2020 Kaiser Permanente Tricare Formulary...2020 Formulary Kaiser Permanente, a TRICARE ® Prime Option This document includes the formulary for Kaiser Permanente, a TRICARE ® Prime

2020 Formulary

Kaiser Permanente, a TRICARE® Prime Option

This document includes the formulary for Kaiser Permanente, a TRICARE® Prime option. For the most up-to-date formulary, please visit our website at kp.org/TRICARE or call 1-833-642-

5973, Monday – Friday 7 a.m. to 7 p.m.

Kaiser Permanente, a TRICARE Prime Option Formulary is for medications covered at Kaiser Permanente pharmacies and Network Pharmacies. All drug product strengths and package sizes of a medication may not be included on the same tier on the formulary. Check with your Kaiser Permanente pharmacist for clarification, if needed. TRICARE is a registered trademark of the Department of Defense, DHA. All rights reserved.

Kaiser Permanente, a TRICARE Prime Option Formulary 1

What is the Kaiser Permanente, a TRICARE® Prime Option Formulary? A formulary is a list of drugs determined to be safe and effective for our members by our Pharmacy and Therapeutics committee. Use of the formulary enables Kaiser Permanente to provide optimal care to you and your family at reasonable costs. Kaiser Permanente continually updates the formulary throughout the year based on new medical evidence, considering the recommendations of appropriate physician experts. Our physicians and pharmacists work closely together to ensure that our formulary meets your needs.

Does the formulary ever change? Yes, Kaiser Permanente periodically updates the formulary based on new medical evidence, considering the recommendations of appropriate physician experts and notifies our doctors, pharmacists, and other clinicians about any changes. If a change in the formulary affects any of your prescriptions, your doctor or pharmacist will let you know.

The enclosed formulary is effective as of January 1, 2020 and represents the most commonly prescribed medications.

How do I use the Formulary? There is an easy way to find your drug within the formulary:

To search for a specific medication or condition, press the ‘CTRL’ key and the

‘F’ key on your keyboard at the same time. In the search window that pops up, enter the text you want to search for and press ‘Enter.’ Press ‘Enter’ again to move to the next result.

Medical Condition The drugs on this formulary are grouped into categories depending on the type of medical condition that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Drugs.” If you know what your drug is used for, simply look for the category name in the list. Then look under the category name for your drug.

Alphabetical Listing If you are not sure what category to look under, you can look for the drug in the Index. The Index provides an alphabetical list of all the drugs included in this document. Both brand-name drugs and generic drugs are listed in the Index. Look in the Index and find your drug. Next to the drug, you will see the page number where you can find coverage information. Go to the page listed in the Index and find the name of your drug on the list.

What are generic drugs? Kaiser Permanente covers both brand-name drugs and generic drugs.

Generic drugs are produced and sold under their chemical names after the patent of the brand name drug expires. Although the price is lower, the



quality and effectiveness of generic drugs is the same as brand name drugs. The Federal Food and Drug Administration (FDA) requires that generic drugs contain the same active ingredients in the same amount as the brand name drug. Generic drugs are listed in lower-case italics (e.g., amoxicillin) within the formulary. Brand-name drugs are capitalized within the formulary (e.g., FLOVENT).

What are Formulary Brand name drugs? Formulary Brand name drugs are drugs that are produced and sold under the original manufacturer’s name. What are Non-Formulary Brand drugs? Non-Formulary Brand drugs are drugs that are not included on the plan's list of preferred prescription drugs.

Because all drug product strengths and package sizes of a formulary drug will be included in your plan’s benefits, just note the drug cost share coverage amount will be based on the specific tier of the formulary, check with your Kaiser Permanente pharmacist for clarification, if needed.

How much will I pay for Covered Drugs? What you pay for covered drugs is determined by the outpatient prescription drug benefit outlined in your Evidence of Coverage. Kaiser Permanente, a TRICARE Prime Option plan has a three-tier open formulary benefit.

Open formulary benefits have a generic cost sharing requirement. This means that if you choose to fill a brand name drug when a generic is available, then in addition to your standard cost share, you will also pay the difference in cost between the brand name and generic drug.

Generics drugs are those covered at the lowest cost share defined as Tier 1 coverage amount. Formulary brand drugs are those brands which will be covered at your formulary brand cost share defined as Tier 2 coverage amount. Non-formulary brands drugs are covered at the non-formulary cost share defined as Tier 3 coverage amount.

Coverage for prescription drugs is limited to drugs for which a prescription is required by law and those that are listed on the Kaiser Permanente, a TRICARE Prime Option drug formulary. Certain diabetic supplies do not require a prescription but must still be listed in our formulary in order to be covered under the benefit.

Each prescription refill is provided on the same basis as the original prescription. Cost shares are applied on a per prescription basis, for up to the lesser of the dispensing amount listed in the “Schedule of Benefits” or the standard prescription amount.

The standard prescription amount for the following items is:



• Migraine medications ― the smallest package size commercially available

• Ophthalmic and otic medications ― the smallest package size commercially available

• Oral and nasal inhalers ― the smallest standard package size

Are there any other restrictions on coverage? Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include:

• Quantity Limits (QL): For certain drugs, Kaiser Permanente limits the amount of the drug that will be covered.

• Age Restriction (Age): For certain drugs, Kaiser Permanente limits coverage based on a designated age.

• Prior Authorization (PA): For certain drugs, Kaiser Permanente requires review and authorization prior to dispensing. Your Provider must obtain this review and authorization. The list of prescription drugs requiring review and authorization is subject to periodic review and modification by our Pharmacy and Therapeutics Committee.

• Step Therapy (ST): For certain drugs, Kaiser Permanente requires the use of similar, alternative medications prior to coverage.

You can find out if the drug has any additional requirements or limits by looking in the Restrictions Column on the formulary list.

What if my drug is not on the Formulary? Because all drug product strengths and package sizes of a formulary drug may not be included on the formulary, check with your Kaiser Permanente pharmacist for clarification, if needed.

For more information For more detailed information about your Kaiser Permanente, a TRICARE Prime Option prescription drug coverage, please review your Evidence of Coverage and other plan materials.

If you have questions about Kaiser Permanente, please call Member Services at 1-833-642-5973 or 770-291-4430, Monday through Friday 7:00 a.m. to 7 p.m. TTY/TDD users should call 1-800-255-0056.

Or visit kp.org/tricare.

Kaiser Permanente, a TRICARE Prime Option Formulary ST = Step Therapy, PA = Prior Authorization, QL = Quantity Limit, Age = Age Restriction

Kaiser Permanente, a TRICARE Prime Option Formulary is for medications covered at Kaiser Permanente pharmacies and Network Pharmacies. All drug product strengths and package sizes of a medication may not be included on the same tier on the formulary. Check with your Kaiser Permanente

pharmacist for clarification, if needed. TRICARE is a registered trademark of the Department of Defense, DHA. All rights reserved.


Restrictions Tier Generic Name Brand Name Coverage Status

Antihistamine Drugs Antihistamine Drugs

ST 1 carbinoxamine maleate ARBINOXA Generic 1 cyproheptadine PERIACTIN Generic

1 chlorpheniramine, phenylephrine & pyrilamine POLY HIST FORTE Generic

1 promethazine & phenylephrine PHENERGAN VC Generic QL 1 promethazine PHENERGAN Generic

Anti-infective Agents Anthelmintics

2 albendazole ALBENZA Formulary Brand

1 ivermectin STROMECTOL Generic

PA, QL 3 ivermectin SOOLANTRA Non-Formulary Brand

ST 1 praziquantel BILTRICIDE Generic Anti-infectives, Miscellaneous

ST 3 bismuth subcitrate & metronidazole PYLERA Non-Formulary Brand

3 metronidazole, tetracycline & bismuth subsalicylate HELIDAC Non-Formulary

Brand

3 benznidazole benznidazole Non-Formulary Brand

Antibacterials

PA 3 amikacin liposomal Inhalation ARIKAYCE Non-Formulary Brand

1 amoxicillin AMOXIL Generic

1 amoxicillin & clavulanate potassium AUGMENTIN Generic

1 amoxicillin & clavulanate potassium extended-release AUGMENTIN XR Generic

1 ampicillin sodium AMPICILLIN Generic 1 azithromycin ZITHROMAX Generic 1 cefaclor CECLOR Generic 1 cefadroxil DURICEF Generic 1 cefdinir OMNICEF Generic

ST 1 cefditoren SPECTRACEF Generic

3 cefixime SUPRAX Non-Formulary Brand

1 cefixime solution SUPRAX Generic






1 cefpodoxime VANTIN Generic 1 cefprozil CEFZIL Generic 1 cefuroxime axetil CEFTIN Generic 1 cephalexin KEFLEX Generic 1 ciprofloxacin CIPRO Generic 1 clarithromycin BIAXIN Generic 1 clarithromycin extended-release BIAXIN XL Generic 1 clindamycin hcl CLEOCIN HCL Generic

1 clindamycin palmitate CLEOCIN PEDIATRIC Generic

ST 3 delafloxacin BEXDELA Non-Formulary Brand

1 demeclocycline DECLOMYCIN Generic 1 dicloxacillin DYNAPEN Generic

3 doxycycline ORACEA Non-Formulary Brand

1 doxycycline hyclate PERIOSTAT Generic

3 doxycycline hyclate DORYX Non-Formulary Brand

1 doxycycline monohydrate ADOXA Generic 1 doxycycline monohydrate MONODOX Generic 1 erythromycin & sulfisoxazole E.S.P Generic 1 erythromycin base ERYTHROMYCIN Generic

1 erythromycin base delayed-release ERY-TAB Generic

1 erythromycin ethylsuccinate E.E.S. Generic

3 erythromycin ethylsuccinate ERYPED Non-Formulary Brand

3 erythromycin sterate ERYTHROCIN Non-Formulary Brand

ST 3 fidaxomicin DIFICID Non-Formulary Brand

1 gentamicin sulfate GARAMYCIN Generic 1 levofloxacin LEVAQUIN Generic 1 linezolid ZYVOX Generic 1 minocycline DYNACIN Generic 1 minocycline MINOCIN Generic 1 minocycline SOLODYN Generic

ST 1 moxifloxacin AVELOX Generic 1 neomycin sulfate MYCIFRADIN Generic






3 norfloxacin NOROXIN Non-Formulary Brand

1 penicillin v potassium PEN-VEE K Generic

ST 3 omadacycline NUZYRA Non-Formulary Brand

ST, QL (200 mg only) 3 rifaximin XIFAXAN Non-Formulary

Brand 1 sulfadiazine SULFADIAZINE Generic 1 sulfamethoxazole & trimethoprim BACTRIM DS Generic 1 sulfamethoxazole & trimethoprim SEPTRA Generic 1 sulfasalazine AZULFIDINE Generic

ST 3 tedizolid SIVEXTRO Non-Formulary Brand

ST 3 telithromycin KETEK Non-Formulary Brand

1 tetracycline TETRACYCLINE Generic

3 tobramycin inhalation powder TOBI PODHALER Non-Formulary Brand

1 tobramycin inhalation solution TOBI Generic 1 Vancomycin capsule VANCOCIN Generic Antifungals

PA, QL 3 efinaconazole JUBLIA Non-Formulary Brand

QL 1 fluconazole DIFLUCAN Generic 1 flucytosine ANCOBON Generic 1 griseofulvin microsize GRIFULVIN V Generic 1 griseofulvin ultramicrosize GRIS-PEG Generic

3 isavuconazonium CRESEMBA Non-Formulary Brand

1 itraconazole SPORANOX Generic 1 ketoconazole NIZORAL Generic

3 luliconazole LUZU Non-Formulary Brand

1 nystatin MYCOSTATIN Generic

PA 3 posaconazole NOXAFIL Non-Formulary Brand

3 tavaborole KERYDIN Non-Formulary Brand

1 terbinafine LAMISIL Generic 1 voriconazole tablet VFEND Generic






ST 3 voriconazole suspension VFEND Non-Formulary Brand

Antimycobacterials 1 cycloserine SEROMYCIN Generic 1 dapsone AVLOSULFON Generic 1 ethambutol MYAMBUTOL Generic

ST 3 ethionamide TRECATOR Non-Formulary Brand

1 isoniazid NYDRAZID Generic 1 pyrazinamide PYRAZINAMIDE Generic 1 rifabutin MYCOBUTIN Generic 1 rifampin RIFADIN Generic 1 rifampin & isoniazid RIFAMATE Generic

ST 3 rifampin, isoniazid, & pryazinamide RIFATER Non-Formulary Brand

3 rifapentine PRIFTIN Non-Formulary Brand

Antiprotozoals

ST 3 artemether & lumefantrine COARTEM Non-Formulary Brand

1 atovaquone MEPRON Generic ST 1 atovaquone & proguanil MALARONE Generic ST 1 chloroquine phosphate ARALEN Generic 1 hydroxychloroquine sulfate PLAQUENIL Generic

ST 1 mefloquine LARIAM Generic 1 metronidazole FLAGYL Generic

3 metronidazoleextended-release FLAGYL ER Non-Formulary Brand

PA 3 miltefosine IMPAVIDO Non-Formulary Brand

3 nitazoxanide ALINIA Non-Formulary Brand

1 paromomycin sulfate HUMATIN Generic

ST 3 pentamidine NEBUPENT Non-Formulary Brand

2 primaquine phosphate PRIMAQUINE Formulary Brand

PA 3 pyrimethamine DARAPRIM Non-Formulary Brand

ST 1 quinine sulfate QUALAQUIN Generic






ST 3 secnidazole SOLOSEC Non-Formulary Brand

Antiviral QL 1 abacavir sulfate & lamivudine EPZICOM Generic

QL 2 abacavir sulfate solution ZIAGEN Formulary Brand

QL 1 abacavir sulfate tablet ZIAGEN Generic

3 abacavir, dolutegravir & lamivudine TRIUMEQ Non-Formulary

Brand

QL 1 abacavir, lamivudine & zidovudine TRIZIVIR Generic

1 acyclovir ZOVIRAX Generic QL,ST 1 adefovir dipivoxil HEPSERA Generic

3 atazanavir & cobicistat EVOTAZ Non-Formulary Brand

QL 2 atazanavir sulfate 150 mg REYATAZ Formulary Brand

QL 1 atazanavir sulfate 200 mg, 300 mg REYATAZ Generic

QL 2 bictegravir & emtricitabine & tenofovir BIKTARVY Formulary

Brand

QL 3 boceprevir VICTRELIS Non-Formulary Brand

PA 3 daclatasvir DAKLINZA Non-Formulary Brand

2 darunavir & cobicistat PREZCOBIX Non-Formulary Brand

QL 2 darunavir ethanolate PREZISTA Formulary Brand

QL 3 darunavir/cobicistat/FTC/tenofovir SYMTUZA Non-Formulary Brand

QL 2 delavirdine mesylate RESCRIPTOR Formulary Brand

QL 1 didanosine VIDEX EC Generic

QL 2 didanosine solution VIDEX Formulary Brand

2 dolutegravir TIVICAY Formulary Brand

QL 3 dolutegravir & rilpivirine JULUCA Non-Formulary Brand






QL 3 dolutegravir & lamivudine DOVATO Non-Formulary Brand

QL 1 efavirenz 600 mg SUSTIVA Generic

QL 3 efavirenz, emtricitabine & tenofovir ATRIPLA Non-Formulary

Brand

QL 2 efavirenz 600 mg, lamivudine & tenofvir SYMFI Formulary

Brand

QL 3 efavirenz 400 mg, lamivudine & tenofvir SYMFI LO Non-Formulary

Brand

PA 3 elbasvir & grazoprevir ZEPATIER Non-Formulary Brand

QL 3 elvitegravir, cobicistat, emtricitabine, & tenofovir STRIBILD Non-Formulary

Brand

QL 2 elvitegravir, cobicistat, emtricitabine, & tenofovir GENVOYA Formulary

Brand

QL 2 emtricitabine EMTRIVA Formulary Brand

QL 2 emtricitabine & tenofovir TRUVADA Formulary Brand

QL 2 emtricitabine & tenofovir DESCOVY Formulary Brand

QL 3 emtricitabine, rilpivirine, & tenofovir COMPLERA Non-Formulary

Brand

QL 2 emtricitabine, rilpivirine, & tenofovir ODEFSEY Formulary

Brand

QL 2 enfuvirtide FUZEON Formulary Brand

QL 1 entecavir BARACLUDE Generic

QL 2 etravirine INTELENCE Formulary Brand

ST 1 famciclovir FAMVIR Generic

QL 2 fosamprenavir calcium LEXIVA Formulary Brand

1 ganciclovir CYTOVENE Generic

QL, PA 3 glecaprevir & pibrentasvir MAVYRET Non-Formulary Brand

QL 2 indinavir sulfate CRIXIVAN Formulary Brand

3 interferon alfacon-1 INFERGEN Non-Formulary Brand






QL, ST 3 lamivudine EPIVIR HBV Non-Formulary Brand

QL 1 lamivudine EPIVIR Generic

QL 2 Lamidudine & tenofovir CIMDUO Formulary Brand

QL 1 lamivudine & zidovudine COMBIVIR Generic

ST 3 letermovir PREVYMIS Non-Formulary Brand

QL, PA 3 ledipasvir & sofosbuvir HARVONI Non-Formulary Brand

QL 2 lopinavir & ritonavir KALETRA Formulary Brand

QL 2 maraviroc SELZENTRY Formulary Brand

QL 2 nelfinavir mesylate VIRACEPT Formulary Brand

QL 1 nevirapine solution VIRAMUNE Generic QL 1 nevirapine tablet VIRAMUNE Generic

PA 3 ombitasvir, paritaprevir & ritonavir TECHNIVIE Non-Formulary Brand

QL, PA 3 ombitasvir, paritaprevir, ritonavir, & dasabuvir VIEKIRA Non-Formulary

Brand

QL, PA 2 sofosbuvir, velpatasvir, voxilaprevir VOSEVI Formulary Brand

QL 1 oseltamivir phosphate TAMIFLU Generic

3 palivizumab SYNAGIS Non-Formulary Brand

QL 2 peginterferon alfa-2a PEGASYS Formulary Brand

2 peginterferon-alfa 2b PEG-INTRON Formulary Brand

QL 2 raltegravir ISENTRESS Formulary Brand

QL 2 raltegravir (600mg) ISENTRESS HD Formulary Brand

1 ribavirin REBETOL Generic

QL 3 rilpivirine EDURANT Non-Formulary Brand

QL 1 rimantadine FLUMADINE Generic QL 1 ritonavir NORVIR Generic






QL 2 saquinavir mesylate INVIRASE Formulary Brand

QL, PA 3 simeprevir OLYSIO Non-Formulary Brand

QL, PA 3 sofosbuvir SOVALDI Non-Formulary Brand

QL, PA 2 sofosbuvir & velpatasvir EPCLUSA Formulary Brand

QL 1 stavudine ZERIT Generic

QL 3 telaprevir INCIVEK Non-Formulary Brand

ST 3 telbivudine TYZEKA Non-Formulary Brand

QL 3 tenofovir VIREAD Non-Formulary Brand

QL 1 tenofovir 300 mg VIREAD Generic

QL, PA 3 tenofovir alafenamide VEMLIDY Non-Formulary Brand

QL 2 tipranavir APTIVUS Formulary Brand

ST 1 valacyclovir VALTREX Generic 1 valganciclovir VALCYTE Generic

QL 2 zanamivir RELENZA Formulary Brand

QL 1 zidovudine RETROVIR Generic Urinary Antiinfectives

ST 3 fosfomycin MONUROL Non-Formulary Brand

ST 1 methenamine hippurate HIPREX Generic

3

methenamine, sodium biphosphate, phenyl salicylate, methylene blue, and hyoscyamine

URELLE Non-Formulary Brand

2 nitrofurantoin FURADANTIN Formulary Brand

1 nitrofurantoin macrocrystal MACRODANTIN Generic 1 nitrofurantoin monohydrate MACROBID Generic 1 trimethoprim PROLOPRIM Generic

Antineoplastic Agents Antineoplastic Agents






3 abemaciclib VERZENIO Non-Formulary Brand

2 abiraterone ZYTIGA Formulary Brand

3 acalabrutinib CALQUENCE Non-Formulary Brand

QL, PA 3 alpelisib PIQRAY BRAND 1 anastrozole ARIMIDEX Generic

3 axitinib INLYTA Non-Formulary Brand

2 bexarotene TARGRETIN Formulary Brand

1 bicalutamide CASODEX Generic

3 binimetinib MEKTOVI Non-Formulary Brand

3 bosutinib BOSULIF Non-Formulary Brand

2 busulfan MYLERAN Formulary Brand

1 capecitabine XELODA Generic

3 ceritinib ZYKADIA Non-Formulary Brand

2 chlorambucil LEUKERAN Formulary Brand

2 cobimetinib COTELLIC Formulary Brand

2 crizotinib XALKORI Formulary Brand

1 cyclophosphamide CYTOXAN Generic

3 dacomitinib VIZIMPRO Non-Formulary Brand

QL 2 dasatinib SPRYCEL Formulary Brand

QL, PA 3 darolutamide NUBEQA Non-Formulary Brand

3 enasidenib IDHIFA Non-Formulary Brand

3 encorafenib BRAFTOVI Non-Formulary Brand

2 enzalutamide XTANDI Formulary Brand






2 erlotinib TARCEVA Formulary Brand

2 estramustine EMCYT Formulary Brand

QL 2 everolimus AFINITOR Formulary Brand

1 exemestane AROMASIN Generic

3 gilteritinib XOSPATA Non-Formulary Brand

3 glasdegib DAURISMO Non-Formulary Brand

1 flutamide EULEXIN Generic 1 hydroxyurea HYDREA Generic

2 hydroxyurea DROXIA Formulary Brand

QL 2 ibrutinib IMBRUVICA Formulary Brand

QL 3 Ibrutinib 140 mg, 280 mg IMBRUVICA Non-Formulary Brand

2 idelalisib ZYDELIG Formulary Brand

1 imatinib mesylate GLEEVEC Generic

3 ivosidenib TIBSOVO Non-Formulary Brand

2 ixazomib NINLARO Formulary Brand

2 lapatinib TYKERB Formulary Brand

QL 2 lenalidomide REVLIMID Formulary Brand

2 lenvatinib LENVIMA Formulary Brand

1 letrozole FEMARA Generic 1 leuprolide acetate LUPRON Generic

ST 1 lomustine GLEOSTINE Generic

3 lorlatinib LORBRENA Non-Formulary Brand

3 mechlorethamine VALCHLOR Non-Formulary Brand






2 melphalan ALKERAN Formulary Brand

1 mercaptopurine PURINETHOL Generic

3 methotrexate RASUVO Non-Formulary Brand

3 methotrexate OTREXUP Non-Formulary Brand

ST 1 methotrexate sodium RHEUMATREX Generic

3 methotrexate sodium TREXALL Non-Formulary Brand

2 mitotane LYSODREN Formulary Brand

2 nilotinib TASIGNA Formulary Brand

ST 3 nilutamide NILANDRON Non-Formulary Brand

QL 2 niraparib ZEJULA Formulary Brand

QL 2 palbociclib IBRANCE Formulary Brand

2 pazopanib VOTRIENT Formulary Brand

QL 2 pomalidomide POMALYST Formulary Brand

3 ponatinib ICLUSIG Non-Formulary Brand

2 procarbazine MATULANE Formulary Brand

2 regorafenib STIVARGA Formulary Brand

3 ruxolitinib JAKAFI Non-Formulary Brand

2 sorafenib tosylate NEXAVAR Formulary Brand

2 sunitinib malate SUTENT Formulary Brand

3 talazoparib TALZENNA Non-Formulary Brand

1 tamoxifen citrate NOLVADEX Generic 1 temozolomide TEMODAR Generic






2 thioguanine TABLOID Formulary Brand

2 topotecan HYCAMTIN Formulary Brand

ST 1 toremifene FARESTON Generic 1 tretinoin VESANOID Generic

2 trifluidine/tipiracil LONSURF Formulary Brand

2 vandetanib CAPRELSA Formulary Brand

2 vemurafenib ZELBORAF Formulary Brand

2 vorinostat ZOLINZA Formulary Brand

Autonomic Drugs Anticholinergic Agents

1 atropine sulfate ATROPINE SULFATE Generic 1 dicyclomine BENTYL Generic 1 glycopyrrolate ROBINUL Generic 1 glycopyrrolate ROBINULFORTE Generic

3 glycopyrrolate inhalation pow SEEBRI NEOHALER Non-Formulary Brand

ST 3 glycopyrrolate nebulizer soln LONHALA MAGNAIR

Non-Formulary Brand

1 hyoscyamine sulfate LEVBID Generic 1 hyoscyamine sulfate LEVSIN Generic 1 hyoscyamine sulfate SYMAX Generic

3 hyoscyamine sulfate SYMAX DUOTAB Non-Formulary Brand

1 ipratropium bromide ATROVENT Generic

2 ipratropium bromide ATROVENT HFA Formulary Brand

ST 1 methscopolamine PAMINE Generic 1 propantheline bromide PRO-BANTHINE Generic

ST 3 revefenacin YUPELRI Non-Formulary Brand

3 tiotropium SPIRIVA Non-Formulary Brand

2 tiotropium 2.5 mcg SPIRIVA RESPIMAT Formulary Brand






3 tiotropium 1.25 mcg SPIRIVA RESPIMAT Non-Formulary Brand

3 umeclidinium INCRUSE ELLIPTA Non-Formulary Brand

Smoking Cessation Agents 1 nicotine gum NICORETTE Generic 1 nicotine lozenge NICORETTE Generic 1 nicotine patch NICODERM Generic

ST 3 nicotine spray NICOTROL Non-Formulary Brand

ST 3 varenicline CHANTIX Non-Formulary Brand

Parasympathomimetic (Cholinergic) Agents 1 bethanechol chloride URECHOLINE Generic 1 cevimeline hcl EVOXAC Generic 1 donepezil ARICEPT Generic 1 donepezil ARICEPT ODT Generic 1 galantamine hydrobromide RAZADYNE Generic 1 galantamine hydrobromide RAZADYNEER Generic 1 neostigmine bromide PROSTIGMIN Generic

ST 1 pilocarpine SALAGEN Generic 1 pyridostigmine MESTION TIMESPAN Generic 1 pyridostigmine MESTION Generic 1 rivastigmine tartrate EXELON Generic

2 rivastigmine tartrate (solution) EXELON Formulary Brand

Skeletal Muscle Relaxants 1 baclofen LIORESAL Generic

ST 1 carisoprodol SOMA Generic

ST 1 carisoprodol & aspirin SOMA COMPOUND Generic

1 chlorzoxazone PARAFON FORTE DSC Generic

1 cyclobenzaprine FLEXERIL Generic

3 cyclobenzaprine extended-release AMRIX Non-Formulary

Brand 1 dantrolene sodium DANTRIUM Generic

ST 1 metaxalone SKELAXIN Generic 1 methocarbamol ROBAXIN Generic 1 orphenadrine citrate NORFLEX Generic






1 orphenadrine, aspirin, & caffeine NORGESIC Generic 1 tizanidine ZANAFLEX Generic Sympatholytic (Adrenergic Blocking) Agents

1 alfuzosin UROXATRAL Generic 1 dihydroergotamine mesylate D.H.E.45 Generic

2 dihydroergotamine mesylate MIGRANAL Formulary Brand

1 ergoloid mesylates HYDERGINE Generic 1 ergotamine & caffeine CAFERGOT Generic

ST 1 phenoxybenzamine DIBENZYLINE Generic

ST 3 silodosin RAPAFLO Non-Formulary Brand

1 tamsulosin hcl FLOMAX Generic Sympathomimetic (Adrenergic) Agents

1 albuterol nebulizer solution ACCUNEB Generic

3 albuterol sulfate PROAIR HFA Non-Formulary Brand

3 albuterol sulfate PROVENTIL HFA Non-Formulary Brand

2 albuterol sulfate VENTOLIN HFA Formulary Brand

3 albuterol sulfate & ipratropium COMBIVENT RESPIMAT

Non-Formulary Brand

1 albuterol sulfate & ipratropium DUONEB Generic 1 albuterol sulfate tablet VOSPIRE ER Generic

3 arformoterol BROVANA Non-Formulary Brand

3 droxidopa NORTHERA Non-Formulary Brand

1 epinephrine ADRENACLICK Generic

3 epinephrine AUVI-Q Non-Formulary Brand

3 epinephrine EPIPEN Non-Formulary Brand

3 epinephrine EPIPEN JR Non-Formulary Brand

3 epinephrine TWINJECT Non-Formulary Brand

3 formoterol fumarate FORADIL Non-Formulary Brand






ST 1 levalbuterol nebulizer solution XOPENEX NEBULIZER Generic

ST 1 levalbuterol tartrate XOPENEX HFA Generic 1 midodrine hcl PROAMATINE Generic

2 olodaterol STRIVERDI RESPIMAT Formulary Brand

ST 3 pirbuterol acetate MAXAIR AUTOHALER

Non-Formulary Brand

1 terbutaline sulfate BRETHINE Generic

3 umeclidinium & vilanterol ANORO ELLIPTA Non-Formulary Brand

Blood Formation, Coagulation, and Thrombosis Coagulants and Anticoagulants

2 aminocaproic acid AMICAR Formulary Brand

1 anagrelide AGRYLIN Generic

ST 3 apixaban ELIQUIS Non-Formulary Brand

1 aspirin & dipyridamole AGGRENOX Generic

ST 3 betrixaban BEVYXXA Non-Formulary Brand

1 cilostazol PLETAL Generic 2 clopidogrel PLAVIX Generic

QL 2 dabigatran PRADAXA Formulary Brand

ST 3 dalteparin FRAGMIN Non-Formulary Brand

1 dipyridamole PERSANTINE Generic

ST 3 edoxaban SAVAYSA Non-Formulary Brand

1 enoxaparin LOVENOX Generic ST 1 fondaparinux ARIXTRA Generic 1 heparin HEPARIN SODIUM Generic 1 pentoxifylline TRENTAL Generic 1 prasugrel EFFIENT Generic

QL, ST 3 rivaroxaban XARELTO Non-Formulary Brand

2 ticagrelor BRILINTA Formulary Brand

ST 1 tranexamic acid LYSTEDA Generic






3 vorapaxar ZONTIVITY Non-Formulary Brand

1 warfarin COUMADIN Generic Hematopoietic Agents

2 darbepoetin alfa ARANESP Formulary Brand

2 eltrombopag PROMACTA Formulary Brand

2 epoetin alfa PROCRIT Formulary Brand

3 epoetin alfa EPOGEN Non-Formulary Brand

3 filgrastim NEUPOGEN Non-Formulary Brand

2 filgrastim ZARXIO Formulary Brand

2 oprelvekin NEUMEGA Formulary Brand

3 pegfilgrastim NEULASTA Non-Formulary Brand

3 pegfilgrastim-jmdb FULPHILA Non-Formulary Brand

2 sargramostim LEUKINE Formulary Brand

Cardiovascular Drugs α-Adrenergic Blocking Agents

1 doxazosin CARDURA Generic

2 prazosin MINIPRESS Non-Formulary Brand

1 terazosin HYTRIN Generic Antilipemic Agents

1 atorvastatin LIPITOR Generic 1 cholestyramine light QUESTRAN LIGHT Generic 1 cholestyramine QUESTRAN Generic

ST 1 colesevelam WELCHOL Generic 1 colestipol COLESTID Generic 1 ezetimibe ZETIA Generic

3 ezetimibe & simvastatin VYTORIN Non-Formulary Brand

1 fenofibrate LOFIBRA TAB Generic






1 fenofibrate TRICOR Generic 1 fenofibrate, micronized LOFIBRA CAP Generic 1 fenofibric acid TRILIPIX Generic

