Source	S100 HSD Community Access
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

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
10328NMPNP	GANCICLOVIR ganciclovir 500 mg injection, 5 vials (PI, CMI)	2	10	1	$250.13	$31.60	$31.60
	Available brands
	Cymevenea
	GANCICLOVIR SXPa

Source	S100 HSD Public
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

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
5749NMP	GANCICLOVIR ganciclovir 500 mg injection, 5 vials (PI, CMI)	2	10	1	$232.18	$31.60	$31.60
	Available brands
	Cymevenea
	GANCICLOVIR SXPa

Source	S100 HSD Private
Body System	ANTIINFECTIVES FOR SYSTEMIC USE > ANTIVIRALS FOR SYSTEMIC USE > DIRECT ACTING ANTIVIRALS

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
6136YMP	GANCICLOVIR ganciclovir 500 mg injection, 5 vials (PI, CMI)	2	10	1	$250.13	$31.60	$31.60
	Available brands
	Cymevenea
	GANCICLOVIR SXPa