ACUTE MEDICATION FORMULARY 2020 - FishMed12232019123547 PM... · SANDOZ CO -AMOXICLAV BD 1000 3 fills per annum Below 704049 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875 -125

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ACUTE MEDICATION FORMULARY

2020

NOTE:

Reference pricing is applied. Patients are advised to discuss the availability of less expensive generics with the pharmacist at the point of dispensing.

If a product is dispensed that is more expensive than the reference price, the patient will need to pay the difference in price at the point of dispensing.

Quantity limits apply to some items on this formulary. Quantities in excess of this limit will need to be funded by the member at the point of dispensing, unless an

authorisation has been obtained for a greater quantity.

The formulary is subject to regular review. Momentum Health reserves the right to update and change the formulary when new information becomes available, prices

change or when new medicines are released.

While every effort has been made to ensure that products listed are available on the market, it is possible that some products may be discontinued by the manufacturers

during the course of the year. Should this be the case, patients are advised to discuss alternatives with the pharmacist or the prescribing doctor.

Nappi code

Therapeutic group Active ingredient Product label name Limitation Above/ below medicine reference price

780081 ANTI-MICROBIALS Penicillin V Potassium Tab 250 MG BETAPEN 250MG TABS 3 fills per annum Below

751111 ANTI-MICROBIALS Penicillin V Potassium For Soln 125 MG/5ML BETAPEN 125MG/5ML SYR 3 fills per annum Below

716611 ANTI-MICROBIALS Penicillin V Potassium For Soln 125 MG/5ML ATHLONE PHENOXYMETHYLPENICIL

3 fills per annum Below

704401 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG AMOXICAPS 250MG CAPS 3 fills per annum Below

704443 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG ALLMOX 250MG CAPS 3 fills per annum Below

744689 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG MOXYPEN 250MG CAPS 3 fills per annum Below

784656 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG AMOCILLIN 250MG CAPS 3 fills per annum Above

785229 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG ADCO-AMOX 250MG CAPS 3 fills per annum Above

788155 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG BETAMOX 250MG CAPS 3 fills per annum Above

806579 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG MOXYMAX 250MG CAPS 3 fills per annum Below

808539 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG ZOXIL 250MG CAPS 3 fills per annum Above

808741 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG PROMOXIL 250MG CAPS 3 fills per annum Below

Page 2 of 43

Nappi code


815268 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG IPCAMOX 250MG CAPS 3 fills per annum Below

707499 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG AUSTELL-AMOXICILLIN 250MG CAPS


708398 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG ZALOXY 250MG CAPS 3 fills per annum Above

713363 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG AURO-AMOXYCILLIN 250MG CAPS


714185 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG AMYN 250MG CAPS 3 fills per annum Below

716122 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG YOMAX 250MG CAPS 3 fills per annum Below

3000309 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 250 MG INDO AMOXYCILLIN 250MG CAPS

3 fills per annum Above

704444 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG ALLMOX 500MG CAPS 3 fills per annum Below

744697 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG MOXYPEN 500MG CAPS 3 fills per annum Below

788546 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG BETAMOX 500MG CAPS 3 fills per annum Above

806587 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG MOXYMAX 500MG CAPS 3 fills per annum Below

808547 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG ZOXIL 500MG CAPS 3 fills per annum Above

808768 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG PROMOXIL 500MG CAPS 3 fills per annum Below

811440 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG ADCO-AMOX 500MG CAPS 3 fills per annum Above

824879 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG RANMOXY 500MG CAPS 3 fills per annum Below

705637 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG AUSTELL-AMOXICILLIN 500MG CAPS


708397 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG ZALOXY 500MG CAPS 3 fills per annum Below

713364 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG AURO-AMOXYCILLIN 500MG CAPS


714184 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG AMYN 500MG CAPS 3 fills per annum Below

716123 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG YOMAX 500MG CAPS 3 fills per annum Above

3000310 ANTI-MICROBIALS Amoxicillin (Trihydrate) Cap 500 MG INDO AMOXYCILLIN 500MG CAPS


829145 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML AMOXIL S 125MG SUSP 3 fills per annum Above

829358 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML BETAMOX S 125MG/5ML SUSP 3 fills per annum Below

830275 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML MOXYMAX S 125MG/5ML SUSP


830291 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML MOXYPEN 125 SUSP 3 fills per annum Below

830488 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML PROMOXIL S 125MG/5ML 3 fills per annum Below

830534 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML SALTERMOX S 125MG/5ML 3 fills per annum Below

830739 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML ZOXIL S 125MG/5ML SUSP 3 fills per annum Below

708396 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML ZALOXY 125MG/5ML SUSP 3 fills per annum Below

Page 3 of 43

Nappi code


714179 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML ALLMOX S 125MG/5ML SUSP 3 fills per annum Below

714182 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 125 MG/5ML AMYN S 125MG/5ML SUSP 3 fills per annum Below

829102 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML ADCO-AMOX 250MG SUSP 3 fills per annum Below

829153 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML AMOXIL SF 250MG SUSP 3 fills per annum Above

830283 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML MOXYMAX 250 SUSP 3 fills per annum Below

830305 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML MOXYPEN 250MG/5ML SUSP 3 fills per annum Below

830496 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML PROMOXIL SF 250MG/5ML 3 fills per annum Below

830747 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML ZOXIL SF 250MG/5ML SUSP 3 fills per annum Below

708395 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML ZALOXY 250MG/5ML SUSP 3 fills per annum Below

714180 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML ALLMOX SF 250MG/5ML SUSP 3 fills per annum Below

714183 ANTI-MICROBIALS Amoxicillin (Trihydrate) For Susp 250 MG/5ML AMYN SF 250MG/5ML SUSP 3 fills per annum Below

809632 ANTI-MICROBIALS Cloxacillin Sodium Cap 250 MG CLOXIN 250MG CAPS 3 fills per annum Below

809640 ANTI-MICROBIALS Cloxacillin Sodium Cap 500 MG CLOXIN 500MG CAPS 3 fills per annum Below

781231 ANTI-MICROBIALS Floxacillin Sodium Cap 250 MG SANDOZ FLUCLOXACILLIN 250MG


710308 ANTI-MICROBIALS Floxacillin Sodium Cap 250 MG FLUPEN 250MG CAPS 3 fills per annum Below

723163 ANTI-MICROBIALS Floxacillin Sodium Cap 250 MG MEDREICH FLUCLOXACILLIN 250MG


705691 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG AUGMENTIN 375MG TABS 3 fills per annum Above

842516 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG CLAMENTIN 375MG TABS 3 fills per annum Below

861936 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG AUGMAXCIL 375MG TABS 3 fills per annum Above

865532 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG BIO-AMOKSIKLAV TABS 3 fills per annum Below

867373 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG RANCLAV 375MG TABS 3 fills per annum Above

878766 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG SANDOZ CO-AMOXYCLAV 375 MG


707184 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG AMOCLAN TABS 3 fills per annum Below

707407 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG AUSTELL CO-AMOXICLAV 375MG


707663 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG APEX-CLAVUTIN 375MG TABS 3 fills per annum Below

713381 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG AURO-AMOXICLAV 375MG TABS


716124 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG BINDOCLAV 375MG TABS 3 fills per annum Above

721444 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG BETACLAV 375MG TABS 3 fills per annum Below

3000394 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG MYCLAV 375MG TABS 3 fills per annum Below

Page 4 of 43

Nappi code


3000747 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 250-125 MG ADCO AMOXYCLAV 375MG TABS


701736 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG SANDOZ CO-AMOXICLAV 625MG TABS


704047 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG CURAM 625MG TABS 3 fills per annum Above

861944 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG AUGMAXCIL 625MG TABS 3 fills per annum Above

867381 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG RANCLAV 625MG TABS 3 fills per annum Above

865524 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG BIO-AMOKSIKLAV 625MG TABS 3 fills per annum Below

707185 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG AMOCLAN FORTE TABS 3 fills per annum Above

707408 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG AUSTELL CO-AMOXICLAV 625MG


707665 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG APEX-CLAVUTIN 625MG TABS 3 fills per annum Below



716125 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG BINDOCLAV 625MG TABS 3 fills per annum Below


3000395 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG MYCLAV 625MG TABS 3 fills per annum Below

3000748 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 500-125 MG ADCO AMOXYCLAV 625MG TABS


703356 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG SANDOZ CO-AMOXICLAV BD 1000


704049 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG CURAM 1000GM BD TABS 3 fills per annum Below

704484 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG AMOCLAN BID 1000MG TABS 3 fills per annum Above

853542 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG AUGMENTIN 1000MG BD TABS 3 fills per annum Above

708893 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG RANCLAV 1000MG TABS 3 fills per annum Below

709232 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG CLAMENTIN 1000MG TABS 3 fills per annum Below

708387 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG BIO-AMOKSIKLAV 1000MG TABS





716126 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG BINDOCLAV 1000MG TABS 3 fills per annum Above

720898 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875-125 MG ADCO-AMOXYCLAV BD 1000MG TABS


829269 ANTI-MICROBIALS Amoxicillin & K Clavulanate For Susp 125-31.25 MG/5ML

AUGMENTIN S SUSP 3 fills per annum Above


CLAMENTIN S 3 fills per annum Above

Page 5 of 43

Nappi code



AUGMAXCIL S 3 fills per annum Below


BIO-AMOKSILAV 3 fills per annum Below


SANDOZ AMOCLAV S 3 fills per annum Below


RANCLAV SUSPENSION 3 fills per annum Below


AMOCLAN S SUSP 3 fills per annum Below


AURO-AMOXICLAV 125/31.25MG



AUGMENTIN BD S SUSP 3 fills per annum Above


AUSTELL CO-AMOXICLAV BD S SUSP



AUGMENTIN SF SUSP 3 fills per annum Above


CLAMENTIN SF 3 fills per annum Above


AUGMAXCIL SF 3 fills per annum Below


BIO-AMOKSIKLAV 3 fills per annum Below


SANDOZ AMOCLAV SF 3 fills per annum Below


RANCLAV FORTE SUSPENSION 3 fills per annum Below


AMOCLAN SF SUSP 3 fills per annum Below


APEX-CLAVUTIN SF 3 fills per annum Below


AURO-AMOXICLAV 250/62.5 MG


704068 ANTI-MICROBIALS Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML AUGMENTIN BD SF SUSP 3 fills per annum Above

705471 ANTI-MICROBIALS Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML SANDOZ CO-AMOCLAV BD SF 3 fills per annum Below

705832 ANTI-MICROBIALS Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML CURAM BD SUSP 3 fills per annum Above

722938 ANTI-MICROBIALS Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML AUSTELL CO-AMOXICLAV BD SF SUS


719283 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab Disint 500-125 MG SANDOZ CO-AMOXYCLAV 625MG DISP


703903 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab Disint 875-125 MG FORCID SOLUTAB 875/125 3 fills per annum Below

Page 6 of 43

Nappi code


719284 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab Disint 875-125 MG SANDOZ CO-AMOXYCLAV 1000MG


723109 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab Disint 875-125 MG KLAVIMAXCIL 1000MG DISP TABS


797561 ANTI-MICROBIALS Amoxicillin-Floxacillin Sodium Cap 250-250 MG MACROPEN CAPS 3 fills per annum Below

830208 ANTI-MICROBIALS Amoxicillin-Floxacillin Sodium For Susp 125-125 MG/5ML

MACROPEN SUSP 3 fills per annum Below

830909 ANTI-MICROBIALS Cephalexin Cap 250 MG RANCEPH 250MG CAPS 3 fills per annum Above

897880 ANTI-MICROBIALS Cephalexin Cap 250 MG CPL ALLIANCE CEPHALEXIN 250MG


837253 ANTI-MICROBIALS Cephalexin Cap 500 MG RANCEPH 500MG CAPS 3 fills per annum Below

897887 ANTI-MICROBIALS Cephalexin Cap 500 MG CPL ALLIANCE CEPHALEXIN 500MG


706327 ANTI-MICROBIALS Cephalexin Cap 500 MG BELEX 500MG CAPS 3 fills per annum Below

860603 ANTI-MICROBIALS Cephalexin For Susp 125 MG/5ML RANCEPH 125MG/5ML SUSP 3 fills per annum Below

860611 ANTI-MICROBIALS Cephalexin For Susp 250 MG/5ML RANCEPH 250MG/5ML SUSP 3 fills per annum Below

700689 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG CEROXIM 250MG 3 fills per annum Below

703697 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG ZEFROXE 250MG TABS 3 fills per annum Above

703867 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG SANDOZ CEFUROXIME 250MG TABS


781339 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG ZINNAT 250MG TABS 3 fills per annum Above

704988 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG CEFU-HEXAL 250MG 3 fills per annum Above

707371 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG CUROAX 250MG TABS 3 fills per annum Below

713531 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG AUROXIME 250MG TABS 3 fills per annum Below

713006 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG ZEFURIME 250MG TABS 3 fills per annum Below

715142 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG ZINOXIME 250MG TABS 3 fills per annum Below

717799 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG ALKOXIME 250MG TABS 3 fills per annum Below

718658 ANTI-MICROBIALS Cefuroxime Axetil Tab 250 MG CEFASYN 250MG TABS (WAS POXIM)


700687 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG CEROXIM 500MG 3 fills per annum Below

703695 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG ZEFROXE 500MG TABS 3 fills per annum Above

703868 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG SANDOZ CEFUROXIME 500MG TABS


713007 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG ZEFURIME 500MG TABS 3 fills per annum Below

781347 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG ZINNAT 500MG TABS 3 fills per annum Above

704990 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG CEFU-HEXAL 500MG TABS 3 fills per annum Above

Page 7 of 43

Nappi code


710531 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG BETAROXIME T 500MG TABS 3 fills per annum Below

713532 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG AUROXIME 500MG TABS 3 fills per annum Below

715261 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG ZINOXIME 500MG TABS 3 fills per annum Below

717992 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG ORCHID CEFUROXIME 500MG TABS


717801 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG ALKOXIME 500MG TABS 3 fills per annum Below

718659 ANTI-MICROBIALS Cefuroxime Axetil Tab 500 MG CEFASYN 500MG TABS (WAS POXIM)


814091 ANTI-MICROBIALS Cefuroxime Axetil For Susp 125 MG/5ML ZINNAT 125MG/5ML SUSP 3 fills per annum Above

710077 ANTI-MICROBIALS Cefuroxime Axetil For Susp 125 MG/5ML SANDOZ CEFUROXIME 125MG/5ML


723411 ANTI-MICROBIALS Cefuroxime Axetil For Susp 125 MG/5ML CEROXIM 125MG/5ML SUSP 3 fills per annum Below

715656 ANTI-MICROBIALS Cefixime Tab 400 MG FIXIME 400MG TABS 3 fills per annum Below

703460 ANTI-MICROBIALS Ceftriaxone Sodium For Inj 250 MG SABAX CEFTRIAXONE 250MG POWD


761257 ANTI-MICROBIALS Ceftriaxone Sodium For Inj 250 MG ROCEPHIN 250MG/VIAL 3 fills per annum Above

707948 ANTI-MICROBIALS Ceftriaxone Sodium For Inj 250 MG FRESENIUS-CEFTRIAXONE 250MG


709240 ANTI-MICROBIALS Ceftriaxone Sodium For Inj 250 MG CEFTRIAXONE-SAFELINE VIAL POWD


713200 ANTI-MICROBIALS Ceftriaxone Sodium For Inj 250 MG MEDAXONE 250MG INJ 3 fills per annum Below

714188 ANTI-MICROBIALS Ceftriaxone Sodium For Inj 250 MG TRIAPHIN VIAL 5ML 250MG INJ 3 fills per annum Below

709334 ANTI-MICROBIALS Erythromycin Stearate Tab 250 MG MERCK-ERYTHROMYCIN 250MG TABS


710310 ANTI-MICROBIALS Erythromycin Stearate Tab 250 MG ERYKO 250MG TABS 3 fills per annum Below

719683 ANTI-MICROBIALS Erythromycin Stearate Tab 250 MG RACEMIN 250MG TABS 3 fills per annum Below

758388 ANTI-MICROBIALS Erythromycin Estolate Cap 250 MG PURMYCIN 250MG CAPS 3 fills per annum Above

780561 ANTI-MICROBIALS Erythromycin Estolate Cap 250 MG ADCO-ERYTHROMYCIN 250 CAPS


824682 ANTI-MICROBIALS Erythromycin Estolate Cap 250 MG XERAMEL 250MG CAPS 3 fills per annum Below

758396 ANTI-MICROBIALS Erythromycin Estolate Susp 125 MG/5ML PURMYCIN 125MG/5ML SUSP 3 fills per annum Below

787108 ANTI-MICROBIALS Erythromycin Estolate Susp 125 MG/5ML ERYMYCIN P 125MG SUSP 3 fills per annum Below

793329 ANTI-MICROBIALS Erythromycin Estolate Susp 125 MG/5ML BETAMYCIN 125MG SUSP 3 fills per annum Below

823570 ANTI-MICROBIALS Erythromycin Estolate Susp 125 MG/5ML XERAMEL S SUSP 3 fills per annum Below

758418 ANTI-MICROBIALS Erythromycin Estolate Susp 250 MG/5ML PURMYCIN 250MG/5ML SUSP 3 fills per annum Above

787086 ANTI-MICROBIALS Erythromycin Estolate Susp 250 MG/5ML ERYMYCIN PF 250MG SUSP 3 fills per annum Above

Page 8 of 43

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848409 ANTI-MICROBIALS Erythromycin Estolate Susp 250 MG/5ML XERAMEL SF 250MG/5ML SUSP 3 fills per annum Below

