Medicines and poisons

Northern Territory hospital formulary

The NT Hospital formulary is a list of core medicines which are approved for use within NT public hospitals and health services. Through a Territory-wide approach to the availability of medicines, NT Department of Health (DoH) aims to optimise the quality use of medicines, improve and promote equity of access to medicines and increase the cost-effectiveness of medicine use across the NT.

Download the NT Hospital formulary DOCX (441.7 KB)

For any queries related to NT Hospital Formulary, email ntmtc.health@nt.gov.au.

Search medicines from the list

Formulary listing key:

  • Y – Listed on NT Hospital Formulary and not restricted
  • S – Highly Specialised Drugs Program (Section 100)
  • R – Listed on NT Hospital Formulary with restrictions

Drug

Dose form

Strength

Formulary Listing

Notes

ABACAVIR

Tablet

300mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

ABIRATERONE

Tablet

250mg

R

Restricted to Haematology and Oncology for PBS listed indications.

ACAMPROSATE

Tablet

333mg

R

Restricted to Addiction medicine prescribers

ACETAZOLAMIDE

Injection

500mg

Y

 

ACETAZOLAMIDE

Tablet

250mg

Y

 

ACETIC ACID

Solution

0.25% & 5%

Y

ACETONE

Liquid

 

Y

 

ACETYLCHOLINE

Intraocular Irrigation

1% (2mg/2mL)

Y

 

ACETYLCYSTEINE

Injection

2g/10mL

Y

 

ACETYLCYSTEINE

Nebulised vial

800mg/4mL

Y

 

ACICLOVIR

Injection

250mg

Y

 

ACICLOVIR

Tablet

200mg & 800mg

Y

 

ACICLOVIR

Ointment

3%

Y

 

ACICLOVIR COLD SORE

Cream

5%

Y

 

ACTIVATED CHARCOAL

Oral Liquid

0.2g/mL

Y

 

ADALIMUMAB

Injection

40mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

ADENOSINE

Injection

6mg/2mL

Y

 

ADRENALINE (EPINEPHRINE)

Injection

1 in 1000 & 1 in 10 000

Y

 

ADRENALINE (EPINEPHRINE)

Min-I-Jet

1 in 1000

Y

 

ADRENALINE (EPINEPHRINE)

Auto-injector

300 microg & 150 microg

R

EPI-PEN® AND EPI-PEN® JUNIOR

Restricted to after-hours use only by the Emergency Department.

Restricted to administration by authorised Medical Radiation Therapists and Pharmacists.

ALBENDAZOLE

Tablet

200mg, 400mg

Y

 

ALCOHOL

Injection

96%

Y

 

ALCOHOL

Solution

70% untinted, 95% untinted, absolute

Y

 

ALCOHOL STERILE SPRAY

Spray

70%

Y

 

ALENDRONATE

Tablet

70mg

Y

 

ALFENTANIL

Injection

1mg/2mL

Y

 

ALLOPURINOL

Tablet

100mg & 300mg

Y

 

ALPROSTADIL

Injection

500 microg

Y

 

ALTEPLASE

Syringe

Vial

2mg/2mL

Y

Vials restricted to services where logistics of delivering and storing the frozen pre-filled syringe is not feasible.

ALTEPLASE

Injection

10mg

R

Restricted for use by respiratory specialists/advanced trainees with experience in its use for empyema management

ALTEPLASE

Injection

50mg

R

Restricted to Cardiology, ICU and ED for management of Acute STEMI OR Massive PE OR Acute ischaemic stroke.

AMIKACIN

Injection

500mg/2mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

AMINO ACID AND CARBOHYDRATE SUPPLEMENT (HEPATICAL®)

Sachet

100grams

Y

 

AMINO ACID LONG CHAIN POLYUNSATURATED FATTY ACIDS

Powder

 

R

Restricted to PBS indications.

AMINO ACIDS 7% GLUCOSE

Solution

7%

Y

 

AMINOPHYLLINE

Injection

250mg

Y

 

AMIODARONE

Injection

150mg

Y

 

AMIODARONE

Tablet

100mg & 200mg

Y

 

AMISULPRIDE

Tablet

100mg, 200mg & 400mg

R

Restricted to Mental Health

AMITRIPTYLINE

Tablet

10mg, 25mg & 50mg

Y

 

AMLODIPINE

Tablet

5mg & 10mg

Y

 

AMOXICILLIN

Suspension

250mg/5mL

Y

 

AMOXICILLIN

Capsule/ Tablet

250mg, 500mg & 1000mg

Y

 

AMOXICILLIN, CLARITHROMYCIN & ESOMEPRAZOLE

Tablet

500mg/ 250mg/ 20mg

Y

 

AMOXICILLIN & CLAVULANIC ACID

Injection

1g+200mg, 500mg+100mg, 2g+200mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

AMOXICILLIN & CLAVULANIC ACID

Tablet

500/125mg & 875/125mg

Y

 

AMOXICILLIN & CLAVULANIC ACID

Suspension

400/57mg /5mL

Y

 

AMPHOTERICIN

Lozenges

10mg

Y

 

AMPHOTERICIN LIPOSOMAL

Injection

50mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

AMPICILLIN

Injection

500mg & 1g

Y

 

ANASTROZOLE

Tablet

1mg

R

Restricted to Oncology and Haematology only

ANIDULAFUNGIN

Injection

100mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

ANTIVENOM BOX JELLYFISH

Injection

20 000 units

Y

 

ANTIVENOM BROWN SNAKE

Injection

1 000 units

Y

 

ANTIVENOM POLYVALENT SNAKE

Injection

40 000 units

Y

 

ANTIVENOM RED BACK SPIDER

Injection

500 units

Y

 

ANTIVENOM SEA SNAKE

Injection

1000 units

Y

 

ANTIVENOM STONE FISH

Injection

2000 units

Y

 

APIXABAN

Tablet

2.5mg & 5mg

R

Restricted to PBS indications.

APRACLONIDINE

Eye drop

0.5% (5mg/mL)

Y

 

AQUEOUS CREAM

Cream

 

Y

 

ARGININE

Injection

15g/25mL

R

Restricted to paediatrics for arginine stimulation test for pituitary function

ARGIPRESSIN (VASOPRESSIN)

Injection

20units

R

Restricted to ICU

ARIPIPRAZOLE

Tablet

10mg, 15mg, 20mg & 30mg

R

Restricted to Mental Health for the treatment of schizophrenia.

ARIPIPRAZOLE

Depot Injection

300mg & 400mg

R

Restricted to Mental Health for the treatment of schizophrenia.

ARTEMETHER & LUMEFANTRINE

Tablet

20mg/120mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

ARTESUNATE

Injection

60mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

ASCORBIC ACID

Tablet

500mg

Y

 

ASPIRIN

Dispersible tablets

300mg

Y

 

ASPIRIN

Tablet

100mg

Y

 

ATAZANAVIR

Capsule

200mg & 300mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

ATAZANAVIR & COBICISTAT

Tablet

300mg+150mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

ATENOLOL

Tablet

50mg

Y

 

ATENOLOL

Liquid

50mg/10mL

Y

 

ATORVASTATIN

Tablet

10mg, 20mg, 40mg & 80mg

Y

 

ATOVAQUONE & PROGUANIL

Tablet

250mg/100mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

ATRACURIUM

Injection

25mg

Y

 

ATROPINE SULFATE

eye drop & Minims

1%

Y

 

ATROPINE SULFATE

Injection

600microg

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

AZACITIDINE

Injection

100mg

R

Restricted to Haematology and Oncology for PBS listed indications.

AZATHIOPRINE

Tablet

25mg & 50mg

Y

 

AZITHROMYCIN

Injection

500mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

AZITHROMYCIN

Suspension

200mg/ 5mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for bronchiectasis in paediatric patients.

AZITHROMYCIN

Tablet

500mg & 600mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for bronchiectasis in paediatric patients and for susceptible infections not listed on the PBS approved by Infectious Disease/Tuberculosis clinic only.

AZTREONAM

Injection

1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

BACLOFEN

Intrathecal Injection

10mg/5mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

BACLOFEN

Tablet

10mg & 25mg

Y

 

BARICITINIB

Tablet

2mg

4mg

R

Restricted to ICU for COVID-19 where there is evidence of systemic inflammation.

BATH WASH (Q.V. SOAP FREE KIDS WASH®)

Wash

 

Y

 

MYCOBACTERIUM BOVIS (BACILLUS CALMETTE AND GUERIN (BCG) STRAIN BLADDER INSTALLATION

Syringe

 

R

Restricted to Urologist

BCG VACCINE

Injection

 

Y

Per NT Immunisation Schedule – BCG

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

Prescribe by brand name.

BECLOMETHASONE

Nasal Spray

50microg

Y

 

BECLOMETASONE with FORMOTEROL & GLYCOPYRRONIUM

pMDI

100-microg6microg-10microg/dose

R

Restricted to PBS indications.

BENDAMUSTINE

Injection

25mg & 100mg

R

Restricted to Haematology/Oncology.

BENZATHINE PENICILLIN

Injection

1,200,000 Units (900mg)/2.3mL,

600,000 Units (517mg)/1.17mL

Y

 

BENZOIN COMPOUND

Tincture

 

Y

 

BENZTROPINE

Injection

2mg

Y

 

BENZTROPINE

Tablet

2mg

Y

 

BENZYDAMINE

Liquid

22.5mg/15mL

Y

 

BENZYDAMINE/ LIDOCAINE /DICHLOROBENZYL ALCOHOL

Lozenges

3mg/4mg/1.2mg

Y

 

BENZYL BENZOATE

Solution

25%

Y

 

BENZYLPENICILLIN

Injection

600mg, 1.2g & 3g

Y

 

BENZYLPENICILLIN

Infusor

Patient-Specific

Y

 

BETAHISTINE

Tablet

16mg

Y

 

BETAMETHASONE

Injection

5.7mg/mL

Y

 

BETAMETHASONE DIPROPIONATE

Ointment/ Cream

0.05%

Y

 

BETAMETHASONE DIPROPIONATE/ CALCIPOTRIOL

Ointment

0.05%/0.005%

Y

 

BETAMETHASONE VALERATE

Cream

0.02%

Y

 

BETAXOLOL

Eye drops

0.25% (single-use)

R

Restricted to Ophthalmology. Ordered on Request.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

BEVACIZUMAB

Intravitreal Injection

 

R

Restricted to eye clinic - for Ophthalmology specialist use only.

Avastin® brand only. Not to substitute with biosimilars.

For SAS Avastin®, please complete appropriate SAS form (Category B) via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

SAS form is not required for TGA-approved Authorised Prescribers.

BEVACIZUMAB

Injection

100mg/4mL, 400mg/16mL

R

Restricted to Haematology and Oncology for PBS listed indications.

BICALUTAMIDE

Tablet

50mg

R

Restricted to Haematology and Oncology

BICTEGRAVIR, EMTRICITABINE & TENOFOVIR ALAFENAMIDE

Tablet

50mg+200mg+25mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

BIFIDOBACTERIA BIFIDUM & LACTOBACILLUS ACIDOPHILIS

Capsule

1 x 109

1 x 109

R

Infloran® brand only

Restricted to Special Care Nursery and Neonatal Intensive Care Unit.

BIFIDOBACTERIUM INFANTIS, BIFIDOBACTERIUM BIFIDUM, LACTOBACILLUS ACIDOPHILUS (Labinic Paediatric Drops ®)

Drops

1.5 billion CFU/0.16mL

R

Labinic Pediatric Drop® brand only

Restricted to Special Care Nursery and Neonatal Intensive Care Unit during the period that Infloran® is unavailable.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

BISACODYL

Tablet

5 mg

Y

 

BISACODYL

Enema

10mg/5mL

Y

 

BISACODYL

Suppository

10mg

Y

 

BISMUTH & IODOFORM GAUZE

GAUZE

 

Y

 

BISOPROLOL

Tablet

2.5mg, 5mg & 10mg

Y

 

BIVALIRUDIN

Injection

250mg

R

Restricted to use in RDH ICU by ICU specialists only – please refer to RDH ICU: Medical Management of suspected Heparin Induced Thrombocytopaenia with or without Thrombosis (HIT/HITTS) guideline

BLEOMYCIN

Injection

15,000 international units

R

Restricted to Haematology and Oncology for PBS listed indications.

BORTEZOMIB

Injection

1mg & 3.5mg

R

Restricted to Haematology and Oncology for PBS listed indications.

BOSENTAN

Tablet

62.5mg & 125mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Restricted to patients <18 years old. Macitentan is first line for adults.

BOTULINUM A TOXIN

Injection

100 units & 500 units

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Restricted to surgical division/gastroenterology for treatment of anal fissure repair for patients who have failed conservative/first-line medical measures (100 unit injection only).

Restricted to Maxillofacial surgeons for patients ≥12 years of age for the following indications (100 unit injection only):
* For muscle relaxation/myofascial pain in MRI-proven temporomandibular joint dysfunction; first bite syndrome

* For salivary leaks/collections following procedures on or through (access to mandibular condyle) the parotid gland/parotidectomy
* For fracture management (e.g. condylar fractures)
* For the management of ‘gustatory sweating’ (Frey Syndrome) after parotid surgery

BREXPIPRAZOLE

Tablet

1mg, 2mg, 3mg & 4mg

Y

 

BRIMONIDINE

Eye drops

0.2%

Y

 

BRINZOLAMIDE

Eye drops

1%

Y

 

BROMHEXINE

Elixir

Tablet

4mg/5mL

8mg

Y

 

BROMOCRIPTINE

Tablet

2.5mg

Y

 

BUDESONIDE

Nasal Spray

64microg

Y

 

BUDESONIDE

Capsule and Tablet

3mg & 9mg

R

Blanket approval for inpatient and outpatient supply. Restricted to gastroenterologists for the;

  • Induction   therapy for extensive ulcerative colitis if no response to sulfasalazine or   mesalazine, or intolerance to either drug – 8 weeks therapy
  • Treatment   of microscopic colitis – ongoing
  • Contraindications   to prednisolone for the treatment of autoimmune gastrointestinal diseases   (e.g. refractory coeliac disease, eosinophilic esophagitis, autoimmune   hepatitis, inflammatory bowel disease) – ongoing

BUDESONIDE

Turbuhaler

100microg, 200microg & 400microg

Y

 

BUDESONIDE

Respule

500microg/2mL & 1mg/2mL

Y

 

BUDESONIDE/ FORMOTEROL

Rapihaler

50/3microg &

100/3microg & 200/6microg

Y

 

BUPIVACAINE

Injection

0.25% & 0.5%

Y

 

BUPIVACAINE & ADRENALINE

Injection

0.5%/1:200,000

0.25%/ 1:400,000

Y

 

BUPRENORPHINE

Sublingual Tablet

400microg, 2mg & 8mg

R

Restricted to Addiction medicine prescribers

BUPRENORPHINE

Sublingual Tablet

200microg

R

Restricted to patients unable to absorb via the oral route or as advised by APS for inpatient use only. Not to be supplied on discharge from NT Hospital Pharmacy Departments

BUPRENORPHINE

Patch

5mg (5 microg/hr)

10mg (10 microg/hr) 20mg (20 microg/hr)

R

Chronic severe disabling pain not responding to non-narcotic analgesics.

