SA Medicines Formulary

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Therapeutic Area:
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Note: Therapeutic areas reflect Australian Medicines Handbook (AMH) Chapters
Disclaimer:

The South Australian Medicines Formulary is currently being established. A staged implementation is underway with medicines added as therapeutic groups undergo the formulary review process.

Information regarding the formulary is available on the following

For further information contact your hospital’s Drug and Therapeutic Committee OR SAFC Executive Officer OR for enquiries regarding High Cost Medicines SAMEP Executive Officer

In response to the Declaration of a Major Emergency by the State Coordinator under the Emergency Management Act 2004 relating to the COVID-19 global pandemic:

An interim listing on the SA Medicines Formulary has been supported for of all agents endorsed by the National COVID-19 Clinical Evidence Taskforce as ‘recommended disease-modifying treatments’ for use by SA Health Consultants involved in the acute management of COVID-19 patients in accordance with the criteria recommended by the National COVID-19 Clinical Evidence Taskforce.

Post the Major Emergency Declaration being rescinded, and removal of the interim Formulary listing, the SAFC will review and assess formulary applications submitted for ongoing access to these medicines as appropriate and clinically indicated.


Medicines listed on the SA Medicines Formulary are for Pharmaceutical Benefits Scheme (PBS) criteria unless otherwise indicated or not available on the PBS. http://pbs.gov.au .

If a medicine is unrestricted or not available on the PBS, indications for use are those approved by the Therapeutic Goods Administration (TGA).

Sometimes it may be necessary to use a medicine for an unapproved or “off-label” indication. The CATAG "Guiding Principles for the quality use of off-label medicines" should be utilised when considering use of off-label medicines.


In the event of medicine shortages please refer to your site’s Pharmacy Department for management and alternatives.

For information on availability of SA Pharmacy manufactured medicines please refer to SA Health Manufactured Product List.

From April 2016 the Therapeutic Goods Administration (TGA) will be updating some medicine ingredient names used in Australia to align with names used internationally, for more information refer to List of affected ingredients.

Medicines:

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |

1. Abacavir

Class: Antiretrovirals - Nucleoside reverse transcriptase inhibitors
20mg/1mL Oral Solution

Restrictions on use:
ID / Sexual Health Physicians advice as per PBS Section 100 criteria

PBS Link

2. Abacavir

Class: Antiretrovirals - Nucleoside reverse transcriptase inhibitors
300mg Tablets

Restrictions on use:
ID / Sexual Health Physicians advice as per PBS Section 100 criteria

PBS Link

3. Abacavir + Lamivudine

Class: Antiretrovirals - Nucleoside reverse transcriptase inhibitors
600mg-300mg Tablets

Restrictions on use:
ID / Sexual Health Physicians advice as per PBS Section 100 criteria

PBS Link

4. Abatacept

Class: Immunosuppressants (rheumatology)
125mg/1mL Prefilled Syringes

PBS Link

5. Abatacept

Class: Immunosuppressants (rheumatology)
250mg Injection

PBS Link

6. Abiraterone

Class: Other hormonal antineoplastics
Abiraterone Acetate 250mg Tablets

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

7. Abiraterone

Class: Other hormonal antineoplastics
Abiraterone Acetate 500mg Tablets

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

8. Acamprosate

Class: Drugs for alcohol dependence
Acamprosate Calcium 333mg Tablets

PBS Link

9. Acetazolamide

Class: Other antiepileptics
250mg Tablets

PBS Link

10. Acetazolamide

Class: Other antiepileptics
500mg Injection

PBS Link

11. Acetazolamide

Class: Drugs for glaucoma
250mg Tablets

PBS Link

12. Acetazolamide

Class: Drugs for glaucoma
500mg Injection

PBS Link

13. Acetazolamide

Class: Other antiepileptics
25mg/mL Suspension

Restrictions on use:
Paediatric Patients

Note: SA Pharmacy Manufactured product

PBS Link

14. Acetazolamide

Class: Drugs for glaucoma
25mg/mL Suspension

Restrictions on use:
Paediatric Patients

Note: SA Pharmacy Manufactured product

PBS Link

15. Acetic Acid

Class: Antiseptics
0.25% Irrigation

PBS Link

16. Acetic Acid

Class: Antiseptics
5% Solution

PBS Link

17. Acetyl L-Carnitine

Class: Drugs to manage metabolic disorders
500mg Capsules

Restrictions on use:
Carnitine deficiency due to inborn errors of metabolism as per Metabolic specialist

PBS Link

18. Acetylcholine Chloride

Class: Drugs for glaucoma
20mg Intraocular Solution

PBS Link

19. Acetylcysteine

Class: Antidotes and gastrointestinal decontaminants
Injection 2g/10mL

Restrictions on use:
For the management of paracetamol overdose OR In combination with intravenous glyceryl trinitrate (GTN) for potentiation of the effects of GTN

PBS Link

20. Acetylcysteine

Class: Drugs for cough
800mg/4mL (20%) Sterile Solution

Restrictions on use:
Respiratory / Thoracics (inhaled) OR
Neonates for treating meconium ileus (oral / rectal)