710609 ANTI-MICROBIALS Azithromycin Cap 250 MG AZIMAX 250MG CAPS Qty limit = 12 units per annum

Above

712447 ANTI-MICROBIALS Azithromycin Cap 250 MG CLAMELLE 250MG CAPS Qty limit = 12 units per annum

Above

717496 ANTI-MICROBIALS Azithromycin Cap 250 MG VARIMAX 250MG CAPS Qty limit = 12 units per annum

Below

704032 ANTI-MICROBIALS Clarithromycin Tab 250 MG CLACEE 250MG TABS 3 fills per annum Above

707255 ANTI-MICROBIALS Clarithromycin Tab 250 MG KLARIZON 250MG TABS 3 fills per annum Below

716675 ANTI-MICROBIALS Clarithromycin Tab 250 MG KLARYVID 250MG TABS 3 fills per annum Below

720976 ANTI-MICROBIALS Clarithromycin Tab 250 MG KLARIBIN 250MG TABS 3 fills per annum Below

704033 ANTI-MICROBIALS Clarithromycin Tab 500 MG CLACEE 500MG TABS 3 fills per annum Above

704464 ANTI-MICROBIALS Clarithromycin Tab 500 MG KLARITHRAN 500MG TABS 3 fills per annum Below

705031 ANTI-MICROBIALS Clarithromycin Tab 500 MG CLARIHEXAL 500MG TABS 3 fills per annum Above

705416 ANTI-MICROBIALS Clarithromycin Tab 500 MG MYLAN CLARITHROMYCIN 500MG


707256 ANTI-MICROBIALS Clarithromycin Tab 500 MG KLARIZON 500MG TABS 3 fills per annum Below

707662 ANTI-MICROBIALS Clarithromycin Tab 500 MG APEX-CLARITHROMYCIN 500MG TABS


719921 ANTI-MICROBIALS Clarithromycin Tab 500 MG KLARYVID 500MG TABS 3 fills per annum Below

720977 ANTI-MICROBIALS Clarithromycin Tab 500 MG KLARIBIN 500MG TABS 3 fills per annum Below

704649 ANTI-MICROBIALS Clarithromycin For Susp 125 MG/5ML KLARITHRAN 125MG/5ML SUSP


830046 ANTI-MICROBIALS Clarithromycin For Susp 125 MG/5ML KLACID 125MG/5ML SUSP 3 fills per annum Above

706758 ANTI-MICROBIALS Clarithromycin For Susp 125 MG/5ML CLARIHEXAL 125 P SUSP 3 fills per annum Below

707357 ANTI-MICROBIALS Clarithromycin For Susp 125 MG/5ML KLARIBIN 125MG/5ML SUSP 3 fills per annum Above

704650 ANTI-MICROBIALS Clarithromycin For Susp 250 MG/5ML KLARITHRAN 250MG/5ML SUSP


830054 ANTI-MICROBIALS Clarithromycin For Susp 250 MG/5ML KLACID 250MG/5ML SUSP 3 fills per annum Above

706759 ANTI-MICROBIALS Clarithromycin For Susp 250 MG/5ML CLARIHEXAL 250 P SUSP 3 fills per annum Below

707358 ANTI-MICROBIALS Clarithromycin For Susp 250 MG/5ML KLARIBIN 250MG/5ML SUSP 3 fills per annum Above

721268 ANTI-MICROBIALS Clarithromycin Tab ER 24HR 500 MG CLARITHROMYCIN UNICORN 500MG X


841552 ANTI-MICROBIALS Clarithromycin Tab ER 24HR 500 MG KLACID XL 500MG TABS 3 fills per annum Above

707761 ANTI-MICROBIALS Clarithromycin Tab ER 24HR 500 MG KLARITHRAN MR 500MG TABS 3 fills per annum Below

717722 ANTI-MICROBIALS Clarithromycin Tab ER 24HR 500 MG CLARIHEXAL XL 500MG TABS 3 fills per annum Below

Page 9 of 43

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798401 ANTI-MICROBIALS Doxycycline Hyclate Cap 50 MG DUMOXIN 50MG CAPS 3 fills per annum Below

808407 ANTI-MICROBIALS Doxycycline Hyclate Cap 50 MG DOXYCYL 50MG CAPS 3 fills per annum Above

809667 ANTI-MICROBIALS Doxycycline Hyclate Cap 100 MG DOXYCYL 100MG CAPS 3 fills per annum Above

893402 ANTI-MICROBIALS Doxycycline Hyclate Cap 100 MG A-LENNON DOXYCYCLINE HCL CAPS


714192 ANTI-MICROBIALS Doxycycline Hyclate Cap 100 MG DOXYTET 100MG CAPS 3 fills per annum Below

703224 ANTI-MICROBIALS Oxytetracycline HCl Cap 250 MG PHARMATET 250MG CAPS 3 fills per annum Below

812072 ANTI-MICROBIALS Oxytetracycline HCl Cap 250 MG TETRACEM 250MG CAPS 3 fills per annum Above

884167 ANTI-MICROBIALS Oxytetracycline HCl Cap 250 MG NUCOTET CAPS 3 fills per annum Below

700284 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CPL ALLIANCE CIPROFLOXACIN 250


702377 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CIPLOXX 250MG TABS 3 fills per annum Above

703043 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CIPROGEN 250MG TABS 3 fills per annum Below

704353 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) AUSTELL CIPROFLOX 250MG TABS


784354 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CIPROBAY 250MG TABS 3 fills per annum Above

892140 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CIFRAN 250MG TABS 3 fills per annum Above

893951 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CIFLOC 250MG TABS 3 fills per annum Above

704777 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CIPROL 250MG TABS 3 fills per annum Above

708015 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) SIMAYLA CIPROFLOXACIN 250MG


713361 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) LOXIP 250MG TABS 3 fills per annum Below

713792 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) BIOTECH CIPROFLOXACIN 250MG


716518 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) CIPROFLOXACIN ACTOR 250MG TABS


719659 ANTI-MICROBIALS Ciprofloxacin HCl Tab 250 MG (Base Equiv) PROFLOXIN 250MG TABS 3 fills per annum Above

700287 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CPL ALLIANCE CIPROFLOXACIN 500


700518 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) DYNAFLOC 500MG TABS 3 fills per annum Above

701210 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) ORPIC 500MG TABS 3 fills per annum Below

702379 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CIPLOXX 500MG TABS 3 fills per annum Above

703045 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CIPROGEN 500MG TABS 3 fills per annum Below




Page 10 of 43

Nappi code


892147 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CIFRAN 500MG TABS 3 fills per annum Below

893955 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CIFLOC 500MG TABS 3 fills per annum Above

704775 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CIPROL 500MG TABS 3 fills per annum Below

708014 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) SIMAYLA CIPROFLOXACIN 500MG


713362 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) LOXIP 500MG TABS 3 fills per annum Below



716519 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CIPROFLOXACIN ACTOR 500MG TABS


719660 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) PROFLOXIN 500MG TABS 3 fills per annum Above

720331 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) FLOPRO 500MG TABS 3 fills per annum Below

723383 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) CIPROFLOXACIN UNICORN 500MG TA


3000796 ANTI-MICROBIALS Ciprofloxacin HCl Tab 500 MG (Base Equiv) BIOFLOXX 500MG TABS 3 fills per annum Below






729566 ANTI-MICROBIALS Griseofulvin Microsize Tab 125 MG MICROCIDAL 125MG TABS 3 fills per annum Below

729574 ANTI-MICROBIALS Griseofulvin Microsize Tab 500 MG MICROCIDAL 500MG TABS 3 fills per annum Below

721667 ANTI-MICROBIALS Fluconazole Cap 150 MG AURO FLUCONAZOLE 150MG CAPS


700149 ANTI-MICROBIALS Fluconazole Cap 150 MG FLUCORIC 150MG CAPS 6 fills per annum Below

700598 ANTI-MICROBIALS Fluconazole Cap 150 MG FLUZOL 150MG CAPS 6 fills per annum Above

703624 ANTI-MICROBIALS Fluconazole Cap 150 MG ASPEN FLUCONAZOLE 150MG CAPS


703635 ANTI-MICROBIALS Fluconazole Cap 150 MG DIFLUZOLE 150MG CAPS 6 fills per annum Below

704357 ANTI-MICROBIALS Fluconazole Cap 150 MG AUSTELL FLUCON 150MG CAPS 6 fills per annum Below

786373 ANTI-MICROBIALS Fluconazole Cap 150 MG DIFLUCAN 150MG CAPS 6 fills per annum Above

705384 ANTI-MICROBIALS Fluconazole Cap 150 MG MYLAN FLUCONAZOLE 150MG CAPS


711530 ANTI-MICROBIALS Fluconazole Cap 150 MG MYCOREST 150MG CAPS 6 fills per annum Below

713556 ANTI-MICROBIALS Fluconazole Cap 150 MG GULF FLUCONAZOLE 150MG CAPS


718565 ANTI-MICROBIALS Fluconazole Cap 150 MG FLUCONAZOLE UNICORN 150MG CAPS


Page 11 of 43

Nappi code


720826 ANTI-MICROBIALS Fluconazole Cap 150 MG INSEP 150MG CAPS 6 fills per annum Below

720858 ANTI-MICROBIALS Fluconazole Tab 150 MG GLENMARK FLUCONAZOLE 150MG TAB


824313 ANTI-MICROBIALS Acyclovir Tab 200 MG CYCLIVEX 200MG TABS 3 fills per annum Above

827282 ANTI-MICROBIALS Acyclovir Tab 200 MG ADCO-ACYCLOVIR TABS 3 fills per annum Above

717370 ANTI-MICROBIALS Acyclovir Tab 200 MG ACICLOVIR SANDOZ 200MG TABS


717157 ANTI-MICROBIALS Acyclovir Tab 200 MG APEX-ACYCLOVIR 200MG TABS 3 fills per annum Above

719670 ANTI-MICROBIALS Acyclovir Tab 200 MG ACYCLOVIR BIOTECH 200MG TABS


860581 ANTI-MICROBIALS Acyclovir Tab 400 MG CYCLIVEX 400MG TABS 3 fills per annum Below

717371 ANTI-MICROBIALS Acyclovir Tab 400 MG ACICLOVIR SANDOZ 400MG TABS


717158 ANTI-MICROBIALS Acyclovir Tab 400 MG APEX-ACYCLOVIR 400MG TABS 3 fills per annum Below

833703 ANTI-MICROBIALS Acyclovir Tab Disint 200 MG ZOVIRAX DISP 200MG TABS 3 fills per annum Above

838225 ANTI-MICROBIALS Acyclovir Tab Disint 200 MG LOVIRE 200MG DISP TABS 3 fills per annum Below

704778 ANTI-MICROBIALS Acyclovir Tab Disint 200 MG ACITAB-200 DISP TABS 3 fills per annum Below

838233 ANTI-MICROBIALS Acyclovir Tab Disint 400 MG LOVIRE 400MG DISP TABS 3 fills per annum Below

704779 ANTI-MICROBIALS Acyclovir Tab Disint 400 MG ACITAB-400 DISP TABS 3 fills per annum Above

876089 ANTI-PROTOZOALS Artemether-Lumefantrine Tab 20-120 MG COARTEM TABS 1 fill per annum Below

712381 ANTHELMINTICS Albendazole Tab 400 MG ZENTEL 400MG TABS 2 fills per annum Below

789720 ANTHELMINTICS Albendazole Susp 100 MG/5ML ZENTEL 100MG/5ML SUSP 2 fills per annum Below

703063 ANTHELMINTICS Mebendazole Tab 100 MG ADCO-WORMEX TABS 2 fills per annum Below

810533 ANTHELMINTICS Mebendazole Tab 100 MG WORMGO 100MG TABS 2 fills per annum Below

845671 ANTHELMINTICS Mebendazole Tab 100 MG WORMSTOP 100MG TABS 2 fills per annum Below

878227 ANTHELMINTICS Mebendazole Tab 100 MG CIPEX 100MG TABS 2 fills per annum Above

704656 ANTHELMINTICS Mebendazole Tab 500 MG ADCO-WORMEX 500MG TABS 2 fills per annum Below

807524 ANTHELMINTICS Mebendazole Tab 500 MG VERMOX SD 500MG TABS 2 fills per annum Above

833894 ANTHELMINTICS Mebendazole Tab 500 MG D-WORM SD TABS 2 fills per annum Above

845701 ANTHELMINTICS Mebendazole Tab 500 MG WORMSTOP 500MG TABS 2 fills per annum Above

775606 ANTHELMINTICS Mebendazole Susp 20 MG/ML VERMOX 100MG/5ML SUSP 2 fills per annum Above

828297 ANTHELMINTICS Mebendazole Susp 20 MG/ML CIPEX SUSP 2 fills per annum Below

845698 ANTHELMINTICS Mebendazole Susp 20 MG/ML WORMSTOP SUSP 2 fills per annum Below

881546 ANTHELMINTICS Mebendazole Susp 50 MG/ML VERMOX SD 500MG/10ML 2 fills per annum Below

Page 12 of 43

Nappi code


828424 ANTHELMINTICS Piperazine Citrate Syrup 500 MG/5ML SB TOX WORM SYR 2 fills per annum Below

708607 ANTHELMINTICS Praziquantel Tab 600 MG BILTRICIDE 600MG TABS 1 fill per annum Below

703389 ANTI-MICROBIALS Metronidazole Tab 200 MG ANAEROBYL 200MG TABS 3 fills per annum Below

726346 ANTI-MICROBIALS Metronidazole Tab 200 MG FLAGYL 200MG TABS 3 fills per annum Above

742872 ANTI-MICROBIALS Metronidazole Tab 200 MG ADCO-METRONIDAZOLE 200MG TABS


772216 ANTI-MICROBIALS Metronidazole Tab 200 MG TRICHAZOLE 200MG TABS 3 fills per annum Below

784710 ANTI-MICROBIALS Metronidazole Tab 200 MG MEDAMET 200MG TABS 3 fills per annum Below

821705 ANTI-MICROBIALS Metronidazole Tab 200 MG BE-METRAZOLE 200MG TABS 3 fills per annum Below

701076 ANTI-MICROBIALS Metronidazole Tab 400 MG ADCO-METRONIDAZOLE 400MG TABS


702148 ANTI-MICROBIALS Metronidazole Tab 400 MG AMZOLE 400MG TABS 3 fills per annum Below

726354 ANTI-MICROBIALS Metronidazole Tab 400 MG FLAGYL 400MG TABS 3 fills per annum Above

772224 ANTI-MICROBIALS Metronidazole Tab 400 MG TRICHAZOLE 400MG TABS 3 fills per annum Above

779822 ANTI-MICROBIALS Metronidazole Tab 400 MG METRAZOLE 400MG TABS 3 fills per annum Below

783544 ANTI-MICROBIALS Metronidazole Tab 400 MG METROSTAT 400MG TABS 3 fills per annum Above

788708 ANTI-MICROBIALS Metronidazole Tab 400 MG BE-METRAZOLE 400MG TABS 3 fills per annum Below

792136 ANTI-MICROBIALS Metronidazole Tab 400 MG SUPRAZOLE 400MG TABS 3 fills per annum Below

793167 ANTI-MICROBIALS Metronidazole Tab 400 MG METAZOL 400MG TABS 3 fills per annum Below

715866 ANTI-MICROBIALS Metronidazole Tab 400 MG ANAEROBYL 400MG TABS 3 fills per annum Below

726338 ANTI-MICROBIALS Metronidazole Susp 200 MG/5ML FLAGYL 200MG/5ML SUSP 3 fills per annum Below

717347 ANTI-MICROBIALS Clindamycin HCl Cap 150 MG DALACIN C 150MG CAPS 3 fills per annum Above

849960 ANTI-MICROBIALS Clindamycin HCl Cap 150 MG CLINDAHEXAL 150MG CAPS 3 fills per annum Below

704095 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG ILVITRIM TABS 3 fills per annum Below

