2020 controlled access formulary list

2020 Controlled Access Formulary List The 2020 Controlled Access Formulary drug list is shown below. The formulary is the list of drugs included in your prescription plan. Inclusion on the list does not guarantee coverage.

The following list is not a complete list of products that are on the formulary.

PLEASE NOTE: Brand-name drugs may move to non-preferred status if a generic version becomes available during the year. Not all the drugs listed are covered by all prescription plans; check your benefit materials for the specific drugs covered and the copayments for your prescription plan. For specific questions about your coverage, please call the phone number printed on your member ID card.

KEY [INJ] – Injectable Drug [SP] – Specialty Drug CR – Controlled Release ER, XR, XL – Extended Release FA – Folic Acid FE – Ferrous (Iron) HCL – Hydrochloride HCTZ – Hydrochlorothiazide LA – Long Acting ODT – Oral Dissolving Tablet

Brand-name drugs are listed in CAPITAL letters. Example: ABILIFY MAINTENA Generic drugs are listed in lower-case letters. Example: ibuprofen

For the member: FDA-approved generic medications meet strict standards and contain the same active ingredients as their corresponding brand-name medications, although they may have a different appearance.

For the physician: Please prescribe preferred products and allow generic substitutions when medically appropriate.

Costs for covered alternatives may vary. THIS LIST IS SUBJECT TO CHANGE.

Addiction ............................... 6 Alcohol Deterrents/ Anti-craving .................................. 6 Opioid Dependence Treatments .............................................. 6 Smoking Cessation Agents ..... 6

ADHD Drugs .......................... 6 Analeptics .............................. 6 Attention Deficit Hyperactivity Disorder Agents, Amphetamines ...................... 6 Attention Deficit Hyperactivity Disorder Agents, Non-amphetamines ....................... 6

Allergy Drugs ......................... 6 Allergenic Extracts ................. 6 Antihistamines ....................... 6 Ophthalmic Anti-Allergy Agents .............................................. 6

Ophthalmic Anti-Inflammatories ...................... 6

Alzheimer's Disease and Dementia Drugs ..................... 6

Cholinesterase Inhibitors ....... 6 N-methyl-D-aspartate (NMDA) Receptor Antagonist .............. 6

Amebicides ............................ 6 All Agents .............................. 6

Antibiotics ............................. 6 Aminoglycosides .................... 6 Antibacterials, Other ............. 6 Beta-Lactam, Cephalosporins . 6 Beta-Lactam, Other ............... 6 Beta-Lactam, Penicillins ......... 7 Macrolides ............................. 7 Quinolones ............................ 7 Sulfonamides ......................... 7

Tetracyclines .......................... 7 Anticonvulsants ..................... 7

All Agents .............................. 7 GABA Modulators .................. 7 Valproic Acid ......................... 7

Antidepressants ..................... 7 All Agents .............................. 7 Antidepressants, Other .......... 7 Monoamine Oxidase Inhibitors .............................................. 7 SSRIs/ SNRIs (Selective Serotonin Reuptake Inhibitors/ Serotonin and Norepinephrine Reuptake Inhibitor) ................ 7 Tricyclics ................................ 7

Antidiarrheal/ Probiotic Agents ................................... 7

Antidiarrheal/ Probiotic Agents .............................................. 7

Gastrointestinal Adsorbents .. 7 Antidotes And Specific Antagonists ............................ 7

All Agents .............................. 7 Benzodiazepine Antagonists .. 7

Antiemetics ............................ 7 5-HT3 Receptor Antagonists .. 7

Antifungals ............................ 7 All Agents .............................. 7 Imidazole-Related Antifungals 7

Antihistamines ....................... 7 Antihistamines - Alkylamines . 7 Antihistamines - Ethanolamines .............................................. 7 Antihistamines - Ethylenediamines .................. 7

Antihyperlipidemics ............... 7 Bile Acid Sequestrants............ 7

Costs for covered alternatives mayTHIS LIST IS SUBJECT TO CHANGE. of 22

Antihypertensives ................. 7 ACE Inhibitors ........................ 7 Antiadrenergic Antihypertensives .................. 7 Vasodilators .......................... 7

Anti-infective Agents ............. 7 All Agents .............................. 7 Anti-infective Misc. - Combinations ........................ 7 Carbapenems ......................... 7 Glycopeptides ........................ 7 Lincosamides ......................... 7 Monobactams ....................... 8 Streptogramins ...................... 8

Antimalarials ......................... 8 All Agents .............................. 8

Antimyasthenic/ Cholinergic Agents ................................... 8

Antimyasthenic/ Cholinergic Agents ................................... 8

Antimycobacterial Agents ..... 8 All Agents .............................. 8

Antineoplastics And Adjunctive Therapies ............. 8

Antineoplastic - Hormonal and Related Agents ...................... 8 Antineoplastic - Immunomodulators ............... 8 Antineoplastic Antibiotics ...... 8 Antineoplastic Enzyme Inhibitors ............................... 8 Antineoplastic Radiopharmaceuticals ........... 8 Antineoplastics Misc. ............. 8 Chemotherapy Adjuncts ......... 8

Antiparkinson And Related Therapy Agents ..................... 8

Antiparkinson Dopaminergics 8 Antipsychotics/ Antimanic Agents ................................... 8

Phenothiazines ...................... 8 Quinolinone Derivatives ......... 8

Antiseptics & Disinfectants .... 8 All Agents .............................. 8 Silver Antiseptics .................... 8

Antivirals ............................... 8

Antiretrovirals ....................... 8 CMV Agents ........................... 8 Herpes Agents ....................... 8 Influenza Agents .................... 8

Anxiety Drugs ........................ 8 Antianxiety Agents ................ 8 Anxiolytics, Other .................. 8 Benzodiazepines .................... 8

Asthma/ Lung Drugs .............. 8 Antiasthmatic - Monoclonal Antibodies ............................. 8 Anti-Inflammatories, Inhaled Corticosteroids ....................... 8 Antileukotrienes .................... 8 Bronchodilators, Anticholinergic....................... 8 Bronchodilators, Sympathomimetic .................. 8 Pulmonary Antihypertensives 8 Respiratory Tract Agents, Other .............................................. 8 Sympathomimetics ................ 9 Xanthines .............................. 9

Beta Blockers ......................... 9 Beta Blockers Cardio-Selective 9 Beta Blockers Non-Selective ... 9

Bladder Control Drugs ........... 9 Antispasmodics, Urinary ........ 9

Bladder, Genital, and Kidney Conditions Drugs ................... 9

Genitourinary Agents, Other .. 9 Blood Clotting Drugs .............. 9

Coagulants ............................ 9 Blood Formation Drugs .......... 9

Blood Formation Modifiers .... 9 Blood Pressure Drugs............. 9

Alpha-Adrenergic Agonists .... 9 Alpha-Adrenergic Blocking Agents ................................... 9 Angiotensin II Receptor Antagonists ........................... 9 Angiotensin-converting Enzyme (ACE) Inhibitors ...................... 9 Beta-Adrenergic Blocking Agents ................................... 9

Calcium Channel Blocking Agents ................................... 9

Blood Thinners ....................... 9 Anticoagulants ...................... 9 Heparins And Heparinoid-Like Agents ................................... 9 In Vitro/ Lock Anticoagulants. 9 Thrombin Inhibitors ............... 9

Bowel Treatment Drugs ......... 9 Antispasmodics, Gastrointestinal ..................... 9 Gastrointestinal Agents, Other .............................................10 Irritable Bowel Syndrome Agents ..................................10 Laxatives ..............................10

Cardiac Drugs ....................... 10 Cardiovascular Agents, Other10 Diuretics, Carbonic Anhydrase Inhibitors ..............................10 Diuretics, Loop ......................10 Diuretics, Potassium-sparing.10 Diuretics, Thiazide ................10

Cardiotonics ......................... 10 Cardiac Glycosides ................10

Cardiovascular Agents ......... 10 Cardioplegic Solutions ..........10 Peripheral Vasodilators ........10 Pulmonary Hypertension - Phosphodiesterase Inhibitors 10

Central Nervous System Drugs ............................................ 10

Central Nervous System, Other .............................................10

Cephalosporins .................... 10 Cephalosporin Combinations 10

Chemotherapy Agents ......... 10 Alkylating Agents .................10 Antiangiogenic Agents ..........10 Antiestrogens/ Modifiers ......10 Antimetabolites ....................11 Antineoplastics, Other ..........11 Aromatase Inhibitors, 3rd Generation ...........................11 Enzyme Inhibitors .................11 Molecular Target Inhibitors ..11

Monoclonal Antibodies .........11 Retinoids ..............................11

Chest Pain Drugs .................. 11 Nitrates ................................11 Vasodilators, Direct-acting Arterial .................................11 Vasodilators, Direct-acting Arterial/ Venous ...................11

Cholesterol Control Drugs .... 11 Dyslipidemics, Fibric Acid Derivatives ...........................11 Dyslipidemics, HMG CoA Reductase Inhibitors .............11 Dyslipidemics, Other .............11

Contraceptives ..................... 11 Implants ...............................11 Injectable ..............................12 IUD .......................................12 Oral ......................................12 Transdermal .........................12 Vaginal .................................12

Corticosteroids ..................... 12 Glucocorticosteroids .............12

Cough/ Cold/ Allergy ............ 12 Antitussives ..........................12 Expectorants .........................12

Cystic Fibrosis Agents ........... 12 All Agents .............................12

Dental and Oral Agents ........ 12 All Agents .............................12

Dermatologicals ................... 12 Acne Products .......................12 Antifungals - Topical .............12 Antipruritics - Topical ............12 Antipsoriatics ........................12 Antiseborrheic Products ........12 Burn Products .......................12 Cauterizing Agents ................13 Keratolytic/ Antimitotic Agents .............................................13 Local Anesthetics - Topical ....13 Misc. Topical .........................13 Scabicides & Pediculicides .....13 Scar Treatment Products .......13

Costs for covered alternatives may vary. THIS LIST IS SUBJECT TO CHANGE. of 22

Wound Care Products ...........13 Diabetic Drugs ..................... 13

Antidiabetic Agents ..............13 Antidiabetic Combinations ....13 DPP-4....................................13 Glycemic Agents ...................13 Incretin Mimetic Agents (GLP-1 Receptor Agonists) ................13 Insulins .................................13 SGLT2 Inhibitors ....................13

Diabetic Supplies ................. 13 Monitoring Devices & Supplies .............................................13

Diagnostic Products ............. 13 Diagnostic Biologicals ...........13 Diagnostic Drugs...................13 Miscellaneous Contrast Media .............................................13 Radiographic Contrast Media .............................................13

Dietary Products/ Dietary Management Products ........ 13

Nutritional Substitutes ..........13 Nutritional Supplements .......13

Digestive Aids ...................... 13 Digestive Enzymes ................13 Gastric Acidifiers ...................13

Diuretics .............................. 13 Carbonic Anhydrase Inhibitors .............................................13 Loop Diuretics .......................13 Osmotic Diuretics ..................13 Potassium Sparing Diuretics..14

Drugs to Regulate Hormones14 Hormonal Agents, Stimulant/ Replacement/ Modifying (Adrenal) ..............................14

Drugs to Treat Airway Disease ............................................ 14

Phosphodiesterase Inhibitors, Airways Disease ....................14

Drugs to Treat Allergies, Cough, Cold and Lung Conditions ........................... 14

Respiratory Tract/ Pulmonary Agents ..................................14

Drugs to Treat Angioedema . 14

Angioedema (HAE) Agents ....14 Drugs to Treat Viral Infections ............................................ 14

Anti-Cytomegalovirus (CMV) Agents ..................................14 Antivirals ..............................14

Ear Drugs ............................. 14 Otic Agents ...........................14