ST 1 fluvastatin extended-release LESCOL XL Generic ST 1 fluvastatin LESCOL Generic 1 gemfibrozil LOPID Generic

ST 3 icosapent VASCEPA Non-Formulary Brand

PA 3 lomitapide JUXTAPID Non-Formulary Brand

1 lovastatin MEVACOR Generic

3 lovastatine extended-release ALTOPREV Non-Formulary Brand

PA 3 mipomersen sodium KYNAMRO Non-Formulary Brand

ST 1 niacin NIASPAN Generic

3 niacin & lovastatin ADVICOR Non-Formulary Brand

1 omega-3 acid ethyl esters LOVAZA Generic

3 omega-3-carboxylic acid EPANOVA Non-Formulary Brand

ST 3 pitavastatin LIVALO Non-Formulary Brand

1 pravastatin PRAVACHOL Generic 1 rosuvastatin CRESTOR Generic 1 simvastatin ZOCOR Generic Calcium Channel Blocking Agents

1 amlodipine NORVASC Generic 1 amlodipine & benazepril LOTREL Generic 1 amlodipine & atorvastatin CADUET Generic

3 amlodipine & olmesartan AZOR Non-Formulary Brand

ST 1 amlodipine & telmisartan TWYNSTA Generic ST 1 amlodipine & valsartan EXFORGE Generic

ST 1 amlodipine, valsartan & hydrochlorothiazide EXFORGE HCT Generic

1 amlodipine, olmesartan & hydrochlorothiazide TRIBENZOR Generic

1 diltiazem extended-release CARDIZEM CD Generic 1 diltiazem extended-release TIAZAC Generic






1 diltiazem extended-release CARTIA XT Generic 1 diltiazem extended-release CARDIZEM LA Generic 1 diltiazem CARDIZEM Generic 1 felodipine PLENDIL Generic

ST 1 isradipine DYNACIRC Generic 1 nicardipine CARDENE Generic 1 nifedipine PROCARDIA Generic 1 nifedipine extended-release ADALAT CC Generic 1 nifedipine extended-release PROCARDIA XL Generic 1 nimodipine NIMOTOP Generic

ST 1 nisoldipine SULAR Generic 1 trandolapril & verapamil TARKA Generic 1 verapamil sustained-release cap VERELAN Generic

3 verapamil COVERA-HS Non-Formulary Brand

1 verapamil extended-release cap VERELAN PM Generic 1 verapamil sustained-release cap CALAN SR Generic 1 verapamil sustained-release tab ISOPTIN SR Generic Cardiac Drugs

1 amiodarone PACERONE Generic 1 digoxin LANOXIN Generic 1 disopyramide NORPACE Generic

2 disopyramide controlled-release NORPACE CR Formulary Brand

1 dofetilide TIKOSYN Generic

ST 3 dronedarone MULTAQ Non-Formulary Brand

1 flecainide TAMBOCOR Generic

3 Ivabradine CORLANOR Non-Formulary Brand

1 mexiletine MEXITIL Generic 1 propafenone RYTHMOL Generic

3 propafenone RYTHMOL SR Non-Formulary Brand

1 quinidine gluconate QUINAGLUTE Generic 1 quinidine QUINIDINE SULFATE Generic

QL 1 ranolazine RANEXA Generic

3 sacubitril & valsartan ENTRESTO Non-Formulary Brand

Hypotensive Agents






ST 1 clonidine extended-release KAPVAY Generic 1 clonidine CATAPRES Generic 1 clonidine transdermal CATAPRES-TTS Generic 1 guanfacine TENEX Generic 1 hydralazine APRESOLINE Generic 1 methyldopa ALDOMET Generic

1 methyldopa & hydrochlorothiazide ALDORIL-25 Generic

1 minoxidil LONITEN Generic

3 reserpine SERPASIL Non-Formulary Brand

Renin-Angiotensin-Aldosterone System Inhibitors

ST 3 aliskiren TEKTURNA Non-Formulary Brand

ST 3 aliskiren, amlodipine & hydrochlorothiazide AMTURNIDE Non-Formulary

Brand

3 aliskiren & amlodipine TEKAMLO Non-Formulary Brand

ST 3 aliskiren & hydrochlorothiazide TEKTURNA HCT Non-Formulary Brand

3 aliskiren & valsartan VALTURNA Non-Formulary Brand

ST 3 azilsartan EDARBI Non-Formulary Brand

1 benazepril LOTENSIN Generic 1 benazepril & hydrochlorothiazide LOTENSIN HCT Generic

ST 1 candesartan ATACAND Generic

ST 1 candesartan & hydrochlorothiazide ATACAND HCT Generic

1 captopril CAPOTEN Generic 1 captopril & hydrochlorothiazide CAPOZIDE Generic 1 enalapril VASOTEC Generic 1 enalapril & hydrochlorothiazide VASERETIC Generic

ST 1 eplerenone INSPRA Generic

ST 3 eprosartan TEVETEN Non-Formulary Brand

3 eprosartan & hydrochlorothiazide TEVETEN Non-Formulary Brand

ST 1 fosinopril MONOPRIL Generic ST 1 fosinopril & hydrochlorothiazide MONOPRIL HCT Generic






ST 1 irbesartan AVAPRO Generic ST 1 irbesartan & hydrochlorothiazide AVALIDE Generic 1 lisinopril ZESTRIL Generic 1 lisinopril & hydrochlorothiazide ZESTORETIC Generic 1 losartan COZAAR Generic 1 losartan & hydrochlorothiazide HYZAAR Generic

ST 1 moexipril UNIVASC Generic ST 1 moexipril & hydrochlorothiazide UNIRETIC Generic ST 1 olmesartan BENICAR Generic ST 1 olmesartan & hydrochlorothiazide BENICAR HCT Generic ST 1 perindopril ACEON Generic ST 1 quinapril hcl ACCUPRIL Generic ST 1 quinapril & hydrochlorothiazide ACCURETIC Generic 1 ramipril ALTACE Generic

1 spironolactone & hydrochlorothiazide ALDACTAZIDE Generic

1 spironolactone ALDACTONE Generic ST 1 telmisartan MICARDIS Generic ST 1 telmisartan & hydrochlorothiazide MICARDIS HCT Generic ST 1 trandolapril MAVIK Generic ST 1 valsartan DIOVAN Generic ST 1 valsartan & hydrochlorothiazide DIOVAN HCT Generic

Vasodilating Agents

2 ambrisentan LETAIRIS Formulary Brand

2 bosentan TRACLEER Formulary Brand

3 isosorbide dinitrate & hydralazine BIDIL Non-Formulary Brand

1 isosorbide dinitrate ISORDIL Generic 1 isosorbide mononitrate IMDUR Generic

2 macitentan OPSUMIT Formulary Brand

3 nitroglycerin aerosol NITROMIST Non-Formulary Brand

1 nitroglycerin solution NITROLINGUAL Generic 1 nitroglycerin sublingual NITROSTAT Generic

2 nitroglycerin topical ointment NITRO-BID Formulary Brand

1 nitroglycerin transdermal patch NITRO-DUR Generic






2 nitroglycerin transdermal patch 0.8 mg strength NITRO-DUR Formulary

Brand

ST 3 nitroglycerin (intra-anal) RECTIV Non-Formulary Brand

1 papaverine PAVABID Generic

3 riociguat ADEMPAS Non-Formulary Brand

1 sildenafil REVATIO Generic

3 tadalafil ADCIRCA Non-Formulary Brand

3 treprostinil ORENITRAM Non-Formulary Brand

2 treprostinil REMODULIN Formulary Brand

β-Adrenergic Blocking Agents 1 acebutolol SECTRAL Generic 1 atenolol TENORMIN Generic 1 atenolol & chlorthalidone TENORETIC Generic

ST 1 betaxolol KERLONE Generic 1 bisoprol & hydrochlorothiazide ZIAC Generic 1 bisoprolol ZEBETA Generic

1 carvedilol COREG Generic

3 carvedilol phosphate COREG CR Non-Formulary Brand

1 labetalol TRANDATE Generic 1 metoprol & hydrochlorothiazide LOPRESSOR HCT Generic 1 metoprolol succinate TOPROL XL Generic 1 metoprolol tartrate LOPRESSOR Generic 1 nadolol CORGARD Generic 1 nadolol & bendroflumethiazide CORZIDE Generic

ST 3 nebivolol BYSTOLIC Non-Formulary Brand

ST 3 penbutolol LEVATOL Non-Formulary Brand

ST 1 pindolol VISKEN Generic 1 propranolol & hydrochlorothiazide INDERIDE Generic

3 propranolol extended-release INNOPRAN XL Non-Formulary Brand

1 propranolol INDERAL Generic 1 propranolol sustained-release INDERAL LA Generic






1 sotalol BETAPACE Generic 1 sotalol BETAPACE AF Generic 1 timolol BLOCADREN Generic

Central Nervous System Agents Analgesics and Antipyretics

1 acetaminophen & codeine TYLENOL W/ CODEINE Generic

1 acetaminophen, caffeine, & dihydrocodine PANLOR SS Generic

1 buprenorphine SUBUTEX Generic QL 1 buprenorphine& naloxone tablet SUBOXONE Generic

QL 3 buprenorphine & naloxone film SUBOXONE Non-Formulary Brand

QL, ST 1 buprenorphine transdermal BUTRANS Generic 1 butalbital & acetaminophen PHRENILIN Generic

3 butalbital & acetaminophen PHRENILIN FORTE Non-Formulary Brand

1 butalbital, acetaminophen, & caffeine FIORICET Generic

1 butalbital, acetaminophen, caffeine, & codeine

FIORICET W/ CODEINE Generic

1 butalbital, aspirin, & caffeine FIORINAL Generic

1 butalbital, aspirin, caffeine, & codeine

FIORINAL W/ CODEINE Generic

1 butorphanol tartrate STADOL Generic

ST 1 carisoprodol, aspirin, & codeine SOMA COMPOUND W/ CODEINE

Generic

ST 1 celecoxib CELEBREX Generic ST 1 codeine CODEINE SULF Generic 1 diclofenac potassium CATAFLAM Generic 1 diclofenac sodium VOLTAREN Generic 1 diclofenac sodium PENNSAID Generic 2 diclofenac sodium & misoprostol ARTHROTEC Generic

1 diclofenac sodium extended release VOLTAREN XR Generic

ST 1 diflunisal DIFLUNISAL Generic 1 etodolac LODINE Generic

ST 3 fenoprofen calcium NALFON Non-Formulary Brand






3 fentanyl film ONSOLIS Non-Formulary Brand

3 fentanyl intranasal LAZANDA Non-Formulary Brand

1 fentanyl lozenge ACTIQ Generic

3 fentanyl sublingual ABSTRAL Non-Formulary Brand

3 fentanyl tablet FENTORA Non-Formulary Brand

QL 1 fentanyl transdermal DURAGESIC Generic ST 1 flurbiprofen ANSAID Generic

ST 3 hydrocodone ZOHYDRO ER Non-Formulary Brand

3 hydrocodone er HYSINGLA ER Non-Formulary Brand

1 hydrocodone & acetaminophen NORCO Generic 1 hydrocodone & ibuprofen VICOPROFEN Generic

3 hydromorphone oral suspension DILAUDID Non-Formulary Brand

1 hydromorphone tablet DILAUDID Generic

ST 3 hydromorphone tablet EXALGO Non-Formulary Brand

1 ibuprofen MOTRIN Generic 1 indomethacin INDOCIN Generic 1 ketoprofen KETOPROFEN Generic

QL 1 ketorolac tablet TORADOL Generic ST 1 levorphanol LEVO-DROMORAN Generic ST 1 meclofenamate MECLOMEN Generic

QL, ST 1 mefenamic acid PONSTEL Generic 1 meloxicam MOBIC Generic 1 meperidine tablet DEMEROL Generic 1 methadone DOLOPHINE Generic

2 morphine MORPHINE SULFATE Formulary Brand

1 morphine MSIR Generic

3 morphine beads AVINZA Non-Formulary Brand

3 morphine extended-relase capsule KADIAN Non-Formulary

Brand 1 morphine extended-release tablet MS CONTIN Generic






ST 3 morphine & naltrexone EMBEDA Non-Formulary Brand

1 nabumetone RELAFEN Generic 1 nalbuphine NUBAIN Generic 1 naproxen NAPROSYN Generic 1 naproxen sodium ANAPROX Generic

3 naproxen sodium NAPRELAN Non-Formulary Brand

1 opium & belladonna alkaloids B & O SUPPRETTES Generic

3 opium tincture OPIUM Non-Formulary Brand

ST 1 oxaprozin DAYPRO Generic ST 1 oxycodone ROXICODONE Generic 1 oxycodone & acetaminophen PERCOCET Generic

2 oxycodone & acetaminophen ROXICET Formulary Brand

3 oxycodone & acetaminophen er XARTEMIS XR Non-Formulary Brand

1 oxycodone & aspirin PERCODAN Generic

QL 3 oxycodone & ibuprofen COMBUNOX Non-Formulary Brand

QL, ST 1 oxycodone controlled-release OXYCONTIN Generic ST 1 oxymorphone OPANA Generic ST 1 oxymorphone extended-release OPANA ER Generic 1 pentazocine & naloxone TALWIN NX Generic

ST 1 piroxicam FELDENE Generic 1 salsalate DISALCID Generic 1 sulindac CLINORIL Generic

QL, ST 3 tapentadol NUCYNTA Non-Formulary Brand

1 tolmetin sodium TOLECTIN 600 Generic 1 tramadol ULTRAM Generic 1 tramadol & acetaminophen ULTRACET Generic

ST 1 tramadol extended-release ULTRAM ER Generic Anorexigenic Agents and Respiratory and Cerebral Stimulants

ST 3 amphetamine sulfate EVEKEO Non-Formulary Brand

ST 3 amphetamine extended-release ADZENYS ER Non-Formulary Brand






1 amphetamine & dextroamphetamine ADDERALL Generic

1 amphetamine & dextroamphetamine extended-release

ADDERALL XR Generic

ST 3 amphetamine & dextroamphetamine extended-release

MYDAYIS Non-Formulary Brand

QL, ST (ST-Brand

only) 1 armodafinil NUVIGIL Generic

QL 1 dexmethylphenidate FOCALIN Generic

ST 1 dexmethylphenidate extended-release FOCALIN XR Generic

QL 1 dextroamphetamine sulfate DEXTROSTAT Generic

QL 1 dextroamphetamine sulfate extended-release DEXEDRINE Generic

QL, ST 3 lisdexamfetamine VYVANSE Non-Formulary Brand

ST 1 methamphetamine DESOXYN Generic 1 methylphenidate METHYLIN Generic 1 methylphenidate RITALIN Generic

QL 1 methylphenidate extended-release METADATE ER Generic

QL 1 methylphenidate extended-release CONCERTA Generic

1 methylphenidate extended-release METADATE CD Generic

QL, ST 1 methylphenidate extended-release RITALIN LA Generic

QL 1 methylphenidate sustained release RITALIN SR Generic

QL, ST 3 methylphenidate transdermal patch DAYTRANA Non-Formulary

Brand

ST Methylphenidate extended-relesase disintegrating tablet COTEMPLA XR-ODT Non-Formulary

Brand QL 1 modafinil PROVIGIL Generic

Anticonvulsants 1 carbamazepine TEGRETOL Generic

1 carbamazepine extended-release cap CARBATROL Generic






3 carbamazepine extended-release cap EQUETRO Non-Formulary

Brand

1 carbamazepine extended-release tab TEGRETOL XR Generic

3 clobazam ONFI Non-Formulary Brand

1 clonazepam KLONOPIN Generic 1 diazepam DIASTAT Generic

2 diazepam DIASTAT ACUDIAL Formulary Brand

1 divalproex sodium DEPAKOTE Generic

1 divalproex sodium capsule DEPAKOTE SPRINKLE Generic

1 divalproex sodium extended release DEPAKOTE ER Generic

3 eslicarbazepine APTIOM Non-Formulary Brand

ST 3 ethontoin PEGANONE Non-Formulary Brand

1 ethosuximide ZARONTIN Generic

ST 3 ezogaine POTIGA Non-Formulary Brand

ST 1 felbamate FELBATOL Generic 1 gabapentin NEURONTIN Generic

ST 3 gabapentin HORIZANT Non-Formulary Brand

QL, ST 3 lacosamide VIMPAT Non-Formulary Brand

1 lamotrigine LAMICTAL Generic 1 lamotrigine extended-release LAMICTAL XR Generic 1 levetiracetam KEPPRA Generic 1 levetiracetam extended-release KEPPRA XR Generic

2 methsuximide CELONTIN Formulary Brand

1 oxcarbazepine TRILEPTAL Generic

3 perampanel FYCOMPA Non-Formulary Brand

1 phenytoin sodium extended-release DILANTIN Generic






1 phenytoin sodium extended-release PHENYTEK Generic

1 phenytoin suspension DILANTIN Generic ST 1 pregabalin LYRICA Generic 1 primidone MYSOLINE Generic

ST 3 rufinamide BANZEL Non-Formulary Brand

ST 1 tiagabine GABITRIL Generic

1 topiramate capsule TOPAMAX SPRINKLE Generic

1 topiramate tablet TOPAMAX Generic 1 valproate sodium DEPAKENE Generic 1 valproic acid DEPAKENE Generic

PA 3 vigabatrin SABRIL Non-Formulary Brand

1 zonisamide ZONEGRAN Generic Antimigraine Agents

ST 1 almotriptan AXERT Generic 1 ergotamine & caffeine MIGERGOT Generic

ST 1 eletriptan RELPAX Generic ST 1 frovatriptan FROVA Generic 1 naratriptan AMERGE Generic 1 rizatriptan MAXALT Generic 1 rizatriptan orally disintegrating MAXALT MLT Generic 1 sumatriptan IMITREX Generic

ST 1 zolmitriptan ZOMIG Generic 1 zolmitriptan orally disintegrating ZOMIG ZMT Generic Antiparkinsonian Agents

1 amantadine SYMMETREL Generic

ST 3 amantadine ER GOCOVRI Non-Formulary Brand

ST 3 apomorphine APOKYN Non-Formulary Brand

1 benztropine COGENTIN Generic 1 bromocriptine PARLODEL Generic

ST 3 bromocriptine CYCLOSET Non-Formulary Brand

1 cabergoline DOSTINEX Generic

ST 3 carbidopa LODOSYN Non-Formulary Brand






1 carbidopa & levodopa SINEMET Generic

3 carbidopa & levodopa PARCOPA Non-Formulary Brand

1 carbidopa & levodopa extended release SINEMET CR Generic

2 carbidopa, levodopa, & entacapone STALEVO Formulary

Brand 1 entacapone COMTAN Generic 1 pramipexole MIRAPEX Generic 1 pramipexole extended-release MIRAPEX ER Generic

ST 3 rasagiline AZILECT Non-Formulary Brand

1 ropinirole REQUIP Generic ST 1 ropinirole extended-release REQUIP XL Generic

ST 3 rotigotine NEUPRO Non-Formulary Brand

1 selegiline ELDEPRYL Generic

ST 3 selegiline ZELAPAR Non-Formulary Brand

ST 3 selegiline transdermal EMSAM Non-Formulary Brand

2 tolcapone TASMAR Formulary Brand

1 trihexyphenidyl ARTANE Generic Anxiolytics, Sedatives, and Hypnotics

1 alprazolam XANAX Generic 1 alprazolam extended-release XANAX XR Generic

3 alprazolam orally disintegrating NIRAVAM Non-Formulary Brand

1 buspirone BUSPAR Generic 1 chlordiazepoxide LIBRIUM Generic 1 clorazepate TRANXENE Generic 1 diazepam VALIUM Generic

ST 3 doxepin (sleep) SILENOR Non-Formulary Brand

1 estazolam PROSOM Generic ST 1 eszopiclone LUNESTA Generic 1 flurazepam DALMANE Generic 1 hydroxyzine hcl ATARAX Generic

ST 1 hydroxyzine pamoate VISTARIL Generic






1 lorazepam ATIVAN Generic 1 meprobamate MILTOWN Generic 1 oxazepam SERAX Generic 1 phenobarbital PHENOBARBITAL Generic

ST 1 ramelteon ROZEREM Generic

3 suvorexant BELSOMRA Non-Formulary Brand

PA 3 tasimelteon HETLIOZ Non-Formulary Brand

1 temazepam RESTORIL Generic 1 triazolam HALCION Generic 1 zaleplon SONATA Generic

3 zolipdem sublingual EDLUAR Non-Formulary Brand

1 zolpidem AMBIEN Generic

3 zolpidem extended-release AMBIEN CR Non-Formulary Brand

3 zolpidem oral spray ZOLPIMIST Non-Formulary Brand

Central Nervous System Agents Miscellaneous ST 1 acamprosate CAMPRAL Generic

ST 3 atomoxetine STRATTERA Non-Formulary Brand

PA 3 cannabidiol EPIDIOLEX Non-Formulary Brand

PA 3 deutetrabenazine AUSTEDO Non-Formulary Brand

ST 3 dextromethorphan & quinidine NUEDEXTA Non-Formulary Brand

1 guanfacine extended-release INTUNIV Generic

ST 3 lofexidine LUCEMYRA Non-Formulary Brand

1 memantine NAMENDA Generic

3 memantine er & donepezil NAMZARIC Non-Formulary Brand

QL, ST 3 milnacipran SAVELLA Non-Formulary Brand

1 riluzole RILUTEK Generic

PA solriamfetol SUNOSI Non-Formulary Brand






PA 3 sodium oxybate XYREM Non-Formulary Brand

PA 3 tetrabenazine XENAZINE Non-Formulary Brand

PA 3 valbenazine INGREZZA Non-Formulary Brand

Opioid Antagonists 1 naloxone NARCAN Generic

QL 2 naloxone nasal spray NARCAN Formulary Brand

1 naltrexone REVIA Generic Psychotherapeutic Agents

1 amitriptyline ELAVIL Generic 1 amitriptyline & perphenazine TRIAVIL Generic 1 amoxapine ASENDIN Generic 1 aripiprazole tablet ABILIFY Generic

ST 3 aripiprazole solution ABILIFY Non-Formulary Brand

ST 3 aripiprazole ABILIFY DISCMELT Non-Formulary Brand

ST 3 asenapine SAPHRIS Non-Formulary Brand

QL, ST 3 brexpiprazole REXULTI Non-Formulary Brand

1 bupropion WELLBUTRIN Generic 1 bupropion extended-release WELLBUTRIN XL Generic

ST 3 bupropion hydrobromide APLENZIN Non-Formulary Brand

1 bupropion sustained-release WELLBUTRIN SR Generic

ST 3 bupropion (smoking deterrent) ZYBAN Non-Formulary Brand

QL, ST 3 cariprazine VRAYLAR Non-Formulary Brand

1 chlordiazepoxide & amitriptyline LIMBITROL DS Generic 1 chlorpromazine THORAZINE Generic 1 citalopram CELEXA Generic 1 clomipramine ANAFRANIL Generic 1 clozapine CLOZARIL Generic 1 clozapine FAZACLO Generic 1 desipramine NORPRAMIN Generic






ST 1 desvenlafaxine succinate extended release PRISTIQ Generic

ST 1 desvenlafaxine extended release KHEDEZLA Generic 1 doxepin SINEQUAN Generic 1 duloxetine CYMBALTA Generic 1 escitalopram LEXAPRO Generic 1 fluoxetine PROZAC Generic

3 fluoxetine PROZAC WEEKLY Non-Formulary Brand

3 fluoxetine SARAFEM Non-Formulary Brand

1 fluphenazine PROLIXIN Generic 1 fluvoxamine LUVOX Generic 1 haloperidol HALDOL Generic

ST 3 iloperidone FANAPT Non-Formulary Brand

1 imipramine TOFRANIL Generic 1 imipramine pamoate TOFRANIL-PM Generic

ST 3 isocarboxazid MARPLAN Non-Formulary Brand

QL 3 levomilnacipran FETZIMA Non-Formulary Brand

1 lithium carbonate capsule LITHIUM CARBONATE Generic 1 lithium carbonate extended release LITHOBID Generic 1 lithium citrate CIBALITH-S Generic

ST 1 loxapine LOXITANE Generic

QL, ST 3 lurasidone LATUDA Non-Formulary Brand

ST 1 maprotiline LUDIOMIL Generic 1 mirtazapine REMERON Generic 1 nefazodone SERZONE Generic 1 nortriptyline PAMELOR Generic 1 olanzapine ZYPREXA Generic 1 olanzapine & fluoxetine hcl SYMBYAX Generic 1 olanzapine orally disintegrating ZYPREXA ZYDIS Generic

ST 1 paliperidone INVEGA Generic 1 paroxetine PAXIL Generic

3 paroxetine extended-release PAXIL CR Non-Formulary Brand






3 paroxetine mesylate PEXEVA Non-Formulary Brand

1 perphenazine TRILAFON Generic 1 phenelzine NARDIL Generic

PA 3 pimavanserin NUPLAZID Non-Formulary Brand

ST 1 pimozide ORAP Generic ST 3 protriptyline VIVACTIL Generic 1 quetiapine SEROQUEL Generic 3 quetiapine extended-release SEROQUEL XR Generic 1 risperidone RISPERDAL Generic

3 risperidone orally disintegrating RISPERDALM-TAB Non-Formulary Brand

1 sertraline ZOLOFT Generic 1 thioridazine MELLARIL Generic 1 thiothixene NAVANE Generic 1 tranylcypromine sulfate PARNATE Generic 1 trazodone DESYREL Generic

3 trazodone extended-release OLEPTRO Non-Formulary Brand

1 trifluoperazine STELAZINE Generic ST 3 trimipramine SURMONTIL Generic 1 venlafaxine EFFEXOR Generic 1 venlafaxine extended-release EFFEXOR XR Generic

QL, ST 3 vilazodone VIIBRYD Non-Formulary Brand

QL, ST 3 vortioxetine TRINTELLIX Non-Formulary Brand

1 ziprasidone GEODON Generic Diabetic Supplies

Diabetic Supplies

QL 3 blood sugar diagnostic ONE TOUCH ULTRA TEST STRIPS

Non-Formulary Brand

QL 1 blood sugar diagnostic ONE TOUCH VERIO TEST STRIPS

Formulary Brand

QL 3 blood sugar diagnostic ACCU-CHEK TEST STRIPS

Non-Formulary Brand

QL 3 blood sugar diagnostic ASCENSIA TEST STRIPS

Non-Formulary Brand






QL 3 blood sugar diagnostic FREESTYLE TEST STRIPS

Non-Formulary Brand

QL 3 blood sugar diagnostic PRODIGY TEST STRIPS

Non-Formulary Brand

QL 3 blood-glucose meter ONE TOUCH ULTRA 2

Non-Formulary Brand

QL 1 blood-glucose meter ONE TOUCH VERIO FLEX

Formulary Brand

QL 3 blood-glucose meter ACCU-CHEK Non-Formulary Brand

QL 3 blood-glucose meter ASCENSIA BREEZE Non-Formulary Brand

QL 3 blood-glucose meter FREESTYLE SYSTEM Non-Formulary Brand

QL 3 blood-glucose meter ONE TOUCH ULTRA SMART

Non-Formulary Brand

QL 3 blood-glucose meter ONE TOUCH ULTRAMINI

Non-Formulary Brand

QL 3 blood-glucose meter PRODIGY Non-Formulary Brand

QL 1 syringe with needle,disposable BD INSULIN SYRINGE Generic

Electrolytic, Caloric and Water Balance Acidifying and Alkalinizing Agents

3 citric acid, sodium citrate, & potassium citrate CYTRA-3 Non-Formulary

Brand 1 potassium citrate UROCIT-K Generic

2 potassium citrate & citric acid POLYCITRA-K Formulary Brand

3 sodium citrate & citric acid BICITRA Non-Formulary Brand

Ammonia Detoxicants

ST 3 carglumic acid CARBAGLU Non-Formulary Brand

PA 3 glycerol phenylbutyrate RAVICTI Non-Formulary Brand

3 sodium phenylbutyrate BUPHENYL Non-Formulary Brand

3 lactulose CHRONULAC Non-Formulary Brand

1 lactulose ENULOSE Generic






3 lactulose KRISTALOSE Non-Formulary Brand

Diuretics ST 1 amiloride MIDAMOR Generic 1 amiloride & hydrochlorothiazide MODURETIC Generic 1 bumetanide BUMEX Generic

ST 1 chlorothiazide DIURIL Generic 1 chlorthalidone HYGROTON Generic

ST 3 ethacrynic acid EDECRIN Non-Formulary Brand

1 furosemide LASIX Generic 1 hydrochlorothiazide MICROZIDE Generic 1 indapamide LOZOL Generic

ST 1 methyclothiazide METHYCLOTHIAZIDE Generic 1 metolazone ZAROXOLYN Generic

PA 3 tolvaptan JYNARQUE Non-Formulary Brand

QL 3 tolvaptan SAMSCA Non-Formulary Brand

1 torsemide DEMADEX Generic

ST 3 triamterene DYRENIUM Non-Formulary Brand

1 triamterene & hydrochlorothiazide DYAZIDE Generic 1 triamterene & hydrochlorothiazide MAXZIDE Generic Ion-Removing Agnets

ST 1 sevelamer carbonate RENVELA Generic 1 sodium polystyrene sulfonate SPS Generic

3 sucroferric oxyhydroxide VELPHORO Non-Formulary Brand

ST 3 lanthanum carbonate FOSRENOL Non-Formulary Brand

3 patiromer VELTASSA Non-Formulary Brand

1 sevelamer hcl RENAGEL Generic

ST 3 sodium zirconium cyclosilicate LOKELMA Non-Formulary Brand

Replacement Products

2 calcium acetate ELIPHOS Formulary Brand

1 calcium acetate PHOSLO Generic






2 calcium acetate PHOSLYRA Formulary Brand

1 potassium bicarbonate & potassium chloride K-LYTE/CL Generic

1 potassium chloride K-DUR Generic

1 potassium chloride K-TAB 10, KLOR-CON 20 MEQ Generic

3 potassium chrloide powder KLOR-CON 20 MEQ Non-Formulary Brand

1 potassium gluconate KAON Generic

2 potassium phosphate PHOSPHA Formulary Brand

3 potassium phosphate, monobasic K-PHOS NEUTRAL Non-Formulary Brand

2 potassium phosphate, monobasic K-PHOS ORIGINAL Formulary Brand

Uricosuric Agents 1 colchicine & probenecid COL-BENEMID Generic 1 probenecid BENEMID Generic

Enzymes Enzymes

2 dornase alfa PULMOZYME Formulary Brand

Eye, Ear, Nose and Throat (EENT) Anti-infectives

3 azithromycin (ophth) AZASITE Non-Formulary Brand

1 bacitracin & polmyxin B (ophth) POLYSPORIN Generic 1 bacitracin (ophth) AK-TRACIN Generic

ST 3 besilfoxacin BESIVANCE Non-Formulary Brand

1 chlorhexidine (mouth-throat) PERIDEX Generic

3 ciprofloxacin (ophth) ointment CILOXAN Non-Formulary Brand

1 ciprofloxacin (ophth) solution CILOXAN Generic 1 erythromycin (ophth) ROMYCIN Generic

