Source	Palliative Care
Body System	ALIMENTARY TRACT AND METABOLISM > DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS > PROPULSIVES

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
10762KMPNP	METOCLOPRAMIDEP metoclopramide hydrochloride 10 mg/2 mL injection, 10 x 2 mL ampoules (PI, CMI)	4	40	2	$43.99	$31.60	$31.60
	Available brands
	METOCLOPRAMIDE INJECTION BPa
	Metoclopramide HCI Medsurgea

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS > PROPULSIVES

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
1206LMPMWNP	METOCLOPRAMIDE metoclopramide hydrochloride 10 mg/2 mL injection, 10 x 2 mL ampoules (PI, CMI)	1	10	0	$21.09	$22.54	$25.99
	Available brands
	METOCLOPRAMIDE INJECTION BPa
	Metoclopramide HCI Medsurgea

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS > PROPULSIVES

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
1207MMPMWNP	METOCLOPRAMIDE metoclopramide hydrochloride 10 mg tablet, 25 (PI, CMI)	1	25	0	$16.15	$17.60	$21.05
	Available brands
	APO-Metoclopramidea
	EMEXLONa
	METOCLOPRAMIDE-WGRa
	Pramina
	Maxolona * Additional charge for this brand is $3.55B	1	25	0	$19.70	$17.60	$24.60

Source	Palliative Care
Body System	ALIMENTARY TRACT AND METABOLISM > DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS > PROPULSIVES

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
12507GMPNP	METOCLOPRAMIDEP metoclopramide hydrochloride 10 mg tablet, 25 (PI, CMI)	4	100	5	$24.23	$25.68	$29.13
	Available brands
	APO-Metoclopramidea
	EMEXLONa
	METOCLOPRAMIDE-WGRa
	Pramina
	Maxolona * Additional charge for this brand is $14.20B	4	100	5	$38.43	$25.68	$43.33

Source	Prescriber Bag
Body System	ALIMENTARY TRACT AND METABOLISM > DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS > PROPULSIVES

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
3476YMPNP	METOCLOPRAMIDE metoclopramide hydrochloride 10 mg/2 mL injection, 10 x 2 mL ampoules (PI, CMI)	1	10	0	$21.09	$0.00	Nil
	Available brands
	METOCLOPRAMIDE INJECTION BPa
	Metoclopramide HCI Medsurgea

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS > PROPULSIVES

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
5151DDP	METOCLOPRAMIDE metoclopramide hydrochloride 10 mg tablet, 25 (PI, CMI)	1	25	0	$16.15	$17.60	$21.05
	Available brands
	APO-Metoclopramidea
	EMEXLONa
	METOCLOPRAMIDE-WGRa
	Pramina
	Maxolona * Additional charge for this brand is $3.55B	1	25	0	$19.70	$17.60	$24.60

Source	General Schedule
Body System	ALIMENTARY TRACT AND METABOLISM > DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS > PROPULSIVES

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
5153FDP	METOCLOPRAMIDE metoclopramide hydrochloride 10 mg/2 mL injection, 10 x 2 mL ampoules (PI, CMI)	1	10	0	$21.09	$22.54	$25.99
	Available brands
	METOCLOPRAMIDE INJECTION BPa
	Metoclopramide HCI Medsurgea