Endocrine And Metabolic Agents ................................. 14

Metabolic Modifiers .............14 Posterior Pituitary Hormones 14

Enzyme Replacement/ Modifying Drugs .................. 14

Enzyme Replacement/ Modifiers ..............................14

EnzymeReplacement/ Modifying Drugs .................. 14

Enzyme Replacements/ Modifiers ..............................14

Estrogens ............................. 14 All Agents .............................14

Eye Drugs ............................. 14 Ophthalmic Agents, Other ....14

Fibromyalgia Drugs .............. 14 Fibromyalgia Agents .............14

Flu Drugs ............................. 14 Anti-Influenza Agents ...........14

Fluoroquinolones ................ 14 All Agents .............................14

Fungal Infection Drugs ......... 15 Antifungals ...........................15

Gastrointestinal Agents ....... 15 Inflammatory Bowel Agents .15

General Anesthetics ............ 15 Anesthetics ...........................15 Barbiturate Anesthetics ........15

Genitourinary Agents .......... 15 Alkalinizers ...........................15 Genitourinary Irrigants .........15

Glaucoma Drugs .................. 15 Ophthalmic Antiglaucoma Agents ..................................15 Ophthalmic Prostaglandin and Prostamide Analogs ..............15

Gout Agents ......................... 15 All Agents .............................15

Gout Drugs........................... 15 Antigout Agents....................15

Heart Regulation Drugs ........ 15 Antiarrhythmics ....................15 Antiarrhythmics Type I-B ......15 Antiarrhythmics Type III ........15

Hematological Agents .......... 15 Antihemophilic Products .......15 Plasma Expanders .................15 Plasma Proteins ....................15 Platelet Aggregation Inhibitors .............................................15 Protamine .............................15

Hematopoietic Agents ......... 15 Agents for Gaucher Disease ..15 Cobalamins ...........................15 Hematopoietic Growth Factors .............................................15

Hemostatics ......................... 15 Hemostatics - Systemic .........15

Hepatitis Drugs .................... 15 Anti-hepatitis B (HBV) Agents .............................................15 Anti-hepatitis C (HCV) Agents15

Herpes Drugs ....................... 15 Antiherpetic Agents ..............15

HIV Drugs ............................. 15 Anti-HIV Agents, Integrase Inhibitors (INSTI) ...................15 Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors (NNRTI) .................................15 Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors (NRTI) .............................................15 Anti-HIV Agents, Other .........16 Anti-HIV Agents, Protease Inhibitors ..............................16

Hormone Replacement/ Modifying Drugs .................. 16

Androgens ............................16 Bulk Chemicals - C's...............16

Bulk Chemicals - D's ..............16 Estrogens ..............................16 Fertility Regulators ...............16 Growth Hormones ................16 Insulin-Like Growth Factors (Somatomedins) ...................16 LHRH/ GnRH Agonist Analog Pituitary Suppressants ..........16 Posterior Pituitary Hormones 16 Progestins .............................16 Selective Estrogen Receptor Modifying Agents .................16

Hormone Suppressants ........ 16 Antiandrogens ......................16 Antineoplastic - Hormonal and Related Agents .....................16 Bulk Chemicals - L's ...............16 GnRH/ LHRH Antagonists ......16 Growth Hormone Receptor Antagonists ..........................16 Growth Hormone Releasing Hormones (GHRH) .................16 Hormonal Agents, Suppressant (Adrenal) ..............................16 Hormonal Agents, Suppressant (Parathyroid) ........................16 LHRH/ GnRH Agonist Analog Pituitary Suppressants ..........16 Prolactin Inhibitors ...............16 Somatostatic Agents .............16

Hypnotics/ Sedatives/ Sleep Disorder Agents ................... 16

Barbiturate Hypnotics ...........16 Non-Barbiturate Hypnotics ...16

Immune System Drugs ......... 16 Immune Suppressants ...........16 Immunizing Agents, Passive ..16 Immunomodulators ..............17

Inflammatory Bowel Disease Drugs ................................... 17

Aminosalicylates ...................17 Glucocorticoids .....................17

Laxatives .............................. 17 Laxative Combinations..........17 Lubricant Laxatives ...............17

Local Anesthetics ................. 17


All Agents .............................17 Local Anesthetics-parenteral 17

Local Anesthetic Combinations .............................................17 Local Anesthetics - Amides ....17 Local Anesthetics - Esters ......17

Macrolides .......................... 17 Erythromycins .......................17

Migraine Drugs .................... 17 Ergot Alkaloids .....................17 Serotonin (5-HT) 1b/ 1d Receptor Agonists .................17

Migraine Products ............... 17 All Agents .............................17 Migraine Products - Monoclonal Antibodies .........17

Minerals & Electrolytes ....... 17 Bicarbonates.........................17 Calcium .................................17 Magnesium ..........................17 Manganese ...........................17 Phosphate ............................17 Potassium .............................17 Sodium .................................17 Trace Minerals ......................17 Zinc .......................................17

Miscellaneous Anti-Infectives ............................................ 17

Antimycobacterials, Other ....17 Miscellaneous Therapeutic Classes ................................. 17

Chelating Agents ..................17 Enzymes................................17 Irrigation Solutions ...............17 Peritoneal Dialysis Solutions .17 Sclerosing Agents..................17

Mood Disorder Drugs .......... 17 1st Generation/ Typical ........17 2nd Generation/ Atypical......17 Mood Stabilizers ...................18 Treatment-Resistant .............18

Mouth/ Throat/ Dental Agents ............................................ 18

Dental Products ....................18

Multiple Sclerosis Drugs ...... 18 Multiple Sclerosis Agents ......18

Musculoskeletal Therapy Agents ................................. 18

Direct Muscle Relaxants ........18 Myasthenia Gravis Drugs ..... 18

Parasympathomimetics ........18 Nausea and Vomiting Drugs 18

Antiemetics, Other ................18 Emetogenic Therapy Adjuncts .............................................18

Neuromuscular Agents ........ 18 Depolarizing Muscle Relaxants .............................................18 Nondepolarizing Muscle Relaxants ..............................18

Neurotoxins ......................... 18 Neuromuscular Blocking Agent - Neurotoxins ........................18

Nutrients ............................. 18 Carbohydrates ......................18 Lipids ....................................18 Lipotropics ............................18 Proteins ................................18

Ophthalmic Agents .............. 18 Miotics..................................18 Ophthalmic Anti-infectives ....18 Ophthalmic Gene Therapy ....18 Ophthalmic Kinase Inhibitors 18 Ophthalmic Surgical Aids ......18 Ophthalmics .........................18

Opioid Pain Relievers ........... 18 Opioid Agonists ....................18 Opioid Analgesics, Long-acting .............................................18 Opioid Analgesics, Short-acting .............................................18 Opioid Combinations ............19 Opioid Partial Agonists .........19

Osteoarthritis ...................... 19 Viscosupplements .................19

Osteoporosis (Bone Loss) Drugs ................................... 19

Metabolic Bone Disease Agents .............................................19

Otic Agents .......................... 19 Otic Combinations ................19

Oxytocics ............................. 19 Abortifacients/ Agents for Cervical Ripening ..................19 All Agents .............................19

Pain/ Anti-Inflammatory Drugs ............................................ 19

Analgesics.............................19 Analgesics Other ...................19 Nonsteroidal Anti-inflammatory Agents (NSAIDs) .............................................19 Nonsteroidal Anti-Inflammatory Drugs..............19 Salicylates.............................19

Pain/ Swelling Management Drugs ................................... 19

Skeletal Muscle Relaxants.....19 Parkinson's Disease Drugs ... 19

Anticholinergics ....................19 Antiparkinson Agents, Other .19 Dopamine Agonists ...............19 Dopamine Precursors/ L-Amino Acid Decarboxylase Inhibitors .............................................19 Monoamine Oxidase B (MAO-B) Inhibitors ..........................19

Passive Immunizing And Treatment Agents ................ 19

Immune Serums ....................19 Penicillins............................. 19

Aminopenicillins ...................19 Natural Penicillins .................19 Penicillin Combinations .........19 Penicillinase-Resistant Penicillins..............................19

Phosphate-Removing Agents ............................................ 19

Phosphate Binders ................19 Platelet Modifying Drugs ..... 19

Platelet Modifying Agents ....19 Prostate Enlargement Drugs 19

Benign Prostatic Hypertrophy Agents ..................................19

Protozoal Infection Drugs .... 19

Antiprotozoals ......................19 Psychotherapeutic And Neurological Agents ............. 20

Antidementia Agents ............20 Postherpetic Neuralgia (PHN)/ Neuropathic Pain Agents ......20

Respiratory Agents .............. 20 Cystic Fibrosis Agents ............20

Scabies and Lice Drugs ......... 20 Pediculicides/ Scabicides .......20

Sedation and Sleep Drugs .... 20 GABA Receptor Modulators ..20 Sleep Disorders, Other ..........20

Seizure Control Drugs........... 20 Anticonvulsants, Other .........20 Calcium Channel Modifying Agents ..................................20 Gamma-Aminobutyric Acid (GABA) Augmenting Agents ..20 Glutamate Reducing Agents .20 Sodium Channel Agents ........20

Skin Agents .......................... 20 Acne Products .......................20 Agents for Wrinkles/ Lipoatrophy/ Other Aesthetic Uses ......................................20 Antifungals - Topical .............20 Anti-inflammatory Agents - Topical ..................................20 Antimetabolites ....................20 Antineoplastic or Premalignant Lesion Agents - Topical .........20 Antipruritics - Topical ............20 Antipsoriatics ........................20 Antiseborrheic Products ........20 Corticosteroids - Topical ........20 Eczema Agents......................20 Emollient/ Keratolytic Agents .............................................20 Emollients .............................20 Enzymes - Topical..................20 Immunomodulating Agents - Topical ..................................21 Immunosuppressive Agents ..21 Immunosuppressive Agents - Topical ..................................21


Inflammatory Bowel Agents .21 Keratolytic/ Antimitotic Agents .............................................21 Leprostatics ..........................21 Local Anesthetics - Topical ....21 Metabolic Modifiers .............21 Nonsteroidal Anti-inflammatory Agents (NSAIDs) .............................................21 Otic Combinations ................21 Rosacea Agents ....................21 Tricyclic Agents .....................21 Wound Care Products ...........21

Sulfonamides....................... 21 All Agents .............................21

Tetracyclines ....................... 21 All Agents .............................21

Thyroid Agents .................... 21 Thyroid Hormones ................21

Thyroid Replacement Drugs 21 Hormonal Agents, Stimulant/ Replacement/ Modifying (Thyroid) ...............................21

Thyroid Suppressing Drugs .. 21 Antithyroid Agents................21

Toxoids ................................ 21 Toxoid Combinations ............21

Tuberculosis Drugs .............. 21 Antituberculars .....................21

Ulcer and Stomach Acid Drugs ............................................ 21

Histamine2 (H2) receptor Antagonists ..........................21 Protectants ...........................21 Proton Pump Inhibitors .........21

Ulcer Drugs/ Antispasmodics/ Anticholinergics ................... 21

Antispasmodics .....................21 Proton Pump Inhibitors .........21

Urinary Anti-infectives ........ 21 All Agents .............................21

Vaccines .............................. 21 All Agents .............................21 Viral Vaccines .......................21

Vaginal Products ................. 21

Miscellaneous Vaginal Products .............................................21

Vasopressors ....................... 21 All Agents .............................21

Vitamins .............................. 21 Water Soluble Vitamins ........21

Vitamins, Minerals, Electrolytes .......................... 21

Electrolyte/ Mineral Modifiers .............................................21 Electrolyte/ Mineral Replacement .........................22 Prenatal Vitamins .................22 Therapeutic Nutrients/ Minerals/ Electrolytes ...........22 Vitamins ...............................22

Worm Infection Drugs ......... 22 Anthelmintics .......................22


Addiction Alcohol Deterrents/ Anti-craving

acamprosate calcium disulfiram naltrexone hydrochloride VIVITROL [SP]

