Commonwealth Coat of Arms of Australia

 

PB 16 of 2024

 

National Health (Pharmaceutical benefits – early supply) Amendment Instrument 2024
(No. 2)

 

National Health Act 1953

 

I, NIKOLAI TSYGANOV, Assistant Secretary, Pricing and PBS Policy Branch, Technology Assessment and Access Division, Department of Health and Aged Care, delegate of the Minister for Health and Aged Care, make this Instrument under subsection 84AAA(2) of the National Health Act 1953.

Dated 28 February 2024

NIKOLAI TSYGANOV

Assistant Secretary

Pricing and PBS Policy Branch

Technology Assessment and Access Division

 

 

Contents

1 Name

2 Commencement

3 Authority

4 Schedules

Schedule 1—Amendments

National Health (Pharmaceutical benefits—early supply) Instrument 2015
(PB 120 of 2015). 2

1 Name

(1)           This instrument is the National Health (Pharmaceutical benefits – early supply) Amendment Instrument 2024 (No. 2).

(2)           This instrument may also be cited as PB 16 of 2024.

2 Commencement

(1)           Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1. The whole of this instrument

1 March 2024

1 March 2024

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2)           Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3 Authority

This instrument is made under subsection 84AAA(2) of the National Health Act 1953.

4 Schedules

Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Amendments

National Health (Pharmaceutical benefits—early supply) Instrument 2015 (PB 120 of 2015)

[1]           Schedule 1, omit entry for Estradiol with dydrogesterone

[2]           Schedule 1, after entry for Ibrutinib in the form Capsule 140 mg [Maximum quantity or number of units: 120; Maximum number of repeats: 5]

insert:

 

Tablet 280 mg

20

30

5

 

 

Tablet 420 mg

20

30

5

 

 

Tablet 560 mg

20

30

5

 

[3]           Schedule 2

insert as first entry:

Acarbose

Tablet 50 mg

50

180

5

 

 

Tablet 100 mg

50

180

5

 

[4]           Schedule 2, after entry for Alendronic acid

insert:

Alendronic acid with colecalciferol

Tablet 70 mg (as alendronate sodium) with 70 micrograms colecalciferol

50

8

5

 

 

Tablet 70 mg (as alendronate sodium) with 140 micrograms colecalciferol

50

8

5

 

[5]           Schedule 2, after entry for Allopurinol in the form Tablet 300 mg

insert:

Alogliptin

Tablet 6.25 mg (as benzoate)

50

56

5

 

 

Tablet 12.5 mg (as benzoate)

50

56

5

 

 

Tablet 25 mg (as benzoate)

50

56

5

 

Alogliptin with metformin

Tablet containing 12.5 mg alogliptin (as benzoate) with 500 mg metformin hydrochloride

50

112

5

 

 

Tablet containing 12.5 mg alogliptin (as benzoate) with 850 mg metformin hydrochloride

50

112

5

 

 

Tablet containing 12.5 mg alogliptin (as benzoate) with 1 g metformin hydrochloride

50

112

5

 

[6]           Schedule 2, after entry for Amlodipine with atorvastatin in the form Tablet 10 mg amlodipine (as besilate) with 40 mg atorvastatin (as calcium)

insert:

 

Tablet 10 mg amlodipine (as besilate) with 80 mg atorvastatin (as calcium)

50

60

5

 

[7]           Schedule 2, after entry for Amlodipine with valsartan and hydrochlorothiazide in the form Tablet 10 mg (as besilate)-320 mg-25 mg

insert:

Anastrozole

Tablet 1 mg

50

60

5

 

[8]           Schedule 2, after entry for Bisoprolol in the form Tablet containing bisoprolol fumarate 10 mg

insert:

Bromocriptine

Tablet 2.5 mg (as mesilate)

50

120

5

 

Cabergoline

Tablet 500 micrograms

50

16

5

 

[9]           Schedule 2, after entry for Candesartan with hydrochlorothiazide in the form Tablet containing candesartan cilexetil 32 mg with hydrochlorothiazide 25 mg

insert:

Carbamazepine

Oral suspension 100 mg per 5 mL, 300 mL

50

2

5

 

 

Tablet 200 mg (controlled release)

