Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
13490BMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 5 mg/24 hours patch, 30 (PI, CMI)	2	60	5	$45.91	$31.60	$31.60
	Available brands
	Transiderm-Nitro 25

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

Note

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
13549DMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 400 microgram/actuation spray, 200 actuations (PI, CMI)	2	2	5	$38.73	$31.60	$31.60
	Available brands
	Nitrolingual Pumpspray

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
13580RMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 10 mg/24 hours patch, 30 (PI, CMI)	2	60	5	$56.01	$31.60	$31.60
	Available brands
	Transiderm-Nitro 50

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
14335LMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 15 mg/24 hours patch, 30 (PI, CMI)	2	60	5	$61.77	$31.60	$31.60
	Available brands
	Minitran 15

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
14371JMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 5 mg/24 hours patch, 30 (PI, CMI)	2	60	5	$45.91	$31.60	$31.60
	Available brands
	Minitran 5

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
14478BMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 10 mg/24 hours patch, 30 (PI, CMI)	2	60	5	$56.01	$31.60	$31.60
	Available brands
	Minitran 10

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
1515RMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 5 mg/24 hours patch, 30 (PI, CMI)	1	30	5	$29.68	$31.13	$31.60
	Available brands
	Transiderm-Nitro 25

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
1516TMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 10 mg/24 hours patch, 30 (PI, CMI)	1	30	5	$34.73	$31.60	$31.60
	Available brands
	Transiderm-Nitro 50

Source	Prescriber Bag
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
3475XMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 400 microgram/actuation spray, 200 actuations (PI, CMI)	1	1	0	$26.09	$0.00	Nil
	Available brands
	Nitrolingual Pumpspray

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
8027LMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 5 mg/24 hours patch, 30 (PI, CMI)	1	30	5	$29.68	$31.13	$31.60
	Available brands
	Minitran 5

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
8028MMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 10 mg/24 hours patch, 30 (PI, CMI)	1	30	5	$34.73	$31.60	$31.60
	Available brands
	Minitran 10

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

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
8119HMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 15 mg/24 hours patch, 30 (PI, CMI)	1	30	5	$37.61	$31.60	$31.60
	Available brands
	Minitran 15

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > CARDIAC THERAPY > VASODILATORS USED IN CARDIAC DISEASES

Note

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
8171CMPNP	GLYCERYL TRINITRATE glyceryl trinitrate 400 microgram/actuation spray, 200 actuations (PI, CMI)	1	1	5	$26.09	$27.54	$30.99
	Available brands
	Nitrolingual Pumpspray