Opioid Dependence Treatments BELBUCA buprenorphine

hydrochloride buprenorphine

hydrochloride [INJ] buprenorphine-naloxone naloxone hcl naloxone hcl [INJ] naltrexone hydrochloride NARCAN SUBOXONE ZUBSOLV

Smoking Cessation Agents bupropion sr CHANTIX

ADHD Drugs Analeptics

caffeine caffeine & sodium

benzoate [INJ]

Attention Deficit Hyperactivity Disorder Agents, Amphetamines

dextroamphetamine sulfate

dextroamphetamine sulfate er

dextroamphetamine-amphet er

dextroamphetamine-amphetamine

EVEKEO methamphetamine hcl MYDAYIS PROCENTRA VYVANSE zenzedi

Attention Deficit Hyperactivity Disorder Agents, Non-amphetamines

atomoxetine hcl clonidine hcl er DAYTRANA dexmethylphenidate hcl dexmethylphenidate hcl er guanfacine hcl er

metadate er methylphenidate er methylphenidate hcl methylphenidate hcl cd methylphenidate la QUILLICHEW ER QUILLIVANT XR

Allergy Drugs Allergenic Extracts

ODACTRA

Antihistamines azelastine hcl carbinoxamine cetirizine hcl chlorpheniramine maleate clemastine fumarate cyproheptadine hcl desloratadine diphenhydramine hcl diphenhydramine hcl [INJ] levocetirizine

dihydrochloride olopatadine hcl pharbedryl phenadoz promethazine hcl promethazine hcl [INJ] promethegan

Ophthalmic Anti-Allergy Agents azelastine hcl BEPREVE cromolyn sodium epinastine hcl olopatadine hcl PAZEO

Ophthalmic Anti-Inflammatories

ALREX bromfenac sodium dexamethasone sodium

phosphate dexamethasone sodium

phosphate [INJ] diclofenac sodium fluorometholone flurbiprofen sodium ILEVRO ketorolac tromethamine ketorolac tromethamine

[INJ] LOTEMAX OZURDEX [SP] prednisolone acetate prednisolone sodium

phosphate

PROLENSA

Alzheimer's Disease and Dementia Drugs Cholinesterase Inhibitors

donepezil hcl galantamine galantamine er rivastigmine

N-methyl-D-aspartate (NMDA) Receptor Antagonist

memantine hcl

Amebicides All Agents

iodoquinol

Antibiotics Aminoglycosides

amikacin sulfate amikacin sulfate [INJ] BETHKIS [SP] GENTAK gentamicin sulfate gentamicin sulfate [INJ] gentamicin sulfate in ns KITABIS PAK [SP] neomycin sulfate paromomycin sulfate streptomycin sulfate TOBI PODHALER [SP] TOBRADEX tobramycin sulfate [SP] tobramycin sulfate [SP]

[INJ]

Antibacterials, Other bacitracin benzalkonium chloride chloramphenicol sod

succinate CLEOCIN PHOSPHATE clindacin etz clindacin p clindamycin hcl clindamycin palmitate hcl clindamycin pediatric clindamycin phosphate clindamycin phosphate

[INJ] colistimethate sodium colistimethate sodium [INJ] daptomycin FEM PH iodine iodoquinol-hydrocortisone-

aloe

lincomycin hcl lincomycin hcl [INJ] linezolid lugol's mafenide acetate methenamine hippurate methenamine mandelate metronidazole mupirocin neomycin-polymyxin b nitrofurantoin nitrofurantoin

macrocrystal phenol polymyxin b sulfate polymyxin b sulfate [INJ] rosadan silver nitrate SILVER NITRATE

APPLICATOR SULFAMYLON tigecycline tinidazole trimethoprim vancomycin hcl vancomycin-ns vandazole VIBATIV XIFAXAN

Beta-Lactam, Cephalosporins cefaclor cefaclor er cefadroxil cefazolin sodium cefazolin sodium [INJ] cefdinir cefditoren pivoxil cefepime hcl cefepime hcl [INJ] cefixime cefotaxime sodium [INJ] cefotetan cefotetan [INJ] cefoxitin cefpodoxime proxetil cefprozil ceftazidime ceftazidime [INJ] ceftriaxone ceftriaxone [INJ] cefuroxime axetil cefuroxime sodium cefuroxime sodium [INJ] cephalexin TEFLARO

Beta-Lactam, Other


imipenem-cilastatin sodium

INVANZ INVANZ [INJ] meropenem meropenem-0.9% nacl

Beta-Lactam, Penicillins amoxicillin amoxicillin-clavulanate pot

er amoxicillin-clavulanate

potass ampicillin trihydrate ampicillin/sulbactam ampicillin/sulbactam [INJ] AUGMENTIN dicloxacillin sodium nafcillin sodium nafcillin sodium [INJ] OXACILLIN SODIUM oxacillin sodium [INJ] penicillin g potassium [INJ] penicillin g procaine penicillin g sodium [INJ] penicillin v potassium PFIZERPEN [INJ] piperacillin-tazobactam ZOSYN

Macrolides AZASITE azithromycin clarithromycin clarithromycin er E.E.S. ery ERYGEL ERY-TAB ERYTHROCIN STEARATE erythromycin erythromycin

ethylsuccinate

Quinolones ciprofloxacin ciprofloxacin er ciprofloxacin hcl FLOXIN gatifloxacin levofloxacin hemihydrate MOXEZA moxifloxacin hcl ofloxacin

Sulfonamides silver sulfadiazine ssd

sulfacetamide sodium sulfadiazine sulfamethoxazole/trimetho

prim sulfasalazine sulfasalazine dr sulfatrim

Tetracyclines avidoxy demeclocycline hcl doxy 100 doxycycline hyclate doxycycline monohydrate MINOCIN minocycline hcl mondoxyne nl morgidox okebo ORACEA SOLODYN tetracycline hcl

Anticonvulsants All Agents

levetiracetam-nacl roweepra xr subvenite

GABA Modulators vigadrone [SP]

Valproic Acid valproate sodium

Antidepressants All Agents

bupropion hcl er

Antidepressants, Other amitriptyline/chlordiazepo

xide amitriptyline-perphenazine bupropion hcl bupropion hcl xl bupropion sr mirtazapine olanzapine-fluoxetine hcl

Monoamine Oxidase Inhibitors phenelzine sulfate tranylcypromine sulfate

SSRIs/ SNRIs (Selective Serotonin Reuptake Inhibitors/ Serotonin and Norepinephrine Reuptake Inhibitor)

citalopram hbr

desvenlafaxine succinate er duloxetine hcl escitalopram oxalate FETZIMA fluoxetine dr fluoxetine hcl fluvoxamine maleate maprotiline hcl paroxetine er paroxetine hcl paroxetine mesylate sertraline hcl trazodone hcl venlafaxine hcl venlafaxine hcl er VIIBRYD

Tricyclics amitriptyline hcl amoxapine clomipramine hcl desipramine hcl doxepin hcl imipramine hcl imipramine pamoate nortriptyline hcl protriptyline hcl trimipramine maleate

Antidiarrheal/ Probiotic Agents Antidiarrheal/ Probiotic Agents

bismuth subgallate

Gastrointestinal Adsorbents kaolin pectin

Antidotes And Specific Antagonists All Agents

activated charcoal BAL IN OIL calcium disodium

versenate [INJ] edetate calcium disodium fomepizole methylene blue physostigmine salicylate

[INJ] PROTOPAM CHLORIDE

[INJ] sodium thiosulfate

Benzodiazepine Antagonists flumazenil

Antiemetics

5-HT3 Receptor Antagonists palonosetron hcl

Antifungals All Agents

ABELCET AMBISOME

Imidazole-Related Antifungals fluconazole in dextrose fluconazole in saline miconazole

Antihistamines Antihistamines - Alkylamines

brompheniramine maleate

Antihistamines - Ethanolamines doxylamine succinate

Antihistamines - Ethylenediamines

pyrilamine maleate tripelennamine hcl

Antihyperlipidemics Bile Acid Sequestrants

colesevelam hcl

Antihypertensives ACE Inhibitors

enalaprilat

Antiadrenergic Antihypertensives

reserpine

Vasodilators sodium nitroprusside

Anti-infective Agents All Agents

baci-im metro iv

Anti-infective Misc. - Combinations

smz-tmp ds

Carbapenems ertapenem [INJ]

Glycopeptides DALVANCE ORBACTIV vancomycin-d5w

Lincosamides


clindamycin phosphate-d5w

Monobactams AZACTAM-ISO-OSMOTIC

DEXTROSE aztreonam [INJ]

Streptogramins SYNERCID

Antimalarials All Agents

quinacrine hcl

Antimyasthenic/ Cholinergic Agents Antimyasthenic/ Cholinergic Agents

ENLON [INJ] REGONOL [INJ]

Antimycobacterial Agents All Agents

aminosalicylic acid

Antineoplastics And Adjunctive Therapies Antineoplastic - Hormonal and Related Agents

ERLEADA [SP] NUBEQA [SP]YONSA

Antineoplastic - Immunomodulators

levamisole hcl

Antineoplastic Antibiotics dactinomycin

Antineoplastic Enzyme Inhibitors

temsirolimus

Antineoplastic Radiopharmaceuticals

LUTATHERA [SP] XOFIGO [SP]

Antineoplastics Misc. BCG (TICE STRAIN)

Chemotherapy Adjuncts ELITEK

Antiparkinson And Related Therapy Agents Antiparkinson Dopaminergics

levodopa

Antipsychotics/ Antimanic Agents Phenothiazines

prochlorperazine edisylate [INJ]

Quinolinone Derivatives ARISTADA INITIO

Antiseptics & Disinfectants All Agents

hydrogen peroxide

Silver Antiseptics silver protein

Antivirals Antiretrovirals

atazanavir sulfate BIKTARVY CIMDUO efavirenz ritonavir SYMFI SYMFI LO tenofovir disoproxil

fumarate TROGARZO [SP]

CMV Agents ganciclovir sodium [SP] PREVYMIS

Herpes Agents acyclovir sodium

Influenza Agents RAPIVAB

Anxiety Drugs Antianxiety Agents

droperidol droperidol [INJ]

Anxiolytics, Other buspirone hcl hydroxyzine hcl hydroxyzine pamoate

Benzodiazepines alprazolam alprazolam er ALPRAZOLAM INTENSOL alprazolam odt alprazolam xr chlordiazepoxide hcl clonazepam

clorazepate dipotassium diazepam diazepam [INJ] estazolam lorazepam lorazepam [INJ] lorazepam intensol midazolam hcl midazolam hcl [INJ] midazolam hcl-nacl triazolam

Asthma/ Lung Drugs Antiasthmatic - Monoclonal Antibodies

FASENRA [SP]

Anti-Inflammatories, Inhaled Corticosteroids

ARNUITY ELLIPTA ASMANEX ASMANEX HFA budesonide FLOVENT DISKUS FLOVENT HFA flunisolide fluticasone propionate mometasone furoate QNASL QVAR QVAR REDIHALER triamcinolone acetonide triamcinolone acetonide

[INJ]

Antileukotrienes montelukast sodium zafirlukast zileuton

Bronchodilators, Anticholinergic

ATROVENT HFA INCRUSE ELLIPTA ipratropium bromide SPIRIVA SPIRIVA RESPIMAT

Bronchodilators, Sympathomimetic

ADRENALIN CHLORIDE [INJ] albuterol sulfate ARCAPTA NEOHALER epinephrine epinephrine [INJ] EPIPEN [INJ] EPIPEN JR. [INJ] levalbuterol hcl

metaproterenol sulfate PERFOROMIST PROAIR HFA PROAIR RESPICLICK SEREVENT DISKUS STRIVERDI RESPIMAT terbutaline sulfate VENTOLIN HFA

Pulmonary Antihypertensives ADEMPAS [SP] epoprostenol sodium [SP] FLOLAN [SP] LETAIRIS [SP] OPSUMIT [SP] REMODULIN [SP] [INJ] sildenafil citrate [SP] TRACLEER [SP] TYVASO [SP] UPTRAVI [SP] VELETRI [SP]

