2015 Drug Formulary

Transcription

2015 Drug Formulary
Commercial
Maximum Performance
Abridged Formulary
2015
LIST OF COVERED DRUGS
MDF15 Lists Updated 10/2015
GlobalHealth, Inc.
701 NE 10th St, Ste. 300
Oklahoma City, OK 73104-5403
2015 GLOBALHEALTH
MAXIMUM PERFORMANCE ABRIDGED FORMULARY
The following is a list of the most commonly prescribed drugs. It represents an abbreviated version of the drug list
(formulary) that is at the core of your Prescription Drug benefits. The list is not all-inclusive and does not guarantee
coverage. In addition to using this list, you are encouraged to ask your doctor to prescribe generic drugs whenever
appropriate. You can get information and updates to this document on our website.
Table of Contents
Helpful Numbers ................................................................................................................. 2
Types of Pharmacy Networks ............................................................................................. 3
GlobalHealth’s Preferred Drug List ..................................................................................... 3
Prior Authorization, Step Therapy, Quantity Limits, and Exceptions .................................. 4
Your Prescription Drug Benefits .......................................................................................... 6
Medication Therapy Management Program........................................................................ 7
Preventive Care .................................................................................................................. 7
Therapeutic Class Index ................................................................................................... 11
Alphabetical Listing Index ................................................................................................. 36
GlobalHealth, Inc. does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity,
sexual orientation, or health status in the administration of the Plan, including enrollment and benefit determinations.
2
Helpful Numbers and Information
Plan Issuer:
GlobalHealth, Inc.
PO Box 2328
Oklahoma City, OK 73101-2328
GlobalHealth Customer Care:
State of Oklahoma Employees:
CommercialAnswers@globalhealth.com
405.280.5600 (local)
1.877.280.5600 (toll-free)
1.800.722.0353 or 711 (TTY/TDD/Voice)
www.globalhealth.com/state
Federal Employees Health Benefits
Program:
CommercialAnswers@globalhealth.com
405.280.2989 (local)
1.877.280.2989 (toll-free)
1.800.722.0353 or 711 (TTY/TDD/Voice)
www.globalhealth.com/fehb
Commercial Employer Groups and
Individuals:
CommercialAnswers@globalhealth.com
405.280.2964 (local)
1.877.280.2964 (toll-free)
1.800.722.0353 or 711 (TTY/TDD/Voice)
www.globalhealth.com/commercial
Marketplace Individuals and SHOP
Employer Groups:
MarketplaceAnswers@globalhealth.com
405.280.5583 (local)
1.877.280.5583 (toll-free)
1.800.722.0353 or 711 (TTY/TDD/Voice)
www.globalhealth.com/marketplace
Language Assistance –
just ask for an interpreter
24/7 Nurse Help Line
Nurse Help Line
1.877.280.2993 (toll-free)
Disease Management
Alere
1.855.894.7487 (toll-free)
Behavioral & Mental
Health/Chemical Dependency:
MHNet
- 1.866.904.5234 (toll-free)
1.866.200.3269 (TTY/TDD/Voice)
Pharmacy Benefits Manager:
Mail Claims to:
Express Scripts
PO Box 66583
St. Louis, MO 63166
Medication Prior Authorizations:
918.878.7361
Express Scripts Marketplace Help Desk:
1.866.211.7824 (toll-free)
1.800.899.2114 (TTY/TDD/Voice)
Express Scripts Help Desk:
1.866.274.1612 (toll-free)
1.800.899.2114 (TTY/TDD/Voice)
Mail Claims to:
Mental Health & Substance Abuse
Claims
MHNet Claims Department
PO Box 7802
London, KY 40742
Marketplace Mail Order Pharmacy:
Express Scripts Customer Care Center
1.866.211.7824 (toll-free)
1.800.899.2114 (TTY/TDD/Voice)
24 hours/7 days a week
www.express-scripts.com/globalhealth
Dental:
Delta Dental of Oklahoma
405.607.4722
1.855.203.5617 (toll-free)
www.DeltaDentalOK.org
Mail Order Pharmacy:
Express Scripts Customer Care Center
1.866.274.1612 (toll-free)
1.800.899.2114 (TTY/TDD/Voice)
24 hours/7 days a week
www.express-scripts.com
Mail Claims to:
Delta Dental of Oklahoma
Claims Processing Center
PO Box 548809
Oklahoma City, OK 73154-8809
3
GlobalHealth Compliance and Privacy
Officer
1.877.280.5852 (toll-free)
405.280.5852
compliance@globalhealth.com
Types of Pharmacy Networks
You have different options to receive your prescribed medications.
Preferred Retail Network Pharmacy
Your Plan may offer preferred and non-preferred pharmacy Networks. When you purchase your prescriptions at a
preferred retail Network pharmacy, you will pay your Plan’s published cost-share for each tier. This is where you
will experience the greatest savings. You may still go to non-preferred retail Network pharmacies, but you will pay
a higher cost-share for each prescription. A list of both preferred and non-preferred retail Network pharmacies can
be found on our website.
Home Delivery Pharmacy Service
Express Scripts, Inc. (“ESI”) offers the convenience of home delivery. Maintenance medications are mailed to your
home in a 90-day supply when prescribed as a 90-day supply by a Network Provider. You may receive a discount
on your medications, depending on the drug tier. See your Schedule of Benefits. Allow 14 days for your
prescription to reach you.
For more information about this optional service, contact ESI.
Express Scripts Commercial Customer
Service:
Express Scripts Marketplace Customer
Service:
1-866-274-1612 (toll-free)
www.express-scripts.com
1-866-211-7824 (toll-free)
www.express-scripts.com/globalhealth
Representatives are available 24 hours a
day, 7 days a week.
Extended Supply Retail Pharmacy Network
You may receive up to a 90-day supply of a maintenance drug at an extended supply retail Network pharmacy for
the applicable home delivery Copayment or Coinsurance. Medications must be prescribed as a 90-day supply by a
Network Provider. An extended supply retail Network pharmacy can be found on our website.
Sovereign Medical Solutions Medications by Mail
Sovereign Medical Solutions is a Native American-owned retail pharmacy located in Oklahoma. It provides
prescription medications to Native Americans. Complete the Native American Prescription Benefit Program Patient
Enrollment form available on our website and submit to Sovereign Medical Solutions. Proof of Native American
status in one of the federally recognized tribes is required. Once Native American heritage is established with
Sovereign Medical Solutions, Members may receive Copayment discounts. Medications are mailed directly to the
Member’s home or designated location.
Specialty Pharmacy
A contracted specialty pharmacy fills your specialty medications and delivers them to your home. Specialty
medications sent to and administered by your doctor are covered under your office visit cost-sharing responsibility.
Specialty medications sent to and administered by you are assessed your prescription drug Copayment or
Coinsurance. A specialty Network pharmacy can be found on our website.
GlobalHealth’s Preferred Drug List
The GlobalHealth preferred drugs are listed in this Drug Formulary. Medications on the list are selected based on
quality (effectiveness and safety) as well as cost-effectiveness. Doctors and pharmacists have worked together to
develop the formulary, which includes generics and brand name medications that are approved by the FDA. The
list of drugs is subject to change. Please check your Schedule of Benefits for detailed information regarding your
drug coverage, benefit limitations, and exclusions. For specific questions about your coverage, please call the
phone number printed on your Member ID card.

Tier One Copayment: Generic medications contain the same active ingredients in the same amounts as
brand name products. However, they may be a different color, shape, or size. You will pay the lowest
Copayment for select low-cost, preferred generics. Most generics are non-preferred medications and have
the corresponding cost-share. Please refer to your Schedule of Benefits.



Tier Two Copayment: Preferred brand name medications on the Formulary have the next highest cost.
Tier Three Copayment: Non-formulary medications have the highest cost of these three tiers. This tier
contains both non-preferred name brand and specified high-cost generic drugs.
Tier Four Copayment (if your Plan has a fourth tier): Specialty medications are filled through a specialty
pharmacy. Specialty drugs are limited to no more than a one-month supply per fill. These medications
must be pre-approved by GlobalHealth. Refer to your Schedule of Benefits.
The applicable Copayments or Coinsurance must be met each time a Prescription Drug is filled or refilled. You will
pay your cost-share or the cost of the Prescription Drug, whichever is less.
Please contact Customer Care if you need assistance locating a pharmacy, understanding your benefits, or printed
copies of the formulary.
Prior Authorization, Step Therapy, Quantity Limits, and Exceptions
Your Plan may include prior authorization, step therapy, or quantity limit requirements. These programs are based
on current medical findings, FDA (U.S. Food and Drug Administration) approved manufacturer labeling information,
cost, and manufacturer rate agreements.
PLEASE NOTE: Not all the drugs listed are covered by all Prescription Drug benefit programs; check your
Schedule of Benefits for specific exclusions and the Copayments for your Prescription Drug benefit
program. For specific questions about your coverage, please call the phone number printed on your
Member ID card.
For the Member: Generic medications contain the same active ingredients in the same amounts as brand name
products. However, they may be a different color, shape, or size.
For the physician: Please prescribe preferred products and allow generic substitutions when medically
appropriate. Thank you.
Prior Authorization:
Step Therapy:
Quantity Limits:
Requesting an Exception:
Medication Utilization Management
Call 918-878-7361
Physicians are required to obtain prior authorization for certain medications,
including compound drugs. This promotes appropriate, cost-effective use. Any
corresponding supplies or equipment also require prior authorization.
GlobalHealth may not cover the drug, supply, or equipment without prior
authorization.
Step therapy requires one or more prerequisite, clinically equivalent drugs to be
tried before a step therapy drug will be covered.
There are limits to the amount of certain medications that you may receive. These
drugs, if taken inappropriately for too long a time period, could be unsafe and
cause adverse effects.
You can request GlobalHealth to waive coverage restrictions and limits.
Generally, GlobalHealth will only approve your request for an exception if:
 The alternative drug is included on the Plan’s Formulary.
 The drug in the lower tier or additional utilization restrictions would not be as
effective in treating your condition.
 It would cause you to have adverse medical effects.
You or your physician should contact GlobalHealth for instructions on obtaining a
utilization restriction exception. Your physician may have to submit a prior
authorization request form with supporting information. Generally, a decision is
made within 72 hours of your request.
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Requesting an Expedited
Exception:
You, your designee, or your prescribing physician may request an expedited
exceptions process when:
 You are suffering from a health condition that may seriously jeopardize
your life, health, or ability to regain maximum function, or
 You are undergoing a current course of treatment using a non-formulary
drug.
We will provide a decision to you, your designee, or the prescribing physician
within 24 hours after receiving the request.
Compound Drugs
Compounds will be considered for coverage for GlobalHealth members after a prior authorization review:
1. For a member that is not able to swallow medications and requires a liquid or suppository dosage form for
alternative route of administration.
2. For a member that is sensitive to dyes, fillers or preservatives in commercially available medications.
3. When the originator medication has been removed from the market for reasons other than safety concerns and
the medication is compounded into the same route of administration as the originator medication.
Some compounded medications are not covered by GlobalHealth.
All claims for compounded medications MUST have a prior authorization in accordance with the GlobalHealth
Pharmacy and Therapeutics Committee requirements. For pharmacist compounded medication to be considered
for coverage all of the following criteria must be met:
1. Ingredients are not identified as for sale over-the-counter (“OTC”) by the Food and Drug Administration (“FDA”);
and
2. Must be prescribed for an indication that is supported by FDA-approval or identified within scientific evidence in
recognized medical literature; and
3. Not for sale by a third party who resells to individual patients, or offers compounded drug products at wholesale
to other state licensed persons or commercial entities for resale; and
4. Contains at least one FDA-approved prescription ingredient; and
5. Prescription ingredient is FDA-approved for medical use in the United States; and
6. If the compound is not being prescribed for the prescription ingredient’s FDA-approved indication then the
supportive medical evidence must be found within the following:
a. Nationally recognized peer-reviewed scientific studies published in American medical journals that meet
recognized requirements for scientific studies which submit most of their articles for review by experts.
These experts will not be part of the publisher’s editorial staff; or
b. Listing of nationally recognized publishing literature such as Medline, Medicus, STARs, National Institute of
Health, Medical Journals recognized by HHS Clinical Pharmacology, AHFS-DI, Centers of Medicare and
Medicaid, National Cancer Institute, Healthcare Research and Quality, or NCCN guidelines.
The following compounded preparations are examples of preparations that the GlobalHealth Pharmacy and
Therapeutics Committee considers to be experimental and/or investigational, because there is inadequate evidence
in the peer-reviewed published medical literature of their effectiveness: This list is not all inclusive and other
compounded medications may also be considered not covered after prior authorization review.
 Nebulized anti-infectives, nasal administration for the treatment of Sinusitis
 Implantable estradiol pellets
 Bioidentical hormones
 Topical verapamil
 Topical ketamine
 Topical flubiprofen
 Topical ketoprofen
 Topical lidocaine
 Topical testosterone
 Topical estrogen
Off-label Uses
Off-label uses of medication used in the treatment of cancer or the study of oncology are covered. Certain
investigational uses of chemotherapy for cancer treatment may be covered if administered as part of an Approved
Clinical Trial.
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GlobalHealth does not cover any other non-FDA approved off-label utilization of medications or medical devices.
This exclusion includes non-FDA approved:
 Indication;
 Dosage;
 Length of therapy;
 Safety and efficacy standards within clinical studies; and
 Warnings, precautions, and potential serious drug interactions.
Your Prescription Drug Benefits
Your Prescription Drug benefit covers outpatient, self-administered medications that require a prescription.
“Prescription” refers to an order written by any licensed physician, or others licensed to prescribe for a medicinal
substance which, under the Federal Food, Drug, and Cosmetic Act (FD&C Act), is required to bear on the
packaging label the following legend: “Caution: Federal law prohibits dispensing without a prescription” or “Rx
Only”.
The Affordable Care Act requires some over-the-counter medications be covered. Please see “Affordable Care
Act”.
How to use your prescription drug benefits:
1. Fill your prescription at any GlobalHealth participating pharmacy. A list of Network pharmacies can be found in
the GlobalHealth Physician & Health Providers Directory and on the website. You may also call Customer Care
for help in locating a pharmacy.
2. Present your GlobalHealth Member ID card to the pharmacist.
3. Pay the applicable Copayment.
Affordable Care Act – No Cost-Share OTC Drugs
Some FDA-approved over-the-counter (“OTC”) medicines and products are covered at no cost-share.
Iron supplements:
For children from birth through 12 months
Oral fluoride
For children from birth through 5 years
supplements:
Folic acid supplements:
For women capable of pregnancy up to age 50
Aspirin:
For men age 45 through 79 and women age 55 through 79
*Tobacco cessation
For adults age 18 and older
products:
Vitamin D supplement:
For adults age 65 and older
*Not all products that may be used for tobacco cessation are included.
Doctors may prescribe risk-reducing medications, such as tamoxifen or raloxifene, for women who are at increased
risk for breast cancer and at low risk for medication side effects. These medications are available at no cost-share,
subject to reasonable medical management.
To receive benefits, you must use an in-network retail pharmacy and present a written prescription from your
physician to the pharmacist. Benefits are limited to recommended prescribed limits.
Contraception Drugs and Devices for Women
Selected FDA-approved contraception prescriptions are provided with no cost-sharing for women. These
contraception drugs and devices are not subject to the Deductible. All others are subject to prescription
Copayment or Coinsurance and possible prior authorization. Over-the-counter contraceptives are not covered
unless they are FDA-approved and prescribed by a Network physician.
Prescriptions Received in an Emergency Room or Urgent Care Facility
Medications prescribed by ER physicians may be filled at either a preferred Network or a non-preferred Network
pharmacy. You will pay your pharmacy cost-share. Utilization management rules may apply.
Pharmacy Coordination of Benefits
Coordination of benefits for pharmacy benefits is handled the same as for medical benefits. See, “When You Are
Covered by More Than One Plan”, in your Member Handbook.
6
Medication Therapy Management Program
If you are taking multiple medications for Chronic Conditions, you can receive support from our Medication Therapy
Management program. Enrollment in this program is automatic. You receive personalized service from registered
pharmacists and staff. The goal of this program is to help eliminate duplicate drug therapies, reduce potential for
negative drug interactions and side effects, and optimize Member benefits by advising of the lowest cost
alternatives.
GLOBALHEALTH 2015 DRUG FORMULARY INDEX
THIS DOCUMENT LIST IS EFFECTIVE JANUARY 1, 2015 THROUGH DECEMBER 31, 2015. THIS LIST IS
SUBJECT TO CHANGE. You can get information and updates to this document on our website.
Preventive Care
Based on the recommendations of the U.S. Preventive Services Task Force (USPSTF) in conjunction with the
recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control
and Prevention and the Health Resources and Services Administration.
