. c) Applications and reapplications for Special Authority to be made by general practitioner or an appropriate specialist. d) Applications and reapplications to be made on a PHARMAC approved form. e) Approvals are valid for three months and for one Mirena insertion only. Note: Levonorgestrel releasing intrauterine system is not subsidised for use as a contraceptive.

MEDROXYPROGESTERONE ACETATE - Retail pharmacy-specialist Tab 100 mg ................................................................................. 104.26 Tab 200 mg ................................................................................... 78.06 Tab 500 mg ................................................................................. 211.68 NORETHISTERONE - Available on a PSO Tab 5 mg ....................................................................................... 25.00 PROGESTERONE Inj 50 mg per ml, 2 ml ................................................................... 35.97 (44.85) 100 30 56 100 10 Gestone Provera Provera Farlutal Primolut N

THYROID AND ANTITHYROID AGENTS

CARBIMAZOLE Tab 5 mg ......................................................................................... 3.13 LIOTHYRONINE Tab 20 µg ...................................................................................... 30.77 THYROXINE Tab 50 µg ...................................................................................... 34.00 Tab 100 µg .................................................................................... 38.00 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations.

100 100 1000 1000

Neo-Mercazole Tertroxin Eltroxin Eltroxin

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Trophic Hormones

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

TROPHIC HORMONES

GROWTH HORMONE BIOSYNTHETIC HUMAN - Special Authority Inj 4 iu per syringe ......................................................................... 80.00 Inj 10 iu per vial ........................................................................ 2,000.00 Inj 12 iu per vial ........................................................................... 240.00 Inj 24 iu per vial ........................................................................ 2,400.00 Cartridge 12 iu per vial ................................................................. 240.00 Cartridge 16 iu per vial .............................................................. 1,600.00 Cartridge 24 iu per vial .............................................................. 2,400.00 480.00 Cartridge 36 iu per vial .............................................................. 3,600.00 1 10 1 5 1 5 5 1 5 Humatrope Saizen Saizen Norditropin Saizen Norditropin Penset 12 Genotropin Saizen Norditropin Penset 24 Genotropin

Special Authority - Hospital pharmacy [HP1] a) Subject to a budgetary cap. Applications will be considered and approved subject to funding availability. b) Subject to a contract negotiated with the growth hormone committee.

(Norditropin inj 12 iu per vial, Norditropin Penset 12 and Norditropin Penset 24 to be delisted 1 May 2003) (Saizen inj 4 iu per syringe to be delisted 1 June 2003) RECOMBINANT HUMAN GROWTH HORMONE - Special Authority - Hospital Pharmacy [HP1] Inj 5 mg ....................................................................................... 300.00 1 Inj 10 mg ..................................................................................... 600.00 1 Inj 15 mg 900.00 1 Norditropin SimpleXx 5mg Norditropin SimpleXx 10mg Norditropin SimpleXx 15mg

GnRH Analogues

BUSERELIN ACETATE - Special Authority Inj 1 mg per ml, 5.5 ml ................................................................ 195.00 (259.55) GOSERELIN ACETATE - Special Authority Inj 3.6 mg .................................................................................... 277.00 Inj 10.8 mg - Subsidised only for treatment of prostate cancer. ..... 739.60 LEUPRORELIN - Special Authority Inj 3.75 mg Subsidised only for treatment of prostate cancer, endometriosis and precocious puberty .................................... 277.00 Inj 11.25 mg Subsidised only for treatment of prostate cancer ...... 739.60 NAFARELIN ACETATE - Special Authority Nasal soln 2 mg per ml ................................................................ 221.60 (311.63) 2 Suprefact 1 1 Zoladex Zoladex

1 1 8 ml OP

Lucrin Lucrin

Synarel

Special Authority (all GnRH Analogues)- Hospital pharmacy [HP3] a) Breast cancer – pre-menopausal women unwilling or unable to undergo surgical or radiation oophorectomy. b) Prostate cancer – for advanced prostatic cancer when orchidectomy is contraindicated, or where the patient strongly opposes orchidectomy. Not to be prescribed with an anti-androgen except for a period of three weeks, if necessary, when GnRH analogue therapy is initiated. - specialist must make application – oncologists, urologists and endocrinologists only. continued…

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

HORMONE PREPARATIONS - SYSTEMIC excluding Contraceptive Hormones

Trophic Hormones Vasopressin Agonists Other Endocrine Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

c) Endometriosis – only after 6 months treatment of one or more of the following agents (medroxyprogesterone acetate or danazol or dimetriose) has been tried and has either proven ineffective or the patient has failed to tolerate the treatment for 6 months. 1) The maximum treatment period for a GnRH analogue is: - 3 months treatment to assess whether surgery is appropriate - 3 months treatment for infertile patients after surgery - 6 months treatment for patients with symptoms of endometriosis. After the first 3 months patients should be assessed to determine whether there has been a satisfactory response to the first 3 months treatment. 2) Specialist must make application - gynaecologists only. d) Precocious puberty – only for patients affected by gonadotropin dependent precocious puberty. 1) Specialist must make application and reapplication – paediatricians and endocrinologists only. 2) Applications are valid for 12 months.

VASOPRESSIN AGONISTS

DESMOPRESSIN Inj 4 µg per ml, 1 ml - Special Authority ......................................... 67.18 v Nasal spray 10 µg per dose 50 dose - Retail pharmacy-specialist .. 78.06 v Nasal drops 100 µg per ml - Retail pharmacy-specialist ................. 39.03 10 5 ml OP 2.5 ml OP Minirin Minirin Minirin

Special Authority - Hospital pharmacy [HP3] a) Only for patients who cannot use the nasal spray and nasal drops. b) Specialist must make application.

OTHER ENDOCRINE AGENTS

BROMOCRIPTINE MESYLATE Tab 2.5 mg .................................................................................... 33.24 Tab 10 mg ................................................................................... 123.96 CABERGOLINE 100 100 Alpha-Bromocriptine Alpha-Bromocriptine

a) Restriction of two tablets per prescription.

b) Special Authority available to waive the above quantity restriction. Tab 0.5 mg .................................................................................. 105.03 8 Dostinex

Special Authority - Retail pharmacy: a) Restriction of two tablets per prescription to be waived for patients with pathological hyperprolactinemia. b) Application can be made by obstetricians, gynaecologists and endocrinologists. c) Approvals valid for two years. d) Prescriptions can be written by either the applying specialist or the patient’s general practitioner.

CLOMIPHENE CITRATE - Retail pharmacy-specialist

Subsidised only on a prescription for a female patient.

Tab 50 mg ....................................................................................... 2.99 DANAZOL - Retail pharmacy-specialist Cap 100 mg ................................................................................... 18.00 Cap 200 mg ................................................................................... 26.00 GESTRINONE - Retail pharmacy-specialist Cap 2.5 mg .................................................................................. 101.87 METYRAPONE - Hospital pharmacy [HP3]-specialist Cap 250 mg ................................................................................. 180.90 5 30 30 8 50 Phenate D-Zol D-Zol Dimetriose Metopirone

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

INFECTIONS - AGENTS FOR SYSTEMIC USE

Anthelmintics Antibacterials

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTHELMINTICS

MEBENDAZOLE - Only on a prescription Tab 100 mg ..................................................................................... 3.79 (6.80) (7.59) Oral liq 100 mg per 5 ml .................................................................. 2.18 (7.17) PYRANTEL EMBONATE Tab 125 mg ..................................................................................... 5.31 (7.00) Tab 250 mg ..................................................................................... 3.76 (4.95) Oral liq 50 mg per ml ....................................................................... 2.52 (4.45) 6 Mindol Vermox 15 ml Vermox 18 Combantrin 6 Combantrin 15 ml Combantrin

ANTIBACTERIALS

For topical antibacterials, refer to DERMATOLOGICALS, page 63, and SENSORY ORGANS page 157.

Cephalosporins and Cephamycins

CEFACLOR MONOHYDRATE Cap 250 mg ................................................................................... 35.50 Grans for oral liq 125 mg per 5 ml .................................................... 4.78 CEFAMANDOLE NAFATE - Hospital pharmacy [HP3]-specialist 100 100 ml Clorotir Clorotir

a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly.

Inj 500 mg ....................................................................................... 3.60 (4.30) Inj 1 g .............................................................................................. 4.30 CEFOXITIN SODIUM - Hospital pharmacy [HP3]-specialist 1 1 Mandol Mandol

a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly.

Inj 1 g ............................................................................................ 20.00 (57.80) CEFTRIAXONE SODIUM - Hospital pharmacy [HP3]-specialist 5 Baxter Mefoxin

a) Subsidised only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly.

Inj 250 mg ....................................................................................... 4.00 Inj 500 mg ..................................................................................... 39.60 Inj 1 g ............................................................................................ 62.50 1 5 5 Rocephin IV Novartis Novartis

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antibacterials

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer CEFUROXIME AXETIL

a) Only if prescribed for prophlyaxis of endocarditis; and b) The prescription is endorsed accordingly.

Tab 250 mg ................................................................................... 98.75 CEFUROXIME SODIUM 50 Zinnat

a) Hospital pharmacy [HP3] - Maximum of 750 mg per prescription; or b) Hospital pharmacy [HP3]-specialist - Only if prescribed for a dialysis or cystic fibrosis patient; and - The prescription is endorsed accordingly.

Inj 250 mg ..................................................................................... 20.97 Inj 750 mg ..................................................................................... 48.00 Inj 1.5 g ....................................................................................... 123.55 CEPHALEXIN MONOHYDRATE - Hospital pharmacy [HP3] Cap 250 mg ................................................................................... 30.00 Tab 500 mg ................................................................................... 54.50 Grans for oral liq 125 mg per 5 ml .................................................... 7.00 Grans for oral liq 250 mg per 5 ml .................................................... 9.50 CEPHALOTHIN SODIUM - Hospital pharmacy [HP3] 10 10 10 Baxter Zinacef Baxter Zinacef Keflex Keflex Keflex Keflex

100 100 100 ml 100 ml

a) Only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly.

Inj 1 g .............................................................................................. 6.90 (Keflin inj 1 g to be delisted 1 September 2003) CEPHAZOLIN SODIUM - Hospital pharmacy [HP3] 1 Keflin

a) Only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly.

Inj 500 mg ....................................................................................... 2.03 Inj 1 g .............................................................................................. 4.16 CEPHRADINE - Hospital pharmacy [HP3] Cap 250 mg ................................................................................... 11.17 Cap 500 mg ................................................................................... 22.05 Inj 500 mg ..................................................................................... 16.78 Inj 1 g ............................................................................................ 31.59 1 1 24 24 5 5 Novartis Novartis Velosef Velosef Velosef Velosef

Injections (both 500 mg and 1 g) subsidised: a) Only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly.

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antibacterials

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Macrolides

AZITHROMYCIN Tab 500 mg ................................................................................... 15.53 2 tab OP Zithromax

a) Subsidised only if prescribed for patients with uncomplicated urethritis or cervicitis due to chlamydia trachomatis and their sexual contacts and prescription is endorsed “certified condition”. b) Maximum one pack (two 500 mg tablets) per prescription.

CLARITHROMYCIN

a) Maximum of 500 mg per prescription; or

Tab 250 mg ..................................................................................... 1.88 2 10 Klacid

Klacid

b) More than 500 mg per prescription.

Tab 250 mg – Special Authority available ......................................... 2.99 (9.40)

Additional subsidy by Special Authority: Approval to fully fund clarithromycin tablets is available as follows: a) General Practitioners and appropriate specialists may apply for eradication of Helicobacter pylori in patients with proven infection and endoscopically proven peptic ulcer disease: • Approvals valid for six months. • Maximum two prescriptions (two courses) per patient. b) Respiratory physicians or infectious disease specialists may apply for patients with either: • Mycobacterium Avium Intracellulare Complex infections in patients with AIDS; or • Atypical and drug-resistant mycobacterial infections; or • Prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infections in patients with both HIV infection and a CD4 count of 50 or less. • Approvals valid for two years. c) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed at the manufacturer’s price identified in the Pharmaceutical Schedule; d) Dispensed by retail pharmacy. Oral liq 125 mg per 5 ml - Special Authority ............................ 23.12 70 ml Klacid

Special Authority - Hospital pharmacy [HP3] Approvals to fund clarithromycin oral liquid will be granted as follows: a) General Practitioners and appropriate specialists may apply for eradication of Helicobacter pylori in patients with proven infection and endoscopically proven peptic ulcer disease: • Approvals valid for six months only. • Maximum two prescriptions (two courses) per patient. b) Respiratory physicians or infectious disease specialists may apply for patients with either: • Mycobacterium Avium Intracellulare Complex infections in patients with AIDS; or • Atypical and drug-resistant mycobacterial infections; or • prophylaxis against disseminated Mycobacterium Avium Intracellulare Complex infections in patients with both HIV infection and a CD4 count of 50 or less. c) Approvals are valid for two years.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antibacterials

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer ERYTHROMYCIN ESTOLATE Tab 500 mg ..................................................................................... 2.99 ERYTHROMYCIN ETHYL SUCCINATE Tab 400 mg - Available on a PSO ................................................... 14.99 Grans for oral liq 200 mg per 5 ml - Available on a PSO ................... 2.75 Grans for oral liq 400 mg per 5 ml - Available on a PSO ................... 4.99 ERYTHROMYCIN LACTOBIONATE Inj 300 mg ....................................................................................... 5.34 Inj 1 g ............................................................................................ 10.57 ERYTHROMYCIN STEARATE Tab 250 mg - Available on a PSO ................................................... 14.95 (22.29) Tab 500 mg ................................................................................... 29.90 (44.58) ROXITHROMYCIN Tab 150 mg ..................................................................................... 2.99 (3.50) Tab 300 mg ..................................................................................... 2.99 (3.50) 10 100 100 ml 100 ml 1 1

Eromycin

E-Mycin E-Mycin E-Mycin Baxter Baxter ERA

100 ERA 100 ERA 10 Romicin 5 Romicin

Penicillins

AMOXYCILLIN Cap 250 mg - Available on a PSO .................................................. 19.25 Cap 500 mg ..................................................................................... 6.30 Grans for oral liq 125 mg per 5 ml - Available on a PSO ................... 1.08 Grans for oral liq 250 mg per 5 ml - Available on a PSO ................... 1.38 Drops 125 mg per 1.25 ml ............................................................... 4.75 Inj 250 mg ....................................................................................... 8.43 Inj 500 mg ..................................................................................... 11.06 Inj 1 g - Available on a PSO ........................................................... 15.66 500 100 100 ml 100 ml 30 ml OP 5 5 5 Ospamox Ospamox Ospamox Ospamox Ospamox Paediatric Drops Ibiamox Ibiamox Ibiamox

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antibacterials

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer AMOXYCILLIN CLAVULANATE - Available on a PSO Tab amoxycillin 500 mg with potassium clavulanate 125 mg ............ 6.40 (7.48) Grans for oral liq amoxycillin 125 mg with potassium clavulanate 31.25 mg per 5 ml ....................................................... 2.75 (3.43) Grans for oral liq amoxycillin 250 mg with potassium clavulanate 62.5 mg per 5 ml .......................................................... 4.75 (5.89) BENZATHINE PENICILLIN Inj 1.2 mega u per 2 ml - Available on a PSO ............................... 112.00 BENZYLPENICILLIN SODIUM (PENICILLIN G) Inj 1 mega u - Available on a PSO .................................................... 6.90 DICLOXACILLIN Cap 250 mg ..................................................................................... 2.47 (4.14) Cap 500 mg ..................................................................................... 3.83 (8.24) Grans for oral liq 125 mg per 5 ml .................................................... 3.55 (3.60) Inj 500 mg ....................................................................................... 6.80 (7.90) Inj 1 g ............................................................................................ 10.20 (13.50) FLUCLOXACILLIN MAGNESIUM - Available on a PSO Grans for oral liq 125 mg per 5 ml .................................................... 3.55 Grans for oral liq 250 mg per 5 ml .................................................... 6.00 FLUCLOXACILLIN SODIUM Cap 250 mg - Available on a PSO .................................................. 10.29 Cap 500 mg ................................................................................... 39.90 Inj 250 mg ....................................................................................... 5.05 Inj 500 mg ....................................................................................... 6.80 Inj 1 g - Available on a PSO ............................................................ 10.20 PHENOXYMETHYLPENICILLIN (PENICILLIN V) Cap potassium salt 250 mg - Available on a PSO ............................. 4.04 Cap potassium salt 500 mg ............................................................. 7.78 Grans for oral liq benzathine 125 mg per 5 ml - Available on a PSO .... 1.79 Grans for oral liq benzathine 250 mg per 5 ml - Available on a PSO .... 1.99 PROCAINE PENICILLIN - Available on a PSO Inj 1.5 mega u ................................................................................ 47.60 Augmentin Synermox Augmentin Synermox Augmentin Synermox

100 ml

(Synermox tab, grans for oral liq 125 mg/31.25 mg per 5 ml and 250 mg/62.5 mg per 5 ml to be delisted 1 June 2003) 10 5 Bicillin Benpen IMM Novartis IMM Diclocil 24 Diclocil 100 ml Diclocil 5 Diclocil 5 Diclocil 100 ml 100 ml 100 250 5 5 5 50 50 100 ml 100 ml 5 Floxapen Floxapen Staphlex Staphlex Flucloxin Flucloxin Flucloxin Cilicaine VK Cilicaine VK AFT AFT Cilicaine

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antibacterials

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Tetracyclines

DOXYCYCLINE HYDROCHLORIDE - Available on a PSO Tab 50 mg ....................................................................................... 2.90 (6.00) Tab 100 mg ..................................................................................... 8.68 MINOCYCLINE HYDROCHLORIDE Tab 50 mg ....................................................................................... 5.79 (12.05) Cap 100 mg ................................................................................... 19.32 (52.04) 30 250 60 Mino-tabs 100 Minomycin Doxy-50 Doxine

Other Antibiotics

For Topical Antibiotics, refer also to DERMATOLOGICALS, Anti-Acne Preparations, page 63 CHLORAMPHENICOL - Retail pharmacy-specialist Cap 250 mg ..................................................................................... 6.06 16 CIPROFLOXACIN - Retail pharmacy-specialist Tab 250 mg ................................................................................... 11.42 (48.16) Tab 500 mg ................................................................................... 20.44 (86.68) Tab 750 mg ................................................................................... 29.87 (138.16) (Ciproxin tab 250 mg, 500 mg and 750 mg to be delisted 1 May 2003) CLINDAMYCIN 28 28 28 Chloromycetin Cipflox Ciproxin Cipflox Ciproxin Cipflox Ciproxin

a) Maximum of 450 mg per prescription; or b) Retail pharmacy-specialist.

Cap hydrochloride 150 mg ............................................................. 11.39 Inj phosphate 150 mg per ml, 4 ml ................................................ 19.45 COLISTIN SULPHOMETHATE - Hospital pharmacy [HP3]-specialist 16 1 Dalacin C Dalacin C

a) Only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly.

Inj 150 mg ..................................................................................... 49.54 CO-TRIMOXAZOLE Tab trimethoprim 80 mg and sulphamethoxazole 400 mg (Available on a PSO) ................................................................ 20.80 Tab trimethoprim 160 mg and sulphamethoxazole 800 mg ............. 11.33 Oral liq sugar-free trimethoprim 40 mg and sulphamethoxazole 200 mg per 5 ml (Available on a PSO) ........................................ 7.20 1 Colymycin-M

500 50 500 ml

Trisul Apo-Sulfatrim DS Trisul

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antibacterials

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer FUSIDIC ACID - Hospital pharmacy [HP3]-specialist Tab 250 mg ................................................................................... 34.50 Oral liq 250 mg per 5 ml ................................................................ 50.15 Inj 500 mg sodium fusidate per 10 ml ............................................ 12.87 (16.95) Injection 500 mg subsidised: Fucidin Fucidin Fucidin

12 90 ml 1

a) Only if prescribed for a dialysis or cystic fibrosis patient; and b) The prescription is endorsed accordingly. (Fucidin oral liq 250 mg per 5 ml to be delisted 1 July 2003)

GENTAMICIN SULPHATE - Hospital pharmacy [HP3]

a) Only if prescribed for a dialysis or cystic fibrosis patient or for prophylaxis of endocarditis and; b) The prescription is endorsed accordingly.

Inj 10 mg per ml, 1 ml ..................................................................... 6.00 Inj 10 mg per ml, 2 ml ................................................................... 16.00 Inj 40 mg per ml, 2 ml ..................................................................... 5.70 NEOMYCIN SULPHATE - Hospital pharmacy [HP3] Tab 500 mg ..................................................................................... 9.95 (Neosulf tab 500 mg to be delisted 1 July 2003) TOBRAMYCIN - Hospital pharmacy [HP3] 5 5 10 25 Baxter Baxter Pharmacia Neosulf

a) Only if prescribed for a dialysis or a cystic fibrosis patient; and b) The prescription is endorsed accordingly.

Inj 40 mg per ml, 2 ml ................................................................... 24.75 (38.10) TRIMETHOPRIM Tab 100 mg ................................................................................... 16.65 Tab 300 mg - Available on a PSO ..................................................... 6.50 (Triprim tab 100 mg to be delisted 1 June 2003) VANCOMYCIN HYDROCHLORIDE - Hospital pharmacy [HP3] 5 Baxter Nebcin Triprim TMP

100 50

a) Only if prescribed for a dialysis or cystic fibrosis patient or in the treatment of pseudomembranous colitis or for prophylaxis of endocarditis; and b) The prescription is endorsed accordingly.

Cap 125 mg ................................................................................. 148.00 Cap 250 mg ................................................................................. 296.00 Inj 50 mg per ml, 10 ml .................................................................... 7.20 20 20 1 Vancocin Vancocin Vancocin

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antifungals Antimalarials Antitrichomonal Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIFUNGALS

For topical antifungals refer to DERMATOLOGICALS page 63, GENITO URINARY, page 80 FLUCONAZOLE - Hospital pharmacy [HP2] & [HP3]-specialist Cap 50 mg ................................................................................... 156.88 Cap 150 mg ................................................................................... 16.81 Cap 200 mg ................................................................................. 627.59 FLUCYTOSINE - Hospital pharmacy [HP2] & [HP3]-specialist Tab 500 mg ................................................................................. 256.15 ITRACONAZOLE - Hospital pharmacy [HP2] & [HP3]-specialist Cap 100 mg ................................................................................... 37.09 KETOCONAZOLE - Retail pharmacy-specialist Tab 200 mg ................................................................................... 38.12 NYSTATIN Tab and cap 500,000 u .................................................................. 11.64 Oral liq 100,000 u per ml ................................................................. 4.28 Oral powder 5,980 u per mg (for reconstitution) ............................. 76.80 TERBINAFINE - Hospital pharmacy [HP2] & [HP3]-specialist Tab 250 mg ................................................................................... 58.10 28 1 28 100 15 30 50 24 ml OP 36 g OP 14 Diflucan Diflucan Diflucan Alcobon Sporanox Nizoral Mycostatin Nilstat Mycostatin Nilstat Lamisil

ANTIMALARIALS

CHLOROQUINE Tab sulphate 200 mg ....................................................................... 4.75 (7.66) Oral liq sulphate 68 mg per 5 ml ...................................................... 9.69 (14.77) HYDROXYCHLOROQUINE SULPHATE Tab 200 mg ................................................................................... 28.26 28 Nivaquine 100 ml Nivaquine 100 Plaquenil

ANTITRICHOMONAL AGENTS

METRONIDAZOLE Tab 200 mg - Available on a PSO ..................................................... 8.99 Tab 400 mg ................................................................................... 16.99 Oral liq benzoate 200 mg per 5 ml .................................................. 17.81 (25.96) Suppos 500 mg ............................................................................. 20.23 Suppos 1 g .................................................................................... 27.53 ORNIDAZOLE Tab 500 mg ................................................................................... 12.38 TINIDAZOLE Tab 500 mg ................................................................................... 41.67 100 100 100 ml 10 10 10 40 Trichozole Trichozole Flagyl-S Flagyl Flagyl Tiberal Dyzole

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antituberculotics and Antileprotics Antivirals

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTITUBERCULOTICS AND ANTILEPROTICS

Note: Effective 1 February 1999 there is no co-payment charge for all pharmaceuticals listed in the the Antituberculotics and Antileprotics group.

CLOFAZIMINE Cap 50 mg ..................................................................................... 18.00 ETHAMBUTOL - Retail pharmacy-specialist Tab 100 mg ................................................................................... 25.75 Tab 400 mg ................................................................................... 40.80 ISONIAZID - Retail pharmacy-specialist Tab 100 mg ................................................................................... 21.00 Tab 100 mg with rifampicin 150 mg ............................................... 90.04 Tab 150 mg with rifampicin 300 mg ............................................. 179.57 PYRAZINAMIDE - Retail pharmacy-specialist Tab 500 mg ................................................................................... 44.69 RIFABUTIN - Hospital pharmacy [HP3]-specialist Cap 150 mg ................................................................................. 213.19 RIFAMPICIN - Retail pharmacy-specialist Cap 150 mg ................................................................................... 58.66 Cap 300 mg ................................................................................. 122.36 Tab 600 mg ................................................................................. 114.40 Oral liq 100 mg per 5 ml ................................................................ 12.66 100 100 100 Lamprene Myambutol Apo-Ethambutol Myambutol PSM Rifinah Rifinah Zinamide Mycobutin Rifadin Rifadin Rifadin Rifadin

100 100 100 100 30 100 100 30 60 ml

ANTIVIRALS Hepatitis B Treatment

LAMIVUDINE - Special Authority Tab 100 mg ................................................................................. 143.00 Oral liq 5 mg per ml ....................................................................... 90.00 28 240 ml Zeffix Zeffix

Special Authority-Retail pharmacy a) Applications may be made for patients who meet any of the inclusion criteria numbered i) to iii) as set out below and who do not meet any of the exclusion criteria numbered i) to vii) as set out below: Inclusion criteria – on first application i) - HBsAg positive for more than 6 months AND - HBeAg positive or HBV DNA positive defined as >0.6 pg/ml by quantitative PCR at reference laboratory; AND - ALT greater than twice upper limit of normal or stage 3 or 4 fibrosis on liver histology or clinical/radiological evidence of cirrhosis; or ii) HBV DNA positive cirrhosis prior to liver transplantation; or iii) HBsAg positive and have had a liver, kidney, heart, lung or bone marrow transplant. continued…

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antivirals

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

…continued Exclusion criteria – on first application i) continuing alcohol abuse and/or continuing intravenous drug use; ii) coinfected with HCV, HDV, or HIV; iii) ALT or AST greater than 10 times upper limit of normal; iv) known or suspected hepatocellular carcinoma (AFP > 100 or liver mass on imaging) unless awaiting liver transplantation or other curative treatment; v) pregnant or breast feeding; vi) history of hypersensitivity to lamivudine; vii) previous lamivudine therapy with breakthrough (presumed YMDD mutant). b) Approvals for first applications are valid for one year. c) Reapplications to maintain continuous treatment beyond one year may be made for all patients who have maintained continuous treatment with lamivudine except for those meeting any of the following two exclusion criteria: Exclusion criteria – on reapplication i) most recent tests show no biochemical response (elevated ALT) AND - HBeAg positive or HBV DNA positive defined as >0.6 pg/ml by quantitative PCR at reference laboratory; or ii) most recent tests show biochemical response (ALT normal) BUT - the patient has already had three years of access to treatment with lamivudine, AND - there is no evidence of cirrhosis. d) Approvals for reapplications are valid for two years. e) Reapplications may not be made for: i) those patients relapsing after completion of three years lamivudine therapy, ii) those who had no response to previous course of lamivudine, iii) those who are still on therapy but have lost response (i.e. ALT returned to baseline and DNA positive again). f) Applications and reapplications may be made by Gastroenterologists, Infectious Diseases Specialists, General Physicians, and Paediatricians.

100

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

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INFECTIONS - AGENTS FOR SYSTEMIC USE

Herpes Treatment Guidelines

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

HERPES TREATMENT

Refer also to SENSORY, Eye Preparations, Anti-infective, page 157.

First episode genital herpes

ACICLOVIR Tab 200 mg ................................................................................... 15.45 Tab dispersible 200 mg .................................................................. 12.50 100 25 Apo-Aciclovir Acicvir

a) Maximum of 25 tablets per prescription – Waiver by Special Authority. b) Dispersible tablets are subsidised only for patients who are unable to swallow tablets and the prescription is endorsed accordingly. Special Authority - Retail pharmacy: a) Waiver of restriction of 25 tablets per prescription for children post liver transplant. b) Special Authority applications can be made by paediatricians and paediatric surgeons, with approvals granted for one year. c) Prescriptions can be written by either the applying specialist or the patient’s general practitioner.

Recurrent episodes of genital herpes

ACICLOVIR Tab 400 mg .................................................................................... 44.20 Tab dispersible 400 mg ................................................................. 28.50 250 56 Alpha-Aciclovir Acicvir

a) Dispersible tablets are subsidised only for patients who are unable to swallow tablets and the prescription is endorsed accordingly.

Acute herpes zoster

ACICLOVIR Tab 800 mg .................................................................................... 34.98 Tab dispersible 800 mg .................................................................. 29.50 100 35 Alpha-Aciclovir Acicvir

a) Maximum of 35 tablets per prescription. b) Dispersible tablets are subsidised only for patients who are unable to swallow tablets and the prescription is endorsed accordingly. For guidelines on prescribing aciclovir, refer to HERPES TREATMENT GUIDELINES on pages 101–105.

Herpes Treatment Guidelines

Effective, consistent management of herpes from prescribing to these guidelines will improve patient outcomes. The guidelines on the following four pages are for the prescribing of aciclovir. The guidelines aim to: • improve patient care and clinical outcome through faster, more accessible treatment • protect patients’ wider wellbeing by reinforcing the psychosocial aspects of treatment • improve the consistency and breadth of medical management of genital herpes in New Zealand. The guidelines are: • integral to ensuring a consistent, effective treatment regimen • the result of consultation with clinicians and patient representatives • set out in line with the recommended international algorithm format for treatment. The guidelines are endorsed by the Herpes Foundation’s professional advisory board whose members represent venereology, NZDS, RNZCGP RNZCOG, psychotherapy and nursing. , Herpes Foundation Helpline: Toll free 0508 11 12 13 Auckland Branch Herpes Foundation: 09 360 1966

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

101

HERPES TREATMENT GUIDELINES

Acute Herpes Zoster

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

102

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

HERPES TREATMENT GUIDELINES

Genital Herpes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

103

HERPES TREATMENT GUIDELINES

First Episode of Genital Herpes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

104

fully subsidised [HP1], [HP2], [HP3], [HP4] refer page 10

“IMM” interchangeable multi-source medicines Sole Subsidised Supply

HERPES TREATMENT GUIDELINES

Recurrent Episodes of Genital Herpes

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Refer to combined footnotes on the previous page.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

105

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antiretrovirals

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIRETROVIRALS

Special Authority - Hospital pharmacy [HP1] Treatment of confirmed HIV/AIDS: a) Patients aged 6 years and over - subsidies for a combination of up to three anti-retroviral medications, but including a maximum of two protease inhibitors, will be granted for patients who meet one or more of the following criteria: - Symptomatic patients with HIV/AIDS regardless of CD4 count; - Asymptomatic HIV-positive patients with CD4 counts < 500 cells/mm3; or - Asymptomatic HIV-positive patients with viral load counts > 10,000 copies per ml (or equivalent value on the Chiron test). b) Patients aged under 6 years – subsidies for a combination of up to three anti-retroviral medications, but including a maximum of two protease inhibitors, will be granted for patients who meet one or more of the following criteria: - Symptomatic patients with HIV/AIDS regardless of CD4 count; - Asymptomatic HIV-positive patients aged 12 months and under; - Asymptomatic HIV-positive patients aged 1 to 5 years with CD4 counts < 1,000 cells/mm3; - Asymptomatic HIV-positive patients aged 1 to 5 years with CD4 counts < 25% of total white cell count; or - Asymptomatic HIV-positive patients with viral load counts > 10,000 copies per ml (or equivalent value on the Chiron test). c) Combinations including ritonavir plus indinavir or saquinavir will be counted as one protease inhibitor for the purpose of accessing funding to anti-retrovirals. d) Applications, and re-applications must be written by a specialist experienced in the treatment of patients with HIV as approved and named by the Ministry of Health (approved specialists). e) Applications must state which medications are to be prescribed. f) Changes to the combination of medications prescribed may be made by the approved specialists without reapplication but only upon notifying HB of the new combination to be prescribed. g) Prescriptions for those patients approved to use these medications can be written either by the specialist or any general practitioner. h) Approvals to treat patients under this Special Authority are valid indefinitely. Prophylaxis a) Subsidies for a combination of up to three anti-retroviral medications, but including a maximum of two protease inhibitors, will be granted for persons suffering percutaneous exposure to blood known to be HIV positive. b) Applications, prescriptions, and re-applications made under this criterion must be written by a specialist experienced in the treatment of patients with HIV as approved and named by the Ministry of Health (approved specialists). c) Applications must state which medications are to be prescribed. d) Approvals to treat patients under this criterion are valid for 6 weeks. Prevention of maternal foetal transmission a) Zidovudine will be subsidised for the prevention of maternal foetal transmission and for treatment of the newborn for up to six weeks. b) Applications, and re-applications made under this criterion must be written by a specialist experienced in the treatment of patients with HIV as approved and named by the Ministry of Health (approved specialists). c) Prescriptions, made under this criterion can be written either by the specialist or any general practitioner. d) Prescriptions made under this criterion can be written for three months but must be collected on a monthly basis. e) Approvals to treat patients under this criterion are valid for one year.

106

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INFECTIONS - AGENTS FOR SYSTEMIC USE

Antiretrovirals

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Non-nucleoside reverse transcriptase inhibitors

Special Authority – anti-retrovirals refer page 106

EFAVIRENZ - Special Authority Cap 50 mg ................................................................................... 158.33 Cap 100 mg ................................................................................. 158.33 Cap 200 mg ................................................................................. 474.99 Tab 600 mg ................................................................................. 474.99 NEVIRAPINE - Special Authority Tab 200 mg ................................................................................. 319.80 30 30 90 30 60 Stocrin Stocrin Stocrin Stocrin Viramune

Nucleoside reverse transcriptase inhibitors

Special Authority – anti-retrovirals refer page 106 ABACAVIR SULPHATE - Special Authority Tab 300 mg ................................................................................. 458.00 Oral liq 20 mg per ml ................................................................... 100.00 DIDANOSINE (ddI) - Special Authority Tab 25 mg reduced mass .............................................................. 46.02 Tab 100 mg reduced mass .......................................................... 184.08 Cap 125 mg ................................................................................. 115.05 Cap 200 mg ................................................................................. 184.08 Cap 250 mg ................................................................................. 230.10 Cap 400 mg ................................................................................. 368.16 (Videx tab 25 mg and tab 100 mg to be delisted 1 May 2003) LAMIVUDINE - Special Authority Tab 150 mg ................................................................................. 307.20 Oral liq 10 mg per ml ................................................................... 100.00 STAVUDINE (d4T) - Special Authority Cap 20 mg ................................................................................... 317.10 Cap 30 mg ................................................................................... 377.80 Cap 40 mg ................................................................................... 503.80 Powder for oral soln 1 mg per ml ................................................. 100.76 ZIDOVUDINE (AZT) - Special Authority Cap 100 mg ................................................................................. 290.00 Oral soln ........................................................................................ 58.00 ZIDOVUDINE (AZT) with LAMIVUDINE - Special Authority Tab 300 mg with lamivudine 150 mg ........................................... 667.20 60 240 ml OP 60 60 30 30 30 30 Ziagen Ziagen Videx Videx Videx EC Videx EC Videx EC Videx EC

60 240 ml OP 60 60 60 200 ml OP 100 200 ml OP 60

3TC 3TC Zerit Zerit Zerit Zerit Retrovir Retrovir Combivir

Note: Combivir counts as two anti-retroviral medications for the purposes of the anti-retroviral Special Authority

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

107

INFECTIONS - AGENTS FOR SYSTEMIC USE

Antiretrovirals Urinary Tract Infections

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Protease inhibitors

Special Authority – anti-retrovirals refer page 106 INDINAVIR - Special Authority Cap 200 mg ................................................................................. 519.75 Cap 400 mg ................................................................................. 519.75 NELFINAVIR - Special Authority Tab 250 mg ................................................................................. 600.00 Powder 50 mg per g ...................................................................... 55.44 RITONAVIR - Special Authority Cap 100 mg ................................................................................. 242.55 Oral liq 80 mg per ml ................................................................... 277.28 SAQUINAVIR - Special Authority Cap 200 mg ................................................................................. 271.00 519.75 360 180 270 144 g OP 168 240 ml OP 180 270 Crixivan Crixivan Viracept Viracept Norvir Norvir Fortovase Invirase

URINARY TRACT INFECTIONS

HEXAMINE HIPPURATE Tab 1 g .......................................................................................... 18.40 (34.57) NITROFURANTOIN Tab 50 mg ..................................................................................... 14.70 Tab 100 mg ................................................................................... 25.70 Oral liq 25 mg per 5 ml .................................................................. 12.50 NORFLOXACIN 100 Hiprex 100 100 200 ml Nifuran Nifuran Furadantin

a) Maximum of 6 tablets per prescription; or b) Retail pharmacy-specialist.

