Document ID: chunk:federal_register_of_legislation:F2025C00158:clause:4_1:p4
Version: federal_register_of_legislation:F2025C00158
Segment Type: clause
Provision Reference: sch 4 cl 1 (pt 4/191)
Character Range: 9491641–9506339

with diathermy; AND
                                                                                                                                                                                                                               Patient must require topical drug therapy.
                                                                                                                                                                                                                               The date of the pathology report and name of the Approved Pathology Authority must be provided at the time of application.
C4242               P4242          CN4242           Vinorelbine                                                                                                                                                                Locally advanced or metastatic non-small cell lung cancer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Compliance with Authority Required procedures

C4243               P4243          CN4243           Cefalexin                                                                                                                                                                  Prophylaxis of urinary tract infection                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Compliance with Authority Required procedures - Streamlined Authority Code 4243

                                                    Trimethoprim

C4244               P4244          CN4244           Diazepam                                                                                                                                                                   Chronic spasticity                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Compliance with Authority Required procedures
                                                                                                                                                                                                                               Patient must be under 18 years of age.
C4246               P4246          CN4246           Amisulpride                                                                                                                                                                Schizophrenia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Compliance with Authority Required procedures - Streamlined Authority Code 4246

                                                    Aripiprazole

                                                    Asenapine

                                                    Brexpiprazole

                                                    Cariprazine

                                                    Lurasidone

                                                    Olanzapine

                                                    Paliperidone

                                                    Quetiapine

                                                    Risperidone

                                                    Ziprasidone

C4253               P4253          CN4253           High fat formula with vitamins, minerals and trace elements and low in protein and carbohydrate                                                                            Ketogenic diet
                                                                                                                                                                                                                               Patient must have intractable seizures requiring treatment with a ketogenic diet.  or
                                                                                                                                                                                                                               Patient must have a glucose transport protein defect.  or
                                                                                                                                                                                                                               Patient must have pyruvate dehydrogenase deficiency.
                                                                                                                                                                                                                               KetoCal 3 1 should only be used under strict supervision of a dietitian, together with a metabolic physician and/or neurologist.
C4268               P4268          CN4268           Apixaban                                                                                                                                                                   Pulmonary embolism                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Compliance with Authority Required procedures - Streamlined Authority Code 4268
                                                                                                                                                                                                                               Continuing treatment
                                                    Rivaroxaban                                                                                                                                                                Patient must have confirmed acute symptomatic pulmonary embolism.

C4269               P4269          CN4269           Apixaban                                                                                                                                                                   Prevention of stroke or systemic embolism                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Compliance with Authority Required procedures - Streamlined Authority Code 4269
                                                                                                                                                                                                                               Patient must have non-valvular atrial fibrillation; AND
                                                    Dabigatran etexilate                                                                                                                                                       Patient must have one or more risk factors for developing stroke or systemic embolism.
                                                                                                                                                                                                                               Risk factors for developing stroke or systemic ischaemic embolism are
                                                    Rivaroxaban                                                                                                                                                                (i) Prior stroke (ischaemic or unknown type), transient ischaemic attack or non-central nervous system (CNS) systemic embolism;
                                                                                                                                                                                                                               (ii) age 75 years or older;
                                                                                                                                                                                                                               (iii) hypertension;
                                                                                                                                                                                                                               (iv) diabetes mellitus;
                                                                                                                                                                                                                               (v) heart failure and/or left ventricular ejection fraction 35% or less.
C4272               P4272          CN4272           Vinorelbine                                                                                                                                                                Advanced breast cancer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Compliance with Authority Required procedures
                                                                                                                                                                                                                               Patient must have failed standard prior therapy, which includes an anthracycline.
C4289               P4289          CN4289           High fat formula with vitamins, minerals and trace elements and low in protein and carbohydrate                                                                            Ketogenic diet
                                                                                                                                                                                                                               Patient must have intractable seizures requiring treatment with a ketogenic diet.  or
                                                                                                                                                                                                                               Patient must have a glucose transport protein defect.  or
                                                                                                                                                                                                                               Patient must have pyruvate dehydrogenase deficiency.
                                                                                                                                                                                                                               KetoCal 4 1 should only be used under strict supervision of a dietitian, together with a metabolic physician and/or neurologist.
C4295               P4295          CN4295           Amino acid formula with carbohydrate without phenylalanine                                                                                                                 Phenylketonuria

                                                    Amino acid formula with carbohydrate, vitamins, minerals and trace elements without phenylalanine

                                                    Amino acid formula with vitamins and minerals without phenylalanine

                                                    Amino acid formula with vitamins and minerals, low phenylalanine and supplemented with docosahexaenoic acid and arachidonic acid

                                                    Amino acid formula with vitamins, minerals and long chain polyunsaturated fatty acids without