Prime Cure Dental Formulary 2025

PLEASE NOTE: Provider Trade Names are not listed on formulary, allowing for generic substitution, but applying Reference Pricing

Should you wish to export the formulary for your own offline use you are welcome to use the export buttons at the top of the table to export the full list in the format you prefer. If you only need a subset of the list please filter the table using the fields provided and then the export buttons will export only your chosen subset of data.

KEY TO QUANTITIES AND LIMITATIONS

  1. “Consumables – Clinic use only” means the medication may only be administrated by a DSP at the rooms. All injectables are consumables. Patients will not be able to collect from DSP pharmacies.
  2. “Max Rx/7 days & 3 Rx/annum” means a script filled to a maximum of 7 days medication supply and 3 prescriptions per year can be claimed.
  3. All items are to be dispensed by a contracted DSP pharmacy.
  4. Benefits for medicine are subject to Mediscor Reference Price (MRP). Should the cost of the item exceed the MRP, the patient will be liable for payment of the difference in cost. If this is the case, please inform the patient that it will be for his/her own personal account.
wdt_ID wdt_created_by wdt_created_at wdt_last_edited_by wdt_last_edited_at MIMS MIMS Sub-category Mims Description Active Ingredient Route of admin Dosage Form Acute Quantities and Limitations
69 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANAESTHETICS Local Anaesthetics Local Anaesthetics Lidocaine HCl Local Inj 2% IJ SOLN A Consumables
70 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANAESTHETICS Local Anaesthetics Local Anaesthetics Lidocaine Inj 2% w/ Epinephrine-1:80000 IJ SOLN A Consumables
71 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Analgesic and Antipyretics Analgesic and Antipyretics Ibuprofen Susp 100 MG/5ML OR SUSP A Max 200ml/Rx & 3 Rx/annum
72 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Analgesic and Antipyretics Analgesic and Antipyretics Mefanamic Acid Susp 50mg/5ml OR SUSP A Max 200ml/Rx & 3 Rx/annum
73 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Analgesic and Antipyretics Analgesic and Antipyretics Mefenamic Acid Cap 250 MG OR CAPS A Max Rx/5 days & 3 Rx/annum
74 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Analgesic and Antipyretics Analgesic and Antipyretics Paracetamol Elixir 120 MG/5ML OR ELIX A Max 200ml/Rx & 3 Rx/annum
75 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Analgesic and Antipyretics Analgesic and Antipyretics Paracetamol Syrup 120 MG/5ML OR ELIX A Max 200ml/Rx & 3 Rx/annum
76 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Analgesic and Antipyretics Analgesic and Antipyretics Paracetamol Tab 500 MG OR TABS A Max Rx/7 days & 3 Rx/annum
77 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Combinations Combination Analgesics Acetaminophen w/ Codeine Cap 500-8 MG OR CAPS A Max Rx/7 days & 3 Rx/annum
78 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Combinations Combination Analgesics Paracetamol w/ Codeine Tab 500-10 MG OR TABS A Max Rx/7 days & 3 Rx/annum
79 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Combinations Combination Analgesics Paracetamol w/ Codeine Tab 500-8 MG OR TABS A Max Rx/7 days & 3 Rx/annum
80 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Combinations Combination Analgesics Paracetamol-Meprobamate-Caff-Cod Tab 320-150-32-8 MG OR TABS A Max Rx/5 days & 3 Rx/annum
81 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANALGESICS Combinations Combination Analgesics Paracetamol-Promethazine w/ Codeine Syrup 120-6.5-5 MG/5ML OR SYRP A Max 100ml/Rx & 3 Rx/annum
82 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM MUSCULO-SKELETAL AGENTS Non-Steroidal Anti-Inflammatory Agents COX Inhibitors Diclofenac Sodium Tab Delayed Release 25 MG OR TBEC A Max Rx/7 days & 3 Rx/annum
83 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM MUSCULO-SKELETAL AGENTS Non-Steroidal Anti-Inflammatory Agents COX Inhibitors Diclofenac Sodium Tab Delayed Release 50 MG OR TBEC A Max Rx/7 days & 3 Rx/annum
84 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM MUSCULO-SKELETAL AGENTS Non-Steroidal Anti-Inflammatory Agents COX Inhibitors Ibuprofen Tab 200 MG OR TABS A Max Rx/7 days & 3 Rx/annum