50

400

2

 

 

Tablet 400 mg (controlled release)

50

400

2

 

Carbimazole

Tablet 5 mg

50

400

2

 

[10]       Schedule 2, after entry for Chlortalidone

insert:

Ciclosporin

Capsule 10 mg

50

240

3

 

 

Capsule 25 mg

50

120

3

 

 

Capsule 50 mg

50

120

3

 

 

Capsule 100 mg

50

120

3

 

 

Oral liquid 100 mg per mL, 50 mL

50

4

3

 

[11]       Schedule 2, after entry for Clopidogrel with aspirin

insert:

Cortisone

Tablet containing cortisone acetate 5 mg

50

100

4

 

 

Tablet containing cortisone acetate 25 mg

50

120

4

 

Cyproterone

Tablet containing cyproterone acetate 50 mg

50

40

5

 

 

 

50

200

5

 

 

Tablet containing cyproterone acetate 100 mg

50

100

5

 

[12]       Schedule 2, after entry for Dabigatran etexilate in the form Capsule 150 mg (as mesilate)

insert:

Dapagliflozin

Tablet 10 mg (as propanediol monohydrate)

50

56

5

 

Dapagliflozin with metformin

Tablet (modified release) containing 5 mg dapagliflozin (as propanediol monohydrate) with 1000 mg metformin hydrochloride

50

112

5

 

 

Tablet (modified release) containing 10 mg dapagliflozin (as propanediol monohydrate) with 500 mg metformin hydrochloride

50

56

5

 

 

Tablet (modified release) containing 10 mg dapagliflozin (as propanediol monohydrate) with 1000 mg metformin hydrochloride

50

56

5

 

Desmopressin

Tablet containing desmopressin acetate 200 micrograms

50

60

5

 

 

 

50

180

5

 

 

Wafer 120 micrograms (as acetate)

50

60

5

 

 

Wafer 240 micrograms (as acetate)

50

60

5

 

Dexamethasone

Tablet 500 micrograms

50

60

4

 

Dutasteride

Capsule 500 micrograms

50

60

5

 

Dutasteride with tamsulosin

Capsule containing dutasteride 500 micrograms with tamsulosin hydrochloride 400 micrograms

50

60

5

 

Empagliflozin

Tablet 10 mg

50

60

5

 

 

Tablet 25 mg

50

60

5

 

Empagliflozin with linagliptin

Tablet containing 10 mg empagliflozin with 5 mg linagliptin

50

60

5

 

 

Tablet containing 25 mg empagliflozin with 5 mg linagliptin

50

60

5

 

Empagliflozin with metformin

Tablet containing 5 mg empagliflozin with 500 mg metformin hydrochloride

50

120

5

 

 

Tablet containing 5 mg empagliflozin with 1 g metformin hydrochloride

50

120

5

 

 

Tablet containing 12.5 mg empagliflozin with 500 mg metformin hydrochloride

50

120

5

 

 

Tablet containing 12.5 mg empagliflozin with 1 g metformin hydrochloride

50

120

5

 

[13]       Schedule 2, after entry for Eplerenone in the form Tablet 50 mg

insert:

Eprosartan

Tablet 600 mg (as mesilate)

50

56

5

 

Estradiol

Pessary (modified release) 10 micrograms (as hemihydrate)

50

36

2

 

 

Tablet 2 mg

50

112

2

 

 

Tablet containing estradiol valerate 1 mg

50

112

2

 

 

Tablet containing estradiol valerate 2 mg

50

112

2

 

 

Transdermal gel 1 mg (as hemihydrate) in 1 g sachet, 28

50

2

5

 

Estradiol and estradiol with dydrogesterone

Pack containing 14 tablets estradiol 1 mg and 14 tablets estradiol 1 mg with dydrogesterone 10 mg

50

2

5

 

 

Pack containing 14 tablets estradiol 2 mg and 14 tablets estradiol 2 mg with dydrogesterone 10 mg

50

2

5

 

Estradiol and estradiol with norethisterone

Pack containing 4 transdermal patches 780 micrograms estradiol (as hemihydrate) and 4 transdermal patches 510 micrograms estradiol (as hemihydrate) with 4.8 mg norethisterone acetate