Aspirin products (Generic OTC only)
ASPIRIN 81 MG
ASPIRIN 325 MG
Fluoride products (Generic OTC & Rx, including combination products)
EPIFLUR 0.25 MG TABLET CHEW
EPIFLUR 0.5 MG TABLET CHEWABLE
ETHEDENT 0.25 MG TAB CHEW
ETHEDENT 0.5 MG TAB CHEW
FLUORABON 0.25 MG/0.6 ML DROPS
FLUOR-A-DAY 2.5 MG/ML DROPS
FLUORIDE 0.25 MG TABLET CHEW
FLUORIDE 0.5 MG TABLET CHEW
FLUORITAB 0.25 MG TABLET CHEW
FLUORITAB 0.5 MG TABLET CHEW
FLURA-DROPS 0.125 MG/DROP
FLURA-DROPS 0.25 MG/DROP
LUDENT FLUORIDE 0.25 MG TB CHEW
LUDENT FLUORIDE 0.5 MG TB CHEW
LURIDE 0.5 MG/ML DROPS
LURIDE LOZI-TABS 0.25 MG CHEW
LURIDE LOZI-TABS 0.5 MG CHEW
MULTI-VITAMIN 0.25 MG/ML DROP
MULTIVIT-FL-IRON 0.5 MG DROP
MULTIVIT-FLUOR 0.25 MG TAB CHEW
MYKIDZ IRON FL SUSPENSION
NAFRINSE PED 0.25 MG/DROP
PHARMAFLUR 0.5MG(1.1MG) TAB
PHLUORIVIT + FE 0.25 MG DROPS
PHLUORIVIT 0.25 MG DROPS
PHLUORIVIT 0.5 MG DROPS
POLYVITAMIN-FLUOR 0.25 MG/ML
POLYVITAMIN-FLUOR 0.5 MG/ML
POLYVIT-FLUORIDE 0.25 MG DROP
POLYVIT-FLUORIDE 0.5 MG DROP
RENAF FLUORIDE 0.25 MG TB CHEW
RENAF FLUORIDE 0.5 MG TAB CHEW
SODIUM FLUORIDE 0.125 MG/DROP
SODIUM FLUORIDE 0.25 (0.55) MG
SODIUM FLUORIDE 0.5 MG(1.1 MG)
SODIUM FLUORIDE 0.5 MG/ML DROP
SODIUM FLUORIDE 0.5% DROPS
TRIPHLUORIVIT 0.25 MG DROPS
TRI-VIT-FLUOR 0.25 MG/ML DROP
TRI-VIT-FLUOR 0.5 MG/ML DROP
VIT A,D,C & FLUOR 0.25 MG/ML
Iron Supplements (Generic OTC & Rx, including combination products)
ED-IN-SOL 75 MG/0.6 ML DROPS
FER-GEN-SOL 15 MG/0.6 ML DROP
FER-IN-SOL 15 MG/ML DROPS
FER-IRON 15 MG/1 ML DROPS
FERRETTS IPS LIQUID
FERROUS SULF 15 MG IRON/ML DROP
FERROUS SULF 220 MG/5 ML ELIX
FERROUS SULF 300 MG/5 ML LIQ
FERROUS SULF 75 (15) MG/0.6 ML
FERROUS SULFATE DRIED POWDER
FERROUS SULFATE GRANULES
ICAR 15 MG/1.25 ML SUSPENSION
MULTI-DELYN WITH IRON LIQUID
MULTIVITAMIN WITH IRON DROP
MULTIVIT-FL-IRON 0.5 MG DROP
MULTIVIT-IRON-FL 0.25 MG/ML
MYKIDZ IRON SUSPENSION
NIFEREX 100 MG/5 ML ELIXIR
PHLUORIVIT + FE 0.25 MG DROPS
POLY VITAMIN W/IRON DROPS
POLY-VI-SOL-IRON DROPS
SIDEROL 75 MG/0.6 ML DROPS
TRI-VI-SOL-IRON DROPS
TRI-VIT-FLUOR-IRON 0.25 MG/ML
VIMAR W/IRON LIQUID
WEE CARE 15 MG/1.25 ML SUSP
Folic Acid Products (Generic OTC & Rx, including combination products)
B-COMPLEX TABLET
B-PLEX TABLET
CEFOL FILMTAB
CITRANATAL ASSURE COMBO PACK
CITRANATAL DHA PACK
CLASSIC PRENATAL TABLET
CORENATE-DHA COMBO PACK
DAILY PRENATAL COMBO PACK
DAILYVITE 800 TABLET
DAILYVITE 800 WITH IRON TAB
7
Folic Acid Products (Generic OTC & Rx, including combination products)
DAILYVITE 800 WITH ZINC
EXTRESS SUPER TABLET
EXTRESS TABLET
FOLIC ACID 0.4 MG TABLET
FOLIC ACID 0.8 MG TABLET
FOLTABS PRENATAL PLUS DHA
FORMULA-B TABLET
FULL SPECTRUM B WITH VIT C TAB
MAXINATE TABLET
MISSION PRENATAL FA TABLET
MISSION PRENATAL HP TABLET
MISSION PRENATAL TABLET
NATALCARE RX TABLET
NATELLE PLUS COMBO PACK
NEEVO CAPLET
NEEVO DHA CAPSULE
NEPHRO-VITE TABLET
NERVO B-12 TABLET SL
ONE-A-DAY PRENATAL DHA PACK
OPTINATE COMBO PACK
P-D NATAL PLUS TABLET
P-D NATAL PLUS-FOLIC ACID TAB
PERRY PRENATAL CAPSULE
PNV-DHA PLUS SOFTGEL
PNV-DHA SOFTGEL
PNV-IRON TABLET
PNV-SELECT TABLET
POTEN B-150 TABLET SA
PRENATAL COMPLETE CAPLET
PRENATAL PLUS DHA TABLET
PRENATAL RX TABLET
PRENATAL S TABLET
PRENATAL TABLET
PRENATAL WITH IRON TABLET
PRENATE ELITE TABLET
PREQUE 10 TABLET
RENAL MULTIVITAMIN TABLET
RENA-VITE TABLET
RIGHT STEP PRENATAL VIT TAB
ROVIN-NV DHA CAPSULE
ROVIN-NV TABLET
STRESS FORMULA VITAMINS TAB
STROVITE TABLET
STUART PRENATAL TABLET
SUPER B-100 TABLET SA
SUPER B-50 COMPLEX PLUS TAB
SUPER B-50 COMPLEX TABLET
SUPER B-COMP-LIVER-IRON TAB
SUPER QUINTS B-50 TABLETS
SUPERVITE LIQUID
TARON A PRENATAL DHA COMB PACK
THEROBEC TABLET
TRIVEEN-TEN TABLETS
VITAPHIL + DHA PACK
VITAPLEX TABLET
V-R BALANCED B-50 TABLET
V-R NATURAL B-100 TABLET
YL FOLIC ACID 0.4 MG TABLET
ZATEAN-PN DHA CAPSULE
ZATEAN-PN TABLET
Immunizations
ADACEL
AFLURIA
AGRIFLU
ATTENUVAX VACCINE WITH DILUENT
BOOSTRIX
CERVARIX
COMVAX
DAPTACEL
DECAVAC
DIPHTHERIA-TETANUS TOXOIDS-PED
DIPHTHERIA-TETANUS TOXOID
ENGERIX-B
FLUARIX
FLUCELVAX
FLULAVAL
FLUMIST
FLUVIRIN
FLUZONE
GARDASIL
HAVRIX
INFANRIX
INFLUENZA A (H1N1) 2009
IPOL
KINRIX
MENACTRA
MENOMUNE-A-C-Y-W-135
MENVEO A-C-Y-W-135-DIP
MERUVAX II VACCINE W-DILUENT
M-M-R II VACCINE
MUMPSVAX VACCINE W-DILUENT
PEDIARIX
PEDVAXHIB
PENTACE
PENTACEL
PHYSICIAN EZ USE FLU 2012-2013
PNEUMOVAX 23
PREVNAR 13
PREVNAR
PROQUAD
RECOMBIVAX HB
ROTARIX
ROTATEQ
TE ANATOXAL BERNA
TENIVAC
TETANUS DIPHTHERIA TOXOIDS
TETANUS TOXOID (FLUID)
TETANUS TOXOID ADSORBED
TETANUS-DIPHTERIA-DECAVAC
TRIHIBIT
TRIPEDIA
TWINRIX
VAQTA
VARIVAX VACCINE
ZOSTAVAX
Travel Vaccines
BIOTHRAX
IMOVAX RABIES VACCINE
IXIARO
JE-VAX
RABAVERT
TYPHIM VI
VIVOTIF BERNA
YF-VAX
Barrier Contraceptive Methods
FEMCAP*
ORTHO-DIAPHRAGM*
WIDE SEAL DIAPHRAGM*
Implant Contraceptive Methods
IMPLANON*
MIRENA*
NEXPLANON*
PARAGARD T 380-A*
SKYLA*
Emergency Contraceptive Methods
ELLA
LEVONORGESTREL
MY WAY
NEXT CHOICE
NEXT CHOICE ONE DOSE
PLAN B**
PLAN B ONE-STEP**
Over-the-Counter Contraceptive Methods
ENCARE**
FC CONDOM, FEMALE*
TODAY CONTRACEPTIVE SPONGE*
VCF*
Hormonal Contraceptive Methods
ALTAVERA
ALYACEN
AMETHIA
AMETHIA LO
AMETHYST
APRI
ARANELLE
AVIANE
AZURETTE
BALZIVA
BEYAZ*
BREVICON**
BRIELLYN
CAMILA
CAMRESE
CAMRESE LO
CAZIANT
CESIA
CHATEAL
CRYSELLE
CYCLAFEM
CYCLESSA**
DASETTA
DAYSEE
DEMULEN**
DEPO-PROVERA**
DEPO-SUBQ PROVERA*
DESOGEN**
DROSPIRENONE-ETHINYL ESTRADIOL
ELINEST
EMOQUETTE
ENPRESSE
ERRIN
ESTARYLLA
ESTROSTEP FE**
FALMINA
FEMCON FE**
GENERESS FE*
GIANVI
GILDAGIA
GILDESS
GILDESS FE
HEATHER
INTROVALE
JOLESSA
JOLIVETTE
JUNEL
JUNEL FE
KARIVA
KELNOR
KURVELO
LEENA
LESSINA
LEVONEST
LEVONORGESTREL-ETH ESTRADIOL
LEVONORG-ETH ESTRAD ETH ESTRAD
LEVORA-28
LO LOESTRIN FE*
LO/OVRAL**
LOESTRIN**
LOESTRIN FE**
LOESTRIN 24 FE*
LORYNA
LOSEASONIQUE**
LOW-OGESTREL
LUTERA
LYBREL**
MARLISSA
MEDROXYPROGESTERONE ACETATE
MICROGESTIN
MICROGESTIN FE
MIRCETTE**
MODICON**
MONO-LINYAH
MONONESSA
MYZILRA
NATAZIA*
NECON
NORETHINDRONE-ETHINYL ESTRADIOL
NORGESTIMATE-ETHINYL ESTRADIOL
NORGESTREL-ETHINYL ESTRADIOL
NORINYL**
NOR-Q-D**
NORTREL
NUVARING*
OCELLA
OGESTREL
ORSYTHIA
ORTHO EVRA*
ORTHO MICRONOR**
ORTHO-NOVUM**
ORTHO-CEPT**
ORTHO-CYCLEN**
ORTHO TRI-CYCLEN**
ORTHO TRI-CYCLEN LO*
OVCON**
OVCON-50
OVRAL**
PHILITH
PORTIA PREVIFEM
QUASENSE
RECLIPSEN
SAFYRAL*
SEASONALE**
SOLIA
SPRINTEC
PREVIFEM
QUASENSE
RECLIPSEN
SAFYRAL*
9
Hormonal Contraceptive Methods cont.
SEASONALE**
SOLIA
SPRINTEC
SRONYX
SYEDA
TILIA FE
TRI-ESTARYLLA
TRI-LEGEST FE
TRI-LINYAH
TRINESSA
TRI-NORINYL**
TRI-PREVIFEM
TRIVORA-28
TRI-SPRINTEC
VELIVET
VESTURA
VIORELE
WERA
WYMZYA FE
YASMIN**
YAZ**
ZARAH
ZENCHENT
ZENCHENT FE
ZEOSA
ZOVIA
Smoking Cessation Products (Generic Rx & OTC plus Chantix)
BUDEPRION SR
BUPROBAN
BUPROPION HCL ER
BUPROPION HCL SR
CHANTIX
NICODERM CQ
NICORELIEF
NICOTINE GUM
NICOTINE LOZENGE
NICOTINE PATCH
THRIVE NICOTINE
Vitamin D Supplements (Generic Rx & OTC, including combination products)
BIO-D-MULSION
CALCARB 600 WITH VITAMIN D
CALCITRATE + VIT D
CALCIUM + D
CALCIUM 600+D PLUS MINERALS
CALCIUM CARBONATE/VITAMIN D3
CALCIUM CITRATE - VITAMIN D
CALTRATE 600 + D
CALTRATE 600+D PLUS
CALTRATE-600 PLUS
CALVITE P&D
CHILDREN'S VITAMIN D
CITRACAL + D
CITRACAL + D MAXIMUM
CITRUS CALCIUM-VITAMIN D
DELTA D3
DICAL-D
D-VI-SOL
D-VITA
HI-CAL
JUST D
OS-CAL 500+D
OS-CAL ULTRA
OYSCO D
OYST-CAL-D
OYSTER SHELL CALCIUM W/VIT D
POSTURE-D
RISACAL-D
SUPER CALCIUM-VITAMIN D
VITAMIN D
Bowel Preps
ALOPHEN PILLS
BISACODYL
BISA-LAX
CITRATE OF MAGNESIA
CITROMA
CLEARLAX
COLYTE
CORRECTIVE LAXATIVE
DUCODYL
DULCOLAX
EX-LAX
FEMATROL LAXATIVE
FEMININE LAXATIVE
GAVILAX
GAVILYTE-C
GAVILYTE-G
GAVILYTE-N
GENTLE LAXATIVE
GENTLELAX
GLYCOLAX
GOLYTELY
HALFLYTELY-BISACODYL
HEALTHYLAX
LAXA CLEAR
LO-SO PREP KIT
MAGNESIUM CITRATE
MILK OF MAGNESIA
MIRALAX
MOVIPREP
NULYTELY
OCL
ORAL SALINE LAXATIVE
OSMOPREP
PEG 3350-ELECTROLYTE
PEG 3350-GRX
PEG-3350 WITH FLAVOR PACKS
PHOSPHATE LAXATIVE
POLYETHYLENE GLYCOL
PREP KIT #1
PREP KIT #3
PREPARATION CLEANSING
PREPOPIK
PURELAX
SMOOTHLAX
SUCLEAR
SUPREP
TRIDRATE
TRILYTE WITH FLAVOR PACKETS
VISICO
*Indicates single source brand. **Indicates multi-source brand product.