Respiratory Tract Agents, Other acetylcysteine ADVAIR DISKUS ADVAIR HFA ANORO ELLIPTA ARALAST NP [SP] BREO ELLIPTA bromipheniramin-

pseudoephed-dm brompheniramine

w/pseudoephed CAYSTON [SP] cromolyn sodium DULERA ESBRIET [SP] EXACTUSS fluticasone-salmeterol GILTUSS GRASTEK hydrocod-cpm-

pseudoephedrine hydrocodone-

chlorpheniramine iodine KALYDECO [SP] lugol's NEOTUSS PLUS OFEV [SP] ORKAMBI [SP] PROLASTIN C [SP] promethazine vc

w/codeine promethazine w/codeine promethazine w/dm pseudoephedrine hcl RAGWITEK SYMBICORT


TRELEGY ELLIPTA ZEMAIRA [SP]

Sympathomimetics ephedrine hcl isoproterenol hcl [INJ]

Xanthines aminophylline theophylline in 5%

dextrose

Beta Blockers Beta Blockers Cardio-Selective

esmolol hcl

Beta Blockers Non-Selective sorine sotalol hcl

Bladder Control Drugs Antispasmodics, Urinary

darifenacin er flavoxate hcl GELNIQUE HYOPHEN me-naphos-mb-hyo 1 MYRBETRIQ oxybutynin chloride oxybutynin chloride er tolterodine tartrate tolterodine tartrate er TOVIAZ trospium chloride UROGESIC uryl VESICARE

Bladder, Genital, and Kidney Conditions Drugs Genitourinary Agents, Other

aminoacetic acid bethanechol chloride CAVERJECT CIALIS DEPEN ELMIRON glycine MUSE phenazopyridine hcl phosphasal RENACIDIN uretron d-s URIMAR-T urin d.s. uro-458 uroav-81 uroav-b

uro-mp ustell utira-c vilamit mb vilevev mb

Blood Clotting Drugs Coagulants

ADVATE [SP] ADYNOVATE [SP] AFSTYLA [SP] ALPHANATE [SP] ALPHANINE SD [SP] ALPROLIX [SP] AMICAR BEBULIN [SP] BENEFIX [SP] COAGADEX [SP] CORIFACT [SP] FEIBA NF [SP] HELIXATE FS [SP] HEMOFIL-M [SP] HUMATE-P [SP] IXINITY [SP] KOGENATE FS [SP] KOVALTRY [SP] MONOCLATE-P [SP] MONONINE [SP] MONSEL'S NOVOEIGHT [SP] NOVOSEVEN RT [SP] NUWIQ [SP] OBIZUR [SP] PROFILNINE SD [SP] RIASTAP [SP] tranexamic acid TRETTEN [SP] VONVENDI [SP] WILATE [SP]

Blood Formation Drugs Blood Formation Modifiers

anagrelide hydrochloride CEPROTIN [SP] GRANIX [SP] LEUKINE [SP] [INJ] MOZOBIL [SP] NEULASTA [SP] NPLATE [SP] PROCRIT [SP] [INJ] PROMACTA [SP] SOLIRIS [SP] ZARXIO [SP] [INJ]

Blood Pressure Drugs Alpha-Adrenergic Agonists

clonidine hcl guanfacine hcl

methyldopa methyldopate hcl midodrine hcl phenylephrine hcl-ns

Alpha-Adrenergic Blocking Agents

doxazosin mesylate phenoxybenzamine hcl phentolamine mesylate phentolamine mesylate

[INJ] prazosin hcl

Angiotensin II Receptor Antagonists

candesartan cilexetil EDARBI eprosartan mesylate irbesartan losartan potassium olmesartan medoxomil telmisartan valsartan

Angiotensin-converting Enzyme (ACE) Inhibitors

benazepril hcl captopril enalapril maleate fosinopril sodium lisinopril moexipril hcl perindopril erbumine quinapril ramipril trandolapril

Beta-Adrenergic Blocking Agents

acebutolol hcl atenolol betaxolol hcl bisoprolol fumarate BYSTOLIC carvedilol carvedilol er labetalol hcl metoprolol succinate metoprolol tartrate nadolol pindolol propranolol hcl propranolol hcl er timolol maleate

Calcium Channel Blocking Agents

afeditab cr

amlodipine besylate cartia xt diltiazem 24hr cd diltiazem cd diltiazem er diltiazem hcl dilt-xr felodipine er isradipine matzim la nicardipine hcl nifedipine nifedipine er nimodipine nisoldipine taztia xt verapamil er verapamil er pm verapamil hcl

Blood Thinners Anticoagulants

acd ACD-A ACTIVASE CATHFLO ACTIVASE [INJ] ELIQUIS enoxaparin sodium [SP] fondaparinux sodium [SP] FRAGMIN [SP] heparin sodium heparin sodium [INJ] heparin sodium in 0.9%

nacl jantoven sodium citrate THROMBATE III TRICITRASOL [INJ] warfarin sodium XARELTO

Heparins And Heparinoid-Like Agents

heparin sodium in 0.45% nacl

heparin sodium in 5% dextrose

In Vitro/ Lock Anticoagulants CITRATE PHOSPHATE

DEXTROSE

Thrombin Inhibitors bivalirudin

Bowel Treatment Drugs Antispasmodics, Gastrointestinal

ANASPAZ


atropine sulfate atropine sulfate [INJ] belladonna & opium belladonna-phenobarbital clidinium

w/chlordiazepoxide dicyclomine hcl ed-spaz glycopyrrolate glycopyrrolate [INJ] hyoscyamine sulfate hyosyne LEVSIN [INJ] methscopolamine bromide oscimin oscimin sl oscimin sr phenohytro propantheline bromide symax-sl symax-sr

Gastrointestinal Agents, Other CHENODAL [SP] CHOLBAM [SP] cromolyn sodium diphenoxylate w/atropine lansoprazol-amoxicil-

clarithro loperamide hcl magnesium oxide opium paregoric PYLERA SEROSTIM [SP] simethicone sodium bicarbonate ursodiol XERMELO [SP]

Irritable Bowel Syndrome Agents

alosetron hcl AMITIZA LINZESS VIBERZI

Laxatives bisacodyl constulose docusate sodium enulose gavilyte-c gavilyte-g gavilyte-h and bisacodyl gavilyte-n generlac glycerin

glycerol formal glycolax lactulose mineral oil peg 3350-electrolyte peg-prep polyethylene glycol PREPOPIK sorbitol SUPREP trilyte with flavor packets

Cardiac Drugs Cardiovascular Agents, Other

ADRENALIN CHLORIDE [INJ] amiloride hcl w/hctz amlodipine besylate-

benazepril amlodipine-atorvastatin amlodipine-olmesartan amlodipine-valsartan amlodipine-valsartan-hctz atenolol w/chlorthalidone benazepril hcl-hctz bisoprolol fumarate/hctz BYVALSON candesartan-

hydrochlorothiazid captopril/hydrochlorothiazi

de CORLANOR DEMSER digitek digox digoxin digoxin [INJ] EDARBYCLOR enalapril maleate/hctz ENTRESTO ephedrine sulfate ephedrine sulfate [INJ] fosinopril-

hydrochlorothiazide irbesartan-

hydrochlorothiazide isoxsuprine hcl lisinopril-hctz losartan-

hydrochlorothiazide methyldopa/hydrochloroth

iazide metoprolol-

hydrochlorothiazide milrinone in 5% dextrose milrinone lactate moexipril-

hydrochlorothiazide nadolol-

bendroflumethiazide

NATRECOR olmesartan-amlodipine-

hctz olmesartan-

hydrochlorothiazide pentoxifylline propranolol hcl-hctz quinapril-

hydrochlorothiazide RANEXA spironolactone w/hctz TEKTURNA TEKTURNA HCT telmisartan-amlodipine telmisartan-

hydrochlorothiazid trandolapril-verapamil triamterene w/hctz valsartan-

hydrochlorothiazide

Diuretics, Carbonic Anhydrase Inhibitors

acetazolamide

Diuretics, Loop bumetanide bumetanide [INJ] ethacrynic acid furosemide furosemide [INJ] torsemide

Diuretics, Potassium-sparing amiloride hcl eplerenone spironolactone

Diuretics, Thiazide chlorothiazide chlorthalidone hydrochlorothiazide indapamide methyclothiazide metolazone

Cardiotonics Cardiac Glycosides

LANOXIN PEDIATRIC [INJ]

Cardiovascular Agents Cardioplegic Solutions

cardioplegic

Peripheral Vasodilators nylidrin hcl

Pulmonary Hypertension - Phosphodiesterase Inhibitors

tadalafil

Central Nervous System Drugs Central Nervous System, Other

[INJ]

benzphetamine hcl caffeine citrated diethylpropion hcl diethylpropion hcl er INGREZZA [SP]NAMZARIC NUEDEXTA phendimetrazine tartrate phentermine hcl RADICAVA [SP] riluzole serotonin hcl succinylcholine chloride succinylcholine chloride

tetrabenazine [SP] Cephalosporins Cephalosporin Combinations

AVYCAZ ZERBAXA

Chemotherapy Agents Alkylating Agents

BENDEKA [SP] BICNU busulfan cyclophosphamide dacarbazine GLEOSTINE HEXALEN ifosfamide LEUKERAN MATULANE [SP] melphalan hcl MUSTARGEN [INJ] MYLERAN TEMODAR [SP] temozolomide [SP] thiotepa thiotepa [INJ] TREANDA [SP] VALCHLOR [SP] YONDELIS [SP] ZANOSAR

Antiangiogenic Agents POMALYST [SP] REVLIMID [SP] THALOMID [SP]

Antiestrogens/ Modifiers EMCYT FARESTON


FASLODEX tamoxifen citrate

Antimetabolites adrucil ALIMTA cladribine clofarabine cytarabine [INJ] DROXIA fluorouracil FOLOTYN [SP] gemcitabine hcl hydroxyurea mercaptopurine PURIXAN [SP] TABLOID thioguanine

Antineoplastics, Other ABRAXANE [SP] ADRIAMYCIN ARRANON [SP] azacitidine [SP] [INJ] bleomycin sulfate [INJ] calcium folinate capecitabine [SP] carboplatin cisplatin daunorubicin hcl decitabine [SP] dexrazoxane docetaxel doxorubicin hcl doxorubicin hcl liposomal epirubicin hcl floxuridine floxuridine [INJ] fludarabine phosphate HALAVEN [SP] idarubicin hcl irinotecan hcl ISTODAX [SP] IXEMPRA [SP] JEVTANA [SP] KYMRIAH [SP] KYPROLIS leucovorin calcium leucovorin calcium [INJ] levoleucovorin calcium lipodox LONSURF [SP] MARQIBO mesna MESNEX mitomycin mitoxantrone [SP] NINLARO [SP]

ONCASPAR [INJ] oxaliplatin paclitaxel PHOTOFRIN PROLEUKIN [SP] SIPULEUCEL-T PROVENGE SYNRIBO [SP] teniposide THERACYS TICE BCG tice bcg [INJ] TRISENOX VALSTAR VELCADE [SP] [INJ] VERZENIO [SP] vinblastine sulfate vincasar pfs vincristine sulfate vinorelbine tartrate VORAXAZE VYXEOS LIPOSOME [SP] YESCARTA [SP] ZALTRAP [SP] ZOLINZA [SP] ZYKADIA [SP]

Aromatase Inhibitors, 3rd Generation

anastrozole exemestane letrozole

Enzyme Inhibitors ALIQOPA [SP] ETOPOPHOS etoposide HYCAMTIN [SP] LYNPARZA [SP] ONIVYDE [SP] RUBRACA [SP] toposar topotecan hcl ZEJULA [SP] ZYDELIG [SP]