Tab 400 mg ................................................................................... 92.00 TRIMETHOPRIM Tab 100 mg ................................................................................... 16.65 Tab 300 mg - Available on a PSO ...................................................... 6.50 (Triprim tab 100 mg to be delisted 1 June 2003) 100 100 50 Noroxin Triprim TMP

108

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MUSCULO-SKELETAL SYSTEM

Anticholinesterases Anti-inflammatory Non Steroidal Drugs (NSAIDs)

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTICHOLINESTERASES

NEOSTIGMINE Inj 2.5 mg per ml, 1 ml .................................................................... 23.80 (26.20) PHYSOSTIGMINE SALICYLATE Inj 500 µg per ml, 2 ml .................................................................... 55.20 PYRIDOSTIGMINE BROMIDE v Tab 60 mg ...................................................................................... 28.60 50 AstraZeneca 5 100 Baxter Mestinon

ANTI-INFLAMMATORY NON STEROIDAL DRUGS (NSAIDs)

Additional subsidy by Special Authority: a) Approval to fully fund NSAIDs is available for patients with inflammatory arthritis (including osteoarthritis with an inflammatory component) who have been stabilised and are well controlled on a particular NSAID medication; b) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed the manufacturer’s price identified in the Pharmaceutical Schedule; c) Applications can be made by any medical practitioner; d) Approvals valid for 2 years; e) The approval numbers are interchangeable for products within this therapeutic group; f) Dispensed by retail pharmacy.

DICLOFENAC SODIUM - Special Authority available, refer above Tab EC 25 mg ................................................................................... 3.55 (7.40) (8.14) Tab EC 50 mg ................................................................................... 5.03 7.48 (14.54) Tab 50 mg dispersible ........................................................................ 1.50 (3.67) Tab long-acting 75 mg ...................................................................... 2.02 2.37 (5.88) Tab long-acting 100 mg .................................................................... 3.01 4.99 (9.14) Cap long-acting 100 mg .................................................................... 3.01 (11.87) Suppos 12.5 mg ............................................................................... 1.32 Suppos 25 mg .................................................................................. 1.85 Suppos 50 mg - Available on a PSO .................................................... 3.20 Suppos 100 mg ................................................................................ 5.30 Inj 25 mg per ml, 3 ml - Available on a PSO ....................................... 12.00 100 FlamerilIMM Apo-Diclofenac IMM VoltarenIMM Apo-DiclofenacIMM FlamerilIMM Voltaren IMM Voltaren D Apo-Diclo SR Diclax SRIMM Flameril RetardIMM Voltaren SR IMM Apo-Diclo SR Diclax SRIMM Flameril RetardIMM Voltaren SR IMM Anfenax SR Voltaren Voltaren Voltaren Voltaren Voltaren

100

20 30

30 10 10 10 10 5

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

109

MUSCULO-SKELETAL SYSTEM

Anti-inflammatory Non Steroidal Drugs (NSAIDs)

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer IBUPROFEN - Special Authority available, refer to page 109 Tab 200 mg ...................................................................................... 2.07 (2.90) Tab 400 mg ...................................................................................... 3.55 (15.20) Tab 600 mg ...................................................................................... 5.32 (22.80) Tab long-acting 800 mg .................................................................... 3.01 (11.87) ‡ Oral liq 100 mg per 5 ml .................................................................... 5.79 (Panafen tab 200 mg to be delisted 1 May 2003) KETOPROFEN - Special Authority available, refer to page 109 Cap 50 mg ....................................................................................... 5.32 (10.76) Tab EC 100 mg ................................................................................. 6.72 (16.20) Cap 100 mg ..................................................................................... 6.72 (19.60) Cap long-acting 100 mg .................................................................... 6.72 (19.60) Cap long-acting 200 mg ................................................................. 13.44 (39.20) Suppos 100 mg ................................................................................ 4.71 (5.18) MEFENAMIC ACID - Special Authority available, refer to page 109 Cap 250 mg ..................................................................................... 2.50 (18.33) NAPROXEN - Special Authority available, refer to page 109 Tab 250 mg .................................................................................... 26.50 100 100 Brufen 100 Brufen 60 200 ml Brufen Retard Brufen I-Profen Panafen

100 Orudis 100 Oruvail EC 100 Orudis 100 Oruvail 100 100 Oruvail 200 10 Oruvail 100 Ponstan 500

Naprosyn IMM Naxen IMM Tab EC 250 mg ................................................................................. 6.36 120 Naprosyn Enteric Tab 500 mg .................................................................................... 53.00 500 Naprosyn IMM Naxen IMM Tab EC 500 mg ................................................................................. 6.36 60 Naprosyn Enteric IMM Tab long-acting 750 mg .................................................................. 18.00 90 Naprosyn SR 750 Tab long-acting 1000 mg ................................................................ 21.00 90 Naprosyn SR 1000 ‡ Oral liq 125 mg per 5 ml .................................................................... 7.90 240 ml Naprosyn (Naprosyn tab 250 mg and 500 mg and Naprosyn Enteric 250 mg and 500 mg to be delisted 1 May 2003)

110

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MUSCULO-SKELETAL SYSTEM

Anti-inflammatory Non Steroidal Drugs (NSAIDs)

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer NAPROXEN SODIUM - Special Authority available, refer to page 109 Tab 275 mg ..................................................................................... 6.40 Tab 550 mg ................................................................................... 12.80 SULINDAC - Special Authority available, refer to page 109 Tab 100 mg ...................................................................................... 5.32 (8.88) (16.76) Tab 200 mg ...................................................................................... 6.72 (16.20) (18.70) (31.74) TENOXICAM - Special Authority available, refer to page 109 Tab 20 mg ...................................................................................... 23.75 Suppos 20 mg .................................................................................. 5.30 Inj 10 mg per ml, 2 ml vial - Available on a PSO .................................. 10.00 TIAPROFENIC ACID - Special Authority available, refer to page 109 Tab 200 mg ...................................................................................... 2.24 (9.08) Tab 300 mg ...................................................................................... 3.36 (14.59) Cap long-acting 300 mg .................................................................... 3.77 (15.92) Synflex Synflex

100 100 100

Daclin IMM Clinoril IMM 100 DaclinIMM SaldacIMM Clinoril IMM 100 10 5 50 Surgam 50 Surgam 56 Surgam SA Tilcotil Tilcotil Tilcotil

NSAIDs Other

INDOMETHACIN Cap 25 mg ....................................................................................... 5.50 Cap 50 mg ....................................................................................... 6.50 Cap long-acting 75 mg ................................................................... 12.50 Suppos 100 mg ............................................................................. 12.00 PIROXICAM Tab dispersible 10 mg ........................................................................ 2.90 Tab dispersible 20 mg ....................................................................... 5.18 100 100 100 30 50 100 Rheumacin Rheumacin Rheumacin SR Arthrexin Piram-D Piram-D

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

111

MUSCULO-SKELETAL SYSTEM

Antirheumatoidal Agents Corticosteroids – Injectables

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIRHEUMATOID AGENTS

AURANOFIN - Retail pharmacy-specialist Tab 3 mg ........................................................................................ 68.99 (70.97) HYDROXYCHLOROQUINE SULPHATE Tab 200 mg .................................................................................... 28.26 LEFLUNOMIDE - Special Authority - Retail pharmacy Tab 10 mg .................................................................................... 176.70 Tab 20 mg .................................................................................... 242.10 Tab 100 mg .................................................................................. 121.35 60 Ridaura 100 30 30 3 Plaquenil Arava Arava Arava

Special Authority – Retail Pharmacy a) Patient has rheumatoid arthritis. b) If the patient is a woman of child-bearing age she has adequate contraception and is not pregnant. c) Patient has been unable to tolerate or has a contraindication to or has had an inadequate response to sulphasalazine and methotrexate (individually or in combination). d) Initial application and re-applications to be made by a rheumatologist. Re-application criteria are: 1. compliance (prescriber determined) with medication; and 2. improved rheumatoid arthritis symptom control. e) Prescriptions may be written by any medical practitioner. f) Initial approval is valid for six months. Subsequent approvals are valid indefinitely. Note: patient should have full blood count and liver function tests regularly monitored.

PENICILLAMINE - Retail pharmacy-specialist Tab 125 mg .................................................................................... 56.30 (61.93) Tab 250 mg .................................................................................... 89.98 (98.98) (Distamine tab 125 mg to be delisted 1 June 2003) SODIUM AUROTHIOMALATE - Retail pharmacy-specialist Inj 10 mg per 0.5 ml ....................................................................... 69.88 Inj 20 mg per 0.5 ml ..................................................................... 102.88 Inj 50 mg per 0.5 ml ..................................................................... 197.48 10 10 10 Myocrisin Myocrisin Myocrisin 100 D-Penamine Distamine 100 D-Penamine Distamine

CORTICOSTEROIDS - INJECTABLES

BETAMETHASONE SODIUM PHOSPHATE WITH BETAMETHASONE ACETATE Inj 3.9 mg with betamethasone acetate 3 mg per ml, 1 ml ................... 19.20 (28.00) METHYLPREDNISOLONE ACETATE Inj 40 mg per ml, 1 ml ....................................................................... 6.03 METHYLPREDNISOLONE ACETATE WITH LIGNOCAINE Inj 40 mg per ml with lignocaine 1 ml ................................................. 6.03 5 Celestone Chronodose 1 1 Depo-Medrol Depo-Medrol with lidocaine

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MUSCULO-SKELETAL SYSTEM

Corticosteroids – Injectables

Enzymes Hyperuricaemia and Antigout Muscle Relaxants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer METHYLPREDNISOLONE SODIUM SUCCINATE - Retail pharmacy-specialist Inj 40 mg per ml, 1 ml ................................................................... 151.40 Inj 62.5 mg per ml, 2 ml ............................................................... 412.59 Inj 500 mg ..................................................................................... 39.16 Inj 1 g ............................................................................................ 70.95 TRIAMCINOLONE ACETONIDE Inj 10 mg per ml, 1 ml ..................................................................... 13.47 Inj 10 mg per ml, 5 ml ..................................................................... 12.50 Inj 40 mg per ml, 1 ml ..................................................................... 34.05 Inj 40 mg per ml, 5 ml ..................................................................... 28.41 Solu-Medrol Solu-Medrol Solu-Medrol Solu-Medrol Kenacort-A Kenacort-A Kenacort-A40 Kenacort-A40

25 25 1 1 5 1 5 1

ENZYMES

HYALURONIDASE Inj 1,500 iu per ml .......................................................................... 18.32 (104.45) 10 Hyalase

HYPERURICAEMIA AND ANTIGOUT

ALLOPURINOL Tab 100 mg .................................................................................... 13.26 Tab 300 mg .................................................................................... 27.00 COLCHICINE Tab 600 µg .................................................................................... 16.50 PROBENECID Tab 500 mg .................................................................................... 55.00 500 500 100 100 Progout Progout Abbott AFT

MUSCLE RELAXANTS

BACLOFEN - Retail pharmacy-specialist Tab 10 mg ........................................................................................ 4.19 DANTROLENE SODIUM - Retail pharmacy-specialist Cap 25 mg ..................................................................................... 32.96 (37.08) Cap 50 mg ..................................................................................... 51.70 (58.16) ORPHENADRINE CITRATE Tab 100 mg .................................................................................... 18.54 Inj 30 mg per ml, 2ml ........................................................................ 9.60 (20.50) 100 100 Dantrium 100 Dantrium 100 3 Norflex Norflex Q 200 Q 300 Pacifen

QUININE SULPHATE 100 Tab 200 mg ...................................................................................... 6.20 Tab 300 mg .................................................................................... 33.30 500 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations of quinine sulphate.

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

113

NERVOUS SYSTEM

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

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NERVOUS SYSTEM

Anaesthetics Analgesics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANAESTHETICS Local

BUPIVACAINE HYDROCHLORIDE - Special Authority Inj 0.5%, 4 ml ................................................................................ 23.32 (24.49) Inj 0.5%, 8% glucose, 4 ml ............................................................ 27.41 (28.78) 5 Marcain Isobaric 5 Marcain Heavy

Special Authority - Hospital pharmacy [HP3] a) For use in the terminally ill in pain management when standard therapy has failed. b) Specialist must make application.

LIGNOCAINE HYDROCHLORIDE - Available on a PSO Inj 0.5% polyamp, 5 ml vial ............................................................. 56.79 Inj 1%, 5 ml .................................................................................... 47.40 Inj 1% 20 ml ................................................................................... 27.00 Inj 1% 50 ml vial ............................................................................. 35.20 (38.80) (Xylocaine inj 1% 50 ml vial to be delisted 1 January 2003) LIGNOCAINE WITH PRILOCAINE HYDROCHLORIDE - Special Authority Crm 2.5% with prilocaine hydrochloride 2.5% ................................. 46.02 Crm 2.5% with prilocaine hydrochloride 2.5% 5 g ......................... 47.55 30 g OP 5 Emla Emla 50 50 5 5 Xylocaine Xylocaine Xylocaine Xylocaine

a) Only if prescribed on prescription for a dialysis patient or child with rheumatic fever or on a PSO for emergency use.

Special Authority - Hospital pharmacy [HP3] a) Approvals granted only for children receiving frequent parenteral injections (ie intradermal, subcutaneous, intravenous or intramuscular) requiring a 21 gauge or larger bore needle. b) Specialist must make application.

ANALGESICS

Refer also to MUSCULO-SKELETAL, Anti-inflammatory, NSAIDs, page 109.

Antipyretics and Non-Opioid Analgesics

ASPIRIN Tab 300 mg - Available on a PSO ..................................................... 26.50 Tab, soluble 300 mg ....................................................................... 30.53 (30.69) (103.68) (118.08) Tab 300 mg, EC ............................................................................... 7.25 Tab 650 mg, EC ............................................................................... 6.88 NEFOPAM HYDROCHLORIDE Tab 30 mg ..................................................................................... 23.39 Inj 20 mg per ml, 1 ml ....................................................................... 9.10 (72.50) 1000 1152 PSM SolprinIMM Disprin IMM Aspro Clear IMM Aspec 300 Ecotrin Acupan Acupan

100 100 90 5

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

115

NERVOUS SYSTEM

Analgesics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer PARACETAMOL Tab 500 mg - Available on a PSO ..................................................... 9.80 1,000 ‡ Oral liq 120 mg per 5 ml 8.10 1,000 ml a) Available on a PSO b) Not in combination (9.15) Pacimol Paracare Junior Suspension PSM Paracetamol Elixir Paediatric Douglas Pamol Paracare Double Strength Suspension Douglas Pamol Panadol Panadol PSM

(14.80) ‡ Oral liq 250 mg per 5 ml - Not in combination ..................................... 8.10

1,000 ml

(9.15) (19.00) Suppos 125 mg ............................................................................... 4.51 20 Suppos 250 mg ............................................................................... 9.38 20 Suppos 500 mg ............................................................................. 22.50 50 (PSM Paracetamol Elixir Paediatric oral liq 120 mg per 5 ml to be delisted 1 August 2003) (Douglas Paracetamol oral liq 120 mg per 5 ml and 250 mg per 5 ml to be delisted 1 September 2003)

Antipyretics with Codeine

PARACETAMOL WITH CODEINE Tab paracetamol 500 mg with codeine phosphate 8 mg .................... 61.64 1440 Panadeine

Opioid Analgesics

BUPRENORPHINE HYDROCHLORIDE - Only on a controlled drug form Inj 0.3 mg per ml, 1 ml ...................................................................... 7.42 (8.53) CODEINE PHOSPHATE Tab 15 mg ........................................................................................ 7.60 (8.20) Tab 30 mg ...................................................................................... 10.60 (12.70) Tab 60 mg ...................................................................................... 20.10 (23.75) DEXTROPROPOXYPHENE Cap napsylate 100 mg ....................................................................... 8.96 (11.83) DEXTROPROPOXYPHENE WITH PARACETAMOL Tab napsylate 50 mg with paracetamol 325 mg ................................. 14.50 (22.50) Cap hydrochloride 32.5 mg with paracetamol 325 mg ..................... 19.91 (24.50) DIHYDROCODEINE TARTRATE Tab long-acting 60 mg ................................................................... 35.70 5 Temgesic 100 PSM 100 PSM 100 PSM 100 Doloxene 500 Paradex 500 Capadex 60 DHC Continus

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NERVOUS SYSTEM

Analgesics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer METHADONE HYDROCHLORIDE

a) Only on a controlled drug form. b) Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets).

Tab 5 mg .......................................................................................... 6.08 ‡ Oral liq 2 mg per ml ........................................................................... 6.55 ‡ Oral liq 5 mg per ml ........................................................................... 6.50 6.86 ‡ Oral liq 10 mg per ml ......................................................................... 9.50 Inj 10 mg per ml, 1 ml ..................................................................... 18.95 ‡ Oral liq (refer page 168) ................................................................. CE MORPHINE HYDROCHLORIDE - Only on a controlled drug form ‡ Oral liq 1 mg per ml ........................................................................... 7.68 ‡ Oral liq 2 mg per ml ........................................................................... 8.15 ‡ Oral liq 5 mg per ml ........................................................................... 9.18 ‡ Oral liq 10 mg per ml ....................................................................... 11.96 MORPHINE SULPHATE - Only on a controlled drug form Tab immediate release 10 mg ............................................................. 3.21 Cap long-acting 10 mg ..................................................................... 4.00 Tab long-acting 10 mg ...................................................................... 4.00 Tab immediate release 20 mg ............................................................. 6.42 Cap long-acting 20 mg ..................................................................... 8.00 Tab long-acting 30 mg .................................................................... 12.00 Cap long-acting 50 mg ................................................................... 16.00 Tab long-acting 60 mg .................................................................... 16.75 Tab long-acting 100 mg .................................................................. 25.50 Cap long-acting 100 mg ................................................................. 25.50 Tab long-acting 200 mg .................................................................. 44.96 Suppos 5 mg ................................................................................. 17.74 Suppos 10 mg ............................................................................... 19.14 Suppos 20 mg ............................................................................... 20.31 Suppos 30 mg ............................................................................... 31.39 Inj 2 mg per ml, 1 ml - Available on a PSO ........................................... 7.23 Inj 5 mg per ml, 1 ml - Available on a PSO ........................................... 5.17 Inj 10 mg per ml, 1 ml - Available on a PSO ....................................... 47.50 Inj 10 mg per ml, 5 ml - Available on a PSO ....................................... 75.00 Inj 15 mg per ml, 1 ml - Available on a PSO ....................................... 47.00 Inj 30 mg per ml, 1 ml - Available on a PSO ....................................... 51.60 10 200 ml 200 ml 200 ml 5 Pallidone PSM BiodoneIMM GlaxoWellcome Biodone Forte Biodone Extra Forte Baxter RA-Morph RA-Morph RA-Morph RA-Morph Sevredol Kapanol MST Continus LA-Morph Sevredol Kapanol MST Continus LA-Morph Kapanol MST Continus LA-Morph MST Continus LA-Morph Kapanol MST Continus RMS RMS RMS RMS Baxter Baxter Baxter AstraZeneca Baxter Baxter AstraZeneca Baxter AstraZeneca

200 ml 200 ml 200 ml 200 ml 10 10 10 10 10 10 10 10 10 10 10 12 12 12 12 5 5 50 50 50 50

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

117

NERVOUS SYSTEM

Analgesics Antidepressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer MORPHINE TARTRATE - Only on a controlled drug form Inj 80 mg per ml, 1.5 ml .................................................................. 20.20 Inj 80 mg per ml, 5 ml ..................................................................... 67.37 OXYCODONE PECTINATE - Only on a controlled drug form Suppos 30 mg ............................................................................... 11.66 (17.10) (Proladone suppos 30 mg to be delisted 1 October 2003) PETHIDINE HYDROCHLORIDE - Only on a controlled drug form Tab 50 mg ....................................................................................... 4.50 Tab 100 mg ...................................................................................... 6.50 Inj 50 mg per ml, 1 ml - Available on a PSO ......................................... 3.40 Inj 50 mg per ml, 1.5 ml - Available on a PSO ..................................... 4.35 Inj 50 mg per ml, 2 ml - Available on a PSO ......................................... 3.80 5 5 12 Proladone Baxter Baxter

10 10 5 5 5

PSM Douglas PSM Douglas Baxter Baxter Baxter

ANTIDEPRESSANTS Cyclic and Related Agents

AMITRIPTYLINE Tab 10 mg ....................................................................................... 2.75 Tab 25 mg ....................................................................................... 3.10 Tab 50 mg ....................................................................................... 4.75 AMOXAPINE Tab 25 mg ..................................................................................... 17.50 CLOMIPRAMINE HYDROCHLORIDE - Retail pharmacy-specialist Tab 10 mg ..................................................................................... 10.00 Tab 25 mg ..................................................................................... 27.50 DESIPRAMINE HYDROCHLORIDE - Hospital pharmacy [HP3] Tab 25 mg ...................................................................................... 32.32 (36.62) DOTHIEPIN HYDROCHLORIDE Cap 25 mg ....................................................................................... 4.50 Tab 75 mg ........................................................................................ 8.75 DOXEPIN HYDROCHLORIDE Cap 10 mg ....................................................................................... 4.99 Cap 25 mg ....................................................................................... 4.19 (5.20) Cap 50 mg ....................................................................................... 6.99 Cap 75 mg ..................................................................................... 10.99 IMIPRAMINE HYDROCHLORIDE Tab 10 mg ........................................................................................ 4.98 Tab 25 mg ........................................................................................ 8.00 MAPROTILINE HYDROCHLORIDE - Retail pharmacy-specialist Tab 25 mg ...................................................................................... 33.88 (38.18) Tab 75 mg ..................................................................................... 28.46 (32.76) 100 100 100 100 100 500 50 Pertofran 100 100 100 100 100 100 50 50 100 Ludiomil 30 Ludiomil Dopress Dopress Anten Anten Anten Anten Tofranil Tofranil Amitrip Amitrip Amitrip Ascendin Clopress Clopress

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NERVOUS SYSTEM

Antidepressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer MIANSERIN - Special Authority Tab 30 mg ...................................................................................... 29.25 Tolvon

Special Authority - Hospital pharmacy [HP3] a) Approval granted for treating depression only in those patients: - who have failed trials with other antidepressants and who have been maintained on mianserin prior to December 1993; or - with co-existent bladder neck obstruction or cardiovascular disease. b) Specialist must make application – psychiatrists only. c) Note: prescriptions must be written by a psychiatrist (need not be original applicant).

NORTRIPTYLINE HYDROCHLORIDE Tab 10 mg ........................................................................................ 4.50 Tab 25 mg ...................................................................................... 30.00 TRIMIPRAMINE MALEATE Tab 25 mg ........................................................................................ 3.19 (6.58) Cap 25 mg ....................................................................................... 6.38 Cap 50 mg ..................................................................................... 12.00 (23.00) (Surmontil tab 25 mg and cap 50 mg to be delisted 1 May 2003) 100 500 50 100 100 Surmontil Tripress Tripress Surmontil Norpress Norpress

Monoamine-Oxidase Inhibitors (MAOIs) - Non Selective

PHENELZINE SULPHATE Tab 15 mg ...................................................................................... 14.90 (Nardil tab 15 mg to be delisted 1 May 2003) TRANYLCYPROMINE SULPHATE Tab 10 mg ...................................................................................... 22.94 50 Nardil

Parnate

Monoamine-Oxidase Type A Inhibitors

Additional subsidy by endorsement for: Moclobemide tab 150 mg x 100 (Aurorix) up to $32.90 Moclobemide tab 300 mg x 60 (Aurorix) up to $39.48 Nefazodone tab 100 mg x 56 (Serzone) up to $20.16 Nefazodone tab 200 mg x 56 (Serzone) up to $40.32 Citalopram tab 20 mg x 28 (Cipramil) up to $31.45 Paroxetine hydrochloride tab 20 mg x 30 (Aropax) up to $35.02 is available for patients who: • were taking moclobemide or nefazodone on 1 December 1999 or citalopram on 1 February 2000; or paroxetine hydrochloride on 1 February 2001; or • have previously responded to treatment with moclobemide or nefazodone or citalopram or paroxetine hydrochloride; or • have had a trial of fluoxetine and have to discontinue due to: - inability to tolerate the drug due to side effects; or - failed to respond to an adequate dose and duration of treatment; or • have contraindications to fluoxetine (eg pre-existing significant levels of nausea, breastfeeding, potential drug interactions); The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are “certified condition” however these particular words are not a requirement.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

119

NERVOUS SYSTEM

Antidepressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer MOCLOBEMIDE - Retail pharmacy-specialist. Additional subsidy by endorsement available (refer to page 119). Tab 150 mg ...................................................................................... 2.57 100 (32.90) Aurorix Tab 300 mg ...................................................................................... 2.24 60 (39.48) Aurorix

Selective Serotonin Reuptake Inhibitors

CITALOPRAM HYDROBROMIDE - Additional subsidy by endorsement available Tab 20 mg ........................................................................................ 1.58 (31.45) FLUOXETINE HYDROCHLORIDE Cap 20 mg ....................................................................................... 5.25 Tab disp 20 mg, scored .................................................................... 4.90 28 Cipramil 90 30 Fluox Fluox

a) Fluoxetine hydrochloride tab dispersible 20 mg restricted to a maximum daily dose of 10 mg. b) Tablets can be combined with capsules to facilitate incremental 10 mg doses.

NEFAZODONE - Retail Pharmacy-specialist. Additional subsidy by endorsement available. Tab 100 mg ...................................................................................... 1.42 56 (20.16) Tab 200 mg ...................................................................................... 1.86 56 (40.32)

Serzone Serzone

* heading used here (Selective Serotonin Reuptake Inhibitors) corresponds to the name of the therapeutic subgroup The

established by PHARMAC for subsidy purposes (see page 5). PHARMAC has decided that, whether or not nefazodone is a Selective Serotonin Reuptake Inhibitor (a subject on which clinical opinion differs), it has the same or similar therapeutic effect as fluoxetine hydrochloride and paroxetine hydrochloride. Nefazodone is listed under this heading on that basis.

PAROXETINE HYDROCHLORIDE - Additional subsidy by endorsement available Tab 20 mg ....................................................................................... 1.90 (35.02)

30 Aropax

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Antidepressants Antiepilepsy Drugs

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Other Antidepressants

LITHIUM CARBONATE Tab 250 mg ...................................................................................... 5.29 Cap 250 mg ..................................................................................... 6.38 Tab 400 mg ...................................................................................... 9.17 Tab long-acting 400 mg .................................................................. 13.35 100 100 100 100 Lithicarb Douglas Lithicarb Priadel

ANTIEPILEPSY DRUGS Agents for Control of Status Epilepticus

CLONAZEPAM Inj 1 mg per ml, 1 ml ......................................................................... 9.36 DIAZEPAM Rectal tubes 5 mg - Available on a PSO ............................................. 26.50 Rectal tubes 10 mg - Available on a PSO ........................................... 32.38 Inj 5 mg per ml, 2 ml - Only on a PSO ................................................. 8.32 (15.41) PARALDEHYDE Inj 5 ml ........................................................................................... 58.00 PHENOBARBITONE SODIUM Inj 200 mg per ml, 1 ml ................................................................... 73.92 PHENYTOIN SODIUM - Available on a PSO Inj 50 mg per ml, 2 ml ..................................................................... 69.24 Inj 50 mg per ml, 5 ml ..................................................................... 77.27 5 5 5 5 Rivotril Stesolid Stesolid Baxter Diazemuls

a) Injection subsidised only on a PSO and PSO is endorsed “not for anaesthetic procedures”.

5 10 5 5 Baxter Gardenal Sodium Baxter Baxter

Control of Epilepsy

ACETAZOLAMIDE v Tab 250 mg ...................................................................................... 8.75 (10.52) Sodium inj 500 mg ......................................................................... 13.95 CARBAMAZEPINE v Tab 200 mg .................................................................................... 14.53

v v v

100 1 100 100 100 100 250 ml 50 Diamox Diamox Tegretol Teril Tegretol CR Tegretol Teril Tegretol CR Tegretol Frisium

Tab long-acting 200 mg .................................................................. 16.98 Tab 400 mg .................................................................................... 34.58 Tab long-acting 400 mg ................................................................. 39.17 liq 100 mg per 5 ml ................................................................ 26.37

v‡ Oral

CLOBAZAM - Retail pharmacy-specialist v Tab 10 mg ....................................................................................... 8.29 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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NERVOUS SYSTEM

Antiepilepsy Drugs

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer CLONAZEPAM Tab 500 µg ...................................................................................... 6.00 Tab 2 mg ....................................................................................... 11.00 100 100 10 ml OP Paxam Rivotril Paxam Rivotril Rivotril

v v

v‡ Oral

drops 2.5 mg per ml ................................................................. 7.38 (Rivotril tab 500 µg and tab 2 mg to be delisted 1 June 2003)

ETHOSUXIMIDE v Cap 250 mg ................................................................................... 32.90 v ‡ Oral liq 250 mg per 5 ml .................................................................. 11.96 PHENOBARBITONE Tab 15 mg ...................................................................................... 23.68 v Tab 30 mg ...................................................................................... 24.59

200 200 ml 500 500 200 200 200 500 ml 500 ml

Zarontin Zarontin PSM PSM Dilantin Dilantin Infatab Dilantin Dilantin Dilantin Forte

PHENYTOIN SODIUM Cap 30 mg ..................................................................................... 15.50 v Tab 50 mg ...................................................................................... 15.63 v Cap 100 mg ................................................................................... 14.69 v ‡ Oral liq 30 mg per 5 ml .................................................................... 11.19 v ‡ Oral liq 100 mg per 5 ml .................................................................. 15.83 (Dilantin Forte oral liquid 100 mg per 5 ml to be delisted 1 July 2003)

v v

PRIMIDONE Tab 250 mg .................................................................................... 17.25

100 100 100 100 300 ml 1

Apo-Primidone Epilim Crushable Epilim Epilim Epilim S/F Liquid Epilim Syrup Epilim IV

SODIUM VALPROATE v Tab 100 mg .................................................................................... 13.65 v Tab 200 mg EC ............................................................................... 27.44 v Tab 500 mg EC ............................................................................... 52.24 v ‡ Oral liq 200 mg per 5 ml .................................................................. 20.48 Inj 100 mg per ml, 4 ml ................................................................... 41.50

New antiepilepsy drugs

GABAPENTIN - Special Authority v Cap 100 mg ................................................................................... 42.08 v Cap 300 mg ................................................................................. 126.23 v Cap 400 mg ................................................................................. 168.30 LAMOTRIGINE - Special Authority Tab 5 mg dispersible ........................................................................ 9.64 v Tab 25 mg dispersible ..................................................................... 51.07 v Tab 50 mg dispersible ..................................................................... 86.82 v Tab 100 mg dispersible ................................................................. 149.81

100 100 100 30 56 56 56 60 60 60 60 60 60

Neurontin Neurontin Neurontin Lamictal Lamictal Lamictal Lamictal Topamax Topamax Topamax Topamax Topamax Topamax

TOPIRAMATE - Special Authority Sprinkle cap 15 mg ......................................................................... 41.20 v Sprinkle cap 25 mg ......................................................................... 51.50 v Tab 25 mg ...................................................................................... 51.50 v Tab 50 mg ...................................................................................... 87.54 v Tab 100 mg ................................................................................. 148.83 v Tab 200 mg ................................................................................. 256.82

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Antiepilepsy Drugs Antimigraine Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer VIGABATRIN - Special Authority v Tab 500 mg ................................................................................. 143.16 120 Sabril

Special Authority - Retail Pharmacy a) Subsidies for the new anti-epilepsy drugs (NAED), gabapentin, lamotrigine, topiramate and vigabatrin (which may be used in conjunction with older anti-epilepsy drug treatment), will be granted for patients in any one of the following groups: 1) patients who were on NAED therapy before 1 September 2000 and who met the previous criteria for access to a subsidy for a NAED. 2) patients whose seizures are not adequately controlled with optimal older anti-epilepsy drug treatment. 3) patients whose seizures are controlled adequately with but who experience unacceptable side effects from older anti-epilepsy drug treatment. b) Approval entitles patients to a subsidy for one NAED. Dual NAED therapy will be subsidised for patients: 1) who were already stabilised on two NAEDs on or before 31 July 2000; or 2) for whom a second NAED has been added to therapy with one NAED provided an attempt to withdraw one NAED has been made and was unsuccessful. c) Further application may be made in writing for temporary approval for three agents for patients on dual therapy who are switching from vigabatrin to another NAED. Applications must contain information regarding current therapy, the proposed additional agent, and the agent to be withdrawn. Approvals would be valid for a maximum six month period, under the existing Special Authority number. d) “Optimal older anti-epilepsy drug therapy” is defined as treatment with those older anti-epilepsy drugs which are indicated and clinically appropriate for the patient, given singly and in combination in adequate doses for the patient’s age, weight, and other features affecting the pharmacokinetics of the drug with good evidence of compliance. e) Initial approvals are valid for 15 months. Re-approvals and initial approvals for patients who were on NAED therapy on or before 31 July 2000 are valid for 18 months. f) Re-applications will be approved only for patients who have been prescribed adequate doses of gabapentin, lamotrigine, topiramate and vigabatrin and tolerated and demonstrated a significant and sustained improvement in seizure rate, seizure severity and/or quality of life to them. (As a guideline, clinical trials have referred to a notional 50% reduction in seizure frequency as an indicator of success with anti-convulsant therapy and have assessed quality of life from the patient’s perspective). g) Special Authority applications and reapplications must be made by a neurologist or paediatric neurologist. Applications from a general physician or paediatrician will be accepted if access to neurology or paediatric neurology services is limited in the locality in which they practice. h) Applications must be made on a PHARMAC approved form. i) Prescriptions for NAEDs may be written by any medical practitioner.

ANTIMIGRAINE PREPARATIONS Acute Migraine Treatment

Refer also to MUSCULO-SKELETAL, Anti-inflammatory NSAIDS, page 109 ERGOTAMINE TARTRATE WITH CAFFEINE Tab 1 mg with caffeine 100 mg ....................................................... 24.20 (31.00) ERGOTAMINE TARTRATE WITH DIPHENHYDRAMINE Cap 1 mg with caffeine citrate 100 mg and diphenhydramine hydrochloride 25 mg ................................................................... 8.81 (Ergodryl cap 1 mg to be delisted 1 July 2003)

100 Cafergot

Ergodryl

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

123

NERVOUS SYSTEM

Antimigraine Preparations Antinausea and Vertigo Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer METOCLOPRAMIDE HYDROCHLORIDE WITH PARACETAMOL Tab 5 mg with paracetamol 500 mg ................................................... 3.25 SUMATRIPTAN Tab 50 mg ...................................................................................... 34.00 Tab 100 mg .................................................................................... 32.00 Inj 12 mg per ml, 0.5 ml - Hospital pharmacy [HP2] & [HP3]-specialist ...... 80.00 a) Injection subsidised only if not more than 6 inj per prescription. 60 4 2 2 inj OP Paramax Imigran Imigran Imigran

Prophylaxis of Migraine

Refer also to Cardiovascular System, Beta Adrenoceptor Blockers, page 56 CLONIDINE HYDROCHLORIDE Tab 25 µg ...................................................................................... 15.53 PIZOTIFEN Tab 500 µg .................................................................................... 21.10 (24.10) 100 100 Sandomigran Dixarit

ANTINAUSEA AND VERTIGO AGENTS

Refer also to ALIMENTARY TRACT, Antispasmodics, page 25 BETAHISTINE DIHYDROCHLORIDE - Retail pharmacy-specialist Tab 16 mg ...................................................................................... 17.49 CYCLIZINE HYDROCHLORIDE - Special Authority available Tab 50 mg ........................................................................................ 1.26 (4.05)

100 10

Vergo

Marzine

Additional subsidy by Special Authority: a) Approval to fully fund cyclizine hydrochloride is available for the control of nausea and vomiting in the treatment of terminal care patients; b) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed the manufacturer ’s price identified in the Pharmaceutical Schedule; c) Approvals valid for 6 months; d) Dispensed by retail pharmacy.

CYCLIZINE LACTATE Inj 50 mg per ml, 1 ml ..................................................................... 14.58 DIMENHYDRINATE Tab 50 mg ........................................................................................ 0.59 (3.07) DOMPERIDONE - Special Authority available Tab 10 mg ........................................................................................ 3.90 (7.99) 5 10 Dramamine 100 Motilium Valoid

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NERVOUS SYSTEM

Antinausea and Vertigo Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer HYOSCINE HYDROBROMIDE Inj 400 µg per ml, 1 ml ..................................................................... 6.00 HYOSCINE (SCOPOLAMINE) - Special Authority Patches, 1.5 mg ............................................................................... 9.56 (12.40) 5 2 Scopoderm TTS Baxter

Special Authority - Hospital pharmacy [HP3] a) Approvals can be granted for the control of nausea in the treatment of malignant disease. b) Approvals only for 6 months.

METOCLOPRAMIDE HYDROCHLORIDE Tab 10 mg ........................................................................................ 3.00 (5.00) ‡ Oral liq 5 mg per 5 ml ........................................................................ 2.74 (4.40) Inj 5 mg per ml, 2 ml - Available on a PSO ...................................... 26.50 ONDANSETRON - Hospital pharmacy [HP3]-specialist 100 100 ml 50 Maxolon AstraZeneca Metamide Maxolon

a) Not to exceed 6 tablets per prescription; and b) Not more than one prescription per month.