Therapeutic Class Index
Tier 1
Therapeutic Class
1prior
Low-Cost Generic
Drugs
Generic Drugs
Tier 2
Tier 3
Preferred Brand
Name Drugs
Non-Formulary Drugs
authorization, 2step therapy, 3quantity limit, Ffertility, SPspecialty (see your plan for F and SP cost-sharing)
ANESTHETICS
ANESTHETICS - Topical
lidocaine hcl
lidocaine-prilocaine
LIDOCAINE HCL
patch1
LIDODERM1
ANTI-INFECTIVES
ANTI-INFECTIVES - Cephalosporins
cefaclor/er
CEDAX
cefadroxil
CEFTIN
cefdinir
SUPRAX
cefpodoxime proxetil
cefprozil
ceftibutin
cefuroxime
cephalexin
ANTI-INFECTIVES - Clindamycins
clindamycin hcl
clindamycin phosphate
ANTI-INFECTIVES - Erythromycins
erythromycin
ERY-TAB
ANTI-INFECTIVES - Other Macrolides
azithromycin
clarithromycin/er
ANTI-INFECTIVES - Penicillins
amoxicillin
125mg/5mL,
400mg/5mL syrup
amoxicillin 250mg
capsules
amoxicillin 875mg
tablets
dicloxacillin 500mg
capsule
penicillin v
potassium 250,
500mg tab
penicillin v
potassium
250mg/5mL susp
ANTI-INFECTIVES - Sulfonamides
sulfamethoxazoletrimethoprim DS
amoxicillin
dicloxacillin
penicillin v potassium
sulfamethoxazoletrimethoprim
AMOXICILLINPOTASSIUM
CLAVULANATE ER
ANTI-INFECTIVES - Tetracyclines
tetracycline hcl
250, 500mg cap
doxycycline hyclate
ACTICLATE2
doxycycline
monohydrate
DORYX2
minocycline hcl
tetracycline hcl
DOXYCYCLINE
HYCLATE DR2
MINOCYCLINE HCL
ER2
ORACEA2
SOLODYN2
ANTI-INFECTIVES - Urinary
nitrofurantoin
trimethoprim
ANTI-INFECTIVES - Quinolones
ciprofloxacin hcl
500mg tab
ciprofloxacin hcl/er
AVELOX/ABC PACK
levofloxacin
FACTIVE
ofloxacin
LEVAQUIN
NOROXIN
ANTI-INFECTIVES - Topical Antibacterial
gentamicin sulfate
ALTABAX
mupirocin
BACTROBAN
silver sulfadiazine
ANTI-INFECTIVES - Oral Antifungal
fluconazole 150mg
tab3
fluconazole
DIFLUCAN2
griseofulvin
GRIFULVIN V
itraconazole
LAMISIL2
ketoconazole
ONMEL
nystatin
ORAVIG
terbinafine hcl
voriconazole
ANTI-INFECTIVES - Vaginal Antifungal
clotrimazole
terconazole
ANTI-INFECTIVES - Other Topical Antifungal
ciclopirox
ERTACZO
clotrimazole
EXELDERM
econazole nitrate
NAFTIN
ketoconazole
OXISTAT
nystatin
ANTI-INFECTIVES - Topical Antifungal-Corticosteroid Combinations
clotrimazolebetamethasone
nystatin-triamcinolone
12
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
abacavir
ATRIPLA
COMBIVIR
lamivudine
EPIVIR SOLUTION
COMPLERA
lamivudine-zidovudine
EPZICOM
COMBIVIR
nevirapine
INTELENCE
COMPLERA
zidovudine
ISENTRESS
EPIVIR TABLET
KALETRA
VICTRELIS1,SP
LEXIVA
VIRAMUNE
NORVIR
ZIAGEN TABLET
PREZISTA
REYATAZ
STRIBILD
SUSTIVA
TRUVADA
VIRAMUNE XR
VIREAD
ZIAGEN SOLUTION
ANTI-INFECTIVES - Other Antiviral Drugs
acyclovir oral
BARACLUDE1
HBVSP
DENAVIR
amantadine
EPIVIR
ribapakSP
FAMCICLOVIR
RELENZA
RIBASPHERE1,SP
ribavirinSP
TAMIFLU
SOVALDI1,SP
VALCYTE1
VALACYCLOVIR HCL
VALTREX
ANTI-INFECTIVES - Topical Antiviral Drugs
ACYCLOVIR TOPICAL
XERESE
ZOVIRAX1
ANTI-INFECTIVES - Antituberculosis Drugs
isoniazid
rifampin
ANTI-INFECTIVES - Plasmodicides
atovaquone-proguanil
hcl
hydroxychloroquine
sulfate
MALARONE
QUALAQUIN
mefloquine hcl
quinine sulfate
ANTI-INFECTIVES - Sulfones
DAPSONE
ANTI-INFECTIVES - Trichomonocides
metronidazole
tinidazole
13
ANTI-INFECTIVES - Other Anti-Infective Drugs
atovaquone
CAYSTON1,3,SP
DIFICID
vancomycin hcl
XIFAXAN1
MEPRON1
ZYVOX1
VANCOCIN HCL
ANTI-INFECTIVES - Aminoglycosides
gentamicin sulfate
BETHKIS1,SP
tobramycin sulfate
inhalation1,SP
TOBI1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
anagrelide hcl
AFINITOR1,SP
ARIMIDEX
anastrozole
ELIGARD1,SP
CELLCEPT1,SP
azathioprineSP
ENBREL1,3,SP
CIMZIA1,3,SP
bicalutamide
HUMIRA1,3,SP
EXEMESTANE1
capecitabine1,SP
IMBRUVICA1,SP
FEMARA
cyclosporine modified
ORENCIA
125mg/mL1,SP
MEGACE ES1
gengraf
RAPAMUNE1,SP
MYFORTIC1,SP
hydroxyurea
REVLIMID1,SP
NEORAL1,SP
SANDOSTATIN
LAR1,SP
STIVARGA1,SP
OTEZLA1,3,SP
leucovorin calcium
tablets
TABLOID1,SP
SANDIMMUNE1,SP
megestrol acetate
TARCEVA1,SP
mercaptopurine
TASIGNA1,SP
SIMPONI1,3,SP
SOMATULINE
DEPOT1,SP
methotrexate
TYKERB1,SP
TEMODAR1,SP
methotrexate sodiumSP
VOTRIENT1,SP
TEMOZOLOMIDE1,SP
mycophenolate
mofetil1,SP
mycophenolic acid
dr1,SP
XTANDI1,SP
XELJANZ1,3,SP
leflunomide
letrozole
PROGRAF1,SP
XELODA1,SP
octreotide acetate1,SP
tacrolimus1,SP
tamoxifen citrate
tretinoin
CARDIOVASCULAR MEDICATIONS
CARDIOVASCULAR MEDICATIONS - Cardiac Glycosides
digoxin
LANOXIN
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
amlodipine besylate
CARDENE SR2
cartia xt
CARDIZEM LA
diltiazem/er
NISOLDIPINE ER
felodipine er
SULAR2
nifediac cc
nifedical xl
nifedipine er
nisoldipine ir
verapamil/er/pm
14
CARDIOVASCULAR MEDICATIONS - Loop Diuretics
bumetanide
furosemide
torsemide
CARDIOVASCULAR MEDICATIONS - Thiazide and Related Drugs
hydrochlorothiazid
e 25mg tab
chlorthalidone
hydrochlorothiazide
indapamide
metolazone
CARDIOVASCULAR MEDICATIONS - Potassium-Sparing Diuretics
amiloride hcl
eplerenone
spironolactone
spironolactone-hctz
triamterene-hctz
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
atenolol 25mg tab
acebutolol hcl
BYSTOLIC2
metoprolol tartrate
50mg tab
atenolol
COREG CR
bisoprolol fumarate
TOPROL XL
carvedilol
labetalol hcl
metoprolol succinate
metoprolol tartrate
nadolol
pindolol
propranolol hcl
timolol maleate
CARDIOVASCULAR MEDICATIONS - Vasodilator Antihypertensives
terazosin hcl
doxazosin mesylate
CARDURA XL
minoxidil
prazosin hcl
CARDIOVASCULAR MEDICATIONS - Centrally-Acting Antihypertensives
clonidine hcl tab
clonidine hcl er
guanfacine hcl
methyldopa
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
lisinopril 10 &
20mg tab
benazepril hcl
captopril
enalapril maleate
fosinopril sodium
lisinopril
moexipril hcl
quinapril hcl
15
CLONIDINE PATCH
ramipril
trandolapril
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
losartan potassium
candesartan cilexetil
ATACAND2
eprosartan mesylate
AVAPRO2
irbesartan
BENICAR2
valsartan
COZAAR2
DIOVAN2
EDARBI2
MICARDIS2
TELMISARTAN
TEVETEN2
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
bisoprolol-hctz
amlodipine besylatebenazepril
AMTURNIDE2
lisinopril-hctz 2025mg tab
atenolol-chlorthalidone
ATACAND HCT2
benazepril-hctz
AVALIDE2
candesartan-hctz
AZOR2
captopril-hctz
BENICAR HCT2
enalapril-hctz
DIOVAN HCT2
fosinopril-hctz
EDARBYCLOR2
irbesartan-hctz
HYZAAR2
lisinopril-hctz
EXFORGE/HCT2
losartan-hctz
LOTREL2
metoprolol-hctz
MICARDIS HCT2
moexipril-hctz
TARKA2
quinapril-hctz
TEKAMLO2
valsartan-hctz
TEKTURNA/HCT2
TEVETEN HCT2
TRIBENZOR2
TWYNSTA2
CARDIOVASCULAR MEDICATIONS - Nitrates
isosorbide/dinitrate
NITROSTAT
nitroglycerin/patch
CARDIOVASCULAR MEDICATIONS - Other Vasodilating Drugs
sildenafil citrate
(pulmonary
hypertension)1,SP
ADCIRCA1,SP
BIDIL
REVATIO1,SP
CARDIOVASCULAR MEDICATIONS - Endothelin Receptor Antagonists
LETAIRIS1,SP
TRACLEER1,SP
16
CARDIOVASCULAR MEDICATIONS - Class 1A
quinidine gluconate cr
quinidine sulfate
CARDIOVASCULAR MEDICATIONS - Class 1C
flecainide acetate
RYTHMOL SR
propafenone hcl
CARDIOVASCULAR MEDICATIONS - Amiodarones
amiodarone hcl
CARDIOVASCULAR MEDICATIONS - Other Antiarrhythmics
sotalol
TIKOSYN
MULTAQ
cholestyramine
VASCEPA1
ANTARA2
colestipol hcl
ZETIA
FENOGLIDE2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
fenofibrate
LIPOFEN2
fenofibric acid
LOVAZA1
gemfibrozil
NIACIN ER
omega-3 acid ethyl
esters1
NIASPAN
TRICOR2
TRIGLIDE2
TRILIPIX2
WELCHOL2
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
pravastatin sodium
10, 20, 40mg
simvastatin 5, 10,
20, 40mg
atorvastatin calcium
ALTOPREV2
fluvastatin sodium
CRESTOR2
lovastatin
LESCOL/XL2
pravastatin sodium
LIPITOR2
simvastatin
LIVALO2
CARDIOVASCULAR MEDICATIONS - HMG-COA Combinations
ADVICOR2
AMLODIPINEATORVASTATIN
CADUET2
LIPTRUZET2
SIMCOR2
VYTORIN2
CARDIOVASCULAR MEDICATIONS - Other Cardiovascular Drugs
midodrine hcl
RANEXA1
pentoxifylline
AUTONOMIC & CNS MEDICATIONS
AUTONOMIC & CNS MEDICATIONS - Analgesics
butorphanol tartrate
tramadol hclacetaminophen
tramadol hcl ir
17
TRAMADOL HCL ER
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
endocet
hydrocodoneacetaminophen
hydrocodone
bitartrate-ibuprofen
ABSTRAL1,3
hydromorphone hcl
EXALGO2,3
hydromorphone hcl er3
FENTANYL3
methadone hcl
FENTORA1,3
morphine sulfate
KADIAN2,3
morphine sulfate er3
LAZANDA1,3
oxycodone hcl
oxycodoneacetaminophen
NUCYNTA
reprexain
ONSOLIS1,3,SP
roxicet tabs
OPANA
zamicet
OXYCONTIN2,3
AVINZA2,3
DILAUDID2
NUCYNTA ER2,3
OXYMORPHONE HCL
OXYMORPHONE HCL
ER3
OPANA ER2,3
ROXICET solution
SUBSYS1,3
ZOHYDRO ER2,3
AUTONOMIC & CNS MEDICATIONS - Class III Narcotics
acetaminophencodeine
BUPRENORPHINE
HCL
BUPRENORPHINENALOXONE1
BUTRANS1
SUBOXONE1
ZUBSOLV1
AUTONOMIC & CNS MEDICATIONS - Class IV Narcotics
pentazocine-naloxone
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
butalbital-aspirincaffeine
butalbital compoundcodeine
naratriptan hcl3
AXERT2,3
nodolor
MAXALT/MLT2,3
sumatriptan3
MIGRANAL3
zolmitriptan
RELPAX2,3
FROVA2,3
IMITREX2,3
RIZATRIPTAN3
SUMATRIPTAN
nasal/injectable3
SUMAVEL
DOSEPRO2,3
TREXIMET2,3
ZOLMITRIPTAN ODT3
ZOMIG/ZMT2,3
18
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
VALIUM2
alprazolam/er/xr
buspirone hcl
chlordiazepoxide hcl
clorazepate
dipotassium
diazepam
lorazepam
oxazepam
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
estazolam
ROZEREM3
AMBIEN/CR3
eszopiclone3
EDLUAR3
flurazepam hcl
INTERMEZZO3
temazepam
LUNESTA3
triazolam
SILENOR3
zaleplon3
ZOLPIMIST3
zolpidem tartrate/er3
AUTONOMIC & CNS MEDICATIONS - Antimania Drugs
lithium carbonate
AUTONOMIC & CNS MEDICATIONS - Carbamazepines
carbamazepine ir
CARBAMAZEPINE XR
CARBATROL
OXCARBAZEPINE
OXTELLAR XR1
TEGRETOL XR
AUTONOMIC & CNS MEDICATIONS - Anticonvulsant Benzodiazepines
clonazepam
ONFI
diazepam rectal gel
AUTONOMIC & CNS MEDICATIONS - Hydantoins
phenytoin sodium
extended
DILANTIN
PHENYTEK
AUTONOMIC & CNS MEDICATIONS - Valproic Acid and Derivatives
divalproex sodium dr
DEPAKOTE ER1
valproic acid
DIVALPROEX
SODIUM ER
AUTONOMIC & CNS MEDICATIONS - Anticonvulsant Barbiturates
phenobarbital
primidone
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
topiramate 15mg
sprinkle
zonisamide 50mg
cap
felbamate
LYRICA2
GRALISE2
gabapentin
POTIGA
HORIZANT2
lamotrigine ir
VIMPAT1
KEPPRA/XR2
levetiracetam
LAMICTAL/ODT
tiagabine hcl
LAMICTAL XR2
19
topiramate
LAMOTRIGINE ER
zonisamide
SABRIL1,SP
TOPAMAX2
ZONEGRAN1
AUTONOMIC & CNS MEDICATIONS - Tertiary Amines
amitriptyline hcl
doxepin hcl
doxepin hcl 10, 25,
50, 100mg cap
CLOMIPRAMINE HCL
imipramine pamoate
imipramine hcl
AUTONOMIC & CNS MEDICATIONS - Secondary Amines
desipramine hcl
nortriptyline hcl
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
citalopram
hydrobromide3
fluoxetine 10,
20mg cap; 10mg
tab3
paroxetine hcl 10,
20mg tab3
sertraline hcl
tablet3
escitalopram oxalate3
LEXAPRO2,3
fluoxetine hcl3
LUVOX CR2,3
fluvoxamine maleate3
VIIBRYD2,3
fluvoxamine maleate
er2,3
paroxetine hcl3
sertraline hcl
concentrate3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
trazodone hcl 50,
100, 150mg tab
venlafaxine hcl
25mg tab3
bupropion hcl/sr/xl3
CYMBALTA2,3
mirtazapine
DULOXETINE HCL2,3
trazodone hcl
EFFEXOR XR2,3
venlafaxine hcl3
PRISTIQ2,3
venlafaxine hcl er
caps3
SAVELLA2,3
VENLAFAXINE HCL
ER TABS2,3
WELLBUTRIN XL2,3
AUTONOMIC & CNS MEDICATIONS - MAO Inhibitors
tranylcypromine sulfate
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
dronabinol1
EMEND3
MARINOL1
granisetron hcl3
SANCUSO3
meclizine hcl
TRANSDERM-SCOP
ondansetron
hcl/odt3
prochlorperazine
maleate
promethazine hcl
promethegan
AUTONOMIC & CNS MEDICATIONS - AntiParkinson Anticholinergic Drugs
benztropine mesylate
trihexyphenidyl hcl
20
ZUPLENZ3
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
bromocriptine
mesylate
AZILECT
carbidopa-levodopa
COMTAN
carbidopa-levodopaentacapone
MIRAPEX/ER
entacapone
NEUPRO
pramipexole
dihydrochloride
REQUIP XL
ropinirole hcl
STALEVO
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
haloperidol 1mg
tab
clozapine
ABILIFY/DISCMELT1
FANAPT
fluphenazine hcl
RISPERDAL CONSTA
GEODON
haloperidol
INVEGA1
perphenazine
LATUDA1
quetiapine fumarate
OLANZAPINE
risperidone/m-tab
SAPHRIS
thioridazine hcl
SEROQUEL
thiothixene
SEROQUEL XR1
trifluoperazine hcl
ZYPREXA/ZYDIS
ZIPRASIDONE HCL
AUTONOMIC & CNS MEDICATIONS - Aliphatic Phenothiazines
chlorpromazine hcl
AUTONOMIC & CNS MEDICATIONS - Psychotherapeutic Combinations
OLANZAPINEFLUOXETINE
SYMBYAX
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
methylphenidate
hcl 5, 10mg tab
amphetamine salt
combo
dexmethylphenidate
hcl
dextroamphetamineamphetamine er
methylin/er
methylphenidate
hcl/la/sr
VYVANSE2
ADDERALL XR2
CONCERTA2
DAYTRANA2
DEXMETHYLPHENIDA
TE ER
DEXTROAMPHETAMI
NE/ER
FOCALIN XR2
METADATE CD2
METHYLPHENIDATE
HCL CD/ER
MODAFINIL1,3
NUVIGIL1
PROVIGIL1
QUILLIVANT XR2
RITALIN LA2
21
AUTONOMIC & CNS MEDICATIONS - Other CNS/Autonomic Drugs
atropine sulfate
NUEDEXTA1
naltrexone hcl
XENAZINE1,SP
ACAMPROSATE
CALCIUM
pyridostigmine
bromide
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
donepezil hcl
NAMENDA2
ARICEPT/ODT
galantamine
hydrobromide
EXELON
rivastigmine
NAMENDA XR2
AUTONOMIC & CNS MEDICATIONS - Drugs to Treat Multiple Sclerosis
AMPYRA1,SP
GILENYA1,SP
TECFIDERA1,SP
AUTONOMIC & CNS MEDICATIONS - Other Drugs for ADHD
STRATTERA2
INTUNIV2
KAPVAY2
DERMATOLOGICAL MEDICATIONS
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
alclomethasone
dipropionate
CLOBEX2
apexicon e
CLODERM
betamethasone
dipropionate
betamethasone
valerate
CORDRAN
HALOBETASOL
PROPIONATE
clobetasol emollient
HALOG
clobetasol propionate
KENALOG
desonide
LOCOID/LIPOCREAM
desoximetasone
OLUX/-E
diflorasone
PRAMOSONE/E
fluocinolone acetonide
ULTRAVATE PAC
fluocinonide
fluticasone propionate
hydrocortisone
hydrocortisone
butyrate
hydrocortisone
valerate
lidocaine hclhydrocortisone acetate
mometasone furoate
triamcinolone
acetonide
DERMATOLOGIC MEDICATIONS - Antipruritic Drugs
hydroxyzine
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
benzoyl peroxide
ACANYA
clindamycin phosphate
ADAPALENE
erythromycin
ATRALIN2
22
erythromycin-benzoyl
peroxide
BENZACLIN
metronidazole
CLINDAMYCINBENZOYL PEROXIDE
sodium sulfacetamidesulfur
DIFFERIN2
tretinoin
DUAC
EPIDUO2
FINACEA
METROGEL
TRETINOIN
MICROSPHERE2
VELTIN2
ZIANA2
DERMATOLOGIC MEDICATIONS - Accutanes
isotretinoin2
ABSORICA2
myorisan2
AMNESTEEM2
zenatane2
CLARAVIS2
DERMATOLOGIC MEDICATIONS - Keratolytic Drugs
CONDYLOX
PODOCON-251
PODOFILOX
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
calcitrene
TAZORAC2,3
ACITRETIN2
selenium sulfide
CALCIPOTRIENE
sodium sulfacetamide
DOVONEX
SORIATANE1
SORILUX
TACLONEX1
VECTICAL
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
diclofenac sodium
PROTOPIC2
CARAC
fluorouracil
SANTYL
ELIDEL2
imiquimod
EPICERAM
FLUOROPLEX
MB HYDROGEL
METRONIDAZOLE
topical
PICATO2
PROMISEB
SOLARAZE
VEREGEN
ZYCLARA2
DERMATOLOGIC MEDICATIONS - Scabicides
permethrin 5%
EURAX
MALATHION
ULESFIA
23
DERMATOLOGIC MEDICATIONS - Topical Anti-inflammatory Drugs
FLECTOR2
PENNSAID2
VOLTAREN gel2
EAR-NOSE-THROAT MEDICATIONS
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
antipyrine-benzocaine
CIPRODEX
CETRAXAL
neomycin-polymyxinhydrocortisone
CIPRO HC
ofloxacin
FLUOCINOLONE
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
azelastine hcl
ASTELIN2,3
flunisolide
ASTEPRO2,3
fluticasone propionate
BECONASE AQ2,3
ipratropium bromide
triamcinolone
acetonide
DYMISTA2,3
NASONEX2,3
OMNARIS2,3
PATANASE
QNASL2,3
RHINOCORT AQUA2,3
VERAMYST2,3
ZETONNA2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Throat and Mouth
pilocarpine hcl
triamcinolone
acetonide
CEVIMELINE HCL
DOXYCYCLINE
HYCLATE
ENDOCRINE MEDICATIONS
ENDOCRINE MEDICATIONS - Insulin
HUMALOG products3
APIDRA/SOLOSTAR3
HUMALOG
KWIKPEN2,3
NOVOLIN products3
HUMULIN products3
NOVOLOG products3
NOVOLOG
FLEXPEN2,3
LANTUS/SOLOSTAR3
LEVEMIR/FLEXPEN3
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
acarbose
glipizide
glipizide er
GLUMETZA2
glipizide er 2.5,
5mg tab
glipizide-metformin hcl
PRANDIMET
glipizide xl
glyburide-metformin
PRANDIN
glyburide/micronize
d
glyburidemetformin hcl 1.25250mg tab
metformin hcl
metformin hcl er
nateglinide
repaglinide
metformin hcl er
500mg tab
24
RIOMET
FORTAMET2
glimepiride
ENDOCRINE MEDICATIONS - Insulin Sensitizers and Combos
pioglitazone hcl
ACTOPLUS MET XR2
pioglitazone hclmetformin hcl
ACTOPLUS MET2
ACTOS2
DUETACT2
ENDOCRINE MEDICATIONS - Amylin Analogues
SYMLINPEN
ENDOCRINE MEDICATIONS - Incretin Mimetics
BYDUREON2,3
TANZEUM2,3
BYETTA2,3
VICTOZA2,3
JANUMET/XR2
KAZANO2
JANUVIA2
KOMBIGLYZE XR2
JENTADUETO2
NESINA2
TRADJENTA2
ONGLYZA2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
OSENI2
ENDOCRINE MEDICATIONS - Sodium-Glucose Co-Transporter 2 Inhibitors
INVOKANA2
FARXIGA2
INVOKAMET2
ENDOCRINE MEDICATIONS - Glucose Elevating Drugs
GLUCAGEN
GLUCAGON
EMERGENCY KIT
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
prednisone 20mg
tab
dexamethasone
RAYOS
dexamethasone
sodium phosphate
hydrocortisone
methylprednisolone
prednisolone
prednisolone sodium
phosphate
prednisone
veripred 20
ENDOCRINE MEDICATIONS - Mineralocorticoid Drugs
fludrocortisone acetate
ENDOCRINE MEDICATIONS - Thyroid Supplements
levothyroxine sod
50, 100mcg tab
levothyroxine sodium
liothyronine
westhroid
ENDOCRINE MEDICATIONS - Antithyroid Drugs
methimazole
propylthiouracil
25
ARMOUR THYROID
CYTOMEL
SYNTHROID
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
alendronate sodium3
FORTEO1,3,SP
ACTONEL2,3
cabergoline
SENSIPAR1
ATELVIA2,3
calcitonin nasal spray
BINOSTO2,3
desmopressin
acetate1,SP
BONIVA tabs2,3
etidronate disodium3
FOSAMAX PLUS D2,3
ibandronate sodium3
GASTROINTESTINAL MEDICATIONS
GASTROINTESTINAL MEDICATIONS - Antidiarrheal Drugs
diphenoxylate-atropine
GASTROINTESTINAL MEDICATIONS - Antispasmodics/Drugs Affecting GI Motility
dicyclomine hcl
chlordiazepoxideclidinium
metoclopramide
hyoscyamine sulfate
hcl
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
cimetidine 300, 400,
800mg tab
cimetidine 300 mg/5
mL solution
famotidine 40mg tab
famotidine 40mg/5 mL
solution
nizatidine 150, 300mg
cap
nizatidine 15mg/mL sol
ranitidine hcl 300mg
cap, tab
ranitidine hcl 15mg/mL
syrup
GASTROINTESTINAL MEDICATIONS - Other Antiulcer Drugs
misoprostol
CARAFATE
sucralfate
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
pantoprazole
sodium
lansoprazole 30mg
ACIPHEX2
omeprazole 10, 40mg
DEXILANT2
rabeprazole2
ESOMEPRAZOLE
MAGNESIUM 40mg2
ESOMEPRAZOLE
STRONTIUM
NEXIUM 40mg2
OMEPRAZOLESODIUM
BICARBONATE2
PREVACID2
PROTONIX2
ZEGERID2
26
GASTROINTESTINAL MEDICATIONS - Heliobacteria Pylori Drugs
HELIDAC
LANSOPRAZOLEAMOXICILLINCLARITHROMYCIN
OMECLAMOX-PAK
PREVPAC
PYLERA
GASTROINTESTINAL MEDICATIONS - Laxatives and Cathartics
peg-3350
OSMOPREP