706434 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG BACTRIM TABS 3 fills per annum Above

716731 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG COZOLE TABS 3 fills per annum Below

721751 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG DUROBAC TABS 3 fills per annum Above

735698 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG LAGATRIM 480MG TABS 3 fills per annum Below

789836 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG TRIMETHOX TABS 3 fills per annum Below

793698 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG XEROPRIM 480MG TABS 3 fills per annum Above

867977 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG NUCOTRIM 480MG TABS 3 fills per annum Below

715609 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG TRIXAZOLE 480MG TABS 3 fills per annum Below

3000786 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 400-80 MG NOVATRIM 400MG/80MG TABS


Page 13 of 43

Nappi code


706442 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 800-160 MG BACTRIM DS TABS 3 fills per annum Above

758256 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 800-160 MG PURBAC DS TABS 3 fills per annum Below

782793 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 800-160 MG SANDOZ CO-TRIMOXAZOLE 960 TABS


3000247 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Tab 800-160 MG CO-TRIMOXAZOLE ASCENDIS DS TAB


758221 ANTI-MICROBIALS Sulfamethoxazole-Trimethoprim Susp 200-40 MG/5ML

PURBAC SUSP 3 fills per annum Below


CO-TRIM SUSP 3 fills per annum Below


DOCTRIM SUSP 3 fills per annum Below


ILVITRIM SUSP 3 fills per annum Below

732826 BIOLOGICALS Influenza Virus Vaccine Whole Inj INFLUVAC 0.5ML 1 fill per annum Below

813338 BIOLOGICALS Influenza Virus Vaccine Split IM Susp VAXIGRIP S/DOSE 0.5ML PREFILL

1 fill per annum Below

836591 BIOLOGICALS Influenza Virus Vaccine Split IM Susp VAXIGRIP S/DOSE 0.25ML PAED


797596 ENDOCRINE SYSTEM Betamethasone Syrup 0.6 MG/5ML STEROMIEN 0.6MG/5ML SYR Max age = 10; 3 fills per annum

Below

826936 ENDOCRINE SYSTEM Betamethasone Syrup 0.6 MG/5ML BETANOID 0.6MG/5ML SYR Max age = 10; 3 fills per annum

Below

703720 ENDOCRINE SYSTEM Prednisolone Tab 5 MG PRELONE 5MG TABS 3 fills per annum Above

800155 ENDOCRINE SYSTEM Prednisolone Tab 5 MG LENISOLONE 5MG TABS 3 fills per annum Below

814407 ENDOCRINE SYSTEM Prednisolone Tab 5 MG CAPSOID 5MG TABS 3 fills per annum Below

805149 ENDOCRINE SYSTEM Prednisolone Syrup 15 MG/5ML (USP Solution Equivalent)

PRELONE 15MG/5ML SYRP Max age = 10; 3 fills per annum

Above


ASPELONE 15MG/5ML SYRP Max age = 10; 3 fills per annum

Below


ADCO PREDNISOLONE 15MG/5ML

Max age = 10; 3 fills per annum

Below

742732 ENDOCRINE SYSTEM Prednisone Tab 5 MG METICORTEN 5MG TABS 3 fills per annum Above

752304 ENDOCRINE SYSTEM Prednisone Tab 5 MG PANAFCORT 5MG TABS 3 fills per annum Below

788783 ENDOCRINE SYSTEM Prednisone Tab 5 MG BE-TABS PREDNISONE 5MG TABS


818267 ENDOCRINE SYSTEM Prednisone Tab 5 MG TROLIC 5MG TABS 3 fills per annum Below

757934 ENDOCRINE SYSTEM Medroxyprogesterone Acetate Tab 5 MG PROVERA 5MG TABS 3 fills per annum Below

808245 ENDOCRINE SYSTEM Medroxyprogesterone Acetate Tab 10 MG PROVERA 10MG TABS 3 fills per annum Below

702072 AUTACOIDS Chlorpheniramine Maleate Tab 4 MG ALLERGEX 4MG TABS 4 fills per annum Above

Page 14 of 43

Nappi code


703162 AUTACOIDS Chlorpheniramine Maleate Tab 4 MG RHINETON 4MG TABS 4 fills per annum Below

702145 AUTACOIDS Chlorpheniramine Maleate Syrup 2 MG/5ML ALLERGEX 2MG/5ML SYR 4 fills per annum Below

754749 AUTACOIDS Promethazine HCl Tab 10 MG PHENERGAN 10MG TABS 4 fills per annum Below

754757 AUTACOIDS Promethazine HCl Tab 25 MG PHENERGAN 25MG TABS 4 fills per annum Below

710873 AUTACOIDS Promethazine HCl Syrup 5 MG/5ML BRUNAZINE 5MG/5ML 4 fills per annum Above

736244 AUTACOIDS Promethazine HCl Syrup 5 MG/5ML LENAZINE 5MG/5ML SYRP 4 fills per annum Below

757373 AUTACOIDS Promethazine HCl Syrup 5 MG/5ML PROHIST 5MG/5ML SYRP 4 fills per annum Below

786837 AUTACOIDS Promethazine HCl Syrup 5 MG/5ML BIOHIST SYR 4 fills per annum Below

703314 AUTACOIDS Cetirizine HCl Tab 10 MG TEXA ALLERGY 10MG TABS 4 fills per annum Above

703315 AUTACOIDS Cetirizine HCl Tab 10 MG ALLECET 10MG TABS 4 fills per annum Above

703821 AUTACOIDS Cetirizine HCl Tab 10 MG ALLERMINE 10MG TABS 4 fills per annum Above

703864 AUTACOIDS Cetirizine HCl Tab 10 MG CETIRIZINE-HEXAL 10MG TABS 4 fills per annum Below

704188 AUTACOIDS Cetirizine HCl Tab 10 MG ASPEN CETIRIZINE 10MG TABS 4 fills per annum Above

704359 AUTACOIDS Cetirizine HCl Tab 10 MG AUSTELL CETIRIZINE 10MG TABS


704659 AUTACOIDS Cetirizine HCl Tab 10 MG ZYNCET 10MG TABS 4 fills per annum Below

785377 AUTACOIDS Cetirizine HCl Tab 10 MG ZYRTEC 10MG TABS 4 fills per annum Above

712890 AUTACOIDS Cetirizine HCl Tab 10 MG ACUZYRT 10MG TABS 4 fills per annum Above

712764 AUTACOIDS Cetirizine HCl Tab 10 MG ZETOP 10MG TABS 4 fills per annum Below

718452 AUTACOIDS Cetirizine HCl Tab 10 MG TRANTRIN 10MG TABS 4 fills per annum Below

720664 AUTACOIDS Cetirizine HCl Tab 10 MG ZINALLERG 10MG TABS 4 fills per annum Below

720846 AUTACOIDS Cetirizine HCl Tab 10 MG GULF CETIRIZINE 10MG TABS 4 fills per annum Below

720873 AUTACOIDS Cetirizine HCl Tab 10 MG CETICIT 10MG TABS 4 fills per annum Below

722334 AUTACOIDS Cetirizine HCl Tab 10 MG ZELARY 10MG TABS 4 fills per annum Above

722488 AUTACOIDS Cetirizine HCl Tab 10 MG CETIRIZINE DIS-CHEM 10MG TABS


723164 AUTACOIDS Cetirizine HCl Tab 10 MG SENSAHIST 10MG TABS 4 fills per annum Below

700899 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) ZETOP 5MG/5ML ORAL SOLN 4 fills per annum Above

703313 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) ALLECET 5MG/5ML SYRUP 4 fills per annum Below

820946 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) ZYRTEC 1MG/ML ORAL SOLN 4 fills per annum Above

707224 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) CETICIT 1MG/ML SYRP 4 fills per annum Above

708117 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) CETIRIZINE-HEXAL 1MG/1ML SOLN


710672 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) TEXA ALLERGY 5MG/5ML SOLN 4 fills per annum Below

Page 15 of 43

Nappi code


712889 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) ACUZYRT 5MG/5ML ORAL SOLN


713231 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) ASPEN CETIRIZINE 5MG/5ML SOLN


717812 AUTACOIDS Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML) ZELARY 1MG/ML ORAL SOLN 4 fills per annum Below

700092 AUTACOIDS Loratadine Tab 10 MG LAURA 10 TABS 4 fills per annum Below

701361 AUTACOIDS Loratadine Tab 10 MG POLLENTYME 10MG TABS 4 fills per annum Above

702159 AUTACOIDS Loratadine Tab 10 MG CLARINESE 10MG TABS 4 fills per annum Above

702518 AUTACOIDS Loratadine Tab 10 MG LORANO 10MG TABS 4 fills per annum Above

704275 AUTACOIDS Loratadine Tab 10 MG ALLERGEX NON DROWSY TABS 4 fills per annum Below

785113 AUTACOIDS Loratadine Tab 10 MG CLARITYNE 10MG TABS 4 fills per annum Below

899430 AUTACOIDS Loratadine Tab 10 MG AP-LORATADINE 10MG TABS 4 fills per annum Above

704780 AUTACOIDS Loratadine Tab 10 MG CIPLA-LORATADINE 10MG TABS


705359 AUTACOIDS Loratadine Tab 10 MG LORFAST 10MG TABS 4 fills per annum Below

705410 AUTACOIDS Loratadine Tab 10 MG RHINIGINE 10MG TABS 4 fills per annum Above

707313 AUTACOIDS Loratadine Tab 10 MG LORHAY 10MG TABS 4 fills per annum Below

713908 AUTACOIDS Loratadine Tab 10 MG LORMEG 10MG TABS 4 fills per annum Above

717051 AUTACOIDS Loratadine Tab 10 MG AUSTELL LORATADINE 10MG TABS


3000616 AUTACOIDS Loratadine Tab 10 MG BIOTECH LORATADINE 10MG TABS


701640 AUTACOIDS Loratadine Syrup 5 MG/5ML ALLERGEX NON DROWSY SYRP 4 fills per annum Below

703918 AUTACOIDS Loratadine Syrup 5 MG/5ML POLLENTYME S 4 fills per annum Below

789291 AUTACOIDS Loratadine Syrup 5 MG/5ML CLARITYNE 5MG/5ML SYRP 4 fills per annum Above

704886 AUTACOIDS Loratadine Syrup 5 MG/5ML AP LORATADINE 5MG/5ML SYRP


705102 AUTACOIDS Loratadine Syrup 5 MG/5ML CLARINESE SYRP 4 fills per annum Below

767212 RESPIRATORY SYSTEM Pseudoephedrine HCl Tab 60 MG SUDAFED SINUS ND TABS 3 fills per annum Above

796972 RESPIRATORY SYSTEM Pseudoephedrine HCl Tab 60 MG ADCO-SUFEDRIN 60MG TABS 3 fills per annum Below

808571 RESPIRATORY SYSTEM Pseudoephedrine HCl Tab 60 MG SINU-MED 60MG TABS 3 fills per annum Above

702620 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.025% DRINASAL PAED MET SPRAY 2 fills per annum Below

732338 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.025% ILIADIN PAED 0.25% MET SPR 2 fills per annum Above

720643 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.025% ZADIN 0.025% NASAL SPRAY 10ML


721387 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% DRISTAN LL N/SPRAY 15ML 2 fills per annum Below

Page 16 of 43

Nappi code


721441 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% DRIXINE 0.05% N/SPRAY 20ML 2 fills per annum Below

732265 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% ILIADIN ADULT 0.05% MET SPR 2 fills per annum Above

732303 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% ILIADIN PLASTIC NASAL SPR 20ML


783870 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% DRISTAN LL MET PUMP 15ML 2 fills per annum Below

814199 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% DRIXINE ADULT M/S 10ML 2 fills per annum Above

720644 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% ZADIN 0.05% NASAL SPRAY 10ML


721976 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% DRIXINE 0.05% METERED SPR 20ML


723748 EAR, NOSE AND THROAT Oxymetazoline HCl Nasal Soln 0.05% OXYSPRAY MOISTURE 0.05% NAS


836141 EAR, NOSE AND THROAT Phenylephrine HCl Nasal Soln 0.25% NAPHENSYL 0.25% DRP 10ML 2 fills per annum Below

836133 EAR, NOSE AND THROAT Phenylephrine HCl Nasal Soln 1% NAPHENSYL 1% DRP 10ML 2 fills per annum Below

820709 EAR, NOSE AND THROAT Beclomethasone Dipropionate Nasal Soln 0.05% BECLATE AQUANASE 50MCG 150D


897937 EAR, NOSE AND THROAT Beclomethasone Dipropionate Nasal Soln 0.05% CLENIL AQUEOUS 3 fills per annum Below

704383 EAR, NOSE AND THROAT Fluticasone Propionate Nasal Susp 50 MCG/ACT FLOMIST AQ NASAL SPRAY 3 fills per annum Below

787795 EAR, NOSE AND THROAT Fluticasone Propionate Nasal Susp 50 MCG/ACT FLIXONASE AQ NASAL SPRAY 3 fills per annum Above

714595 EAR, NOSE AND THROAT Fluticasone Propionate Nasal Susp 50 MCG/ACT FLONASE 120 DOSE 50MCG AQS


704114 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% CHAMIFLOR OCEAN NASAL SPR 3 fills per annum Below

834882 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% SALEX SOLN 30ML 3 fills per annum Below

705007 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% NASAL C SPRAY 25ML 3 fills per annum Below

705831 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% SINUTAB COMF/CARE SALINE 3 fills per annum Below

708578 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% NAZOLEX 25ML NASAL SPRAY 3 fills per annum Below

710021 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% SIMPLY SALINE NASAL SPRAY 3 fills per annum Below

710953 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% CLICKS SALINE NAS 3 fills per annum Below

715096 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% SPRINGBOK PAED NASAL SPRAY 50M


715097 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% SPRINGBOK ADULT NASAL SPRAY 30


714893 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% JUST SALINE NASAL SPR 30ML 3 fills per annum Below

717507 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% SINUSALTS NASAL SPRAY 30ML 3 fills per annum Below

717810 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% SALEX SALINE PAED MET NASAL SP


Page 17 of 43

Nappi code


722152 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% DISCHEM SALINE NASAL SPRAY 100


722153 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% DISCHEM SALINE NASAL SPRAY 50M


722156 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% CONGIVIL SALINE NASAL SPRAY 50


722157 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% CONGIVIL SALINE NASAL SPRAY 10


722155 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% DISCHEM SALINE NASAL SPRAY BAB


722158 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% CONGIVIL SALINE NASAL SPRAY BA


722442 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% BRUNEL SALINE NASAL SPRAY 60ML


722926 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% FLO SALINE PLUS 30ML NASAL 3 fills per annum Below

723083 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% CLICKS NASAL SPRAY 100ML 3 fills per annum Below

723111 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% XCLEAR SALINE W/ XYLITOL 45ML


723112 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% KIDS XCLEAR SALINE W/ XYLITOL


