TOCILIZUMAB

tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes

TOCILIZUMAB (12086D)

tocilizumab 162 mg/0.9 mL injection, 4 x 0.9 mL syringes
12086D
Body System:
Manner of administration:Injection
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 14084)

Indication: Systemic juvenile idiopathic arthritis
Treatment phase: Continuing treatment in a patient weighing less than 30 kg
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 4 # of repeats: 2 DPMQ: $801.70 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Actemra Subcutaneous Injection