Special Authority forms - July 2025

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Special Authority Form Chemical Therapeutic Group Former numbers
SA2118 [PDF] Abiraterone acetate Oncology Agents and Immunosuppressants SA1515 SA1767 SA1914 SA2003
SA2024 [PDF] Acitretin Dermatologicals SA0946 SA0954 SA1476
SA2400 [PDF] Adalimumab (Amgevita) Oncology Agents and Immunosuppressants SA2102 SA2142 SA2177 SA2178
SA2157 [PDF] Adalimumab (Humira - Alternative brand) Oncology Agents and Immunosuppressants
SA2185 [PDF] Adrenaline Respiratory System and Allergies N/A for Initial(s) only forms
SA1772 [PDF] Aflibercept Oncology Agents and Immunosuppressants SA1726
SA1318 [PDF] Albendazole Infections - Agents for Systemic Use
SA1870 [PDF] Alectinib Oncology Agents and Immunosuppressants
SA1986 [PDF] Alglucosidase Alfa Alimentary Tract and Metabolism SA1622 SA1920
SA2486 [PDF] Ambrisentan Cardiovascular System SA2253
SA2092 [PDF] Amino acid formula (Alfamino Junior; Elecare; Neocate) Special Foods SA1111 SA1219 SA1940
SA2139 [PDF] Antiretrovirals Infections - Agents for Systemic Use SA0556 SA0575 SA0754 SA0779 SA1021 SA1025 SA1364 SA1651
SA0987 [PDF] Aprepitant Nervous System
SA2042 [PDF] Arginine Alimentary Tract and Metabolism
SA2395 [PDF] Aripiprazole Nervous System N/A for Initial(s) only forms
SA2443 [PDF] Atezolizumab Oncology Agents and Immunosuppressants SA2195 SA2240 SA2264
SA2458 [PDF] Axitinib Oncology Agents and Immunosuppressants
SA2479 [PDF] Azacitidine Oncology Agents and Immunosuppressants SA1467 SA2141
SA1683 [PDF] Azithromycin Infections - Agents for Systemic Use SA1648
SA2244 [PDF] Bedaquiline Infections - Agents for Systemic Use N/A for Initial(s) only forms
SA1367 [PDF] Bee or wasp venom allergy treatment Respiratory System and Allergies SA0053
SA2398 [PDF] Bendamustine hydrochloride Oncology Agents and Immunosuppressants SA1667 SA2046 SA2153
SA2151 [PDF] Benralizumab Oncology Agents and Immunosuppressants
SA1963 [PDF] Benzbromarone Musculoskeletal System SA1319 SA1537
SA1987 [PDF] Betaine Alimentary Tract and Metabolism SA1727 SA1921
SA2453 [PDF] Bevacizumab Oncology Agents and Immunosuppressants SA2444
SA2355 [PDF] Bortezomib Oncology Agents and Immunosuppressants N/A for Initial(s) only forms
SA2254 [PDF] Bosentan Cardiovascular System SA1703 SA1712 SA1908 SA1991
SA2289 [PDF] Brentuximab Oncology Agents and Immunosuppressants
SA1886 [PDF] Budesonide - Cap 3 mg Controlled Release Alimentary Tract and Metabolism SA0459 SA0488 SA0512 SA0698 SA0913 SA1155
SA2421 [PDF] Budesonide with glycopyrronium and eformoterol Respiratory System and Allergies N/A for Initial(s) only forms
SA1203 [PDF] Buprenorphine with naloxone Nervous System
SA2070 [PDF] Cabergoline Hormone Preparations - Systemic Excluding Contraceptive Hormones SA0175 SA1031 SA1370
SA1289 [PDF] Capsaicin Musculoskeletal System N/A for Initial(s) only forms
SA1930 [PDF] Carbohydrate (Moducal; Polycal) Special Foods SA0579 SA0912 SA1090 SA1373 SA1522
SA1376 [PDF] Carbohydrate and Fat (Duocal Super Soluble Powder) Special Foods SA0581 SA1091
SA2401 [PDF] Cetuximab Oncology Agents and Immunosuppressants