50

2

5

 

 

Pack containing 4 transdermal patches 780 micrograms estradiol (as hemihydrate) and 4 transdermal patches 620 micrograms estradiol (as hemihydrate) with 2.7 mg norethisterone acetate

50

2

5

 

Estradiol with norethisterone

Transdermal patches containing 620 micrograms estradiol (as hemihydrate) with 2.7 mg norethisterone acetate, 8

50

2

5

 

Estriol

Pessaries 500 micrograms, 15

50

2

2

 

 

Vaginal cream 1 mg per g, 15 g

50

2

1

 

Ethosuximide

Oral solution 250 mg per 5 mL, 200 mL

50

2

5

 

Everolimus

Tablet 0.75 mg

50

240

3

 

 

Tablet 1 mg

50

240

3

 

Exemestane

Tablet 25 mg

50

60

5

 

[14]       Schedule 2, after entry for Gemfibrozil

insert:

Glibenclamide

Tablet 5 mg

50

200

5

 

Gliclazide

Tablet 60 mg (modified release)

50

120

5

 

 

Tablet 80 mg

50

200

5

 

Glimepiride

Tablet 1 mg

50

60

5

 

 

Tablet 2 mg

50

60

5

 

 

Tablet 3 mg

50

60

5

 

 

Tablet 4 mg

50

60

5

 

Glipizide

Tablet 5 mg

50

200

5

 

[15]       Schedule 2, after entry for Hydrochlorothiazide with amiloride

insert:

Hydrocortisone

Tablet 4 mg

50

100

4

 

[16]       Schedule 2, after entry for Isosorbide mononitrate in the form Tablet 120 mg (sustained release)

insert:

Labetalol

Tablet containing labetalol hydrochloride 100 mg

50

200

5

 

Lacosamide

Oral solution 10 mg per mL, 200 mL

50

4

5

 

 

 

50

12

5

 

 

Tablet 50 mg

50

112

5

 

 

Tablet 100 mg

50

112

5

 

 

Tablet 150 mg

50

112

5

 

 

Tablet 200 mg

50

112

5

 

Lamotrigine

Tablet 5 mg

50

112

5

 

 

Tablet 25 mg

50

112

5

 

 

Tablet 50 mg

50

112

5

 

 

Tablet 100 mg

50

112

5

 

 

Tablet 200 mg

50

112

5

 

Lanthanum

Tablet, chewable, 500 mg (as carbonate hydrate)

50

180

5

 

 

Tablet, chewable, 750 mg (as carbonate hydrate)

50

180

5

 

 

Tablet, chewable, 1000 mg (as carbonate hydrate)

50

180

5

 

Leflunomide

Tablet 10 mg

50

60

5

 

 

Tablet 20 mg

50

60

5

 

[17]       Schedule 2, after entry for Lercanidipine with enalapril in the form Tablet containing lercanidipine hydrochloride 10 mg with enalapril maleate 20 mg

insert:

Letrozole

Tablet 2.5 mg

50

60

5

 

Levetiracetam

Oral solution 100 mg per mL, 300 mL

50

2

5

 

 

Tablet 250 mg

50

120

5

 

 

Tablet 500 mg

50

120

5

 

 

Tablet 1 g

50

120

5

 

Linagliptin

Tablet 5 mg

50

60

5

 

Linagliptin with metformin

Tablet containing 2.5 mg linagliptin with 500 mg metformin hydrochloride

50

120

5

 

 

Tablet containing 2.5 mg linagliptin with 850 mg metformin hydrochloride

50

120

5

 

 

Tablet containing 2.5 mg linagliptin with 1000 mg metformin hydrochloride

50

120

5

 

Liothyronine

Tablet containing liothyronine sodium 20 micrograms

50

200

2

 

[18]       Schedule 2, after entry for Lisinopril in the form Tablet 20 mg

insert:

Medroxyprogesterone

Tablet containing medroxyprogesterone acetate 5 mg

50

112

2

 

 

Tablet containing medroxyprogesterone acetate 10 mg

50

60

2

 

 

 

50

200

2

 

 

Tablet containing medroxyprogesterone acetate 100 mg

50

200

2

 

 

Tablet containing medroxyprogesterone acetate 200 mg

50

120

2

 

