Preferred Drug List 2013 Standard Formulary with ... - Express Scripts

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DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESRENVELA XCHAPTER 13: OBSTETRICAL & GYNECOLOGICAL MEDICATIONS13.1.1 PRENATAL VITAMINSNEEVO DHA X generic Rx prenatal vitamansPREFERA OB X hemenatal ob tabsPREFERA‐OB ONE X prenatal mv & min capsulePREFERA‐OB PLUS DHA X hemenatal ob+dha combo pkPRENATE DHA X generic Rx prenatal vitamansPRENATE ELITE X generic Rx prenatal vitamansPRENATE ESSENTIAL X generic Rx prenatal vitamans13.1.2 SPECIALIZED OB/GYN DRUGSleuprolide acetate PA Xnovarel XCETROTIDE XGANIRELIX ACETATE XLUPRON DEPOT PA X ELIGARD, TRELSTAROVIDREL X ch.gonadotrpin,novarel13.1.3 OB/GYN TOPICAL ANTIINFECTIVESclindamycin phosphate Xmetronidazole Xvandazole X13.2 OVULATORY STIMULANTSclomiphene citrate XBRAVELLE X GONAL‐F/RFFFOLLISTIM AQ X GONAL‐F/RFFGONAL‐F/RFF X13.3 ANDROGEN DRUGStestosterone cypionate XANDRODERM XANDROGEL XAXIRON XFORTESTA X ANDRODERM, ANDROGEL, AXIRONSTRIANT X ANDRODERM, ANDROGEL, AXIRONTESTIM X ANDRODERM, ANDROGEL, AXIRON13.4 ESTROGEN DRUGSestradiol Xestrogen & methyltestosterone Xestrogen‐methyltestosterone Xestropipate XCENESTIN XDIVIGEL XELESTRIN X estradiol ptch, DIVIGEL, EVAMISTENJUVIA XESTRACE X VAGIFEMTIER
DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESESTRASORB X estradiol ptch, DIVIGEL, EVAMISTESTRING X VAGIFEMESTROGEL X estradiol ptch, DIVIGEL, EVAMISTEVAMIST XMENEST X estradiol, CENESTIN, ENJUVIA, PREMARNMENOSTAR X gen estradiol ptch, VIVELLE‐DOTPREMARIN XVAGIFEM XVIVELLE‐DOT X13.4.1 ESTROGEN/PROGESTIN COMBINATIONSjinteli XACTIVELLA X estradiol/noreth acetateANGELIQ X ee/noreth ac, PREMPHASE/PREMPROCLIMARA PRO XCOMBIPATCH XFEMHRT X ee/noreth ac, PREMPHASE/PREMPROPREFEST X ee/noreth ac, PREMPHASE/PREMPROPREMPHASE XPREMPRO X13.4.3 SELECTIVE ESTROGEN RECEPTOR MODULATOREVISTA X13.5 PROGESTIN DRUGScamila Xerrin Xjolivette Xmedroxyprogesterone acetate Xnora‐be Xnorethindrone Xnorethindrone acetate Xprogesterone in oil XCRINONE XENDOMETRIN XMAKENA XPROMETRIUM X progesterone13.7 CONTRACEPTIVESaltavera Xapri Xaranelle Xaviane Xazurette Xbalziva Xcamrese Xcesia Xcryselle XTIER
Page 4: TABLE OF CONTENTSChapterChapter 1Ch
Page 8 and 9: DRUG NAME1 2 3 4 SUGGESTED PREFFERE
Page 10 and 11: DRUG NAMETIER1 2 3 4SUGGESTED PREFF
Page 12 and 13: DRUG NAME1 2 3 4TIKOSYN XTIERSUGGES
Page 14 and 15: DRUG NAME1 2 3 4MIGRANAL XRELPAX ST
Page 16 and 17: DRUG NAMETIER1 2 3 4SUGGESTED PREFF
Page 26 and 27: DRUG NAME1 2 3 4salsalate XTIERSUGG
Page 34 and 35: DRUG NAMETIER1 2 3 415.1.4 LEUKOTRI
Page 36 and 37: DRUG NAME1 2 3 4PARADIGM XPARADIGM
Page 38 and 39: IndexABILIFY 5.8ABILIFY DISCMELT 5.
Page 40 and 41: carbidopa‐levodopaentacapone5.7.2
Page 42 and 43: EVISTA 13.4.3EXALGO 5.1.1.1EXELDERM
Page 44 and 45: LEXIVA 2.5.1LIALDA 9.6lidocaine hcl
Page 46 and 47: oxycodone‐acetaminophen 5.1.1.1OX
Page 48 and 49: SUMAVEL DOSEPRO 5.1.2SUPRAX 2.1.1SU

Preferred Drug List 2013 Standard Formulary with ... - Express Scripts

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