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

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DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESTOBRADEX X tobramycin sulfate/dexamethTOBRADEX ST XZYLET X14.5 ANTIGLAUCOMA DRUGSacetazolamide Xbrimonidine tartrate Xdorzolamide hcl Xdorzolamide‐timolol Xlatanoprost Xlevobunolol hcl Xpilocarpine hcl Xtimolol maleate XALPHAGAN P X brimonidine tartrateAZOPT XBETIMOL X generic, ALPHAGAN P, AZOPT, COMBIGANCOMBIGAN XCOSOPT PF X generic, ALPHAGAN P, AZOPT, COMBIGANISTALOL X generic, ALPHAGAN P, AZOPT, COMBIGANLUMIGAN ST XTIMOPTIC OCUDOSE X timolol maleateTRAVATAN Z ST XXALATAN ST X latanoprostZIOPTAN ST X latanoprost, LUMIGAN, TRAVATAN Z14.6 OTHER OPHTHALMIC DRUGSatropine sulfate Xazelastine hcl Xcromolyn sodium Xdiclofenac sodium Xepinastine hcl Xketotifen fumarate XACUVAIL XALOCRIL X azelastine, PATADAY, PATANOLALOMIDE X azelastine, PATADAY, PATANOLBEPREVE X azelastine, PATADAY, PATANOLBOTOX XBROMDAY XEMADINE X azelastine, PATADAY, PATANOLLASTACAFT X azelastine, PATADAY, PATANOLNEVANAC XPATADAY XPATANOL XRESTASIS XTIER
TIERDRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESCHAPTER 15: RESPIRATORY MEDICATIONS15.1.1 BETA‐2 ADRENERGIC DRUGSalbuterol sulfate Xmetaproterenol sulfate XARCAPTA NEOHALER X FORADIL, SEREVENTBROVANA X PERFOROMISTFORADIL XMAXAIR AUTOHALER X PROAIR HFA, VENTOLIN HFAPERFOROMIST XPROAIR HFA XPROVENTIL HFA X PROAIR HFA, VENTOLIN HFASEREVENT DISKUS XVENTOLIN HFA XXOPENEX X levalbuterolXOPENEX CONCENTRATE X levalbuterolXOPENEX HFA ST X PROAIR HFA, VENTOLIN HFA15.1.2 METHYL XANTHINE DRUGStheophylline Xtheophylline anhydrous X15.1.3 OTHER DRUGS FOR ASTHMAbudesonide Xcromolyn sodium Xepinephrine Xipratropium bromide Xipratropium‐albuterol XADVAIR DISKUS XADVAIR HFA XALVESCO X ASMANEX, PULMICORT FLEX, QVARASMANEX XATROVENT HFA XCOMBIVENT XCOMBIVENT RESPIMAT XDULERA XEPIPEN 2‐PAK XEPIPEN JR 2‐PAK XFLOVENT DISKUS X ASMANEX, PULMICORT FLEX, QVARFLOVENT HFA X ASMANEX, PULMICORT FLEX, QVARPULMICORT XPULMICORT FLEXHALER XQVAR XSPIRIVA XSYMBICORT XTUDORZA PRESSAIR X
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

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