 

Tablet containing medroxyprogesterone acetate 250 mg

50

120

2

 

 

Tablet containing medroxyprogesterone acetate 500 mg

50

60

2

 

[19]       Schedule 2, after entry for Mesalazine in the form Tablet 1.6 g (enteric coated)

insert:

Metformin

Tablet containing metformin hydrochloride 500 mg

50

200

5

 

 

Tablet containing metformin hydrochloride 850 mg

50

120

5

 

 

Tablet containing metformin hydrochloride 1 g

50

180

5

 

 

Tablet (extended release) containing metformin hydrochloride 500 mg

50

240

5

 

 

Tablet (extended release) containing metformin hydrochloride 1 g

50

120

5

 

Methenamine

Tablet containing methenamine hippurate 1 g

50

200

5

 

Methotrexate

Injection 50 mg in 2 mL vial

50

10

5

 

[20]       Schedule 2, entry for Metoprolol succinate in the form Tablet 190 mg (controlled release)

insert:

Minoxidil

Tablet 10 mg

50

200

5

 

[21]       Schedule 2, after entry for Moxonidine in the form Tablet 400 micrograms

insert:

Mycophenolic acid

Capsule containing mycophenolate mofetil 250 mg

50

600

5

 

 

Powder for oral suspension containing mycophenolate mofetil 1 g per 5 mL, 165 mL

50

2

5

 

 

Tablet containing mycophenolate mofetil 500 mg

50

300

5

 

 

Tablet (enteric coated) containing mycophenolate sodium equivalent to 180 mg mycophenolic acid

50

240

5

 

 

Tablet (enteric coated) containing mycophenolate sodium equivalent to 360 mg mycophenolic acid

50

240

5

 

[22]       Schedule 2, after entry for Nifedipine in the form Tablet 60 mg (controlled release)

insert:

Norethisterone

Tablet 5 mg

50

60

2

 

[23]       Schedule 2, after entry for Olmesartan with amlodipine in the form Tablet containing olmesartan medoxomil 20 mg with amlodipine 5 mg (as besilate)

insert:

 

Tablet containing olmesartan medoxomil 40 mg with amlodipine 5 mg (as besilate)

50

60

5

 

 

Tablet containing olmesartan medoxomil 40 mg with amlodipine 10 mg (as besilate)

50

60

5

 

[24]       Schedule 2, after entry for Olmesartan with amlodipine and hydrochlorothiazide in the form Tablet containing olmesartan medoxomil 40 mg with amlodipine 10 mg (as besilate) and hydrochlorothiazide 12.5 mg

insert:

 

Tablet containing olmesartan medoxomil 40 mg with amlodipine 10 mg (as besilate) and hydrochlorothiazide 25 mg

50

60

5

 

[25]       Schedule 2, after entry for Olmesartan with hydrochlorothiazide in the form Tablet containing olmesartan medoxomil 40 mg with hydrochlorothiazide 25 mg

insert:

Oxcarbazepine

Oral suspension 60 mg per mL, 250 mL

50

4

5

 

 

Tablet 300 mg

50

200

5

 

 

Tablet 600 mg

50

200

5

 

Oxybutynin

Tablet containing oxybutynin hydrochloride 5 mg

50

200

5

 

 

Transdermal patches 36 mg, 8

50

2

5

 

[26]       Schedule 2, after entry for Penicillamine in the form Tablet 250 mg

insert:

Perampanel

Tablet 4 mg (as hemisesquihydrate)

50

56

2

 

 

 

50

56

5

 

 

Tablet 6 mg (as hemisesquihydrate)

50

56

2

 

 

 

50

56

5

 

 

Tablet 8 mg (as hemisesquihydrate)

50

56

5

 

 

Tablet 10 mg (as hemisesquihydrate)

50

56

5

 

 

Tablet 12 mg (as hemisesquihydrate)

50

56

5

 

[27]       Schedule 2, after entry for Perindopril with indapamide in the form Tablet containing perindopril erbumine 4 mg with indapamide hemihydrate 1.25 mg

insert:

Phenoxymethylpenicillin

Capsule 250 mg phenoxymethylpenicillin (as potassium)

50

100

5

 