ST 3 ganciclovir (ophth) ZIRGAN Non-Formulary Brand

ST 1 gatifloxacin (ophth) ZYMAXID Generic 1 gentamicin (ophth) GENTAK Generic






1 levofloxacin (ophth) QUIXIN Generic 2 moxifloxacin (ophth) VIGAMOX Generic

2 natamycin NATACYN Formulary Brand

1 neomycin, bacitracin & polymyxin b (ophth) NEO-POLYCIN Generic

1 neomycin, polymycin b & gramicidin (ophth) NEOSPORIN Generic

1 ofloxacin (ophth) OCUFLOX Generic 1 ofloxacin (otic) FLOXIN Generic

1 polymyxin b & trimethoprim (ophth) POLYTRIM Generic

1 sulfacetamide sodium (ophth) ointment SULFAC Generic

1 sulfacetamide sodium (ophth) solution BLEPH-10 Generic

2 tobramycin sulfate (ophth) ointment TOBREX Formulary

Brand

1 tobramycin sulfate (ophth) solution TOBREX Generic

1 trifluridine VIROPTIC Generic Anti-Inflammatory Agents

1 bacitracin, neomycin, polymyxin B & hydrocortisone (ophth) NEO-POLYCIN HC Generic

ST 3 bromfenac (ophth) XIBROM Non-Formulary Brand

2 ciprofloxacin & dexamethasone (ophth) CIPRODEX Formulary

Brand

ST 3 ciprofloxacin & hydrocortisone (otic) CIPRO HC Non-Formulary

Brand

QL,ST 3 cyclosporine (ophth) CEQUA Non-Formulary Brand

QL, ST 3 cyclosporine (ophth) RESTASIS Non-Formulary Brand

1 dexamethasone (ophth) solution DECADRON Generic

2 dexamethasone (ophth) suspension MAXIDEX Formulary

Brand 1 diclofenac sodium (ophth) VOLTAREN Generic

ST 3 difluprednate DUREZOL Non-Formulary Brand






ST 3 fluocinolone acetonide (otic) DERMOTIC Non-Formulary Brand

1 fluorometholone (ophth) FML Generic

3 fluorometholone (ophth) FML FORTE Non-Formulary Brand

ST 3 fluorometholone (ophth oint) FML OINT Non-Formulary Brand

2 fluorometholone acetate FLAREX Formulary Brand

ST 1 flurbiprofen (ophth) OCUFEN Generic

2 gentamicin & prednisolone PRED-G Formulary Brand

ST 1 hydrocortisone & acetic acid (otic) ACETASOL HC Generic

1 ketorolac (ophth) ACULAR Generic 1 ketorolac (ophth) ACULAR LS Generic

QL, ST 3 lifitegrast XIIDRA Non-preferrred

3 loteprednol ALREX Non-Formulary Brand

ST 3 loteprednol LOTEMAX Non-Formulary Brand

3 loteprednol & tobramycin ZYLET Non-Formulary Brand

3 neomycin, colistin, hydrocortisone & thonzonium (otic) CORTISPORIN-TC Non-Formulary

Brand

1 neomycin, polymyxin B & dexamethasone (ophth) MAXITROL Generic

3 neomycin, polymyxin B & hydrocortisone (ophth) CORTISPORIN Non-Formulary

Brand

1 neomycin, polymyxin B & hydrocortisone (otic) CORTISPORIN Generic

ST 3 nepafenac NEVANAC Non-Formulary Brand

1 prednisolone acetate (ophth) OMNIPRED Generic 1 prednisolone acetate (ophth) PRED FORTE Generic

2 prednisolone acetate (ophth) PRED MILD Formulary Brand

3 prednisolone sodium phosphate (ophth) INFLAMASE FORTE Non-Formulary

Brand






1 prednisolone sodium phosphate (ophth) PREDNISOL Generic

ST 3 rimexolone VEXOL Non-Formulary Brand

1 sulfacetamide sodium & prednisolone BLEPHAMIDE Generic

2 tobramycin & dexamethasone ointment TOBRADEX Formulary

Brand

1 tobramycin & dexamethasone suspension TOBRADEX Generic

Antiallergic Agents

ST 3 aflcaftadine LASTACAFT Non-Formulary Brand

1 azelastine ASTELIN Generic 1 azelastine ASTEPRO Generic

3 azelastine & fluticasone DYMISTA Non-Formulary Brand

ST 1 azelastine (ophth) OPTIVAR Generic

ST 3 bepotastine BEPREVE Non-Formulary Brand

1 cromolyn sodium (ophth) OPTICROM Generic

ST 3 emedastine S Non-Formulary Brand

ST 1 epinastine (ophth) ELESTAT Generic

3 grass pollen allergen extract (5 glass extract) ORALAIR Non-Formulary

Brand

ST 3 lodoxamide tromethamine ALOMIDE Non-Formulary Brand

3 house dust mite allergen extract ODACTRA Non-Formulary Brand

ST 3 nedocromil sodium (ophth) ALOCRIL Non-Formulary Brand

ST 3 olopatadine PATADAY Non-Formulary Brand

ST 3 olopatadine (nasal) PATANASE Non-Formulary Brand

ST 1 olopatadine (ophth) PATANOL Generic

3 short ragweed pollen allergen extract RAGWITEK Non-Formulary

Brand






3 timothy grass pollen allergen extract GRASTEK Non-Formulary

Brand Antiglaucoma Agents

1 acetazolamide DIAMOX Generic 1 acetazolamide DIAMOX SEQUELS Generic 1 betaxolol hcl BETOPTIC Generic

2 betaxolol hcl BETOPTIC S Formulary Brand

ST 3 bimatoprost LUMIGAN Non-Formulary Brand

1 brimonidine ALPHAGAN Generic 1 brimonidine tartrate ALPHAGAN P Generic

ST 3 brimonidine & timolol COMBIGAN Non-Formulary Brand

ST 3 brinzolamide AZOPT Non-Formulary Brand

2 carbachol ISOPTO CARBACHOL

Formulary Brand

ST 1 carteolol (ophth) OCUPRESS Generic 1 dorzolamide TRUSOPT Generic 1 dorzolamide & timolol COSOPT Generic

2 ecothiophate PHOSPHOLINE IODIDE

Formulary Brand

1 latanoprost XALATAN Generic

PA 3 latanoprostene bunod VYZULTA Non-Formulary Brand

1 levobunolol BETAGAN Generic 1 methazolamide NEPTAZANE Generic 1 metipranolol OPTIPRANOLOL Generic

PA 3 netarsudil RHOPRESSA Non-Formulary Brand

1 pilocarpine ISOPTO CARPINE Generic

3 pilocarpine gel PILOPINE HS Non-Formulary Brand

3 timolol BETIMOL Non-Formulary Brand

3 timolol ISTALOL Non-Formulary Brand

1 timolol TIMOPTIC Generic






3 timolol TIMOPTIC-XE Non-Formulary Brand

ST 3 travoprost TRAVATAN Z Non-Formulary Brand

3 unoprostone isopropyl RESCULA Non-Formulary Brand

EENT Drugs, Miscellaneous 1 acetic acid VOSOL Generic

2 apraclonidine IOPIDINE Formulary Brand

ST 3 artificial tear insert LACRISERT Non-Formulary Brand

PA 3 cenegermin-bkbj OXERVATE Non-Formulary Brand

Local Anesthetics 1 antipyrine & benzocaine AURODEX Generic

1 lidocaine (mouth-throat) XYLOCAINE VISCOUS Generic

1 proparacaine OPTHETIC Generic Mydriatics

1 atropine ISOPTO ATROPINE Generic

2 homatropine ISOPTO HOMATROPINE

Formulary Brand

2 scopolamine (ophth) ISOPTO HYOSCINE Formulary Brand

Vasoconstrictors ST 1 tetrahydrozoline TYZINE Generic

Gastrointestinal Drugs Anti-inflammatory Agents 1 alosetron LOTRONEX Generic

1 balsalazide COLAZAL Generic

3 balsalazide GIAZO Non-Formulary Brand

PA 3 eluxadoline VIBERZI Non-Formulary Brand

2 mesalamine controlled-release PENTASA Formulary Brand

2 mesalamine suppository CANASA Formulary Brand

1 mesalamine suspension ROWASA Generic






2 mesalamine tablet LIALDA Formulary Brand

ST 3 olsalazine DIPENTUM Non-Formulary Brand

Antidiarrhea Agents

ST 3 difenoxin & atropine MOTOFEN Non-Formulary Brand

1 diphenoxylate & atropine LOMOTIL Generic

3 paregoric PAREGORIC Non-Formulary Brand

Antiemetics

2 aprepitant EMEND Formulary Brand

ST 3 dolasetron ANZEMET Non-Formulary Brand

1 dronabinol MARINOL Generic

ST 3 granisetron KYTRIL Non-Formulary Brand

3 granisetron SANCUSO Non-Formulary Brand

ST 3 nabilone CESAMET Non-Formulary Brand

2 netupitant & palonosetron AKYNZEO Formulary Brand

1 ondansetron ZOFRAN Generic 1 ondansetron (orally disintegrating) ZOFRAN ODT Generic

QL 1 prochlorperazine COMPAZINE Generic

3 rolapitant VARUBI Non-Formulary Brand

ST 1 scopolamine hydrobromide TRANSDERM-SCOP Generic ST 1 trimethobenzamide TIGAN Generic

Antiulcer Agents and Acid Suppressants

3 amoxicillin, clarithromycin, & lansoprazole PREVPAC Non-Formulary

Brand 1 cimetidine TAGAMET Generic

ST 3 dexlansoprazole DEXILANT Non-Formulary Brand

ST 1 esomeprazole NEXIUM Generic 1 famotidine PEPCID Generic lansoprazole PREVACID Generic






1 misoprostol CYTOTEC Generic ST 1 nizatidine AXID Generic 1 omeprazole PRILOSEC Generic 1 pantoprazole PROTONIX Generic

ST 1 rabeprazole ACIPHEX Generic 1 ranitidine ZANTAC Generic 1 sucralfate tablets CARAFATE Generic

3 sucralfate suspension CARAFATE Non-Formulary Brand

Cathartics and Laxatives

3 polyethylene glycol-electrolyte solution HALFLYTELY Non-Formulary

Brand

ST 3 polyethylene glycol-electrolyte solution MOVIPREP Non-Formulary

Brand

1 polyethylene glycol-electrolyte solution COLYTE Generic

1 polyethylene glycol-electrolyte solution GOLYTELY Generic

1 polyethylene glycol-electrolyte solution GAVILYTE-C Generic

1 polyethylene glycol-electrolyte solution NULYTELY Generic

ST 3 sodium phosphates OSMOPREP Non-Formulary Brand

3 sodium phosphates VISICOL Non-Formulary Brand

ST 3 sodium picosulfate-mag ox-anhyrous citric acid PREPOPIK Non-Formulary

Brand Digestants

2 pancrelipase (lipase-protease-amylase) CREON Formulary

Brand

2 pancrelipase (lipase-protease-amylase) ZENPEP Formulary

Brand

2 pancrelipase (lipase-protease-amylase) PANCREAZE Formulary

Brand

3 pancrelipase (lipase-protease-amylase) VIOKACE Non-Formulary

Brand

3 pancrelipase (lipase-protease-amylase) PERTZYE Non-Formulary

Brand GI Drugs, Miscellaneous






1 clidinium & chlordiazepoxide LIBRAX Generic

QL, ST 3 linaclotide LINZESS Non-Formulary Brand

ST 3 lubiprostone AMITIZA Non-Formulary Brand

ST 3 mepenzolate CANTIL Non-Formulary Brand

1 metoclopramide REGLAN Generic

ST 3 methylnaltrexone RELISTOR Non-Formulary Brand

3 phenobarbital and belladonna alkaloids DONNATAL Non-Formulary

Brand

3 teduglutide GATTEX Non-Formulary Brand

1 ursodiol ACTIGALL Generic 1 ursodiol URSO Generic 1 ursodiol URSO FORTE Generic

Gold Compounds Gold Compounds

2 auranofin RIDAURA Formulary Brand

Heavy Metal Antagonists Heavy Metal Antagonists

2 deferasirox EXJADE Formulary Brand

3 deferiprone FERRIPROX Non-Formulary Brand

2 penicillamine CUPRIMINE Formulary Brand

2 penicillamine DEPEN Formulary Brand

ST 3 succimer CHEMET Non-Formulary Brand

ST 3 trientine SYPRINE Non-Formulary Brand

Hormones and Synthetic Substitutes Adrenals

ST 1 budesonide ENTOCORT EC Generic

3 budesonide UCERIS Non-Formulary Brand






ST 1 cortisone acetate CORTONE ACETATE Generic 1 dexamethasone DECADRON Generic 1 fludrocortisone FLORINEF ACETATE Generic 1 hydrocortisone CORTEF Generic 1 methylprednisolone MEDROL Generic 1 prednisolone PRELONE Generic 1 prednisolone acetate PREDNISOLONE Generic 1 prednisolone sodium phosphate ORAPRED Generic 1 prednisolone sodium phosphate ORAPRED ODT Generic 1 prednisolone sodium phosphate PEDIAPRED Generic 1 prednisone PREDNISONE Generic

3 prednisone RAYOS Non-Formulary Brand

Anabolic Steroid

ST 3 oxymetholone ANADROL-50 Non-Formulary Brand

Androgens 1 danazol DANOCRINE Generic

2 fluoxymesterone ANDROXY Formulary Brand

2 methyltestosterone ANDROID 10 Formulary Brand

3 methyltestosterone METHITEST Non-Formulary Brand

1 methyltestosterone TESTRED Generic 1 oxandrolone OXANDRIN Generic

3 testosterone ANDRODERM Non-Formulary Brand

3 testosterone AXIRON Non-Formulary Brand

ST 1 testosterone ANDROGEL Generic 1 testosterone TESTIM Generic

3 testosterone FORTESTA Non-Formulary Brand

1 testosterone cypionate DEPO-TESTOSTERONE Generic

Contraceptives QL 1 desogestrel & ethinyl estradiol APRI Generic

QL 3 desogestrel & ethinyl estradiol DESOGEN Non-Formulary Brand






QL 3 desogestrel & ethinyl estradiol ORTHO-CEPT Non-Formulary Brand

QL 1 desogestrel & ethinyl estradiol RECLIPSEN Generic

QL 1 desogestrel & ethinyl estradiol (biphasic) KARIVA Generic

QL 1 desogestrel & ethinyl estradiol (triphasic) CYCLESSA Generic

QL 1 desogestrel & ethinyl estradiol (triphasic) VELIVET Generic

QL 1 drospirenone & ethinyl estradiol GIANVI Generic QL 1 drospirenone & ethinyl estradiol OCELLA Generic QL 1 drospirenone & ethinyl estradiol YASMIN Generic QL 1 drospirenone & ethinyl estradiol YAZ Generic

QL 3 drospirenone & ethinyl estradiol w/ folate BEYAZ Non-Formulary

Brand

QL, ST 3 drospirenone & ethinyl estradiol w/ folate SAFYRAL Non-Formulary

Brand 1 estradiol cypionate DELESTROGEN Generic 1 estradiol valerate DEPO-ESTRADIOL Generic

QL, ST 3 estradiol valerate & dienogest NATAZIA Non-Formulary Brand

QL 1 ethynodiol diacetate & ethinyl estradiol KELNOR Generic

QL 1 ethynodiol diacetate & ethinyl estradiol ZOVIA Generic

QL 2 etonogestrel & ethinyl estradiol NUVARING Formulary Brand

AGE 1 levonorgestrel PLAN B Generic QL 1 levonorgestrel & ethinyl estradiol LUTERA Generic QL 1 levonorgestrel & ethinyl estradiol LESSINA Generic QL 1 levonorgestrel & ethinyl estradiol PORTIA Generic

QL 3 levonorgestrel & ethinyl estradiol NORDETTE-28 Non-Formulary Brand

QL 1 levonorgestrel & ethinyl estradiol (91-day) INTROVALE Generic

QL 3 levonorgestrel & ethinyl estradiol (91-day) LOSEASONIQUE Non-Formulary

Brand

QL 1 levonorgestrel & ethinyl estradiol (91-day) SEASONALE Generic






QL 3 levonorgestrel & ethinyl estradiol (91-day) SEASONIQUE Non-Formulary

Brand

QL 1 levonorgestrel & ethinyl estradiol (continuous) AMYTHYST Generic

QL 3 levonorgestrel & ethinyl estradiol (continuous) LYPREL Non-Formulary

Brand

QL 1 levonorgestrel & ethinyl estradiol (triphasic) TRIVORA Generic

QL 3 norelgestromin & ethinyl estradiol ORTHO EVRA Non-Formulary Brand

QL, ST 1 norelgestromin & ethinyl estradiol XULANE Generic QL 1 norethindrone CAMILA Generic QL 1 norethindrone NORA-BE Generic

QL 3 norethindrone NOR-QD Non-Formulary Brand

QL 1 norethindrone & ethinyl estradiol BALZIVA Generic

QL 3 norethindrone & ethinyl estradiol BREVICON Non-Formulary Brand

QL 1 norethindrone & ethinyl estradiol JUNEL Generic QL 1 norethindrone & ethinyl estradiol MICROGESTIN Generic

QL 3 norethindrone & ethinyl estradiol MODICON Non-Formulary Brand

QL 1 norethindrone & ethinyl estradiol NECON Generic

QL 3 norethindrone & ethinyl estradiol NORINYL 1+35 Non-Formulary Brand

QL 1 norethindrone & ethinyl estradiol NORTREL 1/35 Generic QL 1 norethindrone & ethinyl estradiol OVCON-35 Generic

QL 3 norethindrone & ethinyl estradiol OVCON-50 Non-Formulary Brand

QL 1 norethindrone & ethinyl estradiol (biphasic) NECON 10/11 Generic

QL 1 norethindrone & ethinyl estradiol (triphasic) ARANELLE Generic

QL 1 norethindrone & ethinyl estradiol (triphasic) NORTREL 7/7/7 Generic

QL 3 norethindrone & ethinyl estradiol (triphasic) ORTHO-NOVUM Non-Formulary

Brand

QL 3 norethindrone & ethinyl estradiol (triphasic) TRI-NORINYL Non-Formulary

Brand






QL 3 norethindrone & ethinyl estradiol w/ ferrous fumarate ESTROSTEP FE Non-Formulary

Brand

QL, ST 3 norethindrone & ethinyl estradiol w/ ferrous fumarate FEMCON FE Non-Formulary

Brand

QL 1 norethindrone & ethinyl estradiol w/ ferrous fumarate GENERESS FE Generic

QL 3 norethindrone & ethinyl estradiol w/ ferrous fumarate JUNEL FE Non-Formulary

Brand

QL 1 norethindrone & ethinyl estradiol w/ ferrous fumarate MICROGESTIN FE Generic

QL, ST 3 norethindrone & ethinyl estradiol w/ ferrous fumarate MINASTRIN 24 FE Non-Formulary

Brand

QL 3 norethindrone acetate & ethinyl estradiol w/ ferrous fumarate LOESTRIN 24 FE Non-Formulary

Brand

QL 3 norethindrone acetate & ethinyl estradiol w/ ferrous fumarate LOESTRIN FE Non-Formulary

Brand

QL 1 norethindrone acetate & ethinyl estradiol w/ ferrous fumarate TILIA Generic

QL, ST 3 norethindrone acetate & ethinyl estradiol w/ ferrous fumarate (biphasic)

LO LOESTRIN FE Non-Formulary Brand

QL 3 norethindrone-mestranol NORINYL 1+50 Non-Formulary Brand

QL 3 norethindrone-mestranol ORTHO-NOVUM Non-Formulary Brand

QL 1 norgestimate & ethinyl estradiol CRYSELLE Generic QL 1 norgestimate & ethinyl estradiol MONONESSA Generic

QL 3 norgestimate & ethinyl estradiol ORTHO-CYCLEN Non-Formulary Brand

QL 1 norgestimate & ethinyl estradiol SPRINTEC Generic QL 1 norgestimate & ethinyl estradiol TRINESSA Generic

QL 3 norgestimate & ethinyl estradiol (triphasic) ORTHO TRI-CYCLEN Non-Formulary

Brand

QL 1 norgestimate & ethinyl estradiol (triphasic) TRI-LO-SPRINTEC Generic

QL 1 norgestimate & ethinyl estradiol (triphasic) TRI-SPRINTEC Generic

QL 3 norgestrel & ethinyl estradiol LO/OVRAL-28 Non-Formulary Brand

QL 1 norgestrel & ethinyl estradiol LOW-OGESTREL Generic QL 1 norgestrel & ethinyl estradiol OGESTREL Generic






2 ulipristal ELLA Formulary Brand

Diabetic Agents 1 acarbose PRECOSE Generic

PA 3 albiglutide TANZEUM Non-Formulary Brand

PA 3 alirocumab PRALUENT Non-Formulary Brand

PA 1 alogliptin NESINA Generic PA 1 alogliptin & metformin KAZANO Generic PA 1 alogliptin & pioglitazone OSENI Generic

PA 3 canagliflozin INVOKANA Non-Formulary Brand

PA 3 canagliflozin & metformin INVOKAMET Non-Formulary Brand

ST 1 chlorpropamide CHLORPROPAMIDE Generic

PA 3 dapagliflozin FARXIGA Non-Formulary Brand

PA 3 dapagliflozin & metformin XIGDUO XR Non-Formulary Brand

PA 3 dulaglutide TRULICITY Non-Formulary Brand

PA 3 empagliflozin JARDIANCE Non-Formulary Brand

PA 3 empagliflozin & lingaliptin GLYXAMBI Non-Formulary Brand

PA 3 empagliflozin & metformin SYNJARDY Non-Formulary Brand

PA 3 ertufliglozin STEGLATRO Non-Formulary Brand

PA 3 ertugliflozin & metformin SEGLUROMET Non-Formulary Brand

PA 3 ertugliflozin & sitagliptin STEGLUJAN Non-Formulary Brand

PA 3 evolocumab REPATHA Non-Formulary Brand

PA 3 exenatide BYETTA Non-Formulary Brand

PA 3 exenatide extended-release BYDUREON Non-Formulary Brand






1 glimepiride AMARYL Generic 1 glipizide GLUCOTROL Generic 1 glipizide & metformin METAGLIP Generic 1 glipizide extended-release GLUCOTROL XL Generic

2 glucagon GLUCAGON EMERGENCY KIT

Formulary Brand

3 glucagon GLUCAGEN HYPOKIT

Non-Formulary Brand

1 glyburide DIABETA Generic 1 glyburide & metformin GLUCOVANCE Generic 1 glyburide micronized GLYNASE Generic

3 insulin (oral inhalation) AFREZZA Non-Formulary Brand

ST 3 insulin aspart NOVOLOG Non-Formulary Brand

ST 3 insulin aspart FIASP Non-Formulary Brand

ST 3 insulin aspart FIASP FlLEXPEN Non-Formulary Brand

ST 3 insulin aspart protamine & insulin aspart

NOVOLOG MIX 70/30

Non-Formulary Brand

ST 3 insulin aspart protamine & insulin aspart

NOVOLOG MIX 70/30 FLEXPEN

Non-Formulary Brand

ST 3 insulin degludec TRESIBA Non-Formulary Brand

3 insulin degludec/insulin aspart RYZODEG 70/30 Non-Formulary Brand

PA 3 Insulin degludec/ liraglutide XULTOPHY Non-Formulary Brand

ST 3 insulin detemir LEVEMIR Non-Formulary Brand

ST 3 insulin glargine LANTUS Non-Formulary Brand

ST 3 insulin glargine LANTUS SOLOSTAR Non-Formulary Brand

ST 3 insulin glargine BASAGLAR Non-Formulary Brand

PA 3 Insulin glargine/ lixisenatide SOLIQUA Non-Formulary Brand






ST 3 insulin glulisine APIDRA Non-Formulary Brand

3 insulin isophane NOVOLIN N Non-Formulary Brand

2 insulin isophane HUMULIN N Formulary Brand

ST 3 insulin isophane HUMULIN N KWIKPEN

Non-Formulary Brand

3 insulin isophane & regular insulin NOVOLIN 70/30 Non-Formulary Brand

3 insulin isophane & regular insulin HUMULIN 50/50 Non-Formulary Brand

2 insulin isophane & regular insulin HUMULIN 70/30 Formulary Brand

ST 3 insulin isophane & regular insulin HUMULIN 70/30 KIWKPEN

Non-Formulary Brand

ST 3 insulin lispro HUMALOG Non-Formulary Brand

ST 3 insulin lispro HUMALOG KWIKPEN

Non-Formulary Brand

ST 3 insulin lispro ADMELOG Non-Formulary Brand

3 insulin lispro protamine & insulin lispro

HUMALOG MIX 50/50

Non-Formulary Brand

ST 3 insulin lispro protamine & insulin lispro

HUMALOG MIX 75/25

Non-Formulary Brand

ST 3 insulin lispro protamine & insulin lispro

HUMALOG MIX 75/25 KWIKPEN

Non-Formulary Brand

3 insulin regular NOVOLIN R Non-Formulary Brand

2 insulin regular HUMULIN R Formulary Brand

ST 2 insulin regular HUMULIN R U-500 Formulary Brand

PA 3 linagliptin TRADJENTA Non-Formulary Brand

PA 3 linagliptin & metformin JENTADUETO Non-Formulary Brand

PA 3 liraglutide VICTOZA Non-Formulary Brand






PA 3 lixisenatide ADLYXIN Non-Formulary Brand

1 metformin GLUCOPHAGE Generic PA 1 metformin ER FORTAMET Generic PA 1 metformin ER GLUMETZA Generic

3 metformin RIOMET Non-Formulary Brand

1 metformin extended-release GLUCOPHAGE XR Generic

PA 3 mifepristone KORLYM Non-Formulary Brand

ST 3 miglitol GLYSET Non-Formulary Brand

ST 1 nateglinide STARLIX Generic 1 pioglitazone ACTOS Generic

3 pioglitazone & glimepiride DUETACT Non-Formulary Brand

3 pioglitazone & metformin ACTOPLUS MET Non-Formulary Brand

PA 3 pramlintide acetate SYMLIN Non-Formulary Brand

ST 1 repaglinide PRANDIN Generic ST 1 repaglinide & metformin PRANDIMET Generic

ST 3 rosiglitazone AVANDIA Non-Formulary Brand

ST 3 rosiglitazone & glimepiride AVANDARYL Non-Formulary Brand

ST 3 rosiglitazone & metformin AVANDAMET Non-Formulary Brand

PA 3 saxagliptin ONGLYZA Non-Formulary Brand

PA 3 saxagliptin & metformin extended-release KOMBIGLYZE XR Non-Formulary

Brand

PA 3 sitagliptin & metformin JANUMET Non-Formulary Brand

PA 3 sitagliptin & simvastatin JUVISYNC Non-Formulary Brand

PA 3 sitagliptin phosphate JANUVIA Non-Formulary Brand

ST 1 tolazamide TOLINASE Generic ST 1 tolbutamide ORINASE Generic






Estrogens and Antiestrogens

3 conjugated estrogens & bazedoxifene DUAVEE Non-Formulary

Brand

3 conjugated estrogens & medroxyprogesterone acetate PREMPHASE Non-Formulary

Brand

3 conjugated estrogens & medroxyprogesterone acetate PREMPRO Non-Formulary

Brand

3 drospirenone & estradiol ANGELIQ Non-Formulary Brand

ST 3 esterified estrogens MENEST Non-Formulary Brand

1 estradiol ESTRACE TAB Generic 1 estradiol GYNODIOL Generic

ST 3 estradiol & levonorgestrel CLIMARA PRO Non-Formulary Brand

1 estradiol & norethindrone ACTIVELLA Generic

ST 3 estradiol & norethindrone COMBIPATCH Non-Formulary Brand

3 estradiol & norgestimate PREFEST Non-Formulary Brand

3 estradiol acetate FEMTRACE Non-Formulary Brand

ST 3 estradiol acetate vaginal tablets FEMRING Non-Formulary Brand

ST 3 estradiol gel DIVIGEL Non-Formulary Brand

ST 3 estradiol gel ELESTRIN GEL Non-Formulary Brand

ST 3 estradiol transdermal ALORA Non-Formulary Brand

1 estradiol transdermal CLIMARA DIS Generic

3 estradiol transdermal ESTRADERM Non-Formulary Brand

ST 3 estradiol transderomal EVAMIST Non-Formulary Brand

ST 3 estradiol transdermal MENOSTAR Non-Formulary Brand

1 estradiol transdermal MINIVELLE Generic

ST 3 estradiol transdermal VIVELLE-DOT Non-Formulary Brand






1 estradiol vaginal ESTRACE CREAM Generic

2 estradiol vaginal ESTRING Formulary Brand

2 estradiol vaginal 10 mg VAGIFEM Formulary Brand

3 estradiol vaginal VAGIFEM Non-Formulary Brand

1 estradiol vaginal YUVAFEM Generic 1 estradiol vaginal ESTRACE Generic 1 estrogen, ester/me-testosterone ESTRATEST Generic

ST 3 estrogens, conjugated PREMARIN Non-Formulary Brand

3 estrogens, conjugated synthetic a CENESTIN Non-Formulary Brand

ST 3 estrogens, conjugated synthetic b ENJUVIA Non-Formulary Brand

ST 2 estrogens, conjugated vaginal PREMARIN CREAM Formulary Brand

1 estropipate ORTHO-EST Generic

1 norethindrone acetate & ethinyl estradiol FEMHRT Generic

3 ospemifene OSPHENA Non-Formulary Brand

1 raloxifene hcl EVISTA Generic Gonadatropins

2 nafarelin SYNAREL Formulary Brand

Parathyroid

PA 3 abaloparatide TYMLOS Non-Formulary Brand

ST 1 calcitonin salmon FORTICAL Generic ST 1 calcitonin salmon MIACALCIN Generic

PA 3 teriparatide FORTEO Non-Formulary Brand

Pitutary

PA 3 corticotropin ACTHAR Non-Formulary Brand

1 desmopressin (non-refrigerated) DDAVP Generic

3 desmopressin acetate STIMATE Non-Formulary Brand






Progestins 1 medroxyprogesterone acetate PROVERA Generic 1 megestrol acetate MEGACE Generic 1 norethindrone acetate AYGESTIN Generic 1 progesterone, micronized PROMETRIUM Generic Somatotropin Agonists and Antagonists

PA 3 somatropin GENTROPIN Non-Formulary Brand

PA 3 somatropin HUMATROPE Non-Formulary Brand

PA 3 somatropin NORDITROPIN Non-Formulary Brand

PA 3 somatropin NUTROPIN AQ Non-Formulary Brand

PA 3 somatropin OMNITROPE Non-Formulary Brand

PA 3 somatropin SAIZEN Non-Formulary Brand

PA 3 somatropin SEROSTIM Non-Formulary Brand

PA 3 pegvisomant SOMAVERT Non-Formulary Brand

PA 3 somatropin ZORBTIVE Non-Formulary Brand

Thyroid and Antihyroid Agent 1 levothyroxine LEVOTHROID Generic 1 levothyroxine LEVOXYL Generic 1 levothyroxine SYNTHROID Generic

3 levothyroxine TIROSINT Non-Formulary Brand

1 levothyroxine UNITHROID Generic 1 liothyronine CYTOMEL Generic

ST 3 liotrix THYROLAR Non-Formulary Brand

1 methimazole TAPAZOLE Generic 2 potassium iodide & iodine LUGOL’S SOLUTION Brand 1 propylthiouracil PROPYLTHIOURACIL Generic

3 thyroid ARMOUR THYROID Non-Formulary Brand

Miscellaneous Therapeutic Agents






Miscellanous Therapeutic Agents

2 abatacept ORENCIA Formulary Brand

1 acetylcysteine MUCOMYST-10 Generic

2 adalimumab HUMIRA Formulary Brand

ST 3 adalimumab HUMIRA citrate free

Non-Formulary Brand

1 alendronate FOSAMAX Generic

3 alendronate & cholecalciferol FOSAMAX PLUS D Non-Formulary Brand

1 allopurinol ZYLOPRIM Generic

PA 3 amifampridine FIRDAPSE Non-Formulary Brand

3 anakinra KINERET Non-Formulary Brand

2 apremilast OTEZLA Formulary Brand

1 azathioprine AZASAN Generic 1 azathioprine IMURAN Generic

PA 3 baricitnib OLUMIANT Non-Formulary Brand

3 bedaquiline SIRTURO Non-Formulary Brand

ST 3 betaine CYSTADANE POWD Non-Formulary Brand

PA 3 brodalumab SILIQ Non-Formulary Brand

PA 3 c-1 esterase inhibitor HAEGARDA Non-Formulary Brand

PA 3 canakinumab ILARIS Non-Formulary Brand

PA 3 cholic acid CHOLBAM Non-Formulary Brand

2 cinacalcet SENSIPAR Formulary Brand

ST 1 colchicine COLCRYS Generic 1 cyclosporine SANDIMMUNE Generic 1 cyclosporine, modified NEORAL Generic