Molecular Target Inhibitors AFINITOR [SP] AFINITOR DISPERZ [SP] ALECENSA [SP] BOSULIF [SP] CABOMETYX [SP] CAPRELSA [SP] COTELLIC [SP] ERIVEDGE [SP] GILOTRIF [SP] IBRANCE [SP] ICLUSIG [SP] IDHIFA [SP]

imatinib mesylate [SP] IMBRUVICA [SP] INLYTA [SP] IRESSA [SP] JAKAFI [SP] LENVIMA [SP] MEKINIST [SP] NERLYNX [SP] NEXAVAR [SP] RYDAPT [SP] SPRYCEL [SP] STIVARGA [SP] SUTENT [SP] TAFINLAR [SP] TAGRISSO [SP] TARCEVA [SP] TASIGNA [SP] TYKERB [SP] VENCLEXTA [SP] VENCLEXTA STARTING

PACK [SP] VOTRIENT [SP] XALKORI [SP] ZELBORAF [SP]

Monoclonal Antibodies ADCETRIS [SP] ARZERRA [SP] AVASTIN [SP] BAVENCIO [SP] BESPONSA [SP] BLINCYTO [SP] CYRAMZA [SP] DARZALEX [SP] ERBITUX [SP] GAZYVA [SP] HERCEPTIN [SP] IMFINZI [SP] KADCYLA [SP] KEYTRUDA [SP] LARTRUVO [SP] OPDIVO [SP] PERJETA [SP] RITUXAN HYCELA [SP] SYLVANT [SP] TECENTRIQ [SP] UNITUXIN [SP] VECTIBIX [SP] YERVOY [SP] ZEVALIN

Retinoids bexarotene TARGRETIN

Chest Pain Drugs Nitrates

nitroglycerin in d5w

Vasodilators, Direct-acting Arterial

hydralazine hcl hydralazine hcl [INJ] minoxidil papaverine hcl papaverine hcl [INJ]

Vasodilators, Direct-acting Arterial/ Venous

DILATRATE-SR isosorbide dinitrate isosorbide mononitrate NITRO-BID nitroglycerin nitro-time RECTIV

Cholesterol Control Drugs Dyslipidemics, Fibric Acid Derivatives

fenofibrate fenofibric acid gemfibrozil LIPOFEN

Dyslipidemics, HMG CoA Reductase Inhibitors

atorvastatin calcium fluvastatin er fluvastatin sodium LIVALO lovastatin pravastatin sodium rosuvastatin calcium simvastatin

Dyslipidemics, Other cholestyramine cholestyramine light colestipol hcl ezetimibe ezetimibe-simvastatin JUXTAPID [SP] niacin er omega-3 acid ethyl esters PRALUENT PEN [SP] prevalite REPATHA PUSHTRONEX

[SP] REPATHA SURECLICK [SP] REPATHA SYRINGE [SP] VASCEPA

Contraceptives Implants

NEXPLANON


Injectable medroxyprogesterone

acetate

IUD KYLEENA [SP] MIRENA SKYLA

Oral altavera alyacen amethia amethia lo amethyst apri aranelle ashlyna aubra aubra eq aviane azurette balziva bekyree blisovi 24 fe blisovi fe briellyn camila camrese camrese lo caziant chateal chateal eq cryselle cyclafem cyred dasetta daysee deblitane delyla desogestrel-ethinyl

estradiol desogestr-eth estrad eth

estra drospirenone-eth estra-

levomef drospirenone-ethinyl

estradiol elinest emoquette enpresse enskyce errin estarylla ethynodiol-ethinyl

estradiol falmina fayosim

femynor gianvi gildess fe heather incassia introvale isibloom jencycla jolessa jolivette juleber junel junel fe kaitlib fe kariva kelnor 1-35 kelnor 1-50 kurvelo larin larin fe larissia layolis fe leena lessina levonest levonorgestrel-eth

estradiol levonorg-eth estrad eth

estrad levora lillow LO LOESTRIN FE loryna low-ogestrel lutera lyza marlissa melodetta 24 fe mibelas 24 fe microgestin microgestin fe mili mono-linyah mononessa myzilra necon nikki nora-be norethindrone acetate norethindrone-ethin

estradiol norethin-eth estra ferrous

fum norgestimate-ethinyl

estradiol NORGESTREL-ETHINY

ESTRA norlyda norlyroc

nortrel ocella OGESTREL orsythia philith pimtrea pirmella portia previfem quasense rajani reclipsen rivelsa setlakin sharobel sprintec sronyx syeda tarina fe TAYTULLA tilia fe tri femynor tri-estarylla tri-legest fe tri-linyah tri-lo-estarylla tri-lo-marzia tri-lo-sprintec tri-mili trinessa trinessa lo tri-previfem tri-sprintec trivora tri-vylibra tulana tydemy velivet vienva viorele vyfemla vylibra wera wymzya fe zarah zovia

Transdermal XULANE

Vaginal NUVARING

Corticosteroids Glucocorticosteroids

budesonide er decadron dexamethasone-0.9% nacl

methylprednisolone sod succ [INJ]

prednisolone acetate micronize

Cough/ Cold/ Allergy Antitussives

hydrocodone compound

Expectorants bromhexine hydrochloride terpin hydrate

Cystic Fibrosis Agents All Agents

KALYDECO [SP]

Dental and Oral Agents All Agents

cevimeline hcl chlorhexidine gluconate denta 5000 plus dentagel FIRST-MOUTHWASH BLM KEPIVANCE oralone pilocarpine hcl sf sf 5000 plus sodium fluoride triamcinolone acetonide triamcinolone acetonide

[INJ]

Dermatologicals Acne Products

isotretinoin metronidazole benzoate

Antifungals - Topical benzoic acid ciclopirox olamine clioquinol gentian violet iodochlorohydroxyquinolin

e

Antipruritics - Topical camphor

Antipsoriatics anthralin

Antiseborrheic Products glycolic acid

Burn Products nitrofurazone


Cauterizing Agents chloroacetic acid

Keratolytic/ Antimitotic Agents cantharidin podophyllum resin

Local Anesthetics - Topical glydo lidozion pramoxine hcl

Misc. Topical ACUICYN aluminum chloride arnica flower ichthammol tannic acid

Scabicides & Pediculicides crotan

Scar Treatment Products celacyn

Wound Care Products ACTICOAT KENDALL MEDIHONEY RESTORE SILVASORB SP ANTIPRURITIC XEROFORM XEROFORM PETROLATUM

DRESSING

Diabetic Drugs Antidiabetic Agents

acarbose BYDUREON BYDUREON BCISE BYDUREON PEN BYETTA glimepiride glipizide glipizide er glipizide xl glyburide glyburide micronized metformin hcl metformin hcl er miglitol nateglinide pioglitazone hcl repaglinide SYMLINPEN 120 SYMLINPEN 60

tolazamide tolbutamide TRULICITY VICTOZA

Antidiabetic Combinations glipizide-metformin glyburide-metformin hcl GLYXAMBI INVOKAMET INVOKAMET XR JANUMET JANUMET XR JENTADUETO JENTADUETO XR pioglitazone-glimepiride pioglitazone-metformin repaglinide-metformin hcl SEGLUROMET SOLIQUA 100-33 SYNJARDY SYNJARDY XR XIGDUO XR XULTOPHY 100-3.6

DPP-4 JANUVIA TRADJENTA

Glycemic Agents GLUCAGEN [INJ] GLUCAGON EMERGENCY

KIT [INJ] PROGLYCEM

Incretin Mimetic Agents (GLP-1 Receptor Agonists)

OZEMPIC

Insulins HUMALOG HUMALOG JUNIOR

KWIKPEN HUMALOG MIX 50-50 HUMALOG MIX 75-25 HUMULIN R HUMULIN R U-500

KWIKPEN LANTUS LANTUS SOLOSTAR LEVEMIR LEVEMIR FLEXTOUCH NOVOLOG NOVOLOG FLEXPEN NOVOLOG MIX 70-30 TOUJEO MAX SOLOSTAR TOUJEO SOLOSTAR TRESIBA FLEXTOUCH U-100

TRESIBA FLEXTOUCH U-200

SGLT2 Inhibitors FARXIGA INVOKANA JARDIANCE STEGLATRO

Diabetic Supplies Monitoring Devices & Supplies

ACCU-CHEK RAPID D ACCU-CHEK SPIRIT ACCU-CHEK TENDER ACCU-CHEK ULTRAFLEX AUTOSOFT 30 AUTOSOFT 90 AUTOSOFT XC cartridge pump cartridge stamped CLEO 90 INFUSION SET COMFORT COMFORT SHORT CONTACT DETACH

INFUSION SET DELTEC COZMO CLEO

INFUSION SET INFUSION SET INSET 30 INFUSION SET INSET 30 TUBING INSET INFUSION SET insulin cartridge MINIMED MINIMED RESERVOIR MIO INFUSION SET OMNIPOD OMNIPOD DASH ONE TOUCH PING PARADIGM PARADIGM INFUSION PARADIGM SILHOUETTE POLYFIN QR QUICK RELEASE SOFT

TEFLON QUICK-SET PARADIGM REVEL PROGRAMMABLE

PUMP SILHOUETTE SOF-SET SOF-SET MICRO SURE-T PARADIGM T:30 INFUSION SET T:90 T:FLEX T:SLIM T:SLIM G4 TRUE METRIX TEST STRIPS

AND METERS TRUSTEEL INFUSION SET

VARISOFT INFUSION SET VGO 20 VGO 30 VGO 40

Diagnostic Products Diagnostic Biologicals

APLISOL CANDIN TUBERSOL

Diagnostic Drugs d-xyloseHISTATROL INTRADERMAL IC GREEN [INJ]INDIGO CARMINE [INJ]indocyanine green [INJ]isosulfan blueKINEVAC [INJ]LEXISCAN R-GENE 10xylose

Miscellaneous Contrast Media EOVIST

Radiographic Contrast Media barium sulfate OMNIPAQUE

Dietary Products/ Dietary Management Products Nutritional Substitutes

sodium saccharin

Nutritional Supplements FIBERSOURCE HN NOURISH

Digestive Aids Digestive Enzymes

pepsin 3;000 digestion

Gastric Acidifiers l-glutamic acid

Diuretics Carbonic Anhydrase Inhibitors

acetazolamide sodium [INJ]

Loop Diuretics ethacrynate sodium

Osmotic Diuretics mannitol OSMITROL


Potassium Sparing Diuretics triamterene

Drugs to Regulate Hormones Hormonal Agents, Stimulant/ Replacement/ Modifying (Adrenal)

anucort-hc betamethasone acetate betamethasone acetate-

sod phos [INJ] betamethasone sodium

phosphate cortisone acetate deltasone desoximetasone DEXAMETHASONE dexamethasone acetate dexamethasone

micronized dexamethasone sodium

phosphate dexamethasone sodium

phosphate [INJ] fludrocortisone acetate fluticasone propionate fluticasone propionate

micro hemmorex-hc hydrocortisone hydrocortisone acetate mercaptopurine methylprednisolone methylprednisolone [INJ] methylprednisolone ac

micro methylprednisolone

acetate [INJ] MILLIPRED mometasone furoate prednisolone prednisolone sodium phos

odt prednisolone sodium

phosphate prednisone SOLU-CORTEF [INJ] triamcinolone triamcinolone acetonide triamcinolone acetonide

[INJ] triamcinolone diacetate VERIPRED 20

Drugs to Treat Airway Disease Phosphodiesterase Inhibitors, Airways Disease

DALIRESP

ELIXOPHYLLIN theochron theophylline anhydrous

Drugs to Treat Allergies, Cough, Cold and Lung Conditions Respiratory Tract/ Pulmonary Agents

COMBIVENT RESPIMAT dextromethorphan hbr DYMISTA guaifenesin hydrocodone/homatropine hydromet ipratropium-albuterol nebusal NUCALA [SP] promethazine vc pulmosal PULMOZYME [SP] sodium chloride sodium chloride [INJ] STIOLTO RESPIMAT XOLAIR [SP]

Drugs to Treat Angioedema Angioedema (HAE) Agents

CINRYZE [SP] FIRAZYR [SP]

