Preferred Drug List 2013 Standard Formulary (3 ... - Express Scripts

Preferred Drug List
2013
Standard Formulary
(3 tier or high deductible plans)
Printed: May 2013

DEVELOPMENT OF THE DRUG FORMULARY
The Drug Formulary is the cornerstone of drug therapy quality assurance and cost containment
efforts. The Drug Formulary process has been successfully used by hospitals and managed care
organizations to provide comprehensive, cost-effective pharmacy services.
This Drug Formulary document was developed by the Express Scripts’ Pharmacy and Therapeutics
Committee (P&T Committee). Arise Health Plan delegates this responsibility to ESI. The ESI P&T
committee is comprised of physicians from various medical specialties and pharmacists.
Medications are reviewed for safety, effectiveness, and cost. Then, the Committee selects
the drugs considered to offer the greatest value in each category.
Formulary development and maintenance is a dynamic process. The P&T Committee will regularly
review new and existing medications to ensure the Formulary remains responsive to the needs of
our members and providers.
DRUG FORMULARY MEDICATIONS
The Drug Formulary is a listing of medications marketed at the time of the
Formulary printing, and intended for use by the health plan physicians and
pharmacy providers. Unless exceptions are noted, all forms (tablet,
capsule, liquid, topical) and strengths of a drug product are included in
the Formulary and will be covered by the plan.
The Drug Formulary applies to prescription medications dispensed to outpatients by participating
pharmacies. The Formulary does not apply to inpatient medications or to most medications
administered in a physician’s office.
Non-Prescription Medication (OTC) Policy
Over-the-counter (OTC) products are typically not covered, but some are listed for informational
purposes. (When available, non-prescription products may be less costly to the patient than a
covered product.) Also, if a prescription product is available in the identical strength, dosage form,
and active ingredient(s) as an OTC product, the prescription product will not be covered. In these
instances, physicians and pharmacists should refer members to the OTC equivalent product. If the
member or physician insists on the prescription equivalent product, the member must pay the entire
cost of the prescription.
Generic Drug Policy
If a member requests the brand name product in place of its generic equivalent, the patient must
pay the applicable copay plus the cost difference between the brand name and generic drug.
Prescriptions for Non-Formulary Medications
Providers are requested to comply with the Drug Formulary when prescribing medications for plan
members. If a pharmacist receives a prescription for a non-Formulary medication, the pharmacist
may attempt to contact the physician to request a change to a Formulary product.

Prior Authorization Process
If a patient requires a medication that is subject to prior authorization,
the provider should direct such inquiries to:
Express Scripts, Inc.
Drug Prior Authorization Department
Fax: 800-357-9577
Tel: 800-417-8164
If a provider wishes to request that a new or existing medication be added to the Drug Formulary, a
letter indicating the significant advantages of the drug product over current formulary medications,
along with supporting medical literature, should be mailed to the following address. Thank you.
Arise Health Plan
Formulary Department
421 Lawrence Drive, Suite 100
DePere, WI 54115

TABLE OF CONTENTS
Chapter
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Name
ANESTHETICS
ANTIINFECTIVES
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
CARDIOVASCULAR MEDICATIONS
AUTONOMIC & CNS MEDICATIONS
DERMATOLOGICAL MEDICATIONS
EAR-NOSE-THROAT MEDICATIONS
ENDOCRINE MEDICATIONS
GASTROINTESTINAL MEDICATIONS
IMMUNOLOGICALS & VACCINES
MUSCULOSKELETAL MEDICATIONS
NUTRITION, BLOOD
OBSTETRICAL & GYNECOLOGICAL MEDICATIONS
OPHTHALMIC MEDICATIONS
RESPIRATORY MEDICATIONS
UROLOGICAL MEDICATIONS
DIAGNOSTIC & MISCELLANEOUS MEDICATIONS
MEDICAL (MISCELLANEOUS) SUPPLIES
DRUG NAME
TIER
1 2 3
CHAPTER 1: ANESTHETICS
1.2 TOPICAL ANESTHETICS
lidocaine hcl X
lidocaine‐prilocaine X
LIDODERM X
CHAPTER 2: ANTIINFECTIVES
SUGGESTED PREFFERED ALTERNATIVES
2.1.1 CEPHALOSPORINS
cefaclor er X
cefadroxil X
cefdinir X
cefpodoxime proxetil X
cefprozil X
cefuroxime X
cephalexin X
CEDAX X cefpodoxime,cefuroxime,cefdinr
SUPRAX X cefpodoxime,cefuroxime,cefdinr
2.1.3 CLINDAMYCINS
clindamycin hcl X
clindamycin phosphate X
2.1.4 ERYTHROMYCINS
erythromycin X
2.1.4.1 OTHER MACROLIDES
azithromycin X
clarithromycin/er X

DRUG NAME
2.1.5 PENICILLINS
amox tr‐potassium clavulanate X
amoxicillin X
amoxicillin‐clavulanate er X
dicloxacillin sodium X
penicillin v potassium X
2.1.6 SULFONAMIDES
sulfamethoxazole‐trimethoprim X
TIER
1 2 3
SUGGESTED PREFFERED ALTERNATIVES
2.1.7 TETRACYCLINES
doxycycline hyclate X
doxycycline monohydrate X
minocycline hcl X
tetracycline hcl X
DORYX ST X doxycyclne hyclate delayed‐rel
ORACEA ST X doxycycline hyclate
SOLODYN ST X minocycline extended‐release
2.1.8 URINARY ANTIINFECTIVES
nitrofurantoin X
nitrofurantoin mono‐macro X
trimethoprim X
2.1.9 QUINOLONES
ciprofloxacin er X
ciprofloxacin hcl X
levofloxacin X
ofloxacin X
AVELOX/ABC PACK X
FACTIVE X ciproflox,levoflo,oflox,AVELOX
LEVAQUIN X levofloxacin
NOROXIN X ciproflox,levoflo,oflox,AVELOX
2.2 TOPICAL ANTIBACTERIAL DRUGS
gentamicin sulfate X
mupirocin X
silver sulfadiazine X
ALTABAX X
BACTROBAN X
2.3 ORAL ANTIFUNGAL DRUGS
fluconazole X
griseofulvin X
itraconazole ST X
ketoconazole X
nystatin X
terbinafine hcl X
voriconazole X
GRIFULVIN V X

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
ORAVIG X gen nystat, clotrimazol troche
2.4.1 VAGINAL ANTIFUNGALS
clotrimazole X
terconazole X
2.4.2 OTHER TOPICAL ANTIFUNGALS
ciclopirox X
clotrimazole X
econazole nitrate X
ketoconazole X
nystatin X
ERTACZO X ciclopirox, ketoconazole
EXELDERM X econazole, ketoconazole
OXISTAT X ciclopirox, ketoconazole
2.4.3 TOPICAL ANTIFUNGAL‐CORTICOSTEROID COMB.
clotrimazole‐betamethasone X
nystatin‐triamcinolone X
2.5.1 ANTIRETROVIRALS & PROTEASE INHIBITORS
lamivudine X
lamivudine‐zidovudine X
nevirapine X
ATRIPLA X
COMBIVIR X lamivudine/zidovudine
COMPLERA X ATRIPLA
EPIVIR X
EPZICOM X
INCIVEK X
INTELENCE X
ISENTRESS X
KALETRA X
LEXIVA X
NORVIR X
PREZISTA X
REYATAZ X
SUSTIVA X
TRUVADA X
VICTRELIS X
VIRAMUNE X nevirapine
VIRAMUNE XR X
VIREAD X
ZIAGEN X abacavir
2.5.2 OTHER ANTIVIRAL DRUGS
acyclovir X
amantadine X
famciclovir X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
ribapak X
ribavirin PA X
valacyclovir X
BARACLUDE X
DENAVIR X
EPIVIR HBV X
RELENZA X
TAMIFLU X
VALTREX X valacyclovir
2.6 TOPICAL ANTIVIRAL DRUGS
XERESE X
ZOVIRAX X
2.7.2 ANTITUBERCULOSIS DRUGS
isoniazid X
rifampin X
2.7.3 PLASMODICIDES
atovaquone‐proguanil hcl X
hydroxychloroquine sulfate X
mefloquine hcl X
MALARONE X atovaquone/proguanil hcl
QUALAQUIN X quinine sulfate
2.7.4 SULFONES
DAPSONE X
2.7.5 TRICHOMONOCIDES
metronidazole X
tinidazole X
2.8 OTHER ANTIINFECTIVE DRUGS
bacitracin X
vancomycin hcl X
DIFICID X metronidazole
VANCOCIN HCL X vancomycin
XIFAXAN X
ZYVOX X
2.8.2 AMINOGLYCOSIDES
gentamicin sulfate X
tobramycin sulfate X
TOBI X
CHAPTER 3: ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
3.0 ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
anagrelide hcl X
anastrozole X
azathioprine X
bicalutamide X
cyclosporine modified X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
exemestane X
hydroxyurea X
leflunomide X
letrozole X
leucovorin calcium X
megestrol acetate X
mercaptopurine X
methotrexate X
mycophenolate mofetil X
tacrolimus X
tamoxifen citrate X
tretinoin X
ARIMIDEX X anastrozole
CELLCEPT X mycophenolate mofetil
CIMZIA PA X ENBREL, HUMIRA
CIMZIA PA X ENBREL, HUMIRA
ELIGARD PA X
ENBREL PA X
FEMARA X letrozole
GLEEVEC X
HUMIRA PA X
MEGACE ES X megestrol acetate
MYFORTIC X
ORENCIA PA X
PROGRAF X tacrolimus
RAPAMUNE X
REVLIMID X
SANDOSTATIN LAR X
SIMPONI PA X ENBREL, HUMIRA
SOMATULINE DEPOT X
STELARA PA X
STELARA PA X
TYKERB X
XELODA X
CHAPTER 4: CARDIOVASCULAR MEDICATIONS
4.1 CARDIAC GLYCOSIDES
digoxin X
LANOXIN X digoxin
4.2 CALCIUM ANTAGONISTS
amlodipine besylate X
cartia xt X
diltiazem/er X
felodipine er X
nifediac cc X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
nifedical xl X
nifedipine er X
nisoldipine X
verapamil X
verapamil er pm X
CARDENE SR X immediate‐release nicardipine
CARDIZEM LA X diltiazem 24 hr er
SULAR X nisoldipine er
4.3.1 LOOP DIURETICS
bumetanide X
furosemide X
torsemide X
4.3.2 THIAZIDE AND RELATED DRUGS
chlorthalidone X
hydrochlorothiazide X
indapamide X
metolazone X
4.3.3 POTASSIUM SPARING DIURETICS
amiloride hcl X
eplerenone X
spironolactone X
spironolactone‐hctz X
triamterene‐hctz X
triamterene‐hydrochlorothiazid X
4.4 BETA‐ADRENERGIC ANTAGONIST DRUGS
acebutolol hcl X
atenolol X
bisoprolol fumarate X
carvedilol X
labetalol hcl X
metoprolol succinate X
metoprolol tartrate X
nadolol X
pindolol X
propranolol hcl X
timolol maleate X
BYSTOLIC X
COREG CR X
TOPROL XL X metoprolol succinate er
4.5.1 VASODILATOR ANTIHYPERTENSIVES
doxazosin mesylate X
minoxidil X
prazosin hcl X
terazosin hcl X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
CARDURA XL X alfuzosn er,tamsulosn,RAPAFLO
4.5.2 CENTRALLY ACTING ANTIHYPERTENSIVES
clonidine X
clonidine hcl X
guanfacine hcl X
methyldopa X
4.5.4.1 ANGIOTENSIN CONVERTING ENZYME INHIBITORS
benazepril hcl X
captopril X
enalapril maleate X
fosinopril sodium X
lisinopril X
moexipril hcl X
quinapril hcl X
ramipril X
trandolapril X
4.5.4.2 ANGIOTENSIN II RECEPTOR ANTAGONISTS
eprosartan mesylate X
irbesartan X
losartan potassium X
ATACAND ST X losartan, BENICAR, DIOVAN
ATACAND HCT ST X candesartan/hydrochlorothiazde
AVALIDE ST X irbesartan/hydrochlorothiazide
AVAPRO ST X irbesartan
BENICAR ST X
BENICAR HCT ST X
COZAAR ST X losartan potassium
DIOVAN ST X
DIOVAN HCT ST X valsartan/hydrochlorthiazide
EDARBI X losartan, BENICAR, DIOVAN
HYZAAR ST X losartan‐hctz
MICARDIS ST X losartan, BENICAR, DIOVAN
MICARDIS HCT ST X losar‐ht,valsar‐ht,BENICAR HCT
TEVETEN ST X eprosartan
TEVETEN HCT ST X losar‐ht,valsar‐ht,BENICAR HCT
4.5.6 OTHER ANTIHYPERTENSIVES
amlodipine besylate‐benazepril X
atenolol‐chlorthalidone X
benazepril‐hydrochlorothiazide X
bisoprolol‐hydrochlorothiazide X
captopril‐hydrochlorothiazide X
enalapril‐hydrochlorothiazide X
fosinopril‐hydrochlorothiazide X
irbesartan‐hydrochlorothiazide X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
lisinopril‐hydrochlorothiazide X
losartan‐hydrochlorothiazide X
metoprolol‐hydrochlorothiazide X
moexipril‐hydrochlorothiazide X
quinapril‐hydrochlorothiazide X
AMTURNIDE X
AZOR ST X
EDARBYCLOR X losar‐ht,valsar‐ht,BENICAR HCT
EXFORGE ST X
EXFORGE HCT ST X
LOTREL X amlodipine‐benazepril
TARKA X
TEKAMLO X
TEKTURNA X
TEKTURNA HCT X
TRIBENZOR ST X
TWYNSTA ST X AZOR, EXFORGE/HCT, TRIBENZOR
4.6.1 NITRATES
isosorbide X
isosorbide dinitrate X
nitroglycerin X
nitroglycerin patch X
NITROSTAT X
4.6.2 OTHER VASODILATING DRUGS
ADCIRCA X
BIDIL X isosorbide dn + hydralazine
REVATIO X sildenafil
4.6.3 ENDOTHELIN RECEPTOR ANTAGONIST
LETAIRIS X
TRACLEER X
4.7.1.3 CLASS 1C
flecainide acetate X
propafenone hcl X
RYTHMOL SR X propafenone er
4.7.3 AMIODARONES
amiodarone hcl X
4.7.5 OTHER ANTIARRHYTHMICS
sotalol X
MULTAQ X amiodarone
TIKOSYN X
4.8.1 HYPOLIPOPROTEINEMICS
cholestyramine X
colestipol hcl X
fenofibrate X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
fenofibric acid X
gemfibrozil X
ANTARA X fenofibrate, TRICOR, TRILPIX
FENOGLIDE X fenofibrate, TRICOR, TRILPIX
FIBRICOR X fenofibric acid
LIPOFEN X fenofibrate, TRICOR, TRILPIX
LOVAZA X
NIASPAN X
TRICOR X
TRIGLIDE X fenofibrate, TRICOR, TRILPIX
TRILIPIX X
WELCHOL X
ZETIA X
4.8.2 HMG‐COA REDUCTASE INHIBITORS
atorvastatin calcium X
fluvastatin sodium X
lovastatin X
pravastatin sodium X
simvastatin X
ALTOPREV ST X atorvastatn,simvastatn,CRESTOR
CRESTOR ST X
LESCOL ST X fluvastatin
LESCOL XL ST X atorvastatn,simvastatn,CRESTOR
LIPITOR ST X atorvastatin
LIVALO ST X atorvastatn,simvastatn,CRESTOR
4.8.2.1 HMG‐COA COMBINATIONS
amlodipine‐atorvastatin X
ADVICOR ST X
CADUET ST X amlodipine/atorvastatin
CADUET ST X amlodipine/atorvastatin
SIMCOR ST X
VYTORIN ST X simvastatin + ZETIA, CRESTOR
VYTORIN ST X simvastatin + ZETIA, CRESTOR
4.9 OTHER CARDIOVASCULAR DRUGS
pentoxifylline X
RANEXA X
CHAPTER 5: AUTONOMIC AND CNS MEDICATIONS
5.1.1 ANALGESICS
butorphanol tartrate X
tramadol hcl/er X
tramadol hcl‐acetaminophen X
5.1.1.1 CLASS II NARCOTICS
endocet X
fentanyl X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
hydromorphone hcl X
methadone hcl X
morphine sulfate/er X
oxycodone hcl X
oxycodone‐acetaminophen X
oxymorphone hcl X
roxicet X
ABSTRAL X
AVINZA X gen,NUCYN ER,OPANA ER,OXYCONTN
EXALGO X gen,NUCYN ER,OPANA ER,OXYCONTN
FENTORA X
KADIAN X gen,NUCYN ER,OPANA ER,OXYCONTN
LAZANDA X fentanyl citra,ABSTRAL,FENTORA
NUCYNTA/ER X
ONSOLIS X fentanyl citra,ABSTRAL,FENTORA
OPANA X oxymorphone
OPANA ER X
OXYCONTIN X
SUBSYS X fentanyl citra,ABSTRAL,FENTORA
5.1.1.2 CLASS III NARCOTICS
acetaminophen‐codeine X
buprenorphine hcl X
hydrocodone bit‐ibuprofen X
hydrocodone‐acetaminophen X
reprexain X
zamicet X
BUTRANS X
SUBOXONE X
5.1.1.3 CLASS IV NARCOTICS
buprenorphine hcl X
5.1.2 DRUGS TO PREVENT AND TREAT HEADACHES
butalbital compound‐codeine X
butalbital‐aspirin‐caffeine X
naratriptan hcl X
sumatriptan X
AXERT ST X sumatriptan, RELPAX, ZOMIG/ZMT
FROVA ST X sumatriptan, RELPAX, ZOMIG/ZMT
IMITREX ST X sumatriptan
MAXALT/MLT ST X sumatriptan, RELPAX, ZOMIG/ZMT
MIGRANAL X
RELPAX ST X
SUMAVEL DOSEPRO ST X
TREXIMET ST X
ZOMIG/ZMT ST X
TIER

