AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDES

amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides with 2-fucosyllactose and lacto-N-neotetraose powder for oral liquid, 400 g

AMINO ACID SYNTHETIC FORMULA SUPPLEMENTED WITH LONG CHAIN POLYUNSATURATED FATTY ACIDS AND MEDIUM CHAIN TRIGLYCERIDES (13615N)

amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides with 2-fucosyllactose and lacto-N-neotetraose powder for oral liquid, 400 g
13615N
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Cows' milk protein enteropathy
Treatment phase: Continuing treatment

Restriction

Indication: Severe cows' milk protein enteropathy with failure to thrive
Treatment phase: Continuing treatment

Restriction

Indication: Combined intolerance to cows' milk protein, soy protein and protein hydrolysate formulae
Treatment phase: Continuing treatment

Restriction

Indication: Cows' milk anaphylaxis

Restriction

Indication: Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and soy protein
Treatment phase: Continuing treatment

Restriction

Indication: Severe intestinal malabsorption including short bowel syndrome

Restriction

Indication: Eosinophilic oesophagitis
Treatment phase: Continuing treatment
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 8 Max qty units: 8 # of repeats: 5 DPMQ: $317.12 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Alfamino