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Western New York Medicaid-Approved Preferred Drug List Effective May 1, 2020 Legend In each class, drugs are listed alphabetically by either brand name or generic name. Brand name drug: Uppercase in bold type Generic drug: Lowercase in plain type AL: Age Limit Restrictions DO: Dose Optimization Program GR: Gender Restriction OTC: Over the counter medication available with a prescription. (Prescribers please indicate OTC on the prescription) PA: Prior authorization is required. Prior authorization is the process of obtaining approval of benefits before certain prescriptions are filled. QL: Quantity limits; certain prescription medications have specific quantity limits per prescription or per month. SP: Specialty Pharmacy ST: Step therapy is required. You may need to use one medication before benefits for the use of another medication can be authorized.

Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

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Page 1: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Western New York

Medicaid-Approved

Preferred Drug List

Effective May 1, 2020

Legend

In each class, drugs are listed alphabetically by either brand name or generic name.

Brand name drug: Uppercase in bold type

Generic drug: Lowercase in plain type

AL: Age Limit Restrictions

DO: Dose Optimization Program

GR: Gender Restriction

OTC: Over the counter medication available with a prescription. (Prescribers please indicate OTC on the prescription)

PA: Prior authorization is required. Prior authorization is the process of obtaining approval of benefits before certain prescriptions are filled.

QL: Quantity limits; certain prescription medications have specific quantity limits per prescription or per month.

SP: Specialty Pharmacy

ST: Step therapy is required. You may need to use one medication before benefits for the use of another medication can be authorized.

