LANSOPRAZOLE

lansoprazole 30 mg orally disintegrating tablet, 28

LANSOPRAZOLE (12276D)

lansoprazole 30 mg orally disintegrating tablet, 28
12276D
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Complex gastro-oesophageal reflux disease (GORD)
Treatment phase: One of: (1) establishment of symptom control, (2) maintenance treatment, (3) re-establishment of symptom control
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 56 # of repeats: 5 DPMQ: $22.40 Max safety net: $23.88 General Patient Charge: $25.00
Available brands
APO-Lansoprazole ODT
Lansoprazole ODT GH
Zopral ODT
Zoton FasTabs
*Additional charge for this brand is $9.36
 DPMQ: $31.76 Max safety net: $23.88 General Patient Charge: $34.36