724007 EAR, NOSE AND THROAT Saline Nasal Spray 0.9% NASOCLEAR NASAL SPRAY 20ML


703661 EAR, NOSE AND THROAT Phenylephrine-Naphazoline Nasal Soln 2.5-0.25 MG/ML

JACKS THICK NOSE DROPS 2 fills per annum Above


ENT DROPS 25ML 2 fills per annum Above


ENT SPRAY 25ML 2 fills per annum Above


NASDRO DROPS 15ML 2 fills per annum Above


SINUS S NASAL DROPS 2 fills per annum Above


UNIVERSAL NOSE DROPS 15ML 2 fills per annum Below


NITRO DROPS 2 fills per annum Below


NAZO-EZZE DOSE DROPS 2 fills per annum Above


TERINE NASAL DROPS 15ML 2 fills per annum Below


RINOL 25ML NASAL DROPS 2 fills per annum Below

Page 18 of 43

Nappi code


755214 RESPIRATORY SYSTEM Pholcodine Syrup 4.052 MG/5ML PHOLCOLINCT 4.05MG/5ML SYR


704178 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML BENYLIN WET COUGH 3 fills per annum Above

799319 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML LENNON COUGH SYRP 3 fills per annum Above

882829 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML DILINCT JUNIOR 3 fills per annum Below

895150 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML BENYLIN WET COUGH MENTHOL


708182 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML FLUTEX COUGH MIXTURE HONEY


708183 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML FLUTEX COUGH MIXTURE ORANG


708184 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML FLUTEX COUGH MIXTURE BLACK


708185 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML LENNON COUGH MIXTURE HONEY


708187 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML LENNON COUGH MIXTURE ORAN


715523 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML LCC-G GUAIPHENESIN COUGH REM


715524 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML LCC COUGH MIXTURE SYRUP 3 fills per annum Below

715455 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML LCC-G GUAIPHENESIN COUGH REM


715471 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML STEARNS PEPPERMINT WAS EXPIGEN


722013 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML STEARNS GUAIPHENESIN COUGH CHE


704178 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML BENYLIN WET COUGH 200MG/10ML L


895150 RESPIRATORY SYSTEM Guaifenesin Syrup 100 MG/5ML BENYLIN WET COUGH MENTHOL 100M


738263 RESPIRATORY SYSTEM *Ipecac-Squill Syrup*** LINCTUS TUSSI INFANS 3 fills per annum Below

701673 RESPIRATORY SYSTEM Ammonium Chloride & Ipecac Syrup 22-0.24 MG/5ML

SB CIROGEN COUGH MIXTURE 3 fills per annum Below

722779 RESPIRATORY SYSTEM Ammonium Chloride & Ipecac Syrup 22-0.24 MG/5ML

RESMED CHILDRENS COUGH MIX MIS


781169 RESPIRATORY SYSTEM Carbocysteine Syrup 125 MG/5ML MUCOSPECT PAED SYR 3 fills per annum Below

703394 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML DIS-CHEM MUCOLYTIC SYRP 3 fills per annum Above

708151 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML BETAPHLEM 250MG/5ML SYRP


710520 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML BRONCHETTE 250MG/5ML SYRP


Page 19 of 43

Nappi code


744816 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML MUCOSPECT SYRP 3 fills per annum Below

779814 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML CO-FLEM 250MG SYRP 3 fills per annum Below

785164 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML FLEMLITE SYRP 3 fills per annum Below

789739 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML FLEMGO SYRP 3 fills per annum Below

717241 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML FLUSIN MUCOUS COUGH 250MG/5ML


717745 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML FLUTEX MUCOUS COUGH 250MG/5ML


794341 RESPIRATORY SYSTEM Carbocysteine Syrup 250 MG/5ML MUCOPAN 250MG/5ML SYRP 3 fills per annum Below

826146 RESPIRATORY SYSTEM Pseudoephedrine w/ Acetaminophen Liquid 15-160 MG/5ML

SINUMAX PED SYR 3 fills per annum Below

773875 RESPIRATORY SYSTEM Pyrilamine-Phenylephrine-Acetaminophen Tab 5-5-500 MG

SINU-FLU TABS 3 fills per annum Below

715301 RESPIRATORY SYSTEM Chlorphen-Ephedrine-APAP-Caffeine Tab 2-6-200-20 MG

COLCLEER TABS 3 fills per annum Below


FLUSIN TABS 3 fills per annum Above


SINUCON TABS 3 fills per annum Above


SINUEND TABS 3 fills per annum Below

704332 RESPIRATORY SYSTEM Chlorphen-PE w/ APAP-Caffeine Syrup 2-2.5-75-7.5 MG/5ML

COLCLEER PAED SYR 3 fills per annum Below

726710 RESPIRATORY SYSTEM Diphenhydramine-Phenyleph-APAP-Vit C Cap 10-5-400-50 MG

FLUEND CAPS 3 fills per annum Below

715506 RESPIRATORY SYSTEM PE-CPM-APAP-Atropine-Caff-Vit C Cap 5-2-300-0.125-30-75 MG

COLSTAT CAPS 3 fills per annum Above

725544 RESPIRATORY SYSTEM PE-CPM-APAP-Atropine-Caff-Vit C Cap 5-2-300-0.125-30-75 MG

FAMUCAPS CAPS 3 fills per annum Below

710881 RESPIRATORY SYSTEM Ephedrine-Promethazine-Codeine Syrup 7-3-9.2 MG/5ML

BRUNACOD SYRP 3 fills per annum Below

791148 RESPIRATORY SYSTEM Phenylprop-Phenyltolox w/ Cod-APAP Tab 25-22-15-300 MG

ADCO-SINAL CO TABS 3 fills per annum Below

873322 RESPIRATORY SYSTEM Phenyleph-Chlorphen-DM w/APAP Syrup 2.5-0.5-2-120 MG/5ML

KIDDYFLU SYRP 3 fills per annum Below

796824 RESPIRATORY SYSTEM DM-Phenylpropanolamine-APAP Syrup 15-25-500 MG/20ML

SINUSTAT FLU SYRP 3 fills per annum Below

807656 RESPIRATORY SYSTEM DM-Phenylpropanolamine-APAP Syrup 15-25-500 MG/20ML

FLUSTAT SYRP 3 fills per annum Below

710652 RESPIRATORY SYSTEM Dextromethorphan-AmCl Syrup 15-90 MG/5ML BRONCOL 3 fills per annum Below

710652 RESPIRATORY SYSTEM Dextromethorphan-AmCl Syrup 15-90 MG/5ML BRONCOL COUGH SYRP 3 fills per annum Below

Page 20 of 43

Nappi code


702172 RESPIRATORY SYSTEM Diphenhydramine-AmCl-Sod Citrate Syr 13.33-130-54.17 MG/5ML

PHENORANT 3 fills per annum Below

703350 RESPIRATORY SYSTEM Diphenhydramine-AmCl-Sod Citrate Syr 13.33-130-54.17 MG/5ML

PHENORANT (GLASS) 3 fills per annum Below

710636 RESPIRATORY SYSTEM Diphenhydramine-AmCl-Sod Citrate Syrup 14.07-137-57 MG/5ML

BRONCLEER SYRP 3 fills per annum Above

720291 RESPIRATORY SYSTEM Diphenhydramine-AmCl-Sod Citrate Syrup 14.07-137-57 MG/5ML

DPH EXPECTORANT SYRP 3 fills per annum Below

783595 RESPIRATORY SYSTEM Diphenhydramine-AmCl-Sod Citrate-Men Syr 12.5-125-50-1MG/5ML

FAMTUSS SYRP 3 fills per annum Below

810649 RESPIRATORY SYSTEM Diphenhydramine-AmCl-Sod Citrate-Men Syr 12.5-125-50-1MG/5ML

DIPHENHYDRAMINE EXPECT SYRP


702080 RESPIRATORY SYSTEM DPH-AmCl-Sod Citrate-Men Syr 28.1-273.9-113.7-2.5 MG/5ML

ALLERGIN EXPECT 3 fills per annum Below

727008 RESPIRATORY SYSTEM Diphenhydramine-Pholcodine-GG Syr 15-8-100 MG/5ML

FOLCOFEN SYRP 3 fills per annum Below

757233 RESPIRATORY SYSTEM Diphenhydramine-Pholcodine-GG Syr 15-8-100 MG/5ML

PROCOF SYRP 3 fills per annum Above

700920 RESPIRATORY SYSTEM Albuterol Sulfate Syrup 2 MG/5ML VARI-SALBUTAMOL SYRUP Max age = 6; 2 fills per annum

Below

775274 RESPIRATORY SYSTEM Albuterol Sulfate Syrup 2 MG/5ML VENTOLIN 2MG/5ML SYRP Max age = 6; 2 fills per annum

Above

775452 RESPIRATORY SYSTEM Albuterol Sulfate Syrup 2 MG/5ML VENTEZE 2MG/5ML SYRP Max age = 6; 2 fills per annum

Below

824186 RESPIRATORY SYSTEM Albuterol Sulfate Syrup 2 MG/5ML ASTHAVENT 2MG/5ML SYRP Max age = 6; 2 fills per annum

Below

700715 RESPIRATORY SYSTEM Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv)

ASTHAVENT 300D ECOHALER 2 fills per annum Below


VENTOLIN INH 200D CFC FREE 2 fills per annum Above


ASTHAVENT 200D ECOHALER 2 fills per annum Below


VENTEZE CFC FREE 200D 100MCG



VENTIMAX CFC FREE 100MCG 200D


701211 SYMPATHOMIMETICS Epinephrine HCl Inj 1 MG/ML ADRENALINE FSK 1ML Max age = 7; 1 fills per annum

Below

895164 SYMPATHOMIMETICS Epinephrine HCl Inj 1 MG/ML PHARMA-Q ADRENALINE 1MG Max age = 7; 1 fills per annum

Below

739413 RESPIRATORY SYSTEM Aminophylline-Diphenhyd-Ammon Cl Syrup 32-8-30 MG/5ML

LOTUSSIN EXPECT 3 fills per annum Below

720283 RESPIRATORY SYSTEM Aminophylline-Diphenhyd-Ammon Cl-Sod Citrate Syrup

DIPHENAMILL SYRP 3 fills per annum Below

Page 21 of 43

Nappi code


700238 RESPIRATORY SYSTEM Theophylline-Etofylline-Diphenylpyraline-Ammon Cl Syrup

THEOPHEN CO ELIX (UNBOXED) 3 fills per annum Below

715681 RESPIRATORY SYSTEM Theophylline-Etofylline-Diphenylpyraline-Ammon Cl Syrup

DYNALEX SYRUP 3 fills per annum Above

701742 RESPIRATORY SYSTEM Theophylline-Etofylline-Diphenhyd-Ammon Cl-Sod Cit Syrup

ALCOPHYLLEX SYRP 3 fills per annum Below

710032 RESPIRATORY SYSTEM Metaproterenol-Bromhexine Syrup 5-4 MG/5ML BISOLVON LINCTUS 3 fills per annum Above

710687 RESPIRATORY SYSTEM Metaproterenol-Bromhexine Syrup 5-4 MG/5ML BRONKESE CO SYRP 3 fills per annum Below

819743 RESPIRATORY SYSTEM Metaproterenol-Bromhexine Syrup 5-4 MG/5ML FLEMEZE SYRP 3 fills per annum Above

827304 RESPIRATORY SYSTEM Metaproterenol-Bromhexine Syrup 5-4 MG/5ML ADCO-LINCTOPENT SYRP 3 fills per annum Below

862037 RESPIRATORY SYSTEM Metaproterenol-Bromhexine Syrup 5-4 MG/5ML BENYLIN CHESTY 3 fills per annum Above

701518 GASTRO-INTESTINAL TRACT *Sodium Phosphates - Enema*** ENA-CLEAR 1 fill per annum Below

726435 GASTRO-INTESTINAL TRACT *Sodium Phosphates - Enema*** LEN-O-LAX PAED 64ML 1 fill per annum Below

726443 GASTRO-INTESTINAL TRACT *Sodium Phosphates - Enema*** LEN-O-LAX ADULT 135ML 1 fill per annum Below

727202 GASTRO-INTESTINAL TRACT *Sodium Phosphates - Enema*** FOSENEMA 1 fill per annum Below

721549 GASTRO-INTESTINAL TRACT Bisacodyl Tab Delayed Release 5 MG DULCOLAX 5MG TABS 2 fills per annum Above

708008 GASTRO-INTESTINAL TRACT Bisacodyl Tab Delayed Release 5 MG LAXADOR BISACODYL 5MG TABS


715545 GASTRO-INTESTINAL TRACT Bisacodyl Tab Delayed Release 5 MG FRESHEN BISACODYL LAXATIVE 2 fills per annum Below

722655 GASTRO-INTESTINAL TRACT Bisacodyl Tab Delayed Release 5 MG BROOKLAX BISACODYL 5MG LAXATIV


723016 GASTRO-INTESTINAL TRACT Bisacodyl Tab Delayed Release 5 MG PURITONE BISACODYL LAXATIVE 5M


721530 GASTRO-INTESTINAL TRACT Bisacodyl Suppos 5 MG DULCOLAX 5MG PAED SUPP 2 fills per annum Below

721522 GASTRO-INTESTINAL TRACT Bisacodyl Suppos 10 MG DULCOLAX 10MG SUPP 2 fills per annum Below

708867 GASTRO-INTESTINAL TRACT Sennosides Tab 7.5 MG SENNA-PIN 7.5MG TABS 2 fills per annum Below

710368 GASTRO-INTESTINAL TRACT Sennosides Tab 7.5 MG LENNON SENNA 7.5MG TABS 2 fills per annum Above

710370 GASTRO-INTESTINAL TRACT Sennosides Tab 7.5 MG LAXADOR SENNA 7.5MG TABS 2 fills per annum Above

868078 GASTRO-INTESTINAL TRACT Sennosides Tab 13.5 MG SOFLAX TABS 2 fills per annum Below

797723 GASTRO-INTESTINAL TRACT Lactulose Solution 10 GM/15ML LACSON SYRP 2 fills per annum Above

817309 GASTRO-INTESTINAL TRACT Lactulose Solution 10 GM/15ML LAXETTE SYRP 2 fills per annum Above

708722 GASTRO-INTESTINAL TRACT Lactulose Solution 10 GM/15ML ACULAX 3.3G/5ML SYRUP 2 fills per annum Below

717972 GASTRO-INTESTINAL TRACT Lactulose Solution 10 GM/15ML ANLAC SYRP 2 fills per annum Below

3000645 GASTRO-INTESTINAL TRACT Lactulose Solution 10 GM/15ML LACTULAX 3.35G/5ML SYRP 2 fills per annum Above

796808 GASTRO-INTESTINAL TRACT *PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate Packet*** KLEAN-PREP SACHETS 1 fill per annum Below

Page 22 of 43

Nappi code


812900 GASTRO-INTESTINAL TRACT *PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate Packet*** GOLYTELY 68.5775G 1 fill per annum Below

716697 GASTRO-INTESTINAL TRACT *PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate Packet*** MOVIPREP 2XSACH A 122GM+B 11GM