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
anucort-hc
APRISO
ANALPRAM
ADVANCED/E/HC
balsalazide disodium
CANASA
ASACOL HD2
hydrocortisone
BUDESONIDE EC
hydrocortisone acetate
CREON1
COLYTE WITH
FLAVOR PACKS
lidocaine hclhydrocortisone acetate
PENTASA1
DELZICOL
mesalamine
RECTIV
DIPENTUM
pancrelipase 5,000
RELISTOR
ENTOCORT EC2
peg 3350-electrolyte
GOLYTELY
proctozone-hc
HALFLYTELYBISACODYL
LIALDA1
sulfasalazine/dr
MOVIPREP
trilyte with flavor
packets
NULYTELY WITH
FLAVOR PACKS
ursodiol
PANCREAZE1
proctosol-hc
PERTZYE
PREPOPIK
SFROWASA
SUCLEAR
SUPREP
ULTRESA
ZENPEP1
GASTROINTESTINAL MEDICATIONS - Irritable Bowel Drugs
LINZESS1
AMITIZA1
IMMUNOLOGICALS & VACCINES
IMMUNOLOGICALS & VACCINES - Myeloid Stimulants
PROMACTA1
IMMUNOLOGICALS & VACCINES - Interferons
AVONEX/ADMINISTR
ATION PACK/
PEN1,3,SP
COPAXONE1,3,SP
BETASERON1,3,SP
EXTAVIA1,3,SP
PEGASYS/PROCLICK1
PEGINTRON/REDIPEN1,3,SP
,3,SP
REBIF/REBIDOSE1,3,SP
27
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
TEV-TROPIN1,SP
GENOTROPIN1,SP
HUMATROPE1,SP
NORDITROPIN
FLEXPRO/
NORDIFLEX1,SP
NUTROPIN/AQ/AQ
NUSPIN1,SP
OMNITROPE1,SP
SAIZEN1,SP
IMMUNOLOGICALS & VACCINES - Interleukin Receptor Antagonist
ARCALYST1,SP
KINERET1,3,SP
ILARIS1,SP
MUSCULOSKELETAL MEDICATIONS
MUSCULOSKELETAL MEDICATIONS - Salicylates and Related Drugs
aspirin/ec
choline mag
trisalicylate
diflunisal
salsalate
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
ibuprofen 400, 600,
800mg tab
indomethacin
25mg cap
ketoprofen 50mg
cap
diclofenac potassium
CAMBIA2
diclofenac sodium
CELEBREX2
etodolac/er
CELECOXIB2
ketorolac 10mg tab
flurbiprofen
DUEXIS2
ketorolac 30mg/mL
vial
indomethacin/er
MEFENAMIC ACID
meloxicam3
ketoprofen
NAPRELAN2
ketoprofen er2
SPRIX2
ketorolac
VIMOVO2
naproxen 375,
500mg tab (nonenteric coated)
naproxen
125mg/5mL susp
nabumetone
naproxen 250mg
naproxen dr
naproxen ec
naproxen sodium 275,
550mg
oxaprozin
piroxicam
sulindac
MUSCULOSKELETAL MEDICATIONS - Drugs to Prevent and Treat Gout
allopurinol
probenecid
COLCRYS
ULORIC2
28
MUSCULOSKELETAL MEDICATIONS - Direct Muscle Relaxants
baclofen
tizanidine hcl
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
cyclobenzaprine
hcl 10mg tab
chlorzoxazone
AMRIX2
cyclobenzaprine hcl
CYCLOBENZAPRINE
ER
methocarbamol
METAXALONE
orphenadrine citrate
SKELAXIN
SOMA
MUSCULOSKELETAL MEDICATIONS - Other Musculoskeletal Drugs
RILUTEK1
NUTRITION, BLOOD
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
ferocon
BIFERA RX
ferraplus
CEREFOLIN
folbee
FERRALET
multigen
INTEGRA F/PLUS
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
calcitriol
HECTOROL
calcium acetate
NASCOBAL
eliphos
PHOSLYRA
folic acid
ZEMPLAR
levocarnitine
NUTRITION, BLOOD - Fluoride Products
ludent fluoride
PREVIDENT
sodium fluoride
NUTRITION, BLOOD - Potassium Supplements
potassium chloride
NUTRITION, BLOOD - Oral Anticoagulants, Vitamin K
warfarin sod 1, 2.5,
3, 4, 5mg tab
warfarin sodium
COUMADIN
NUTRITION, BLOOD - Heparin and Heparin Antagonists
fondaparinux
sodium3,SP
ARIXTRA1,3,SP
heparin sodium
ENOXAPARIN
SODIUM3,SP
FRAGMIN3,SP
LOVENOX3,SP
NUTRITION, BLOOD - Other Drugs Affecting Coagulation
ELIQUIS2
XARELTO2
NUTRITION, BLOOD - Thrombin Inhibitors
PRADAXA1
29
NUTRITION, BLOOD - Antiplatelet Drugs
cilostazol
AGGRENOX2
clopidogrel
BRILINTA1
dipyridamole
EFFIENT1
PLAVIX
NUTRITION, BLOOD - Hemostatics
tranexamic acid
LYSTEDA
NUTRITION, BLOOD - Blood Detoxicants
RENVELA1
enulose
lactulose
FOSRENOL1
KRISTALOSE
RENAGEL1
NUTRITION, BLOOD - Nutritional/Supplement Products
CEREFOLIN NAC
FOLTX
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Specialized OB/GYN Drugs
chorionic
gonadotropin1,F
GANIRELIX
ACETATE1,F
NOVAREL1,F
OVIDREL1,F
PREGNYL1,F
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - OB/GYN Topical Anti-Infectives
clindamycin phosphate
CLEOCIN
metronidazole
CLINDESSE
vandazole
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Ovulatory Stimulants
GONAL-F RFF/REDIJECT1,F
clomiphene citrate
MENOPUR1,F
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Androgen Drugs
DEPOTESTOSTERONE1
oxandrolone
testosterone
cypionate1
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
estradiol 1mg tab
estradiol
MENEST
CENESTIN
estropipate
estrogen &
methyltestosterone
VAGIFEM
CLIMARA
DIVIGEL
ELESTRIN
ENJUVIA
ESTRACE
ESTRASORB
ESTRING3
ESTROGEL
EVAMIST
FEMRING3
MENOSTAR
30
MINIVELLE
PREMARIN
VIVELLE-DOT
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin Combinations
jinteli
ACTIVELLA
ANGELIQ
CLIMARA PRO
COMBIPATCH
FEMHRT
PREFEST
PREMPHASE
PREMPRO
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Selective Estrogen Receptor Modulator
raloxifene hcl
EVISTA
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Progestin Drugs
medroxyprogestero
ne acetate tab
norethindrone acetate
ENDOMETRIN1,F
CRINONE1,F
PROMETRIUM1,F
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
additional contraceptives can be found on the Preventive Care List
BEYAZ
FEMCON FE
GENERESS FE
LO LOESTRIN FE
LO MINASTRIN FE
LOSEASONIQUE
MINASTRIN 24 FE
NATAZIA
NUVARING
ORTHO EVRA
ORTHO TRICYCLEN/LO
QUARTETTE
SAFYRAL
SEASONIQUE
YASMIN 28
YAZ
OPHTHALMIC MEDICATIONS
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
neomycinbacitracinpolymyxin
bacitracin
MOXEZA
AZASITE
bacitracin-polymyxin
BESIVANCE
ciprofloxacin hcl
VIGAMOX
erythromycin
ZYMAXID
gentamicin sulfate
ofloxacin
31
polymyxin b sultrimethoprim
sulfacetamide sodium
tobramycin
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antiviral Drugs
trifluridine
ZIRGAN
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
fluorometholone
ALREX
prednisolone acetate
DUREZOL
FML FORTE
LOTEMAX3
VEXOL
OPHTHALMIC MEDICATIONS - Ophthalmic Anti-Infective/Corticosteroids
neomycin-polymyxindexamethasone
neomycin-polymyxinhydrocortisone
tobramycindexamethasone
TOBRADEX/ST
ZYLET
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
acetazolamide/er
ALPHAGAN P
brimonidine tartrate
AZOPT
dorzolamide hcl
BETIMOL
dorzolamide-timolol
BETOPTIC S
latanoprost
COMBIGAN
levobunolol hcl
COSOPT PF
pilocarpine hcl
ISTALOL
timolol maleate
LUMIGAN
travoprost
RESCULA
SIMBRINZA
TIMOPTIC OCUDOSE
TRAVATAN Z
XALATAN
ZIOPTAN
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
atropine sulfate
RESTASIS1,3
ACUVAIL
azelastine hcl
ALOCRIL
cromolyn sodium
ALOMIDE
diclofenac sodium
BEPREVE3
epinastine hcl
EMADINE
ILEVRO
LASTACAFT
NEVANAC
PATADAY2
PATANOL
PROLENSA
32
RESPIRATORY MEDICATIONS
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
albuterol 2, 4mg
tab
albuterol 2mg/5mL
syrup
albuterol 0.083%
inhal sol
albuterol
FORADIL
ARCAPTA NEOHALER
metaproterenol sulfate
PERFOROMIST
BROVANA
PROAIR HFA
LEVALBUTEROL HCL
MAXAIR AUTOHALER
PROVENTIL HFA
SEREVENT DISKUS
VENTOLIN HFA
XOPENEX/CONCENT
RATE
XOPENEX HFA
RESPIRATORY MEDICATIONS - Methyl Xanthine Drugs
theophylline/anhydrous
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
budesonide
ATROVENT HFA
ADVAIR DISKUS2,3
cromolyn sodium
COMBIVENT/RESPIM
AT1,3
ADVAIR HFA2,3
epinephrine
DULERA2,3
ALVESCO
ipratropium bromide
QVAR
ASMANEX
ipratropium-albuterol
SYMBICORT2,3
BREO ELLIPTA
TUDORZA PRESSAIR
EPIPEN/JR 2-PAK3
FLOVENT
DISKUS/HFA
PULMICORT/FLEXHA
LER
SPIRIVA
RESPIRATORY MEDICATIONS - Leukotriene Modifiers
montelukast sodium
ACCOLATE
zafirlukast
SINGULAIR
ZYFLO/CR2
RESPIRATORY MEDICATIONS - Antihistamines
promethazine hcl
25mg tab
promethazine hcldm
arbinoxa
CLARINEX
cyproheptadine hcl
XYZAL
levocetirizine
dihydrochloride
promethazine hcl
RESPIRATORY MEDICATIONS - Antihistamine/Decongestant Combinations
promethazine vc
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
benzonatate
REZIRA
guaifenesin-codeine
TUSSICAPS
promethazine-codeine
TUSSIONEX
promethazine vccodeine
promethazinedextromethorphan
33
ZUTRIPRO
RESPIRATORY MEDICATIONS - Other Respiratory Drugs
PULMOZYME1,SP
DALIRESP
UROLOGICAL MEDICATIONS
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
oxybutynin chloride/er
DETROL/LA
tolterodine tartrate
ENABLEX
GELNIQUE
OXYTROL
SANCTURA XR
TOVIAZ
TROSPIUM
CHLORIDE
VESICARE2
UROLOGICAL MEDICATIONS - Cholinergic Stimulants
bethanechol chloride
UROLOGICAL MEDICATIONS - Urinary Anesthetics
phenazopyridine hcl
100, 200mg
UROLOGICAL MEDICATIONS - Other Genitourinary Products
alfuzosin hcl er
ELMIRON1
AVODART
finasteride
FLOMAX
potassium citrate
JALYN
tamsulosin hcl
MYRBETRIQ2
RAPAFLO
UROXATRAL
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Diagnostic Products
EXJADE1,SP
MINILINK REAL-TIME
TRANSMITTER
PARADIGM REALTIME
SOF-SENSOR
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Miscellaneous Drugs
THALOMID1,SP
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Appetite Suppressants
QSYMIA2
phentermine hcl
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Other Weight Loss Products
BELVIQ2
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Alcohol Antagonists
disulfiram
MEDICAL (MISCELLANEOUS) SUPPLIES
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
CONCEPTION3
MINIMED/RESERVOIR
OPTICHAMBER
PARADIGM/INFUSION
/SILHOUETTE
34
POLYFIN/QR
PRIMABELLA
QUICK RELEASE
SOFT TEFLON
SILHOUETTE
SOF-SET/MICRO
SURE-T
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK
FASTCLIX
ACCU-CHEK
SOFTCLIX
FORA LANCING
DEVICE
FORACARE LANCETS
FREESTYLE
FREEDOM LITE
FREESTYLE
INSULINX TEST
STRIPS3
FREESTYLE
LANCETS
FREESTYLE LITE
TEST STRIPS3
FREESTYLE TEST
STRIPS3
NOVOFINE/32/AUTOC
OVER
ACCU-CHEK
ACCU-CHEK ACTIVE
ACCU-CHEK
AVIVA/PLUS
ACCU-CHEK
COMFORT CURVE
ACCU-CHEK
COMPACT/BLUE
CONTROL
ACCU-CHEK NANO
SMARTVIEW
ACCU-CHEK
SMARTVIEW
ASCENSIA
AUTODISC3
AUTODISC NORMAL3
BREEZE 2
ONE TOUCH DELICA
CLEVER CHOICE
VOICE + TEST
STRIPS3
ONE TOUCH
LANCETS
CONTOUR/NEXT/EZ
PRECISION
CONTROL SOLUTION
PRODIGY INSULIN
SYRINGE
PRODIGY PEN
NEEDLES
SOFT TOUCH
DEXCOM G4
FORA TEST STRIPS3
FORA V30A
SURE COMFORT
LANCETS
GLUCOSE TEST
STRIPS3
ONE TOUCH TEST
STRIPS3
TRUEPLUS LANCETS
ONE TOUCH ULTRA 2
SOFTCLIX
ULTRA COMFORT
VGO 20/30/40
ONE TOUCH ULTRA
SMART
ONE TOUCH ULTRA
SYSTEM
ONE TOUCH ULTRA
TEST STRIPS3
ONE TOUCH
ULTRAMINI
ONE TOUCH
VERIO/IQ
PRECISION XTRA
PRODIGY/NO
CODING/POCKET
SURESTEP
35
TRUETEST TEST
STRIPS3
TRUETRACK TEST
STRIPS3
1prior
authorization, 2step therapy, 3quantity limit, Ffertility, SPspecialty (see your plan for SP cost-sharing)
36
Alphabetical Listing Index
DRUG/PRODUCT NAME
CLASS
abacavir
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
ABILIFY/DISCMELT1
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
ABSORICA2
DERMATOLOGIC MEDICATIONS - Accutanes
ABSTRAL1,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
ACAMPROSATE CALCIUM
AUTONOMIC & CNS MEDICATIONS - Other CNS/Autonomic Drugs
ACANYA
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
acarbose
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
ACCOLATE
RESPIRATORY MEDICATIONS - Leukotriene Modifiers
ACCU-CHEK
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK ACTIVE
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK AVIVA/PLUS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK COMFORT CURVE
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK COMPACT/BLUE CONTROL
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK FASTCLIX
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK NANO SMARTVIEW
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK SMARTVIEW
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ACCU-CHEK SOFTCLIX
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
acebutolol hcl
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
acetaminophen-codeine
AUTONOMIC & CNS MEDICATIONS - Class III Narcotics
acetazolamide/er
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
ACIPHEX2
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
ACITRETIN2
ACTIVELLA
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
ACTONEL2,3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
ACTOPLUS MET XR2
ACTOPLUS
MET2
ENDOCRINE MEDICATIONS - Insulin Sensitizers and Combos
ENDOCRINE MEDICATIONS - Insulin Sensitizers and Combos
ACTOS2
ENDOCRINE MEDICATIONS - Insulin Sensitizers and Combos
ACUVAIL
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
acyclovir oral
ANTI-INFECTIVES - Other Antiviral Drugs
ACYCLOVIR TOPICAL
ANTI-INFECTIVES - Topical Antiviral Drugs
ADAPALENE
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
ADCIRCA1,SP
CARDIOVASCULAR MEDICATIONS - Other Vasodilating Drugs
ADDERALL XR2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
ADVAIR
DISKUS2,3
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
ADVAIR
HFA2,3
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
ADVICOR2
CARDIOVASCULAR MEDICATIONS - HMG-COA Combinations
AFINITOR1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
AGGRENOX
NUTRITION, BLOOD - Antiplatelet Drugs
albuterol
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
alclomethasone dipropionate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
alendronate sodium3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
alfuzosin hcl er
UROLOGICAL MEDICATIONS - Other Genitourinary Products
allopurinol
MUSCULOSKELETAL MEDICATIONS - Drugs to Prevent and Treat Gout
37
DRUG/PRODUCT NAME
CLASS
ALOCRIL
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
ALOMIDE
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
ALPHAGAN P
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
alprazolam/er/xr
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
ALREX
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
ALTABAX
ANTI-INFECTIVES - Topical Antibacterial
ALTOPREV2
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
ALVESCO
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
amantadine
ANTI-INFECTIVES - Other Antiviral Drugs
AMBIEN/CR3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
amiloride hcl
CARDIOVASCULAR MEDICATIONS - Potassium-Sparing Diuretics
amiodarone hcl
CARDIOVASCULAR MEDICATIONS - Amiodarones
AMITIZA1
GASTROINTESTINAL MEDICATIONS - Irritable Bowel Drugs
amitriptyline hcl
AUTONOMIC & CNS MEDICATIONS - Tertiary Amines
amlodipine besylate
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
amlodipine besylate-benazepril
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
AMLODIPINE-ATORVASTATIN
CARDIOVASCULAR MEDICATIONS - HMG-COA Combinations
AMNESTEEM2
DERMATOLOGIC MEDICATIONS - Accutanes
amoxicillin
ANTI-INFECTIVES - Penicillins
AMOXICILLIN-POTASSIUM CLAVULANATE/ER
ANTI-INFECTIVES - Penicillins
amphetamine salt combo
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
AMPYRA1,SP
AUTONOMIC & CNS MEDICATIONS - Drugs to Treat Multiple Sclerosis
AMRIX2
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
AMTURNIDE
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
anagrelide hcl
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
ANALPRAM ADVANCED/E/HC
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
anastrozole
ANGELIQ
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
ANTARA2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
antipyrine-benzocaine
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
anucort-hc
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
apexicon e
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
APIDRA/SOLOSTAR3
ENDOCRINE MEDICATIONS - Insulin
arbinoxa
RESPIRATORY MEDICATIONS - Antihistamines
ARCALYST1,SP
IMMUNOLOGICALS & VACCINES - Interleukin Receptor Antagonist
ARCAPTA NEOHALER
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
ARICEPT/ODT
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
ARIMIDEX
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
ARIXTRA1,3,SP
NUTRITION, BLOOD - Heparin and Heparin Antagonists
ARMOUR THYROID
ENDOCRINE MEDICATIONS - Thyroid Supplements
ASACOL
HD2
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
ASCENSIA AUTODISC
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ASMANEX
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
aspirin/ec
MUSCULOSKELETAL MEDICATIONS - Salicylates and Related Drugs
ASTELIN2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
38
DRUG/PRODUCT NAME
CLASS
ASTEPRO2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
ATACAND
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
ATACAND HCT
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
ATELVIA2,3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
atenolol
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
atenolol-chlorthalidone
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
atorvastatin calcium
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
atovaquone
ANTI-INFECTIVES - Other Anti-Infective Drugs
atovaquone-proguanil hcl
ANTI-INFECTIVES - Plasmodicides
ATRALIN2
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
ATRIPLA
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
atropine sulfate
AUTONOMIC & CNS MEDICATIONS - Other CNS/Autonomic Drugs
atropine sulfate
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
ATROVENT HFA
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
AUTODISC NORMAL
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
AVALIDE
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
AVAPRO
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
AVELOX/ABC PACK
ANTI-INFECTIVES - Quinolones
AVINZA2,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
AVODART
UROLOGICAL MEDICATIONS - Other Genitourinary Products
AVONEX/ADMINISTRATION PACK/PEN1,3,SP
IMMUNOLOGICALS & VACCINES - Interferons
AXERT2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
AZASITE
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
azathioprineSP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
azelastine hcl
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
azelastine hcl
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
AZILECT
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
azithromycin
ANTI-INFECTIVES - Other Macrolides
AZOPT
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
AZOR
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
bacitracin
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
bacitracin-polymyxin
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
baclofen
MUSCULOSKELETAL MEDICATIONS - Direct Muscle Relaxants
BACTROBAN
ANTI-INFECTIVES - Topical Antibacterial
balsalazide disodium
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
BARACLUDE
ANTI-INFECTIVES - Other Antiviral Drugs
BECONASE AQ2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
BELVIQ2
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Other Weight Loss Products
benazepril hcl
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
benazepril-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
BENICAR
