Document ID: chunk:federal_register_of_legislation:F2025C00158:clause:4_1:p8
Version: federal_register_of_legislation:F2025C00158
Segment Type: clause
Provision Reference: sch 4 cl 1 (pt 8/191)
Character Range: 9531304–9539575

elements and medium chain triglycerides                                                               Must be treated by a specialist allergist, clinical immunologist or specialist paediatric gastroenterologist and hepatologist at intervals not greater than 12 months; AND
                                                                                                                                                                                                                               The condition must not be isolated infant colic or reflux;
                                                    Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids                                                                                      Patient must be older than 24 months of age.
                                                                                                                                                                                                                               The name of the specialist and the date of birth of the patient must be included in the authority application.
                                                    Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides

                                                    Amino acids-synthetic, formula

C4339               P4339          CN4339           Amino acid formula supplemented with prebiotics, probiotics and long chain polyunsaturated fatty acids                                                                     Proven combined immunoglobulin E (IgE) mediated allergy to cows' milk protein and soy protein                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Compliance with Authority Required procedures
                                                                                                                                                                                                                               Continuing treatment
                                                    Amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides                                                               Must be treated by a specialist allergist, clinical immunologist or specialist paediatric gastroenterologist and hepatologist; AND
                                                                                                                                                                                                                               Patient must have failed a trial of protein hydrolysate formulae (with or without medium chain triglycerides) prior to commencement with initial treatment;
                                                    Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids                                                                                      Patient must be up to the age of 24 months.
                                                                                                                                                                                                                               The name of the specialist and the date of birth of the patient must be included in the authority application.
                                                    Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides

                                                    Amino acids-synthetic, formula

C4343               P4343          CN4343           Bimatoprost with timolol                                                                                                                                                   Elevated intra-ocular pressure
                                                                                                                                                                                                                               The condition must have been inadequately controlled with monotherapy; AND
                                                    Brimonidine with timolol                                                                                                                                                   Patient must have open-angle glaucoma.  or
                                                                                                                                                                                                                               Patient must have ocular hypertension.
                                                    Brinzolamide with timolol

                                                    Dorzolamide with timolol

                                                    Latanoprost with timolol

                                                    Travoprost with timolol

C4345               P4345          CN4345           Amino acid formula supplemented with prebiotics, probiotics and long chain polyunsaturated fatty acids                                                                     Severe cows' milk protein enteropathy with failure to thrive                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Compliance with Authority Required procedures
                                                                                                                                                                                                                               Continuing treatment
                                                    Amino acid formula with fat, carbohydrate, vitamins, minerals, trace elements and medium chain triglycerides                                                               Must be treated by a specialist allergist, clinical immunologist or specialist paediatric gastroenterologist and hepatologist, or have been assessed at least once or have an appointment to be assessed by one of these specialists; AND
                                                                                                                                                                                                                               The condition must not be isolated infant colic or reflux; AND
                                                    Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids                                                                                      Patient must have had failure to thrive prior to commencement with initial treatment;
                                                                                                                                                                                                                               Patient must be up to the age of 24 months.
                                                    Amino acid synthetic formula supplemented with long chain polyunsaturated fatty acids and medium chain triglycerides                                                       The name of the specialist and the date of birth of the patient must be included in the authority application.