Page 2: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

*ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS*

ALLI ORAL CAPSULE PA; OTC; QL

amphetamine-dextroamphet er oral capsule extended release 24 hour

Adderall XR AL; QL

amphetamine-dextroamphetamine oral tablet

Adderall AL

atomoxetine hcl oral capsule Strattera AL; QL

caffeine citrate intravenous solution Cafcit

caffeine citrate oral solution

clonidine hcl er oral tablet extended release 12 hour

Kapvay AL; QL

dexmethylphenidate hcl er oral capsule extended release 24 hour

Focalin XR AL; QL

dexmethylphenidate hcl oral tablet 10 mg Focalin AL; QL

dexmethylphenidate hcl oral tablet 2.5 mg Focalin AL

dexmethylphenidate hcl oral tablet 5 mg Focalin PA; QL

dextroamphetamine sulfate er oral capsule extended release 24 hour

Dexedrine AL; QL

dextroamphetamine sulfate oral tablet Zenzedi AL; QL

METADATE ER ORAL TABLET EXTENDED RELEASE

AL; QL

methylphenidate hcl er (cd) oral capsule extended release

AL; QL

methylphenidate hcl er (la) oral capsule extended release 24 hour

Ritalin LA AL; QL

methylphenidate hcl er oral tablet extended release 10 mg

AL

methylphenidate hcl er oral tablet extended release 18 mg, 27 mg, 36 mg, 54 mg

Concerta AL; QL

methylphenidate hcl er oral tablet extended release 20 mg

Metadate ER AL; QL

methylphenidate hcl er oral tablet extended release 24 hour

AL; QL

methylphenidate hcl oral solution Methylin AL

methylphenidate hcl oral tablet Ritalin AL

*ALTERNATIVE MEDICINES*

glucosamine chondroitin complx oral capsule

Glucosamine Chondr 500 Complex

OTC

2

Page 3: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

*AMINOGLYCOSIDES*

neomycin sulfate oral tablet

paromomycin sulfate oral capsule

tobramycin inhalation nebulization solution Kitabis Pak SP; QL

*ANALGESICS - ANTI-INFLAMMATORY*

ADDAPRIN ORAL TABLET PA; OTC; QL

ADVIL JUNIOR STRENGTH ORAL TABLET

OTC

ADVIL JUNIOR STRENGTH ORAL TABLET CHEWABLE

OTC; QL

all day pain relief oral tablet Mediproxen OTC; QL

all day relief oral tablet Mediproxen OTC; QL

childrens ibuprofen 100 oral suspension Childrens Medi-Profen OTC; QL

childrens ibuprofen oral suspension Childrens Medi-Profen OTC; QL

CHILDRENS MEDI-PROFEN ORAL SUSPENSION

OTC; QL

cvs all day pain relief oral tablet Mediproxen OTC; QL

cvs childrens ibuprofen oral suspension Childrens Medi-Profen OTC; QL

cvs ibuprofen childrens oral suspension Childrens Medi-Profen OTC; QL

cvs ibuprofen infants oral suspension Medi-Profen OTC; QL

cvs ibuprofen junior strength oral tablet chewable

Advil Junior Strength OTC; QL

cvs ibuprofen oral capsule Medi-Profen OTC

cvs ibuprofen oral tablet Addaprin OTC; QL

cvs naproxen sodium oral capsule Aleve OTC

cvs naproxen sodium oral tablet Mediproxen OTC; QL

diclofenac potassium oral tablet

diclofenac sodium er oral tablet extended release 24 hour

PA

diclofenac sodium oral tablet delayed release

dyspel oral tablet Addaprin PA; OTC; QL

ENBREL MINI SUBCUTANEOUS SOLUTION CARTRIDGE

PA; SP; QL

ENBREL SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

ENBREL SUBCUTANEOUS SOLUTION RECONSTITUTED

PA; SP; QL

3

Page 4: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

ENBREL SURECLICK SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; SP; QL

eq all day pain relief oral tablet Mediproxen OTC; QL

eq ibuprofen childrens oral suspension Childrens Medi-Profen OTC; QL

eq ibuprofen infants oral suspension Medi-Profen OTC; QL

eq ibuprofen junior oral tablet chewable Advil Junior Strength OTC; QL

eq ibuprofen oral capsule Medi-Profen OTC

eq ibuprofen oral tablet Addaprin PA; OTC; QL

eq naproxen sodium oral capsule Aleve OTC

eq naproxen sodium oral tablet Mediproxen OTC; QL

eql childrens ibuprofen oral suspension Childrens Medi-Profen OTC; QL

eql ibuprofen infants oral suspension Medi-Profen OTC; QL

eql ibuprofen junior strength oral tablet chewable

Advil Junior Strength OTC; QL

eql ibuprofen oral capsule Medi-Profen OTC

eql ibuprofen oral tablet Addaprin OTC; QL

eql naproxen sodium oral capsule Aleve OTC

eql naproxen sodium oral tablet Mediproxen OTC; QL

etodolac er oral tablet extended release 24 hour

etodolac oral capsule

etodolac oral tablet Lodine

fenoprofen calcium oral capsule Nalfon

fenoprofen calcium oral tablet Nalfon

flurbiprofen oral tablet

genpril oral tablet Addaprin PA; OTC; QL

gnp all day pain relief oral tablet Mediproxen OTC; QL

gnp childrens ibuprofen oral suspension Childrens Medi-Profen OTC; QL

gnp ibuprofen infants oral suspension Medi-Profen OTC; QL

gnp ibuprofen junior strength oral tablet chewable

Advil Junior Strength OTC; QL

gnp ibuprofen oral capsule Medi-Profen OTC

gnp ibuprofen oral tablet Addaprin OTC; QL

gnp naproxen sodium oral capsule Aleve OTC

gnp naproxen sodium oral tablet Mediproxen OTC; QL

goodsense ibuprofen childrens oral suspension

Childrens Medi-Profen OTC; QL

goodsense ibuprofen infants oral suspension Medi-Profen OTC; QL

4

Page 5: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

goodsense ibuprofen junior st oral tablet chewable

Advil Junior Strength OTC; QL

goodsense ibuprofen oral capsule Medi-Profen OTC

goodsense ibuprofen oral tablet Addaprin OTC; QL

goodsense naproxen sodium oral tablet Mediproxen OTC; QL

hm ibuprofen childrens oral suspension Childrens Medi-Profen OTC; QL

hm ibuprofen ib oral tablet Addaprin OTC; QL

hm ibuprofen ib oral tablet chewable Advil Junior Strength OTC; QL

hm ibuprofen infants oral suspension Medi-Profen OTC; QL

hm ibuprofen oral capsule Medi-Profen OTC

hm ibuprofen oral tablet Addaprin OTC; QL

hm ibuprofen oral tablet chewable Advil Junior Strength OTC; QL

hm naproxen sodium oral capsule Aleve OTC

hm naproxen sodium oral tablet Mediproxen OTC; QL

HUMIRA PEDIATRIC CROHNS START SUBCUTANEOUS PREFILLED SYRINGE KIT

PA; SP; QL

HUMIRA PEN SUBCUTANEOUS PEN-INJECTOR KIT

PA; SP; QL

HUMIRA PEN-CD/UC/HS STARTER SUBCUTANEOUS PEN-INJECTOR KIT

PA; SP; QL

HUMIRA PEN-PS/UV/ADOL HS START SUBCUTANEOUS PEN-INJECTOR KIT

PA; SP; QL

HUMIRA SUBCUTANEOUS PREFILLED SYRINGE KIT

PA; SP; QL

hy-vee all day relief oral tablet Mediproxen OTC; QL

HYVEE IBUPROFEN CHILDRENS ORAL SUSPENSION

OTC; QL

IBU ORAL TABLET

ibu-200 oral tablet Addaprin PA; OTC; QL

ibuprofen 100 junior strength oral tablet chewable

Advil Junior Strength OTC; QL

ibuprofen childrens oral suspension Childrens Medi-Profen OTC; QL

ibuprofen infants drops oral suspension Medi-Profen OTC

ibuprofen infants oral suspension Medi-Profen OTC; QL

ibuprofen junior strength oral tablet chewable

Advil Junior Strength OTC; QL

ibuprofen oral capsule Medi-Profen OTC

ibuprofen oral suspension Childrens Medi-Profen QL

5

Page 6: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

ibuprofen oral tablet 200 mg Addaprin OTC; QL

ibuprofen oral tablet 400 mg, 600 mg, 800 mg

IBU

indomethacin er oral capsule extended release

indomethacin oral capsule

infants ibuprofen oral suspension Medi-Profen OTC; QL

ketoprofen er oral capsule extended release 24 hour

QL

ketoprofen oral capsule

ketorolac tromethamine oral tablet QL

kls ibuprofen oral tablet Addaprin OTC; QL

kls naproxen sodium oral tablet Mediproxen OTC; QL

ks ibuprofen oral capsule Medi-Profen OTC

leflunomide oral tablet Arava

meclofenamate sodium oral capsule

MEDI-PROFEN ORAL CAPSULE OTC

MEDI-PROFEN ORAL SUSPENSION OTC; QL

MEDI-PROFEN ORAL TABLET PA; OTC; QL

MEDIPROXEN ORAL TABLET OTC; QL

mefenamic acid oral capsule PA; QL

meijer ibuprofen oral tablet Addaprin OTC; QL

meloxicam oral tablet 15 mg Mobic

meloxicam oral tablet 7.5 mg Mobic PA

MOTRIN IB ORAL CAPSULE OTC

MOTRIN IB ORAL TABLET PA; OTC; QL

nabumetone oral tablet 500 mg QL

nabumetone oral tablet 750 mg

naproxen oral suspension Naprosyn

naproxen oral tablet

naproxen sodium oral capsule Aleve OTC

naproxen sodium oral tablet 220 mg Mediproxen OTC; QL

naproxen sodium oral tablet 275 mg

naproxen sodium oral tablet 550 mg Anaprox DS

oxaprozin oral tablet Daypro

PAMPRIN ALL DAY RELIEF MAX ST ORAL TABLET

OTC; QL

piroxicam oral capsule Feldene PA

6

Page 7: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

PROVIL ORAL TABLET OTC; QL

px all day relief oral tablet Mediproxen OTC; QL

px childrens profen ib oral suspension Childrens Medi-Profen OTC; QL

px ibuprofen junior strength oral tablet chewable

Advil Junior Strength OTC; QL

px ibuprofen oral tablet Addaprin OTC; QL

px infants profen ib oral suspension Medi-Profen OTC; QL

qc childrens ibuprofen oral suspension Childrens Medi-Profen OTC; QL

qc ibuprofen ib oral tablet Addaprin OTC; QL

qc ibuprofen infants oral suspension Medi-Profen OTC; QL

qc ibuprofen oral capsule Medi-Profen OTC

qc ibuprofen oral tablet Addaprin OTC; QL

qc naproxen sodium oral tablet Mediproxen OTC; QL

ra ibuprofen childrens oral suspension Childrens Medi-Profen OTC; QL

ra ibuprofen infants oral suspension Medi-Profen OTC; QL

ra ibuprofen junior strength oral tablet chewable

Advil Junior Strength OTC; QL

ra ibuprofen oral capsule Medi-Profen OTC

ra ibuprofen oral suspension Childrens Medi-Profen OTC; QL

ra ibuprofen oral tablet Addaprin OTC; QL

ra naproxen sodium oral capsule Aleve OTC

ra naproxen sodium oral tablet Mediproxen OTC; QL

ra pain relief ibuprofen oral tablet Addaprin OTC; QL

RIDAURA ORAL CAPSULE

sb ibuprofen oral tablet Addaprin OTC; QL

sb infants ibuprofen oral suspension Medi-Profen OTC; QL

sb naproxen sodium oral tablet Mediproxen OTC; QL

sm childrens ibuprofen oral suspension Childrens Medi-Profen OTC; QL

sm ibuprofen ib oral tablet Addaprin OTC; QL

sm ibuprofen ib oral tablet chewable Advil Junior Strength OTC; QL

sm ibuprofen jr oral tablet Advil Junior Strength OTC

sm ibuprofen oral capsule Medi-Profen OTC

sm ibuprofen oral tablet Addaprin OTC; QL

sm infants ibuprofen oral suspension Medi-Profen OTC; QL

sm naproxen sodium oral capsule Aleve OTC

sm naproxen sodium oral tablet Mediproxen OTC; QL

sulindac oral tablet

7

Page 8: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

tgt childrens ibuprofen oral suspension Childrens Medi-Profen OTC; QL

tgt ibuprofen childrens oral suspension Childrens Medi-Profen OTC; QL

tgt ibuprofen junior strength oral tablet chewable

Advil Junior Strength OTC; QL

tgt ibuprofen oral capsule Medi-Profen OTC

tgt ibuprofen oral tablet Addaprin OTC; QL

tgt infants ibuprofen oral suspension Medi-Profen OTC; QL

tgt naproxen sodium oral capsule Aleve OTC

tgt naproxen sodium oral tablet Mediproxen OTC; QL

tolmetin sodium oral capsule

tolmetin sodium oral tablet

WAL-PROFEN ORAL CAPSULE OTC

WAL-PROFEN ORAL TABLET OTC; QL

*ANALGESICS - NONNARCOTIC*

8 hour pain reliever oral tablet extended release

Midol OTC; QL

acetaminophen childrens oral solution OTC; QL

acetaminophen childrens oral suspension PediaCare Children OTC; QL

acetaminophen er oral tablet extended release

Midol OTC; QL

acetaminophen extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

acetaminophen infants oral suspension PediaCare Children OTC; QL

acetaminophen junior strength oral tablet dispersible

OTC

acetaminophen oral liquid Little Remedies for Fever OTC; QL

acetaminophen oral solution OTC; QL

acetaminophen oral suspension 160 mg/5ml PediaCare Children OTC; QL

acetaminophen oral suspension 650 mg/20.3ml

PediaCare Children QL

acetaminophen oral tablet 325 mg Pharbetol OTC

acetaminophen oral tablet 500 mgHealthy Mama Shake That Ache

OTC; QL

acetaminophen oral tablet chewable Childrens Medi-Tabs OTC

acetaminophen rapid tabs child oral tablet dispersible

OTC

acetaminophen rectal suppository FeverAll Adults OTC

adult aspirin regimen oral tablet delayed release

Aspir-Low OTC

8

Page 9: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

aminofen oral tablet 325 mg Pharbetol OTC

aminofen oral tablet 500 mgHealthy Mama Shake That Ache

OTC; QL

apap oral elixir Medi-Tabs Childrens OTC

apra oral elixir Medi-Tabs Childrens OTC

arthritis pain relief oral tablet extended release

Midol OTC; QL

arthritis pain reliever oral tablet extended release

Midol OTC; QL

aspirin 81 oral tablet chewable Bayer Low Dose OTC; QL

aspirin 81 oral tablet delayed release Aspir-Low OTC

aspirin adult low dose oral tablet delayed release

Aspir-Low OTC

aspirin adult low strength oral tablet chewable

Bayer Low Dose OTC; QL

aspirin adult low strength oral tablet delayed release

Aspir-Low OTC

aspirin adult oral tabletBayer Advanced Aspirin Reg St

OTC

aspirin childrens oral tablet chewable Bayer Low Dose OTC; QL

aspirin ec adult low strength oral tablet delayed release

Aspir-Low OTC

aspirin ec low dose oral tablet delayed release

Aspir-Low OTC

aspirin ec low strength oral tablet delayed release

Aspir-Low OTC

aspirin ec oral tablet delayed release Aspir-Low OTC

aspirin low dose oral tablet chewable Bayer Low Dose OTC; QL

aspirin low dose oral tablet delayed release Aspir-Low OTC

aspirin low strength oral tablet chewable Bayer Low Dose OTC; QL

aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

aspirin oral tablet chewable Bayer Low Dose OTC; QL

aspirin oral tablet delayed release Aspir-Low OTC

aspirin rectal suppository OTC

ASPIR-LOW ORAL TABLET DELAYED RELEASE

OTC

aspirtab maximum strength oral tabletBayer Advanced Aspirin Ex St

OTC

aspirtab oral tablet delayed release Bayer Aspirin OTC

9

Page 10: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

aurophen childrens oral suspension PediaCare Children OTC; QL

back & body extra strength oral tablet Bayer Back & Body OTC

BAYER ADVANCED ASPIRIN EX ST ORAL TABLET

OTC

BAYER ADVANCED ASPIRIN REG ST ORAL TABLET

OTC

BAYER ASPIRIN EC LOW DOSE ORAL TABLET DELAYED RELEASE

OTC

BAYER ASPIRIN EXTRA STRENGTH ORAL TABLET

OTC

BAYER ASPIRIN ORAL TABLET OTC

BAYER ASPIRIN ORAL TABLET DELAYED RELEASE

OTC

BAYER LOW DOSE ORAL TABLET DELAYED RELEASE

OTC

BAYER MIGRAINE ORAL TABLET OTC

betatemp childrens oral suspension PediaCare Children OTC; QL

BUFFERIN ORAL TABLET OTC

butalbital-acetaminophen oral capsule QL

butalbital-acetaminophen oral tablet Tencon QL

butalbital-apap-caffeine oral capsule Esgic QL

butalbital-apap-caffeine oral tablet Esgic QL

butalbital-aspirin-caffeine oral capsule Fiorinal QL

butalbital-aspirin-caffeine oral tablet QL

childrens acetaminophen oral suspension PediaCare Children OTC; QL

childrens acetaminophen oral tablet dispersible

OTC

childrens apap oral tablet chewable Childrens Medi-Tabs OTC

childrens aspirin free oral elixir Medi-Tabs Childrens OTC

childrens aspirin low strength oral tablet chewable

Bayer Low Dose OTC; QL

childrens aspirin oral tablet chewable Bayer Low Dose OTC; QL

CHILDRENS MEDI-TABS ORAL TABLET CHEWABLE

OTC

childrens non-aspirin oral suspension PediaCare Children OTC; QL

childrens non-aspirin oral tablet chewable Childrens Medi-Tabs OTC

childrens pain reliever oral tablet chewable Childrens Medi-Tabs OTC

childrens pain reliever oral tablet dispersible OTC

childrens silapap oral liquid Little Remedies for Fever OTC; QL

10

Page 11: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

childrens tactinal oral tablet chewable Childrens Medi-Tabs OTC

CHLORASEPTIC SORE THROAT ORAL LIQUID

OTC

choline-mag trisalicylate oral liquid

cvs 8hr arthritis pain relief oral tablet extended release

Midol OTC; QL

cvs acetaminophen ex st oral liquid Chloraseptic Sore Throat OTC

cvs acetaminophen ex st oral tabletHealthy Mama Shake That Ache

OTC; QL

cvs acetaminophen oral liquid Chloraseptic Sore Throat OTC

cvs antacid & pain reliever oral tablet effervescent

Alka-Seltzer OTC

cvs arthritis pain relief oral tablet extended release

Midol OTC; QL

cvs aspirin adult low dose oral tablet chewable

Bayer Low Dose OTC; QL

cvs aspirin adult low strength oral tablet delayed release

Aspir-Low OTC

cvs aspirin ec oral tablet delayed release Aspir-Low OTC

cvs aspirin low dose oral tablet delayed release

Aspir-Low OTC

cvs aspirin low strength oral tablet delayed release

Aspir-Low OTC

cvs aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

cvs childs non-aspirin oral tablet chewable Childrens Medi-Tabs OTC

cvs fever reducing childrens rectal suppository

FeverAll Childrens OTC

cvs headache relief oral tablet Bayer Migraine OTC

cvs infants pain relief drops oral suspension PediaCare Children OTC; QL

cvs migraine relief oral tablet Bayer Migraine OTC

cvs non-aspirin childrens oral tablet chewable

Childrens Medi-Tabs OTC

cvs non-aspirin extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

cvs pain & fever childrens oral suspension PediaCare Children OTC; QL

cvs pain & fever infants oral suspension PediaCare Children OTC; QL

cvs pain relief childrens oral suspension PediaCare Children OTC; QL

cvs pain relief extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

11

Page 12: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

cvs pain relief oral tabletHealthy Mama Shake That Ache

OTC; QL

cvs pain relief oral tablet extended release Midol OTC; QL

cvs pain relief regular st oral tablet Pharbetol OTC

diflunisal oral tablet

ECOTRIN LOW STRENGTH ORAL TABLET DELAYED RELEASE

OTC

ECPIRIN ORAL TABLET DELAYED RELEASE

OTC

ed-apap oral liquid Little Remedies for Fever OTC; QL

effervescent antacid/pain oral tablet effervescent

Alka-Seltzer OTC

effervescent pain relief oral tablet effervescent

Alka-Seltzer OTC

eq 8hr arthritis pain relief oral tablet extended release

Midol OTC; QL

eq acetaminophen childrens oral tablet dispersible

OTC

eq acetaminophen oral tablet 325 mg Pharbetol OTC

eq acetaminophen oral tablet 500 mgHealthy Mama Shake That Ache

OTC; QL

eq adult aspirin low strength oral tablet delayed release

Aspir-Low OTC

eq antacid & pain relief oral tablet effervescent

Alka-Seltzer OTC

eq arthritis pain oral tablet extended release Midol OTC; QL

eq aspirin adult low dose oral tablet delayed release

Aspir-Low OTC

eq aspirin low dose oral tablet chewable Bayer Low Dose OTC; QL

eq aspirin low dose oral tablet delayed release

Aspir-Low OTC

eq aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

eq aspirin oral tablet delayed release Bayer Aspirin OTC

eq buffered aspirin oral tablet Bufferin OTC

eq childrens aspirin oral tablet chewable Bayer Low Dose OTC; QL

eq childrens pain reliever oral tablet chewable

Childrens Medi-Tabs OTC

eq effervescent pain relief oral tablet effervescent

Alka-Seltzer OTC

eq pain & fever childrens oral suspension PediaCare Children OTC; QL

12

Page 13: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

eq pain & fever infants oral suspension PediaCare Children OTC; QL

eq pain relief/rapid burst oral liquid Chloraseptic Sore Throat OTC

eq pain reliever oral tablet 325 mg Pharbetol OTC

eq pain reliever oral tablet 500 mgHealthy Mama Shake That Ache

OTC; QL

eql acetaminophen childrens oral suspension

PediaCare Children OTC; QL

eql acetaminophen ex st oral tabletHealthy Mama Shake That Ache

OTC; QL

eql acetaminophen infants oral suspension PediaCare Children OTC; QL

eql acetaminophen oral tablet Pharbetol OTC

eql acetaminophen rapid tabs oral tablet dispersible

OTC

eql antacid/pain relief oral tablet effervescent Alka-Seltzer OTC

eql arthritis pain relief oral tablet extended release

Midol OTC; QL

eql aspirin ec oral tablet delayed release Bayer Aspirin OTC

eql aspirin low dose oral tablet chewable Bayer Low Dose OTC; QL

eql aspirin low dose oral tablet delayed release

Aspir-Low OTC

eql aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

eql headache relief ex str oral tablet Bayer Migraine OTC

eql menstrual relief max st oral tablet Midol Complete OTC

eql migraine formula oral tablet Bayer Migraine OTC

fever reducer childrens rectal suppository FeverAll Childrens OTC

FEVERALL ADULTS RECTAL SUPPOSITORY

OTC

FEVERALL CHILDRENS RECTAL SUPPOSITORY

OTC

FEVERALL INFANTS RECTAL SUPPOSITORY

OTC

gnp 8 hour pain reliever oral tablet extended release

Midol OTC; QL

gnp acetaminophen oral tablet Pharbetol OTC

gnp adult aspirin low strength oral tablet chewable

Bayer Low Dose OTC; QL

gnp arthritis pain relief oral tablet extended release

Midol OTC; QL

13

Page 14: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

gnp aspirin low dose oral tablet delayed release

Aspir-Low OTC

gnp aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

gnp aspirin oral tablet delayed release Aspir-Low OTC

gnp childrens easy-melts oral tablet dispersible

OTC

gnp effervescent antacid/pain oral tablet effervescent

Alka-Seltzer OTC

gnp headache relief extra str oral tablet Bayer Migraine OTC

gnp infants pain relief oral suspension PediaCare Children OTC; QL

gnp infants pain/fever oral suspension PediaCare Children OTC; QL

gnp migraine relief oral tablet Bayer Migraine OTC

gnp pain & fever childrens oral suspension PediaCare Children OTC; QL

gnp pain relief extra strength oral liquid Chloraseptic Sore Throat OTC

gnp pain relief extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

gnp pain relief oral tablet Pharbetol OTC

goodsense antacid/pain relief oral tablet effervescent

Alka-Seltzer OTC

goodsense arthritis pain oral tablet extended release

Midol OTC; QL

goodsense aspirin adult low st oral tablet chewable

Bayer Low Dose OTC; QL

goodsense aspirin low dose oral tablet delayed release

Aspir-Low OTC

goodsense aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

goodsense aspirin oral tablet chewable Bayer Low Dose OTC; QL

goodsense aspirin oral tablet delayed release

Bayer Aspirin OTC

goodsense migraine formula oral tablet Bayer Migraine OTC

goodsense pain & fever child oral suspension

PediaCare Children OTC; QL

goodsense pain & fever infants oral suspension

PediaCare Children OTC; QL

goodsense pain relief extra st oral tabletHealthy Mama Shake That Ache

OTC; QL

goodsense pain relief oral tablet extended release

Midol OTC; QL

headache relief oral tablet Bayer Migraine OTC

14

Page 15: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

HEALTHY MAMA SHAKE THAT ACHE ORAL TABLET

OTC; QL

h-e-b aspirin oral tablet delayed release Aspir-Low OTC

hm acetaminophen childrens oral tablet chewable

Mapap Childrens OTC

hm arthritis pain relief oral tablet extended release

Midol OTC; QL

hm aspirin ec low dose oral tablet delayed release

Aspir-Low OTC

hm aspirin ec oral tablet delayed release Bayer Aspirin OTC

hm aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

hm aspirin oral tablet chewable Bayer Low Dose OTC; QL

hm aspirin oral tablet delayed release Bayer Aspirin OTC

hm migraine relief oral tablet Bayer Migraine OTC

hm pain & fever childrens oral suspension PediaCare Children OTC; QL

hm pain & fever infants oral suspension PediaCare Children OTC; QL

hm pain relief extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

hm pain reliever oral tablet Pharbetol OTC

infants pain & fever oral suspension PediaCare Children OTC; QL

kls acetaminophen ex st oral tabletHealthy Mama Shake That Ache

OTC; QL

kls aspirin ec oral tablet delayed release Bayer Aspirin OTC

kls aspirin low dose oral tablet delayed release

Aspir-Low OTC

kls rapid release pain oral tabletHealthy Mama Shake That Ache

OTC; QL

kp aspirin oral tablet delayed release Aspir-Low OTC

liquid pain relief oral liquid Little Remedies for Fever OTC; QL

LITTLE REMEDIES FOR FEVER ORAL LIQUID

OTC; QL

MAPAP ACETAMINOPHEN EXTRA STR ORAL LIQUID

OTC

mapap arthritis pain oral tablet extended release

Midol OTC; QL

MAPAP CHILDRENS ORAL TABLET CHEWABLE

OTC

mapap oral capsule OTC; QL

mapap oral liquid Little Remedies for Fever OTC; QL

15

Page 16: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

mapap oral tablet Pharbetol OTC

mapap oral tablet chewable Childrens Medi-Tabs OTC

MEDIQUE ASPIRIN ORAL TABLET OTC

medi-seltzer oral tablet effervescent Alka-Seltzer OTC

MEDI-TABS CHILDRENS ORAL ELIXIR OTC

MEDI-TABS EXTRA STRENGTH ORAL TABLET

OTC; QL

meijer aspirin ec oral tablet delayed release Bayer Aspirin OTC

meijer aspirin free oral tablet 325 mg Pharbetol OTC

meijer aspirin free oral tablet 500 mgHealthy Mama Shake That Ache

OTC; QL

migraine formula oral tablet Bayer Migraine OTC

migraine relief oral tablet Bayer Migraine OTC

MINIPRIN LOW DOSE ORAL TABLET DELAYED RELEASE

OTC

mm aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

m-pap oral liquid Little Remedies for Fever OTC

neutralin oral tablet effervescent Alka-Seltzer OTC

non-aspirin childrens oral suspension PediaCare Children OTC; QL

non-aspirin extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

non-aspirin oral tablet 325 mg Pharbetol OTC

non-aspirin oral tablet 500 mgHealthy Mama Shake That Ache

OTC; QL

non-aspirin pain relief oral tablet Pharbetol OTC

NORWICH ASPIRIN ORAL TABLET OTC

pain & fever childrens oral suspension PediaCare Children OTC; QL

pain & fever infants oral suspension PediaCare Children OTC; QL

pain relief childrens oral elixir Medi-Tabs Childrens OTC

pain relief childrens oral suspension PediaCare Children OTC; QL

pain relief extra strength oral capsule OTC

pain relief extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

pain relief oral liquid Chloraseptic Sore Throat

pain relief oral tablet Pharbetol OTC

pain relief regular strength oral tablet Pharbetol OTC

pain reliever extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

16

Page 17: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

pain reliever oral liquid Chloraseptic Sore Throat OTC

pain reliever oral tablet 325 mg Pharbetol OTC

pain reliever oral tablet 500 mgHealthy Mama Shake That Ache

OTC; QL

pain reliever plus oral tablet Bayer Migraine OTC

pain reliever/fever reducer rectal suppository FeverAll Childrens OTC

pain-off oral tablet Bayer Migraine OTC

PAMPRIN MAX ORAL TABLET OTC

PEDIACARE CHILDREN ORAL SUSPENSION

OTC; QL

PEDIACARE INFANT FEVER/PAIN ORAL SUSPENSION

OTC; QL

PEDIACARE INFANTS ORAL SUSPENSION

OTC; QL

PHARBETOL EXTRA STRENGTH ORAL TABLET

OTC; QL

PHARBETOL ORAL TABLET OTC

PREMSYN PMS ORAL TABLET OTC

px arthritis pain relief oral tablet extended release

Midol OTC; QL

px aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

px aspirin oral tablet chewable Bayer Low Dose OTC; QL

px childrens pain relief oral suspension PediaCare Children OTC; QL

px effervescent oral tablet effervescent Alka-Seltzer OTC

px enteric aspirin oral tablet delayed release Bayer Aspirin OTC

px migraine relief oral tablet Bayer Migraine OTC

px pain relief extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

qc acetaminophen 8 hours oral tablet extended release

Midol OTC; QL

qc acetaminophen 8hr arth pain oral tablet extended release

Midol OTC; QL

qc acetaminophen 8hr musc ache oral tablet extended release

Midol OTC; QL

qc arthritis pain relief oral tablet extended release

Midol OTC; QL

qc aspirin low dose oral tablet chewable Bayer Low Dose OTC; QL

qc aspirin low dose oral tablet delayed release

Aspir-Low OTC

17

Page 18: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

qc aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

qc aspirin oral tablet delayed release Bayer Aspirin OTC

qc effervescent antacid/pain oral tablet effervescent

Alka-Seltzer OTC

qc enteric aspirin oral tablet delayed release Bayer Aspirin OTC

qc headache relief oral tablet Bayer Migraine OTC

qc non-aspirin childrens oral suspension PediaCare Children OTC; QL

qc non-aspirin extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

qc non-aspirin jr strength oral tablet dispersible

OTC

qc pain relief childrens oral suspension PediaCare Children OTC; QL