DRUG NAME
5.2.1 ANXIOLYTICS
alprazolam/er/xr X
buspirone hcl X
chlordiazepoxide hcl X
clorazepate dipotassium X
diazepam X
lorazepam X
oxazepam X
TIER
1 2 3
SUGGESTED PREFFERED ALTERNATIVES
5.2.2 SEDATIVE/HYPNOTIC DRUGS
estazolam X
flurazepam hcl X
temazepam X
triazolam X
zaleplon X
zolpidem tartrate/er X
AMBIEN ST X zolpidem
AMBIEN CR ST X zolpidem er
EDLUAR ST X zolpidem immed‐rel/er, LUNESTA
INTERMEZZO ST X zolpidem immed‐rel/er, LUNESTA
LUNESTA ST X
ROZEREM ST X
SILENOR ST X zolpidem immed‐rel/er, LUNESTA
ZOLPIMIST ST X zolpidem tablet
5.3 ANTIMANIA DRUGS
lithium carbonate X
5.4.1 CARBAMAZEPINES
carbamazepine/er/xr X
oxcarbazepine X
CARBATROL X carbamazepine er
TEGRETOL XR X
TEGRETOL XR X carbamazepine xr
5.4.2 ANTICONVULSANT BENZODIAZEPINES
clonazepam X
diazepam X
5.4.3 HYDANTOINS
phenytoin sodium extended X
DILANTIN X
PHENYTEK X phenytoin sodium extended
5.4.4 VALPROIC ACID AND DERIVATIVES
divalproex sodium/er X
VALPROIC ACID X
DEPAKOTE ER X divalproex sodium er
5.4.6 ANTICONVULSANT BARBITURATES
phenobarbital X

TIER
DRUG NAME
1 2 3
primidone X
SUGGESTED PREFFERED ALTERNATIVES
5.4.7 OTHER ANTICONVULSANTS
gabapentin X
lamotrigine X
levetiracetam X
topiramate X
zonisamide X
GRALISE ST X gabapentin
HORIZANT ST X gabapentin
KEPPRA X levetiracetam
KEPPRA XR X levetiracetam er
LAMICTAL X lamotrigine
LAMICTAL ODT X
LAMICTAL XR X
LYRICA ST X
POTIGA X
TOPAMAX X topiramate sprinkle caps
VIMPAT PA X
5.5.1.1 TERTIARY AMINES
amitriptyline hcl X
clomipramine hcl X
doxepin hcl X
imipramine hcl X
5.5.1.2 SECONDARY AMINES
desipramine hcl X
nortriptyline hcl X
5.5.1.3 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
citalopram X
citalopram hbr X
escitalopram oxalate X
fluoxetine hcl X
fluvoxamine maleate X
paroxetine hcl X
sertraline hcl X
LEXAPRO X escitalopram
LUVOX CR X generic SSRIs, VIIBRYD
VIIBRYD ST X
5.5.1.4 OTHER ANTIDEPRESSANTS
bupropion hcl X
bupropion hcl sr X
bupropion xl X
mirtazapine X
trazodone hcl X
venlafaxine hcl X

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
venlafaxine hcl er X
VENLAFAXINE HCL ER ST X venlafax er(NOT UCB NDCS‐65580
CYMBALTA PA X
EFFEXOR XR ST X venlafax er(NOT UCB NDCS‐65580
PRISTIQ ER ST X
SAVELLA PA X
WELLBUTRIN XL X bupropion xl
5.5.2 MAO INHIBITORS
tranylcypromine sulfate X
5.6 ANTIVERTIGO AND ANTIEMETIC DRUGS
dronabinol X
granisetron hcl X
meclizine hcl X
ondansetron hcl X
ondansetron odt X
prochlorperazine maleate X
promethazine hcl X
promethegan X
EMEND X
SANCUSO X
TRANSDERM‐SCOP X meclizine
ZUPLENZ X ondansetron odt
5.7.1 ANTIPARKINSON ANTICHOLINERGIC DRUGS
benztropine mesylate X
trihexyphenidyl hcl X
5.7.2 OTHER ANTIPARKINSON DRUGS
bromocriptine mesylate X
carbidopa‐levodopa X
carbidopa‐levodopa‐entacapone X
pramipexole dihydrochloride X
ropinirole hcl X
AZILECT X
COMTAN X entacapone
MIRAPEX X pramipexole
MIRAPEX ER X
NEUPRO X pramipex,ropinir/er,MIRAPEX ER
REQUIP XL X ropinirole er
STALEVO 100 X carbidopa/levodopa/entacapone
5.8 ANTIPSYCHOTIC DRUGS
clozapine X
fluphenazine hcl X
haloperidol X
olanzapine X
olanzapine odt X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
perphenazine X
quetiapine fumarate X
risperidone X
thioridazine hcl X
thiothixene X
trifluoperazine hcl X
ziprasidone hcl X
ABILIFY X
ABILIFY DISCMELT X
generic, ABILIFY/DISC, LATUDA, SEROQUEL
FANAPT
X XR
GEODON X ziprasidone
generic, ABILIFY/DISC, LATUDA, SEROQUEL
INVEGA
X XR
LATUDA X
RISPERDAL CONSTA X
generic, ABILIFY/DISC, LATUDA, SEROQUEL
SAPHRIS
X XR
SEROQUEL X quetiapine fumarate
SEROQUEL XR X
ZYPREXA X olanzapine
ZYPREXA ZYDIS X olanzapine odt
5.8.1 ALIPHATIC PHENOTHIAZINES
chlorpromazine hcl X
5.8.1.1 PSYCHOTHERAPEUTIC COMBINATIONS
olanzapine‐fluoxetine hcl X
SYMBYAX X
SYMBYAX X olanzapine/fluoxetine hcl
5.9.1 CNS STIMULANT DRUGS
amphetamine salt combo X
dexmethylphenidate hcl X
dextroamphetamine sulfate X
dextroamphetamine‐amphetamine X
methylphenidate er X
methylphenidate hcl X
methylphenidate sr X
modafinil PA X
ADDERALL XR ST X dextroamphetamne‐amphetamne er
CONCERTA ST X methylphenidate er
DAYTRANA ST X methylphenidate cd, er,VYVANSE
FOCALIN XR ST X methylphenidate cd, er,VYVANSE
METADATE CD ST X methylphenidate cd
NUVIGIL PA X modafinil
PROVIGIL PA X modafinil
RITALIN LA ST X methylphenidate cd, er,VYVANSE
TIER