703393 GASTRO-INTESTINAL TRACT Loperamide HCl Tab 2 MG DIS-CHEM ANTI-DIARRHOEAL TABS


732486 GASTRO-INTESTINAL TRACT Loperamide HCl Tab 2 MG IMODIUM 2MG TABS 3 fills per annum Above

791768 GASTRO-INTESTINAL TRACT Loperamide HCl Tab 2 MG ADCO-PRODIUM 2MG TABS 3 fills per annum Below

792071 GASTRO-INTESTINAL TRACT Loperamide HCl Tab 2 MG ADCO-LOPERAMIDE TABS 3 fills per annum Above

792691 GASTRO-INTESTINAL TRACT Loperamide HCl Tab 2 MG BETAPERAMIDE 2MG TABS 3 fills per annum Above

810916 GASTRO-INTESTINAL TRACT Loperamide HCl Tab 2 MG GASTRON 2MG TABS 3 fills per annum Below

707342 GASTRO-INTESTINAL TRACT Loperamide HCl Tab 2 MG CIPLA LOPERAMIDE TABS 3 fills per annum Below

732478 GASTRO-INTESTINAL TRACT Loperamide HCl Syrup 1 MG/5ML IMODIUM SYRP 3 fills per annum Above

811467 GASTRO-INTESTINAL TRACT Loperamide HCl Syrup 1 MG/5ML ADCO-LOPERAMIDE SYRP 3 fills per annum Below

820563 GASTRO-INTESTINAL TRACT Loperamide HCl Syrup 1 MG/5ML LOPERASTAT 1MG/5ML SYRP 3 fills per annum Below

810908 GASTRO-INTESTINAL TRACT Loperamide HCl Syrup 1 MG/5ML GASTRON 1MG/5ML SYRUP 3 fills per annum Below

728284 GASTRO-INTESTINAL TRACT Kaolin-Pectin Susp 1-0.05 GM/5ML GASTROPECT SUSP 3 fills per annum Below

823546 GASTRO-INTESTINAL TRACT Kaolin-Pectin Susp 6-0.45 GM/30ML PECTIN-K SUSP 3 fills per annum Below

892661 GASTRO-INTESTINAL TRACT Kaolin-Pectin Susp 6-0.45 GM/30ML PECTIKON SUSP 3 fills per annum Below

723428 GASTRO-INTESTINAL TRACT Kaolin-Pectin w/ Electrolytes Susp 6-0.12 GM/30ML ENTEROLYTE SUSP 3 fills per annum Below

734942 GASTRO-INTESTINAL TRACT Kaolin-Pectin w/ Electrolytes Susp 6-0.12 GM/30ML KAOSTATEX SUSP 3 fills per annum Below

708976 GASTRO-INTESTINAL TRACT Kaolin-Pectin-Bismuth Carbonate Susp 8-0.25-0.2 GM/30ML

BISKAPECT SUSP 3 fills per annum Below

740551 GASTRO-INTESTINAL TRACT Aluminum Hydroxide-Mag Oxide Susp 282-120 MG/15ML

ADCO-MAYOGEL SUSP 3 fills per annum Below

700771 GASTRO-INTESTINAL TRACT Alum Hydrox-Mag Oxide-Dicyclomine Susp 400-200-5 MG/10ML

AMGEL SUSP 3 fills per annum Below


DICYCLOMINE CO GEL 3 fills per annum Below


ALUMAG D SUSP 3 fills per annum Below


CO-GEL SUSP 3 fills per annum Above


NEUTRAGEL D SUSP 3 fills per annum Below


GELUMEN SUSP 3 fills per annum Below


ALUMITE D SUSP 3 fills per annum Above

Page 23 of 43

Nappi code


765538 GASTRO-INTESTINAL TRACT Alum Oxide-Mag Oxide-Dicyclomine Gel 200-200-5 MG/10ML

SPASMOGEL 3 fills per annum Below

740683 GASTRO-INTESTINAL TRACT Al & Mg Oxides-Dicycl-Methylcell-Simeth Susp MEDIGEL SUSP 3 fills per annum Below

711276 GASTRO-INTESTINAL TRACT Scopolamine N-Butylbromide Tab 10 MG BUSCOPAN 10MG TABS Above

731951 GASTRO-INTESTINAL TRACT Scopolamine N-Butylbromide Tab 10 MG HYOSPASMOL 10MG TABS Below

762725 GASTRO-INTESTINAL TRACT Scopolamine N-Butylbromide Tab 10 MG SCOPEX 10MG TABS Below

703383 GASTRO-INTESTINAL TRACT Scopolamine N-Butylbromide Syrup 5 MG/5ML SCOPEX SYRUP Below

797413 GASTRO-INTESTINAL TRACT Scopolamine N-Butylbromide Syrup 5 MG/5ML BUSCOPAN 5MG/5ML SYRP Above

707213 GASTRO-INTESTINAL TRACT Scopolamine N-Butylbromide Syrup 5 MG/5ML HYOSPASMOL 5MG/5ML SYRUP

Below

701892 GASTRO-INTESTINAL TRACT Mebeverine HCl Tab 135 MG MYLAN MEBEVERINE HCL TABS 3 fills per annum Below

715476 GASTRO-INTESTINAL TRACT Mebeverine HCl Tab 135 MG COLOFAC 135MG TABS 3 fills per annum Above

822019 GASTRO-INTESTINAL TRACT Mebeverine HCl Tab 135 MG BEVISPAS 135MG TABS 3 fills per annum Below

825328 GASTRO-INTESTINAL TRACT Mebeverine HCl Tab 135 MG SANDOZ MEBEVERINE TABS 3 fills per annum Above

700119 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 150 MG CPL ALLIANCE RANITIDINE 150MG

Qty limit = 90 units per annum

Below

841609 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 150 MG RANIHEXAL 150MG TABS Qty limit = 90 units per annum

Above

867934 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 150 MG ULTAK 150MG TABS Qty limit = 90 units per annum

Below

713553 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 150 MG GULF RANITIDINE 150MG TABS Qty limit = 90 units per annum

Below

717160 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 150 MG APEX-RANITIDINE 150MG TABS Qty limit = 90 units per annum

Below

719669 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 150 MG RANITIDINE BIOTECH 150MG TABS


Below

700120 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 300 MG CPL ALLIANCE RANITIDINE 300MG


Below

867942 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 300 MG ULTAK 300MG TABS Qty limit = 90 units per annum

Below

713554 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 300 MG GULF RANITIDINE 300MG TABS Qty limit = 90 units per annum

Below

717159 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 300 MG APEX-RANITIDINE 300MG TABS Qty limit = 90 units per annum

Below

718482 GASTRO-INTESTINAL TRACT Ranitidine HCl Tab 300 MG RANITIDINE BIOTECH 300MG TABS


Below

704752 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG LANSOLOC 15MG OTC CAPS Qty limit = 90 units per annum

Above

715079 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG LANSOPRAZOLE UNICORN 15MG CAPS


Below

Page 24 of 43

Nappi code


704839 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG ASPEN LANSOPRAZOLE 15MG CAPS


Above

707192 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG BURNLOC 15MG (WAS ADCO-ROZNAL


Below

707192 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG ADCO-ROZNAL Qty limit = 90 units per annum

Below

708052 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG LANCAP 15MG CAPS Qty limit = 90 units per annum

Below

715812 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG LANCAP OTC 15MG CAPS Qty limit = 90 units per annum

Below

716841 GASTRO-INTESTINAL TRACT Lansoprazole Cap Delayed Release 15 MG ROZNAL 15MG CAPS OTC Qty limit = 90 units per annum

Above

772143 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG TRIAZINE 50MG TABS Below

774634 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG VALOID 50MG TABS Above

792853 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG MEDAZINE NAUSEA 50MG TABS

Above

799424 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG NAUZINE 50MG TABS Below

808954 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG ADCO-CYCLIZINE 50MG TABS Below

809322 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG COVAMET 50MG TABS Below

811513 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG DISCHEM EMITEX 50MG TABS Above

792217 CENTRAL NERVOUS SYSTEM Cyclizine HCl Tab 50 MG ACULOID 50MG TABS Below

774642 CENTRAL NERVOUS SYSTEM Cyclizine HCl Syrup 12.5 MG/5ML VALOID 2.5MG/ML SYRP Above

792225 CENTRAL NERVOUS SYSTEM Cyclizine HCl Syrup 12.5 MG/5ML ACULOID 12.5MG/5ML SYRP Below

792845 CENTRAL NERVOUS SYSTEM Cyclizine HCl Syrup 12.5 MG/5ML MEDAZINE-S 2.5MG/ML SYRP Below

796700 CENTRAL NERVOUS SYSTEM Cyclizine HCl Syrup 12.5 MG/5ML TRIAZINE PEAD SYRP Below

808962 CENTRAL NERVOUS SYSTEM Cyclizine HCl Syrup 12.5 MG/5ML ADCO-CYCLIZINE 2.5MG SYRP Below

820571 CENTRAL NERVOUS SYSTEM Cyclizine HCl Syrup 12.5 MG/5ML NAUZINE S 12.5MG/5 SYRP Below

772135 CENTRAL NERVOUS SYSTEM Cyclizine HCl Supp 50 MG TRIAZINE 50MG SUPP Qty limit = 6 units per annum; 3 fills per annum

Below

774618 CENTRAL NERVOUS SYSTEM Cyclizine HCl Supp 50 MG VALOID 50MG SUPP Qty limit = 6 units per annum; 3 fills per annum

Above

774626 CENTRAL NERVOUS SYSTEM Cyclizine HCl Supp 100 MG VALOID 100MG SUPP Qty limit = 6 units per annum; 3 fills per annum

Below

784346 CENTRAL NERVOUS SYSTEM Phosphorated Carbohydrate Syrup EMEX SYR Below

778265 CENTRAL NERVOUS SYSTEM Buclizine-Pyridoxine Tab 25-50 MG VOMIFENE TABS Max age = 45; Females only

Below

Page 25 of 43

Nappi code


723037 CENTRAL NERVOUS SYSTEM *Fructose-Dextrose-Phosphoric Acid Oral Soln*** EMETROL LIQ Below

700712 CENTRAL NERVOUS SYSTEM Metoclopramide HCl Tab 10 MG (Salt Equivalent) CLOMAX 10MG TABS Below

714828 CENTRAL NERVOUS SYSTEM Metoclopramide HCl Tab 10 MG (Salt Equivalent) CLOPAMON 10MG TABS Above

715875 CENTRAL NERVOUS SYSTEM Metoclopramide HCl Tab 10 MG (Salt Equivalent) ADCO-CONTROMET 10MG TABS

Below

717891 CENTRAL NERVOUS SYSTEM Metoclopramide HCl Tab 10 MG (Salt Equivalent) BIO METOCLOPRAMIDE 10MG TABS

Below

757845 CENTRAL NERVOUS SYSTEM Metoclopramide HCl Tab 10 MG (Salt Equivalent) METOCLOPRAMIDE 10MG TABS OETHM

Above

714844 CENTRAL NERVOUS SYSTEM Metoclopramide HCl Syrup 5 MG/5ML CLOPAMON 5MG/5ML SYRP Above

783064 CENTRAL NERVOUS SYSTEM Metoclopramide HCl Syrup 5 MG/5ML ADCO-CONTROMET 5MG/5ML Below

745685 URINARY SYSTEM Nalidixic Acid Tab 500 MG PUROMYLON 500MG TABS 3 fills per annum Below

778672 URINARY SYSTEM Nalidixic Acid Susp 250 MG/5ML WINLOMYLON SUSP 3 fills per annum Below

739839 URINARY SYSTEM Nitrofurantoin Macrocrystalline Cap 50 MG MACRODANTIN 50MG CAPS 3 fills per annum Below

739847 URINARY SYSTEM Nitrofurantoin Macrocrystalline Cap 100 MG MACRODANTIN 100MG CAPS 3 fills per annum Below

703548 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% CANESTEN 1% VCR 3 fills per annum Above

826960 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% A-POR VCR 3 fills per annum Below

831875 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% CANALBA VCR 3 fills per annum Below

831883 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% CANDASPOR VCR 3 fills per annum Above

831913 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% CANEX VAG CREAM 3 fills per annum Below

832332 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% COVOSPOR VAGINAL CREAM 3 fills per annum Above

832391 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% MEDASPOR VCR 3 fills per annum Above

832405 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% MICOMISAN VAG CREAM 3 fills per annum Below

832421 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% ADCO-NORMOSPOR VCR 10MG/GM


832499 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% XERASPOR-V CREAM 3 fills per annum Below

832596 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% CANDIZOLE VCR 3 fills per annum Below

846341 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% FUNGISPOR VCR 3 fills per annum Below

878448 GENITAL SYSTEM Clotrimazole Vaginal Cream 1% GYNEZOL 10MG/GM VCR 3 fills per annum Below

839760 URINARY SYSTEM Potassium Citrate & Citric Acid Soln 45-21 MG/15ML GENCIT SIMPLEX 3 fills per annum Below

778702 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.25 MG XANOR 0.25MG TABS Qty limit = 90 units per annum

Above

821071 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.25 MG ADCO-ALZAM 0.25MG TABS Qty limit = 90 units per annum

Below

823244 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.25 MG AZOR 0.25MG TABS Qty limit = 90 units per annum

Below

Page 26 of 43

Nappi code


826685 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.25 MG ZOPAX 0.25MG TABS Qty limit = 90 units per annum

Below

897929 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.25 MG CPL ALLIANCE ALPRAZOLAM 0.25MG


Below

897965 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.25 MG MYLAN ALPRAZOLAM 0.25MG TABS


Below

778710 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.5 MG XANOR 0.5MG TABS Qty limit = 90 units per annum

Above

821098 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.5 MG ADCO-ALZAM 0.5MG TABS Qty limit = 90 units per annum

Below

823252 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.5 MG AZOR 0.5MG TABS Qty limit = 90 units per annum

Below

826693 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.5 MG ZOPAX 0.5MG TABS Qty limit = 90 units per annum

Below

895173 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.5 MG MYLAN ALPRAZOLAM 0.5MG TABS


Below

897930 CENTRAL NERVOUS SYSTEM Alprazolam Tab 0.5 MG CPL ALLIANCE ALPRAZOLAM 0.5MG


Below

778729 CENTRAL NERVOUS SYSTEM Alprazolam Tab 1 MG XANOR 1MG TABS Qty limit = 90 units per annum

Above

821101 CENTRAL NERVOUS SYSTEM Alprazolam Tab 1 MG ADCO-ALZAM 1MG TABS Qty limit = 90 units per annum

Below

823260 CENTRAL NERVOUS SYSTEM Alprazolam Tab 1 MG AZOR 1MG TABS Qty limit = 90 units per annum

Below

826707 CENTRAL NERVOUS SYSTEM Alprazolam Tab 1 MG ZOPAX 1MG TABS Qty limit = 90 units per annum

Below

897968 CENTRAL NERVOUS SYSTEM Alprazolam Tab 1 MG MYLAN ALPRAZOLAM 1MG TABS


Below

710784 CENTRAL NERVOUS SYSTEM Bromazepam Tab 3 MG SANDOZ BROMAZEPAM 3MG TABS


Below

737933 CENTRAL NERVOUS SYSTEM Bromazepam Tab 3 MG LEXOTAN 3MG TABS Qty limit = 90 units per annum

Above

796999 CENTRAL NERVOUS SYSTEM Bromazepam Tab 3 MG BRAZEPAM 3MG TABS Qty limit = 90 units per annum

Below

710792 CENTRAL NERVOUS SYSTEM Bromazepam Tab 6 MG SANDOZ BROMAZEPAM 6MG TABS


Below

737941 CENTRAL NERVOUS SYSTEM Bromazepam Tab 6 MG LEXOTAN 6MG TABS Qty limit = 90 units per annum

Above

800066 CENTRAL NERVOUS SYSTEM Bromazepam Tab 6 MG BRAZEPAM 6MG TABS Qty limit = 90 units per annum

Below

821616 CENTRAL NERVOUS SYSTEM Bromazepam Tab 6 MG BROMAZE 6MG TABS Qty limit = 90 units per annum

Above

708062 CENTRAL NERVOUS SYSTEM Diazepam Tab 5 MG BETAPAM 5MG TABS Qty limit = 90 units per annum

Below

Page 27 of 43

Nappi code


721174 CENTRAL NERVOUS SYSTEM Diazepam Tab 5 MG DOVAL 5MG TABS Qty limit = 90 units per annum

Below

774472 CENTRAL NERVOUS SYSTEM Diazepam Tab 5 MG VALIUM 5MG TABS Qty limit = 90 units per annum

Above

758183 CENTRAL NERVOUS SYSTEM Oxazepam Tab 10 MG PURATA 10MG TABS Qty limit = 90 units per annum

Below

763500 CENTRAL NERVOUS SYSTEM Oxazepam Tab 10 MG SEREPAX 10MG TABS Qty limit = 90 units per annum

Above

751758 CENTRAL NERVOUS SYSTEM Oxazepam Tab 15 MG SANDOZ OXAZEPAM 15MG TABS


Below


Below


Above

751766 CENTRAL NERVOUS SYSTEM Oxazepam Tab 30 MG SANDOZ OXAZEPAM 30MG TABS


Below


Below


Above

772003 CENTRAL NERVOUS SYSTEM Amitriptyline HCl Tab 10 MG TREPILINE 10MG TABS Qty limit = 60 units per annum

Below

980013 CENTRAL NERVOUS SYSTEM Amitriptyline HCl Tab 10 MG NOV AMITRIPTYLINE 10MG CAPS NA


Below

771996 CENTRAL NERVOUS SYSTEM Amitriptyline HCl Tab 25 MG TREPILINE 25MG TABS Qty limit = 60 units per annum

Above

784230 CENTRAL NERVOUS SYSTEM Amitriptyline HCl Tab 25 MG SANDOZ AMITRIPTYL 25MG TABS


Below

718746 CENTRAL NERVOUS SYSTEM Amitriptyline HCl Tab 25 MG GULF AMITRIPTYLINE 25MG TABS


Below

980014 CENTRAL NERVOUS SYSTEM Amitriptyline HCl Tab 25 MG NOV AMITRIPTYLINE 25MG CAPS NA


Above

724661 CENTRAL NERVOUS SYSTEM Imipramine HCl Tab 10 MG ETHIPRAMINE 10MG TABS Qty limit = 60 units per annum

Below

771120 CENTRAL NERVOUS SYSTEM Imipramine HCl Tab 10 MG TOFRANIL 10MG TABS Qty limit = 60 units per annum

Above

724688 CENTRAL NERVOUS SYSTEM Imipramine HCl Tab 25 MG ETHIPRAMINE 25MG TABS Qty limit = 60 units per annum

Below

771139 CENTRAL NERVOUS SYSTEM Imipramine HCl Tab 25 MG TOFRANIL 25MG TABS Qty limit = 60 units per annum

Above

744182 CENTRAL NERVOUS SYSTEM Prochlorperazine Maleate Tab 5 MG (Base Equivalent)

MITIL 5MG TABS Below


SCRIPTO-METIC 5MG TABS Below

Page 28 of 43

Nappi code



STEMETIL 5MG TABS Above

700722 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG ZOPIVANE 7.5MG TABS Qty limit = 90 units per annum