BUPRENORPHINE & NALOXONE

Sublingual Film

2mg/0.5mg 8mg/2mg

R

Restricted to Addiction medicine prescribers

BUPRENORPHINE (Buvidal®)

Weekly Depot Injection

8 mg/0.16 mL

16 mg/0.32 mL

24 mg/0.48 mL

32 mg/0.64 mL

R

Restricted to Addiction medicine prescribers

BUPRENORPHINE (Buvidal®)

Monthly Depot Injection

64 mg/0.18 mL

96 mg/0.27 mL

128 mg/0.36 mL

160mg/0.45mL

R

Restricted to Addiction medicine prescribers

BUPRENORPHINE (Sublocade®)

Monthly Depot Injection

100mg/0.5mL

300mg/1.5mL

R

Restricted to Addiction medicine prescribers

CABAZITAXEL

Injection

60mg

R

Restricted to Haematology and Oncology for PBS listed indications.

CABERGOLINE

Tablet

1mg

Y

 

CABOTEGRAVIR

Tablet

30mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

CABOTEGRAVIR & RILPIRIVINE (combination pack)

Injection

600mg/3mL & 900mg/3mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

CABOTEGRAVIR (Apretude)

Tablet

30mg

R

Restricted to Clinic 34 for HIV-1 PrEP Medicine Access Program.

CABOTEGRAVIR (Apretude)

Injection

600mg/3mL

R

Restricted to Clinic 34 for HIV-1 PrEP Medicine Access Program.

CAFFEINE (BASE)

Oral Solution

10mg/mL (50mL)

Y

 

CAFFEINE (BASE)

Injection

20mg/2mL

Y

 

CALAMINE

Lotion

15%

Y

 

CALCITRIOL

Capsule

0.25microg

Y

 

CALCIUM CARBONATE

Tablet

1.25g

Y

 

CALCIUM CARBONATE/COLECALCIFEROL (CHOLECALCIFEROL)

Tablet

1.5g/12.5microg

R

Restricted to Haematology and Oncology.

CALCIUM CHLORIDE

Injection

10%

Y

 

CALCIUM DISODIUM EDETATE

Injection

500mg/10mL

R

Stock held by RDH Emergency Department for treatment of severe lead poisoning.

CALCIUM FOLINATE

Injection

50mg

Y

 

CALCIUM FOLINATE

Tablet

15mg

Y

 

CALCIUM GLUCONATE

Injection

931mg/10mL

(2.2 mmol/10mL elemental calcium); also formerly known as Calcium Gluconate

10%

Y

 

CALCIUM GLUCONATE

Gel

2.5%

Y

 

CANDESARTAN

Tablet

4mg & 16mg

Y

 

CAPECITABINE

Tablet

150mg & 500mg

R

Restricted to Haematology and Oncology for PBS listed indications AND for EOX protocol for upper GI.

CAPSAICIN

Cream

0.075%

Y

For acute treatment of cannabinoid hyperemesis syndrome.

CAPTOPRIL

Solution

25mg/5mL

Y

 

CARBAMAZEPINE

Modified release Tablets

200mg & 400mg

Y

 

CARBAMAZEPINE

Tablet

200mg

Y

 

CARBAMAZEPINE

Suspension

100mg/5mL

Y

 

CARBIMAZOLE

Tablet

5mg

Y

 

CARBETOCIN

Injection

100microg/mL

R

Restricted to Obstetrician or Anaesthetist in attendance for prevention of uterine atony and postpartum haemorrhage following the delivery of an infant by elective caesarean section under epidural or spinal anaesthesia

CARBOMER 980

Eye Gel

0.2% (10g)

[multi-dose] &

0.2% (30 x 600mg) [Single use]

Y

0.2% (10g) [multi-dose] contains preservative,

0.2% (30 x 600mg) [Single use] is preservative free.

CARBOPLATIN

Injection

150mg/5mL, 450mg/45mL & 50mg/5mL

R

Restricted to Haematology and Oncology for PBS listed indications.

CARBOPROST

Injection

250microg/mL

Y

 

CARMELLOSE

Eye drop

0.50%

Y

 

CARNITINE

Solution

1g/10mL

Y

 

CARVEDILOL

Tablet

3.125mg, 6.25mg, 12.5mg & 25mg

Y

 

CASPOFUNGIN

Injection

50mg & 70mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFALEXIN MONOHYDRATE

Capsules

250mg & 500mg

Y

 

CEFALEXIN MONOHYDRATE

Suspension

250mg/5mL

Y

 

CEFAZOLIN

Eye drop

5%

R

Restricted to eye clinic (Manufactured at RDH).

Blanket outpatient approval for treatment or prevention of ophthalmic infections.

CEFAZOLIN

Injection

1g

Y

 

CEFAZOLIN

Infusor

Patient-Specific

Y

 

CEFEPIME

Injection

1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFIDEROCOL

Injection

1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Prescribing to be restricted to Infectious disease (IFD) in susceptible infections for patients in whom other alternatives are inappropriate

CEFOTAXIME

Injection

1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFOXITIN

Infusor

Patient-Specific

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFTAROLINE

Injection

600mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFTAZIDIME

Injection

1g & 2g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFTAZIDIME

Infusor

Patient-Specific

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFTAZIDIME/AVIBACTAM

Injection

2g/0.5g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Prescribing to be restricted to Infectious disease (IFD) in susceptible infections for patients in whom other alternatives are inappropriate

CEFTRIAXONE

Infusor

Patient-Specific

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFTRIAXONE

Injection

1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFUROXIME

Tablet

250mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CEFUROXIME

Suspension

125mg/5mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CELECOXIB

Capsule

100mg & 200mg

Y

 

CETIRIZINE

Tablet

10mg

R

For patients who fail to respond to loratadine. Restricted to dermatology and immunology.

CETOMACROGOL

Cream

100g

Y

 

CETUXIMAB

Injection

100mg/20mL & 500mg/100mL

R

Restricted to Haematology and Oncology for PBS listed indications.

CHLORAL HYDRATE

Solution

1g/10mL

Y

 

CHLORAMBUCIL

Tablet

2mg

Y

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

CHLORAMPHENICOL

Injection

1g

R

Restricted to ICU and IFD only.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

CHLORAMPHENICOL

Eye ointment

1%

Y

 

CHLORAMPHENICOL

Eye Drops/Mims

0.5%

Y

 

CHLORHEXIDINE

Obstetric cream

1%

Y

 

CHLORHEXIDINE

Mouth wash

0.2%

Y

 

CHLORHEXIDINE 3mg/PHENYLEPHRINE 2.5mg

Nasal Ointment

0.3%/0.25%

Y

 

CHLORHEXIDINE IN ALCOHOL 70%

Solution

0.5%

Y

 

CHLORHEXIDINE/ CETRIMIDE

Irrigation

0.015/0.15%

Y

 

CHLORHEXIDINE/ CETRIMIDE

Solution

0.015/0.15%

Y

 

CHLORHEXIDINE/ CETRIMIDE

Cream

0.1%/0.5%

Y

 

CHLORPROMAZINE

Injection

50mg/2mL

Y

 

CHLORPROMAZINE

Tablet

10mg, 25mg & 100mg

Y

 

CHLORPROMAZINE

Syrup

25mg/5mL

Y

 

CHOLINE SALICYLATE

Dental Gel

8.7%

Y

 

CICLOSPORIN

Injection

50mg/mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

CICLOSPORIN

Capsule

10mg, 25mg, 50mg & 100mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

CINACALCET

Tablet

30mg, 60mg & 90mg

R

Restricted to nephrologists for patients who meet the PBS criteria

CINCHOCAINE & HYDROCORTISONE

Suppositories

5mg/5mg

Y

 

CINCHOCAINE & HYDROCORTISONE

Ointment

0.5%/0.5%

Y

 

CINCHOCAINE & ZINC OXIDE

Ointment

0.5%/20%

Y

 

CIPROFLOXACIN

Ear Drops

0.30%

Y

 

CIPROFLOXACIN

Tablet

250mg, 500mg & 750mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for susceptible infections not listed on the PBS approved by Infectious Diseases.

CIPROFLOXACIN

Injection

200mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CIPROFLOXACIN/ HYDROCORTISONE

Ear Drops

0.2%/1%

Y

 

CISPLATIN

Injection

100mg/100mL & 50mg/50mL

R

Restricted to Haematology and Oncology for PBS listed indications.

CITALOPRAM

Tablet

20mg

Y

 

CLADRIBINE

Injection

10mg/10mL & 10mg/5mL

R

Restricted to Haematology and Oncology for PBS listed indications.

CLARITHROMYCIN

Tablet

250mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for susceptible infections not listed on the PBS approved by Infectious Diseases.

CLINDAMYCIN

Capsule

150mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline

CLINDAMYCIN

Solution

75mg/5mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Use restricted to discharge and outpatients only.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form which can be located on the TGA website.

CLINDAMYCIN

Injection

300mg & 600mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

CLOFAZAMINE/ DAPSONE/ RIFAMPICIN (LEPROSY PACK)

Capsules & Tablets

300mg/100mg/ 100mg

R

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

CLONAZEPAM

Injection

1mg

Y

Blanket outpatient approval for Palliative care patients.

CLONAZEPAM

Solution

2.5mg/mL

Y

Blanket outpatient approval for Palliative care patients.

CLONAZEPAM

Tablet

500microg & 2mg

Y

Blanket outpatient approval for Palliative care patients.

CLONIDINE

Injection

150microg/1mL

Y

 

CLONIDINE

Tablet

100microg & 150microg

Y

 

CLOPIDOGREL

Tablet

75mg

Y

 

CLOTRIMAZOLE

Pessary

500mg

Y

 

CLOTRIMAZOLE

Vaginal Cream

1%

Y

 

CLOTRIMAZOLE

Cream

1%

Y

 

CLOVE OIL BP

Oil

10mL

Y

 

CLOZAPINE

Tablet

25mg, 50mg, 100mg & 200mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

COAL TAR

Solution

200mL

Y

 

COBICISTAT, ELVITEGRAVIR, EMTRICITABINE & TENOFOVIR ALAFENAMIDE

Tablet

150mg+150mg+

200mg+10mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

COCAINE

Solution

10%

Y

 

CODEINE PHOSPHATE

Tablet

30mg

Y

 

COLCHICINE

Tablet

500microg

Y

 

COLECALCIFEROL

Capsule

1000 units

Y

 

COLECALCIFEROL

Oral Solution

5000 units / mL

Y

 

COLESTYRAMINE LIGHT

Sachets

4g

Y

 

Colistimethate Sodium (Colistin)

Injection

150mg/2ml

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

COLLOIDAL OATMEAL (DermaVeen®)

Lotion

20mg/g

R

Restricted to burns unit & wound clinic

COMBINATION ANTACIDS

Suspension

Tablet

 

Y

 

CONJUGATED ESTROGENS

Tablet

300microg & 625microg

Y

 

CORTISONE ACETATE

Tablet

5mg & 25mg

Y

 

COVID-19 VACCINE

Injection

 

R

Per National COVID-19 Vaccine Program. See The Australian Immunisation Handbook.

Prescribe by brand name.

CROTAMITON

Cream

10%

Y

 

CYCLIZINE

Tablet

50mg

R

Restricted to Anaesthetics and Palliative Care. Blanket outpatient approval for prevention of nausea and vomiting in Palliative Care patients.

Restricted to Obstetrics as a 2nd line treatment of nausea and vomiting in pregnancy.

CYCLIZINE

Injection

50mg/mL

R

Restricted to Anaesthetics and Palliative Care.

Blanket outpatient approval for prevention of nausea and vomiting in Palliative Care patients.

CYCLOPENTOLATE

eye drop & Minims

1%

Y

 

CYCLOPENTOLATE

Minims

0.5%

Y

 

CYCLOPHOSPHAMIDE

Infusor

Patient-Specific

Y

 

CYCLOPHOSPHAMIDE

Injection

500mg, 1gram & 2gram

Y

 

CYCLOPHOSPHAMIDE

Tablet

50mg

Y

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

CYPROTERONE

Tablet

50mg

Y

 

CYTARABINE

Injection

100mg/5mL

R

Restricted to Haematology and Oncology for PBS listed indications.

DABRAFENIB

Capsules

50mg, 75mg

R

Restricted to Haematology and Oncology for PBS listed indications.

DACARBAZINE

Infusion

 

R

Restricted to Haematology and Oncology for Metastatic Melanoma and Hodgkin’s Lymphoma.

DACTINOMYCIN

Injection

 

R

Restricted to Haematology and Oncology for Low Risk Gestational Trophoblastic Disease.

DANTROLENE

Injection

20mg

Y

 

DANTROLENE

Capsules

25mg & 50mg

Y

 

DAPAGLIFLOZIN

TABLET

10mg

Y

 

DAPSONE

Tablet

100mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

DAPTOMYCIN

Injection

500mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

DARBEPOETIN ALFA

Injection

10microg, 20microg, 30microg, 40microg, 60microg, 80microg, 100microg & 150microg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DARUNAVIR

Tablet

600mg & 800mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DARUNAVIR & COBICISTAT

Tablet

800mg+150mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DARUNAVIR, COBICISTAT, EMTRICITABINE & TENOFOVIR ALAFENAMIDE

Tablet

800mg+150mg+

200mg+10mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DAUNORUBICIN MINIBAG

Injection

 

R

Restricted to Haematology and Oncology for Acute Myeloid Leukaemia.

DEFERASIROX

tablets

90mg, 180mg & 360mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DEGARELIX

Injection

80mg & 120mg

R

Restricted for PBS listed indications.

Blanket approval for outpatient supply with PBS prescription.

DENOSUMAB

Injection

60mg

R

Restricted to prescribing by Endocrinology/Geriatrics/Rehabilitation for initiation of therapy for long stay patients (greater than 14 days) for the management of osteoporosis where bisphosphonates are not suitable or not tolerated AND as per PBS criteria.

*Ensure continuation of therapy is included in communication at transitions of care (e.g. discharge summary).

DENOSUMAB

Injection

60mg & 120mg

R

Restricted to Haematology and Oncology for PBS listed indications.