Tab 4 mg ........................................................................................ 86.00 Tab disp 4 mg ................................................................................. 86.00 Tab 8 mg ...................................................................................... 247.60 Tab disp 8 mg ............................................................................... 123.80 PROCHLORPERAZINE Tab 3 mg buccal ............................................................................... 5.97 (14.42) Tab 5 mg - Available on a PSO ......................................................... 13.49 Suppos 5 mg ................................................................................... 9.52 (14.98) Suppos 25 mg ............................................................................... 12.54 (19.73) Inj 12.5 mg per ml, 1 ml - Available on a PSO ................................... 14.91 (21.33) PROMETHAZINE THEOCLATE Tab 25 mg ........................................................................................ 1.20 (5.67) TROPISETRON - Hospital pharmacy [HP3]-specialist Cap 5 mg ..................................................................................... 154.82 a) Not to exceed 3 capsules per prescription; and b) Not more than one prescription per month. 10 10 20 10 50 500 5 5 Stemetil 10 Stemetil 10 Avomine 5 Navoban Buccastem Antinaus Stemetil Zofran Zofran Zydis Zofran Zofran Zydis

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

125

NERVOUS SYSTEM

AntiParkinson Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIPARKINSON AGENTS Dopamine Agonists and Related Agents

AMANTADINE HYDROCHLORIDE - Retail pharmacy-specialist v Cap 100 mg ................................................................................... 57.82 (63.00) APOMORPHINE HYDROCHLORIDE - Special Authority v Inj 10 mg per ml, 1 ml ..................................................................... 50.43 Special Authority - Hospital pharmacy [HP3] 60 Symmetrel 5 Baxter

a) A declaration is required to demonstrate that the patient: - has idiopathic Parkinson’s disease; and - has responded to L-dopa; and - has resistance to conventional treatment of severe motor fluctuations, or severe “off” period disability, or severe “off” period dystonic cramps. b) A declaration is required that the patient does not have dementia and/or neuropsychiatric disorders. c) Neurologists or Physician for the Elderly (FRACP) must make application. d) Neurologists or Physician for the Elderly (FRACP) must write prescription. e) Approvals valid for two years.

BROMOCRIPTINE MESYLATE v Tab 2.5 mg ..................................................................................... 33.24 v Tab 10 mg .................................................................................... 123.96 LEVODOPA WITH BENSERAZIDE v Cap 50 mg with benserazide 12.5 mg .............................................. 14.00 v Tab dispersible 50 mg with benserazide 12.5 mg .............................. 14.00 v Cap 100 mg with benserazide 25 mg ............................................... 25.00 v Cap long acting 100 mg with benserazide 25 mg - Retail pharmacy-specialist .................... 25.00 v Cap 200 mg with benserazide 50 mg ............................................... 40.00

v v v

100 100 100 100 100 100 100 100 100 100 30 100 100 100 100

Alpha-Bromocriptine Alpha-Bromocriptine Madopar 62.5 Madopar Dispersible Madopar 125 Madopar HBS Madopar SindopaIMM SinemetIMM Sinemet Sinemet CR Dopergin Permax Permax Selgene Tasmar

LEVODOPA WITH CARBIDOPA Tab 100 mg with carbidopa 25 mg .................................................. 20.00 Tab 250 mg with carbidopa 25 mg .................................................. 57.50 Tab long-acting 200 mg with carbidopa 50 mg - Retail pharmacy-specialist .............................. 70.00

LISURIDE HYDROGEN MALEATE v Tab 200 µg .................................................................................... 27.50 PERGOLIDE - Retail pharmacy-specialist v Tab 0.25 mg ................................................................................... 74.75 v Tab 1 mg ...................................................................................... 299.00 SELEGILINE HYDROCHLORIDE - Retail pharmacy-specialist v Tab 5 mg ......................................................................................... 8.90

TOLCAPONE - Retail pharmacy-specialist prescription

Tab 100 mg .................................................................................. 171.67 a) Specialist must be either a neurologist, geriatrician or general physician.

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NERVOUS SYSTEM

AntiParkinson Agents Antipsychotics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Anticholinergics

BENZTROPINE MESYLATE Tab 2 mg .......................................................................................... 5.60 Inj 1 mg per ml, 2 ml - Only on a PSO ............................................... 36.35 ORPHENADRINE HYDROCHLORIDE Tab 50 mg ...................................................................................... 31.93 PROCYCLIDINE HYDROCHLORIDE Tab 5 mg .......................................................................................... 7.40 100 5 250 100 Cogentin Cogentin Disipal Kemadrin

ANTIPSYCHOTICS

Guidelines for the use of atypical anti-psychotic agents Diagnosis: Schizophrenia and related psychoses when positive symptoms (delusions, hallucinations and thought disorder) are prominent and/or disabling or when both positive symptoms and negative symptoms (flattened affect, emotional and social withdrawal and poverty of speech) are present. Treatment: Before initiating atypical anti-psychotic therapy, physicians should consider whether the patient is likely to respond to and/or tolerate conventional anti-psychotic therapy and, where appropriate, trial one or more conventional agents prior to use of an atypical agent.

General

CHLORPROMAZINE HYDROCHLORIDE - Available on a PSO Tab 10 mg ...................................................................................... 11.24 Tab 25 mg ...................................................................................... 11.84 Tab 100 mg .................................................................................... 27.83 ‡ Oral liq 100 mg per 5 ml .................................................................. 13.64 Inj 25 mg per ml, 2 ml ..................................................................... 23.33 CLOZAPINE - Hospital pharmacy [HP4]-specialist prescription Tab 25 mg ...................................................................................... 22.00 Tab 100 mg .................................................................................... 57.00 HALOPERIDOL Tab 500 µg - Available on a PSO ........................................................ 4.80 Tab 1.5 mg - Available on a PSO ...................................................... 18.80 Tab 5 mg - Available on a PSO ......................................................... 23.88 Oral liq 2 mg per ml - Available on a PSO .......................................... 17.85 Inj 5 mg per ml, 1 ml - Available on a PSO ......................................... 14.58 LITHIUM CARBONATE Tab 250 mg .................................................................................... 26.45 Cap 250 mg ..................................................................................... 6.38 Tab 400 mg ..................................................................................... 9.17 Tab long-acting 400 mg ................................................................. 13.35 100 100 100 100 ml 10 50 50 Largactil Largactil Largactil Largactil Forte Largactil Clopine Clozaril Clopine Clozaril Serenace Serenace Serenace Serenace Serenace Lithicarb Douglas Lithicarb Priadel

100 250 100 100 ml 10 500 100 100 100

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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NERVOUS SYSTEM

Antipsychotics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer METHOTRIMEPRAZINE Tab 25 mg ..................................................................................... 15.39 Tab 100 mg .................................................................................... 39.96 Inj 25 mg per ml, 1 ml ..................................................................... 66.98 OLANZAPINE - Special Authority Tab 2.5 mg .................................................................................... 60.80 Tab 5 mg ...................................................................................... 120.49 Tab 10 mg .................................................................................... 243.44 100 100 10 30 30 30 Nozinan Nozinan Nozinan Zyprexa Zyprexa Zyprexa

Special Authority – Retail pharmacy a) Subject to a budgetary cap. Applications will be considered and approved subject to funding availability. b) Subsidised for: (i) patients presenting with first episode schizophrenia or related psychoses; and (ii) patients suffering from schizophrenia and related psychoses who are likely to benefit from anti-psychotic treatment after trial of an effective dose of risperidone that has been discontinued either because of: - recurrent acute dystonias; or - excessive Parkinson-like symptoms; or - hyperprolactinaemia; or - inadequate clinical response after four weeks. c) Initial application and application for renewal of Special Authority to be made by a psychiatrist. d) First prescription to be written by a psychiatrist or psychiatric registrar. e) Subsequent prescriptions may be written by a General Practitioner. f) Discontinued treatment should be notified to Health Benefits if possible. g) Approvals valid for two years.

PERICYAZINE Tab 2.5 mg ..................................................................................... 11.35 Tab 10 mg ...................................................................................... 40.41 PIMOZIDE - Retail pharmacy-specialist Tab 2 mg ........................................................................................ 14.72 QUETIAPINE - Subsidy by endorsement Tab 25 mg ...................................................................................... 55.00 Tab 100 mg .................................................................................. 110.00 Tab 150 mg .................................................................................. 159.00 Tab 200 mg .................................................................................. 210.00 100 100 50 60 60 60 60 Neulactil Neulactil Orap Seroquel Seroquel Seroquel Seroquel

Retail pharmacy – subsidy by endorsement a) Subsidised for: i) patients presenting with first episode schizophrenia or related psychoses; and ii) patients suffering from schizophrenia or related psychoses after a trial of an effective dose of risperidone that has been discontinued because of unacceptable side effects or inadequate response. b) Initial prescription must be written by a relevant specialist. c) Subsequent prescriptions may be written by a general practitioner. d) The prescription must be endorsed “certified condition”.

RISPERIDONE - Retail pharmacy-specialist Tab 1 mg ....................................................................................... 91.84 Tab 2 mg ...................................................................................... 183.66 Tab 3 mg ...................................................................................... 275.56 Tab 4 mg ..................................................................................... 367.30 Oral liq 1 mg per ml ....................................................................... 45.92

60 60 60 60 30 ml

Risperdal Risperdal Risperdal Risperdal Risperdal

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NERVOUS SYSTEM

Antipsychotics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer THIORIDAZINE HYDROCHLORIDE Tab 10 mg ....................................................................................... 6.38 Tab 25 mg 7.35 (7.75) Tab 50 mg ...................................................................................... 10.16 (10.69) Tab 100 mg .................................................................................... 16.64 (22.04) Tab long-acting 200 mg .................................................................. 45.00 (70.00) ‡ Oral liq 1% ..................................................................................... 25.99 THIOTHIXENE Tab 2 mg ........................................................................................ 11.22 Tab 10 mg ...................................................................................... 32.50 TRIFLUOPERAZINE HYDROCHLORIDE Tab 1 mg .......................................................................................... 9.83 (10.22) Tab 2 mg ........................................................................................ 13.63 (15.61) Tab 5 mg ........................................................................................ 15.79 (17.77) Cap long-acting 15 mg ................................................................... 33.05 (35.03) ‡ Oral liq 1 mg per ml ......................................................................... 74.80 90 90 90 90 100 500 ml 100 100 100 Stelazine 100 Stelazine 100 Stelazine 50 Stelazine Spansules Stelazine Melleril Retard Melleril Thixit Thixit Aldazine Aldazine Melleril Aldazine Melleril Aldazine Melleril

1,000 ml

Depot Injections

FLUPENTHIXOL DECANOATE - Retail pharmacy-specialist Inj 20 mg per ml, 1 ml - Available on a PSO ....................................... 13.14 Inj 20 mg per ml, 2 ml - Available on a PSO ....................................... 20.90 Inj 100 mg per ml, 1 ml - Available on a PSO ..................................... 40.87 FLUPHENAZINE DECANOATE - Retail pharmacy-specialist Inj 12.5 mg per 0.5 ml, 0.5 ml - Available on a PSO ........................ 17.60 (29.00) Inj 25 mg per ml, 1 ml - Available on a PSO .................................... 27.90 (48.75) Inj 25 mg per ml, 2 ml - Available on a PSO ....................................... 97.50 Inj 100 mg per ml, 1 ml - Available on a PSO ................................ 168.00 5 5 5 5 5 5 5 Fluanxol Fluanxol Fluanxol Modecate Baxter Modecate Baxter Baxter Baxter Modecate

(Baxter inj 12.5 mg per 0.5 ml, 0.5ml and 25 mg per ml, 1 ml to be delisted 1 June 2003) HALOPERIDOL DECANOATE - Retail pharmacy-specialist Inj 50 mg per ml, 1 ml - Available on a PSO .................................... 28.39 Inj 100 mg per ml, 1 ml - Available on a PSO ..................................... 55.90 PIPOTHIAZINE PALMITATE - Retail pharmacy-specialist Inj 50 mg per ml, 1 ml - Available on a PSO .................................. 162.25 Inj 50 mg per ml, 2 ml - Available on a PSO .................................. 321.20 5 5 10 10 Haldol Haldol Concentrate Piportil Piportil

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

129

NERVOUS SYSTEM

Anxiolytics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANXIOLYTICS

ALPRAZOLAM

a) Retail pharmacy-specialist b) Month restriction

Tab 250 µg ...................................................................................... 4.77 (8.11) Tab 500 µg ...................................................................................... 9.54 (16.26) Tab 1 mg ........................................................................................ 19.08 (32.51) ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. BUSPIRONE HYDROCHLORIDE - Special Authority Tab 5 mg ......................................................................................... 5.95 Tab 10 mg 5.95 Special Authority - Hospital pharmacy [HP3] 100 Xanax 100 Xanax 100 Xanax

100 100

Pacific Buspirone Pacific Buspirone

a) For subsidisation only as an anxiolytic where other agents are contraindicated or have failed. b) Month restriction. c) Specialist must make application – psychiatrists/geriatricians/respiratory physicians.

CLOBAZAM - Retail pharmacy-specialist Tab 10 mg ........................................................................................ 8.29 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. DIAZEPAM - Month restriction Tab 2 mg .......................................................................................... 1.08 Tab 5 mg .......................................................................................... 3.99 Tab 10 mg ........................................................................................ 2.50 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. LORAZEPAM - Month restriction Tab 1 mg .......................................................................................... 4.10 Tab 2.5 mg ....................................................................................... 4.20 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. OXAZEPAM - Month restriction Tab 10 mg ........................................................................................ 1.98 (4.90) Tab 15 mg ........................................................................................ 2.45 (6.90) ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. 50 Frisium

100 250 100

Pro-Pam Pro-Pam Pro-Pam

250 100

Lorapam Lorapam

100 Ox-Pam 100 Ox-Pam

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NERVOUS SYSTEM

Sedatives and Hypnotics

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

SEDATIVES AND HYPNOTICS

LORMETAZEPAM - Month restriction Tab 1 mg ......................................................................................... 3.11 (12.00) ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. MIDAZOLAM Tab 7.5 mg - Month restriction ......................................................... 10.38 (12.00) Inj 1 mg per ml, 5 ml - Special Authority ........................................... 12.65 Inj 5 mg per ml, 3 ml - Special Authority ........................................... 14.00 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. 30 Noctamid

100 10 5 Hypnovel Hypnovel Hypnovel

Special Authority - Hospital pharmacy [HP3] a) For terminally ill patients. b) Specialist must make application.

NITRAZEPAM - Month restriction Tab 5 mg .......................................................................................... 2.00 (3.50) (4.05) ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. TEMAZEPAM - Month restriction Cap 10 mg ....................................................................................... 3.16 Cap 20 mg ....................................................................................... 5.50 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. TRIAZOLAM - Month restriction Tab 125 µg ...................................................................................... 1.93 Tab 250 µg ...................................................................................... 3.45 (5.20) ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. (Halcion tab 250 µg to be delisted 1 July 2003) ZOPICLONE - Month restriction Tab 7.5 mg ...................................................................................... 2.25 100 Insoma Nitrados Euhypnos Euhypnos Halcion Hypam Halcion

100 100

Imovane

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

131

NERVOUS SYSTEM

Other CNS Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

OTHER CNS AGENTS

DEXAMPHETAMINE SULPHATE - Special Authority - as for methylphenidate hydrochloride below Tab 5 mg ....................................................................................... 19.00 100 PSM METHYLPHENIDATE HYDROCHLORIDE - Special Authority Tab 10 mg ....................................................................................... 6.88 30 Rubifen Tab long-acting 20 mg ................................................................... 75.00 100 Ritalin SR

Special Authority - Retail pharmacy, Controlled Drug Form a) Subsidised only for: - Narcolepsy; and - ADHD (Attention Deficient and Hyperactivity Disorder) where diagnosed according to DSM-IV or ICD 10 criteria; b) Applications and reapplications for: - ADHD patients under 5 years of age must be made by a Child & Adolescent Psychiatrist or Paediatrician; - ADHD patients aged 5 years or more must be made by an Adult Psychiatrist, Child & Adolescent Psychiatrist, Paediatrician or GP on the recommendation of such a specialist. GP applications must specify that specialist recommendation has been obtained (the steps required for “specialist recommendation” are found in the front of the Pharmaceutical Schedule in section A under the headings hospital pharmacy-specialist and retail pharmacy-specialist); - Narcolepsy must be made by a Neurologist or medical practitioner vocationally registered in Internal medicine specialising in Respiratory medicine; c) The first prescription should be written by: - a Child & Adolescent Psychiatrist or Paediatrician (in the case of ADHD patients under 5 years of age only); - a Neurologist or medical practitioner vocationally registered in Internal medicine specialising in Respiratory medicine (in the case of patients with narcolepsy); d) For subsidy purposes, all prescriptions require annotation of the Special Authority number. Where a prescription is written by a GP on the recommendation of a specialist, annotation of the specialist endorsement is not required to be on the prescription form. A Special Authority number for methylphenidate can be used for both the 10 mg tablet and the 20 mg slow release tablet. e) Approvals valid for: - 12 months for ADHD patients under 5 years of age; - 24 months for ADHD aged 5 years or over and for narcoleptic patients.

DISULFIRAM Tab 200 mg .................................................................................... 24.30 TETRABENAZINE Tab 25 mg .................................................................................... 243.00 100 112 Antabuse Xenazine 25

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ONCOLOGY AGENTS AND IMMUNOSUPPRESSANTS

Chemotherapeutic Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

CHEMOTHERAPEUTIC AGENTS Alkylating Agents

BUSULPHAN - Retail pharmacy-specialist Tab 2 mg ....................................................................................... 47.89 CHLORAMBUCIL- Retail pharmacy-specialist Tab 2 mg ....................................................................................... 22.35 CYCLOPHOSPHAMIDE - Retail pharmacy-specialist Tab 50 mg ..................................................................................... 25.71 Inj 500 mg ................................................................................... 141.60 Inj 1 g .......................................................................................... 127.80 MELPHALAN - Retail pharmacy-specialist Tab 2 mg ....................................................................................... 31.31 THIOTEPA - Retail pharmacy-specialist Inj 15 mg ....................................................................................... 14.65 100 25 50 12 6 25 each Myleran Leukeran FC Cycloblastin Cytoxan Cytoxan Alkeran Thiotepa

Antimetabolites

CALCIUM FOLINATE - Hospital pharmacy [HP1] or [HP3]-specialist Tab 15 mg [HP3] ........................................................................... 38.90 (55.60) Inj 3 mg per ml, 1 ml [HP1] ........................................................... 17.10 Inj 15 mg [HP1] ............................................................................. 57.20 Inj 50 mg [HP1] ............................................................................. 29.95 (48.50) (Leucovorin inj 50 mg to be delisted 1 August 2003) CYTARABINE - Retail pharmacy-specialist Inj 100 mg ..................................................................................... 80.00 Inj 500 mg ..................................................................................... 67.00 Inj 1 g .......................................................................................... 118.00 FLUOROURACIL SODIUM - Retail pharmacy-specialist Crm 5% ......................................................................................... 23.89 Inj 250 mg per 10 ml ..................................................................... 18.24 Inj 500 mg per 10 ml ..................................................................... 28.75 Inj 500 mg per 20 ml ..................................................................... 55.60 MERCAPTOPURINE - Retail pharmacy-specialist Tab 50 mg ..................................................................................... 47.06 10 5 5 each Baxter Leucovorin Leucovorin Calcium Leucovorin Calcium Baxter Leucovorin

5 each each 20 g OP 5 5 10 25

Baxter Pharmacia Baxter Baxter Efudix Baxter Baxter Baxter Purinethol

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

133

ONCOLOGY AGENTS AND IMMUNOSUPPRESSANTS

Chemotherapeutic Agents

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer METHOTREXATE - Hospital pharmacy [HP1] & [HP3]-specialist Tab 2.5 mg [HP3] ............................................................................ 5.80 Tab 10 mg [HP3] ........................................................................... 40.93 Inj 5 mg per 2 ml vial [HP1] ........................................................... 23.65 Inj 20 mg per 2 ml vial [HP1] ......................................................... 28.55 Inj 50 mg per 2 ml vial [HP1] ........................................................ 46.10 Inj 100 mg per 4 ml vial [HP1] ....................................................... 92.50 Inj 5 g per 50 ml vial [HP1] .......................................................... 900.24 Inj 500 mg, 20 ml vial [HP1] ......................................................... 80.25 Inj 1 g per 10 ml vial [HP1] ............................................................ 72.90 THIOGUANINE - Hospital pharmacy [HP3]-specialist Tab 40 mg ..................................................................................... 97.16 Methoblastin Methoblastin Baxter Baxter Baxter Baxter Baxter Baxter Baxter Lanvis

30 50 5 5 5 5 each each each 25

Other Cytotoxic Agents

ETOPOSIDE - Hospital pharmacy [HP1] & [HP3]-specialist Cap 50 mg [HP3] ........................................................................ 413.00 Cap 100 mg [HP3] ....................................................................... 413.00 Inj 20 mg per ml, 5 ml [HP1] ......................................................... 61.22 HYDROXYUREA - Retail pharmacy-specialist Cap 500 mg ................................................................................... 38.50 VINBLASTINE SULPHATE - Retail pharmacy-specialist Inj 10 mg ..................................................................................... 137.50 VINCRISTINE SULPHATE - Retail pharmacy-specialist Inj 1 mg per ml, 1 ml ................................................................... 133.00 Inj 1 mg per ml, 2 ml ................................................................... 266.20 20 10 each Vepesid Vepesid Vepesid Baxter Hydrea Baxter Baxter Baxter

100 5 5 5

Protein-tyrosine Kinase Inhibitors

IMATINIB MESYLATE - Special Authority - access by application Cap 100 mg .............................................................................. 4,800.00 120 Glivec

Special Authority criteria and guidelines for Glivec: Application forms are available from, and prescriptions should be sent to: The Glivec Coordinator Tel: 09 580 9176 Fax: 09 580 9205 Email: murray@ppc.govt.nz Level 3, Unisys House, 650 Great South Road, Penrose, Private Bag 92 522, AUCKLAND Special Authority criteria for CML - access by application a) Funded for patients with diagnosis (confirmed by a haematologist) of a chronic myeloid leukaemia (CML) in blast crisis, accelerated phase, or in chronic phase. b) Maximum dose of 600 mg/day for accelerated or blast phase, and 400 mg/day for chronic phase CML. c) Subsidised for use as monotherapy only. d) Initial approvals valid seven months. e) Subsequent approval(s) are granted on application and are valid for six months. The first re-application (after seven months) should provide details of the haematological response. The third re-application should provide details of the cytogenetic response after 14–18 months from initiating therapy. All other re-applications should provide details of haematological response, and cytogenetic response if such data is available. Applications to be made and subsequent prescriptions can be written by a haematologist or an oncologist. continued…

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Chemotherapeutic Agents Endocrine Therapy

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Guideline on discontinuation of treatment for patients with CML a) Prescribers should consider discontinuation of treatment if after 6 months from initiating therapy a patient did not obtain a haematological response as defined as any one of the following three levels of response: - complete haematologic response (as characterised by an absolute neutrophil count (ANC) > 1.5 x 109/L, platelets > 100 x 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0–35% metaphases), and absence of extramedullary disease); or - no evidence of leukaemia (as characterised by an absolute neutrophil count (ANC) > 1.0 x 109/L, platelets > 20 x 109/L, absence of peripheral blood (PB) blasts, bone marrow (BM) blasts < 5% (or FISH Ph+ 0-35% metaphases), and absence of extramedullary disease); or - return to chronic phase (as characterised by BM and PB blasts < 15%, BM and PB blasts and promyelocytes < 30%, PB basophils < 20% and absence of extramedullary disease other than spleen and liver). b) Prescribers should consider discontinuation of treatment if after 18 months from initiating therapy a patient did not obtain a major cytogenetic response defined as 0–35% Ph+ metaphases. Special Authority criteria for GIST - access by application a) Funded for patients: - with a diagnosis (confirmed by an oncologist) of unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST); and - who have immunohistochemical documentation of c-kit (CD117) expression by the tumour. b) Maximum dose of 400 mg/day. c) Applications to be made and subsequent prescriptions can be written by an oncologist. d) Initial and subsequent applications are valid for one year. The re-application criterion is an adequate clinical response to the treatment with imatinib (prescriber determined).

ENDOCRINE THERAPY

GnRH ANALOGUES - refer to HORMONE PREPARATIONS, Trophic Hormones, page 89. AMINOGLUTETHIMIDE - Retail pharmacy-specialist Tab 250 mg ................................................................................. 244.10 ANASTROZOLE - Special Authority available Tab 1 mg ..................................................................................... 136.70 (224.00) 100 28 Arimidex Cytadren

Additional subsidy by Special Authority - Retail pharmacy: a) Approval to fully subsidise anastrozole tablets is available for patients being treated for advanced breast cancer who are refractory to tamoxifen. b) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed the manufacturer’s price identified in the Pharmaceutical Schedule. c) Relevant specialists must make application. d) Approvals are valid for three years. e) Dispensed by retail pharmacy.

FLUTAMIDE Tab 250 mg - Hospital pharmacy [HP3]-specialist .......................... 69.00 100 Flutamin

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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Endocrine Therapy

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer LETROZOLE - Special Authority available Tab 2.5 mg .................................................................................. 146.46 (230.70)

30 Femara

Additional subsidy by Special Authority - Retail pharmacy: a) Approval to fully subsidise letrozole tablets is available for patients being treated for advanced breast cancer who are refractory to tamoxifen and who are unable to tolerate any one of the following: - aminoglutethimide; - megestrol acetate; or - medroxyprogesterone acetate. b) Prescriptions with a valid Special Authority (CHEM) number will be reimbursed the manufacturer’s price identified in the Pharmaceutical Schedule. c) Relevant specialists must make application. d) Approvals are valid for three years. e) Dispensed by retail pharmacy.

MEGESTROL ACETATE - Retail pharmacy-specialist Tab 160 mg ................................................................................... 90.00 OCTREOTIDE (somatostatin analogue) - Special Authority Inj 50 µg per ml, 1 ml .................................................................... 43.50 Inj 100 µg per ml, 1 ml .................................................................. 81.00 Inj 500 µg per ml, 1 ml ................................................................ 399.00 LAR inj 10 mg ........................................................................... 1772.50 LAR inj 20 mg ........................................................................... 2358.75 LAR inj 30 mg ........................................................................... 2951.25 30 5 5 5 1 1 1 Megace Sandostatin Sandostatin Sandostatin Sandostatin LAR Sandostatin LAR Sandostatin LAR

Special Authority - Hospital pharmacy [HP3] a) Acromegaly – in patients who have failed surgery, radiotherapy, bromocriptine and other oral therapies. b) VIPomas and Glucagonomas – for patients who are seriously ill in order to improve their clinical state prior to definitive surgery. c) Gastrinoma – for those who have failed surgery, or in metastatic disease after H2 antagonists (or proton pump inhibitors) have failed. d) Insulinomas – where surgery is contraindicated or where surgery has failed. e) For pre-operative control of hypoglycaemia and for maintenance therapy. f) Carcinoid syndrome (diagnosed by tissue pathology and/or urinary 5HIAA analysis) – for treatment of disabling symptoms not controlled by maximal medical therapy. g) The use of octreotide in patients with fistulae, oesophageal varices, miscellaneous diarrhoea and hypotension will not be funded as a Special Authority item. h) Specialist must make application. i) Special Authority numbers for Sandostatin and Sandostatin LAR can be interchangeable.

TAMOXIFEN CITRATE Tab 10 mg ....................................................................................... 2.60 Tab 20 mg ....................................................................................... 2.99 30 30 Genox Genox

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Immunosuppressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

IMMUNOSUPPRESSANTS Cytotoxic Immunosuppressants

AZATHIOPRINE - Retail pharmacy-specialist Tab 50 mg ..................................................................................... 25.00 (34.90) Inj 50 mg ....................................................................................... 46.33 (47.72) MYCOPHENOLATE MOFETIL - Special Authority Cap 250 mg ................................................................................. 206.66 Tab 500 mg ................................................................................. 206.66 100 Thioprine IMM Azamun IMM Imuran IMM Imuran 100 50 Cellcept Cellcept

each

Special Authority - Hospital pharmacy [HP3] a) Renal transplant recipients only. b) Nephrologists and transplant surgeons must make application. c) Approvals valid for 12 months (no reapplications available except as provided below). d) Re-application available for re-grafts only.

Immune Modulators

INTERFERON ALPHA-2A - Special Authority Inj 3 m iu prefilled syringe .............................................................. 31.32 Inj 4.5 m iu prefilled syringe ........................................................... 46.98 Inj 6 m iu prefilled syringe .............................................................. 62.64 Inj 9 m iu prefilled syringe .............................................................. 93.96 Inj 18 m iu multidose cartridge .................................................... 187.92 Inj 18 m iu multidose cartridge starter pack ................................. 187.92 1 1 1 1 1 1 Roferon-A Roferon-A Roferon-A Roferon-A Roferon-A Roferon-A

Note: Only one multidose cartridge starter pack to be prescribed and dispensed per patient per approval. Special Authority - Hospital pharmacy [HP3] a) Chronic myelogenous leukaemia, hairy cell leukaemia, cutaneous T cell lymphoma, essential thrombocythaemia, multiple myeloma, chronic hepatitis C (12 month approval only), chronic active hepatitis B, basal cell carcinoma. b) Approvals for basal cell carcinoma: - only for basal cell carcinoma unable to be treated surgically or by radiotherapy; - applications only from radiation oncologists, plastic surgeons and dermatologists – applications from dermatologists will only be accepted with evidence from either a plastic surgeon or oncologist that the patient was unsuitable for surgery; - maximum reimbursable dosage 15 million iu/week. c) Specialist must make application. d) No further approvals for: - renal cell carcinoma - malignant melanoma. Note: Patients with existing approvals can continue to have therapy.

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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Immunosuppressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer INTERFERON ALPHA-2B - Special Authority Inj 18 m iu, 1.2 ml multidose pen ................................................. 187.92 Inj 30 m iu, 1.2 ml multidose pen ................................................. 313.20 Inj 60 m iu, 1.2 ml multidose pen ................................................. 626.40 Special Authority - Hospital pharmacy [HP3] 1 1 1 Intron-A Intron-A Intron-A

a) Hairy cell leukaemia, chronic active hepatitis B, chronic hepatitis C (12 month approval only), chronic myelogenous leukaemia, multiple myeloma, basal cell carcinoma. b) Approvals for basal cell carcinoma - only for basal cell carcinoma unable to be treated surgically or by radiotherapy; - applications only from radiation oncologists, plastic surgeons and dermatologists – applications from dermatologists will only be accepted with evidence from either a plastic surgeon or oncologist that the patient was unsuitable for surgery; - maximum reimbursable dosage 15 m iu per week. c) Specialist must make application. d) No further approvals for malignant melanoma. (Note: Patients with existing approvals can continue to have therapy.) Guidelines for the use of interferon in the treatment of hepatitis C: Physicians considering treatment of patients with hepatitis C should discuss cases with a gastroenterologist or an infectious disease physician. All subjects undergoing treatment require careful monitoring for side effects. Patients should be otherwise fit. Hepatocellular carcinoma should be excluded by ultrasound examination and alpha-fetoprotein level. Criteria for Treatment a) Diagnosis - Anti-HCV positive on at least two occasions with a positive PCR for HCV-RNA and preferably confirmed by a supplementary RIBA test; or - PCR-RNA positive for HCV on at least 2 occasions if antibody negative; or - Anti-HCV positive on at least two occasions with a positive supplementary RIBA test with a negative PCR for HCV RNA but with a liver biopsy consistent with 2(b) following. b) Establishing Active Chronic Liver Disease - Confirmed HCV infection and serum ALT/AST levels measured on at least three occasions over six months averaging > 1.5 x upper limit of normal. (ALT is the preferable enzyme); or - Liver biopsy showing significant inflammatory activity (active hepatitis) with or without cirrhosis. This is not a necessary requirement for those patients with coagulopathy. (Some patients have active disease on histology with normal transaminase enzymes). Exclusion Criteria a) Autoimmune liver disease. (Interferon may exacerbate autoimmune liver disease as well as other autoimmune diseases such as thyroid disease). b) Pregnancy. c) Neutropenia (<2.0 x 109) and/or thrombocytopenia. d) Continuing alcohol abuse and/or continuing intravenous drug users. Dosage The current recommended dosage is 3 million units of interferon alpha-2a or interferon alpha-2b administered subcutaneously three times a week for 52 weeks (twelve months). Exit Criteria The patient’s response to interferon treatment should be reviewed at either three or four months. Interferon treatment should be discontinued in patients who do not show a substantial reduction (50%) in their mean pre-treatment ALT level at this stage.

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Immunosuppressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer INTERFERON ALPHA-N - Special Authority Inj 3 m iu per ml, 1 ml .................................................................... 31.32 (36.26)

1 Wellferon

Special Authority - Hospital pharmacy [HP3] a) Hairy cell leukaemia, chronic active hepatitis B. b) Specialist must make application.

Multiple Sclerosis Treatment

INTERFERON BETA-1-ALPHA - Access by application Inj 6 million iu per vial ............................................................... 1,219.26 INTERFERON BETA-1-BETA - Access by application Inj 8 million iu per 1 ml ............................................................. 1,347.26 4 15 Avonex Betaferon

Access by application a) Budget managed by appointed clinicians on the Multiple Sclerosis Treatment Assessments Committee (MSTAC). b) Applications will be considered by MSTAC at its regular meetings and approved subject to eligibility according to the Entry and Stopping criteria (below). c) Applications to be made on the approved forms which are available from the co-ordinator for MSTAC: The Co-ordinator Phone: 09 580 9175 or 09 580 9176 Multiple Sclerosis Treatment Assessments Committee Facsimile: 09 580 9205 Level 3, Unisys House Email: linley@ppc.govt.nz or murray@ppc.govt.nz 650 Great South Road, Penrose Private Bag 92 522, AUCKLAND d) Completed application forms must be sent to the co-ordinator for MSTAC and will be considered by MSTAC at the next practicable opportunity. e) Notification of MSTAC’s decision will be sent to the patient, the applying clinician and the patient’s GP (if specified). f) These agents will NOT be subsidised if dispensed from a community or hospital pharmacy. Regular supplies will be distributed to all approved patients or their clinicians by courier. g) Prescribers must fax quarterly prescriptions for approved patients to the MSTAC co-ordinator. h) Only prescriptions for 6 million iu of interferon beta-1-alpha per week or 8 million iu of interferon beta-1-beta every other day will be subsidised. i) Appeals against MSTAC’s decision and/or the processing of any application may be lodged with the MSTAC coordinator. Concerns that cannot be or have not been adequately addressed by MSTAC will be forwarded to a separate Appeal Committee if necessary. j) Entry and Stopping criteria Entry Criteria • Diagnosis of multiple sclerosis (MS) must be confirmed by a neurologist. Diagnosis should as a rule include MRI confirmation. For patients diagnosed before MRI was widely utilised in New Zealand, confirmation of diagnosis via clinical assessment and laboratory/ancillary data must be provided; and • patients must have active relapsing MS (confirmed by MR scan where necessary) with or without underlying progression; and continued…

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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Immunosuppressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

• patients must have experienced at least two significant relapses of MS in the previous 12 months. Each relapse must: - be confirmed by a neurologist or general physician; - be associated with new symptom(s)/sign(s) of MS or exacerbation of previously experienced symptom(s)/sign(s); - last at least one week; - follow a period of stability of at least one month; - be severe enough to change EDSS or Kurtzke functional systems score by at least 1 point; - be distinguishable from the effects of general fatigue; and - not be associated with a fever (T > 37.5 °C); and • applications must be made not less than four weeks after the date of the onset of the last known relapse; and • patients must have an EDSS score of between 3.0 and 6.5 inclusive; and • patients must have no previous history of lack of response to beta-interferon (see criteria for stopping beta-interferon). • Applications must be submitted to the Multiple Sclerosis Treatment Assessment Committee (MSTAC) by the patient’s neurologist or a general physician; and • patients must agree (via informed consent) to co-operate if as a result of their meeting the stopping criteria, funding is withdrawn. Patients must agree to the collection of clinical data relating to their MS and use of those data by PHARMAC; and • patients must agree to allow clinical data to be collected and reviewed by the MSTAC annually for each year in which they receive funding for beta-interferon. Stopping Criteria • Confirmed progression of disability that is sustained for three months after a minimum of one year of treatment. Progression of disability is defined as either a loss of 1 EDSS point on the Kurtzke scale or an increase in EDSS score to 7.0 or more; or • stable or increasing (relative to 12 months preceding commencement of treatment) relapse rate over 12 months of treatment; or • pregnancy and/or lactation; or • intolerance to both interferon beta-1-alpha and interferon beta-1-beta; or • non-compliance with treatment, including refusal to undergo annual assessment and/or for the results of the assessment to be submitted to MSTAC; or • patients may, subject to conclusions drawn from published evidence available at the time, be excluded if they develop a high titre of neutralising anti-bodies to beta-interferon.

