CYSTIC FIBROSIS. Pace4 Pace3 Pace2 A AMOXYCILLIN ADCO-AMOX 125MG SUSP YES ADCO-AMOX 500MG CAP ADCO-AMOX 250MG SUSP A-LENNON AMOXYCILLIN 250M
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1 Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular group of generic equivalent medicines which is reviewed and updated regularly. MRP sets a maximum reimbursable price for a list of generically similar medicines with a cost lower than that of the original medicine. There may be instances where a generic alternative costs more than the set MRP. If you opt to use the original medicine and a generic alternative is available, or you use a medicine that costs more than the MRP, you will have to pay the difference between the price of the chosen medicine and that of MRP. This formulary is effective from 1 January This formulary is subject to change without notice. CYSTIC FIBROSIS ACTIVE INGREDIENT A AMOXYCILLIN ADCO-AMOX 125MG SUSP ADCO-AMOX 250MG CAP ADCO-AMOX 250MG SUSP ADCO-AMOX 500MG CAP A-LENNON AMOXYCILLIN 125 A-LENNON AMOXYCILLIN 250M ALLMOX 250MG CAP ALLMOX 500MG CAP AMOCAS 250MG CAP AMOCILLIN 250MG CAP AMOCILLIN 125MG SUSP AMOCILLIN 500MG CAP AMOXICAP 250MG CAP AMOXICILLIN HEXAL 500MG AMOXIL 250MG CAP AMOXIL 500MG CAP AMOXIL S 125MG SUSP AMOXIL SF 250MG SUSP AURO-AMOXYCILLIN 250MG CAP AURO-AMOXYCILLIN 500MG CAP AUSTELL-AMOXICILLIN 250MG 1
2 AUSTELL-AMOXICILLIN 500MG BETAMOX 250MG CAP BETAMOX 500MG CAP BETAMOX S 125MG/5ML SUS BETAMOX SF 250MG/5ML SUS DYNA-AMOXYCIL 125MG/5ML IPCAMOX 250MG CAP MOXYMAX 125 SUSP MOXYMAX 250 SUSP MOXYPEN 125 SUSP MOXYPEN 250MG CAP MOXYPEN 250MG/5ML SUSP MOXYPEN 500MG CAP MYMOX 250MG CAP MYMOX 500MG CAP PROMOXIL 250MG CAP PROMOXIL 500MG CAP PROMOXIL S 125MG/5ML PROMOXIL SF 250MG/5ML RANMOXY 250MG CAP RANMOXY 500MG CAP RANMOXY SUSP 125MG RANMOXY SUSP 250MG SALTERMOX S 125MG/5ML SALTERMOX SF 250MG/5ML ZALOXY 125MG/5ML SUSP ZALOXY 250MG CAP ZALOXY 250MG/5M SUSP ZALOXY 500MG CAP 2
3 ZOXIL 250MG CAP ZOXIL 500MG CAP ZOXIL S 125MG/5ML SUS ZOXIL SF 250MG/5ML SUS AMOXICILLIN / CLAVULANIC ADCO-AMOCLAV 375 ADCO-AMOCLAV 625 ADCO-AMOCLAV BD 1000MG ADCO-AMOCLAV S ADCO-AMOCLAV SF AMOCLAN TAB AMOCLAN BID 1000MG TAB AMOCLAN FORTE TAB AMOCLAN S SUSP AMOCLAN SF SUSP APEX-CLAVUTIN 375MG TAB APEX-CLAVUTIN 625MG TAB APEX-CLAVUTIN SF AUGMAXCIL 375 AUGMAXCIL 625 AUGMAXCIL S AUGMAXCIL SF AUGMENTIN 375MG TAB AUGMENTIN 625MG TAB AUGMENTIN 1000MG BD TAB AUGMENTIN BD S SUSP AUGMENTIN BD SF SUSP AUGMENTIN S SUSP AUGMENTIN SF SUSP AUGMENTIN SR 1000MG AURO-AMOXICLAV 1000MG TAB 3
4 AURO-AMOXICLAV 125/31.25MG AURO-AMOXICLAV 250/62.5 MG AURO-AMOXICLAV 375MG TAB AURO-AMOXICLAV 625MG TAB AUSTELL-CO-AMOXICLAV 375MG AUSTELL-CO-AMOXICLAV 625MG BIO-AMOKSIKLAV 1000MG TAB BIO-AMOKSIKLAV 156 SUSP BIO-AMOKSIKLAV 312 SUSP BIO-AMOKSIKLAV 375 BIO-AMOKSIKLAV 625 TAB CLAMENTIN 1000MG TAB CLAMENTIN 375MG CLAMENTIN S CLAMENTIN SF CLAVUMOX 375MG CLAVUMOX S CLAVUMOX SF CURAM 1000GM BD TAB CURAM 625MG TAB CURAM BD SUSP FORCID SOLUTAB 875/125 MOXYCLAV 375MG MOXYCLAV S MOXYCLAV SF RANCLAV 1000MG TAB RANCLAV 375MG RANCLAV 625MG RANCLAV FORTE SUSPENSION RANCLAV SUSPENSION 4