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

DESFERASIOXAMINE

Injection

2g

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DESLORATADINE

Liquid

2.5mg/5mL

Y

 

DESMOPRESSIN

Injection

4microg

Y

 

DESMOPRESSIN

Nasal Solution

100microg/mL

Y

 

DESMOPRESSIN

Tablet

200microg

Y

 

DESMOPRESSIN

Nasal Spray

10microg/dose

Y

 

DEXAMETHASONE

eye drop

0.10%

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

DEXAMETHASONE

Tablet

500microg & 4mg

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

DEXAMETHASONE

Liquid

1mg/mL

Y

 

DEXAMETHASONE

Injection

4mg & 8mg

Y

 

DEXAMETHASONE, FRAMYCETIN & GRAMICIDIN

Ear Drops

0.05%/ 0.5%/ 0.005%

Y

 

DEXAMFETAMINE

Tablet

5mg

R

Use in attention deficit hyperactivity disorder

DEXCHLORPHENIRAMINE

Tablet

2mg

Y

 

DEXMEDETOMIDINE

Injection

200microg/2mL

R

Restricted to ICU, ED, Paediatrics, Palliative Care and Anaesthetics only

DIAZEPAM

Suspension

10mg/10mL

Y

 

DIAZEPAM

Tablet

2mg & 5mg

Y

 

DIAZEPAM

Injection

10mg

Y

 

DIAZOXIDE

Tablet

25mg

R

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

DICLOFENAC

Enteric Coated Tablet

25mg & 50mg

Y

 

DICLOFENAC

Gel

1%

Y

 

DICLOFENAC

Suppositories

100mg

Y

 

DICLOXACILLIN

Capsule

250mg & 500mg

Y

 

DIGOXIN

Suspension

250microg/5mL

Y

 

DIGOXIN

Tablet

62.5microg & 250microg

Y

 

DIGOXIN

Injection

50microg & 500microg

Y

 

DIGOXIN-SPECIFIC ANTIBODY

Injection

40mg

R

This medication is restricted to ED, ICU and CCU for the treatment of digoxin toxicity, or for other cardiac glycoside poisoning such as Oleander and Bufotoxin (cane toad).

DILTIAZEM

Modified release Capsules

180mg, 240mg & 360mg

Y

 

DILTIAZEM

Tablet

60mg

Y

 

DIMERCAPROL

Injection

200mg

R

Stock held by RDH Emergency Department for treatment of severe lead poisoning.

DIMETHICONE

Topical Solution

Various

Y

Product strength may vary due to availability.

DINOPROSTONE (PROSTAGLANDIN E2)

Vaginal Gel

1mg & 2mg

R

Restricted to Specialist Obstetricians and their Registrars for induction of labour according to local/SA guidelines.

DINOPROSTONE CR (PROSTAGLANDIN E2)

Controlled Release Pessary

10mg

R

Restricted to Specialist Obstetricians and their Registrars for induction of labour according to local/SA guidelines.

DIPHENOXYLATE & ATROPINE

Tablet

2.5/0.025mg

Y

 

DIPHTHERIA ANTITOXIN (DAT)

Injection

10,000 units

Y

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

DIPHTHERIA & TETANUS VACCINE

Injection

 

Y

See The Australian Immunisation Handbook. Prescribe by brand name.

DIPHTHERIA TETANUS & PERTUSSIS VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups

Prescribe an age-appropriate brand and prescribe by brand name.

DIPHTHERIA, TETANUS, PERTUSSIS & POLIO

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups

Prescribe by brand name.

DISODIUM EDETATE

Injection

3%

Y

 

DOBUTAMINE

Injection

250mg

Y

 

DOCETAXEL

Injection

20mg, 80mg & 160mg

R

Restricted to Haematology and Oncology for PBS listed indications.

DOCUSATE & SENNA

Tablet

50/8mg

Y

 

DOCUSATE SODIUM

Tablet

50mg & 120mg

Y

 

DOCUSATE SODIUM

Ear Drops

 

Y

 

DOLUTEGRAVIR

Tablet

50mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DOLUTEGRAVIR, ABACAVIR & LAMIVUDINE

Tablet

50mg+600mg+

300mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DOLUTEGRAVIR & LAMIVUDINE

Tablet

50mg+300mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DOLUTEGRAVIR & RILPIVIRINE

Tablet

50mg+25mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

DOMPERIDONE

Tablet

10mg

Y

Blanket outpatient approval for the stimulation of lactation.

DONEPEZIL

Tablet

5mg & 10mg

Y

 

DOPAMINE

Injection

200mg

Y

 

DORNASE ALFA

Nebulised solution

2.5mg/2.5mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Restricted for use by with respiratory specialists/advanced trainees with experience in its use for empyema management.

DOSULEPIN (DOTHIEPIN)

Tablet

75mg

Y

 

DOSULEPIN (DOTHIEPIN)

Capsule

25mg

Y

 

DOXORUBICIN

Injection

50mg/25mL & 200mg/100mL

R

Restricted to Haematology and Oncology for PBS listed indications.

DOXORUBICIN LIPOSOMAL

Injection

20mg/10mL & 50mg/25mL

R

Restricted to Haematology and Oncology for PBS listed indications.

DOXYCYCLINE

Tablet

100mg

Y

Blanket outpatient approval for melioidosis eradication in patients who cannot tolerate trimethoprim/sulfamethoxazole approved by IFD.

DOXYCYCLINE

Injection

100mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

DOXYLAMINE

Tablets

25mg

Y

 

DROPERIDOL

Injection

2.5mg/1mL 10mg/2mL

Y/ R

10mg/2mL restricted to Emergency Departments and Mental Health

DULAGLUTIDE

Syringe

1.5mg

R

Restricted to PBS indications

(Use restricted to continuation treatment only; Treatment initiation requires IPU approval)

DULOXETINE

Capsules

30mg & 60mg

R

Restricted to PBS indications.

DUTASTERIDE/TAMSULOSIN

Capsules

500microg/400microg

R

Restricted to PBS indications.

ECULIZUMAB

Injection

300mg/30mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Note: Eculizumab is reimbursed by the PBS under S100 HSD arrangements for both outpatients and public hospital admitted patients for the treatment of aHUS.

EDROPHONIUM

Injection

10mg

Y

 

EFAVIRENZ

Tablet

200mg & 600mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

EMICIZUMAB

Syringe

30mg/mL

60mg/0.4mL

105mg/0.7mL &

150mg/1mL

R

Restricted to inpatient and outpatient Haematology patients that meet the National Product List (NPL) restrictions.

EMPAGLIFLOZIN

Tablet

10mg & 25mg

Y

 

EMTRICITABINE, RILPIVIRINE & TENOFOVIR ALAFENAMIDE

Tablet

200mg+25mg+25mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

EMTRICITABINE & TENOFOVIR ALAFENAMIDE

Tablet

200mg+25mg & 200mg+10mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

ENALAPRIL

Tablet

5mg, 10mg, 20mg

Y

For paediatric patients with heart failure or breastfeeding women with hypertension or heart failure

ENOXAPARIN

Injection

20mg, 40mg, 60mg, 80mg 100mg, 120mg & 150mg

Y

 

ENTECAVIR

Tablet

500microg & 1mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Blanket outpatient approval for the prevention of hepatitis B virus reactivation or progression in patients >16 years old who are immunosuppressed or live in a remote area and do not meet PBS criteria restricted to prescribers under the direction of Infectious Diseases or Liver Clinic Specialists.

EPHEDRINE

Injection

30mg

Y

 

EPIRUBICIN

Injection

2mg/mL

R

Restricted to Oncology/Haematologist use only

EPLERENONE

Tablet

25mg & 50mg

R

Restricted to Cardiology

EPOPROSTENOL

Injection

500 microg & 1.5mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

EPTACOG ALPHA

Injection

1mg & 2mg

R

Available at RDH only. Restricted to ICU, stock is kept in ICU. 1.2mg strength is non-formulary and stock is supplied by blood transfusion services for Haematology protocol use.

ERGOMETRINE

Injection

500microg

Y

 

ERGOMETRINE & OXYTOCIN

Injection

500microg/5 IU

Y

 

ERLOTINIB

Tablet

25mg, 100mg & 150mg

R

Restricted to Haematology and Oncology for PBS listed indications.

ERTAPENEM

Injection

1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

ERYTHROMYCIN

Capsule

250mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

ERYTHROMYCIN ETHYL SUCCINATE

Suspension

200mg/5mL

Y

 

ERYTHROMYCIN LACTOBIONATE

Injection

1g

Y

 

ESCITALOPRAM

Tablets

10mg & 20mg

R

PBS indications only.

ESMOLOL

Injection

100mg/10mL

Y

 

ESTRIOL (ESTRADIOL VALERATE)

Tablet

1mg

Y

 

ESTRIOL (ESTRADIOL)

Patch

25microg, 50microg & 100microg

Y

 

ESTRIOL (ESTRADIOL)

Implant

100mg

Y

 

ESTRIOL (ESTRIOL)

Vaginal Cream

1mg/g

Y

 

ETANERCEPT

Injection

25mg

Y

 

ETHAMBUTOL

Tablet

100mg & 400mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of Tuberculosis approved by TB clinic/IFD.

ETONOGESTREL

Implant

68mg

R

Restricted to:

O&G use for inpatients where access to Implanon NXT® insertion in primary care is not appropriate or not available

or

Paediatricians (for TEHS only) for high-risk adolescents

ETOPOSIDE

Capsule

50mg & 100mg

R

Restricted to Haematology and Oncology for PBS listed indications.

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

ETOPOSIDE

Injection

100mg & 1gram

R

Restricted to Haematology and Oncology for PBS listed indications.

ETRAVIRINE

Tablet

200mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

EVEROLIMUS

Tablet

500microg & 750microg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

EXEMESTANE

Tablet

25mg

Y

 

EZETIMIBE

Tablet

10mg

Y

For patients with inadequate response on a maximum tolerated statin dose or who are contraindicated or intolerant of statins.

FAMOTIDINE

Tablet

20mg & 40mg

Y

 

FENOFIBRATE

Tablet

48mg & 145mg

Y

 

FENTANYL

Injection

100microg & 500microg

Y

 

FENTANYL

Patch

12microg, 25microg, 50microg, 75microg & 100microg

Y

 

FENTANYL (ABSTRAL®)

Sublingual Tablets

100microg, 300microg & 400microg

R

Restricted to Palliative Care as per the PBS Criteria

FERRIC CARBOXYMALTOSE (IRON)

Injection

1000mg/20mL, 500mg/10mL & 100mg/2mL

R

Restricted to use in remote health according to approved protocol. All stock to be dispensed from pharmacy on an individual patient basis.

Restricted to use in outpatients who are able to access supply via a PBS prescription (500mg/10mL strength only).

Restricted to use in inpatients for the following indications;

  • Previously documented adverse drug reaction to iron   polymaltose.
  • Heart failure with a documented fluid restriction.

FERRIC DERISOMALTOSE (IRON)

Injection

500mg/5mL

R

Restricted to use in outpatients who are able to access supply via a PBS prescription.

Restricted to use in inpatients for the following indications for patients requiring more than 1000mg of elemental iron:

  • Previously documented adverse drug reaction to iron   polymaltose.
  • Heart failure with a documented fluid restriction.

FERRIC SUBSULPHATE (IRON)

Gel

21%

R

Restricted to gynaecology use only.

FERROUS FUMARATE (Ferro-tab®)

Tablets

200mg

Y

 

FERROUS FUMARATE & FOLIC ACID (Ferro-F®)

Modified Release Tablets

310mg/350microg

Y

 

FERROUS SULFATE HEPTAHYDRATE

Liquid

150mg/5mL

Y

 

FILGRASTIM

Injection

300microg & 480microg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

FLECAINIDE

Injection

150mg

Y

 

FLECAINIDE

Tablet

50mg & 100mg

Y

 

FLUCLOXACILLIN

Injection

500mg & 1g

Y

 

FLUCLOXACILLIN

Infusor

Patient-Specific

Y

 

FLUCLOXACILLIN

Suspension

250mg/5mL

Y

 

FLUCONAZOLE

Capsule

50mg, 100mg & 200mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Restricted to Haematology and Oncology for PBS listed indications.

Blanket outpatient approval for susceptible infections not listed on the PBS approved by Infectious Diseases and for antifungal prophylaxis in haematological malignancies with immunosuppressive chemotherapy.

FLUCONAZOLE

Injection

100mg & 200mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Restricted to Haematology and Oncology for PBS listed indications.

FLUCONAZOLE

Suspension

50mg/5mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Restricted to Haematology and Oncology for PBS listed indications.

FLUCYTOSINE

Capsule

500mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

FLUDARABINE

Injection

50mg

R

Restricted to Haematology and Oncology for PBS listed indications.

FLUDARABINE

Tablet

10mg

R

Restricted to Haematology and Oncology for PBS listed indications.

FLUDROCORTISONE

Tablet

100microg

Y

 

FLUMAZENIL

Injection

500microg

Y

 

FLUORESCEIN

Strips

1mg

Y

 

FLUORESCEIN SODIUM

Minims

2%

Y

 

FLUORESCEIN SODIUM

Injection

10%

Y

 

FLUOROMETHOLONE (Flucon®)

Eye drops

0.1%

R

Restricted to Ophthalmologist use only

FLUOROMETHOLONE ACETATE

Eye drops

0.1%

R

Restricted to Ophthalmologist use only

FLUOROURACIL

Infusion

 

R

Restricted to Haematology and Oncology for PBS listed indications.

FLUOROURACIL

Injection

500mg, 1gram, 2.5gram & 5gram

R

Restricted to Haematology and Oncology for PBS listed indications.

FLUOXETINE

Capsule & Dispersible tablets

20mg

R

Dispersible tablets are restricted to Paediatrics and Mental Health

FLUPENTHIXOL DECANOATE

Injection

20mg, 40mg & 100mg

Y

*Order on request

FLUTICASONE

pMDI

50microg/dose

125microg/dose

250microg/dose

Y

 

FLUTICASONE PROPIONATE with SALMETEROL

pMDI

100/50microg, 250/50microg & 500/50microg

Y

 

FLUTICASONE PROPIONATE with SALMETEROL

DPI

50/25microg, 125/25microg & 250/25microg

Y

 

FLUTICASONE FUROATE with VILANTEROL

DPI

100microg/25microg, 200microg/25microg

Y

 

FOLIC ACID

Injection

15mg

Y

 

FOLIC ACID

Tablet

500microg

5mg

Y

Blanket outpatient approval for prevention of sulfamethoxazole/trimethoprim induced folate deficiency in patients receiving treatment for melioidosis.

FONDAPARINUX

Injection

2.5mg/0.5mL

R

Restricted to use by ICU and Haematology for Heparin Inducted Thrombocytopenia/Thrombosis (HIT).

FORMALIN

Solution

10%

Y

 

FOSAMPRENAVIR

Tablet

700mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

FOSAPREPITANT

Injection

150mg

R

Restricted to Haematology and Oncology for PBS listed indications in patients who cannot tolerate orals

FOSFOMYCIN

Granules for Solution

3g Sachet

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for multi-resistant UTI approved by IFD

FOSFOMYCIN

Injection

4g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

FOTEMUSTINE

Injection

208mg

R

Restricted to Haematology and Oncology for PBS listed indications.

FUROSEMIDE

Solution (SyrSpend®)

50mg/5mL

Y

PBS 20mg tablets should be prescribed where doses can be divided into 5mg increments.

Blanket outpatient approval for paediatrics where the dose is not in 5mg increments.

FUROSEMIDE

Injection

20mg/2mL

250mg/25mL

Y

 

FUROSEMIDE

Tablet

20mg

40mg

500mg

Y

 

GABAPENTIN

Capsule

100mg

300mg

400mg

800mg

Y

Blanket outpatient approval for the treatment of neuropathic pain.

GANCICLOVIR

Injection

Patient Specific

S

CYTOTOXIC – Consult Pharmacy for supply

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

GEFITINIB

Tablet

250mg

R

Restricted to Haematology and Oncology for PBS listed indications.

GEMCITABINE

Injection

200mg, 1g & 2g

R

Restricted to Haematology and Oncology for PBS listed indications.