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Immunosuppressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Other Immunosuppressants

CYCLOSPORIN A - Special Authority Cap 25 mg ..................................................................................... 85.00 Cap 50 mg ................................................................................... 169.34 Cap 100 mg ................................................................................. 338.69 Oral liq 100 mg per ml ................................................................. 377.38 50 50 50 50 ml OP Neoral Neoral Neoral Neoral

Special Authority - Hospital pharmacy [HP3] a) Organ transplant – specialist must make application. b) Bone marrow transplant – specialist must make application. c) Graft v host disease – specialist must make application. d) Psoriasis - after other systemic and topical therapy has failed (statement as to what else has been tried is necessary) - specialist must make application – dermatologists only. e) Severe atopic dermatitis - that is not responsive to topical therapy, oral antihistamines and other commonly used orthodox therapies; - specialist must make application and reapplication – dermatologists only. f) Endogenous uveitis – specialist must make application. g) Nephrotic Syndrome - Corticosteroid dependent patients who have failed on cytotoxic therapy - specialist must make application. h) Severe rheumatoid arthritis (see Guidelines) - unless contraindicated, patients must have had a trial of, and be either unresponsive to or unable to tolerate, both sulphasalazine and methotrexate; and - patients must have two serum creatinine test results within the normal range within the three months prior to initiation of therapy. - Rheumatologists must make application and write prescriptions. i) Approvals are valid for two years except where approved for a) where approvals are valid indefinitely or e) where approvals are valid for six months. Guidelines for use of cyclosporin A in rheumatoid arthritis Monitoring: All patients require frequent monitoring for creatinine levels and blood pressure: • fortnightly, in the first three months of therapy and then monthly, if results are stable; • if dose is increased or there is a rise in serum creatinine or blood pressure, then more frequent monitoring is required. Cyclosporin A is contraindicated in patients with the following conditions: • current or past malignancy; • uncontrolled hypertension; • renal dysfunction (abnormal serum creatinine for age and sex); • immunodeficiency and neutropenia; • abnormally low white blood cell count or platelet count; or • liver function tests more than twice the upper limit of normal. Caution in use: • age above 65 years; • controlled hypertension; • use of anti-epileptic medication; continued…

‡ safety cap reimbursed Preferred Brand

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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Immunosuppressants

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Guidelines continued • use of ketoconazole, fluconazole, trimethoprim, erythromycin, verapamil, and diltiazem; • concurrent or previous use of alkylating agents such as cyclophosphamide; • use of any experimental drug within the past three months; • premalignant conditions such as leukoplakia, monoclonal paraprotoinaemia, myelodysplastic syndrome and dysplastic naevi; • active infection may necessitate temporary discontinuation; • pregnancy and lactation. Therapy should be discontinued if there has been no improvement after 6 months with the patient on the maximum tolerated dose. For further information please consult the data sheet.

TACROLIMUS - Special Authority Cap 1 mg .................................................................................... 504.00 Cap 5 mg ................................................................................. 1,260.00 100 50 Prograf Prograf

Special Authority - Hospital Pharmacy [HP3] a) Liver transplant recipients. b) Renal transplant recipients – as rescue therapy only. c) Specialists must make application. d) Approvals are valid indefinitely.

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Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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RESPIRATORY SYSTEM AND ALLERGIES

Antiallergy Preparations Antihistamines

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

ANTIALLERGY PREPARATIONS

ADRENALINE Inj 1 in 1,000, 1 ml - Available on a PSO ........................................ 4.95 Inj 1 in 10,000, 10 ml - Available on a PSO ................................. 125.00 ALLERGY TREATMENT SET Extract of inhaled allergens ......................................................... CBS BEE VENOM ALLERGY TREATMENT - Special Authority Treatment kit - 1 vial 550 µg freeze dried venom, 1 diluent 9 ml, 3 diluent 1.8 ml .............................................. 154.30 Maintenance kit - 6 vials 120 µg freeze dried venom, 6 diluent 1.8 ml ..................................................................... 154.30 WASP VENOM ALLERGY TREATMENT - Special Authority Treatment kit (Yellow jacket venom) - 1 vial 550 µg freeze dried vespula venom, 1 diluent 9 ml, 1 diluent 1.8 ml ............ 154.30 Treatment kit (Paper wasp venom) - 1 vial 550 µg freeze dried polister venom, 1 diluent 9 ml, 1 diluent 1.8 ml ............. 154.30 1 OP 1 OP Albay Albay 5 50 Baxter Baxter Allpyral

1 OP 1 OP

Albay Albay

Special Authority - Hospital pharmacy [HP3] a) RAST or skin test positive and the patient has had a severe generalised reaction to the sensitising agent. b) Specialist must make application.

ANTIHISTAMINES

AZATADINE MALEATE Tab 1 mg ....................................................................................... 6.94 (15.65) ‡ Oral liq 500 µg per 5 ml ................................................................. 2.27 (10.29) CETIRIZINE HYDROCHLORIDE Tab 10 mg ..................................................................................... 2.50 CHLORPHENIRAMINE MALEATE Cap long-acting 8 mg .................................................................... 8.38 (17.41) Cap long-acting 12 mg ................................................................ 13.94 (21.81) ‡ Oral liq 2 mg per 5 ml .................................................................... 3.74 (7.26) (Histafen cap long-acting 12 mg to be delisted 1 September 2003) CYPROHEPTADINE HYDROCHLORIDE Tab 4 mg ....................................................................................... 6.27 100 Periactin 50 Zadine 100 ml Zadine 30 100 Histafen 100 Histafen 500 ml Histafen Razene

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Antihistamines

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer DEXTROCHLORPHENIRAMINE MALEATE Tab 2 mg ....................................................................................... 2.52 (8.82) Tab long-acting 6 mg ..................................................................... 6.75 (13.86) ‡ Oral liq 2 mg per 5 ml .................................................................... 1.77 (9.35) FEXOFENADINE HYDROCHLORIDE Tab 60 mg ..................................................................................... 4.34 (10.15) Tab 120 mg ................................................................................. 14.22 (28.94) KETOTIFEN Oral liq 1 mg per 5 ml .................................................................... 3.99 LORATADINE Tab 10 mg ..................................................................................... 4.90 Oral liq 1 mg per ml ....................................................................... 4.00 (8.95) PHENIRAMINE MALEATE Tab long-acting 75 mg ................................................................... 3.56 (11.65) PROMETHAZINE HYDROCHLORIDE Tab 10 mg ..................................................................................... 2.37 (6.24) Tab 25 mg ..................................................................................... 4.74 (9.56) ‡ Oral liq 5 mg per 5 ml .................................................................... 3.53 (6.73) Inj 25 mg per ml, 1 ml - Available on a PSO ................................. 12.68 (18.40) Inj 25 mg per ml, 2 ml - Available on a PSO ................................... 7.75 TRIMEPRAZINE TARTRATE ‡ Oral liq 30 mg per 5 ml .................................................................. 2.79 (7.33) 50 Polaramine 50 Polaramine Repetab 100 ml Polaramine 20 Telfast 30 Telfast 200 ml 30 100 ml Asmafen Lora-tabs Claratyne 50 Avil Retard 50 Phenergan 50 Phenergan 100 ml Phenergan 10 5 100 ml Vallergan Forte Phenergan Baxter

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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RESPIRATORY SYSTEM AND ALLERGIES

Asthma Preventative Medicines

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

ASTHMA PREVENTATIVE MEDICINES Inhaled corticosteroids - metered dose inhalers Low dose

BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 50 µg per dose ...................................................... 8.54 FLUTICASONE Aerosol inhaler, 25 µg per dose ...................................................... 5.12 200 dose OP 0.04 Beclazone 50 Flixotide

120 dose OP

0.04

Medium dose

BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 100 µg per dose .................................................. 12.50 200 dose OP 0.06 Beclazone 100 Respocort 100 Flixotide

FLUTICASONE Aerosol inhaler, 50 µg per dose CFC-free ........................................ 7.50

120 dose OP

0.06

High dose

BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 250 µg per dose .................................................. 22.67 (Respocort 250 aerosol inhaler to be delisted 1 June 2003) FLUTICASONE Aerosol inhaler, 125 µg per dose CFC-free .................................... 13.60 120 dose OP 0.11 Flixotide 200 dose OP 0.11 Beclazone 250IMM Respocort 250IMM

Very high dose

FLUTICASONE Aerosol inhaler, 250 µg per dose CFC-free .................................... 27.20 120 dose OP 0.23 Flixotide

Inhaled corticosteroids - metered dose inhalers with spacers Medium dose

BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 100 µg per dose .................................................. 25.00 (Respocort 100-S aerosol inhaler to be delisted 1 May 2003) 200 dose OP 0.13 Respocort 100-S

High dose

BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 250 µg per dose .................................................. 45.33 (Respocort Forte-S aerosol inhaler to be delisted 1 June 2003) 200 dose OP 0.23 Respocort Forte-S

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Asthma Preventative Medicines

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

Inhaled corticosteroids - breath activated devices Medium dose

BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 100 µg per dose, breath activated ....................... 13.00 200 dose OP (17.00) BUDESONIDE Powder for inhalation, 100 µg per dose ........................................ 13.00 FLUTICASONE Powder for inhalation, 50 µg per dose, breath activated .................. 3.90 (8.67) 0.07 Respocort 100 Autohaler 0.07 Pulmicort Turbuhaler

200 dose OP

60 dose OP

0.07 Flixotide Accuhaler

High dose

BECLOMETHASONE DIPROPIONATE Aerosol inhaler, 250 µg per dose, breath activated ....................... 28.13 BUDESONIDE Powder for inhalation, 200 µg per dose ........................................ 22.50 FLUTICASONE Powder for inhalation, 100 µg per dose, 4 doses per disk .............. 6.75 (13.87) Powder for inhalation, breath activated, 100 µg per dose, ............... 6.75 (13.87) 200 dose OP 0.14 Respocort Forte Autohaler Pulmicort Turbuhaler

200 dose OP

0.11

15 disks 60 dose OP

0.11 Flixotide 0.11 Flixotide Accuhaler

Very high dose

BUDESONIDE Powder for inhalation, 400 µg per dose ........................................ 38.55 FLUTICASONE Powder for inhalation, 250 µg per dose, 4 doses per disk ............ 14.46 (24.51) Powder for inhalation, breath activated, 250 µg per dose .............. 14.46 (24.51) 200 dose OP 0.19 Pulmicort Turbuhaler

15 disks 60 dose OP

0.24 Flixotide 0.24 Flixotide Accuhaler

Extremely high dose

FLUTICASONE Powder for inhalation, 500 µg per dose, 4 doses per disk ............. 28.92 (45.11) 15 disks 0.48 Flixotide

(Flixotide powder for inhalation 500 µg per dose to be delisted 1 September 2003)

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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Asthma Preventative Medicines Bronchodilators

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

Inhaled corticosteroids - nebuliser solution

BUDESONIDE

Note: The cost of nebuliser therapy greatly exceeds other inhaled forms. Steroid nebulising solution can cause cataract formation.

Nebuliser soln, 500 µg per ml, 2 ml - Special Authority .............. 124.00 30 4.13 Pulmicort

Special Authority - Hospital pharmacy [HP3] a) Only for children under 2 years of age or children with major physical or intellectual disabilities who lack the necessary coordination to use aerosols with a spacer device. b) Specialist must make application – paediatrician/respiratory physician.

Nedocromil

NEDOCROMIL Aerosol inhaler, 2 mg per dose CFC-free ...................................... 23.20 112 dose OP 0.21 Tilade

Sodium cromoglycate

SODIUM CROMOGLYCATE Aerosol inhaler, 5 mg per dose CFC-free ...................................... 23.20 Powder for inhalation, 20 mg per dose ......................................... 16.31 Nebuliser soln, 10 mg per ml, 2 ml .............................................. 30.60 112 dose OP 50 60 0.21 0.33 0.51 Vicrom Intal Spincaps Intal

BRONCHODILATORS Inhaled beta-adrenoceptor agonists - metered dose inhalers Low dose

SALBUTAMOL - Available on a PSO Aerosol inhaler, 100 µg per dose CFC-free ..................................... 3.72 200 dose OP (6.00) Aerosol inhaler, 100 µg per dose CFC-free ..................................... 6.00 200 dose OP Aerosol inhaler, 100 µg per dose .................................................... 3.72 200 dose OP TERBUTALINE SULPHATE Aerosol inhaler, 250 µg per dose .................................................... 7.44 400 dose OP 0.02 0.03 0.02 0.02 AiromirIMM Ventolin Asmol IMM Bricanyl Aerosol

Inhaled beta-adrenoceptor agonists - breath activated devices Medium dose

SALBUTAMOL - Available on a PSO Aerosol inhaler, 100 µg per dose, breath activated ........................ 21.22 400 dose OP 0.05 Respolin Autohaler

High dose

TERBUTALINE SULPHATE Powder for inhalation, 250 µg per dose, breath activated .............. 13.54 200 dose OP 0.07 Bricanyl Turbuhaler

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Bronchodilators

Subsidy Fully Brand or Cost (Manufacturer’s Price) Subsidised Generic per dose $ Per $ Manufacturer

Inhaled beta-adrenoceptor agonists - long acting Breath activated devices

EFORMOTEROL FUMARATE Powder for inhalation, 6 µg per dose, breath activated - Subsidy by endorsement ...................................................................... 21.50 60 dose OP 0.36 Oxis Turbuhaler

Subsidy is available for patients with poorly controlled asthma where: a) at least three months of 750 µg or more daily of inhaled beclomethasone or budesonide (or 400 µg of fluticasone) for adults has been used; or b) at least three months of 400 µg or more daily of inhaled beclomethasone or budesonide (or 200 µg of fluticasone) for children 12 years or older has been used; The prescription must be endorsed accordingly. We recommend that the words used to indicate eligibility are “poor control with ICS” or “certified condition”. BUDESONIDE WITH EFORMOTEROL - Special Authority

Powder for inhalation 100 µg with eformoterol fumarate 6 µg ....... 74.10 Powder for inhalation 200 µg with eformoterol fumarate 6 µg ....... 90.80 120 dose OP 120 dose OP 0.62 0.76 Symbicort Turbuhaler 100/6 Symbicort Turbuhaler 200/6 Foradil Oxis Turbuhaler Serevent Serevent Accuhaler

EFORMOTEROL FUMARATE - Special Authority

Powder for inhalation, 12 µg per dose, and monodose device ...... 35.80 Powder for inhalation, 12 µg per dose, breath activated ................ 35.80 60 doses 60 dose OP 0.60 0.60

SALMETEROL - Special Authority Powder for inhalation, 50 µg per dose, 4 doses per disk ............... 35.80 15 disks 0.60 Powder for inhalation, 50 µg per dose, breath activated ................ 35.80 60 dose OP 0.60 (Serevent powder for inhalation, 50 µg per dose, 4 doses per disk to be delisted 1 June 2003)

Special Authority - Retail pharmacy for eformoterol fumarate (12 µg per dose), eformoterol fumarate with budesonide and salmeterol . a) Special Authority criteria either under point I (in its entirety), or point II (in its entirety), or point III (in its entirety) must apply before patients have access to subsidy. b) Special Authority approvals (CHEM numbers) are interchangeable among all presentations of inhaled long-acting beta agonists and eformoterol fumarate with budesonide. c) Applications for Special Authority to be made by general practitioners or an appropriate specialist. d) Approvals valid for two years. e) Patients are to be reviewed at least at six months to assess compliance and effectiveness of therapy. f) Applications to be made on a PHARMAC approved form. g) The re-application criteria under each point below (I, II or III) are: (1) compliance (prescriber determined) with medication; and (2) improved asthma symptom control. h) Children who turn 12, and are stabilised on an inhaled LABA, are not required to try Oxis Turbuhaler 6 µg in order to have continued access to their original inhaled LABA. I. Serevent MDI, Serevent Diskhaler, Serevent Accuhaler, Foradil, Oxis Turbuhaler 12 µg, Symbicort Turbuhaler Subsidy is available for: - children with poorly controlled asthma under the age of 12 who required at least three months of 400 µg or more daily inhaled beclomethasone or budesonide (or 200 µg or more of fluticasone); or continued…

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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Bronchodilators

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

Special Authority continued - adults with poorly controlled asthma who required at least three months of 1500 µg or more daily of inhaled beclomethasone or budesonide (or 750 µg or more of fluticasone). II. Serevent MDI, Serevent Diskhaler, Serevent Accuhaler Subsidy is available for patients with poorly controlled asthma aged 12 years and over, under the following criteria: - at least three months of 750 µg or more daily of inhaled beclomethasone or budesonide (or 400 µg of fluticasone) for adults, or 400 µg or more daily inhaled beclomethasone or budesonide (or 200 µg of fluticasone) for children 12 years or older has been used; and - patients either: • are hypersensitive to eformoterol; or • have developed a product related adverse event that resolved on cessation and recurred on re-challenge with Oxis Turbuhaler 6 µg; or • after a six week trial of Oxis Turbuhaler 6 µg (with doses of 12–24 µg daily) failed to show evidence of improved asthma control.III. Serevent MDI and spacer (with or without mask) Subsidy is available in rare circumstances for patients with poorly controlled asthma aged 12 years and over, under the following criteria: - have documented serious mental or physical* disability who are incapable of being taught to use the appropriate breath activated device; and - at least three months of 750 µg or more daily of inhaled beclomethasone or budesonide (or 400 µg of fluticasone) for adults, or 400 µg or more daily inhaled beclomethasone or budesonide (or 200 µg of fluticasone) for children 12 years or older has been used; ii) Applications must be made on a PHARMAC approved form, which contains a free text box for “Turbuhaler failures” where the nature of the documented serious mental or physical disability is to be recorded. *Hand grips for the Turbuhaler are available free of charge from AstraZeneca for patients with problems with manual dexterity.

Metered dose inhalers

SALMETEROL - Special Authority (See page 149-150) Aerosol inhaler, 25 µg per dose .................................................... 33.75 120 dose OP 0.28 Serevent

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Bronchodilators

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

Inhaled beta-adrenoceptor agonists - nebuliser solutions Low dose

SALBUTAMOL - Available on a PSO Nebuliser soln, 1 mg per ml, 2.5 ml ................................................ 4.83 20 0.24 Ventolin Nebules (per 2.5 ml)

High dose

SALBUTAMOL - Available on a PSO Nebuliser soln, 2 mg per ml, 2.5 ml ................................................ 5.10 20 0.26 Ventolin Nebules (per 2.5 ml)

Very high dose

TERBUTALINE SULPHATE Nebuliser soln, 10 mg per ml ....................................................... 16.02 50 ml OP 0.32 Bricanyl (per ml)

Inhaled anticholinergic agents - metered dose inhalers Low dose

IPRATROPIUM BROMIDE Aerosol inhaler, 20 µg per dose .................................................... 13.50 200 dose OP 0.07 Atrovent

High dose

IPRATROPIUM BROMIDE Aerosol inhaler, 40 µg per dose .................................................... 14.95 200 dose OP 0.07 Atrovent Forte

Inhaled anticholinergic agents - nebuliser solutions Low dose

IPRATROPIUM BROMIDE - Available on a PSO Nebuliser soln, 250 µg per 1 ml, 1 ml ............................................ 5.90 20 0.30 Ipra 250

High dose

IPRATROPIUM BROMIDE - Available on a PSO Nebuliser soln, 500 µg per 2 ml, 2 ml ............................................ 7.55 20 0.38 Ipra 500

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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RESPIRATORY SYSTEM AND ALLERGIES

Bronchodilators

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

Inhaled beta-adrenoceptor agonist and anticholinergic agents - metered dose inhalers

SALBUTAMOL WITH IPRATROPIUM BROMIDE Aerosol inhaler, 100 µg with ipratropium bromide, 20 µg per dose ....................................... 12.19 Combivent

200 dose OP

0.06

Inhaled beta-adrenoceptor agonist and anticholinergic agents - nebuliser solution Salbutamol

SALBUTAMOL WITH IPRATROPIUM BROMIDE - Available on a PSO Nebuliser soln, 2.5 mg with ipratropium bromide 0.5 mg per 2.5 ml vial, 2.5 ml ................. 10.45 0.53 Duolin (per 2.5 ml)

Beta-adrenoceptor agonists - long-acting tablets Low dose

BAMBUTEROL HYDROCHLORIDE Tab 10 mg ................................................................................... 39.93 SALBUTAMOL Tab long-acting 4 mg ................................................................... 11.18 100 56 0.40 0.20 Bambec Volmax

High dose

SALBUTAMOL Tab long-acting 8 mg ................................................................... 15.30 56 0.27 Volmax

Beta-adrenoceptor agonists - oral liquids

BAMBUTEROL HYDROCHLORIDE Oral liq 1 mg per ml ..................................................................... 15.50 SALBUTAMOL ‡ Oral liq 2 mg per 5 ml .................................................................... 7.32 300 ml 0.26 Bambec (per 5 ml) 0.12 Ventolin (per 5 ml)

300 ml

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Bronchodilators

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

Beta-adrenoceptor agonists - injection

SALBUTAMOL Inj 500 µg per ml, 1 ml - Available on a PSO ................................ 12.90 Infusion 1 mg per ml, 5 ml ......................................................... 118.38 (130.21) TERBUTALINE SULPHATE Inj 500 µg per ml, 1 ml ................................................................ 10.21 5 10 Ventolin Ventolin 5 Bricanyl

Theophylline derivatives

AMINOPHYLLINE Inj 25 mg per ml, 10 ml - Available on a PSO ................................ 11.95 THEOPHYLLINE Tab long-acting 175 mg ............................................................... 16.14 Tab long-acting 250 mg ............................................................... 21.51 Tab long-acting 300 mg ............................................................... 14.07 Tab long-acting 350 mg ............................................................... 29.28 Tab long-acting 500 mg ............................................................... 40.80 ‡ Oral liq 80 mg per 15 ml ................................................................ 4.06 (7.83) (Nuelin-SR tab long-acting 175 mg to be delisted 1 June 2003) (Theo-Dur tab long-acting 300 mg to be delisted 1 July 2003) (Nuelin-SR tab long-acting 500 mg to be delisted 1 September 2003) 5 100 100 100 100 100 500 ml Baxter

0.16 Nuelin-SR 0.22 Nuelin-SR 0.14 Theo-Dur 0.29 Nuelin-SR 0.41 Nuelin-SR 0.12 (per 15 ml) Nuelin

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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RESPIRATORY SYSTEM AND ALLERGIES

Cough preparations Cystic Fibrosis Nasal Preparations

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

COUGH PREPARATIONS

CODEINE PHOSPHATE ‡ Linctus diabetic 15 mg per 5 ml (refer page 168) ......................... CE ‡ Linctus paediatric 3 mg per 5 ml (refer page 168) ........................ CE METHADONE HYDROCHLORIDE - Refer to Opioid Analgesics page 116

CYSTIC FIBROSIS

DORNASE ALFA - Special Authority Nebuliser soln, 2.5 mg per 2.5 ml ampoule ................................ 294.30 6 Pulmozyme

Special Authority - Hospital pharmacy [HP1] a) Dornase alfa will be subsidised for patients meeting the treatment guidelines and who are approved by the Cystic Fibrosis DN’ase Advisory Panel. Application details may be obtained from: The Co-ordinator Phone: 09 580 9176 Cystic Fibrosis DN’ase Advisory Panel Facsimile: 09 580 9205 Level 3, Unisys House Email: murray@ppc.govt.nz 650 Great South Road, Penrose Private Bag 92 522 AUCKLAND b) Prescriptions for patients approved for treatment must be written by respiratory physicians or paediatricians who have experience and expertise in treating cystic fibrosis.

NASAL PREPARATIONS Allergy Prophylactics

BECLOMETHASONE DIPROPIONATE Metered aqueous nasal spray, 50 µg per dose .............................. 2.40 Metered aqueous nasal spray, 100 µg per dose ............................ 2.60 BUDESONIDE Metered aqueous nasal spray, 50 µg per dose ............................... 2.60 Metered aqueous nasal spray, 100 µg per dose ............................ 2.95 IPRATROPIUM BROMIDE Aqueous nasal spray, 0.03% ........................................................ 11.79 SODIUM CROMOGLYCATE Nasal spray, 4% ........................................................................... 16.08 (23.30) 200 dose OP 200 dose OP 200 dose OP 200 dose OP 0.01 0.01 0.01 0.02 Alanase Aqueous Alanase Aqueous Butacort Aqueous Butacort Aqueous Atrovent Nasal Aqueous

15 ml OP

22 ml OP

Rynacrom Forte

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Respiratory Devices

Cost Subsidy Fully Brand or per dose (Manufacturer’s Price) Subsidised Generic $ Manufacturer $ Per

RESPIRATORY DEVICES

PEAK FLOW METERS - Only on a WSO Low range - maximum 10 per WSO ............................................. 17.00 (Note: maximum of 20 peak flow meters available on a WSO from 1 November 2002 until 30 April 2003) 1 OP Air-O-Breath Pocketpeak Breath-Alert Mini Wright Personal Best Vitalograph Assess Air-O-Breath Pocketpeak Breath-Alert Mini Wright Personal Best Vitalograph Space Chamber Foremount Child’s Silicone Mask

(22.73) Normal range - maximum 10 per WSO ......................................... 17.00 (Note: maximum of 20 peak flow meters available on a WSO from 1 November 2002 until 30 April 2003)

1 OP

SPACER DEVICES AND MASKS- Only on a WSO Spacer device - maximum 5 per WSO .......................................... 12.50 Mask, size 2 - maximum 5 per WSO .............................................. 4.10

OP OP

a) Spacer devices and masks also available to paediatricians employed by a DHB on a wholesale supply order signed by the paediatrician. Limited to one pack of 20 per order. Orders via a hospital pharmacy. b) Only available for children aged six years and under. c) For Space Chamber and Foremount Child’s Silicone Mask wholesale supply order must indicate clearly if either the spacer device, the mask, or both are required. d) Distributed by Airflow Products. Forward orders to: Airflow Products Telephone: 04 499 1240 or 0800 AIR FLOW PO Box 1485, Wellington Facsimile: 04 499 1245 or 0800 323 270

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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SENSORY ORGANS

Ear Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

EAR PREPARATIONS

ACETIC ACID WITH 1, 2-PROPANEDIOL DIACETATE AND BENZETHONIUM Ear drops 2% with 1, 2- propanediol diacetate 3% and benzethonium chloride 0.02% ...................................................... 5.83 Ear drops 2% with 1, 2- propanediol diacetate 3% and benzethonium chloride 0.02% and hydrocortisone 1% (refer page 168) .......................................................................... CE CHLORAMPHENICOL Ear drops 0.5% ................................................................................ 1.87 COLISTIN SULPHATE WITH NEOMYCIN AND HYDROCORTISONE Ear drops 3 mg with neomycin sulphate 3.3 mg and hydrocortisone acetate 10 mg per ml ............................................ 9.00 (Colymycin-S Otic ear drops to be delisted 1 July 2003) Vosol 5 ml OP Chloromycetin

35 ml OP

5 ml OP

Colymycin-S Otic

DEXAMETHASONE WITH FRAMYCETIN AND GRAMICIDIN Ear/Eye drops 500 µg with framycetin sulphate 5 mg and gramicidin 50 µg per ml ............................................................... 4.50 8 ml OP (7.33) Ear/Eye oint 0.5 mg with framycetin sulphate 5 mg and gramicidin 50 µg per g ................................................................ 4.50 5 g OP (7.33) FLUMETASONE PIVALATE Ear drops 0.02% with clioquinol 1% ................................................. 4.46 7.5 ml OP (4.65) FRAMYCETIN SULPHATE Ear/Eye drops 0.5% ......................................................................... 4.13 8 ml OP (6.84) Ear/Eye oint 0.5% ............................................................................ 3.65 5g OP (6.20) OXYPENTIFYLLINE - Special Authority Tab 400 mg ................................................................................... 36.94 50

Sofradex

Locorten-Vioform

Soframycin Soframycin Trental 400

Special Authority - Hospital pharmacy [HP3] Approvals granted for: a) chronic post-thrombotic venous stasis ulcers of more than 4 months duration where other interventions have failed; or b) sudden hearing loss – ENT specialist only.

TRIAMCINOLONE ACETONIDE WITH GRAMICIDIN, NEOMYCIN AND NYSTATIN Ear drops 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 µg per g ............................... 3.67 7.5 ml OP

Kenacomb

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Eye Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

EYE PREPARATIONS Anti-Infective Preparations

See also Corticosteroids & Other Anti-Inflammatory Preparations, page 158 ACICLOVIR - Retail pharmacy-specialist Eye oint 3% ................................................................................... 29.54 4.5 g OP (30.71) CHLORAMPHENICOL Eye drops 0.5% ............................................................................... 1.02 10 ml OP Eye oint 1% ..................................................................................... 1.80 4 g OP CIPROFLOXACIN - Retail pharmacy-specialist prescription Eye drops 0.3% ............................................................................. 12.43 5 ml OP

Zovirax Chlorsig Chlorsig Ciloxan

a) Specialist must be an ophthalmologist. b) For treatment of bacterial keratitis or severe bacterial conjunctivitis resistant to chloramphenicol.

DIBROMOPROPAMIDINE ISETHIONATE Eye oint 0.15% ................................................................................ 2.97 (6.60) FRAMYCETIN SULPHATE Ear/Eye drops 0.5% ......................................................................... 4.13 (6.84) Ear/Eye oint 0.5% ............................................................................ 3.65 (6.20) FUSIDIC ACID Eye drops 1% .................................................................................. 4.50 (6.60) GENTAMICIN SULPHATE - Retail pharmacy-specialist Eye drops 0.3% ............................................................................. 11.40 PROPAMIDINE ISETHIONATE Eye drops 0.1% ............................................................................... 2.97 (6.60) SULPHACETAMIDE SODIUM Eye drops 10% ................................................................................ 3.60 TOBRAMYCIN - Retail pharmacy-specialist Eye drops 0.3% ............................................................................. 11.48 Eye oint 0.3% ................................................................................ 10.45 5 g OP Brolene 8 ml OP Soframycin 5 g OP Soframycin 5 g OP Fucithalmic 5 ml OP 10 ml OP Brolene 15 ml OP 5 ml OP 3.5 g OP Acetopt Tobrex Tobrex Genoptic

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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SENSORY ORGANS

Eye Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Corticosteroids and Other Anti-Inflammatory Preparations

DEXAMETHASONE - Retail pharmacy-specialist Eye drops 0.1% ............................................................................... 4.50 (8.80) Eye oint 0.1% .................................................................................. 5.86 5 ml OP 3.5 g OP Maxidex Maxidex

DEXAMETHASONE WITH FRAMYCETIN AND GRAMICIDIN - Retail pharmacy-specialist when used in the treatment of eye conditions Ear/Eye drops 500 µg with framycetin sulphate 5 mg and gramicidin 50 µg per ml ................................................................................. 4.50 8 ml OP (7.33) Sofradex Ear/Eye oint 0.5 mg with framycetin sulphate 5 mg and gramicidin 50 µg per g .................................................................................. 4.50 5 g OP (7.33) Sofradex DEXAMETHASONE WITH NEOMYCIN AND POLYMYXIN B SULPHATE - Retail pharmacy-specialist Eye drops 0.1% with neomycin sulphate 0.35% and polymyxin B sulphate 6,000 u per ml ...................................... 4.50 5 ml OP Maxitrol Eye oint 0.1% with neomycin sulphate 0.35% Maxitrol and polymyxin B sulphate 6,000 u per g ....................................... 5.39 3.5 g OP DICLOFENAC SODIUM - Retail pharmacy-specialist Eye drops 1 mg per ml ................................................................... 13.80 FLUOROMETHOLONE - Retail pharmacy-specialist Eye drops 0.1% ............................................................................... 4.50 LEVOCABASTINE Eye drops 0.5 mg per ml .................................................................. 8.71 (11.26) LODOXAMIDE TROMETAMOL Eye drops 0.1% ............................................................................... 8.71 PREDNISOLONE ACETATE - Retail pharmacy-specialist Eye drops 0.12% ............................................................................. 4.50 (7.53) Eye drops 1% .................................................................................. 4.50 (9.44) SODIUM CROMOGLYCATE Eye drops 2% .................................................................................. 8.71 5 ml OP 5 ml OP Voltaren Ophtha Flucon FML Livostin 10 ml OP 5 ml OP Pred Mild 5 ml OP Pred Forte 10 ml OP Opticrom Lomide

4 ml OP

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Eye Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Glaucoma Preparations

ACETAZOLAMIDE v Tab 250 mg ..................................................................................... 8.75 (10.52) v Sodium inj 500 mg ........................................................................ 13.95 BETAXOLOL HYDROCHLORIDE - Retail pharmacy-specialist v Eye drops 0.25% ........................................................................... 13.18 v Eye drops 0.5% ............................................................................... 7.54 BRIMONIDINE TARTRATE - Retail pharmacy-specialist v Eye drops 0.2% ............................................................................. 14.00 100 1 5 ml OP 5 ml OP 5 ml OP Diamox Diamox Betoptic S Apo-Betaxolol Alphagan

Prescribing Guidelines Alphagan is subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Alphagan should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: a) that person has previously trialled all other such subsidised agents (except dorzolamide hydrochloride); and b) those trials have indicated that that person does not respond adequately to or does not tolerate treatment with those other agents.

CARBACHOL - Retail pharmacy-specialist v Eye drops 1.5% ............................................................................... 6.82 (8.83) v Eye drops 3% .................................................................................. 6.99 (8.99) DORZOLAMIDE HYDROCHLORIDE - Retail pharmacy-specialist v Eye drops 2% ................................................................................ 13.95 See prescribing guidelines below. 15 ml OP Isopto Carbachol 15 ml OP Isopto Carbachol 5 ml OP Trusopt

DORZOLAMIDE HYDROCHLORIDE WITH TIMOLOL MALEATE - Retail pharmacy-specialist v Eye drops 2% with timolol maleate 0.5% ........................................ 23.95 5 ml OP

Cosopt

Prescribing Guidelines Both Trusopt and Cosopt are subsidised for use as either monotherapy or as an adjunctive agent for the treatment of glaucoma. Trusopt and Cosopt should not be prescribed for a person in whom less expensive first line agents for the treatment of glaucoma are not contraindicated unless: a) that person has previously trialled all other such subsidised agents (except brimonidine tartrate); and b) those trials have indicated that that person does not respond adequately to treatment with those other agents.

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

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SENSORY ORGANS

Eye Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

LATANOPROST - Special Authority Eye drops 50 µg per ml, 2.5 ml ...................................................... 34.54

2.5 ml OP

Xalatan

Special Authority - Retail pharmacy: a) Subsidised when used as monotherapy for the treatment of: - patients with primary open-angle glaucoma who cannot tolerate or in whom beta-blockers, pilocarpine and dorzolamide are contraindicated; or - patients with primary open-angle glaucoma in whom a reduction in intraocular pressure of 15% or more is not achieved or maintained using dorzolamide either alone or in combination with a beta-blocker; or - patients in whom there is progressive visual field loss and/or optic nerve damage persists after treatment with dorzolamide either alone or in combination with a beta-blocker. b) Subsidised for adjunctive use for the treatment of patients who have met criterion (a) and in whom latanoprost monotherapy has been ineffective in controlling intraocular pressure. An adjunctive agent may be added without a further Special Authority application. c) Initial applications and re-applications valid for two years. d) Re-applications must indicate whether the patient is using monotherapy or adjunctive therapy. e) Specialist application and reapplication – ophthalmologist only. f) Subsequent prescriptions can be written by any medical practitioner.

LEVOBUNOLOL - Retail pharmacy-specialist v Eye drops 0.25% ............................................................................. 8.00 v Eye drops 0.5% ............................................................................... 8.20 PILOCARPINE Eye drops 0.5% ............................................................................... 2.77 v Eye drops 1% .................................................................................. 2.95 v Eye drops 2% .................................................................................. 3.76 v Eye drops 3% .................................................................................. 4.75 v Eye drops 4% .................................................................................. 5.48 v Eye drops 6% .................................................................................. 7.78 v Eye drops 2%, single dose - Special Authority ................................ 31.95 (32.72)

5 ml OP 5 ml OP 15 ml OP 15 ml OP 15 ml OP 15 ml OP 15 ml OP 15 ml OP 20

Betagan Alcon-Levobunolol Pilopt Pilopt Pilopt Pilopt Pilopt Pilopt Minims

Special Authority - Hospital pharmacy [HP3] a) Minims for a general practice are considered to be “tools of trade” and are not approved as Special Authority items. b) Approvals are granted only for an individual patient who has to use an unpreserved solution due to an allergy to the preservative or who wears soft contact lenses.

TIMOLOL MALEATE - Retail pharmacy-specialist v Eye drops 0.25%, gel forming .......................................................... 8.00 v Eye drops 0.25% ............................................................................. 2.93 4.30 v Eye drops 0.5%, gel forming ............................................................ 8.50 v Eye drops 0.5% ............................................................................... 3.14 4.30 (Note: Timoptol eye drops 0.25% and 0.5% to be delisted 1 June 2003) TIMOLOL MALEATE WITH PILOCARPINE - Retail pharmacy-specialist v Eye drops 0.5% with pilocarpine 2% ............................................... 13.95 v Eye drops 0.5% with pilocarpine 4% .............................................. 13.95 2.5 ml OP 5 ml OP 5 ml OP 2.5 ml OP 5 ml OP 5 ml OP Timoptol XE Apo-Timop Timoptol Timoptol XE Apo-Timop Timoptol

5 ml OP 5 ml OP

Timpilo 2 Timpilo 4

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SENSORY ORGANS

Eye Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Mydriatics and Cycloplegics

ATROPINE SULPHATE Eye drops 0.5% ............................................................................... 4.02 Eye drops 1% .................................................................................. 4.02 CYCLOPENTOLATE HYDROCHLORIDE Eye drops 1% .................................................................................. 8.76 HOMATROPINE HYDROBROMIDE Eye drops 2% .................................................................................. 7.18 (9.17) Eye drops 5% .................................................................................. 8.73 (10.73) HYOSCINE HYDROBROMIDE Eye drops 0.25% ............................................................................. 6.79 TROPICAMIDE Eye drops 0.5% ............................................................................... 7.15 Eye drops 1% .................................................................................. 8.66 15 ml OP 15 ml OP 15 ml OP 15 ml OP Isopto Homatropine 15 ml OP Isopto Homatropine 15 ml OP 15 ml OP 15 ml OP Isopto Hyoscine Mydriacyl Mydriacyl Atropt Atropt Cyclogyl

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

161

SENSORY ORGANS

Eye Preparations

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Preparations for Tear Deficiency

ACETYLCYSTEINE - Special Authority Eyedrops (refer page 168) ................................................................ CE

Special Authority - Hospital pharmacy [HP1] a) Filamentary keratitis. b) Specialist must make application.