Drugs to Treat Viral Infections Anti-Cytomegalovirus (CMV) Agents

cidofovir valganciclovir hcl

Antivirals ribavirin [SP]

Ear Drugs Otic Agents

acetasol hc acetic acid acetic acid/hydrocortisone CIPRODEX ciprofloxacin hcl CORTANE-B exotic-hc fluocinolone acetonide oil neomycin/polymyxin/hc otomax-hc OTOVEL

Endocrine And Metabolic Agents Metabolic Modifiers

CRYSVITA [SP] MEPSEVII [SP] PALYNZIQ [SP] sodium phenylacet-sod

benzoate

Posterior Pituitary Hormones vasopressin-ns

Enzyme Replacement/ Modifying Drugs Enzyme Replacement/ Modifiers

ADAGEN [SP] ALDURAZYME [SP] CERDELGA [SP] CEREZYME [SP] CREON CYSTADANE [SP] CYSTAGON [SP] ELAPRASE [SP] FABRAZYME [SP] KANUMA [SP] KUVAN [SP] LUMIZYME [SP] NAGLAZYME [SP] NITYR [SP] OCALIVA [SP] ORFADIN [SP] RAVICTI [SP] sodium phenylbutyrate STRENSIQ [SP] SUCRAID [SP] VIMIZIM [SP] VIOKACE ZENPEP

EnzymeReplacement/ Modifying Drugs Enzyme Replacements/ Modifiers

BRINEURA [SP] [INJ]

Estrogens All Agents

ethinyl estradiol

Eye Drugs Ophthalmic Agents, Other

altacaine altafluor atropine sulfate atropine sulfate [INJ] bacitracin/polymyxin bio glo cyclopentolate hcl CYSTARAN [SP] EYLEA [SP]

flucaine ful-glo green glo homatropaire homatropine

hydrobromide JETREA [SP] neo/polymyxin/dexametha

sone neomycin/bacitracin/poly/

hc neomycin/bacitracin/poly

myxin neomycin/polymyxin/gram

icidin neomycin/polymyxin/hc neomycin-polymyxin-

dexamethaso neo-polycin neo-polycin hc phenylephrine hcl phenylephrine hcl [INJ] polycin polymyxin b sul-

trimethoprim proparacaine hcl proparacaine-fluorescein RESTASIS RESTASIS MULTIDOSE sulfacetamide

w/prednisolone tetcaine tetracaine hcl tetracaine hcl [INJ] TOBRADEX TOBRADEX ST tobramycin-

dexamethasone tropicamide VISUDYNE [SP] XIIDRA ZYLET

Fibromyalgia Drugs Fibromyalgia Agents

duloxetine hcl LYRICA SAVELLA

Flu Drugs Anti-Influenza Agents

oseltamivir phosphate RELENZA rimantadine hcl

Fluoroquinolones All Agents

ciprofloxacin-d5w levofloxacin-d5w


Fungal Infection Drugs Antifungals

amphotericin b amphotericin b [INJ] caspofungin acetate ciclodan ciclopirox clotrimazole CRESEMBA econazole nitrate ERAXIS(WATER DILUENT) fluconazole flucytosine griseofulvin griseofulvin ultramicrosize itraconazole ketoconazole MICONAZOLE 3 miconazole nitrate MYCAMINE naftifine hcl NATACYN NOXAFIL nyamyc nystatin nystatin w/triamcinolone nystatin/triamcinolone nystop oxiconazole nitrate SPORANOX terbinafine terconazole tolnaftate voriconazole

Gastrointestinal Agents Inflammatory Bowel Agents

aminosalicylic acid sulfazine

General Anesthetics Anesthetics

etomidate ketamine hcl ketamine hcl [INJ] propofol

Barbiturate Anesthetics BREVITAL SODIUM [INJ]

Genitourinary Agents Alkalinizers

potassium citrate

Genitourinary Irrigants aqua care sodium chloride

curity

Glaucoma Drugs Ophthalmic Antiglaucoma Agents

ALPHAGAN P apraclonidine hcl betaxolol hcl bimatoprost brimonidine tartrate carteolol hcl COMBIGAN dorzolamide hcl dorzolamide-timolol levobunolol hcl methazolamide metipranolol PHOSPHOLINE IODIDE pilocarpine hcl ROCKLATANtimolol maleate

Ophthalmic Prostaglandin and Prostamide Analogs

bimatoprost latanoprost LUMIGAN TRAVATAN Z

Gout Agents All Agents

allopurinol sodium ALOPRIM

Gout Drugs Antigout Agents

allopurinol colchicine COLCRYS KRYSTEXXA [SP] MITIGARE probenecid probenecid w/colchicine ULORIC

Heart Regulation Drugs Antiarrhythmics

adenosine amiodarone hcl dofetilide flecainide acetate mexiletine hcl pacerone procainamide hcl procainamide hcl [INJ] propafenone hcl propafenone hcl er quinidine gluconate quinidine gluconate [INJ]

quinidine sulfate sotalol sotalol af SOTYLIZE

Antiarrhythmics Type I-B lidocaine hcl in dextrose

Antiarrhythmics Type III ibutilide fumarate NEXTERONE

Hematological Agents Antihemophilic Products

HEMLIBRA [SP]

Plasma Expanders hetastarch w/sodium

chloride HEXTEND LACTATED

ELECTROLYTE LMD 10% WITH 0.9%

SODCHLORIDE LMD 10% WITH 5%

DEXTROSE VOLUVEN

Plasma Proteins albumin alburx albutein buminate plasbumin PLASMANATE

Platelet Aggregation Inhibitors eptifibatide REOPRO

Protamine protamine sulfate

Hematopoietic Agents Agents for Gaucher Disease

miglustat [SP]

Cobalamins hydroxocobalamin

Hematopoietic Growth Factors DOPTELET [SP]

Hemostatics Hemostatics - Systemic

aminocaproic acid

Hepatitis Drugs Anti-hepatitis B (HBV) Agents

adefovir dipivoxil BARACLUDE entecavir EPIVIR HBV lamivudine VEMLIDY

Anti-hepatitis C (HCV) Agents EPCLUSA [SP] HARVONI [SP] INTRON A [SP] [INJ] MAVYRET [SP] moderiba [SP] RIBAPAK [SP] ribasphere [SP] ribavirin [SP] SOVALDI [SP] SYLATRON [SP] TECHNIVIE [SP] VIEKIRA PAK [SP] VIEKIRA XR [SP] VOSEVI [SP]

Herpes Drugs Antiherpetic Agents

acyclovir famciclovir trifluridine valacyclovir ZOVIRAX

HIV Drugs Anti-HIV Agents, Integrase Inhibitors (INSTI)

DESCOVY ISENTRESS ISENTRESS HD STRIBILD TIVICAY

Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors (NNRTI)

COMPLERA EDURANT GENVOYA INTELENCE nevirapine nevirapine er ODEFSEY RESCRIPTOR

Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors (NRTI)

abacavir abacavir-lamivudine


abacavir-lamivudine-zidovudine

didanosine EMTRIVA lamivudine lamivudine-zidovudine RETROVIR stavudine TEMIXYSTRIUMEQ TRUVADA VIDEX VIREAD zidovudine

Anti-HIV Agents, Other FUZEON [SP] SELZENTRY

Anti-HIV Agents, Protease Inhibitors

APTIVUS CRIXIVAN fosamprenavir calcium INVIRASE KALETRA LEXIVA lopinavir-ritonavir NORVIR PREZISTA REYATAZ VIRACEPT

Hormone Replacement/ Modifying Drugs Androgens

ANDRODERM ANDROGEL danazol METHITEST methyltestosterone methyltestosterone

micronized oxandrolone testosterone testosterone cypionate testosterone enanthate testosterone micronized

Bulk Chemicals - C's chorionic gonadotropin

[SP]

Bulk Chemicals - D's desmopressin acetate

Estrogens amabelz COMBIPATCH

covaryx covaryx h.s. DEPO-ESTRADIOL DIVIGEL DUAVEE eemt eemt hs estradiol estradiol valerate estradiol-norethindrone

acetat ESTRING estrogen &

methyltestosterone fyavolv jevantique lo jinteli lopreeza mimvey mimvey lo MINIVELLE norethindrone-ethin

estradiol PREMARIN PREMARIN [INJ] PREMPHASE PREMPRO yuvafem

Fertility Regulators FOLLISTIM AQ [SP] MENOPUR [SP] NOVAREL [SP] OVIDREL [SP]

Growth Hormones GENOTROPIN [SP]

Insulin-Like Growth Factors (Somatomedins)

INCRELEX [SP]

LHRH/ GnRH Agonist Analog Pituitary Suppressants

TRIPTODUR [SP]

Posterior Pituitary Hormones desmopressin acetate desmopressin acetate [INJ] STIMATE [SP]

Progestins CRINONE DEPO-PROVERA hydroxyprogesterone

caproate [SP] MAKENA [SP] medroxyprogesterone

acetate

megestrol acetate norethindrone acetate progesterone

Selective Estrogen Receptor Modifying Agents

clomiphene citrate raloxifene hcl

Hormone Suppressants Antiandrogens

bicalutamide flutamide nilutamide XTANDI [SP] ZYTIGA [SP]

Antineoplastic - Hormonal and Related Agents

ELIGARD [SP] FIRMAGON [SP] leuprolide acetate [SP] LUPRON DEPOT [SP] VANTAS [SP] ZOLADEX [SP]

Bulk Chemicals - L's leuprolide acetate [SP]

GnRH/ LHRH Antagonists CETROTIDE [SP]

Growth Hormone Receptor Antagonists

SOMAVERT [SP]

Growth Hormone Releasing Hormones (GHRH)

EGRIFTA [SP]

Hormonal Agents, Suppressant (Adrenal)

LYSODREN

Hormonal Agents, Suppressant (Parathyroid)

SENSIPAR

LHRH/ GnRH Agonist Analog Pituitary Suppressants

SYNAREL

Prolactin Inhibitors cabergoline

Somatostatic Agents octreotide acetate [SP]

[INJ] SIGNIFOR [SP]

SOMATULINE DEPOT [SP]

Hypnotics/ Sedatives/ Sleep Disorder Agents Barbiturate Hypnotics

AMYTAL SODIUM [INJ] pentobarbital sodium pentobarbital sodium [INJ] phenobarbital sodium [INJ]

Non-Barbiturate Hypnotics chloral hydrate

Immune System Drugs Immune Suppressants

azathioprine azathioprine sodium [INJ] cyclosporine ENBREL [SP] gengraf HUMIRA [SP] HUMIRA PEDIATRIC [SP] methotrexate methotrexate [INJ] methotrexate sodium methotrexate sodium [INJ] mycophenolate mofetil mycophenolic acid NULOJIX [SP] OTREXUP PROGRAF RAPAMUNE RASUVO REMICADE [SP] RINVOQ [SP]SANDIMMUNE sirolimus tacrolimus TORISEL [SP] ZORTRESS

Immunizing Agents, Passive ATGAM CYTOGAM [SP] GAMASTAN S-D [SP] GAMMAGARD LIQUID [SP]

[INJ] GAMMAGARD S-D [SP] GAMUNEX-C [SP] [INJ] HEPAGAM B [INJ] HIZENTRA [SP] HYPERHEP B S-D HYPERRAB S-D HYPERRHO S-D [SP] HYPERTET S-D IMOGAM RABIES-HT PRIVIGEN [SP] THYMOGLOBULIN VARIZIG


Immunomodulators ACTIMMUNE [SP] ALFERON N [INJ] BENLYSTA [SP] ILARIS [SP] leflunomide OTEZLA [SP] RIDAURA SIMULECT SYNAGIS [SP]

Inflammatory Bowel Disease Drugs Aminosalicylates

APRISO balsalazide disodium CANASA mesalamine PENTASA

Glucocorticoids budesonide ec colocort hc pramoxine hydrocortisone pramcort procto-med hc procto-pak proctosol-hc proctozone-hc UCERIS