SA2170 [PDF] Cinacalcet Hormone Preparations - Systemic Excluding Contraceptive Hormones SA1594 SA1618
SA1857 [PDF] Clarithromycin Infections - Agents for Systemic Use SA0070 SA0394 SA0443 SA0657 SA0988 SA1131
SA2039 [PDF] Coenzyme Q10 Alimentary Tract and Metabolism
SA0500 [PDF] Combined oral contraceptives; Progestogen-only contraceptives Genito-Urinary System SA0265
SA2371 [PDF] Continuous glucose monitor (interoperable) Alimentary Tract and Metabolism
SA2370 [PDF] Continuous glucose monitor (standalone) Alimentary Tract and Metabolism
SA2459 [PDF] Crizotinib Oncology Agents and Immunosuppressants
SA2494 [PDF] Dabrafenib Oncology Agents and Immunosuppressants SA2484
SA2385 [PDF] Dasatinib Oncology Agents and Immunosuppressants SA1805
SA1492 [PDF] Deferasirox Various
SA1480 [PDF] Deferiprone Various N/A for Initial(s) only forms
SA2441 [PDF] Denosumab Musculoskeletal System N/A for Initial(s) only forms
SA1680 [PDF] Dexamethasone 700 mcg ocular implants Sensory Organs
SA2410 [PDF] Dexamfetamine Sulfate Nervous System N/A for Initial(s) only forms
SA1095 [PDF] Diabetic products (Diason RTH; Glucerna Select RTH; Diasip; Glucerna Select; Resource Diabetic) Special Foods SA0594
SA1320 [PDF] Diazoxide Alimentary Tract and Metabolism
SA1978 [PDF] Dornase Alfa Respiratory System and Allergies
SA2492 [PDF] Dulaglutide Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA2425 [PDF] Durvalumab Oncology Agents and Immunosuppressants SA2147 SA2164
SA2456 [PDF] Elexacaftor with tezacaftor, ivacaftor and ivacaftor Respiratory System and Allergies N/A for Initial(s) only forms
SA1743 [PDF] Eltrombopag Blood and Blood Forming Organs SA1412 SA1418
SA2272 [PDF] Emicizumab Blood and Blood Forming Organs N/A for Initial(s) only forms
SA2408 [PDF] Empagliflozin; Empagliflozin with metformin hydrochloride Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA2138 [PDF] Emtricitabine with tenofovir disoproxil Infections - Agents for Systemic Use SA1714 SA1842 SA1904 SA1994
SA2152 [PDF] Enoxaparin sodium Blood and Blood Forming Organs SA0975 SA1174 SA1646
SA1953 [PDF] Enteral liquid peptide formula (Nutrini Peptisorb; Nutrini Peptisorb Energy) Special Foods
SA1728 [PDF] Eplerenone Cardiovascular System N/A for Initial(s) only forms
SA2256 [PDF] Epoprostenol Cardiovascular System
SA2422 [PDF] Erlotinib Oncology Agents and Immunosuppressants SA1044 SA1411 SA1519 SA1577 SA1641 SA1653 SA1915 SA2000 SA2115
SA2399 [PDF] Etanercept Oncology Agents and Immunosuppressants SA0667 SA0868 SA1060 SA1157 SA1372 SA1450 SA1478 SA1620 SA1812 SA1891 SA1949 SA1974 SA2048 SA2103
SA2414 [PDF] Everolimus Oncology Agents and Immunosuppressants SA1491 SA1913 SA2008
SA1557 [PDF] Extensively hydrolysed formula Special Foods SA1112 SA1220 SA1380
SA2204 [PDF] Fat (Calogen; Liquigen; MCT oil (Nutricia)) Special Foods SA0580 SA0899 SA1092 SA1374 SA1523
SA2205 [PDF] Fat Modified Products (Monogen) Special Foods SA0593 SA0615 SA1096 SA1381 SA1525
SA2054 [PDF] Febuxostat Musculoskeletal System SA1431 SA1538 SA1931 SA1996
SA2394 [PDF] Ferric carboxymaltose Alimentary Tract and Metabolism SA1675 SA1840 SA1840
SA1259 [PDF] Filgrastim Blood and Blood Forming Organs N/A for Initial(s) only forms