PA 3 cysteamine delayed-release PROCYSBI Non-Formulary Brand

ST 3 cysteamine immediate-release CYSTAGON Non-Formulary Brand

1 dalfampridine AMPYRA Generic

QL, PA 3 dichlorphenamide KEVEYIS Non-Formulary Brand

PA 3 daflazacort EMFLAZA Non-Formulary Brand

PA 3 dimethyl fumarate TECFIDERA Non-Formulary Brand

PA 3 dupilumab DUPIXENT Non-Formulary Brand

1 disulfiram ANTABUSE Generic ST 1 dutasteride AVODART Generic 1 dutasteride & tamsulosin JALYN Generic

PA 3 elagolix ORILISSA Non-Formulary Brand

PA 3 eliglustat CERDELGA Non-Formulary Brand

PA 3 emicizumab-kxwh HEMLIBRA Non-Formulary Brand

PA 3 erenumab-aooe AIMOVIG Non-Formulary Brand

2 etanercept ENBREL Formulary Brand

ST 1 etidronate DIDRONEL Generic

3 everolimus ZORTRESS Non-Formulary Brand

ST 3 febuxostat ULORIC Non-Formulary Brand

PA 3 fingolimod GILENYA Non-Formulary Brand

PA 3 fostamatinib TAVALISSE Non-Formulary Brand

PA 3 galcanezumab EMGALITY Non-Formulary Brand

PA 3 guselkumab TREMFYA Non-Formulary Brand

PA 3 glatiramer acetate COPAXONE 20 mg Non-Formulary Brand






1 glatiramer acetate COPAXONE 40 mg Generic 1 glatiramer acetate GLATOPA Generic

3 golimumab SIMPONI Non-Formulary Brand

ST 1 ibandronate BONIVA Generic

PA 3 icatibant FIRAZYR Non-Formulary Brand

PA 3 immune globulin HYQVIA Non-Formulary Brand

PA 3 Immune globulin HIZENTRA Non-Formulary Brand

PA 3 Inotersen TEGSEDI Non-Formulary Brand

PA 3 interferon beta-1a AVONEX Non-Formulary Brand

PA 3 interferon beta-1a PLEGRIDY Non-Formulary Brand

PA 3 interferon beta-1a REBIF Non-Formulary Brand

PA 3 interferon beta-1a REBIF REBIDOSE Non-Formulary Brand

3 interferon beta-1b BETASERON Non-Formulary Brand

2 Interferon beta-1b EXTAVIA Formulary Brand

2 interferon gamma-1b ACTIMMUNE Formulary Brand

PA 3 ixekizumab TALTZ Non-Formulary Brand

PA 3 lanadelumab TAKHZYRO Non-Formulary Brand

3 lanreotide SOMATULINE DEPOT

Non-Formulary Brand

3 lesinurad ZURAMPIC Non-Formulary Brand

1 leflunomide ARAVA Generic 1 leucovorin LEUCOVORIN Generic

PA 3 l-glutamine ENDARI Non-Formulary Brand

2 mesna MESNEX Formulary Brand






1

methenamine, sodium biphosphate, phenyl salicylate, methylene blue, and hyoscyamine

URO-MP Generic

1 methylergonovine maleate METHERGINE Generic

3 metreleptin MYALEPT Non-Formulary Brand

3 mifepristone MIFEPREX Non-Formulary Brand

PA 3 migalastat GALAFOLD Non-Formulary Brand

PA 3 miglustat ZAVESCA Non-Formulary Brand

1 mycophenolate mofetil CELLCEPT Generic 1 mycophenolate sodium MYFORTIC Generic

3 nitisinone ORFADIN Non-Formulary Brand

1 octreotide acetate SANDOSTATIN Generic

PA 3 parathyroid hormone NATPARA Non-Formulary Brand

PA 3 pasireotide SIGNIFOR Non-Formulary Brand

1 pediatric multivitamins w/ fluoride POLY-VI-FLOR Generic

1 pediatric multivitamins w/ fluoride & iron

POLY-VI-FLOR W/IRON Generic

1 pediatric vitamins a, c, & d, w/ fluoride TRI-VI-FLOR Generic

1 pediatric vitamins a, c, & d, w/ fluoride & iron TRI-VI-FLOR W/IRON Generic

PA 3 pegvaliase PALYNZIQ Non-Formulary Brand

2 pentosan polysulfate sodium ELMIRON Formulary Brand

PA 3 risankizumab SKYRIZI Non-Formulary Brand

ST 1 risedronate sodium ACTONEL Generic

3 risedronate sodium ATELVIA Non-Formulary Brand

PA 3 sapropterin dihydrochloride KUVAN Non-Formulary Brand






PA 3 sarilumab KEVZARA Non-Formulary Brand

2 secukinumab COSENTYX Formulary Brand

3 sirolimus solution RAPAMUNE Non-Formulary Brand

1 sirolimus RAPAMUNE Generic 3 sodium fluoride FLUORABON BASIC Generic 1 sodium fluoride FLUORITAB Generic 1 sodium fluoride LURIDE CHEW Generic 1 sodium fluoride (dental) PREVIDENT Generic

1 sodium fluoride (dental) PREVIDENT 5000 PLUS Generic

1 sodium fluoride drops LURIDE DROPS Generic

2 stannous fluoride GEL-KAM Formulary Brand

1 tacrolimus PROGRAF Generic

PA 3 teriflunomide AUBAGIO Non-Formulary Brand

QL 2 thalidomide THALOMID Formulary Brand

PA 3 tildrakizumab-asmn ILUMYA Non-Formulary Brand

ST 3 tiludronate SKELID Non-Formulary Brand

2 tocilizumab ACTEMRA Formulary Brand

2 tofacitinib XELJANZ Formulary Brand

PA 3 ustekinumab STELARA Non-Formulary Brand

Respiratory Tract Agents Antitussives

1 benzonatate TESSALON PERLES Generic 1 guaifenesin & codeine CHERATUSSIN AC Generic

3 hydrocodone & chlorpheniramine TUSSIONEX Non-Formulary Brand

1 hydrocodone & homatropine HYCODAN Generic

1 promethazine & codeine PHENERGAN W/ CODEINE Generic






1 promethazine & dextromethorphan PROMETHAZINE-DM Generic

1 promethazine, phenylephrine & codeine

PHENERGAN VC W/CODEINE Generic

3 pseudoephedrine, brompheniramine & codeine M-END MAX D Non-Formulary

Brand Anti-Inflammatory Agents

3 cromolyn sodium GASTROCROM Non-Formulary Brand

1 cromolyn sodium INTAL Generic 1 montelukast SINGULAIR Generic

ST 3 zafirlukast ACCOLATE Non-Formulary Brand

ST 1 zileuton ZYFLO CR Generic

ST 3 zileuton ZYFO Non-Formulary Brand

Respiratory Agents, Miscellaneous

3 beclomethasone dipropionate QVAR RediHaler Non-Formulary Brand

3 budesonide PULMICORT FLEXHALER

Non-Formulary Brand

1 budesonide PULMICORT RESPULES Generic

ST 3 budesonide & formoterol SYMBICORT Non-Formulary Brand

2 ciclesonide ALVESCO Formulary Brand

ST 3 fluticasone & salmeterol (100/50 mcg) ADVAIR DISKUS Non-Formulary

Brand

ST 2 fluticasone & salmeterol (250/50 mcg and 500/50 mcg) ADVAIR DISKUS Formulary

Brand

ST 3 fluticasone & salmeterol ADVAIR HFA Non-Formulary Brand

ST 3 fluticasone & vilanterol BREO ELLIPTA Non-Formulary Brand

3 fluticasone propionate FLOVENT DISKUS AER

Non-Formulary Brand

3 fluticasone propionate FLOVENT HFA Non-Formulary Brand

ST 3 fluticasone & umeclidinium & vilanterol TRELEGY ELLIPTA Non-Formulary

Brand






3 glycopyrrolate & indacaterol UTIBRON NEOHALER Non-Preferrred

ST 3 indacaterol ARCAPTA NEOHALER

Non-Formulary Brand

PA 3 ivacaftor KALYDECO Non-Formulary Brand

PA 3 lumacaftor& ivacaftor ORKAMBI Non-Formulary Brand

ST 3 mometasone & formoterol DULERA Non-Formulary Brand

2 mometasone furoate ASMANEX Formulary Brand

PA 3 mepolizumab NUCALA Non-Formulary Brand

3 nintedanib OFEV Non-Formulary Brand

PA 3 omalizumab XOLAIR Non-Formulary Brand

3 pirfenidone ESBRIET Non-Formulary Brand

ST 3 roflumilast DALIRESP Non-Formulary Brand

3 salmeterol SEREVENT DISKUS Non-Formulary Brand

3 sodium chloride HYPERSAL Non-Formulary Brand

PA 3 tezacaftor & ivacaftor SYMDEKO Non-Formulary Brand

2 tiotropium bromide and olodaterol STIOLTO RESPIMAT Formulary

Brand Skin and Mucous Membrane Agents

Anti-infectives (Skin and Mucous Membranes) ST 1 acyclovir ZOVIRAX Generic

3 benzoyl peroxide & erythromycin BENZAMYCIN Non-Formulary Brand

ST 3 butenafine MENTAX Non-Formulary Brand

3 butoconazole nitrate (vaginal) GYNAZOLE-1 Non-Formulary Brand

1 ciclopirox LOPROX Generic 1 ciclopirox PENLAC Generic






ST 1 clindamycin & benzoyl peroxide BENZACLIN Generic 1 clindamycin & benzoyl peroxide DUAC Generic

PA 3 clindamycin & benzoyl peroxide ONEXTON Non-Formulary Brand

1 clindamycin phosphate (topical) CLEOCIN T Generic 1 clindamycin phosphate (topical) CLINDAGEL Generic

3 clindamycin phosphate (topical) EVOCLIN Non-Formulary Brand

1 clindamyinc phosphate (vaginal) CLEOCIN Generic 1 clotrimazole MYCELEX Generic

ST 1 clotrimazole & betametmethasone LOTRISONE Generic

ST 3 crotamiton EURAX Non-Formulary Brand

1 econazole nitrate SPECTAZOLE Generic

3 erythromycin (acne acid) AKNE-MYCIN Non-Formulary Brand

1 erythromycin (acne acid) ERYGEL Generic 1 gentamicin sulfate (topical) GARAMYCIN Generic

3 hexachlorophene PHISOHEX Non-Formulary Brand

1 iodoquinol & hydrocortisone VYTONE Generic 1 ketoconazole (topical) NIZORAL Generic 1 lindane KWELL Generic

ST 3 mafenide acetate SULFAMYLON Non-Formulary Brand

1 malathion OVIDE Generic 1 metronidazole (topical) METROCREAM Generic 1 metronidazole (topical) METROGEL Generic 1 metronidazole (topical) METROLOTION Generic

1 metronidazole (vaginal) METROGEL-VAGINAL Generic

3 miconazole nitrate & zinc oxide VUSION Non-Formulary Brand

1 mupirocin BACTROBAN Generic

3 mupirocin calcium BACTROBAN NASAL

Non-Formulary Brand

3 na sulfacetm/avobenzone/sulfur ROSAC Non-Formulary Brand

ST 1 naftifine cream NAFTIN Generic






ST 3 Naftifine gel NAFTIN Non-Formulary Brand

1 nystatin (topical) NYSTATIN Generic

ST 3 oxiconazole nitrate OXISTAT Non-Formulary Brand

ST 3 penciclovir DENAVIR Non-Formulary Brand

1 permethrin ELIMITE Generic

ST 3 retapamulin ALTABAX Non-Formulary Brand

3 selenium sulfide SELSEB Non-Formulary Brand

3 selenium sulfide SELSUN RX Non-Formulary Brand

ST 3 sertaconazole nitrate ERTACZO Non-Formulary Brand

1 silver sulfadiazine SILVADENE Generic

3 spinosad NATROBA Non-Formulary Brand

ST 3 sulconazole nitrate EXELDERM Non-Formulary Brand

1 sulfacetamide sodium (acne) KLARON Generic

3 sulfacetamide sodium (acne) SEB-PREV Non-Formulary Brand

3 sulfanilamide AVC Non-Formulary Brand

ST 1 terconazole TERAZOL 7 Generic ST 1 terconazole (vaginal) TERAZOL 3 Generic

Anti-inflammatory Agents (Skin and Mucous Membranes) 1 alclometasone dipropionate ACLOVATE Generic

ST 1 amcinonide CYCLOCORT Generic

ST 3 bacitracin, polymyxin, neomycin & hydrocortisone CORTISPORIN Non-Formulary

Brand

3 benzoyl peroxide & hydrocortisone VANOXIDE-HC Non-Formulary

Brand

1 betamethasone dipropionate (topical) DIPROSONE Generic

1 betamethasone dipropionate augmented DIPROLENE Generic

1 betamethasone valerate LUXIQ Generic






1 betamethasone valerate VALISONE Generic ST 1 calcipotriene & betamethasone TACLONEX Generic 1 clobetasol propionate CLOBEX Generic 1 clobetasol propionate TEMOVATE Generic 1 clobetasol propionate emollient TEMOVATE E Generic

3 clobetasol propionate emulsion OLUX-E Non-Formulary Brand

ST 1 clocortolone pivalate CLODERM Generic

ST 3 crisaborole EUCRISA Non-Formulary Brand

QL 1 desonide DESOWEN Generic ST 1 desoximetasone TOPICORT Generic ST 1 diflorasone diacetate APEXICON Generic

3 fluocinolone acetonide CAPEX SHAMPOO Non-Formulary Brand

1 fluocinolone acetonide DERMA-SMOOTHE/FS OIL Generic

1 fluocinolone acetonide SYNALAR Generic 1 fluocinonide LIDEX Generic

3 fluocinonide VANOS Non-Formulary Brand

1 fluocinonide emollient LIDEX-E Generic

ST 1, 3 flurandrenolide CORDRAN Generic

ST 1 fluticasone propionate (topical) CUTIVATE Generic

ST 3 halcinonide HALOG Non-Formulary Brand

1 halobetasol propionate ULTRAVATE Generic 1 hydrocortisone (intrarectal) CORTENEMA Generic

3 hydrocortisone (rectal) ANUSOL-HC Non-Formulary Brand

1 hydrocortisone (rectal) PROCTOCORT Generic 1 hydrocortisone (topical) HYTONE Generic 1 hydrocortisone acetate & urea CARMOL HC Generic

3 hydrocortisone acetate (intrarectal) CORTIFOAM Non-Formulary

Brand 1 hydrocortisone butyrate LOCOID Generic

3 hydrocortisone butyrate hydrophilic lipo base

LOCOID LIPOCREAM

Non-Formulary Brand






3 hydrocortisone probutate PANDEL Non-Formulary Brand

1 hydrocortisone valerate WESTCORT Generic 1 mometasone furoate ELOCON Generic

ST 1 nystatin & triamcinolone MYCOLOG II Generic ST 1 prednicarbate DERMATOP Generic 1 triamcinolone acetonide (topical) KENALOG Generic Antipruritics and Local Anesthetics

ST 3 doxepin (antipuritic) ZONALON Non-Formulary Brand

3 hydrocortisone & pramoxine ANALPRAM HC Non-Formulary Brand

3 hydrocortisone & pramoxine PRAMOSONE Non-Formulary Brand

3 hydrocortisone & pramoxine PRAMOSONE-E Non-Formulary Brand

3 hydrocortisone & pramoxine PROCTOFOAM-HC Non-Formulary Brand

1 lidocaine (jelly, topical) XYLOCAINE Generic

3 lidocaine & hydrocortisone LIDAMANTLE Non-Formulary Brand

1 lidocaine & prilocaine EMLA Generic

ST 3 lidocaine & tetracaine SYNERA PATCH Non-Formulary Brand

1 pramoxine PROCTOFOAM Generic Astringents

2 aluminum chloride hexahydrate HYPERCARE Formulary Brand

Keratolytic Agents

3 sulfacetamide sodium & sulfur AVAR Non-Formulary Brand

1 sulfacetamide sodium & sulfur PLEXION Generic

3 sulfacetamide sodium & sulfur PLEXION SCT Non-Formulary Brand

1 sulfacetamide sodium & sulfur ROSULA Generic 1 urea CARMOL Generic Keratoplastic Agents

ST 3 anthralin DRITHOCREME HP Non-Formulary Brand






3 anthralin PSORIATEC Non-Formulary Brand

Cell Stimulants and Proliferants QL, AGE 1 tretinoin RETIN-A Generic

QL, AGE 3 tretinoin microspheres RETIN-A MICRO Non-Formulary Brand

Skin and Mucous Membrane Agents, Miscellaneous ST 1 acitretin SORIATANE Generic

QL, AGE, ST 1 adapalene DIFFERIN Generic

QL, AGE, ST 3 adapalene & benzoyl peroxide EPIDUO Non-Formulary

Brand

QL, AGE 3 alitretinoin PANRETIN Non-Formulary Brand

1 ammonium lactate LAC-HYDRIN Generic

ST 3 azelaic acid FINACEA Non-Formulary Brand

ST 3 azelaic acid (acne) AZELEX Non-Formulary Brand

2 becaplermin REGRANEX Formulary Brand

3 bexarotene (topical) TARGRETIN Non-Formulary Brand

PA, QL 3 brimonidine (topical) MIRVASO Non-Formulary Brand

1 calcipotriene DOVONEX Generic

3 calcipotriene SORILUX Non-Formulary Brand

2 calcitriol (topical) VECTICAL Formulary Brand

AGE, ST 3 clindamycin & tretinoin VELTIN Non-Formulary Brand

AGE, ST 3 clindamycin & tretinoin ZIANA Non-Formulary Brand

2 collagenase SANTYL Formulary Brand

3 dapsone (topical) ACZONE Non-Formulary Brand

3 diclofenac epolamine FLECTOR Non-Formulary Brand






1 diclofenac sodium VOLTAREN GEL Generic

3 diclofenac sodium (actinic keratosis) SOLARAZE Non-Formulary

Brand

ST 3 doxepin (antipuritic) PRUDOXIN Non-Formulary Brand

3 doxycycline (rosacea) ORACEA Non-Formulary Brand

3 fluorouracil (topical) CARAC Non-Formulary Brand

1 fluorouracil (topical) EFUDEX Generic

2 fluorouracil (topical) FLUOROPLEX Formulary Brand

1 imiquimod ALDARA Generic

3 imiquimod ZYCLARA Non-Formulary Brand

PA 3 ingenol mebutate PICATO Non-Formulary Brand

1 isotretinoin ACCUTANE Generic 1 isotretinoin CLARAVIS Generic

3 lactic acid (ammonium lactate) LACTINOL Non-Formulary Brand

2 methoxsalen 8-MOP Formulary Brand

1 methoxsalen, rapid OXSORALEN-ULTRA Generic

2 pimecrolimus ELIDEL Formulary Brand

1 podofilox CONDYLOX Generic

ST 3 sinecatechins VEREGEN Non-Formulary Brand

1 tacrolimus (topical) PROTOPIC Generic QL, AGE,

ST 3 tazarotene TAZORAC Non-Formulary Brand

Smooth Muscle Relaxants Smooth Muscle Relaxants

1 darifenacin ENABLEX Generic

ST 3 dyphylline LUFYLLIN Non-Formulary Brand

ST 3 fesoterodine TOVIAZ Non-Formulary Brand






ST 3 flavoxate FLAVOXATE Non-Formulary Brand

ST 3 mirabegron MYRBETRIQ Non-Formulary Brand

1 oxybutynin DITROPAN Generic 1 oxybutynin extended-release DITROPAN XL Generic

3 oxybutynin transdermal OXYTROL Non-Formulary Brand

1 solifenacin VESICARE Generic 1 theophylline UNIPHYL Generic

ST 1 tolterodine DETROL Generic ST 1 tolterodine extended-release DETROL LA Generic 1 trospium SANCTURA Generic

3 trospium extended-release SANCTURA XR Non-Formulary Brand

Vitamins Vitamins

1 calcitriol ROCALTROL Generic ST 1 doxercalciferol HECTOROL Generic 1 ergocalciferol DRISDOL Generic 1 niacin NIACOR Generic

ST 1 paricalcitol ZEMPLAR Generic

2 phytonadione MEPHYTON Formulary Brand

Kaiser Permanente, a TRICARE® Prime Option Formulary


Index of Drugs

8 8-MOP ............................................................................................. 70

A abacavir sulfate & lamivudine ........................................................ 8 abacavir sulfate solution ................................................................. 8 abacavir sulfate tablet ..................................................................... 8 abacavir, dolutegravir & lamivudine .............................................. 8 abacavir, lamivudine & zidovudine ................................................ 8 abaloparatide .................................................................................. 56 abatacept ........................................................................................ 58 abemaciclib ..................................................................................... 12 ABILIFY ........................................................................................... 33 ABILIFY DISCMELT ...................................................................... 33 abiraterone ...................................................................................... 12 ABSTRAL ........................................................................................ 26 acalabrutinib ................................................................................... 12 acamprosate ................................................................................... 32 acarbose ......................................................................................... 51 ACCOLATE .................................................................................... 63 ACCU-CHEK ............................................................................ 35, 36 ACCU-CHEK TEST STRIPS ........................................................ 35 ACCUNEB ...................................................................................... 17 ACCUPRIL ...................................................................................... 23 ACCURETIC ................................................................................... 23 ACCUTANE .................................................................................... 70 acebutolol ........................................................................................ 24 ACEON ............................................................................................ 23 acetaminophen & codeine ............................................................ 25 acetaminophen, caffeine, & dihydrocodine ................................ 25 ACETASOL HC .............................................................................. 40 acetazolamide ................................................................................ 42 acetic acid ................................................................................. 40, 43 acetylcysteine ................................................................................. 58 ACIPHEX ........................................................................................ 45 acitretin ............................................................................................ 69 ACLOVATE ..................................................................................... 66 ACTEMRA ...................................................................................... 62 ACTHAR.......................................................................................... 56 ACTIGALL ....................................................................................... 46 ACTIMMUNE .................................................................................. 60 ACTIQ .............................................................................................. 26 ACTIVELLA .................................................................................... 55 ACTONEL ....................................................................................... 61 ACTOPLUS MET ........................................................................... 54 ACTOS ............................................................................................ 54 ACULAR .......................................................................................... 40 ACULAR LS .................................................................................... 40 acyclovir ...................................................................................... 8, 64

ACZONE ......................................................................................... 69 ADALAT CC ................................................................................... 21 adalimumab .................................................................................... 58 adapalene ....................................................................................... 69 adapalene & benzoyl peroxide .................................................... 69 ADCIRCA ........................................................................................ 24 ADDERALL ..................................................................................... 28 ADDERALL XR .............................................................................. 28 adefovir dipivoxil .............................................................................. 8 ADEMPAS ...................................................................................... 24 ADLYXIN......................................................................................... 54 ADMELOG ...................................................................................... 53 ADOXA .............................................................................................. 5 ADRENACLICK ............................................................................. 17 ADVAIR DISKUS ........................................................................... 63 ADVAIR HFA .................................................................................. 63 ADVICOR ....................................................................................... 20 ADZENYS ER ................................................................................ 27 AFINITOR ....................................................................................... 13 aflcaftadine ..................................................................................... 41 AFREZZA ....................................................................................... 52 AGGRENOX ................................................................................... 18 AGRYLIN ........................................................................................ 18 AIMOVIG......................................................................................... 59 AKNE-MYCIN ................................................................................. 65 AK-TRACIN .................................................................................... 38 AKYNZEO ....................................................................................... 44 albendazole ...................................................................................... 4 ALBENZA ......................................................................................... 4 albiglutide ........................................................................................ 51 albuterol nebulizer solution .......................................................... 17 albuterol sulfate.............................................................................. 17 albuterol sulfate & ipratropium ..................................................... 17 albuterol sulfate tablet ................................................................... 17 alclometasone dipropionate ......................................................... 66 ALDACTAZIDE .............................................................................. 23 ALDACTONE ................................................................................. 23 ALDARA .......................................................................................... 70 ALDOMET ...................................................................................... 22 ALDORIL-25 ................................................................................... 22 alendronate ..................................................................................... 58 alendronate & cholecalciferol ....................................................... 58 alfuzosin .......................................................................................... 17 ALINIA ............................................................................................... 7 alirocumab ...................................................................................... 51 aliskiren ........................................................................................... 22 aliskiren & amlodipine ................................................................... 22 aliskiren & hydrochlorothiazide .................................................... 22 aliskiren & valsartan ...................................................................... 22 aliskiren, amlodipine & hydrochlorothiazide ............................... 22 alitretinoin ....................................................................................... 69



ALKERAN ....................................................................................... 14 allopurinol ........................................................................................ 58 almotriptan ...................................................................................... 30 ALOCRIL ......................................................................................... 41 alogliptin .......................................................................................... 51 alogliptin & metformin .................................................................... 51 alogliptin & pioglitazone ................................................................ 51 ALOMIDE ........................................................................................ 41 ALORA ............................................................................................ 55 alosetron ......................................................................................... 43 alpelisib ........................................................................................... 12 ALPHAGAN .................................................................................... 42 ALPHAGAN P................................................................................. 42 alprazolam ...................................................................................... 31 alprazolam extended-release ....................................................... 31 alprazolam orally disintegrating ................................................... 31 ALREX ............................................................................................. 40 ALTABAX ........................................................................................ 66 ALTACE .......................................................................................... 23 ALTOPREV ..................................................................................... 20 aluminum chloride hexahydrate ................................................... 68 ALVESCO ....................................................................................... 63 amantadine ..................................................................................... 30 amantadine ER............................................................................... 30 AMARYL.......................................................................................... 52 AMBIEN ........................................................................................... 32 AMBIEN CR .................................................................................... 32 ambrisentan .................................................................................... 23 amcinonide...................................................................................... 66 AMERGE ......................................................................................... 30 AMICAR .......................................................................................... 18 amifampridine ................................................................................. 58 amikacin liposomal Inhalation ........................................................ 4 amiloride .......................................................................................... 37 amiloride & hydrochlorothiazide ................................................... 37 aminocaproic acid .......................................................................... 18 amiodarone ..................................................................................... 21 AMITIZA .......................................................................................... 46 amitriptyline ..................................................................................... 33 amitriptyline & perphenazine ........................................................ 33 amlodipine ................................................................................. 20, 22 amlodipine & atorvastatin ............................................................. 20 amlodipine & benazepril ................................................................ 20 amlodipine & olmesartan .............................................................. 20 amlodipine & telmisartan............................................................... 20 amlodipine & valsartan .................................................................. 20 amlodipine, olmesartan & hydrochlorothiazide .......................... 20 amlodipine, valsartan & hydrochlorothiazide ............................. 20 ammonium lactate ................................................................... 69, 70 amoxapine ...................................................................................... 33 amoxicillin................................................................................ 2, 4, 44 amoxicillin & clavulanate potassium .............................................. 4 amoxicillin & clavulanate potassium extended-release .............. 4 amoxicillin, clarithromycin, & lansoprazole ................................. 44

AMOXIL............................................................................................. 4 amphetamine & dextroamphetamine .......................................... 28 amphetamine & dextroamphetamine extended-release .......... 28 amphetamine extended-release .................................................. 27 amphetamine sulfate ..................................................................... 27 AMPICILLIN ..................................................................................... 4 ampicillin sodium ............................................................................. 4 AMPYRA ......................................................................................... 59 AMRIX ............................................................................................. 16 AMTURNIDE .................................................................................. 22 AMYTHYST .................................................................................... 49 ANADROL-50 ................................................................................. 47 ANAFRANIL ................................................................................... 33 anagrelide ....................................................................................... 18 anakinra .......................................................................................... 58 ANALPRAM HC ............................................................................. 68 ANAPROX ...................................................................................... 27 anastrozole ..................................................................................... 12 ANCOBON ....................................................................................... 6 ANDRODERM................................................................................ 47 ANDROGEL ................................................................................... 47 ANDROID 10 .................................................................................. 47 ANDROXY ...................................................................................... 47 ANGELIQ ........................................................................................ 55 ANORO ELLIPTA .......................................................................... 18 ANSAID ........................................................................................... 26 ANTABUSE .................................................................................... 59 anthralin .................................................................................... 68, 69 antipyrine & benzocaine ............................................................... 43 ANUSOL-HC .................................................................................. 67 ANZEMET ....................................................................................... 44 APEXICON ..................................................................................... 67 APIDRA ........................................................................................... 53 apixaban ......................................................................................... 18 APLENZIN ...................................................................................... 33 APOKYN ......................................................................................... 30 apomorphine .................................................................................. 30 apraclonidine .................................................................................. 43 apremilast ....................................................................................... 58 aprepitant ........................................................................................ 44 APRESOLINE ................................................................................ 22 APRI ................................................................................................ 47 APTIOM .......................................................................................... 29 APTIVUS......................................................................................... 11 ARALEN ............................................................................................ 7 ARANELLE ..................................................................................... 49 ARANESP ....................................................................................... 19 ARAVA ............................................................................................ 60 ARBINOXA ....................................................................................... 4 ARCAPTA NEOHALER ................................................................ 64 arformoterol .................................................................................... 17 ARICEPT ........................................................................................ 16 ARICEPT ODT ............................................................................... 16 ARIKAYCE ....................................................................................... 4



ARIMIDEX ....................................................................................... 12 aripiprazole ..................................................................................... 33 aripiprazole solution ....................................................................... 33 aripiprazole tablet ........................................................................... 33 ARIXTRA ......................................................................................... 18 armodafinil ...................................................................................... 28 ARMOUR THYROID ..................................................................... 57 AROMASIN ..................................................................................... 13 ARTANE .......................................................................................... 31 artemether & lumefantrine .............................................................. 7 ARTHROTEC ................................................................................. 25 artificial tear insert .......................................................................... 43 ASCENSIA BREEZE ..................................................................... 36 ASCENSIA TEST STRIPS ........................................................... 35 asenapine........................................................................................ 33 ASENDIN ........................................................................................ 33 ASMANEX ...................................................................................... 64 aspirin & dipyridamole ................................................................... 18 ASTELIN ......................................................................................... 41 ASTEPRO ....................................................................................... 41 ATACAND ....................................................................................... 22 ATACAND HCT .............................................................................. 22 ATARAX .......................................................................................... 31 atazanavir & cobicistat .................................................................... 8 atazanavir sulfate 150 mg............................................................... 8 atazanavir sulfate 200 mg, 300 mg ............................................... 8 ATELVIA.......................................................................................... 61 atenolol ............................................................................................ 24 atenolol & chlorthalidone............................................................... 24 ATIVAN ........................................................................................... 32 atomoxetine .................................................................................... 32 atorvastatin ............................................................................... 19, 20 atovaquone ....................................................................................... 7 atovaquone & proguanil .................................................................. 7 ATRIPLA ........................................................................................... 9 atropine ............................................................................... 15, 43, 44 atropine sulfate ............................................................................... 15 ATROPINE SULFATE ................................................................... 15 ATROVENT .................................................................................... 15 ATROVENT HFA ........................................................................... 15 ATROVENTHFA ............................................................................ 15 AUBAGIO ........................................................................................ 62 AUGMENTIN .................................................................................... 4 AUGMENTIN XR ............................................................................. 4 auranofin ......................................................................................... 46 AURODEX ...................................................................................... 43 AUSTEDO ....................................................................................... 32 AUVI-Q ............................................................................................ 17 AVALIDE ......................................................................................... 23 AVANDAMET ................................................................................. 54 AVANDARYL .................................................................................. 54 AVANDIA ........................................................................................ 54 AVAPRO ......................................................................................... 23 AVAR ............................................................................................... 68

