CARDIAC FAILURE - Bestmed...1 Benefits are subject to the following: Pre-authorisation Bestmed...

1

Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP)

This price represents the reasonable price in the market place for a particular group of generic equivalent medicines which is reviewed and updated regularly. MRP sets a maximum reimbursable price for a list of generically similar medicines with a cost lower than that of the original medicine. There may be instances where a generic alternative costs more than the set MRP. If you opt to use the original medicine and a generic alternative is available, or you use a medicine that costs more than the MRP, you will have to pay the difference between the price of the chosen medicine and that of MRP.

This formulary is effective from 1 January 2016.

This formulary is subject to change without notice.

ONLY the following medicine classes will be considered for Beat1 and Beat2: Angiotensin converting enzyme (ACE) inhibitors Beta blockers Cardiac glycosides Diuretics Platelet aggregation inhibitors Potassium supplement

YES = formulary NO = non-formulary NO BENEFIT = excluded

CARDIAC FAILURE

ACTIVE INGREDIENT MEDICINE TRADE NAME

Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

A

AMILORIDE AMILORETIC TAB NO YES YES

BETARETIC TAB NO YES YES

DEZRETIC 5MG/50MG TAB NO YES YES

MODURETIC TAB NO YES YES

SPEC-CO-AMILORIDE TAB NO YES YES

ASPIRIN ASPIRIN 300MG TAB YES YES YES

BAYER ASPIRIN CARDIO 100M YES YES YES

BAYER ASPIRIN TAB YES YES YES

BE-TABS ASPIRIN 300MG TAB YES YES YES

DISPRIN TAB YES YES YES

DISPRIN CARDIOCARE 100MG YES YES YES

ECOTRIN 81MG TAB NO YES YES

GULF ASPIRIN YES YES YES

LO-ASPIRIN 125MG TAB YES YES YES

MYOPRIN 100MG YES YES YES

2


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

SOLUSPIRIN 300MG YES YES YES

ATENOLOL ADCO-ATENOLOL 50MG TAB NO YES YES

ADCO-ATENOLOL 100MG TAB NO YES YES

B-BLOCK 100MG NO YES YES

B-BLOCK 50MG NO YES YES

BIO-ATENOLOL 100 NO YES YES

BIO-ATENOLOL 50 NO YES YES

HEXABLOK 50MG TAB NO YES YES

HEXABLOK 100MG TAB NO YES YES

SANDOZ ATENOLOL 100 NO YES YES

SANDOZ ATENOLOL 50 NO YES YES

TEN-BLOKA 100MG TAB NO YES YES

TEN-BLOKA 50MG TAB NO YES YES

TENOPRESS 100MG TAB NO YES YES



TENORMIN 100MG TAB NO YES YES



ZETENOL 100MG TAB NO YES YES

ZETENOL 50MG TAB NO YES YES

ATENOLOL / CHLORTHALIDONE SANDOZ CO-TENIDONE 100/25 NO YES YES

SANDOZ CO-TENIDON 50/12.5 NO YES YES

TENCHLOR TAB NO YES YES

TENCHLOR-HS TAB NO YES YES

TENORET TAB NO YES YES

TENORETIC TAB NO YES YES

B

BISOPROLOL ADCO-BISOCOR 10MG TAB NO NO YES

ADCO-BISOCOR 5MG TAB NO NO YES

BETACOR 10MG TAB NO NO YES

BETACOR 5MG TAB NO NO YES

BILOCOR 10 TAB NO NO YES

3


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

BILOCOR 5 TAB NO NO YES

BISBETA 10MG TAB NO NO YES

