CITRIC ACID + LAURYL SULFOACETATE SODIUM + SORBITOL

sodium citrate dihydrate 450 mg/5 mL + lauryl sulfoacetate sodium 45 mg/5 mL + sorbitol 3.125 g/5 mL enema, 12 x 5 mL

CITRIC ACID + LAURYL SULFOACETATE SODIUM + SORBITOL (5331N)

sodium citrate dihydrate 450 mg/5 mL + lauryl sulfoacetate sodium 45 mg/5 mL + sorbitol 3.125 g/5 mL enema, 12 x 5 mL
5331N
Body System:
Manner of administration:Rectal
Palliative Care
Restricted Benefit

Restriction

Indication: Constipation
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 2 # of repeats: 3 DPMQ: $37.54 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Micolette