SULFASALAZINE

sulfasalazine 500 mg enteric tablet, 100

SULFASALAZINE (13433B)

sulfasalazine 500 mg enteric tablet, 100
13433B
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 400 # of repeats: 5 DPMQ: $100.48 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Pyralin EN
Salazopyrin-EN
*Additional charge for this brand is $8.00
 DPMQ: $108.48 Max safety net: $25.00 General Patient Charge: $33.00