BISBETA 5MG TAB NO NO YES

BISOHEXAL 10MG TAB NO NO YES

BISOHEXAL 5MG TAB NO NO YES

BISLO 10MG TAB NO NO YES

BISLO 5MG TAB NO NO YES

BISOPROLOL HEXAL 10MG TAB NO NO YES

BISOPROLOL HEXAL 5MG TAB NO NO YES

BISOPROLOL UNICORN 10MG NO NO YES

BISOPROLOL UNICORN 5MG NO NO YES

BISOPROLOL ZYDUS 10MG TAB NO NO YES

BISOPROLOL ZYDUS 5MG TAB NO NO YES

CARDICOR 10MG TAB NO NO YES

CARDICOR 2.5MG TAB NO NO YES

CARDICOR 5MG TAB NO NO YES

CONCOR 10MG TAB NO NO YES

CONCOR 5MG TAB NO NO YES

RETOCAR 10MG TAB NO NO YES

RETOCAR 5MG TAB NO NO YES

ZIAPRO 10MG TAB NO NO YES

ZIAPRO 5MG TABS NO NO YES

BISOPROLOL / HYDROCHLOROTHIAZ

BILOCOR CO 10MG/6.25MG TAB NO

NO YES

BILOCOR CO 2.5MG/6.25MG TAB NO NO YES

BILOCOR CO 5MG/6.25MG TAB NO NO YES

BISOPROLOL HCTZ 10/6.25MG NO NO YES

BISOPROLOL HCTZ 2.5/6.25MG NO NO YES

BISOPROLOL HCTZ 5/6.25MG NO NO YES

ZIABETA 10/6.25MG TAB NO NO YES

ZIABETA 2.5/6.25MG TAB NO NO YES

ZIABETA 5/6.25MG TAB NO NO YES

ZIAK 10MG TAB NO NO YES

ZIAK 2.5MG TAB NO NO YES

4


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

ZIAK 5MG TAB NO NO YES

ZIRINAK CO 10MG/6.25MG T NO NO YES

ZIRINAK CO 2.5MG/6.25MG T NO NO YES

ZIRINAK CO 5MG/6.25MG T NO NO YES

C

CAPTOPRIL BIO-CAPTOPRIL 25MG NO YES YES

CAPACE 25MG TAB NO YES YES

CAPTOMAX 25MG TAB NO YES YES

CAPTOMAX 50MG TAB NO YES YES

CAPTOHEXAL 12.5MG NO YES YES

CAPTOHEXAL 25MG NO YES YES

CAPTOHEXAL 50MG NO YES YES

MYLAN CAPTOPRIL 25MG NO YES YES

MYLAN CAPTOPRIL 50MG NO YES YES

SANDOZ CAPTOPRIL 25MG NO YES YES

SANDOZ CAPTOPRIL 50MG NO YES YES

ZAPTO 25MG TAB NO YES YES

ZAPTO 50MG TAB NO YES YES

CARVEDILOL ASPEN-CARVEDILOL 12.5MG NO

BENEFIT YES YES

ASPEN-CARVEDILOL 25MG NO

BENEFIT YES YES

ASPEN-CARVEDILOL 6.25MG NO

BENEFIT YES YES

CARLOC 12.5MG TAB NO

BENEFIT YES YES

CARLOC 25MG TAB NO

BENEFIT YES YES

CARLOC 6.25MG TAB NO

BENEFIT YES YES

CARVEDILOL-HEXAL 12.5MG NO

BENEFIT YES YES

CARVEDILOL-HEXAL 25MG NO

BENEFIT YES YES

CARVEDILOL-HEXAL 6.25MG NO

BENEFIT YES YES

5


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

CARVEDILOL UNICORN 12.5MG NO

BENEFIT YES YES

CARVEDILOL UNICORN 25MG NO

BENEFIT YES YES

CARVEDILOL UNICORN 6.25MG NO

BENEFIT YES YES

CARVETREND 12.5MG TAB NO

BENEFIT YES YES

CARVETREND 25MG TAB NO

BENEFIT YES YES

CARVETREND 6.25MG TAB NO

BENEFIT YES YES

DILATREND 12.5MG TAB NO

BENEFIT YES YES

DILATREND 25MG TAB NO

BENEFIT YES YES

DILATREND 6.25MG TAB NO

BENEFIT YES YES

VEDIBLOK 12.5MG TAB NO

BENEFIT YES YES

VEDIBLOK 25MG TAB NO

BENEFIT YES YES

VEDIBLOK 6.25MG TAB NO

BENEFIT YES YES

D LANOXIN 0.0625MG PG TAB YES YES YES

DIGOXIN LANOXIN 0.25MG TAB YES YES YES

LANOXIN PAED .05MG/ML SYR NO YES YES

PURGOXIN 0.25MG TAB YES YES YES

E

ENALAPRIL ADCO-ENALAPRIL 5MG YES YES YES

ADCO-ENALAPRIL 10MG YES YES YES

