DOXYCYCLINE

DOXYCYCLINE (14484H)

doxycycline 50 mg modified release capsule, 25
14484H
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Bronchiectasis

Restriction

Indication: Chronic bronchitis

Restriction

Indication: Severe acne
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 50 # of repeats: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Doryx
*Additional charge for this brand is $9.48
 DPMQ: $29.66 Max safety net: $21.72 General Patient Charge: $33.99
Mayne Pharma Doxycycline
*Additional charge for this brand is $4.82
 DPMQ: $25.00 Max safety net: $21.72 General Patient Charge: $29.33