Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11268CMPNP	METHOTREXATE methotrexate 15 mg/0.3 mL injection, 0.3 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11275KMPNP	METHOTREXATE methotrexate 7.5 mg/0.15 mL injection, 0.15 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11283WMPNP	METHOTREXATE methotrexate 10 mg/0.2 mL injection, 0.2 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11288DMPNP	METHOTREXATE methotrexate 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
11295LMPNP	METHOTREXATE methotrexate 25 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

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
13882PMP	METHOTREXATE methotrexate 50 mg/2 mL injection, 5 x 2 mL vials (PI, CMI)	2	10	5	$68.31	$31.60	$31.60
	Available brands
	DBL Methotrexate

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
14089MMP	METHOTREXATE methotrexate 10 mg/0.2 mL injection, 0.2 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
14091PMP	METHOTREXATE methotrexate 7.5 mg/0.15 mL injection, 0.15 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
14097YMP	METHOTREXATE methotrexate 20 mg/0.4 mL injection, 0.4 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
14102FMP	METHOTREXATE methotrexate 15 mg/0.3 mL injection, 0.3 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
14103GMP	METHOTREXATE methotrexate 25 mg/0.5 mL injection, 0.5 mL syringe (PI, CMI)	4	4	5	$90.87	$31.60	$31.60
	Available brands
	Trexject

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

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
14643QMPNP	METHOTREXATE methotrexate 10 mg tablet, 10 (PI, CMI)	1	10	5	$21.52	$22.97	$26.42
	Available brands
	Methoblastin

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
14643QMPNP	METHOTREXATE methotrexate 10 mg tablet, 10 (PI, CMI)	1	10	5	$21.52	$22.97	$26.42
	Available brands
	Methoblastin

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

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
1622JMPNP	METHOTREXATE methotrexate 2.5 mg tablet, 30 (PI, CMI)	1	30	5	$19.29	$20.74	$24.19
	Available brands
	ARX-Methotrexatea
	Chexatea
	Methoblastina

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
1622JMPNP	METHOTREXATE methotrexate 2.5 mg tablet, 30 (PI, CMI)	1	30	5	$19.29	$20.74	$24.19
	Available brands
	ARX-Methotrexatea
	Chexatea
	Methoblastina

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

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
1623KMPNP	METHOTREXATE methotrexate 10 mg tablet, 50 (PI, CMI)	1	50	2	$53.78	$31.60	$31.60
	Available brands
	ARX-Methotrexatea
	Chexatea
	Methoblastina

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
1623KMPNP	METHOTREXATE methotrexate 10 mg tablet, 50 (PI, CMI)	1	50	2	$53.78	$31.60	$31.60
	Available brands
	ARX-Methotrexatea
	Chexatea
	Methoblastina

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

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
2272NMPNP	METHOTREXATE methotrexate 10 mg tablet, 15 (PI, CMI)	1	15	3	$25.56	$27.01	$30.46
	Available brands
	ARX-Methotrexatea
	Chexatea
	Methoblastina

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

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
2272NMPNP	METHOTREXATE methotrexate 10 mg tablet, 15 (PI, CMI)	1	15	3	$25.56	$27.01	$30.46
	Available brands
	ARX-Methotrexatea
	Chexatea
	Methoblastina

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

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
2395CMPNP	METHOTREXATE methotrexate 50 mg/2 mL injection, 5 x 2 mL vials (PI, CMI)	1	5	5	$40.88	$31.60	$31.60
	Available brands
	DBL Methotrexate

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

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
2396DMPNP	METHOTREXATE methotrexate 5 mg/2 mL injection, 5 x 2 mL vials (PI, CMI)	1	5	0	$42.31	$31.60	$31.60
	Available brands
	DBL Methotrexate

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
4502YMP	METHOTREXATE Injection (PI, CMI) Available brands DBL Methotrexate (methotrexate 5 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 50 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 1 g/10 mL injection, 10 mL vial) DBL Methotrexate (methotrexate 500 mg/20 mL injection, 20 mL vial) Methotrexate Accord (methotrexate 1 g/10 mL injection, 10 mL vial) Methotrexate Ebewe (methotrexate 5 g/50 mL injection, 50 mL vial)	250 mg	5	$115.63	$31.60	$31.60

Source	Chemotherapy Items for Public Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

Restricted Benefit

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
4512LMP	METHOTREXATE Injection (PI, CMI) Available brands DBL Methotrexate (methotrexate 5 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 50 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 1 g/10 mL injection, 10 mL vial) DBL Methotrexate (methotrexate 500 mg/20 mL injection, 20 mL vial) Methotrexate Accord (methotrexate 1 g/10 mL injection, 10 mL vial) Methotrexate Ebewe (methotrexate 5 g/50 mL injection, 50 mL vial)	20000 mg	0	$843.53	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
7250NMP	METHOTREXATE Injection (PI, CMI) Available brands DBL Methotrexate (methotrexate 5 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 50 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 1 g/10 mL injection, 10 mL vial) DBL Methotrexate (methotrexate 500 mg/20 mL injection, 20 mL vial) Methotrexate Accord (methotrexate 1 g/10 mL injection, 10 mL vial) Methotrexate Ebewe (methotrexate 5 g/50 mL injection, 50 mL vial)	250 mg	5	$160.65	$31.60	$31.60

Source	Chemotherapy Items for Private Hospital use - Explanatory Notes
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > ANTIMETABOLITES

Restricted Benefit

Code & Prescriber	Name, manner of administration	Max amount	No. of repeats	DPMA	Max Safety Net	General Patient Charge
7251PMP	METHOTREXATE Injection (PI, CMI) Available brands DBL Methotrexate (methotrexate 5 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 50 mg/2 mL injection, 5 x 2 mL vials) DBL Methotrexate (methotrexate 1 g/10 mL injection, 10 mL vial) DBL Methotrexate (methotrexate 500 mg/20 mL injection, 20 mL vial) Methotrexate Accord (methotrexate 1 g/10 mL injection, 10 mL vial) Methotrexate Ebewe (methotrexate 5 g/50 mL injection, 50 mL vial)	20000 mg	0	$898.76	$31.60	$31.60