HYPROMELLOSE Eye drops 0.3% ............................................................................... 2.65 Eye drops 0.5% ............................................................................... 1.79 Eye drops 1% .................................................................................. 1.91 POLYVINYL ALCOHOL Eye drops 1.4% ............................................................................... 3.62 Eye drops 3% .................................................................................. 3.88 POLYVINYL ALCOHOL WITH POVIDONE Eye drops 1.4% with povidone 0.6% ................................................ 3.62 TYLOXAPOL Eye drops 0.25% 8.63 15 ml OP 15 ml OP 15 ml OP 15 ml OP 15 ml OP 15 ml OP 15 ml OP Poly-Tears Methopt Methopt Forte Liquifilm Tears Liquifilm Forte Tears Plus Enuclene

Other Eye Preparations

NAPHAZOLINE HYDROCHLORIDE Eye drops 0.1% ............................................................................... 4.15 PARAFFIN LIQUID WITH SOFT WHITE PARAFFIN Eye oint with soft white paraffin ....................................................... 3.63 PARAFFIN LIQUID WITH WOOL FAT LIQUID Eye oint 3% with wool fat liq 3% ....................................................... 3.63 PHENYLEPHRINE HYDROCHLORIDE Eye drops 0.12% ............................................................................. 3.25 (4.18) PHENYLEPHRINE HYDROCHLORIDE WITH ZINC SULPHATE 0.12% with zinc sulphate 0.25% eye drops ...................................... 4.51 15 ml OP 3.5 g OP 3.5 g OP 15 ml OP Naphcon Forte Lacri-Lube Poly-Visc Isopto Frin Prefrin Zincfrin

15 ml OP

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VARIOUS

Agents Used in the Treatment of Poisonings Detection of Substances in Urine

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

AGENTS USED IN THE TREATMENT OF POISONINGS

Refer also to MUSCULO-SKELETAL, Anticholinesterases, page 109 AMYL NITRITE Ampoule, 0.3 ml crushable ............................................................ 62.92 (73.40) CHARCOAL Tab 300 mg ................................................................................... 7.13 Oral liq 50 g per 300 ml – Only on a PSO ....................................... 19.95 DESFERRIOXAMINE MESYLATE - Hospital pharmacy [HP3] Inj 500 mg per 10 ml vial ............................................................. 130.00 IPECACUANHA Tincture ......................................................................................... 41.20 (43.40) NALOXONE HYDROCHLORIDE - Only on a PSO Inj 20 µg per ml, 2 ml .................................................................... 59.90 Inj 400 µg per ml, 1 ml .................................................................. 59.90 PENICILLAMINE - Retail pharmacy-specialist Tab 125 mg ................................................................................... 56.30 (61.93) Tab 250 mg ................................................................................... 89.98 (98.98) (Distamine tab 250 mg to be delisted 1 June 2003) SODIUM CALCIUM EDETATE Inj 200 mg per ml, 5 ml ................................................................. 53.31 (55.99) 6 Calcium Disodium Versenate 12 Baxter 100 300 ml OP 10 500 ml PSM 10 10 Baxter Narcan Neonatal Narcan Baxter Red Seal Carbosorb Desferal

100 D-Penamine Distamine 100 D-Penamine Distamine

DETECTION OF SUBSTANCES IN URINE

ORTHO-TOLIDINE Compound diagnostic sticks ............................................................ 7.50 50 stick OP (8.25) TETRABROMOPHENOL Blue diagnostic strips ....................................................................... 7.02 100 strip OP (13.92)

Hemastix

Albustix

‡ safety cap reimbursed

Three months supply may be dispensed at one time if endorsed “certified exemption” by the prescriber.

163

SECTION C EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

INTRODUCTION

The following extemporaneously compounded products are eligible for subsidy:

• The “Standard Formulae”. • Oral liquid mixtures for patients unable to swallow subsidised solid dose oral formulations. • The preparation of syringe drivers when prescribed by a general practitioner. • Dermatological preparations; - One or more subsidised dermatological galenical(s) in a subsidised dermatological base. - Dilution of proprietary Topical Corticosteroid-Plain preparations with a dermatological base (Retail pharmacy-specialist). - Phenol liquefied and/or menthol crystals only in the following bases: Aqueous cream BP Urea cream 10% (Aquacare HP Nutraplus and Calmurid) , Wool fat with mineral oil lotion (Alpha Keri, BK, DP and Hydroderm) Hydrocortisone 1% with wool fat and mineral oil lotion (DP lotn HC) Glycerol, paraffin and cetyl alcohol lotion (QV).

Glossary

Dermatological base: The products listed in the Barrier creams and Emollients section and the Topical CorticosteroidsPlain section of the Pharmaceutical Schedule are classified as dermatological bases for the purposes of extemporaneous compounding and are the bases to which the dermatological galenicals can be added. Also the dermatological bases in the Barrier Creams and Emollients section of the Pharmaceutical Schedule can be used for diluting proprietary Topical Corticosteroid-Plain preparations. The following products are dermatological bases: • • • • • • • • • • • • • • Aqueous cream Cetomacrogol cream BP Emulsifying ointment BP Glycerol with paraffin and cetyl alcohol lotion Hydrocortisone with wool fat and mineral oil lotion Oil in water emulsion Oily cream Urea cream 10% White soft paraffin Wool fat with mineral oil lotion Zinc cream BP Zinc ointment BP Zinc and castor oil ointment BP Proprietary Topical Corticosteroid-Plain preparations

164

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Dermatological galenical: Dermatological galenicals will only be subsidised when added to a dermatological base. More than one dermatological galenical can be added to a dermatological base. The following are dermatological galenicals: • • • • Coal tar solution BP – up to 10% Hydrocortisone powder – up to 5% Salicylic acid powder Sulphur precipitated powder

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Standard formulae: Standard formulae are a list of fomulae for ECPs that are subsidised. They are listed under the appropriate therapeutic heading in Section B of the Pharmaceutical Schedule and also in Section C.

Explanatory notes

Oral liquid mixtures Oral liquid mixtures are subsidised for patients unable to swallow subsidised solid oral dose forms where no suitable alternative proprietary formulation is subsidised. Suitable alternatives include dispersible and sublingual formulations, oral liquid formulations or rectal formulations. Before extemporaneously compounding an oral liquid mixture, other alternatives such as dispersing the solid dose form (if appropriate) or crushing the solid dose form in jam, honey or soft foods such as yoghurt should be explored. Subsidy for extemporaneously compounded oral liquid mixtures is based on: Solid dose form Preservative Suspending agent Water to qs qs qs 100%

Prescribers may prescribe or pharmacists may add extra non-subsidised ingredients such as flavouring and colouring agents, but these extra ingredients will not be reimbursed. The subsidised ingredients in the formula will be reimbursed and a compounding fee paid. The majority of extemporaneously compounded oral liquid mixtures should contain a preservative and suspending agent. Methylcellulose 3% is considered a suitable suspending agent and compound hydroxybenzoate solution or methyl hydroxybenzoate 10% solution are considered to be suitable preservatives. Usually 1 ml of these preservative solutions is added to 100 ml of oral liquid mixture. Some solid oral dose forms are not appropriate for compounding into oral liquid mixtures and should therefore not be used/considered for extemporaneously compounded oral liquid mixtures. This includes long-acting solid dose formulations, enteric coated tablets or capsules, sugar coated tablets, hard gelatin capsules and chemotherapeutic agents. The following practices will not be subsidised: Mixing one or more proprietary oral liquids (eg an antihistamine with pholcodine linctus). Extemporaneously compounding an oral liquid with more than one solid dose chemical. Mixing more than one extemporaneously compounded oral liquid mixture. Mixing one or more extemporaneously compounded oral liquid mixtures with one or more proprietary oral liquids. • The addition of a chemical/powder/agent/solution to a proprietary oral liquid or extemporaneously compounded oral mixture. • • • •

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10 Preferred Supplier

165

EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Standard formulae A list of standard formulae is contained in this section. All ingredients associated with a standard formula will be subsidised and an appropriate compounding fee paid. Prescribers may prescribe or pharmacists may add extra non-subsidised ingredients, but these extra ingredients will not be reimbursed. The subsidised ingredients in the formula will be reimbursed and a compounding fee paid. Dermatological Preparations Proprietary topical corticosteroid preparations may be diluted with a dermatological base (see page 164) from the Barrier Creams and Emollients section of the Pharmaceutical Schedule (Retail pharmacy-Specialist). Dilution of proprietary topical corticosteroid preparations should only be prescribed for withdrawing patients off higher strength proprietary topical corticosteroid products where there is no suitable proprietary product of a lower strength available or an extemporaneously compounded product with up to 5% hydrocortisone is not appropriate. (In general proprietary topical corticosteroid preparations should not be diluted because dilution effects can be unpredictable and may not be linear, and usually there is no stability data available for diluted products). One or more dermatological galenicals may be added to a dermatological base (including proprietary topical corticosteroid preparations). Prescribers may prescribe or pharmacists may add extra non-subsidised ingredients, but these extra ingredients will not be reimbursed. The subsidised ingredients in the formula will be reimbursed and a compounding fee paid. The addition of dermatological galenicals to diluted proprietary Topical Corticosteroids-Plain will not be subsidised. The flow diagram on page 167 may assist you in deciding whether or not a dermatological ECP is subsidised.

166

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

Dermatological ECPs

IS IT SUBSIDISED?

Does the formula contain a subsidised dermatological base? Yes Is there only one dermatological base (e.g. aqueous cream)? Yes Is the galenical(s) a subsidised dermatological galenical? No Yes Entire product is NSS No Is the second base a proprietary topical corticosteriod-plain? No Yes Entire product is NSS No Entire product is NSS

Is prescription written by a specialist or on the recommendation of a specialist? No Yes Entire product is NSS

This part of the product is subsidised

Has a non-subsidised ingredient been added: e.g. glycerol? Yes The non-subsidised ingredient is not subsidised but the rest is

Has a dermatological galenical or other non-subsidised ingredient been added? Yes The dermatological galenicals & nonsubsidised ingredients are NSS

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10 Preferred Supplier

167

EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Standard Formulae

ACETYLCYSTEINE EYE DROPS Acetylcysteine inj 200 mg per ml, 10 ml Suitable eye drop base

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer

qs qs

ALLOPURINOL MOUTHWASH Allopurinol 100 mg tab 5 tabs Methylcellulose 2.0 g Preservative qs Water to 500 ml (Preservative should be used if quantity supplied is for more than 5 days. Maximum 500 ml per prescription.) ASPIRIN & CHLOROFORM APPLICATION Aspirin Soluble tabs 300 mg 12 tabs Chloroform to 100 ml CODEINE LINCTUS PAEDIATRIC (3 mg per 5 ml) Codeine phosphate 60 mg Glycerol 40 ml Preservative qs Water to 100 ml CODEINE LINCTUS DIABETIC (15 mg per 5 ml) Codeine phosphate 300 mg Glycerol 40 ml Preservative qs Water to 100 ml FOLINIC MOUTHWASH Folinic acid 15 mg tab 1 tab Preservative qs Water to 500 ml (Preservative should be used if quantity supplied is for more than 5 days. Maximum 500 ml per prescription.) MAGNESIUM HYDROXIDE MIXTURE Magnesium hydroxide paste 275 g Methyl hydroxybenzoate 1.5 g Water 770 ml METHADONE MIXTURE Methadone powder Glycerol Water qs qs to 100 ml

METHYL HYDROXYBENZOATE 10% SOLUTION Methyl hydroxybenzoate 10 g Propylene glycol to 100 ml (Use 1 ml of the 10% solution per 100 ml of oral liquid mixture) PILOCARPINE ORAL LIQUID Pilocarpine 6% eye drops qs Preservative qs Water to 500 ml (Preservative should be used if quantity supplied is for more than 5 days.) SALICYLIC ACID 20% SOLUTION Salicylic acid 4g Collodian flexible to 20 ml SALICYLIC ACID 40% SOLUTION Salicylic acid 8g Collodian flexible to 20 ml SALICYLIC ACID 20% OINTMENT Salicylic acid White soft paraffin SALICYLIC ACID 40% OINTMENT Salicylic acid White soft paraffin SALICYLIC ACID 60% OINTMENT Salicylic acid White soft paraffin 4g 16 g 8g 12 g 12 g 8g

SALIVA SUBSTITUTE Methylcellulose 5g Preservative qs Water to 500 ml (Preservative should be used if quantity supplied is for more than 5 days. Maximum 500 ml per prescription.) VOSOL EAR DROPS with HYDROCORTISONE POWDER 1% Hydrocortisone powder 1% Vosol ear drops to 35 ml

METHYLCELLULOSE 3% SUSPENSION BASE Methylcellulose 3g Water to 100 ml (Methylcellulose 3% suspension base to be delisted 1 August 2003)

168

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer ACETYLCYSTEINE Inj 200 mg per ml, 10 ml .............................................................. 137.06 (242.50) AQUEOUS CREAM ............................................................................... 2.65 BENZOIN Tincture compound BP .................................................................... 24.42 (32.72) CETOMACROGOL Cream BP ........................................................................................ 2.80 (4.35) CHLOROFORM BP .............................................................................. 21.30 (Only in aspirin and chloroform application) (23.35) COAL TAR Solution BP ..................................................................................... 32.45 (39.35) (45.95) 10 Parvolex 500 g 500 ml PSM 500 g PSM IPW 500 ml PSM 500 ml David Craig PSM AFT

a) Up to 10%; b) Only in combination with a dermatological base or proprietary Topical Corticosteroid - Plain; (refer to page 164) c) With or without other dermatological galenicals.

CODEINE PHOSPHATE Powder ........................................................................................... 63.09 (72.55) ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. COLLODION FLEXIBLE ........................................................................ 14.60 (19.90) COMPOUND HYDROXYBENZOATE Solution ............................................................................................ 3.83 (Only in extemporaneously compounded oral mixtures) EMULSIFYING OINTMENT BP ............................................................... 4.09 GLYCEROL ......................................................................................... 26.66 (29.00) (David Craig Glycerol to be delisted 1 September 2003) GLYCEROL WITH PARAFFIN AND CETYL ALCOHOL - Only on the prescription of a doctor Lotion 5% with paraffin liq 5% and cetyl alcohol 2% ........................... 1.40 250 ml (7.35) HYDROCORTISONE Powder ............................................................................................ 46.20 25 g 25 g Douglas

(Only in extemporaneously compounded codeine linctus diabetic or codeine linctus paediatric) 100 ml PSM 100 ml 500 g 2,000 ml David Craig AFT David Craig PSM

(Only in extemporaneously compounded methadone mixture, codeine linctus diabetic or codeine linctus paediatric)

QV m-Hydrocortisone

a) Up to 5%; b) In a dermatological base (not proprietary Topical Corticosteroid - Plain); (refer to page 164) c) With or without other dermatological galenicals.

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10 Preferred Supplier

169

EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer HYDROCORTISONE WITH WOOL FAT AND MINERAL OIL - Only on the prescription of a doctor Lotn 1% with wool fat hydrous 3% and mineral oil .............................. 5.92 250 ml MAGNESIUM HYDROXIDE Paste ............................................................................................ 22.61 (39.90) MENTHOL Crystals ........................................................................................... 32.20 (32.80) (42.40) 500 g PSM 100 g PSM David Craig

DP Lotn HC

METHADONE HYDROCHLORIDE

a) Only on a controlled drug form. b) Extemporaneously compounded methadone will only be reimbursed at the rate of the cheapest form available (methadone powder, not methadone tablets).

Powder ........................................................................................... 10.70 ‡ Safety caps reimbursed for extemporaneously compounded oral liquid preparations. (PSM powder to be delisted 1 August 2003) METHYLCELLULOSE .......................................................................... 16.11 (19.59) (PSM methylcellulose to be delisted 1 August 2003) METHYLHYDROXYBENZOATE ............................................................. 15.62 (18.45) OILY CREAM BP ................................................................................... 2.80 (9.96) (14.00) PARAFFIN White soft ...................................................................................... 17.89 (39.50) PHENOL Liquefied ......................................................................................... 21.20 (29.70) (37.00) 100 g PSM 25 g PSM 500 g David Craig PSM 2,500 g IPW PSM 1g Douglas PSM

a) Only in combination with a dermatological galenical or as a diluent for a proprietary topical corticosteroid-plain.

500 ml PSM David Craig

a) Only in combination with aqueous cream, 10% urea cream, wool fat with mineral oil lotion, 1% hydrocortisone with wool fat and mineral oil lotion, and glycerol, paraffin and cetyl alcohol lotion; b) With or without menthol crystals. (David Craig phenol liquified to be delisted 1 July 2003) (PSM phenol to be delisted 1 August 2003)

PROPYLENE GLYCOL ......................................................................... 16.20 500 ml (19.20) (Only in extemporaneously compounded methylhydroxybenzoate 10% solution) PSM

170

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

EXTEMPORANEOUSLY COMPOUNDED PREPARATIONS & GALENICALS

Subsidy Fully Brand or (Manufacturer’s Price) Subsidised Generic $ Per Manufacturer SALICYLIC ACID ................................................................................. 29.52 (37.95) (38.40) 500 g David Craig PSM

a) In a dermatological base or proprietary Topical Corticosteroid - Plain; (refer to page 164) b) With or without other dermatological galenicals. c) In a ‘standard formula’.

SULPHUR Precipitated ....................................................................................... 7.92 (9.25) 100 g PSM

a) Only in combination with a dermatological base or proprietary Topical Corticosteroid - Plain; (refer to page 164) b) With or without other dermatological galenicals.

UREA Crm 10% ........................................................................................... 2.52 100 g OP Nutraplus

WOOL FAT WITH MINERAL OIL - Only on the prescription of a doctor Lotn hydrous 3% with mineral oil ..................................................... 0.70 125 ml OP (4.78) Lotn hydrous 3% with mineral oil ..................................................... 1.12 200 ml OP (5.00) Lotn hydrous 3% with mineral oil ..................................................... 1.40 250 ml OP (2.18) (6.56) Lotn hydrous 3% with mineral oil ..................................................... 2.10 375 ml OP (9.38) Lotn hydrous 3% with mineral oil ..................................................... 5.60 1,000 ml (8.70) (18.43) (20.37) ZINC Cream BP .......................................................................................... 6.55 (8.90) Ointment BP ...................................................................................... 6.55 (8.95) (PSM Zinc ointment BP to be delisted 1 September 2003) ZINC AND CASTOR OIL Ointment BP ..................................................................................... 6.20 500 g

BK Lotion Alpha-Keri Lotion DP Lotion Hydroderm Lotion BK Lotion Alpha-Keri Lotion DP Lotion Hydroderm Lotion Alpha-Keri Lotion BK Lotion

PSM 500 g PSM

500 g

Sigma Cream

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10 Preferred Supplier

171

SECTION D: SPECIAL FOODS

EXPLANATORY NOTES

The list of special foods to which Subsidies apply is contained in this section. The list of available products, guidelines for use, subsidies and charges is reviewed as required. Applications for new listings and changes to subsidies and access criteria will be considered by the special foods sub-committee of PTAC which meets as and when required. In all cases, Subsidies are available by Special Authority only. This means that, unless a patient has a valid Special Authority number for their special food requirements, they must pay the full cost of the products themselves.

Eligibility for Special Authority

Special Authorities will be approved for patients meeting conditions specified under the Medical Conditions and Guidelines for each product. In some cases there are also limits to how products can be prescribed (for example quantity, use or duration). Only those brands, presentations and flavours of special foods listed in this section are subsidised.

Who can apply for Special Authority?

Initial applications: Only specialists Reapplications: Specialist or general practitioner on recommendation of specialist. Reapplications by general practitioners on specialist recommendation must include the name of the specialist and the date the specialist was contacted. All applications must be made on an official form available from HB. All applications must include specific details as requested on the form relating to the application. A supporting letter may be included if desired. Applications must be forwarded to: HealthPAC Special Authorities Section Private Bag 3015 Wanganui Freefax 0800 100 131

How long are approvals valid?

1.Three years for inborn errors of metabolism, cystic fibrosis, Coeliac disease and renal disorders 2. All others are one year, unless specified otherwise.

Special Authority Intechangeability

Special Authority numbers for some Special Food products are interchangeable from 1 November 1999. Where a Special Authority number is interchangeable patients will have access to a subsidy for all products within the group under one number and all specified flavours and pack sizes of these products are included. See table below (and over) for details. Special Food Group Nutrient modules – carbohydrates Nutrient modules – fat Nutrient Modules – protein Oral Supplements Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed) Products for which Special Authority numbers are Interchangeable Moducal, Morrex Maltodextrin, Polycal and Polycose Calogen neutral and Calogen strawberry Promod and Protifar 90 Ensure Powder, Nutridrink Powder, Resource Standard and Sustagen Hospital Formula Ensure Plus, Fortisip and Resource Plus IsoSource 1.5 and Nutrison Energy Nepro, NovaSource Renal and Nutrison Concentrated Nutrivent and Pulmocare

continued…

172

SPECIAL FOODS

…continued Special Food Group Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed) – Diabetic Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed) – Paediatric Standard Products and Added Fibre Products Food Thickeners Gluten Free Foods Phenyl Free Foods Protein Supplements Infant Formulae Infant Formulae for Gastrointestinal and other Malabsorptive Problems Products for which Special Authority numbers are Interchangeable Glucerna*, and Resource Diabetic

Nutrini, Pediasure*, and Resource Just For Kids

Isosource Standard*, Nutrison Standard RTH, Osmolite*, Fibresource*, Jevity*and Nutrison Multi Fibre Karicare Food Thickener and Resource Thicken Up All products listed under the Gluten Free Bread and Bake Mixes and Gluten Free Pastas All products listed under the Phenyl Free Bread Mixes and Phenyl Free Pastas Aminogran Mineral Mixture and Metabolic Mineral Mixture S26LBW and Similac Special Care Infasoy, Isomil and Karicare Soya Infant Formula

* includes RTH pack Subsidies and manufacturer’s surcharges

The Subsidies for some special foods are based on the lowest priced product within each group. Where this is so, or where special foods are otherwise not fully subsidised, a manufacturer’s surcharge may be payable by the patient. The manufacturer’s surcharge is the difference between the price of the product and the subsidy attached to it and may be subject to mark-ups applied at a pharmacy level. As a result the manufacturer’s surcharge may vary. Fully subsidised alternatives are available in most cases (as indicated by a tick in the left hand column). Patients should only have to pay a co-payment on these products.

Where are special foods available from?

Distribution arrangements for special foods vary from region to region. Special foods are available from hospital pharmacies providing an outpatient dispensing service as well as retail pharmacies in the Northern, Midland and Central (including Nelson and Blenheim) regions.

Definitions

Failure to thrive Growth deficiency An inability to gain or maintain weight resulting in physiological impairment. Where the weight of the child is less than the fifth or possibly third percentile for their age, with evidence of malnutrition.

173

SPECIAL FOODS

Nutrient Modules

Product

= fully subsidised

Pack Size

Subsidy (Mnfr’s Price) $

NUTRIENT MODULES Carbohydrate*

Medical Conditions • cystic fibrosis • cancer in children • cancers affecting alimentary tract where there • failure to thrive are malabsorption problems in patients over the • growth deficiency age of 20 years • bronchopulmonary dysplasia • premature and post premature infants • chronic renal failure and CAPD patients Special Authority – Hospital pharmacy [HP3] Moducal .................................................................................................. 368 g OP 1.30 (12.00) Morrex Maltodextrin ................................................................................ 5,000 g 36.50 Polycal (neutral) ...................................................................................... 400 g OP 1.30 (5.29) Polycose ................................................................................................. 350 g OP 1.14 (7.85)

Fat*

Medical Conditions • failure to thrive • bronchopulmonary dysplasia • fat malabsorption • short bowel syndrome • biliary atresia • • • • growth deficiency inborn errors of metabolism lymphangiectasia infants with necrotising enterocolitis

Special Authority – Hospital pharmacy [HP3] Calogen (neutral) ................................................................................. 1,000 ml OP Calogen (strawberry) .............................................................................. 250 ml OP Liquigen (neutral) ................................................................................ 1,000 ml OP MCT oil (Nutricia) .................................................................................. 500 ml OP

61.50 15.38 (17.05) 95.75 25.00

Carbohydrate and Fat

Guidelines To be used only in infants aged four years or under, with the medical conditions outlined under Carbohydrate. Special Authority – Hospital pharmacy [HP3] Duocal Super Soluble Powder (neutral) ................................................. 400 g OP 50.26

Protein*

Medical Conditions • protein losing enteropathy • high protein needs (eg burns) Special Authority – Hospital pharmacy [HP3] Promod (vanilla) ...................................................................................... 275 g OP Protifar 90 ............................................................................................... 225 g OP

* Special Authority numbers may be interchangeable, refer pages 172–173

12.90 7.90

174

SPECIAL FOODS

Nutrient Modules Oral Supplements

Product Pack Size Subsidy (Mnfr’s Price) $

= fully subsidised

ORAL SUPPLEMENTS*

Guidelines These products are to be used only as supplements to a person's dietary needs. Subsidy for up to 500 ml a day. Amounts prescribed in excess of this amount must be paid for by the patient. Medical Conditions • cancer in children • inflammatory bowel disease • cancers affecting alimentary tract where there • malnutrition requiring nutritional support are malabsorption problems in patients • cystic fibrosis over the age of 20 years Special Authority – Hospital pharmacy [HP3] Ensure Powder (banana, chocolate, strawberry, vanilla) .......................... 400 g OP Nutridrink Powder (chocolate, strawberry, vanilla) ............................... 860 g OP Resource Standard (chocolate, strawberry, vanilla) ............................ 237 ml OP Sustagen Hospital Formula (chocolate, vanilla) ....................................... 900 g OP 6.13 (8.60) 12.23 0.89 12.29 (13.65)

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

175

SPECIAL FOODS

Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed)

Product

= fully subsidised

Pack Size

Subsidy (Mnfr’s Price) $

ORAL SUPPLEMENTS/COMPLETE DIET (nasogastric/gastrostomy tube feed)*

Guidelines • This group of products can be used either as a supplement or as a complete diet • Applications must state whether the product is to be used as a complete feed or as a supplement. • If a product is being used as a supplement, the limit is 500 ml per day. • Cystic fibrosis patients are exempt the 500 ml per day volume restriction when using Ensure Plus, Fortisip, or Resource Plus as a supplement. Medical Conditions • any condition causing malabsorption

• failure to thrive

• increased nutritional requirements

Special Authority – Hospital pharmacy [HP3] Ensure Plus (banana, chocolate, fruit/forest, strawberry, vanilla) ........... 200 ml OP

1.12 (1.45) Ensure Plus (chocolate, coffee, strawberry, vanilla) ............................ 237 ml OP 1.33 Ensure Plus RTH ................................................................................... 1,000 ml OP 7.00 Fortisip (banana, chocolate, strawberry, toffee, tropical fruit, vanilla) .... 200 ml OP 1.12 Resource Plus (chocolate, strawberry, vanilla) ................................... 237 ml OP 1.33 Two Cal HN (vanilla) .............................................................................. 237 ml OP 2.25 Two Cal HN is only to be used as a nutritional supplement after other lower calorie products have been tried and should only be used in patients with substantially increased metabolic requirements. IsoSource 1.5 ........................................................................................ 250 ml OP IsoSource 1.5 ....................................................................................... 1,000 ml OP Nutrison Energy (vanilla) ...................................................................... 500 ml OP Nutrison Energy (vanilla) ..................................................................... 1,000 ml OP 1.75 7.00 3.50 7.00

Guidelines (in addition to the Guidelines above) Applications for Special Authorities to be made by renal physicians or gastroenterologists. Where possible, the requirements for oral supplementation should be established in conjunction with assessment by a dietician. Medical Condition • undialysed end stage renal patients Special Authority – Hospital pharmacy [HP3] Suplena .................................................................................................. 237 ml OP 3.80

Medical Conditions • acute or chronic renal failure Special Authority – Hospital pharmacy [HP3] Nepro (vanilla) ...................................................................................... 237 ml OP NovaSource Renal ................................................................................. 237 ml OP Nutrison Concentrated (vanilla) ............................................................ 500 ml OP

2.88 2.88 6.08

176

* Special Authority numbers may be interchangeable, refer pages 172–173

SPECIAL FOODS

Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed)

Product

= fully subsidised

Pack Size

Subsidy (Mnfr’s Price) $

Medical Conditions • CORD patients who have hypercapnia Special Authority – Hospital pharmacy [HP3] Nutrivent (vanilla) ................................................................................. 250 ml OP Pulmocare (vanilla) ............................................................................... 237 ml OP

1.75 1.66

Medical Conditions For patients who have anorexia and weight loss associated with any of the following conditions: • decompensating liver disease without encephalopathy • protein losing gastro-enteropathy Special Authority – Hospital pharmacy [HP3] Fortimel (vanilla) ................................................................................... 200 ml OP 1.50

Diabetic*

Medical Conditions • Type I and II diabetics who require nutritional supplementation. Special Authority – Hospital pharmacy [HP3] Glucerna (vanilla) .................................................................................. 237 ml OP Glucerna RTH ....................................................................................... 1,000 ml OP Resource Diabetic (chocolate, strawberry, vanilla) ............................. 237 ml OP Resource Diabetic (vanilla) ................................................................. 1,000 ml OP

2.30 9.70 2.30 9.70

Paediatric*

Guidelines These products are for use in infants aged one to six years. They may be used either as a supplement or as a complete diet. Where used as a supplement the limit is three units per day. Medical Conditions • any condition causing malabsorption • failure to thrive • increased nutritional requirements Special Authority – Hospital pharmacy [HP3] Nutrini .................................................................................................... 200 ml OP 1.60 Pediasure (chocolate, strawberry, vanilla) ........................................... 237 ml OP 1.90 Pediasure RTH ....................................................................................... 500 ml OP 4.00 Resource Just for Kids (chocolate, vanilla) .......................................... 237 ml OP 1.90

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

177

SPECIAL FOODS

Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed)

Product

= fully subsidised

Pack Size

Subsidy (Mnfr’s Price) $

Standard Products*

Medical Conditions Inability to take oral food: • enteral feeding • nasoduodenal • gastrostomy/jejunostomy

• nasogastric • nasojejunal

Special Authority – Hospital pharmacy [HP3] Isosource Standard ............................................................................... 250 ml OP Isosource Standard RTH ...................................................................... 1,000 ml OP Nutrison Standard RTH (vanilla) ........................................................... 500 ml OP Nutrison Standard RTH (vanilla) .......................................................... 1,000ml OP Osmolite ................................................................................................ 946 ml OP Osmolite RTH ........................................................................................ 1,000 ml OP

1.24 5.29 2.65 5.29 4.69 5.29

Added Fibre Products*

Special Authority – Hospital pharmacy [HP3] Fibresource ........................................................................................... 250 ml OP Fibresource RTH .................................................................................. 1,000 ml OP Jevity ..................................................................................................... 946 ml OP Jevity RTH ............................................................................................ 1,000 ml OP Nutrison Multi Fibre .............................................................................. 500 ml OP Nutrison Multi Fibre ............................................................................. 1,000 ml OP 1.24 5.29 5.00 5.29 2.65 5.29

Specialised Complete Foods

Guidelines Each of these products is highly specialised and would be prescribed only by an expert for a specific disorder. The alternative is hospitalisation. Note Elemental 028 Extra is more expensive than other products listed in this section and should only be used where the alternatives have been tried first and/or are unsuitable. Medical Conditions • malabsorption • short bowel syndrome • enterocutaneous fistulas • pancreatitis Special Authority – Hospital pharmacy [HP3] Alitraq ...................................................................................................... 76 g OP 7.50 Elemental 028 (orange & unflavoured) ................................................. 100 g OP 16.69 Elemental 028 Extra (grapefruit, pineapple/orange & summer fruit) .. 250 ml OP 7.35 6.02 Peptisorb ............................................................................................... 500 ml OP Peptisorb .............................................................................................. 1,000 ml OP 12.04 Stresson Multi-Fibre ............................................................................. 500 ml OP 9.98 Vital HN ................................................................................................... 79 g OP 4.40 Vivonex TEN (unflavoured – with or without flavour sachets) ......... 80.4 g sachet OP 4.00

178

* Special Authority numbers may be interchangeable, refer pages 172–173

SPECIAL FOODS

Oral Supplements/Complete Diet (nasogastric/gastrostomy tube feed) Food Thickeners Gluten Free Foods

Product

= fully subsidised

Pack Size

Subsidy (Mnfr’s Price) $

Guidelines For use as a complete diet in patients who have metabolic disorders of fat metabolism or chylothorax where Portagen is not appropriate or available. Special Authority – Hospital pharmacy [HP3] Monogen ................................................................................................. 400 g OP 50.40 Special Authority- Hospital pharmacy [HP3] Kindergen ............................................................................................... 400 g OP a) For children (up to 18 years) with chronic renal failure. b) Initial applications must be made by an authorised Paediatrician c) Prescriptions can be written by any medical practitioner d) Approvals are valid for 3 years e) Reapplications must be made by an authorised Paediatrician Special Authority- Hospital pharmacy [HP3] Generaid Plus ......................................................................................... 400 g OP a) For children (up to 18 years) who are awaiting liver transplant b) Initial applications must be made by a Paediatrician c) Prescriptions can be written by any medical practitioner d) Approvals are valid for 3 years e) Reapplications must be made by a Paediatrician

45.00

65.81

FOOD THICKENERS*

Guidelines Only available as a subsidy for patients with swallowing disorders in motor neurone disease. Special Authority – Hospital pharmacy [HP3] Karicare Food Thickener (neutral) .......................................................... 200 g OP 3.20 Karicare Food Thickener (neutral) .......................................................... 500 g OP 8.00 Resource Thicken Up ............................................................................. 250 g OP 4.00

GLUTEN FREE FOODS*

Guidelines Gluten Free Foods will only be approved where gluten enteropathy has been diagnosed by biopsy, or where a person suffers from dermatitis herpetiformis. A premium may be payable if the subsidy does not match the price charged by the manufacturer.

Bread and Bake Mixes*

Special Authority – Hospital pharmacy [HP3] NZB Low Gluten Bread Mix ..................................................................... 1,000 g OP Healtheries Wheat and Gluten Free Baking Mix ........................................ 1,000 g OP Horleys Bread Mix .................................................................................. 1,000 g OP Horleys Flour .......................................................................................... 2,000 g OP Gluten Free Bread Mix 100% Bakels ....................................................... 1,000 g OP 3.93 (4.61) 2.81 (5.15) 3.51 (5.49) 5.62 (9.46) 4.77 (7.23)

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

179

SPECIAL FOODS

Gluten Free Foods Foods for PKU and Other Inborn Errors of Metabolism

Product Pack Size Subsidy (Mnfr’s Price) $

= fully subsidised

Pastas*

2.00 (2.63) Orgran Corn & Parsley Spirals ................................................................. 250 g OP 2.00 (2.63) Orgran Corn & Spinach Rigatini ............................................................... 250 g OP 2.00 (2.63) Orgran Corn & Vegetable Shells ............................................................... 250 g OP 2.00 (2.63) Orgran Garlic & Parsley Spirals ............................................................... 250 g OP 2.00 (2.63) Orgran Rice & Maize Pasta Spirals .......................................................... 250 g OP 2.00 (2.63) Orgran Rice & Maize Spaghetti ................................................................ 250 g OP 2.00 (2.63) Orgran Rice & Millet Spirals ..................................................................... 250 g OP 2.00 (2.63) Orgran Tomato & Basil Spirals ................................................................. 250 g OP 2.00 (2.63) Orgran Corn Spaghetti ............................................................................. 250 g OP 2.00 (2.63) Orgran Vegetable & Rice Spirals .............................................................. 250 g OP 2.00 (2.85) Orgran Corn, Tomato & Chilli Spirals ....................................................... 250 g OP 2.00 (2.85) Orgran Buckwheat Spirals ....................................................................... 250 g OP 2.00 (2.85) The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products. Special Authority – Hospital pharmacy [HP3] Orgran Corn & Parsley Fettucine .............................................................. 250 g OP

FOODS FOR PKU AND OTHER INBORN ERRORS OF METABOLISM

Guidelines It can cost up to $70,000 a year to keep an adult on protein supplements. Because protein substitutes are so expensive and because they are only effective in controlling PKU if a restricted diet is followed, adults with PKU will be required to demonstrate they are following the prescribed diet by regular blood testing. The requirement for testing applies to those aged over 16 years. Failure to follow an appropriate diet results in high blood phenylalanine levels. Those consistently testing above 15 mg (900 µmol) over a twelve month period will not be able to claim these products as a Special Authority. Specialists will be required to renew applications for their PKU patients every year and, when they do so, will have to submit the results of two blood tests. Medical Conditions • dietary management of homocystinuria. • PKU and other inborn errors of metabolism • dietary management of maple syrup urine disease.