Below

732494 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG IMOVANE 7.5MG TABS Qty limit = 90 units per annum

Above

857785 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG SANDOZ ZOPICLONE TABS Qty limit = 90 units per annum

Below

867365 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG ADCO-ZOPIMED 7.5MG TABS Qty limit = 90 units per annum

Above

874728 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG ALCHERA 7.5MG TABS Qty limit = 90 units per annum

Below

894220 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG Z-DORM TABS Qty limit = 90 units per annum

Above

705115 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG ZOPIGEN 7.5MG TABS Qty limit = 90 units per annum

Below

707688 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG ZOPICLONE UNICORN 7.5MG TABS


Below

712508 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG AUSTELL-ZOPICLONE 7.5MG TABS


Above

718473 CENTRAL NERVOUS SYSTEM Zopiclone Tab 7.5 MG BIO ZOPICLONE 7.5MG TABS Qty limit = 90 units per annum

Below

700909 ANALGESICS Aspirin Tab 300 MG GULF ASPIRIN 300MG TABS Qty limit = 400 units per annum

Below

706930 ANALGESICS Aspirin Tab 300 MG BAYER ASPIRIN TABS Qty limit = 400 units per annum

Below

701634 ANALGESICS Acetaminophen Tab 500 MG DIS-CHEM PARACETAMOL Qty limit = 200 units per annum

Above

704465 ANALGESICS Acetaminophen Tab 500 MG PAINOGESIC TABS Qty limit = 200 units per annum

Below

704643 ANALGESICS Acetaminophen Tab 500 MG CETAPON TABS Qty limit = 200 units per annum

Below

720860 ANALGESICS Acetaminophen Tab 500 MG DOLOROL 500MG TABS Qty limit = 200 units per annum

Above

745723 ANALGESICS Acetaminophen Tab 500 MG ADCO-NAPAMOL 500MG TABS Qty limit = 200 units per annum

Below

752274 ANALGESICS Acetaminophen Tab 500 MG PANADO 500MG TABS Qty limit = 200 units per annum

Above

752878 ANALGESICS Acetaminophen Tab 500 MG PARAPANE 500MG TABS Qty limit = 200 units per annum

Below

757403 ANALGESICS Acetaminophen Tab 500 MG ADCO-PROLIEF 500MG TABS Qty limit = 200 units per annum

Below

784443 ANALGESICS Acetaminophen Tab 500 MG PARAMED 500MG TABS Qty limit = 200 units per annum

Above

Page 29 of 43

Nappi code


805467 ANALGESICS Acetaminophen Tab 500 MG ANTALGIC 500MG TABS Qty limit = 200 units per annum

Below

824992 ANALGESICS Acetaminophen Tab 500 MG GENCETAMOL 500MG TABS Qty limit = 200 units per annum

Below

867950 ANALGESICS Acetaminophen Tab 500 MG GULF PARACETAMOL 500MG TABS


Below

867969 ANALGESICS Acetaminophen Tab 500 MG PAINBLOK 500MG TABS Qty limit = 200 units per annum

Above

885863 ANALGESICS Acetaminophen Tab 500 MG VON PARACETAMOL TABS Qty limit = 200 units per annum

Below

894212 ANALGESICS Acetaminophen Tab 500 MG JP PARACETAMOL TABS Qty limit = 200 units per annum

Below

713153 ANALGESICS Acetaminophen Tab 500 MG AUSTELL-PARACETAMOL 500MG


Above

714499 ANALGESICS Acetaminophen Tab 500 MG CLICKS PARACETAMOL 500MG TABS


Above

714707 ANALGESICS Acetaminophen Tab 500 MG PYNGESIC T 500MG TABS Qty limit = 200 units per annum

Below

715860 ANALGESICS Acetaminophen Tab 500 MG GRAND-PA PARACETAMOL TABS


Above

716045 ANALGESICS Acetaminophen Tab 500 MG ADCO-NAPAMOL 500MG TABS Qty limit = 200 units per annum

Above

717725 ANALGESICS Acetaminophen Tab 500 MG ACTAMOL 500MG TABS Qty limit = 200 units per annum

Below

720327 ANALGESICS Acetaminophen Tab 500 MG PANADO 500MG TABS BLISTER PACK


Above

703118 ANALGESICS Acetaminophen Elixir 120 MG/5ML PANADO SYRUP STRAWBERRY Above

703349 ANALGESICS Acetaminophen Elixir 120 MG/5ML PAINBLOK 120MG/5ML (GLASS BOT

Above

703820 ANALGESICS Acetaminophen Elixir 120 MG/5ML FEVERPAIN (UNBOXED) Below

704093 ANALGESICS Acetaminophen Elixir 120 MG/5ML ACTAMOL RED (UN-BOXED) Below

704450 ANALGESICS Acetaminophen Elixir 120 MG/5ML PAINOGESIC SYRP Below

745715 ANALGESICS Acetaminophen Elixir 120 MG/5ML ADCO-NAPAMOL 120MG/5ML SYRP

Below

752118 ANALGESICS Acetaminophen Elixir 120 MG/5ML PAINAMOL 120MG/5ML SYRP Below

752282 ANALGESICS Acetaminophen Elixir 120 MG/5ML PANADO SYRUP Above

758558 ANALGESICS Acetaminophen Elixir 120 MG/5ML PYRALEN 120MG/5ML SYRP Below

792101 ANALGESICS Acetaminophen Elixir 120 MG/5ML ACTAMOL 120MG/5ML SYRP Below

863742 ANALGESICS Acetaminophen Elixir 120 MG/5ML FEVERPAIN ELIX Below

889772 ANALGESICS Acetaminophen Elixir 120 MG/5ML PAINBLOK 120MG/5ML SYRP Below

Page 30 of 43

Nappi code


788953 ANALGESICS Acetaminophen Syrup 120 MG/5ML PANADO(NO ALCOHOL) SYRP Above

895199 ANALGESICS Acetaminophen Syrup 120 MG/5ML GO-PAIN P Below

710452 ANALGESICS Acetaminophen Syrup 120 MG/5ML WOODWARDS PARACETAMOL Below

717187 ANALGESICS Acetaminophen Syrup 120 MG/5ML BARRS PARACETAMOL 120MG/5ML

Below

819697 ANALGESICS Acetaminophen Suppos 125 MG EMPAPED 125MG SUPP 3 fills per annum Below

819700 ANALGESICS Acetaminophen Suppos 250 MG EMPAPED 250MG SUPP 3 fills per annum Below

711292 GASTRO-INTESTINAL TRACT Dipyrone-Scopolamine Butylbromide Tab 250-10 MG BUSCOPAN CO TABS 3 fills per annum Below

797146 ANALGESICS Tramadol HCl Cap 50 MG TRAMAL 50MG CAPS Qty limit = 60 units per annum

Above

864900 ANALGESICS Tramadol HCl Cap 50 MG TRAMAHEXAL 50MG CAPS Qty limit = 60 units per annum

Below

705175 ANALGESICS Tramadol HCl Cap 50 MG DOMADOL 50MG CAPS Qty limit = 60 units per annum

Below

705379 ANALGESICS Tramadol HCl Cap 50 MG DOLOTRAM 50MG CAPS Qty limit = 60 units per annum

Below

706475 ANALGESICS Tramadol HCl Cap 50 MG TRAMAZAC 50MG CAPS Qty limit = 60 units per annum

Below

710250 ANALGESICS Tramadol HCl Cap 50 MG AUSTELL-TRAMADOL 50MG CAPS


Below

717391 ANALGESICS Tramadol HCl Cap 50 MG TRAMASPEN 50MG CAPS Qty limit = 60 units per annum

Below

765635 ANALGESICS Acetaminophen w/ Codeine Cap 320-8 MG SPECTRAPAIN CAPS Qty limit = 200 units per annum

Below

700742 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG AMSTIL TABS Qty limit = 200 units per annum

Below

707910 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG PAINAMOL PLUS Qty limit = 200 units per annum

Below

720879 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG DOLOROL FORTE TABS Qty limit = 200 units per annum

Above

761303 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG ROCODIN TABS Qty limit = 200 units per annum

Above

787043 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG CODOROL TABS Qty limit = 200 units per annum

Below

837652 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG DINO-COD TABS Qty limit = 200 units per annum

Below

895030 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG PAINCODEIN TABS Qty limit = 200 units per annum

Above

713688 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG VARI-COCODAMOL 8MG/500MG TABS


Below

719662 ANALGESICS Acetaminophen w/ Codeine Tab 500-8 MG COGESIC TABS Qty limit = 200 units per annum

Below

Page 31 of 43

Nappi code


745707 ANALGESICS Acetaminophen w/ Codeine Tab 500-10 MG ADCO-NAPACOD TABS Qty limit = 200 units per annum

Below

795402 ANALGESICS Acetaminophen w/ Codeine Tab 500-10 MG KODAPON TABS Qty limit = 200 units per annum

Below

732753 ANALGESICS Acetaminophen-Promethazine w/ Codeine Syrup 120-6.5-5 MG/5ML

INFAPAIN FORTE SYRP 3 fills per annum Below


LENTOGESIC SYRP 3 fills per annum Above


PAINAGON SYRP 3 fills per annum Below


STILPANE SYRP 3 fills per annum Below


STOPAYNE SYRP 3 fills per annum Above


PYNMED PAIN AND FEVER SYRUP



GOLDGESIC SYRP 3 fills per annum Below


ADCO-SALTERPYN SYRP 3 fills per annum Below


GO-PAIN SYRP 3 fills per annum Below


MEDIPYN S 3 fills per annum Below


KID-EEZE SYRP 3 fills per annum Below


ADCO-KIDDIPAYNE 3 fills per annum Below


BAN PAIN SYRUP 3 fills per annum Above

766828 ANALGESICS Acetaminophen-Meprobamate-Caff-Cod Tab 320-150-32-8 MG

STILPANE TABS Qty limit = 200 units per annum

Above


XEROGESIC TABS Qty limit = 200 units per annum

Below


BRISCOPYN TABS Qty limit = 200 units per annum

Above


ADCO-SALTERPYN TABS Qty limit = 200 units per annum

Below


SPECTRAPAIN FORTE TABS Qty limit = 200 units per annum

Below


NUCOPAIN TABS Qty limit = 200 units per annum

Below


GOLDGESIC TABS Qty limit = 200 units per annum

Below

Page 32 of 43

Nappi code


700243 ANALGESICS Tramadol-Acetaminophen Tab 37.5-325 MG TRAMACET TABS Qty limit = 60 units per annum

Above

719052 ANALGESICS Tramadol-Acetaminophen Tab 37.5-325 MG TRAMAZAC CO 37.5/325MG TABS


Below

719300 ANALGESICS Tramadol-Acetaminophen Tab 37.5-325 MG ULTRACET TABS Qty limit = 60 units per annum

Above

721680 ANALGESICS Tramadol-Acetaminophen Tab 37.5-325 MG TRAMAHEXAL CO 37.5/325 TABS


Below

723073 ANALGESICS Tramadol-Acetaminophen Tab 37.5-325 MG PATRAM 37.5MG/325MG TABS Qty limit = 60 units per annum

Below

723749 ANALGESICS Tramadol-Acetaminophen Tab 37.5-325 MG TAMOLTRA 37.5MG/325MG TABS


Below

967949 ANALGESICS Tramadol-Acetaminophen Tab 37.5-325 MG TRAMADOL+PARACETA BELUPO 37.5/


Above

718479 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 25 MG DICLOFENAC BIOTECH 25MG TABS


Below

752371 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 25 MG PANAMOR 25MG TABS Qty limit = 200 units per annum

Above

786012 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 25 MG MYLAN DICLOFENAC 25 MG TABS


Below

893390 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 25 MG A-LENNON DICLOFENAC 25MG TABS


Below

752398 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 50 MG PANAMOR AT 50MG TABS Qty limit = 200 units per annum

Below

778222 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 50 MG VOLTAREN GT 50MG TABS Qty limit = 200 units per annum

Above

786020 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 50 MG MYLAN DICLOFENAC 50MG TABS


Below

893391 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Tab Delayed Release 50 MG A-LENNON DICLOFENAC 50MG TABS


Below

780855 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Suppos 12.5 MG VOLTAREN 12.5MG SUP Max age = 6; 3 fills per annum

Above

807605 MUSCULO-SKELETAL AGENTS Diclofenac Sodium Suppos 12.5 MG PANAMOR 12.5MG SUPP Max age = 6; 3 fills per annum

Below

708186 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG BETAGESIC 200MG TABS Qty limit = 200 units per annum

Above

733741 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG INZA 200MG TABS Qty limit = 200 units per annum

Below

748560 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG NUROFEN TABS Qty limit = 200 units per annum

Above

787426 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG BETAPROFEN 200MG TABS Qty limit = 200 units per annum

Below

809268 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG IBUMED 200MG TABS Qty limit = 200 units per annum

Above

Page 33 of 43

Nappi code


824852 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG RANFEN 200MG TABS Qty limit = 200 units per annum

Below

868221 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG IBUNATE 200MG TABS Qty limit = 200 units per annum

Below

868469 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG LENAFEN 200MG TABS Qty limit = 200 units per annum

Above

705940 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG IBU 200MG TABS Qty limit = 200 units per annum

Below

721118 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG AUSTIFEN 200MG TABS Qty limit = 200 units per annum

Above

708536 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG IBUSOR 200MG TABS Qty limit = 200 units per annum

Below

710822 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG BRUFEN 200MG TABS Qty limit = 200 units per annum

Above

721114 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG IBUCARE 200MG TABS Qty limit = 200 units per annum

Above

717155 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 200 MG AUSTELL IBUPROFEN 200MG TABS


Above

701654 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 400 MG RANFEN 400MG TABS Qty limit = 200 units per annum

Below

701975 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 400 MG BETAPROFEN 400 TABS Qty limit = 200 units per annum

Below

733768 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 400 MG INZA 400MG TABS Qty limit = 200 units per annum

Below

708290 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 400 MG BREN 400MG TABS Qty limit = 200 units per annum

Below

721119 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 400 MG AUSTIFEN 400MG TABS Qty limit = 200 units per annum

Above

721116 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 400 MG IBUCARE 400MG TABS Qty limit = 200 units per annum