qc pain relief extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

qc pain relief infants oral suspension PediaCare Children OTC; QL

qc pain relief oral tablet Pharbetol OTC

ra 8 hour pain relief oral tablet extended release

Midol OTC; QL

ra acetaminophen childrens oral tablet chewable

Mapap Childrens OTC

ra acetaminophen ex st oral tabletHealthy Mama Shake That Ache

OTC; QL

ra acetaminophen oral tablet Pharbetol OTC

ra acetaminophen oral tablet extended release

Midol OTC; QL

ra acetaminophen rapid melts oral tablet dispersible

OTC

ra antacid pain relief oral tablet effervescent Alka-Seltzer OTC

ra arthritis pain relief oral tablet extended release

Midol OTC; QL

ra aspirin adult low dose oral tablet chewable

Bayer Low Dose OTC; QL

ra aspirin adult low strength oral tablet chewable

Bayer Low Dose OTC; QL

ra aspirin adult low strength oral tablet delayed release

Aspir-Low OTC

ra aspirin childrens oral tablet chewable Bayer Low Dose OTC; QL

ra aspirin ec adult low st oral tablet delayed release

Aspir-Low OTC

ra aspirin ec oral tablet delayed release Bayer Aspirin OTC

18

Page 19: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

ra aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

ra back & body pain relief oral tablet Bayer Back & Body OTC

ra fever reducer/pain reliever oral suspension

PediaCare Children OTC; QL

ra menstrual pain relief oral tablet Premsyn PMS OTC

ra menstrual relief oral tablet Midol Complete OTC

ra migraine relief oral tablet Bayer Migraine OTC

ra pain relief acetaminophen oral tablet 325 mg

Pharbetol OTC

ra pain relief acetaminophen oral tablet 500 mg

Healthy Mama Shake That Ache

OTC; QL

ra pain relief aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

ra pain reliever ex st oral liquid Chloraseptic Sore Throat OTC

ra pain reliever ex st oral tablet Bayer Migraine OTC

ra tri-buffered aspirin oral tablet Bufferin OTC

sb aspirin adult low strength oral tablet delayed release

Aspir-Low OTC

sb aspirin ec oral tablet delayed release Bayer Aspirin OTC

sb aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

sb aspirin oral tablet delayed release Aspir-Low OTC

sb childrens aspirin oral tablet chewable Bayer Low Dose OTC; QL

sb childrens non-aspirin oral tablet dispersible

OTC

sb effervescent pain relief oral tablet effervescent

Alka-Seltzer OTC

sb low dose asa ec oral tablet delayed release

Aspir-Low OTC

sb non-aspirin extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

sb non-aspirin jr strength oral tablet dispersible

OTC

sb non-aspirin oral tablet Pharbetol OTC

sb non-aspirin oral tablet chewable Childrens Medi-Tabs OTC

sb pain relief x-str oral tablet Bayer Migraine OTC

sb pain reliever childrens oral suspension PediaCare Children OTC; QL

sb pain reliever ex st oral tabletHealthy Mama Shake That Ache

OTC; QL

19

Page 20: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

sm 8 hour pain relief oral tablet extended release

Midol OTC; QL

sm arthritis pain relief oral tablet extended release

Midol OTC; QL

sm arthritis pain reliever oral tablet extended release

Midol OTC; QL

sm aspirin adult low strength oral tablet chewable

Bayer Low Dose OTC; QL

sm aspirin adult low strength oral tablet delayed release

Aspir-Low OTC

sm aspirin ec low strength oral tablet delayed release

Aspir-Low OTC

sm aspirin ec oral tablet delayed release Bayer Aspirin OTC

sm aspirin low dose oral tablet chewable Bayer Low Dose OTC; QL

sm aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

sm aspirin tri-buffered oral tablet Bufferin OTC

sm childrens aspirin oral tablet chewable Bayer Low Dose OTC; QL

sm effervescent pain relief oral tablet effervescent

Alka-Seltzer OTC

sm migraine relief oral tablet Bayer Migraine OTC

sm pain & fever childrens oral suspension PediaCare Children OTC; QL

sm pain & fever infants oral suspension PediaCare Children OTC; QL

sm pain relief extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

sm pain reliever ex st oral tabletHealthy Mama Shake That Ache

OTC; QL

sm pain reliever ex st oral tablet extended release

Midol OTC; QL

sm pain reliever oral capsule OTC; QL

sm pain reliever oral tablet Pharbetol OTC

sm rapid melts junior oral tablet dispersible OTC

ST JOSEPH ASPIRIN ORAL TABLET DELAYED RELEASE

OTC

ST JOSEPH LOW DOSE ORAL TABLET DELAYED RELEASE

OTC

tactinal extra strength oral tabletHealthy Mama Shake That Ache

OTC; QL

tactinal oral tablet Pharbetol OTC

TENCON ORAL TABLET QL

20

Page 21: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

tgt acetaminophen childrens oral suspension PediaCare Children OTC; QL

tgt acetaminophen ex st oral tabletHealthy Mama Shake That Ache

OTC; QL

tgt arthritis pain relief oral tablet extended release

Midol OTC; QL

tgt aspirin ec oral tablet delayed release Bayer Aspirin OTC

tgt aspirin low dose oral tablet delayed release

Aspir-Low OTC

tgt aspirin oral tabletBayer Advanced Aspirin Reg St

OTC

tgt aspirin oral tablet chewable Bayer Low Dose OTC; QL

tgt aspirin oral tablet delayed release Aspir-Low OTC

tgt childrens acetaminophen oral suspension PediaCare Children OTC; QL

tgt childrens aspirin oral tablet chewable Bayer Low Dose OTC; QL

tgt migraine relief oral tablet Bayer Migraine OTC

tri-buffered aspirin oral tablet Bufferin OTC

*ANALGESICS - OPIOID*

acetaminophen-codeine #2 oral tablet AL; QL

acetaminophen-codeine #3 oral tablet Tylenol with Codeine #3 PA; AL; QL

acetaminophen-codeine #4 oral tablet PA; AL; QL

acetaminophen-codeine oral solution PA; AL; QL

acetaminophen-codeine oral tablet 300-15 mg

AL; QL

acetaminophen-codeine oral tablet 300-30 mg

Tylenol with Codeine #3 PA; AL; QL

acetaminophen-codeine oral tablet 300-60 mg

PA; AL; QL

ASCOMP-CODEINE ORAL CAPSULE PA; AL; QL

buprenorphine hcl sublingual tablet sublingual

QL

buprenorphine hcl-naloxone hcl sublingual film

Suboxone QL

buprenorphine hcl-naloxone hcl sublingual tablet sublingual

QL

butalbital-apap-caff-cod oral capsule PA; AL; QL

butalbital-asa-caff-codeine oral capsule Ascomp-Codeine PA; AL; QL

butorphanol tartrate nasal solution PA; QL

codeine sulfate oral tablet PA; AL; QL

ENDOCET ORAL TABLET PA; QL

21

Page 22: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

fentanyl citrate buccal lozenge on a handle Actiq PA; QL

fentanyl transdermal patch 72 hour Duragesic-50 PA; QL

hydrocodone-acetaminophen oral solution PA; QL

hydrocodone-acetaminophen oral tablet Lorcet PA; QL

hydrocodone-ibuprofen oral tablet PA; QL

hydromorphone hcl oral liquid Dilaudid PA; QL

hydromorphone hcl oral tablet Dilaudid PA; QL

meperidine hcl oral solution PA; QL

meperidine hcl oral tablet PA; QL

METHADONE HCL INTENSOL ORAL CONCENTRATE

PA; QL

methadone hcl oral concentrate Methadone HCl Intensol PA; QL

methadone hcl oral solution PA; QL

methadone hcl oral tablet Dolophine PA; QL

methadone hcl oral tablet soluble Methadose PA; QL

METHADOSE ORAL CONCENTRATE PA; QL

METHADOSE ORAL TABLET SOLUBLE PA; QL

METHADOSE SUGAR-FREE ORAL CONCENTRATE

PA; QL

morphine sulfate (concentrate) oral solution PA; QL

morphine sulfate er oral tablet extended release

MS Contin PA; QL

morphine sulfate oral solution PA; QL

morphine sulfate oral tablet QL

oxycodone hcl oral capsule PA; QL

oxycodone hcl oral concentrate PA; QL

oxycodone hcl oral solution PA; QL

oxycodone hcl oral tablet Roxicodone PA; QL

oxycodone-acetaminophen oral tablet Endocet PA; QL

oxycodone-aspirin oral tablet PA; QL

pentazocine-naloxone hcl oral tablet PA; QL

tramadol hcl oral tablet Ultram PA; AL; QL

tramadol-acetaminophen oral tablet Ultracet PA; AL; QL

*ANDROGENS-ANABOLIC*

testosterone cypionate intramuscular solution

Depo-Testosterone PA

testosterone enanthate intramuscular solution

PA

22

Page 23: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

testosterone transdermal gel AndroGel PA; QL

*ANORECTAL AGENTS*

COLOCORT RECTAL ENEMA

cvs hemorrhoidal rectal ointment Major-Prep Hemorrhoidal OTC

eq hemorrhoidal rectal suppository OTC

gnp hemorrhoidal rectal suppository Medicone OTC

hemorrhoidal rectal ointment Major-Prep Hemorrhoidal OTC

hemorrhoidal rectal suppository Medicone OTC

hydrocortisone (perianal) external cream Proctozone-HC QL

hydrocortisone rectal enema Colocort

MEDICONE RECTAL SUPPOSITORY OTC

PROCTOZONE-HC EXTERNAL CREAM QL

px hemorrhoidal rectal ointment OTC

px hemorrhoidal rectal suppository OTC

qc hemorrhoidal rectal ointment Major-Prep Hemorrhoidal OTC

qc hemorrhoidal rectal suppository Preparation H OTC

ra hemorrhoid relief rectal suppository OTC

ra hemorrhoidal rectal ointment OTC

rectacaine rectal suppository Medicone OTC

sb hemorrhoid rectal ointment OTC

sm hemorrhoidal rectal suppository Medicone OTC

tgt hemorrhoidal rectal suppository OTC

TRONOLANE RECTAL SUPPOSITORY OTC

*ANTACIDS*

ACID GONE ORAL SUSPENSION OTC

ACID GONE ORAL TABLET CHEWABLE OTC

ALMACONE DOUBLE STRENGTH ORAL SUSPENSION

OTC

ALMACONE ORAL SUSPENSION OTC

aluminum hydroxide gel oral suspension OTC

antacid advanced oral suspensionAlmacone Double Strength

OTC

antacid anti-gas max strength oral suspension

Almacone Double Strength

OTC

antacid anti-gas oral suspension Almacone OTC

antacid anti-gas reg strength oral suspension

Almacone OTC

23

Page 24: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

antacid calcium extra strength oral tablet chewable

Antacid Flavor Chews OTC

antacid calcium oral tablet chewable Cal-Gest Antacid OTC; QL

antacid extra strength oral suspensionAlmacone Double Strength

OTC

antacid extra strength oral tablet chewable 160-105 mg

Acid Gone

antacid extra strength oral tablet chewable 750 mg

Antacid Flavor Chews OTC

antacid fast relief oral suspension Almacone OTC

ANTACID FLAVOR CHEWS ORAL TABLET CHEWABLE

OTC

antacid iii oral suspensionAlmacone Double Strength

OTC

antacid liquid oral suspension Almacone OTC

antacid m oral suspension Almacone OTC

antacid maximum oral tablet chewable Tums Ultra 1000 OTC; QL

antacid maximum strength oral suspensionAlmacone Double Strength

OTC

antacid oral suspension Almacone OTC

antacid oral tablet chewable 500 mg Cal-Gest Antacid OTC; QL

antacid oral tablet chewable 550-110 mg Rolaids OTC

antacid plus anti-gas fast act oral suspension

Almacone OTC

antacid plus anti-gas relief oral suspension Almacone OTC

antacid regular strength oral tablet chewable Cal-Gest Antacid OTC; QL

antacid ultra strength oral tablet chewable Tums Ultra 1000 OTC; QL

antacid/simethicone ds oral suspensionAlmacone Double Strength

OTC

calcium antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

calcium antacid oral tablet chewable Cal-Gest Antacid OTC; QL

calcium antacid ultra max st oral tablet chewable

Tums Ultra 1000 OTC; QL

calcium antacid ultra strength oral tablet chewable

Tums Ultra 1000 OTC; QL

calcium carbonate antacid oral suspension OTC

calcium carbonate antacid oral tablet OTC; QL

calcium carbonate antacid oral tablet chewable 500 mg

Cal-Gest Antacid OTC; QL

24

Page 25: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

calcium carbonate antacid oral tablet chewable 750 mg

Antacid Flavor Chews OTC

calcium carbonate oral tablet chewable Cal-Gest Antacid OTC; QL

CAL-GEST ANTACID ORAL TABLET CHEWABLE

OTC; QL

childrens pepto oral tablet chewable Childrens Soothe OTC

CHILDRENS SOOTHE ORAL TABLET CHEWABLE

OTC

comfort gel antacid & anti-gas oral suspension

Almacone OTC

comfort gel antacid anti-gas oral suspensionAlmacone Double Strength

OTC

cvs antacid extra oral tablet chewable Antacid Flavor Chews OTC

cvs antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

cvs antacid kids oral tablet chewable Antacid Flavor Chews OTC

cvs antacid maximum strength oral tablet chewable

Tums Ultra 1000 OTC; QL

cvs antacid plus antigas oral suspensionAlmacone Double Strength

OTC

cvs antacid supreme oral suspension OTC

cvs antacid ultra strength oral tablet chewable

Tums Ultra 1000 OTC; QL

cvs antacid/anti-gas oral suspension Almacone OTC

CVS CHEWY NOT CHALKY FLAVOR ORAL TABLET CHEWABLE

OTC

cvs heartburn relief oral tablet chewable Acid Gone OTC

cvs smooth antacid extra st oral tablet chewable

Antacid Flavor Chews OTC

eq antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

eq antacid maximum strength oral suspension

Almacone Double Strength

OTC

eq antacid oral suspension Almacone OTC

eq antacid ultra strength oral tablet chewable

Tums Ultra 1000 OTC; QL

eq antacid/anti-gas oral suspension Almacone OTC

eql antacid advanced max st oral suspension

Almacone Double Strength

OTC

eql antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

25

Page 26: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

eql antacid oral tablet chewable Cal-Gest Antacid OTC; QL

eql antacid ultra strength oral tablet chewable

Tums Ultra 1000 OTC; QL

eql antacid/anti-gas oral suspension Almacone OTC

fast acting antacid/anti-gas oral suspensionAlmacone Double Strength

OTC

gavis-care oral suspension Acid Gone OTC

geri-lanta oral suspension Almacone OTC

geri-lanta supreme oral suspension OTC

gnp antacid & anti-gas oral suspensionAlmacone Double Strength

OTC

gnp antacid anti-gas oral suspension Almacone OTC

gnp antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

gnp antacid oral tablet chewable Cal-Gest Antacid OTC; QL

gnp antacid regular strength oral suspension Almacone OTC

gnp antacid ultra strength oral tablet chewable

Tums Ultra 1000 OTC; QL

gnp foaming antacid oral suspension Acid Gone OTC

gnp foaming antacid oral tablet chewable OTC

gnp magnesium oxide oral tablet OTC

goodsense antacid oral tablet chewable 1000 mg

Tums Ultra 1000 OTC; QL

goodsense antacid oral tablet chewable 500 mg

Cal-Gest Antacid OTC; QL

goodsense antacid oral tablet chewable 750 mg

Antacid Flavor Chews OTC

heartburn antacid ex st oral tablet chewable Acid Gone OTC

hm advanced antacid max st oral suspension

Almacone Double Strength

OTC

hm antacid anti-gas ex st oral suspensionAlmacone Double Strength

OTC

hm antacid oral suspension Almacone OTC

hm antacid/antigas oral suspension Almacone OTC

hm calcium antacid ex st oral tablet chewable

Antacid Flavor Chews OTC

hm calcium antacid oral tablet chewable 500 mg

Cal-Gest Antacid OTC; QL

hm calcium antacid oral tablet chewable 750 mg

Antacid Flavor Chews OTC

26

Page 27: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

hm calcium antacid ultra st oral tablet chewable

Tums Ultra 1000 OTC; QL

hm magnesium oral tablet 250 mg OTC

hm magnesium oral tablet 400 mg OTC; QL

MAALOX CHILDRENS ORAL TABLET CHEWABLE

OTC

MAALOX MAX ORAL SUSPENSION OTC

MAALOX MULTI SYMPTOM MAX ST ORAL SUSPENSION

OTC

mag-al plus oral liquid Almacone OTC

mag-al plus xs oral liquidAlmacone Double Strength

OTC

magnesium oxide (antacid) oral capsule OTC

magnesium oxide oral tablet 250 mg OTC

magnesium oxide oral tablet 400 mg OTC; QL

magnesium oxide oral tablet 420 mg Maox OTC

MAOX ORAL TABLET OTC

meijer antacid oral suspensionAlmacone Double Strength

OTC

mi-acid maximum strength oral suspensionAlmacone Double Strength

OTC

MI-ACID ORAL SUSPENSION OTC

milantex extra strength oral suspensionAlmacone Double Strength

OTC

mintox maximum strength oral suspensionAlmacone Double Strength

OTC

MINTOX ORAL SUSPENSION OTC

MINTOX PLUS ORAL TABLET CHEWABLE

OTC

MINTOX REGULAR STRENGTH ORAL SUSPENSION

OTC

MYLANTA MAXIMUM STRENGTH ORAL SUSPENSION

OTC

px antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

px antacid maximum strength oral suspension

Almacone Double Strength

OTC

px antacid maximum strength oral tablet chewable

Tums Ultra 1000 OTC; QL

px antacid regular strength oral suspension Almacone OTC

27

Page 28: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

px calcium antacid oral tablet chewable Cal-Gest Antacid OTC; QL

qc antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

qc antacid oral suspension Almacone OTC

qc antacid oral tablet chewable Cal-Gest Antacid OTC; QL

qc antacid ultra strength oral tablet chewable Tums Ultra 1000 OTC; QL

qc antacid/anti-gas oral suspension Almacone OTC

qc heartburn antacid oral tablet chewable Acid Gone OTC

qc magnesium oral tablet OTC

ra antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

ra antacid oral tablet chewable Cal-Gest Antacid OTC; QL

ra antacid ultra strength oral tablet chewable Tums Ultra 1000 OTC; QL

ra antacid/anti-gas max st oral suspensionAlmacone Double Strength

OTC

ra antacid/anti-gas oral suspension Almacone OTC

ra antacid/gas relief max st oral suspensionAlmacone Double Strength

OTC

ra smooth antacid ex st oral tablet chewable Antacid Flavor Chews OTC

ra stomach relief kids oral tablet chewable Childrens Soothe OTC

sb antacid anti-gas oral suspension Almacone OTC

sb antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

sb antacid oral tablet chewable Cal-Gest Antacid OTC; QL

sm antacid advanced max st oral suspension

Almacone Double Strength

OTC

sm antacid advanced oral suspension Almacone OTC

sm antacid anti-gas oral suspension Almacone OTC

sm antacid maximum strength oral suspension

Almacone Double Strength

OTC

sm antacid/antigas oral suspension Almacone OTC

sm calcium antacid ex st oral tablet chewable

Antacid Flavor Chews OTC

sm calcium antacid oral tablet chewable Cal-Gest Antacid OTC; QL

sm foaming antacid oral tablet chewable OTC

sm smooth antacid ex st oral tablet chewable

Antacid Flavor Chews OTC

sodium bicarbonate oral tablet OTC

tgt antacid anti-gas oral suspension Almacone OTC

28

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Drug Name Reference Notes

tgt antacid extra strength oral tablet chewable

Antacid Flavor Chews OTC

tgt antacid oral tablet chewable Tums Ultra 1000 OTC; QL

TITRALAC ORAL TABLET CHEWABLE OTC

*ANTHELMINTICS*

ivermectin oral tablet Stromectol

praziquantel oral tablet Biltricide

reeses pinworm medicine oral suspension OTC

*ANTIANGINAL AGENTS*

isosorbide dinitrate oral tablet

isosorbide mononitrate er oral tablet extended release 24 hour

isosorbide mononitrate oral tablet

NITRO-BID TRANSDERMAL OINTMENT

NITRO-DUR TRANSDERMAL PATCH 24 HOUR

nitroglycerin sublingual tablet sublingual Nitrostat

nitroglycerin transdermal patch 24 hour Nitro-Dur

*ANTIANXIETY AGENTS*

ALPRAZOLAM INTENSOL ORAL CONCENTRATE

alprazolam oral tablet Xanax

alprazolam oral tablet dispersible

buspirone hcl oral tablet

chlordiazepoxide hcl oral capsule

clorazepate dipotassium oral tablet

DIAZEPAM INTENSOL ORAL CONCENTRATE

diazepam oral concentrate Diazepam Intensol

diazepam oral solution

diazepam oral tablet Valium

hydroxyzine hcl oral syrup

hydroxyzine hcl oral tablet

hydroxyzine pamoate oral capsule

lorazepam oral tablet Ativan

oxazepam oral capsule

*ANTIARRHYTHMICS*

amiodarone hcl oral tablet 200 mg Pacerone QL

29

Page 30: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

amiodarone hcl oral tablet 400 mg Pacerone

disopyramide phosphate oral capsule Norpace

flecainide acetate oral tablet QL

mexiletine hcl oral capsule

PACERONE ORAL TABLET 200 MG QL

PACERONE ORAL TABLET 400 MG

propafenone hcl er oral capsule extended release 12 hour

Rythmol SR

propafenone hcl oral tablet

quinidine gluconate er oral tablet extended release

quinidine sulfate oral tablet

*ANTIASTHMATIC AND BRONCHODILATOR AGENTS*

albuterol sulfate er oral tablet extended release 12 hour

albuterol sulfate hfa inhalation aerosol solution

ProAir HFA QL

albuterol sulfate inhalation nebulization solution

QL

albuterol sulfate oral syrup

albuterol sulfate oral tablet

ANORO ELLIPTA INHALATION AEROSOL POWDER BREATH ACTIVATED

ARNUITY ELLIPTA INHALATION AEROSOL POWDER BREATH ACTIVATED

QL

ATROVENT HFA INHALATION AEROSOL SOLUTION

QL

BREO ELLIPTA INHALATION AEROSOL POWDER BREATH ACTIVATED 100-25 MCG/INH

QL

BREO ELLIPTA INHALATION AEROSOL POWDER BREATH ACTIVATED 200-25 MCG/INH

PA; QL

budesonide inhalation suspension Pulmicort PA; AL; QL

budesonide-formoterol fumarate inhalation aerosol

Symbicort QL

COMBIVENT RESPIMAT INHALATION AEROSOL SOLUTION

30

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Drug Name Reference Notes

cromolyn sodium inhalation nebulization solution

FLOVENT DISKUS INHALATION AEROSOL POWDER BREATH ACTIVATED

QL

FLOVENT HFA INHALATION AEROSOL QL

fluticasone-salmeterol inhalation aerosol powder breath activated

AirDuo RespiClick 55/14 QL

ipratropium bromide inhalation solution QL

ipratropium-albuterol inhalation solution

levalbuterol hcl inhalation nebulization solution

Xopenex QL

levalbuterol tartrate inhalation aerosol Xopenex HFA QL

metaproterenol sulfate oral syrup

montelukast sodium oral packet Singulair QL

montelukast sodium oral tablet Singulair

montelukast sodium oral tablet chewable Singulair

SEREVENT DISKUS INHALATION AEROSOL POWDER BREATH ACTIVATED

QL

SPIRIVA RESPIMAT INHALATION AEROSOL SOLUTION

QL

STIOLTO RESPIMAT INHALATION AEROSOL SOLUTION

QL

terbutaline sulfate oral tablet

THEO-24 ORAL CAPSULE EXTENDED RELEASE 24 HOUR

QL

theophylline er oral tablet extended release 12 hour

theophylline er oral tablet extended release 24 hour

theophylline oral solution

WIXELA INHUB INHALATION AEROSOL POWDER BREATH ACTIVATED

QL

XOLAIR SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP

XOLAIR SUBCUTANEOUS SOLUTION RECONSTITUTED

PA; SP

zafirlukast oral tablet Accolate QL

31

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Drug Name Reference Notes

*ANTICOAGULANTS*

COUMADIN ORAL TABLET

ELIQUIS DVT/PE STARTER PACK ORAL TABLET

QL

ELIQUIS ORAL TABLET 2.5 MG

ELIQUIS ORAL TABLET 5 MG QL

enoxaparin sodium injection solution Lovenox SP; QL

enoxaparin sodium subcutaneous solution Lovenox SP; QL

heparin sodium (porcine) injection solution

heparin sodium (porcine) pf injection solution

JANTOVEN ORAL TABLET

warfarin sodium oral tablet Coumadin

warfarin sodium powder

*ANTICONVULSANTS*

carbamazepine er oral capsule extended release 12 hour

Carbatrol QL

carbamazepine er oral tablet extended release 12 hour

TEGretol-XR

carbamazepine oral suspension TEGretol

carbamazepine oral tablet Epitol

carbamazepine oral tablet chewable

clonazepam oral tablet KlonoPIN

clonazepam oral tablet dispersible

diazepam rectal gel Diastat Pediatric QL

DILANTIN INFATABS ORAL TABLET CHEWABLE

DILANTIN ORAL CAPSULE

DILANTIN ORAL SUSPENSION

divalproex sodium er oral tablet extended release 24 hour

Depakote ER QL

divalproex sodium oral capsule delayed release sprinkle

Depakote Sprinkles QL

divalproex sodium oral tablet delayed release 125 mg, 250 mg

Depakote QL

divalproex sodium oral tablet delayed release 500 mg

Depakote

EPITOL ORAL TABLET

ethosuximide oral capsule Zarontin

ethosuximide oral solution Zarontin

32

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Drug Name Reference Notes

felbamate oral suspension Felbatol

felbamate oral tablet Felbatol

gabapentin oral capsule Neurontin QL

gabapentin oral solution Neurontin QL

gabapentin oral tablet Neurontin QL

lamotrigine er oral tablet extended release 24 hour

LaMICtal XR

lamotrigine oral tablet 100 mg, 150 mg, 200 mg

Subvenite

lamotrigine oral tablet 25 mg Subvenite QL

lamotrigine oral tablet chewable LaMICtal

lamotrigine oral tablet dispersible 100 mg, 50 mg

LaMICtal ODT QL

lamotrigine oral tablet dispersible 200 mg, 25 mg

LaMICtal ODT

lamotrigine starter kit-blue oral kit Subvenite Starter Kit-Blue

lamotrigine starter kit-green oral kitSubvenite Starter Kit-Green

lamotrigine starter kit-orange oral kitSubvenite Starter Kit-Orange

levetiracetam er oral tablet extended release 24 hour

Roweepra XR QL

levetiracetam oral solution Keppra

levetiracetam oral tablet Roweepra QL

oxcarbazepine oral suspension Trileptal

oxcarbazepine oral tablet Trileptal

PHENYTOIN INFATABS ORAL TABLET CHEWABLE

phenytoin oral suspension Dilantin

phenytoin oral tablet chewable Dilantin Infatabs

phenytoin sodium extended oral capsule Phenytek

pregabalin oral capsule Lyrica QL

pregabalin oral solution Lyrica QL

primidone oral tablet Mysoline

ROWEEPRA ORAL TABLET QL

ROWEEPRA XR ORAL TABLET EXTENDED RELEASE 24 HOUR

QL

SUBVENITE ORAL TABLET 100 MG, 150 MG, 200 MG

33

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Drug Name Reference Notes

SUBVENITE ORAL TABLET 25 MG QL

SUBVENITE STARTER KIT-BLUE ORAL KIT

SUBVENITE STARTER KIT-GREEN ORAL KIT

SUBVENITE STARTER KIT-ORANGE ORAL KIT

TEGRETOL ORAL SUSPENSION

TEGRETOL ORAL TABLET

TEGRETOL-XR ORAL TABLET EXTENDED RELEASE 12 HOUR

tiagabine hcl oral tablet Gabitril

topiramate oral capsule sprinkle Topamax Sprinkle

topiramate oral tablet Topamax

valproic acid oral capsule QL

valproic acid oral solution

ZARONTIN ORAL CAPSULE PA

ZARONTIN ORAL SOLUTION PA

zonisamide oral capsule Zonegran QL

*ANTIDEPRESSANTS*

amitriptyline hcl oral tablet

amoxapine oral tablet

bupropion hcl er (sr) oral tablet extended release 12 hour

Wellbutrin SR

bupropion hcl er (xl) oral tablet extended release 24 hour

Wellbutrin XL QL

bupropion hcl oral tablet

citalopram hydrobromide oral solution QL

citalopram hydrobromide oral tablet 10 mg, 40 mg

CeleXA

citalopram hydrobromide oral tablet 20 mg CeleXA QL

clomipramine hcl oral capsule Anafranil

desipramine hcl oral tablet Norpramin

doxepin hcl oral capsule

doxepin hcl oral concentrate

escitalopram oxalate oral solution

escitalopram oxalate oral tablet Lexapro QL

fluoxetine hcl oral capsule PROzac QL

fluoxetine hcl oral capsule delayed release

34

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Drug Name Reference Notes

fluoxetine hcl oral solution

fluoxetine hcl oral tablet QL

fluvoxamine maleate oral tablet

imipramine hcl oral tablet

imipramine pamoate oral capsule

maprotiline hcl oral tablet

mirtazapine oral tablet Remeron

mirtazapine oral tablet dispersible Remeron SolTab

nefazodone hcl oral tablet

nortriptyline hcl oral capsule Pamelor

nortriptyline hcl oral solution

paroxetine hcl er oral tablet extended release 24 hour 12.5 mg, 37.5 mg

Paxil CR

paroxetine hcl er oral tablet extended release 24 hour 25 mg

Paxil CR QL

paroxetine hcl oral tablet Paxil QL

phenelzine sulfate oral tablet Nardil

protriptyline hcl oral tablet

sertraline hcl oral concentrate Zoloft QL

sertraline hcl oral tablet Zoloft QL

tranylcypromine sulfate oral tablet Parnate

trazodone hcl oral tablet

trimipramine maleate oral capsule

venlafaxine hcl er oral capsule extended release 24 hour

Effexor XR QL

venlafaxine hcl er oral tablet extended release 24 hour

QL

venlafaxine hcl oral tablet QL

*ANTIDIABETICS*

acarbose oral tablet 100 mg Precose

acarbose oral tablet 25 mg, 50 mg Precose QL

ADMELOG SOLOSTAR SUBCUTANEOUS SOLUTION PEN-INJECTOR

QL

ADMELOG SUBCUTANEOUS SOLUTION QL

BASAGLAR KWIKPEN SUBCUTANEOUS SOLUTION PEN-INJECTOR

AL; QL

cvs glucose bits oral tablet chewable OTC

cvs glucose oral gel Gluco Burst OTC

35

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Drug Name Reference Notes

cvs glucose oral tablet chewableDex4 Quick Dissolve Glucose

OTC

cvs soft glucose oral tablet chewableDex4 Quick Dissolve Glucose

OTC

DEX4 GLUCOSE ORAL TABLET CHEWABLE

OTC

DEX4 NATURALS ORAL TABLET CHEWABLE

OTC

DEX4 ORAL TABLET CHEWABLE OTC

DEX4 POUCH PACK ORAL TABLET CHEWABLE

OTC

DEX4 QUICK DISSOLVE GLUCOSE ORAL TABLET CHEWABLE

OTC

glimepiride oral tablet Amaryl PA

glipizide er oral tablet extended release 24 hour

Glucotrol XL PA

glipizide oral tablet Glucotrol PA

glipizide xl oral tablet extended release 24 hour

Glucotrol XL PA

glipizide-metformin hcl oral tablet PA