TIER
DRUG NAME
1 2 3
VYVANSE ST X
5.9.2 OTHER CNS/AUTONOMIC DRUGS
atropine sulfate X
naltrexone hcl X
pyridostigmine bromide X
NUEDEXTA X
5.9.3 ANTIDEMENTIA DRUGS
donepezil hcl X
galantamine hbr X
rivastigmine X
ARICEPT X donepezil
ARICEPT ODT X donepezil odt
EXELON X rivastigmine
NAMENDA X
5.9.4 DRUGS TO TREAT MULTIPLE SCLEROSIS
AMPYRA X
5.9.5 SMOKING CESSATION PRODUCTS
bupropion hcl sr X
CHANTIX X
SUGGESTED PREFFERED ALTERNATIVES
5.9.6 OTHER DRUGS FOR ADHD
INTUNIV X methylphenidate er
KAPVAY X generic clonidine(imm release)
STRATTERA X
CHAPTER 6: DERMATOLOGICAL MEDICATIONS
6.1 TOPICAL CORTICOSTEROID DRUGS
alclometasone dipropionate X
betamethasone dipropionate X
betamethasone valerate X
clobetasol emollient X
clobetasol propionate X
desonide X
desoximetasone X
fluocinolone acetonide X
fluocinonide X
fluticasone propionate X
halobetasol propionate X
hydrocortisone X
hydrocortisone butyrate X
hydrocortisone valerate X
mometasone furoate X
triamcinolone acetonide X
CLOBEX X clobetasol solution
HALOG X betmeth val, triamcin 0.1% crm
KENALOG X triamcinolone acetonide

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
LOCOID X hydrocortisone butyrate
LOCOID LIPOCREAM X hydrocortisone butyrate
OLUX X clobetasol propion 0.05% foam
OLUX‐E X clobetasol propionate crm,oint
PRAMOSONE X hydrocort 2.5/pramoxine 1% crm
PRAMOSONE E X hydrocort 2.5/pramoxine 1% crm
ULTRAVATE PAC X halobetasol propionate oint
6.2 ANTIPRURITIC DRUGS
hydroxyzine X
6.3 ANTIACNE DRUGS
adapalene X
benzoyl peroxide X
clindamycin phosphate X
clindamycin‐benzoyl peroxide X
erythromycin X
erythromycin‐benzoyl peroxide X
metronidazole X
sodium sulfacetamide‐sulfur X
tretinoin X
ACANYA X
ATRALIN X
BENZACLIN X
DIFFERIN X adapalene
DUAC X clindamycin phos/benzoyl perox
EPIDUO X
FINACEA X
METROGEL X
RETIN‐A MICRO X generics, ATRALIN, DIFFERIN LOTN, EPIDUO
RETIN‐A MICRO PUMP X generics, ATRALIN, DIFFERIN LOTN, EPIDUO
VELTIN X
ZIANA X generics, ACANYA, BENZACLIN, VELTIN
6.3.1 ACCUTANES
isotretinoin X
6.7 KERATOLYTIC DRUGS
CONDYLOX X podofilox
6.8 ANTIPSORIASIS AND ANTIECZEMA DRUGS
calcipotriene X
calcitrene X
selenium sulfide X
sulfacetamide sodium X
DOVONEX X calcipotriene
SORILUX X calcipotriene,TACLONEX
TACLONEX X
TAZORAC X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
VECTICAL X calcitriol
6.9.2 TOPICAL DERMATOLOGICAL DRUGS
fluorouracil X
imiquimod X
tretinoin X
CARAC X
ELIDEL X
EPICERAM X emulsion sb, tl‐cermide
FLUOROPLEX X fluorouracil, imiquimod, ZYCLARA
PICATO X fluorouracil, imiquimod, ZYCLARA
PROMISEB X selenium sulfide, sod sulfacet
PROTOPIC X
SANTYL X
SOLARAZE X
VEREGEN X imiquimod, podofilox
ZYCLARA X
6.9.3 SCABICIDES
permethrin X
EURAX X
ULESFIA X permethrin
6.9.5 TOPICAL ANTI‐INFLAMMATORY DRUGS
FLECTOR X
PENNSAID X FLECTOR, VOLTAREN GEL
VOLTAREN X
CHAPTER 7: EAR‐NOSE‐THROAT MEDICATIONS
7.1 DRUGS AFFECTING THE EAR
antipyrine‐benzocaine X
neomycin‐polymyxin‐hc X
neomycin‐polymyxin‐hydrocort X
ofloxacin X
CETRAXAL X ciprofloxacin 0.2% otic
CIPRO HC X CIPRODEX
CIPRODEX X
7.2 DRUGS AFFECTING THE NOSE
azelastine hcl X
flunisolide X
fluticasone propionate X
ipratropium bromide X
triamcinolone acetonide X
ASTELIN X azelastine
ASTEPRO X
BECONASE AQ ST X flunisoli, flutic, NASONEX,QNASL
DYMISTA ST X azelastine + fluticasone
NASACORT AQ ST X triamcinolone acetonide
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
NASONEX ST X
OMNARIS ST X flunisoli, flutic, NASONEX,QNASL
PATANASE X azelastine, ASTEPRO
QNASL ST X
RHINOCORT AQUA ST X flunisoli, flutic, NASONEX, QNASL
VERAMYST ST X flunisoli, flutic, NASONEX, QNASL
ZETONNA ST X flunisoli, flutic, NASONEX, QNASL
7.3 DRUGS AFFECTING THE THROAT AND MOUTH
doxycycline hyclate X
pilocarpine hcl X
triamcinolone acetonide X
CHAPTER 8: ENDOCRINE MEDICATIONS
8.1.1 INSULIN
APIDRA/SOLOSTAR X HUMALOG, NOVOLOG
HUMALOG products X
HUMULIN products X
LANTUS/SOLOSTAR X
LEVEMIR/FLEXPEN X
NOVOLIN products X HUMULIN
NOVOLOG products X
8.1.2 ORAL HYPOGLYCEMIC DRUGS
acarbose X
glimepiride X
glipizide/er X
glipizide‐metformin X
glyburide X
glyburide micronized X
glyburide‐metformin hcl X
metformin hcl X
metformin hcl er X
nateglinide X
FORTAMET X metformin hcl er
PRANDIMET X
PRANDIN X
RIOMET X
8.1.3 INSULIN SENSITIZERS
ACTOPLUS MET X pioglitazone/metformin
ACTOPLUS MET XR X
ACTOS X pioglitazone
AVANDAMET X pioglit+metfor, ACTOPLUS MET XR
AVANDARYL X pioglitzone/glimepiride
AVANDIA X pioglitazone
DUETACT X pioglitazone/glimepiride
TIER

DRUG NAME
TIER
1 2 3
8.1.4 AMYLIN ANALOGUES
SYMLINPEN X
8.1.5.1 INCRETIN MIMETICS
BYDUREON X
BYETTA X
VICTOZA X
8.1.5.2 DIPEPTIDYL PEPTIDASE‐IV INHIBITORS
JANUMET/XR X
JANUVIA X
JENTADUETO X
JUVISYNC X
KOMBIGLYZE XR X
ONGLYZA X
TRADJENTA X
8.2 GLUCOSE ELEVATING DRUGS
GLUCAGEN X
GLUCAGON EMERGENCY KIT X
SUGGESTED PREFFERED ALTERNATIVES
8.3.1 GLUCOCORTICOID DRUGS
dexamethasone X
dexamethasone sodium phosphate X
hydrocortisone X
methylprednisolone X
prednisolone X
prednisolone sodium phosphate X
prednisone X
veripred 20 X
RAYOS X immediate‐release prednisone
8.3.2 MINERALOCORTICOID DRUGS
fludrocortisone acetate X
8.4.1 THYROID SUPPLEMENTS
levothyroxine sodium X
levoxyl X
ARMOUR THYROID X
CYTOMEL X liothyronine
SYNTHROID X levothyroxine sodium
8.4.2 ANTITHYROID DRUGS
methimazole X
propylthiouracil X
8.6 OTHER ENDOCRINE DRUGS
alendronate sodium X
calcitonin nasal spray X
desmopressin acetate X
etidronate disodium X
ibandronate sodium X

TIER
DRUG NAME
1 2 3
ACTONEL ST X
ATELVIA ST X
BINOSTO ST X
FORTEO PA X
SUGGESTED PREFFERED ALTERNATIVES
alendronate, ibandronate, ACTONEL,
ATELVIA
FOSAMAX PLUS D ST X
alendronate, ibandronate, ACTONEL,
ATELVIA
SENSIPAR X
CHAPTER 9: GASTROINTESTINAL MEDICATIONS
9.1.2 OTC H2 ANTAGONISTS
famotidine X
9.2 ANTIDIARRHEAL DRUGS
diphenoxylate‐atropine X
loperamide X
9.3 ANTISPASMODICS/DRUGS AFFECT GI MOTILITY
chlordiazepoxide‐clidinium X
dicyclomine hcl X
hyoscyamine sulfate X
metoclopramide hcl X
9.4 ANTIULCER DRUGS
cimetidine X
famotidine X
nizatidine X
ranitidine hcl X
9.4.1 OTHER ANTIULCER DRUGS
misoprostol X
sucralfate X
CARAFATE X sucralfate
9.4.2 PROTON PUMP INHIBITORS
lansoprazole X
omeprazole X
omeprazole‐sodium bicarbonate ST X
pantoprazole sodium X
ACIPHEX ST X generics, NEXIUM
DEXILANT ST X generics, NEXIUM
NEXIUM ST X
PREVACID ST X lansoprazole
PROTONIX ST X pantoprazole sodium
ZEGERID ST X generics, NEXIUM
9.4.2.1 PROTON PUMP INHIBITORS ‐ OTC
omeprazole X
9.4.3 HELICOBACTER PYLORI DRUGS
HELIDAC X bismuth+metroni+tetracy, PYLERA
OMECLAMOX‐PAK X omepraz+clarithro+amox, PYLERA

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
PREVPAC X amox+clarith+lansoprazo, PYLERA
PYLERA X
9.5 LAXATIVES AND CATHARTICS
OSMOPREP X generic, HALFLYT, MOVIPRP,SUPREP
9.6 OTHER GI DRUGS
anucort‐hc X
balsalazide disodium X
budesonide ec X
hydrocortisone X
hydrocortisone acetate X
pancrelipase 5,000 X
peg 3350‐electrolyte X
proctosol‐hc X
proctozone‐hc X
sulfasalazine X
trilyte with flavor packets X
ursodiol X
ANALPRAM ADVANCED X hydrocortisone/pramoxine cream
ANALPRAM E X hydrocortisone/pramoxine cream
ANALPRAM HC X hydrocortisone/pramoxine cream
APRISO X balsalazide, ASACOL/HD, LIALDA, PENTASA
ASACOL X
ASACOL HD X
CANASA X
CREON X
DIPENTUM X balsalazide, ASACOL/HD, LIALDA, PENTASA
GOLYTELY X generics, HALFLYTELY, MOVIPREP, SUPREP
HALFLYTELY‐BISACODYL X
LIALDA X
MOVIPREP X
NULYTELY WITH FLAVOR PACKS X peg‐3350 w/flavor packs soln
PANCREAZE X generics, CREON, ZENPEP
PENTASA X
PERTZYE X generics, CREON, ZENPEP
PREPOPIK X generics, HALFLYTELY, MOVIPREP, SUPREP
RELISTOR X
SFROWASA X mesalamine 4 gm/60 ml enema
SUPREP X
ZENPEP X
9.7 IRRITABLE BOWEL DRUGS
AMITIZA X
LINZESS X
TIER

TIER
DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
CHAPTER 10: IMMUNOLOGICALS AND VACCINES
10.0 IMMUNOLOGICALS AND VACCINES
SYNAGIS X
ZOSTAVAX X
10.2.1 MYELOID STIMULANTS
NEULASTA X
NEUPOGEN X
10.2.2 ERYTHROID STIMULANTS
ARANESP X
PROCRIT X
10.2.3 INTERFERONS
AVONEX PA X
AVONEX ADMINISTRATION PACK PA X
AVONEX PEN PA X
BETASERON PA X
COPAXONE X
EXTAVIA PA X AVONEX, BETASERON, REBIF
PEGASYS/PROCLICK X
PEGINTRON/REDIPEN X
REBIF PA X
10.2.4 GROWTH HORMONES AND RELATED DRUGS
GENOTROPIN PA X
HUMATROPE PA X
NORDITROPIN FLEXPRO PA X GENOTROP,HUMATROP,NUTROPIN/AQ
NORDITROPIN NORDIFLEX PA X GENOTROP,HUMATROP,NUTROPIN/AQ
NUTROPIN/AQ/AQ NUSPIN PA X
OMNITROPE PA X GENOTROP,HUMATROP,NUTROPIN/AQ
SAIZEN PA X GENOTROP,HUMATROP,NUTROPIN/AQ
TEV‐TROPIN PA X GENOTROP,HUMATROP,NUTROPIN/AQ
10.2.6 INTERLEUKIN RECEPTOR ANTAGONIST
KINERET PA X ORENCIA
10.2.7 IMMUNOGLOBULIN ANTIBODIES
XOLAIR X
CHAPTER 11: MUSCULOSKELETAL MEDICATIONS
11.1.1 SALICYLATES AND RELATED DRUGS
aspirin X
aspirin ec X
choline mag trisalicylate X
diflunisal X
salsalate X
11.1.2 NON‐STEROIDAL ANTIINFLAMMATORY AGENTS
diclofenac potassium X
diclofenac sodium X
etodolac X