GENTAMICIN

Injection

80mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

GENTAMICIN with CITRATE

Syringe

10mg/31.3mg

Y

 

GLECAPREVIR with PIBRENTASVIR

Tablets

100/40mg

S

Restricted to specialists working in the liver clinic running the HCV treatment program. For initiation in outpatients via the Highly specialised Drugs Program (Section 100). Refer to PBS Criteria.

GLICLAZIDE

Modified release tablets

30mg

Y

 

GLICLAZIDE

Modified release tablets

60mg

R

For discharge prescriptions only

GLICLAZIDE

Tablet

80mg

Y

 

GLIMEPIRIDE

Tablet

1mg

2mg

4mg

Y

 

GLUCAGON

Injection

1mg

Y

 

GLUCOSE

Injection

10%

Y

 

GLUCOSE

Injection

5% (500mL & 1L)

Y

Supplied by Stores Department

GLUCOSE

Injection

50% (50mL vial)

50% 500mL

Y

50% (500mL) - Supplied by Stores Department

GLUCOSE & SODIUM CHLORIDE

2.5%/0.45%, 4%/0.18%

500mL & 1L

Y

Supplied by Stores Department

GLUCOSE & SODIUM CHLORIDE

5%/0.9%

1L

Y

Supplied by Stores Department

GLUCOSE TOLERANCE TEST

Solution

75g

Y

 

GLYCEROL

Suppositories

700mg, 2.8g

Y

 

GLYCEROL BP

Solution

200mL

Y

 

GLYCERYL TRINITRATE

Sublingual Tablet

300microg, 600microg

Y

*300microg added for short-term listing while 600microg is out of stock.

GLYCERYL TRINITRATE

Ointment

0.2%

Y

 

GLYCERYL TRINITRATE

Spray

400microg

Y

 

GLYCERYL TRINITRATE

Patch

5mg/24 hour & 10mg/24 hour

Y

 

GLYCERYL TRINITRATE

Injection

50mg

Y

 

GLYCINE

Irrigation

1.5%

Y

 

GLYCOPYRRONIUM BROMIDE

Injection

200microg

Y

Blanket outpatient approval for Palliative care patients.

GOSERELIN

Implant

3.6mg & 10.8mg

R

Restricted to PBS listed indications AND for Ovarian Suppression with chemotherapy (3.6mg only).

Blanket approval for outpatient supply with PBS prescription.

GRAMICIDIN/NEOMYCIN/NYSTATIN/TRIAMCINOLONE ACETONIDE

Ear Ointment

0.25mg/2.5mg/100,000 units/1mg/g

Y

 

GRANISETRON

Tablet

2mg

R

Restricted to Haematology and Oncology for PBS listed indications (outpatient/same day admission only).

GRISEOFULVIN

Tablet

125mg & 500mg

Y

 

HAEMOPHILUS INFLUENZA B VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups. Prescribe by brand name.

HALOPERIDOL

Tablet

500microg

1.5mg

5mg

Y

 

HALOPERIDOL

Injection

5mg

Y

Blanket outpatient approval for Palliative care patients.

HALOPERIDOL

Solution

10mg/5mL

Y

 

HALOPERIDOL DECANOATE

Injection

50mg

Y

 

HEPARIN SODIUM

Injection

5000units/0.2mL

5000units/5mL 25000units/5mL

Y

 

HEPARIN SODIUM

Pre-filled Syringe

5000 units/0.5mL

Y

 

HEPARINISED SALINE

Injection

50units/5mL

Y

 

HEPARINOIDS (HEPARINOID CREAM)

Cream

0.3%

Y

 

HEPATITIS A VACCINE

Injection

 

Y

See The Australian Immunisation Handbook

Prescribe an age-appropriate brand and prescribe by brand name.

HEPATITIS A and HEPATITIS B VACCINE

Injection

 

Y

See The Australian Immunisation Handbook

Prescribe an age-appropriate brand and prescribe by brand name.

HEPATITIS B VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups

Prescribe an age-appropriate brand and prescribe by brand name.

HEPATITIS B VACCINE (DIALYSIS FORMULATION)

Injection

 

Y

See The Australian Immunisation Handbook.

Prescribe by brand name.

HEPATITIS B, Hib & POLIO (Infanrix-Hexa®)

Injection

 

Y

See The Australian Immunisation Handbook

Prescribe an age-appropriate brand and prescribe by brand name.

HUMAN PAPILLOMAVIRUS (HPV) VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups.

Prescribe by brand name.

HYALURONIDASE

Injection

1500 units

Y

 

HYDRALAZINE

Injection

20mg

Y

 

HYDRALAZINE

Tablet

25mg

50mg

Y

 

HYDROCHLORIC ACID

Injection

2M

Y

 

HYDROCHLOROTHIAZIDE

Tablet

25mg

Y

 

HYDROCORTISONE

Ointment

1%

Y

 

HYDROCORTISONE

Cream

1%

Y

 

HYDROCORTISONE

Tablet

4mg & 20mg

Y

 

HYDROCORTISONE

Eye ointment

1%

Y

 

HYDROCORTISONE

Foam

10%

Y

 

HYDROCORTISONE SODIUM SUCCINATE

Injection

100mg

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

HYDROCORTISONE/ CLOTRIMAZOLE

Cream

1%

Y

 

HYDROGEN PEROXIDE

Solution

3%

Y

 

HYDROMORPHONE

Tablet

2mg, 4mg & 8mg

R

Restricted to Palliative Care, Rehabilitation and Pain teams only

HYDROMORPHONE

Liquid

5mg/5mL

R

Restricted to Palliative Care, Rehabilitation and Pain teams only

HYDROMORPHONE

Injection

2mg, 10mg & 50mg

R

Restricted to Palliative Care, Rehabilitation and Pain teams only.

Blanket outpatient approval for chronic pain in palliative care patients.

HYDROXOCOBALAMIN

Injection

1000microg

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

HYDROXYCHLOROQUINE

Tablet

200mg

Y

 

HYDROXYCARBAMIDE (HYDROXYUREA)

Capsule

500mg

Y

 

HYOSCINE BUTYLBROMIDE

Injection

20mg

Y

Blanket outpatient approval for Palliative care patients.

HYOSCINE BUTYLBROMIDE

Tablet

10mg

Y

 

HYOSCINE HYDROBROMIDE

Injection

400microg

Y

Blanket outpatient approval for excess respiratory tract secretions.

HYOSCINE HYDROBROMIDE

Tablet

300microg

R

For the treatment of hypersalivation restricted to inpatients who have clozapine induced sialorrhoea (CIS).

HYPROMELLOSE

Eye drop

0.5%

Y

 

IBUPROFEN

Injection

10mg

Y

 

IBUPROFEN

Tablet

200mg & 400mg

Y

 

IBUPROFEN

Syrup

100mg/5mL

Y

 

ICATIBANT ACETATE

Pre-filled Syringe

30mg/3mL

R

Restricted to Emergency Medicine consultants under the advice of the duty immunologist for the emergency treatment of:

  • Alteplase induced angioedema;
  • Severe   angioedema affecting the airway due to ACE inhibitors;
  • Symptomatic treatment of acute attacks of hereditary   angioedema in adults with C1 esterase inhibitor deficiency.

IDARUBICIN

Injection

5mg & 10mg

R

Restricted to Haematology and Oncology for PBS listed indications.

IDARUBICIN

Capsules

5mg & 10mg

R

Restricted to Haematology and Oncology for PBS listed indications AND for Myeloma.

IFOSFAMIDE

Injection

1gram & 2gram

R

Restricted to Haematology and Oncology for PBS listed indications.

ILOPROST

Injection

20microg/2mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

INCREMIN IRON MIXTURE

Mixture

 

Y

 

INDAPAMIDE

Modified Release Tablets

1.5mg

Y

 

INDOMETHACIN

Capsule

25mg

Y

 

INDOMETHACIN

Injection

1mg

Y

 

INDOMETHACIN

Suppositories

100mg

Y

 

INFLIXIMAB

Injection

100mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

INFLUENZA VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Influenza

Prescribe an age-appropriate brand and prescribe by brand name.

INSULIN ASPART (NovoRapid®)

Flexpen (3mL)

Penfill (3mL)

Vial (10mL)

100 units/mL

Y

Order on request (vial)

INSULIN ASPART PROTAMINE 70 units/mL + INSULIN ASPART 30 units/mL (Novomix 30 ®)

Flexpen (3mL)

Penfill (3mL)

100 units/mL

Y

 

INSULIN ASPART 30 units/mL + INSULIN DEGLUDEC 70 units/mL  (Ryzodeg® 70/30)

Penfill (3mL)

100 units/mL

Y

 

INSULIN GLARGINE (Optisulin®)

Solostar (3mL)

Cartridge (3mL)

100 units/mL

Y

 

INSULIN ISOPHANE (Protaphane®)

Vial (10mL)

Penfill (3mL)

100 units/mL

Y

Order on request (vial)

Penfill anticipated discontinuation December 2026

INSULIN ISOPHANE NPH (Humulin NPH®)

Cartridges (3mL)

100 units/mL

R

To be used second line when other formulary insulin products are not suitable, or as continuing therapy for patients commenced in the community.

INSULIN LISPRO (Humalog®)

Cartridges (3mL)

Kwik Pen (3mL)

100 units/mL

R

To be used second line when other formulary insulin products are not suitable, or as continuing therapy for patients commenced in the community.

INSULIN LISPRO 25 units/mL /INSULIN LISPRO PROTAMINE 75 units/mL (Humalog 25®)

Cartridges (3mL)

Kwik Pen (3mL)

100 units/mL

R

To be used second line when other formulary insulin products are not suitable, or as continuing therapy for patients commenced in the community.

INSULIN NEUTRAL (Actrapid®)

Penfill (3mL)

Vial (10mL)

100 units/mL

Y

Penfill anticipated discontinuation December 2026

Order on request (vial)

IODINE/POTASSIUM IODIDE

Solution (100mL)

5%/10% w/v

Y

 

IPILIMUMAB

Injection

213mg

R

For oncologist use only - restricted to patients eligible for compassionate supply programme.

IPILIMUMAB

Injection

50mg & 200mg

R

Restricted to Haematology and Oncology for PBS listed indications.

IPRATROPIUM

Inhaler

21microg

Y

 

IPRATROPIUM

nebulised solution

500microg

Y

 

IRBESARTAN

Tablet

75mg, 150mg & 300mg

Y

 

IRBESARTAN &HYDROCHLOROTHIAZIDE

Tablet

150/12.5mg & 300/12.5mg

Y

 

IRINOTECAN

Injection

40mg, 100mg & 500mg

R

Restricted to Haematology and Oncology for PBS listed indications.

IRON POLYMALTOSE

Injection

100mg

Y

 

ISOFLURANE

Liquid for inhalation

 

Y

 

ISONIAZID

Tablet

100mg & 300mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of active or latent tuberculosis by TB clinic/IFD.

ISONIAZID & RIFAMPICIN

Tablet

50mg + 75mg & 75mg + 150mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of active or latent tuberculosis by TB clinic/IFD.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

ISONIAZID & RIFAPENTINE

Tablet

300mg + 300mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of latent tuberculosis by TB clinic/IFD.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

ISONIAZID, PYRAZINAMIDE & RIFAMPICIN

Tablet

50mg +150mg + 75mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of active or latent tuberculosis by TB clinic/IFD.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

ISONIAZID, ETHAMBUTOL, PYRAZINAMIDE & RIFAMPICIN

Tablet

75mg + 275mg + 400mg + 150mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of active or latent tuberculosis by TB clinic/IFD.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

ISOPRENALINE

Injection

200microg

Y

 

ISOPROPYL ALCOHOL BP

Solution

 

Y

 

ISOSORBIDE DINITRATE

Sublingual Tablet

5mg

Y

 

ISOSORBIDE MONONITRATE

Modified Release Tablets

60mg

Y

 

ITRACONAZOLE

Solution

50mg/5mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

ITRACONAZOLE (LOZANOC®)

Capsule

50mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

IVABRADINE

Tablet

5mg & 7.5mg

R

Restricted to Cardiologists for treatment of Chronic heart failure for patients that meet the PBS criteria.

Restricted to Cardiology for use in patients with a heart rate greater than 60 beats per minute prior to computed tomography coronary angiography (CTCA) when beta blockers and/or calcium channel blockers are contraindicated or insufficient.

IVERMECTIN

Tablet

3mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

JAPANESE ENCEPHALITIS VACCINE

Injection

 

R

See The Australian Immunisation Handbook.

Prescribe by brand name.

KETAMINE

Injection

200mg

Y

 

KETAMINE

Wafer

25mg

R

Restricted to use by RDH Acute Pain Service (APS) as an analgesic agent for painful procedures on the ward.

KETOCONAZOLE

Shampoo

2%

Y

 

KETOROLAC

Injection

30mg

Y

 

KETOROLAC

Eye drop

0.5%

Y

 

LABETALOL

Tablet

100mg

Y

 

LABETALOL

Injection

50mg/10mL

R

Restricted to ICU/OT for severe pre-eclampsia - refer to protocol on the PGC.

Restricted to ED/ICU for the management of hypertension in Stroke Thrombolysis or Pulmonary Embolism thrombolysis – refer to protocols on the PGC.

LACTASE

Drops

 

Y

 

LACTULOSE

Syrup

 

Y

 

LAMIVUDINE

Solution

10mg/mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

LAMIVUDINE

Tablet

100mg, 150mg & 300mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

LAMIVUDINE & ZIDOVUDINE

Tablet

150mg+300mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

LAMOTRIGINE

Tablet

5mg, 25mg, 50mg & 100mg

Y

 

LANOLIN BP

Ointment

5gram

Y

 

LANREOTIDE

Injection

60mg & 90mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

LATANOPROST

Eye drop

50microg

Y

 

LENALIDOMIDE

Capsule

5mg, 10mg, 15mg & 25mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

LETROZOLE

Tablet

2.5mg

R

Restricted to Haematology and Oncology

LEUCOVORIN

Tablet

15mg

R

Restricted to Haematology and Oncology for PBS listed indications.

LEUCOVORIN

Injection

50mg, 100mg, 300mg & 1gram

R

Restricted to Haematology and Oncology for PBS listed indications.

LEVAMISOLE

Tablets

50mg

R

Blanket outpatient/inpatient approval. Restricted to Paediatric nephrologists.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form which can be located on the TGA website.

LEVETIRACETAM

Injection

500mg/5mL

Y

 

LEVETIRACETAM

Solution

500mg/5mL

Y

 

LEVETIRACETAM

Tablet

250mg, 500mg & 1000mg

Y

 

LEVODOPA/ CARBIDOPA MONOHYDRATE (Kinson® or Sinemet®)

Tablet

100/25mg & 250/25mg

Y

 

LEVODOPA/BENSERAZIDE (Madopar®)

Tablet

100/25mg

Y

 

LEVODOPA/BENSERAZIDE (Madopar®)

Capsule

100mg/25mg & 200mg/50mg

Y

 

LEVODOPA/BENSERAZIDE (Madopar® HBS)

Controlled Release Capsules

100/25mg

Y

 

LEVODOPA/BENSERAZIDE (Madopar® Rapid)

Dispersible Tablets

100mg/25mg

Y

 

LEVODOPA/CARBIDOPA MONOHYDRATE (Sinemet CR®)

Controlled Release Tablets

200/50mg

Y

 

LEVOFLOXACIN

Tablets

500mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

Blanket outpatient/inpatient approval for the treatment of Helicobacter pylori (H. pylori) infection following documented treatment failure with a clarithromycin based regimen; or, for primary treatment of H. pylori infection in a patient who cannot tolerate clarithromycin (due to drug allergy or unavoidable drug interactions).

