Document ID: chunk:federal_register_of_legislation:F2025C00215:schedule:4:p1
Version: federal_register_of_legislation:F2025C00215
Segment Type: schedule
Provision Reference: sch 4 (pt 1/11)
Character Range: 30734–35461

Schedule 4—Pharmaceutical benefits to be supplied as complete packs only
Note: See section 10.

Pharmaceutical benefits to be supplied as complete packs only
Column 1                                                                     Column 2
Listed drug                                                                  Form
Abiraterone and methylprednisolone                                           Pack containing 120 tablets abiraterone acetate 125 mg and 30 tablets methylprednisolone 4 mg
Abiraterone and methylprednisolone                                           Pack containing 120 tablets abiraterone acetate 125 mg and 60 tablets methylprednisolone 4 mg
Aciclovir                                                                    Eye ointment 30 mg per g, 4.5 g
Aclidinium                                                                   Powder for oral inhalation in breath actuated device 322 micrograms (as bromide) per dose, 60 doses
Aclidinium with formoterol                                                   Powder for oral inhalation in breath actuated device containing aclidinium 340 micrograms (as bromide) with formoterol fumarate dihydrate 12 micrograms per dose, 60 doses
Adapalene with benzoyl peroxide                                              Gel 1 mg‑25 mg per g, 30 g
Amoxicillin                                                                  Powder for paediatric oral drops 100 mg (as trihydrate) per mL, 20 mL
Amoxicillin                                                                  Powder for oral suspension 125 mg (as trihydrate) per 5 mL, 100 mL
Amoxicillin                                                                  Powder for oral suspension 250 mg (as trihydrate) per 5 mL, 100 mL
Amoxicillin                                                                  Powder for oral suspension 500 mg (as trihydrate) per 5 mL, 100 mL
Amoxicillin with clavulanic acid                                             Powder for oral suspension containing 125 mg amoxicillin (as trihydrate) with 31.25 mg clavulanic acid (as potassium clavulanate) per 5 mL, 75 mL
Amoxicillin with clavulanic acid                                             Powder for oral suspension containing 400 mg amoxicillin (as trihydrate) with 57 mg clavulanic acid (as potassium clavulanate) per 5 mL, 60 mL
Apremilast                                                                   Pack containing 4 tablets 10 mg, 4 tablets 20 mg and 19 tablets 30 mg
Atenolol                                                                     Oral solution 50 mg in 10 mL, 300 mL
Atovaquone                                                                   Oral suspension 750 mg per 5 mL, 210 mL
Atropine                                                                     Eye drops containing atropine sulfate monohydrate 10 mg per mL, 15 mL
Azithromycin                                                                 Powder for oral suspension 200 mg (as dihydrate) per 5 mL, 15 mL
Beclometasone                                                                Pressurised inhalation containing beclometasone dipropionate 50 micrograms per dose, 200 doses (CFC‑free formulation)
Beclometasone                                                                Pressurised inhalation containing beclometasone dipropionate 100 micrograms per dose, 200 doses (CFC‑free formulation)
Beclometasone                                                                Pressurised inhalation in breath actuated device containing beclometasone dipropionate 50 micrograms per dose, 200 doses (CFC‑free formulation)
Beclometasone                                                                Pressurised inhalation in breath actuated device containing beclometasone dipropionate 100 micrograms per dose, 200 doses (CFC‑free formulation)
Beclometasone with formoterol                                                Pressurised inhalation containing beclometasone dipropionate 100 micrograms and formoterol fumarate dihydrate 6 micrograms per dose,120 dose
Beclometasone with formoterol                                                Pressurised inhalation containing beclometasone dipropionate 200 micrograms and formoterol fumarate dihydrate 6 micrograms per dose, 120 doses
Beclometasone with formoterol and glycopyrronium                             Pressurised inhalation containing beclometasone dipropionate 100 micrograms with formoterol fumarate dihydrate 6 micrograms and glycopyrronium 10 micrograms (as bromide) per dose, 120 doses
Beclometasone with formoterol and glycopyrronium                             Pressurised inhalation containing beclometasone dipropionate 200 micrograms with formoterol fumarate dihydrate 6