SA0928 [PDF] Finasteride Genito-Urinary System N/A for Initial(s) only forms
SA1359 [PDF] Fluconazole oral liquid Infections - Agents for Systemic Use SA1148
SA2326 [PDF] Fluticasone furoate with umeclidinium and vilanterol Respiratory System and Allergies N/A for Initial(s) only forms
SA1106 [PDF] Food Thickeners (Karicare Food Thickener; Nutilis) Special Foods SA0595
SA2357 [PDF] Foods and Supplements For Inborn Errors Of Metabolism Special Foods N/A for Initial(s) only forms
SA2406 [PDF] Fosfomycin Infections - Agents for Systemic Use
SA1895 [PDF] Fulvestrant Oncology Agents and Immunosuppressants
SA1988 [PDF] Galsulfase Alimentary Tract and Metabolism SA1593 SA1922
SA2423 [PDF] Gefitinib Oncology Agents and Immunosuppressants SA1226 SA1520 SA1578 SA1654 SA1916 SA2001 SA2116
SA2269 [PDF] Gemtuzumab ozogamicin Oncology Agents and Immunosuppressants N/A for Initial(s) only forms
SA1729 [PDF] Gluten Free Foods (Bakels Gluten Free Health Bread Mix; Horleys Bread Mix; Horleys Flour; NZB Low Gluten Bread Mix; Orgran; Healtheries Simple Baking Mix) Special Foods N/A for Initial(s) only forms
SA1329 [PDF] Glyceryl trinitrate Oint 0.2% Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA1195 [PDF] High Calorie Products (Two Cal HN; Nutrison Concentrated) Special Foods SA0585 SA1105
SA1197 [PDF] High fat formula with vitamins, minerals and trace elements and low in protein and carbohydrate (KetoCal) Special Foods
SA1321 [PDF] Hydralazine Cardiovascular System N/A for Initial(s) only forms
SA1998 [PDF] Hyoscine (Scopolamine) Nervous System SA0051 SA0727 SA0939 SA1387 SA1927
SA2266 [PDF] Hypoplastic and Haemolytic Blood and Blood Forming Organs SA0922 SA1469 SA1775
SA2480 [PDF] Ibrutinib Oncology Agents and Immunosuppressants SA2168
SA1558 [PDF] Icatibant Respiratory System and Allergies
SA1623 [PDF] Idursulfase Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA2257 [PDF] Iloprost Cardiovascular System
SA1110 [PDF] Infant Formulae - For Williams Syndrome (Locasol) Special Foods SA0601
SA2487 [PDF] Infliximab Oncology Agents and Immunosuppressants SA1778 SA1831 SA1951 SA1982 SA2050 SA2082 SA2179 SA2402
SA2460 [PDF] Inotuzumab ozogamicin Oncology Agents and Immunosuppressants
SA2380 [PDF] Insulin Pump Consumables Alimentary Tract and Metabolism SA1985 SA1906 SA1604 SA1240
SA2367 [PDF] Insulin pump with algorithm Alimentary Tract and Metabolism
SA2461 [PDF] Ipilimumab Oncology Agents and Immunosuppressants N/A for Initial(s) only forms
SA2449 [PDF] Isotretinoin Dermatologicals SA0955 SA1475 SA2023
SA1322 [PDF] Itraconazole Infections - Agents for Systemic Use
SA2017 [PDF] Ivacaftor Respiratory System and Allergies N/A for Initial(s) only forms
SA2294 [PDF] Ivermectin Dermatologicals SA1225 SA2228
SA2267 [PDF] Lacosamide Nervous System SA1125 SA2223
SA1685 [PDF] Lamivudine Infections - Agents for Systemic Use SA0538 SA0772 SA0832 SA1360 SA1650
SA1695 [PDF] Laronidase Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA1605 [PDF] Ledipasvir with sofosbuvir Infections - Agents for Systemic Use N/A for Initial(s) only forms
SA2353 [PDF] Lenalidomide Oncology Agents and Immunosuppressants
SA2442 [PDF] Lenvatinib Oncology Agents and Immunosuppressants SA2407
