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Mepha Pharma AG Bestell-Fax 0800 00 44 88 - bei Mepha Pharma ...

Mepha Pharma AG Bestell-Fax 0800 00 44 88 - bei Mepha Pharma ...

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<strong>Mepha</strong> <strong>Pharma</strong> <strong>AG</strong><br />

<strong>Bestell</strong>formular<br />

<strong>Bestell</strong>-Telefon: <strong>08<strong>00</strong></strong> <strong>00</strong> 33 <strong>88</strong><br />

Präparat <strong>Pharma</strong>code Menge Präparat <strong>Pharma</strong>code Menge<br />

Olfen ® -25 119 57 21 _______ OP 30 Lactab ®<br />

Lactab ® 119 57 <strong>44</strong> _______ OP 1<strong>00</strong> Lactab ®<br />

Olfen ® -50 119 57 67 _______ OP 20 Lactab ®<br />

Lactab ® 119 57 96 _______ OP 1<strong>00</strong> Lactab ®<br />

Olfen ® -1<strong>00</strong> 119 58 91 _______ OP 10 Depocaps ®<br />

Depocaps ® 119 59 22 _______ OP 30 Depocaps ®<br />

119 59 45 _______ OP 1<strong>00</strong> Depocaps ®<br />

Olfen ® -50<br />

Rectocaps ® 476 95 36 _______ OP 10 Rectocaps ®<br />

Olfen ® -1<strong>00</strong><br />

Rectocaps ® 476 16 64 _______ OP 5 Rectocaps ®<br />

Olfen ® -75 retard 226 65 93 _______ OP 20 Depotabs ®<br />

Depotabs ® 226 66 18 _______ OP 1<strong>00</strong> Depotabs ®<br />

Olfen ® -75 duo release 309 25 11 _______ OP 10 Kapseln<br />

Kapseln 309 25 28 _______ OP 30 Kapseln<br />

524 04 99 _______ OP 1<strong>00</strong> Kapseln<br />

Olfen ® 130 35 99 _______ OP 50 g Gel<br />

Gel<br />

Olfen<br />

130 36 07 _______ OP 1<strong>00</strong> g Gel<br />

® Roll-on<br />

Gel 364 39 74 _______ OP 50 g Gel<br />

Olfen Patch ® 370 13 29 _______ OP 2 Pflaster<br />

Pflaster 370 13 35 _______ OP 5 Pflaster<br />

370 13 41 _______ OP 10 Pflaster<br />

Olflex ® plus 465 07 75 _______ OP 60 Tabletten<br />

Tabletten<br />

Omezol-<strong>Mepha</strong><br />

465 07 69 _______ OP 180 Tabletten<br />

® 40 i.v.<br />

Stechampulle 310 94 30 _______ OP 5 Stechamp.<br />

Omezol-<strong>Mepha</strong> ® 10 MT 275 65 29 _______ OP 14 Kapseln<br />

Kapseln 275 65 35 _______ OP 28 Kapseln<br />

275 65 41 _______ OP 56 Kapseln<br />

275 65 58 _______ OP 1<strong>00</strong> Kapseln<br />

Omezol-<strong>Mepha</strong> ® 20 MT 275 65 64 _______ OP 7 Kapseln<br />

Kapseln 275 65 70 _______ OP 14 Kapseln<br />

275 65 87 _______ OP 28 Kapseln<br />

275 66 01 _______ OP 56 Kapseln<br />

275 66 18 _______ OP 1<strong>00</strong> Kapseln<br />

Omezol-<strong>Mepha</strong> ® 40 MT 275 66 24 _______ OP 7 Kapseln<br />

Kapseln 275 66 30 _______ OP 28 Kapseln<br />

377 71 43 _______ OP 56 Kapseln<br />

Ondansetron-<strong>Mepha</strong><br />

377 71 89 _______ OP 1<strong>00</strong> Kapseln<br />

® 8 oro<br />

Schmelztabletten<br />

Paclitaxel-<strong>Mepha</strong><br />

378 79 63 _______ OP 6 Schmelztabl.<br />

® 30/5ml<br />

Infusionskonzentrat 476 71 87 _______ OP 1 Stechamp.<br />

Paclitaxel-<strong>Mepha</strong> ® 1<strong>00</strong>/16.7ml<br />

Infusionskonzentrat 476 71 70 _______ OP 1 Stechamp.<br />

Paclitaxel-<strong>Mepha</strong> ® 3<strong>00</strong>mg/50ml<br />

Infusionskonzentrat 476 72 01 _______ OP 1 Stechamp.<br />

Pamidronat-<strong>Mepha</strong> ® 15mg/5ml<br />

Stechampullen 340 22 42 _______ OP 1 Stechamp.<br />

Pamidronat-<strong>Mepha</strong> ® 30mg/10ml<br />

Stechampullen 340 22 59 _______ OP 1 Stechamp.<br />

Pamidronat-<strong>Mepha</strong> ® 60mg/20ml<br />

Stechampullen 340 22 65 _______ OP 1 Stechamp.<br />

Pamidronat-<strong>Mepha</strong> ® 90mg/30ml<br />

Stechampullen 340 22 71 _______ OP 1 Stechamp.<br />

<strong>Bestell</strong>-<strong>Fax</strong> <strong>08<strong>00</strong></strong> <strong>00</strong> <strong>44</strong> <strong>88</strong><br />