PBS Link

21. Acetylcysteine (preservative Free)

Class: Drugs for dry eyes
5% Eye Drops

Restrictions on use:
Ophthalmology for the management of chemical burns

Note: SA Pharmacy Manufactured Product

PBS Link

22. Aciclovir

Class: Drugs for eye infections
3% Eye Ointment

PBS Link

23. Aciclovir

Class: Drugs for skin infections (topical)
5% Cream

PBS Link

24. Aciclovir

Class: Antivirals - Guanine analogues
200mg Tablets

Restrictions on use:
ID / Microbiology advice OR
Pregnant patients or paediatric patients or patients requiring administration via enteral tubes for: prophylaxis / treatment of herpes virus infection if immunocompromised, herpes zoster, mucocutaneous herpes and genital herpes

PBS Link

25. Aciclovir

Class: Antivirals - Guanine analogues
250mg/10mL Injection

Restrictions on use:
ID / Microbiology advice OR
Intensive Care Units OR
Herpes encephalitis, severe varicella-zoster or severe herpes simplex infections OR Patients fitting famclovir / valaciclovir / aciclovir (oral) criteria unable to tolerate oral therapy

PBS Link

26. Aciclovir

Class: Antivirals - Guanine analogues
500mg/20mL Injection

Restrictions on use:
ID / Microbiology advice OR
Intensive Care Units OR
Herpes encephalitis, severe varicella-zoster or severe herpes simplex infections OR Patients fitting famclovir / valaciclovir / aciclovir (oral) criteria unable to tolerate oral therapy

PBS Link

27. Aciclovir

Class: Antivirals - Guanine analogues
800mg Tablets

Restrictions on use:
ID / Microbiology advice OR
Pregnant patient for prophylaxis / treatment of herpes virus infection if immunocompromised, herpes zoster, mucocutaneous herpes and genital herpes

PBS Link

28. Acitretin

Class: Drugs for acne
10mg Capsules

Restrictions on use:
As per PBS criteria and Controlled Substances (Poisons) Regulations

PBS Link

29. Acitretin

Class: Drugs for acne
25mg Capsules

Restrictions on use:
As per PBS criteria and Controlled Substances (Poisons) Regulations

PBS Link

30. Adalimumab

Class: Drugs for psoriasis
40mg Injection

Restrictions on use:
Dermatology as per PBS criteria

Note: Current brand to continue being utilised until advised.

PBS Link

31. Adalimumab

Class: TNF-alpha antagonists (Gastrointestinal)
20mg injection

Restrictions on use:
PBS criteria only OR adult patients with non-infectious posterior, intermediate or panuveitis that is refractory to corticosteroids and at least two other corticosteroid sparing agents (SAMEP reviewed indication). An eligibility checklist must be completed for the SAMEP reviewed indication.

Note: Current brand to continue being utilised until advised.

Note: All other indications are to be referred to Drug and Therapeutic Committee for Individual Patient Use (IPU) approval process.

PBS Link

32. Adalimumab

Class: TNF-alpha antagonists (Gastrointestinal)
40mg injection

Restrictions on use:
PBS criteria OR adult patients with non-infectious posterior, intermediate or panuveitis that is refractory to corticosteroids and at least two other corticosteroid sparing agents (SAMEP reviewed indication). An eligibility checklist must be completed for the SAMEP reviewed indication

Note: Current brand to continue being utilised until advised.

Note: All other indications are to be referred to Drug and Therapeutic Committee for Individual Patient Use (IPU) approval process.

PBS Link

33. Adalimumab

Class: TNF-alpha antagonists (rheumatology)
20mg injection

Restrictions on use:
PBS criteria OR
Adult patients with non-infectious posterior, intermediate or panuveitis that is refractory to corticosteroids and at least two other corticosteroid sparing agents (SAMEP reviewed indication). An eligibility checklist must be completed for the SAMEP reviewed indication. OR
First line biologic treatment for paediatric patients with active non-infectious sight threatening uveitis who had an inadequate response to corticosteroid and failed or intolerant of methotrexate as per SAMEP clinical pathway for paediatric active non-infectious sight threatening uveitis

Note: Current brand to continue being utilised until advised.

Note: All other indications are to be referred to Drug and Therapeutic Committee for Individual Patient Use (IPU) approval process.

PBS Link

34. Adalimumab

Class: TNF-alpha antagonists (rheumatology)
40mg Injection

Restrictions on use:
PBS criteria OR
Adult patients with non-infectious posterior, intermediate or panuveitis that is refractory to corticosteroids and at least two other corticosteroid sparing agents (SAMEP reviewed indication). An eligibility checklist must be completed for the SAMEP reviewed indication. OR
First line biologic treatment for paediatric patients with active non-infectious sight threatening uveitis who had an inadequate response to corticosteroid and failed or intolerant of methotrexate as per SAMEP clinical pathway for paediatric active non-infectious sight threatening uveitis

Note: Current brand to continue being utilised until advised.

Note: All other indications are to be referred to Drug and Therapeutic Committee for Individual Patient Use (IPU) approval process.