ADCO-ENALAPRIL 20MG YES YES YES

ALAPREN 5MG TAB YES YES YES



CIPLATEC 10MG YES YES YES


6


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4


ENAP 10MG TAB YES YES YES



ENVAS 10MG TABS YES YES YES

ENVAS 5MG TABS YES YES YES

HR-ENALAPRIL 10MG YES YES YES



HYPACE 5MG MG TABS YES YES YES

PHARMAPRESS 10MG YES YES YES



RENITEC 10MG TAB YES YES YES

RENITEC 2.5MG TAB YES YES YES



ENALAPRIL / HYDROCHLOROTHIAZ

CO-RENITEC TAB YES

YES YES

ENAP CO 20MG/12.5MG TAB YES YES YES

PHARMAPRESS CO YES YES YES

F

FUROSEMIDE AUSTELL-FUROSEMIDE 40MG YES YES YES

BEURESIS 40MG TAB YES YES YES

DIURESIX 40MG TAB YES YES YES

LASIX 40MG TAB YES YES YES

LASIX ORAL SOL NO YES YES

MYLAN FUROSEMIDE 40MG YES YES YES

PURESIS 40MG TAB YES YES YES

SANDOZ FUROSEMIDE 40 MG YES YES YES

G

GLYCERYL TRINITRATE ANGISED 0.5MG TAB NO

BENEFIT YES YES

7


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

H

HYDROCHLOROTHIAZIDE HEXAZIDE 25MG TAB YES YES YES

RIDAQ 12.5MG TAB YES YES YES

RIDAQ 25MG TAB YES YES YES

HYDRALLAZINE HYPERPHEN 10MG TAB NO

BENEFIT YES YES

HYPERPHEN 50MG TAB NO

BENEFIT YES YES

SANDOZ HYDRALAZINE 25 NO

BENEFIT YES YES

SANDOZ HYDRALAZINE 50 NO

BENEFIT YES YES

HYDROCHLORTHIAZIDE / KCI URIREX-K TAB NO NO YES

I

INDAPAMIDE ADCO-DAPAMAX 2.5MG TAB NO YES YES

CIPLA-INDAPAMIDE 2.5MG NO YES YES

DAPTRIL 2.5MG TAB NO YES YES

HYDRO-LESS 2.5MG TAB NO YES YES

MYLAN INDAPAMIDE 2.5MG NO YES YES

SANDOZ INDAPAMIDE 2.5MG NO YES YES

ISOSORBIDE DINITRATE ISORDIL 5MG TAB NO

BENEFIT YES YES

ISORDIL 10MG TAB NO

BENEFIT YES YES

ISORDIL 30MG TAB NO

BENEFIT YES YES

ISORDIL TEMBID 40MG NO

BENEFIT NO YES

SANDOZ ISOSORBIDE 10 NO

BENEFIT YES YES


BENEFIT YES YES


BENEFIT YES YES

ISOSORBIDE MONONITRATE ELANTAN 20MG TAB NO

BENEFIT YES YES

ELANTAN LA 50MG NO

BENEFIT YES YES

8


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

IMDUR 60MG TAB NO

BENEFIT NO YES

ISMO 20MG TAB NO

BENEFIT YES YES

MONICOR SR 60MG SRT NO

BENEFIT NO YES

L

LISINOPRIL ADCO-ZETOMAX 10MG TAB NO YES YES

ADCO-ZETOMAX 20MG TAB NO YES YES

ADCO-ZETOMAX 5MG TAB NO YES YES

AUSTELL-LISINOPRIL 10MG NO YES YES

AUSTELL-LISINOPRIL 2.5MG NO YES YES

AUSTELL-LISINOPRIL 20MG NO YES YES

HEXAL-LISINOPRIL 10MG TAB NO YES YES



LIZRO 10MG TAB NO YES YES



LYSIN 20MG TAB NO YES YES

LYSIN 5MG TAB NO YES YES

SINOPREN 10MG TAB NO YES YES



ZESTRIL 10MG TAB NO YES YES



LISINOPRIL / HYDROCHLOROTHIAZ

ADCO-ZETOMAX-CO 10/12.5 NO

YES YES

ADCO-ZETOMAX-CO 20/12.5 NO YES YES

AURO-LISINOPRIL CO 10MG NO YES YES

AURO-LISINOPRIL CO 20MG NO YES YES

DIACE CO 20/12.5 MG TAB NO YES YES

HEXAL-LISINOPRIL CO 10MG NO YES YES

HEXAL-LISINOPRIL CO 20MG NO YES YES

9


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

LISINOPRIL CO UNIC 10MG/12.5 NO YES YES

LISINOPRIL CO UNIC 20MG/12.5 NO YES YES