LEVOMEPROMAZINE

Injection

25mg/mL

R

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

Blanket outpatient/inpatient approval for intractable nausea and vomiting and second line sedative for delirium/agitation in palliative care patients.

LEVONORGESTREL

Tablet

1.5mg

Y

 

LEVONORGESTREL

Intra-uterine system (IUS)

52mg

R

Restricted to O&G use for:

  • Inpatients where access to Mirena® insertion in primary care is not appropriate or not available.
  • Outpatients where supply cannot be accessed via the PBS.

All Mirena® will be supplied by hospital pharmacies on an individual patient basis.

LEVOSIMENDAN

Injection

12.5mg

R

Restricted to ICU.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

LEVOTHYROXINE SODIUM (Brands: Eutroxsig and Eltroxin only)

Tablet

50microg

75microg

100microg

Y

Not all brands are bioequivalent. If changing to a brand that is not bioequivalent (refer to PBS website), monitor thyroid function and adjust dose if necessary

LEVOTHYROXINE

Injection

200microg/mL

R

Restricted to Endocrinologists, Emergency Medicine and Intensive Care Specialists for the treatment of myxoedema coma and symptomatic hypothyroidism in patients unable to be treated effectively with oral medications

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

LIDOCAINE & ADRENALINE (EPINERPHERINE)

Injection

1%-1:100,000

2%-1:80,000

2%-1:200,000

Y

 

LIDOCAINE

Ointment

5%

Y

 

LIDOCAINE

Injection

0.5%, 1% & 2% & 500mg

Y

 

LIDOCAINE

Topical Solution

4%

Y

 

LIDOCAINE

Jelly

2%

Y

 

LIDOCAINE

Catheter Syringe

2%

Y

 

LIDOCAINE

Spray

10%

Y

 

LIDOCAINE

Oral Gel

2%

Y

 

LIDOCAINE / GLUCOSE

Injection

0.4%/5%

Y

 

LIDOCAINE/PRILOCAINE

Patch

2.5%/2.5%

Y

 

LIGNOCAINE/PHENYEPHRINE (Co-phenylcaine Forte®)

Nasal Spray

5%/0.5%

Y

 

LINAGLIPTIN

Tablet

5mg

Y

 

LINEZOLID

Infusion

600mg/300mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

LINEZOLID

Tablet

600mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for treatment of infections approved by IFD.

LINEZOLID

Suspension

100mg/5mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

LIOTHYRONINE

Injection

20microg

R

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

LIOTHYRONINE

Tablet

20microg

Y

 

LIPID EMULSION (SMOFlipid®)

Emulsion

20%

Y

Blanket approval for Renal outpatients

LIQUID PARAFFIN EMULSION (Parachoc®)

Emulsion

 

Y

 

LIQUID PARAFFIN LIGHT (Hamilton®)

Bath Oil

500mL

Y

 

LIRAGLUTIDE

Syringe

6mg/mL

R

Blanket outpatient approval for RDPH Weight Management Clinic

LITHIUM CARBONATE

Tablet

250mg

Y

 

LITHIUM CARBONATE

Modified Release Tablets

450mg

Y

 

LOPERAMIDE

Capsule

2mg

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

LOPINAVIR & RITONAVIR

Tablet

200mg+50mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

LOPINAVIR & RITONAVIR

Liquid

400mg+100mg/5mL (60mL)

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

LORATADINE

Tablet

10mg

Y

 

LORAZEPAM

Tablet

1mg & 2.5mg

Y

 

LORAZEPAM

Injection

4mg/1mL

R

Restricted to Mental Health

Short-term listing during shortage of midazolam 5mg/mL injections.

LUBRICATING JELLY

Sachets or Tube

 

Y

 

MACITENTAN

Tablets

10mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

MACROGOL/ASCORBIC ACID/ELECTROLYTES (Plenvu®)

Sachets

 

Y

 

MACROGOL/POTASSIUM CHLORIDE/SODIUM BICARBONATE/SODIUM CHLORIDE LAXATIVE (Lax®)

Sachets

13.125g/46.6mg/178.5mg/350.7mg

Y

 

MAGNESIUM ASPARTATE TETRAHYDRATE

Tablet

500mg

Y

 

MAGNESIUM CHLORIDE

Injection

5mmol

Y

 

MAGNESIUM SULPHATE

Injection

2mmol & 10mmol

Y

 

MAGNESIUM SULPHATE CO (Magnoplasm®)

Paste

 

Y

 

MANNITOL

Injection

20%

Y

Supplied by Stores Department

MANNITOL

Diagnostic Kit

(containing capsules & inhalation device)

 

R

Restricted for use by respiratory specialists for bronchial challenge testing

MEASLES, MUMPS and RUBELLA VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups.

Prescribe by brand name.

MEDROXYPROGESTERONE

Tablet

10mg & 100mg

Y

 

MEDROXYPROGESTERONE

Injection

150mg

Y

 

MEFLOQUINE

Tablet

250mg

Y

 

MELATONIN

Modified Release Tablet

2mg

Y

Restricted to Geriatrics, Rehabilitation and General medicine for inpatient use only for patients greater than 55 years of age with sleep disturbance, where other hypnotics are contraindicated (e.g. falls risk, dementia, behavioural disturbance), and non-pharmacological measures have been ineffective. For a maximum of 13 weeks.

MELPHALAN

Tablet

2mg

Y

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

MEMANTINE

Tablet

10mg

R

Restricted to patients who meet the PBS criteria

MENINGOCOCCAL A, C, W, Y VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups.

Prescribe by brand name.

MENINGOCOCCAL B VACCINE

Injection

0.5mL

Y

Per NT Immunisation Schedule - Children and Adolescents, NT Immunisation Schedule - Adult and Special Risk groups and NTG Funded Program for Infants & Adolescents.

Prescribe by brand name.

MERCAPTOPURINE

Tablet

50mg

Y

 

MEROPENEM

Injection

500mg & 1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

MESALAZINE

Enteric Coated Tablet

250mg

Y

 

MESNA

Injection

400mg & 1g

R

Restricted to Haematology and Oncology for PBS listed indications.

MESNA

Tablets

400mg & 600mg

R

Restricted to Haematology and Oncology for the prevention of haemorrhagic cystitis with cyclophosphamide or ifosfamide.

METARAMINOL

Injection

2.5mg/5mL

5mg/10mL

10mg/mL

Y

Prediluted vial or prefilled syringe available

METFORMIN

Tablet

500mg, 850mg & 1000mg

Y

 

METFORMIN MR

Modified Release Tablet

500mg & 1000mg

Y

 

METHADONE

Tablet

10mg

Y

 

METHADONE

Injection

10mg

Y

 

METHADONE

Syrup

5mg/mL

R

Restricted to Addiction medicine prescribers, Pain team and Palliative Care.

METHOTREXATE

Tablet

2.5mg & 10mg

Y

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

METHOTREXATE

Syringe

10mg, 12mg, 15mg, 20mg, 25mg, 50mg & 75mg

Y

 

METHOTREXATE

Injection

5mg, 50mg, 500mg, 1gram & 5gram

R

Restricted to Haematology and Oncology for PBS listed indications.

METHOXY POLYETHYLENE GLYCOL-EPOETIN BETA

Injection

30microg, 50microg, 75microg, 100microg, 120microg, 200microg & 360microg.

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

METHOXYFLURANE

Liquid for inhalation

3mL

R

Restricted to haematology use for analgesia during bone marrow biopsy procedure

Restricted to Emergency Department & Anaesthetics Use

METHYL SALICYLATE/EUCALYPTUS MENTHOL

Rub

 

Y

 

METHYLDOPA SESQUIHYDRATE

Tablet

250mg

Y

 

METHYLENE BLUE

Injection

1% (50mg)

Y

 

METHYLNALTREXONE

Injection

12mg

R

Palliative Care and ICU only for treatment of opioid-induced constipation in patients who have failed to respond to laxatives.

METHYLPHENIDATE

Tablet

10mg

R

Use in attention deficit hyperactivity disorder

METHYLPREDISOLONE ACETATE (Depo- Nisolone®)

Depot injection

40mg/mL

Y

 

METHYLPREDISOLONE ACETATE in FATTY OINTMENT

Ointment

0.1%

Y

 

METHYLPREDNISOLONE SODIUM SUCCINATE

Injection

1g & 40mg

Y

 

METOCLOPRAMIDE

Injection

10mg

Y

 

METOCLOPRAMIDE

Tablet

10mg

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

METOPROLOL

Modified Release Tablet

23.75mg, 47.5mg, 95mg & 190mg

Y

 

METOPROLOL

Tablet

50mg & 100mg

Y

 

METOPROLOL TARTRATE

Injection

1mg

Y

 

METRONIDAZOLE

Suspension

200mg/5mL

Y

 

METRONIDAZOLE

Suppositories

500mg

Y

 

METRONIDAZOLE

Tablet

200mg & 400mg

Y

 

METRONIDAZOLE

Infusion

500mg

Y

 

MICONAZOLE

Oral gel

2%

Y

 

MIDAZOLAM

Injection

5mg/mL, 5mg/5mL, 15mg/3mL & 50mg/10mL

Y

Blanket outpatient approval for epilepsy in paediatric patients (5mg/mL plastic ampoules).

Blanket outpatient approval for palliative care patients for various indications.

MIDODRINE

Tablet

2.5mg & 5mg

R

Blanket outpatient approval for management of symptomatic hypotension (including orthostatic and intradialytic) where non-pharmacological management has failed, restricted to medical and renal physicians.

MIFEPRISTONE

Tablet

200mg

Y

Restricted to Obstetrics & Gynaecology specialists for the medical termination of pregnancy beyond the first trimester up to 22 completed weeks gestation and beyond 22 weeks for foetal death in utero only.

MIFEPRISTONE/ MISOPROSTOL (MS 2 STEP®)

Tablet

200mg/200microg

Y

Restricted to Katherine Hospital only, for medical termination of an intrauterine pregnancy (MTOP) up to 63 days gestation (PBS indications).

MS2Step can be accessed in community pharmacies in other areas of the NT.

MILRINONE

Injection

10mg/10mL

R

Restricted to ICU and CCU

MINOCYCLINE

Tablet

50mg

Y

 

MINOCYCLINE

Injection

100mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Prescribing to be restricted to Infectious disease (IFD) in susceptible infections for patients in whom other alternatives are inappropriate

MINOXIDIL

Tablet

10mg

Y

 

MIRTAZAPINE

Orally disintegrating tablet & tablets

15mg, 30mg & 45mg

Y

 

MISOPROSTOL (Augusta®)

Tablet

25 microg

Y

Prescribe by brand name.

MISOPROSTOL (Cytotec®)

Tablet

200microg

Y

Prescribe by brand name.

MITOMYCIN

Eye drop

0.02%

R

Restricted to Ophthalmologist use only

MITOMYCIN

Bladder instillation Syringe

40mg

R

Restricted to Urologist

MITOMYCIN

Injection

 

R

0.02% & 0.05% for Ophthalmologist use.

Oncologist use for treatment of Anal Cancer.

MITOZANTRONE

Injection

20mg/10mL & 25mg/12.5mL

R

Restricted to Haematology and Oncology for PBS listed indications.

MIVACURIUM

Injection

20mg/10mL

Y

 

MOLNUPIRAVIR

Capsule

400mg

R

Restricted for COVID-19 Treatment where Nirmatrelvir & Ritonavir AND Remdesivir are contraindicated, OR when recommended by IFD.

Outpatient use per PBS criteria.

MOMETASONE FUROATE

Nasal Spray

50microg

Y

 

MOMETASONE FUROATE

Lotion

1%

Y

 

MONKEYPOX VACCINE

  

R

See The Australian Immunisation Handbook

Stock via National Medicines Stockpile (NMS).

Prescribe by brand name.

MONKEYPOX VIRUS TREATMENTS

  

R

Restricted for use by Infectious Diseases and/or Sexual Health physicians.

Approved treatments are Tecovirimat 200mg capsules (Tpoxx®), Vaccinia Immunoglobulin (VIG) ≥50,000 units/15mL and Cidofovir 375mg/5mL injection vials (Empovir®).

Stock is managed via National Medicines Stockpile (NMS). NMS approval required prior to access.

MORPHINE HCl MIXTURE

Mixture

1mg/mL & 5mg/mL

Y

 

MORPHINE INTRATHECAL

Injection

500microgram/mL

R

Restricted for use by anaesthetics for patients requiring spinal anaesthetic undergoing a caesarean section or as an adjunct analgesia for patients undergoing major surgery

MORPHINE SULFATE

Injection

10mg & 30mg

Y

Blanket outpatient approval for Palliative care patients.

MORPHINE SULFATE (Kapanol®)

Capsule

10mg, 20mg, 50mg & 100mg

Y

 

MORPHINE SULPHATE (MS Contin®) SLOW RELEASE

Slow Release Tablets

5mg, 10mg, 30mg, 60mg & 100mg

Y

 

MORPHINE TATRATE

Injection

120mg

R

Restricted to palliative care and pain team

Blanket outpatient approval for Palliative care patients.

MOXIFLOXACIN

Tablet & Injection

400mg & 400mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for treatment of infections approved by IFD (for oral form).

MOXONIDINE

Tablet

200microg

Y

 

MULTI-B VITAMINS (Cenovis Mega-B®)

Tablet

 

Y

 

MULTIVITAMIN & MINERALS

Tablets

 

Y

 

MULTIVITAMIN (CERNEVIT)

Injection

 

Y

 

MULTIVITAMIN (Pentavite Infant®)

Infant drops

 

Y

 

MULTIVITAMIN WITH IRON (Pentavite®)

Syrup

 

Y

 

MULTIVITAMINS PLUS ZINC (VitABDECK®)

Capsule

 

R

Vitamin for Cystic Fibrosis patients.

Blanket outpatient approval as a vitamin for Cystic Fibrosis patients.

MUPIROCIN

Ointment & Nasal Ointment

2%

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

MYCOPHENOLATE MOFETIL

Capsule

250mg & 500mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Formulary for renal transplant use

MYCOPHENOLATE MOFETIL

Injection

500mg

Y

 

MYCOPHENOLATE SODIUM

Tablet

180mg & 360mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Restricted for use in Lupus Nephritis HSD indications only. The capsules are the formulary mycophenolate option for renal transplant indications.

NADOLOL

Tablet

20mg & 40mg

R

Restricted to Paediatric Cardiology for Congenital Long QT Syndrome

NALOXONE

Injection

400microg

Y

 

NALOXONE

Nasal Spray

1.8mg

R

Restricted to Alcohol and Other Drug (AOD) prescribers for Opioid Pharmacotherapy (OPP) patients

NALTREXONE

Tablet

50mg

R

Restricted to Addiction Medicine prescribers for use as an adjunct for the treatment of alcohol dependence.