180

* Special Authority numbers may be interchangeable, refer pages 172–173

SPECIAL FOODS

Foods for PKU and Other Inborn Errors of Metabolism

Product

= fully subsidised

Pack Size

Subsidy (Mnfr’s Price) $

Phenyl Free Bread Mixes*

Special Authority – Hospital pharmacy [HP3] Loprofin Mix ............................................................................................ 500 g OP 6.70 (8.22)

Phenyl Free Pastas*

Special Authority – Hospital pharmacy [HP3] Aproten Chicchi (Rice) Low Protein Pasta ............................................... 500 g OP 10.65 (11.91) Loprofin Pasta spirals, macaroni, spaghetti ............................................. 500 g OP 10.65 (11.91) The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products.

Protein Supplements*

Special Authority – Hospital pharmacy [HP3] Aminogran Food Supplement ................................................................. 500 g OP 244.18 Aminogran Mineral Mix .......................................................................... 250 g OP 45.06 Analog LCP ............................................................................................. 400 g OP 145.60 Maxamaid MSUD*(unflavoured) ............................................................ 500 g OP 250.45 Maxamum MSUD*(unflavoured) ............................................................ 500 g OP 364.35 Maxamaid RVHB*(unflavoured) ............................................................ 200 g OP 90.75 Maxamaid XP (orange, unflavoured) ..................................................... 500 g OP 195.00 Maxamum XP (orange, unflavoured) ..................................................... 500 g OP 305.00 Metabolic Mineral Mixture ..................................................................... 250 g OP 48.70 Phlexy 10, Capsules ............................................................................. 200 cap OP 110.12 Phlexy 10, Drink sachets 20 g (blackcurrent/apple) ................................. 1 OP 9.00 * Used for inborn errors of metabolism other than PKU. At present there are only one or two individuals using each product. MSUD Aid ............................................................................................... 500 g OP 487.38 XMET Maxamum .................................................................................... 500 g OP 384.95

(Maxamaid RVHB unflavoured to be delisted 1 October 2003)

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

181

SPECIAL FOODS

Multi Vitamin Supplements Infant Formulae

Product Pack Size Subsidy (Mnfr’s Price) $

= fully subsidised

MULTI VITAMIN SUPPLEMENTS

Guidelines Vitamin supplements are only available on subsidy for inborn errors of metabolism. Special Authority – Hospital pharmacy [HP3] Ketovite Syrup ........................................................................................ 150 ml OP Ketovite Tablets ........................................................................................... 100 Paediatric Seravite .................................................................................. 100 g OP

8.98 (13.50) 19.65 30.00

INFANT FORMULAE*

Guidelines Reimbursed only for infants suffering from Williams Syndrome and associated hypercalcaemia. Special Authority – Hospital pharmacy [HP3] Locasol (unflavoured) ............................................................................ 400 g OP 36.99 Guidelines To be used for infants weighing less than 1.5 kg at birth. A Special Authority will be granted for six months only. Special Authority – Hospital pharmacy [HP3] S26LBW .................................................................................................. 454 g OP 7.41 Similac Special Care ............................................................................. 120 ml OP 0.98

Infant Formulae for Gastrointestinal and Other Malabsorptive Problems*

The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products. Guidelines To be used in infants suffering from malabsorption and other gastrointestinal problems. Note Vivonex Pediatric may be a suitable and less expensive alternative for many children who would otherwise be eligible for a subsidy for Neocate and should, therefore, be tried first in these cases. Neocate should be used only as a last resort when the infant is unable to absorb any of the formulae below. The objective with each of the formulae below prescribed is to get the infant off them as soon as possible. This may take six months, it may take three years. Because of this, variation on age limit is not regarded as appropriate. Special Authority – Hospital pharmacy [HP3] Neocate ................................................................................................... 400 g OP 63.97 (67.08) Pepti Junior ............................................................................................. 450 g OP 15.52 (19.01) Vivonex Pediatric ..................................................................................... 48.5 g OP 5.62 (6.00)

182

* Special Authority numbers may be interchangeable, refer pages 172–173

SPECIAL FOODS

Infant Formulae

Product

= fully subsidised

Pack Size

Subsidy (Mnfr’s Price) $

The subsidy for these products reflects the philosophy that the patient incurs no additional financial burden for purchasing specialised more expensive products. Guidelines For use in infants diagnosed as suffering from congenital lactase deficiency. In these cases approval should be given for up to two years. Secondary lactose intolerance in children is usually short lasting, and can be controlled by dietary measures and by giving sufficient calories to regenerate digestive enzymes. Approvals will not be given beyond the age of two years. When these products are used for infants with an intolerance to cows’ milk, approvals will be given for six months only, after which the specialist must reapply. These products are available from community pharmacies. Special Authority - Retail pharmacy Delact ...................................................................................................... 900 g OP 5.66 (13.08) Infasoy .................................................................................................... 450 g OP 3.37 (6.86) 6.34 Infasoy .................................................................................................... 900 g OP (14.55) Isomil ...................................................................................................... 400 g OP 2.89 (7.20) Karicare Goats Milk Infant Formula .......................................................... 900 g OP 9.42 (18.75) Karicare Soya Infant Formula ................................................................... 900 g OP 9.03 (18.11)

(Isomil 400 g OP to be delisted 1 May 2003)

fully subsidised

[HP1], [HP2], [HP3], [HP4] refer page 10

183

SECTION E PART I PRACTITIONER’S AND WHOLESALE SUPPLY ORDERS

Please refer to Section A for a definition, and conditions of supply, of Practitioner’s Supply Orders.

Pharmaceuticals that may be obtained on a Practitioner’s Supply Order

Therapeutic group Chemical Alimentary tract and metabolism Atropine sulphate Dicyclomine hydrochloride Glucagon hydrochloride Hyoscine N-Butylbromide Loperamide hydrochloride Blood and Blood forming agents Aspirin Compound electrolytes Dextrose Phytomenadione Sodium chloride 0.9% Presentation Inj 400 µg per 1ml, Inj 600 µg per 1ml and Inj 1,200 µg per ml Tab 10 mg Inj 1 mg syringe kit Inj 20 mg per ml Cap 2 mg Tab 300 mg Powder for oral solution in sachets Inj 50%, 10ml Inj 2 mg per 0.2 ml Inj 10 mg per ml, 1 ml Inj 5 ml and 10 ml Inf 500 ml Inf 1,000 ml Injection 2 ml, 5 ml, 10 ml and 20 ml Tab 2.5 mg (may be supplied for reasons other than emergency) Tab 62.5 µg Tab 40 mg Inj 10 mg per ml, 2 ml Tab 600 µg Inj twin pack 100 mg/5 ml Inj 2.5 mg per ml, 2 ml Crm 1% with chlorhexidine digluconate 0.2% With or without spermicidal agent Extra strength Ortho All-flex Ortho Coil Di-isobutylphenoxypolyethoxy-ethanol jelly 1% Nonoxynol 9 pessary Inj 500 µg/ml Tab Tab Tab Tab Tab Tab 500 µg Tab 30 µg Tab 750 µg Inj 150 mg per 1 ml Tab 350 µg Tab Inj 5 iu per ml, 1 ml, 10 iu per ml, 1 ml Inj 5 iu with 500 µg ergometrine maleate per ml, 1 ml Quantity 5 30 5 5 30 30 10 5 5 5 5 4 2 5 150 30 30 5 100 6 5 500 g 72 144 1 each size 1 pack 1 pack 5 63 or 84 63 or 84 63 or 84 63 or 84 63 84 84 10 5 84 63 or 84 5 5

Water for injection Cardiovascular Bendrofluazide Digoxin Frusemide Glyceryl trinitrate Lignocaine Verapamil Dermatological Genito-urinary Silver sulphadiazine Condoms Diaphragm Spermicidal agents Ergometrine maleate Ethinyloestradiol with desogestrel Ethinyloestradiol with gestodene Ethinyloestradiol with levonorgestrel Ethinyloestradiol with norethisterone Ethinyloestradiol with norgestrel Ethynodiol diacetate Levonorgestrel Medroxyprogesterone acetate Norethisterone Norethisterone with mestranol Oxytocin Oxytocin with ergometrine maleate

184

PRACTITIONER’S AND WHOLESALE SUPPLY ORDERS

Therapeutic group Chemical Hormone preparations

Presentation

Quantity 30 5 5 30 30 ml 30 200 ml 30 5 200 ml 30 5 5 200 ml 30 30 200 ml 30 200 ml 30 5 30 200 ml 30 5 30 5 10 5 5 5 5 5 5 5 5 5 5 5 5 200 ml 30 5 200 ml 30 5

Dexamethasone Tab 1 mg and 4 mg Dexamethasone sodium phosphate Inj 4 mg per ml, 1 ml and 2 ml Hydrocortisone Inj 50 mg per ml, 2 ml Norethisterone Tab 5 mg Prednisolone sodium phosphate Oral liq 5 mg per ml Prednisone Tab 5 mg Amoxycillin Grans for oral liq 125 mg per 5 ml and 250 mg per 5 ml Cap 250 mg Inj 1 g Grans for oral liq 125 mg/31.25 mg per 5 ml and 250 mg/62.5 mg per 5 ml Tab 500 mg/125 mg Inj 1.2 mega u per 2 ml Inj 1 mega u Oral liq 240 mg per 5 ml Tab 480 mg Tab 50 mg and 100 mg Oral liq 200 mg per 5 ml and 400 mg per 5 ml Tab 250 mg or 400 mg Grans for oral liq 125 mg per 5 ml and 250 mg per 5 ml Cap 250 mg Inj 1 gm Tab 200 mg Grans for oral liq or oral liq 125 mg per 5 ml and 250 mg per 5 ml Cap 250 mg Inj 1.5 mega unit Tab 300 mg Inj 25 mg per ml, 3 ml Suppos 50 mg Inj 10 mg per ml, 2 ml Inj 1 mg per ml, 2 ml Rectal tubes 5 mg and 10 mg Inj 5 mg per ml, 2 ml Inj 50 mg per ml, 2 ml and 5 ml Inj 20 mg per ml, 1 and 2 ml vials Inj 100 mg per ml, 1 ml Inj 25 mg per ml, 0.5 ml, 1 ml and 2 ml Inj 100 mg per ml, 1 ml Inj 50 mg per ml, 1 ml Inj 100 mg per ml, 1 ml Inj 50 mg per ml, 1 ml and 2 ml Oral liq 100 mg per 5 ml Tab 10 mg, 25 mg and 100 mg Inj 25 mg/ml, 2 ml Oral liq 2 mg per ml Tab 500 µg, 1.5 mg and 5 mg Inj 5 mg per ml, 1 ml

Infections

Amoxycillin clavulanate

Benzathine penicillin Benzylpenicillin sodium Co-trimoxazole Doxycycline HCl Erythromycin Flucloxacillin

Metronidazole Phenoxymethylpenicillin Procaine Penicillin Trimethoprim Musculoskeletal Diclofenac Tenoxicam Nervous System Benztropine Mesylate Diazepam Phenytoin sodium Flupenthixol decanoate Fluphenazine decanoate Haloperidol decanoate Pipothiazine palmitate Chlorpromazine

Haloperidol

185

PRACTITIONER’S AND WHOLESALE SUPPLY ORDERS

Therapeutic group Chemical Nervous System (continued) Metoclopromide hydrochloride Prochlorperazine Lignocaine hydrochloride Morphine sulphate

Presentation Inj 5 mg per ml, 2 ml Tabs 5 mg Inj 12.5 mg per ml, 1 ml Inj 0.5%, 5 ml Inj 1%, 20 ml and 50 ml Inj 2 mg per ml, 1 ml; 5 mg per ml, 1 ml; 10 mg per ml, 1ml and 5 ml; 15 mg per ml, 1ml; 30 mg per ml, 1 ml Oral liq 120 mg per 5 ml Tab 500 mg Inj 50 mg per ml, 1 ml, 1.5 ml and 2 ml Inj 1 in 1,000, 1 ml Inj 1 in 10,000, 10 ml Injection 25 mg per ml, 10 ml Nebuliser soln 250 µg and 500 µg per neb Inj 25mg per ml, 1 ml and 2 ml Aerosol inhalers 100 µg and 200 µg per dose Nebuliser soln 1 mg per ml and 2 mg per ml, 2.5 ml Inj 500 µg per ml, 1 ml Nebuliser soln 2.5 mg with ipratroprium bromide 0.5 mg per 2.5 ml, 2.5 ml Oral liq 50 g per 300 ml Injection 20 µg per ml, 2 ml, and 400 µg per ml, 1 ml

Quantity 5 30 5 5 5 5

Paracetamol Pethidine hydrochloride Respiratory Adrenaline Aminophylline Ipratropium bromide Promethazine hydrochloride Salbutamol

200 ml 30 5 5 5 5 40 5 5 30 5 20 300 ml 5

Salbutamol with ipratroprium bromide Agents used in the treatment of poisoning Charcoal Naloxone hydrochloride

Pharmaceuticals that may be obtained on a Wholesale Supply Order

CONTRACEPTIVES, Cervical caps Dumas Vault Prentif Vimule (Dumas Vault, Prentif and Vimule to be delisted 1 August 2003) CONTRACEPTIVES, Intra-Uterine Devices Multiload Cu 375 Multiload Cu 375SL Nova-T PEAK FLOW METERS Air-O-Breath Pocketpeak Assess Breath-Alert low range & normal range Mini Wright low range & standard Personal Best low range & normal range Vitalograph low & standard PREGNANCY TESTS - HCG Urine MDS Quick Card SPACER DEVICES & MASKS Space Chamber Foremount Child’s Silicone Mask

186

SECTION E PART II: REMOTE AREAS

No subsidy is available for any pharmaceutical specifically restricted in Section B and C of the Schedule. In effect, this means that doctors practising in the following areas may order any item in the Pharmaceutical Schedule excepting those which are subject to any restriction, for example ‘only on a prescription’ and ‘not in combination’.

Remote Areas for Practitioner’s Supply Orders

Ward

Northern Whangaroa Kerikeri Kawakawa Kaikohe Hokianga Hikurangi Ruawai Otamatea Wellsford Warkworth Helensville Kumeu Coromandel-Colville Mercury Bay Tairua Whangamata Hauraki Paeroa Waihi Te Aroha Morrinsville Matamata Waihi Beach Katikati Te Puke Galatea Waimana Opotiki Waioeka Otara Matakoa Uawa Waiapu Waikohu

District

Far North Far North Far North Far North Far North Far North Whangarei Kaipara Kaipara Rodney Rodney Rodney Rodney Thames Coromandel Thames Coromandel Thames Coromandel Thames Coromandel Hauraki Hauraki Hauraki Matamata Piako Matamata Piako Matamata Piako Western Bay of Plenty Western Bay of Plenty Bay of Plenty Whakatane Whakatane Opotiki Opotiki Gisborne Gisborne Gisborne Gisborne

Ward

Maungakawa Whangane Raglan Onewhero Te Awamutu Kawhia North Otorohanga Mangaokewa Paemako Putaruru Pouakani Tongariro Taumarunui Waimarino Waiouru Clifton Inglewood Okato Western Egmont Plains Eltham Patea Taihape Hunterville Tuhara-Frasertown Wairoa Tikokino Waipawa Waipukurau Dannevirke Pahiatua Carterton Greytown Featherston Martinborough

District

Waikato Waikato Waikato Port Waikato Waipa Otorohanga Otorohanga Waitomo Waitomo South Waikato Taupo Taupo Ruapehu Ruapehu Ruapehu New Plymouth New Plymouth New Plymouth Stratford South Taranaki South Taranaki South Taranaki Rangitikei Rangitikei Wairoa Wairoa Central Hawkes Bay Central Hawkes Bay Central Hawkes Bay Tararua Tararua Tararua South Wairarapa South Wairarapa South Wairarapa

187

REMOTE AREAS

Ward

Sounds Awatere Kaikoura Golden Bay Moutere Waimea Lakes Inangahua Seddon Moana Ahaura Amuri Cheviot Hurunui Amberley Hanmer Springs Oxford Darfield Lincoln-Prebbleton Leeston Akaroa Diamond Harbour Northern Southern Cental Mt Hutt Geraldine Temuka Fairlie Twizel Deep Creek Ahuriri Waihemo Wanaka Cromwell

District

Marlborough Marlborough Kaikoura Tasman Tasman Tasman Tasman Buller Buller Grey Grey Hurunui Hurunui Hurunui Hurunui Hurunui Waimakariri Selwyn Selwyn Selwyn Banks Peninsula Canterbury Westland Westland Westland Ashburton Timaru Timaru McKenzie McKenzie Waimate Waitaki Waitaki Queenstown Lakes Central Otago

Ward

Maniototo Alexandra Roxburgh Lawrence-Tuapeka Bruce Catlins Mataura Te Anau Five Rivers Otautau Winton Tuatapere Riverton Toetoes Stewart Island Bluff

District

Central Otago Central Otago Central Otago Clutha Clutha Clutha Gore Southland Southland Southland Southland Southland Southland Southland Southland Invercargill

188

SECTION F: PHARMACEUTICALS EXEMPT FROM MONTHLY DISPENSING

PHARMACEUTICALS EXEMPT FROM MONTHLY DISPENSING

Section F pharmaceuticals may be dispensed in lots of up to three months supply at a time. These medicines are identified within the sections by the symbol “v” and are also listed on the following page for your convenience.

Certified Exemptions

Section F medicines are for patients whose medical condition could seriously deteriorate in 48 hours if they could not access their medication. To qualify for the exemption, the prescriber must write “certified exemption” beside the prescription item(s) to which the exemption applies. Preprinted forms must be initialled. In marking prescription items for exemption, the prescriber is certifying that: • the patient wished to have the medicine dispensed in a quantity greater than a Monthly Lot; and • the patient has been stabilised on the same medicine for a “reasonable” period of time; and • the prescriber has reason to believe the patient will continue on the medicine and is compliant.

Access Exemptions

Patients who have difficulty getting to and from a pharmacy may receive an exemption from monthly dispensing. The patient must sign the back of the prescription to qualify. In signing the prescription, the patient is certifying that they meet one of the following criteria: • have limited physical mobility • live and work more than 30 minutes from the nearest pharmacy by their normal form of transport • are relocating to another area • are travelling extensively and will be out of town when the repeat prescriptions are due.

189

EXEMPT PHARMACEUTICALS

INSULIN Insulin – Short-acting Preparations INSULIN NEUTRAL INSULIN ANIMAL Insulin – Intermediate and Longacting Preparations INSULIN ISOPHANE INSULIN ISOPHANE WITH INSULIN NEUTRAL INSULIN ZINC SUSPENSION INSULIN ANIMAL INSULIN – Rapid-acting insulin analogues INSULIN LISPRO INSULIN SYRINGES AND NEEDLES INSULIN SYRINGES, disposable INSULIN PEN NEEDLES ORAL ANTICOAGULANTS WARFARIN SODIUM ANTIARRHYTHMICS AMIODARONE HYDROCHLORIDE Tab 100 mg Tab 200 mg DISOPYRAMIDE PHOSPHATE FLECAINIDE ACETATE Tab 50 mg Tab 100 mg Cap long-acting 100 mg Cap long-acting 200 mg MEXILETINE HYDROCHLORIDE PROPAFENONE HYDROCHLORIDE BETA ADRENOCEPTOR BLOCKERS ACEBUTOLOL ATENOLOL CELIPROLOL LABETALOL Tab 50 mg Tab 100 mg Tab 200 mg Tab 400 mg

METOPROLOL SUCCINATE METOPROLOL TARTRATE Tab 50 mg Tab 100 mg Tab long-acting 200 mg NADOLOL OXPRENOLOL PINDOLOL PROPRANOLOL SOTALOL Tab 80 mg Tab 160 mg TIMOLOL NITRATES GLYCERYL TRINITRATE ISOSORBIDE DINITRATE ISOSORBIDE MONONITRATE CORTICOSTEROIDS AND RELATED AGENTS FOR SYSTEMIC USE CORTISONE ACETATE DEXAMETHASONE Tab 1 mg Tab 4 mg FLUDROCORTISONE ACETATE HYDROCORTISONE Tab 5 mg Tab 20 mg METHYLPREDNISOLONE Tab 4 mg Tab 100 mg PREDNISONE VASOPRESSIN AGONISTS DESMOPRESSIN Nasal spray 10 µg per dose, 50 dose Nasal drops 100 µg per ml ANTICHOLINESTERASES PYRIDOSTIGMINE BROMIDE

CONTROL OF EPILEPSY ACETAZOLAMIDE Tab 250 mg CARBAMAZEPINE CLOBAZAM CLONAZEPAM ETHOSUXIMIDE PHENOBARBITONE PHENYTOIN SODIUM PRIMIDONE SODIUM VALPROATE Tab 100 mg Tab 200 mg EC Tab 500 mg EC Oral liq 200 mg per 5 ml NEW ANTIEPILEPSY DRUGS GABAPENTIN LAMOTRIGINE TOPIRAMATE VIGABATRIN DOPAMINE AGONISTS AND RELATED AGENTS AMANTADINE HYDROCHLORIDE APOMORPHINE HYDROCHLORIDE BROMOCRIPTINE MESYLATE LEVODOPA WITH BENSERAZIDE LEVODOPA WITH CARBIDOPA LISURIDE HYDROGEN MALEATE PERGOLIDE SELEGILINE HYDROCHLORIDE TOLCAPONE GLAUCOMA PREPARATIONS

ACETAZOLAMIDE BETAXOLOL HYDROCHLORIDE BRIMONIDINE TARTRATE CARBACHOL DORZOLAMIDE HYDROCHLORIDE DORZOLAMIDE HYDROCHLORIDE WITH TIMOLOL MALEATE LATANOPROST LEVOBUNOLOL PILOCARPINE TIMOLOL MALEATE TIMOLOL MALEATE WITH PILOCARPINE

190

SECTION G: SAFETY CAP MEDICINES

Pharmacists are required, under their agreement with the Government, to use safety caps when dispensing any of the medicines listed in Section G in an oral liquid formulation pursuant to a prescription or Practitioner’s Supply Order. This includes all proprietary and extemporaneously compounded oral liquid preparations of those pharmaceuticals listed in Section G of the Pharmaceutical Schedule. These medicines will be identified throughout Section B of the Pharmaceutical Schedule with the symbol ‘‡’.

Exemptions

Oral liquid preparations of the pharmaceuticals listed in Section G of the Pharmaceutical Schedule will be dispensed in a container with a safety cap unless: • The practitioner has endorsed the Prescription or Practitioner’s Supply Order, stating that, the Pharmaceutical is not to be dispensed in a container with a safety cap; or • The Contractor has annotated the Prescription or Practitioner’s Supply Order stating that, because of infirmity of the particular person, the Pharmaceutical to be used by that person should not be dispensed in a container with a safety cap; or • The Pharmaceutical is packaged in an Original Pack so designed that on the professional judgement of the Contractor, transfer to a container with a safety cap would be inadvisable or a retrograde procedure.

Reimbursment

Pharmacists will be reimbursed according to their agreement. Where an additional fee is paid on safety caps it will be paid on all dispensings of oral liquid preparations for those pharmaceuticals listed in Section G of the Pharmaceutical Schedule unless the practitioner has endorsed or the contractor has annotated the Prescription or Practitioners Supply Order that a safety cap has not been supplied.

Safety caps (NZS 5825:1991)

20 mm ..................................... Clic-Loc, United Closures & Plastics PLC, England Kerr, Cormack Packaging, Sydney, under licence to Kerr USA 24 mm ..................................... Clic-Loc, United Closures & Plastics PLC, England Clic-Loc, ACI Closures under license to Owens-Illinois Kerr, Cormack Packaging, Sydney, under licence to Kerr USA 28 mm ..................................... Clic-Loc, United Closures & Plastics PLC, England Clic-Loc, ACI Closures under license to Owens-Illinois Kerr, Cormack Packaging, Sydney, under licence to Kerr USA PDL Squeezlok PDL FG

191

SAFETY CAP MEDICINES

NARCOTICS/COUGH PREPARATIONS METHADONE HYDROCHLORIDE Oral liq 2 mg per ml Biodone Oral liq 5 mg per ml Biodone Forte GlaxoWellcome Oral liq 10 mg per ml Biodone Extra Forte Powder Douglas PSM METHADONE HYDROCHLORIDE Extemporaneously compounded oral liquid preparations MORPHINE HYDROCHLORIDE Oral liq 1 mg per ml RA-Morph Oral liq 2 mg per ml RA-Morph Oral liq 5 mg per ml RA-Morph Oral liq 10 mg per ml RA-Morph CODEINE PHOSPHATE Linctus diabetic Linctus paediatric CARDIAC DRUGS CAPTOPRIL Oral liq 5 mg per ml, DIGOXIN Oral liq 50 mcg per ml FRUSEMIDE Oral liq 10 mg per ml AMILORIDE Oral liq 1 mg per ml, 25 ml OP SPIRONOLACTONE Oral liq 5 mg per ml, 25 ml OP CHLOROTHIAZIDE Oral liq 50 mg per ml, 25 ml OP CE CE

ANTICONVULSANTS CARBAMAZEPINE Oral liq 100 mg per 5 ml CLONAZEPAM Oral drops 2.5 mg per ml, 10 ml OP ETHOSUXIMIDE Oral liq 250 mg per 5 ml PHENYTOIN SODIUM Oral liq 30 mg per 5 ml Oral liq 100 mg per 5 ml SODIUM VALPROATE Oral liq 200 mg per 5 ml

Tegretol

Rivotril Zarontin Dilantin Dilantin Forte Epilim S/F Liquid Epilim Syrup

THEOPHYLLINE THEOPHYLLINE Oral liq 80 mg per 15 ml

Nuelin

Capoten Lanoxin Lasix

BENZODIAZEPINES Extemporaneously compounded oral liquid preparations made from subsidised brands of any of the following chemical entities: ALPRAZOLAM CLOBAZAM DIAZEPAM LORAZEPAM LORMETAZEPAM MIDAZOLAM NITRAZEPAM OXAZEPAM

Biomed

TEMAZEPAM TRIAZOLAM

Biomed

QUININE SULPHATE Extemporaneously compounded oral liquid preparations

192

SAFETY CAP MEDICINES

IRON SALTS FERROUS GLUCONATE Oral liq 300 mg per 5 ml

Fergon

PARACETAMOL PARACETAMOL Oral liq 120 mg per 5 ml

- Available on a PSO

PHENOTHIAZINES INCLUDING SEDATING ANTIHISTAMINES METOCLOPRAMIDE HYDROCHLORIDE Oral liq 5 mg per 5 ml Maxolon CHLORPROMAZINE HYDROCHLORIDE Oral liq 100 mg per 5 ml Largactil Forte THIORIDAZINE HYDROCHLORIDE Oral liq 1% Melleril TRIFLUOPERAZINE HYDROCHLORIDE Oral liq 1 mg per ml Stelazine AZATADINE MALEATE Oral liq 500 µg per 5 ml Zadine Oral liq 250 mg per 5 ml

Douglas Pamol PSM Paracetamol Elixir Paediatric Paracare Junior Suspension Douglas Pamol Paracare Double Strength Suspension

CHLORPHENIRAMINE MALEATE Oral liq 2 mg per 5 ml Histafen DEXTROCHLORPHENIRAMINE MALEATE Oral liq 2 mg per 5 ml Polaramine PROMETHAZINE HYDROCHLORIDE Oral liq 5 mg per 5 ml Phenergan TRIMEPRAZINE TARTRATE Oral liq 30 mg per 5 ml BETA-2-AGONISTS SALBUTAMOL Oral liq 2 mg per 5 ml Vallergan Forte

Ventolin

THYROXINE THYROXINE Extemporaneously compounded oral liquid preparations SALICYLATES/NSAIDs IBUPROFEN Oral liq 100 mg per 5 ml NAPROXEN Oral liq 125 mg per 5 ml

Brufen Naprosyn

193

INDEX

Generic Chemicals and Brands

Symbols

3TC .............................................................................. 107

Abacavir sulphate ......................................................... 107 Acarbose ........................................................................ 30 ACB ............................................................................... 56 Accupril .......................................................................... 53 Accuretic 10 ................................................................... 54 Accuretic 20 ................................................................... 54 Accutrend ....................................................................... 32 Acebutolol ...................................................................... 56 Acetazolamide Anticonvulsants ..................................................... 121 Eye preparations .................................................... 159 Acetic acid with 1, 2-propanediol diacetate and benethonium ................................................... 156 Acetic acid with hydroxyquinoline and ricinoleic acid ....... 80 Acetopt ........................................................................ 157 Acetylcysteine .............................................................. 162 Aci-Jel ............................................................................ 80 Aciclovir Eye ointment .......................................................... 157 Tablet ..................................................................... 101 Acicvir .......................................................................... 101 Acipimox ........................................................................ 44 Acitretin .......................................................................... 71 Actigall ........................................................................... 33 Actrapid ......................................................................... 29 Actrapid Penfill ............................................................... 29 Acupan ........................................................................ 115 Adalat 10 ........................................................................ 58 Adalat Oros .................................................................... 58 Adrenaline Antiallergy preparations ......................................... 144 Sympathomimetics .................................................. 62 Advantage II ................................................................... 32 Advantan ........................................................................ 67 Air-O-Breath Pocketpeak ............................................... 155 Airomir ......................................................................... 148 Alanase Aqueous .......................................................... 154 Albay ............................................................................ 144 Albustix ........................................................................ 163 Alcobon ......................................................................... 98 Alcon-Levobunolol ........................................................ 160 Aldazine ....................................................................... 129 Alendronate .................................................................... 82 Alfacalcidol .................................................................... 37 Alginic acid .................................................................... 23 Alitraq .......................................................................... 178 Alkeran ......................................................................... 133 Allergy treatment set ..................................................... 144 Allopurinol Mouthwash .............................................................. 36 Tab ......................................................................... 113 Allpyral ......................................................................... 144

Alpha tocopheryl acetate ................................................ 38 Alpha-Aciclovir ............................................................. 101 Alpha-Bromocriptine Antiparkinson agents ............................................. 126 Endocrine agents ..................................................... 90 Alpha-Keri Lotion ............................................................ 70 Alphagan ...................................................................... 159 Alprazolam ................................................................... 130 Alu-Tab .......................................................................... 23 Aluminium hydroxide ...................................................... 23 Amantadine hydrochloride ............................................ 126 Amiloride ........................................................................ 60 Amiloride with frusemide ................................................ 60 Amiloride with hydrochlorothiazide .................................. 60 Aminoglutethimide ........................................................ 135 Aminogran Food Supplement ........................................ 181 Aminogran Mineral Mix ................................................. 181 Aminophylline ............................................................... 153 Amiodarone hydrochloride .............................................. 55 Amitrip ......................................................................... 118 Amitriptyline ................................................................. 118 Amizide .......................................................................... 60 Amlodipine ..................................................................... 58 Amorolfine ..................................................................... 63 Amoxapine ................................................................... 118 Amoxycillin ..................................................................... 94 Amoxycillin clavulanate ................................................... 95 Amphotericin B ............................................................... 35 Amyl nitrite Treatment of poisonings ........................................ 163 Vasodilators ............................................................. 62 Analog LCP .................................................................. 181 Anastrozole .................................................................. 135 Androcur Depot .............................................................. 84 Anfenax SR .................................................................. 109 Anginine ......................................................................... 61 Antabuse ...................................................................... 132 Anten ........................................................................... 118 Antinaus ....................................................................... 125 Anusol ............................................................................ 25 Apo-Aciclovir ................................................................ 101 Apo-Ascorbic Acid ......................................................... 37 Apo-B-Complex .............................................................. 37 Apo-Betaxolol ............................................................... 159 Apo-Cimetidine ............................................................... 27 Apo-Diclo SR ............................................................... 109 Apo-Diclofenac ............................................................. 109 Apo-Ethambutol .............................................................. 99 Apo-Famotidine .............................................................. 27 Apo-Folic Acid ................................................................ 40 Apo-Gliclazide ................................................................ 31 Apo-Nadolol ................................................................... 57 Apo-Nicotinic Acid .......................................................... 44 Apo-Oxybutynin .............................................................. 81 Apo-Pindolol .................................................................. 57

194

INDEX

Generic Chemicals and Brands

Apo-Prednisone .............................................................. 84 Apo-Primidone ............................................................. 122 Apo-Pyridoxine ............................................................... 37 Apo-Ranitidine ................................................................ 27 Apo-Sotalol .................................................................... 57 Apo-Sulfatrim DS ............................................................ 96 Apo-Thiamine ................................................................. 37 Apo-Timolol .................................................................... 57 Apo-Timop ................................................................... 160 Apomorphine hydrochloride .......................................... 126 Apresoline ...................................................................... 62 Aproten Chicchi (Rice) Low Protein Pasta ..................... 181 Aprotinin ........................................................................ 40 Aquabloc 30+ ............................................................... 74 Aquasun 30+ ................................................................ 74 Aqueous cream .............................................................. 69 Aramine ......................................................................... 62 Aratac ............................................................................ 55 Arava ........................................................................... 112 Arimidex ....................................................................... 135 Aristocort ....................................................................... 67 Aropax ......................................................................... 120 Arthrexin ...................................................................... 111 Asacol ............................................................................ 24 Ascendin ...................................................................... 118 Ascensia Glucodisc ........................................................ 32 Ascorbic acid ................................................................. 37 Ascorbic acid and sodium ascorbate .............................. 37 Asmafen ....................................................................... 145 Asmol .......................................................................... 148 Aspec 300 .................................................................... 115 Aspirin Analgesics ............................................................. 115 Antithrombotic agents .............................................. 41 Aspirin & chloroform ...................................................... 75 Aspro Clear Analgesics ............................................................. 115 Antithrombotic agents .............................................. 41 Assess ......................................................................... 155 Atacand .......................................................................... 54 Atenolol .......................................................................... 56 Atorvastatin .................................................................... 45 Atropine sulphate Eye drops .............................................................. 161 Injection ................................................................... 25 Atropt ........................................................................... 161 Atrovent ....................................................................... 151 Atrovent Forte ............................................................... 151 Atrovent Nasal Aqueous ................................................ 154 Augmentin ...................................................................... 95 Auranofin ..................................................................... 112 Aurorix ......................................................................... 120 Avil Retard .................................................................... 145 Avomine ....................................................................... 125 Avonex ......................................................................... 139

Azamun ........................................................................ 137 Azatadine maleate ........................................................ 144 Azathioprine ................................................................. 137 Azithromycin .................................................................. 93 AZT .............................................................................. 107

B-D Micro-Fine ............................................................... 32 B-D Ultra Fine ................................................................. 32 B-D Ultra Fine II .............................................................. 32 Baclofen ....................................................................... 113 Bactroban ....................................................................... 63 Bambec ........................................................................ 152 Bambuterol hydrochloride ............................................. 152 Batrafen ......................................................................... 64 Beclazone 100 .............................................................. 146 Beclazone 250 .............................................................. 146 Beclazone 50 ................................................................ 146 Beclomethasone dipropionate Inhaled cortosteroids .................................... 146, 147 Nasal preparations ................................................. 154 Bee venom allergy treatment ......................................... 144 Bendrofluazide ................................................................ 60 Benhex ........................................................................... 70 Benpen ........................................................................... 95 Benzathine penicillin ....................................................... 95 Benzoin tincture ............................................................ 169 Benztropine mesylate .................................................... 127 Benzydamine hydrochloride ............................................ 35 Benzylpenicillin sodium (Penicillin G) .............................. 95 Beta Cream .................................................................... 66 Beta Ointment ................................................................. 66 Beta Scalp ...................................................................... 73 Betadine ......................................................................... 70 Betadine Skin Prep .......................................................... 70 Betaferon ..................................................................... 139 Betagan ........................................................................ 160 Betahistine dihydrochloride ........................................... 124 Betaloc ........................................................................... 57 Betaloc CR ..................................................................... 57 Betamethasone dipropionate Cream/ointment ....................................................... 66 Scalp lotion .............................................................. 73 Betamethasone dipropionate with clotrimazole ................ 68 Betamethasone dipropionate with salicylic acid ............... 68 Betamethasone sodium phosphate with betamethasone acetate Hormone preparations ............................................. 83 Musculo-skeletal system ....................................... 112 Betamethasone valerate Cream, oint, lotion ................................................... 66 Scalp application ..................................................... 73 Betamethasone valerate with clioquinol ........................... 68 Betamethasone valerate with fusidic acid ........................ 68 Betaxolol hydrochloride ................................................. 159 Betnovate ....................................................................... 66 Betnovate-C ................................................................... 68