SA2040 [PDF] Levocarnitine Alimentary Tract and Metabolism
SA2234 [PDF] Linezolid Infections - Agents for Systemic Use N/A for Initial(s) only forms
SA2440 [PDF] Liraglutide Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA2415 [PDF] Lisdexamfetamine dimesilate Nervous System N/A for Initial(s) only forms
SA1584 [PDF] Long-Acting Muscarinic Antagonists with Long-Acting Beta-Adrenoceptor Agonists Respiratory System and Allergies
SA2445 [PDF] Long-acting Somatostatin Analogues Oncology Agents and Immunosuppressants SA0099 SA0445 SA0563 SA1016 SA1918 SA2004 SA2072 SA2119
SA1666 [PDF] Melatonin Nervous System
SA2331 [PDF] Mepolizumab Oncology Agents and Immunosuppressants SA1896 SA2154
SA1725 [PDF] Mercaptopurine Oncology Agents and Immunosuppressants
SA1691 [PDF] Methylnaltrexone bromide Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA2411 [PDF] Methylphenidate Hydrochloride (Rubifen; Rubifen SR; Ritalin; Methylphenidate ER - Teva) Nervous System N/A for Initial(s) only forms
SA2450 [PDF] Methylphenidate Hydrochloride Extended Release (Concerta; Ritalin LA) Nervous System N/A for Initial(s) only forms
SA1474 [PDF] Midodrine Cardiovascular System SA0934
SA2342 [PDF] Midostaurin Oncology Agents and Immunosuppressants N/A for Initial(s) only forms
SA1355 [PDF] Minocycline hydrochloride Tab 50 mg Infections - Agents for Systemic Use N/A for Initial(s) only forms
SA2451 [PDF] Modafinil Nervous System N/A for Initial(s) only forms
SA1740 [PDF] Moxifloxacin Infections - Agents for Systemic Use SA1065 SA1358
SA2274 [PDF] Multiple Sclerosis Nervous System SA2026 SA2051 SA2140 SA2176
SA1546 [PDF] Multivitamin renal (Clinicians Renal Vit) Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA1036 [PDF] Multivitamins (Paediatric Seravit) Alimentary Tract and Metabolism SA0600 SA0963
SA1408 [PDF] Naltrexone Nervous System SA0714 SA0909 SA1397
SA2301 [PDF] Nilotinib Oncology Agents and Immunosuppressants SA1489
SA2012 [PDF] Nintedanib Respiratory System and Allergies SA1755 SA1928
SA2325 [PDF] Niraparib Oncology Agents and Immunosuppressants
SA2490 [PDF] Nivolumab Oncology Agents and Immunosuppressants SA1911 SA2006 SA2120 SA2306 SA2405 SA2454
SA2174 [PDF] Nusinersen Nervous System
SA2155 [PDF] Obinutuzumab Oncology Agents and Immunosuppressants
SA2273 [PDF] Ocrelizumab Nervous System
SA2313 [PDF] Olanzapine depot injection Nervous System SA1146 SA1428
SA2163 [PDF] Olaparib Oncology Agents and Immunosuppressants SA1883 SA2148
SA1744 [PDF] Omalizumab Oncology Agents and Immunosuppressants SA1490
SA2418 [PDF] Osimertinib Oncology Agents and Immunosuppressants
SA1098 [PDF] Paediatric Product For Children Awaiting Liver Transplant (Heparon Junior) Special Foods SA0607
SA1099 [PDF] Paediatric Product For Children With Chronic Renal Failure (Kindergen) Special Foods SA0606
SA1379 [PDF] Paediatric Products Special Foods SA0590 SA0896 SA1100 SA1224
SA1196 [PDF] Paediatric enteral feed with fibre 0.75 kcal/ml (Nutrini Low Energy Multi Fibre) Special Foods
SA1698 [PDF] Paediatric oral/enteral feed 1 kcal/ml (Infatrini) Special Foods
SA2345 [PDF] Palbociclib (Ibrance) Oncology Agents and Immunosuppressants SA1894
SA2396 [PDF] Paliperidone depot injection Nervous System SA1429