5 SANDOZ CO AMOCLAV S SANDOZ CO AMOCLAV SF SANDOZ CO AMOXYCLAV 375 SANDOZ CO-AMOXYCLAV BD 1 SANDOZ CO-AMOXYCLAV 625 SANDOZ CO-AMOXYCLAV BD AMOXYCILLIN / FLUCLOXACILLIN MACROPEN CAP MACROPEN SUSP AMPICILLIN AMPIPEN 250MG CAP BE-AMPICIL 125MG SUSP BE-AMPICIL 250MG CAP SANDOZ AMPICILLIN 250MG AMPICILLIN / CLOXACILLIN APEN 500MG CAP APEN SUSP CLOXAM 500MG CAP B BECLOMETHASONE BECLATE 50MCG INHALER BECLATE 100MCG INHALER BECLATE 200MCG INHALER BECEZE 50MCG INHALER BECEZE 100MCG INHALER BECOTIDE DISKHALER BECOTIDE ROTACAPS 100 BECOTIDE ROTACAPS 200 BECOTIDE ROTAHALER QVAR AUTOHALER 100MCG QVAR AUTOHALER 50MCG QVAR PRESS/BREATH 100MCG QVAR PRESS/BREATH 50MCG BETAMETHASONE BETANOID 0.6MG/5ML SYR STEROMIEN 0.6MG/5ML SYR 5
6 BUDESONIDE BUDEFLAM DP 200MCG INH CA BUDEFLAM HFA 100MCG 300D BUDEFLAM HFA 200MCG 300D INFLAMMIDE 100MCG INH 300 INFLAMMIDE 200 MCG NOVOLI INFLAMMIDE 200MCG INH 300 INFLAMMIDE 400MCG NOVOLI INFLAMMIDE 50MCG INH 300D INFLAMMIDE COMP NOVOLIZER INFLAMMIDE REF NOVOLIZER PULMICORT TURBU 100MCG PULMICORT TURBU 200MCG PULMICORT TURBU 400MCG BUDESONIDE / FORMOTEROL SYMBICORD INH 320/9MCG SYMBICORD INH 80/4.5MCG SYMBICORD TURBU 160/4.5 SYMBICORD TURBU 160/ VANNAIR 160/4.5MCG INH VANNAIR 80/4.5MCG INH C CARBOCISTEINE CO-FLEM 250MG SYR LESSMUSEC 250MG/5ML MUCOSPECT SYR CEFPODOXIME CEPODEM 100MG TAB CEPODEM 200MG TAB CEPODEM SUSP ORELOX 100MG TAB ORELOX JUNIOR SUSP SANDOZ CEFPODOXIME 100MG SANDOZ CEFPODOXIME 40MG/5 SIMAYLA CEFPODOXIME 100MG 6
7 SIMAYLA CEFPODOXIME 40MG/ CIPROFLOXACIN AUSTELL CIPROFLOX 250MG AUSTELL CIPROFLOX 500MG AUSTELL CIPROFLOX 750MG BIOCIP 250MG TAB BIOCIP 500MG TAB BIOTECH CIPROFLOXACIN 50 BIOTECH CIPROFLOXACIN 250 BIOTECH CIPROFLOXACIN 750 CIFLOC 250MG TAB CIFLOC 500MG TAB CIFLOC 750MG TAB CIFRAN 250 CIFRAN 500 CILOFLOC 250MG TAB CILOFLOC 500MG TAB CIPLOXX 250 CIPLOXX 500 CIPROBAY 250MG TAB CIPROBAY 500MG TAB CIPROBAY 750MG TAB CIPROGEN 250MG TAB CIPROGEN 500MG TAB CIPRO-HEXAL 250MG CIPRO-HEXAL 500MG CIPROL 250MG TAB CIPROL 500MG TAB CPL ALNCE CIPROFLOXACIN 2 CPL ALNCE CIPROFLOXACIN 5 DYNAFLOC 250MG TAB DYNAFLOC 500MG TAB 7
8 LOXIP 250MG TAB LOXIP 500MG TAB ORPIC 250MG TAB ORPIC 500MG TAB ORPIC 750MG TAB SIMAYLA CIPROFLOXACIN 250 SIMAYLA CIPROFLOXACIN 500 CLARITHROMYCIN CLARIHEXAL 125 P SUS CLARIHEXAL 250 P SUS KLACID 125MG/5ML SUSP KLACID 250MG/5ML SUSP KLARITHRAN 125MG/5ML SUS KLARITHRAN 250MG/5ML SUS RAN-CLARITHROMYCIN 250MG RAN-CLARITHROMYCIN 125MG CLINDAMYCIN CLINDAHEXAL 150MG DALACIN C 150MG CAP CLOXACILLIN CLOXIN 250MG CAP CLOXIN 500MG CAP SANDOZ CLOXACILLIN 500 D DOXYCYLINE A-LENNON DOXYCYCLINE HCL CYCLIDOX 100MG CAP CYCLIDOX EC 100MG CAP CYCLIDOX EC 50MG CAP DOXITAB DOXYCYL 50MG CAP DOXYCYL 100MG CAP DUMOXIN 50MG CAP E ERYTHROMYCIN ADCO-ERYTHROMYCIN 250 CAP 8