195

INDEX

Generic Chemicals and Brands

Betoptic S .................................................................... 159 Bezafibrate ..................................................................... 44 Bezalip Retard ................................................................ 44 Bicillin ............................................................................ 95 Biocil .............................................................................. 70 Biodone ........................................................................ 117 Biodone Extra Forte ...................................................... 117 Biodone Forte ............................................................... 117 Bisacodyl ....................................................................... 34 BK Lotion ....................................................................... 70 BM-Test 1-44 ................................................................. 32 Bonjela ........................................................................... 35 Breath-Alert .................................................................. 155 Brevinor 1/21 ................................................................. 78 Brevinor 1/28 ................................................................. 78 Brevinor 21 .................................................................... 78 Brevinor 28 .................................................................... 78 Bricanyl Injection ................................................................. 153 Nebuliser solution .................................................. 151 Bricanyl Aerosol ........................................................... 148 Bricanyl Turbuhaler ....................................................... 148 Brimonidine tartrate ...................................................... 159 Brolene ......................................................................... 157 Bromocriptine mesylate Antiparkinson agents ............................................. 126 Endocrine agents ..................................................... 90 Brufen .......................................................................... 110 Brufen Retard ............................................................... 110 Buccastem ................................................................... 125 Budesonide Cap .......................................................................... 24 Inhalers .................................................................. 147 Nasal spray ............................................................ 154 Nebuliser solution .................................................. 148 Budesonide with eformoterol ........................................ 149 Bumetanide .................................................................... 60 Bupivacaine hydrochloride ............................................ 115 Buprenorphine hydrochloride ........................................ 116 Burinex ........................................................................... 60 Buscopan ....................................................................... 26 Buserelin acetate ............................................................ 89 Buspirone hydrochloride ............................................... 130 Busulphan .................................................................... 133 Butacort Aqueous ......................................................... 154

Cabergoline .................................................................... 90 Cafergot ....................................................................... 123 Calamine ........................................................................ 65 Calciferol ........................................................................ 37 Calcipotriol ..................................................................... 71 Calcitonin ....................................................................... 82 Calcitriol ......................................................................... 37

Calcium carbonate Antacids & antiflatulents .......................................... 23 Minerals ................................................................... 38 Calcium chloride ............................................................. 38 Calcium Disodium Versenate ........................................ 163 Calcium folinate ............................................................ 133 Calcium gluconate .......................................................... 38 Calcium lactate-gluconate ............................................... 38 Calcium polystyrene sulphonate ...................................... 43 Calcium Resonium ......................................................... 43 Calcium-Sandoz 1000 .................................................... 38 Calogen ........................................................................ 174 Candesartan ................................................................... 54 Canesten ........................................................................ 64 Capadex ....................................................................... 116 Capoten ......................................................................... 53 Captohexal ..................................................................... 53 Captol 40 ....................................................................... 57 Captol 80 ....................................................................... 57 Captopril ........................................................................ 53 Carafate ......................................................................... 28 Carbachol ..................................................................... 159 Carbamazepine ............................................................. 121 Carbimazole ................................................................... 88 Carbosorb .................................................................... 163 Cardinol ......................................................................... 57 Cardinol LA .................................................................... 57 Cardizem CD .................................................................. 59 Carvedilol ....................................................................... 56 Catapres ......................................................................... 59 Catapres-TTS-1 .............................................................. 59 Catapres-TTS-2 .............................................................. 59 Catapres-TTS-3 .............................................................. 59 Cefaclor monohydrate .................................................... 91 Cefamandole nafate ........................................................ 91 Cefoxitin sodium ............................................................. 91 Ceftriaxone sodium ......................................................... 91 Cefuroxime axetil ............................................................ 92 Cefuroxime sodium ........................................................ 92 Celestone Chronodose Hormone preparations ............................................. 83 Musculo-skeletal system ....................................... 112 Celiprolol ........................................................................ 56 Cellcept ........................................................................ 137 Celol .............................................................................. 56 Cephalexin monohydrate ................................................. 92 Cephalothin sodium ........................................................ 92 Cephazolin sodium ......................................................... 92 Cephradine ..................................................................... 92 Cerezyme ....................................................................... 35 Cervagem ...................................................................... 80 Cervical cap ................................................................... 76 Cetirizine hydrochloride ................................................ 144 Cetomacrogol ................................................................. 69 Charcoal ....................................................................... 163

196

INDEX

Generic Chemicals and Brands

Chlorambucil ................................................................ 133 Chloramphenicol Cap .......................................................................... 96 Ear drops ............................................................... 156 Eye drops/oint ....................................................... 157 Chlorhexidine gluconate .................................................. 68 Chlorhexidine mouthwash ............................................... 35 Chloroform BP .............................................................. 169 Chloromycetin Cap .......................................................................... 96 Ear drops ............................................................... 156 Chloroquine .................................................................... 98 Chlorothiazide ................................................................. 61 Chlorpheniramine maleate ............................................. 144 Chlorpromazine hydrochloride ...................................... 127 Chlorsig ....................................................................... 157 Chlorthalidone ................................................................ 61 Chlorvescent .................................................................. 44 Cholestyramine with aspartame ...................................... 44 Choline salicylate with cetalkonium chloride .................... 35 Ciclopiroxolamine ........................................................... 64 Cilazapril ........................................................................ 53 Cilazapril with hydrochlorothiazide .................................. 54 Cilicaine ......................................................................... 95 Cilicaine VK .................................................................... 95 Ciloxan ......................................................................... 157 Cimetidine ...................................................................... 27 Cipflox ............................................................................ 96 Cipramil ....................................................................... 120 Ciprofloxacin Eye drops .............................................................. 157 Tab ........................................................................... 96 Ciproxin .......................................................................... 96 Cisapride ........................................................................ 25 Citalopram hydrobromide ............................................. 120 Citravescent ................................................................... 81 Civicor ........................................................................... 59 Claratyne ...................................................................... 145 Clarithromycin ................................................................ 93 Cliane ............................................................................. 87 Climara 100 ................................................................... 86 Climara 50 ..................................................................... 85 Clindamycin ................................................................... 96 Clinistix .......................................................................... 31 Clinitest .......................................................................... 31 Clinoril .......................................................................... 111 Clobazam Anticonvulsants ..................................................... 121 Anxiolytics ............................................................. 130 Clobetasol propionate Cream, oint .............................................................. 66 Scalp appl ................................................................ 73 Clobetasone butyrate ...................................................... 66 Clocreme Cream ...................................................................... 64

Vaginal crm .............................................................. 80 Clofazimine .................................................................... 99 Clomiphene citrate .......................................................... 90 Clomipramine hydrochloride ......................................... 118 Clonazepam Injection ................................................................. 121 Tab, oral drops ....................................................... 122 Clonidine ........................................................................ 59 Clonidine hydrochloride ................................................ 124 Clopine ......................................................................... 127 Clopress ....................................................................... 118 Clorotir ........................................................................... 91 Clotrihexal ...................................................................... 80 Clotrimaderm 2% ............................................................ 80 Clotrimazole Cream, solution ....................................................... 64 Pessaries, vaginal cream ......................................... 80 Clozapine ..................................................................... 127 Clozaril ......................................................................... 127 Co-trimoxazole ............................................................... 96 Co-Renitec ..................................................................... 54 Coal tar .......................................................................... 71 Coal tar with allantoin, menthol, phenol and sulphur ........ 71 Coal tar with salicyclic acid and sulphur .......................... 71 Cocois ........................................................................... 71 Codeine Linctus ............................................................ 154 Codeine phosphate Analgesics ............................................................. 116 Antidiarrhoeals ......................................................... 23 Cogentin ....................................................................... 127 Colchicine .................................................................... 113 Colestid .......................................................................... 44 Colestipol hydrochloride ................................................. 44 Colifoam ........................................................................ 24 Colistin sulphate with neomycin and hydrocortisone ..... 156 Colistin sulphomethate ................................................... 96 Collodion flexible .......................................................... 169 Colofac .......................................................................... 26 Coloxyl ........................................................................... 34 Colymycin-M .................................................................. 96 Colymycin-S Otic .......................................................... 156 Combantrin .................................................................... 91 Combivent .................................................................... 152 Combivir ...................................................................... 107 Combizym ...................................................................... 32 Compound electrolytes ................................................... 43 Compound hydroxybenzoate ......................................... 169 Condoms extra strength .................................................. 76 Condoms with spermicide .............................................. 76 Condoms without spermicide ......................................... 76 Condyline ....................................................................... 74 Conthram ....................................................................... 34 Conthram Forte .............................................................. 34 Copper ........................................................................... 31

197

INDEX

Generic Chemicals and Brands

Corangin ........................................................................ 61 Cordarone-X ................................................................... 55 Coronex ......................................................................... 61 Cortisone acetate ........................................................... 83 Cosopt ......................................................................... 159 Cotazym ECS ................................................................. 32 Coumadin ....................................................................... 42 Coversyl ......................................................................... 53 Cozaar ........................................................................... 54 Creon 10000 .................................................................. 32 Creon Forte .................................................................... 32 Crixivan ........................................................................ 108 Crotamiton ..................................................................... 65 Cyclizine hydrochloride ................................................. 124 Cyclizine lactate ............................................................ 124 Cycloblastin ................................................................. 133 Cyclogyl ....................................................................... 161 Cyclopenthiazide ............................................................ 61 Cyclopentolate hydrochloride ........................................ 161 Cyclophosphamide ....................................................... 133 Cyclosporin A Dermatologicals ....................................................... 72 Oncology agents .................................................... 141 Cyklokapron ................................................................... 41 Cyproheptadine hydrochloride ....................................... 144 Cyproterone acetate ........................................................ 84 Cyproterone acetate with ethinyloestradiol ....................... 79 Cytadren ...................................................................... 135 Cytarabine .................................................................... 133 Cytine ............................................................................ 27 Cytotec .......................................................................... 26 Cytoxan ........................................................................ 133

D-Penamine Antirheumatoid agents ........................................... 112 Poisoning treatments ............................................. 163 D-Zol .............................................................................. 90 d4T .............................................................................. 107 Daclin ........................................................................... 111 Daivonex ........................................................................ 71 Daktarin Crm, lotn, tincture .................................................... 64 Oral gel .................................................................... 35 Dalacin C ........................................................................ 96 Danazol .......................................................................... 90 Danthron with poloxamer ................................................ 34 Dantrium ...................................................................... 113 Dantrolene sodium ....................................................... 113 ddI ............................................................................... 107 De-nol ............................................................................ 28 Deca-Durabolin Orgaject ................................................. 82 Delact .......................................................................... 183 Depo-Medrol ................................................................ 112 Depo-Medrol with lidocaine .......................................... 112 Depo-Provera ................................................................. 79

Depo-Testosterone .......................................................... 84 Derbac-M ....................................................................... 70 Dermol Cream, oint .............................................................. 66 Scalp appl ................................................................ 73 Desferal ........................................................................ 163 Desferrioxamine mesylate ............................................. 163 Desipramine hydrochloride ........................................... 118 Desmopressin ................................................................ 90 Dexamethasone Eye drops, ointment ............................................... 158 Tab, Oral liq .............................................................. 83 Dexamethasone sodium phosphate ................................. 83 Dexamethasone with framycetin and gramicidin Ear drops, oint ....................................................... 156 Eye drops, oint ....................................................... 158 Dexamethasone with neomycin and polymyxin b sulphate ... 158 Dexamphetamine sulphate ............................................ 132 Dextrochlorpheniramine maleate ................................... 145 Dextropropoxyphene ..................................................... 116 Dextropropoxyphene with paracetamol .......................... 116 Dextrose ......................................................................... 42 Dextrose with electrolytes ............................................... 43 DHC Continus ............................................................... 116 Di-isobutylphenoxypolyethoxy-ethanol ............................ 76 Diabur 5000 ................................................................... 31 Diamicron ...................................................................... 31 Diamox Anticonvulsants ..................................................... 121 Eye preparations .................................................... 159 Diaphragm ..................................................................... 76 Diastix ............................................................................ 31 Diastop .......................................................................... 23 Diatol ............................................................................. 31 Diazemuls .................................................................... 121 Diazepam Rectal tubes, inj ..................................................... 121 Tab ......................................................................... 130 Dibenyline Cardiovascular system ............................................ 52 Genito urinary system .............................................. 81 Dibromopropamidine isethionate ................................... 157 Dicap ............................................................................. 24 Diclax SR ..................................................................... 109 Diclocil ........................................................................... 95 Diclofenac sodium Eye drops .............................................................. 158 Tab, cap, suppos, inj .............................................. 109 Dicloxacillin .................................................................... 95 Dicyclomine hydrochloride .............................................. 26 Didanosine ................................................................... 107 Difflam ........................................................................... 35 Diflucan .......................................................................... 98 Diflucortolone valerate ................................................... 66 Diflucortolone valerate with chlorquinaldol ...................... 68

198

INDEX

Generic Chemicals and Brands

Digoxin Anti-arrhythmics ...................................................... 55 Cardiac glycosides .................................................. 59 Dihydrocodeine tartrate ................................................ 116 Dilantin ......................................................................... 122 Dilantin Forte ................................................................ 122 Dilantin Infatab ............................................................. 122 Dilatrend ......................................................................... 56 Diltiazem hydrochloride .................................................. 59 Dilzem ............................................................................ 59 Dilzem LA ....................................................................... 59 Dilzem SR ...................................................................... 59 Dimenhydrinate ............................................................ 124 Dimetriose ...................................................................... 90 Dipentum ....................................................................... 24 Diphemanil methylsulphate ............................................. 69 Diphenoxylate hydrochloride with atropine sulphate ......... 23 Diprosalic ....................................................................... 68 Diprosone Cream/ointment ....................................................... 66 Scalp lotion .............................................................. 73 Diprosone OV ................................................................. 66 Dipyridamole .................................................................. 41 Disipal .......................................................................... 127 Disopyramide phosphate ................................................ 55 Disprin Analgesics ............................................................. 115 Antithrombotic agents .............................................. 41 Distamine ............................................................ 112, 163 Disulfiram ..................................................................... 132 Dithranol ........................................................................ 72 Diurin ............................................................................. 60 Diurin 40 ........................................................................ 60 Dixarit .......................................................................... 124 Docusate sodium ........................................................... 34 Docusate sodium with bisacodyl ..................................... 34 Docusate sodium with sennosides .................................. 34 Doloxene ...................................................................... 116 Domperidone Antinausea and vertigo agents ............................... 124 Antispasmodics and other agents altering gut motil . 26 Dopergin ...................................................................... 126 Dopress ....................................................................... 118 Dornase alfa ................................................................. 154 Dorzolamide hydrochloride ........................................... 159 Dorzolamide hydrochloride with timolol maleate ............ 159 Dosan ............................................................................ 52 Dostinex ......................................................................... 90 Dothiepin hydrochloride ................................................ 118 Doxazosin mesylate ........................................................ 52 Doxepin hydrochloride .................................................. 118 Doxine ............................................................................ 96 Doxy-50 ......................................................................... 96 Doxycycline hydrochloride .............................................. 96 DP Lotion ....................................................................... 70

DP Lotn HC .................................................................... 67 Dramamine .................................................................. 124 Dulcolax ......................................................................... 34 Dumas Vault ................................................................... 76 Duocal Super Soluble Powder ....................................... 174 Duolin .......................................................................... 152 Duphaston ...................................................................... 88 Durex Confidence ........................................................... 76 Durex Extra Confidence ................................................... 76 Duride ............................................................................ 61 Dydrogesterone .............................................................. 88 Dyzole ............................................................................ 98

E-Mycin ......................................................................... 94 Econazole nitrate Cream, foaming soln, soln ....................................... 64 Pessaries ................................................................. 80 Ecotrin ......................................................................... 115 Ecreme .......................................................................... 64 Efavirenz ...................................................................... 107 Eformoterol fumarate .................................................... 149 Efudix Antimetabolites ...................................................... 133 Antineoplastics ........................................................ 75 Egocort .......................................................................... 67 Egopsoryl TA .................................................................. 71 Elemental 028 .............................................................. 178 Elemental 028 Extra ...................................................... 178 Elocon ............................................................................ 67 Eltroxin ........................................................................... 88 Emla ............................................................................ 115 Emulsifying ointment BP ................................................. 69 Enahexal ......................................................................... 53 Enalapril ......................................................................... 53 Enalapril with hydrochlorothiazide ................................... 54 Ensure Plus .................................................................. 176 Ensure Plus RTH ........................................................... 176 Ensure Powder ............................................................. 175 Entocort CIR ................................................................... 24 Enuclene ...................................................................... 162 Epilim ........................................................................... 122 Epilim Crushable .......................................................... 122 Epilim IV ....................................................................... 122 Epilim S/F Liquid ........................................................... 122 Epilim Syrup ................................................................. 122 Eprex .............................................................................. 39 ERA ................................................................................ 94 Ergodryl ....................................................................... 123 Ergometrine maleate ....................................................... 80 Ergotamine tartrate with caffeine ................................... 123 Ergotamine tartrate with diphenhydramine ..................... 123 Eromycin ........................................................................ 94 Erythromycin .................................................................. 93 Erythromycin estolate ..................................................... 94 Erythromycin ethyl succinate .......................................... 94

199

INDEX

Generic Chemicals and Brands

Erythromycin lactobionate .............................................. 94 Erythromycin stearate ..................................................... 94 Erythropoietin alpha ........................................................ 39 Erythropoietin beta ......................................................... 39 Estelle 35 ....................................................................... 79 Estraderm TTS 100 ........................................................ 86 Estraderm TTS 25 .......................................................... 85 Estraderm TTS 50 .......................................................... 85 Estrapak ......................................................................... 87 Estrofem ................................................................. 85, 86 Ethambutol ..................................................................... 99 Ethinyloestradiol ............................................................. 87 Ethinyloestradiol with desogestrel ................................... 77 Ethinyloestradiol with gestodene ..................................... 77 Ethinyloestradiol with levonorgestrel ............................... 78 Ethinyloestradiol with norethisterone ............................... 78 Ethinyloestradiol with norgestrel ...................................... 78 Ethosuximide ................................................................ 122 Ethynodiol diacetate ........................................................ 79 Etidrate ........................................................................... 82 Etidronate disodium ........................................................ 82 Etoposide ..................................................................... 134 Euhypnos ..................................................................... 131 Eumovate ....................................................................... 66 Eurax .............................................................................. 65

Famotidine ...................................................................... 27 Famox ............................................................................ 27 Farlutal ........................................................................... 88 Felodipine ....................................................................... 58 Femara ......................................................................... 136 Femodene 21 ................................................................. 77 Femodene 28 ................................................................. 77 Femtran 100 ................................................................... 86 Femtran 50 ..................................................................... 85 Femulen ......................................................................... 79 Fergon ............................................................................ 40 Ferro-Gradumet .............................................................. 40 Ferrograd-Folic ............................................................... 40 Ferrous gluconate ........................................................... 40 Ferrous gluconate with ascorbic acid .............................. 40 Ferrous sulphate ............................................................. 40 Ferrous sulphate with folic acid ....................................... 40 Ferrum H ........................................................................ 40 Fexofenadine hydrochloride .......................................... 145 Fibalip ............................................................................ 44 Fibresource .................................................................. 178 Fibresource RTH ........................................................... 178 Fibro-vein ....................................................................... 41 Flagyl ............................................................................. 98 Flagyl-S .......................................................................... 98 Flameril ........................................................................ 109 Flameril Retard ............................................................. 109 Flecainide acetate ........................................................... 55 Fleet Bisacodyl Suppositories ......................................... 34

Fleet Glycerin Suppositories ............................................ 34 Fleet Phosphate Enema ................................................... 34 Flixotide ............................................................... 146, 147 Flixotide Accuhaler ........................................................ 147 Florinef ........................................................................... 83 Floxapen ......................................................................... 95 Fluanxol ........................................................................ 129 Flucloxacillin magnesium ................................................ 95 Flucloxacillin sodium ...................................................... 95 Flucloxin ......................................................................... 95 Flucon .......................................................................... 158 Fluconazole .................................................................... 98 Flucytosine ..................................................................... 98 Fludrocortisone acetate .................................................. 83 Flumetasone pivalate .................................................... 156 Fluocinolone acetonide Cream, ointment ...................................................... 67 Gel ........................................................................... 73 Fluorometholone ........................................................... 158 Fluorouracil sodium Dermatologicals ....................................................... 75 Oncology agents and immunosuppressants .......... 133 Fluox ............................................................................ 120 Fluoxetine hydrochloride ............................................... 120 Flupenthixol decanoate ................................................. 129 Fluphenazine decanoate ................................................ 129 Flutamide ..................................................................... 135 Flutamin ....................................................................... 135 Fluticasone .......................................................... 146, 147 FML ............................................................................. 158 Folic acid ........................................................................ 40 Folinic acid ..................................................................... 36 Foradil .......................................................................... 149 Foremount Child’s Silicone Mask .................................. 155 Formaldehyde ................................................................. 74 Fortimel ........................................................................ 177 Fortisip ......................................................................... 176 Fortovase ..................................................................... 108 Fosamax ........................................................................ 82 Framycetin sulphate Ear preparations ..................................................... 156 Eye preparations .................................................... 157 Framycetin sulphate with gramicidin ............................... 63 Frisium Anticonvulsants ..................................................... 121 Anxiolytics ............................................................. 130 Frumil ............................................................................. 60 Frusemide ...................................................................... 60 Fucicort .......................................................................... 68 Fucidin Cream, oint, gel ....................................................... 63 Tab, oral liq, inj ........................................................ 97 Fucithalmic ................................................................... 157 Fungilin .......................................................................... 35 Furadantin .................................................................... 108

200

INDEX

Generic Chemicals and Brands

Fusidic acid Cream, oint, gel ....................................................... 63 Eye drops .............................................................. 157 Tab, oral liq, inj ........................................................ 97

Gyno-Trosyd ................................................................... 80

Halcion ......................................................................... 131 Haldol .......................................................................... 129 Haldol Concentrate ....................................................... 129 Halibut-liver Oil ............................................................... 36 Haloperidol ................................................................... 127 Haloperidol decanoate .................................................. 129 Hamilton Sunscreen ....................................................... 74 Healtheries Iron with Vitamin C ....................................... 40 Healtheries Multi-vitamin tablets ...................................... 38 Healtheries Vitamin C ...................................................... 37 Healtheries Wheat and Gluten Free Baking Mix .............. 179 Helicosec ....................................................................... 26 Hemastix ...................................................................... 163 Heparin sodium .............................................................. 42 Heparinised saline .......................................................... 42 Hexamine hippurate ...................................................... 108 Hiprex .......................................................................... 108 Histafen ........................................................................ 144 Homatropine hydrobromide .......................................... 161 Horleys Bread Mix ........................................................ 179 Horleys Flour ................................................................ 179 Humalog ........................................................................ 30 Humatrope ..................................................................... 89 Humulin 70/30 ............................................................... 29 Humulin 80/20 ............................................................... 29 Humulin L ....................................................................... 29 Humulin N ...................................................................... 29 Humulin R ...................................................................... 29 Humulin U ...................................................................... 29 Hyalase ........................................................................ 113 Hyaluronidase .............................................................. 113 Hybloc ........................................................................... 56 Hydralazine .................................................................... 62 Hydrea ......................................................................... 134 Hydrocortisone Cream, powder ........................................................ 67 Tab, inj ..................................................................... 83 Hydrocortisone acetate ................................................... 24 Hydrocortisone butyrate Cream, oint, lipocream ............................................ 67 Scalp lotion .............................................................. 73 Hydrocortisone butyrate with chlorquinaldol .................... 68 Hydrocortisone with cinchocaine .................................... 25 Hydrocortisone with miconazole ..................................... 68 Hydrocortisone with natamycin and neomycin ................ 68 Hydrocortisone with wool fat and mineral oil Corticosteroids ........................................................ 67 Emollients ................................................................ 69 Hydroderm Lotion ........................................................... 70 Hydrogen peroxide 10 vol ...................................................................... 36 20 vol ...................................................................... 75 Hydromet ....................................................................... 60

Gabapentin ................................................................... 122 Gamma benzene hexachloride ........................................ 70 Gardenal Sodium .......................................................... 121 Gastrogel ........................................................................ 23 Gastrolyte (Fruit) ............................................................ 43 Gastrolyte (Natural) ........................................................ 43 Gastrolyte (Orange) ........................................................ 43 Gaviscon ........................................................................ 23 Gaviscon Infant .............................................................. 23 Gemeprost ..................................................................... 80 Gemfibrozil ..................................................................... 44 Gemizol .......................................................................... 44 Generaid Plus ............................................................... 179 Genoptic ...................................................................... 157 Genotropin ..................................................................... 89 Genox .......................................................................... 136 Gentamicin sulphate Eye drops .............................................................. 157 Inj ............................................................................ 97 Gestone .......................................................................... 88 Gestrinone ...................................................................... 90 Gliben ............................................................................ 31 Glibenclamide ................................................................. 31 Gliclazide ........................................................................ 31 Glipizide ......................................................................... 31 Glivec ........................................................................... 134 Glucagen Hypokit ........................................................... 29 Glucagon hydrochloride .................................................. 29 Glucerna ...................................................................... 177 Glucerna RTH ............................................................... 177 Glucobay ........................................................................ 30 Glucocard ...................................................................... 32 Glucometer Elite ............................................................. 32 Glucometer Esprit ........................................................... 32 Glucose oxidase ...................................................... 31, 32 Gluten Free Bread Mix 100% Bakels .............................. 179 Glycerol Liquid .................................................................... 169 Suppositories ........................................................... 34 Glycerol with paraffin and cetyl alcohol ........................... 69 Glyceryl trinitrate ............................................................ 61 Glytrin ............................................................................ 61 Gold Knight .................................................................... 76 Gopten ........................................................................... 53 Goserelin acetate ............................................................ 89 Granocol ........................................................................ 33 Growth hormone biosynthetic human .............................. 89 Guanethidine sulphate ..................................................... 52 Gutron ............................................................................ 56 Gyno-Pevaryl .................................................................. 80

201

INDEX

Generic Chemicals and Brands

Hydroxocobalamin Anti-anaemics .......................................................... 40 Vitamins .................................................................. 36 Hydroxychloroquine sulphate Antimalarials ............................................................ 98 Antirheumatoid agents ........................................... 112 Hydroxyurea ................................................................. 134 Hygroton ........................................................................ 61 Hyoscine (scopolamine) ............................................... 125 Hyoscine hydrobromide Eye drops .............................................................. 161 Inj .......................................................................... 125 Hyoscine N-butylbromide ............................................... 26 Hypam ......................................................................... 131 Hypermol ....................................................................... 57 Hypnovel ...................................................................... 131 Hypromellose ............................................................... 162 Hyprosin ........................................................................ 52 Hytrin Cardiovascular system ............................................ 52 Genito urinary system .............................................. 81 Hytrin BPH Starter Pack Cardiovascular system ............................................ 52 Genito urinary system .............................................. 81

I-Profen ........................................................................ 110 Ibiamox .......................................................................... 94 Ibuprofen ...................................................................... 110 Imatinib mesylate ......................................................... 134 Imiglucerase ................................................................... 35 Imigran ......................................................................... 124 Imipramine hydrochloride ............................................. 118 Imovane ....................................................................... 131 Imuran ......................................................................... 137 Indapamide .................................................................... 61 Indinavir ....................................................................... 108 Indomethacin ............................................................... 111 Infasoy ......................................................................... 183 Inhibace ......................................................................... 53 Inhibace Plus .................................................................. 54 Insoma ......................................................................... 131 Insulatard ....................................................................... 29 Insulin animal ................................................................. 29 Insulin aspart ................................................................. 30 Insulin isophane ............................................................. 29 Insulin isophane with insulin neutral ................................ 29 Insulin lispro ................................................................... 30 Insulin neutral ................................................................. 29 Insulin pen needles ......................................................... 32 Insulin syringes .............................................................. 32 Insulin zinc suspension ................................................... 29 Intal .............................................................................. 148 Intal Spincaps ............................................................... 148 Interferon alpha-2A ....................................................... 137

Interferon alpha-2B ....................................................... 138 Interferon alpha-N ......................................................... 139 Interferon beta-1-alpha ................................................. 139 Interferon beta-1-beta ................................................... 139 Intra-uterine devices ....................................................... 76 Intron-A ........................................................................ 138 Invirase ........................................................................ 108 Ipecacuanha ................................................................. 163 Ipra 250 ....................................................................... 151 Ipra 500 ....................................................................... 151 Ipratropium bromide Inhaler, nebules ...................................................... 151 Nasal preparations ................................................. 154 Iron polymaltose ............................................................. 40 Ismelin ........................................................................... 52 Ismo 20 ......................................................................... 61 Isogel ............................................................................. 33 Isomil ........................................................................... 183 Isoniazid ......................................................................... 99 Isoprenaline hydrochloride .............................................. 62 Isoptin ............................................................................ 59 Isopto Carbachol .......................................................... 159 Isopto Frin .................................................................... 162 Isopto Homatropine ...................................................... 161 Isopto Hyoscine ........................................................... 161 Isosorbide dinitrate ......................................................... 61 Isosorbide mononitrate ................................................... 61 IsoSource 1.5 ............................................................... 176 Isosource Standard ...................................................... 178 Isosource Standard RTH ............................................... 178 Isotretinoin ..................................................................... 63 Isuprel ............................................................................ 62 Itraconazole .................................................................... 98

Janola ............................................................................ 68 Jevity ........................................................................... 178 Jevity RTH .................................................................... 178

K-SR .............................................................................. 44 K-Thrombin .................................................................... 41 Kapanol ........................................................................ 117 Karicare Food Thickener ............................................... 179 Karicare Goats Milk Infant Formula ................................ 183 Karicare Soya Infant Formula ........................................ 183 Keflex ............................................................................. 92 Keflin .............................................................................. 92 Kemadrin ...................................................................... 127 Kenacomb Crm, oint ................................................................. 68 Ear drops ............................................................... 156 Kenacort-A ................................................................... 113 Kenacort-A40 ............................................................... 113 Keto-Diabur 5000 ........................................................... 31 Keto-Diastix .................................................................... 31

202

INDEX

Generic Chemicals and Brands

Ketoconazole Crm ......................................................................... 64 Scalp preparations ................................................... 73 Tab ........................................................................... 98 Ketoprofen .................................................................... 110 Ketostix .......................................................................... 31 Ketotifen ....................................................................... 145 Ketovite Syrup .............................................................. 182 Ketovite Tablets ............................................................ 182 Ketur-Test ....................................................................... 31 Kindergen ..................................................................... 179 Klacid ............................................................................. 93 Klacid Hp7 ..................................................................... 26 Kliogest .......................................................................... 87 Kliovance ....................................................................... 87 Konakion ........................................................................ 41 Konakion MM ................................................................. 41 Konsyl D ........................................................................ 33

LA-Morph ..................................................................... 117 Labetalol ........................................................................ 56 Lacri-Lube .................................................................... 162 Lactulose ....................................................................... 34 Lamictal ....................................................................... 122 Lamisil ........................................................................... 98 Lamivudine Anti-retrovirals ....................................................... 107 Hepatitis B treatment ............................................... 99 Lamotrigine .................................................................. 122 Lamprene ....................................................................... 99 Lanoxin Anti-arrhythmics ...................................................... 55 Cardiac glycosides .................................................. 59 Lanoxin PG Anti-arrhythmics ...................................................... 55 Cardiac glycosides .................................................. 59 Lansoprazole .................................................................. 28 Lanvis .......................................................................... 134 Largactil ....................................................................... 127 Largactil Forte .............................................................. 127 Lasix .............................................................................. 60 Latanoprost .................................................................. 160 Laxsol ............................................................................ 34 Le Tan SPF 15+ ............................................................. 74 Leflunomide ................................................................. 112 Lemnis Fatty Cream ........................................................ 69 Lemnis Fatty Cream HC .................................................. 67 Letrozole ...................................................................... 136 Leucovorin ................................................................... 133 Leucovorin Calcium ...................................................... 133 Leukeran FC ................................................................. 133 Leuprorelin ..................................................................... 89 Levlen ED ....................................................................... 78 Levobunolol .................................................................. 160 Levocabastine .............................................................. 158

Levodopa with benserazide ........................................... 126 Levodopa with carbidopa .............................................. 126 Levonorgestrel ......................................................... 79, 88 Lifestyles Flared ............................................................. 76 Lifestyles Spermicidal ..................................................... 76 Lignocaine hydrochloride Anaesthetics .......................................................... 115 Anti-arrhythmics ...................................................... 55 Lignocaine with prilocaine hydrochloride ....................... 115 Liothyronine ................................................................... 88 Lipex .............................................................................. 46 Lipitor ............................................................................ 45 Liquifilm Forte .............................................................. 162 Liquifilm Tears .............................................................. 162 Liquigen ....................................................................... 174 Lisinopril ........................................................................ 53 Lisuride hydrogen maleate ............................................ 126 Lithicarb Antidepressants ..................................................... 121 Antipsychotics ....................................................... 127 Lithium carbonate Antidepressants ..................................................... 121 Antipsychotics ....................................................... 127 Livostin ........................................................................ 158 Locasol ........................................................................ 182 Loceryl ........................................................................... 63 Locoid Cream, oint .............................................................. 67 Scalp lotion .............................................................. 73 Locoid C ........................................................................ 68 Locoid Crelo ................................................................... 67 Locoid Lipocream ........................................................... 67 Locorten-Vioform ......................................................... 156 Lodoxamide trometamol ............................................... 158 Loette ............................................................................. 78 Lomide ......................................................................... 158 Loperamide hydrochloride .............................................. 24 Lopresor ........................................................................ 57 Loprofin Mix ................................................................. 181 Loprofin Pasta .............................................................. 181 Lora-tabs ..................................................................... 145 Lorapam ...................................................................... 130 Loratadine .................................................................... 145 Lorazepam ................................................................... 130 Lormetazepam ............................................................. 131 Losartan ........................................................................ 54 Losec ............................................................................. 28 Losec Hp7 OAC .............................................................. 26 Loten .............................................................................. 56 Lotricomb ....................................................................... 68 Lucrin ............................................................................ 89 Ludiomil ....................................................................... 118 Lyderm .......................................................................... 71

m-Hydrocortisone .......................................................... 67

203

INDEX

Generic Chemicals and Brands

Madopar ....................................................................... 126 Madopar 125 ................................................................ 126 Madopar 62.5 ............................................................... 126 Madopar Dispersible ..................................................... 126 Madopar HBS ............................................................... 126 Magnesium hydroxide Minerals ................................................................... 38 Osmotic laxatives ..................................................... 34 Magnesium sulphate Inj ............................................................................ 38 Paste ....................................................................... 75 Malathion ....................................................................... 70 Maldison ........................................................................ 70 Mandol ........................................................................... 91 Maprotiline hydrochloride .............................................. 118 Marcain Heavy ............................................................. 115 Marcain Isobaric ........................................................... 115 Marevan ......................................................................... 42 Marvelon 21 ................................................................... 77 Marvelon 28 ................................................................... 77 Marzine ........................................................................ 124 Maxamaid MSUD .......................................................... 181 Maxamaid RVHB .......................................................... 181 Maxamaid XP ............................................................... 181 Maxamum MSUD ......................................................... 181 Maxamum XP ............................................................... 181 Maxidex ........................................................................ 158 Maxitrol ........................................................................ 158 Maxolon Antinausea ............................................................. 125 Antispasmodics ....................................................... 26 MCT oil ........................................................................ 174 MDS Quick Card ............................................................. 81 Mebendazole .................................................................. 91 Mebeverine hydrochloride ............................................... 26 Medrol ........................................................................... 83 Medroxyprogesterone acetate HRT - systemic ................................................. 86, 88 Progestogen-only contraceptives ............................. 79 Mefenamic acid ............................................................ 110 Mefoxin .......................................................................... 91 Megace ........................................................................ 136 Megestrol acetate ......................................................... 136 Melleril ......................................................................... 129 Melleril Retard .............................................................. 129 Melodene ....................................................................... 77 Melphalan .................................................................... 133 Menadione sodium bisulphite .......................................... 41 Menoprem ...................................................................... 87 Menoprem Continuous ................................................... 87 Menthol .......................................................................... 65 Merbentyl ....................................................................... 26 Merbentyl Dospan .......................................................... 26 Mercaptopurine ............................................................ 133 Mercilon 21 .................................................................... 77

Mercilon 28 .................................................................... 77 Mesalazine ..................................................................... 24 Mestinon ...................................................................... 109 Metabolic Mineral Mixture ............................................. 181 Metamide Antinausea ............................................................. 125 Antispasmodics ....................................................... 26 Metamucil ...................................................................... 33 Metaraminol tartrate ....................................................... 62 Metformin hydrochloride ................................................. 31 Methadone hydrochloride Analgesics ............................................................. 117 Cough preparations ............................................... 154 Methoblastin ................................................................. 134 Methopt ........................................................................ 162 Methopt Forte ............................................................... 162 Methotrexate ................................................................ 134 Methotrimeprazine ........................................................ 128 Methoxsalen ................................................................... 72 Methyldopa .................................................................... 60 Methyldopa with hydrochlorothiazide .............................. 60 Methylphenidate hydrochloride ..................................... 132 Methylprednisolone ........................................................ 83 Methylprednisolone aceponate ........................................ 67 Methylprednisolone acetate .......................................... 112 Methylprednisolone acetate with lignocaine ................... 112 Methylprednisolone sodium succinate .................... 84, 113 Metoclopramide hydrochloride Antinausea ............................................................. 125 Antispasmodics ....................................................... 26 Metoclopramide hydrochloride with paracetamol ........... 124 Metomin ......................................................................... 31 Metopirone ..................................................................... 90 Metoprolol succinate ...................................................... 57 Metoprolol tartrate .......................................................... 57 Metronidazole ................................................................. 98 Metyrapone .................................................................... 90 Mexiletine hydrochloride ................................................. 55 Mexitil ............................................................................ 55 Mexitil PL ....................................................................... 55 Miacalcic ........................................................................ 82 Mianserin ..................................................................... 119 Micanol .......................................................................... 72 Micelle E ........................................................................ 38 Miconazole ..................................................................... 35 Miconazole nitrate Crm, lotn, tincture .................................................... 64 Vaginal crm .............................................................. 80 Micozole ........................................................................ 80 Micreme Cream ...................................................................... 64 Vaginal crm .............................................................. 80 Micreme H ..................................................................... 68 Microgynon 20 ED .......................................................... 78 Microgynon 30 ............................................................... 78