LISINOZIDE 10MG/12.5MG TAB NO YES YES

LISINOZIDE 20MG/12.5MG TAB NO YES YES

LISORETIC 10/12.5 NO YES YES

LISORETIC 20/12.5 NO YES YES

LISOZIDE 10MG/12.5MG TAB NO YES YES

LISOZIDE 20MG/12.5MG TAB NO YES YES

ZESTORETIC 10MG TAB NO YES YES

ZESTORETIC 20MG TAB NO YES YES

ZESTOZIDE 20MG TAB NO YES YES

LOSARTAN AURO LOSARTAN 100MG TAB NO

BENEFIT YES YES

AURO LOSARTAN 50MG TABS NO

BENEFIT YES YES

AUSTELL LOSARTAN 100MG NO

BENEFIT YES YES

AUSTELL LOSARTAN 50MG NO

BENEFIT YES YES

CIPLA LOSARTAN 100MG TAB NO

BENEFIT YES YES

CIPLA LOSARTAN 50MG TAB NO

BENEFIT YES YES

CIPLAZAR 100MG TAB NO

BENEFIT YES YES

CIPLAZAR 50MG TAB NO

BENEFIT YES YES

COZAAR 100MG TAB NO

BENEFIT YES YES

COZAAR 50MG TAB NO

BENEFIT YES YES

HYTENZA 100MG TAB NO

BENEFIT YES YES

HYTENZA 50MG TAB NO

BENEFIT YES YES

LOS-ARB 50MG TAB NO

BENEFIT YES YES

10


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

LOSARTAN-WINTHROP TAB NO

BENEFIT YES YES

LOZAAN 50MG TAB NO

BENEFIT YES YES

LOZAAN 100MG TAB NO

BENEFIT YES YES

RASOL 100MG TAB NO

BENEFIT YES YES

RASOL 50MG TAB NO

BENEFIT YES YES

RENICARD 50MG TAB NO

BENEFIT YES YES

SPEC-LOSARTAN 100MG TAB NO

BENEFIT YES YES

SPEC-LOSARTAN 50MG TAB NO

BENEFIT YES YES

ZARTAN 100MG TAB NO

BENEFIT YES YES

ZARTAN 50MG TAB NO

BENEFIT YES YES

LOSARTAN / HYDROCHLOROTHIAZ

AUSTELL LOSARTAN CO 50MG/12.5

NO BENEFIT

YES YES

COZAAR COMP TAB NO

BENEFIT YES YES

FORTZAAR TAB NO

BENEFIT YES YES

HYTENZA CO 100MG/25MG NO

BENEFIT YES YES

HYTENZA CO 50MG/12.5MG NO

BENEFIT YES YES

LOHYPE FORTE PLUS 100MG/2 NO

BENEFIT YES YES

LOHYPE PLUS 50MG/12.5MG NO

BENEFIT YES YES

LOSAAR PLUS 100/25 TAB NO

BENEFIT YES YES

LOSAAR PLUS 50/12.5 TAB NO

BENEFIT YES YES

LOZAAN CO 100/25 TAB NO

BENEFIT YES YES

11


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

LOZAAN CO 50/12.5 TAB NO

BENEFIT YES YES

NETRASOL CO 100/25MG TAB NO

BENEFIT YES YES

NETRASOL CO 50/12.5MG TAB NO

BENEFIT YES YES

SARTOC 100MG/25MG TAB NO

BENEFIT YES YES

SARTOC 50/12.5 TAB NO

BENEFIT YES YES

ZARTAN CO 100MG/25MG NO

BENEFIT YES YES

ZARTAN CO 50MG/12.5MG NO

BENEFIT YES YES

P

PERINDOPRIL ACESYL 4MG TAB NO NO YES

ACTI-PREX 4MG TAB NO NO YES

AURO PERINDOPRIL 4MG TAB NO NO YES

AURO PERINDOPRIL 8MG TAB NO NO YES

BINDACE 4MG TAB NO NO YES

BINDACE 8MG TAB NO NO YES

CIPLA-PERINDOPRIL 4MG TAB NO NO YES

CIPLA-PERINDOPRIL 8MG TAB NO NO YES

CIPLASYL 4MG TABS NO NO YES

CIPLASYL 8MG TABS NO NO YES

COVERSYL 4MG TAB NO NO YES

PEARINDA 4MG TABS NO NO YES

PEARINDA 8MG TABS NO NO YES

PERINDOPRIL UNICORN 4MG NO NO YES

PERINDOPRIL UNICORN 8MG NO NO YES

PREXUM 4MG TAB NO NO YES

PREXUM 5MG TAB NO NO YES

RAN-PERINDOPRIL 4MG TAB NO NO YES

SPEC-PERINDOPRIL 4MG TAB NO NO YES

SPEC-PERINDOPRIL 8MG TAB NO NO YES