 

Tablet 250 mg phenoxymethylpenicillin (as potassium)

50

100

5

 

Phenytoin

Capsule containing phenytoin sodium 30 mg

50

400

2

 

 

Capsule containing phenytoin sodium 100 mg

50

400

2

 

 

Oral suspension 30 mg per 5 mL, 500 mL

50

2

3

 

 

Tablet 50 mg

50

400

2

 

Pioglitazone

Tablet 15 mg (as hydrochloride)

50

56

5

 

 

Tablet 30 mg (as hydrochloride)

50

56

5

 

 

Tablet 45 mg (as hydrochloride)

50

56

5

 

Pizotifen

Tablet 500 micrograms (as malate)

50

200

2

 

[28]       Schedule 2, after entry for Prazosin in the form Tablet 5 mg (as hydrochloride)

insert:

Prednisolone

Oral solution 5 mg (as sodium phosphate) per mL, 30 mL

50

2

5

 

 

Tablet 1 mg

50

200

4

 

 

Tablet 5 mg

50

120

4

 

Prednisone

Tablet 1 mg

50

200

4

 

 

Tablet 5 mg

50

120

4

 

Probenecid

Tablet 500 mg

50

200

5

 

Propantheline

Tablet containing propantheline bromide 15 mg

50

400

5

 

[29]       Schedule 2, after entry for Propranolol in the form Tablet containing propranolol hydrochloride 40 mg

insert:

Propylthiouracil

Tablet 50 mg

50

400

2

 

Quinagolide

Tablet 75 micrograms (as hydrochloride)

50

60

5

 

[30]       Schedule 2, after entry for Sacubitril with valsartan in the form Tablet containing sacubitril 97.2 mg with valsartan 102.8 mg

insert:

Saxagliptin

Tablet 2.5 mg (as hydrochloride)

50

56

5

 

 

Tablet 5 mg (as hydrochloride)

50

56

5

 

Saxagliptin with dapagliflozin

Tablet containing saxagliptin 5 mg with dapaglifozin 10 mg

50

56

5

 

Saxagliptin with metformin

Tablet (modified release) containing 2.5 mg saxagliptin (as hydrochloride) with 1000 mg metformin hydrochloride

50

112

5

 

 

Tablet (modified release) containing 5 mg saxagliptin (as hydrochloride) with 500 mg metformin hydrochloride

50

56

5

 

 

Tablet (modified release) containing 5 mg saxagliptin (as hydrochloride) with 1000 mg metformin hydrochloride

50

56

5

 

Sevelamer

Tablet containing sevelamer carbonate 800 mg

50

360

5

 

 

Tablet containing sevelamer hydrochloride 800 mg

50

360

5

 

[31]       Schedule 2, after entry for Simvastatin in the form Tablet 80 mg

insert:

Sirolimus

Oral solution 1 mg per mL, 60 mL

50

2

3

 

 

Tablet 0.5 mg

50

200

3

 

 

Tablet 1 mg

50

200

3

 

 

Tablet 2 mg

50

200

3

 

Sitagliptin

Tablet 25 mg

50

56

5

 

 

Tablet 50 mg

50

56

5

 

 

Tablet 100 mg

50

56

5

 

Sitagliptin with metformin

Tablet containing 50 mg sitagliptin with 500 mg metformin hydrochloride

50

112

5

 

 

Tablet containing 50 mg sitagliptin with 850 mg metformin hydrochloride

50

112

5

 

 

Tablet (modified release) containing 50 mg sitagliptin with 1000 mg metformin hydrochloride

50

112

5

 

 

Tablet containing 50 mg sitagliptin with 1000 mg metformin hydrochloride

50

112

5

 

 

Tablet (modified release) containing 100 mg sitagliptin with 1000 mg metformin hydrochloride

50

56

5

 

Sodium acid phosphate

Tablet, compound effervescent, equivalent to 500 mg phosphorus

50

200

5

 

Sodium bicarbonate

Capsule 840 mg

50

200

2

 

[32]       Schedule 2, after entry for Spironolactone in the form Tablet 25 mg

insert:

 

Tablet 100 mg

50

200

5

 

[33]       Schedule 2, after entry for Spironolactone in the form Tablet 100 mg

insert:

Sucroferric oxyhydroxide

Tablet, chewable, 2.5 g (equivalent to 500 mg iron)

50

180

5

 

[34]       Schedule 2, after entry for Sulfasalazine in the form Tablet 500 mg (enteric coated)

insert:

Sulthiame

Tablet 50 mg

50

400

2

 

 

Tablet 200 mg

50

400

2

 

Tacrolimus

Capsule 0.5 mg

50

200

3

 

 

Capsule 0.5 mg (once daily prolonged release)

50

60

3

 

 

Capsule 0.75 mg

50

200

3

 

 

Capsule 1 mg

50

200

3

 

 

Capsule 1 mg (once daily prolonged release)

50

120

3

 

 

Capsule 2 mg

50

200

3

 

 

Capsule 3 mg (once daily prolonged release)

50

100

2

 

 

Capsule 5 mg

50

100

3

 

 

Capsule 5 mg (once daily prolonged release)

50

60

3

 

Tamoxifen

Tablet 20 mg (as citrate)

50

60

5

 

 

 

50

120

5

 

[35]       Schedule 2, after entry for Telmisartan with hydrochlorothiazide in the form Tablet 80 mg-25 mg

insert:

Teriparatide

Injection 250 micrograms per mL, 2.4 mL in multi-dose pre-filled cartridge

50

2

5

 

Testosterone

Transdermal gel 50 mg in 5 g sachet, 30

50

2

5

 

 

Transdermal gel (pump pack) 12.5 mg per 1.25 g dose, 60 doses, 2

50

2

4

 

 

Transdermal gel (pump pack) 23 mg per 1.15 g dose, 56 doses

50

2

5

 

[36]       Schedule 2, after entry for Thiamine

insert:

Tiagabine

Tablet 5 mg (as hydrochloride)

50

200

5

 

 

Tablet 10 mg (as hydrochloride)

50

200

5

 

 

Tablet 15 mg (as hydrochloride)

50

200

5

 

[37]       Schedule 2, after entry for Ticagrelor

insert:

Tobramycin

Capsule containing powder for oral inhalation 28 mg (for use in podhaler)

50

448

2

 

 

Solution for inhalation 300 mg in 5 mL

50

112

2

 

Topiramate

Capsule 15 mg

50

120

5

 

 

Capsule 25 mg

50

120

5

 

 

Capsule 50 mg

50

120

5

 

 

Tablet 25 mg

50

120

5

 

 

Tablet 50 mg

50

120

5

 

 

Tablet 100 mg

50

120

5

 

 

Tablet 200 mg

50

120

5

 

Toremifene

Tablet 60 mg (as citrate)

50

60

5

 

[38]       Schedule 2, after entry for Trandolapril with verapamil in the form Tablet containing trandolapril 4 mg with verapamil hydrochloride 240 mg (sustained release)

insert:

Valproic acid

Oral liquid containing sodium valproate 200 mg per 5 mL, 300 mL

50

4

2

 

 

Oral solution containing sodium valproate 200 mg per 5 mL, 300 mL

50

4

2

 

 

Tablet, crushable, containing sodium valproate 100 mg

50

400

2

 

 

Tablet (enteric coated) containing sodium valproate 200 mg

50

400

2

 

 

Tablet (enteric coated) containing sodium valproate 500 mg

50

400

2

 

[39]       Schedule 2, after entry for Verapamil in the form Tablet containing verapamil hydrochloride 240 mg (sustained release)

insert:

Vigabatrin

Oral powder, sachet 500 mg

50

120

5

 

 

Tablet 500 mg

50

200

5

 

Vildagliptin

Tablet 50 mg

50

120

5

 

Vildagliptin with metformin

Tablet containing 50 mg vildagliptin with 500 mg metformin hydrochloride

50

120

5

 

 

Tablet containing 50 mg vildagliptin with 850 mg metformin hydrochloride

50

120

5

 

 

Tablet containing 50 mg vildagliptin with 1000 mg metformin hydrochloride

50

120

5

 

Zonisamide

Capsule 25 mg

50

112

5

 

 

Capsule 50 mg

50

112

5

 

 

Capsule 100 mg

50

224

5