204

INDEX

Generic Chemicals and Brands

Microgynon 30 ED .......................................................... 78 Microgynon 50 ED .......................................................... 78 Microlax ......................................................................... 34 Microlut .......................................................................... 79 Microshield Handrub ...................................................... 68 Microval ......................................................................... 79 Midamor ........................................................................ 60 Midazolam ................................................................... 131 Midodrine ....................................................................... 56 Mindol ............................................................................ 91 Mini Wright ................................................................... 155 Minidiab ......................................................................... 31 Minims ......................................................................... 160 Minirin ............................................................................ 90 Mino-tabs ....................................................................... 96 Minocycline hydrochloride .............................................. 96 Minomycin ..................................................................... 96 Minulet 28 ...................................................................... 77 Mirena ............................................................................ 88 Misoprostol .................................................................... 26 Mixtard 30 ...................................................................... 29 Mixtard 50 ...................................................................... 29 Moclobemide ............................................................... 120 Modecate ..................................................................... 129 Moducal ....................................................................... 174 Mometasone furoate ....................................................... 67 Monofeme ...................................................................... 78 Monogen ...................................................................... 179 Monoparin ...................................................................... 42 Monotard ....................................................................... 29 Morphine hydrochloride ................................................ 117 Morphine sulphate ........................................................ 117 Morphine tartrate .......................................................... 118 Morrex Maltodextrin ...................................................... 174 Motilium ................................................................ 26, 124 MST Continus ............................................................... 117 MSUD Aid .................................................................... 181 Mucilaginous laxatives .................................................... 33 Mucilaginous laxatives with stimulants ............................ 33 Mucilax .......................................................................... 33 Multiload Cu 375 ............................................................ 76 Multiload Cu 375SL ........................................................ 76 Multiparin ....................................................................... 42 Mupirocin ....................................................................... 63 Myambutol ..................................................................... 99 Mycobutin ...................................................................... 99 Mycophenolate mofetil .................................................. 137 Mycostatin Crm, oint, paste ....................................................... 64 Oral liq, pastilles ...................................................... 36 Tab & cap, oral liq & powder .................................... 98 Mydriacyl ..................................................................... 161 Mylanta .......................................................................... 23 Mylanta P ....................................................................... 23 Myleran ........................................................................ 133 Myocrisin ..................................................................... 112

Nadolol ........................................................................... 57 Nafarelin acetate ............................................................. 89 Nalcrom ......................................................................... 24 Naloxone hydrochloride ................................................ 163 Nandrolone decanoate .................................................... 82 Naphazoline hydrochloride ............................................ 162 Naphcon Forte .............................................................. 162 Naplin ............................................................................ 61 Naprosyn ..................................................................... 110 Naprosyn Enteric .......................................................... 110 Naprosyn SR 1000 ....................................................... 110 Naprosyn SR 750 ......................................................... 110 Naproxen ...................................................................... 110 Naproxen sodium ......................................................... 111 Narcan ......................................................................... 163 Narcan Neonatal ........................................................... 163 Nardil ........................................................................... 119 Navidrex ......................................................................... 61 Navoban ....................................................................... 125 Naxen ........................................................................... 110 Nebcin ........................................................................... 97 Nedocromil ................................................................... 148 Nefazodone .................................................................. 120 Nefopam hydrochloride ................................................. 115 Nelfinavir ...................................................................... 108 Neo-Cytamen Iron therapy ............................................................. 40 Vitamin B group ....................................................... 36 Neo-Mercazole ............................................................... 88 Neo-Naclex ..................................................................... 60 Neocate ........................................................................ 182 Neomycin sulphate ......................................................... 97 Neoral Dermatologicals ....................................................... 72 Oncology agents .................................................... 141 Neostigmine ................................................................. 109 Neosulf .......................................................................... 97 Neotigason ..................................................................... 71 Nepro ........................................................................... 176 Nerisone ......................................................................... 66 Nerisone C ..................................................................... 68 Neulactil ....................................................................... 128 Neurontin ..................................................................... 122 Nevirapine .................................................................... 107 Nicotine .......................................................................... 61 Nicotinell ........................................................................ 61 Nicotinic acid ................................................................. 44 Nicotrol .......................................................................... 61 Nifedipine ....................................................................... 58 Nifuran ......................................................................... 108 Nilstat Crm, oint, paste ....................................................... 64 Tab & cap, oral liq & powder .................................... 98 Vaginal crm .............................................................. 80

205

INDEX

Generic Chemicals and Brands

Nitrados ....................................................................... 131 Nitrazepam ................................................................... 131 Nitroderm TTS ................................................................ 61 Nitrofurantoin ............................................................... 108 Nitrolingual Pumpspray ................................................... 61 Nivaquine ....................................................................... 98 Nizoral Crm ......................................................................... 64 Tab ........................................................................... 98 Noctamid ..................................................................... 131 Nonoxynol 9 ................................................................... 76 Nordette 28 .................................................................... 78 Nordiol 21 ...................................................................... 78 Nordiol 28 ...................................................................... 78 Norditropin ..................................................................... 89 Norditropin Penset 12 ..................................................... 89 Norditropin Penset 24 ..................................................... 89 Norditropin SimpleXx 10mg ............................................ 89 Norditropin SimpleXx 15mg ............................................ 89 Norditropin SimpleXx 5mg .............................................. 89 Norethisterone Tab 350 µg .............................................................. 79 Tab 5 mg ................................................................. 88 Norethisterone with mestranol ........................................ 79 Norflex ......................................................................... 113 Norfloxacin ................................................................... 108 Noriday 28 ..................................................................... 79 Norimin .......................................................................... 78 Norinyl-1/21 ................................................................... 79 Norinyl-1/28 ................................................................... 79 Normacol ....................................................................... 33 Normacol Plus ................................................................ 33 Noroxin ........................................................................ 108 Norpress ...................................................................... 119 Nortriptyline hydrochloride ............................................ 119 Norvasc ......................................................................... 58 Norvir ........................................................................... 108 Nova-T ........................................................................... 76 NovaSource Renal ........................................................ 176 NovoRapid ..................................................................... 30 NovoRapid Penfill ........................................................... 30 Nozinan ........................................................................ 128 Nuelin ........................................................................... 153 Nuelin-SR ..................................................................... 153 Nutraplus ....................................................................... 69 Nutridrink Powder ......................................................... 175 Nutrini .......................................................................... 177 Nutrison Concentrated .................................................. 176 Nutrison Energy ............................................................ 176 Nutrison Multi Fibre ...................................................... 178 Nutrison Standard RTH ................................................. 178 Nutrivent ...................................................................... 177 Nuvelle ........................................................................... 86 Nyefax Retard ................................................................. 58

Nystatin Crm, oint, paste ....................................................... 64 Oral liq, pastilles ...................................................... 36 Tab & cap, oral liq & powder .................................... 98 Vaginal crm .............................................................. 80 NZB Low Gluten Bread Mix ........................................... 179

Octreotide .................................................................... 136 Odrik .............................................................................. 53 Oestradiol Implant .................................................................... 87 Tab .................................................................... 85, 86 TDDS ................................................................ 85, 86 Oestradiol valerate ................................................... 85, 86 Oestradiol with levonorgestrel ......................................... 86 Oestradiol with norethisterone ......................................... 87 Oestriol Pessaries, vaginal crm ............................................. 81 Tab ........................................................................... 87 Oestrogens .............................................................. 85, 86 Oestrogens with medroxyprogesterone ........................... 87 Oestrogens with norgestrel ............................................. 87 Oil in water emulsion ...................................................... 69 Oily cream BP ................................................................ 69 Oily phenol ..................................................................... 25 Olanzapine .................................................................... 128 Olbetam ......................................................................... 44 Olsalazine ....................................................................... 24 Omeprazole .................................................................... 28 Omeprazole, amoxycillin and clarithromycin .................... 26 Omeprazole, amoxycillin and metronidazole .................... 26 Ondansetron ................................................................. 125 One-Alpha ...................................................................... 37 Opticrom ...................................................................... 158 Orabase ......................................................................... 35 Oracort .......................................................................... 35 Orap ............................................................................. 128 Oratane .......................................................................... 63 Orgran Buckwheat Spirals ............................................. 180 Orgran Corn & Parsley Fettucine ................................... 180 Orgran Corn & Parsley Spirals ....................................... 180 Orgran Corn & Spinach Rigatini .................................... 180 Orgran Corn & Vegetable Shells .................................... 180 Orgran Corn Spaghetti .................................................. 180 Orgran Corn, Tomato & Chilli Spirals ............................. 180 Orgran Garlic & Parsley Spirals ..................................... 180 Orgran Rice & Maize Pasta Spirals ................................ 180 Orgran Rice & Maize Spaghetti ...................................... 180 Orgran Rice & Millet Spirals .......................................... 180 Orgran Tomato & Basil Spirals ...................................... 180 Orgran Vegetable & Rice Spirals .................................... 180 Ornidazole ...................................................................... 98 Orphenadrine citrate ..................................................... 113 Orphenadrine hydrochloride .......................................... 127

206

INDEX

Generic Chemicals and Brands

Ortho ............................................................................. 76 Ortho All-flex .................................................................. 76 Ortho Applicator ............................................................. 76 Ortho Coil ....................................................................... 76 Ortho-Gynol ................................................................... 76 Ortho-tolidine ............................................................... 163 Orudis .......................................................................... 110 Oruvail ......................................................................... 110 Oruvail 100 .................................................................. 110 Oruvail 200 .................................................................. 110 Oruvail EC .................................................................... 110 Osmolite ....................................................................... 178 Osmolite RTH ............................................................... 178 Ospamox ........................................................................ 94 Ospamox Paediatric Drops .............................................. 94 Osteo~500 .................................................................... 38 Osteo~600 .................................................................... 38 Ovestin Pessaries, vaginal crm ............................................. 81 Tab ........................................................................... 87 Ovral .............................................................................. 78 Ox-Pam ........................................................................ 130 Oxazepam .................................................................... 130 Oxis Turbuhaler ............................................................. 149 Oxprenolol ...................................................................... 57 Oxsoralen ....................................................................... 72 Oxybutynin ..................................................................... 81 Oxycodone pectinate .................................................... 118 Oxypentifylline Cardiovascular system ............................................ 62 Sensory organs ..................................................... 156 Oxytocin ......................................................................... 81

Pacifen ......................................................................... 113 Pacific Buspirone .......................................................... 130 Pacimol ........................................................................ 116 Paediatric Seravite ........................................................ 182 Pallidone ...................................................................... 117 Pamidronate disodium .................................................... 83 Pamisol .......................................................................... 83 Pamol .......................................................................... 116 Panadeine .................................................................... 116 Panadol ........................................................................ 116 Panafen ........................................................................ 110 Pancrease ...................................................................... 32 Pancreatic enzyme ......................................................... 32 Pancrex V ....................................................................... 32 Pancrex V Forte .............................................................. 32 Panteston ....................................................................... 84 Pantoprazole ................................................................... 28 Panzytrat ........................................................................ 32 Papaverine hydrochloride ................................................ 80 Paracare Double Strength Suspension ........................... 116 Paracare Junior Suspension .......................................... 116 Paracetamol ................................................................. 116

Paracetamol with codeine ............................................. 116 Paradex ........................................................................ 116 Paraffin liquid with soft white paraffin ............................ 162 Paraffin liquid with wool fat liquid .................................. 162 Paraffin, white soft .......................................................... 70 Paraldehyde ................................................................. 121 Paramax ....................................................................... 124 Parnate ......................................................................... 119 Paroxetine hydrochloride ............................................... 120 Paxam .......................................................................... 122 Peak flow meters .......................................................... 155 Pedialyte ........................................................................ 43 Pedialyte Fruit ................................................................. 43 Pediasure ..................................................................... 177 Pediasure RTH .............................................................. 177 Penicillamine Antirheumatoid agents ........................................... 112 Poisoning treatments ............................................. 163 PenMix 10 ...................................................................... 29 PenMix 20 ...................................................................... 29 PenMix 30 ...................................................................... 29 PenMix 40 ...................................................................... 29 PenMix 50 ...................................................................... 29 Pentasa .......................................................................... 24 Pepcidine ....................................................................... 27 Pepti Junior .................................................................. 182 Peptisorb ...................................................................... 178 Pepzan ........................................................................... 27 Pergolide ...................................................................... 126 Perhexiline maleate ......................................................... 59 Periactin ....................................................................... 144 Pericyazine ................................................................... 128 Perindopril ...................................................................... 53 Permax ......................................................................... 126 Permethrin ...................................................................... 71 Persantin ........................................................................ 41 Persantin PL ................................................................... 41 Personal Best ............................................................... 155 Pertofran ...................................................................... 118 Pethidine hydrochloride ................................................ 118 Pevaryl ........................................................................... 64 Pexsig ............................................................................ 59 Phenate .......................................................................... 90 Phenelzine sulphate ...................................................... 119 Phenergan .................................................................... 145 Pheniramine maleate .................................................... 145 Phenobarbitone ............................................................ 122 Phenobarbitone sodium ................................................ 121 Phenol ............................................................................ 65 Phenoxybenzamine hydrochloride Cardiovascular system ............................................ 52 Genito urinary system .............................................. 81 Phenoxymethylpenicillin (Penicillin V) .............................. 95 Phentolamine mesylate ................................................... 52 Phenylephrine hydrochloride ......................................... 162

207

INDEX

Generic Chemicals and Brands

Phenylephrine hydrochloride with zinc sulphate ............. 162 Phenytoin sodium Cap, tab, oral liq .................................................... 122 Inj .......................................................................... 121 Phillips Milk of Magnesia ................................................ 34 Phlexy 10 ..................................................................... 181 Phosphate-Sandoz ......................................................... 44 Physostigmine salicylate ............................................... 109 Phytomenadione ............................................................. 41 Pilocarpine Eye drops .............................................................. 160 Oral liquid ................................................................ 36 Pilopt ........................................................................... 160 Pimafucort ..................................................................... 68 Pimozide ...................................................................... 128 Pindol ............................................................................. 57 Pindolol .......................................................................... 57 Pinetarsol ....................................................................... 73 Piportil ......................................................................... 129 Pipothiazine palmitate ................................................... 129 Piram-D ....................................................................... 111 Piroxicam ..................................................................... 111 Pizotifen ....................................................................... 124 Plaquenil ............................................................... 98, 112 Plasma-Lyte Oral ............................................................ 43 Plendil ER ....................................................................... 58 Podophyllotoxin .............................................................. 74 Polaramine ................................................................... 145 Polaramine Repetab ...................................................... 145 Poly-Tears .................................................................... 162 Poly-Visc ...................................................................... 162 Polycal ......................................................................... 174 Polycose ...................................................................... 174 Polynoxylin ..................................................................... 63 Polysiloxane ................................................................... 23 Polytar Emollient ............................................................. 73 Polyvinyl alcohol ........................................................... 162 Polyvinyl alcohol with povidone .................................... 162 Ponoxylan ...................................................................... 63 Ponstan ........................................................................ 110 Postinor-2 ...................................................................... 79 Potassium bicarbonate ................................................... 44 Potassium chloride Inj ............................................................................ 42 Tab ........................................................................... 44 Potassium permanganate ............................................... 72 Povidone iodine .............................................................. 70 Prantal ............................................................................ 69 Prazosin hydrochloride ................................................... 52 Precision Plus ................................................................ 32 Pred Forte .................................................................... 158 Pred Mild ...................................................................... 158 Prednisolone acetate .................................................... 158 Prednisolone sodium phosphate Oral liquid ................................................................ 84

Prednisone ..................................................................... 84 Prefrin .......................................................................... 162 Pregnancy test - HCG urine ............................................. 81 Premarin ................................................................. 85, 86 Premia 2.5 Continuous ................................................... 87 Premia 5 ........................................................................ 87 Premia 5 Continuous ...................................................... 87 Prempak-C ..................................................................... 87 Prentif ............................................................................ 76 Prepulsid ........................................................................ 25 Priadel Antidepressants ..................................................... 121 Antipsychotics ....................................................... 127 Primidone ..................................................................... 122 Primolut N ...................................................................... 88 Primoteston .................................................................... 84 Prinivil ............................................................................ 53 Prioderm ........................................................................ 70 Pro-Pam ....................................................................... 130 Probenecid ................................................................... 113 Procaine penicillin ........................................................... 95 Prochlorperazine ........................................................... 125 Proctosedyl .................................................................... 25 Procyclidine hydrochloride ............................................ 127 Prodopa ......................................................................... 60 Progesterone .................................................................. 88 Progout ........................................................................ 113 Prograf ......................................................................... 142 Progynova ............................................................... 85, 86 Proladone ..................................................................... 118 Promethazine hydrochloride .......................................... 145 Promethazine theoclate ................................................. 125 Promod ........................................................................ 174 Propafenone hydrochloride ............................................. 55 Propamidine isethionate ................................................ 157 Propranolol ..................................................................... 57 Protamine sulphate ......................................................... 42 Protaphane ..................................................................... 29 Protaphane Penfill ........................................................... 29 Protifar 90 .................................................................... 174 Provera ................................................................... 86, 88 PSM Paracetamol Elixir Paediatric ................................. 116 PSO ............................................................................. 184 Psorigel .......................................................................... 71 Pulmicort Nebuliser soln ........................................................ 148 Pulmicort Turbuhaler .................................................... 147 Pulmocare .................................................................... 177 Pulmozyme .................................................................. 154 Purinethol ..................................................................... 133 Pyrantel embonate .......................................................... 91 Pyrazinamide .................................................................. 99 Pyridostigmine bromide ................................................ 109 Pyridoxine hydrochloride ................................................. 37 Pytazen SR ..................................................................... 41

208

INDEX

Generic Chemicals and Brands

Q 200 ........................................................................... 113 Q 300 ........................................................................... 113 Quellada-P ...................................................................... 71 Questran Light ................................................................ 44 Quetiapine .................................................................... 128 Quinapril ......................................................................... 53 Quinapril with hydrochlorothiazide ................................... 54 Quinine sulphate ........................................................... 113 QV .................................................................................. 69

Roferon A ..................................................................... 137 Romicin ......................................................................... 94 Roxithromycin ................................................................ 94 Rubifen ........................................................................ 132 Rynacrom Forte ............................................................ 154 Rythmodan ..................................................................... 55 Rythmodan Retard .......................................................... 55 Rytmonorm .................................................................... 55

S26LBW ....................................................................... 182 Sabril ........................................................................... 123 Safety Cap Medicines ................................................... 191 Sagami Silver De Luxe .................................................... 76 Sagami Sustaining .......................................................... 76 Saizen ............................................................................ 89 Salazopyrin .................................................................... 24 Salazopyrin EN ............................................................... 24 Salbutamol Inhaler .................................................................... 148 Nebuliser soln ........................................................ 151 Tab,oral liq, inj, inf ........................................ 152, 153 Salbutamol with ipratropium bromide Inhaler .................................................................... 152 Nebuliser soln ........................................................ 152 Saldac .......................................................................... 111 Salicylic acid Oint and soln ........................................................... 74 Powder .................................................................... 73 Saliva substitute ............................................................. 36 Salmeterol .................................................................... 149 Sandomigran ................................................................ 124 Sandostatin .................................................................. 136 Sandostatin LAR ........................................................... 136 Saquinavir .................................................................... 108 Scopoderm TTS ........................................................... 125 Sebizole ......................................................................... 73 Selegiline hydrochloride ................................................ 126 Selgene ........................................................................ 126 Senna ............................................................................. 34 Senokot .......................................................................... 34 Serenace ...................................................................... 127 Serevent ....................................................................... 149 Serevent Accuhaler ....................................................... 149 Seroquel ....................................................................... 128 Serzone ........................................................................ 120 Sevredol ....................................................................... 117 Shield Blue ..................................................................... 76 Shield Gold ..................................................................... 76 Silvazine ......................................................................... 63 Silver sulphadiazine ........................................................ 63 Simethicone ................................................................... 23 Similac Special Care ..................................................... 182 Simvastatin .................................................................... 46 Sindopa ........................................................................ 126 Sinemet ........................................................................ 126

R V Paque ...................................................................... 74 R3 Superfeucht .............................................................. 76 RA-Morph .................................................................... 117 Ranitidine hydrochloride ................................................. 27 Razene ......................................................................... 144 Recombinant human growth hormone ............................ 89 Recormon ...................................................................... 39 Redipred ........................................................................ 84 Regitine .......................................................................... 52 Remote Areas for Practitioner’s Supply Orders .............. 187 Rendells Plus ................................................................. 76 Resonium-A ................................................................... 44 Resource Diabetic ........................................................ 177 Resource Just for Kids ................................................. 177 Resource Plus .............................................................. 176 Resource Standard ....................................................... 175 Resource Thicken Up .................................................... 179 Respocort 100 ............................................................. 146 Respocort 100 Autohaler .............................................. 147 Respocort 100-S .......................................................... 146 Respocort 250 ............................................................. 146 Respocort Forte Autohaler ............................................ 147 Respocort Forte-S ........................................................ 146 Respolin Autohaler ........................................................ 148 Retrovir ........................................................................ 107 Rheumacin ................................................................... 111 Rheumacin SR ............................................................. 111 Ridaura ........................................................................ 112 Rifabutin ......................................................................... 99 Rifadin ........................................................................... 99 Rifampicin ...................................................................... 99 Rifinah ........................................................................... 99 Risperdal ...................................................................... 128 Risperidone .................................................................. 128 Ritalin SR ..................................................................... 132 Ritonavir ....................................................................... 108 Rivotril Injection ................................................................. 121 Tab, oral drops ....................................................... 122 RMS ............................................................................. 117 Roaccutane .................................................................... 63 Rocaltrol ........................................................................ 37 Rocaltrol solution ............................................................ 37 Rocephin IV .................................................................... 91

209

INDEX

Generic Chemicals and Brands

Sinemet CR .................................................................. 126 Siterone .......................................................................... 84 Slow K ........................................................................... 44 Slow-Lopresor ................................................................ 57 Sodium acid phosphate .................................................. 34 Sodium alginate .............................................................. 23 Sodium aurothiomalate ................................................. 112 Sodium bicarbonate ........................................................ 42 Sodium calcium edetate ............................................... 163 Sodium carboxymethylcellulose ...................................... 35 Sodium chloride ............................................................. 43 Sodium citrate with sodium lauryl sulphoacetate ............. 34 Sodium citro-tartrate ...................................................... 81 Sodium cromoglycate Cap .......................................................................... 24 Eye drops .............................................................. 158 Nasal spray ............................................................ 154 Respiratory system ................................................ 148 Sodium fluoride Minerals ................................................................... 38 Mouth and throat ..................................................... 36 Sodium hypochlorite ....................................................... 68 Sodium nitroprusside ..................................................... 31 Sodium polystyrene sulphonate ...................................... 44 Sodium tetradecyl sulphate ............................................. 41 Sodium valproate .......................................................... 122 Sofradex Ear drops, oint ....................................................... 156 Eye drops, oint ....................................................... 158 Soframycin Antibacterials topical ................................................ 63 Ear preparations ..................................................... 156 Eye preparations .................................................... 157 Solprin Analgesics ............................................................. 115 Antithrombotic agents .............................................. 41 Solu-Cortef .................................................................... 83 Solu-Medrol Hormone preparations ............................................. 84 Musculo-skeletal system ....................................... 113 Somac ........................................................................... 28 Sotacor .......................................................................... 57 Sotalol ............................................................................ 57 Space Chamber ............................................................ 155 Spacer devices and masks ........................................... 155 Special Authority Applications ......................................... 12 Spironolactone Diuretics .................................................................. 60 Sex hormones non-contraceptive ............................ 84 Spirotone Diuretics .................................................................. 60 Sex hormones non-contraceptive ............................ 84 Sporanox ........................................................................ 98 Staphlex ......................................................................... 95

Stavudine ..................................................................... 107 Stelazine ....................................................................... 129 Stelazine Spansules ...................................................... 129 Stemetil ........................................................................ 125 Stesolid ........................................................................ 121 Stocrin ......................................................................... 107 Stomahesive .................................................................. 35 Stresson Multi-Fibre ..................................................... 178 Sucralfate ....................................................................... 28 Sulindac ....................................................................... 111 Sulphacetamide sodium ................................................ 157 Sulphasalazine ............................................................... 24 Sulphur .......................................................................... 73 Sumatriptan .................................................................. 124 Sunscreens, proprietary .................................................. 74 Suplena ........................................................................ 176 Suprefact ....................................................................... 89 Surgam ........................................................................ 111 Surgam SA ................................................................... 111 Surmontil ..................................................................... 119 Sustagen Hospital Formula ........................................... 175 Sustanon 250 Orgaject ................................................... 84 Symbicort Turbuhaler 100/6 ......................................... 149 Symbicort Turbuhaler 200/6 ......................................... 149 Symmetrel .................................................................... 126 Synacthen ...................................................................... 84 Synacthen Depot ............................................................ 84 Synalar ........................................................................... 67 Synalar Gel ..................................................................... 73 Synarel ........................................................................... 89 Synermox ....................................................................... 95 Synflex ......................................................................... 111 Synphasic 28 ................................................................. 78 Syntocinon ..................................................................... 81 Syntometrine .................................................................. 81

Tacrolimus ................................................................... 142 Tambocor ....................................................................... 55 Tambocor CR ................................................................. 55 Tamoxifen citrate .......................................................... 136 Tar with cade oil ............................................................. 73 Tar with triethanolamine lauryl sulphate and fluorescein ... 73 Tasmar ......................................................................... 126 Tears Plus .................................................................... 162 Tegretol ........................................................................ 121 Tegretol CR ................................................................... 121 Telfast .......................................................................... 145 Temazepam .................................................................. 131 Temgesic ...................................................................... 116 Tenoxicam .................................................................... 111 Terazosin hydrochloride Cardiovascular system ............................................ 52 Genito urinary system .............................................. 81 Terbinafine ...................................................................... 98

210

INDEX

Generic Chemicals and Brands

Terbutaline sulphate Inhaler .................................................................... 148 Inj .......................................................................... 153 Nebuliser soln ........................................................ 151 Turbuhaler .............................................................. 148 Teril .............................................................................. 121 Tertroxin ......................................................................... 88 Testosterone cypionate ................................................... 84 Testosterone enanthate ................................................... 84 Testosterone esters ........................................................ 84 Testosterone undecanoate .............................................. 84 Tetrabenazine ............................................................... 132 Tetrabromophenol ......................................................... 163 Tetracosactrin ................................................................. 84 Theo-Dur ...................................................................... 153 Theophylline ................................................................. 153 Thiamine hydrochloride .................................................. 37 Thioguanine .................................................................. 134 Thioprine ...................................................................... 137 Thioridazine hydrochloride ............................................ 129 Thiotepa ....................................................................... 133 Thiothixene ................................................................... 129 Thixit ............................................................................ 129 Thymol glycerin mouthwash ........................................... 36 Thyroxine ....................................................................... 88 Tiaprofenic acid ............................................................ 111 Tiberal ............................................................................ 98 Tilade ........................................................................... 148 Tilcotil .......................................................................... 111 Timolol ........................................................................... 57 Timolol maleate ............................................................ 160 Timolol maleate with pilocarpine ................................... 160 Timoptol ....................................................................... 160 Timoptol XE .................................................................. 160 Timpilo 2 ...................................................................... 160 Timpilo 4 ...................................................................... 160 Tinaderm ........................................................................ 65 Tinidazole ....................................................................... 98 Tioconazole .................................................................... 80 Titralac ........................................................................... 23 Titralac-Sil ...................................................................... 23 TMP Infections - agents for systemic use ........................ 97 Urinary tract infections .......................................... 108 Tobramycin Eye drops & oint .................................................... 157 Inj ............................................................................ 97 Tobrex .......................................................................... 157 Tofranil ......................................................................... 118 Tolbutamide .................................................................... 31 Tolcapone ..................................................................... 126 Tolciclate ........................................................................ 65 Tolmicen ........................................................................ 65 Tolnaftate ....................................................................... 65 Tolvon .......................................................................... 119

Topamax ...................................................................... 122 Topiramate ................................................................... 122 Total Parenteral Nutrition (TPN) ....................................... 43 Trandate ......................................................................... 56 Trandolapril .................................................................... 53 Tranexamic acid ............................................................. 41 Tranylcypromine sulphate ............................................. 119 Trasylol .......................................................................... 40 Trental 400 Cardiovascular system ............................................ 62 Sensory organs ..................................................... 156 Triamcinolone acetonide Crm, oint ................................................................. 67 Inj .......................................................................... 113 Paste ....................................................................... 35 Triamcinolone acetonide with gramicidin, neomycin & nystatin Crm, oint ................................................................. 68 Ear drops ............................................................... 156 Triamizide ....................................................................... 60 Triamterene with hydrochlorothiazide .............................. 60 Triazolam ...................................................................... 131 Trichozole ....................................................................... 98 Trifeme ........................................................................... 78 Trifluoperazine hydrochloride ........................................ 129 Trimeprazine tartrate ..................................................... 145 Trimethoprim Infections - agents for systemic use ........................ 97 Urinary tract infections .......................................... 108 Trimipramine maleate ................................................... 119 Triphasil 28 .................................................................... 78 Tripotassium dicitratobismuthate ..................................... 28 Tripress ........................................................................ 119 Triprim Infections - agents for systemic use ........................ 97 Urinary tract infections .......................................... 108 Triquilar ED ..................................................................... 78 Trisequens ...................................................................... 87 Trisul .............................................................................. 96 Tropicamide ................................................................. 161 Tropisetron ................................................................... 125 Trusopt ......................................................................... 159 Two Cal HN .................................................................. 176 Tyloxapol ...................................................................... 162

Ultratard ......................................................................... Ural ................................................................................ Urea ............................................................................... Ursodeoxycholic acid ..................................................... 29 81 69 33

Vallergan Forte ............................................................. 145 Valoid ........................................................................... 124 Vancocin ........................................................................ 97 Vancomycin hydrochloride .............................................. 97 Velosef ........................................................................... 92 Velosulin ........................................................................ 29

211

INDEX

Generic Chemicals and Brands

Ventolin Inhaler .................................................................... 148 Inj, inf, oral liq ............................................... 152, 153 Ventolin Nebules ........................................................... 151 Vepesid ........................................................................ 134 Verapamil hydrochloride ................................................. 59 Vergo ........................................................................... 124 Vermox .......................................................................... 91 Verpamil ......................................................................... 59 Verpamil SR ................................................................... 59 Viaderm KC .................................................................... 68 Vicrom ......................................................................... 148 Videx ............................................................................ 107 Videx EC ....................................................................... 107 Vigabatrin ..................................................................... 123 Vimule ............................................................................ 76 Vinblastine sulphate ...................................................... 134 Vincristine sulphate ...................................................... 134 Viodine ........................................................................... 70 Viracept ........................................................................ 108 Viramune ...................................................................... 107 Vitadol C ........................................................................ 36 Vital HN ........................................................................ 178 Vitalograph ................................................................... 155 Vitamin A with vitamin D ................................................. 36 Vitamin A with vitamins D and C ..................................... 36 Vitamin B complex .......................................................... 37 Vitamins ......................................................................... 38 Vivonex Pediatric .......................................................... 182 Vivonex TEN ................................................................. 178 Volmax ......................................................................... 152 Voltaren ........................................................................ 109 Voltaren D .................................................................... 109 Voltaren Ophtha ............................................................ 158 Voltaren SR .................................................................. 109 Vosol ............................................................................ 156

Zeffix .............................................................................. 99 Zerit ............................................................................. 107 Ziagen .......................................................................... 107 Zidovudine .................................................................... 107 Zidovudine with lamivudine ........................................... 107 Zinacef ........................................................................... 92 Zinamide ........................................................................ 99 Zinc and castor oil .......................................................... 69 Zinc cream ..................................................................... 69 Zinc ointment ................................................................. 69 Zinc oxide ....................................................................... 25 Zinc sulphate .................................................................. 38 Zincaps .......................................................................... 38 Zincfrin ......................................................................... 162 Zinnat ............................................................................. 92 Zithromax ....................................................................... 93 Zocor ............................................................................. 46 Zofran .......................................................................... 125 Zofran Zydis ................................................................. 125 Zoladex .......................................................................... 89 Zopiclone ..................................................................... 131 Zoton ............................................................................. 28 Zovirax ......................................................................... 157 Zyprexa ........................................................................ 128

Warfarin sodium ............................................................. 42 Wasp venom allergy treatment ...................................... 144 Water ............................................................................. 43 Wellferon ...................................................................... 139 Wholesale Supply Order ................................................ 186 Wool fat with mineral oil ................................................. 70

Xalatan ......................................................................... 160 Xanax ........................................................................... 130 Xenazine 25 .................................................................. 132 XMET Maxamum .......................................................... 181 Xylocaine ..................................................................... 115 Xylocard ......................................................................... 55

Zadine .......................................................................... 144 Zantac ............................................................................ 27 Zarontin ........................................................................ 122

212

NOTES INDEX

Generic Chemicals and Brands

213

NOTES

214

NOTES

AUTHORITY TO SUBSTITUTE

✄

Dear Pharmacist This authority to substitute is valid unless I have indicated on the prescription an instruction not to substitute. Please inform my patient that I have authorised substitution. Name: Signature: NZMC: Date:

Where PHARMAC has entered into sole supply or preferred brand (preferred supplier) arrangements, I give authority to substitute an alternative brand of the same medicinal substance in the same strength and pharmaceutical form in the following situations: Sole Supply Products You may substitute the sole supply brand, except if the patient chooses to pay for the non-sole supply brand. This includes repeat dispensings where the brand I have prescribed is no longer subsidised or is partly subsidised. Preferred Brand (Preferred Supplier) Products You may substitute the preferred brand, except if the patient specifically requests the brand prescribed. This includes repeat dispensings where the brand I have prescribed is no longer subsidised or is partly subsidised. Exceptions I do not want substitution to occur for the following chemical entities, unless I am contacted verbally in each specific case.

This authority to substitute replaces all previous authorities relating to these particular chemical entities which I may have provided previously.

Authority for the dispensing pharmacist to change a prescribed medicine in this way is contained in regulation 42 (4) of the Medicines Regulations 1984.

215

NOTES

216

NOTES

AUTHORITY TO SUBSTITUTE

✄

This authority to substitute replaces all previous authorities relating to these particular chemical entities which I may have provided previously.

Authority for the dispensing pharmacist to change a prescribed medicine in this way is contained in regulation 42 (4) of the Medicines Regulations 1984.

217

NOTES

218

NOTES

AUTHORITY TO SUBSTITUTE

✄

This authority to substitute replaces all previous authorities relating to these particular chemical entities which I may have provided previously.

Authority for the dispensing pharmacist to change a prescribed medicine in this way is contained in regulation 42 (4) of the Medicines Regulations 1984.

219

NOTES

220

NOTES

AUTHORITY TO SUBSTITUTE

✄

This authority to substitute replaces all previous authorities relating to these particular chemical entities which I may have provided previously.

Authority for the dispensing pharmacist to change a prescribed medicine in this way is contained in regulation 42 (4) of the Medicines Regulations 1984.

221

NOTES

222

NOTES

AUTHORITY TO SUBSTITUTE

✄

This authority to substitute replaces all previous authorities relating to these particular chemical entities which I may have provided previously.

Authority for the dispensing pharmacist to change a prescribed medicine in this way is contained in regulation 42 (4) of the Medicines Regulations 1984.

223

NOTES

224

Publishing and subscription details

IT Manager Schedule Advisor Schedule Administrator Email

Circulation

John Geering Ursula Egan Mary Chesterfield schedule@pharmac.govt.nz

The Pharmaceutical Schedule is published in April, August and December each year. Changes to the contents of the Schedule are published in monthly Updates. An annual subscription includes three Pharmaceutical Schedule books, 12 Updates, and occasional additional information on rule changes and news items. The Schedule is distributed free to over 9000 health professionals, and is also available on an annual subscription. Back issues are available on request, subject to supply.

Prices

All prices include postage, and exclude GST. $22.22 $4.44 $120.00 One Schedule book One Update Annual subscription

ISSN 1172 - 9376

Copyright 1994 Pharmaceutical Management Agency This Schedule is copyright. Apart from any fair dealing for the purposes of private study, research, criticism or review, as permitted under the Copyright Act, no part may be reproduced in any form or by any process without written permission, nor be used in any form of advertising, sales, promotion or publicity. While care has been taken in compiling this Schedule, Pharmaceutical Management Agency takes no responsibility for any errors or omissions and shall not be liable to any person for any damages or loss arising out of reliance by that person for any purpose on any of the contents of this Schedule. Errors and omissions brought to the attention of Pharmaceutical Management Agency will be corrected if necessary by an erratum or otherwise in the next edition of the Schedule.

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Metadata

Title

Pharmaceutical Schedule - effective 1 April 2003

Abstract

A comprehensive list of PHARMAC subsidised medicines.

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