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
flurbiprofen X
ibuprofen X
indomethacin X
ketoprofen X
ketorolac tromethamine X
meloxicam X
nabumetone X
naproxen X
naproxen sodium X
oxaprozin X
piroxicam X
sulindac X
CAMBIA X diclofenac potassium
CELEBREX X
DUEXIS X ibuprofen plus famotidine
NAPRELAN X naproxen sodium
VIMOVO X
11.2 DRUGS TO PREVENT AND TREAT GOUT
allopurinol X
probenecid X
COLCRYS X
ULORIC ST X
11.3.1 DIRECT MUSCLE RELAXANTS
baclofen X
tizanidine hcl X
11.3.2 CNS MUSCLE RELAXANTS
chlorzoxazone X
cyclobenzaprine hcl X
metaxalone X
methocarbamol X
orphenadrine citrate X
AMRIX X immed‐release cyclobenzaprine
SKELAXIN X metaxalone
SOMA X metaxalone, tizanidine
CHAPTER 12: NUTRITION,BLOOD
12.1.2 VITAMINS & MINERALS & RELATED PRODUCTS
BIFERA RX X hemetab iron supplement tabs
CEREFOLIN X folic acid
CEREFOLIN NAC X folic acid
12.1.3 THERAPEUTIC VITAMINS & MINERALS
calcitriol X
calcium acetate X
eliphos X
folic acid X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
levocarnitine X
vitamin d X
DEPLIN X folic acid
HECTOROL X
NASCOBAL X
PHOSLYRA X calcium acetate caps, ELIPHOS
ZEMPLAR X
12.1.4 FLUORIDE PRODUCTS
sodium fluoride X
12.2 POTASSIUM SUPPLEMENTS
potassium chloride X
12.3.1 ORAL ANTICOAGULANTS, VITAMIN K
warfarin sodium X
COUMADIN X warfarin sodium
12.3.2 HEPARIN AND HEPARIN ANTAGONISTS
enoxaparin sodium X
fondaparinux sodium X
heparin sodium X
ARIXTRA X fondaparinux sodium
FRAGMIN X enoxaparin, fondaparinux
LOVENOX X enoxaparin
12.3.3 OTHER DRUGS AFFECTING COAGULATION
XARELTO X
12.3.5 THROMBIN INHIBITORS
PRADAXA X
12.4 ANTIPLATELET DRUGS
cilostazol X
dipyridamole X
AGGRENOX X
BRILINTA X
EFFIENT X
PLAVIX X clopidogrel
12.5 HEMOSTATICS
LYSTEDA X
12.7 BLOOD DETOXICANTS
enulose X
lactulose X
FOSRENOL X
RENAGEL X
RENVELA X
CHAPTER 13: OBSTETRICAL & GYNECOLOGICAL MEDICATIONS
13.1.1 PRENATAL VITAMINS
NEEVO DHA X generic Rx prenatal vitamans
PREFERA OB X hemenatal ob tabs
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
PREFERA‐OB ONE X prenatal mv & min capsule
PREFERA‐OB PLUS DHA X hemenatal ob+dha combo pk
PRENATE DHA X generic Rx prenatal vitamans
PRENATE ELITE X generic Rx prenatal vitamans
PRENATE ESSENTIAL X generic Rx prenatal vitamans
13.1.2 SPECIALIZED OB/GYN DRUGS
leuprolide acetate PA X
novarel X
CETROTIDE X
GANIRELIX ACETATE X
LUPRON DEPOT PA X ELIGARD, TRELSTAR
OVIDREL X ch.gonadotrpin,novarel
13.1.3 OB/GYN TOPICAL ANTIINFECTIVES
clindamycin phosphate X
metronidazole X
vandazole X
13.2 OVULATORY STIMULANTS
clomiphene citrate X
BRAVELLE X GONAL‐F/RFF
FOLLISTIM AQ X GONAL‐F/RFF
GONAL‐F/RFF X
13.3 ANDROGEN DRUGS
testosterone cypionate X
ANDRODERM X
ANDROGEL X
AXIRON X
FORTESTA X ANDRODERM, ANDROGEL, AXIRON
STRIANT X ANDRODERM, ANDROGEL, AXIRON
TESTIM X ANDRODERM, ANDROGEL, AXIRON
13.4 ESTROGEN DRUGS
estradiol X
estrogen & methyltestosterone X
estrogen‐methyltestosterone X
estropipate X
CENESTIN X
DIVIGEL X
ELESTRIN X estradiol ptch, DIVIGEL, EVAMIST
ENJUVIA X
ESTRACE X VAGIFEM
ESTRASORB X estradiol ptch, DIVIGEL, EVAMIST
ESTRING X VAGIFEM
ESTROGEL X estradiol ptch, DIVIGEL, EVAMIST
EVAMIST X
MENEST X estradiol, CENESTIN, ENJUVIA, PREMARN
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
MENOSTAR X gen estradiol ptch, VIVELLE‐DOT
PREMARIN X
VAGIFEM X
VIVELLE‐DOT X
13.4.1 ESTROGEN/PROGESTIN COMBINATIONS
jinteli X
ACTIVELLA X estradiol/noreth acetate
ANGELIQ X ee/noreth ac, PREMPHASE/PREMPRO
CLIMARA PRO X
COMBIPATCH X
FEMHRT X ee/noreth ac, PREMPHASE/PREMPRO
PREFEST X ee/noreth ac, PREMPHASE/PREMPRO
PREMPHASE X
PREMPRO X
13.4.3 SELECTIVE ESTROGEN RECEPTOR MODULATOR
EVISTA X
13.5 PROGESTIN DRUGS
camila X
errin X
jolivette X
medroxyprogesterone acetate X
nora‐be X
norethindrone X
norethindrone acetate X
progesterone in oil X
CRINONE X
ENDOMETRIN X
MAKENA X
PROMETRIUM X progesterone
13.7 CONTRACEPTIVES
altavera X
apri X
aranelle X
aviane X
azurette X
balziva X
camrese X
cesia X
cryselle X
cyclafem X
enpresse X
gildess fe X
jolessa X
junel X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
junel fe X
kariva X
kelnor 1‐35 X
leena X
lessina X
levora‐28 X
loryna X
low‐ogestrel X
lutera X
microgestin X
microgestin fe X
mononessa X
necon X
nortrel X
ocella X
ogestrel X
portia X
previfem X
quasense X
reclipsen X
solia X
sprintec X
sronyx X
syeda X
tilia fe X
tri‐legest fe X
trinessa X
tri‐previfem X
tri‐sprintec X
trivora‐28 X
velivet X
zarah X
zenchent X
zovia 1‐35e X
zovia 1‐50e X
BEYAZ X
FEMCON FE X zenchent fe chewable, zeosa
GENERESS FE X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,
NATAZIA, NUVARING, SAFYRAL
LO LOESTRIN FE X
LOESTRIN 24 FE X
LOSEASONIQUE X amethia lo, camrese lo
NATAZIA X
NUVARING X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
ORTHO EVRA X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,
NATAZIA, NUVARING, SAFYRAL
ORTHO TRI‐CYCLEN X trinesa, tri‐previ, tri‐sprint
ORTHO TRI‐CYCLEN LO X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,
NATAZIA, NUVARING, SAFYRAL
SAFYRAL X
SEASONIQUE X amethia, camrese
YASMIN 28 X ocella,syeda,zarah
YAZ X gianvi, loryna, vestura
CHAPTER 14: OPHTHALMIC MEDICATIONS
14.1.1 OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS
bacitracin X
bacitracin‐polymyxin X
ciprofloxacin hcl X
erythromycin X
gentamicin sulfate X
neomycin‐bacitracin‐polymyxin X
ofloxacin X
polymyxin b sul‐trimethoprim X
sulfacetamide sodium X
AZASITE X
BESIVANCE X generic, MOXEZA, VIGAMOX, ZYMAXID
MOXEZA X
VIGAMOX X
ZYMAXID X
14.1.2 OPHTHALMIC TOPICAL ANTIVIRAL DRUGS
trifluridine X
14.2 OPHTHALMIC CORTICOSTEROID DRUGS
fluorometholone X
prednisolone acetate X
ALREX X azelastine, PATADAY, PATANOL
DUREZOL X
FML FORTE X generics, DUREZOL, LOTEMAX SOLN
LOTEMAX X
VEXOL X generics, DUREZOL, LOTEMAX SOLN
14.3 OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDS
neomycin‐polymyxin‐dexameth X
neomycin‐polymyxin‐hc X
tobramycin‐dexamethasone X
TOBRADEX X tobramycin sulfate/dexameth
TOBRADEX ST X
ZYLET X
14.5 ANTIGLAUCOMA DRUGS
acetazolamide X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
brimonidine tartrate X
dorzolamide hcl X
dorzolamide‐timolol X
latanoprost X
levobunolol hcl X
pilocarpine hcl X
timolol maleate X
ALPHAGAN P X brimonidine tartrate
AZOPT X
BETIMOL X generic, ALPHAGAN P, AZOPT, COMBIGAN
COMBIGAN X
COSOPT PF X generic, ALPHAGAN P, AZOPT, COMBIGAN
ISTALOL X generic, ALPHAGAN P, AZOPT, COMBIGAN
LUMIGAN ST X
TIMOPTIC OCUDOSE X timolol maleate
TRAVATAN Z ST X
XALATAN ST X latanoprost
ZIOPTAN ST X latanoprost, LUMIGAN, TRAVATAN Z
14.6 OTHER OPHTHALMIC DRUGS
atropine sulfate X
azelastine hcl X
cromolyn sodium X
diclofenac sodium X
epinastine hcl X
ketotifen fumarate X
ACUVAIL X
ALOCRIL X azelastine, PATADAY, PATANOL
ALOMIDE X azelastine, PATADAY, PATANOL
BEPREVE X azelastine, PATADAY, PATANOL
BOTOX X
BROMDAY X
EMADINE X azelastine, PATADAY, PATANOL
LASTACAFT X azelastine, PATADAY, PATANOL
NEVANAC X
PATADAY X
PATANOL X
RESTASIS X
CHAPTER 15: RESPIRATORY MEDICATIONS
15.1.1 BETA‐2 ADRENERGIC DRUGS
albuterol sulfate X
metaproterenol sulfate X
ARCAPTA NEOHALER X FORADIL, SEREVENT
BROVANA X PERFOROMIST
FORADIL X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
MAXAIR AUTOHALER X PROAIR HFA, VENTOLIN HFA
PERFOROMIST X
PROAIR HFA X
PROVENTIL HFA X PROAIR HFA, VENTOLIN HFA
SEREVENT DISKUS X
VENTOLIN HFA X
XOPENEX X levalbuterol
XOPENEX CONCENTRATE X levalbuterol
XOPENEX HFA ST X PROAIR HFA, VENTOLIN HFA
15.1.2 METHYL XANTHINE DRUGS
theophylline X
theophylline anhydrous X
15.1.3 OTHER DRUGS FOR ASTHMA
budesonide X
cromolyn sodium X
epinephrine X
ipratropium bromide X
ipratropium‐albuterol X
ADVAIR DISKUS X
ADVAIR HFA X
ALVESCO X ASMANEX, PULMICORT FLEX, QVAR
ASMANEX X
ATROVENT HFA X
COMBIVENT X
COMBIVENT RESPIMAT X
DULERA X
EPIPEN 2‐PAK X
EPIPEN JR 2‐PAK X
FLOVENT DISKUS X ASMANEX, PULMICORT FLEX, QVAR
FLOVENT HFA X ASMANEX, PULMICORT FLEX, QVAR
PULMICORT X
PULMICORT FLEXHALER X
QVAR X
SPIRIVA X
SYMBICORT X
TUDORZA PRESSAIR X
15.1.4 LEUKOTRIENE MODIFIERS
montelukast sodium X
zafirlukast X
ACCOLATE ST X zafirlukast
SINGULAIR ST X montelukast
15.2.1 ANTIHISTAMINES
arbinoxa X
cetirizine X
TIER