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
BENICAR HCT
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
BENZACLIN
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
benzonatate
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
benzoyl peroxide
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
39
DRUG/PRODUCT NAME
CLASS
benztropine mesylate
AUTONOMIC & CNS MEDICATIONS - AntiParkinson Anticholinergic Drugs
BEPREVE3
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
BESIVANCE
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
betamethasone dipropionate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
betamethasone valerate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
BETASERON1,3,SP
IMMUNOLOGICALS & VACCINES - Interferons
bethanechol chloride
UROLOGICAL MEDICATIONS - Cholinergic Stimulants
BETHKIS1,SP
ANTI-INFECTIVES - Aminoglycosides
BETIMOL
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
BETOPTIC S
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
BEYAZ
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
bicalutamide
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
BIDIL
CARDIOVASCULAR MEDICATIONS - Other Vasodilating Drugs
BIFERA RX
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
BINOSTO2,3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
bisoprolol fumarate
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
bisoprolol-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
BONIVA
tabs2,3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
BREEZE 2
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
BREO ELLIPTA
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
BRILINTA
NUTRITION, BLOOD - Antiplatelet Drugs
brimonidine tartrate
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
bromocriptine mesylate
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
BROVANA
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
budesonide
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
BUDESONIDE EC
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
bumetanide
CARDIOVASCULAR MEDICATIONS - Loop Diuretics
BUPRENORPHINE HCL
AUTONOMIC & CNS MEDICATIONS - Class III Narcotics
BUPRENORPHINE-NALOXONE1
AUTONOMIC & CNS MEDICATIONS - Class III Narcotics
bupropion
hcl/sr/xl3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
buspirone hcl
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
butalbital compound-codeine
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
butalbital-aspirin-caffeine
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
butorphanol tartrate
AUTONOMIC & CNS MEDICATIONS - Analgesics
BUTRANS
AUTONOMIC & CNS MEDICATIONS - Class III Narcotics
BYDUREON2,3
ENDOCRINE MEDICATIONS - Incretin Mimetics
BYETTA2,3
ENDOCRINE MEDICATIONS - Incretin Mimetics
BYSTOLIC
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
cabergoline
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
CADUET2
CARDIOVASCULAR MEDICATIONS - HMG-COA Combinations
CALCIPOTRIENE
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
calcitonin nasal spray
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
calcitrene
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
calcitriol
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
calcium acetate
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
40
DRUG/PRODUCT NAME
CLASS
CAMBIA2
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
candesartan cilexetil
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
candesartan-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
capecitabine1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
captopril
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
captopril-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
CARAC
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
CARAFATE
GASTROINTESTINAL MEDICATIONS - Other Antiulcer Drugs
carbamazepine ir
AUTONOMIC & CNS MEDICATIONS - Carbamazepines
CARBAMAZEPINE/XR
AUTONOMIC & CNS MEDICATIONS - Carbamazepines
CARBATROL
AUTONOMIC & CNS MEDICATIONS - Carbamazepines
carbidopa-levodopa
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
carbidopa-levodopa-entacapone
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
SR2
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
CARDIZEM LA
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
CARDURA XL
CARDIOVASCULAR MEDICATIONS - Vasodilator Antihypertensives
cartia xt
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
carvedilol
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
CAYSTON1,3,SP
ANTI-INFECTIVES - Other Anti-Infective Drugs
CEDAX
ANTI-INFECTIVES - Cephalosporins
cefaclor/er
ANTI-INFECTIVES - Cephalosporins
cefadroxil
ANTI-INFECTIVES - Cephalosporins
cefdinir
ANTI-INFECTIVES - Cephalosporins
cefpodoxime proxetil
ANTI-INFECTIVES - Cephalosporins
cefprozil
ANTI-INFECTIVES - Cephalosporins
ceftibutin
ANTI-INFECTIVES - Cephalosporins
CEFTIN
ANTI-INFECTIVES - Cephalosporins
cefuroxime
ANTI-INFECTIVES - Cephalosporins
CELEBREX2
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
CELECOXIB
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
CELLCEPT1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
CENESTIN
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
cephalexin
ANTI-INFECTIVES - Cephalosporins
CEREFOLIN
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
CEREFOLIN NAC
NUTRITION, BLOOD - Nutritional/Supplement Products
CETRAXAL
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
CEVIMELINE HCL
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Throat and Mouth
chlordiazepoxide hcl
chlordiazepoxide-clidinium
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
GASTROINTESTINAL MEDICATIONS - Antispasmodics/Drugs Affecting GI
Motility
chlorpromazine hcl
AUTONOMIC & CNS MEDICATIONS - Aliphatic Phenothiazines
chlorthalidone
CARDIOVASCULAR MEDICATIONS - Thiazide and Related Drugs
chlorzoxazone
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
cholestyramine
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
choline mag trisalicylate
MUSCULOSKELETAL MEDICATIONS - Salicylates and Related Drugs
CARDENE
41
DRUG/PRODUCT NAME
chorionic gonadotropin1,F
CLASS
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Specialized OB/GYN
Drugs
ciclopirox
ANTI-INFECTIVES - Other Topical Antifungal
cilostazol
NUTRITION, BLOOD - Antiplatelet Drugs
cimetidine 300 mg/5 mL solution
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
cimetidine 300, 400, 800mg tab
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
CIMZIA1,3,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
CIPRO HC
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
CIPRODEX
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
ciprofloxacin hcl
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
ciprofloxacin hcl/er
ANTI-INFECTIVES - Quinolones
citalopram
hydrobromide3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
CLARAVIS2
DERMATOLOGIC MEDICATIONS - Accutanes
CLARINEX
RESPIRATORY MEDICATIONS - Antihistamines
clarithromycin/er
CLEOCIN
ANTI-INFECTIVES - Other Macrolides
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - OB/GYN Topical AntiInfectives
CLEVER CHOICE VOICE + TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
CLIMARA
CLIMARA PRO
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
clindamycin hcl
ANTI-INFECTIVES - Clindamycins
clindamycin phosphate
ANTI-INFECTIVES - Clindamycins
clindamycin phosphate
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - OB/GYN Topical AntiInfectives
clindamycin phosphate
CLINDAMYCIN-BENZOYL PEROXIDE
CLINDESSE
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - OB/GYN Topical AntiInfectives
clobetasol emollient
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
clobetasol propionate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
CLOBEX
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
CLODERM
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
clomiphene citrate
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Ovulatory Stimulants
CLOMIPRAMINE HCL
AUTONOMIC & CNS MEDICATIONS - Tertiary Amines
clonazepam
AUTONOMIC & CNS MEDICATIONS - Anticonvulsant Benzodiazepines
clonidine hcl/er
CARDIOVASCULAR MEDICATIONS - Centrally-Acting Antihypertensives
CLONIDINE PATCH
CARDIOVASCULAR MEDICATIONS - Centrally-Acting Antihypertensives
clopidogrel
NUTRITION, BLOOD - Antiplatelet Drugs
clorazepate dipotassium
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
clotrimazole
ANTI-INFECTIVES - Vaginal Antifungal
clotrimazole
ANTI-INFECTIVES - Other Topical Antifungal
clotrimazole-betamethasone
ANTI-INFECTIVES - Topical Antifungal-Corticosteroid Combinations
clozapine
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
COLCRYS
MUSCULOSKELETAL MEDICATIONS - Drugs to Prevent and Treat Gout
colestipol hcl
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
COLYTE WITH FLAVOR PACKS
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
COMBIGAN
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
42
DRUG/PRODUCT NAME
COMBIPATCH
CLASS
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
COMBIVENT/RESPIMAT1,3
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
COMBIVIR
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
COMPLERA
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
COMTAN
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
CONCEPTION3
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
CONCERTA2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
CONDYLOX
DERMATOLOGIC MEDICATIONS - Keratolytic Drugs
CONTOUR/NEXT/EZ
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
CONTROL SOLUTION
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
COPAXONE1,3,SP
IMMUNOLOGICALS & VACCINES - Interferons
CORDRAN
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
COREG CR
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
COSOPT PF
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
COUMADIN
NUTRITION, BLOOD - Oral Anticoagulants, Vitamin K
COZAAR
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
CRESTOR2
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
CRINONE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Progestin Drugs
cromolyn sodium
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
cromolyn sodium
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
CYCLOBENZAPRINE ER
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
cyclobenzaprine hcl
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
cyclosporine modified
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
CYMBALTA2,3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
cyproheptadine hcl
RESPIRATORY MEDICATIONS - Antihistamines
CYTOMEL
ENDOCRINE MEDICATIONS - Thyroid Supplements
DALIRESP
RESPIRATORY MEDICATIONS - Other Respiratory Drugs
DAPSONE
ANTI-INFECTIVES - Sulfones
DAYTRANA2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
DELZICOL
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
DENAVIR
ANTI-INFECTIVES - Other Antiviral Drugs
DEPAKOTE ER1
AUTONOMIC & CNS MEDICATIONS - Valproic Acid and Derivatives
DEPO-TESTOSTERONE1
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Androgen Drugs
desipramine hcl
AUTONOMIC & CNS MEDICATIONS - Secondary Amines
desmopressin
acetate1,SP
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
desonide
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
desoximetasone
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
DETROL/LA
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
dexamethasone
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
dexamethasone sodium phosphate
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
DEXCOM G4
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
DEXILANT2
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
DEXMETHYLPHENIDATE ER
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
dexmethylphenidate hcl
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
DEXTROAMPHETAMINE/ER
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
43
DRUG/PRODUCT NAME
CLASS
dextroamphetamine-amphetamine er
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
diazepam
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
diazepam rectal gel
AUTONOMIC & CNS MEDICATIONS - Anticonvulsant Benzodiazepines
diclofenac potassium
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
diclofenac sodium
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
diclofenac sodium
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
diclofenac sodium
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
dicloxacillin
dicyclomine hcl
ANTI-INFECTIVES - Penicillins
GASTROINTESTINAL MEDICATIONS - Antispasmodics/Drugs Affecting GI
Motility
DIFFERIN2
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
DIFICID
ANTI-INFECTIVES - Other Anti-Infective Drugs
diflorasone
DIFLUCAN
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
2
ANTI-INFECTIVES - Oral Antifungal
diflunisal
MUSCULOSKELETAL MEDICATIONS - Salicylates and Related Drugs
digoxin
CARDIOVASCULAR MEDICATIONS - Cardiac Glycosides
DILANTIN
AUTONOMIC & CNS MEDICATIONS - Hydantoins
diltiazem/er
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
DIOVAN
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
DIOVAN HCT
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
DIPENTUM
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
diphenoxylate-atropine
GASTROINTESTINAL MEDICATIONS - Antidiarrheal Drugs
dipyridamole
NUTRITION, BLOOD - Antiplatelet Drugs
disulfiram
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Alcohol Antagonists
divalproex sodium/dr
AUTONOMIC & CNS MEDICATIONS - Valproic Acid and Derivatives
DIVALPROEX SODIUM/ER
AUTONOMIC & CNS MEDICATIONS - Valproic Acid and Derivatives
DIVIGEL
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
donepezil hcl
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
DORYX2
ANTI-INFECTIVES - Tetracyclines
dorzolamide hcl
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
dorzolamide-timolol
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
DOVONEX
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
doxazosin mesylate
CARDIOVASCULAR MEDICATIONS - Vasodilator Antihypertensives
doxepin hcl
AUTONOMIC & CNS MEDICATIONS - Tertiary Amines
doxycycline hyclate
ANTI-INFECTIVES - Tetracyclines
doxycycline hyclate
DOXYCYCLINE HYCLATE
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Throat and Mouth
DR2
ANTI-INFECTIVES - Tetracyclines
doxycycline monohydrate
ANTI-INFECTIVES - Tetracyclines
dronabinol1
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
DUAC
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
DUETACT2
ENDOCRINE MEDICATIONS - Insulin Sensitizers and Combos
DUEXIS2
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
DULERA2,3
DULOXETINE
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
HCL2,3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
DUREZOL
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
DYMISTA2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
44
DRUG/PRODUCT NAME
CLASS
econazole nitrate
ANTI-INFECTIVES - Other Topical Antifungal
EDARBI
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
EDARBYCLOR
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
EDLUAR3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
EFFEXOR XR2,3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
EFFIENT1
NUTRITION, BLOOD - Antiplatelet Drugs
ELESTRIN
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
ELIDEL2
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
ELIGARD1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
eliphos
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
ELIQUIS1
NUTRITION, BLOOD - Other Drugs Affecting Coagulation
ELMIRON
UROLOGICAL MEDICATIONS - Other Genitourinary Products
EMADINE
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
EMEND3
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
ENABLEX
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
enalapril maleate
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
enalapril-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
ENBREL1,3,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
endocet
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
ENDOMETRIN
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Progestin Drugs
ENJUVIA
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
ENOXAPARIN
SODIUM3,SP
entacapone
NUTRITION, BLOOD - Heparin and Heparin Antagonists
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
ENTOCORT
EC2
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
enulose
NUTRITION, BLOOD - Blood Detoxicants
EPICERAM
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
EPIDUO
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
epinastine hcl
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
epinephrine
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
EPIPEN/JR
EPIVIR
2-PAK3
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
HBVSP
ANTI-INFECTIVES - Other Antiviral Drugs
EPIVIR
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
eplerenone
CARDIOVASCULAR MEDICATIONS - Potassium-Sparing Diuretics
eprosartan mesylate
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
EPZICOM
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
ERTACZO
ANTI-INFECTIVES - Other Topical Antifungal
ERY-TAB
ANTI-INFECTIVES - Erythromycins
erythromycin
ANTI-INFECTIVES - Erythromycins
erythromycin
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
erythromycin
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
erythromycin-benzoyl peroxide
escitalopram
oxalate3
esomeprazole magnesium
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
40mg2
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
ESOMEPRAZOLE STRONTIUM
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
estazolam
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
45
DRUG/PRODUCT NAME
CLASS
ESTRACE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
estradiol
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
ESTRASORB
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
ESTRING3
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
ESTROGEL
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
estrogen & methyltestosterone
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
estropipate
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
eszopiclone3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
etidronate
disodium3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