PBS Link

35. Adapalene + Benzoyl Peroxide

Class: Drugs for acne
Adapalene - Benzoyl Peroxide 0.1%-2.5% Gel

PBS Link

36. Adefovir Dipivoxil

Class: Antivirals - For viral hepatitis
10mg Tablets

Restrictions on use:
ID / Microbiology / Gastroenterology / Hepatology as per PBS Section 100 criteria

PBS Link

37. Adenosine

Class: Antiarrhythmics
6mg/2mL Injection

PBS Link

38. Adenosine

Class: Antiarrhythmics
30mg/10mL Injection

PBS Link

39. Adrenaline (epinephrine)

Class: Sympathomimetics (cardiovascular)
1 in 1,000 (1mg/1mL) Injection

PBS Link

40. Adrenaline (epinephrine)

Class: Sympathomimetics (cardiovascular)
1 in 10,000 (1mg/10mL) Injection, Ampoule

PBS Link

41. Adrenaline (epinephrine)

Class: Sympathomimetics (cardiovascular)
1 in 10,000 (1mg/10mL) Injection, Syringe

PBS Link

42. Adrenaline (epinephrine)

Class: Sympathomimetics (anaphylaxis)
1 in 1,000 (1mg/1mL) Injection

PBS Link

43. Adrenaline (epinephrine)

Class: Sympathomimetics (anaphylaxis)
1 in 10,000 (1mg/10mL) Injection, Ampoule

PBS Link

44. Adrenaline (epinephrine)

Class: Sympathomimetics (anaphylaxis)
1 in 10,000 (1mg/10mL) Injection, Syringe

PBS Link

45. Adrenaline (epinephrine)

Class: Sympathomimetics (anaphylaxis)
150microg/0.3mL Injection

Restrictions on use:
Outpatient or discharge supply as per Pharmaceutical Benefits Scheme (PBS) criteria OR
For emergency use when medical or qualified nursing / midwifery staff not available as per approved local Drug and Therapeutic Committee (DTC) guideline / protocol

PBS Link

46. Adrenaline (epinephrine)

Class: Sympathomimetics (anaphylaxis)
300microg/0.3mL Injection

Restrictions on use:
Outpatient or discharge supply as per Pharmaceutical Benefits Scheme (PBS) criteria OR
Patients within SA Prison Health Services and SA Health Forensic Hospitals OR
For emergency use when medical or qualified nursing / midwifery staff not available as per approved local Drug and Therapeutic Committee (DTC) guideline / protocol

PBS Link

47. Afatinib

Class: Kinase inhibitors
20mg Tablets

Restrictions on use:
Haematology / Oncology second or third line when other agents not tolerated as per PBS criteria

PBS Link

48. Afatinib

Class: Kinase inhibitors
30mg Tablets

Restrictions on use:
Haematology / Oncology second or third line when other agents not tolerated as per PBS criteria

PBS Link

49. Afatinib

Class: Kinase inhibitors
40mg Tablets

Restrictions on use:
Haematology / Oncology second or third line when other agents not tolerated as per PBS criteria

PBS Link

50. Afatinib

Class: Kinase inhibitors
50mg Tablets

Restrictions on use:
Haematology / Oncology second or third line when other agents not tolerated as per PBS criteria

PBS Link

51. Aflibercept

Class: Agents for macular degeneration
3.6 mg/0.09 mL Intravitreal Inj, syringe

Restrictions on use:
Ophthalmology as per PBS criteria for patients where ranibizumab is not effective or appropriate

PBS Link

52. Agalsidase alfa

Class: Specialised Products
3.5mg/3.5mL Injection

Restrictions on use:
For use via the Life Saving Drugs Program (LSDP)

PBS Link

53. Agalsidase beta-rch

Class: Specialised Products
5mg Injection

Restrictions on use:
For use via the Life Saving Drugs Program (LSDP)

PBS Link

54. Agalsidase beta-rch

Class: Specialised Products
35mg Injection

Restrictions on use:
For use via the Life Saving Drugs Program (LSDP)

PBS Link

55. Agomelatine

Class: Other antidepressants
25mg Tablets

Restrictions on use:
Not on formulary: Available via streamlined non-formulary approval process on psychiatry initiation only; for treatment of major depression with sleep disturbances, where other pharmacological therapies are not effective or tolerated. AND Patient fulfils all the following criteria:
Adult patients < 75 years AND not taking potent CYP1A2 inhibitor AND no significant hepatic impairment AND aminotransferase concentration < 3 times ULN AND no risk factors for hepatic damage
AND Liver function tests (LFTs) performed prior to commencing therapy and provisions made to repeat LFTs 2 weeks after commencing therapy and clinical review one month after commencement of therapy

PBS Link

56. Albendazole

Class: Anthelmintics
400mg Chewable Tablets

Restrictions on use:
• ID / Microbiology advice OR
• Cestode or nematodes infections

Note:

PBS Link

57. Alcohol

Class: Antiseptics
70% Solution

PBS Link

58. Alcohol

Class: Antiseptics
70% Sterile Solution

PBS Link

59. Alcohol [Ethanol], Dehydrated

Class: Antidotes and gastrointestinal decontaminants
100% Injection

Note: Available via the Special Access Scheme (SAS) process

PBS Link

60. Alectinib

Class: Kinase inhibitors
150mg Capsules

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

61. Alemtuzumab

Class: Antineoplastic antibodies
12 mg/1.2 mL injection

Restrictions on use:
Outpatients for multiple sclerosis restricted to PBS criteria