NAPHAZOLINE/ PHEIRAMINE (Naphcon-A®)

Eye drop

0.025%/0.3%

Y

 

NAPROXEN

Tablet

250mg

Y

 

NAPROXEN

Modified Release Tablet

1g

Y

 

NATALIZUMAB

Injection

300mg/15mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

NATALIZUMAB

Injection

150mg/1mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

NATAMYCIN

Eye drop

5%

Y

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

NEBIVOLOL

Tablet

1.25mg, 5mg

Y

Restricted to PBS criteria.

NEOSTIGMINE

Injection

500 microg & 2.5mg

Y

 

NEOSTIGMINE/GLYCOPYRROLATE

Injection

2.5mg/500microg

Y

 

NETUPITANT/PALONOSETRON

Capsules

300microg/500microg

R

Restricted to Haematology and Oncology for PBS listed indications.

NEVIRAPINE

Tablet

200mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

NICORANDIL

Tablet

10mg & 20mg

Y

 

NICOTINE

Lozenge

2mg & 4mg

Y

 

NICOTINE

Patch

7mg, 14mg & 21mg

Y

 

NICOTINE

Gum

2mg & 4mg

Y

 

NIFEDIPINE

Tablet

10mg & 20mg

Y

 

NIFEDIPINE MR

Modified Release Tablet

30mg & 60mg

Y

 

NIMODIPINE

Injection

10mg

Y

 

NIMODIPINE

Tablet

30mg

Y

 

NIRMATRELVIR & RITONAVIR (PAXLOVID®)

Tablet

150mg & 100mg

R

Per COVID-19 Treatment of at Risk Adults and Adolescents not Requiring Oxygen Guidelines.

Outpatient use per PBS criteria.

NIRSEVIMAB

Prefilled Syringe

50mg & 100mg

R

See The Australian Immunisation Handbook.

For use by nurses, midwives, and Aboriginal and Torres Strait Islander Health Practitioners in accordance with the Nirsevimab Scheduled Substance Treatment Protocol.

NITAZOXANIDE

Suspension

100mg/5mL

Y

 

NITRIC OXIDE

Inhalation

800ppm

Y

 

NITROFURANTOIN

Capsule

50mg & 100mg

Y

 

NIVOLUMAB

Infusion

Variable

R

Restricted to Medical Oncologists for use in patients enrolled in the Nivolumab Extended Access Program.

NORADRENALINE

Injection

2mg

Y

 

NORETHISTERONE

Tablet

5mg

Y

 

NORFLOXACIN

Tablet

400mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

NYSTATIN

Capsules

500 000 units

Y

 

NYSTATIN

Oral drops

100 000 units

Y

 

OCTREOTIDE

Depot Injection

10mg, 20mg & 30mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

OCTREOTIDE

Injection

50microg, 100microg & 500mg

Y

 

OFLOXACIN

Eye drop

3mg

R

Restricted to Ophthalmologist use only

OLANZAPINE

Tablet

2.5mg, 5mg & 10mg

Y

 

OLANZAPINE

Injection

10mg

R

Restricted to Mental Health & ED

OLANZAPINE (Zyprexa Zydis®)

Wafers

5mg, 10mg. 15mg & 20mg

Y

 

OLANZAPINE PAMOATE (Zyprexa Relprevv®)

Long-Acting Injection

210mg, 300mg & 405mg

R

Restricted to Mental Health

OLIVE OIL

Liquid

 

Y

 

OMEPRAZOLE

Solution

2mg/mL

Y

Blanket outpatient approval for administration via NG/PEG tube in paediatric patients

OMEPRAZOLE

Injection

40mg

Y

Pantoprazole is first line therapy

OMEPRAZOLE

Tablet

10mg & 20mg

Y

Pantoprazole is first line therapy

ONDANSETRON

Injection

4mg & 8mg

Y

 

ONDANSETRON

Wafers

4mg & 8mg

Y

 

OPSITE SPRAY DRESSING

Spray

 

Y

 

ORABASE (CARMELLOSE/ PECTIN/ GELATIN)

Paste

 

Y

 

ORAL REHYDRATION SALTS SOLUTION

Sachets

Ice Blocks

 

Y

 

OSELTAMIVIR

Liquid

6mg/mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

OSELTAMIVIR

Capsule

30mg & 75mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

OXALIPLATIN

Injection

50mg, 100mg & 200mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

OXAZEPAM

Tablet

15mg & 30mg

Y

 

OXYBUPROCAINE

Minims

0.4%

Y

 

OXYBUTYNIN

Tablet

5mg

Y

 

OXYCODONE

Liquid

5mg/5mL

Y

 

OXYCODONE (Mayne Pharma Oxycodone®)

Tablet

5mg

Y

 

OXYCODONE (Oxycontin SR ®)

Slow Release Tablets

10mg, 15mg 20mg, 30mg, 40mg & 80mg

Y

NB: Not all strengths are stocked at all sites

OXYCODONE (Oxynorm®)

Capsule

10mg & 20mg

Y

 

OXYCODONE HYDROCHLORIDE/NALOXONE HYDROCHLORIDE DIHYDRATE

Tablet

5/2.5mg, 10/5mg, 20/10mg & 40/20mg

R

Restricted to chronic pain when opioid-induced constipation is refractory to optimised regular laxatives

OXYCODONE

Injection

10mg/mL

R

Restricted to Anaesthetics for perioperative analgesia and short-term control of post-operative pain.

OXYCODONE

Intravenous

50mg/mL

R

Restricted to Acute Pain Service/Anaesthetics for Patient Controlled Analgesia (PCA)

OXYMETAZOLINE

Nasal Spray

0.05%

Y

 

OXYTOCIN

Injection

10units

Y

 

PACLITAXEL

Injection

30mg, 100mg, 150mg & 300mg

R

Restricted to Haematology and Oncology for PBS listed indications AND advanced or recurrent endometrial cancer, AND as neoadjuvant upper GI with RT.

PACLITAXEL NANOPARTICLE ALBUMIN BOUND

Injection

100mg

R

Restricted to Haematology and Oncology for PBS listed indications.

PALIPERIDONE

Modified Release Tablet

3mg, 6mg & 9mg

R

Restricted to Mental Health

PALIPERIDONE PALMITATE 1 MONTHLY

Depot injection

25mg, 50mg, 75mg, 100mg & 150mg

R

Restricted to Mental Health

PALIPERIDONE PALMITATE 3 MONTHLY

Depot injection

175mg, 263mg, 350mg & 525mg

R

Restricted to Mental Health.

For initiation in the outpatient setting only in patients who meet PBS criteria.

PALONOSETRON

Injection

250microg/5mL

R

Restricted to Haematology and Oncology for prevention of nausea and vomiting induced by moderately emetogenic chemotherapy protocols.

PAMIDRONATE DISODIUM

Injection

90mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

PANCREATIC ENZYMES (LIPASE/AMYLASE/PROTEASE)

Granules (enteric coated)

5,000 U

Y

Strength expressed as lipase content

PANCREATIC ENZYMES

(LIPASE/AMYLASE/PROTEASE)

Capsules (enteric coated)

10,000 U

25,000 U

Y

Strength expressed as lipase content

PANCURONIUM

Injection

4mg

Y

 

PANITUMUMAB

Injection

100mg/5mL & 400mg/20mL

R

Restricted to Haematology and Oncology for PBS listed indications.

PANTHENOL/BENZALKONIUM CHLORIDE (BEPANTHEN®)

Cream

5%/0.05%

Y

 

PANTOPRAZOLE

Tablet

20mg & 40mg

Y

 

PANTOPRAZOLE

Injection

40mg

Y

 

PAPAVERINE

Injection

120mg

Y

 

PARACETAMOL

Tablet

500mg

Y

Blanket approval for outpatient supply. Restricted to: Haematology/Oncology.

PARACETAMOL

Suppositories

125mg, 250mg & 500mg

Y

 

PARACETAMOL

Drops & Elixir

100mg/mL & 240mg/5mL

Y

 

PARACETAMOL

Soluble Tablet

500mg

Y

 

PARACETAMOL

Injection

1000mg

R

Restricted for post-surgery and patients unable to tolerate oral or rectal route

PARACETAMOL & CODEINE

Tablet

500mg/30mg

Y

 

PARACETAMOL

Modified Release Tablet

665mg

Y

 

PARAFFIN with LANOLIN

Eye ointment

3.5g

Y

 

PARAFFIN LIQUID (EMULSION)

Oral Liquid

50%, 200mL

Y

Parachoc® brand only

PARAFFIN STERILE

Sterile Liquid

5g

Y

 

PARAFFIN WHITE SOFT

Cream

10g (sterile), 50g & 500g

Y

 

PARAFFIN WHITE SOFT & LIQUID PARAFFIN

Ointment

50%/50%

Y

 

PARALDEHYDE

Injection

 

Y

NB: Not stocked at all sites. May need to be ordered on a case by case basis.

PARECOXIB SODIUM

Injection

40mg

R

Restricted to Pain team and ICU

PATENT BLUE VIOLET 2.5%

Pre-Filled Syringe

2.5%

Y

 

PATIROMER

Sachets

8.4g

R

Restricted to renal team/nephrologists for short-term use in patients with End Stage Renal Disease on haemodialysis where renal replacement therapy is not accessible.

PAW-PAW

Ointment

 

Y

 

PAZOPANIB

Tablet

200mg

400mg

R

Restricted to PBS listed indications.

PEGFILGRASTIM

Injection

6mg/0.6mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

PEMETREXED

Injection

100mg & 500mg

R

Restricted to Haematology and Oncology for PBS listed indications.

PENTAMIDINE

Injection

300mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Restricted to haematology/oncology patients and others under the management /recommendation of IFD

PEPPERMINT

Lip Balm

20g

R

Restricted to Palliative Care only

PERHEXILINE

Tablet

100mg

Y

 

PERICIAZINE

Tablet

2.5mg

10mg

Y

 

PERINDOPRIL

Tablet

2.5mg

5mg

10mg

Y

 

PERINDOPRIL & INDAPAMIDE

Tablet

5-1.25mg

Y

 

PERMETHRIN

Cream

5%

Y

 

PHENTERMINE

Tablet

15mg

R

Blanket outpatient approval for RDPH Weight Management Clinic

PHENTOLAMINE MESYLATE

Injection

5mg

R

Restricted to Emergency Department for the treatment of dermal necrosis and sloughing following intravenous administration or extravasation of noradrenaline or adrenaline.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

PHENOBARBITAL

Injection

200mg

Y

 

PHENOBARBITAL

Tablet

30mg

Y

 

PHENOBARBITAL

Syrup

15mg/5mL

Y

 

PHENOXYMETHYLPENICILLIN

Capsule

250mg & 500mg

Y

 

PHENOXYMETHYLPENICILLIN (PENICILLIN V)

Suspension

150mg/5mL

Y

 

PHENYLEPHRINE

Minims

2.5% & 10%

Y

 

PHENYTOIN

Injection

100mg & 250mg

Y

 

PHENYTOIN

Chewable tablets

50mg

Y

 

PHENYTOIN

Capsule

30mg & 100mg

Y

 

PHENYTOIN

Suspension

30mg/5mL

Y

 

PHOSPHATE (Fleet®)

Enema

133mL

Y

 

PHOSPHATE, SODIUM ACID (Phosphate Sandoz®)

Effervescent Tablet

500mg

Y

 

PHYSOSTIGMINE

Injection

2mg

Y

 

PHYTOMENADIONE (Vitamin K®)

Injection

2mg & 10mg

Y

Blanket outpatient approval.

PILOCARPINE

Eye Drop

2% (single use)

R

Restricted to Ophthalmology

PILOCARPINE

Eye drop

1% (multi-dose)

2% (multi-dose)

4% (multi-dose)

Y

 

PIMECROLIMUS

Cream

1%

R

For patients who fail to hydrocortisone 1% cream/ointment.

PIPERACILLIN with TAZOBACTAM

Infusor

Patient-Specific

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

PIPERACILLIN with TAZOBACTAM

Injection

4g-0.5g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

PIROXICAM

Capsule

10mg

Y

 

PLASMA-LYTE 148 in WATER

IV fluid

 

Y

Supplied by Stores Department

PLASMA-LYTE 148 with GLUCOSE 5%

IV fluid

1 L

R

Supplied by Stores Department

PNEUMOCOCCAL VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups.

See NT Immunisation Schedule - Pneumococcal Vaccination

Prescribe by brand name.

PODOPHYLLOTOXIN

Solution

0.5%

R

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.  Blanket approval for use in Clinic 34.

POLIOMYELITIS VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Children and Adolescents and NT Immunisation Schedule - Adult and Special Risk groups.

Prescribe by brand name.

POLOXAMER

Drops

100mg/mL

Y

 

POLYMYXIN B

Injection

500,000 units

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Prescribing to be restricted to Infectious disease (IFD) in susceptible infections for patients in whom other alternatives are inappropriate

PORACTANT ALFA

Suspension (intratracheal)

240mg/3mL

Y

 

POSACONAZOLE

Controlled Release Tablet

Oral Suspension

100mg

40mg/mL (105mL)

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for non-PBS indications, restricted to Haematology and Oncology/ Infectious Diseases.

POSACONAZOLE

Injection

300mg/16.7mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

POTASSIUM ACETATE

Injection

25mmol

Y

 

POTASSIUM CHLORIDE

Effervescent tablets

14mmol

Y

 

POTASSIUM CHLORIDE

Injection

10mmol/10mL

Y

 

POTASSIUM CHLORIDE

Modified Release Tablet

600mg

Y

 

POTASSIUM CHLORIDE in GLUCOSE

IV fluid

10mmol/10% in 500mL

 

Supplied by Stores Department

POTASSIUM CHLORIDE in SODIUM CHLORIDE

IV fluid

10mmol-0.29% (100mL) 20mmol/0.9% in 1000mL, 30mmol/0.9% in 1000mL, 40mmol/0.9% in 1000mL

 

Supplied by Stores Department

POTASSIUM CHLORIDE in SODIUM LACTATE COMPOUND

IV fluid

30mmol in 1L

Y

Supplied by Stores Department

POTASSIUM CHLORIDE in SODIUM CHLORIDE with GLUCOSE

IV fluid

20mmol/0.18%/4% in 1L,

20mmol/0.9%/5% in 1L,

40mmol/0.9%/5% in 1L,

10mmol/0.225%/

10% in 500mL

Y

Supplied by Stores Department

POTASSIUM DIHYDROGEN PHOSPHATE

Injection

10mmol/10mL

R

Wards can contact pharmacy or ICU liaison if further support is required

POTASSIUM PERMANGANATE

Crystals

 

Y

 

POVIDONE IODINE

Ointment Sachets

10%

Y

 

POVIDONE IODINE

Topical Antiseptic

5% (100mL)

R

Restricted to ophthalmological procedures and surgery

POVIDONE IODINE

Solution

10% (100mL & 500mL)

Y

 

POVIDONE IODINE

Topical Antiseptic (sterile)

10% (30mL)

Y

 

PRALIDOXIME IODIDE

Injection

500mg

Y

 

PRAMIPEXOLE

Tablet

180microg

250microg

R

Blanket approval for Machado Joseph Disease

PRAZIQUANTEL

Tablet

600mg

R

Blanket outpatient approval for susceptible infections approved by Infectious Disease/Paediatrics.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

PRAZOSIN

Tablet

1mg

2mg

5mg

Y

 

PREDNISOLONE

Tablet

1mg

5mg

25mg

Y

Blanket approval for outpatient supply restricted to: Haematology/Oncology.