GLUCAGEN HYPOKIT INJECTION SOLUTION RECONSTITUTED

QL

GLUCAGON EMERGENCY INJECTION KIT

QL

GLUCO BURST ORAL GEL OTC

glucose instant energy oral tablet chewable Dex4 OTC

glucose oral gel Gluco Burst OTC

glucose oral tablet chewableDex4 Quick Dissolve Glucose

OTC

glucose-vitamin c oral tablet chewable Dex4 OTC

glyburide micronized oral tablet Glynase PA

glyburide oral tablet PA

glyburide-metformin oral tablet PA

gnp glucose oral tablet chewableDex4 Quick Dissolve Glucose

OTC

gnp quick dissolve glucose oral tablet chewable

Dex4 Quick Dissolve Glucose

OTC

goodsense glucose oral tablet chewable Dex4 OTC

hm glucose oral tablet chewable Dex4 OTC

36

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Drug Name Reference Notes

HUMALOG MIX 50/50 KWIKPEN SUBCUTANEOUS SUSPENSION PEN-INJECTOR

QL

HUMALOG MIX 50/50 SUBCUTANEOUS SUSPENSION

QL

HUMALOG MIX 75/25 KWIKPEN SUBCUTANEOUS SUSPENSION PEN-INJECTOR

QL

HUMALOG MIX 75/25 SUBCUTANEOUS SUSPENSION

QL

HUMULIN 70/30 KWIKPEN SUBCUTANEOUS SUSPENSION PEN-INJECTOR

OTC; QL

HUMULIN 70/30 SUBCUTANEOUS SUSPENSION

OTC; QL

HUMULIN N KWIKPEN SUBCUTANEOUS SUSPENSION PEN-INJECTOR

OTC; QL

HUMULIN N SUBCUTANEOUS SUSPENSION

OTC; QL

HUMULIN R INJECTION SOLUTION OTC; QL

HUMULIN R U-500 (CONCENTRATED) SUBCUTANEOUS SOLUTION

PA; QL

HUMULIN R U-500 KWIKPEN SUBCUTANEOUS SOLUTION PEN-INJECTOR

PA; QL

hy-vee glucose oral tablet chewable Dex4 OTC

insulin asp prot & asp flexpen subcutaneous suspension pen-injector

NovoLOG Mix 70/30 FlexPen

QL

insulin aspart prot & aspart subcutaneous suspension

NovoLOG Mix 70/30 QL

insulin lispro (1 unit dial) subcutaneous solution pen-injector

Admelog SoloStar PA; QL

insulin lispro subcutaneous solution Admelog QL

JANUMET ORAL TABLET PA; QL

JANUMET XR ORAL TABLET EXTENDED RELEASE 24 HOUR

PA; QL

JANUVIA ORAL TABLET PA; QL

JARDIANCE ORAL TABLET PA; QL

kroger glucose oral tablet chewable Dex4 OTC

leader glucose oral tablet chewable Dex4 OTC

leader quick dissolve glucose oral tablet chewable

Dex4 Quick Dissolve Glucose

OTC

37

Page 38: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

longs glucose oral tablet chewable Dex4 OTC

meijer glucose oral tablet chewable Dex4 OTC

metformin hcl er oral tablet extended release 24 hour

metformin hcl oral tablet

nateglinide oral tablet Starlix PA; QL

NOVOLIN 70/30 FLEXPEN RELION SUBCUTANEOUS SUSPENSION PEN-INJECTOR

OTC; QL

NOVOLIN 70/30 FLEXPEN SUBCUTANEOUS SUSPENSION PEN-INJECTOR

OTC; QL

NOVOLIN 70/30 RELION SUBCUTANEOUS SUSPENSION

OTC; QL

NOVOLIN 70/30 SUBCUTANEOUS SUSPENSION

OTC; QL

NOVOLIN N FLEXPEN RELION SUBCUTANEOUS SUSPENSION PEN-INJECTOR

OTC; QL

NOVOLIN N FLEXPEN SUBCUTANEOUS SUSPENSION PEN-INJECTOR

OTC; QL

NOVOLIN N RELION SUBCUTANEOUS SUSPENSION

OTC; QL

NOVOLIN N SUBCUTANEOUS SUSPENSION

OTC; QL

NOVOLIN R FLEXPEN INJECTION SOLUTION PEN-INJECTOR

OTC; QL

NOVOLIN R FLEXPEN RELION INJECTION SOLUTION PEN-INJECTOR

OTC; QL

NOVOLIN R INJECTION SOLUTION OTC; QL

NOVOLIN R RELION INJECTION SOLUTION

OTC; QL

NOVOLOG MIX 70/30 FLEXPEN SUBCUTANEOUS SUSPENSION PEN-INJECTOR

QL

NOVOLOG MIX 70/30 SUBCUTANEOUS SUSPENSION

QL

OZEMPIC (0.25 OR 0.5 MG/DOSE) SUBCUTANEOUS SOLUTION PEN-INJECTOR

PA; QL

OZEMPIC (1 MG/DOSE) SUBCUTANEOUS SOLUTION PEN-INJECTOR

PA; QL

38

Page 39: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

pioglitazone hcl oral tablet Actos PA; QL

pioglitazone hcl-glimepiride oral tablet Duetact PA

pioglitazone hcl-metformin hcl oral tablet Actoplus Met PA

preferred plus glucose oral tablet chewable Dex4 OTC

px glucose oral tablet chewable Dex4 OTC

ra glucose oral tablet chewable Dex4 OTC

RELION GLUCOSE ORAL GEL OTC

RELION GLUCOSE ORAL TABLET CHEWABLE

OTC

repaglinide oral tablet PA

sm glucose oral tablet chewableDex4 Quick Dissolve Glucose

OTC

SMART SENSE GLUCOSE ORAL TABLET CHEWABLE

OTC

SYMLINPEN 120 SUBCUTANEOUS SOLUTION PEN-INJECTOR

PA; QL

SYMLINPEN 60 SUBCUTANEOUS SOLUTION PEN-INJECTOR

PA

tgt glucose oral tablet chewable Dex4 OTC

up & up glucose oral tablet chewable Dex4 OTC

value plus glucose oral gel Gluco Burst OTC

value plus glucose oral tablet chewable Dex4 OTC

VICTOZA SUBCUTANEOUS SOLUTION PEN-INJECTOR

PA; QL

walgreens glucose oral tablet chewableDex4 Quick Dissolve Glucose

OTC

*ANTIDIARRHEAL/PROBIOTIC AGENTS*

bismatrol maximum strength oral suspensionKaopectate Extra Strength

OTC

bismatrol oral suspension Kaopectate OTC; QL

bismatrol oral tablet chewable Pepto-Bismol OTC

bismuth oral tablet chewable Pepto-Bismol OTC

bismuth subsalicylate oral tablet chewable Pepto-Bismol OTC

cvs bismuth oral tablet chewable Pepto-Bismol OTC

cvs stomach relief max st oral suspensionKaopectate Extra Strength

OTC

cvs stomach relief oral suspension 525 mg/15ml

Kaopectate Extra Strength

OTC

39

Page 40: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

cvs stomach relief oral suspension 525 mg/30ml

Kaopectate OTC; QL

cvs stomach relief oral tablet Soothe OTC

cvs stomach relief oral tablet chewable Pepto-Bismol OTC

diarrhea oral suspension Kaopectate OTC; QL

eq pink-bismuth oral tablet chewable Pepto-Bismol OTC

eq stomach relief oral suspension Kaopectate OTC; QL

eq stomach relief oral tablet chewable Pepto-Bismol OTC

eql stomach relief max st oral suspensionKaopectate Extra Strength

OTC

eql stomach relief oral suspension Kaopectate OTC; QL

eql stomach relief oral tablet chewable Pepto-Bismol OTC

gnp k-pec oral suspension Kaopectate OTC; QL

gnp pink bismuth oral tablet Soothe OTC

gnp pink bismuth oral tablet chewable Pepto-Bismol OTC

gnp stomach relief max st oral suspensionKaopectate Extra Strength

OTC

gnp stomach relief oral suspension Kaopectate OTC; QL

goodsense stomach relief oral suspension 1050 mg/30ml

Kaopectate Extra Strength

OTC

goodsense stomach relief oral suspension 525 mg/30ml

Kaopectate OTC; QL

goodsense stomach relief oral tablet chewable

Pepto-Bismol OTC

hm stomach relief max strength oral suspension

Kaopectate Extra Strength

OTC

hm stomach relief oral suspension Kaopectate OTC; QL

hm stomach relief oral tablet chewable Pepto-Bismol OTC

hm stomach relief ultra oral suspensionKaopectate Extra Strength

OTC

KAOPECTATE EXTRA STRENGTH ORAL SUSPENSION

OTC

KAOPECTATE ORAL SUSPENSION OTC; QL

medi-bismuth oral tablet chewable Pepto-Bismol OTC

peptic relief oral tablet chewable Pepto-Bismol OTC

PEPTO-BISMOL ORAL TABLET CHEWABLE

OTC

PEPTO-BISMOL TO-GO ORAL TABLET CHEWABLE

OTC

40

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Drug Name Reference Notes

pink bismuth maximum strength oral suspension

Kaopectate Extra Strength

OTC

pink bismuth oral suspension Kaopectate OTC; QL

px stomach relief max st oral suspensionKaopectate Extra Strength

OTC

px stomach relief oral suspension Kaopectate OTC; QL

px stomach relief oral tablet chewable Pepto-Bismol OTC

qc diarrhea relief oral suspension Kaopectate OTC; QL

qc pink bismuth oral tablet Soothe OTC

qc pink bismuth oral tablet chewable Pepto-Bismol OTC

ra pink bismuth oral tablet Soothe OTC

ra pink bismuth oral tablet chewable Pepto-Bismol OTC

ra stomach relief max st oral suspensionKaopectate Extra Strength

OTC

ra stomach relief oral suspension Kaopectate OTC; QL

ra stomach relief oral tablet chewable Pepto-Bismol OTC

sb bismuth oral tablet Soothe OTC

sm stomach relief oral suspension Kaopectate OTC; QL

sm stomach relief oral tablet Soothe OTC

sm stomach relief oral tablet chewable Pepto-Bismol OTC

SOOTHE MAXIMUM STRENGTH ORAL SUSPENSION

OTC

SOOTHE ORAL SUSPENSION OTC; QL

SOOTHE ORAL TABLET OTC

SOOTHE ORAL TABLET CHEWABLE OTC

stomach relief max st oral suspensionKaopectate Extra Strength

OTC

stomach relief oral suspension 262 mg/15ml, 525 mg/30ml

Kaopectate OTC; QL

stomach relief oral suspension 525 mg/15mlKaopectate Extra Strength

OTC

stomach relief oral tablet chewable Pepto-Bismol OTC

stomach relief plus oral suspensionKaopectate Extra Strength

OTC

*ANTIDIARRHEALS*

anti-diarrheal oral capsule Imodium A-D OTC; QL

anti-diarrheal oral liquid OTC; QL

anti-diarrheal oral tablet Imodium A-D OTC; QL

41

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Drug Name Reference Notes

bismatrol maximum strength oral suspensionKaopectate Extra Strength

OTC

bismatrol oral suspension Kaopectate OTC; QL

bismatrol oral tablet chewable Pepto-Bismol OTC

bismuth oral tablet chewable Pepto-Bismol OTC

bismuth subsalicylate oral tablet chewable Pepto-Bismol OTC

cvs anti-diarrheal oral capsule Imodium A-D OTC; QL

cvs anti-diarrheal oral tablet Imodium A-D OTC; QL

cvs bismuth oral tablet chewable Pepto-Bismol OTC

cvs stomach relief max st oral suspensionKaopectate Extra Strength

OTC

cvs stomach relief oral suspension 525 mg/15ml

Kaopectate Extra Strength

OTC

cvs stomach relief oral suspension 525 mg/30ml

Kaopectate OTC; QL

cvs stomach relief oral tablet Soothe OTC

cvs stomach relief oral tablet chewable Pepto-Bismol OTC

diamode oral tablet Imodium A-D OTC; QL

diarrhea oral suspension Kaopectate OTC; QL

diphenoxylate-atropine oral liquid

diphenoxylate-atropine oral tablet Lomotil

eq anti-diarrheal oral capsule Imodium A-D OTC; QL

eq anti-diarrheal oral liquid OTC; QL

eq anti-diarrheal oral tablet Imodium A-D OTC; QL

eq pink-bismuth oral tablet chewable Pepto-Bismol OTC

eq stomach relief oral suspension Kaopectate OTC; QL

eq stomach relief oral tablet chewable Pepto-Bismol OTC

eql anti-diarrheal oral tablet Imodium A-D OTC; QL

eql stomach relief max st oral suspensionKaopectate Extra Strength

OTC

eql stomach relief oral suspension Kaopectate OTC; QL

eql stomach relief oral tablet chewable Pepto-Bismol OTC

gnp anti-diarrheal oral capsule Imodium A-D OTC; QL

gnp anti-diarrheal oral tablet Imodium A-D OTC; QL

gnp k-pec oral suspension Kaopectate OTC; QL

gnp pink bismuth oral tablet Soothe OTC

gnp pink bismuth oral tablet chewable Pepto-Bismol OTC

42

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Drug Name Reference Notes

gnp stomach relief max st oral suspensionKaopectate Extra Strength

OTC

gnp stomach relief oral suspension Kaopectate OTC; QL

goodsense stomach relief oral suspension 1050 mg/30ml

Kaopectate Extra Strength

OTC

goodsense stomach relief oral suspension 525 mg/30ml

Kaopectate OTC; QL

goodsense stomach relief oral tablet chewable

Pepto-Bismol OTC

hm anti-diarrheal anti-gas oral tabletImodium Multi-Symptom Relief

OTC

hm anti-diarrheal oral capsule Imodium A-D OTC; QL

hm anti-diarrheal oral tablet Imodium A-D OTC; QL

hm loperamide hcl oral capsule Imodium A-D OTC; QL

hm stomach relief max strength oral suspension

Kaopectate Extra Strength

OTC

hm stomach relief oral suspension Kaopectate OTC; QL

hm stomach relief oral tablet chewable Pepto-Bismol OTC

hm stomach relief ultra oral suspensionKaopectate Extra Strength

OTC

KAOPECTATE EXTRA STRENGTH ORAL SUSPENSION

OTC

KAOPECTATE ORAL SUSPENSION OTC; QL

kls anti-diarrheal oral tablet Imodium A-D OTC; QL

loperamide hcl oral capsule Imodium A-D QL

loperamide hcl oral liquid OTC; QL

loperamide hcl oral tablet Imodium A-D OTC; QL

medi-bismuth oral tablet chewable Pepto-Bismol OTC

meijer anti-diarrheal oral tablet Imodium A-D OTC; QL

mm anti-diarrheal oral tablet Imodium A-D OTC; QL

peptic relief oral tablet chewable Pepto-Bismol OTC

PEPTO-BISMOL ORAL TABLET CHEWABLE

OTC

PEPTO-BISMOL TO-GO ORAL TABLET CHEWABLE

OTC

pink bismuth maximum strength oral suspension

Kaopectate Extra Strength

OTC

pink bismuth oral suspension Kaopectate OTC; QL

px anti-diarrheal oral tablet Imodium A-D OTC; QL

43

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Drug Name Reference Notes

px stomach relief max st oral suspensionKaopectate Extra Strength

OTC

px stomach relief oral suspension Kaopectate OTC; QL

px stomach relief oral tablet chewable Pepto-Bismol OTC

qc anti-diarrheal oral capsule Imodium A-D OTC; QL

qc anti-diarrheal oral tablet Imodium A-D OTC; QL

qc diarrhea relief oral suspension Kaopectate OTC; QL

qc pink bismuth oral tablet Soothe OTC

qc pink bismuth oral tablet chewable Pepto-Bismol OTC

ra anti-diarrheal oral capsule Imodium A-D OTC; QL

ra anti-diarrheal oral liquid OTC; QL

ra anti-diarrheal oral tablet Imodium A-D OTC; QL

ra pink bismuth oral tablet Soothe OTC

ra pink bismuth oral tablet chewable Pepto-Bismol OTC

ra stomach relief max st oral suspensionKaopectate Extra Strength

OTC

ra stomach relief oral suspension Kaopectate OTC; QL

ra stomach relief oral tablet chewable Pepto-Bismol OTC

sb anti-diarrhea oral tablet Imodium A-D OTC; QL

sb bismuth oral tablet Soothe OTC

sm anti-diarrheal oral capsule Imodium A-D OTC; QL

sm anti-diarrheal oral tablet Imodium A-D OTC; QL

sm stomach relief oral suspension Kaopectate OTC; QL

sm stomach relief oral tablet Soothe OTC

sm stomach relief oral tablet chewable Pepto-Bismol OTC

SOOTHE MAXIMUM STRENGTH ORAL SUSPENSION

OTC

SOOTHE ORAL SUSPENSION OTC; QL

SOOTHE ORAL TABLET OTC

SOOTHE ORAL TABLET CHEWABLE OTC

stomach relief max st oral suspensionKaopectate Extra Strength

OTC

stomach relief oral suspension 262 mg/15ml, 525 mg/30ml

Kaopectate OTC; QL

stomach relief oral suspension 525 mg/15mlKaopectate Extra Strength

OTC

stomach relief oral tablet chewable Pepto-Bismol OTC

stomach relief plus oral suspensionKaopectate Extra Strength

OTC

44

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Drug Name Reference Notes

tgt anti-diarrheal oral tablet Imodium A-D OTC; QL

tgt loperamide hcl oral capsule Imodium A-D OTC; QL

*ANTIDOTES AND SPECIFIC ANTAGONISTS*

deferoxamine mesylate injection solution reconstituted

Desferal SP

*ANTIDOTES*

deferoxamine mesylate injection solution reconstituted

Desferal SP

EVZIO INJECTION SOLUTION AUTO-INJECTOR

PA; QL

naloxone hcl injection solution QL

naloxone hcl injection solution auto-injector Evzio PA; QL

naloxone hcl injection solution cartridge QL

naloxone hcl injection solution prefilled syringe

QL

naltrexone hcl oral tablet

NARCAN NASAL LIQUID QL

*ANTIEMETICS*

anti-nausea oral solutionLittle Tummys Nausea Relief

OTC

anti-nausea/rekematol oral solutionLittle Tummys Nausea Relief

OTC

cvs motion sickness ii oral tablet Dramamine Less Drowsy OTC

cvs motion sickness oral tablet Driminate OTC

cvs motion sickness relief oral tablet chewable

Bonine OTC

cvs nausea relief oral liquidLittle Tummys Nausea Relief

OTC

dimenhydrinate oral tablet Driminate OTC

DRAMAMINE LESS DROWSY ORAL TABLET

OTC

DRIMINATE ORAL TABLET OTC

eq motion sickness relief oral tablet Dramamine Less Drowsy OTC

eql anti-nausea oral solutionLittle Tummys Nausea Relief

OTC

eql motion sickness relief oral tablet Dramamine Less Drowsy OTC

formula em oral solutionLittle Tummys Nausea Relief

OTC

gnp motion sickness relief oral tablet Dramamine Less Drowsy OTC

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Drug Name Reference Notes

gnp nausea relief oral solutionLittle Tummys Nausea Relief

OTC

goodsense motion sickness oral tablet Driminate OTC

hm anti-nausea oral solutionLittle Tummys Nausea Relief

OTC

hm motion relief oral tablet Dramamine Less Drowsy OTC

LITTLE TUMMYS NAUSEA RELIEF ORAL SOLUTION

OTC

meclizine hcl oral tablet

meclizine hcl oral tablet chewable Bonine OTC

motion sickness relief oral tablet Driminate OTC

motion sickness relief oral tablet chewable Bonine OTC

nausea control oral solutionLittle Tummys Nausea Relief

OTC

nausea relief oral solutionLittle Tummys Nausea Relief

OTC

ondansetron oral tablet dispersible QL

ra anti-nausea oral solutionLittle Tummys Nausea Relief

OTC

ra motion sickness relief oral tablet Driminate OTC

ra motion sickness relief oral tablet chewable

Bonine OTC

sb anti-nausea oral solutionLittle Tummys Nausea Relief

OTC

sb motion sickness oral tablet Driminate OTC

sm anti-nausea oral solutionLittle Tummys Nausea Relief

OTC

sm motion sickness oral tablet Dramamine Less Drowsy OTC

sm motion sickness relief oral tablet Driminate OTC

travel sickness oral tablet Driminate OTC

travel sickness oral tablet chewable Bonine OTC

trimethobenzamide hcl oral capsule Tigan

WAL-DRAM ORAL TABLET OTC

*ANTIFUNGALS*

bio-statin oral powder

fluconazole oral suspension reconstituted 10 mg/ml

Diflucan

fluconazole oral suspension reconstituted 40 mg/ml

Diflucan QL

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Drug Name Reference Notes

fluconazole oral tablet 100 mg, 150 mg, 50 mg

Diflucan

fluconazole oral tablet 200 mg Diflucan QL

flucytosine oral capsule Ancobon PA

griseofulvin microsize oral suspension

griseofulvin ultramicrosize oral tablet

itraconazole oral capsule Sporanox PA

ketoconazole oral tablet

nystatin oral tablet

terbinafine hcl oral tablet LamISIL QL

voriconazole intravenous solution reconstituted

Vfend IV PA

voriconazole oral suspension reconstituted Vfend PA

voriconazole oral tablet Vfend PA

*ANTIHISTAMINES*

24hr allergy relief oral tablet KLS Aller-Fex PA; OTC; QL

ALAVERT ORAL TABLET DISPERSIBLE OTC; QL

aler-cap oral capsule Banophen OTC; QL

alertab oral tablet Alka-Seltzer Plus Allergy OTC

ALKA-SELTZER PLUS ALLERGY ORAL TABLET

OTC

ALLEGRA ALLERGY CHILDRENS ORAL TABLET DISPERSIBLE

PA; OTC

aller-chlor oral tablet Wal-finate OTC

aller-ease oral tablet Wal-Fex Allergy PA; OTC; QL

allergy 24-hr oral tablet KLS Aller-Fex PA; OTC; QL

allergy childrens oral liquid Banophen OTC; QL

allergy childrens oral syrup Wal-itin OTC; QL

allergy oral capsule Banophen OTC; QL

allergy oral tablet Wal-finate OTC

allergy oral tablet extended release Chlor-Trimeton Allergy OTC

allergy relief child oral syrup Wal-itin OTC; QL

allergy relief childrens oral liquid Banophen OTC; QL

allergy relief childrens oral syrup Wal-itin OTC; QL

allergy relief childrens oral tablet dispersibleWal-Dryl Allergy Rel Childrens

OTC

allergy relief loratadine oral tablet KLS AllerClear OTC; QL

allergy relief oral capsule Banophen OTC; QL

47

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Drug Name Reference Notes

allergy relief oral tablet 10 mg KLS AllerClear OTC; QL

allergy relief oral tablet 180 mg KLS Aller-Fex PA; OTC; QL

allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

allergy relief oral tablet 4 mg Wal-finate OTC

allergy relief oral tablet 60 mg Wal-Fex Allergy PA; OTC; QL

allergy relief oral tablet dispersible Alavert OTC; QL

allergy-time oral tablet Wal-finate OTC

anti-hist allergy oral tablet Alka-Seltzer Plus Allergy OTC

aurodryl allergy childrens oral liquid Banophen OTC; QL

BANOPHEN ORAL CAPSULE 25 MG OTC; QL

BANOPHEN ORAL CAPSULE 50 MG OTC

BANOPHEN ORAL LIQUID OTC; QL

BANOPHEN ORAL TABLET OTC

carbinoxamine maleate oral solution

carbinoxamine maleate oral tablet

childrens loratadine oral solution Wal-itin OTC; QL

childrens loratadine oral syrup Wal-itin OTC; QL

chlorhist oral tablet Wal-finate OTC

chlorpheniramine maleate er oral tablet extended release

Chlor-Trimeton Allergy OTC

chlorpheniramine maleate oral tablet Wal-finate OTC

complete allergy medicine oral capsule Banophen OTC; QL

complete allergy medicine oral tablet Alka-Seltzer Plus Allergy OTC

complete allergy relief oral tablet Alka-Seltzer Plus Allergy OTC

cvs allergy oral capsule Banophen OTC; QL

cvs allergy relief adult oral liquid Banophen OTC; QL

cvs allergy relief childrens oral liquid Banophen OTC; QL

cvs allergy relief childrens oral suspension Allegra Allergy Childrens OTC; QL

cvs allergy relief childrens oral syrup Wal-itin OTC; QL

cvs allergy relief childrens oral tablet chewable

Claritin OTC

cvs allergy relief childrens oral tablet dispersible

Wal-Dryl Allergy Rel Childrens

OTC

cvs allergy relief oral capsule Banophen OTC; QL

cvs allergy relief oral liquid Banophen OTC; QL

cvs allergy relief oral tablet 10 mg KLS AllerClear OTC; QL

cvs allergy relief oral tablet 180 mg KLS Aller-Fex PA; OTC; QL

cvs allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

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Drug Name Reference Notes

cvs allergy relief oral tablet 4 mg Wal-finate OTC

cvs allergy relief oral tablet 60 mg Wal-Fex Allergy PA; OTC; QL

cvs allergy relief oral tablet dispersible Alavert OTC; QL

cvs allergy relief oral tablet extended release Chlor-Trimeton Allergy OTC

cvs childrens allergy oral liquid Banophen OTC; QL

cyproheptadine hcl oral syrup

cyproheptadine hcl oral tablet

DAYHIST ALLERGY 12 HOUR RELIEF ORAL TABLET

OTC

DIABETIC TUSSIN ALLERGY ORAL SYRUP

OTC

diphen oral elixir QL

diphen oral tablet Alka-Seltzer Plus Allergy OTC

diphenhist oral capsule Banophen OTC; QL

diphenhydramine hcl oral capsule 25 mg Banophen OTC; QL

diphenhydramine hcl oral capsule 50 mg Banophen OTC

diphenhydramine hcl oral elixir QL

diphenhydramine hcl oral liquid 12.5 mg/5ml Banophen OTC; QL

diphenhydramine hcl oral liquid 6.25 mg/mlPediaClear Cough Childrens

OTC

diphenhydramine hcl oral tablet Alka-Seltzer Plus Allergy OTC

dye-free allergy relief oral liquid Banophen OTC; QL

ed chlorped jr oral syrup Diabetic Tussin Allergy OTC

eq allergy childrens oral syrup Wal-itin OTC; QL

eq allergy oral capsule Banophen OTC; QL

eq allergy relief childrens oral elixir OTC; QL

eq allergy relief childrens oral liquid Banophen OTC; QL

eq allergy relief childrens oral syrup Wal-itin OTC; QL

eq allergy relief childrens oral tablet dispersible

Wal-Dryl Allergy Rel Childrens

OTC

eq allergy relief oral capsule Banophen OTC; QL

eq allergy relief oral tablet 10 mg KLS AllerClear OTC; QL

eq allergy relief oral tablet 180 mg KLS Aller-Fex PA; OTC; QL

eq allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

eq childrens loratadine oral syrup Wal-itin OTC; QL

eq chlortabs oral tablet Wal-finate OTC

eq loratadine childrens oral tablet chewable Claritin OTC

eq loratadine oral tablet KLS AllerClear OTC; QL

49

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Drug Name Reference Notes

eq loratadine oral tablet dispersible Alavert OTC; QL

eql aller-ease oral tablet KLS Aller-Fex PA; OTC; QL

eql allergy oral tablet Wal-finate OTC

eql allergy relief childrens oral tablet dispersible

Wal-Dryl Allergy Rel Childrens

OTC

eql allergy relief oral capsule Banophen OTC; QL

eql allergy relief oral tablet 10 mg KLS AllerClear OTC; QL

eql allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

eql childrens allergy oral liquid Banophen OTC; QL

fexofenadine hcl oral tablet Wal-Fex Allergy PA; OTC; QL

genahist oral capsule Banophen OTC; QL

geri-dryl oral capsule Banophen OTC; QL

geri-dryl oral liquid Banophen OTC; QL

geri-dryl oral tablet Alka-Seltzer Plus Allergy OTC

gnp allergy antihistamine oral liquid Banophen OTC; QL

gnp allergy oral capsule Banophen OTC; QL

gnp allergy oral tablet Wal-finate OTC

gnp allergy relief oral capsule Banophen OTC; QL

gnp allergy relief oral tablet 180 mg KLS Aller-Fex PA; OTC; QL

gnp allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

gnp allergy relief oral tablet chewableBenadryl Allergy Childrens

OTC

gnp allergy relief oral tablet dispersible Alavert OTC; QL

gnp childrens allergy oral liquid Banophen OTC; QL

gnp dayhist allergy oral tabletDayhist Allergy 12 Hour Relief

OTC

gnp loratadine childrens oral solution Wal-itin OTC; QL

gnp loratadine childrens oral tablet chewable Claritin OTC

gnp loratadine oral syrup Wal-itin OTC; QL

gnp loratadine oral tablet KLS AllerClear OTC; QL

gnp loratadine oral tablet dispersible Alavert OTC; QL

goodsense aller-ease oral tablet KLS Aller-Fex PA; OTC; QL

goodsense allergy relief oral capsule Claritin OTC

hm allergy relief childrens oral liquid Banophen OTC; QL

hm allergy relief oral capsule Banophen OTC; QL

hm allergy relief oral tablet Wal-finate OTC

hm allergy relief oral tablet dispersible Alavert OTC; QL

hm fexofenadine hcl oral tablet Wal-Fex Allergy PA; OTC; QL

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Drug Name Reference Notes

hm loratadine childrens oral syrup Wal-itin OTC; QL

hm loratadine oral tablet KLS AllerClear OTC; QL

KLS ALLERCLEAR ORAL TABLET OTC; QL

KLS ALLER-FEX ORAL TABLET PA; OTC; QL

kls allergy medicine oral tablet Alka-Seltzer Plus Allergy OTC

kp diphenhydramine hcl oral capsule Banophen OTC

kp fexofenadine hcl oral tablet Wal-Fex Allergy PA; OTC; QL

kp loratadine oral tablet KLS AllerClear OTC; QL

loradamed oral tablet KLS AllerClear OTC; QL

loratadine childrens oral syrup Wal-itin OTC; QL

loratadine oral capsule Claritin OTC

loratadine oral syrup Wal-itin OTC; QL

loratadine oral tablet KLS AllerClear OTC; QL

m-dryl oral liquid Banophen OTC

MEDI-PHEDRYL ORAL CAPSULE OTC; QL

meijer allergy relief oral tablet KLS AllerClear OTC; QL

meijer allergy relief oral tablet dispersible Alavert OTC; QL

meijer antihistamine allergy oral capsule Banophen OTC; QL

meijer loratadine oral syrup Wal-itin OTC; QL

NARAMIN ORAL LIQUID OTC; QL

PEDIACARE CHILDRENS ALLERGY ORAL LIQUID

OTC; QL

PEDIACLEAR COUGH CHILDRENS ORAL LIQUID

OTC

pharbechlor oral tablet Wal-finate OTC

pharbedryl oral capsule 25 mg Banophen OTC; QL

pharbedryl oral capsule 50 mg Banophen OTC

PHENADOZ RECTAL SUPPOSITORY AL

promethazine hcl oral solution AL

promethazine hcl oral syrup AL

promethazine hcl oral tablet 12.5 mg, 50 mg AL

promethazine hcl oral tablet 25 mg AL; QL

promethazine hcl rectal suppository Phenadoz AL

PROMETHEGAN RECTAL SUPPOSITORY AL

px allergy oral capsule Banophen OTC; QL

px allergy oral liquid Banophen OTC; QL

px allergy oral tablet Alka-Seltzer Plus Allergy OTC

51

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Drug Name Reference Notes

px allergy relief loratadine oral tablet KLS AllerClear OTC; QL

px allergy relief oral tablet KLS Aller-Fex PA; OTC; QL

px allergy relief oral tablet dispersible Alavert OTC; QL

PX DAYHIST ALLERGY ORAL TABLET OTC

qc allergy childrens oral liquid Banophen OTC; QL

qc allergy relief 4-hour oral tablet Wal-finate OTC

qc allergy relief childrens oral syrup Wal-itin OTC; QL

qc allergy relief oral tablet 180 mg KLS Aller-Fex OTC; QL

qc allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

qc allergy relief oral tablet dispersible Alavert OTC; QL

qc chlor-pheniramine oral tablet Wal-finate OTC

qc complete allergy medicine oral tablet Alka-Seltzer Plus Allergy OTC

qc fexofenadine hydrochloride oral tablet KLS Aller-Fex PA; OTC; QL

qc loratadine allergy relief oral tablet KLS AllerClear OTC; QL

ra allergy medication oral capsule Banophen OTC; QL

ra allergy medication oral liquid Banophen OTC; QL

ra allergy medication oral tablet Alka-Seltzer Plus Allergy OTC

ra allergy oral liquid Banophen OTC; QL

ra allergy oral tablet Alka-Seltzer Plus Allergy OTC

ra allergy relief childrens oral liquid Banophen OTC; QL

ra allergy relief childrens oral tablet chewable

Claritin OTC

ra allergy relief childrens oral tablet dispersible

Wal-Dryl Allergy Rel Childrens

OTC

ra allergy relief oral capsule Banophen OTC; QL

ra allergy relief oral tablet 10 mg KLS Aller-Tec OTC; QL

ra allergy relief oral tablet 180 mg KLS Aller-Fex PA; OTC; QL

ra allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

ra allergy relief oral tablet 4 mg Wal-finate OTC

ra allergy relief oral tablet dispersible Alavert OTC; QL

ra chlorpheniramine maleate oral tablet Wal-finate OTC

ra complete allergy oral tablet Alka-Seltzer Plus Allergy OTC

RA DIPHEDRYL ALLERGY ORAL LIQUID OTC; QL

ra loratadine childrens oral syrup Wal-itin OTC; QL

ra loratadine oral syrup Wal-itin OTC; QL

ra loratadine oral tablet KLS AllerClear OTC; QL

ra loratadine oral tablet dispersible Alavert OTC; QL

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Drug Name Reference Notes