PBS Link

62. Alemtuzumab

Class: Drugs for multiple sclerosis
12 mg/1.2 mL injection

Restrictions on use:
Outpatients for multiple sclerosis restricted to PBS criteria

PBS Link

63. Alfentanil

Class: Other agents used in anaesthesia
1mg/2mL Injection

PBS Link

64. Alginic Acid compound (sodium alginate, magnesium alginate)

Class: Other drugs for reflux and ulcers
225 mg - 87.5 mg oral sachets

Restrictions on use:
Paediatric patients

PBS Link

65. Alglucosidase Alfa

Class: Specialised Products
50mg Injection

Restrictions on use:
For use via the Life Saving Drugs Program (LSDP)

PBS Link

66. Allergen extract - Pollen, dust mite, mould and/or animal dander

Class: Allergens
For subcutaneous immunotherapy

Restrictions on use:
As per Immunology

PBS Link

67. Allergen pollen extract of 5 grasses - Anthoxanthum odoratum, Dactylis glomerata, Lolium perenne, Phleum pratense, Poa pratensis

Class: Allergens
Brand: Oralair

100 IR Sublingual Tablets

Restrictions on use:
As per Immunology for allergic rhinitis and/or asthma, for patients sensitised to temperate grasses as their predominant clinical grass allergens, where allergen extract subcutaneous immunotherapy not clinically appropriate (e.g. severe needle phobia not managed with psychotherapy)

PBS Link

68. Allergen pollen extract of 5 grasses - Anthoxanthum odoratum, Dactylis glomerata, Lolium perenne, Phleum pratense, Poa pratensis

Class: Allergens
Brand: Oralair

300 IR Sublingual Tablets

Restrictions on use:
As per Immunology for allergic rhinitis and/or asthma, for patients sensitised to temperate grasses as their predominant clinical grass allergens, where allergen extract subcutaneous immunotherapy not clinically appropriate (e.g. severe needle phobia not managed with psychotherapy)

PBS Link

69. Allopurinol

Class: Drugs for gout
100mg Tablets

PBS Link

70. Allopurinol

Class: Drugs for gout
300mg Tablets

PBS Link

71. Alprostadil

Class: Other cardiovascular agents
500microg/1mL Injection

Restrictions on use:
Neonatology

PBS Link

72. Alteplase

Class: Thrombolytics
10mg Injection

Restrictions on use:
Management of acute STEMI OR Massive PE OR
Acute ischaemic stroke OR Adult patients for fibrinolysis of loculated pleural effusion (in combination with Dornase) as per approved protocol OR
Paediatric patients for use in pleural effusion and empyema (without Dornase) as per “SA Paediatric Practice Guidelines - Paediatric empyema excluding neonates” OR
To maintain patency of central venous catheters (CVC) / peripherally inserted central catheters (PICC) OR
Treatment of arterial/graft thrombosis with distal ischemia of the lower limb or abdominal viscera, intra-procedure for distal embolisation/thrombosis and acute/chronic venous thrombosis in accordance with SA Health approved clinical guideline

PBS Link

73. Alteplase

Class: Thrombolytics
50mg Injection

Restrictions on use:
Management of acute STEMI OR Massive PE OR
Acute ischaemic stroke

PBS Link

74. Alteplase

Class: Thrombolytics
2mg Injection

Restrictions on use:
For occluded central vascular access catheter use as per approved local Drug and Therapeutics Committee (DTC) guideline / protocol

Note: Available via the Special Access Scheme (SAS) process

PBS Link

75. Alteplase

Class: Miscellaneous eye drugs
50microg intravitreal injection

Restrictions on use:
Ophthalmology for submacular haemorrhage secondary to wet age-related macular degeneration.

Note: SA Pharmacy Manufactured Product

PBS Link

76. Aluminium Hydroxide

Class: Phosphate binders
600mg tablets

PBS Link

77. Aluminium Hydroxide

Class: Other drugs for reflux and ulcers
600mg tablets

Note: For use as a phosphate binder in chronic renal failure

PBS Link

78. Aluminium Hydroxide - Magnesium Trisilicate - Magnesium Hydroxide

Class: Other drugs for reflux and ulcers
Brand: Gastrogel

500mg-240mg-240mg/10mL oral suspension

PBS Link

79. Amantadine

Class: Other drugs for Parkinson's disease
100mg Capsules

PBS Link

80. American house dust mite extract, European house dust mite extract

Class: Allergens
Brand: Actair

100 IR Sublingual Tablets

Restrictions on use:
As per Immunology for allergic rhinitis and/or asthma, where allergen extract subcutaneous immunotherapy not clinically appropriate (e.g. severe needle phobia not managed with psychotherapy)

PBS Link

81. American house dust mite extract, European house dust mite extract

Class: Allergens
Brand: Actair

300 IR Sublingual Tablets

Restrictions on use:
As per Immunology for allergic rhinitis and/or asthma, where allergen extract subcutaneous immunotherapy not clinically appropriate (e.g. severe needle phobia not managed with psychotherapy)