SA2167 [PDF] Paliperidone palmitate Nervous System
SA2419 [PDF] Palivizumab Oncology Agents and Immunosuppressants
SA1689 [PDF] Paromomycin Infections - Agents for Systemic Use SA1324
SA2429 [PDF] Pazopanib Oncology Agents and Immunosuppressants SA1190
SA1979 [PDF] Pegaspargase Oncology Agents and Immunosuppressants SA1325
SA1912 [PDF] Pegfilgrastim Blood and Blood Forming Organs N/A for Initial(s) only forms
SA2034 [PDF] Pegylated Interferon alfa-2A Infections - Agents for Systemic Use SA0692 SA0742 SA0802 SA0952 SA1134 SA1365 SA1400 SA1936 SA1972 SA1995
SA2498 [PDF] Pembrolizumab Oncology Agents and Immunosuppressants SA1615 SA1657 SA1862 SA1910 SA2007 SA2121 SA2197 SA2241 SA2265 SA2307 SA2386 SA2491
SA2276 [PDF] Pertuzumab Oncology Agents and Immunosuppressants SA1606
SA1386 [PDF] Phenobarbitone Nervous System N/A for Initial(s) only forms
SA0895 [PDF] Pilocarpine - Eye drops 2% single dose Sensory Organs SA0121
SA1970 [PDF] Pimecrolimus Dermatologicals N/A for Initial(s) only forms
SA2013 [PDF] Pirfenidone Respiratory System and Allergies SA1628 SA1748 SA1864 SA1929
SA2354 [PDF] Pomalidomide Oncology Agents and Immunosuppressants
SA2383 [PDF] Posaconazole Infections - Agents for Systemic Use SA1285
SA1083 [PDF] Potassium Citrate Genito-Urinary System
SA1715 [PDF] Prednisolone sodium phosphate Sensory Organs SA1547
SA2431 [PDF] Preservative Free Ocular Lubricants Sensory Organs N/A for Initial(s) only forms
SA1684 [PDF] Primaquine Infections - Agents for Systemic Use SA1326
SA1327 [PDF] Propranolol Cardiovascular System
SA1199 [PDF] Propylthiouracil Hormone Preparations - Systemic Excluding Contraceptive Hormones
SA1524 [PDF] Protein (Protifar; Promod; Resource Beneprotein) Special Foods SA0582 SA1093 SA1375
SA1328 [PDF] Pyrimethamine Infections - Agents for Systemic Use N/A for Initial(s) only forms
SA1779 [PDF] Raloxifene Musculoskeletal System N/A for Initial(s) only forms
SA1101 [PDF] Renal Products (Nepro; NovaSource Renal; Renilon 7.5; Suplena) Special Foods SA0586 SA0587 SA1103
SA2495 [PDF] Ribociclib Oncology Agents and Immunosuppressants SA2343
SA2041 [PDF] Riboflavin Alimentary Tract and Metabolism
SA1461 [PDF] Rifaximin Alimentary Tract and Metabolism
SA1403 [PDF] Riluzole Nervous System
SA2203 [PDF] Risdiplam Nervous System
SA2397 [PDF] Risperidone Nervous System SA0792 SA0926 SA1427
SA1976 [PDF] Rituximab (Mabthera) Oncology Agents and Immunosuppressants SA0777 SA0884 SA0961 SA1050 SA1152 SA1631 SA1655 SA1686 SA1783 SA1818 SA1861 SA1884 SA1901
SA2497 [PDF] Rituximab (Riximyo) Oncology Agents and Immunosuppressants SA1885 SA1902 SA1937 SA2028 SA2061 SA2083 SA2114 SA2233
SA1488 [PDF] Rivastigmine patches Nervous System
SA2093 [PDF] Rosuvastatin Cardiovascular System N/A for Initial(s) only forms
SA1890 [PDF] Ruxolitinib Oncology Agents and Immunosuppressants SA1753
SA2302 [PDF] Sacubitril with valsartan Cardiovascular System N/A for Initial(s) only forms
SA1989 [PDF] Sapropterin dihydrochloride Alimentary Tract and Metabolism SA1757 SA1923
SA2488 [PDF] Secukinumab Oncology Agents and Immunosuppressants SA1754 SA2044 SA2084 SA2403 SA2482