9 BETAMYCIN 250MG TAB ERYKO-250 TABLETS ERYMYCIN AF 250MG CAP ERYMYCIN P 125MG SUSP ERYMYCIN PF 250MG SUSP ERYTHROCIN 250MG TAB MERCK-ERYTHROMYCIN 250MG PURMYCIN 250MG CAP PURMYCIN 125MG/5ML SUSP PURMYCIN 250MG/5ML SUSP RUBIMYCIN 250MG TAB SPECTRASONE 250MG CAP SPECTRASONE 125MG SUS SPECTRASONE 250MG SUS XERAMEL 250MG CAP XERAMEL S SUS I IPRATROPIUM ATROVENT 20 HFA 200DOSE IPVENT-40MCG INH 300DOSE IPRATROPIUM / SALBUTAMOL COMBIVENT INHALER DUOLIN HFA 200DOSE INH F FENOTEROL ADCO FENOTEROL 0.5MG/2ML BEROTEC 100 HFA 200DOSE BEROTEC UDV PAED 0.5MG FENOTEROL / IPRATROPIUM DUOVENT HFA 200DOSE INH FLUCLOXACILLIN FLOXAPEN 125MG/5ML FLOXAPEN 250MG CAP FLUPEN 250MG CAPS SANDOZ FLUCLOXACILLIN 250 FORMOTEROL FORADIL INHALETS 9
10 FORATEC DP INH CAP FORATEC HFA 120 DOSE INH OXIS TURBUHALER L LACTULOSE ACULAX 3.3G/5ML SYR ADCO-LIQUILAX SYR ANLAC SYR LORACARBEF LORABID 100MG/5ML SUSP LORABID 200MG/5ML SUSP LORABID 200MG CAP M METRONIDAZOLE ACUZOLE 200MG TAB ACUZOLE 400MG TAB ADCO-METRONIDAZOLE 200MG ADCO-METRONIDAZOLE 400MG AMZOLE 400MG BE-METRAZOLE 200MG TAB BE-METRAZOLE 400MG TAB BIO-METRONIDAZOLE 200MG BIO-METRONIDAZOLE 400MG FLAGYL 200MG TAB FLAGYL 400MG TAB METAZOL 200MG METAZOL 400MG METRAZOLE 400MG TAB METROSTAT 400MG TAB NAROBIC 200MG CAP SUPRAZOLE 400MG TAB TRICHAZOLE 200MG TAB TRICHAZOLE 400MG TAB 10
11 N NORFLOXACIN FLOXIN 400MG TAB UTIN-400 TAB O OFLOXACIN TAFLOC 200MG TAFLOC 400MG TARIVID 200MG TAB OXYTETRACYCLINE BE-OXYTET 250MG CAP DYNOXYTET 250MG CAP NUCOTET O-4 CYCLINE 250MG CAP OXY 250MG CAP OXYPAN 250MG CAP PHARMATET 250MG CAP ROXY 250MG CAP TETRACEM 250MG CAP P PHENOXYMETHYLPENICILLIN BETAPEN 125MG/5ML SYR BETAPEN 250MG TAB PREDNISONE BE-TABS PREDNISONE 5MG TAB METICORTEN 5MG TAB PANAFCORT 5MG TAB TROLIC 5MG TAB S SALBUTAMOL ASTHAVENT 200D ECOHALER ASTHAVENT 300D ECOHALER ASTHAVENT DP 200MCG CAP ASTHAVENT INH 200D VENTEZE CFC FREE 200 DOSE VENTEZE INH COMP 200D VENTIMAX CFC FREE 100MCG 11
12 VENTOLIN INH 200D CFC-FRE SALMETEROL SEREVENT ACCUHALER SEREVENT CFC-FREE 120DOSE SALMETEROL / FLUTICASONE FOXAIR 25/ DOSE T TRIMETHOPRIM / SULPHAMETHOXAZOLE FOXAIR 25/ DOSE FOXAIR 25/ DOSE FOXAIR 50/100 ACCUHALER FOXAIR 50/250 ACCUHALER FOXAIR 50/500 ACCUHALER SEREFLO 25/125 SEREFLO 25/250 SEREFLO 25/50 SERETIDE 25/ DOSE SERETIDE 25/ DOSE SERETIDE 25/ DOSE SERETIDE 50/100 ACCUHALER SERETIDE 50/250 ACCUHALER SERETIDE 50/500 ACCUHALER ADCO-CO-TRIMOXAZOLE BACTRIM DS TAB BACTRIM TAB CASICOT TAB COZOLE TAB CO-TRIM SUSP DUROBAC DS TAB DUROBAC TAB ILVITRIM TAB LAGATRIM TAB NUCOTRIM 480MG 12
13 PURBAC DS TAB PURBAC TAB SANDOZ CO-TRIMOXAZOL 960 TRIMETHOX TAB XERAZOLE SUSP XEROPRIM 480MG 13
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