Above

717153 MUSCULO-SKELETAL AGENTS Ibuprofen Tab 400 MG AUSTELL IBUPROFEN 400MG TABS


Above

700315 ANALGESICS Ibuprofen Susp 100 MG/5ML IBUCINE SUSP 3 fills per annum Below

700695 ANALGESICS Ibuprofen Susp 100 MG/5ML NUROFEN CHILDREN SUGAR FR 3 fills per annum Above

710857 ANALGESICS Ibuprofen Susp 100 MG/5ML BRUFEN PAED SUSP 3 fills per annum Above

704781 ANALGESICS Ibuprofen Susp 100 MG/5ML IBUGESIC 100MG/5ML SUSP 3 fills per annum Below

712683 ANALGESICS Ibuprofen Susp 100 MG/5ML NUROFEN FOR CHILD STRAWBERRY


721335 ANALGESICS Ibuprofen Susp 100 MG/5ML INFLAMAX PAED 100MG/5ML SUSP


704725 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG ARTHREXIN 25MG CAPS Qty limit = 200 units per annum

Above

Page 34 of 43

Nappi code


704725 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG ARTHREXIN 25MG CAPS Qty limit = 200 units per annum

Above

704776 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG SANDOZ INDOMETHACIN 25MG CAPS


Below

787833 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG BETACIN 25MG CAPS Qty limit = 200 units per annum

Below

788996 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG MEDIFLEX 25MG CAPS Qty limit = 200 units per annum

Above

814393 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG METHOCAPS 25MG CAPS Qty limit = 200 units per annum

Below

868213 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG GULF INDOMETHACIN 25MG CAPS


Below

788996 MUSCULO-SKELETAL AGENTS Indomethacin Cap 25 MG MEDIFLEX 25MG CAPS Qty limit = 200 units per annum

Above

796433 ANALGESICS Mefenamic Acid Cap 250 MG PONAC 250MG CAPS Qty limit = 200 units per annum

Below

797707 ANALGESICS Mefenamic Acid Cap 250 MG FENAMIN 250MG CAPS Qty limit = 200 units per annum

Below

812250 ANALGESICS Mefenamic Acid Cap 250 MG PONSTEL 250MG CAPS Qty limit = 200 units per annum

Above

883102 ANALGESICS Mefenamic Acid Cap 250 MG ADCO-MEFENAMIC ACID CAPS Qty limit = 200 units per annum

Below

756156 ANALGESICS Mefenamic Acid Susp 50 MG/5ML PONSTAN 10MG/ML SUSP 3 fills per annum Below

756156 ANALGESICS Mefenamic Acid Susp 50 MG/5ML PONSTAN 50MG/5ML SUSP 3 fills per annum Below

793264 ANALGESICS Mefenamic Acid Susp 50 MG/5ML PONAC 50MG/5ML SUSP 3 fills per annum Below

797014 ANALGESICS Mefenamic Acid Susp 50 MG/5ML FENAMIN 50MG/5ML SUSP 3 fills per annum Below

810398 ANALGESICS Mefenamic Acid Susp 50 MG/5ML PONSTEL S 50MG/5ML SUSP 3 fills per annum Above

875643 ANALGESICS Mefenamic Acid Susp 50 MG/5ML ADCO-MEFENAMIC ACID 3 fills per annum Below

807435 ANALGESICS Mefenamic Acid Supp 125 MG PONSTAN PEAD 125MG SUP 3 fills per annum Below

701520 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG LOXIFLAM 7.5MG TABS Qty limit = 90 units per annum

Above

818615 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG MOBIC 7.5MG TABS Qty limit = 90 units per annum

Above

899066 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG COXFLAM 7.5MG TABS Qty limit = 90 units per annum

Below

704829 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG FLEXOCAM 7.5MG TABS Qty limit = 90 units per annum

Below

705176 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG M-CAM 7.5MG TABS Qty limit = 90 units per annum

Below

705229 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG ZYDUS-MELOXICAM 7.5MG TABS


Below

Page 35 of 43

Nappi code


705296 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG MELFLAM 7.5 MG TABS Qty limit = 90 units per annum

Above

705375 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG ADCO-MELOXICAM 7.5MG TABS


Above

707667 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG APEX-MELOXICAM 7.5MG TABS


Below

711324 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG ARROW MELOXICAM 7.5MG TABS


Above

716168 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG MELOXICAM UNICORN 7.5MG TABS


Below

717091 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG FLAMARYX 7.5MG TABS Qty limit = 90 units per annum

Above

718381 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG MEDOXICAM 7.5MG TABS Qty limit = 90 units per annum

Below

718306 MUSCULO-SKELETAL AGENTS Meloxicam Tab 7.5 MG COXITEC 7.5MG TABS Qty limit = 90 units per annum

Above

805238 MUSCULO-SKELETAL AGENTS Naproxen Tab 250 MG NAPROSCRIPT 250MG TABS Qty limit = 200 units per annum

Below

810185 MUSCULO-SKELETAL AGENTS Naproxen Tab 250 MG MYLAN NAPROXEN TABS Qty limit = 200 units per annum

Below

722843 MUSCULO-SKELETAL AGENTS Naproxen Tab 500 MG BIO-NAPROXEN 500MG TABS Qty limit = 200 units per annum

Below

808474 MUSCULO-SKELETAL AGENTS Naproxen Tab 500 MG NAPFLAM 500MG TABS Qty limit = 200 units per annum

Below

810177 ANALGESICS Ibuprofen-Acetaminophen Cap 200-250 MG MYPAID CAPS Qty limit = 200 units per annum

Above

705266 ANALGESICS Ibuprofen-Acetaminophen Cap 200-250 MG DENTOPAIN CAPS Qty limit = 200 units per annum

Below

716543 ANALGESICS Ibuprofen-Acetaminophen Cap 200-250 MG PANADO PLUS CAPS Qty limit = 200 units per annum

Above

719663 ANALGESICS Ibuprofen-Acetaminophen Cap 200-250 MG IBUPAIN CAPS BLISTER PACK Qty limit = 200 units per annum

Below

707087 CENTRAL NERVOUS SYSTEM Sumatriptan Succinate Tab 50 MG MIGREX 50MG TABS Qty limit = 4 units per annum; 3 fills per annum

Below

707088 CENTRAL NERVOUS SYSTEM Sumatriptan Succinate Tab 100 MG MIGREX 100MG TABS Qty limit = 4 units per annum; 3 fills per annum

Below

738778 MUSCULO-SKELETAL AGENTS Allopurinol Tab 100 MG SANDOZ ALLOPURINOL 100MG TABS

Below

758310 MUSCULO-SKELETAL AGENTS Allopurinol Tab 100 MG PURICOS 100MG TABS Below

779466 MUSCULO-SKELETAL AGENTS Allopurinol Tab 100 MG ZYLOPRIM 100MG TABS Above

721623 MUSCULO-SKELETAL AGENTS Allopurinol Tab 100 MG AUSTELL ALLOPURINOL 100MG TABS

Below

Page 36 of 43

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738786 MUSCULO-SKELETAL AGENTS Allopurinol Tab 300 MG SANDOZ ALLOPURINOL 300MG TABS

Below

758329 MUSCULO-SKELETAL AGENTS Allopurinol Tab 300 MG PURICOS 300MG TABS Below

779474 MUSCULO-SKELETAL AGENTS Allopurinol Tab 300 MG ZYLOPRIM 300MG TABS Above

721624 MUSCULO-SKELETAL AGENTS Allopurinol Tab 300 MG AUSTELL ALLOPURINOL 300MG TABS

Below

719128 MUSCULO-SKELETAL AGENTS Allopurinol Tab 300 MG ADCO-ALLOPURINOL 300MG TABS

Below

715298 MUSCULO-SKELETAL AGENTS Colchicine Tab 1 MG COLCHICINE HOUDE 1MG TABS 3 fills per annum Above

722289 MUSCULO-SKELETAL AGENTS Colchicine Tab 1 MG ASPEN COLCHICINE DS 1MG TABS


704600 VITAMINS, TONICS, MINERALS AND ELECTROLYTES

*Prenatal Vitamin Tab** CALCIPREG TABS Females only; 9 consecutive fills

Below


*Prenatal Vitamin Tab** PURITANS PRENATAL VITAMIN TABS

Females only; 9 consecutive fills

Below


*Prenatal Vitamin Tab** PREGWISE TABS Females only; 9 consecutive fills

Below


*Prenatal Multivitamins & Minerals w/ Iron Cap*** BAO FILIVIT CAPSULES Females only; 9 consecutive fills

Below


*Prenatal Multivitamins & Minerals w/Iron & FA Tab 0.8 MG***

RDA-PREG TABS Females only; 9 consecutive fills

Below



CLICKS PAY LESS PRENATAL SUPPL


Below



9 MONTHS + TABS Females only; 9 consecutive fills

Below


*Prenatal Multivitamins & Minerals w/Iron & FA Cap 0.5 MG***

CLICKS PREGNANCY SUPPL CAPS


Below


*Prenatal Vit w/ Fe Fumarate-FA Cap 30-0.8 MG*** NIKIBON CAPS Females only; 9 consecutive fills

Below


*Prenatal Vit w/ Fe Fumarate-FA Cap 30-1 MG*** FILIBON CAPS Females only; 9 consecutive fills

Below


*Oral Electrolyte - Packet*** HYDROL SACH Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** ELECTROPAK Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** REHIDRAT BLACKCURR PACK Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** REHIDRAT ORANGE PACK 14G Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** PIN-HYDRATE (ORANGE) SAC Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** PIN-HYDRATE BLACKCURRANT SAC


Below

Page 37 of 43

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*Oral Electrolyte - Packet*** SMART ORS SACH Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** ELECTRAL WITH ORANGE FLAVOUR


Below


*Oral Electrolyte - Packet*** REHIDRAT 14G BLACKCURRANT SAC


Below


*Oral Electrolyte - Packet*** REHIDRAT HYDRATION 14G LEMON


Below


*Oral Electrolyte - Packet*** HYDRACHOICE CREME SODA SACH


Below


*Oral Electrolyte - Packet*** HYDRACHOICE NAARTJIE SACH Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** HYDRACHOICE TROPICAL SACH Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** REHIDRAT VANILLA 14G SACHET


Below


*Oral Electrolyte - Packet*** SPRINGBOK ELECTROLYTE 14G SAC


Below


*Oral Electrolyte - Packet*** RESTORE HYDRATION 6G SACHETS


Below


*Oral Electrolyte - Packet*** REHIDRAT SPORT NAARTJIE 14G


Below


*Oral Electrolyte - Packet*** SMART ORS 21G SACH Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** SMART ORS BLACK CURRENT 4.2G S


Below


*Oral Electrolyte - Packet*** SMART ORS BLACK CURRENT 21G SA


Below


*Oral Electrolyte - Packet*** NUDRATE CITRUS 5.3G SACHET Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** NUDRATE BLACKCURRANT 5.6G SACH


Below


*Oral Electrolyte - Packet*** NETCARE HYDRATION POWD BLACKCU


Below


*Oral Electrolyte - Packet*** SPAR HYDRATION POWDER BLACKCUR


Below


*Oral Electrolyte - Packet*** MEDIRITE ELECTROLYTES TANGY TA


Below


*Oral Electrolyte - Packet*** MEDIRITE HYDRATION POWDER BLAC


Below


*Oral Electrolyte - Packet*** OS BLACKCURRANT 5.3G SACH Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** OS ORANGE 5.3G SACH Qty limit = 6 units per annum

Below

Page 38 of 43

Nappi code



*Oral Electrolyte - Packet*** SPAR ELECTROLYTES TANGY TANGER


Below


*Oral Electrolyte - Packet*** SPAR ELECTROLYTES LUSTY LEMON


Below


*Oral Electrolyte - Packet*** HYDRASSIST ORS 4.31G SACH Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** PROHYDRATE BLACKCURRENT SACH


Below


*Oral Electrolyte - Packet*** HYDROL 24.69G SACHET Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** PROGAST ADVANCED HYDRATION POW


Below


*Oral Electrolyte - Packet*** PAEDHYDRATE ORS 5.16G SACHET


Below


*Oral Electrolyte - Packet*** CLICKS HYDRATION POWD SACH BLA


Below




Below




Below


*Oral Electrolyte - Packet*** ELECTROLYTE ORS VH 26.4G SACH


Below


*Oral Electrolyte - Packet*** DYNAFORCE BLUEBERRY 60G SACHET


Below


*Oral Electrolyte - Packet*** DYNAFORCE NAARTJIE 60G SACHET


Below


*Oral Electrolyte - Packet*** DYNAFORCE TROPICAL 60G SACHET


Below


*Oral Electrolyte - Packet*** DYNAFORCE CHERRY GRAPE 60G SAC


Below


*Oral Electrolyte - Packet*** HYDRASSIST ORS 4.31G SACHET


Below


*Oral Electrolyte - Packet*** NUDRATE 5.3G SACHET CITRUS Qty limit = 6 units per annum

Below


*Oral Electrolyte - Packet*** NUDRATE 5.3G SACHET BLACKCURRA


Below


*Oral Electrolyte - Packet*** ELECTRAL ORAL REHYDR SALT BP B


Below


Folic Acid Tab 5 MG BE-TABS FOLIC ACID 5MG TABS Below


Folic Acid Tab 5 MG FOLIC ACID 5MG TABS Below


Folic Acid Tab 5 MG GULF FOLIC ACID 5MG TABS Below

Page 39 of 43

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877832 BLOOD AND HAEMOPOEITIC Ferrous Sulfate Tab 30 MG FERROUS SULPHATE 30MG 3 fills per annum Below

705532 BLOOD AND HAEMOPOEITIC Ferrous Sulfate Tab 30 MG AHA FERROUS SULPH 30MG TABS


710580 BLOOD AND HAEMOPOEITIC Ferrous Sulfate Tab 30 MG EGOLI FERROUS SULPHATE 30 3 fills per annum Below

723552 BLOOD AND HAEMOPOEITIC Ferrous Sulfate Tab 30 MG FERROUS SULPHATE 30MG TABS






713558 BLOOD AND HAEMOPOEITIC Ferrous Sulfate Tab 75 MG BODY BALANCE FERROUS SULPH




756571 BLOOD AND HAEMOPOEITIC Ferrous Fumarate-Folic Acid Tab 200-0.1 MG PREGAMAL TABS 3 fills per annum Below

723551 BLOOD AND HAEMOPOEITIC Ferrous Sulfate-Folic Acid Tab 100-0.5 MG FERROUS SULPHATE FOLIC ACID CO


713274 BLOOD AND HAEMOPOEITIC Iron Polymaltose w/FA & B12 Syrup 33-0.6-0.002 MG/5ML(Fe Eq)

FEROFOL SYRP 3 fills per annum Below

713724 OPHTHALMICS Chloramphenicol Ophth Oint 1% CHLORAMEX 3.5GM 1% EYE OINT


713759 OPHTHALMICS Chloramphenicol Ophth Oint 1% CHLORCOL EYE OINT 3 fills per annum Below

765880 OPHTHALMICS Chloramphenicol Ophth Oint 1% SPERSANICOL EYE OINT 3 fills per annum Above

817201 OPHTHALMICS Chloramphenicol Ophth Oint 1% CHLORPHEN 1% 3.5G EYE OINT 3 fills per annum Below

783641 OPHTHALMICS Fusidic Acid Ophth Soln 10 MG/GM (1%) FUCITHALMIC 5ML DROPS 3 fills per annum Below

702935 OPHTHALMICS Ofloxacin Ophth Soln 0.3% OCTIN OPTH DROPS 3 fills per annum Below

839957 OPHTHALMICS Ofloxacin Ophth Soln 0.3% EXOCIN 5ML EYE DROPS 3 fills per annum Above

767360 OPHTHALMICS Sulfacetamide Sodium Ophth Oint 10% LENNON SULPHACETAMIDE EYE 3.5G


716634 OPHTHALMICS Neomycin-Chloramphenicol-Naphazoline Oph Soln 0.5-0.2-0.05%

COVOMYCIN 7.5ML DROPS 3 fills per annum Below

708267 OPHTHALMICS Betamethasone Sodium Phosphate Ophth-Otic-Nasal Soln 0.1%

BETNESOL 5ML DROPS 3 fills per annum Below

765821 OPHTHALMICS Dexamethasone Sodium Phosphate Ophth Soln 0.1% SPERSADEX 0.1% 10ML DROPS 3 fills per annum Below

756466 OPHTHALMICS Prednisolone Acetate Ophth Susp 0.125% PRED-MILD 5ML DROPS 3 fills per annum Below

750271 OPHTHALMICS Naphazoline 0.005% w/ Zinc Sulfate Ophth Soln OCULOSAN 10ML EYE DROPS 3 fills per annum Below

728608 OPHTHALMICS Tetrahydrozoline-Antazoline Ophth Soln 0.04-0.05% GEMINI EYE 15ML 3 fills per annum Below

765856 OPHTHALMICS Tetrahydrozoline-Antazoline Ophth Soln 0.04-0.05% SPERSALLERG DROPS 3 fills per annum Above

827150 OPHTHALMICS Tetrahydrozoline-Antazoline Ophth Soln 0.04-0.05% OCULERGE 20ML EYE DROPS 3 fills per annum Below

Page 40 of 43

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701668 OPHTHALMICS Phenylephrine-Boric Acid Ophth Soln 1.25-20 MG/ML SB UNIVERSAL EYE DROPS 15ML