PBS Link

82. Amikacin

Class: Antibacterials - Aminoglycosides
500mg/2mL Injection

Restrictions on use:
ID / Microbiology advice OR Tuberculosis service OR Adults under care of Respiratory / Thoracics for treatment of Mycobacterium avium complex (MAC) & tuberculosis (TB)

PBS Link

83. Amiloride

Class: Potassium sparing diuretics
Amiloride Hydrochloride 1mg/mL Suspension

Restrictions on use:
Paediatric Patients

Note: SA Pharmacy Manufactured product

PBS Link

84. Amiloride Hydrochloride

Class: Potassium sparing diuretics
5mg Tablets

PBS Link

85. Aminophylline

Class: Other drugs for reactive airways diseases
250mg/10mL Injection

Restrictions on use:
Cardiology and Nuclear Medicine for reversal of dipyridamole testing, Respiratory, Intensive Care Unit, Emergency Department, and Paediatrics

PBS Link

86. Amiodarone

Class: Antiarrhythmics
100mg Tablets

PBS Link

87. Amiodarone

Class: Antiarrhythmics
200mg Tablets

PBS Link

88. Amiodarone

Class: Antiarrhythmics
150mg/3mL Injection

PBS Link

89. Amiodarone

Class: Antiarrhythmics
Amiodarone Hydrochloride 5mg/mL Suspension

Restrictions on use:
Paediatric Patients

Note: SA Pharmacy Manufactured product

PBS Link

90. Amisulpride

Class: Antipsychotics (Oral and short acting injections)
100mg Tablets

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

91. Amisulpride

Class: Antipsychotics (Oral and short acting injections)
100mg/1mL Oral Solution

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

92. Amisulpride

Class: Antipsychotics (Oral and short acting injections)
200mg Tablets

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

93. Amisulpride

Class: Antipsychotics (Oral and short acting injections)
400mg Tablets

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

94. Amitriptyline

Class: Tricyclic antidepressants
10mg Tablets

PBS Link

95. Amitriptyline

Class: Tricyclic antidepressants
25mg Tablets

PBS Link

96. Amitriptyline

Class: Tricyclic antidepressants
50mg Tablets

PBS Link

97. Amlodipine

Class: Calcium channel blockers
1mg/mL Suspension

Restrictions on use:
Paediatric Patients

Note: SA Pharmacy Manufactured product

PBS Link

98. Amlodipine

Class: Calcium channel blockers
5mg Tablets

PBS Link

99. Amlodipine

Class: Calcium channel blockers
10mg Tablets

PBS Link

100. Amoxicillin

Class: Antibacterials - Penicillins
1g Injection

PBS Link

101. Amoxicillin

Class: Antibacterials - Penicillins
250mg Capsules

PBS Link

102. Amoxicillin

Class: Antibacterials - Penicillins
250mg/5mL Syrup

PBS Link

103. Amoxicillin

Class: Antibacterials - Penicillins
500mg Capsules

PBS Link

104. Amoxicillin

Class: Antibacterials - Penicillins
500mg Injection

PBS Link

105. Amoxicillin + Clavulanic Acid

Class: Antibacterials - Penicillins
400mg-57mg/5mL Oral Suspension

PBS Link

106. Amoxicillin + Clavulanic Acid

Class: Antibacterials - Penicillins
500mg-125mg Tablets

PBS Link

107. Amoxicillin + Clavulanic Acid

Class: Antibacterials - Penicillins
875mg-125mg Tablets

PBS Link

108. Amoxicillin + Clavulanic Acid

Class: Antibacterials - Penicillins
500mg/100mg Injection

Restrictions on use:
• ID / Microbiology advice OR
• The following indications when oral therapy is not appropriate for up to 48 hours then on ID / Microbiology advice:
o For moderate - severe bite wounds / clench fist injuries
o Diabetic foot infection in patients that do not require empiric therapy for pseudomonas as per approved DTC guidelines
o Aspiration Pneumonia / Hospital Acquired Pneumonia (HAP) / Ventilator-Associated Pneumonia (VAP) where indicated in approved DTC guidelines
o Intra-abdominal infections in patients where aminoglycosides are contraindicated (e.g. CrCl < 40ml/min).

PBS Link

109. Amoxicillin + Clavulanic Acid

Class: Antibacterials - Penicillins
1000/200mg Injection

Restrictions on use:
• ID / Microbiology advice OR
• The following indications when oral therapy is not appropriate for up to 48 hours then on ID / Microbiology advice:
o For moderate - severe bite wounds / clench fist injuries
o Diabetic foot infection in patients that do not require empiric therapy for pseudomonas as per approved DTC guidelines
o Aspiration Pneumonia / Hospital Acquired Pneumonia (HAP) / Ventilator-Associated Pneumonia (VAP) where indicated in approved DTC guidelines
o Intra-abdominal infections in patients where aminoglycosides are contraindicated (e.g. CrCl < 40ml/min).