85 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM MUSCULO-SKELETAL AGENTS Non-Steroidal Anti-Inflammatory Agents COX Inhibitors Ibuprofen Tab 400 MG OR TABS A Max Rx/7 days & 3 Rx/annum
86 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM EAR, NOSE AND THROAT Mouth and throat preparations Mouth and Throat Preparations Benzocaine Lozenge 10 MG MT LOZG A Max 20/Rx & 4 Rx/annum
87 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM EAR, NOSE AND THROAT Mouth and throat preparations Mouth and Throat Preparations Chlorhexidine Gluconate Soln 0.2% MT SOLN A Max 200ml/annum
88 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM EAR, NOSE AND THROAT Mouth and throat preparations Mouth and Throat Preparations Povidone-Iodine Mouthwash 1% MT SOLN A Max 200ml/annum
89 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM EAR, NOSE AND THROAT Mouth and throat preparations Mouth and Throat Preparations Tetracaine HCl Ointment 0.5% MT OINT A Max 1 op/annum
90 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin & K Clavulanate For Susp 125-31.25 MG/5ML OR SUSR A Max 4 fills/annum
91 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin & K Clavulanate For Susp 250-62.5 MG/5ML OR SUSR A Max 4 fills/annum
92 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML OR SUSR A Max 4 fills/annum
93 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin & K Clavulanate Tab 250-125 MG OR TABS A Max 4 fills/annum
94 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin & K Clavulanate Tab 500-125 MG OR TABS A Max 4 fills/annum
95 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin (Trihydrate) For Susp 125 MG/5ML OR SUSR A Max 4 fills/annum
96 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin (Trihydrate) For Susp 250 MG/5ML OR SUSR A Max 4 fills/annum
97 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin (Trihydrate) Cap 250 MG OR CAPS A Max 4 fills/annum
98 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Amoxicillin (Trihydrate) Cap 500 MG OR CAPS A Max 4 fills/annum
99 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Ampicillin-Cloxacillin Cap 250-250 MG OR CAPS A Max 4 fills/annum
100 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Ampicillin-Cloxacillin For Susp 125-125 MG/5ML OR SUSR A Max 4 fills/annum
101 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Cloxacillin Sodium Cap 250 MG OR CAPS A Max 4 fills/annum
102 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Cloxacillin Sodium Cap 500 MG OR CAPS A Max 4 fills/annum
103 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Floxacillin Sodium Cap 250 MG OR CAPS A Max 4 fills/annum
104 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Penicillin G Procaine Intramuscular Susp 300000 Unit/ML IM SUSP A Consumables - Clinic use only
105 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Penicillin G Benzathine For Intramuscular Susp 2400000 Unit IM SUSR A Consumables - Clinic use only
106 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Penicillin V Potassium For Soln 125 MG/5ML OR SOLR A Max 4 fills/annum
107 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Penicillins Penicillin V Potassium Tab 250 MG OR TABS A Max 4 fills/annum
108 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Cephalosporins Cefotaxime Sodium For Inj 500 MG IJ SOLR A Consumables - Clinic use only
109 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Cephalosporins Cefoxitin Sodium For Inj 1 GM IV SOLR A Consumables - Clinic use only
110 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Cephalosporins Ceftriaxone Sodium For Inj 1 GM IJ SOLR A Consumables - Clinic use only
111 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Cephalosporins Ceftriaxone Sodium For IV Soln 2 GM IV SOLN A Consumables - Clinic use only
112 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Cephalosporins Cefuroxime Sodium For Inj 250 MG IJ SOLR A Consumables - Clinic use only
113 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Cephalosporins Cefuroxime Sodium For Inj 750 MG IJ SOLR A Consumables - Clinic use only