AVC ................................................................................................. 66 AVELOX ............................................................................................ 5 AVINZA ........................................................................................... 26 AVLOSULFON ................................................................................. 7 AVODART ...................................................................................... 59 AVONEX ......................................................................................... 60 AXERT ............................................................................................ 30 AXID ................................................................................................ 45 AXIRON .......................................................................................... 47 axitinib ............................................................................................. 12 AYGESTIN ..................................................................................... 57 AZASAN .......................................................................................... 58 AZASITE ......................................................................................... 38 azathioprine .................................................................................... 58 azelaic acid ..................................................................................... 69 azelaic acid (acne)......................................................................... 69 azelastine ........................................................................................ 41 azelastine & fluticasone ................................................................ 41 azelastine (ophth) .......................................................................... 41 AZELEX .......................................................................................... 69 AZILECT ......................................................................................... 31 azilsartan......................................................................................... 22 azithromycin ............................................................................... 4, 38 azithromycin (ophth) ...................................................................... 38 AZOPT ............................................................................................ 42 AZOR .............................................................................................. 20 AZULFIDINE .................................................................................... 6

B B & O SUPPRETTES ................................................................... 27 bacitracin & polmyxin B (ophth) ................................................... 38 bacitracin (ophth) ........................................................................... 38 bacitracin, neomycin, polymyxin B & hydrocortisone (ophth) .. 39 bacitracin, polymyxin, neomycin & hydrocortisone ................... 66 baclofen .......................................................................................... 16 BACTRIM DS ................................................................................... 6 BACTROBAN ................................................................................. 65 BACTROBAN NASAL ................................................................... 65 balsalazide ...................................................................................... 43 BALZIVA ......................................................................................... 49 BANZEL .......................................................................................... 30 BARACLUDE ................................................................................... 9 baricitnib .......................................................................................... 58 BASAGLAR .................................................................................... 52 BD INSULIN SYRINGE ................................................................ 36 becaplermin .................................................................................... 69 beclomethasone dipropionate ...................................................... 63 bedaquiline ..................................................................................... 58 BELSOMRA ................................................................................... 32 benazepril ................................................................................. 20, 22 benazepril & hydrochlorothiazide ................................................ 22 BENEMID ....................................................................................... 38 BENICAR ........................................................................................ 23



BENICAR HCT ............................................................................... 23 BENTYL .......................................................................................... 15 BENZACLIN .................................................................................... 65 BENZAMYCIN ................................................................................ 64 benznidazole .................................................................................... 4 benzonatate .................................................................................... 62 benzoyl peroxide & erythromycin ................................................ 64 benzoyl peroxide & hydrocortisone ............................................. 66 benztropine ..................................................................................... 30 bepotastine ..................................................................................... 41 BEPREVE ....................................................................................... 41 besilfoxacin ..................................................................................... 38 BESIVANCE ................................................................................... 38 BETAGAN ....................................................................................... 42 betaine ............................................................................................. 58 betamethasone dipropionate (topical) ......................................... 66 betamethasone dipropionate augmented ................................... 66 betamethasone valerate ......................................................... 66, 67 BETAPACE ..................................................................................... 25 BETAPACE AF............................................................................... 25 BETASERON ................................................................................. 60 betaxolol .................................................................................... 24, 42 betaxolol hcl .................................................................................... 42 bethanechol chloride ..................................................................... 16 BETIMOL ........................................................................................ 42 BETOPTIC ...................................................................................... 42 BETOPTIC S .................................................................................. 42 betrixaban ....................................................................................... 18 BEVYXXA ....................................................................................... 18 bexarotene ................................................................................ 12, 69 bexarotene (topical) ....................................................................... 69 BEXDELA.......................................................................................... 5 BEYAZ ............................................................................................. 48 BIAXIN ............................................................................................... 5 BIAXIN XL ......................................................................................... 5 bicalutamide .................................................................................... 12 BICITRA .......................................................................................... 36 bictegravir & emtricitabine & tenofovir .......................................... 8 BIDIL ................................................................................................ 23 BIKTARVY ........................................................................................ 8 BILTRICIDE ...................................................................................... 4 bimatoprost ..................................................................................... 42 binimetinib ....................................................................................... 12 bismuth subcitrate & metronidazole .............................................. 4 bisoprol & hydrochlorothiazide ..................................................... 24 bisoprolol ......................................................................................... 24 BLEPH-10 ....................................................................................... 39 BLEPHAMIDE ................................................................................ 41 BLOCADREN ................................................................................. 25 blood sugar diagnostic ............................................................ 35, 36 blood-glucose meter ...................................................................... 36 boceprevir ......................................................................................... 8 BONIVA ........................................................................................... 60 bosentan ......................................................................................... 23

BOSULIF......................................................................................... 12 bosutinib .......................................................................................... 12 BRAFTOVI ...................................................................................... 12 BREO ELLIPTA ............................................................................. 63 BRETHINE ..................................................................................... 18 BREVICON ..................................................................................... 49 brexpiprazole .................................................................................. 33 BRILINTA ........................................................................................ 18 brimonidine ............................................................................... 42, 69 brimonidine & timolol ..................................................................... 42 brimonidine (topical) ...................................................................... 69 brimonidine tartrate ....................................................................... 42 brinzolamide ................................................................................... 42 brodalumab ..................................................................................... 58 bromfenac (ophth) ......................................................................... 39 bromocriptine.................................................................................. 30 BROVANA ...................................................................................... 17 budesonide ............................................................................... 46, 63 budesonide & formoterol .............................................................. 63 bumetanide ..................................................................................... 37 BUMEX ........................................................................................... 37 BUPHENYL .................................................................................... 36 buprenorphine ................................................................................ 25 buprenorphine & naloxone film .................................................... 25 buprenorphine transdermal .......................................................... 25 buprenorphine& naloxone tablet ................................................. 25 bupropion ........................................................................................ 33 bupropion (smoking deterrent)..................................................... 33 bupropion extended-release ........................................................ 33 bupropion hydrobromide ............................................................... 33 bupropion sustained-release ........................................................ 33 BUSPAR ......................................................................................... 31 buspirone ........................................................................................ 31 busulfan .......................................................................................... 12 butalbital & acetaminophen .......................................................... 25 butalbital, acetaminophen, & caffeine ......................................... 25 butalbital, acetaminophen, caffeine, & codeine ......................... 25 butalbital, aspirin, & caffeine ........................................................ 25 butalbital, aspirin, caffeine, & codeine ........................................ 25 butenafine ....................................................................................... 64 butoconazole nitrate (vaginal) ...................................................... 64 butorphanol tartrate ....................................................................... 25 BUTRANS ....................................................................................... 25 BYDUREON ................................................................................... 51 BYETTA .......................................................................................... 51 BYSTOLIC ...................................................................................... 24

C c-1 esterase inhibitor ..................................................................... 58 cabergoline ..................................................................................... 30 CADUET ......................................................................................... 20 CAFERGOT ................................................................................... 17 CALAN SR ...................................................................................... 21



calcipotriene .............................................................................. 67, 69 calcipotriene & betamethasone.................................................... 67 calcitonin salmon ........................................................................... 56 calcitriol ..................................................................................... 69, 71 calcitriol (topical) ............................................................................ 69 calcium acetate ........................................................................ 37, 38 CALQUENCE ................................................................................. 12 CAMILA ........................................................................................... 49 CAMPRAL ....................................................................................... 32 canagliflozin .................................................................................... 51 canagliflozin & metformin .............................................................. 51 canakinumab .................................................................................. 58 CANASA.......................................................................................... 43 candesartan .................................................................................... 22 candesartan & hydrochlorothiazide ............................................. 22 cannabidiol ...................................................................................... 32 CANTIL ............................................................................................ 46 capecitabine .................................................................................... 12 CAPEX SHAMPOO ....................................................................... 67 CAPOTEN ....................................................................................... 22 CAPOZIDE ...................................................................................... 22 CAPRELSA ..................................................................................... 15 captopril ........................................................................................... 22 captopril & hydrochlorothiazide .................................................... 22 CARAC ............................................................................................ 70 CARAFATE ..................................................................................... 45 carbachol ......................................................................................... 42 CARBAGLU .................................................................................... 36 carbamazepine ......................................................................... 28, 29 carbamazepine extended-release cap .................................. 28, 29 carbamazepine extended-release tab ......................................... 29 CARBATROL .................................................................................. 28 carbidopa .................................................................................. 30, 31 carbidopa & levodopa.................................................................... 31 carbidopa & levodopa extended release .................................... 31 carbidopa, levodopa, & entacapone ............................................ 31 carbinoxamine maleate ................................................................... 4 CARDENE ...................................................................................... 21 CARDIZEM ............................................................................... 20, 21 CARDIZEM CD .............................................................................. 20 CARDIZEM LA ............................................................................... 21 CARDURA ...................................................................................... 19 carglumic acid................................................................................. 36 cariprazine ...................................................................................... 33 carisoprodol .............................................................................. 16, 25 carisoprodol & aspirin .................................................................... 16 carisoprodol, aspirin, & codeine ................................................... 25 CARMOL ................................................................................... 67, 68 CARMOL HC .................................................................................. 67 carteolol (ophth) ............................................................................. 42 CARTIA XT ..................................................................................... 21 carvedilol ......................................................................................... 24 carvedilol phosphate...................................................................... 24 CASODEX ...................................................................................... 12

CATAFLAM .................................................................................... 25 CATAPRES .................................................................................... 22 CATAPRES-TTS ........................................................................... 22 CECLOR ........................................................................................... 4 cefaclor .............................................................................................. 4 cefadroxil........................................................................................... 4 cefdinir ............................................................................................... 4 cefditoren .......................................................................................... 4 cefixime ............................................................................................. 4 cefixime solution .............................................................................. 4 cefpodoxime ..................................................................................... 5 cefprozil ............................................................................................. 5 CEFTIN ............................................................................................. 5 cefuroxime axetil .............................................................................. 5 CEFZIL .............................................................................................. 5 CELEBREX .................................................................................... 25 celecoxib ......................................................................................... 25 CELEXA .......................................................................................... 33 CELLCEPT ..................................................................................... 61 CELONTIN ..................................................................................... 29 cenegermin-bkbj ............................................................................ 43 CENESTIN ..................................................................................... 56 cephalexin......................................................................................... 5 CEQUA ........................................................................................... 39 CERDELGA .................................................................................... 59 ceritinib ............................................................................................ 12 CESAMET ...................................................................................... 44 cevimeline hcl ................................................................................. 16 CHANTIX ........................................................................................ 16 CHEMET ......................................................................................... 46 CHERATUSSIN AC....................................................................... 62 chlorambucil ................................................................................... 12 chlordiazepoxide ................................................................ 31, 33, 46 chlordiazepoxide & amitriptyline .................................................. 33 chlorhexidine (mouth-throat) ........................................................ 38 chloroquine phosphate ................................................................... 7 chlorothiazide ................................................................................. 37 chlorpheniramine, phenylephrine & pyrilamine ........................... 4 chlorphenirmine, phenylephrine & pyrilamine.............................. 4 chlorpromazine .............................................................................. 33 chlorpropamide .............................................................................. 51 CHLORPROPAMIDE .................................................................... 51 chlorthalidone ........................................................................... 24, 37 chlorzoxazone ................................................................................ 16 CHOLBAM ...................................................................................... 58 cholestyramine ............................................................................... 19 cholestyramine light....................................................................... 19 cholic acid ....................................................................................... 58 CHRONULAC ................................................................................ 36 CIBALITH-S .................................................................................... 34 ciclesonide ...................................................................................... 63 ciclopirox ......................................................................................... 64 cilostazol ......................................................................................... 18 CILOXAN ........................................................................................ 38



CIMDUO .......................................................................................... 10 cimetidine ........................................................................................ 44 cinacalcet ........................................................................................ 58 CIPRO ......................................................................................... 5, 39 CIPRO HC ...................................................................................... 39 CIPRODEX ..................................................................................... 39 ciprofloxacin .......................................................................... 5, 38, 39 ciprofloxacin & dexamethasone (ophth) ..................................... 39 ciprofloxacin & hydrocortisone (otic) ........................................... 39 ciprofloxacin (ophth) ointment ...................................................... 38 ciprofloxacin (ophth) solution ....................................................... 38 citalopram........................................................................................ 33 citric acid, sodium citrate, & potassium citrate ........................... 36 CLARAVIS ...................................................................................... 70 clarithromycin ............................................................................. 5, 44 clarithromycin extended-release .................................................... 5 CLEOCIN .................................................................................... 5, 65 CLEOCIN HCL ................................................................................. 5 CLEOCIN PEDIATRIC .................................................................... 5 CLEOCIN T ..................................................................................... 65 clidinium & chlordiazepoxide ........................................................ 46 CLIMARA DIS................................................................................. 55 CLIMARA PRO............................................................................... 55 CLINDAGEL ................................................................................... 65 clindamycin & benzoyl peroxide .................................................. 65 clindamycin & tretinoin .................................................................. 69 clindamycin hcl ................................................................................. 5 clindamycin palmitate ...................................................................... 5 clindamycin phosphate (topical) .................................................. 65 clindamyinc phosphate (vaginal) ................................................. 65 CLINORIL........................................................................................ 27 clobazam ......................................................................................... 29 clobetasol propionate .................................................................... 67 clobetasol propionate emollient ................................................... 67 clobetasol propionate emulsion ................................................... 67 CLOBEX .......................................................................................... 67 clocortolone pivalate ...................................................................... 67 CLODERM ...................................................................................... 67 clomipramine .................................................................................. 33 clonazepam .................................................................................... 29 clonidine .......................................................................................... 22 clonidine extended-release........................................................... 22 clonidine transdermal .................................................................... 22 clopidogrel ....................................................................................... 18 clorazepate ..................................................................................... 31 clotrimazole ..................................................................................... 65 clotrimazole & betametmethasone .............................................. 65 clozapine ......................................................................................... 33 CLOZARIL ...................................................................................... 33 COARTEM ........................................................................................ 7 cobimetinib ...................................................................................... 12 codeine ................................................................................ 25, 62, 63 CODEINE SULF ............................................................................. 25 COGENTIN ..................................................................................... 30

COLAZAL ....................................................................................... 43 COL-BENEMID .............................................................................. 38 colchicine .................................................................................. 38, 58 colchicine & probenecid ................................................................ 38 COLCRYS ...................................................................................... 58 colesevelam ................................................................................... 19 COLESTID ...................................................................................... 19 colestipol ......................................................................................... 19 collagenase .................................................................................... 69 COLYTE .......................................................................................... 45 COMBIGAN .................................................................................... 42 COMBIPATCH ............................................................................... 55 COMBIVENT RESPIMAT ............................................................. 17 COMBIVIR ...................................................................................... 10 COMBUNOX .................................................................................. 27 COMPAZINE .................................................................................. 44 COMPLERA ..................................................................................... 9 COMTAN ........................................................................................ 31 CONCERTA ................................................................................... 28 CONDYLOX ................................................................................... 70 conjugated estrogens & bazedoxifene ....................................... 55 conjugated estrogens & medroxyprogesterone acetate .......... 55 COPAXONE 20 mg ....................................................................... 59 COPAXONE 40 mg ....................................................................... 60 CORDRAN ..................................................................................... 67 COREG ........................................................................................... 24 COREG CR .................................................................................... 24 CORGARD ..................................................................................... 24 CORLANOR ................................................................................... 21 CORTEF ......................................................................................... 47 CORTENEMA ................................................................................ 67 corticotropin .................................................................................... 56 CORTIFOAM .................................................................................. 67 cortisone acetate ........................................................................... 47 CORTISPORIN ........................................................................ 40, 66 CORTISPORIN-TC ....................................................................... 40 CORTONE ACETATE .................................................................. 47 CORZIDE ........................................................................................ 24 COSENTYX .................................................................................... 62 COSOPT ......................................................................................... 42 COTELLIC ...................................................................................... 12 COTEMPLA XR-ODT ................................................................... 28 COUMADIN .................................................................................... 19 COVERA-HS .................................................................................. 21 COZAAR ......................................................................................... 23 CREON ........................................................................................... 45 CRESEMBA ..................................................................................... 6 CRESTOR ...................................................................................... 20 crisaborole ...................................................................................... 67 CRIXIVAN ......................................................................................... 9 crizotinib .......................................................................................... 12 cromolyn sodium ...................................................................... 41, 63 cromolyn sodium (ophth) .............................................................. 41 crotamiton ....................................................................................... 65



CRYSELLE ..................................................................................... 50 CUPRIMINE .................................................................................... 46 CUTIVATE ...................................................................................... 67 CYCLESSA ..................................................................................... 48 cyclobenzaprine ............................................................................. 16 cyclobenzaprine extended-release .............................................. 16 CYCLOCORT ................................................................................. 66 cyclophosphamide ......................................................................... 12 cycloserine ........................................................................................ 7 CYCLOSET .................................................................................... 30 cyclosporine .............................................................................. 39, 58 cyclosporine (ophth) ...................................................................... 39 cyclosporine, modified ................................................................... 58 CYMBALTA .................................................................................... 34 cyproheptadine ................................................................................. 4 CYSTADANE POWD .................................................................... 58 CYSTAGON .................................................................................... 59 cysteamine delayed-release ......................................................... 59 cysteamine immediate-release .................................................... 59 CYTOMEL ....................................................................................... 57 CYTOTEC ....................................................................................... 45 CYTOVENE ...................................................................................... 9 CYTOXAN ....................................................................................... 12 CYTRA-3 ......................................................................................... 36

D D.H.E.45 .......................................................................................... 17 dabigatran ....................................................................................... 18 daclatasvir ......................................................................................... 8 dacomitinib ...................................................................................... 12 daflazacort ...................................................................................... 59 DAKLINZA ........................................................................................ 8 dalfampridine .................................................................................. 59 DALIRESP ...................................................................................... 64 DALMANE ....................................................................................... 31 dalteparin ........................................................................................ 18 danazol ............................................................................................ 47 DANOCRINE .................................................................................. 47 DANTRIUM ..................................................................................... 16 dantrolene sodium ......................................................................... 16 dapagliflozin .................................................................................... 51 dapagliflozin & metformin ............................................................. 51 dapsone ....................................................................................... 7, 69 dapsone (topical) ........................................................................... 69 DARAPRIM ....................................................................................... 7 darbepoetin alfa ............................................................................. 19 darifenacin ...................................................................................... 70 darolutamide ................................................................................... 12 darunavir & cobicistat ...................................................................... 8 darunavir ethanolate ........................................................................ 8 darunavir/cobicistat/FTC/tenofovir ................................................. 8 dasatinib .......................................................................................... 12 DAURISMO .................................................................................... 13

DAYPRO ......................................................................................... 27 DAYTRANA .................................................................................... 28 DDAVP ............................................................................................ 56 DECADRON ............................................................................. 39, 47 DECLOMYCIN ................................................................................. 5 deferasirox ...................................................................................... 46 deferiprone ..................................................................................... 46 delafloxacin ....................................................................................... 5 delavirdine mesylate ....................................................................... 8 DELESTROGEN ............................................................................ 48 DEMADEX ...................................................................................... 37 demeclocycline ................................................................................ 5 DEMEROL ...................................................................................... 26 DENAVIR ........................................................................................ 66 DEPAKENE .................................................................................... 30 DEPAKOTE .................................................................................... 29 DEPAKOTE ER ............................................................................. 29 DEPAKOTE SPRINKLE ............................................................... 29 DEPEN ............................................................................................ 46 DEPO-ESTRADIOL....................................................................... 48 DEPO-TESTOSTERONE ............................................................. 47 DERMA-SMOOTHE/FS OIL ........................................................ 67 DERMATOP ................................................................................... 68 DERMOTIC .................................................................................... 40 DESCOVY ........................................................................................ 9 desipramine .................................................................................... 33 desmopressin (non-refrigerated) ................................................. 56 desmopressin acetate ................................................................... 56 DESOGEN ...................................................................................... 47 desogestrel & ethinyl estradiol ............................................... 47, 48 desogestrel & ethinyl estradiol (biphasic) ................................... 48 desogestrel & ethinyl estradiol (triphasic) .................................. 48 desonide ......................................................................................... 67 DESOWEN ..................................................................................... 67 desoximetasone ............................................................................. 67 DESOXYN ...................................................................................... 28 desvenlafaxine extended release ................................................ 34 desvenlafaxine succinate extended release .............................. 34 DESYREL ....................................................................................... 35 DETROL ......................................................................................... 71 DETROL LA ................................................................................... 71 deutetrabenazine ........................................................................... 32 dexamethasone ........................................................... 39, 40, 41, 47 dexamethasone (ophth) solution ................................................. 39 dexamethasone (ophth) suspension ........................................... 39 DEXEDRINE .................................................................................. 28 DEXILANT ...................................................................................... 44 dexlansoprazole ............................................................................. 44 dexmethylphenidate ...................................................................... 28 dexmethylphenidate extended-release ...................................... 28 dextroamphetamine sulfate .......................................................... 28 dextroamphetamine sulfate extended-release .......................... 28 dextromethorphan & quinidine ..................................................... 32 DEXTROSTAT ............................................................................... 28



DIABETA ......................................................................................... 52 DIAMOX .......................................................................................... 42 DIAMOX SEQUELS ...................................................................... 42 DIASTAT ......................................................................................... 29 DIASTAT ACUDIAL ....................................................................... 29 diazepam ................................................................................... 29, 31 DIBENZYLINE ................................................................................ 17 dichlorphenamide ........................................................................... 59 diclofenac epolamine ..................................................................... 69 diclofenac potassium ..................................................................... 25 diclofenac sodium .............................................................. 25, 39, 70 diclofenac sodium & misoprostol ................................................. 25 diclofenac sodium (actinic keratosis) .......................................... 70 diclofenac sodium (ophth)............................................................. 39 diclofenac sodium extended release ........................................... 25 dicloxacillin ........................................................................................ 5 dicyclomine ..................................................................................... 15 didanosine ......................................................................................... 8 didanosine solution .......................................................................... 8 DIDRONEL ..................................................................................... 59 difenoxin & atropine ....................................................................... 44 DIFFERIN........................................................................................ 69 DIFICID ............................................................................................. 5 diflorasone diacetate ..................................................................... 67 DIFLUCAN ........................................................................................ 6 diflunisal .......................................................................................... 25 DIFLUNISAL ................................................................................... 25 difluprednate ................................................................................... 39 digoxin ............................................................................................. 21 dihydroergotamine mesylate ........................................................ 17 DILANTIN .................................................................................. 29, 30 DILAUDID ....................................................................................... 26 diltiazem .................................................................................... 20, 21 diltiazem extended-release ..................................................... 20, 21 dimethyl fumarate .......................................................................... 59 DIOVAN ........................................................................................... 23 DIOVAN HCT ................................................................................. 23 DIPENTUM ..................................................................................... 44 diphenoxylate & atropine .............................................................. 44 DIPROLENE ................................................................................... 66 DIPROSONE .................................................................................. 66 dipyridamole ................................................................................... 18 DISALCID........................................................................................ 27 disopyramide .................................................................................. 21 disopyramide controlled-release .................................................. 21 disulfiram ......................................................................................... 59 DITROPAN ..................................................................................... 71 DITROPAN XL ............................................................................... 71 DIURIL ............................................................................................. 37 divalproex sodium .......................................................................... 29 divalproex sodium capsule ........................................................... 29 divalproex sodium extended release........................................... 29 DIVIGEL .......................................................................................... 55 dofetilide .......................................................................................... 21

dolasetron ....................................................................................... 44 DOLOPHINE .................................................................................. 26 dolutegravir ................................................................................... 8, 9 dolutegravir & lamivudine ........................................................... 8, 9 dolutegravir & rilpivirine .................................................................. 8 donepezil................................................................................... 16, 32 DONNATAL .................................................................................... 46 dornase alfa .................................................................................... 38 DORYX ............................................................................................. 5 dorzolamide .................................................................................... 42 dorzolamide & timolol .................................................................... 42 DOSTINEX ..................................................................................... 30 DOVATO ........................................................................................... 9 DOVONEX ...................................................................................... 69 doxazosin ........................................................................................ 19 doxepin .......................................................................... 31, 34, 68, 70 doxepin (antipuritic) ................................................................. 68, 70 doxepin (sleep) .............................................................................. 31 doxercalciferol ................................................................................ 71 doxycycline ................................................................................. 5, 70 doxycycline (rosacea) ................................................................... 70 doxycycline hyclate ......................................................................... 5 doxycycline monohydrate ............................................................... 5 DRISDOL ........................................................................................ 71 DRITHOCREME HP ..................................................................... 68 dronabinol ....................................................................................... 44 dronedarone ................................................................................... 21 drospirenone & estradiol ............................................................... 55 drospirenone & ethinyl estradiol .................................................. 48 drospirenone & ethinyl estradiol w/ folate .................................. 48 DROXIA .......................................................................................... 13 droxidopa ........................................................................................ 17 DUAC .............................................................................................. 65 DUAVEE ......................................................................................... 55 DUETACT ....................................................................................... 54 dulaglutide ...................................................................................... 51 DULERA ......................................................................................... 64 duloxetine ....................................................................................... 34 DUONEB......................................................................................... 17 dupilumab ....................................................................................... 59 DUPIXENT ..................................................................................... 59 DURAGESIC .................................................................................. 26 DUREZOL ....................................................................................... 39 DURICEF .......................................................................................... 4 dutasteride ...................................................................................... 59 dutasteride & tamsulosin .............................................................. 59 DYAZIDE ........................................................................................ 37 DYMISTA ........................................................................................ 41 DYNACIN .......................................................................................... 5 DYNACIRC ..................................................................................... 21 DYNAPEN ........................................................................................ 5 dyphylline ........................................................................................ 70 DYRENIUM .................................................................................... 37



E E.E.S.................................................................................................. 5 E.S.P .................................................................................................. 5 econazole nitrate ............................................................................ 65 ecothiophate ................................................................................... 42 EDARBI ........................................................................................... 22 EDECRIN ........................................................................................ 37 EDLUAR .......................................................................................... 32 edoxaban ........................................................................................ 18 EDURANT ....................................................................................... 10 efavirenz 400 mg, lamivudine & tenofvir ....................................... 9 efavirenz 600 mg ............................................................................. 9 efavirenz 600 mg, lamivudine & tenofvir ....................................... 9 efavirenz, emtricitabine & tenofovir ............................................... 9 EFFEXOR ....................................................................................... 35 EFFEXOR XR................................................................................. 35 EFFIENT ......................................................................................... 18 efinaconazole ................................................................................... 6 EFUDEX .......................................................................................... 70 elagolix ............................................................................................ 59 ELAVIL ............................................................................................ 33 elbasvir & grazoprevir ...................................................................... 9 ELDEPRYL ..................................................................................... 31 ELESTAT ........................................................................................ 41 ELESTRIN GEL ............................................................................. 55 eletriptan ......................................................................................... 30 ELIDEL ............................................................................................ 70 eliglustat .......................................................................................... 59 ELIMITE .......................................................................................... 66 ELIPHOS ......................................................................................... 37 ELIQUIS .......................................................................................... 18 ELLA ................................................................................................ 51 ELMIRON ........................................................................................ 61 ELOCON ......................................................................................... 68 eltrombopag .................................................................................... 19 eluxadoline ...................................................................................... 43 elvitegravir, cobicistat, emtricitabine, & tenofovir ........................ 9 EMBEDA ......................................................................................... 27 EMCYT ............................................................................................ 13 emedastine ..................................................................................... 41 EMEND ........................................................................................... 44 EMFLAZA........................................................................................ 59 EMGALITY ...................................................................................... 59 emicizumab-kxwh .......................................................................... 59 EMLA ............................................................................................... 68 empagliflozin ................................................................................... 51 empagliflozin & lingaliptin ............................................................. 51 empagliflozin & metformin ............................................................ 51 EMSAM ........................................................................................... 31 emtricitabine ................................................................................. 8, 9 emtricitabine & tenofovir ............................................................. 8, 9 emtricitabine, rilpivirine, & tenofovir............................................... 9 EMTRIVA .......................................................................................... 9

ENABLEX ....................................................................................... 70 enalapril .......................................................................................... 22 enalapril & hydrochlorothiazide ................................................... 22 enasidenib ...................................................................................... 12 ENBREL .......................................................................................... 59 encorafenib ..................................................................................... 12 ENDARI........................................................................................... 60 enfuvirtide ......................................................................................... 9 ENJUVIA ......................................................................................... 56 enoxaparin ...................................................................................... 18 entacapone ..................................................................................... 31 entecavir ........................................................................................... 9 ENTOCORT EC ............................................................................. 46 ENTRESTO .................................................................................... 21 ENULOSE ....................................................................................... 36 enzalutamide .................................................................................. 12 EPANOVA ...................................................................................... 20 EPCLUSA ....................................................................................... 11 EPIDIOLEX ..................................................................................... 32 EPIDUO .......................................................................................... 69 epinastine (ophth) .......................................................................... 41 epinephrine ..................................................................................... 17 EPIPEN ........................................................................................... 17 EPIPEN JR ..................................................................................... 17 EPIVIR ............................................................................................ 10 EPIVIR HBV ................................................................................... 10 eplerenone ...................................................................................... 22 epoetin alfa ..................................................................................... 19 EPOGEN......................................................................................... 19 eprosartan....................................................................................... 22 eprosartan & hydrochlorothiazide................................................ 22 EPZICOM ......................................................................................... 8 EQUETRO ...................................................................................... 29 erenumab-aooe.............................................................................. 59 ergocalciferol .................................................................................. 71 ergoloid mesylates......................................................................... 17 ergotamine & caffeine ............................................................. 17, 30 erlotinib ............................................................................................ 13 ERTACZO ....................................................................................... 66 ertufliglozin ..................................................................................... 51 ertugliflozin & metformin ............................................................... 51 ertugliflozin & sitagliptin ................................................................ 51 ERYGEL ......................................................................................... 65 ERYPED ........................................................................................... 5 ERY-TAB .......................................................................................... 5 ERYTHROCIN ................................................................................. 5 ERYTHROMYCIN ........................................................................... 5 erythromycin & sulfisoxazole ......................................................... 5 erythromycin (acne acid) .............................................................. 65 erythromycin (ophth) ..................................................................... 38 erythromycin base ........................................................................... 5 erythromycin base delayed-release .............................................. 5 erythromycin ethylsuccinate ........................................................... 5 erythromycin sterate ........................................................................ 5