sb allergy medicine oral liquid Banophen OTC; QL

sb allergy medicine oral tablet Alka-Seltzer Plus Allergy OTC

sb allergy oral capsule Banophen OTC; QL

sb allergy relief oral tablet dispersible Alavert OTC; QL

sb chlorpheniramine oral tablet Wal-finate OTC

sb loratadine allergy relief oral tablet KLS AllerClear OTC; QL

sb loratadine oral syrup Wal-itin OTC; QL

sb loratadine oral tablet KLS AllerClear OTC; QL

siladryl allergy oral liquid Banophen OTC; QL

sm allergy 4 hour oral tablet Wal-finate OTC

sm allergy childrens oral syrup Wal-itin OTC; QL

sm allergy relief childrens oral liquid Banophen OTC; QL

sm allergy relief oral capsule Banophen OTC; QL

sm allergy relief oral liquid Banophen OTC; QL

sm allergy relief oral tablet Alka-Seltzer Plus Allergy OTC

sm allergy relief oral tablet dispersible Alavert OTC; QL

sm childrens loratadine oral syrup Wal-itin OTC; QL

sm fexofenadine hcl oral tablet Wal-Fex Allergy PA; OTC; QL

sm loratadine allergy relief oral tablet dispersible

Alavert OTC; QL

sm loratadine oral syrup Wal-itin OTC; QL

sm loratadine oral tablet KLS AllerClear OTC; QL

tgt allergy melts childrens oral tablet dispersible

Wal-Dryl Allergy Rel Childrens

OTC

tgt allergy relief childrens oral liquid Banophen OTC; QL

tgt allergy relief oral capsule Banophen OTC; QL

tgt allergy relief oral tablet 10 mg KLS AllerClear OTC; QL

tgt allergy relief oral tablet 180 mg KLS Aller-Fex PA; OTC; QL

tgt allergy relief oral tablet 25 mg Alka-Seltzer Plus Allergy OTC

tgt allergy relief oral tablet dispersible Alavert OTC; QL

tgt loratadine childrens oral syrup Wal-itin OTC; QL

TOTAL ALLERGY MEDICINE ORAL LIQUID

OTC; QL

total allergy oral tablet Alka-Seltzer Plus Allergy OTC

TRIAMINIC ALLERCHEWS ORAL TABLET DISPERSIBLE

OTC; QL

WAL-DRYL ALLERGY CHILDRENS ORAL LIQUID

OTC; QL

53

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Drug Name Reference Notes

WAL-DRYL ALLERGY ORAL CAPSULE OTC; QL

WAL-DRYL ALLERGY ORAL LIQUID OTC; QL

WAL-DRYL ALLERGY ORAL TABLET OTC

WAL-DRYL ALLERGY REL CHILDRENS ORAL TABLET DISPERSIBLE

OTC

WAL-FEX ALLERGY ORAL TABLET PA; OTC; QL

WAL-FEX ORAL TABLET PA; OTC; QL

WAL-FINATE ORAL TABLET OTC

WAL-ITIN ALLERGY REDITABS ORAL TABLET DISPERSIBLE

OTC; QL

WAL-ITIN ALLER-MELTS ORAL TABLET DISPERSIBLE

OTC; QL

WAL-ITIN CHILDRENS ORAL SOLUTION OTC; QL

WAL-ITIN ORAL SYRUP OTC; QL

WAL-ITIN ORAL TABLET OTC; QL

WAL-ITIN ORAL TABLET DISPERSIBLE OTC; QL

WAL-VERT ORAL TABLET DISPERSIBLE OTC; QL

*ANTIHYPERLIPIDEMICS*

atorvastatin calcium oral tablet 10 mg, 20 mg, 40 mg

Lipitor DO; QL

atorvastatin calcium oral tablet 80 mg Lipitor QL

cholestyramine light oral packet Prevalite

cholestyramine light oral powder Prevalite

cholestyramine oral packet Questran

cholestyramine oral powder Questran

colestipol hcl oral granules Colestid

colestipol hcl oral packet Colestid

colestipol hcl oral tablet Colestid

fenofibrate micronized oral capsule 134 mg

fenofibrate micronized oral capsule 200 mg, 43 mg

QL

fenofibrate micronized oral capsule 67 mg PA; QL

fenofibrate oral capsule 134 mg

fenofibrate oral capsule 200 mg QL

fenofibrate oral capsule 67 mg PA; QL

fenofibrate oral tablet Triglide QL

fenofibric acid oral capsule delayed release Trilipix PA; QL

gemfibrozil oral tablet Lopid

54

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Drug Name Reference Notes

lovastatin oral tablet 10 mg, 20 mg DO; QL

lovastatin oral tablet 40 mg QL

pravastatin sodium oral tablet Pravachol QL

PREVALITE ORAL PACKET

PREVALITE ORAL POWDER

simvastatin oral tablet 10 mg, 20 mg, 40 mg, 5 mg

Zocor DO; QL

simvastatin oral tablet 80 mg Zocor PA; QL

*ANTIHYPERTENSIVES*

amlodipine besy-benazepril hcl oral capsule QL

atenolol-chlorthalidone oral tablet Tenoretic 100

benazepril hcl oral tablet QL

benazepril-hydrochlorothiazide oral tablet QL

bisoprolol-hydrochlorothiazide oral tablet Ziac

candesartan cilexetil oral tablet Atacand

candesartan cilexetil-hctz oral tablet 16-12.5 mg

Atacand HCT

candesartan cilexetil-hctz oral tablet 32-12.5 mg, 32-25 mg

Atacand HCT QL

captopril oral tablet QL

captopril-hydrochlorothiazide oral tablet QL

clonidine hcl oral tablet Catapres

doxazosin mesylate oral tablet Cardura QL

enalapril maleate oral tablet Vasotec QL

enalapril-hydrochlorothiazide oral tablet QL

fosinopril sodium oral tablet QL

fosinopril sodium-hctz oral tablet QL

guanfacine hcl oral tablet 1 mg

guanfacine hcl oral tablet 2 mg QL

hydralazine hcl oral tablet

irbesartan oral tablet 150 mg, 75 mg Avapro DO; QL

irbesartan oral tablet 300 mg Avapro QL

irbesartan-hydrochlorothiazide oral tablet Avalide QL

lisinopril oral tablet 10 mg, 20 mg Prinivil DO; QL

lisinopril oral tablet 2.5 mg, 5 mg Zestril DO; QL

lisinopril oral tablet 30 mg, 40 mg Zestril QL

lisinopril-hydrochlorothiazide oral tablet 10-12.5 mg

Zestoretic DO; QL

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Drug Name Reference Notes

lisinopril-hydrochlorothiazide oral tablet 20-12.5 mg, 20-25 mg

Zestoretic QL

losartan potassium oral tablet Cozaar QL

losartan potassium-hctz oral tablet 100-12.5 mg, 100-25 mg

Hyzaar QL

losartan potassium-hctz oral tablet 50-12.5 mg

Hyzaar DO; QL

methyldopa oral tablet

methyldopa-hydrochlorothiazide oral tablet

metoprolol-hydrochlorothiazide oral tablet Lopressor HCT QL

minoxidil oral tablet

moexipril hcl oral tablet

perindopril erbumine oral tablet QL

prazosin hcl oral capsule Minipress

propranolol-hctz oral tablet

quinapril hcl oral tablet Accupril QL

quinapril-hydrochlorothiazide oral tablet Accuretic QL

ramipril oral capsule Altace QL

terazosin hcl oral capsule QL

trandolapril oral tablet Mavik

valsartan oral tablet Diovan QL

valsartan-hydrochlorothiazide oral tablet Diovan HCT QL

*ANTI-INFECTIVE AGENTS - MISC.*

clindamycin hcl oral capsule Cleocin

clindamycin palmitate hcl oral solution reconstituted

Cleocin

dapsone oral tablet

linezolid oral suspension reconstituted Zyvox PA; QL

linezolid oral tablet Zyvox PA; QL

metronidazole oral capsule Flagyl

metronidazole oral tablet Flagyl

sulfamethoxazole-trimethoprim oral suspension

Sulfatrim Pediatric

sulfamethoxazole-trimethoprim oral tablet Bactrim

SULFATRIM PEDIATRIC ORAL SUSPENSION

tinidazole oral tablet QL

trimethoprim oral tablet

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Drug Name Reference Notes

*ANTIMALARIALS*

atovaquone-proguanil hcl oral tablet Malarone

chloroquine phosphate oral tablet QL

hydroxychloroquine sulfate oral tablet Plaquenil QL

mefloquine hcl oral tablet QL

primaquine phosphate oral tablet

*ANTIMYASTHENIC AGENTS*

pyridostigmine bromide er oral tablet extended release

Mestinon

pyridostigmine bromide oral solution Mestinon

pyridostigmine bromide oral tablet Mestinon

*ANTIMYASTHENIC/CHOLINERGIC AGENTS*

pyridostigmine bromide er oral tablet extended release

Mestinon

pyridostigmine bromide oral solution Mestinon

pyridostigmine bromide oral tablet Mestinon

*ANTIMYCOBACTERIAL AGENTS*

ethambutol hcl oral tablet Myambutol

isoniazid oral syrup

isoniazid oral tablet

PRIFTIN ORAL TABLET

pyrazinamide oral tablet

rifabutin oral capsule Mycobutin

rifampin oral capsule Rifadin

RIFATER ORAL TABLET

*ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES*

anastrozole oral tablet Arimidex QL

bicalutamide oral tablet Casodex

cyclophosphamide oral capsule SP

EMCYT ORAL CAPSULE PA; SP

etoposide oral capsule SP

exemestane oral tablet Aromasin QL

flutamide oral capsule

hydroxyprogesterone caproate intramuscular solution

PA; SP; QL

hydroxyurea oral capsule Hydrea

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Drug Name Reference Notes

imatinib mesylate oral tablet Gleevec PA; SP; QL

IRESSA ORAL TABLET PA; SP; QL

letrozole oral tablet Femara QL

leucovorin calcium injection solution reconstituted

leucovorin calcium oral tablet

LEUKERAN ORAL TABLET

megestrol acetate oral suspension PA

megestrol acetate oral tablet PA

melphalan oral tablet Alkeran SP

mercaptopurine oral tablet

MESNEX ORAL TABLET PA

methotrexate oral tablet

methotrexate sodium (pf) injection solution

methotrexate sodium injection solution

methotrexate sodium injection solution reconstituted

methotrexate sodium oral tablet

MYLERAN ORAL TABLET SP

TABLOID ORAL TABLET

tamoxifen citrate oral tablet

tretinoin oral capsule

TREXALL ORAL TABLET

VANTAS SUBCUTANEOUS KIT PA; SP

VELCADE INJECTION SOLUTION RECONSTITUTED

PA; SP

*ANTIPARKINSON AGENTS*

amantadine hcl oral capsule QL

amantadine hcl oral syrup

amantadine hcl oral tablet

benztropine mesylate oral tablet

bromocriptine mesylate oral capsule Parlodel

bromocriptine mesylate oral tablet Parlodel

carbidopa-levodopa er oral tablet extended release

carbidopa-levodopa oral tablet Sinemet

carbidopa-levodopa oral tablet dispersible

carbidopa-levodopa-entacapone oral tablet Stalevo 50

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Drug Name Reference Notes

entacapone oral tablet Comtan

pramipexole dihydrochloride oral tablet Mirapex QL

ropinirole hcl oral tablet

selegiline hcl oral capsule

selegiline hcl oral tablet

trihexyphenidyl hcl oral solution

trihexyphenidyl hcl oral tablet

*ANTIPSYCHOTICS/ANTIMANIC AGENTS*

ABILIFY MAINTENA INTRAMUSCULAR PREFILLED SYRINGE

PA; AL

ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION RECONSTITUTED ER

PA; AL; QL

aripiprazole oral tablet Abilify AL; QL

ARISTADA INTRAMUSCULAR PREFILLED SYRINGE

PA; AL

chlorpromazine hcl oral tablet AL

clozapine oral tablet Clozaril AL; QL

CLOZARIL ORAL TABLET PA; AL; QL

COMPRO RECTAL SUPPOSITORY

fluphenazine decanoate injection solution AL

fluphenazine hcl injection solution AL

fluphenazine hcl oral concentrate AL

fluphenazine hcl oral elixir AL

fluphenazine hcl oral tablet AL

haloperidol decanoate intramuscular solution 100 mg/ml

Haldol Decanoate AL; QL

haloperidol decanoate intramuscular solution 50 mg/ml

Haldol Decanoate AL

haloperidol lactate injection solution Haldol AL

haloperidol lactate oral concentrate AL

haloperidol oral tablet AL

INVEGA SUSTENNA INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

PA; AL; QL

INVEGA TRINZA INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

PA; AL; QL

lithium carbonate er oral tablet extended release

Lithobid

lithium carbonate oral capsule

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Drug Name Reference Notes

lithium carbonate oral tablet

lithium oral solution AL

loxapine succinate oral capsule AL

olanzapine intramuscular solution reconstituted

ZyPREXA AL

olanzapine oral tablet ZyPREXA AL; QL

paliperidone er oral tablet extended release 24 hour

Invega AL

perphenazine oral tablet AL

prochlorperazine edisylate injection solution

prochlorperazine maleate oral tablet

prochlorperazine rectal suppository Compro

quetiapine fumarate oral tablet SEROquel AL; QL

RISPERDAL CONSTA INTRAMUSCULAR SUSPENSION RECONSTITUTED ER

PA; AL; QL

risperidone oral solution RisperDAL AL; QL

risperidone oral tablet RisperDAL AL; QL

thioridazine hcl oral tablet

thiothixene oral capsule AL

trifluoperazine hcl oral tablet AL

ziprasidone hcl oral capsule Geodon AL; QL

ZYPREXA RELPREVV INTRAMUSCULAR SUSPENSION RECONSTITUTED

PA; AL

*ANTIRETROVIRALS - CD4-DIRECTED POST-ATTACHMENT INHIBITOR***

TROGARZO INTRAVENOUS SOLUTION PA; SP; QL

*ANTIRETROVIRALS ADJUVANTS***

TYBOST ORAL TABLET SP; QL

*ANTISEPTICS & DISINFECTANTS*

antiseptic skin cleanser external solution Dyna-Hex 4 OTC; QL

APLICARE POVIDONE-IODINE SCRUB EXTERNAL SOLUTION

OTC

BETADINE EXTERNAL SOLUTION OTC

BETADINE SURGICAL SCRUB EXTERNAL SOLUTION

OTC

BETASEPT SURGICAL SCRUB EXTERNAL LIQUID

OTC; QL

chlorhexidine gluconate external liquid OTC

cvs antiseptic skin cleanser external solution Dyna-Hex 4 OTC; QL

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Drug Name Reference Notes

cvs hydrogen peroxide external solution OTC

eq hydrogen peroxide external solution OTC

eql hydrogen peroxide external solution OTC

gnp antiseptic skin cleanser external solution Dyna-Hex 4 OTC; QL

gnp hydrogen peroxide external solution OTC

goodsense hydrogen peroxide external solution

OTC

hm antiseptic skin cleanser external solution Dyna-Hex 4 OTC; QL

hm hydrogen peroxide external solution OTC

hydrogen peroxide external solution OTC

hydrogen peroxide solution

meijer hydrogen peroxide external solution OTC

pvp scrub external solutionAplicare Povidone-Iodine Scrub

OTC

px hydrogen peroxide external solution OTC

qc hydrogen peroxide external solution OTC

ra hydrogen peroxide external solution OTC

sm hydrogen peroxide external solution OTC

tgt hydrogen peroxide external solution OTC

*ANTIVIRALS*

abacavir sulfate oral solution Ziagen SP; QL

abacavir sulfate oral tablet Ziagen SP; QL

abacavir sulfate-lamivudine oral tablet Epzicom SP; QL

abacavir-lamivudine-zidovudine oral tablet Trizivir SP; QL

acyclovir oral capsule

acyclovir oral suspension Zovirax

acyclovir oral tablet Zovirax

adefovir dipivoxil oral tablet Hepsera PA; SP

APTIVUS ORAL CAPSULE PA; SP; QL

APTIVUS ORAL SOLUTION PA; SP; QL

atazanavir sulfate oral capsule Reyataz SP; QL

BARACLUDE ORAL SOLUTION PA; SP

BIKTARVY ORAL TABLET SP; QL

CIMDUO ORAL TABLET SP; QL

DESCOVY ORAL TABLET PA; SP; QL

didanosine oral capsule delayed release SP; QL

DOVATO ORAL TABLET PA; SP

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Drug Name Reference Notes

EDURANT ORAL TABLET SP; QL

EMTRIVA ORAL CAPSULE SP; QL

EMTRIVA ORAL SOLUTION SP; QL

entecavir oral tablet Baraclude PA; SP; QL

EPIVIR HBV ORAL SOLUTION PA; SP; QL

EVOTAZ ORAL TABLET SP; QL

famciclovir oral tablet QL

FUZEON SUBCUTANEOUS SOLUTION RECONSTITUTED

PA; SP; QL

GENVOYA ORAL TABLET SP; QL

INTELENCE ORAL TABLET PA; SP; AL; QL

ISENTRESS HD ORAL TABLET SP; QL

ISENTRESS ORAL PACKET SP; QL

ISENTRESS ORAL TABLET SP; QL

ISENTRESS ORAL TABLET CHEWABLE SP; QL

JULUCA ORAL TABLET PA; SP; QL

lamivudine oral solution Epivir SP; AL; QL

lamivudine oral tablet 100 mg Epivir HBV PA; SP; QL

lamivudine oral tablet 150 mg, 300 mg Epivir SP; QL

lamivudine-zidovudine oral tablet Combivir SP; QL

lopinavir-ritonavir oral solution Kaletra SP; QL

nevirapine er oral tablet extended release 24 hour

SP; QL

nevirapine oral suspension Viramune SP; QL

nevirapine oral tablet Viramune SP; QL

NORVIR ORAL SOLUTION SP; QL

ODEFSEY ORAL TABLET SP; QL

oseltamivir phosphate oral capsule Tamiflu QL

oseltamivir phosphate oral suspension reconstituted

Tamiflu QL

PEGASYS PROCLICK SUBCUTANEOUS SOLUTION

SP

PEGASYS SUBCUTANEOUS SOLUTION180 MCG/0.5ML

SP

PEGASYS SUBCUTANEOUS SOLUTION180 MCG/ML

SP; QL

PEGINTRON SUBCUTANEOUS KIT SP

PREZCOBIX ORAL TABLET SP; QL

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Drug Name Reference Notes

PREZISTA ORAL SUSPENSION SP; QL

PREZISTA ORAL TABLET SP; QL

RELENZA DISKHALER INHALATION AEROSOL POWDER BREATH ACTIVATED

QL

RETROVIR INTRAVENOUS SOLUTION SP

REYATAZ ORAL PACKET SP; QL

ribavirin oral capsule SP

ribavirin oral tablet SP; QL

rimantadine hcl oral tablet

ritonavir oral tablet Norvir SP; QL

SELZENTRY ORAL SOLUTION SP; QL

SELZENTRY ORAL TABLET SP; QL

stavudine oral capsule SP; QL

STRIBILD ORAL TABLET SP; QL

tenofovir disoproxil fumarate oral tablet Viread PA; SP; QL

TIVICAY ORAL TABLET SP; QL

TRIUMEQ ORAL TABLET SP; QL

TRUVADA ORAL TABLET SP; QL

valacyclovir hcl oral tablet Valtrex QL

valganciclovir hcl oral solution reconstituted Valcyte SP

valganciclovir hcl oral tablet Valcyte SP

VIREAD ORAL POWDER PA; SP; QL

VIREAD ORAL TABLET PA; SP; QL

zidovudine oral capsule Retrovir SP; QL

zidovudine oral syrup Retrovir SP; QL

zidovudine oral tablet SP

*ASSORTED CLASSES*

ARGYLE STERILE WATER IRRIGATION SOLUTION

azathioprine oral tablet Imuran

CLOVIQUE ORAL CAPSULE PA; SP; QL

cyclosporine modified oral capsule SP

cyclosporine modified oral solution Gengraf SP

cyclosporine oral capsule SandIMMUNE SP

GENGRAF ORAL CAPSULE SP

GENGRAF ORAL SOLUTION SP

mycophenolate mofetil oral capsule CellCept SP

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Drug Name Reference Notes

mycophenolate mofetil oral suspension reconstituted

CellCept SP

mycophenolate mofetil oral tablet CellCept SP

mycophenolate sodium oral tablet delayed release

Myfortic SP

penicillamine oral tablet Depen Titratabs PA

PHYSIOLYTE IRRIGATION SOLUTION

PHYSIOSOL IRRIGATION IRRIGATION SOLUTION

SANDIMMUNE ORAL SOLUTION SP

sirolimus oral solution Rapamune SP

sirolimus oral tablet Rapamune SP

sodium polystyrene sulfonate oral suspension

SPS

sodium polystyrene sulfonate rectal suspension

SPS ORAL SUSPENSION

sterile water for irrigation irrigation solution Argyle Sterile Water

tacrolimus oral capsule Prograf SP

trientine hcl oral capsule Clovique PA; SP; QL

water for irrigation, sterile irrigation solution Argyle Sterile Water

*BETA BLOCKERS*

acebutolol hcl oral capsule

atenolol oral tablet Tenormin

betaxolol hcl oral tablet

bisoprolol fumarate oral tablet

carvedilol oral tablet Coreg QL

labetalol hcl oral tablet

metoprolol succinate er oral tablet extended release 24 hour

Toprol XL

metoprolol tartrate oral tablet 100 mg, 50 mg Lopressor QL

metoprolol tartrate oral tablet 25 mg, 37.5 mg, 75 mg

nadolol oral tablet Corgard

pindolol oral tablet

propranolol hcl er oral capsule extended release 24 hour

Inderal LA

propranolol hcl oral solution

propranolol hcl oral tablet

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Drug Name Reference Notes

SORINE ORAL TABLET

sotalol hcl (af) oral tablet 120 mg Betapace AF QL

sotalol hcl (af) oral tablet 160 mg, 80 mg Betapace AF

sotalol hcl oral tablet Sorine

timolol maleate oral tablet

*CALCIUM CHANNEL BLOCKERS*

AFEDITAB CR ORAL TABLET EXTENDED RELEASE 24 HOUR 30 MG

DO; QL

AFEDITAB CR ORAL TABLET EXTENDED RELEASE 24 HOUR 60 MG

QL

amlodipine besylate oral tablet 10 mg Norvasc QL

amlodipine besylate oral tablet 2.5 mg, 5 mg Norvasc DO; QL

CARTIA XT ORAL CAPSULE EXTENDED RELEASE 24 HOUR 120 MG, 180 MG, 240 MG

DO; QL

CARTIA XT ORAL CAPSULE EXTENDED RELEASE 24 HOUR 300 MG

QL

diltiazem hcl er beads oral capsule extended release 24 hour 120 mg, 180 mg

Taztia XT DO; QL

diltiazem hcl er beads oral capsule extended release 24 hour 240 mg, 300 mg, 360 mg

Taztia XT QL

diltiazem hcl er beads oral capsule extended release 24 hour 420 mg

Tiadylt ER QL

diltiazem hcl er coated beads oral capsule extended release 24 hour 120 mg, 180 mg, 240 mg

Cartia XT DO; QL

diltiazem hcl er coated beads oral capsule extended release 24 hour 300 mg

Cartia XT QL

diltiazem hcl er coated beads oral capsule extended release 24 hour 360 mg

Cardizem CD QL

diltiazem hcl er coated beads oral tablet extended release 24 hour 180 mg, 240 mg

Matzim LA DO; QL

diltiazem hcl er coated beads oral tablet extended release 24 hour 300 mg, 360 mg, 420 mg

Matzim LA QL

diltiazem hcl er oral capsule extended release 12 hour

QL

diltiazem hcl er oral capsule extended release 24 hour

DO; QL

diltiazem hcl oral tablet Cardizem QL

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Drug Name Reference Notes

dilt-xr oral capsule extended release 24 hour 120 mg, 180 mg

DO; QL

dilt-xr oral capsule extended release 24 hour 240 mg

QL

felodipine er oral tablet extended release 24 hour 10 mg

QL

felodipine er oral tablet extended release 24 hour 2.5 mg, 5 mg

DO; QL

isradipine oral capsule QL

MATZIM LA ORAL TABLET EXTENDED RELEASE 24 HOUR 180 MG, 240 MG

DO; QL

MATZIM LA ORAL TABLET EXTENDED RELEASE 24 HOUR 300 MG, 360 MG, 420 MG

QL

nicardipine hcl oral capsule QL

nifedipine er oral tablet extended release 24 hour 30 mg

Afeditab CR DO; QL

nifedipine er oral tablet extended release 24 hour 60 mg

Afeditab CR QL

nifedipine er oral tablet extended release 24 hour 90 mg

QL

nifedipine er osmotic release oral tablet extended release 24 hour 30 mg

Procardia XL DO; QL

nifedipine er osmotic release oral tablet extended release 24 hour 60 mg

Nifedical XL QL

nifedipine er osmotic release oral tablet extended release 24 hour 90 mg

Procardia XL QL

nifedipine oral capsule QL

TAZTIA XT ORAL CAPSULE EXTENDED RELEASE 24 HOUR 120 MG, 180 MG

DO; QL

TAZTIA XT ORAL CAPSULE EXTENDED RELEASE 24 HOUR 240 MG, 300 MG, 360 MG

QL

TIADYLT ER ORAL CAPSULE EXTENDED RELEASE 24 HOUR 120 MG, 180 MG

DO; QL

TIADYLT ER ORAL CAPSULE EXTENDED RELEASE 24 HOUR 240 MG, 300 MG, 360 MG, 420 MG

QL

verapamil hcl er oral capsule extended release 24 hour 100 mg, 200 mg, 300 mg

Verelan PM DO; QL

verapamil hcl er oral capsule extended release 24 hour 120 mg, 180 mg

Verelan DO; QL

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Drug Name Reference Notes

verapamil hcl er oral capsule extended release 24 hour 240 mg, 360 mg

Verelan QL

verapamil hcl er oral tablet extended release Calan SR QL

verapamil hcl oral tablet QL

*CARDIOTONICS*

DIGITEK ORAL TABLET

DIGOX ORAL TABLET

digoxin injection solution Lanoxin

digoxin oral solution

digoxin oral tablet Digitek

LANOXIN INJECTION SOLUTION

LANOXIN ORAL TABLET

*CARDIOVASCULAR AGENTS - MISC.*

ALYQ ORAL TABLET PA; SP; QL

ambrisentan oral tablet Letairis PA; SP; QL

eql niacin flush free oral capsule OTC

niacin flush free oral capsule OTC

qc niacin oral capsule OTC

sildenafil citrate oral tablet Revatio PA; SP; QL

tadalafil (pah) oral tablet Alyq PA; SP; QL

*CEPHALOSPORINS*

cefaclor er oral tablet extended release 12 hour

cefaclor oral capsule

cefaclor oral suspension reconstituted

cefadroxil oral capsule

cefadroxil oral suspension reconstituted

cefadroxil oral tablet

cefdinir oral capsule QL

cefdinir oral suspension reconstituted QL

cefpodoxime proxetil oral suspension reconstituted

cefpodoxime proxetil oral tablet

cefprozil oral suspension reconstituted

cefprozil oral tablet

ceftriaxone sodium injection solution reconstituted

QL

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Drug Name Reference Notes

ceftriaxone sodium intravenous solution reconstituted

cefuroxime axetil oral tablet

cephalexin oral capsule Keflex

cephalexin oral suspension reconstituted

cephalexin oral tablet

*CHEMICALS*

cvs isopropyl alcohol solution OTC

cvs rubbing alcohol solution OTC

eql isopropyl alcohol solution OTC

eql isopropyl rubbing alcohol solution OTC

glycerin liquid OTC

glycerin solution

gnp isopropyl alcohol solution OTC

goodsense isopropyl alcohol solution 70 % OTC

goodsense isopropyl alcohol solution 91 %

hm isopropyl alcohol solution OTC

isopropanol solution

isopropyl alcohol (rubbing) solution OTC

isopropyl alcohol solution OTC

isopropyl alcohol, rubbing solution OTC

meijer isopropyl alcohol solution OTC

qc isopropyl rubbing alcohol solution OTC

ra isopropyl alcohol solution OTC

ra isopropyl rubbing alcohol solution OTC

sm alcohol solution OTC

sm isopropyl alcohol solution OTC

*CONTRACEPTIVES*

AFIRMELLE ORAL TABLET AL; QL

AFTERA ORAL TABLET OTC; QL

ALTAVERA ORAL TABLET AL; QL

alyacen 1/35 oral tablet Cyclafem 1/35 AL

alyacen 7/7/7 oral tablet Cyclafem 7/7/7 AL

AMETHIA LO ORAL TABLET AL; QL

AMETHIA ORAL TABLET AL; QL

AMETHYST ORAL TABLET AL

APRI ORAL TABLET AL

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Drug Name Reference Notes

ARANELLE ORAL TABLET AL

ASHLYNA ORAL TABLET AL; QL

AUBRA EQ ORAL TABLET AL

AUBRA ORAL TABLET AL

AUROVELA 1.5/30 ORAL TABLET AL

AUROVELA 1/20 ORAL TABLET AL

AUROVELA 24 FE ORAL TABLET AL

AUROVELA FE 1.5/30 ORAL TABLET AL; QL

AUROVELA FE 1/20 ORAL TABLET AL

AVIANE ORAL TABLET AL

AYUNA ORAL TABLET AL; QL

AZURETTE ORAL TABLET AL; QL

BALZIVA ORAL TABLET AL

BEKYREE ORAL TABLET AL; QL

BLISOVI 24 FE ORAL TABLET AL

BLISOVI FE 1.5/30 ORAL TABLET AL

BLISOVI FE 1/20 ORAL TABLET AL

briellyn oral tablet Balziva AL

CAMILA ORAL TABLET AL

CAMRESE LO ORAL TABLET AL; QL

CAMRESE ORAL TABLET AL; QL

CAZIANT ORAL TABLET AL

CHATEAL EQ ORAL TABLET AL; QL

CHATEAL ORAL TABLET AL; QL

CRYSELLE-28 ORAL TABLET AL

CYCLAFEM 1/35 ORAL TABLET AL

CYCLAFEM 7/7/7 ORAL TABLET AL

CYRED EQ ORAL TABLET AL

CYRED ORAL TABLET AL

DASETTA 1/35 ORAL TABLET AL

DASETTA 7/7/7 ORAL TABLET AL

DAYSEE ORAL TABLET AL; QL

DEBLITANE ORAL TABLET AL

DELYLA ORAL TABLET AL

desogestrel-ethinyl estradiol oral tablet 0.15-0.02/0.01 mg (21/5)

Azurette AL; QL

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Drug Name Reference Notes

desogestrel-ethinyl estradiol oral tablet 0.15-30 mg-mcg

Apri AL

drospiren-eth estrad-levomefol oral tablet Beyaz AL

drospirenone-ethinyl estradiol oral tablet Ocella AL

ECONTRA EZ ORAL TABLET OTC; QL

ECONTRA ONE-STEP ORAL TABLET OTC; QL

ELINEST ORAL TABLET AL

ELLA ORAL TABLET QL

ELURYNG VAGINAL RING AL; QL

EMOQUETTE ORAL TABLET AL

ENPRESSE-28 ORAL TABLET AL

ENSKYCE ORAL TABLET AL

ERRIN ORAL TABLET AL

ESTARYLLA ORAL TABLET AL

ethynodiol diac-eth estradiol oral tablet Kelnor 1/35 AL

etonogestrel-ethinyl estradiol vaginal ring EluRyng AL; QL

FALMINA ORAL TABLET AL

FAYOSIM ORAL TABLET AL; QL

FEMYNOR ORAL TABLET AL

GIANVI ORAL TABLET AL

HAILEY 1.5/30 ORAL TABLET DO

HAILEY 24 FE ORAL TABLET AL; QL

HEATHER ORAL TABLET AL

INCASSIA ORAL TABLET AL

INTROVALE ORAL TABLET AL; QL

ISIBLOOM ORAL TABLET AL

JAIMIESS ORAL TABLET AL; QL

JASMIEL ORAL TABLET AL; QL

JENCYCLA ORAL TABLET AL

JOLESSA ORAL TABLET AL; QL

JULEBER ORAL TABLET AL

JUNEL 1.5/30 ORAL TABLET AL

JUNEL 1/20 ORAL TABLET AL

JUNEL FE 1.5/30 ORAL TABLET AL

JUNEL FE 1/20 ORAL TABLET AL

JUNEL FE 24 ORAL TABLET AL

KAITLIB FE ORAL TABLET CHEWABLE AL

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Drug Name Reference Notes

KALLIGA ORAL TABLET AL

KARIVA ORAL TABLET AL; QL

KELNOR 1/35 ORAL TABLET AL

KELNOR 1/50 ORAL TABLET AL

KURVELO ORAL TABLET AL; QL

LARIN 1.5/30 ORAL TABLET AL

LARIN 1/20 ORAL TABLET AL

LARIN 24 FE ORAL TABLET AL

LARIN FE 1.5/30 ORAL TABLET AL

LARIN FE 1/20 ORAL TABLET AL

LARISSIA ORAL TABLET AL

LAYOLIS FE ORAL TABLET CHEWABLE AL

LEENA ORAL TABLET AL

LESSINA ORAL TABLET AL

LEVONEST ORAL TABLET AL

levonorgest-eth est & eth est oral tablet Fayosim AL; QL

levonorgest-eth estrad 91-day oral tablet Introvale AL; QL

levonorgestrel oral tablet Aftera OTC; QL

levonorgestrel-ethinyl estrad oral tablet 0.1-20 mg-mcg

Afirmelle AL

levonorgestrel-ethinyl estrad oral tablet 0.15-30 mg-mcg

Altavera AL; QL

levonorgestrel-ethinyl estrad oral tablet 90-20 mcg

Amethyst AL

levonorg-eth estrad triphasic oral tablet Enpresse-28 AL

LEVORA 0.15/30 (28) ORAL TABLET AL; QL

LILLOW ORAL TABLET AL; QL

LOJAIMIESS ORAL TABLET AL; QL

LORYNA ORAL TABLET AL

LOW-OGESTREL ORAL TABLET AL

LO-ZUMANDIMINE ORAL TABLET AL; QL

LUTERA ORAL TABLET AL

LYZA ORAL TABLET AL

marlissa oral tablet Altavera AL; QL

medroxyprogesterone acetate intramuscular suspension

Depo-Provera AL; QL

medroxyprogesterone acetate intramuscular suspension prefilled syringe

Depo-Provera AL; QL

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Drug Name Reference Notes

MELODETTA 24 FE ORAL TABLET CHEWABLE

AL

MIBELAS 24 FE ORAL TABLET CHEWABLE

AL

MICROGESTIN 1.5/30 ORAL TABLET AL

MICROGESTIN 1/20 ORAL TABLET AL

MICROGESTIN FE 1.5/30 ORAL TABLET AL

MICROGESTIN FE 1/20 ORAL TABLET AL

MILI ORAL TABLET AL

MONO-LINYAH ORAL TABLET AL

MONONESSA ORAL TABLET AL

MY CHOICE ORAL TABLET OTC; QL

MY WAY ORAL TABLET OTC; QL

NECON 0.5/35 (28) ORAL TABLET AL

NEW DAY ORAL TABLET OTC; QL

NIKKI ORAL TABLET AL

NORA-BE ORAL TABLET AL

norethin ace-eth estrad-fe oral tablet 1.5-30 mg-mcg

Aurovela Fe 1.5/30 AL; QL

norethin ace-eth estrad-fe oral tablet 1-20 mg-mcg

Aurovela FE 1/20 AL

norethin ace-eth estrad-fe oral tablet 1-20 mg-mcg(24)

