MYCOPHENOLATE
mycophenolate 180 mg enteric tablet, 120
MYCOPHENOLATE (6369F)
6369F
Manner of administration:Oral
Restriction (Streamlined authority code: 9692)
Indication: Prophylaxis of renal allograft rejection
Treatment phase: Management
Restriction (Streamlined authority code: 9809)
Indication: WHO Class III, IV or V lupus nephritis
Treatment phase: Management
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 240 | # of repeats: 5 | DPMQ: $187.32 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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