114 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Beta-Lactams Others NONE LISTED
115 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Erythromycin and other Macrolides Erythromycin and other Macrolides Erythromycin Estolate Cap 250 MG OR CAPS A Max 4 fills/annum
116 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Erythromycin and other Macrolides Erythromycin and other Macrolides Erythromycin Estolate Susp 125 MG/5ML OR SUSP A Max 4 fills/annum
117 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Erythromycin and other Macrolides Erythromycin and other Macrolides Erythromycin Estolate Susp 250 MG/5ML OR SUSP A Max 4 fills/annum
118 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Erythromycin and other Macrolides Erythromycin and other Macrolides Erythromycin Stearate Tab 250 MG OR TABS A Max 4 fills/annum
119 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Aminoglycosides Aminoglycosides Gentamicin Sulfate Inj 40 MG/ML IJ SOLN A Consumables - Clinic use only
120 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Aminoglycosides Aminoglycosides Streptomycin Sulfate Inj 1000 MG/3ML IJ SOLN A Consumables - Clinic use only
121 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Tetracyclines Tetracyclines Doxycycline Hyclate Cap 100 MG OR CAPS A Max 4 fills/annum
122 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Tetracyclines Tetracyclines Oxytetracycline HCl Cap 250 MG OR CAPS A Max 4 fills/annum
123 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Chloramphenicols Chloramphenicols Chloramphenicol Cap 250 MG OR CAPS A Max 4 fills/annum
124 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Chloramphenicols Chloramphenicols Chloramphenicol Susp 125 MG/5ML OR SUSP A Max 4 fills/annum
125 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Sulphonamides and combinations Sulphonamides and combinations Sulfamethoxazole-Trimethoprim IV Soln 400-80 MG/5ML IV SOLN A Consumables - Clinic use only
126 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Sulphonamides and combinations Sulphonamides and combinations Sulfamethoxazole-Trimethoprim Susp 200-40 MG/5ML OR SUSP A Max 4 fills/annum
127 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Sulphonamides and combinations Sulphonamides and combinations Sulfamethoxazole-Trimethoprim Tab 400-80 MG OR TABS A Max 4 fills/annum
128 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Quinolones Quinolones Ciprofloxacin HCl Tab 250 MG OR TABS A Max 4 fills/annum
129 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Quinolones Quinolones Ciprofloxacin HCl Tab 500 MG OR TABS A Max 4 fills/annum
130 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Other anti-bacterial agents Other anti-bacterial agents Clindamycin HCl Cap 150 MG OR CAPS A Max 2 fills/annum
131 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Anti-Fungal agents Anti-Fungal agents Nystatin Susp 100000 Unit/ML MT SUSP A Max 2 fills/annum
132 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Anti-protozoal agents Anti-protozoal agents Metronidazole Susp 200 MG/5ML OR SUSP A Max 3 fills/annum
133 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM Anti-protozoal agents Anti-protozoal agents Metronidazole Tab 200 MG OR TABS A Max 3 fills/annum
134 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM Anti-protozoal agents Anti-protozoal agents Metronidazole Tab 400 MG OR TABS A Max 3 fills/annum
135 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ANTI-MICROBIALS Other Anti-viral Agents Other Anti-viral Agents Acyclovir Cream 5% EX CREA A Max 1 Rx/annum
136 Kirsty Knighton-Fitt 27/12/2024 09:26 AM Kirsty Knighton-Fitt 27/12/2024 09:26 AM ENDOCRINE SYSTEM Corticosteroids Corticosteroids Prednisone Tab 5 MG OR TABS A Max 3 fills/annum
MIMS MIMS Sub-category Mims Description Active Ingredient Route of admin Dosage Form

Disclaimer:
Please note that the formulary will be reviewed regularly by clinical and pharmaceutical advisors to ensure it complies with the latest industry norms for the treatment of dental conditions. Prime Cure reserves the right to change medication on the formulary when important information comes to light that requires us to do so, e.g. new findings regarding safety of medicine.