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
cyproheptadine hcl X
diphenhydramine hcl X
fexofenadine hcl X
levocetirizine dihydrochloride X
loratadine X
promethazine hcl X
CLARINEX X desloratadine
XYZAL X levocetirizine
ZYRTEC X
15.2.3 ANTIHISTAMINE/DECONGESTANT COMBINATIONS
promethazine vc X
ALLEGRA‐D 24 HOUR X
CLARINEX‐D 12 HOUR X desloratadine
CLARINEX‐D 24 HOUR X desloratadine
ZYRTEC‐D X
15.3 ANTITUSSIVE AND EXPECTORANT DRUGS
benzonatate X
guaifenesin/codiene X
guaifenesin‐codeine X
promethazine vc‐codeine X
promethazine‐codeine X
promethazine‐dm X
REZIRA X promethazine vc with codeine
TUSSICAPS X
TUSSIONEX X hydrocodone/chlorphen polis
ZUTRIPRO X promethazine vc with codeine
15.4 OTHER RESPIRATORY DRUGS
DALIRESP X
PULMOZYME X
CHAPTER 16: UROLOGICAL MEDICATIONS
16.1.1 ANTICHOLINERGIC ANTISPASMODICS
oxybutynin chloride X
oxybutynin chloride er X
tolterodine tartrate X
DETROL ST X tolterodine
DETROL LA ST X
ENABLEX ST X
GELNIQUE ST X
OXYTROL ST X
SANCTURA XR ST X trospium er
TOVIAZ ST X
VESICARE ST X
16.1.2 CHOLINERGIC STIMULANTS
bethanechol chloride X
TIER

DRUG NAME
16.1.3 URINARY ANESTHETICS
phenazopyridine hcl X
TIER
1 2 3
SUGGESTED PREFFERED ALTERNATIVES
16.1.4 OTHER GENITOURINARY PRODUCTS
alfuzosin hcl X
finasteride X
potassium citrate X
tamsulosin hcl X
AVODART X finasteride
CIALIS X
ELMIRON X
FLOMAX X tamsulosin hcl
JALYN X alfuzosn, finasterid, tamsulos
LEVITRA X CIALIS, VIAGRA
MUSE X
MYRBETRIQ X
RAPAFLO X
STAXYN X CIALIS, VIAGRA
VIAGRA X
CHAPTER 17: DIAGNOSTIC & MISCELLANEOUS MEDICATIONS
17.1 DIAGNOSTIC PRODUCTS
MINILINK REAL‐TIME TRANSMITTER X
PARADIGM REAL‐TIME X
PRECISION XTRA X
SOF‐SENSOR X ACCU‐CHEK, ONE TOUCH
17.2 MISCELLANEOUS DRUGS
THALOMID X
17.3.1 APPETITE SUPPRESSANTS
phentermine hcl X
QSYMIA X benzphet,diethylprop,phenterm
CHAPTER 18: MEDICAL (MISCELLANEOUS) SUPPLIES
18.0 MEDICAL (MISCELLANEOUS) SUPPLIES
AEROCHAMBER X
CONCEPTION X
MINIMED X
MINIMED RESERVOIR X
OPTICHAMBER X
PARADIGM X
PARADIGM INFUSION X
PARADIGM SILHOUETTE X
POLYFIN X
POLYFIN QR X
PRIMABELLA X
QUICK RELEASE SOFT TEFLON X
SILHOUETTE X

TIER
DRUG NAME
1 2 3
SOF‐SET X
SOF‐SET MICRO X
SURE‐T X
SUGGESTED PREFFERED ALTERNATIVES
18.1 DIABETIC SUPPLIES
ACCU‐CHEK X
ACCU‐CHEK ACTIVE X
ACCU‐CHEK AVIVA X
ACCU‐CHEK AVIVA PLUS X
ACCU‐CHEK COMFORT CURVE X
ACCU‐CHEK COMPACT X
ACCU‐CHEK COMPACT BLUE CONTROL X
ACCU‐CHEK FASTCLIX X
ACCU‐CHEK NANO SMARTVIEW X
ACCU‐CHEK SMARTVIEW X
ACCU‐CHEK SOFTCLIX X
ASCENSIA AUTODISC X ACCU‐CHEK, ONE TOUCH
AUTODISC NORMAL X ACCU‐CHEK, ONE TOUCH
BREEZE 2 X ACCU‐CHEK, ONE TOUCH
CONTOUR X ACCU‐CHEK, ONE TOUCH
CONTOUR NEXT X ACCU‐CHEK, ONE TOUCH
CONTOUR NEXT EZ X ACCU‐CHEK, ONE TOUCH
CONTOUR USB X ACCU‐CHEK, ONE TOUCH
CONTROL SOLUTION X ACCU‐CHEK, ONE TOUCH
FORA LANCETS X
FORA LANCING DEVICE X
FORA TEST STRIP X ACCU‐CHEK, ONE TOUCH
FORA V30A X ACCU‐CHEK, ONE TOUCH
FREESTYLE FREEDOM LITE X ACCU‐CHEK, ONE TOUCH
FREESTYLE INSULINX X ACCU‐CHEK, ONE TOUCH
FREESTYLE INSULINX TEST STRIPS X ACCU‐CHEK, ONE TOUCH
FREESTYLE LITE METER X ACCU‐CHEK, ONE TOUCH
FREESTYLE LITE STRIPS X ACCU‐CHEK, ONE TOUCH
FREESTYLE TEST STRIPS X ACCU‐CHEK, ONE TOUCH
GLUCOSE TEST STRIP X ACCU‐CHEK, ONE TOUCH
GUARDIAN RT STARTER KIT X
NOVOFINE X
NOVOFINE 32 X
NOVOFINE AUTOCOVER X
ONE TOUCH LANCETS X
ONE TOUCH TEST STRIPS X
ONE TOUCH ULTRA 2 X
ONE TOUCH ULTRA SMART X
ONE TOUCH ULTRA SYSTEM X
ONE TOUCH ULTRA TEST STRIPS X

DRUG NAME
1 2 3 SUGGESTED PREFFERED ALTERNATIVES
ONE TOUCH ULTRAMINI X
ONE TOUCH VERIO X
ONE TOUCH VERIO IQ X
PRECISION X
PRECISION XTRA X
PRODIGY X ACCU‐CHEK, ONE TOUCH
PRODIGY INSULIN SYRINGE X
PRODIGY NO CODING X ACCU‐CHEK, ONE TOUCH
PRODIGY PEN NEEDLE X
PRODIGY POCKET X ACCU‐CHEK, ONE TOUCH
PRODIGY VOICE X ACCU‐CHEK, ONE TOUCH
SOFT TOUCH X
SOFTCLIX X
SURESTEP X
TRUE2GO BLOOD GLUCOSE SYSTEM X ACCU‐CHEK, ONE TOUCH
TRUERESULT BLOOD GLUCOSE SYSTM X ACCU‐CHEK, ONE TOUCH
TRUETEST TEST STRIPS X ACCU‐CHEK, ONE TOUCH
TRUETRACK SMART SYSTEM X ACCU‐CHEK, ONE TOUCH
TRUETRACK TEST STRIP X ACCU‐CHEK, ONE TOUCH
VGO 20 X
VGO 30 X
VGO 40 X
TIER

Index
ABILIFY 5.8
ABILIFY DISCMELT 5.8
ABSTRAL 5.1.1.1
ACANYA 6.3
acarbose 8.1.2
ACCOLATE 15.1.4
ACCU‐CHEK 18.1
ACCU‐CHEK ACTIVE 18.1
ACCU‐CHEK AVIVA 18.1
ACCU‐CHEK AVIVA PLUS 18.1
ACCU‐CHEK COMFORT CURVE 18.1
ACCU‐CHEK COMPACT 18.1
ACCU‐CHEK COMPACT BLUE 18.1
CONTROL
ACCU‐CHEK FASTCLIX 18.1
ACCU‐CHEK NANO SMARTVIEW 18.1
ACCU‐CHEK SMARTVIEW 18.1
ACCU‐CHEK SOFTCLIX 18.1
acebutolol hcl 4.4
acetaminophen‐codeine 5.1.1.2
acetazolamide 14.5
ACIPHEX 9.4.2
ACTIVELLA 13.4.1
ACTONEL 8.6
ACTOPLUS MET 8.1.3
ACTOPLUS MET XR 8.1.3
ACTOS 8.1.3
ACUVAIL 14.6
acyclovir 2.5.2
adapalene 6.3
ADCIRCA 4.6.2
ADDERALL XR 5.9.1
ADVAIR DISKUS 15.1.3
ADVAIR HFA 15.1.3
ADVICOR 4.8.2.1
AEROCHAMBER 18
AGGRENOX 12.4
albuterol sulfate 15.1.1
alclometasone dipropionate 6.1
alendronate sodium 8.6
alfuzosin hcl 16.1.4
ALLEGRA‐D 24 HOUR 15.2.3
allopurinol 11.2
ALOCRIL 14.6
ALOMIDE 14.6
ALPHAGAN P 14.5
alprazolam/er/xr 5.2.1
ALREX 14.2
ALTABAX 2.2
altavera 13.7
ALTOPREV 4.8.2
ALVESCO 15.1.3
amantadine 2.5.2
AMBIEN 5.2.2
AMBIEN CR 5.2.2
amiloride hcl 4.3.3
amiodarone hcl 4.7.3
AMITIZA 9.7
amitriptyline hcl 5.5.1.1
amlodipine besylate 4.2
amlodipine besylate‐benazepril 4.5.6
amlodipine‐atorvastatin 4.8.2.1
amox tr‐potassium clavulanate 2.1.5
amoxicillin 2.1.5
amoxicillin‐clavulanate er 2.1.5
amphetamine salt combo 5.9.1
AMPYRA 5.9.4
AMRIX 11.3.2
AMTURNIDE 4.5.6
anagrelide hcl 3
ANALPRAM ADVANCED 9.6
ANALPRAM E 9.6
ANALPRAM HC 9.6
anastrozole 3
ANDRODERM 13.3
ANDROGEL 13.3
ANGELIQ 13.4.1
ANTARA 4.8.1
antipyrine‐benzocaine 7.1
anucort‐hc 9.6
APIDRA/SOLOSTAR 8.1.1
apri 13.7
APRISO 9.6
aranelle 13.7
ARANESP 10.2.2
arbinoxa 15.2.1
ARCAPTA NEOHALER 15.1.1
ARICEPT 5.9.3
ARICEPT ODT 5.9.3
ARIMIDEX 3
ARIXTRA 12.3.2
ARMOUR THYROID 8.4.1
ASACOL 9.6
ASACOL HD 9.6
ASCENSIA AUTODISC 18.1
ASMANEX 15.1.3
aspirin 11.1.1
aspirin ec 11.1.1
ASTELIN 7.2
ASTEPRO 7.2
ATACAND 4.5.4.2
ATACAND HCT 4.5.4.2
ATELVIA 8.6
atenolol 4.4
atenolol‐chlorthalidone 4.5.6
atorvastatin calcium 4.8.2
atovaquone‐proguanil hcl 2.7.3
ATRALIN 6.3
ATRIPLA 2.5.1
atropine sulfate 14.6
atropine sulfate 5.9.2
ATROVENT HFA 15.1.3
AUTODISC NORMAL 18.1