PBS Link

110. Amoxicillin + Clavulanic Acid

Class: Antibacterials - Penicillins
2000mg/200mg Injection

Restrictions on use:
ID/Microbiology advice, or treatment of susceptible infection in intensive care patients for up to 48 hours then on ID/Microbiology advice

PBS Link

111. Amphotericin

Class: Drugs for eye infections
0.15% Eye Drops

Restrictions on use:
Ophthalmology for treatment of fungal keratitis

Note: SA Pharmacy Manufactured product

PBS Link

112. Amphotericin B (amphotericin)

Class: Antifungals - Other
10mg Lozenges

PBS Link

113. Amphotericin B (amphotericin) (Liposomal)

Class: Antifungals - Other
50mg Injection

Restrictions on use:
ID / Microbiology advice OR
Haematology patients with an invasive fungal infection as per unit protocol with ID or Microbiology input

PBS Link

114. Anagrelide

Class: Other non-cytotoxic antineoplastics
500microg Capsules

Restrictions on use:
SAMEP criteria: Essential thrombocythaemia. Patients must have failed treatment with hydroxyurea due to intolerance or lack of efficacy. Patients < 80 years must also fail or be contraindicated to interferon-α2a. Patients over 80 years must have failed or be contraindicated to busulfan. Max dose on formulary is 1mg twice daily.

PBS Link

115. Anakinra

Class: Immunosuppressants (rheumatology)
100mg/0.67mL Subcutaneous Injection

Restrictions on use:
On advice of Rheumatology or Immunology for moderate to severe cryopyrin-associated periodic syndromes (CAPS) as per PBS criteria

PBS Link

116. Anidulafungin

Class: Antifungals - Echinocandins
100mg Injection

Restrictions on use:
ID / Microbiology advice OR
Adult Intensive Care Units for 48 hours then on ID / Microbiology advice OR
Adult Oncology / Haematology as per unit guidelines

PBS Link

117. Anticoagulant Citrate Glucose

Class: Fluids - Anticoagulant
Anticoagulant Citrate Glucose Sterile Solution, 500mL Bag

PBS Link

118. Anticoagulant Citrate Glucose with Correct Connect

Class: Fluids - Anticoagulant
Anticoagulant Citrate Glucose with Correct Connect Solution, 750mL Bag

PBS Link

119. Antithymocyte Globulin (Equine)

Class: Immunosuppressant antibodies
250mg/5mL Injection

Restrictions on use:
For the prevention or treatment of transplant rejection OR Management of aplastic anaemia OR
Prevention or treatment of graft-versus-host disease

PBS Link

120. Antithymocyte Globulin (Rabbit)

Class: Immunosuppressant antibodies
25mg Injection

Restrictions on use:
For the prevention and treatment of transplant rejection

PBS Link

121. Antivenom, Black Snake

Class: Antivenoms
18,000units Injection

PBS Link

122. Antivenom, Brown Snake

Class: Antivenoms
1,000units Injection

PBS Link

123. Antivenom, Death Adder

Class: Antivenoms
6,000units Injection

PBS Link

124. Antivenom, Exotic snake

Class: Antivenoms
Types held depending on current need

PBS Link

125. Antivenom, Funnel Web Spider

Class: Antivenoms
125units Injection

PBS Link

126. Antivenom, Polyvalent Snake, Australia and PNG

Class: Antivenoms
40,000units Injection

PBS Link

127. Antivenom, Polyvalent, Rattlesnake, Sth American

Class: Antivenoms
Injection

PBS Link

128. Antivenom, Redback Spider

Class: Antivenoms
500units Injection

PBS Link

129. Antivenom, Taipan

Class: Antivenoms
12,000units Injection

PBS Link

130. Antivenom, Tiger Snake

Class: Antivenoms
3,000units Injection

PBS Link

131. Apixaban

Class: Oral anticoagulants
2.5mg Tablets

PBS Link

132. Apixaban

Class: Oral anticoagulants
5mg Tablets

PBS Link

133. Apomorphine

Class: Dopamine agonists (parkinsonism)
100mg/20mL Injection

Restrictions on use:
Neurology, general physicians or geriatricians with experience in the management of Parkinson disease, or on advice of these as per PBS criteria

PBS Link

134. Apomorphine

Class: Dopamine agonists (parkinsonism)
20mg/2mL Injection

Restrictions on use:
Neurology, general physicians or geriatricians with experience in the management of Parkinson disease, or on advice of these as per PBS criteria

PBS Link

135. Apomorphine

Class: Dopamine agonists (parkinsonism)
50mg/10mL Syringe Injection

Restrictions on use:
Neurology, general physicians or geriatricians with experience in the management of Parkinson disease, or on advice of these as per PBS criteria

PBS Link

136. Apomorphine

Class: Dopamine agonists (parkinsonism)
30mg/3mL Injection Pen Device

Restrictions on use:
Neurology, general physicians or geriatricians experienced in the management of Parkinson disease, or on advice of these, as per PBS criteria

PBS Link

137. Apomorphine

Class: Dopamine agonists (parkinsonism)
30mg/3mL Injection Intermittent Cartridges

Restrictions on use:
Neurology, general physicians or geriatricians experienced in the management of Parkinson disease, or on advice of these, as per PBS criteria

