LANSOPRAZOLE

lansoprazole 30 mg orally disintegrating tablet, 28

LANSOPRAZOLE (14339Q)

lansoprazole 30 mg orally disintegrating tablet, 28
14339Q
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Complex gastro-oesophageal reflux disease (GORD)
Treatment phase: One of: (1) establishment of symptom control, (2) maintenance treatment, (3) re-establishment of symptom control
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 4 Max qty units: 112 # of repeats: 5 DPMQ: $31.00 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Lansoprazole ODT
Lansoprazole ODT GH
Zopral ODT
Zoton FasTabs
*Additional charge for this brand is $18.72
 DPMQ: $49.72 Max safety net: $25.00 General Patient Charge: $43.72