AVALIDE 4.5.4.2
AVANDAMET 8.1.3
AVANDARYL 8.1.3
AVANDIA 8.1.3
AVAPRO 4.5.4.2
AVELOX/ABC PACK 2.1.9
aviane 13.7
AVINZA 5.1.1.1
AVODART 16.1.4
AVONEX 10.2.3
AVONEX ADMINISTRATION 10.2.3
PACK
AVONEX PEN 10.2.3
AXERT 5.1.2
AXIRON 13.3
AZASITE 14.1.1
azathioprine 3
azelastine hcl 7.2
azelastine hcl 14.6
AZILECT 5.7.2
azithromycin 2.1.4.1
AZOPT 14.5
AZOR 4.5.6
azurette 13.7
bacitracin 2.8
bacitracin 14.1.1
bacitracin‐polymyxin 14.1.1
baclofen 11.3.1
BACTROBAN 2.2
balsalazide disodium 9.6
balziva 13.7
BARACLUDE 2.5.2
BECONASE AQ 7.2
benazepril hcl 4.5.4.1
benazepril‐hydrochlorothiazide 4.5.6
BENICAR 4.5.4.2
BENICAR HCT 4.5.4.2
BENZACLIN 6.3
benzonatate 15.3
benzoyl peroxide 6.3
benztropine mesylate 5.7.1
BEPREVE 14.6
BESIVANCE 14.1.1
betamethasone dipropionate 6.1
betamethasone valerate 6.1
BETASERON 10.2.3
bethanechol chloride 16.1.2
BETIMOL 14.5
BEYAZ 13.7
bicalutamide 3
BIDIL 4.6.2
BIFERA RX 12.1.2
BINOSTO 8.6
bisoprolol fumarate 4.4
bisoprolol‐hydrochlorothiazide 4.5.6
BOTOX 14.6
BRAVELLE 13.2
BREEZE 2 18.1
BRILINTA 12.4
brimonidine tartrate 14.5
BROMDAY 14.6
bromocriptine mesylate 5.7.2
BROVANA 15.1.1
budesonide 15.1.3
budesonide ec 9.6
bumetanide 4.3.1
buprenorphine hcl 5.1.1.2
buprenorphine hcl 5.1.1.3
bupropion hcl 5.5.1.4
bupropion hcl sr 5.5.1.4
bupropion hcl sr 5.9.5
bupropion xl 5.5.1.4
buspirone hcl 5.2.1
butalbital compound‐codeine 5.1.2
butalbital‐aspirin‐caffeine 5.1.2
butorphanol tartrate 5.1.1
BUTRANS 5.1.1.2
BYDUREON 8.1.5.1
BYETTA 8.1.5.1
BYSTOLIC 4.4
CADUET 4.8.2.1
CADUET 4.8.2.1
calcipotriene 6.8
calcitonin nasal spray 8.6
calcitrene 6.8
calcitriol 12.1.3
calcium acetate 12.1.3
CAMBIA 11.1.2
camila 13.5
camrese 13.7
CANASA 9.6
captopril 4.5.4.1
captopril‐hydrochlorothiazide 4.5.6
CARAC 6.9.2
CARAFATE 9.4.1
carbamazepine/er/xr 5.4.1
CARBATROL 5.4.1
carbidopa‐levodopa 5.7.2
carbidopa‐levodopa‐entacapone 5.7.2
CARDENE SR 4.2
CARDIZEM LA 4.2
CARDURA XL 4.5.1
cartia xt 4.2
carvedilol 4.4
CEDAX 2.1.1
cefaclor er 2.1.1
cefadroxil 2.1.1
cefdinir 2.1.1
cefpodoxime proxetil 2.1.1
cefprozil 2.1.1
cefuroxime 2.1.1
CELEBREX 11.1.2
CELLCEPT 3
CENESTIN 13.4
cephalexin 2.1.1
CEREFOLIN 12.1.2
CEREFOLIN NAC 12.1.2
cesia 13.7
cetirizine 15.2.1
CETRAXAL 7.1

CETROTIDE 13.1.2
CHANTIX 5.9.5
chlordiazepoxide hcl 5.2.1
chlordiazepoxide‐clidinium 9.3
chlorpromazine hcl 5.8.1
chlorthalidone 4.3.2
chlorzoxazone 11.3.2
cholestyramine 4.8.1
choline mag trisalicylate 11.1.1
CIALIS 16.1.4
ciclopirox 2.4.2
cilostazol 12.4
cimetidine 9.4
CIMZIA 3
CIMZIA 3
CIPRO HC 7.1
CIPRODEX 7.1
ciprofloxacin er 2.1.9
ciprofloxacin hcl 14.1.1
ciprofloxacin hcl 2.1.9
citalopram 5.5.1.3
citalopram hbr 5.5.1.3
CLARINEX 15.2.1
CLARINEX‐D 12 HOUR 15.2.3
CLARINEX‐D 24 HOUR 15.2.3
clarithromycin/er 2.1.4.1
CLIMARA PRO 13.4.1
clindamycin hcl 2.1.3
clindamycin phosphate 6.3
clindamycin phosphate 13.1.3
clindamycin phosphate 2.1.3
clindamycin‐benzoyl peroxide 6.3
clobetasol emollient 6.1
clobetasol propionate 6.1
CLOBEX 6.1
clomiphene citrate 13.2
clomipramine hcl 5.5.1.1
clonazepam 5.4.2
clonidine 4.5.2
clonidine hcl 4.5.2
clorazepate dipotassium 5.2.1
clotrimazole 2.4.1
clotrimazole 2.4.2
clotrimazole‐betamethasone 2.4.3
clozapine 5.8
COLCRYS 11.2
colestipol hcl 4.8.1
COMBIGAN 14.5
COMBIPATCH 13.4.1
COMBIVENT 15.1.3
COMBIVENT RESPIMAT 15.1.3
COMBIVIR 2.5.1
COMPLERA 2.5.1
COMTAN 5.7.2
CONCEPTION 18
CONCERTA 5.9.1
CONDYLOX 6.7
CONTOUR 18.1
CONTOUR NEXT 18.1
CONTOUR NEXT EZ 18.1
CONTOUR USB 18.1
CONTROL SOLUTION 18.1
COPAXONE 10.2.3
COREG CR 4.4
COSOPT PF 14.5
COUMADIN 12.3.1
COZAAR 4.5.4.2
CREON 9.6
CRESTOR 4.8.2
CRINONE 13.5
cromolyn sodium 14.6
cromolyn sodium 15.1.3
cryselle 13.7
cyclafem 13.7
cyclobenzaprine hcl 11.3.2
cyclosporine modified 3
CYMBALTA 5.5.1.4
cyproheptadine hcl 15.2.1
CYTOMEL 8.4.1
DALIRESP 15.4
DAPSONE 2.7.4
DAYTRANA 5.9.1
DENAVIR 2.5.2
DEPAKOTE ER 5.4.4
DEPLIN 12.1.3
desipramine hcl 5.5.1.2
desmopressin acetate 8.6
desonide 6.1
desoximetasone 6.1
DETROL 16.1.1
DETROL LA 16.1.1
dexamethasone 8.3.1
dexamethasone sodium 8.3.1
phosphate
DEXILANT 9.4.2
dexmethylphenidate hcl 5.9.1
dextroamphetamine sulfate 5.9.1
dextroamphetamineamphetamine
5.9.1
diazepam 5.2.1
diazepam 5.4.2
diclofenac potassium 11.1.2
diclofenac sodium 14.6
diclofenac sodium 11.1.2
dicloxacillin sodium 2.1.5
dicyclomine hcl 9.3
DIFFERIN 6.3
DIFICID 2.8
diflunisal 11.1.1
digoxin 4.1
DILANTIN 5.4.3
diltiazem/er 4.2
DIOVAN 4.5.4.2
DIOVAN HCT 4.5.4.2
DIPENTUM 9.6
diphenhydramine hcl 15.2.1
diphenoxylate‐atropine 9.2
dipyridamole 12.4
divalproex sodium/er 5.4.4
DIVIGEL 13.4

donepezil hcl 5.9.3
DORYX 2.1.7
dorzolamide hcl 14.5
dorzolamide‐timolol 14.5
DOVONEX 6.8
doxazosin mesylate 4.5.1
doxepin hcl 5.5.1.1
doxycycline hyclate 7.3
doxycycline hyclate 2.1.7
doxycycline monohydrate 2.1.7
dronabinol 5.6
DUAC 6.3
DUETACT 8.1.3
DUEXIS 11.1.2
DULERA 15.1.3
DUREZOL 14.2
DYMISTA 7.2
econazole nitrate 2.4.2
EDARBI 4.5.4.2
EDARBYCLOR 4.5.6
EDLUAR 5.2.2
EFFEXOR XR 5.5.1.4
EFFIENT 12.4
ELESTRIN 13.4
ELIDEL 6.9.2
ELIGARD 3
eliphos 12.1.3
ELMIRON 16.1.4
EMADINE 14.6
EMEND 5.6
ENABLEX 16.1.1
enalapril maleate 4.5.4.1
enalapril‐hydrochlorothiazide 4.5.6
ENBREL 3
endocet 5.1.1.1
ENDOMETRIN 13.5
ENJUVIA 13.4
enoxaparin sodium 12.3.2
enpresse 13.7
enulose 12.7
EPICERAM 6.9.2
EPIDUO 6.3
epinastine hcl 14.6
epinephrine 15.1.3
EPIPEN 2‐PAK 15.1.3
EPIPEN JR 2‐PAK 15.1.3
EPIVIR 2.5.1
EPIVIR HBV 2.5.2
eplerenone 4.3.3
eprosartan mesylate 4.5.4.2
EPZICOM 2.5.1
errin 13.5
ERTACZO 2.4.2
erythromycin 6.3
erythromycin 14.1.1
erythromycin 2.1.4
erythromycin‐benzoyl peroxide 6.3
escitalopram oxalate 5.5.1.3
estazolam 5.2.2
ESTRACE 13.4
estradiol 13.4
ESTRASORB 13.4
ESTRING 13.4
ESTROGEL 13.4
estrogen & methyltestosterone 13.4
estrogen‐methyltestosterone 13.4
estropipate 13.4
etidronate disodium 8.6
etodolac 11.1.2
EURAX 6.9.3
EVAMIST 13.4
EVISTA 13.4.3
EXALGO 5.1.1.1
EXELDERM 2.4.2
EXELON 5.9.3
exemestane 3
EXFORGE 4.5.6
EXFORGE HCT 4.5.6
EXTAVIA 10.2.3
FACTIVE 2.1.9
famciclovir 2.5.2
famotidine 9.4
famotidine 9.1.2
FANAPT 5.8
felodipine er 4.2
FEMARA 3
FEMCON FE 13.7
FEMHRT 13.4.1
fenofibrate 4.8.1
fenofibric acid 4.8.1
FENOGLIDE 4.8.1
fentanyl 5.1.1.1
FENTORA 5.1.1.1
fexofenadine hcl 15.2.1
FIBRICOR 4.8.1
FINACEA 6.3
finasteride 16.1.4
flecainide acetate 4.7.1.3
FLECTOR 6.9.5
FLOMAX 16.1.4
FLOVENT DISKUS 15.1.3
FLOVENT HFA 15.1.3
fluconazole 2.3
fludrocortisone acetate 8.3.2
flunisolide 7.2
fluocinolone acetonide 6.1
fluocinonide 6.1
fluorometholone 14.2
FLUOROPLEX 6.9.2
fluorouracil 6.9.2
fluoxetine hcl 5.5.1.3
fluphenazine hcl 5.8
flurazepam hcl 5.2.2
flurbiprofen 11.1.2
fluticasone propionate 6.1
fluticasone propionate 7.2
fluvastatin sodium 4.8.2
fluvoxamine maleate 5.5.1.3
FML FORTE 14.2
FOCALIN XR 5.9.1