etodolac/er
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
EURAX
DERMATOLOGIC MEDICATIONS - Scabicides
EVAMIST
EVISTA
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Selective Estrogen
Receptor Modulator
EXALGO2,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
EXELDERM
ANTI-INFECTIVES - Other Topical Antifungal
EXELON
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
EXEMESTANE1
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
EXFORGE/HCT2
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
EXJADE1,SP
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Diagnostic Products
EXTAVIA1,3,SP
IMMUNOLOGICALS & VACCINES - Interferons
FACTIVE
ANTI-INFECTIVES - Quinolones
FAMCICLOVIR
ANTI-INFECTIVES - Other Antiviral Drugs
famotidine 40mg tab
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
famotidine 40mg/5 mL solution
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
FANAPT
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
FARXIGA2
ENDOCRINE MEDICATIONS - Sodium-Glucose Co-Transporter 2 Inhibitors
felbamate
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
felodipine er
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
FEMARA
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
FEMCON FE
FEMHRT
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
FEMRING3
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
fenofibrate
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
fenofibric acid
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
FENOGLIDE2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
FENTANYL3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
FENTORA1,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
ferocon
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
FERRALET
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
ferraplus
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
FINACEA
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
finasteride
UROLOGICAL MEDICATIONS - Other Genitourinary Products
flecainide acetate
CARDIOVASCULAR MEDICATIONS - Class 1C
FLECTOR2
DERMATOLOGIC MEDICATIONS - Topical Anti-inflammatory Drugs
46
DRUG/PRODUCT NAME
CLASS
FLOMAX
UROLOGICAL MEDICATIONS - Other Genitourinary Products
FLOVENT DISKUS/HFA
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
fluconazole
ANTI-INFECTIVES - Oral Antifungal
fludrocortisone acetate
ENDOCRINE MEDICATIONS - Mineralocorticoid Drugs
flunisolide
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
FLUOCINOLONE
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
fluocinolone acetonide
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
fluocinonide
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
fluorometholone
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
FLUOROPLEX
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
fluorouracil
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
fluoxetine hcl3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
fluphenazine hcl
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
flurazepam hcl
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
flurbiprofen
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
fluticasone propionate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
fluticasone propionate
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
fluvastatin sodium
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
fluvoxamine maleate
er2,3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
fluvoxamine maleate3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
FML FORTE
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
FOCALIN
XR2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
folbee
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
folic acid
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
FOLTX
fondaparinux
NUTRITION, BLOOD - Nutritional/Supplement Products
sodium3,SP
NUTRITION, BLOOD - Heparin and Heparin Antagonists
FORA LANCING DEVICE
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FORA TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FORA V30A
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FORACARE LANCETS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FORADIL
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
FORTAMET2
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
FORTEO1,3,SP
FOSAMAX PLUS
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
D2,3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
fosinopril sodium
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
fosinopril-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
FOSRENOL1
NUTRITION, BLOOD - Blood Detoxicants
FRAGMIN3,SP
NUTRITION, BLOOD - Heparin and Heparin Antagonists
FREESTYLE FREEDOM LITE
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FREESTYLE INSULINX TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FREESTYLE LANCETS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FREESTYLE LITE TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FREESTYLE TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
FROVA2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
furosemide
CARDIOVASCULAR MEDICATIONS - Loop Diuretics
47
DRUG/PRODUCT NAME
CLASS
gabapentin
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
galantamine hydrobromide
GANIRELIX ACETATE1,F
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Specialized OB/GYN
Drugs
GELNIQUE
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
gemfibrozil
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
GENERESS FE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
gengraf
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
GENOTROPIN1,SP
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
gentamicin sulfate
ANTI-INFECTIVES - Topical Antibacterial
gentamicin sulfate
ANTI-INFECTIVES - Aminoglycosides
gentamicin sulfate
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
GEODON
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
GILENYA
1,SP
AUTONOMIC & CNS MEDICATIONS - Drugs to Treat Multiple Sclerosis
glimepiride
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
glipizide/er/xl
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
glipizide-metformin hcl
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
GLUCAGEN
ENDOCRINE MEDICATIONS - Glucose Elevating Drugs
GLUCAGON EMERGENCY KIT
ENDOCRINE MEDICATIONS - Glucose Elevating Drugs
GLUCOSE TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
GLUMETZA2
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
glyburide/micronized
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
glyburide-metformin hcl
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
GOLYTELY
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
GONAL-F RFF/REDI-JECT1,F
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Ovulatory Stimulants
GRALISE2
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
granisetron
hcl3
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
GRIFULVIN V
ANTI-INFECTIVES - Oral Antifungal
griseofulvin
ANTI-INFECTIVES - Oral Antifungal
guaifenesin-codeine
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
guanfacine hcl
CARDIOVASCULAR MEDICATIONS - Centrally-Acting Antihypertensives
HALFLYTELY-BISACODYL
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
HALOBETASOL PROPIONATE
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
HALOG
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
haloperidol
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
HECTOROL
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
HELIDAC
GASTROINTESTINAL MEDICATIONS - Heliobacteria Pylori Drugs
heparin sodium
NUTRITION, BLOOD - Heparin and Heparin Antagonists
HORIZANT2
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
HUMALOG KWIKPEN2,3
ENDOCRINE MEDICATIONS - Insulin
HUMALOG products3
ENDOCRINE MEDICATIONS - Insulin
HUMATROPE1,SP
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
HUMIRA1,3,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
HUMULIN
products3
ENDOCRINE MEDICATIONS - Insulin
hydrochlorothiazide
CARDIOVASCULAR MEDICATIONS - Thiazide and Related Drugs
hydrocodone bitartrate-ibuprofen
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
48
DRUG/PRODUCT NAME
CLASS
hydrocodone-acetaminophen
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
hydrocortisone
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
hydrocortisone
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
hydrocortisone
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
hydrocortisone acetate
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
hydrocortisone butyrate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
hydrocortisone valerate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
hydromorphone hcl
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
hydromorphone hcl
er3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
hydroxychloroquine sulfate
ANTI-INFECTIVES - Plasmodicides
hydroxyurea
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
hydroxyzine
hyoscyamine sulfate
DERMATOLOGIC MEDICATIONS - Antipruritic Drugs
GASTROINTESTINAL MEDICATIONS - Antispasmodics/Drugs Affecting GI
Motility
HYZAAR
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
ibandronate sodium3
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
ibuprofen 400, 600, 800mg tab
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
ILARIS1,SP
IMMUNOLOGICALS & VACCINES - Interleukin Receptor Antagonist
ILEVRO
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
IMBRUVICA1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
imipramine hcl
AUTONOMIC & CNS MEDICATIONS - Tertiary Amines
imipramine pamoate
AUTONOMIC & CNS MEDICATIONS - Tertiary Amines
imiquimod
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
IMITREX2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
indapamide
CARDIOVASCULAR MEDICATIONS - Thiazide and Related Drugs
indomethacin/er
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
INTEGRA F/PLUS
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
INTELENCE
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
INTERMEZZO3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
INTUNIV2
AUTONOMIC & CNS MEDICATIONS - Other Drugs for ADHD
INVEGA1
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
INVOKAMET2
ENDOCRINE MEDICATIONS - Sodium-Glucose Co-Transporter 2 Inhibitors
INVOKANA2
ENDOCRINE MEDICATIONS - Sodium-Glucose Co-Transporter 2 Inhibitors
ipratropium bromide
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
ipratropium bromide
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
ipratropium-albuterol
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
irbesartan
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
irbesartan-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
ISENTRESS
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
isoniazid
ANTI-INFECTIVES - Antituberculosis Drugs
isosorbide/dinitrate
CARDIOVASCULAR MEDICATIONS - Nitrates
isotretinoin2
DERMATOLOGIC MEDICATIONS - Accutanes
ISTALOL
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
itraconazole
ANTI-INFECTIVES - Oral Antifungal
JALYN
UROLOGICAL MEDICATIONS - Other Genitourinary Products
JANUMET/XR2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
49
DRUG/PRODUCT NAME
CLASS
JANUVIA2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
JENTADUETO2
jinteli
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
KADIAN2,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
KALETRA
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
KAPVAY2
AUTONOMIC & CNS MEDICATIONS - Other Drugs for ADHD
KAZANO2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
KENALOG
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
KEPPRA/XR2
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
ketoconazole
ANTI-INFECTIVES - Oral Antifungal
ketoconazole
ANTI-INFECTIVES - Other Topical Antifungal
ketoprofen
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
ketoprofen er
2
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
ketorolac
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
KINERET1,3,SP
IMMUNOLOGICALS & VACCINES - Interleukin Receptor Antagonist
KOMBIGLYZE XR2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
KRISTALOSE
NUTRITION, BLOOD - Blood Detoxicants
labetalol hcl
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
lactulose
NUTRITION, BLOOD - Blood Detoxicants
LAMICTAL
XR2
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
LAMICTAL/ODT
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
LAMISIL2
ANTI-INFECTIVES - Oral Antifungal
lamivudine
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
lamivudine-zidovudine
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
LAMOTRIGINE/ER
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
lamotrigine/ir
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
LANOXIN
CARDIOVASCULAR MEDICATIONS - Cardiac Glycosides
lansoprazole 30mg
LANSOPRAZOLE-AMOXICILLINCLARITHROMYCIN
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
LANTUS/SOLOSTAR3
ENDOCRINE MEDICATIONS - Insulin
LASTACAFT
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
latanoprost
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
LATUDA1
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
LAZANDA1,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
leflunomide
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
LESCOL/XL2
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
LETAIRIS1,SP
CARDIOVASCULAR MEDICATIONS - Endothelin Receptor Antagonists
letrozole
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
leucovorin calcium tablets
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
LEVALBUTEROL HCL
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
LEVAQUIN
ANTI-INFECTIVES - Quinolones
LEVEMIR/FLEXPEN3
ENDOCRINE MEDICATIONS - Insulin
levetiracetam
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
levobunolol hcl
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
GASTROINTESTINAL MEDICATIONS - Heliobacteria Pylori Drugs
50
DRUG/PRODUCT NAME
CLASS
levocarnitine
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
levocetirizine dihydrochloride
RESPIRATORY MEDICATIONS - Antihistamines
levofloxacin
ANTI-INFECTIVES - Quinolones
levothyroxine sodium
ENDOCRINE MEDICATIONS - Thyroid Supplements
LEXAPRO3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
LEXIVA
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
LIALDA1
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
lidocaine hcl
ANESTHETICS - Topical
lidocaine hcl-hydrocortisone acetate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
lidocaine hcl-hydrocortisone acetate
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
LIDOCAINE HCL
patch1
ANESTHETICS - Topical
lidocaine patch1
ANESTHETICS - Topical
lidocaine-prilocaine
ANESTHETICS - Topical
LIDODERM1
ANESTHETICS - Topical
LINZESS1
GASTROINTESTINAL MEDICATIONS - Irritable Bowel Drugs
liothyronine
ENDOCRINE MEDICATIONS - Thyroid Supplements
LIPITOR2
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
LIPOFEN2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
LIPTRUZET2
CARDIOVASCULAR MEDICATIONS - HMG-COA Combinations
lisinopril
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
lisinopril-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
lithium carbonate
AUTONOMIC & CNS MEDICATIONS - Antimania Drugs
LIVALO2
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
LO LOESTRIN FE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
LO MINASTRIN FE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
LOCOID/LIPOCREAM
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
lorazepam
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
losartan potassium
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
losartan-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
LOSEASONIQUE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
LOTEMAX
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
LOTREL
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
lovastatin
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
LOVAZA1
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
LOVENOX3,SP
NUTRITION, BLOOD - Heparin and Heparin Antagonists
ludent fluoride
NUTRITION, BLOOD - Fluoride Products
LUMIGAN
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
LUNESTA3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
LUVOX
CR3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
LYRICA2
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
LYSTEDA
NUTRITION, BLOOD - Hemostatics
MALARONE
ANTI-INFECTIVES - Plasmodicides
MALATHION
DERMATOLOGIC MEDICATIONS - Scabicides
MARINOL1
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
MAXAIR AUTOHALER
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
51
DRUG/PRODUCT NAME
CLASS
MAXALT/MLT2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
MB HYDROGEL
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
meclizine hcl
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
medroxyprogesterone acetate tab
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Progestin Drugs
MEFENAMIC ACID
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
mefloquine hcl
ANTI-INFECTIVES - Plasmodicides
MEGACE
ES1
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
megestrol acetate
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
meloxicam3
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
MENEST
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
MENOPUR1,F
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Ovulatory Stimulants
MENOSTAR
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
MEPRON1
ANTI-INFECTIVES - Other Anti-Infective Drugs
mercaptopurine
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
mesalamine
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
METADATE
CD2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
metaproterenol sulfate
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
METAXALONE
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
metformin hcl/er
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
methadone hcl
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
methimazole
ENDOCRINE MEDICATIONS - Antithyroid Drugs
methocarbamol
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
methotrexate
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
methotrexate
sodiumSP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
methyldopa