ESBRIET ......................................................................................... 64 escitalopram ................................................................................... 34 eslicarbazepine .............................................................................. 29 esomeprazole ................................................................................. 44 estazolam ........................................................................................ 31 esterified estrogens ....................................................................... 55 ESTRACE ................................................................................. 55, 56 ESTRACE CREAM ........................................................................ 56 ESTRACE TAB .............................................................................. 55 ESTRADERM ................................................................................. 55 estradiol ............................................................. 47, 48, 49, 50, 55, 56 estradiol & levonorgestrel ............................................................. 55 estradiol & norethindrone .............................................................. 55 estradiol & norgestimate ............................................................... 55 estradiol acetate ............................................................................. 55 estradiol acetate vaginal tablets .................................................. 55 estradiol cypionate ......................................................................... 48 estradiol gel .................................................................................... 55 estradiol transdermal ..................................................................... 55 estradiol transderomal ................................................................... 55 estradiol vaginal ............................................................................. 56 estradiol vaginal 10 mg ................................................................. 56 estradiol valerate ............................................................................ 48 estradiol valerate & dienogest ...................................................... 48 estramustine ................................................................................... 13 ESTRATEST .................................................................................. 56 ESTRING ........................................................................................ 56 estrogen, ester/me-testosterone .................................................. 56 estrogens, conjugated ................................................................... 56 estrogens, conjugated synthetic a ............................................... 56 estrogens, conjugated synthetic b ............................................... 56 estrogens, conjugated vaginal ..................................................... 56 estropipate ...................................................................................... 56 ESTROSTEP FE ............................................................................ 50 eszopiclone ..................................................................................... 31 etanercept ....................................................................................... 59 ethacrynic acid ............................................................................... 37 ethambutol ........................................................................................ 7 ethionamide ...................................................................................... 7 ethontoin ......................................................................................... 29 ethosuximide .................................................................................. 29 ethynodiol diacetate & ethinyl estradiol ...................................... 48 etidronate ........................................................................................ 59 etodolac ........................................................................................... 25 etonogestrel & ethinyl estradiol .................................................... 48 etravirine............................................................................................ 9 EUCRISA ........................................................................................ 67 EULEXIN ......................................................................................... 13 EURAX ............................................................................................ 65 EVAMIST ........................................................................................ 55 EVEKEO.......................................................................................... 27 everolimus ................................................................................. 13, 59 EVISTA ............................................................................................ 56 EVOCLIN ........................................................................................ 65

evolocumab .................................................................................... 51 EVOTAZ ............................................................................................ 8 EVOXAC ......................................................................................... 16 EXALGO ......................................................................................... 26 EXELDERM .................................................................................... 66 EXELON ......................................................................................... 16 exemestane .................................................................................... 13 exenatide ........................................................................................ 51 exenatide extended-release ......................................................... 51 EXFORGE ...................................................................................... 20 EXFORGE HCT ............................................................................. 20 EXJADE .......................................................................................... 46 EXTAVIA ......................................................................................... 60 ezetimibe......................................................................................... 19 ezetimibe & simvastatin ................................................................ 19 ezogaine ......................................................................................... 29

F famciclovir ......................................................................................... 9 famotidine ....................................................................................... 44 FAMVIR............................................................................................. 9 FANAPT .......................................................................................... 34 FARESTON .................................................................................... 15 FARXIGA ........................................................................................ 51 FAZACLO ....................................................................................... 33 febuxostat ....................................................................................... 59 felbamate ........................................................................................ 29 FELBATOL ..................................................................................... 29 FELDENE ....................................................................................... 27 felodipine......................................................................................... 21 FEMARA ......................................................................................... 13 FEMCON FE .................................................................................. 50 FEMHRT ......................................................................................... 56 FEMRING ....................................................................................... 55 FEMTRACE .................................................................................... 55 fenofibrate ................................................................................. 19, 20 fenofibrate, micronized ................................................................. 20 fenofibric acid ................................................................................. 20 fenoprofen calcium ........................................................................ 25 fentanyl film .................................................................................... 26 fentanyl intranasal ......................................................................... 26 fentanyl lozenge ............................................................................. 26 fentanyl sublingual ......................................................................... 26 fentanyl tablet ................................................................................. 26 fentanyl transdermal ...................................................................... 26 FENTORA ....................................................................................... 26 FERRIPROX .................................................................................. 46 fesoterodine .................................................................................... 70 FETZIMA......................................................................................... 34 FIASP .............................................................................................. 52 FIASP FlLEXPEN .......................................................................... 52 fidaxomicin ........................................................................................ 5 filgrastim .......................................................................................... 19



FINACEA ......................................................................................... 69 fingolimod ........................................................................................ 59 FIORICET ....................................................................................... 25 FIORICET W/ CODEINE .............................................................. 25 FIORINAL........................................................................................ 25 FIORINAL W/ CODEINE............................................................... 25 FIRAZYR ......................................................................................... 60 FIRDAPSE ...................................................................................... 58 FLAGYL ............................................................................................. 7 FLAGYL ER ...................................................................................... 7 FLAREX .......................................................................................... 40 flavoxate .......................................................................................... 71 FLAVOXATE .................................................................................. 71 flecainide ......................................................................................... 21 FLECTOR ....................................................................................... 69 FLEXERIL ....................................................................................... 16 FLOMAX.......................................................................................... 17 FLORINEF ACETATE ................................................................... 47 FLOVENT DISKUS AER............................................................... 63 FLOVENT HFA............................................................................... 63 FLOXIN ........................................................................................... 39 fluconazole ........................................................................................ 6 flucytosine ......................................................................................... 6 fludrocortisone ................................................................................ 47 FLUMADINE ................................................................................... 10 fluocinolone acetonide ............................................................ 40, 67 fluocinolone acetonide (otic) ......................................................... 40 fluocinonide ..................................................................................... 67 fluocinonide emollient .................................................................... 67 FLUORABON BASIC .................................................................... 62 FLUORITAB .................................................................................... 62 fluorometholone (ophth oint) ........................................................ 40 fluorometholone (ophth) ................................................................ 40 fluorometholone acetate ............................................................... 40 FLUOROPLEX ............................................................................... 70 fluorouracil (topical) ....................................................................... 70 fluoxetine ......................................................................................... 34 fluoxymesterone ............................................................................. 47 fluphenazine ................................................................................... 34 flurandrenolide ................................................................................ 67 flurazepam ...................................................................................... 31 flurbiprofen ................................................................................ 26, 40 flurbiprofen (ophth) ........................................................................ 40 flutamide .......................................................................................... 13 fluticasone & salmeterol ................................................................ 63 fluticasone & salmeterol (100/50 mcg) ....................................... 63 fluticasone & salmeterol (250/50 mcg and 500/50 mcg) .......... 63 fluticasone & umeclidinium & vilanterol ...................................... 63 fluticasone & vilanterol .................................................................. 63 fluticasone propionate ............................................................. 63, 67 fluticasone propionate (topical) .................................................... 67 fluvastatin ........................................................................................ 20 fluvastatin extended-release ........................................................ 20 fluvoxamine ..................................................................................... 34

FML.................................................................................................. 40 FML FORTE ................................................................................... 40 FML OINT ....................................................................................... 40 FOCALIN ........................................................................................ 28 FOCALIN XR .................................................................................. 28 fondaparinux ................................................................................... 18 FORADIL ........................................................................................ 17 formoterol fumarate ....................................................................... 17 FORTAMET .................................................................................... 54 FORTEO ......................................................................................... 56 FORTESTA .................................................................................... 47 FORTICAL ...................................................................................... 56 FOSAMAX ...................................................................................... 58 FOSAMAX PLUS D ....................................................................... 58 fosamprenavir calcium .................................................................... 9 fosfomycin ....................................................................................... 11 fosinopril .......................................................................................... 22 fosinopril & hydrochlorothiazide................................................... 22 FOSRENOL .................................................................................... 37 fostamatinib .................................................................................... 59 FRAGMIN ....................................................................................... 18 FREESTYLE SYSTEM ................................................................. 36 FREESTYLE TEST STRIPS ........................................................ 36 FROVA ............................................................................................ 30 frovatriptan ...................................................................................... 30 FULPHILA ....................................................................................... 19 FURADANTIN ................................................................................ 11 furosemide ...................................................................................... 37 FUZEON ........................................................................................... 9 FYCOMPA ...................................................................................... 29

G gabapentin ...................................................................................... 29 GABITRIL ....................................................................................... 30 GALAFOLD .................................................................................... 61 galantamine hydrobromide ........................................................... 16 galcanezumab ................................................................................ 59 ganciclovir ................................................................................... 9, 38 ganciclovir (ophth) ......................................................................... 38 GARAMYCIN.............................................................................. 5, 65 GASTROCROM ............................................................................. 63 gatifloxacin (ophth) ........................................................................ 38 GATTEX .......................................................................................... 46 GAVILYTE-C .................................................................................. 45 GEL-KAM ........................................................................................ 62 gemfibrozil ...................................................................................... 20 GENERESS FE ............................................................................. 50 GENTAK ......................................................................................... 38 gentamicin & prednisolone ........................................................... 40 gentamicin (ophth) ......................................................................... 38 gentamicin sulfate ...................................................................... 5, 65 gentamicin sulfate (topical) .......................................................... 65 GENTROPIN .................................................................................. 57



GENVOYA ........................................................................................ 9 GEODON ........................................................................................ 35 GIANVI ............................................................................................ 48 GIAZO ............................................................................................. 43 GILENYA ......................................................................................... 59 gilteritinib ......................................................................................... 13 glasdegib ......................................................................................... 13 glatiramer acetate ............................................................... 59, 60 GLATOPA ....................................................................................... 60 glecaprevir & pibrentasvir ............................................................... 9 GLEEVEC ....................................................................................... 13 GLEOSTINE ................................................................................... 13 glimepiride ................................................................................. 52, 54 glipizide ........................................................................................... 52 glipizide & metformin ..................................................................... 52 glipizide extended-release ............................................................ 52 GLUCAGEN HYPOKIT ................................................................. 52 glucagon .......................................................................................... 52 GLUCAGON EMERGENCY KIT ................................................. 52 GLUCOPHAGE .............................................................................. 54 GLUCOPHAGE XR ....................................................................... 54 GLUCOTROL ................................................................................. 52 GLUCOTROL XL ........................................................................... 52 GLUCOVANCE .............................................................................. 52 GLUMETZA .................................................................................... 54 glyburide .......................................................................................... 52 glyburide & metformin ................................................................... 52 glyburide micronized...................................................................... 52 glycerol phenylbutyrate ................................................................. 36 glycopyrrolate ........................................................................... 15, 64 glycopyrrolate & indacaterol ......................................................... 64 glycopyrrolate inhalation pow ....................................................... 15 glycopyrrolate nebulizer soln ........................................................ 15 GLYNASE ....................................................................................... 52 GLYSET .......................................................................................... 54 GLYXAMBI ...................................................................................... 51 GOCOVRI ....................................................................................... 30 golimumab ...................................................................................... 60 GOLYTELY ..................................................................................... 45 granisetron ...................................................................................... 44 grass pollen allergen extract (5 glass extract) ........................... 41 GRASTEK ....................................................................................... 42 GRIFULVIN V ................................................................................... 6 griseofulvin microsize ...................................................................... 6 griseofulvin ultramicrosize .............................................................. 6 GRIS-PEG ........................................................................................ 6 guaifenesin & codeine ................................................................... 62 guanfacine ................................................................................ 22, 32 guanfacine extended-release ....................................................... 32 guselkumab .................................................................................. 59 GYNAZOLE-1 ................................................................................. 64 GYNODIOL ..................................................................................... 55

H HAEGARDA ................................................................................... 58 halcinonide ..................................................................................... 67 HALCION ........................................................................................ 32 HALDOL .......................................................................................... 34 HALFLYTELY ................................................................................. 45 halobetasol propionate ................................................................. 67 HALOG ............................................................................................ 67 haloperidol ...................................................................................... 34 HARVONI ....................................................................................... 10 HECTOROL ................................................................................... 71 HELIDAC .......................................................................................... 4 HEMLIBRA ..................................................................................... 59 heparin ............................................................................................ 18 HEPARIN SODIUM ....................................................................... 18 HEPSERA ......................................................................................... 8 HETLIOZ ......................................................................................... 32 hexachlorophene ........................................................................... 65 HIPREX ........................................................................................... 11 HIZENTRA ...................................................................................... 60 homatropine ............................................................................. 43, 62 HORIZANT ..................................................................................... 29 house dust mite allergen extract ................................................. 41 HUMALOG ..................................................................................... 53 HUMALOG KWIKPEN .................................................................. 53 HUMALOG MIX 50/50 .................................................................. 53 HUMALOG MIX 75/25 .................................................................. 53 HUMALOG MIX 75/25 KWIKPEN ............................................... 53 HUMATIN ......................................................................................... 7 HUMATROPE ................................................................................ 57 HUMIRA .......................................................................................... 58 HUMIRA citrate free ...................................................................... 58 HUMULIN 50/50 ............................................................................ 53 HUMULIN 70/30 ............................................................................ 53 HUMULIN 70/30 KIWKPEN ......................................................... 53 HUMULIN N ................................................................................... 53 HUMULIN N KWIKPEN ................................................................ 53 HUMULIN R ................................................................................... 53 HUMULIN R U-500 ........................................................................ 53 HYCAMTIN ..................................................................................... 15 HYCODAN ...................................................................................... 62 HYDERGINE .................................................................................. 17 hydralazine ............................................................................... 22, 23 HYDREA ......................................................................................... 13 hydrochlorothiazide ............................................... 20, 22, 23, 24, 37 hydrocodone ............................................................................. 26, 62 hydrocodone & acetaminophen ................................................... 26 hydrocodone & chlorpheniramine................................................ 62 hydrocodone & homatropine ........................................................ 62 hydrocodone & ibuprofen ............................................................. 26 hydrocodone er .............................................................................. 26 hydrocortisone............................................. 39, 40, 47, 65, 66, 67, 68 hydrocortisone & acetic acid (otic) .............................................. 40



hydrocortisone & pramoxine ......................................................... 68 hydrocortisone (intrarectal) ........................................................... 67 hydrocortisone (rectal) .................................................................. 67 hydrocortisone (topical) ................................................................. 67 hydrocortisone acetate & urea ..................................................... 67 hydrocortisone acetate (intrarectal) ............................................. 67 hydrocortisone butyrate ................................................................ 67 hydrocortisone butyrate hydrophilic lipo base ............................ 67 hydrocortisone probutate .............................................................. 68 hydrocortisone valerate ................................................................. 68 hydromorphone oral suspension ................................................. 26 hydromorphone tablet ................................................................... 26 hydroxychloroquine sulfate ............................................................. 7 hydroxyurea .................................................................................... 13 hydroxyzine hcl............................................................................... 31 hydroxyzine pamoate .................................................................... 31 HYGROTON ................................................................................... 37 hyoscyamine sulfate ...................................................................... 15 HYPERCARE ................................................................................. 68 HYPERSAL ..................................................................................... 64 HYQVIA ........................................................................................... 60 HYSINGLA ER ............................................................................... 26 HYTONE ......................................................................................... 67 HYTRIN ........................................................................................... 19 HYZAAR .......................................................................................... 23

I ibandronate ..................................................................................... 60 IBRANCE ........................................................................................ 14 ibrutinib ............................................................................................ 13 Ibrutinib 140 mg, 280 mg .............................................................. 13 ibuprofen ................................................................................... 26, 27 icatibant ........................................................................................... 60 ICLUSIG .......................................................................................... 14 icosapent ......................................................................................... 20 idelalisib ........................................................................................... 13 IDHIFA ............................................................................................. 12 ILARIS ............................................................................................. 58 iloperidone ...................................................................................... 34 ILUMYA ........................................................................................... 62 imatinib mesylate ........................................................................... 13 IMBRUVICA .................................................................................... 13 IMDUR ............................................................................................. 23 imipramine ...................................................................................... 34 imipramine pamoate ...................................................................... 34 imiquimod ........................................................................................ 70 IMITREX .......................................................................................... 30 immune globulin ............................................................................. 60 Immune globulin ............................................................................. 60 IMPAVIDO ........................................................................................ 7 IMURAN .......................................................................................... 58 INCIVEK .......................................................................................... 11 INCRUSE ELLIPTA ....................................................................... 16

indacaterol ...................................................................................... 64 indapamide ..................................................................................... 37 INDERAL ........................................................................................ 24 INDERAL LA .................................................................................. 24 INDERIDE ....................................................................................... 24 indinavir sulfate ................................................................................ 9 INDOCIN ......................................................................................... 26 indomethacin .................................................................................. 26 INFERGEN ....................................................................................... 9 INFLAMASE FORTE ..................................................................... 40 ingenol mebutate ........................................................................... 70 INGREZZA ..................................................................................... 33 INLYTA ............................................................................................ 12 INNOPRAN XL ............................................................................... 24 Inotersen ......................................................................................... 60 INSPRA ........................................................................................... 22 insulin (oral inhalation) .................................................................. 52 insulin aspart .................................................................................. 52 insulin aspart protamine & insulin aspart ................................... 52 insulin degludec ............................................................................. 52 Insulin degludec/ liraglutide .......................................................... 52 insulin degludec/insulin aspart ..................................................... 52 insulin detemir ................................................................................ 52 insulin glargine ............................................................................... 52 Insulin glargine/ lixisenatide ......................................................... 52 insulin glulisine ............................................................................... 53 insulin isophane ............................................................................. 53 insulin isophane & regular insulin ................................................ 53 insulin lispro .................................................................................... 53 insulin lispro protamine & insulin lispro....................................... 53 insulin regular ................................................................................. 53 INTAL .............................................................................................. 63 INTELENCE ..................................................................................... 9 interferon alfacon-1 ......................................................................... 9 interferon beta-1a .......................................................................... 60 interferon beta-1b .......................................................................... 60 Interferon beta-1b .......................................................................... 60 interferon gamma-1b ..................................................................... 60 INTROVALE ................................................................................... 48 INTUNIV .......................................................................................... 32 INVEGA........................................................................................... 34 INVIRASE ....................................................................................... 11 INVOKAMET .................................................................................. 51 INVOKANA ..................................................................................... 51 iodoquinol & hydrocortisone ......................................................... 65 IOPIDINE ........................................................................................ 43 ipratropium bromide ...................................................................... 15 irbesartan ........................................................................................ 23 irbesartan & hydrochlorothiazide ................................................. 23 isavuconazonium ............................................................................. 6 ISENTRESS ................................................................................... 10 ISENTRESS HD ............................................................................ 10 isocarboxazid ................................................................................. 34 isoniazid ............................................................................................ 7



ISOPTIN SR ................................................................................... 21 ISOPTO ATROPINE...................................................................... 43 ISOPTO CARBACHOL ................................................................. 42 ISOPTO CARPINE ........................................................................ 42 ISOPTO HOMATROPINE ............................................................ 43 ISOPTO HYOSCINE ..................................................................... 43 ISORDIL .......................................................................................... 23 isosorbide dinitrate ......................................................................... 23 isosorbide dinitrate & hydralazine ................................................ 23 isosorbide mononitrate .................................................................. 23 isotretinoin ....................................................................................... 70 isradipine ......................................................................................... 21 ISTALOL.......................................................................................... 42 itraconazole ...................................................................................... 6 Ivabradine ....................................................................................... 21 ivacaftor ........................................................................................... 64 ivermectin .......................................................................................... 4 ivosidenib ........................................................................................ 13 ixazomib .......................................................................................... 13 ixekizumab ...................................................................................... 60

J JAKAFI ............................................................................................ 14 JALYN ............................................................................................. 59 JANUMET ....................................................................................... 54 JANUVIA ......................................................................................... 54 JARDIANCE ................................................................................... 51 JENTADUETO ............................................................................... 53 JUBLIA .............................................................................................. 6 JULUCA ............................................................................................ 8 JUNEL ....................................................................................... 49, 50 JUNEL FE ....................................................................................... 50 JUVISYNC ...................................................................................... 54 JUXTAPID ....................................................................................... 20 JYNARQUE .................................................................................... 37

K KADIAN ........................................................................................... 26 KALETRA ........................................................................................ 10 KALYDECO .................................................................................... 64 KAON............................................................................................... 38 KAPVAY .......................................................................................... 22 KARIVA ........................................................................................... 48 KAZANO.......................................................................................... 51 K-DUR ............................................................................................. 38 KEFLEX ............................................................................................. 5 KELNOR.......................................................................................... 48 KENALOG ....................................................................................... 68 KEPPRA .......................................................................................... 29 KEPPRA XR ................................................................................... 29 KERLONE ....................................................................................... 24 KERYDIN .......................................................................................... 6

KETEK .............................................................................................. 6 ketoconazole .............................................................................. 6, 65 ketoconazole (topical) ................................................................... 65 ketoprofen ....................................................................................... 26 KETOPROFEN .............................................................................. 26 ketorolac (ophth) ............................................................................ 40 ketorolac tablet ............................................................................... 26 KEVEYIS......................................................................................... 59 KEVZARA ....................................................................................... 62 KHEDEZLA ..................................................................................... 34 KINERET ........................................................................................ 58 KLARON ......................................................................................... 66 KLONOPIN ..................................................................................... 29 KLOR-CON 20 MEQ ..................................................................... 38 K-LYTE/CL ..................................................................................... 38 KOMBIGLYZE XR ......................................................................... 54 KORLYM ......................................................................................... 54 K-PHOS NEUTRAL ....................................................................... 38 K-PHOS ORIGINAL ...................................................................... 38 KRISTALOSE ................................................................................. 37 K-TAB 10, KLOR-CON 20 MEQ ................................................. 38 K-TAB, KLOR-CON 20 MEQ ...................................................... 38 KUVAN ............................................................................................ 61 KWELL ............................................................................................ 65 KYNAMRO ..................................................................................... 20 KYTRIL ............................................................................................ 44

L labetalol ........................................................................................... 24 LAC-HYDRIN ................................................................................. 69 lacosamide ..................................................................................... 29 LACRISERT ................................................................................... 43 lactic acid (ammonium lactate) .................................................... 70 LACTINOL ...................................................................................... 70 lactulose .................................................................................... 36, 37 LAMICTAL ...................................................................................... 29 LAMICTAL XR................................................................................ 29 Lamidudine & tenofovir ................................................................. 10 LAMISIL ............................................................................................ 6 lamivudine............................................................................... 8, 9, 10 lamivudine & zidovudine ........................................................... 8, 10 lamotrigine ...................................................................................... 29 lamotrigine extended-release....................................................... 29 lanadelumab ................................................................................... 60 LANOXIN ........................................................................................ 21 lanreotide ........................................................................................ 60 lansoprazole ................................................................................... 44 lanthanum carbonate .................................................................... 37 LANTUS .......................................................................................... 52 LANTUS SOLOSTAR ................................................................... 52 lapatinib ........................................................................................... 13 LARIAM ............................................................................................. 7 LASIX .............................................................................................. 37



LASTACAFT ................................................................................... 41 latanoprost ...................................................................................... 42 latanoprostene bunod.................................................................... 42 LATUDA .......................................................................................... 34 LAZANDA........................................................................................ 26 ledipasvir & sofosbuvir .................................................................. 10 leflunomide...................................................................................... 60 lenalidomide .................................................................................... 13 lenvatinib ......................................................................................... 13 LENVIMA ........................................................................................ 13 LESCOL .......................................................................................... 20 LESCOL XL .................................................................................... 20 lesinurad .......................................................................................... 60 LESSINA ......................................................................................... 48 LETAIRIS ........................................................................................ 23 letermovir ........................................................................................ 10 letrozole ........................................................................................... 13 leucovorin ........................................................................................ 60 LEUCOVORIN ................................................................................ 60 LEUKERAN .................................................................................... 12 LEUKINE ......................................................................................... 19 leuprolide acetate ........................................................................... 13 levalbuterol nebulizer solution ...................................................... 18 levalbuterol tartrate ........................................................................ 18 LEVAQUIN ........................................................................................ 5 LEVATOL ........................................................................................ 24 LEVBID ............................................................................................ 15 LEVEMIR ........................................................................................ 52 levetiracetam .................................................................................. 29 levetiracetam extended-release ................................................... 29 levobunolol ...................................................................................... 42 LEVO-DROMORAN ...................................................................... 26 levofloxacin ................................................................................. 5, 39 levofloxacin (ophth)........................................................................ 39 levomilnacipran .............................................................................. 34 levonorgestrel ..................................................................... 48, 49, 55 levonorgestrel & ethinyl estradiol ........................................... 48, 49 levonorgestrel & ethinyl estradiol (91-day) ........................... 48, 49 levonorgestrel & ethinyl estradiol (continuous) .......................... 49 levonorgestrel & ethinyl estradiol (triphasic) .............................. 49 levorphanol ..................................................................................... 26 LEVOTHROID ................................................................................ 57 levothyroxine .................................................................................. 57 LEVOXYL ........................................................................................ 57 LEVSIN ............................................................................................ 15 LEXAPRO ....................................................................................... 34 LEXIVA .............................................................................................. 9 l-glutamine ...................................................................................... 60 LIALDA ............................................................................................ 44 LIBRAX ............................................................................................ 46 LIBRIUM .......................................................................................... 31 LIDAMANTLE ................................................................................. 68 LIDEX .............................................................................................. 67 LIDEX-E .......................................................................................... 67

lidocaine & hydrocortisone ........................................................... 68 lidocaine & prilocaine .................................................................... 68 lidocaine & tetracaine .................................................................... 68 lidocaine (jelly, topical) .................................................................. 68 lidocaine (mouth-throat) ................................................................ 43 lifitegrast .......................................................................................... 40 LIMBITROL DS .............................................................................. 33 linaclotide ........................................................................................ 46 linagliptin ......................................................................................... 53 linagliptin & metformin ................................................................... 53 lindane ............................................................................................. 65 linezolid ............................................................................................. 5 LINZESS ......................................................................................... 46 LIORESAL ...................................................................................... 16 liothyronine ..................................................................................... 57 liotrix ................................................................................................ 57 LIPITOR .......................................................................................... 19 liraglutide................................................................................... 52, 53 lisdexamfetamine ........................................................................... 28 lisinopril ........................................................................................... 23 lisinopril & hydrochlorothiazide .................................................... 23 LITHIUM CARBONATE ................................................................ 34 lithium carbonate capsule ............................................................. 34 lithium carbonate extended release ............................................ 34 lithium citrate .................................................................................. 34 LITHOBID ....................................................................................... 34 LIVALO ............................................................................................ 20 lixisenatide ................................................................................ 52, 54 LO LOESTRIN FE ......................................................................... 50 LO/OVRAL-28 ................................................................................ 50 LOCOID .......................................................................................... 67 LOCOID LIPOCREAM .................................................................. 67 LODINE ........................................................................................... 25 LODOSYN ...................................................................................... 30 lodoxamide tromethamine ............................................................ 41 LOESTRIN 24 FE .......................................................................... 50 LOESTRIN FE................................................................................ 50 lofexidine ......................................................................................... 32 LOFIBRA CAP ............................................................................... 20 LOFIBRA TAB ................................................................................ 19 LOKELMA ....................................................................................... 37 lomitapide ....................................................................................... 20 LOMOTIL ........................................................................................ 44 lomustine......................................................................................... 13 LONHALA MAGNAIR ................................................................... 15 LONITEN ........................................................................................ 22 LONSURF ....................................................................................... 15 LOPID .............................................................................................. 20 lopinavir & ritonavir ........................................................................ 10 LOPRESSOR ................................................................................. 24 LOPRESSOR HCT ........................................................................ 24 LOPROX ......................................................................................... 64 lorazepam ....................................................................................... 32 LORBRENA .................................................................................... 13



lorlatinib ........................................................................................... 13 losartan ............................................................................................ 23 losartan & hydrochlorothiazide ..................................................... 23 LOSEASONIQUE .......................................................................... 48 LOTEMAX ....................................................................................... 40 LOTENSIN ...................................................................................... 22 LOTENSIN HCT ............................................................................. 22 loteprednol ...................................................................................... 40 loteprednol & tobramycin .............................................................. 40 LOTREL .......................................................................................... 20 LOTRISONE ................................................................................... 65 LOTRONEX .................................................................................... 43 lovastatin ......................................................................................... 20 lovastatine extended-release ....................................................... 20 LOVAZA .......................................................................................... 20 LOVENOX ....................................................................................... 18 LOW-OGESTREL .......................................................................... 50 loxapine ........................................................................................... 34 LOXITANE ...................................................................................... 34 LOZOL ............................................................................................. 37 lubiprostone .................................................................................... 46 LUCEMYRA .................................................................................... 32 LUDIOMIL ....................................................................................... 34 LUFYLLIN ....................................................................................... 70 luliconazole ....................................................................................... 6 lumacaftor& ivacaftor ..................................................................... 64 LUMIGAN ........................................................................................ 42 LUNESTA........................................................................................ 31 LUPRON ......................................................................................... 13 lurasidone........................................................................................ 34 LURIDE CHEW .............................................................................. 62 LURIDE DROPS ............................................................................ 62 LUTERA .......................................................................................... 48 LUVOX ............................................................................................ 34 LUXIQ .............................................................................................. 66 LUZU ................................................................................................. 6 LYPREL ........................................................................................... 49 LYRICA ........................................................................................... 30 LYSODREN .................................................................................... 14 LYSTEDA ........................................................................................ 18

M macitentan ...................................................................................... 23 MACROBID .................................................................................... 11 MACRODANTIN ............................................................................ 11 mafenide acetate ........................................................................... 65 MALARONE ...................................................................................... 7 malathion ......................................................................................... 65 maprotiline ...................................................................................... 34 maraviroc ........................................................................................ 10 MARINOL ........................................................................................ 44 MARPLAN ....................................................................................... 34 MATULANE .................................................................................... 14

MAVIK ............................................................................................. 23 MAVYRET ........................................................................................ 9 MAXAIR AUTOHALER ................................................................. 18 MAXALT .......................................................................................... 30 MAXALT MLT ................................................................................. 30 MAXIDEX ........................................................................................ 39 MAXITROL ..................................................................................... 40 MAXZIDE ........................................................................................ 37 mechlorethamine ........................................................................... 13 meclofenamate .............................................................................. 26 MECLOMEN ................................................................................... 26 MEDROL......................................................................................... 47 medroxyprogesterone acetate ............................................... 55, 57 mefenamic acid .............................................................................. 26 mefloquine ........................................................................................ 7 MEGACE ........................................................................................ 57 megestrol acetate .......................................................................... 57 MEKTOVI ........................................................................................ 12 MELLARIL ...................................................................................... 35 meloxicam ....................................................................................... 26 melphalan ....................................................................................... 14 memantine ...................................................................................... 32 memantine er & donepezil ............................................................ 32 M-END MAX D ............................................................................... 63 MENEST ......................................................................................... 55 MENOSTAR ................................................................................... 55 MENTAX ......................................................................................... 64 mepenzolate ................................................................................... 46 meperidine tablet ........................................................................... 26 MEPHYTON ................................................................................... 71 mepolizumab .................................................................................. 64 meprobamate ................................................................................. 32 MEPRON .......................................................................................... 7 mercaptopurine .............................................................................. 14 mesalamine controlled-release .................................................... 43 mesalamine suppository ............................................................... 43 mesalamine suspension ............................................................... 43 mesalamine tablet ......................................................................... 44 mesna .............................................................................................. 60 MESNEX ......................................................................................... 60 MESTION ....................................................................................... 16 MESTION TIMESPAN .................................................................. 16 METADATE CD ............................................................................. 28 METADATE ER ............................................................................. 28 METAGLIP ..................................................................................... 52 metaxalone ..................................................................................... 16 metformin ...................................................................... 51, 52, 53, 54 metformin ER ................................................................................. 54 metformin extended-release ........................................................ 54 methadone ...................................................................................... 26 methamphetamine ......................................................................... 28 methazolamide ............................................................................... 42 methenamine hippurate ................................................................ 11



methenamine, sodium biphosphate, phenyl salicylate, methylene blue, and hyoscyamine ................................... 11, 61