folic acid 12.1.3
FOLLISTIM AQ 13.2
fondaparinux sodium 12.3.2
FORA LANCETS 18.1
FORA LANCING DEVICE 18.1
FORA TEST STRIP 18.1
FORA V30A 18.1
FORADIL 15.1.1
FORTAMET 8.1.2
FORTEO 8.6
FORTESTA 13.3
FOSAMAX PLUS D 8.6
fosinopril sodium 4.5.4.1
fosinopril‐hydrochlorothiazide 4.5.6
FOSRENOL 12.7
FRAGMIN 12.3.2
FREESTYLE FREEDOM LITE 18.1
FREESTYLE INSULINX 18.1
FREESTYLE INSULINX TEST 18.1
STRIPS
FREESTYLE LITE METER 18.1
FREESTYLE LITE STRIPS 18.1
FREESTYLE TEST STRIPS 18.1
FROVA 5.1.2
furosemide 4.3.1
gabapentin 5.4.7
galantamine hbr 5.9.3
GANIRELIX ACETATE 13.1.2
GELNIQUE 16.1.1
gemfibrozil 4.8.1
GENERESS FE 13.7
GENOTROPIN 10.2.4
gentamicin sulfate 2.2
gentamicin sulfate 14.1.1
gentamicin sulfate 2.8.2
GEODON 5.8
gildess fe 13.7
GLEEVEC 3
glimepiride 8.1.2
glipizide/er 8.1.2
glipizide‐metformin 8.1.2
GLUCAGEN 8.2
GLUCAGON EMERGENCY KIT 8.2
GLUCOSE TEST STRIP 18.1
glyburide 8.1.2
glyburide micronized 8.1.2
glyburide‐metformin hcl 8.1.2
GOLYTELY 9.6
GONAL‐F/RFF 13.2
GRALISE 5.4.7
granisetron hcl 5.6
GRIFULVIN V 2.3
griseofulvin 2.3
guaifenesin/codiene 15.3
guaifenesin‐codeine 15.3
guanfacine hcl 4.5.2
GUARDIAN RT STARTER KIT 18.1
HALFLYTELY‐BISACODYL 9.6
halobetasol propionate 6.1
HALOG 6.1
haloperidol 5.8
HECTOROL 12.1.3
HELIDAC 9.4.3
heparin sodium 12.3.2
HORIZANT 5.4.7
HUMALOG products 8.1.1
HUMATROPE 10.2.4
HUMIRA 3
HUMULIN products 8.1.1
hydrochlorothiazide 4.3.2
hydrocodone bit‐ibuprofen 5.1.1.2
hydrocodone‐acetaminophen 5.1.1.2
hydrocortisone 6.1
hydrocortisone 9.6
hydrocortisone 8.3.1
hydrocortisone acetate 9.6
hydrocortisone butyrate 6.1
hydrocortisone valerate 6.1
hydromorphone hcl 5.1.1.1
hydroxychloroquine sulfate 2.7.3
hydroxyurea 3
hydroxyzine 6.2
hyoscyamine sulfate 9.3
HYZAAR 4.5.4.2
ibandronate sodium 8.6
ibuprofen 11.1.2
imipramine hcl 5.5.1.1
imiquimod 6.9.2
IMITREX 5.1.2
INCIVEK 2.5.1
indapamide 4.3.2
indomethacin 11.1.2
INTELENCE 2.5.1
INTERMEZZO 5.2.2
INTUNIV 5.9.6
INVEGA 5.8
ipratropium bromide 7.2
ipratropium bromide 15.1.3
ipratropium‐albuterol 15.1.3
irbesartan 4.5.4.2
irbesartan‐hydrochlorothiazide 4.5.6
ISENTRESS 2.5.1
isoniazid 2.7.2
isosorbide 4.6.1
isosorbide dinitrate 4.6.1
isotretinoin 6.3.1
ISTALOL 14.5
itraconazole 2.3
JALYN 16.1.4
JANUMET/XR 8.1.5.2
JANUVIA 8.1.5.2
JENTADUETO 8.1.5.2
jinteli 13.4.1
jolessa 13.7
jolivette 13.5
junel 13.7
junel fe 13.7
JUVISYNC 8.1.5.2
KADIAN 5.1.1.1
KALETRA 2.5.1

KAPVAY 5.9.6
kariva 13.7
kelnor 1‐35 13.7
KENALOG 6.1
KEPPRA 5.4.7
KEPPRA XR 5.4.7
ketoconazole 2.3
ketoconazole 2.4.2
ketoprofen 11.1.2
ketorolac tromethamine 11.1.2
ketotifen fumarate 14.6
KINERET 10.2.6
KOMBIGLYZE XR 8.1.5.2
labetalol hcl 4.4
lactulose 12.7
LAMICTAL 5.4.7
LAMICTAL ODT 5.4.7
LAMICTAL XR 5.4.7
lamivudine 2.5.1
lamivudine‐zidovudine 2.5.1
lamotrigine 5.4.7
LANOXIN 4.1
lansoprazole 9.4.2
LANTUS/SOLOSTAR 8.1.1
LASTACAFT 14.6
latanoprost 14.5
LATUDA 5.8
LAZANDA 5.1.1.1
leena 13.7
leflunomide 3
LESCOL 4.8.2
LESCOL XL 4.8.2
lessina 13.7
LETAIRIS 4.6.3
letrozole 3
leucovorin calcium 3
leuprolide acetate 13.1.2
LEVAQUIN 2.1.9
LEVEMIR/FLEXPEN 8.1.1
levetiracetam 5.4.7
LEVITRA 16.1.4
levobunolol hcl 14.5
levocarnitine 12.1.3
levocetirizine dihydrochloride 15.2.1
levofloxacin 2.1.9
levora‐28 13.7
levothyroxine sodium 8.4.1
levoxyl 8.4.1
LEXAPRO 5.5.1.3
LEXIVA 2.5.1
LIALDA 9.6
lidocaine hcl 1.2
lidocaine‐prilocaine 1.2
LIDODERM 1.2
LINZESS 9.7
LIPITOR 4.8.2
LIPOFEN 4.8.1
lisinopril 4.5.4.1
lisinopril‐hydrochlorothiazide 4.5.6
lithium carbonate 5.3
LIVALO 4.8.2
LO LOESTRIN FE 13.7
LOCOID 6.1
LOCOID LIPOCREAM 6.1
LOESTRIN 24 FE 13.7
loperamide 9.2
loratadine 15.2.1
lorazepam 5.2.1
loryna 13.7
losartan potassium 4.5.4.2
losartan‐hydrochlorothiazide 4.5.6
LOSEASONIQUE 13.7
LOTEMAX 14.2
LOTREL 4.5.6
lovastatin 4.8.2
LOVAZA 4.8.1
LOVENOX 12.3.2
low‐ogestrel 13.7
LUMIGAN 14.5
LUNESTA 5.2.2
LUNESTA 5.2.2
LUPRON DEPOT 13.1.2
lutera 13.7
LUVOX CR 5.5.1.3
LYRICA 5.4.7
LYSTEDA 12.5
MAKENA 13.5
MALARONE 2.7.3
MAXAIR AUTOHALER 15.1.1
MAXALT/MLT 5.1.2
meclizine hcl 5.6
medroxyprogesterone acetate 13.5
mefloquine hcl 2.7.3
MEGACE ES 3
megestrol acetate 3
meloxicam 11.1.2
MENEST 13.4
MENOSTAR 13.4
mercaptopurine 3
METADATE CD 5.9.1
metaproterenol sulfate 15.1.1
metaxalone 11.3.2
metformin hcl 8.1.2
metformin hcl er 8.1.2
methadone hcl 5.1.1.1
methimazole 8.4.2
methocarbamol 11.3.2
methotrexate 3
methyldopa 4.5.2
methylphenidate er 5.9.1
methylphenidate hcl 5.9.1
methylphenidate sr 5.9.1
methylprednisolone 8.3.1
metoclopramide hcl 9.3
metolazone 4.3.2
metoprolol succinate 4.4
metoprolol tartrate 4.4
metoprolol‐hydrochlorothiazide 4.5.6
METROGEL 6.3
metronidazole 6.3

metronidazole 13.1.3
metronidazole 2.7.5
MICARDIS 4.5.4.2
MICARDIS HCT 4.5.4.2
microgestin 13.7
microgestin fe 13.7
MIGRANAL 5.1.2
MINILINK REAL‐TIME
17.1
TRANSMITTER
MINIMED 18
MINIMED RESERVOIR 18
minocycline hcl 2.1.7
minoxidil 4.5.1
MIRAPEX 5.7.2
MIRAPEX ER 5.7.2
mirtazapine 5.5.1.4
misoprostol 9.4.1
modafinil 5.9.1
moexipril hcl 4.5.4.1
moexipril‐hydrochlorothiazide 4.5.6
mometasone furoate 6.1
mononessa 13.7
montelukast sodium 15.1.4
morphine sulfate/er 5.1.1.1
MOVIPREP 9.6
MOXEZA 14.1.1
MULTAQ 4.7.5
mupirocin 2.2
MUSE 16.1.4
mycophenolate mofetil 3
MYFORTIC 3
MYRBETRIQ 16.1.4
nabumetone 11.1.2
nadolol 4.4
naltrexone hcl 5.9.2
NAMENDA 5.9.3
NAPRELAN 11.1.2
naproxen 11.1.2
naproxen sodium 11.1.2
naratriptan hcl 5.1.2
NASACORT AQ 7.2
NASCOBAL 12.1.3
NASONEX 7.2
NATAZIA 13.7
nateglinide 8.1.2
necon 13.7
NEEVO DHA 13.1.1
neomycin‐bacitracin‐polymyxin 14.1.1
neomycin‐polymyxin‐dexameth 14.3
neomycin‐polymyxin‐hc 7.1
neomycin‐polymyxin‐hc 14.3
neomycin‐polymyxin‐hydrocort 7.1
NEULASTA 10.2.1
NEUPOGEN 10.2.1
NEUPRO 5.7.2
NEVANAC 14.6
nevirapine 2.5.1
NEXIUM 9.4.2
NIASPAN 4.8.1
nifediac cc 4.2
nifedical xl 4.2
nifedipine er 4.2
nisoldipine 4.2
nitrofurantoin 2.1.8
nitrofurantoin mono‐macro 2.1.8
nitroglycerin 4.6.1
nitroglycerin patch 4.6.1
NITROSTAT 4.6.1
nizatidine 9.4
nora‐be 13.5
NORDITROPIN FLEXPRO 10.2.4
NORDITROPIN NORDIFLEX 10.2.4
norethindrone 13.5
norethindrone acetate 13.5
NOROXIN 2.1.9
nortrel 13.7
nortriptyline hcl 5.5.1.2
NORVIR 2.5.1
novarel 13.1.2
NOVOFINE 18.1
NOVOFINE 32 18.1
NOVOFINE AUTOCOVER 18.1
NOVOLIN products 8.1.1
NOVOLOG products 8.1.1
NUCYNTA/ER 5.1.1.1
NUEDEXTA 5.9.2
NULYTELY WITH FLAVOR PACKS 9.6
NUTROPIN/AQ/AQ NUSPIN 10.2.4
NUVARING 13.7
NUVIGIL 5.9.1
nystatin 2.3
nystatin 2.4.2
nystatin‐triamcinolone 2.4.3
ocella 13.7
ofloxacin 7.1
ofloxacin 14.1.1
ofloxacin 2.1.9
ogestrel 13.7
olanzapine 5.8
olanzapine odt 5.8
olanzapine‐fluoxetine hcl 5.8.1.1
OLUX 6.1
OLUX‐E 6.1
OMECLAMOX‐PAK 9.4.3
omeprazole 9.4.2
omeprazole 9.4.2.1
omeprazole‐sodium bicarbonate 9.4.2
OMNARIS 7.2
OMNITROPE 10.2.4
ondansetron hcl 5.6
ondansetron odt 5.6
ONE TOUCH LANCETS 18.1
ONE TOUCH TEST STRIPS 18.1
ONE TOUCH ULTRA 2 18.1
ONE TOUCH ULTRA SMART 18.1
ONE TOUCH ULTRA SYSTEM 18.1
ONE TOUCH ULTRA TEST STRIPS 18.1
ONE TOUCH ULTRAMINI 18.1
ONE TOUCH VERIO 18.1
ONE TOUCH VERIO IQ 18.1