PREDNISOLONE

Suspension

25mg/5mL

Y

 

PREDNISOLONE with PHENYLEPHRINE

Eye drops

1%-0.12%

Y

 

PREDNISOLONE ENEMA

Enema

0.2mg/mL

Y

 

PREDNISOLONE SODIUM PHOSPHATE

Eye drop minims

0.5%

R

Restricted to use by ophthalmology.

Blanket outpatient approval for patients with allergy to preservatives in prednisolone containing eye drops or for patients where prednisolone as a single ingredient is required.

PREGABALIN

Capsule

25mg, 75mg & 150mg

R

Blanket outpatient approval for neuropathic pain for patients with fibromyalgia syndrome only. Prescriber to annotate script as “fibromyalgia syndrome/non-PBS indication”.

PRILOCAINE

Injection

0.50%

Y

 

PRIMAQUINE

Tablet

7.5mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for prevention or relapse of malaria or treatment of Pneumocystis carinii pneumonia (PCP).

PRIMIDONE

Tablet

250mg

Y

 

PROBENECID

Tablet

500mg

Y

 

PROCARBAZINE

Capsule

50mg

R

Restricted to Haematology and Oncology for BEACOPP (Hodgkin Lymphoma) AND PCV (Neuro).

PROCHLORPERAZINE

Injection

12.5mg/5mL

Y

 

PROCHLORPERAZINE

Tablet

5mg

Y

 

PROGESTERONE

Pessaries

200mg

R

Restricted to O&G for PBS listed indications.

PROMETHAZINE

Elixir

1mg/mL

Y

 

PROMETHAZINE

Tablet

10mg & 25mg

Y

 

PROMETHAZINE

Injection

50mg

R

Restricted to haematology/oncology patients on chemotherapy requiring hypersensitivity reaction rescue AND remote primary health care for indications outlined in CARPA

PROPANTHELINE

Tablet

15mg

Y

 

PROPOFOL

Injection

200mg, 500mg & 1g

Y

 

PROPRANOLOL

Suspension

10mg/5mL

Y

 

PROPRANOLOL

Tablet

10mg, 40mg & 160mg

Y

 

PROPYLTHIOURACIL

Tablet

50mg

Y

 

PROTAMINE SULPHATE

Injection

50mg/5mL

Y

 

PSEUDOEPHEDRINE

Tablet

60mg

Y

 

PSYLLIUM

Powder

 

Y

 

PYRANTEL

Tablet

125mg

Y

 

PYRAZINAMIDE

Tablet

500mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of tuberculosis by TB clinic/IFD.

PYRIDOSTIGMINE

Tablet

10mg & 60mg

Y

 

PYRIDOXINE

Tablet

25mg

Y

Blanket outpatient approval for the prevention of isoniazid-induced peripheral neuropathy.

PYRIDOXINE

Injection

100mg/2mL

Y

 

PYRIMETHAMINE

Tablet

25mg

Y

 

QUETIAPINE

Tablet

25mg

100mg

200mg

300mg

Y

 

QUETIAPINE

Modified Release Tablet

50mg

200mg

300mg

Y

 

RABIES VACCINE

Injection

 

Y

See The Australian Immunisation Handbook.

Prescribe by brand name.

RALTEGRAVIR

Tablet

400mg

600mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

RALTITREXED

Injection

2mg

R

Restricted to Haematology and Oncology for PBS listed indications.

RAMIPRIL

Tablet OR Capsules

1.25mg

2.5mg

5mg

10mg

Y

 

RANIBIZUMAB

Injection

2.3mg & 3mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

RASBURICASE

Injection

1.5mg/1mL

R

Restricted to use in Haematology and Oncology for the treatment of acute hyperuricaemia of presumed or confirmed tumour lysis syndrome, in accordance with approved guidelines.

REMDESIVIR

Injection

100mg

R

Approved for use as per the NT Health COVID-19 Treatment of at Risk Adults and Adolescents not Requiring Oxygen Guidelines AND in patients requiring oxygen but do not require ventilation.

REMIFENTANIL

Injection

1mg & 5mg

Y

 

RESPIRATORY SYNCYTIAL VIRUS VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Adult and Special Risk groups.

Individual Patient Use approval for non-National Immunisation Program indications.

Prescribe by brand name.

RIFABUTIN

Capsule

150mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

RIFAMPICIN

Syrup

100mg/5mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for susceptible infections not listed on the PBS approved by Infectious Diseases.

RIFAMPICIN

Injection

600mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

RIFAMPICIN

Capsule

150mg

300mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for susceptible infections approved by Infectious Diseases.

RIFAPENTINE

Tablet

150mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for the treatment of latent tuberculosis by TB clinic/IFD.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

RIFAXIMIN

Tablet

550mg

Y

Restricted to PBS indications.

RILPIVIRINE

Tablet

25mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

RISPERIDONE

Oral Liquid

1mg/mL (100mL)

Y

 

RISPERIDONE

Tablet

0.5mg

1mg

2mg

3mg

4mg

Y

 

RISPERIDONE

Injection

(powder + solvent)

25mg

37.5mg

50mg

R

Restricted to Mental Health for continuing treatment in patients already stabilised or initial treatment where paliperidone depot is unsuitable or not tolerated.

RITONAVIR

Tablet

100mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

RITUXIMAB

Injection

100mg/10mL, 500mg/50mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

RITUXIMAB

Infusion

Patient-Specific

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

RIVAROXABAN

Tablets

2.5mg

10mg

15mg

20mg

R

Restricted to PBS indications.

RIZATRIPTAN

Wafer

10mg

Y

Short-term listing while oral zolmitriptan is out of stock.

ROCURONIUM

Injection

50mg

Y

 

ROPIVACAINE

Injection

40mg/20mL (0.2%)

75mg/10mL (0.75%)

200mg/20mL (1%)

Y

Other strengths are available on request.

ROPIVACAINE

Infusion

200mg/200mL (0.1%)

Y

 

ROPIVACAINE

Infusion

400mg/200mL(0.2%)

Y

 

ROPIVACAINE/FENTANYL

Infusion

0.1%/2microg/mL

Y

 

ROPIVACAINE/FENTANYL

Infusion

0.2%/2microg/mL

Y

 

ROSUVASTATIN

Tablets

5mg, 10mg, 20mg & 40mg

Y

 

ROTAVIRUS VACCINE

Oral Solution

 

Y

Per NT Immunisation Schedule - Children and Adolescents.

Prescribe by brand name.

ROXITHROMYCIN

Tablet

150mg

Y

 

SACUBITRIL with VALSARTAN

Tablet

24-26mg

49-51mg

97-103mg

Y

Restricted to PBS indications.

SALBUTAMOL

Injection

500microg

Y

 

SALBUTAMOL

Nebule (single-dose)

2.5mg/2.5mL

5mg/2.5mL

Y

 

SALBUTAMOL

pMDI

100microg/dose

Y

 

SALICYLIC ACID / COAL TAR in AQUEOUS CREAM

Cream

6%/6%

Y

 

SALICYLIC ACID/ LACTIC ACID

Paint

16.70%

Y

 

SALINE LAXATIVE (Fleet®) FLEET

Mixture & Enema

 

Y

 

SALIVA ARTIFICIAL

Solution

 

Y

 

SEMAGLUTIDE

Injection

0.25mg or 0.5mg/dose

1mg/dose

R

Ozempic brand only. Restricted to PBS indications.

SEMAGLUTIDE

Injection

0.25mg, 0.5mg, 1mg, 1.7mg, 2.4mg

R

Wegovy® brand.

Restricted access only through NT Health Weight Management Services (RDPH or ASH) or paediatric endocrinology services for a maximum total duration of 12 months.

Blanket outpatient approval applies when the following criteria are met.

Criteria for adults:

*Approved only for priority Groups 1 (Inpatients with weight related barrier to discharge AND BMI ≥ 45 kg/m2) and 2 (weight as a barrier to life-saving treatment, e.g. unable to be waitlisted for lung or kidney transplant, unable to have cardiac surgery due to weight AND BMI ≥ 45 kg/m2)

*Patients must achieve at least 5% loss of baseline body weight within 6 months to continue treatment.

Criteria for adolescents:

  1. Patient has   been reviewed and medication will be prescribed by paediatric endocrinologist
  2. Patient aged   12 to 17 years of age
  3. Patient and   care givers are motivated and committed to lifestyle measures, and engaged   with multidisciplinary team

AND (a) The patient has not achieved meaningful weight loss despite 6 months of lifestyle measures (under supervision of treating paediatrician)

OR (b) There are complex social/neurodevelopmental factors that make it unlikely weight loss will be achieved with lifestyle intervention alone.

  1. Either:

(a)    BMI Z score (CDC extended BMI percentile 2022) >= 3 OR

BMI Z score (CDC extended BMI percentile 2022) >= 2 AND any of these co-morbidities: i) Insulin resistance/ pre- diabetes (fasting glucose 5.6 – 6.9mmol/L (IFG), 120min OGTT glucose 7.8 – 11.0mmol/L (IGT) or HbA1c 5.7 – 6.4%), OR type 2 diabetes

ii) Moderate-severe obstructive sleep apnoea

iii) Hypertension requiring anti-hypertensive medication

iv) Idiopathic intercranial hypertension on acetazolamide

v) Metabolic associated fatty liver disease

vi) Mobility issues related to disability limiting exercise capacity

vii) History of Slipped Capital Femoral Epiphysis

viii) Requires weight loss for solid organ transplant or surgery to proceed

ix) Known obesity syndrome diagnosed with genetic testing

SENNA

Tablets

7.5mg

Y

 

SERTRALINE

Tablets

50mg & 100mg

Y

 

SEVELAMER

Tablets

800mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

SEVOFLURANE

Liquid for inhalation

 

Y

 

SILDENAFIL

Injection

10mg/12.5ml

R

Restricted to ICU use only for patients with pulmonary arterial hypertension.

SILDENAFIL

Tablets

20mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

SILVER NITRATE/POTASSIUM NITRATE

Pencil & Sticks

427.5mg/22.5mg

Y

 

SILVER SULFADIAZINE

Cream

1%

R

Restricted where silver-impregnated wound care dressings are not suitable or appropriate.

Product has been discontinued. Consult Pharmacy for supply requirements.

SIMETHICONE

Drops

100mg/mL

Y

 

SIMETHICONE

Liquid

120mg/mL

Y

*For short-term listing while drops are out of stock

SIMVASTATIN

Tablet

10mg, 20mg 40mg & 80mg

Y

 

SIROLIMUS

Tablet

0.5mg, 1mg & 2mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

SITAGLIPTIN

Tablet

25mg, 50mg & 100mg

Y

 

SODIUM BENZOATE

Injection

2g/10mL

R

Restricted to Paediatricians under the advice of a Metabolic Specialist for the emergency treatment of hyperammonaemia in urea cycle defects.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

SODIUM BICARBONATE

Capsule

840mg

Y

 

SODIUM BICARBONATE

Injection

100mmol

Y

 

SODIUM CHLORIDE

Tablets

600mg

Y

 

SODIUM CHLORIDE

Injection

0.9%/5% (1L)

Y

Supplied by Stores Department

SODIUM CHLORIDE

Eye Drops

5%

R

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

Blanket outpatient approval for corneal oedema.

SODIUM CHLORIDE

Injection

0.45% (500mL), 0.9% (10mL, 20mL, 50mL, 100mL, 250mL, 500mL, 1L & 2L), 3% (1L), 23.4% (10mL),

Y

Supplied by Stores Department

(except for 10mL & 20mL ampoules)

SODIUM CHLORIDE (HYPERTONIC)

Inhalation

6%

R

Restricted to cystic fibrosis (CF) or non-CF bronchiectasis in paediatric patients.

Blanket approval for outpatient supply to CF or non-CF bronchiectasis in paediatric patients.

SODIUM CHLORIDE, SODIUM BICARBONATE, POTASSIUM CHLORIDE, GLUCOSE ANHYDROUS, CALCIUM LACTATE PENTAHYDRATE (Flo®)

Nasal Sachets/ Irrigation kit

 

R

Restricted to ENT and Radiation Oncology

SODIUM CHONDROITIN SULPHATE/SODIUM HYALURONATE (Viscoat®)

Eye Irrigation

40mg/30mg/mL

Y

 

SODIUM CITRATE

Solution

8.80%

Y

 

SODIUM CITRATE/ SODIUM LAURYL SULFOACETATE (Microlax®)

Enema

90mg/9mg/mL

Y

 

SODIUM CITRO-TARTRATE

Sachets

 

Y

 

SODIUM CROMOGLYCATE

Eye Drops

2%

Y

 

SODIUM DIHYDROGEN PHOSPHATE

Injection

10mmol/10mL

Y

FUSIDIC ACID HEMIHYDRATE

Tablet

250mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for susceptible infections not listed on the PBS approved by Infectious Diseases.

SODIUM HYALURONATE (Provisc®)

Intraocular Injection

8.5mg/0.85mL

Y

 

LACTATE CO (Hartmann’s®)

IV fluid

 

Y

Supplied by Stores Department

SODIUM NITROPRUSSIDE

Injection

50mg

Y

 

SODIUM PICOSULFATE

Oral liquid

7.5mg/mL

R

Restricted to palliative care.

SODIUM PICOSULFATE, MAGNESIUM OXIDE & CITRIC ACID (Picoprep®)

Sachets

 

Y

 

SODIUM POLYSTYRENE SULFONATE (Resonium A®)

Powder

454g

Y

 

SODIUM SULFATE DECAHYDRATE / MACROGOL/ ELECTROLYTES (COLONLYTELY®)

Sachets

 

Y

 

SODIUM TETRADECYL SULPHATE

Injection

3%

Y

 

SODIUM THIOSULFATE

Injection

25g/100mL

R

Blanket outpatient approval for calciphylaxis, restricted to nephology.

SODIUM VALPROATE

Injection

400mg

Y

 

SODIUM VALPROATE

Suspension

200mg/5mL

Y

 

SODIUM VALPROATE

Chewable Tablet

100mg

Y

 

SODIUM VALPROATE

Enteric Coated Tablet

200mg & 500mg

Y

 

SOFOSBUVIR/VELPATASVIR (Epclusa®)

Tablet

400mg/100mg

S

Restricted to specialists working in the liver clinic running the HCV treatment program. For initiation in outpatients via the Highly specialised Drugs Program (Section 100). Refer to PBS Criteria.

SOFOSBUVIR/VELPATASVIR/ VOXILAPREVIR (VOSEVI®)

Tablet

400mg/100mg/ 100mg

S

Restricted to specialists working in the liver clinic running the HCV treatment program. For initiation in outpatients via the Highly specialised Drugs Program (Section 100). Refer to PBS Criteria.

