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

Caution

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
13886WMP	SIROLIMUS sirolimus 2 mg tablet, 100 (PI, CMI)	2	200	3	$2512.73	$31.60	$31.60
	Available brands
	Rapamune

Source	S100 HSD Private
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
6457WMP	SIROLIMUS sirolimus 2 mg tablet, 100 (PI, CMI)	2	200	5	$2398.79	$31.60	$31.60
	Available brands
	Rapamune

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

Caution

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
8833XMP	SIROLIMUS sirolimus 2 mg tablet, 100 (PI, CMI)	1	100	3	$1270.70	$31.60	$31.60
	Available brands
	Rapamune

Source	S100 HSD Public
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > IMMUNOSUPPRESSANTS > IMMUNOSUPPRESSANTS

Caution

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
9548MMP	SIROLIMUS sirolimus 2 mg tablet, 100 (PI, CMI)	2	200	5	$2350.12	$31.60	$31.60
	Available brands
	Rapamune