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

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DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVEScyclafem Xenpresse Xgildess fe Xjolessa Xjunel Xjunel fe Xkariva Xkelnor 1‐35 Xleena Xlessina Xlevora‐28 Xloryna Xlow‐ogestrel Xlutera Xmicrogestin Xmicrogestin fe Xmononessa Xnecon Xnortrel Xocella Xogestrel Xportia Xprevifem Xquasense Xreclipsen Xsolia Xsprintec Xsronyx Xsyeda Xtilia fe Xtri‐legest fe Xtrinessa Xtri‐previfem Xtri‐sprintec Xtrivora‐28 Xvelivet Xzarah Xzenchent Xzovia 1‐35e Xzovia 1‐50e XBEYAZ XFEMCON FE X zenchent fe chewable, zeosaGENERESS FE X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,NATAZIA, NUVARING, SAFYRALTIER
DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESLO LOESTRIN FE XLOESTRIN 24 FE XLOSEASONIQUE X amethia lo, camrese loNATAZIA XNUVARING XORTHO EVRA X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,NATAZIA, NUVARING, SAFYRALORTHO TRI‐CYCLEN X trinesa, tri‐previ, tri‐sprintORTHO TRI‐CYCLEN LO X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,NATAZIA, NUVARING, SAFYRALSAFYRAL XSEASONIQUE X amethia, camreseYASMIN 28 X ocella,syeda,zarahYAZ X gianvi, loryna, vesturaCHAPTER 14: OPHTHALMIC MEDICATIONS14.1.1 OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGSbacitracin Xbacitracin‐polymyxin Xciprofloxacin hcl Xerythromycin Xgentamicin sulfate Xneomycin‐bacitracin‐polymyxin Xofloxacin Xpolymyxin b sul‐trimethoprim Xsulfacetamide sodium XAZASITE XBESIVANCE X generic, MOXEZA, VIGAMOX, ZYMAXIDMOXEZA XVIGAMOX XZYMAXID X14.1.2 OPHTHALMIC TOPICAL ANTIVIRAL DRUGStrifluridine X14.2 OPHTHALMIC CORTICOSTEROID DRUGSfluorometholone Xprednisolone acetate XALREX X azelastine, PATADAY, PATANOLDUREZOL XFML FORTE X generics, DUREZOL, LOTEMAX SOLNLOTEMAX XVEXOL X generics, DUREZOL, LOTEMAX SOLN14.3 OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDSneomycin‐polymyxin‐dexameth Xneomycin‐polymyxin‐hc Xtobramycin‐dexamethasone 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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