VECTORYL 4MG TAB NO NO YES

12


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

VECTORYL 8MG TAB NO NO YES

ZYDUS PERINDOPRIL 4MG NO NO YES

PERINDOPRIL / AMLODIPINE COVERAM 10/10MG TAB NO NO YES

COVERAM 10/5MG TAB NO NO YES



PERINDOPRIL / INDAPAMIDE ACESYL CO 2MG/0.625MG TAB NO NO YES

ACESYL CO 4MG/1.25MG TAB NO NO YES

ARIPREL PLUS 4MG/1.25MG NO NO YES

COVERSYL PLUS TAB NO NO YES

PEARINDA PLUS 4MG/1.25MG NO NO YES

PERINDOPRIL CO UNI 4MG/1.2 NO NO YES

PREXUM PLUS TAB NO NO YES

PREXUM PLUS 5MG/1.25MG NO NO YES

SPEC-PERINDOPRIL PLUS 2MG NO NO YES

SPEC-PERINDOPRIL PLUS 4MG NO NO YES

VECTORYL PLUS TAB NO NO YES

ZYDUS PERINDOPRIL 4MG/1.25 NO NO YES

POTASSIUM CHLORIDE PLENISH K 600MG TAB YES YES YES

SANDOZ K-600 YES YES YES

SLOW-K 600MG TAB YES YES YES

ULTIPOT 600MG YES YES YES

PROPRANOLOL INDERAL 10MG TAB YES YES YES

INDERAL 40MG TAB YES YES YES

INDOBLOK 10MG YES YES YES

INDOBLOK 40MG YES YES YES

PRODOROL 10MG TAB YES YES YES

PRODOROL 40MG TAB YES YES YES

PUR-BLOKA 10MG TAB YES YES YES

PUR-BLOKA 40MG TAB YES YES YES

Q

QUINAPRIL ACCUMAX 10MG NO YES YES

ACCUMAX 20MG NO YES YES

13


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

ACCUPRIL 10MG TAB NO YES YES




QUINACE 10MG TAB NO YES YES

QUINACE 20MG TAB NO YES YES

QUINAGEN 10MG TAB NO YES YES




QUINASPEN 10MG TAB NO YES YES

QUINASPEN 20MG TAB NO YES YES

QUINAPRIL / HYDROCHLOROTHIAZ

ACCUMAX CO 10/12.5MG NO

YES YES

ACCUMAX CO 20/12.5MG NO YES YES

ACCURETIC 10/12.5 TAB NO YES YES

ACCURETIC 20/12.5 TAB NO YES YES

ADCO-QUINARETIC 10/12.5 NO YES YES

ADCO-QUINARETIC 20/12.5 NO YES YES

AURO QUINAPRIL CO 10MG/12.5 NO YES YES

AURO QUINAPRIL CO 20MG/12.5 NO YES YES

BIQURETIC 10MG/12.5MG TAB NO YES YES

BIQURETIC 20MG/12.5MG TAB NO YES YES

QUINACE CO 10/12.5MG TAB NO YES YES

QUINACE CO 20/12.5MG TAB NO YES YES

QUINAZIDE 10/12.5 TAB NO YES YES

QUINAZIDE 20/12.5 TAB NO YES YES

S

SPIRONOLACTONE ALDACTONE 100MG TAB YES YES YES

ALDACTONE 25MG TAB YES YES YES

SANDOZ SPIRONOLACTONE 25 YES YES YES

SPIRACTIN 100MG TAB YES YES YES

SPIRACTIN 25MG TAB YES YES YES

14


Beat4

Beat1 Beat 3 Pace2

Beat2 Pace1 Pace3

Pace4

T

TRIAMTERENE / HYDROCHLOROTHIA

DYAZIDE TAB NO

YES YES

RENEZIDE TAB NO YES YES

W

WARFARIN SODIUM ASPEN-WARFARIN 5MG TAB NO

BENEFIT YES YES

CIPLA-WARFARIN 1MG TAB NO

BENEFIT YES YES


BENEFIT YES YES


BENEFIT YES YES

VACCINES FLUARIX PREFILLED SYRINGE YES YES YES

FLUVAX 2009 PRE-FILLED YES YES YES

IMOVAX PNEUMO 23 YES YES YES

INFLUVAC 0.5ML YES YES YES

MUTAGRIP SINGLE DOSE YES YES YES

PNEUMOVAX VAC YES YES YES

VAXIGRIP PREFIL S/DOSE 0. YES YES YES

X-FLU PREFILLED SYR 0.5ML YES YES YES

CARDIAC FAILURE - Bestmed...1 Benefits are subject to the following: Pre-authorisation Bestmed...

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