Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
14743YMP	MOMELOTINIB momelotinib 100 mg tablet, 30 (PI, CMI)	1	30	5	$5800.38	$31.60	$31.60
	Available brands
	Omjjara

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
14744BMP	MOMELOTINIB momelotinib 150 mg tablet, 30 (PI, CMI)	1	30	5	$5800.38	$31.60	$31.60
	Available brands
	Omjjara

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14762YMP	MOMELOTINIB momelotinib 150 mg tablet, 30 (PI, CMI)	1	30	0	$5800.38	$31.60	$31.60
	Available brands
	Omjjara

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14763BMP	MOMELOTINIB momelotinib 200 mg tablet, 30 (PI, CMI)	1	30	0	$5800.38	$31.60	$31.60
	Available brands
	Omjjara

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

Authority Required

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
14769HMP	MOMELOTINIB momelotinib 100 mg tablet, 30 (PI, CMI)	1	30	0	$5800.38	$31.60	$31.60
	Available brands
	Omjjara

Source	General Schedule
Body System	ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS > ANTINEOPLASTIC AGENTS > PROTEIN KINASE INHIBITORS

Note

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
14770JMP	MOMELOTINIB momelotinib 200 mg tablet, 30 (PI, CMI)	1	30	5	$5800.38	$31.60	$31.60
	Available brands
	Omjjara