CARDIOVASCULAR MEDICATIONS - Centrally-Acting Antihypertensives
methylin/er
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
METHYLPHENIDATE HCL/CD/ER/LA/SR
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
methylprednisolone
metoclopramide hcl
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
GASTROINTESTINAL MEDICATIONS - Antispasmodics/Drugs Affecting GI
Motility
metolazone
CARDIOVASCULAR MEDICATIONS - Thiazide and Related Drugs
metoprolol succinate
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
metoprolol tartrate
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
metoprolol-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
METROGEL
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
metronidazole
ANTI-INFECTIVES - Trichomonocides
metronidazole
metronidazole
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - OB/GYN Topical AntiInfectives
METRONIDAZOLE topical
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
MICARDIS
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
MICARDIS HCT
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
midodrine hcl
CARDIOVASCULAR MEDICATIONS - Other Cardiovascular Drugs
MIGRANAL3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
MINASTRIN 24 FE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
MINILINK REAL-TIME TRANSMITTER
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Diagnostic Products
52
DRUG/PRODUCT NAME
CLASS
MINIMED/RESERVOIR
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
MINIVELLE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
minocycline hcl
ANTI-INFECTIVES - Tetracyclines
MINOCYCLINE HCL ER2
ANTI-INFECTIVES - Tetracyclines
minoxidil
CARDIOVASCULAR MEDICATIONS - Vasodilator Antihypertensives
MIRAPEX/ER
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
mirtazapine
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
misoprostol
GASTROINTESTINAL MEDICATIONS - Other Antiulcer Drugs
MODAFINIL1,3
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
moexipril hcl
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
moexipril-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
mometasone furoate
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
montelukast sodium
RESPIRATORY MEDICATIONS - Leukotriene Modifiers
morphine sulfate
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
morphine sulfate
er3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
MOVIPREP
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
MOXEZA
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
MULTAQ
CARDIOVASCULAR MEDICATIONS - Other Antiarrhythmics
multigen
NUTRITION, BLOOD - Vitamins and Minerals and Related Products
mupirocin
ANTI-INFECTIVES - Topical Antibacterial
mycophenolate mofetil1,SP
mycophenolic acid
dr1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
MYFORTIC1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
myorisan2
DERMATOLOGIC MEDICATIONS - Accutanes
MYRBETRIQ
UROLOGICAL MEDICATIONS - Other Genitourinary Products
nabumetone
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
nadolol
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
NAFTIN
ANTI-INFECTIVES - Other Topical Antifungal
naltrexone hcl
AUTONOMIC & CNS MEDICATIONS - Other CNS/Autonomic Drugs
NAMENDA
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
NAMENDA XR
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
NAPRELAN2
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
naproxen/dr/ec
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
naproxen sodium 275, 550mg
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
naratriptan
hcl3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
NASCOBAL
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
NASONEX2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
NATAZIA
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
nateglinide
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
neomycin-bacitracin-polymyxin
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
neomycin-polymyxin-dexamethasone
OPHTHALMIC MEDICATIONS - Ophthalmic Anti-Infective/Corticosteroids
neomycin-polymyxin-hydrocortisone
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
neomycin-polymyxin-hydrocortisone
OPHTHALMIC MEDICATIONS - Ophthalmic Anti-Infective/Corticosteroids
NEORAL1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
NESINA2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
53
DRUG/PRODUCT NAME
CLASS
NEUPRO
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
NEVANAC
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
nevirapine
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
NEXIUM 40mg2
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
NIACIN ER
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
NIASPAN
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
nifediac cc
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
nifedical xl
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
nifedipine er
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
NISOLDIPINE ER
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
nisoldipine ir
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
nitrofurantoin
ANTI-INFECTIVES - Urinary
nitroglycerin/patch
CARDIOVASCULAR MEDICATIONS - Nitrates
NITROSTAT
CARDIOVASCULAR MEDICATIONS - Nitrates
nizatidine 150, 300mg cap
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
nizatidine 15mg/mL sol
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
nodolor
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
NORDITROPIN
FLEXPRO/NORDIFLEX1,SP
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
norethindrone acetate
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Progestin Drugs
NOROXIN
ANTI-INFECTIVES - Quinolones
nortriptyline hcl
AUTONOMIC & CNS MEDICATIONS - Secondary Amines
NORVIR
NOVAREL1,F
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Specialized OB/GYN
Drugs
NOVOFINE/32/AUTOCOVER
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
NOVOLIN
products3
ENDOCRINE MEDICATIONS - Insulin
NOVOLOG
FLEXPEN2,3
ENDOCRINE MEDICATIONS - Insulin
NOVOLOG
products3
ENDOCRINE MEDICATIONS - Insulin
NUCYNTA
NUCYNTA
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
ER2,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
NUEDEXTA1
AUTONOMIC & CNS MEDICATIONS - Other CNS/Autonomic Drugs
NULYTELY WITH FLAVOR PACKS
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
NUTROPIN/AQ/AQ NUSPIN1,SP
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
NUVARING
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
NUVIGIL1
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
nystatin
ANTI-INFECTIVES - Oral Antifungal
nystatin
ANTI-INFECTIVES - Other Topical Antifungal
nystatin-triamcinolone
octreotide
acetate1,SP
ANTI-INFECTIVES - Topical Antifungal-Corticosteroid Combinations
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
ofloxacin
ANTI-INFECTIVES - Quinolones
ofloxacin
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Ear
ofloxacin
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
OLANZAPINE
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
OLANZAPINE-FLUOXETINE
AUTONOMIC & CNS MEDICATIONS - Psychotherapeutic Combinations
OLUX/-E
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
OMECLAMOX-PAK
GASTROINTESTINAL MEDICATIONS - Heliobacteria Pylori Drugs
54
DRUG/PRODUCT NAME
omega-3 acid ethyl
esters1
omeprazole 10, 40mg
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
OMEPRAZOLE-SODIUM
BICARBONATE2
OMNARIS2,3
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
OMNITROPE1,SP
ondansetron
CLASS
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
hcl/odt3
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
ONE TOUCH DELICA
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH LANCETS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH ULTRA 2
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH ULTRA SMART
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH ULTRA SYSTEM
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH ULTRA TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH ULTRAMINI
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONE TOUCH VERIO/IQ
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ONFI
AUTONOMIC & CNS MEDICATIONS - Anticonvulsant Benzodiazepines
ONGLYZA2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
ONMEL
ANTI-INFECTIVES - Oral Antifungal
ONSOLIS1,3,SP
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
OPANA
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
OPANA ER2,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
OPTICHAMBER
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
ORACEA2
ANTI-INFECTIVES - Tetracyclines
ORAVIG
ORENCIA
ANTI-INFECTIVES - Oral Antifungal
125mg/mL1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
orphenadrine citrate
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
ORTHO EVRA
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
ORTHO TRI-CYCLEN/LO
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
OSENI2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
OSMOPREP
GASTROINTESTINAL MEDICATIONS - Laxatives and Cathartics
OTEZLA1,3,SP
OVIDREL1,F
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Specialized OB/GYN
Drugs
oxandrolone
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Androgen Drugs
oxaprozin
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
oxazepam
AUTONOMIC & CNS MEDICATIONS - Anxiolytics
OXCARBAZEPINE
AUTONOMIC & CNS MEDICATIONS - Carbamazepines
OXISTAT
ANTI-INFECTIVES - Other Topical Antifungal
OXTELLAR
XR1
AUTONOMIC & CNS MEDICATIONS - Carbamazepines
oxybutynin chloride/er
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
oxycodone hcl
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
oxycodone-acetaminophen
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
OXYCONTIN2,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
OXYMORPHONE HCL
OXYMORPHONE HCL
OXYTROL
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
ER3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
55
DRUG/PRODUCT NAME
CLASS
PANCREAZE1
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
pancrelipase 5,000
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
pantoprazole sodium
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
PARADIGM REAL-TIME
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Diagnostic Products
PARADIGM/INFUSION/SILHOUETTE
paroxetine hcl 10, 20mg
paroxetine
tab3
hcl3
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
PATADAY
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
PATANASE
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
PATANOL
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
peg 3350-electrolyte
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
peg-3350
GASTROINTESTINAL MEDICATIONS - Laxatives and Cathartics
PEGASYS/PROCLICK1,3,SP
IMMUNOLOGICALS & VACCINES - Interferons
PEG-INTRON/REDIPEN1,3,SP
IMMUNOLOGICALS & VACCINES - Interferons
penicillin v potassium
ANTI-INFECTIVES - Penicillins
PENNSAID2
DERMATOLOGIC MEDICATIONS - Topical Anti-inflammatory Drugs
pentazocine-naloxone
AUTONOMIC & CNS MEDICATIONS - Class IV Narcotics
pentoxifylline
CARDIOVASCULAR MEDICATIONS - Other Cardiovascular Drugs
PERFOROMIST
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
permethrin 5%
DERMATOLOGIC MEDICATIONS - Scabicides
perphenazine
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
PERTZYE
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
phenazopyridine hcl 100, 200mg
UROLOGICAL MEDICATIONS - Urinary Anesthetics
phenobarbital
AUTONOMIC & CNS MEDICATIONS - Anticonvulsant Barbiturates
phentermine hcl
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Appetite Suppressants
PHENYTEK
AUTONOMIC & CNS MEDICATIONS - Hydantoins
phenytoin sodium extended
AUTONOMIC & CNS MEDICATIONS - Hydantoins
PHOSLYRA
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
PICATO2
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
pilocarpine hcl
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Throat and Mouth
pilocarpine hcl
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
pindolol
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
pioglitazone hcl
ENDOCRINE MEDICATIONS - Insulin Sensitizers and Combos
pioglitazone hcl-metformin hcl
ENDOCRINE MEDICATIONS - Insulin Sensitizers and Combos
piroxicam
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
PLAVIX
NUTRITION, BLOOD - Antiplatelet Drugs
PODOCON-251
DERMATOLOGIC MEDICATIONS - Keratolytic Drugs
PODOFILOX
DERMATOLOGIC MEDICATIONS - Keratolytic Drugs
POLYFIN/QR
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
polymyxin b sul-trimethoprim
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
potassium chloride
NUTRITION, BLOOD - Potassium Supplements
potassium citrate
UROLOGICAL MEDICATIONS - Other Genitourinary Products
POTIGA
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
PRADAXA1
NUTRITION, BLOOD - Thrombin Inhibitors
pramipexole dihydrochloride
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
56
DRUG/PRODUCT NAME
CLASS
PRAMOSONE/E
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
PRANDIMET
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
PRANDIN
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
pravastatin sodium
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
prazosin hcl
CARDIOVASCULAR MEDICATIONS - Vasodilator Antihypertensives
PRECISION
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
PRECISION XTRA
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
prednisolone
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
prednisolone acetate
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
prednisolone sodium phosphate
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
prednisone
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Specialized OB/GYN
Drugs
PREFEST
PREGNYL1,F
PREMARIN
PREMPRO
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen/Progestin
Combinations
PREPOPIK
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
PREVACID2
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
PREVIDENT
NUTRITION, BLOOD - Fluoride Products
PREVPAC
GASTROINTESTINAL MEDICATIONS - Heliobacteria Pylori Drugs
PREZISTA
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
PRIMABELLA
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
primidone
AUTONOMIC & CNS MEDICATIONS - Anticonvulsant Barbiturates
PRISTIQ2,3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
PROAIR HFA
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
probenecid
MUSCULOSKELETAL MEDICATIONS - Drugs to Prevent and Treat Gout
prochlorperazine maleate
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
proctosol-hc
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
proctozone-hc
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
PRODIGY INSULIN SYRINGE
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
PRODIGY PEN NEEDLES
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
PRODIGY/NO CODING/POCKET
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
PROGRAF1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
PROLENSA
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
PROMACTA1
IMMUNOLOGICALS & VACCINES - Myeloid Stimulants
promethazine hcl
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
promethazine hcl
RESPIRATORY MEDICATIONS - Antihistamines
promethazine hcl-dm
RESPIRATORY MEDICATIONS - Antihistamines
promethazine vc
RESPIRATORY MEDICATIONS - Antihistamine/Decongestant Combinations
promethazine vc-codeine
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
promethazine-codeine
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
promethazine-dextromethorphan
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
promethegan
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
PROMETRIUM
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Progestin Drugs
PREMPHASE
57
DRUG/PRODUCT NAME
CLASS
PROMISEB
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
propafenone hcl
CARDIOVASCULAR MEDICATIONS - Class 1C
propranolol hcl
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
propylthiouracil
ENDOCRINE MEDICATIONS - Antithyroid Drugs
PROTONIX2
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
PROTOPIC2
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
PROVENTIL HFA
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
PROVIGIL1
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
PULMICORT/FLEXHALER
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
PULMOZYME1,SP
RESPIRATORY MEDICATIONS - Other Respiratory Drugs
PYLERA
GASTROINTESTINAL MEDICATIONS - Heliobacteria Pylori Drugs
pyridostigmine bromide
AUTONOMIC & CNS MEDICATIONS - Other CNS/Autonomic Drugs
QNASL2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
QSYMIA2
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Appetite Suppressants
QUALAQUIN
ANTI-INFECTIVES - Plasmodicides
QUARTETTE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
quetiapine fumarate
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
QUICK RELEASE SOFT TEFLON
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
QUILLIVANT
XR2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
quinapril hcl
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
quinapril-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
quinidine gluconate cr
CARDIOVASCULAR MEDICATIONS - Class 1A
quinidine sulfate
CARDIOVASCULAR MEDICATIONS - Class 1A
quinine sulfate
ANTI-INFECTIVES - Plasmodicides
QVAR
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
rabeprazole2
raloxifene hcl
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Selective Estrogen
Receptor Modulator
ramipril
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
RANEXA1
CARDIOVASCULAR MEDICATIONS - Other Cardiovascular Drugs
ranitidine hcl 15mg/mL syrup
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
ranitidine hcl 300mg cap, tab
GASTROINTESTINAL MEDICATIONS - Antiulcer Drugs
RAPAFLO
UROLOGICAL MEDICATIONS - Other Genitourinary Products
RAPAMUNE1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
RAYOS
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
REBIF/REBIDOSE1,3,SP
IMMUNOLOGICALS & VACCINES - Interferons
RELENZA
ANTI-INFECTIVES - Other Antiviral Drugs
RELPAX2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
RENAGEL1
NUTRITION, BLOOD - Blood Detoxicants
RENVELA1
NUTRITION, BLOOD - Blood Detoxicants
repaglinide
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
reprexain
