Preferred Drug List 2013 Standard Formulary (3 ... - Express Scripts
Preferred Drug List 2013 Standard Formulary (3 ... - Express Scripts
Preferred Drug List 2013 Standard Formulary (3 ... - Express Scripts
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DRUG NAME<br />
1 2 3 SUGGESTED PREFFERED ALTERNATIVES<br />
venlafaxine hcl er X<br />
VENLAFAXINE HCL ER ST X venlafax er(NOT UCB NDCS‐65580<br />
CYMBALTA PA X<br />
EFFEXOR XR ST X venlafax er(NOT UCB NDCS‐65580<br />
PRISTIQ ER ST X<br />
SAVELLA PA X<br />
WELLBUTRIN XL X bupropion xl<br />
5.5.2 MAO INHIBITORS<br />
tranylcypromine sulfate X<br />
5.6 ANTIVERTIGO AND ANTIEMETIC DRUGS<br />
dronabinol X<br />
granisetron hcl X<br />
meclizine hcl X<br />
ondansetron hcl X<br />
ondansetron odt X<br />
prochlorperazine maleate X<br />
promethazine hcl X<br />
promethegan X<br />
EMEND X<br />
SANCUSO X<br />
TRANSDERM‐SCOP X meclizine<br />
ZUPLENZ X ondansetron odt<br />
5.7.1 ANTIPARKINSON ANTICHOLINERGIC DRUGS<br />
benztropine mesylate X<br />
trihexyphenidyl hcl X<br />
5.7.2 OTHER ANTIPARKINSON DRUGS<br />
bromocriptine mesylate X<br />
carbidopa‐levodopa X<br />
carbidopa‐levodopa‐entacapone X<br />
pramipexole dihydrochloride X<br />
ropinirole hcl X<br />
AZILECT X<br />
COMTAN X entacapone<br />
MIRAPEX X pramipexole<br />
MIRAPEX ER X<br />
NEUPRO X pramipex,ropinir/er,MIRAPEX ER<br />
REQUIP XL X ropinirole er<br />
STALEVO 100 X carbidopa/levodopa/entacapone<br />
5.8 ANTIPSYCHOTIC DRUGS<br />
clozapine X<br />
fluphenazine hcl X<br />
haloperidol X<br />
olanzapine X<br />
olanzapine odt X<br />
TIER