Laxatives Laxative Combinations

CLENPIQ

Lubricant Laxatives mineral oil heavy mineral oil light MURI-LUBE MINERAL OIL

Local Anesthetics All Agents

bupivacaine hcl bupivacaine hcl [INJ] cocaine hcl dermacinrx prizopak ethyl chloride lidocaine lidocaine hcl lidocaine hcl [INJ] lidocaine-prilocaine lido-k lidopin lidopril lorenza MARCAINE [INJ]

relador pak relador pak plus SCAR sensorcaine [INJ] sensorcaine-mpf [INJ] zeruvia

Local Anesthetics-parenteral Local Anesthetic Combinations

bupivacaine hcl-epinephrine [INJ]

lidocaine hcl w/epinephrine [INJ]

SENSORCAINE WITH EPINEPHRINE [INJ]

xylocaine dental-epinephrine [INJ]

Local Anesthetics - Amides bupivacaine w/dextrose

[INJ] CARBOCAINE [INJ] lidocaine hcl in 7.5%

dextrose polocaine [INJ] ropivacaine hcl/pf [INJ] ropivacaine hcl-ns [INJ]

Local Anesthetics - Esters chloroprocaine hcl [INJ] procaine hcl

Macrolides Erythromycins

ERYTHROCIN LACTOBIONATE

erythromycin stearate

Migraine Drugs Ergot Alkaloids

dihydroergotamine mesylate

dihydroergotamine mesylate [INJ]

ergotamine-caffeine MIGERGOT

Serotonin (5-HT) 1b/ 1d Receptor Agonists

almotriptan malate eletriptan hbr frovatriptan succinate naratriptan hcl rizatriptan sumatriptan succinate sumatriptan succ-naproxen

sod zolmitriptan zolmitriptan odt

ZOMIG

Migraine Products All Agents

ergotamine tartrate

Migraine Products - Monoclonal Antibodies

AIMOVIG AUTOINJECTOR AIMOVIG AUTOINJECTOR

(2 PACK)

Minerals & Electrolytes Bicarbonates

NEUT sodium acetate sodium bicarbonate-water sodium lactate

Calcium calcium chloride calcium lactate calcium phosphate calcium phosphate tribasic

Magnesium magnesium carbonate magnesium chloride magnesium chloride [INJ] magnesium sulfate in

dextrose

Manganese manganese

Phosphate GLYCOPHOS sodium phosphate

Potassium potassium acetate

Sodium monoject 0.9% nacl [INJ] monoject prefill advanced

[INJ] normal saline [INJ] saline flush [INJ] sodium chloride-water syrex [INJ]

Trace Minerals chromium copper chloride cupric sulfate MULTITRACE-4 multitrace-5 selenium

TRACE ELEMENTS-4

Zinc zinc chloride

Miscellaneous Anti-Infectives Antimycobacterials, Other

dapsone rifabutin

Miscellaneous Therapeutic Classes Chelating Agents

penicillamine(d-) trientine hcl

Enzymes bromelain chymotrypsin

Irrigation Solutions aqua care sterile water irrig curity lactated ringers

Peritoneal Dialysis Solutions DELFLEX W/DEXTROSE EXTRANEAL ICODEXTRIN

DIALYSIS

Sclerosing Agents ETHAMOLIN SOTRADECOL

Mood Disorder Drugs 1st Generation/ Typical

chlorpromazine hcl chlorpromazine hcl [INJ] fluphenazine decanoate fluphenazine decanoate

[INJ] fluphenazine hcl fluphenazine hcl [INJ] haloperidol haloperidol [INJ] haloperidol decanoate haloperidol lactate haloperidol lactate [INJ] loxapine succinate pimozide thioridazine hcl thiothixene trifluoperazine hcl

2nd Generation/ Atypical ABILIFY MAINTENA aripiprazole


aripiprazole odt ARISTADA clozapine odt LATUDA olanzapine olanzapine odt paliperidone er quetiapine fumarate quetiapine fumarate er RISPERDAL CONSTA risperidone risperidone odt ziprasidone hcl

Mood Stabilizers lithium carbonate lithium citrate

Treatment-Resistant clozapine

Mouth/ Throat/ Dental Agents Dental Products

zinc acetate

Multiple Sclerosis Drugs Multiple Sclerosis Agents

AMPYRA [SP] AVONEX ADMINISTRATION

PACK [SP] AVONEX PEN [SP] COPAXONE [SP] GILENYA [SP] glatiramer acetate [SP] glatopa [SP] MAYZENT [SP]OCREVUS [SP] PLEGRIDY [SP] TECFIDERA [SP]

Musculoskeletal Therapy Agents Direct Muscle Relaxants

revonto

Myasthenia Gravis Drugs Parasympathomimetics

guanidine hcl MESTINON neostigmine methylsulfate pyridostigmine bromide pyridostigmine bromide er

Nausea and Vomiting Drugs Antiemetics, Other

AKYNZEO compro dimenhydrinate

dimenhydrinate [INJ] meclizine hcl metoclopramide hcl metoclopramide hcl [INJ] metoclopramide hcl odt perphenazine prochlorperazine maleate trimethobenzamide hcl

Emetogenic Therapy Adjuncts aprepitant dronabinol granisetron hcl ondansetron hcl ondansetron hcl [INJ] ondansetron odt SANCUSO VARUBI

Neuromuscular Agents Depolarizing Muscle Relaxants

ANECTINE [INJ]

Nondepolarizing Muscle Relaxants

atracurium besylate cisatracurium besylate pancuronium bromide rocuronium bromide vecuronium bromide

Neurotoxins Neuromuscular Blocking Agent - Neurotoxins

BOTOX [SP] [INJ] MYOBLOC [SP]

Nutrients Carbohydrates

dextrose dextrose in water fructose

Lipids intralipid

Lipotropics choline bitartrate

Proteins alanine AMINOSYN AMINOSYN II AMINOSYN M AMINOSYN WITH

ELECTROLYTES AMINOSYN-RF CLINIMIX

CLINIMIX E FREAMINE HBC FREAMINE III HEPATAMINE histidine hcl l-alaninel-arginine basel-cysteinel-glutamic acidl-leucinel-prolinel-threoninel-valineNEPHRAMINEphenylalanine (dl)plenaminePREMASOL PROCALAMINEPROSOL taurinethreonineTRAVASOL TROPHAMINEtryptophan (l)

Ophthalmic Agents Miotics

MIOSTAT

Ophthalmic Anti-infectives ak-poly-bac

Ophthalmic Gene Therapy LUXTURNA [SP]

Ophthalmic Kinase Inhibitors RHOPRESSA

Ophthalmic Surgical Aids ocucoat

Ophthalmics balanced salt BSS FLUORESCITE

Opioid Pain Relievers Opioid Agonists

alfentanil hydrochloride [INJ]

codeine phosphate duramorph [INJ] morphine sulfate cr morphine sulfate in

dextrose remifentanil hcl sufentanil citrate ULTIVA

Opioid Analgesics, Long-acting diskets fentanyl hydromorphone er HYSINGLA ER INFUMORPH [INJ] levorphanol tartrate methadone hcl methadone hcl [INJ] METHADOSE morphine sulfate er NUCYNTA ER OXYCONTIN oxymorphone hcl oxymorphone hcl er tramadol hcl erXTAMPZA ER

Opioid Analgesics, Short-acting acetaminophen w/codeine apap-caffeine-

dihydrocodeine asa-butalb-caff-cod ascomp with codeine butalbital compound

w/codeine butalbit/caff/apap/codeinebutorphanol tartrate butorphanol tartrate [INJ] codeine sulfate endocet fentanyl citrate fentanyl citrate [INJ] fentanyl citrate/ns hydrocodone bitartrate hydrocodone bit-ibuprofen hydrocodone w/acetamin

hydromorphone hcl hydromorphone hcl [INJ] hydromorphone hcl/ns lorcet lorcet hd lorcet plus meperidine hcl morphine sulfate morphine sulfate [INJ] morphine sulfate/ns nalbuphine hcl nalbuphine hcl [INJ] NUCYNTA oxycodone hcl oxycodone hcl-ibuprofen oxycodone w/acetaminophen oxycodone w/aspirin oxymorphone hcl tramadol hcl


tramadol hcl-acetaminophen

verdrocet vicodin vicodin es vicodin hp

Opioid Combinations panlor

Opioid Partial Agonists SUBLOCADE [SP]

Osteoarthritis Viscosupplements

EUFLEXXA [SP] MONOVISC [SP] ORTHOVISC [SP]

Osteoporosis (Bone Loss) Drugs Metabolic Bone Disease Agents

alendronate sodium calcitonin-salmon calcitriol doxercalciferol etidronate disodium FORTEO [SP] ibandronate sodium MIACALCIN [INJ] NATPARA [SP] pamidronate disodium paricalcitol risedronate sodium risedronate sodium dr TYMLOS [SP] XGEVA [SP] zoledronic acid ZOMETA

Otic Agents Otic Combinations

antibiotic ear solution

Oxytocics Abortifacients/ Agents for Cervical Ripening

HEMABATE

All Agents oxytocin [INJ]

Pain/ Anti-Inflammatory Drugs Analgesics

acetaminophen acetaminophen

w/butalbital

butalbital compound butalbital

w/acetaminophen butalbital/apap/caffeine butalbital-asp-caffeine phrenilin forte PRIALT [SP] TENCON zebutal

Analgesics Other OFIRMEV

Nonsteroidal Anti-inflammatory Agents (NSAIDs)

ibuprofen lysine phenylbutazone

Nonsteroidal Anti-Inflammatory Drugs

aspirin CALDOLOR celecoxib choline mag trisalicylate diclofenac potassium diclofenac sodium diclofenac sodium-

misoprostol diflunisal etodolac etodolac er fenoprofen calcium FLECTOR flurbiprofen ibu ibuprofen indomethacin ketoprofen ketorolac tromethamine ketorolac tromethamine

[INJ] klofensaid ii meclofenamate sodium mefenamic acid meloxicam nabumetone nabumetone micronized naproxen naproxen sodium naproxen sodium ds naproxen sodium er oxaprozin piroxicam profeno salsalate sulindac tolmetin sodium

Salicylates

acetyl salicylic acid sodium salicylate

Pain/ Swelling Management Drugs Skeletal Muscle Relaxants

baclofen carisoprodol chlorzoxazone cyclobenzaprine hcl dantrolene sodium GABLOFEN LIORESAL metaxall metaxalone methocarbamol methocarbamol [INJ] orphenadrine citrate orphenadrine citrate [INJ] tizanidine hcl

Parkinson's Disease Drugs Anticholinergics

benztropine mesylate benztropine mesylate [INJ] trihexyphenidyl hcl

Antiparkinson Agents, Other amantadine hcl entacapone tolcapone

Dopamine Agonists APOKYN [SP] apomorphine hcl bromocriptine mesylate pramipexole di-hcl pramipexole er ropinirole hcl

Dopamine Precursors/ L-Amino Acid Decarboxylase Inhibitors

carbidopa carbidopa/levodopa carbidopa-levodopa er carbidopa-levodopa-

entacapone

Monoamine Oxidase B (MAO-B) Inhibitors

rasagiline mesylate selegiline hcl

Passive Immunizing And Treatment Agents Immune Serums

HYPERRAB

Penicillins Aminopenicillins

ampicillin sodium ampicillin sodium [INJ]

Natural Penicillins BICILLIN L-A penicillin gk-iso-osm

dextrose

Penicillin Combinations BICILLIN C-R

Penicillinase-Resistant Penicillins

nafcill in dextrose

Phosphate-Removing Agents Phosphate Binders

calcium acetate lanthanum carbonate PHOSLYRA sevelamer carbonate VELPHORO

Platelet Modifying Drugs Platelet Modifying Agents

aspirin-dipyridamole er BRILINTA cilostazol clopidogrel dipyridamole prasugrel hcl ZONTIVITY