PBS Link

138. Apraclonidine

Class: Drugs for glaucoma
0.5% Eye Drops

Restrictions on use:
For use in ophthalmic procedures

PBS Link

139. Aprepitant

Class: Other antiemetics
165mg capsules

Restrictions on use:
When netupitant and palonosetron capsules (Akynzeo®) not appropriate for:
• For PBS listed indications OR
• For paediatric oncology patients receiving course of highly emetogenic chemotherapy and second line for courses of moderately emetogenic chemotherapy OR
• Chemotherapy induced nausea and vomiting (CINV) for patients receiving highly emetogenic chemotherapy (defined by eviQ) as first line therapy not included in PBS restriction OR
• Chemotherapy induced nausea and vomiting (CINV) for patients receiving moderately emetogenic chemotherapy (defined by eviQ) with a prior episode of CINV not included in PBS restriction

PBS Link

140. Argatroban

Class: Heparins and other parenteral anticoagulants
250mg/2.5mL Injection

Restrictions on use:
Haematology advice for the management of heparin induced thrombocytopenia

Note: Available via the Special Access Scheme (SAS) process

PBS Link

141. Argipressin

[Vasopressin]
Class: Antidiuretic hormones agonists and antagonists
20units/1mL Injection

PBS Link

142. Aripiprazole

Class: Antipsychotics (Depot preparations)
Modified Release Injection 300mg

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

143. Aripiprazole

Class: Antipsychotics (Depot preparations)
Modified Release Injection 400mg

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

144. Aripiprazole

Class: Antipsychotics (Oral and short acting injections)
5mg Tablets

Restrictions on use:
Psychiatry advice for inpatient use only OR Paediatric patients on specialist advice for the management of disruptive behaviour disorders as second line therapy after risperidone. For initial trial of therapy for 3 months, and ongoing therapy if clinical response

Note: Not available on the PBS

PBS Link

145. Aripiprazole

Class: Antipsychotics (Oral and short acting injections)
10mg Tablets

Restrictions on use:
Psychiatry advice as per PBS criteria OR
Paediatric patients on specialist advice for the management of disruptive behaviour disorders as second line therapy after risperidone. For initial trial of therapy for 3 months, and ongoing therapy if clinical response (Non-PBS)

PBS Link

146. Aripiprazole

Class: Antipsychotics (Oral and short acting injections)
15mg Tablets

Restrictions on use:
Psychiatry advice as per PBS criteria OR
Paediatric patients on specialist advice for the management of disruptive behaviour disorders as second line therapy after risperidone. For initial trial of therapy for 3 months, and ongoing therapy if clinical response (Non-PBS)

PBS Link

147. Aripiprazole

Class: Antipsychotics (Oral and short acting injections)
20mg Tablets

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

148. Aripiprazole

Class: Antipsychotics (Oral and short acting injections)
30mg Tablets

Restrictions on use:
Psychiatry advice as per PBS criteria

PBS Link

149. Arsenic

Class: Other non-cytotoxic antineoplastics
Arsenic trioxide 10mg/10mL Injection

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

150. Artemether + Lumefantrine

Class: Antiprotozoals
Artemether - Lumefantrine 20mg-120mg Tablets

Restrictions on use:
ID / Microbiology advice OR Paediatrics on ID / Microbiology advice or ID approved local guidelines

PBS Link

151. Artesunate

Class: Antiprotozoals
(SAS) 60mg Injection

Restrictions on use:
ID / Microbiology advice

Note: Available via the Special Access Scheme (SAS) process

PBS Link

152. Ascorbic Acid

Class: Miscellaneous eye drugs
10% Eye Drop

Restrictions on use:
Ophthalmology for the management of lime burns

Note: SA Pharmacy Manufactured Product

PBS Link

153. Ascorbic Acid

Class: Vitamins - Miscellaneous
500mg Chewable Tablets

PBS Link

154. Aspirin

Class: Non-opioid analgesics
300mg Soluble Tablets

PBS Link

155. Aspirin

Class: Antiplatelet drugs
100mg Tablets

PBS Link

156. Aspirin

Class: Antiplatelet drugs
300mg Soluble Tablets

PBS Link

157. Aspirin

Class: Antiplatelet drugs
500mg Injection

Restrictions on use:
• Ischaemic stroke patients with dysphagia without a functioning nasogastric tube
• Acute coronary syndrome patients who are unable to swallow without a functioning nasogastric tube as per approved local Drug and Therapeutics Committee (DTC) guideline / protocol

Note: Available via the Special Access Scheme (SAS) process

PBS Link

158. Atazanavir

Class: Antiretrovirals - Protease inhibitors
200mg Capsules

Restrictions on use:
ID / Sexual Health Physicians advice as per PBS Section 100 criteria OR ID / Sexual Health Physicians for HIV PEP in combination with basic two drug regimen (usually tenofovir/emtricitabine) if the source is known to be HIV positive with unknown or detectable viral load (non PBS)

PBS Link

159. Atazanavir

Class: Antiretrovirals - Protease inhibitors
300mg Capsules

Restrictions on use:
ID / Sexual Health Physicians advice as per PBS Section 100 criteria OR ID / Sexual Health Physicians for HIV PEP in combination with basic two drug regimen (usually tenofovir/emtricitabine) if the source is known to be HIV positive with unknown or detectable viral load (non PBS)