METHERGINE ............................................................................... 61 methimazole ................................................................................... 57 METHITEST ................................................................................... 47 methocarbamol............................................................................... 16 methotrexate ................................................................................... 14 methotrexate sodium ..................................................................... 14 methoxsalen ................................................................................... 70 methoxsalen, rapid ........................................................................ 70 methscopolamine ........................................................................... 15 methsuximide ................................................................................. 29 methyclothiazide ............................................................................ 37 METHYCLOTHIAZIDE .................................................................. 37 methyldopa ..................................................................................... 22 methyldopa & hydrochlorothiazide .............................................. 22 methylergonovine maleate ........................................................... 61 METHYLIN ...................................................................................... 28 methylnaltrexone ............................................................................ 46 methylphenidate ............................................................................. 28 methylphenidate extended-release ............................................. 28 Methylphenidate extended-relesase disintegrating tablet ........ 28 methylphenidate sustained release ............................................. 28 methylphenidate transdermal patch ............................................ 28 methylprednisolone........................................................................ 47 methyltestosterone ........................................................................ 47 metipranolol .................................................................................... 42 metoclopramide .............................................................................. 46 metolazone ..................................................................................... 37 metoprol & hydrochlorothiazide ................................................... 24 metoprolol succinate...................................................................... 24 metoprolol tartrate .......................................................................... 24 metreleptin ...................................................................................... 61 METROCREAM ............................................................................. 65 METROGEL .................................................................................... 65 METROGEL-VAGINAL ................................................................. 65 METROLOTION ............................................................................. 65 metronidazole ......................................................................... 4, 7, 65 metronidazole (topical) .................................................................. 65 metronidazole (vaginal) ................................................................. 65 metronidazole, tetracycline & bismuth subsalicylate .................. 4 metronidazoleextended-release .................................................... 7 MEVACOR ...................................................................................... 20 mexiletine ........................................................................................ 21 MEXITIL .......................................................................................... 21 MIACALCIN .................................................................................... 56 MICARDIS ...................................................................................... 23 MICARDIS HCT ............................................................................. 23 miconazole nitrate & zinc oxide ................................................... 65 MICROGESTIN ........................................................................ 49, 50 MICROGESTIN FE ........................................................................ 50 MICROZIDE .................................................................................... 37 MIDAMOR ....................................................................................... 37 midodrine hcl .................................................................................. 18

MIFEPREX ..................................................................................... 61 mifepristone .............................................................................. 54, 61 migalastat ....................................................................................... 61 MIGERGOT .................................................................................... 30 miglitol ............................................................................................. 54 miglustat .......................................................................................... 61 MIGRANAL ..................................................................................... 17 milnacipran ..................................................................................... 32 miltefosine......................................................................................... 7 MILTOWN ....................................................................................... 32 MINASTRIN 24 FE ........................................................................ 50 MINIPRESS .................................................................................... 19 MINIVELLE ..................................................................................... 55 MINOCIN .......................................................................................... 5 minocycline ....................................................................................... 5 minoxidil .......................................................................................... 22 mipomersen sodium ...................................................................... 20 mirabegron ..................................................................................... 71 MIRAPEX ........................................................................................ 31 MIRAPEX ER ................................................................................. 31 mirtazapine ..................................................................................... 34 MIRVASO ....................................................................................... 69 misoprostol ............................................................................... 25, 45 mitotane .......................................................................................... 14 MOBIC ............................................................................................ 26 modafinil .......................................................................................... 28 MODICON ...................................................................................... 49 MODURETIC.................................................................................. 37 moexipril .......................................................................................... 23 moexipril & hydrochlorothiazide................................................... 23 mometasone & formoterol ............................................................ 64 mometasone furoate ............................................................... 64, 68 MONODOX ....................................................................................... 5 MONONESSA ................................................................................ 50 MONOPRIL .................................................................................... 22 MONOPRIL HCT ........................................................................... 22 montelukast .................................................................................... 63 MONUROL ..................................................................................... 11 morphine ................................................................................... 26, 27 morphine & naltrexone .................................................................. 27 morphine beads ............................................................................. 26 morphine extended-relase capsule ............................................. 26 morphine extended-release tablet ............................................... 26 MORPHINE SULFATE ................................................................. 26 MOTOFEN ...................................................................................... 44 MOTRIN .......................................................................................... 26 MOVIPREP ..................................................................................... 45 moxifloxacin ................................................................................ 5, 39 moxifloxacin (ophth) ...................................................................... 39 MS CONTIN ................................................................................... 26 MSIR................................................................................................ 26 MUCOMYST-10 ............................................................................. 58 MULTAQ ......................................................................................... 21 mupirocin ........................................................................................ 65



mupirocin calcium .......................................................................... 65 MYALEPT ....................................................................................... 61 MYAMBUTOL ................................................................................... 7 MYCELEX ....................................................................................... 65 MYCIFRADIN ................................................................................... 5 MYCOBUTIN .................................................................................... 7 MYCOLOG II .................................................................................. 68 mycophenolate mofetil .................................................................. 61 mycophenolate sodium ................................................................. 61 MYCOSTATIN .................................................................................. 6 MYDAYIS ........................................................................................ 28 MYFORTIC ..................................................................................... 61 MYLERAN ....................................................................................... 12 MYRBETRIQ .................................................................................. 71 MYSOLINE ..................................................................................... 30

N na sulfacetm/avobenzone/sulfur .................................................. 65 nabilone ........................................................................................... 44 nabumetone .................................................................................... 27 nadolol ............................................................................................. 24 nadolol & bendroflumethiazide ..................................................... 24 nafarelin ........................................................................................... 56 naftifine ............................................................................................ 65 naftifine cream ................................................................................ 65 Naftifine gel ..................................................................................... 66 NAFTIN ..................................................................................... 65, 66 nalbuphine ...................................................................................... 27 NALFON .......................................................................................... 25 naloxone .............................................................................. 25, 27, 33 naloxone nasal spray .................................................................... 33 naltrexone ................................................................................. 27, 33 NAMENDA ...................................................................................... 32 NAMZARIC ..................................................................................... 32 NAPRELAN .................................................................................... 27 NAPROSYN .................................................................................... 27 naproxen ......................................................................................... 27 naproxen sodium ........................................................................... 27 naratriptan ....................................................................................... 30 NARCAN ......................................................................................... 33 NARDIL ........................................................................................... 35 NATACYN ....................................................................................... 39 natamycin ........................................................................................ 39 NATAZIA ......................................................................................... 48 nateglinide ....................................................................................... 54 NATPARA ....................................................................................... 61 NATROBA ....................................................................................... 66 NAVANE.......................................................................................... 35 nebivolol .......................................................................................... 24 NEBUPENT ...................................................................................... 7 NECON ........................................................................................... 49 NECON 10/11................................................................................. 49 nedocromil sodium (ophth) ........................................................... 41

nefazodone ..................................................................................... 34 nelfinavir mesylate ......................................................................... 10 neomycin sulfate .............................................................................. 5 neomycin, bacitracin & polymyxin b (ophth) .............................. 39 neomycin, colistin, hydrocortisone & thonzonium (otic) ........... 40 neomycin, polymycin b & gramicidin (ophth) ............................. 39 neomycin, polymyxin B & dexamethasone (ophth)................... 40 neomycin, polymyxin B & hydrocortisone (ophth) ............... 39, 40 neomycin, polymyxin B & hydrocortisone (otic) ........................ 40 NEO-POLYCIN .............................................................................. 39 NEO-POLYCIN HC ....................................................................... 39 NEORAL ......................................................................................... 58 NEOSPORIN .................................................................................. 39 neostigmine bromide ..................................................................... 16 nepafenac ....................................................................................... 40 NEPTAZANE .................................................................................. 42 NESINA ........................................................................................... 51 netarsudil ........................................................................................ 42 netupitant & palonosetron ............................................................ 44 NEULASTA ..................................................................................... 19 NEUMEGA ..................................................................................... 19 NEUPOGEN ................................................................................... 19 NEUPRO......................................................................................... 31 NEURONTIN .................................................................................. 29 NEVANAC ...................................................................................... 40 nevirapine solution......................................................................... 10 nevirapine tablet ............................................................................ 10 NEXAVAR ....................................................................................... 14 NEXIUM .......................................................................................... 44 niacin ......................................................................................... 20, 71 niacin & lovastatin .......................................................................... 20 NIACOR .......................................................................................... 71 NIASPAN ........................................................................................ 20 nicardipine ...................................................................................... 21 NICODERM .................................................................................... 16 NICORETTE ................................................................................... 16 nicotine gum ................................................................................... 16 nicotine lozenge ............................................................................. 16 nicotine patch ................................................................................. 16 nicotine spray ................................................................................. 16 NICOTROL ..................................................................................... 16 nifedipine......................................................................................... 21 nifedipine extended-release ......................................................... 21 NILANDRON .................................................................................. 14 nilotinib ............................................................................................ 14 nilutamide ....................................................................................... 14 nimodipine ...................................................................................... 21 NIMOTOP ....................................................................................... 21 NINLARO ........................................................................................ 13 nintedanib ....................................................................................... 64 niraparib .......................................................................................... 14 NIRAVAM ....................................................................................... 31 nisoldipine ....................................................................................... 21 nitazoxanide ..................................................................................... 7



nitisinone ......................................................................................... 61 NITRO-BID ...................................................................................... 23 NITRO-DUR .............................................................................. 23, 24 nitrofurantoin ................................................................................... 11 nitrofurantoin macrocrystal ........................................................... 11 nitrofurantoin monohydrate ........................................................... 11 nitroglycerin (intra-anal) ................................................................ 24 nitroglycerin aerosol ...................................................................... 23 nitroglycerin solution ...................................................................... 23 nitroglycerin sublingual .................................................................. 23 nitroglycerin topical ointment ........................................................ 23 nitroglycerin transdermal patch .............................................. 23, 24 nitroglycerin transdermal patch 0.8 mg strength ....................... 24 NITROLINGUAL ............................................................................. 23 NITROMIST .................................................................................... 23 NITROSTAT ................................................................................... 23 nizatidine ......................................................................................... 45 NIZORAL ..................................................................................... 6, 65 NOLVADEX .................................................................................... 14 NORA-BE ........................................................................................ 49 NORCO ........................................................................................... 26 NORDETTE-28 .............................................................................. 48 NORDITROPIN .............................................................................. 57 norelgestromin & ethinyl estradiol ............................................... 49 norethindrone ......................................................... 49, 50, 55, 56, 57 norethindrone & ethinyl estradiol ........................................... 49, 50 norethindrone & ethinyl estradiol (biphasic) ............................... 49 norethindrone & ethinyl estradiol (triphasic) ............................... 49 norethindrone & ethinyl estradiol w/ ferrous fumarate .............. 50 norethindrone acetate ....................................................... 50, 56, 57 norethindrone acetate & ethinyl estradiol ............................. 50, 56 norethindrone acetate & ethinyl estradiol w/ ferrous fumarate 50 norethindrone acetate & ethinyl estradiol w/ ferrous fumarate

(biphasic) .................................................................................... 50 norethindrone-mestranol ............................................................... 50 NORFLEX ....................................................................................... 16 norfloxacin ......................................................................................... 6 NORGESIC ..................................................................................... 17 norgestimate & ethinyl estradiol ................................................... 50 norgestimate & ethinyl estradiol (triphasic) ................................ 50 norgestrel & ethinyl estradiol ........................................................ 50 NORINYL 1+35 .............................................................................. 49 NORINYL 1+50 .............................................................................. 50 NOROXIN ......................................................................................... 6 NORPACE ...................................................................................... 21 NORPACE CR ............................................................................... 21 NORPRAMIN .................................................................................. 33 NOR-QD .......................................................................................... 49 NORTHERA .................................................................................... 17 NORTREL 1/35 ............................................................................. 49 NORTREL 7/7/7 ............................................................................. 49 nortriptyline ..................................................................................... 34 NORVASC ...................................................................................... 20 NORVIR .......................................................................................... 10

NOVOLIN 70/30 ............................................................................. 53 NOVOLIN N .................................................................................... 53 NOVOLIN R .................................................................................... 53 NOVOLOG ..................................................................................... 52 NOVOLOG MIX 70/30 .................................................................. 52 NOVOLOG MIX 70/30 FLEXPEN ............................................... 52 NOXAFIL........................................................................................... 6 NUBAIN........................................................................................... 27 NUBEQA ......................................................................................... 12 NUCALA ......................................................................................... 64 NUCYNTA ...................................................................................... 27 NUEDEXTA .................................................................................... 32 NULYTELY ..................................................................................... 45 NUPLAZID ...................................................................................... 35 NUTROPIN AQ .............................................................................. 57 NUVARING ..................................................................................... 48 NUVIGIL .......................................................................................... 28 NUZYRA ........................................................................................... 6 NYDRAZID ....................................................................................... 7 nystatin .................................................................................. 6, 66, 68 NYSTATIN ...................................................................................... 66 nystatin & triamcinolone................................................................ 68 nystatin (topical) ............................................................................. 66

O OCELLA .......................................................................................... 48 octreotide acetate .......................................................................... 61 OCUFEN ......................................................................................... 40 OCUFLOX ...................................................................................... 39 OCUPRESS ................................................................................... 42 ODACTRA ...................................................................................... 41 ODEFSEY ......................................................................................... 9 OFEV ............................................................................................... 64 ofloxacin (ophth) ............................................................................ 39 ofloxacin (otic) ................................................................................ 39 OGESTREL .................................................................................... 50 olanzapine ...................................................................................... 34 olanzapine & fluoxetine hcl .......................................................... 34 olanzapine orally disintegrating ................................................... 34 OLEPTRO ....................................................................................... 35 olmesartan ................................................................................ 20, 23 olmesartan & hydrochlorothiazide ......................................... 20, 23 olodaterol .................................................................................. 18, 64 olopatadine ..................................................................................... 41 olopatadine (nasal) ........................................................................ 41 olopatadine (ophth) ....................................................................... 41 olsalazine ........................................................................................ 44 OLUMIANT ..................................................................................... 58 OLUX-E ........................................................................................... 67 OLYSIO ........................................................................................... 11 omadacycline ................................................................................... 6 omalizumab .................................................................................... 64 ombitasvir, paritaprevir & ritonavir ............................................... 10



ombitasvir, paritaprevir, ritonavir, & dasabuvir........................... 10 omega-3 acid ethyl esters............................................................. 20 omega-3-carboxylic acid ............................................................... 20 omeprazole ..................................................................................... 45 OMNICEF.......................................................................................... 4 OMNIPRED .................................................................................... 40 OMNITROPE .................................................................................. 57 ondansetron .................................................................................... 44 ondansetron (orally disintegrating) .............................................. 44 ONE TOUCH ULTRA 2 ................................................................. 36 ONE TOUCH ULTRA SMART ..................................................... 36 ONE TOUCH ULTRA TEST STRIPS ......................................... 35 ONE TOUCH ULTRAMINI ............................................................ 36 ONE TOUCH VERIO FLEX .......................................................... 36 ONE TOUCH VERIO TEST STRIPS .......................................... 35 ONEXTON ...................................................................................... 65 ONFI ................................................................................................ 29 ONGLYZA ....................................................................................... 54 ONSOLIS ........................................................................................ 26 OPANA ............................................................................................ 27 OPANA ER ..................................................................................... 27 OPIUM ............................................................................................. 27 opium & belladonna alkaloids ...................................................... 27 opium tincture ................................................................................. 27 oprelvekin ........................................................................................ 19 OPSUMIT ........................................................................................ 23 OPTHETIC ...................................................................................... 43 OPTICROM .................................................................................... 41 OPTIPRANOLOL ........................................................................... 42 OPTIVAR ........................................................................................ 41 ORACEA ..................................................................................... 5, 70 ORALAIR ........................................................................................ 41 ORAP............................................................................................... 35 ORAPRED ...................................................................................... 47 ORAPRED ODT ............................................................................. 47 ORENCIA ........................................................................................ 58 ORENITRAM .................................................................................. 24 ORFADIN ........................................................................................ 61 ORILISSA........................................................................................ 59 ORINASE ........................................................................................ 54 ORKAMBI........................................................................................ 64 orphenadrine citrate ....................................................................... 16 orphenadrine, aspirin, & caffeine ................................................. 17 ORTHO EVRA ................................................................................ 49 ORTHO TRI-CYCLEN ................................................................... 50 ORTHO-CEPT ................................................................................ 48 ORTHO-CYCLEN .......................................................................... 50 ORTHO-EST .................................................................................. 56 ORTHO-NOVUM ..................................................................... 49, 50 oseltamivir phosphate ................................................................... 10 OSENI ............................................................................................. 51 OSMOPREP ................................................................................... 45 ospemifene ..................................................................................... 56 OSPHENA ...................................................................................... 56

OTEZLA .......................................................................................... 58 OTREXUP ...................................................................................... 14 OVCON-35 ..................................................................................... 49 OVCON-50 ..................................................................................... 49 OVIDE ............................................................................................. 65 OXANDRIN ..................................................................................... 47 oxandrolone .................................................................................... 47 oxaprozin ........................................................................................ 27 oxazepam ....................................................................................... 32 oxcarbazepine ................................................................................ 29 OXERVATE .................................................................................... 43 oxiconazole nitrate......................................................................... 66 OXISTAT......................................................................................... 66 OXSORALEN-ULTRA ................................................................... 70 oxybutynin....................................................................................... 71 oxybutynin extended-release ....................................................... 71 oxybutynin transdermal ................................................................. 71 oxycodone ...................................................................................... 27 oxycodone & acetaminophen....................................................... 27 oxycodone & acetaminophen er .................................................. 27 oxycodone & aspirin ...................................................................... 27 oxycodone & ibuprofen ................................................................. 27 oxycodone controlled-release ...................................................... 27 OXYCONTIN .................................................................................. 27 oxymetholone ................................................................................. 47 oxymorphone.................................................................................. 27 oxymorphone extended-release .................................................. 27 OXYTROL ....................................................................................... 71

P PACERONE ................................................................................... 21 palbociclib ....................................................................................... 14 paliperidone .................................................................................... 34 palivizumab ..................................................................................... 10 PALYNZIQ ...................................................................................... 61 PAMELOR ...................................................................................... 34 PAMINE .......................................................................................... 15 PANCREAZE ................................................................................. 45 pancrelipase (lipase-protease-amylase) .................................... 45 PANDEL .......................................................................................... 68 PANLOR SS ................................................................................... 25 PANRETIN ..................................................................................... 69 pantoprazole ................................................................................... 45 papaverine ...................................................................................... 24 PARAFON FORTE DSC .............................................................. 16 parathyroid hormone ..................................................................... 61 PARCOPA ...................................................................................... 31 paregoric ......................................................................................... 44 PAREGORIC .................................................................................. 44 paricalcitol ....................................................................................... 71 PARLODEL .................................................................................... 30 PARNATE ....................................................................................... 35 paromomycin sulfate ....................................................................... 7



paroxetine ................................................................................. 34, 35 paroxetine extended-release ........................................................ 34 paroxetine mesylate ...................................................................... 35 pasireotide ...................................................................................... 61 PATADAY ....................................................................................... 41 PATANASE ..................................................................................... 41 PATANOL ....................................................................................... 41 patiromer ......................................................................................... 37 PAVABID ......................................................................................... 24 PAXIL............................................................................................... 34 PAXIL CR ........................................................................................ 34 pazopanib........................................................................................ 14 PEDIAPRED ................................................................................... 47 pediatric multivitamins w/ fluoride ................................................ 61 pediatric multivitamins w/ fluoride & iron .................................... 61 pediatric vitamins a, c, & d, w/ fluoride ....................................... 61 pediatric vitamins a, c, & d, w/ fluoride & iron ............................ 61 PEGANONE ................................................................................... 29 PEGASYS ....................................................................................... 10 pegfilgrastim ................................................................................... 19 pegfilgrastim-jmdb ......................................................................... 19 peginterferon alfa-2a ..................................................................... 10 peginterferon-alfa 2b ..................................................................... 10 PEG-INTRON ................................................................................. 10 pegvaliase ....................................................................................... 61 pegvisomant ................................................................................... 57 penbutolol........................................................................................ 24 penciclovir ....................................................................................... 66 penicillamine ................................................................................... 46 penicillin v potassium ...................................................................... 6 PENLAC .......................................................................................... 64 PENNSAID ...................................................................................... 25 pentamidine ...................................................................................... 7 PENTASA ....................................................................................... 43 pentazocine .................................................................................... 27 pentazocine & naloxone ................................................................ 27 pentosan polysulfate sodium ........................................................ 61 pentoxifylline ................................................................................... 18 PEN-VEE K ....................................................................................... 6 PEPCID ........................................................................................... 44 perampanel ..................................................................................... 29 PERCOCET .................................................................................... 27 PERCODAN ................................................................................... 27 PERIACTIN ....................................................................................... 4 PERIDEX ........................................................................................ 38 perindopril ....................................................................................... 23 PERIOSTAT ..................................................................................... 5 permethrin ....................................................................................... 66 perphenazine ............................................................................ 33, 35 PERSANTINE................................................................................. 18 PERTZYE........................................................................................ 45 PEXEVA .......................................................................................... 35 phenelzine ....................................................................................... 35 PHENERGAN ....................................................................... 4, 62, 63

PHENERGAN VC ...................................................................... 4, 63 PHENERGAN VC W/CODEINE .................................................. 63 PHENERGAN W/ CODEINE ....................................................... 62 phenobarbital ........................................................................... 32, 46 PHENOBARBITAL ........................................................................ 32 phenobarbital and belladonna alkaloids ..................................... 46 phenoxybenzamine ....................................................................... 17 PHENYTEK .................................................................................... 30 phenytoin sodium extended-release ..................................... 29, 30 phenytoin suspension ................................................................... 30 PHISOHEX ..................................................................................... 65 PHOSLO ......................................................................................... 37 PHOSLYRA .................................................................................... 38 PHOSPHA ...................................................................................... 38 PHOSPHOLINE IODIDE .............................................................. 42 PHRENILIN .................................................................................... 25 PHRENILIN FORTE ...................................................................... 25 phytonadione .................................................................................. 71 PICATO ........................................................................................... 70 pilocarpine ................................................................................ 16, 42 pilocarpine gel ................................................................................ 42 PILOPINE HS ................................................................................. 42 pimavanserin .................................................................................. 35 pimecrolimus .................................................................................. 70 pimozide .......................................................................................... 35 pindolol ............................................................................................ 24 pioglitazone .............................................................................. 51, 54 pioglitazone & glimepiride ............................................................ 54 pioglitazone & metformin .............................................................. 54 PIQRAY........................................................................................... 12 pirbuterol acetate ........................................................................... 18 pirfenidone ...................................................................................... 64 piroxicam......................................................................................... 27 pitavastatin ..................................................................................... 20 PLAN B ........................................................................................... 48 PLAQUENIL ..................................................................................... 7 PLAVIX ............................................................................................ 18 PLEGRIDY ..................................................................................... 60 PLENDIL ......................................................................................... 21 PLETAL ........................................................................................... 18 PLEXION ........................................................................................ 68 PLEXION SCT ............................................................................... 68 podofilox .......................................................................................... 70 POLY HIST FORTE ........................................................................ 4 POLYCITRA-K ............................................................................... 36 polyethylene glycol-electrolyte solution ...................................... 45 polymyxin b & trimethoprim (ophth) ............................................ 39 POLYSPORIN ................................................................................ 38 POLYTRIM ..................................................................................... 39 POLY-VI-FLOR .............................................................................. 61 POLY-VI-FLOR W/IRON .............................................................. 61 pomalidomide ................................................................................. 14 POMALYST .................................................................................... 14 ponatinib ......................................................................................... 14



PONSTEL ....................................................................................... 26 PORTIA ........................................................................................... 48 posaconazole ................................................................................... 6 potassium bicarbonate & potassium chloride ............................ 38 potassium chloride ......................................................................... 38 potassium chrloide powder ........................................................... 38 potassium citrate ............................................................................ 36 potassium citrate & citric acid ....................................................... 36 potassium gluconate...................................................................... 38 potassium iodide & iodine ............................................................. 57 potassium phosphate .................................................................... 38 potassium phosphate, monobasic ............................................... 38 POTIGA ........................................................................................... 29 PRADAXA ....................................................................................... 18 PRALUENT ..................................................................................... 51 pramipexole .................................................................................... 31 pramipexole extended-release ..................................................... 31 pramlintide acetate ........................................................................ 54 PRAMOSONE ................................................................................ 68 PRAMOSONE-E ............................................................................ 68 pramoxine ....................................................................................... 68 PRANDIMET .................................................................................. 54 PRANDIN ........................................................................................ 54 prasugrel ......................................................................................... 18 PRAVACHOL ................................................................................. 20 pravastatin ...................................................................................... 20 praziquantel ...................................................................................... 4 prazosin ........................................................................................... 19 PRECOSE ...................................................................................... 51 PRED FORTE ................................................................................ 40 PRED MILD .................................................................................... 40 PRED-G .......................................................................................... 40 prednicarbate .................................................................................. 68 PREDNISOL ................................................................................... 41 prednisolone ....................................................................... 40, 41, 47 PREDNISOLONE .......................................................................... 47 prednisolone acetate ............................................................... 40, 47 prednisolone acetate (ophth) ....................................................... 40 prednisolone sodium phosphate ...................................... 40, 41, 47 prednisolone sodium phosphate (ophth) .............................. 40, 41 prednisone ...................................................................................... 47 PREDNISONE ................................................................................ 47 PREFEST........................................................................................ 55 pregabalin ....................................................................................... 30 PRELONE ....................................................................................... 47 PREMARIN ..................................................................................... 56 PREMARIN CREAM...................................................................... 56 PREMPHASE ................................................................................. 55 PREMPRO ...................................................................................... 55 PREPOPIK ...................................................................................... 45 PREVACID ...................................................................................... 44 PREVIDENT ................................................................................... 62 PREVIDENT 5000 PLUS ............................................................. 62 PREVPAC ....................................................................................... 44

PREVYMIS ..................................................................................... 10 PREZCOBIX ..................................................................................... 8 PREZISTA ........................................................................................ 8 PRIFTIN ............................................................................................ 7 PRILOSEC ..................................................................................... 45 PRIMAQUINE .................................................................................. 7 primaquine phosphate .................................................................... 7 primidone ........................................................................................ 30 PRISTIQ .......................................................................................... 34 PROAIR HFA ................................................................................. 17 PROAMATINE ............................................................................... 18 PRO-BANTHINE ............................................................................ 15 probenecid ...................................................................................... 38 procarbazine ................................................................................... 14 PROCARDIA .................................................................................. 21 PROCARDIA XL ............................................................................ 21 prochlorperazine ............................................................................ 44 PROCRIT ........................................................................................ 19 PROCTOCORT ............................................................................. 67 PROCTOFOAM ............................................................................. 68 PROCTOFOAM-HC ...................................................................... 68 PROCYSBI ..................................................................................... 59 PRODIGY ....................................................................................... 36 PRODIGY TEST STRIPS ............................................................. 36 progesterone, micronized ............................................................. 57 PROGRAF ...................................................................................... 62 PROLIXIN ....................................................................................... 34 PROLOPRIM .................................................................................. 11 PROMACTA ................................................................................... 19 promethazine........................................................................ 4, 62, 63 promethazine & codeine ............................................................... 62 promethazine & dextromethorphan ............................................. 63 promethazine & phenylephrine ...................................................... 4 promethazine, phenylephrine & codeine .................................... 63 PROMETHAZINE-DM ................................................................... 63 PROMETRIUM .............................................................................. 57 propafenone ................................................................................... 21 propantheline bromide .................................................................. 15 proparacaine .................................................................................. 43 propranolol ...................................................................................... 24 propranolol & hydrochlorothiazide ............................................... 24 propranolol extended-release ...................................................... 24 propranolol sustained-release ..................................................... 24 propylthiouracil ............................................................................... 57 PROPYLTHIOURACIL ................................................................. 57 PROSOM ........................................................................................ 31 PROSTIGMIN ................................................................................ 16 PROTONIX ..................................................................................... 45 PROTOPIC ..................................................................................... 70 protriptyline ..................................................................................... 35 PROVENTIL HFA .......................................................................... 17 PROVERA ...................................................................................... 57 PROVIGIL ....................................................................................... 28 PROZAC ......................................................................................... 34



PROZAC WEEKLY ........................................................................ 34 PRUDOXIN ..................................................................................... 70 pseudoephedrine, brompheniramine & codeine ........................ 63 PSORIATEC ................................................................................... 69 PULMICORT FLEXHALER .......................................................... 63 PULMICORT RESPULES ............................................................ 63 PULMOZYME ................................................................................. 38 PURINETHOL ................................................................................ 14 PYLERA ............................................................................................ 4 pyrazinamide .................................................................................... 7 PYRAZINAMIDE .............................................................................. 7 pyridostigmine ................................................................................ 16 pyrimethamine .................................................................................. 7

Q QUALAQUIN .................................................................................... 7 QUESTRAN .................................................................................... 19 QUESTRAN LIGHT ....................................................................... 19 quetiapine........................................................................................ 35 quetiapine extended-release ........................................................ 35 QUINAGLUTE ................................................................................ 21 quinapril & hydrochlorothiazide .................................................... 23 quinapril hcl ..................................................................................... 23 quinidine .................................................................................... 21, 32 quinidine gluconate ........................................................................ 21 QUINIDINE SULFATE .................................................................. 21 quinine sulfate .................................................................................. 7 QUIXIN ............................................................................................ 39 QVAR............................................................................................... 63 QVAR RediHaler ............................................................................ 63

R

rabeprazole ..................................................................................... 45 RAGWITEK ..................................................................................... 41 raloxifene hcl .................................................................................. 56 raltegravir ........................................................................................ 10 raltegravir (600mg) ........................................................................ 10 ramelteon ........................................................................................ 32 ramipril ............................................................................................. 23 RANEXA.......................................................................................... 21 ranitidine .......................................................................................... 45 ranolazine........................................................................................ 21 RAPAFLO ....................................................................................... 17 RAPAMUNE ................................................................................... 62 rasagiline ......................................................................................... 31 RASUVO ......................................................................................... 14 RAVICTI .......................................................................................... 36 RAYOS ............................................................................................ 47 RAZADYNE .................................................................................... 16 RAZADYNEER ............................................................................... 16 REBETOL ....................................................................................... 10 REBIF .............................................................................................. 60