SA2255 [PDF] Sildenafil (Vedafil) Cardiovascular System SA1738 SA1825 SA1909 SA1992
SA1596 [PDF] Siltuximab Oncology Agents and Immunosuppressants
SA2270 [PDF] Sirolimus (Rapamune) Oncology Agents and Immunosuppressants SA0866 SA2005 SA2218
SA1599 [PDF] Sodium benzoate Alimentary Tract and Metabolism
SA1990 [PDF] Sodium phenylbutyrate Alimentary Tract and Metabolism SA1598 SA1924
SA2053 [PDF] Sodium picosulfate Alimentary Tract and Metabolism
SA2032 [PDF] Somatropin Hormone Preparations - Systemic Excluding Contraceptive Hormones SA1451 SA1629
SA1377 [PDF] Specialised And Elemental Products Special Foods SA0592 SA1102
SA1859 [PDF] Standard Supplements Special Foods SA0583 SA0702 SA1104 SA1228 SA1554
SA2268 [PDF] Stiripentol Nervous System SA1330 SA2217
SA1331 [PDF] Sulfadiazine Infections - Agents for Systemic Use N/A for Initial(s) only forms
SA2452 [PDF] Sunitinib Oncology Agents and Immunosuppressants SA1055 SA1162 SA1200 SA1266 SA1917 SA2002 SA2117 SA2430
SA2455 [PDF] Tacrolimus Oncology Agents and Immunosuppressants N/A for Initial(s) only forms
SA2074 [PDF] Tacrolimus Ointment Dermatologicals N/A for Initial(s) only forms
SA2137 [PDF] Taliglucerase alfa Alimentary Tract and Metabolism
SA1032 [PDF] Tamsulosin Genito-Urinary System N/A for Initial(s) only forms
SA2043 [PDF] Taurine Alimentary Tract and Metabolism
SA2275 [PDF] Temozolomide Oncology Agents and Immunosuppressants SA1063 SA1610 SA1616 SA1741
SA1139 [PDF] Teriparatide Musculoskeletal System N/A for Initial(s) only forms
SA1332 [PDF] Tetracycline Infections - Agents for Systemic Use N/A for Initial(s) only forms
SA2356 [PDF] Thalidomide Oncology Agents and Immunosuppressants SA1124 SA0817 SA0882
SA1955 [PDF] Ticagrelor Blood and Blood Forming Organs SA1382 SA1887
SA2489 [PDF] Tocilizumab Oncology Agents and Immunosuppressants SA1781 SA1858 SA1977 SA2078 SA2100 SA2159 SA2332 SA2404
SA2166 [PDF] Tolvaptan Cardiovascular System
SA0906 [PDF] Topical local anaesthetics (EMLA; LMX4) Nervous System SA0323
SA2496 [PDF] Trametinib Oncology Agents and Immunosuppressants SA2485
SA2293 [PDF] Trastuzumab (Herzuma) Oncology Agents and Immunosuppressants
SA2420 [PDF] Trastuzumab deruxtecan Oncology Agents and Immunosuppressants
SA2424 [PDF] Trastuzumab emtansine Oncology Agents and Immunosuppressants SA1871 SA2144
SA2324 [PDF] Trientine Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA2483 [PDF] Upadacitinib Oncology Agents and Immunosuppressants SA2079
SA2448 [PDF] Ursodeoxycholic Acid Alimentary Tract and Metabolism SA0458 SA0841 SA0914 SA1003 SA1188 SA1383 SA1739
SA2182 [PDF] Ustekinumab Oncology Agents and Immunosuppressants
SA1993 [PDF] Valganciclovir Infections - Agents for Systemic Use SA1274 SA1404
SA1845 [PDF] Varenicline tartrate Nervous System SA1135 SA1054 SA1161 SA1575 SA1771
SA2183 [PDF] Vedolizumab Oncology Agents and Immunosuppressants
SA2481 [PDF] Venetoclax Oncology Agents and Immunosuppressants SA1868
SA2088 [PDF] Vigabatrin Nervous System SA0875 SA0937 SA1010 SA1072 SA1907 SA1997
SA1720 [PDF] Vitabdeck Alimentary Tract and Metabolism N/A for Initial(s) only forms
SA2384 [PDF] Voriconazole Infections - Agents for Systemic Use SA1273

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