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
REQUIP XL
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
RESCULA
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
RESTASIS
OPHTHALMIC MEDICATIONS - Other Ophthalmic Drugs
REVATIO1,SP
CARDIOVASCULAR MEDICATIONS - Other Vasodilating Drugs
58
DRUG/PRODUCT NAME
CLASS
REVLIMID1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
REYATAZ
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
REZIRA
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
RHINOCORT AQUA2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
ribapakSP
ANTI-INFECTIVES - Other Antiviral Drugs
RIBASPHERE1,SP
ANTI-INFECTIVES - Other Antiviral Drugs
ribavirinSP
ANTI-INFECTIVES - Other Antiviral Drugs
rifampin
ANTI-INFECTIVES - Antituberculosis Drugs
RILUTEK1
MUSCULOSKELETAL MEDICATIONS - Other Musculoskeletal Drugs
RIOMET
ENDOCRINE MEDICATIONS - Oral Hypoglycemics and Combos
RISPERDAL CONSTA
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
risperidone/m-tab
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
RITALIN LA2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
rivastigmine
AUTONOMIC & CNS MEDICATIONS - Antidementia Drugs
RIZATRIPTAN3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
ropinirole hcl
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
ROXICET solution
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
roxicet tabs
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
ROZEREM3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
RYTHMOL SR
CARDIOVASCULAR MEDICATIONS - Class 1C
SABRIL1,SP
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
SAFYRAL
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
SAIZEN1,SP
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
salsalate
MUSCULOSKELETAL MEDICATIONS - Salicylates and Related Drugs
SANCTURA XR
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
SANCUSO3
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
SANDIMMUNE1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
SANDOSTATIN LAR1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
SANTYL
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
SAPHRIS
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
SAVELLA2,3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
SEASONIQUE
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
selenium sulfide
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
SENSIPAR
ENDOCRINE MEDICATIONS - Other Endocrine Drugs
SEREVENT DISKUS
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
SEROQUEL
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
SEROQUEL XR1
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
sertraline
hcl3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
SFROWASA
sildenafil citrate (pulmonary
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
hypertension)1,SP
CARDIOVASCULAR MEDICATIONS - Other Vasodilating Drugs
SILENOR3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
SILHOUETTE
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
silver sulfadiazine
ANTI-INFECTIVES - Topical Antibacterial
SIMBRINZA
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
SIMCOR2
CARDIOVASCULAR MEDICATIONS - HMG-COA Combinations
59
DRUG/PRODUCT NAME
CLASS
SIMPONI1,3,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
simvastatin
CARDIOVASCULAR MEDICATIONS - HMG-COA Reductase Inhibitors
SINGULAIR
RESPIRATORY MEDICATIONS - Leukotriene Modifiers
SKELAXIN
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
sodium fluoride
NUTRITION, BLOOD - Fluoride Products
sodium sulfacetamide
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
sodium sulfacetamide-sulfur
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
SOF-SENSOR
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Diagnostic Products
SOF-SET/MICRO
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
SOFT TOUCH
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
SOFTCLIX
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
SOLARAZE
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
SOLODYN2
ANTI-INFECTIVES - Tetracyclines
SOMA
MUSCULOSKELETAL MEDICATIONS - CNS Muscle Relaxants
SOMATULINE
DEPOT1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
SORIATANE1
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
SORILUX
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
sotalol
CARDIOVASCULAR MEDICATIONS - Other Antiarrhythmics
SOVALDI1,SP
ANTI-INFECTIVES - Other Antiviral Drugs
SPIRIVA
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
spironolactone
CARDIOVASCULAR MEDICATIONS - Potassium-Sparing Diuretics
spironolactone-hctz
CARDIOVASCULAR MEDICATIONS - Potassium-Sparing Diuretics
SPRIX2
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
STALEVO
AUTONOMIC & CNS MEDICATIONS - Other AntiParkinson Drugs
STIVARGA1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
STRATTERA2
AUTONOMIC & CNS MEDICATIONS - Other Drugs for ADHD
STRIBILD
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
SUBOXONE1
AUTONOMIC & CNS MEDICATIONS - Class III Narcotics
SUBSYS1,3
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
SUCLEAR
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
sucralfate
GASTROINTESTINAL MEDICATIONS - Other Antiulcer Drugs
SULAR2
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
sulfacetamide sodium
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
sulfamethoxazole-trimethoprim/DS
ANTI-INFECTIVES - Sulfonamides
sulfasalazine/dr
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
sulindac
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
sumatriptan3
SUMATRIPTAN
SUMAVEL
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
nasal/injectable3
DOSEPRO2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
SUPRAX
ANTI-INFECTIVES - Cephalosporins
SUPREP
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
SURE COMFORT LANCETS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
SURESTEP
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
SURE-T
MEDICAL (MISCELLANEOUS) SUPPLIES - Medical (Miscellaneous) Supplies
SUSTIVA
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
60
DRUG/PRODUCT NAME
CLASS
SYMBICORT2,3
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
SYMBYAX
AUTONOMIC & CNS MEDICATIONS - Psychotherapeutic Combinations
SYMLINPEN
ENDOCRINE MEDICATIONS - Amylin Analogues
SYNTHROID
ENDOCRINE MEDICATIONS - Thyroid Supplements
TABLOID1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
TACLONEX1
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
tacrolimus1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
TAMIFLU
ANTI-INFECTIVES - Other Antiviral Drugs
tamoxifen citrate
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
tamsulosin hcl
UROLOGICAL MEDICATIONS - Other Genitourinary Products
TANZEUM2,3
ENDOCRINE MEDICATIONS - Incretin Mimetics
TARCEVA1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
TARKA
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
TASIGNA1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
TAZORAC2
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
TECFIDERA1,SP
AUTONOMIC & CNS MEDICATIONS - Drugs to Treat Multiple Sclerosis
TEGRETOL XR
AUTONOMIC & CNS MEDICATIONS - Carbamazepines
TEKAMLO
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
TEKTURNA/HCT
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
TELMISARTAN
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
temazepam
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
TEMODAR1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
TEMOZOLOMIDE1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
terazosin hcl
CARDIOVASCULAR MEDICATIONS - Vasodilator Antihypertensives
terbinafine hcl
ANTI-INFECTIVES - Oral Antifungal
terconazole
ANTI-INFECTIVES - Vaginal Antifungal
testosterone
cypionate1
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Androgen Drugs
tetracycline hcl
ANTI-INFECTIVES - Tetracyclines
TEVETEN
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
TEVETEN HCT
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
TEV-TROPIN1,SP
IMMUNOLOGICALS & VACCINES - Growth Hormones and Related Drugs
THALOMID1,SP
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS - Miscellaneous Drugs
theophylline/anhydrous
RESPIRATORY MEDICATIONS - Methyl Xanthine Drugs
thioridazine hcl
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
thiothixene
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
tiagabine hcl
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
TIKOSYN
CARDIOVASCULAR MEDICATIONS - Other Antiarrhythmics
timolol maleate
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
timolol maleate
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
TIMOPTIC OCUDOSE
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
tinidazole
ANTI-INFECTIVES - Trichomonocides
tizanidine hcl
MUSCULOSKELETAL MEDICATIONS - Direct Muscle Relaxants
TOBI1,SP
ANTI-INFECTIVES - Aminoglycosides
TOBRADEX/ST
OPHTHALMIC MEDICATIONS - Ophthalmic Anti-Infective/Corticosteroids
tobramycin
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
61
DRUG/PRODUCT NAME
tobramycin sulfate
inhalation1,SP
CLASS
ANTI-INFECTIVES - Aminoglycosides
tobramycin-dexamethasone
OPHTHALMIC MEDICATIONS - Ophthalmic Anti-Infective/Corticosteroids
tolterodine tartrate
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
TOPAMAX2
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
topiramate
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
TOPROL XL
CARDIOVASCULAR MEDICATIONS - Beta-Adrenergic Antagonist Drugs
torsemide
CARDIOVASCULAR MEDICATIONS - Loop Diuretics
TOVIAZ
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
TRACLEER1,SP
CARDIOVASCULAR MEDICATIONS - Endothelin Receptor Antagonists
TRADJENTA2
ENDOCRINE MEDICATIONS - Dipeptidyl Peptidase-IV Inhibitors
TRAMADOL HCL/ER
AUTONOMIC & CNS MEDICATIONS - Analgesics
tramadol hcl/ir
AUTONOMIC & CNS MEDICATIONS - Analgesics
tramadol hcl-acetaminophen
AUTONOMIC & CNS MEDICATIONS - Analgesics
trandolapril
CARDIOVASCULAR MEDICATIONS - Angiotensin Converting Enzyme Inhibitors
tranexamic acid
NUTRITION, BLOOD - Hemostatics
TRANSDERM-SCOP
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
tranylcypromine sulfate
AUTONOMIC & CNS MEDICATIONS - MAO Inhibitors
TRAVATAN Z
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
travoprost
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
trazodone hcl
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
tretinoin
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
tretinoin
TRETINOIN
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
MICROSPHERE2
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
TREXIMET2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
triamcinolone acetonide
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
triamcinolone acetonide
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
triamcinolone acetonide
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Throat and Mouth
triamterene-hctz
CARDIOVASCULAR MEDICATIONS - Potassium-Sparing Diuretics
triazolam
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
TRIBENZOR
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
TRICOR2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
trifluoperazine hcl
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
trifluridine
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antiviral Drugs
TRIGLIDE2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
trihexyphenidyl hcl
AUTONOMIC & CNS MEDICATIONS - AntiParkinson Anticholinergic Drugs
TRILIPIX2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
trilyte with flavor packets
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
trimethoprim
ANTI-INFECTIVES - Urinary
TROSPIUM CHLORIDE
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
TRUEPLUS LANCETS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
TRUETEST TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
TRUETRACK TEST STRIPS
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
TRUVADA
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
TUDORZA PRESSAIR
RESPIRATORY MEDICATIONS - Other Drugs for Asthma
TUSSICAPS
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
62
DRUG/PRODUCT NAME
CLASS
TUSSIONEX
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
TWYNSTA
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
TYKERB1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
ULESFIA
DERMATOLOGIC MEDICATIONS - Scabicides
ULORIC2
MUSCULOSKELETAL MEDICATIONS - Drugs to Prevent and Treat Gout
ULTRA COMFORT
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
ULTRAVATE PAC
DERMATOLOGIC MEDICATIONS - Topical Corticosteroid Drugs
ULTRESA
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
UROXATRAL
UROLOGICAL MEDICATIONS - Other Genitourinary Products
ursodiol
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
VAGIFEM
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
VALACYCLOVIR HCL
ANTI-INFECTIVES - Other Antiviral Drugs
VALCYTE1
ANTI-INFECTIVES - Other Antiviral Drugs
valproic acid
AUTONOMIC & CNS MEDICATIONS - Valproic Acid and Derivatives
valsartan
CARDIOVASCULAR MEDICATIONS - Angiotensin II Receptor Antagonists
valsartan-hctz
CARDIOVASCULAR MEDICATIONS - Other Antihypertensives
VALTREX
ANTI-INFECTIVES - Other Antiviral Drugs
VANCOCIN HCL
ANTI-INFECTIVES - Other Anti-Infective Drugs
vancomycin hcl
vandazole
ANTI-INFECTIVES - Other Anti-Infective Drugs
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - OB/GYN Topical AntiInfectives
VASCEPA1
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
VECTICAL
DERMATOLOGIC MEDICATIONS - Antipsoriasis and Antieczema Drugs
VELTIN2
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
VENLAFAXINE HCL ER TABS2,3
venlafaxine
hcl3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
VENTOLIN HFA
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
VERAMYST2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
verapamil/er/pm
CARDIOVASCULAR MEDICATIONS - Calcium Antagonists
VEREGEN
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
veripred 20
ENDOCRINE MEDICATIONS - Glucocorticoid Drugs
VESICARE2
UROLOGICAL MEDICATIONS - Anticholinergic Antispasmodics
VEXOL
OPHTHALMIC MEDICATIONS - Ophthalmic Corticosteroid Drugs
VGO 20/30/40
MEDICAL (MISCELLANEOUS) SUPPLIES - Diabetic Supplies
VICTOZA2,3
ENDOCRINE MEDICATIONS - Incretin Mimetics
VICTRELIS1,SP
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
VIGAMOX
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
VIIBRYD3
AUTONOMIC & CNS MEDICATIONS - Selective Serotonin Reuptake Inhibitors
VIMOVO2
MUSCULOSKELETAL MEDICATIONS - Non-Steroidal Anti-Inflammatory Agents
VIMPAT1
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
VIRAMUNE
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
VIRAMUNE XR
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
VIREAD
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
VIVELLE-DOT
VOLTAREN
voriconazole
gel2
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Estrogen Drugs
DERMATOLOGIC MEDICATIONS - Topical Anti-inflammatory Drugs
ANTI-INFECTIVES - Oral Antifungal
63
DRUG/PRODUCT NAME
CLASS
VOTRIENT1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
VYTORIN2
CARDIOVASCULAR MEDICATIONS - HMG-COA Combinations
VYVANSE2
AUTONOMIC & CNS MEDICATIONS - CNS Stimulant Drugs
warfarin sodium
NUTRITION, BLOOD - Oral Anticoagulants, Vitamin K
WELCHOL2
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
WELLBUTRIN
XL2,3
AUTONOMIC & CNS MEDICATIONS - Other Antidepressants
westhroid
ENDOCRINE MEDICATIONS - Thyroid Supplements
XALATAN
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
XARELTO1
NUTRITION, BLOOD - Other Drugs Affecting Coagulation
XELJANZ1,3,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
XELODA1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
XENAZINE1,SP
AUTONOMIC & CNS MEDICATIONS - Other CNS/Autonomic Drugs
XERESE
ANTI-INFECTIVES - Topical Antiviral Drugs
XIFAXAN1
ANTI-INFECTIVES - Other Anti-Infective Drugs
XOPENEX HFA
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
XOPENEX/CONCENTRATE
RESPIRATORY MEDICATIONS - Beta-2 Adrenergic Drugs
XTANDI1,SP
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
XYZAL
RESPIRATORY MEDICATIONS - Antihistamines
YASMIN 28
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
YAZ
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS - Contraceptives
zafirlukast
RESPIRATORY MEDICATIONS - Leukotriene Modifiers
zaleplon3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
zamicet
AUTONOMIC & CNS MEDICATIONS - Class II Narcotics
ZEGERID2
GASTROINTESTINAL MEDICATIONS - Proton Pump Inhibitors
ZEMPLAR
NUTRITION, BLOOD - Therapeutic Vitamins and Minerals
zenatane2
DERMATOLOGIC MEDICATIONS - Accutanes
ZENPEP1
GASTROINTESTINAL MEDICATIONS - Other GI Drugs
ZETIA
CARDIOVASCULAR MEDICATIONS - Hypolipoproteinemics
ZETONNA2,3
EAR-NOSE-THROAT MEDICATIONS - Drugs Affecting the Nose
ZIAGEN TABLET
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
ZIANA2
DERMATOLOGIC MEDICATIONS - Antiacne Drugs
zidovudine
ANTI-INFECTIVES - Antiretrovirals & Protease Inhibitors
ZIOPTAN
OPHTHALMIC MEDICATIONS - Antiglaucoma Drugs
ZIPRASIDONE HCL
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
ZIRGAN
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antiviral Drugs
zolmitriptan
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
ZOLMITRIPTAN/ODT3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
zolpidem
tartrate/er3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
ZOLPIMIST3
AUTONOMIC & CNS MEDICATIONS - Sedative/Hypnotic Drugs
ZOMIG/ZMT2,3
AUTONOMIC & CNS MEDICATIONS - Drugs to Prevent and Treat Headaches
ZONEGRAN1
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
zonisamide
AUTONOMIC & CNS MEDICATIONS - Other Anticonvulsants
ZOVIRAX
ANTI-INFECTIVES - Topical Antiviral Drugs
ZUBSOLV1
AUTONOMIC & CNS MEDICATIONS - Class III Narcotics
ZUPLENZ3
AUTONOMIC & CNS MEDICATIONS - Antivertigo and Antiemetic Drugs
64
DRUG/PRODUCT NAME
CLASS
ZUTRIPRO
RESPIRATORY MEDICATIONS - Antitussive and Expectorant Drugs
ZYCLARA2
DERMATOLOGIC MEDICATIONS - Topical Dermatological Drugs
ZYFLO/CR2
RESPIRATORY MEDICATIONS - Leukotriene Modifiers
ZYLET
OPHTHALMIC MEDICATIONS - Ophthalmic Anti-Infective/Corticosteroids
ZYMAXID
OPHTHALMIC MEDICATIONS - Ophthalmic Topical Antibacterial Drugs
ZYPREXA/ZYDIS
AUTONOMIC & CNS MEDICATIONS - Antipsychotic Drugs
ZYVOX1
ANTI-INFECTIVES - Other Anti-Infective Drugs
65
66
PO Box 2328 – Oklahoma City, OK 73101-2328
MDF15 Lists Updated 10/2015
MDF15