Prostate Enlargement Drugs Benign Prostatic Hypertrophy Agents

alfuzosin hcl er CIALIS dutasteride dutasteride-tamsulosin finasteride RAPAFLO tamsulosin hcl terazosin hcl

Protozoal Infection Drugs Antiprotozoals

ALINIA atovaquone atovaquone-proguanil hcl chloroquine phosphate COARTEM DARAPRIM [SP] hydroxychloroquine sulfate mefloquine hcl


NEBUPENT primaquine quinine sulfate

Psychotherapeutic And Neurological Agents Antidementia Agents

memantine hcl er

Postherpetic Neuralgia (PHN)/ Neuropathic Pain Agents

LYRICA CR

Respiratory Agents Cystic Fibrosis Agents

SYMDEKO [SP]

Scabies and Lice Drugs Pediculicides/ Scabicides

lindane malathion permethrin spinosad

Sedation and Sleep Drugs GABA Receptor Modulators

eszopiclone flurazepam hcl zaleplon zolpidem tartrate zolpidem tartrate er

Sleep Disorders, Other armodafinilmodafinilROZEREMSECONAL SODIUM SUNOSIXYREM

Seizure Control Drugs Anticonvulsants, Other

BRIVIACT levetiracetam roweepra

Calcium Channel Modifying Agents

CELONTIN ethosuximide zonisamide

Gamma-Aminobutyric Acid (GABA) Augmenting Agents

diazepam diazepam [INJ] divalproex sodium divalproex sodium er gabapentin

GRALISE ONFI phenobarbital primidone SABRIL [SP] tiagabine hcl valproic acid vigabatrin [SP]

Glutamate Reducing Agents felbamate lamotrigine lamotrigine (blue) lamotrigine (green) lamotrigine (orange) lamotrigine odt QUDEXY XR

Sodium Channel Agents carbamazepine carbamazepine er epitol fosphenytoin sodium [INJ] oxcarbazepine PEGANONE phenytoin phenytoin sodium VIMPAT

Skin Agents Acne Products

10-1ABSORICA ACANYAadapaleneadapalene-benzoyl

peroxide amnesteem avar avita benzepro benzoyl peroxide bp foam BPO claravis CLEANSING WASH clindacin etz clindamycin phos-tretinoin clindamycin-benzoyl

peroxide dapsone EPIDUO FORTE erythromycin-benzoyl

peroxide myorisan neuac ONEXTON retinoic acid

sodium sulfacetamide/sulfur

ss 10-2 sss 10-5 sulfacetamide sodium sulfacetamide sodium-

sulfur sulfacleanse 8/4 tretinoin tretinoin acid tretinoin microsphere zenatane

Agents for Wrinkles/ Lipoatrophy/ Other Aesthetic Uses

REFISSA

Antifungals - Topical clotrimazole/betamethaso

ne dermazene cream hydrocortisone

w/iodoquinol hydrocortisone-iodoquinol-

aloe

Anti-inflammatory Agents - Topical

diclofenac sodium

Antimetabolites fluorouracil

Antineoplastic or Premalignant Lesion Agents - Topical

CARAC diclofenac sodium fluorouracil PICATO

Antipruritics - Topical doxepin hcl PRUDOXIN

Antipsoriatics acitretincalcipotrienecalcitrene calcitriol COSENTYX 150MG [SP]COSENTYX 300MG [SP]DRITHOCREME HPmethoxsalenSTELARA [SP]tazaroteneTAZORACTREMFYA [SP]

Antiseborrheic Products

seb-prev selenium sulfide sodium sulfacetamide sulfacetamide sodium

Corticosteroids - Topical ala-cort alclometasone

dipropionate amcinonide APEXICON E betamethasone

dipropionate betamethasone valerate calcipotriene-

betamethasone dp clobetasol e clobetasol emulsion clobetasol propionate clodan desonide desoximetasone diflorasone diacetate ENSTILAR fluocinolone acetonide fluocinonide fluocinonide-e flurandrenolide fluticasone propionate halobetasol propionate hc pramoxine hydrocortisone hydrocortisone acetate hydrocortisone butyrate hydrocortisone valerate mometasone furoate nolix prednicarbate TACLONEX triamcinolone acetonide TRIANEX triderm

Eczema Agents DUPIXENT [SP]

Emollient/ Keratolytic Agents CEM-UREA k50 rea-lo umecta urea ure-k

Emollients ammonium lactate

Enzymes - Topical


collagenase SANTYL

Immunomodulating Agents - Topical

imiquimod

Immunosuppressive Agents tacrolimus

Immunosuppressive Agents - Topical

ELIDEL tacrolimus

Inflammatory Bowel Agents STELARA [SP]

Keratolytic/ Antimitotic Agents podofilox salicylic acid salicylic acid er salimez SALVAX

Leprostatics dapsone

Local Anesthetics - Topical capsaicin

Metabolic Modifiers calcitriol

Nonsteroidal Anti-inflammatory Agents (NSAIDs)

diclofenac sodium

Otic Combinations CORTANE-B

Rosacea Agents FINACEA MIRVASO SOOLANTRA

Tricyclic Agents doxepin hcl

Wound Care Products REGRANEX

Sulfonamides All Agents

sulfamethoxazole sulfapyridine sulfathiazole sulfisoxazole

Tetracyclines All Agents

coremino minocycline hcl er oxytetracycline hcl

Thyroid Agents Thyroid Hormones

PCCA T3 SODIUM DILUTION

Thyroid Replacement Drugs Hormonal Agents, Stimulant/ Replacement/ Modifying (Thyroid)

ARMOUR THYROID levothyroxine sodium levoxyl liothyronine sodium NATURE-THROID np thyroid thyroid unithroid WESTHROID

Thyroid Suppressing Drugs Antithyroid Agents

methimazole propylthiouracil

Toxoids Toxoid Combinations

PEDIARIX PENTACEL QUADRACEL DTAP-IPV

Tuberculosis Drugs Antituberculars

CAPASTAT SULFATE [INJ] cycloserine ethambutol hcl isoniazid isoniazid [INJ] PRIFTIN pyrazinamide rifampin SIRTURO

Ulcer and Stomach Acid Drugs Histamine2 (H2) receptor Antagonists

cimetidine famotidine nizatidine ranitidine hcl ranitidine hcl [INJ]

Protectants misoprostolsucralfate

Proton Pump Inhibitors DEXILANT esomeprazole magnesium FIRST-LANSOPRAZOLE FIRST-OMEPRAZOLE lansoprazole omeppi omeprazole omeprazole-sodium

bicarbonate pantoprazole sodium rabeprazole sodium

Ulcer Drugs/ Antispasmodics/ Anticholinergics Antispasmodics

isopropamide iodide scopolamine

hydrobromide

Proton Pump Inhibitors esomeprazole sodium

Urinary Anti-infectives All Agents

nalidixic acid

Vaccines All Agents

ACTHIB ADACEL AFLURIA BEXSERO BIOTHRAX BOOSTRIX DAPTACEL diphtheria-tetanus toxoids-

ped ENGERIX-B FLUARIX FLULAVAL FLUZONE FLUZONE HIGH-DOSE GARDASIL 9 HAVRIX HIBERIX IMOVAX RABIES VACCINE INFANRIX IPOL [INJ] IXIARO MENACTRA

M-M-R II VACCINEW/DILUENT

PEDVAXHIB PNEUMOVAX 23 [INJ] PREVNAR 13 RABAVERT RECOMBIVAX HB ROTATEQ SHINGRIX STAMARIL tetanus diphtheria toxoids TICE BCG tice bcg [INJ] TRUMENBA TWINRIX TYPHIM VI VARIVAX VACCINE VAXCHORA VACCINE VIVOTIF YF-VAX

Viral Vaccines AFLURIA QUAD 2018-2019 FLUAD 2018-2019 FLUBLOK QUAD 2018-2019 PROQUAD

Vaginal Products Miscellaneous Vaginal Products

TRIMO-SAN

Vasopressors All Agents

dobutamine hcl dobutamine hcl in dextrose dopamine hcl dopamine hcl in 5%

dextrose epinephrine hcl epinephrine-d5w norepinephrine bitar-0.9%

nacl norepinephrine bitartrate norepinephrine bitartrate-

d5w phenylephrine hcl-d5w

Vitamins Water Soluble Vitamins

aminobenzoic acid calcium pantothenate sodium ascorbate

Vitamins, Minerals, Electrolytes Electrolyte/ Mineral Modifiers

CHEMET EXJADE [SP]


FERRIPROX [SP] JADENU [SP] JADENU SPRINKLE [SP] kionex SAMSCA [SP] sodium polystyrene

sulfonate sps

Electrolyte/ Mineral Replacement

calcium carbonate calcium gluconate CARBAGLU [SP] cytra-k effer-k FERAHEME ferrous sulfate ISOLYTE S k effervescent klor-con klor-con m klor-con sprinkle klor-con-ef K-PHOS ORIGINAL K-TABmagnesium sulfatemagnesium sulfate [INJ]MULTIGEN phospho-trin 250 neutralPLASMA-LYTE 148 PLASMA-LYTE A PH 7.4 potassium bicarbonatepotassium chl-normal

saline potassium chloride potassium citrate er potassium phosphate sod ferric gluconate

complex sodium chloride sodium chloride [INJ] sodium fluoride VELTASSA VENOFER zinc sulfate

Prenatal Vitamins BAL-CARE DHA C-NATE DHA COMPLETE NATAL DHA COMPLETENATE DOTHELLE DHA ELITE-OB FOLIVANE-OB HEMENATAL OB HEMENATAL OB + DHA MYNATAL

MYNATAL ADVANCE MYNATAL PLUS MYNATAL-Z MYNATE 90 PLUS NEWGEN OBSTETRIX DHA PNV 29-1 PNV OB+DHA PNV-DHA PNV-DHA + DOCUSATE PNV-OMEGA PNV-SELECT PR NATAL 400 PR NATAL 400 EC PR NATAL 430 PR NATAL 430 EC PRENA1 CHEW PRENA1 PEARL PRENA1 TRUE PRENAISSANCE PRENAISSANCE PLUS PRENATABS RX PRENATAL 19 PRENATAL LOW IRON PRENATAL PLUS PRENATAL VITAMIN PLUS

LOW IRON PRENATAL-U PREPLUS PRETAB SE-NATAL 19 TARON PRENATAL TARON-BC TARON-C DHA TRINATAL RX 1 TRINATE TRI-TABS DHA TRIVEEN-DUO DHA ULTIMATECARE ONE VINATE II VINATE ONE VINATE-M VIRT-C DHA VIRT-NATE DHA VIRT-PN VIRT-PN DHA VIRT-PN PLUS VP-HEME OB + DHA ZATEAN-PN DHA ZATEAN-PN PLUS

Therapeutic Nutrients/ Minerals/ Electrolytes

levocarnitine ringers tis-u-sol

Vitamins

AQUASOL A ascorbic acid ascorbic acid [INJ] b-complex [INJ]biotincalcium ascorbatecod liver oilcyanocobalamin cyanocobalamin [INJ]d-biotinergocalciferolfabbfolic acid folic acid [INJ]FOLTANXINFUVITEl-methyl-b6-b12L-METHYLFOLATE-

MECOBALAMIN-NAC L-METHYL-MC NAC M.V.I. ADULT M.V.I. PEDIATRIC METAFOLBIC METAFOLBIC PLUS n-acetyl-l-cysteineNASCOBALnephronex-slniacinniacinamideNUTRIVIT phytonadionephytonadione [INJ]pyridoxine hclpyridoxine hcl [INJ]SUPPORT thiamine hclthiamine hcl [INJ]TL G-FOL OS vitacelvitamin avitamin d2vitamin evitamin k [INJ]wheat germ oil

Worm Infection Drugs Anthelmintics

ALBENZA benznidazole EMVERM ivermectin mebendazole praziquantel thiabendazole

2020 controlled access formulary list

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