Aurovela 24 FE AL

norethin ace-eth estrad-fe oral tablet chewable

Melodetta 24 Fe AL

norethindrone acet-ethinyl est oral tablet Aurovela 1/20 AL

norethindrone oral tablet Camila AL

norethin-eth estradiol-fe oral tablet chewable Wymzya Fe AL

norgestimate-eth estradiol oral tablet Estarylla AL

norgestim-eth estrad triphasic oral tablet 0.18/0.215/0.25 mg-25 mcg

Tri-Lo-Estarylla AL; QL

norgestim-eth estrad triphasic oral tablet 0.18/0.215/0.25 mg-35 mcg

Tri Femynor AL

NORLYDA ORAL TABLET AL

NORLYROC ORAL TABLET AL

NORTREL 0.5/35 (28) ORAL TABLET AL

NORTREL 1/35 (21) ORAL TABLET AL

NORTREL 1/35 (28) ORAL TABLET AL

NORTREL 7/7/7 ORAL TABLET AL

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Drug Name Reference Notes

OCELLA ORAL TABLET AL

OGESTREL ORAL TABLET AL

OPCICON ONE-STEP ORAL TABLET OTC; QL

OPTION 2 ORAL TABLET OTC; QL

ORSYTHIA ORAL TABLET AL

PHILITH ORAL TABLET AL

PIMTREA ORAL TABLET AL; QL

PIRMELLA 1/35 ORAL TABLET AL

PIRMELLA 7/7/7 ORAL TABLET AL

PORTIA-28 ORAL TABLET AL; QL

PREVENTEZA ORAL TABLET OTC; QL

PREVIFEM ORAL TABLET AL

REACT ORAL TABLET OTC; QL

RECLIPSEN ORAL TABLET AL

RIVELSA ORAL TABLET AL; QL

SETLAKIN ORAL TABLET AL; QL

SHAROBEL ORAL TABLET AL

SIMLIYA ORAL TABLET AL; QL

SIMPESSE ORAL TABLET AL; QL

SPRINTEC 28 ORAL TABLET AL

SRONYX ORAL TABLET AL

SYEDA ORAL TABLET AL

TAKE ACTION ORAL TABLET OTC; QL

TARINA 24 FE ORAL TABLET AL

TARINA FE 1/20 EQ ORAL TABLET AL

TARINA FE 1/20 ORAL TABLET AL

TILIA FE ORAL TABLET AL; QL

TRI FEMYNOR ORAL TABLET AL

TRI-ESTARYLLA ORAL TABLET AL

TRI-LEGEST FE ORAL TABLET AL; QL

TRI-LINYAH ORAL TABLET AL

TRI-LO-ESTARYLLA ORAL TABLET AL; QL

TRI-LO-MARZIA ORAL TABLET AL; QL

TRI-LO-MILI ORAL TABLET AL; QL

TRI-LO-SPRINTEC ORAL TABLET AL; QL

TRI-MILI ORAL TABLET AL

TRINESSA (28) ORAL TABLET AL

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Drug Name Reference Notes

TRI-PREVIFEM ORAL TABLET AL

TRI-SPRINTEC ORAL TABLET AL

TRIVORA (28) ORAL TABLET AL

TRI-VYLIBRA LO ORAL TABLET AL; QL

TRI-VYLIBRA ORAL TABLET AL

TULANA ORAL TABLET AL

TYDEMY ORAL TABLET AL

VELIVET ORAL TABLET AL

VIENVA ORAL TABLET AL

viorele oral tablet Azurette AL; QL

VOLNEA ORAL TABLET AL; QL

VYFEMLA ORAL TABLET AL

VYLIBRA ORAL TABLET AL

WERA ORAL TABLET AL

WYMZYA FE ORAL TABLET CHEWABLE AL

XULANE TRANSDERMAL PATCH WEEKLY

AL; QL

ZARAH ORAL TABLET AL

ZOVIA 1/35E (28) ORAL TABLET AL

ZUMANDIMINE ORAL TABLET AL; QL

*CORTICOSTEROIDS*

betamethasone sod phos & acet injection suspension

Celestone Soluspan

budesonide oral capsule delayed release particles

Entocort EC QL

cortisone acetate oral tablet

DECADRON ORAL TABLET

DEXAMETHASONE INTENSOL ORAL CONCENTRATE

dexamethasone oral elixir

dexamethasone oral solution

dexamethasone oral tablet Decadron

dexamethasone oral tablet therapy pack DexPak 6 Day

dexamethasone sod phosphate pf injection solution

dexamethasone sodium phosphate injection solution

DEXPAK 10 DAY ORAL TABLET THERAPY PACK

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Drug Name Reference Notes

DEXPAK 13 DAY ORAL TABLET THERAPY PACK

DEXPAK 6 DAY ORAL TABLET THERAPY PACK

fludrocortisone acetate oral tablet

hydrocortisone oral tablet Cortef

methylprednisolone acetate injection suspension

DEPO-Medrol

methylprednisolone oral tablet Medrol

methylprednisolone oral tablet therapy pack Medrol

methylprednisolone sodium succ injection solution reconstituted

Solu-MEDROL

MILLIPRED ORAL TABLET

prednisolone oral solution

prednisolone oral syrup

prednisolone sodium phosphate oral solution

prednisolone sodium phosphate oral tablet dispersible

Orapred ODT QL

PREDNISONE INTENSOL ORAL CONCENTRATE

prednisone oral solution

prednisone oral tablet

prednisone oral tablet therapy pack

TAPERDEX 12-DAY ORAL TABLET THERAPY PACK

TAPERDEX 6-DAY ORAL TABLET THERAPY PACK

TAPERDEX 7-DAY ORAL TABLET THERAPY PACK

triamcinolone acetonide injection suspension Kenalog

*COUGH/COLD/ALLERGY*

acetylcysteine inhalation solution

ALAVERT ALLERGY/SINUS ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC; QL

allergy relief d oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

allergy relief d-24 oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

allergy relief/nasal decongest oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

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Drug Name Reference Notes

allergy relief-d oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

allergy relief-d oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

allergy/congestion relief oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

altarussin oral syrup Diabetic Tussin EX OTC

antihistamine & nasal deconges oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

APRODINE ORAL TABLET OTC

benzonatate oral capsule

biocotron oral liquid Diabetic Tussin DM OTC; QL

biogtuss oral liquid Giltuss Cough & Cold OTC

brontuss sf nr oral liquid Giltuss Cough & Cold OTC

cheratussin ac oral syrup AL; QL

chest congestion childrens oral liquid Diabetic Tussin OTC

chest congestion relief oral tablet Fenesin IR OTC

childrens cough oral liquid Mucinex Cough Childrens AL; OTC

childrens mucus relief cough oral liquid Mucinex Cough Childrens AL; OTC

childrens mucus relief expect oral liquid Diabetic Tussin OTC

cold & flu severe daytime oral tabletMucinex Fast-Max Cold Flu

OTC

cold head congestion severe oral tabletMucinex Fast-Max Cold Flu

OTC

cough dm childrens oral suspension extended release

Delsym AL; OTC

cough dm oral suspension extended release Delsym AL; OTC

coughtab oral tablet AL; OTC

cvs allergy relief d oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

cvs allergy relief-d oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

cvs allergy relief-d12 oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

cvs chest congest/cough child oral liquid Mucinex Cough Childrens AL; OTC

cvs chest congestion relief oral tablet Fenesin IR OTC

cvs cough dm oral suspension extended release

Delsym AL; OTC

cvs mucus extended release oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

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Drug Name Reference Notes

cvs tussin adult chest congest oral liquid Diabetic Tussin OTC

cvs tussin dm oral liquid Diabetic Tussin DM OTC; QL

cvs tussin maximum strength oral syrup Wal-Tussin Cough OTC

daytime cough oral liquid Vicks DayQuil Cough OTC

despec eda oral liquid Desgen Pediatric OTC

dextromethorphan polistirex er oral suspension extended release

Delsym AL; OTC

dextromethorphan-guaifenesin oral liquid 10-100 mg/5ml

Diabetic Tussin DM OTC; QL

dextromethorphan-guaifenesin oral liquid 20-200 mg/10ml

Diabetic Tussin DM QL

dextromethorphan-guaifenesin oral syrup Robafen DM Cough Clear OTC; QL

diabetic siltussin-dm oral liquid Diabetic Tussin DM OTC; QL

DIABETIC TUSSIN DM ORAL LIQUID OTC; QL

DIABETIC TUSSIN EX ORAL SYRUP OTC

DIABETIC TUSSIN FOR CHILDREN ORAL LIQUID

OTC; QL

DIABETIC TUSSIN ORAL LIQUID OTC

eq allergy relief d 24 hour oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

eq cold flu & sore throat oral tabletMucinex Fast-Max Cold Flu

OTC

eq cold/allergy childrens oral elixir OTC

eq cough childrens oral liquid Mucinex Cough Childrens AL; OTC

eq cough dm oral suspension extended release

Delsym AL; OTC

EQ MUCUS ER ORAL TABLET EXTENDED RELEASE 12 HOUR

AL; OTC

eq mucus relief dm oral tablet extended release 12 hour

Mucinex DM OTC

eq tussin dm cough/chest oral syrup Robafen DM Cough Clear OTC; QL

eql allergy/congestion relief oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

eql cold multi-symptom severe oral tabletMucinex Fast-Max Cold Flu

OTC

eql mucus relief max strength oral tabletMucinex Fast-Max Cold Flu

OTC

eql mucus-dm oral tablet extended release 12 hour

Mucinex DM OTC

eql tussin cough long-acting oral syrup Wal-Tussin Cough OTC

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Drug Name Reference Notes

eql tussin dm cough/chest cong oral syrup Robafen DM Cough Clear OTC; QL

eql tussin mucus/chest congest oral liquid Diabetic Tussin OTC

extra action cough oral syrup Robafen DM Cough Clear OTC; QL

FENESIN IR ORAL TABLET OTC

fexofenadine-pseudoephed er oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

fexofenadine-pseudoephed er oral tablet extended release 24 hour

Wal-Fex D Allergy & Congestion

OTC; QL

g tussin ac oral solution AL; OTC; QL

geri-tussin oral syrup Diabetic Tussin EX OTC

GILTUSS COUGH & CHEST CHILDREN ORAL LIQUID

OTC; QL

GILTUSS COUGH & CHEST ORAL LIQUID OTC; QL

GILTUSS COUGH & COLD CHILDRENS ORAL LIQUID

OTC

GILTUSS COUGH & COLD ORAL LIQUID OTC

GILTUSS DIABETIC COUGH & COLD ORAL LIQUID

OTC; QL

gnp allergy & congestion oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

gnp allergy/congestion relief oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

gnp allergy-d allergy & conges oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

gnp cold relief cold & flu oral tabletMucinex Fast-Max Cold Flu

OTC

gnp cold severe congestion day oral tabletMucinex Fast-Max Cold Flu

OTC

gnp cold/flu severe oral tabletMucinex Fast-Max Cold Flu

OTC

gnp cough dm er oral suspension extended release

Delsym AL; OTC

gnp fexofenadine/pse er oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

gnp mucus er oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

gnp mucus relief cold flu oral tabletMucinex Fast-Max Cold Flu

OTC

gnp mucus relief cough child oral liquid Mucinex Cough Childrens AL; OTC

gnp mucus relief dm max oral liquid Mucinex Cough Childrens AL; OTC

gnp mucus relief oral tablet Fenesin IR OTC

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Drug Name Reference Notes

gnp tab tussin oral tablet Fenesin IR OTC

gnp tussin cough long acting oral syrup Wal-Tussin Cough OTC

gnp tussin dm cough oral liquid Diabetic Tussin DM OTC; QL

gnp tussin mucus & chest cong oral liquid Diabetic Tussin OTC

goodsense cold & flu oral tabletMucinex Fast-Max Cold Flu

OTC

goodsense cough dm oral suspension extended release

Delsym AL; OTC

goodsense day time cold & flu oral tabletMucinex Fast-Max Cold Flu

OTC

goodsense mucus relief oral tablet Fenesin IR OTC

goodsense pressure/pain pe oral tabletSudafed PE Sinus Pressure+Pain

AL; OTC

goodsense severe cold/cough oral liquid 666 Cold Preparation AL; OTC

guaiasorb dm oral liquid Diabetic Tussin DM OTC; QL

guaiatussin ac oral syrup AL; QL

guaifenesin ac oral syrup AL; OTC; QL

guaifenesin dac oral solution AL; OTC

guaifenesin er oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

guaifenesin oral liquid Diabetic Tussin OTC

guaifenesin oral solution Diabetic Tussin OTC

guaifenesin oral syrup Diabetic Tussin EX OTC

guaifenesin oral tablet 200 mg AL; OTC

guaifenesin oral tablet 400 mg Fenesin IR OTC

guaifenesin-codeine oral solution AL; OTC; QL

guaifenesin-dm oral syrup Robafen DM Cough Clear OTC; QL

hm allergy & congestion oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

hm allergy relief/nasal decong oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

hm chest congestion relief oral tablet Fenesin IR OTC

hm cough dm oral suspension extended release

Delsym AL; OTC

hm cough relief oral liquidWal-Tussin Cough Long Acting

OTC

hm daytime cold & flu oral tabletMucinex Fast-Max Cold Flu

AL; OTC

hm mucus er oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

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Drug Name Reference Notes

hm mucus relief fm cold/flu oral tabletMucinex Fast-Max Cold Flu

OTC

hm mucus relief fm severe oral tabletMucinex Fast-Max Cold Flu

OTC

hm severe cold/flu oral tabletMucinex Fast-Max Cold Flu

OTC

hm tussin adult dm oral liquid Diabetic Tussin DM OTC; QL

hm tussin adult oral liquid Diabetic Tussin OTC

hydrocodone-homatropine oral syrup AL

hydrocodone-homatropine oral tablet AL

hydromet oral syrup AL

intense cough reliever oral liquid OTC

KLS ALLERCLEAR D-12HR ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC; QL

KLS ALLERCLEAR D-24HR ORAL TABLET EXTENDED RELEASE 24 HOUR

OTC; QL

kls mucus relief chest oral tablet Fenesin IR OTC

LOHIST-D ORAL LIQUID OTC

loratadine-d 12hr oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

loratadine-d 24hr oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

m-clear wc oral solution AL; OTC

medi-tussin dm double strength oral liquid OTC

meijer allergy relief-d oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

mm loratadine-d 24 hour oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

MUCINEX COUGH CHILDRENS ORAL LIQUID

AL; OTC

MUCINEX DM ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC

MUCINEX FAST-MAX COLD FLU ORAL TABLET

AL; OTC

MUCINEX FAST-MAX DM MAX ORAL LIQUID

AL; OTC

MUCINEX SINUS-MAX ORAL TABLET OTC

mucosa oral tablet Fenesin IR OTC

mucus dm oral tablet extended release 12 hour

Mucinex DM AL; OTC

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Drug Name Reference Notes

mucus relief chest congestion oral tablet Fenesin IR OTC

mucus relief cough childrens oral liquid Mucinex Cough Childrens AL; OTC

mucus relief dm max oral liquid Mucinex Cough Childrens AL; OTC

mucus relief dm oral tablet extended release 12 hour

Mucinex DM AL; OTC

mucus relief er oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

mucus relief max st oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

mucus relief oral tablet Fenesin IR OTC

mucus relief plus oral tabletMucinex Fast-Max Cold Flu

OTC

mucus relief severe cong/cold oral tabletMucinex Fast-Max Cold Flu

OTC

mucus-dm oral tablet extended release 12 hour

Mucinex DM AL; OTC

mucus-er max oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

nasal mist inhalation aerosol solution Simply Saline Baby OTC

NEBUSAL INHALATION NEBULIZATION SOLUTION

neotuss oral liquid OTC

organ-i nr oral tablet AL; OTC

pediatric formula cough/congst oral liquid Diabetic Tussin DM OTC; QL

PERCOGESIC EXTRA STRENGTH ORAL TABLET

OTC

promethazine vc/codeine oral syrup AL; QL

promethazine-codeine oral solution AL; QL

promethazine-codeine oral syrup AL; QL

promethazine-dm oral syrup AL; QL

promethazine-phenyleph-codeine oral syrup AL; QL

promethazine-phenylephrine oral syrup AL; QL

PULMOSAL INHALATION NEBULIZATION SOLUTION

px allergy relief d (loratid) oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

px allergy relief d oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

px severe cold oral tabletMucinex Fast-Max Cold Flu

OTC

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Drug Name Reference Notes

px tussin dm oral liquid Diabetic Tussin DM OTC; QL

px tussin max oral syrup Wal-Tussin Cough OTC

px tussin oral solution Diabetic Tussin OTC

qc cold multi-symptom daytime oral tabletMucinex Fast-Max Cold Flu

OTC

qc cough relief oral liquidWal-Tussin Cough Long Acting

OTC

qc loratadine-d oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

qc medifin 400 oral tablet Fenesin IR OTC

qc mucus relief er oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

qc tussin dm cough/congestion oral liquid Diabetic Tussin DM OTC; QL

qc tussin mucus/congestion oral liquid Diabetic Tussin OTC

ra allergy relief-d oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

ra allergy/congestion oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

ra allergy/congestion relief oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

ra cold multi-symptom daytime oral tabletMucinex Fast-Max Cold Flu

OTC

ra cold/flu/sore throat max oral tabletMucinex Fast-Max Cold Flu

OTC

ra cough dm oral suspension extended release

Delsym AL; OTC

ra head congest cold daytime oral tabletMucinex Fast-Max Cold Flu

OTC

ra lorata-d oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

ra mucus relief dm oral tablet extended release 12 hour

Mucinex DM OTC

ra mucus relief max st oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

ra mucus relief oral tablet Fenesin IR OTC

ra mucus relief plus oral tabletMucinex Fast-Max Cold Flu

OTC

ra severe congestion/cold max oral tabletMucinex Fast-Max Cold Flu

OTC

ra tussin cgh/chest congest dm oral liquid Diabetic Tussin DM OTC; QL

ra tussin chest congestion oral liquid Diabetic Tussin OTC

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Drug Name Reference Notes

ra tussin chest congestion oral syrup Diabetic Tussin EX OTC

ra tussin cough oral liquid Diabetic Tussin DM OTC; QL

ra tussin dm oral liquid Diabetic Tussin DM OTC; QL

ra tussin long acting cough oral liquidWal-Tussin Cough Long Acting

OTC

ra tussin maximum strength oral syrup Wal-Tussin Cough OTC

ra tussin oral syrup Diabetic Tussin EX OTC

ROBAFEN DM CGH/CHEST CONGEST ORAL LIQUID

OTC; QL

ROBAFEN DM COUGH CLEAR ORAL SYRUP

OTC; QL

ROBAFEN DM COUGH ORAL LIQUID OTC; QL

robafen dm oral syrup Robafen DM Cough Clear OTC; QL

ROBAFEN DM PEAK COLD CGH/CONG ORAL LIQUID

OTC; QL

ROBAFEN MUCUS/CHEST CONGESTION ORAL LIQUID

OTC

robafen oral syrup Diabetic Tussin EX OTC

ROBITUSSIN PEAK COLD DM ORAL SYRUP

OTC; QL

rynex pse oral liquid OTC

SAFE TUSSIN DM ORAL LIQUID OTC; QL

sb allergy relief/nasal decong oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

sb cold head congestion severe oral tabletMucinex Fast-Max Cold Flu

OTC

sb cold multi-symptom severe oral tabletMucinex Fast-Max Cold Flu

OTC

sb cough control oral syrup Diabetic Tussin EX OTC

severe cold & flu oral tabletMucinex Fast-Max Cold Flu

OTC

SHOPKO ALLERGY RELIEF-D (LORA) ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC; QL

siltussin dm das oral liquid Diabetic Tussin DM OTC; QL

siltussin sa oral syrup Diabetic Tussin EX OTC

siltussin-dm alcohol free oral syrup Robafen DM Cough Clear OTC; QL

SIMPLY SALINE BABY INHALATION AEROSOL SOLUTION

OTC

sm chest congestion relief oral tablet Fenesin IR OTC

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Drug Name Reference Notes

sm cold & allergy childrens oral elixir OTC

sm cold & flu severe oral tabletMucinex Fast-Max Cold Flu

OTC

sm cough relief oral syrup Wal-Tussin Cough OTC

sm loratadine d 12hr oral tablet extended release 12 hour

Alavert Allergy/Sinus OTC; QL

sm lorata-dine d oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

sm mucus relief cough children oral liquid Mucinex Cough Childrens AL; OTC

sm mucus relief max strength oral tablet extended release 12 hour

EQ Mucus ER AL; OTC

sm tussin cf oral liquid OTC

sm tussin cough/chest congest oral syrup Robafen DM Cough Clear OTC; QL

sm tussin dm oral syrup Robafen DM Cough Clear OTC; QL

sm tussin mucus+chest congest oral liquid Diabetic Tussin OTC

sodium chloride inhalation nebulization solution

Nebusal

SORBUGEN NR ORAL LIQUID OTC; QL

supress-dx pediatric oral liquid Desgen Pediatric OTC

tgt allergy/congestion relief oral tablet extended release 24 hour

KLS AllerClear D-24HR OTC; QL

tgt allergy+ congestion relief oral tablet extended release 12 hour

Wal-Fex D Allergy & Congestion

OTC; QL

tgt cough formula dm oral liquid Diabetic Tussin DM OTC; QL

THERAFLU EXPRESSMAX SEV CLD/FL ORAL TABLET

OTC

trymine cg oral liquid Mar-Cof CG Expectorant AL; OTC

TUSNEL C ORAL SYRUP AL; OTC

tusnel diabetic oral liquid Diabetic Tussin DM OTC; QL

tussin cough oral syrup Wal-Tussin Cough OTC

tussin dm cough + chest oral liquid Diabetic Tussin DM OTC; QL

tussin dm oral liquid Diabetic Tussin DM OTC; QL

tussin dm oral syrup Robafen DM Cough Clear OTC; QL

tussin mucus & chest congest oral liquid Diabetic Tussin OTC

tussin mucus+chest congestion oral liquid Diabetic Tussin OTC

tussin mucus+chest congestion oral syrup Diabetic Tussin EX OTC

tussin oral syrup Diabetic Tussin EX OTC

VICKS DAYQUIL COUGH ORAL LIQUID OTC

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Drug Name Reference Notes

VICKS DAYQUIL SEVERE COLD/FLU ORAL TABLET

OTC

virtussin a/c oral solution AL; OTC; QL

virtussin ac w/alc oral liquid AL; OTC; QL

WAL-ACT ORAL TABLET OTC

WAL-FEX D ALLERGY & CONGESTION ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC; QL