PBS Link

160. Atenolol

Class: Beta-blockers
50mg Tablets

PBS Link

161. Atenolol

Class: Beta-blockers
50mg/10mL Oral Solution

PBS Link

162. Atezolizumab

Class: Antineoplastic antibodies
Injection 1200mg/20mL

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

163. Atomoxetine

Class: Drugs for attention deficit hyperactivity disorder
10mg Capsules

Restrictions on use:
SA Prison Services & SA Health Forensic Hospitals

PBS Link

164. Atomoxetine

Class: Drugs for attention deficit hyperactivity disorder
25mg Capsules

Restrictions on use:
SA Prison Services & SA Health Forensic Hospitals

PBS Link

165. Atomoxetine

Class: Drugs for attention deficit hyperactivity disorder
40mg Capsules

Restrictions on use:
SA Prison Services & SA Health Forensic Hospitals

PBS Link

166. Atomoxetine

Class: Drugs for attention deficit hyperactivity disorder
60mg Capsules

Restrictions on use:
SA Prison Services & SA Health Forensic Hospitals

PBS Link

167. Atomoxetine

Class: Drugs for attention deficit hyperactivity disorder
80mg Capsules

Restrictions on use:
SA Prison Services & SA Health Forensic Hospitals

PBS Link

168. Atorvastatin

Class: Statins
10mg Tablets

PBS Link

169. Atorvastatin

Class: Statins
20mg Tablets

PBS Link

170. Atorvastatin

Class: Statins
40mg Tablets

PBS Link

171. Atorvastatin

Class: Statins
80mg Tablets

PBS Link

172. Atracurium

Class: Neuromuscular blockers
25mg/2.5mL Injection

PBS Link

173. Atropine Sulfate

Class: Antiarrhythmics
1.2mg/1mL Injection

PBS Link

174. Atropine Sulfate

Class: Antiarrhythmics
600microg/1mL Injection

PBS Link

175. Atropine Sulfate

Class: Drugs for eye examinations and procedures
1% Eye Drops

PBS Link

176. Atropine Sulfate

Class: Drugs for eye examinations and procedures
1% Single Use Eye Drops

PBS Link

177. Atropine Sulfate

Class: Drugs for eye examinations and procedures
0.5% Eye Drops

Restrictions on use:
Paediatric ophthalmology

Note: SA Pharmacy Manufactured Product

PBS Link

178. Avelumab

Class: Specialised Products
200 mg/10 mL Injection

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

179. Axitinib

Class: Kinase inhibitors
1mg Tablets

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

180. Axitinib

Class: Kinase inhibitors
5mg Tablets

Restrictions on use:
Haematology / Oncology as per PBS criteria

PBS Link

181. Azacitidine

Class: Antimetabolites
100mg Injection

Restrictions on use:
Haematology / Oncology for PBS criteria

PBS Link

182. Azathioprine

Class: Other immunosuppressants
50mg Injection

PBS Link

183. Azathioprine

Class: Other immunosuppressants
25mg Tablets

PBS Link

184. Azathioprine

Class: Other immunosuppressants
50mg Tablets

PBS Link

185. Azathioprine

Class: Other immunosuppressants
50mg/5mL Oral Suspension

Restrictions on use:
Paediatric Patients OR
Patients requiring administration via enteral tubes OR
Patients with swallowing difficulties

Note: Available via the Special Access Scheme (SAS) process

PBS Link

186. Azelaic Acid

Class: Drugs for rosacea
15% Gel

PBS Link

187. Azelaic Acid

Class: Drugs for acne
15% Gel

PBS Link

188. Azithromycin

Class: Antibacterials - Macrolides
200mg/5mL Oral Suspension

Restrictions on use:
ID / Microbiology advice OR
Respiratory / Thoracics for management of Mycobacterium avium complex (MAC) and tuberculosis OR
Community acquired pneumonia (CAP); up to 5 day course, if Legionella positive a 10 day course OR
Atypical pneumonia in paediatric patients OR
Cystic Fibrosis OR
Chlamydia trachomatis / Neisseria gonorrhoea infection OR
Pertussis - treatment or prophylaxis

PBS Link

189. Azithromycin

Class: Antibacterials - Macrolides
500mg Injection

Restrictions on use:
ID / Microbiology advice OR
Adult Intensive Care units OR
Community acquired pneumonia (CAP) when unable to tolerate oral therapy OR Respiratory / Thoracics for 72 hours then on ID / Microbiology advice

PBS Link

190. Azithromycin

Class: Antibacterials - Macrolides
500mg Tablets

Restrictions on use:
ID / Microbiology advice OR
Respiratory / Thoracics for management of Mycobacterium avium complex (MAC) & tuberculosis OR
Community-acquired pneumonia (CAP); up to 5 day course, if Legionella positive a 10 day course OR
Atypical pneumonia in paediatric patients OR
Cystic fibrosis OR
Chlamydia trachomatis / Neisseria gonorrhoea infection OR
Pertussis - treatment or prophylaxis

PBS Link

191. Azithromycin

Class: Antibacterials - Macrolides
600mg Tablets

Restrictions on use:
Prophylaxis against Mycobacterium avium complex (MAC) in HIV positive pts as per PBS criteria

PBS Link

192. Aztreonam

Class: Antibacterials - Other
1g Injection

Restrictions on use:
ID / Microbiology advice OR
Infective exacerbations in adult Cystic fibrosis / Lung transplant patients for multi-resistant organisms or contraindications to other agents

PBS Link