ONGLYZA 8.1.5.2
ONSOLIS 5.1.1.1
OPANA 5.1.1.1
OPANA ER 5.1.1.1
OPTICHAMBER 18
ORACEA 2.1.7
ORAVIG 2.3
ORENCIA 3
orphenadrine citrate 11.3.2
ORTHO EVRA 13.7
ORTHO TRI‐CYCLEN 13.7
ORTHO TRI‐CYCLEN LO 13.7
OSMOPREP 9.5
OVIDREL 13.1.2
oxaprozin 11.1.2
oxazepam 5.2.1
oxcarbazepine 5.4.1
OXISTAT 2.4.2
oxybutynin chloride 16.1.1
oxybutynin chloride er 16.1.1
oxycodone hcl 5.1.1.1
oxycodone‐acetaminophen 5.1.1.1
OXYCONTIN 5.1.1.1
oxymorphone hcl 5.1.1.1
OXYTROL 16.1.1
PANCREAZE 9.6
pancrelipase 5,000 9.6
pantoprazole sodium 9.4.2
PARADIGM 18
PARADIGM INFUSION 18
PARADIGM REAL‐TIME 17.1
PARADIGM SILHOUETTE 18
paroxetine hcl 5.5.1.3
PATADAY 14.6
PATANASE 7.2
PATANOL 14.6
peg 3350‐electrolyte 9.6
PEGASYS/PROCLICK 10.2.3
PEGINTRON/REDIPEN 10.2.3
penicillin v potassium 2.1.5
PENNSAID 6.9.5
PENTASA 9.6
pentoxifylline 4.9
PERFOROMIST 15.1.1
permethrin 6.9.3
perphenazine 5.8
PERTZYE 9.6
phenazopyridine hcl 16.1.3
phenobarbital 5.4.6
phentermine hcl 17.3.1
PHENYTEK 5.4.3
phenytoin sodium extended 5.4.3
PHOSLYRA 12.1.3
PICATO 6.9.2
pilocarpine hcl 7.3
pilocarpine hcl 14.5
pindolol 4.4
piroxicam 11.1.2
PLAVIX 12.4
POLYFIN 18
POLYFIN QR 18
polymyxin b sul‐trimethoprim 14.1.1
portia 13.7
potassium chloride 12.2
potassium citrate 16.1.4
POTIGA 5.4.7
PRADAXA 12.3.5
pramipexole dihydrochloride 5.7.2
PRAMOSONE 6.1
PRAMOSONE E 6.1
PRANDIMET 8.1.2
PRANDIN 8.1.2
pravastatin sodium 4.8.2
prazosin hcl 4.5.1
PRECISION 18.1
PRECISION XTRA 17.1
PRECISION XTRA 18.1
prednisolone 8.3.1
prednisolone acetate 14.2
prednisolone sodium phosphate 8.3.1
prednisone 8.3.1
PREFERA OB 13.1.1
PREFERA‐OB ONE 13.1.1
PREFERA‐OB PLUS DHA 13.1.1
PREFEST 13.4.1
PREMARIN 13.4
PREMPHASE 13.4.1
PREMPRO 13.4.1
PRENATE DHA 13.1.1
PRENATE ELITE 13.1.1
PRENATE ESSENTIAL 13.1.1
PREPOPIK 9.6
PREVACID 9.4.2
previfem 13.7
PREVPAC 9.4.3
PREZISTA 2.5.1
PRIMABELLA 18
primidone 5.4.6
PRISTIQ ER 5.5.1.4
PROAIR HFA 15.1.1
probenecid 11.2
prochlorperazine maleate 5.6
PROCRIT 10.2.2
proctosol‐hc 9.6
proctozone‐hc 9.6
PRODIGY 18.1
PRODIGY INSULIN SYRINGE 18.1
PRODIGY NO CODING 18.1
PRODIGY PEN NEEDLE 18.1
PRODIGY POCKET 18.1
PRODIGY VOICE 18.1
progesterone in oil 13.5
PROGRAF 3
promethazine hcl 5.6
promethazine hcl 15.2.1
promethazine vc 15.2.3
promethazine vc‐codeine 15.3
promethazine‐codeine 15.3
promethazine‐dm 15.3
promethegan 5.6

PROMETRIUM 13.5
PROMISEB 6.9.2
propafenone hcl 4.7.1.3
propranolol hcl 4.4
propylthiouracil 8.4.2
PROTONIX 9.4.2
PROTOPIC 6.9.2
PROVENTIL HFA 15.1.1
PROVIGIL 5.9.1
PULMICORT 15.1.3
PULMICORT FLEXHALER 15.1.3
PULMOZYME 15.4
PYLERA 9.4.3
pyridostigmine bromide 5.9.2
QNASL 7.2
QSYMIA 17.3.1
QUALAQUIN 2.7.3
quasense 13.7
quetiapine fumarate 5.8
QUICK RELEASE SOFT TEFLON 18
quinapril hcl 4.5.4.1
quinapril‐hydrochlorothiazide 4.5.6
QVAR 15.1.3
ramipril 4.5.4.1
RANEXA 4.9
ranitidine hcl 9.4
RAPAFLO 16.1.4
RAPAMUNE 3
RAYOS 8.3.1
REBIF 10.2.3
reclipsen 13.7
RELENZA 2.5.2
RELISTOR 9.6
RELPAX 5.1.2
RENAGEL 12.7
RENVELA 12.7
reprexain 5.1.1.2
REQUIP XL 5.7.2
RESTASIS 14.6
RETIN‐A MICRO 6.3
RETIN‐A MICRO PUMP 6.3
REVATIO 4.6.2
REVLIMID 3
REYATAZ 2.5.1
REZIRA 15.3
RHINOCORT AQUA 7.2
ribapak 2.5.2
ribavirin 2.5.2
rifampin 2.7.2
RIOMET 8.1.2
RISPERDAL CONSTA 5.8
risperidone 5.8
RITALIN LA 5.9.1
rivastigmine 5.9.3
ropinirole hcl 5.7.2
roxicet 5.1.1.1
ROZEREM 5.2.2
RYTHMOL SR 4.7.1.3
SAFYRAL 13.7
SAIZEN 10.2.4
salsalate 11.1.1
SANCTURA XR 16.1.1
SANCUSO 5.6
SANDOSTATIN LAR 3
SANTYL 6.9.2
SAPHRIS 5.8
SAVELLA 5.5.1.4
SEASONIQUE 13.7
selenium sulfide 6.8
SENSIPAR 8.6
SEREVENT DISKUS 15.1.1
SEROQUEL 5.8
SEROQUEL XR 5.8
sertraline hcl 5.5.1.3
SFROWASA 9.6
SILENOR 5.2.2
SILHOUETTE 18
silver sulfadiazine 2.2
SIMCOR 4.8.2.1
SIMPONI 3
simvastatin 4.8.2
SINGULAIR 15.1.4
SKELAXIN 11.3.2
sodium fluoride 12.1.4
sodium sulfacetamide‐sulfur 6.3
SOF‐SENSOR 17.1
SOF‐SET 18
SOF‐SET MICRO 18
SOFT TOUCH 18.1
SOFTCLIX 18.1
SOLARAZE 6.9.2
solia 13.7
SOLODYN 2.1.7
SOMA 11.3.2
SOMATULINE DEPOT 3
SORILUX 6.8
sotalol 4.7.5
SPIRIVA 15.1.3
spironolactone 4.3.3
spironolactone‐hctz 4.3.3
sprintec 13.7
sronyx 13.7
STALEVO 100 5.7.2
STAXYN 16.1.4
STELARA 3
STELARA 3
STRATTERA 5.9.6
STRIANT 13.3
SUBOXONE 5.1.1.2
SUBSYS 5.1.1.1
sucralfate 9.4.1
SULAR 4.2
sulfacetamide sodium 6.8
sulfacetamide sodium 14.1.1
sulfamethoxazole‐trimethoprim 2.1.6
sulfasalazine 9.6
sulindac 11.1.2
sumatriptan 5.1.2
SUMAVEL DOSEPRO 5.1.2
SUPRAX 2.1.1

SUPREP 9.6
SURESTEP 18.1
SURE‐T 18
SUSTIVA 2.5.1
syeda 13.7
SYMBICORT 15.1.3
SYMBYAX 5.8.1.1
SYMBYAX 5.8.1.1
SYMLINPEN 8.1.4
SYNAGIS 10
SYNTHROID 8.4.1
TACLONEX 6.8
tacrolimus 3
TAMIFLU 2.5.2
tamoxifen citrate 3
tamsulosin hcl 16.1.4
TARKA 4.5.6
TAZORAC 6.8
TEGRETOL XR 5.4.1
TEGRETOL XR 5.4.1
TEKAMLO 4.5.6
TEKTURNA 4.5.6
TEKTURNA HCT 4.5.6
temazepam 5.2.2
terazosin hcl 4.5.1
terbinafine hcl 2.3
terconazole 2.4.1
TESTIM 13.3
testosterone cypionate 13.3
tetracycline hcl 2.1.7
TEVETEN 4.5.4.2
TEVETEN HCT 4.5.4.2
TEV‐TROPIN 10.2.4
THALOMID 17.2
theophylline 15.1.2
theophylline anhydrous 15.1.2
thioridazine hcl 5.8
thiothixene 5.8
TIKOSYN 4.7.5
tilia fe 13.7
timolol maleate 4.4
timolol maleate 14.5
TIMOPTIC OCUDOSE 14.5
tinidazole 2.7.5
tizanidine hcl 11.3.1
TOBI 2.8.2
TOBRADEX 14.3
TOBRADEX ST 14.3
tobramycin sulfate 2.8.2
tobramycin‐dexamethasone 14.3
tolterodine tartrate 16.1.1
TOPAMAX 5.4.7
topiramate 5.4.7
TOPROL XL 4.4
torsemide 4.3.1
TOVIAZ 16.1.1
TRACLEER 4.6.3
TRADJENTA 8.1.5.2
tramadol hcl/er 5.1.1
tramadol hcl‐acetaminophen 5.1.1
trandolapril 4.5.4.1
TRANSDERM‐SCOP 5.6
tranylcypromine sulfate 5.5.2
TRAVATAN Z 14.5
trazodone hcl 5.5.1.4
tretinoin 3
tretinoin 6.3
tretinoin 6.9.2
TREXIMET 5.1.2
triamcinolone acetonide 6.1
triamcinolone acetonide 7.2
triamcinolone acetonide 7.3
triamterene‐hctz 4.3.3
triamterene‐hydrochlorothiazid 4.3.3
triazolam 5.2.2
TRIBENZOR 4.5.6
TRICOR 4.8.1
trifluoperazine hcl 5.8
trifluridine 14.1.2
TRIGLIDE 4.8.1
trihexyphenidyl hcl 5.7.1
tri‐legest fe 13.7
TRILIPIX 4.8.1
trilyte with flavor packets 9.6
trimethoprim 2.1.8
trinessa 13.7
tri‐previfem 13.7
tri‐sprintec 13.7
trivora‐28 13.7
TRUE2GO BLOOD GLUCOSE 18.1
SYSTEM
TRUERESULT BLOOD GLUCOSE 18.1
SYSTM
TRUETEST TEST STRIPS 18.1
TRUETRACK SMART SYSTEM 18.1
TRUETRACK TEST STRIP 18.1
TRUVADA 2.5.1
TUDORZA PRESSAIR 15.1.3
TUSSICAPS 15.3
TUSSIONEX 15.3
TWYNSTA 4.5.6
TYKERB 3
ULESFIA 6.9.3
ULORIC 11.2
ULTRAVATE PAC 6.1
ursodiol 9.6
VAGIFEM 13.4
valacyclovir 2.5.2
VALPROIC ACID 5.4.4
VALTREX 2.5.2
VANCOCIN HCL 2.8
vancomycin hcl 2.8
vandazole 13.1.3
VECTICAL 6.8
velivet 13.7
VELTIN 6.3
venlafaxine hcl 5.5.1.4
venlafaxine hcl er 5.5.1.4
VENLAFAXINE HCL ER 5.5.1.4
VENTOLIN HFA 15.1.1

VERAMYST 7.2
verapamil 4.2
verapamil er pm 4.2
VEREGEN 6.9.2
veripred 20 8.3.1
VESICARE 16.1.1
VEXOL 14.2
VGO 20 18.1
VGO 30 18.1
VGO 40 18.1
VIAGRA 16.1.4
VICTOZA 8.1.5.1
VICTRELIS 2.5.1
VIGAMOX 14.1.1
VIIBRYD 5.5.1.3
VIMOVO 11.1.2
VIMPAT 5.4.7
VIRAMUNE 2.5.1
VIRAMUNE XR 2.5.1
VIREAD 2.5.1
vitamin d 12.1.3
VIVELLE‐DOT 13.4
VOLTAREN 6.9.5
voriconazole 2.3
VYTORIN 4.8.2.1
VYTORIN 4.8.2.1
VYVANSE 5.9.1
warfarin sodium 12.3.1
WELCHOL 4.8.1
WELLBUTRIN XL 5.5.1.4
XALATAN 14.5
XARELTO 12.3.3
XELODA 3
XERESE 2.6
XIFAXAN 2.8
XOLAIR 10.2.7
XOPENEX 15.1.1
XOPENEX CONCENTRATE 15.1.1
XOPENEX HFA 15.1.1
XYZAL 15.2.1
YASMIN 28 13.7
YAZ 13.7
zafirlukast 15.1.4
zaleplon 5.2.2
zamicet 5.1.1.2
zarah 13.7
ZEGERID 9.4.2
ZEMPLAR 12.1.3
zenchent 13.7
ZENPEP 9.6
ZETIA 4.8.1
ZETONNA 7.2
ZIAGEN 2.5.1
ZIANA 6.3
ZIOPTAN 14.5
ziprasidone hcl 5.8
zolpidem tartrate/er 5.2.2
ZOLPIMIST 5.2.2
ZOMIG/ZMT 5.1.2
zonisamide 5.4.7
ZOSTAVAX 10
zovia 1‐35e 13.7
zovia 1‐50e 13.7
ZOVIRAX 2.6
ZUPLENZ 5.6
ZUTRIPRO 15.3
ZYCLARA 6.9.2
ZYLET 14.3
ZYMAXID 14.1.1
ZYPREXA 5.8
ZYPREXA ZYDIS 5.8
ZYRTEC 15.2.1
ZYRTEC‐D 15.2.3
ZYVOX 2.8