SOMATROPIN

Injection

1mg, 8mg, 10mg & 12mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

SORAFENIB

Tablet

200mg

R

Restricted to Haematology and Oncology for PBS listed indications.

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

SORBITOL

Solution

70%

Y

 

SOTALOL

Injection

40mg

Y

 

SOTALOL

Tablet

80mg & 160mg

Y

 

SPIRONOLACTONE

Tablet

25mg

100mg

Y

 

SPIRONOLACTONE

Solution

12.5mg/5mL

Y

 

STREPTOMYCIN

Injection

1g

Y

 

SUCROFERRIC OXYHYDROXIDE

Chewable tablet

2.5 g

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

SUCROSE

Oral Solution

24%

Y

 

SUFENTANIL

Injection

50microg

R

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

Blanket outpatient approval for cancer pain.

SUGAMMADEX

Injection

200mg

R

Restricted to use by Anaesthetic, ICU and ED specialists only.

SULFASALAZINE

Enteric Coated Tablet

500mg

Y

 

SULPHAMETHOXAZOLE/ TRIMETHOPRIM

Suspension

200mg/40mg/ 5mL

Y

 

SULPHAMETHOXAZOLE/ TRIMETHOPRIM

Tablet

400mg/80mg & 800mg/160mg

Y

Blanket outpatient approval for melioidosis eradication and Pneumocystis carinii pneumonia (PCP). Restricted to: Haematology/Oncology and Infectious Diseases.

SULPHAMETHOXAZOLE/ TRIMETHOPRIM

Injection

400mg/80mg

Y

 

SUNITINIB

Capsule

12.5mg

25mg

50mg

R

Restricted to PBS listed indications.

SUXAMETHONIUM

Injection

100mg

Y

 

TACROLIMUS

Capsule

500microg

1mg

5mg

S

Prograf® brand only.

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

TACROLIMUS

Capsule

(Controlled Release)

500microg

1mg

3mg

5mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

TAMOXIFEN

Tablet

10mg & 20mg

Y

 

TAMSULOSIN

Tablets

400microg

R

Restricted to urologists and geriatricians.

Restricted ONLY for the treatment of benign prostate hypertension (BPH) in patients where prazosin is not appropriate or not tolerated.

TAPENTADOL

Tablet

50mg

R

Restricted to inpatient use, where tramadol is not appropriate or intolerant. Not to be supplied on discharge from NT Hospital Pharmacy Departments

TAPENTADOL

Tablet

(Controlled Release)

50mg

100mg

150mg

200mg

250mg

R

Restricted to PBS indications.

TEA TREE

Oil

 

Y

 

TEICOPLANIN

Injection

400mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

TEMAZEPAM

Tablet

10mg

Y

 

TEMOZOLOMIDE

Capsule

5mg

20mg

100mg

140mg

180mg

250mg

R

Restricted to PBS listed indications.

TENECTEPLASE

Injection

(powder + solvent)

25mg

50mg

R

Restricted to use in the treatment of acute stroke (25mg strength)

TENOFOVIR ALAFENAMIDE

Tablet

25mg

R

Restricted to Infectious Disease and Gastroenterology teams for treatment of chronic hepatitis B virus infection in adult patients with resistance to entecavir AND when tenofovir disoproxil is not appropriate (e.g. established/high risk of osteoporosis, renal impairment or renal toxicity with tenofovir disoproxil)

TENOFOVIR DISOPROXIL

Tablet

300mg OR 291mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

TENOFOVIR DISOPROXIL & EMTRICITABINE

Tablet

300mg+200mg

OR 291mg+200mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

TENOFOVIR DISOPROXIL,  EMTRICITABINE & EFAVIRENZ

Tablet

300mg+200mg+ 600mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

TERBINAFINE

Tablet

250mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

TERBINAFINE

Cream

1%

R

Restricted to indications meeting PBS criteria.

TERBUTALINE

Injection

500microg/mL

R

Restricted to use in obstetrics for pregnant women with foetal distress requiring immediate delivery, or prior to External Cephalic Version (ECV)

TERBUTALINE

Turbuhaler

500microg

Y

 

TERLIPRESSIN

Injection

0.85mg/mL

R

Restricted to Emergency Physicians, Intensive Care Physicians and Gastroenterologists for haemorrhaging oesophageal varices.

Restricted to Intensive Care Physicians, Gastroenterologists and Nephrologists for Type 1 Hepatorenal Syndrome.

TESTOSTERONE ESTERS

Injection

100mg & 250mg

Y

 

TETRABENAZINE

Tablet

25mg

Y

 

TETRACAINE (AMETHOCAINE) HYDROCHLORIDE

Minims

1%

Y

 

TETRACAINE (AMETHOCAINE) HYDROCHLORIDE

Gel

4%

Y

 

TETRACAINE (AMETHOCAINE) HYDROCHLORIDE / LIDOCAINE/ ADRENALINE (EPINEPHRINE) (LACERAINE®)

Gel

40mg/5mg/1mg/5mL

Y

 

TETRACAINE (AMETHOCAINE) / LIDOCAINE/ ADRENALINE (EPINEPHRINE)

Injection

0.5%/ 4%/ 1:1000

Y

 

TETRACOSACTIDE

Injection

250microg

Y

 

TETRACOSACTIDE

Injection (suspension)

1mg/1mL

  

THALIDOMIDE

Capsule

50mg

100mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

THEOPHYLLINE

Modified Release Tablet

200mg, 250mg & 300mg

Y

 

THIAMINE

Tablet

100mg

Y

 

THIAMINE

Injection

300mg

Y

 

THIOPENTONE

Injection

500mg

Y

 

THROMBIN

Injection

5000units

Y

 

THYMOL

Mouthwash

 

Y

 

TICAGRELOR

Tablet

90mg

R

Restricted to Cardiologists & Interventional Cardiologists for patients undergoing planned PCI and CABG, and for patients who have had a cardiac event whilst taking clopidogrel.

TIGECYCLINE

Injection

50mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

TIMOLOL

Eye Drops

0.5%

Y

 

TIMOLOL

Eye Drops (Gel-forming)

0.5%

Y

 

TIOGUANINE

Tablet

40mg

R

Restricted to Haematology and Oncology for PBS listed indications.

Blanket approval for outpatient supply with PBS prescription. Restricted to: Haematology/Oncology.

TIOTROPIUM

Capsules for Inhalation

18microg

Y

 

TIOTROPIUM

Inhaler

 

Y

 

TIROFIBAN

Injection

12.5mg

R

Restricted to Cardiology

TIRZEPATIDE

Injection

2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, 15mg

R

Restricted access only through NT Health Weight Management Services (RDPH or ASH) for adult patients.

Blanket outpatient approval applies when the following criteria are met.

Criteria for adults:

*Approves only for priority Groups 1 (Inpatients with weight related barrier to discharge AND BMI ≥ 45 kg/m2) and 2 (weight as a barrier to life-saving treatment, e.g. unable to be waitlisted for lung or kidney transplant, unable to have cardiac surgery due to weight AND BMI ≥ 45 kg/m2)

*Patients must achieve at least 5% loss of baseline body weight within 6 months to continue treatment for a maximum total duration of 12 months.

TOBRAMYCIN

Injection

80mg (with preservative & preservative free for inhalation) & 500mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

TOBRAMYCIN

Eye drops

0.3%

1.4% (compounded)

R

Restricted to Ophthalmologist use only.

Blanket outpatient approval for treatment or prevention of ophthalmic infections.

TOBRAMYCIN

Eye ointment

0.30%

Y

 

TOCILIZUMAB

Injection

200mg/10mL  400mg/20mL

R

S

Restricted to ICU for COVID-19 where there is evidence of systemic inflammation.

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

TOPIRAMATE

Sprinkle Capsule

25mg

Y

 

TOPIRAMATE

Tablet

25mg, 50mg & 100mg

Y

Blanket outpatient approval for RDPH Weight Management Clinic

TOPOTECAN

Injection

4mg

R

Restricted to Haematology and Oncology for PBS listed indications AND Small Cell Lung Cancer, AND Neuroendocrine Unknown Primary Cancer.

TPN ADULT STD TRIPLE PHASE BAG (SmofKabiven®)

IV fluid

1970mL

Y

 

TPN NEONATE 34 WEEK TO TERM

IV fluid

1200mL

Y

ASH Stocked

TPN NEONATE CONCENTRATED PRETERM

IV fluid

750mL

Y

Order on request

TPN NEONATE HIGH SODIUM PRETERM

IV fluid

750mL

Y

Order on request

TPN NEONATE PRETERM (5% GLUCOSE)

IV fluid

750mL

Y

Order on request

TPN NEONATE PRETERM (7.5% GLUCOSE)

IV fluid

750mL

Y

Order on request

TPN NEONATE PERIPHERAL PRETERM

IV fluid

750mL

Y

RDH Stocked

TPN NEONATE STANDARD PRETERM

IV fluid

750mL

Y

ASH Stocked

TPN NEONATE STARTER

IV fluid

750mL

Y

RDH Stocked

TPN NEONATE STARTER CONCENTRATED

IV fluid

750mL

Y

Order on request.

TRAMADOL

Capsule

50mg

Y

 

TRAMADOL

Injection

100mg

Y

 

TRANEXAMIC ACID

Injection

1000mg/10mL

Y

 

TRANEXAMIC ACID

Tablet

500mg

Y

 

TRASTUZUMAB

Injection

60mg, 150mg, 600mg/5mL

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

TRIAMCINOLONE

Injection

10mg & 40mg

Y

 

TRIAMCINOLONE

Dental paste

0.10%

Y

 

TRICLOSAN

Solution

1%

Y

 

TRIHEXYPHENIDYL (BENZHEXOL) HYDROCHLORIDE

Tablet

2mg

Y

 

TRIMETHOPRIM

Tablet

300mg

Y

 

TROPICAMIDE

Minims

0.5% & 1%

Y

 

TROPONIN

Test strips

 

Y

 

TRYPAN BLUE

Injection

0.10%

Y

 

TUBERCULIN PPD

Injection

100units/mL

Y

 

ULIPRISTAL

Tablet

30mg

R

Restricted to women who require emergency contraception between 72 to 120 hours after unprotected intercourse or contraception failure (For GDH only).

UMECLIDINIUM

Inhaler

62.5microg

Y

 

UMECLIDINIUM, FLUTICASONE & VILANTEROL

Inhaler

62.5microg/ 100microg/ 25microg

Y

 

UMECLIDINIUM with VILANTEROL

Inhaler

62.5microg/ 25microg

Y

 

UREA (Dermadrate®)

Cream

10%

Y

 

UREA (Ure-Na®)

Sachets

15gm

R

Restricted to Endocrinology.

This is a Special Access Scheme (SAS) product. Please complete appropriate SAS form via the TGA’s Special Access Scheme Online Portal and ensure your account is linked to your work organisation.

URSODEOXYCHOLIC ACID

Suspension

250mg/5mL

Y

 

URSODEOXYCHOLIC ACID

Capsule

250mg

Y

Blanket outpatient approval for obstetric cholestasis.

USTEKINUMAB

Injection

130mg and 45mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

Note: The 45mg injection is to be sourced under PBS general schedule for outpatients.

VALACICLOVIR

Tablet

500mg

S

Restricted to PBS criteria

Blanket inpatient/outpatient approval for viral prophylaxis in haematology patients undergoing suppressive chemotherapy OR Ophthalmic Herpes Simplex.

VALGANCICLOVIR

Tablet

Oral Liquid

450mg

50mg/mL

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket inpatient/outpatient approval for treatments and prophylaxis of susceptible infections not listed on the PBS approved by Infectious Diseases.

VANCOMYCIN

Infusor

Patient-Specific

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

VANCOMYCIN

Injection

500mg & 1g

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

VANCOMYCIN

Capsules

125mg & 250mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

VARICELLA (CHICKEN POX) VACCINE

Injection

 

Y

Per NT Immunisation Schedule - Adult and Special Risk groups. Prescribe by brand name.

VECURONIUM

Injection

4mg, 10mg

Y

 

VEDOLIZUMAB

Injection

300mg

S

Restricted to Gastroenterologists for Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

VENLAFAXINE

Modified Release Capsule

37.5mg, 75mg & 150mg

Y

 

VERAPAMIL

Injection

5mg

Y

 

VERAPAMIL

Tablet

40mg & 80mg

Y

 

VERAPAMIL

Modified Release Capsule

180mg & 240mg

Y

 

VINBLASTINE

Injection

Patient-Specific

R

Restricted to Haematology and Oncology for PBS listed indications.

VINCRISTINE

Injection

Patient-Specific

R

Restricted to Haematology and Oncology for PBS listed indications.

VINORELBINE

Capsule

20mg

30mg

R

Restricted to Haematology and Oncology for PBS listed indications.

VINORELBINE

Injection

Patient-Specific

R

Restricted to Haematology and Oncology for PBS listed indications.

VITAMIN A

Ointment

 

Y

 

VITAMIN A (RETINOL PALMITATE)

Oral Liquid

5000 IU/0.2mL

Y

 

VITAMIN B COMPLEX (Cenovis Mega B®)

Tablets

 

Y

 

VITAMIN E

Oral Liquid

156iu

Y

 

VITAMIN PREGNANCY & BREASTFEEDING (I-Folic®)

Tablets

 

R

Restricted to remote health and maternity inpatients for women who are pregnant or breastfeeding.

VORICONAZOLE

Injection

200mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

VORICONAZOLE

Tablet

50mg & 200mg

R

Protected antimicrobial - Please refer to the NT Protected Antimicrobials Guideline.

Blanket outpatient approval for susceptible infections not listed on the PBS approved by Infectious Diseases.

WARFARIN

Tablet

1mg

2mg

5mg

Y

Coumadin® stocked. Consult Pharmacy for supply of Marevan®

WATER FOR INJECTIONS

Injection

10mL

20mL

1L

Y

Supplied by Stores Department

(except for 10mL & 20mL ampoules)

WATER FOR IRRIGATION

Irrigation

1L

2L

Y

Supplied by Stores Department

WOOL ALCOHOLS

Ointment

100g

Y

 

XYLOMETAZOLINE

Nasal Drops

0.05%

Y

 

ZINC & CASTOR OIL

Cream

20g

Y

 

ZINC

Capsule

50mg

Y

 

ZINC OXIDE

Cream

 

Y

 

ZINC SULPHATE

Solution

50mg/mL

Y

Contains elemental Zinc 11.3mg/mL

ZOLEDRONIC ACID

Injection

5mg

R

Restricted to PBS listed indications.

ZOLEDRONIC ACID

Injection

4mg

S

Highly Specialised Drugs Program (Section 100). Refer to PBS Criteria.

ZOLMITRIPTAN

Tablet

2.5

Y

 

ZOSTER (HERPES ZOSTER) VACCINE

Injection

0.5mL

Y

Per NT Immunisation Schedule - Adult and Special Risk groups. Prescribe by brand name.

ZUCLOPENTHIXOL ACETATE

Immediate-Acting Injection

50mg

R

Restricted to prescribing by or upon consultation with psychiatrists.

ZUCLOPENTHIXOL

Tablet

10mg

Y

 

ZUCLOPENTHIXOL DECANOATE

Long-Acting Injection

200mg/1mL

Y

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