Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > ANTIINFECTIVES

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
1002RMPNP	ACICLOVIR aciclovir 3% eye ointment, 4.5 g (PI, CMI)	1	1	0	$28.60	$30.05	$31.60
	Available brands
	ViruPOSa
	XOROXa

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
1003TMPNP	ACICLOVIR aciclovir 200 mg tablet, 25 (PI, CMI)	2	50	0	$23.57	$25.02	$28.47
	Available brands
	Aciclovir Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
1007BMPNP	ACICLOVIR aciclovir 200 mg tablet, 90 (PI, CMI)	1	90	5	$31.65	$31.60	$31.60
	Available brands
	ACICLOVIR-WGRa
	APO-Aciclovira
	ARX-ACICLOVIRa
	Aciclovir APOTEXa
	Aciclovir GHa
	Aciclovir Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
1052JMPNP	ACICLOVIR aciclovir 800 mg tablet, 35 (PI, CMI)	1	35	0	$35.48	$31.60	$31.60
	Available brands
	ACICLOVIR-WGRa
	APO-Aciclovira
	ARX-ACICLOVIRa
	Aciclovir APOTEXa
	Aciclovir Sandoza

Source	General Schedule
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

Note

Authority Required (STREAMLINED)

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
1555WMPNP	ACICLOVIR aciclovir 200 mg tablet, 50 (PI, CMI)	1	50	0	$23.57	$25.02	$28.47
	Available brands
	APO-Aciclovira
	Aciclovir APOTEXa

Source	General Schedule
Body System	SENSORY ORGANS > OPHTHALMOLOGICALS > ANTIINFECTIVES

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
5501MOP	ACICLOVIR aciclovir 3% eye ointment, 4.5 g (PI, CMI)	1	1	0	$28.60	$30.05	$31.60
	Available brands
	ViruPOSa
	XOROXa