WAL-FEX D ALLERGY & CONGESTION ORAL TABLET EXTENDED RELEASE 24 HOUR

OTC; QL

WAL-ITIN D 24 HOUR ORAL TABLET EXTENDED RELEASE 24 HOUR

OTC; QL

WAL-ITIN D ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC; QL

wal-tap cold/allergy oral elixir OTC

wal-tussin cf oral liquid OTC

WAL-TUSSIN CHEST CONGESTION ORAL LIQUID

OTC

WAL-TUSSIN COUGH LONG ACTING ORAL LIQUID

OTC

WAL-TUSSIN COUGH LONG ACTING ORAL SYRUP

OTC

WAL-TUSSIN COUGH ORAL SYRUP OTC

WAL-TUSSIN COUGH/CHEST DM ORAL SYRUP

OTC; QL

WAL-TUSSIN DM CGH/CHEST CONG ORAL LIQUID

OTC; QL

wal-tussin oral syrup Diabetic Tussin EX OTC

*DERMATOLOGICALS*

2ND SKIN QUICK HEAL EXTERNAL GEL OTC

5 DAY EXTERNAL LIQUID OTC

A+D PREVENT EXTERNAL OINTMENT OTC

acne external padClearasil Rapid Rescue Deep

OTC

acne foaming wash external liquid PanOxyl Foaming Wash OTC

acne medication 10 external gelClean & Clear Persa-Gel Max St

OTC; QL

acne medication 10 external lotion OTC; QL

acne medication 5 external gel OTC

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Drug Name Reference Notes

acne medication 5 external lotion OTC; QL

acne treatment external bar OTC

acne treatment external gelClean & Clear Persa-Gel Max St

OTC; QL

acne-clear external gelClean & Clear Persa-Gel Max St

OTC; QL

ACTICOAT 7 EXTERNAL PAD

ACTICOAT 7 EXTERNAL SHEET

ACTICOAT ABSORBENT EXTERNAL PAD

ACTICOAT ANTIMICROBIAL EXTERNAL PAD

ACTICOAT EXTERNAL SHEET

ACTICOAT FLEX 3 EXTERNAL SHEET

ACTICOAT FLEX 7 EXTERNAL SHEET

acyclovir external ointment Zovirax PA; QL

advanced acne wash external liquid extended release

OTC

afterburn external gel OTC

AL12 EXTERNAL LOTION OTC

ala-cort external cream 1 % Aveeno Anti-Itch Max St QL

ala-cort external cream 2.5 % PA; QL

alcohol wipes external OTC

alevazol external ointment OTC

ALGICELL CALCIUM DRESS 3/4"X12 EXTERNAL

OTC

ALGICELL CALCIUM DRESSING 2"X2 EXTERNAL

OTC

ALGICELL CALCIUM DRESSING 4"X4 EXTERNAL

OTC

ALGICELL CALCIUM DRESSING 4"X8 EXTERNAL

OTC

ALGISITE M 2"X2" EXTERNAL OTC

ALGISITE M 3/4"X12" EXTERNAL OTC

ALGISITE M 4"X4" EXTERNAL OTC

ALGISITE M 6"X8" EXTERNAL OTC

allevess external patch OTC

aloe vera burn relief external aerosol Solarcaine Cool Aloe OTC

ALOE VESTA CLEANSING FOAM EXTERNAL LIQUID

OTC

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Drug Name Reference Notes

ALOE VESTA MULTI PURPOSE EXTERNAL FOAM

OTC

ALOE VESTA PERINEAL/SKIN EXTERNAL LIQUID

OTC

aloe/lidocaine pain reliever external gel OTC

ALPHABATH EXTERNAL OIL OTC

alph-e-cream external cream OTC

amcinonide external lotion

amcinonide external ointment QL

AMEDA TRIPLE ZERO LANOLIN EXTERNAL CREAM

OTC

AMERIPHOR EXTERNAL OINTMENT OTC

AMLACTIN EXTERNAL LOTION OTC

ammonium lactate external cream Geri-Hydrolac 12 OTC; QL

ammonium lactate external lotion AL12 OTC

AMNESTEEM ORAL CAPSULE PA

ANECREAM EXTERNAL CREAM OTC

anti-dandruff external shampoo Selsun Blue Daily OTC

antifungal external aerosol Tinactin OTC

antifungal external cream Carrington Antifungal OTC

anti-fungal external cream Clotrimazole GRx OTC; QL

anti-fungal external liquidElon Dual Defense Anti-Fungal

OTC

anti-fungal external powder Odor Eaters Antifungal OTC

anti-itch maximum strength external cream Aveeno Anti-Itch Max St OTC; QL

AQUA GLYCOLIC SHAMPOO/BODY EXTERNAL LIQUID

OTC

AQUACEL HYDROFIBER 0.39"X18" EXTERNAL

OTC

AQUACEL-AG EXTRA HYDROFIBER EXTERNAL PAD

OTC

AQUACEL-AG HYDROFIBER EXTERNAL OTC

AQUACEL-AG SURGICAL HYDROFIBER EXTERNAL PAD

OTC

ARGLAES EXTERNAL POWDER OTC

ASPERCREME LIDOCAINE EXTERNAL LIQUID

OTC

ASPERCREME LIDOCAINE EXTERNAL PATCH

OTC

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Drug Name Reference Notes

ASPERCREME MAX STRENGTH EXTERNAL AEROSOL

OTC

ASPERCREME PAIN RELIEF PATCH EXTERNAL PAD

OTC

ASPERCREME W/LIDOCAINE EXTERNAL CREAM

OTC

athletes foot af external cream LamISIL AT OTC

athletes foot external cream LamISIL AT OTC

athletes foot external powder Desenex OTC

athletes foot powder spray external aerosol powder

Odor Eaters Foot/Sneaker Spray

OTC

athletes foot spray external aerosol Tinactin OTC

ATRAPRO DERMAL SPRAY EXTERNAL LIQUID

AVEENO ANTI-ITCH MAX ST EXTERNAL CREAM

OTC; QL

AVEENO INTENSE RELIEF EXTERNAL CREAM

OTC

AVO CREAM EXTERNAL EMULSION

AVOGEL DRESSING 4"X4" EXTERNAL OTC

AVOGEL DRESSING 6"X48" EXTERNAL OTC

AVOGEL SHEET EXTERNAL OTC

bacitracin external ointment Bacitraycin Plus OTC; QL

bacitracin zinc external ointment OTC; QL

BACITRAYCIN PLUS EXTERNAL OINTMENT

OTC; QL

BALNEOL EXTERNAL LOTION OTC

bedding spray lice treatment aerosol Licide OTC

BENGAY LIDOCAINE EXTERNAL CREAM OTC

benzoyl peroxide cleanser external liquid OTC; QL

benzoyl peroxide external foam BenzePrO OTC

benzoyl peroxide external gel 2.5 %, 5 % OTC

benzoyl peroxide gel 10 % external (otc)Clean & Clear Persa-Gel Max St

OTC; QL

benzoyl peroxide wash external liquid 10 % PanOxyl Foaming Wash OTC

benzoyl peroxide wash external liquid 5 % Benzac AC Wash OTC; QL

beta care external lotion Cam OTC

betamethasone dipropionate aug external cream

Diprolene AF

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Drug Name Reference Notes

betamethasone dipropionate external lotion QL

betamethasone valerate external cream QL

betamethasone valerate external ointment QL

BIAFINE EXTERNAL EMULSION

BIOBRANE GLOVES LARGE EXTERNAL OTC

BIOBRANE GLOVES MEDIUM EXTERNAL OTC

BIOBRANE GLOVES PEDIATRIC EXTERNAL

OTC

BIOBRANE GLOVES SMALL EXTERNAL OTC

BIO-THERM PAIN RELIEVING EXTERNAL LOTION

OTC

BLIS-TO-SOL EXTERNAL LIQUID OTC

blue gel external gel Mineral Ice OTC

bp gel external gel 10 %Clean & Clear Persa-Gel Max St

OTC; QL

bp gel external gel 5 % OTC

bp wash external liquid 10 % PanOxyl Foaming Wash OTC

bp wash external liquid 2.5 % PanOxyl

bp wash external liquid 5 % Benzac AC Wash OTC; QL

bp wash external liquid 7 % BenzePrO Creamy Wash

BREEZEE MIST EXTERNAL AEROSOL POWDER

OTC

calamine external lotion OTC

calamine phenolated external lotion OTC

calamine-zinc oxide external suspension OTC

calcipotriene external cream Dovonex QL

calcipotriene external ointment Calcitrene

calcipotriene external solution QL

CALCITRENE EXTERNAL OINTMENT

CAM EXTERNAL LOTION OTC

CAMEO OIL EXTERNAL OIL OTC

capsaicin external cream OTC

capsaicin external padAspercreme Pain Relief Patch

OTC

capsaicin hot patch external padAspercreme Pain Relief Patch

OTC

capsaicin hp external cream Zostrix HP OTC

capzix external cream Zostrix HP OTC

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Drug Name Reference Notes

CARRAGINATE EXTERNAL OTC

CARRASORB H EXTERNAL OTC

CARRINGTON ANTIFUNGAL EXTERNAL CREAM

OTC

CAVILON EXTERNAL CREAM OTC

CERAVE HYDRATING CLEANSER EXTERNAL LIQUID

OTC

CERAVE PM EXTERNAL LOTION OTC

CICA-CARE EXTERNAL SHEET OTC

ciclopirox external solution Ciclodan QL

ciclopirox olamine external cream Loprox QL

ciclopirox olamine external suspension Loprox QL

CLARAVIS ORAL CAPSULE PA

CLEAN & CLEAR PERSA-GEL MAX ST EXTERNAL GEL

OTC; QL

CLEARASIL RAPID RESCUE DEEP EXTERNAL PAD

OTC

CLINDACIN ETZ EXTERNAL SWAB QL

CLINDACIN-P EXTERNAL SWAB QL

clindamycin phos-benzoyl perox external gel Neuac QL

clindamycin phosphate external gel Cleocin-T

clindamycin phosphate external solution QL

clindamycin phosphate external swab Clindacin ETZ QL

clobetasol prop emollient base external cream

QL

clobetasol propionate e external cream QL

clobetasol propionate external cream Temovate QL

clobetasol propionate external gel

clobetasol propionate external ointment Temovate QL

clobetasol propionate external solution QL

clotrimazole af external cream Clotrimazole GRx OTC; QL

clotrimazole anti-fungal external cream Clotrimazole GRx OTC; QL

clotrimazole athletes foot external cream Clotrimazole GRx OTC

clotrimazole external cream Clotrimazole GRx QL

clotrimazole external solutionFungiCure Intensive/NailGuard

OTC

CLOTRIMAZOLE GRX EXTERNAL CREAM

OTC; QL

clotrimazole-betamethasone external cream QL

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Drug Name Reference Notes

clotrimazole-betamethasone external lotion QL

complete lice treatment combination kit CVS Lice Solution OTC; QL

COMPOUND W EXTERNAL LIQUID OTC

CONFORMANT 2 WOUND VEIL EXTERNAL

OTC

cooling external gel OTC

COOLMAGIC EXTERNAL SHEET OTC

COOLMAGIC TUBE SITE DRESSING EXTERNAL SHEET

OTC

corn & callus remover external liquid Compound W OTC

corn remover one-step external strip Compound W for Kids OTC

CORTAID MAXIMUM STRENGTH EXTERNAL CREAM

OTC; QL

CORTIZONE-10 INTENSIVE HEALING EXTERNAL CREAM

PA; OTC; QL

CORTIZONE-10 PLUS EXTERNAL CREAM

PA; OTC; QL

CORTIZONE-10/ALOE EXTERNAL CREAM

PA; OTC; QL

CRUEX PRESCRIPTION STRENGTH EXTERNAL AEROSOL POWDER

OTC

CURAD HYDROCORTISONE EXTERNAL CREAM

OTC; QL

CUTTER BACKWOODS EXTERNAL AEROSOL

OTC

CUTTER SKINSATIONS EXTERNAL LIQUID

OTC

cvs acne cleansing external bar OTC

cvs acne control cleanser external cream Clean & Clear Continuous OTC

cvs acne external cream Clean & Clear Continuous OTC

cvs acne foaming face wash external liquid PanOxyl Foaming Wash OTC

cvs acne treatment external gelClean & Clear Persa-Gel Max St

OTC; QL

cvs advanced healing external ointment DermaPhor OTC

cvs af spray powder external aerosol powderOdor Eaters Foot/Sneaker Spray

OTC

cvs aftersun aloe/lidocaine external gel OTC

cvs antibiotic external ointment Curad Triple Antibiotic OTC; QL

cvs antibiotic pain/scar external ointmentNeosporin + Pain Relief Max St

OTC; QL

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Drug Name Reference Notes

cvs antifungal external cream Fungoid-D OTC

cvs antifungal maximum str external liquidElon Dual Defense Anti-Fungal

OTC

cvs anti-itch maximum strength external cream

Aveeno Anti-Itch Max St OTC; QL

cvs athletes foot external aerosol powderCruex Prescription Strength

OTC

cvs athletes foot external cream LamISIL AT OTC

cvs bacitracin external ointment OTC; QL

cvs bacitracin zinc external ointment OTC; QL

cvs bedding spray lice treat aerosol Licide OTC

cvs capsaicin hp external cream Zostrix HP OTC

cvs clotrimazole external cream Clotrimazole GRx OTC; QL

cvs clotrimazole external solutionFungiCure Intensive/NailGuard

OTC

cvs corn/callus remover external kit OTC

cvs cortisone intense healing external cream Aveeno Anti-Itch Max St OTC; QL

cvs cortisone maximum strength external cream

Aveeno Anti-Itch Max St OTC; QL

cvs creamy acne face wash external liquid PanOxyl Creamy Wash OTC

cvs daily moisturizing external lotion Aveeno Daily Moisturizing OTC

cvs diaper rash external ointment Boudreauxs Butt Paste OTC; QL

cvs eczema anti-itch external cream Aveeno Anti-Itch Max St OTC; QL

cvs foaming acne face wash external liquid PanOxyl Foaming Wash OTC

cvs foot & sneaker external aerosol powderOdor Eaters Foot/Sneaker Spray

OTC

cvs hydrating skin treatment external lotion AL12 OTC

cvs hydrocortisone anti-itch external cream Aveeno Anti-Itch Max St OTC; QL

cvs hydrocortisone max st external cream Aveeno Anti-Itch Max St OTC; QL

cvs hygienic cleansing external lotion Balneol OTC

cvs instant burn relief external aerosol Solarcaine Cool Aloe OTC

cvs isopropyl alcohol wipes external OTC

cvs itch relief external cream Clotrimazole GRx OTC; QL

cvs jock itch external cream LamISIL AT OTC

cvs lice killing external shampoo Licide OTC

CVS LICE SOLUTION COMBINATION KIT OTC; QL

cvs lice treatment external liquid Nix Creme Rinse OTC; QL

cvs lidocaine maximum strength external cream

Aspercreme w/Lidocaine OTC

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Drug Name Reference Notes

cvs medicated heat patch external padAspercreme Pain Relief Patch

OTC

cvs moisturizing external lotion Cam OTC

cvs pain relief external cream Aspercreme w/Lidocaine OTC

cvs pain relief external patch Aspercreme Lidocaine OTC

cvs pediatric ointment external ointment A+D Prevent OTC

cvs poly bacitracin external ointment Neosporin OTC

cvs psoriasis medicated external shampoo Dermarest Psoriasis OTC

cvs ringworm external cream Clotrimazole GRx OTC; QL

cvs scar external gel Celacyn OTC

cvs silver external gel SilvaSorb OTC

cvs skin treatment external lotion AL12 OTC

cvs special care external lotion Cam OTC

cvs therapeutic dandruff external shampoo Dermarest Psoriasis OTC

cvs therapeutic menthol external gel Mineral Ice OTC

cvs triple antibiotic/pain external ointmentNeosporin + Pain Relief Max St

OTC; QL

cvs vitamin a&d external ointment Curad Vitamin A & D OTC

cvs vitamin e external oil OTC

cvs vitamin e moisturizing external cream GRX Vitamin E OTC

cvs wart remover external liquid Compound W OTC

cvs wart remover one step external strip Compound W for Kids OTC

cvs wart remover pen external gel Sal-Plant OTC

cvs wound wash advanced external liquid Atrapro Dermal Spray OTC

cvs zinc oxide external ointment OTC; QL

daily face wash external liquidClean & Clear Advantage 3-in-1

OTC

DERMACERIN EXTERNAL CREAM OTC; QL

DERMAGAUZE HYDROGEL DRESSING EXTERNAL

OTC

DERMAGINATE DRESSING 12" EXTERNAL

OTC

DERMAGINATE DRESSING 4"X4" EXTERNAL PAD

OTC

DERMAPHOR EXTERNAL OINTMENT OTC

DERMAPLEX EXTERNAL GEL OTC

DERMAREST PSORIASIS EXTERNAL SHAMPOO

OTC

DERMAVANTAGE EXTERNAL LOTION OTC

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Drug Name Reference Notes

DESENEX EXTERNAL CREAM OTC; QL

DESENEX EXTERNAL POWDER OTC

DESENEX JOCK ITCH EXTERNAL AEROSOL POWDER

OTC

DIABETIDERM MASSAGE STIMULATOR EXTERNAL LIQUID

OTC

diaper rash external ointment Boudreauxs Butt Paste OTC; QL

diclofenac sodium transdermal gel Voltaren PA; QL

diclofenac sodium transdermal solution PA; QL

DIFFERIN EXTERNAL GEL OTC; QL

diflorasone diacetate external cream QL

docosanol external cream Abreva OTC; QL

DOLOGESIC PAIN RELIEF ROLL-ON EXTERNAL LIQUID

OTC

double antibiotic external ointment Neosporin OTC

DOULEURIN EXTERNAL LOTION OTC

DRS CHOICE DIABETIC BANDAGES EXTERNAL KIT

OTC

DRS CHOICE SKIN CLOSURE EXTERNAL KIT

OTC

DRS CHOICE SLOW HEAL BANDAGES EXTERNAL KIT

OTC

DRS CHOICE ULTRA-FLEX EXTERNAL OTC

dry skin treatment external ointment DermaPhor OTC

DUODERM CGF BORDER EXTERNAL OTC

DUODERM CGF DRESSING EXTERNAL OTC

DUODERM CGF EXTRA THIN EXTERNAL OTC

DUODERM CGF SPOTS EXTRA THIN EXTERNAL

OTC

DUODERM HYDROACTIVE EXTERNAL OTC

DUODERM HYDROACTIVE EXTERNAL GEL

OTC

DUODERM HYDROACTIVE EXTERNAL PASTE

OTC

DUODERM SIGNAL DRESSING EXTERNAL

OTC

DUOFILM EXTERNAL SOLUTION OTC

DY-O-DERM VITILIGO STAIN EXTERNAL SOLUTION

OTC

e-cream complex external cream OTC

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Drug Name Reference Notes

ELON DUAL DEFENSE ANTI-FUNGAL EXTERNAL LIQUID

OTC

e-oil external oil OTC

eq antifungal external cream Clotrimazole GRx OTC; QL

eq athletes foot (tolnaftate) external cream Fungoid-D OTC

eq athletes foot external aerosol powderOdor Eaters Foot/Sneaker Spray

OTC

eq athletes foot external cream Clotrimazole GRx OTC; QL

eq athletes foot spray external aerosol powder

Cruex Prescription Strength

OTC

eq bacitracin zinc external ointment OTC; QL

eq capsaicin patch external padAspercreme Pain Relief Patch

OTC

eq hydrocortisone external cream Aveeno Anti-Itch Max St OTC; QL

eq hydrocortisone max st external cream Aveeno Anti-Itch Max St OTC; QL

eq hydrocortisone plus external cream Aveeno Anti-Itch Max St OTC; QL

eq jock itch external cream Clotrimazole GRx OTC; QL

eq lice killing max st external shampoo Licide OTC

eq lidocaine pain relieving external patch Aspercreme Lidocaine OTC

eq pain relieving external cream Aspercreme w/Lidocaine OTC

eq tolnaftate external aerosol Tinactin OTC

eq triple antibiotic external ointment Curad Triple Antibiotic OTC; QL

eq wart remover external liquid Compound W OTC

eql antifungal (tolnaftate) external cream Fungoid-D OTC

eql antifungal external cream Clotrimazole GRx OTC; QL

eql anti-itch intensive heal external cream Aveeno Anti-Itch Max St OTC; QL

eql anti-itch maximum strength external cream

Aveeno Anti-Itch Max St OTC; QL

eql anti-itch maximum strength external ointment

Cortizone-10 OTC; QL

eql athletes foot external cream Clotrimazole GRx OTC; QL

eql athletes foot(terbinafine) external cream LamISIL AT OTC

eql baby basics diaper rash external ointment

Boudreauxs Butt Paste OTC; QL

eql bacitracin zinc external ointment OTC; QL

eql first aid antibiotic external ointmentNeosporin + Pain Relief Max St

OTC; QL

eql lice killing max st external shampoo Licide OTC

ery external pad QL

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Drug Name Reference Notes

erythromycin external solution QL

EUCERIN ORIGINAL HEALING EXTERNAL LOTION

OTC

EXU-DRY BOOT/FOOT CHILD EXTERNAL OTC

EXU-DRY BURN JACKET 36"X40" EXTERNAL

OTC

EXU-DRY BURN VEST 26"X38" EXTERNAL

OTC

EXU-DRY BURN VEST CHILD 15X20" EXTERNAL

OTC

EXU-DRY LEG 34"X37" EXTERNAL OTC

EXU-DRY NON-PERMEABLE 36"X72" EXTERNAL SHEET

OTC

EXU-DRY QUILTED 36"X72" EXTERNAL SHEET

OTC

FIRST CARE PAIN RELIEF EXTERNAL PATCH

OTC

fluocinonide emulsified base external cream

fluorouracil external cream Efudex QL

fluorouracil external solution QL

fluticasone propionate external cream QL

fluticasone propionate external ointment QL

FREEDERM ADHESIVE REMOVER EXTERNAL LIQUID

OTC

fungi-guard external cream Fungoid-D OTC

FUNGI-NAIL EXTERNAL SOLUTION OTC

FUNGOID-D EXTERNAL CREAM OTC

gentamicin sulfate external cream

gentamicin sulfate external ointment

GERI-HYDROLAC 12 EXTERNAL CREAM OTC; QL

GERI-HYDROLAC 12 EXTERNAL LOTION OTC

GERI-HYDROLAC 5 EXTERNAL LOTION OTC

gerisilk bath oil external oil Cameo Oil OTC

GETS-IT CORN/CALLUS REMOVER EXTERNAL LIQUID

OTC

glycerin external liquid OTC

g-myco nail external solution Myco Nail OTC

gnp athletes foot external aerosol powderCruex Prescription Strength

OTC

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Drug Name Reference Notes

gnp athletes foot external cream Clotrimazole GRx OTC; QL

gnp bacitracin zinc external ointment OTC; QL

gnp burn relief external aerosol Solarcaine Cool Aloe OTC

gnp burn relief spray external aerosol Solarcaine Cool Aloe OTC

gnp calamine external lotion OTC

gnp calamine phenolated external lotion OTC

gnp capsaicin external cream Zostrix HP OTC

gnp diaper rash creamy external ointment Dr Smiths Adult Barrier OTC

gnp glycerin external liquid OTC

gnp hydrocortisone external cream OTC; QL

gnp hydrocortisone max st external ointment Cortizone-10 OTC; QL

gnp hydrocortisone plus external cream Aveeno Anti-Itch Max St OTC; QL

gnp hydrocortisone/aloe external creamCortizone-10 Intensive Healing

OTC; QL

gnp lice bedding aerosol Licide OTC

gnp lice treatment external liquid Nix Creme Rinse OTC; QL

gnp lice treatment external shampoo Licide OTC

gnp lidocaine pain relief external patch Aspercreme Lidocaine OTC

gnp liquid bandage external liquid OTC

gnp miconazole nitrate external aerosol powder

Cruex Prescription Strength

OTC

gnp miconazorb af external powder Desenex OTC

gnp terbinafine hydrochloride external cream LamISIL AT OTC

gnp therapeutic blue external gel Mineral Ice OTC

gnp tolnaftate external cream Fungoid-D OTC

gnp triple antibiotic plus external ointmentNeosporin + Pain Relief Max St

OTC; QL

gnp vitamin a & d external ointment Curad Vitamin A & D OTC

gnp wart remover external liquid Compound W OTC

gnp zinc oxide external ointment OTC; QL

GOLD BOND MULTI-SYMPTOM EXTERNAL CREAM

OTC

goodsense calamine external suspension OTC

goodsense muscle rub external cream Bengay Ultra Strength OTC

GORDOCHOM EXTERNAL SOLUTION OTC

GORDONS-VITE A EXTERNAL CREAM OTC

gordons-vite e external cream GRX Vitamin E OTC

halobetasol propionate external cream QL

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Drug Name Reference Notes

halobetasol propionate external ointment QL

hm bacitracin zinc external ointment OTC; QL

hm calamine external lotion OTC

hm double antibiotic external ointment Neosporin OTC

hm glycerin external liquid OTC

hm hydrocortisone plus external creamCortizone-10 Intensive Healing

OTC; QL

hm hydrocortisone-aloe max st external cream

Cortizone-10 Intensive Healing

OTC; QL

hm lice killing max st external shampoo Licide OTC

hm lice treatment external liquid Nix Creme Rinse OTC; QL

hm lidocaine patch external patch Aspercreme Lidocaine OTC

hm triple antibiotic external ointment Curad Triple Antibiotic OTC; QL

hm triple antibiotic max st external ointmentNeosporin + Pain Relief Max St

OTC; QL

HONGO CURA ANTI-FUNGAL EXTERNAL LIQUID

OTC

horizontal drain/tube att dev OTC

hydrocerin external lotion Amerigel Barrier OTC

hydrocortisone anti-itch external cream Aveeno Anti-Itch Max St OTC; QL

hydrocortisone external cream 0.5 % OTC; QL

hydrocortisone external cream 1 % Aveeno Anti-Itch Max St QL

hydrocortisone external cream 2.5 % QL

hydrocortisone external ointment 0.5 % OTC

hydrocortisone external ointment 1 % Cortizone-10 QL

hydrocortisone external ointment 2.5 % QL

hydrocortisone max st external cream Aveeno Anti-Itch Max St OTC; QL

hydrocortisone max st/12 moist external cream

Aveeno Anti-Itch Max St OTC; QL

hydrocortisone plus external cream Aveeno Anti-Itch Max St OTC; QL

hydrocortisone-aloe external cream OTC; QL

HYDROLATUM EXTERNAL OINTMENT OTC

HYPERCARE EXTERNAL SOLUTION OTC

ice blue external gel Mineral Ice OTC

imiquimod external cream Aldara PA; QL

INSTACLEAN EXTERNAL LIQUID OTC

isopropyl alcohol external liquid OTC

isotretinoin oral capsule Amnesteem PA

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Drug Name Reference Notes