Express (CHF 15.–)<br />

18355-321202<br />

Datum<br />

Unterschrift<br />

Pantoprazol-<strong>Mepha</strong> ® 20 455 66 16 _______ OP 15 Lactab ®<br />

Lactab ® 455 66 22 _______ OP 30 Lactab ®<br />

455 66 45 _______ OP 60 Lactab ®<br />

455 66 68 _______ OP 120 Lactab ®<br />

Pantoprazol-<strong>Mepha</strong> ® 40 455 66 74 _______ OP 7 Lactab ®<br />

Lactab ® 455 66 80 _______ OP 15 Lactab ®<br />

455 69 12 _______ OP 30 Lactab ®<br />

455 69 29 _______ OP 60 Lactab ®<br />

458 42 16 _______ OP 1<strong>00</strong> Lactab ®<br />

Paroxetin-<strong>Mepha</strong> ® 20 273 50 65 _______ OP 14 Filmtabletten<br />

Filmtabletten 273 50 71 _______ OP 28 Filmtabletten<br />

Pectoral <strong>Mepha</strong><br />

273 50 <strong>88</strong> _______ OP 98 Filmtabletten<br />

® N<br />

Sirup<br />

Pentoxi-<strong>Mepha</strong><br />

180 01 97 _______ OP 150 ml Sirup<br />

® 4<strong>00</strong><br />

Retardtabletten 135 73 71 _______ OP 1<strong>00</strong> Retardtabletten<br />

Perindopril-<strong>Mepha</strong> ® 4 435 95 31 _______ OP 30 Tabletten<br />

Tabletten 435 95 77 _______ OP 90 Tabletten<br />

Perindopril-<strong>Mepha</strong> ® 8 435 95 48 _______ OP 30 Tabletten<br />

Tabletten 435 96 08 _______ OP 90 Tabletten<br />

Pioglitazon-<strong>Mepha</strong> ® 15 533 60 06 _______ OP 28 Tabletten<br />

Tabletten 533 60 29 _______ OP 98 Tabletten<br />

Pioglitazon-<strong>Mepha</strong> ® 30 533 60 35 _______ OP 28 Tabletten<br />

Tabletten 533 60 58 _______ OP 98 Tabletten<br />

Pioglitazon-<strong>Mepha</strong> ® 45 533 60 64 _______ OP 28 Tabletten<br />

Tabletten 533 60 87 _______ OP 98 Tabletten<br />

Piroxicam-<strong>Mepha</strong> ® 20 136 87 42 _______ OP 10 Tabletten<br />

Tabletten 136 87 59 _______ OP 30 Tabletten<br />

136 87 65 _______ OP 1<strong>00</strong> Tabletten<br />

Pravalotin-<strong>Mepha</strong> ® 20 3<strong>88</strong> 92 09 _______ OP 30 Tabletten<br />

Tabletten 3<strong>88</strong> 92 15 _______ OP 1<strong>00</strong> Tabletten<br />

Pravalotin-<strong>Mepha</strong> ® 40 3<strong>88</strong> 92 21 _______ OP 30 Tabletten<br />

Tabletten<br />

Pramipexol-<strong>Mepha</strong><br />

3<strong>88</strong> 92 38 _______ OP 1<strong>00</strong> Tabletten<br />

® 0.125<br />

Tabletten 476 36 86 _______ OP 30 Tabletten<br />

Pramipexol-<strong>Mepha</strong> ® 0.25 476 37 <strong>00</strong> _______ OP 30 Tabletten<br />

Tabletten<br />

Pramipexol-<strong>Mepha</strong><br />

476 37 17 _______ OP 1<strong>00</strong> Tabletten<br />

® 0.5<br />

Tabletten<br />

Pramipexol-<strong>Mepha</strong><br />

476 37 46 _______ OP 1<strong>00</strong> Tabletten<br />

® 1<br />

Tabletten<br />

Quetiapin-<strong>Mepha</strong><br />

476 37 52 _______ OP 1<strong>00</strong> Tabletten<br />

® 25<br />

Filmtabletten 515 76 11 _______ OP 60 Filmtabletten<br />

Quetiapin-<strong>Mepha</strong> ® 1<strong>00</strong> 515 76 28 _______ OP 60 Filmtabletten<br />

Filmtabletten 515 76 34 _______ OP 1<strong>00</strong> Filmtabletten<br />

Quetiapin-<strong>Mepha</strong> ® 2<strong>00</strong> 515 76 40 _______ OP 60 Filmtabletten<br />

Filmtabletten 515 76 57 _______ OP 1<strong>00</strong> Filmtabletten<br />

Quetiapin-<strong>Mepha</strong> ® 3<strong>00</strong> 515 76 63 _______ OP 60 Filmtabletten<br />

Filmtabletten<br />

Rhagadil<br />

515 76 86 _______ OP 1<strong>00</strong> Filmtabletten<br />

®<br />

Spray 482 04 15 _______ OP 1 Spray 9ml<br />

Ranitidin-<strong>Mepha</strong> ® 150 359 11 19 _______ OP 20 Lactab ®<br />

Lactab ® 359 11 25 _______ OP 60 Lactab ®<br />

359 11 48 _______ OP 120 Lactab ®<br />

Stempel/Adresse<br />

02 /12 August<br />

Dornacherstr. 114<br />

Postfach <strong>44</strong>5<br />

4147 Aesch<br />

www.mepha.ch<br />

Neu<br />

6

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