Note:: Schedule 2, Part 3 of the MPMR provides a list of diversion-risk medicines. This form only relates to diversion-risk medicines that are NOT monitored medicines.
Information: Diversion-risk medicine/s should be listed using only the terms used in the Australian Standard of Uniform Scheduling of Medicines and Poisons (SUSMP/Poisons Standard). These terms do not include brand names of products, they only refer to active ingredients. If a substance is not listed in the SUSMP/Poisons Standard but is a derivative of one that is listed in the SUSMP, then select the substance that is listed.
MPMR-233, Version 1