773883 OPHTHALMICS Phenylephrine-Boric Acid Ophth Soln 1.25-20 MG/ML UNIVERSAL 15ML EYE SOLN 3 fills per annum Below

706558 OPHTHALMICS Azelastine HCl Ophth Soln 0.05% OPTILAST 3 fills per annum Below

804630 OPHTHALMICS Cromolyn Sodium Ophth Soln 2% VIVIDRIN EYE 10ML EYE DROPS 3 fills per annum Below

822698 OPHTHALMICS Cromolyn Sodium Ophth Soln 2% CROMOHEXAL EYE DROPS 3 fills per annum Above

894605 OPHTHALMICS Cromolyn Sodium Ophth Soln 2% STOP ALLERG 13.5ML 3 fills per annum Below

827762 EAR, NOSE AND THROAT Acetic Acid Otic Soln 1% SWIMMERS EAR CLEANSER 3 fills per annum Below

707464 EAR, NOSE AND THROAT Acetic Acid Otic Soln 1% AQUA 7.5ML EAR 3 fills per annum Below

711967 EAR, NOSE AND THROAT Acetic Acid Otic Soln 1% ACETIC ACID 1% ML 3 fills per annum Below

80539 EAR, NOSE AND THROAT Acetic Acid Otic Soln 1% SWIMMERS EAR DROPS 3 fills per annum Below

721264 EAR, NOSE AND THROAT Acetic Acid Otic Soln 1% SPORT SWIMMERS EAR LIQUID 3 fills per annum Below

723092 EAR, NOSE AND THROAT Acetic Acid Otic Soln 1% CLICKS EAR DROPS 30ML 3 fills per annum Below

721221 EAR, NOSE AND THROAT Acetic Acid Otic Soln 2% ACETIC ACID 2% 3 fills per annum Below

746568 EAR, NOSE AND THROAT Neomycin-Sodium Propionate Otic Soln 3-50 MG/ML NEOPAN 15ML EAR DROPS 1 fill per annum Below

701100 ANTI-MICROBIALS Nystatin Susp 100000 Unit/ML CANDACIDE SUSP 20ML 3 fills per annum Above

701100 ANTI-MICROBIALS Nystatin Susp 100000 Unit/ML CANDACIDE SUSP 30ML 3 fills per annum Above

835056 ANTI-MICROBIALS Nystatin Susp 100000 Unit/ML CANSTAT ORAL DROPS 3 fills per annum Below

835285 ANTI-MICROBIALS Nystatin Susp 100000 Unit/ML NYSTACID ORAL 100000 SUSP 3 fills per annum Above

731005 DISINFECTANTS Chlorhexidine Gluconate Soln 0.2% CORSODYL 2MG/ML SOLN 3 fills per annum Below

808377 DISINFECTANTS Chlorhexidine Gluconate Soln 0.2% CORSODYL 2MG/ML MINT SOLN


3000520 DISINFECTANTS Chlorhexidine Gluconate Soln 0.2% SEPTOCHLOR 2MG/1ML MOUTHWASH


785210 EAR, NOSE AND THROAT Povidone-Iodine Mouthwash 1% PODINE MOUTHW & GARGLE 3 fills per annum Below

799688 EAR, NOSE AND THROAT Povidone-Iodine Mouthwash 1% DERMADINE GARGLE 3 fills per annum Below

819859 EAR, NOSE AND THROAT Povidone-Iodine Mouthwash 1% SEPTADINE ORAL ANTISEPTIC 3 fills per annum Above

890365 EAR, NOSE AND THROAT Povidone-Iodine Mouthwash 1% STERIDINE MOUTHWASH AND GAR


751340 EAR, NOSE AND THROAT Benzocaine Lozenge 10 MG OROCAINE LOZ 3 fills per annum Below

772674 EAR, NOSE AND THROAT Benzocaine Lozenge 10 MG TROCHAIN LOZ 3 fills per annum Below

826391 EAR, NOSE AND THROAT Tetracaine HCl Ointment 0.5% DYNEXAN OINT 1 fill per annum Below

756849 GASTRO-INTESTINAL TRACT *Rectal Protectant-Emollient Ointments** PREPARATION H OINT 3 fills per annum Below

756830 GASTRO-INTESTINAL TRACT *Rectal Protectant-Emollient Suppositories** PREPARATION H SUPP 3 fills per annum Below

Page 41 of 43

Nappi code


826375 SUPPOSITORIES / ANAL OINTMENTS Pramoxine w/ Zinc Oxide in Mineral Oil Rectal Oint 1-12.5%

ANUSOL OINT 3 fills per annum Below

807842 DERMATOLOGICALS Benzoyl Peroxide Gel 5% BENZAC AC 5 GEL 3 fills per annum Above

896079 DERMATOLOGICALS Benzoyl Peroxide Gel 5% CREME CLASSIQUE ACNE 5 GEL 3 fills per annum Below

727377 DERMATOLOGICALS Fusidate Sodium Oint 2% FUCIDIN OINT 3 fills per annum Below

727431 DERMATOLOGICALS Fusidic Acid Cream 2% FUCIDIN CREAM 3 fills per annum Below

706493 DERMATOLOGICALS Mupirocin Oint 2% BACTROBAN TOPICAL OINT 3 fills per annum Above

721587 DERMATOLOGICALS Mupirocin Oint 2% NUBAN 2GM/100GM OINTMENT


80631 DERMATOLOGICALS Mupirocin Oint 2% MUPIROCIN:POVID-I 1:5 3 fills per annum Below

715837 DERMATOLOGICALS Mupirocin Oint 2% SUPIROBAN 2GM/100GM OINTMENT


721693 DERMATOLOGICALS Mupirocin Oint 2% DERMOBAN 20MG/1G OINT 3 fills per annum Below

723040 DERMATOLOGICALS Mupirocin Oint 2% BANOGON 2% OINTMENT 3 fills per annum Below

702504 DERMATOLOGICALS Mupirocin Calcium Cream 2% BACTROBAN CREAM 3 fills per annum Below

797022 DERMATOLOGICALS Nystatin Oint 100000 Unit/GM NYSTACID OINT 3 fills per annum Below

712205 DERMATOLOGICALS Clotrimazole Cream 1% CANESTEN TOPICAL CREAM 3 fills per annum Above

788554 DERMATOLOGICALS Clotrimazole Cream 1% CANDASPOR CREAM 3 fills per annum Above

793493 DERMATOLOGICALS Clotrimazole Cream 1% ADCO-NORMOSPOR CREAM 3 fills per annum Below

796336 DERMATOLOGICALS Clotrimazole Cream 1% CANALBA CREAM 3 fills per annum Above

797006 DERMATOLOGICALS Clotrimazole Cream 1% CANDIZOLE CREAM 3 fills per annum Above

799505 DERMATOLOGICALS Clotrimazole Cream 1% MICOMISAN CREAM 3 fills per annum Above

799696 DERMATOLOGICALS Clotrimazole Cream 1% MEDASPOR CREAM 3 fills per annum Above

816299 DERMATOLOGICALS Clotrimazole Cream 1% XERASPOR-T CREAM 3 fills per annum Below

824011 DERMATOLOGICALS Clotrimazole Cream 1% CANEX TOPICAL CREAM 3 fills per annum Below

826952 DERMATOLOGICALS Clotrimazole Cream 1% A-POR CREAM 3 fills per annum Below

839639 DERMATOLOGICALS Clotrimazole Cream 1% TRIMAZE CREAM 3 fills per annum Above

846422 DERMATOLOGICALS Clotrimazole Cream 1% FUNGISPOR CREAM 3 fills per annum Below

878421 DERMATOLOGICALS Clotrimazole Cream 1% CLOMADERM CREAM 3 fills per annum Below

705246 DERMATOLOGICALS Clotrimazole Cream 1% DIS-CHEM CLOTRIMAZOLE CREAM


716106 DERMATOLOGICALS Clotrimazole Cream 1% INNOSPORE 1% CREAM 3 fills per annum Below

776300 DERMATOLOGICALS Iodoquinol-Chlorobutanol-Benzocaine Cream 30-10-10 MG/GM

VIODOR CREAM 3 fills per annum Below

776297 DERMATOLOGICALS Iodoquinol-Chlorobutanol-HC Cream 3-1-0.25% VIOCORT CREAM 3 fills per annum Below

Page 42 of 43

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701102 DERMATOLOGICALS Pyrilamine Maleate Cream 2% MEPYRADERM CREAM 3 fills per annum Below

703834 DERMATOLOGICALS Pyrilamine Maleate Cream 2% ANTHISAN CREAM 3 fills per annum Above

800511 DERMATOLOGICALS Pyrilamine Maleate Cream 2% MEPYRIMAL 2% CREAM 3 fills per annum Below

897334 DERMATOLOGICALS Pyrilamine Maleate Cream 2% ALSAN 2% CREAM 3 fills per annum Above

731269 DERMATOLOGICALS Diphenhydramine-Pyrilamine Cream 1-1% HISTODOR CREAM 3 fills per annum Below

794120 DERMATOLOGICALS Diphenhydramine-Calamine-Phenol Lotion 1-15-0.4% BIOHIST LOT 3 fills per annum Below

828076 MUSCULO-SKELETAL AGENTS Ibuprofen Gel 5% IBULEVE GEL 2 fills per annum Below

833096 MUSCULO-SKELETAL AGENTS Ibuprofen Gel 5% DEEP RELIEF GEL 50MG/1GM 2 fills per annum Above

823473 ANTI-MICROBIALS Acyclovir Cream 5% ACTIVIR PUMP CREAM 3 fills per annum Above

824674 ANTI-MICROBIALS Acyclovir Cream 5% ADCO-ACYCLOVIR 50MG/GM CREAM


826340 ANTI-MICROBIALS Acyclovir Cream 5% ZOVIRAX 50MG/GM CREAM 3 fills per annum Above

873551 ANTI-MICROBIALS Acyclovir Cream 5% ACITOP 5% CREAM 3 fills per annum Below

713942 ANTI-MICROBIALS Acyclovir Cream 5% BETA-VIRA 5% CREAM 3 fills per annum Below

784524 ANTI-MICROBIALS Nitrofurazone Oint 0.2% FURASEPT OINT 3 fills per annum Below

805416 DERMATOLOGICALS Nitrofurazone Oint 0.2% FUREX OINT 3 fills per annum Below

701138 DERMATOLOGICALS Betamethasone Valerate Cream 0.1% (Base Equivalent)

VARI-BETAMETHASONE CREAM



PERSIVATE CREAM 3 fills per annum Above


LENOVATE 0.1% CREAM 3 fills per annum Above


ADCO-BETAMETHASONE CREAM



TOPIVATE 1MG/GM CREAM 3 fills per annum Below


REPIVATE CREAM 3 fills per annum Below

754072 DERMATOLOGICALS Betamethasone Valerate Oint 0.1% (Base Equivalent) PERSIVATE OINT 3 fills per annum Above

800171 DERMATOLOGICALS Betamethasone Valerate Oint 0.1% (Base Equivalent) LENOVATE 0.1% OINT 3 fills per annum Below

807249 DERMATOLOGICALS Clobetasol Propionate Cream 0.05% DOVATE .5MG/GM CREAM 3 fills per annum Below

807230 DERMATOLOGICALS Clobetasol Propionate Oint 0.05% DOVATE .5MG/GM OINT 3 fills per annum Below

764353 DERMATOLOGICALS Hydrocortisone Cream 0.5% SKINCALM CREAM 3 fills per annum Above

700445 DERMATOLOGICALS Hydrocortisone Cream 1% VARI-HYDROCORTISONE 1% CREAM


720011 DERMATOLOGICALS Hydrocortisone Acetate Cream 0.5% DILUCORT CREAM 3 fills per annum Below

Page 43 of 43

Nappi code


745472 DERMATOLOGICALS Hydrocortisone Acetate Cream 1% MYLOCORT 1GM/100GM CREAM


807834 DERMATOLOGICALS Hydrocortisone Acetate Cream 1% BIOCORT CREAM 3 fills per annum Below

810223 DERMATOLOGICALS Hydrocortisone Acetate Cream 1% STOPITCH CREAM 3 fills per annum Above

703591 ANAESTHETICS Tetracaine HCl Cream 1% ANETHAINE CREAM 3 fills per annum Above

799211 ANAESTHETICS Tetracaine HCl Cream 1% AMETHOCAINE CREAM 3 fills per annum Below

700205 DERMATOLOGICALS Benzyl Benzoate Emulsion 25% APP BENZYL BENZOATE 1 fill per annum Below

704857 DERMATOLOGICALS Benzyl Benzoate Emulsion 25% ASCABIOL EMULSION 1 fill per annum Above

885588 DERMATOLOGICALS Benzyl Benzoate Emulsion 25% BENZYL BENZOATE APPL 1 fill per annum Below

706448 DERMATOLOGICALS Benzyl Benzoate Emulsion 25% BENZYL BENZOATE APPLICATION

1 fill per annum Above

770116 DERMATOLOGICALS Sulfiram Bar 5% TETMOSOL 5% 75GM BAR 1 fill per annum Below

722436 DERMATOLOGICALS Sulfiram Bar 5% TEMODERM 5% SOAP 75G 1 fill per annum Below

715602 DERMATOLOGICALS *Calamine Lotion*** CALAMINE LOTION - DAROL LOTION


861758 DERMATOLOGICALS *Calamine Phenolated Lotion*** LINK LOT CALAMINE 3 fills per annum Below

865311 DERMATOLOGICALS *Calamine Phenolated Lotion*** CALAMINE LOTION 3 fills per annum Below

872490 DERMATOLOGICALS *Calamine Phenolated Lotion*** CALAMINE LOTION BP 3 fills per annum Below

705561 DERMATOLOGICALS *Calamine Phenolated Lotion*** CALAMINE LOTION BP 3 fills per annum Below

706615 DERMATOLOGICALS *Calamine Phenolated Lotion*** ARM CALAMINE LOT 3 fills per annum Below

712969 DERMATOLOGICALS *Calamine Phenolated Lotion*** CLICKS CALAMINE LOT 3 fills per annum Below

717243 DERMATOLOGICALS *Calamine Phenolated Lotion*** CALAMINE - ALCHEMIST LOTN 3 fills per annum Below

3000385 DERMATOLOGICALS *Calamine Phenolated Lotion*** CALAMINE LOTN 3 fills per annum Below

704716 DISINFECTANTS Chlorhexidine Gluconate Soln 0.2 MG/ML HIBITANE 0.2% IN WATER 1 fill per annum Below

702549 DERMATOLOGICALS Povidone-Iodine Oint 10% BARRS POVIDONE IODINE 3 fills per annum Above

755834 DERMATOLOGICALS Povidone-Iodine Oint 10% PODINE OINT 3 fills per annum Above

821713 DERMATOLOGICALS Povidone-Iodine Oint 10% SEPTADINE ANTISEPT OINT 3 fills per annum Above

717217 DERMATOLOGICALS Povidone-Iodine Oint 10% BARRS POVIDONE-IODINE 10%OINT


Documents

ACUTE MEDICATION FORMULARY 2020 - FishMed12232019123547 PM... · SANDOZ CO -AMOXICLAV BD 1000 3 fills per annum Below 704049 ANTI-MICROBIALS Amoxicillin & K Clavulanate Tab 875 -125