REBIF REBIDOSE ........................................................................ 60 RECLIPSEN ................................................................................... 48 RECTIV ........................................................................................... 24 REGLAN ......................................................................................... 46 regorafenib ..................................................................................... 14 REGRANEX ................................................................................... 69 RELAFEN ....................................................................................... 27 RELENZA ....................................................................................... 11 RELISTOR ...................................................................................... 46 RELPAX .......................................................................................... 30 REMERON ..................................................................................... 34 REMODULIN .................................................................................. 24 RENAGEL ....................................................................................... 37 RENVELA ....................................................................................... 37 repaglinide ...................................................................................... 54 repaglinide & metformin ................................................................ 54 REPATHA ....................................................................................... 51 REQUIP .......................................................................................... 31 REQUIP XL .................................................................................... 31 RESCRIPTOR.................................................................................. 8 RESCULA ....................................................................................... 43 reserpine ......................................................................................... 22 RESTASIS ...................................................................................... 39 RESTORIL ...................................................................................... 32 retapamulin ..................................................................................... 66 RETIN-A .......................................................................................... 69 RETIN-A MICRO ........................................................................... 69 RETROVIR ..................................................................................... 11 REVATIO ........................................................................................ 24 revefenacin ..................................................................................... 15 REVIA .............................................................................................. 33 REVLIMID ....................................................................................... 13 REXULTI ......................................................................................... 33 REYATAZ ......................................................................................... 8 RHEUMATREX .............................................................................. 14 RHOPRESSA ................................................................................. 42 ribavirin ............................................................................................ 10 RIDAURA ........................................................................................ 46 rifabutin ............................................................................................. 7 RIFADIN ............................................................................................ 7 RIFAMATE ....................................................................................... 7 rifampin ............................................................................................. 7 rifampin & isoniazid ......................................................................... 7 rifampin, isoniazid, & pryazinamide .............................................. 7 rifapentine ......................................................................................... 7 RIFATER........................................................................................... 7 rifaximin ............................................................................................. 6 rilpivirine .................................................................................. 8, 9, 10 RILUTEK ......................................................................................... 32 riluzole ............................................................................................. 32 rimantadine ..................................................................................... 10 rimexolone ...................................................................................... 41 riociguat .......................................................................................... 24 RIOMET .......................................................................................... 54



risankizumab .................................................................................. 61 risedronate sodium ........................................................................ 61 RISPERDAL ................................................................................... 35 RISPERDALM-TAB ....................................................................... 35 risperidone ...................................................................................... 35 risperidone orally disintegrating ................................................... 35 RITALIN ........................................................................................... 28 RITALIN LA ..................................................................................... 28 RITALIN SR .................................................................................... 28 ritonavir ............................................................................................ 10 rivaroxaban ..................................................................................... 18 rivastigmine tartrate ....................................................................... 16 rivastigmine tartrate (solution) ...................................................... 16 rizatriptan ........................................................................................ 30 rizatriptan orally disintegrating ..................................................... 30 ROBAXIN ........................................................................................ 16 ROBINUL ........................................................................................ 15 ROBINULFORTE ........................................................................... 15 ROCALTROL .................................................................................. 71 roflumilast ........................................................................................ 64 rolapitant ......................................................................................... 44 ROMYCIN ....................................................................................... 38 ropinirole ......................................................................................... 31 ropinirole extended-release .......................................................... 31 ROSAC ............................................................................................ 65 rosiglitazone .................................................................................... 54 rosiglitazone & glimepiride ............................................................ 54 rosiglitazone & metformin ............................................................. 54 ROSULA.......................................................................................... 68 rosuvastatin .................................................................................... 20 rotigotine ......................................................................................... 31 ROWASA ........................................................................................ 43 ROXICET ........................................................................................ 27 ROXICODONE ............................................................................... 27 ROZEREM ...................................................................................... 32 rufinamide ....................................................................................... 30 ruxolitinib ......................................................................................... 14 RYTHMOL ...................................................................................... 21 RYTHMOL SR ................................................................................ 21 RYZODEG 70/30 ........................................................................... 52

S S 5, 34, 41, 42, 57, 102 SABRIL ............................................................................................ 30 sacubitril & valsartan ..................................................................... 21 SAFYRAL ........................................................................................ 48 SAIZEN ........................................................................................... 57 SALAGEN ....................................................................................... 16 salmeterol.................................................................................. 63, 64 salsalate .......................................................................................... 27 SAMSCA ......................................................................................... 37 SANCTURA .................................................................................... 71 SANCTURA XR ............................................................................. 71

SANCUSO ...................................................................................... 44 SANDIMMUNE .............................................................................. 58 SANDOSTATIN ............................................................................. 61 SANTYL .......................................................................................... 69 SAPHRIS ........................................................................................ 33 sapropterin dihydrochloride .......................................................... 61 saquinavir mesylate....................................................................... 11 SARAFEM ...................................................................................... 34 sargramostim.................................................................................. 19 sarilumab ........................................................................................ 62 SAVAYSA ....................................................................................... 18 SAVELLA ........................................................................................ 32 saxagliptin ....................................................................................... 54 saxagliptin & metformin extended-release ................................. 54 scopolamine (ophth) ...................................................................... 43 scopolamine hydrobromide .......................................................... 44 SEASONALE.................................................................................. 48 SEASONIQUE ............................................................................... 49 SEB-PREV ..................................................................................... 66 secnidazole ....................................................................................... 8 SECTRAL ....................................................................................... 24 secukinumab .................................................................................. 62 SEEBRI NEOHALER .................................................................... 15 SEGLUROMET .............................................................................. 51 selegiline ......................................................................................... 31 selegiline transdermal ................................................................... 31 selenium sulfide ............................................................................. 66 SELSEB .......................................................................................... 66 SELSUN RX ................................................................................... 66 SELZENTRY .................................................................................. 10 SENSIPAR ..................................................................................... 58 SEPTRA ............................................................................................ 6 SERAX ............................................................................................ 32 SEREVENT DISKUS .................................................................... 64 SEROMYCIN.................................................................................... 7 SEROQUEL ................................................................................... 35 SEROQUEL XR ............................................................................. 35 SEROSTIM ..................................................................................... 57 SERPASIL ...................................................................................... 22 sertaconazole nitrate ..................................................................... 66 sertraline ......................................................................................... 35 SERZONE ...................................................................................... 34 sevelamer carbonate ..................................................................... 37 sevelamer hcl ................................................................................. 37 short ragweed pollen allergen extract ......................................... 41 SIGNIFOR ...................................................................................... 61 sildenafil .......................................................................................... 24 SILENOR ........................................................................................ 31 SILIQ ............................................................................................... 58 silodosin .......................................................................................... 17 SILVADENE ................................................................................... 66 silver sulfadiazine .......................................................................... 66 simeprevir ....................................................................................... 11 SIMPONI ......................................................................................... 60



simvastatin .......................................................................... 19, 20, 54 sinecatechins .................................................................................. 70 SINEMET ........................................................................................ 31 SINEMET CR ................................................................................. 31 SINEQUAN ..................................................................................... 34 SINGULAIR .................................................................................... 63 sirolimus .......................................................................................... 62 sirolimus solution ........................................................................... 62 SIRTURO ........................................................................................ 58 sitagliptin & metformin ................................................................... 54 sitagliptin & simvastatin ................................................................. 54 sitagliptin phosphate ...................................................................... 54 SIVEXTRO ........................................................................................ 6 SKELAXIN ...................................................................................... 16 SKELID ............................................................................................ 62 SKYRIZI .......................................................................................... 61 sodium chloride .............................................................................. 64 sodium citrate & citric acid ............................................................ 36 sodium fluoride ............................................................................... 62 sodium fluoride (dental) ................................................................ 62 sodium fluoride drops .................................................................... 62 sodium oxybate .............................................................................. 33 sodium phenylbutyrate .................................................................. 36 sodium phosphates........................................................................ 45 sodium picosulfate-mag ox-anhyrous citric acid ........................ 45 sodium polystyrene sulfonate ....................................................... 37 sodium zirconium cyclosilicate ..................................................... 37 sofosbuvir .................................................................................. 10, 11 sofosbuvir & velpatasvir ................................................................ 11 sofosbuvir, velpatasvir, voxilaprevir............................................. 10 SOLARAZE ..................................................................................... 70 solifenacin ....................................................................................... 71 SOLIQUA ........................................................................................ 52 SOLODYN ........................................................................................ 5 SOLOSEC ......................................................................................... 8 solriamfetol ...................................................................................... 32 SOMA ........................................................................................ 16, 25 SOMA COMPOUND................................................................ 16, 25 SOMA COMPOUND W/ CODEINE............................................. 25 somatropin ...................................................................................... 57 SOMATULINE DEPOT ................................................................. 60 SOMAVERT .................................................................................... 57 SONATA.......................................................................................... 32 SOOLANTRA ................................................................................... 4 sorafenib tosylate ........................................................................... 14 SORIATANE ................................................................................... 69 SORILUX ........................................................................................ 69 sotalol .............................................................................................. 25 SOVALDI ......................................................................................... 11 SPECTAZOLE ................................................................................ 65 SPECTRACEF ................................................................................. 4 spinosad .......................................................................................... 66 SPIRIVA .................................................................................... 15, 16 SPIRIVA RESPIMAT ............................................................... 15, 16

spironolactone ................................................................................ 23 spironolactone & hydrochlorothiazide ......................................... 23 SPORANOX ..................................................................................... 6 SPRINTEC ..................................................................................... 50 SPRYCEL ....................................................................................... 12 SPS.................................................................................................. 37 STADOL .......................................................................................... 25 STALEVO ....................................................................................... 31 stannous fluoride ........................................................................... 62 STARLIX ......................................................................................... 54 stavudine......................................................................................... 11 STEGLATRO.................................................................................. 51 STEGLUJAN .................................................................................. 51 STELARA ....................................................................................... 62 STELAZINE .................................................................................... 35 STIMATE ........................................................................................ 56 STIOLTO RESPIMAT ................................................................... 64 STIVARGA ..................................................................................... 14 STRATTERA .................................................................................. 32 STRIBILD .......................................................................................... 9 STRIVERDI RESPIMAT ............................................................... 18 STROMECTOL ................................................................................ 4 SUBOXONE ................................................................................... 25 SUBUTEX ....................................................................................... 25 succimer .......................................................................................... 46 sucralfate suspension ................................................................... 45 sucralfate tablets ............................................................................ 45 sucroferric oxyhydroxide ............................................................... 37 SULAR ............................................................................................ 21 sulconazole nitrate......................................................................... 66 SULFAC .......................................................................................... 39 sulfacetamide sodium & prednisolone ........................................ 41 sulfacetamide sodium & sulfur ..................................................... 68 sulfacetamide sodium (acne) ....................................................... 66 sulfacetamide sodium (ophth) ointment ..................................... 39 sulfacetamide sodium (ophth) solution ....................................... 39 sulfadiazine ................................................................................. 6, 66 SULFADIAZINE ............................................................................... 6 sulfamethoxazole & trimethoprim .................................................. 6 SULFAMYLON ............................................................................... 65 sulfanilamide .................................................................................. 66 sulfasalazine ..................................................................................... 6 sulindac ........................................................................................... 27 sumatriptan ..................................................................................... 30 sunitinib malate .............................................................................. 14 SUNOSI .......................................................................................... 32 SUPRAX ........................................................................................... 4 SURMONTIL .................................................................................. 35 SUSTIVA........................................................................................... 9 SUTENT .......................................................................................... 14 suvorexant ...................................................................................... 32 SYMAX ............................................................................................ 15 SYMAX DUOTAB .......................................................................... 15 SYMBICORT .................................................................................. 63



SYMBYAX ....................................................................................... 34 SYMDEKO ...................................................................................... 64 SYMFI ................................................................................................ 9 SYMFI LO ......................................................................................... 9 SYMLIN ........................................................................................... 54 SYMMETREL ................................................................................. 30 SYMTUZA ......................................................................................... 8 SYNAGIS ........................................................................................ 10 SYNALAR ....................................................................................... 67 SYNAREL ....................................................................................... 56 SYNERA PATCH ........................................................................... 68 SYNJARDY ..................................................................................... 51 SYNTHROID .................................................................................. 57 SYPRINE ........................................................................................ 46 syringe with needle,disposable .................................................... 36

T TABLOID ......................................................................................... 15 TACLONEX .................................................................................... 67 tacrolimus .................................................................................. 62, 70 tacrolimus (topical) ......................................................................... 70 tadalafil ............................................................................................ 24 TAGAMET ....................................................................................... 44 TAKHZYRO .................................................................................... 60 talazoparib ...................................................................................... 14 TALTZ .............................................................................................. 60 TALWIN ........................................................................................... 27 TALWIN NX .................................................................................... 27 TALZENNA ..................................................................................... 14 TAMBOCOR ................................................................................... 21 TAMIFLU ......................................................................................... 10 tamoxifen citrate ............................................................................. 14 tamsulosin hcl ................................................................................. 17 TANZEUM ....................................................................................... 51 TAPAZOLE ..................................................................................... 57 tapentadol ....................................................................................... 27 TARCEVA ....................................................................................... 13 TARGRETIN ............................................................................. 12, 69 TARKA ............................................................................................. 21 TASIGNA ........................................................................................ 14 tasimelteon...................................................................................... 32 TASMAR ......................................................................................... 31 tavaborole ......................................................................................... 6 TAVALISSE .................................................................................... 59 tazarotene ....................................................................................... 70 TAZORAC ....................................................................................... 70 TECFIDERA ................................................................................... 59 TECHNIVIE ..................................................................................... 10 tedizolid ............................................................................................. 6 teduglutide ...................................................................................... 46 TEGRETOL .............................................................................. 28, 29 TEGRETOL XR .............................................................................. 29 TEGSEDI ........................................................................................ 60

TEKAMLO ....................................................................................... 22 TEKTURNA .................................................................................... 22 TEKTURNA HCT ........................................................................... 22 telaprevir ......................................................................................... 11 telbivudine....................................................................................... 11 telithromycin ..................................................................................... 6 telmisartan ................................................................................ 20, 23 telmisartan & hydrochlorothiazide ............................................... 23 temazepam ..................................................................................... 32 TEMODAR ...................................................................................... 14 TEMOVATE .................................................................................... 67 TEMOVATE E ................................................................................ 67 temozolomide ................................................................................. 14 TENEX ............................................................................................ 22 tenofovir ............................................................................ 8, 9, 10, 11 tenofovir 300 mg ............................................................................ 11 tenofovir alafenamide .................................................................... 11 TENORETIC ................................................................................... 24 TENORMIN .................................................................................... 24 TERAZOL 3 .................................................................................... 66 TERAZOL 7 .................................................................................... 66 terazosin ......................................................................................... 19 terbinafine ......................................................................................... 6 terbutaline sulfate .......................................................................... 18 terconazole ..................................................................................... 66 terconazole (vaginal) ..................................................................... 66 teriflunomide ................................................................................... 62 teriparatide ...................................................................................... 56 TESSALON PERLES .................................................................... 62 TESTIM ........................................................................................... 47 testosterone .............................................................................. 47, 56 testosterone cypionate .................................................................. 47 TESTRED ....................................................................................... 47 tetrabenazine ................................................................................. 33 tetracycline ................................................................................... 4, 6 TETRACYCLINE ............................................................................. 6 tetrahydrozoline ............................................................................. 43 TEVETEN ....................................................................................... 22 tezacaftor & ivacaftor .................................................................... 64 thalidomide ..................................................................................... 62 THALOMID ..................................................................................... 62 theophylline .................................................................................... 71 thioguanine ..................................................................................... 15 thioridazine ..................................................................................... 35 thiothixene ...................................................................................... 35 THORAZINE ................................................................................... 33 thyroid .............................................................................................. 57 THYROLAR .................................................................................... 57 tiagabine ......................................................................................... 30 TIAZAC ........................................................................................... 20 TIBSOVO ........................................................................................ 13 ticagrelor ......................................................................................... 18 TIGAN ............................................................................................. 44 TIKOSYN ........................................................................................ 21



tildrakizumab-asmn........................................................................ 62 TILIA ................................................................................................ 50 tiludronate ....................................................................................... 62 timolol .................................................................................. 25, 42, 43 TIMOPTIC ................................................................................. 42, 43 TIMOPTIC-XE ................................................................................ 43 timothy grass pollen allergen extract ........................................... 42 tiotropium ............................................................................ 15, 16, 64 tiotropium 1.25 mcg ....................................................................... 16 tiotropium 2.5 mcg ......................................................................... 15 tiotropium bromide and olodaterol ............................................... 64 tipranavir.......................................................................................... 11 TIROSINT ....................................................................................... 57 TIVICAY ............................................................................................ 8 tizanidine ......................................................................................... 17 TOBI................................................................................................... 6 TOBI PODHALER ............................................................................ 6 TOBRADEX .................................................................................... 41 tobramycin & dexamethasone ointment ..................................... 41 tobramycin & dexamethasone suspension ................................ 41 tobramycin inhalation powder ........................................................ 6 tobramycin inhalation solution ........................................................ 6 tobramycin sulfate (ophth) ointment ............................................ 39 tobramycin sulfate (ophth) solution ............................................. 39 TOBREX.......................................................................................... 39 tocilizumab ...................................................................................... 62 tofacitinib ......................................................................................... 62 TOFRANIL ...................................................................................... 34 TOFRANIL-PM ............................................................................... 34 tolazamide ....................................................................................... 54 tolbutamide ..................................................................................... 54 tolcapone ......................................................................................... 31 TOLECTIN 600............................................................................... 27 TOLINASE ...................................................................................... 54 tolmetin sodium .............................................................................. 27 tolterodine ....................................................................................... 71 tolterodine extended-release ........................................................ 71 tolvaptan .......................................................................................... 37 TOPAMAX ...................................................................................... 30 TOPAMAX SPRINKLE .................................................................. 30 TOPICORT ..................................................................................... 67 topiramate capsule ........................................................................ 30 topiramate tablet ............................................................................ 30 topotecan ........................................................................................ 15 TOPROL XL .................................................................................... 24 TORADOL ....................................................................................... 26 toremifene ....................................................................................... 15 torsemide ........................................................................................ 37 TOVIAZ ........................................................................................... 70 TQYNSTA ....................................................................................... 20 TRACLEER ..................................................................................... 23 TRADJENTA .................................................................................. 53 tramadol .......................................................................................... 27 tramadol & acetaminophen ........................................................... 27

tramadol extended-release .......................................................... 27 TRANDATE .................................................................................... 24 trandolapril ................................................................................ 21, 23 trandolapril & verapamil ................................................................ 21 tranexamic acid .............................................................................. 18 TRANSDERM-SCOP .................................................................... 44 TRANXENE .................................................................................... 31 tranylcypromine sulfate ................................................................. 35 TRAVATAN Z ................................................................................. 43 travoprost ........................................................................................ 43 trazodone ........................................................................................ 35 trazodone extended-release ........................................................ 35 TRECATOR ...................................................................................... 7 TRELEGY ELLIPTA ...................................................................... 63 TREMFYA ....................................................................................... 59 TRENTAL ....................................................................................... 18 treprostinil ....................................................................................... 24 TRESIBA......................................................................................... 52 tretinoin ..................................................................................... 15, 69 tretinoin microspheres ................................................................... 69 TREXALL ........................................................................................ 14 triamcinolone acetonide (topical) ................................................. 68 triamterene ..................................................................................... 37 triamterene & hydrochlorothiazide .............................................. 37 TRIAVIL........................................................................................... 33 triazolam ......................................................................................... 32 TRIBENZOR ................................................................................... 20 TRICOR .......................................................................................... 20 trientine ........................................................................................... 46 trifluidine/tipiracil ............................................................................ 15 trifluoperazine ................................................................................. 35 trifluridine ........................................................................................ 39 trihexyphenidyl ............................................................................... 31 TRILAFON ...................................................................................... 35 TRILEPTAL .................................................................................... 29 TRILIPIX ......................................................................................... 20 TRI-LO-SPRINTEC ....................................................................... 50 trimethobenzamide ........................................................................ 44 trimethoprim ......................................................................... 6, 11, 39 trimipramine .................................................................................... 35 TRINESSA ...................................................................................... 50 TRI-NORINYL ................................................................................ 49 TRINTELLIX ................................................................................... 35 TRI-SPRINTEC .............................................................................. 50 TRIUMEQ ......................................................................................... 8 TRI-VI-FLOR .................................................................................. 61 TRI-VI-FLOR W/IRON .................................................................. 61 TRIVORA ........................................................................................ 49 TRIZIVIR ........................................................................................... 8 trospium .......................................................................................... 71 trospium extended-release ........................................................... 71 TRULICITY ..................................................................................... 51 TRUSOPT ....................................................................................... 42 TRUVADA ......................................................................................... 9



TUSSIONEX ................................................................................... 62 TWINJECT ...................................................................................... 17 TWYNSTA ...................................................................................... 20 TYKERB .......................................................................................... 13 TYLENOL W/ CODEINE ............................................................... 25 TYMLOS.......................................................................................... 56 TYZEKA .......................................................................................... 11 TYZINE ............................................................................................ 43

U UCERIS ........................................................................................... 46 ulipristal ........................................................................................... 51 ULORIC ........................................................................................... 59 ULTRACET ..................................................................................... 27 ULTRAM.......................................................................................... 27 ULTRAM ER ................................................................................... 27 ULTRAVATE .................................................................................. 67 umeclidinium ....................................................................... 16, 18, 63 umeclidinium & vilanterol ........................................................ 18, 63 UNIPHYL ......................................................................................... 71 UNIRETIC ....................................................................................... 23 UNITHROID .................................................................................... 57 UNIVASC ........................................................................................ 23 unoprostone isopropyl ................................................................... 43 urea ............................................................................................ 67, 68 URECHOLINE ................................................................................ 16 URELLE .......................................................................................... 11 UROCIT-K ....................................................................................... 36 URO-MP .......................................................................................... 61 UROXATRAL .................................................................................. 17 URSO .............................................................................................. 46 URSO FORTE ................................................................................ 46 ursodiol ............................................................................................ 46 ustekinumab ................................................................................... 62 UTIBRON NEOHALER ................................................................. 64

V VAGIFEM ........................................................................................ 56 valacyclovir ..................................................................................... 11 valbenazine ..................................................................................... 33 VALCHLOR .................................................................................... 13 VALCYTE ........................................................................................ 11 valganciclovir .................................................................................. 11 VALISONE ...................................................................................... 67 VALIUM ........................................................................................... 31 valproate sodium ............................................................................ 30 valproic acid .................................................................................... 30 valsartan ........................................................................ 20, 21, 22, 23 valsartan & hydrochlorothiazide ............................................. 20, 23 VALTREX ........................................................................................ 11 VALTURNA ..................................................................................... 22 VANCOCI .......................................................................................... 6

VANCOCIN ....................................................................................... 6 vancomycin ....................................................................................... 6 Vancomycin capsule ....................................................................... 6 vandetanib ...................................................................................... 15 VANOS ............................................................................................ 67 VANOXIDE-HC .............................................................................. 66 VANTIN ............................................................................................. 5 varenicline....................................................................................... 16 VARUBI ........................................................................................... 44 VASCEPA ....................................................................................... 20 VASERETIC ................................................................................... 22 VASOTEC ....................................................................................... 22 VECTICAL ...................................................................................... 69 VELIVET ......................................................................................... 48 VELPHORO ................................................................................... 37 VELTASSA ..................................................................................... 37 VELTIN ............................................................................................ 69 VEMLIDY ........................................................................................ 11 vemurafenib .................................................................................... 15 venlafaxine ..................................................................................... 35 venlafaxine extended-release ...................................................... 35 VENTOLIN HFA ............................................................................. 17 verapamil ........................................................................................ 21 verapamil extended-release cap ................................................. 21 verapamil sustained-release cap ................................................. 21 verapamil sustained-release tab ................................................. 21 VEREGEN ...................................................................................... 70 VERELAN ....................................................................................... 21 VERELAN PM ................................................................................ 21 VERZENIO ..................................................................................... 12 VESANOID ..................................................................................... 15 VESICARE ..................................................................................... 71 VEXOL ............................................................................................ 41 VFEND .......................................................................................... 6, 7 VIBERZI .......................................................................................... 43 VICOPROFEN ............................................................................... 26 VICTOZA ........................................................................................ 53 VICTRELIS ....................................................................................... 8 VIDEX ................................................................................................ 8 VIDEX EC ......................................................................................... 8 VIEKIRA .......................................................................................... 10 vigabatrin ........................................................................................ 30 VIGAMOX ....................................................................................... 39 VIIBRYD .......................................................................................... 35 vilazodone....................................................................................... 35 VIMPAT ........................................................................................... 29 VIOKACE ........................................................................................ 45 VIRACEPT ...................................................................................... 10 VIRAMUNE ..................................................................................... 10 VIREAD ........................................................................................... 11 VIROPTIC ....................................................................................... 39 VISICOL .......................................................................................... 45 VISKEN ........................................................................................... 24 VISTARIL ........................................................................................ 31



VIVACTIL ........................................................................................ 35 VIVELLE-DOT ................................................................................ 55 VIZIMPRO ....................................................................................... 12 VOLTAREN ........................................................................ 25, 39, 70 VOLTAREN GEL ........................................................................... 70 VOLTAREN XR .............................................................................. 25 vorapaxar ........................................................................................ 19 voriconazole suspension................................................................. 7 voriconazole tablet ........................................................................... 6 vorinostat ......................................................................................... 15 vortioxetine...................................................................................... 35 VOSEVI ........................................................................................... 10 VOSOL ............................................................................................ 43 VOSPIRE ER .................................................................................. 17 VOTRIENT ...................................................................................... 14 VRAYLAR ....................................................................................... 33 VUSION ........................................................................................... 65 VYTONE.......................................................................................... 65 VYTORIN ........................................................................................ 19 VYVANSE ....................................................................................... 28 VYZULTA ........................................................................................ 42

W warfarin ............................................................................................ 19 WELCHOL ...................................................................................... 19 WELLBUTRIN ................................................................................ 33 WELLBUTRIN SR .......................................................................... 33 WELLBUTRIN XL .......................................................................... 33 WESTCORT ................................................................................... 68

X XALATAN ........................................................................................ 42 XALKORI ......................................................................................... 12 XANAX ............................................................................................ 31 XANAX XR ...................................................................................... 31 XARELTO ....................................................................................... 18 XARTEMIS XR ............................................................................... 27 XELJANZ ........................................................................................ 62 XELODA .......................................................................................... 12 XENAZINE ...................................................................................... 33 XIBROM .......................................................................................... 39 XIFAXAN ........................................................................................... 6 XIGDUO XR .................................................................................... 51 XIIDRA ............................................................................................. 40 XOLAIR ........................................................................................... 64 XOPENEX HFA .............................................................................. 18 XOPENEX NEBULIZER ............................................................... 18 XOSPATA ....................................................................................... 13 XTANDI ........................................................................................... 12 XULANE .......................................................................................... 49 XULTOPHY .................................................................................... 52 XYLOCAINE ............................................................................. 43, 68

XYLOCAINE VISCOUS ................................................................ 43 XYREM ........................................................................................... 33

Y YASMIN .......................................................................................... 48 YAZ .................................................................................................. 48 YUPELRI......................................................................................... 15 YUVAFEM ...................................................................................... 56

Z zafirlukast ........................................................................................ 63 zaleplon ........................................................................................... 32 ZANAFLEX ..................................................................................... 17 zanamivir......................................................................................... 11 ZANTAC .......................................................................................... 45 ZARONTIN ..................................................................................... 29 ZAROXOLYN ................................................................................. 37 ZARXIO ........................................................................................... 19 ZAVESCA ....................................................................................... 61 ZEBETA .......................................................................................... 24 ZEJULA ........................................................................................... 14 ZELAPAR ....................................................................................... 31 ZELBORAF ..................................................................................... 15 ZEMPLAR ....................................................................................... 71 ZENPEP .......................................................................................... 45 ZEPATIER ........................................................................................ 9 ZERIT .............................................................................................. 11 ZESTORETIC ................................................................................ 23 ZESTRIL ......................................................................................... 23 ZETIA .............................................................................................. 19 ZIAC ................................................................................................ 24 ZIAGEN ............................................................................................. 8 ZIANA .............................................................................................. 69 zidovudine............................................................................. 8, 10, 11 zileuton ............................................................................................ 63 ziprasidone ..................................................................................... 35 ZIRGAN........................................................................................... 38 ZITHROMAX .................................................................................... 4 ZOCOR ........................................................................................... 20 ZOFRAN ......................................................................................... 44 ZOFRAN ODT ................................................................................ 44 ZOHYDRO ER ............................................................................... 26 ZOLINZA ......................................................................................... 15 zolipdem sublingual ....................................................................... 32 zolmitriptan ..................................................................................... 30 zolmitriptan orally disintegrating .................................................. 30 ZOLOFT .......................................................................................... 35 zolpidem .......................................................................................... 32 zolpidem extended-release .......................................................... 32 zolpidem oral spray ....................................................................... 32 ZOLPIMIST ..................................................................................... 32 ZOMIG ............................................................................................ 30



ZOMIG ZMT .................................................................................... 30 ZONALON ....................................................................................... 68 ZONEGRAN ................................................................................... 30 zonisamide ...................................................................................... 30 ZONTIVITY ..................................................................................... 19 ZORBTIVE ...................................................................................... 57 ZORTRESS .................................................................................... 59 ZOVIA .............................................................................................. 48 ZOVIRAX .................................................................................... 8, 64 ZURAMPIC ..................................................................................... 60 ZYBAN ............................................................................................. 33 ZYCLARA........................................................................................ 70

ZYDELIG......................................................................................... 13 ZYFLO ............................................................................................. 63 ZYFLO CR ...................................................................................... 63 ZYFO ............................................................................................... 63 ZYKADIA......................................................................................... 12 ZYLET ............................................................................................. 40 ZYLOPRIM ..................................................................................... 58 ZYMAXID ........................................................................................ 38 ZYPREXA ....................................................................................... 34 ZYPREXA ZYDIS .......................................................................... 34 ZYTIGA ........................................................................................... 12 ZYVOX .............................................................................................. 5

60577109_ACA_1557_MarCom_GA_2017_Taglines


NONDISCRIMINATION NOTICE Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Health Plan) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kaiser Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We also:

• Provide no cost aids and services to people with disabilities to communicate effectively with us, such as: • Qualified sign language interpreters • Written information in other formats, such as large print, audio, and

accessible electronic formats

• Provide no cost language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages

If you need these services, call 1-888-865-5813 (TTY: 711)

If you believe that Kaiser Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail at: Member Relations Unit (MRU), Attn: Kaiser Civil Rights Coordinator, Nine Piedmont Center, 3495 Piedmont Road, NE Atlanta, GA 30305-1736. Telephone Number: 1-888-865-5813.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services,

200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

http://www.hhs.gov/ocr/office/file/index.html






HELP IN YOUR LANGUAGE

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-865-5813 (TTY: 711).

አማርኛ (Amharic) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-888-865-5813 (TTY: 711).

.ملحوظة: إذا كنت تتحدث العربية، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان (Arabic) العربية

.)711 :TTY( 1-888-865-5813 مرقب اتصل

中文 (Chinese) 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電

1-888-865-5813（TTY：711）。

توجه: اگر به زبان فارسی گفتگو می کنید، تسهيالت زبانی بصورت رایگان برای (Farsi) فارسی

. گیریدب ماست (711 :TTY) 1-888-865-5813 با . اشدب اھمفر می شما

Français (French) ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-865-5813 (TTY: 711).

Deutsch (German) ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.

Rufnummer: 1-888-865-5813 (TTY: 711).

ગજ◌ુર◌ાત◌ી

(Gujarati) સચ◌ુ

ન◌ા: જ◌ો

તમ◌ે ગજ◌ુ

ર◌ાત◌ી બ◌ોલત◌ા હો, તો નન:શ�્◌ ુક ભાષ◌ા સહ◌ાય

સ◌વેાઓ

તમારા માટ◌ે ઉપલબ્ધ છ◌ે. ફોન કરો 1-888-865-5813 (TTY: 711).

Kreyòl Ayisyen (Haitian Creole) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-888-865-5813 (TTY: 711).

िह�ी (Hindi) �ान द◌े◌ं: यहद आप हि◌ि◌◌ंदी बोलत◌े ि◌◌ै◌ं तो आपक◌े ललए मुफ्त म◌े◌ं भाषा िस◌ायता स◌ेवाएि◌◌ं उपलब◌्ध ि◌◌ै◌ं। 1-888-865-5813 (TTY: 711) पर कॉल कर◌े◌ं। 日本語 (Japanese) 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1-888-865-5813（TTY: 711）まで、お電話にてご連絡ください。

한국어 (Korean) 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-888-865-5813 (TTY: 711) 번으로 전화해 주십시오.



Naabeehó (Navajo) Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’dé̖ é̖ ’, t’áá jiik’eh, éí ná hóló̖ , koji̖ ’ hódíílnih 1-888-865-5813 (TTY: 711).

Português (Portuguese) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-888-865-5813 (TTY: 711).

Pусский (Russian) ВНИМАНИЕ: eсли вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-888-865-5813 (TTY: 711).

Español (Spanish) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-865-5813 (TTY: 711).

Tagalog (Tagalog) PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.

Tumawag sa 1-888-865-5813 (TTY: 711).

Tiếng Việt (Vietnamese) CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-865-5813 (TTY: 711).

Documents

2020 Kaiser Permanente Tricare Formulary...2020 Formulary Kaiser Permanente, a TRICARE ® Prime Option This document includes the formulary for Kaiser Permanente, a TRICARE ® Prime