Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
13027PMP	LAROTRECTINIB larotrectinib 25 mg capsule, 56 (PI, CMI)	1	56	5	$2637.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
13029RMP	LAROTRECTINIB larotrectinib 25 mg capsule, 56 (PI, CMI)	1	56	2	$2637.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
13031WMP	LAROTRECTINIB larotrectinib 100 mg capsule, 56 (PI, CMI)	1	56	2	$10062.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
13043LMP	LAROTRECTINIB larotrectinib 100 mg capsule, 56 (PI, CMI)	1	56	5	$10062.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
13281BMP	LAROTRECTINIB larotrectinib 20 mg/mL oral liquid, 2 x 50 mL (PI, CMI)	1	1	2	$3462.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
13289KMP	LAROTRECTINIB larotrectinib 20 mg/mL oral liquid, 2 x 50 mL (PI, CMI)	1	1	5	$3462.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14230YMP	LAROTRECTINIB larotrectinib 20 mg/mL oral liquid, 2 x 50 mL (PI, CMI)	1	1	2	$3462.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14256HMP	LAROTRECTINIB larotrectinib 20 mg/mL oral liquid, 2 x 50 mL (PI, CMI)	1	1	5	$3462.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14257JMP	LAROTRECTINIB larotrectinib 25 mg capsule, 56 (PI, CMI)	1	56	2	$2637.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14258KMP	LAROTRECTINIB larotrectinib 25 mg capsule, 56 (PI, CMI)	1	56	5	$2637.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14282QMP	LAROTRECTINIB larotrectinib 100 mg capsule, 56 (PI, CMI)	1	56	5	$10062.60	$31.60	$31.60
	Available brands
	Vitrakvi

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14300PMP	LAROTRECTINIB larotrectinib 100 mg capsule, 56 (PI, CMI)	1	56	2	$10062.60	$31.60	$31.60
	Available brands
	Vitrakvi