JOBST IT STAYS EXTERNAL LIQUID OTC

jock itch external cream Clotrimazole GRx OTC; QL

jock itch relief external cream Clotrimazole GRx OTC; QL

jock itch spray external aerosol powderOdor Eaters Foot/Sneaker Spray

OTC

jock itch spray powder external aerosol powder

Odor Eaters Foot/Sneaker Spray

OTC

KALTOSTAT ROPE EXTERNAL OTC

KENDALL CA ALGINATE 12" ROPE EXTERNAL

OTC

KENDALL CA ALGINATE 12"X24" EXTERNAL

OTC

KENDALL CA ALGINATE 2"X2" EXTERNAL

OTC

KENDALL CA ALGINATE 24" ROPE EXTERNAL

OTC

KENDALL CA ALGINATE 36" ROPE EXTERNAL

OTC

KENDALL CA ALGINATE 4"X4" EXTERNAL

OTC

KENDALL CA ALGINATE 4"X5-1/2" EXTERNAL

OTC

KENDALL CA ALGINATE 6"X10" EXTERNAL

OTC

KENDALL CA ALGINATE 8"X4" EXTERNAL

OTC

KENDALL CA ALGINATE PLUS 4"X4" EXTERNAL

OTC

KENDALL HYDROGEL WOUND DRESS EXTERNAL

KERASAL FUNGAL NAIL RENEWAL EXTERNAL LIQUID

OTC

KERICORT 10 EXTERNAL CREAM OTC; QL

ketoconazole external cream QL

ketoconazole external shampoo Nizoral QL

kls hydrocortisone plus external creamCortizone-10 Intensive Healing

OTC; QL

kp bacitracin zinc external ointment OTC; QL

kp benzoyl peroxide external gelClean & Clear Persa-Gel Max St

OTC; QL

kp benzoyl peroxide wash external liquid Benzac AC Wash OTC; QL

99

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Drug Name Reference Notes

kp clotrimazole external cream Clotrimazole GRx OTC; QL

kp double antibiotic external ointment Neosporin OTC

kp hydrocortisone external cream Aveeno Anti-Itch Max St OTC; QL

kp hydrocortisone max st external ointment Cortizone-10 OTC; QL

kp hydrocortisone-aloe external cream OTC; QL

kp miconazole nitrate external cream Carrington Antifungal OTC

kp terbinafine hydrochloride external cream LamISIL AT OTC

kp tolnaftate external cream Fungoid-D OTC

LAMISIL AT EXTERNAL CREAM OTC

LAMISIL AT JOCK ITCH EXTERNAL CREAM

OTC

LAN-O-SOOTHE EXTERNAL CREAM OTC

LANSINOH LANOLIN EXTERNAL CREAM OTC

LANSINOH LANOLIN MINIS NIPPLE EXTERNAL CREAM

OTC

LANSINOH LANOLIN NIPPLE EXTERNAL CREAM

OTC

lice killing external shampoo Licide OTC

lice killing maximum strength external shampoo

Licide OTC

lice treatment external liquid Nix Creme Rinse OTC; QL

lice treatment external lotion OTC; QL

LICIDE COMPLETE LICE TREATMENT COMBINATION KIT

OTC; QL

LICIDE MAXIMUM STRENGTH EXTERNAL LIQUID

OTC; QL

LIDO KING EXTERNAL PATCH OTC

lidocaine external cream Lipocaine 5 OTC

lidocaine external patch 4 % Aspercreme Lidocaine OTC

lidocaine external patch 5 % Lidoderm PA; QL

lidocaine hcl external cream Aspercreme w/Lidocaine OTC

lidocaine hcl external solution PA; QL

lidocaine hcl urethral/mucosal external gel

lidocaine pain relief external patch Aspercreme Lidocaine OTC

lidocaine plus external cream Aspercreme w/Lidocaine OTC

lidocaine-prilocaine external cream QL

LIDOCREAM EXTERNAL CREAM OTC

LIDODOSE EXTERNAL GEL OTC

100

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Drug Name Reference Notes

LIDODOSE PEDIATRIC BULK PACK EXTERNAL GEL

OTC

LIPOCAINE 5 EXTERNAL CREAM OTC

liquid corn & callus remover external liquid Compound W OTC

liquid wart remover external liquid Compound W OTC

LOTRIMIN AF DEODORANT POWDER EXTERNAL AEROSOL POWDER

OTC

LOTRIMIN AF EXTERNAL AEROSOL OTC

LOTRIMIN AF EXTERNAL CREAM OTC; QL

LOTRIMIN AF EXTERNAL POWDER OTC

LOTRIMIN AF JOCK ITCH EXTERNAL CREAM

OTC; QL

LOTRIMIN AF JOCK ITCH POWDER EXTERNAL AEROSOL POWDER

OTC

LOTRIMIN AF POWDER EXTERNAL AEROSOL POWDER

OTC

LUBRIDERM SKIN NOURISHING EXTERNAL LOTION

OTC

LUBRISILK EXTERNAL LOTION OTC

LUBRISKIN EXTERNAL LOTION OTC

LUBRISOFT EXTERNAL LOTION OTC

MAPO BATH EXTERNAL OIL OTC

MASTISOL ADHESIVE EXTERNAL LIQUID

OTC

MAXORB EXTRA ROPE EXTERNAL OTC

MEDFIX EZ EXTERNAL OTC

medicated anti-fungal external solution Blis-To-Sol OTC

meijer calamine external lotion OTC

meijer hydrocortisone external cream Aveeno Anti-Itch Max St OTC; QL

meijer zinc oxide external ointment OTC; QL

MENTHOZEN EXTERNAL CREAM OTC

metronidazole external cream Rosadan QL

metronidazole external gel 0.75 % Rosadan

metronidazole external gel 1 % Metrogel QL

metronidazole external lotion MetroLotion

micaderm external cream Carrington Antifungal OTC

MICATIN EXTERNAL CREAM OTC

miconazole antifungal external cream Carrington Antifungal OTC

miconazole nitrate external cream Carrington Antifungal OTC

101

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Drug Name Reference Notes

MICRO GUARD EXTERNAL POWDER OTC

mineral freez external gel Mineral Ice OTC

mineral oil light external oil OTC

mineral oil-hydrophil petrolat external ointment

OTC

MINERIN EXTERNAL CREAM OTC; QL

MINERIN EXTERNAL LOTION OTC

MIRODERM BIOLOGIC WOUND MATRIX EXTERNAL SHEET

mometasone furoate external cream QL

mometasone furoate external ointment QL

mometasone furoate external solution QL

MOSCO CALLUS/CORN REMOVER EXTERNAL SOLUTION

OTC

mupirocin external ointment Centany QL

MYCO NAIL A EXTERNAL SOLUTION OTC

MYCO NAIL EXTERNAL SOLUTION OTC

MYORISAN ORAL CAPSULE PA

NAIL SCRUB EXTERNAL LIQUID OTC

NATRAPEL 12-HOUR TICK/INSECT EXTERNAL AEROSOL

OTC

natural oatmeal bath treatment external packet

Aveeno Baby Bath Treatment

OTC

NEOSPORIN + PAIN RELIEF MAX ST EXTERNAL OINTMENT

OTC; QL

NEOSPORIN + PAIN/ITCH/SCAR EXTERNAL OINTMENT

OTC; QL

NEOSPORIN EXTERNAL OINTMENT OTC

NEOSPORIN/BURN RELIEF EXTERNAL OINTMENT

OTC; QL

NEUROMED7 EXTERNAL CREAM OTC

NEUTROGENA RAPID CLEAR EXTERNAL PAD

OTC

NEW DIGNITY ODOR ELIMINATOR EXTERNAL SOLUTION

OTC

NIZORAL A-D EXTERNAL SHAMPOO OTC

NOBLE FORMULA HC EXTERNAL CREAM

OTC; QL

NYAMYC EXTERNAL POWDER QL

nystatin external cream QL

102

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Drug Name Reference Notes

nystatin external ointment QL

nystatin external powder Nyamyc QL

NYSTOP EXTERNAL POWDER QL

OASIS ULTRA TRI-LAYER MATRIX EXTERNAL SHEET

OASIS WOUND MATRIX FENESTRATED EXTERNAL SHEET

odor control foot & sneaker external aerosol powder

Odor Eaters Foot/Sneaker Spray

OTC

ODOR EATERS ANTIFUNGAL EXTERNAL POWDER

OTC

ODOR EATERS FOOT/SNEAKER SPRAY EXTERNAL AEROSOL POWDER

OTC

OFF ACTIVE EXTERNAL AEROSOL OTC

OFF DEEP WOODS DRY EXTERNAL AEROSOL

OTC

OFF DEEP WOODS EXTERNAL AEROSOL

OTC

OFF SMOOTH & DRY EXTERNAL AEROSOL

OTC

one step perineal external lotion Balneol OTC

pain relief maximum strength external patch Aspercreme Lidocaine OTC

pain relief roll-on external liquid Aspercreme Lidocaine OTC

pain relieving external cream Aspercreme w/Lidocaine OTC

pain relieving lidocaine external patch Aspercreme Lidocaine OTC

PANOXYL CREAMY WASH EXTERNAL LIQUID

OTC

PANOXYL FOAMING WASH EXTERNAL LIQUID

OTC

PEDI-PRE TAPE SPRAY EXTERNAL LIQUID

OTC

PERIFRESH EXTERNAL LIQUID OTC

perineal cleansing external lotion Balneol OTC

perineal skin cleanser external liquidAloe Vesta Cleansing Foam

OTC

PERISCENT EXTERNAL LIQUID OTC

permethrin external cream Elimite QL

pimecrolimus external cream Elidel PA; AL; QL

podactin external cream Carrington Antifungal OTC

podactin external powder Odor Eaters Antifungal OTC

103

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Drug Name Reference Notes

podofilox external solution PA

poly bacitracin external ointment Neosporin OTC

prednicarbate external ointment QL

PREPARATION H EXTERNAL CREAM OTC; QL

pro-ex antifungal external cream Clotrimazole GRx OTC; QL

PROSHIELD FOAM/SPRAY CLEANSER EXTERNAL FOAM

OTC

PRUTECT EXTERNAL EMULSION

px athletic foot external cream Clotrimazole GRx OTC; QL

px hydrocream external cream Aveeno Anti-Itch Max St OTC; QL

px triple external ointment Curad Triple Antibiotic OTC; QL

qc athletes foot external cream LamISIL AT OTC

qc bacitracin external ointment Bacitraycin Plus OTC; QL

qc calamine external lotion OTC

qc clotrimazole external cream Clotrimazole GRx OTC; QL

qc lidocaine pain relief external patch Aspercreme Lidocaine OTC

qc tolnaftate external cream Fungoid-D OTC

ra acne cleanser oil-free external liquidClean & Clear Advantage 3-in-1

OTC

ra acne maximum external pad OTC

ra acne treatment external cream Clean & Clear Continuous OTC

ra advanced healing external ointment DermaPhor OTC

ra aloe vera/lidocaine external gel OTC

ra antibiotic/pain relief external ointmentNeosporin + Pain Relief Max St

OTC; QL

ra antifungal external aerosol Tinactin OTC

ra antifungal external cream Carrington Antifungal OTC

ra anti-fungal foot care external solution Fungi-Nail OTC

ra anti-itch maximum strength external cream

Aveeno Anti-Itch Max St OTC; QL

ra anti-itch maximum strength external ointment

Cortizone-10 OTC; QL

ra atheletes foot external aerosol powderCruex Prescription Strength

OTC

ra athletes foot (tolnaftate) external cream Fungoid-D OTC

ra athletes foot external cream Clotrimazole GRx OTC; QL

ra bacitracin external ointment OTC; QL

ra bacitracin zinc first aid external ointment OTC; QL

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Drug Name Reference Notes

ra burn relief aloe extra external aerosol Solarcaine Cool Aloe OTC

ra calamine external suspension OTC

ra capsicum hot patch external padAspercreme Pain Relief Patch

OTC

ra clotrimazole external cream Clotrimazole GRx OTC; QL

ra double antibiotic external ointment Neosporin OTC

ra foot care antifungal external cream LamISIL AT OTC

ra gentle skin external lotion Cam OTC

ra hydrating healing external ointment DermaPhor OTC

ra hydrocortisone max st external cream Aveeno Anti-Itch Max St OTC; QL

ra hydrocortisone plus 12 external cream Aveeno Anti-Itch Max St OTC; QL

ra hydrocortisone plus external creamCortizone-10 Intensive Healing

OTC; QL

ra isopropyl alcohol wipes external OTC

ra jock itch external cream Clotrimazole GRx OTC; QL

ra jock itch max st external aerosol powderOdor Eaters Foot/Sneaker Spray

OTC

ra lice bedding aerosol Licide OTC

ra lice maximum strength external shampoo Licide OTC

ra lice solution combination kit OTC; QL

ra lice treatment external lotion OTC; QL

ra lidocaine pain relieving external patch Aspercreme Lidocaine OTC

ra liquid bandage external liquid OTC

ra moisturizing oatmeal external lotion Cam OTC

ra pain relief external cream Aspercreme w/Lidocaine OTC

RA RENEWAL ACNE TREATMENT EXTERNAL GEL

OTC; QL

RA RENEWAL ADVANCED HEALING EXTERNAL OINTMENT

OTC

RA RENEWAL SHOWER & BATH EXTERNAL OIL

OTC

ra scalp itch/dandruff relief external liquid Psoriasin OTC

ra scar external gel Celacyn OTC

ra triple antibiotic external ointment Curad Triple Antibiotic OTC; QL

ra triple antibiotic plus external ointmentNeosporin + Pain Relief Max St

OTC; QL

ra vitamin a & d external ointment Curad Vitamin A & D OTC

ra vitamin e external oil OTC

ra vitamin e-vit a & d external cream OTC

105

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Drug Name Reference Notes

ra wart remover external gel Sal-Plant OTC

ra wart remover external solution Duofilm OTC

ra wart remover max strength external liquid Compound W OTC

ra zinc oxide external ointment OTC; QL

RADIADRES GEL SHEET EXTERNAL SHEET

OTC

recort plus external cream Aveeno Anti-Itch Max St OTC; QL

REGENECARE HA EXTERNAL GEL OTC

REGENECARE HA EXTERNAL LIQUID OTC

REGRANEX EXTERNAL GEL

RE-LIEVED MAXIMUM STRENGTH EXTERNAL PATCH

OTC

reliever external patch OTC

REMEDY ANTIFUNGAL EXTERNAL CREAM

OTC

REMEDY ANTIFUNGAL EXTERNAL POWDER

OTC

REMEDY PHYTOPLEX ANTIFUNGAL EXTERNAL POWDER

OTC

REMOVE ADHESIVE REMOVER EXTERNAL LIQUID

OTC

REPEL SPORTSMEN DRY EXTERNAL AEROSOL

OTC

REPEL SPORTSMEN EXTERNAL AEROSOL

OTC

REPEL SPORTSMEN MAX EXTERNAL AEROSOL

OTC

RESTORE CALCICARE DRESSING EXTERNAL

OTC

RESTORE SILVER DRESSING EXTERNAL

OTC

RESTORE SILVER DRESSING EXTERNAL PAD

RIAX EXTERNAL FOAM

RID COMPLETE LICE ELIMINATION COMBINATION KIT

OTC; QL

ROSADAN EXTERNAL CREAM QL

ROSADAN EXTERNAL GEL

SAF-CLENS AF EXTERNAL LIQUID OTC

SAL-PLANT EXTERNAL GEL OTC

106

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Drug Name Reference Notes

SAWYER INSECT REPELLENT EXTERNAL LIQUID

OTC

sb anti-fungal external cream Fungoid-D OTC

sb bacitracin external ointment Bacitraycin Plus OTC; QL

sb clotrimazole foot external cream Clotrimazole GRx OTC; QL

sb hydrocortisone external cream Aveeno Anti-Itch Max St OTC; QL

sb hydrocortisone max st external ointment Cortizone-10 OTC; QL

sb lice killing max st external shampoo Licide OTC

sb lice treatment external liquid Nix Creme Rinse OTC; QL

sb triple antibiotic external ointment Curad Triple Antibiotic OTC; QL

scalp relief maximum strength external solution

Scalpicin Maximum Strength

OTC

SCALPICIN MAXIMUM STRENGTH EXTERNAL SOLUTION

OTC

sebex external shampoo Sebulex OTC

selenium sulfide external lotion QL

SELSUN BLUE DAILY EXTERNAL LOTION

OTC

SELSUN BLUE DEEP CLEANSING EXTERNAL SHAMPOO

OTC

SELSUN BLUE MEDICATED EXTERNAL LOTION

OTC

SELSUN BLUE NATURALS DRY SCALP EXTERNAL SHAMPOO

OTC

SENSI-CARE PERINEAL/SKIN EXTERNAL LIQUID

OTC

SHOPKO ATHLETES FOOT EXTERNAL CREAM

OTC; QL

SILVASORB EXTERNAL GEL

silver sulfadiazine external cream SSD

SILVERMED EXTERNAL GEL OTC

SILVERMED EXTERNAL LIQUID OTC

SKINTEGRITY WOUND EXTERNAL LIQUID

OTC

sm antibiotic external ointment OTC; QL

sm antifungal clotrimazole external cream Clotrimazole GRx OTC; QL

sm antifungal miconazole external cream Carrington Antifungal OTC

sm antifungal tolnaftate external cream Fungoid-D OTC

sm arthricream rub external cream Aspercreme/Aloe OTC

107

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Drug Name Reference Notes

sm athletes foot external cream LamISIL AT OTC

sm bedding lice treatment aerosol Licide OTC

sm calamine external lotion OTC

sm calamine phenolated external lotion OTC

sm double antibiotic external ointment Neosporin OTC

sm glycerin external liquid OTC

sm hydrocortisone external cream OTC; QL

sm hydrocortisone external ointment OTC

sm hydrocortisone max st external ointment Cortizone-10 OTC; QL

sm hydrocortisone plus external creamCortizone-10 Intensive Healing

OTC; QL

sm hydrocortisone-aloe max st external cream

Cortizone-10 Intensive Healing

OTC; QL

sm lice killing external shampoo Licide Maximum Strength OTC; QL

sm lice killing max strength external shampoo

Licide OTC

sm lice solution kit combination kit CVS Lice Solution OTC; QL

sm lice treatment external lotion OTC; QL

sm oatmeal bath external packetAveeno Baby Bath Treatment

OTC

sm triple antibiotic external ointment Curad Triple Antibiotic OTC; QL

sm triple antibiotic max st external ointmentNeosporin + Pain Relief Max St

OTC; QL

sm triple antibiotic original external ointment Curad Triple Antibiotic OTC; QL

SOLARCAINE COOL ALOE EXTERNAL AEROSOL

OTC

SONAFINE EXTERNAL EMULSION

SOOTHE & COOL INZO ANTIFUNGAL EXTERNAL CREAM

OTC

SORBIDON HYDRATE EXTERNAL CREAM

OTC; QL

spinosad external suspension Natroba

SSD EXTERNAL CREAM

STIK-IT EXTERNAL LIQUID OTC

STIMULEN EXTERNAL POWDER OTC

stop lice complete treatment combination kit CVS Lice Solution OTC; QL

stop lice maximum strength external liquid Licide Maximum Strength OTC; QL

STRI-DEX MAXIMUM STRENGTH EXTERNAL PAD

OTC

108

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Drug Name Reference Notes

suction tube attachment device OTC

sure result sr relief external cream OTC

tacrolimus external ointment Protopic PA; AL; QL

TEGADERM AG MESH EXTERNAL PAD

TEGADERM HIGH GELLING ALGINATE EXTERNAL

OTC

TEGADERM HIGH INTEG ALGINATE EXTERNAL

OTC

TEGADERM HYDROCOLLOID EXTERNAL OTC

TEGADERM HYDROCOLLOID THIN EXTERNAL

OTC

terbinafine hcl external cream LamISIL AT OTC

TEXACORT EXTERNAL SOLUTION

tgt antifungal external cream Fungoid-D OTC

tgt antifungal spray powder external aerosol powder

Odor Eaters Foot/Sneaker Spray

OTC

tgt anti-itch plus oatmeal external cream Aveeno Anti-Itch Max St OTC; QL

tgt anti-itch/aloe/vit e external cream Aveeno Anti-Itch Max St OTC; QL

tgt athletes foot external cream LamISIL AT OTC

tgt clotrimazole external cream Clotrimazole GRx OTC; QL

tgt wart remover external liquid Compound W OTC

therabath external oil AlphaBath OTC

theracare pain relief external patch Aspercreme Lidocaine OTC

thera-derm external lotion Cam OTC

therapeutic t+plus max st external shampoo Dermarest Psoriasis OTC

THUM EXTERNAL LIQUID OTC

TINACTIN DEODORANT EXTERNAL AEROSOL POWDER

OTC

TINACTIN EXTERNAL AEROSOL POWDER

OTC

TINACTIN EXTERNAL CREAM OTC

TINACTIN JOCK ITCH EXTERNAL AEROSOL POWDER

OTC

TINEACIDE EXTERNAL CREAM OTC

tolnaftate antifungal external cream Fungoid-D OTC

tolnaftate external aerosol powderOdor Eaters Foot/Sneaker Spray

OTC

tolnaftate external cream Fungoid-D OTC

tolnaftate external powder Odor Eaters Antifungal OTC

109

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Drug Name Reference Notes

tretinoin (emollient) external cream Refissa PA; AL

tretinoin external cream Retin-A PA

tretinoin external gel Retin-A PA; QL

tretinoin microsphere external gel Retin-A Micro PA; AL; QL

triamcinolone acetonide external cream Triderm QL

triamcinolone acetonide external ointment QL

TRIANEX EXTERNAL OINTMENT QL

tri-biozene external ointmentNeosporin + Pain Relief Max St

OTC; QL

TRIDERM EXTERNAL CREAM 0.1 % QL

TRIDERM EXTERNAL CREAM 0.5 % PA; QL

triple antibiotic external ointment Curad Triple Antibiotic OTC; QL

triple antibiotic pain relief external ointmentNeosporin + Pain Relief Max St

OTC; QL

triple antibiotic plus external ointmentNeosporin + Pain Relief Max St

OTC; QL

triple antibiotic plus max st external ointmentNeosporin + Pain Relief Max St

OTC; QL

triple antibiotic+pain relief external ointmentNeosporin + Pain Relief Max St

OTC; QL

triple helix collagen 12" rope externalAquacel Hydrofiber 0.39"x18"

OTC

triple helix collagen external powder Arglaes OTC

ULTRA MIDE 25 EXTERNAL LOTION OTC

universal catheter access port OTC

UNNA-FLEX ELASTIC UNNA BOOT EXTERNAL

OTC

UNNA-FLEX PLUS VENOUS ULCER EXTERNAL KIT

OTC

urea 20 intensive hydrating external cream OTC

urea external cream QL

urea nail external gel Uramaxin

vertical drain/tube att device OTC

vitamin a & d external ointment Curad Vitamin A & D OTC

vitamin a&d external ointment Curad Vitamin A & D OTC

vitamin e external cream OTC

vitamin e skin external cream OTC

vitamin e skin external oil OTC

vitamins a & d external ointment Curad Vitamin A & D OTC

110

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Drug Name Reference Notes

wal-sporin external ointment Neosporin OTC

wart remover external gel Sal-Plant OTC

wart remover maximum strength external gel Sal-Plant OTC

wart remover maximum strength external liquid

Compound W OTC

wart remover maximum strength external strip

Compound W for Kids OTC

wound cleanser external liquid Atrapro Dermal Spray OTC

wound drainage collector OTC

XEROFORM OIL EMULSION 2"X2" EXTERNAL PAD

XEROFORM OIL EMULSION GAUZE EXTERNAL PAD

XEROFORM OIL EMULSION STRIP EXTERNAL

XEROFORM OIL ROLL 4"X9' EXTERNAL

XEROFORM PETROLAT GAUZE 1"X8" EXTERNAL

XEROFORM PETROLAT GAUZE 5"X9" EXTERNAL

XEROFORM PETROLAT PATCH 2"X2" EXTERNAL PAD

XEROFORM PETROLAT PATCH 4"X4" EXTERNAL PAD

XEROFORM PETROLATUM ROLL 4"X9' EXTERNAL

xolido external cream OTC

xolido xp external cream Aspercreme w/Lidocaine OTC

XOTEN-C EXTERNAL LOTION OTC

ZEASORB-AF EXTERNAL POWDER OTC

ZENATANE ORAL CAPSULE PA

zinc oxide external ointment Boudreauxs Butt Paste OTC; QL

ZOSTRIX HP EXTERNAL CREAM OTC

*DIAGNOSTIC PRODUCTS*

AZO TEST IN VITRO STRIP OTC

CHEMSTRIP K IN VITRO STRIP OTC; QL

cosyntropin injection solution reconstituted Cortrosyn

CVS KETONE CARE IN VITRO STRIP OTC

DIASTIX IN VITRO STRIP OTC; QL

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Drug Name Reference Notes

FORA GTEL BLOOD KETONE TEST IN VITRO STRIP

OTC; QL

GLUCAGEN DIAGNOSTIC INJECTION SOLUTION RECONSTITUTED

GOJJI BLOOD KETONE TEST IN VITRO STRIP

OTC

KETOSTIX IN VITRO STRIP OTC; QL

NOVA MAX PLUS KETONE TEST IN VITRO STRIP

OTC; QL

PRECISION XTRA KETONE IN VITRO STRIP

OTC; QL

PTS PANELS KETONE TEST IN VITRO STRIP

OTC; QL

RELION KETONE IN VITRO STRIP OTC; QL

RELION KETONE TEST IN VITRO STRIP OTC; QL

TRUE METRIX BLOOD GLUCOSE TEST IN VITRO STRIP

OTC; QL

TRUETEST TEST IN VITRO STRIP OTC; QL

urinary tract infection test in vitro strip Reveal Urinary Tract OTC

*DIETARY PRODUCTS/DIETARY MANAGEMENT PRODUCTS*

ACERFLEX ORAL POWDER OTC

BCAD 2 ORAL POWDER OTC

BRIGHT BEGINNINGS SOY ORAL LIQUID OTC

CYCLINEX-2 ORAL POWDER OTC

DUOCAL ORAL POWDER OTC

EGG/PRO ORAL POWDER OTC

ELECARE JR ORAL POWDER OTC

ENSURE MUSCLE HEALTH REVIGOR ORAL LIQUID

OTC

ENSURE NUTRITION SHAKE ORAL LIQUID

OTC

FOLBIC ORAL TABLET QL

GA ORAL POWDER OTC

GLUCERNA CEREAL ORAL OTC

GLUTAREX-2 ORAL POWDER OTC

HCY 2 ORAL POWDER OTC

HOM 2 ORAL POWDER OTC

HOMINEX-2 ORAL POWDER OTC

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Drug Name Reference Notes

IMMULIFE ORAL POWDER OTC

I-VALEX-2 ORAL POWDER OTC

KETOCAL 3:1 ORAL POWDER OTC

KETOCAL 4:1 LQ MULTI FIBER ORAL LIQUID

OTC

KETOCAL 4:1 ORAL LIQUID OTC

KETOCAL 4:1 ORAL POWDER OTC

KETONEX-2 ORAL POWDER OTC

KETOVOLVE 4:1 ORAL POWDER OTC

LIPISTART ORAL POWDER OTC

LMD ORAL POWDER OTC

l-methylfolate calcium oral tablet Elfolate

l-methylfolate oral tablet Elfolate

MCT PRO-CAL ORAL PACKET OTC

METHIONAID ORAL POWDER OTC

MSUD 2 ORAL POWDER OTC

MSUD AID ORAL POWDER OTC

MSUD MAXAMAID ORAL POWDER OTC

MSUD MAXAMUM ORAL POWDER OTC

NEOCATE JUNIOR ORAL POWDER OTC

NEOCATE JUNIOR PREBIOTICS ORAL POWDER

OTC

NEOCATE NUTRA ORAL POWDER OTC

NUTRA BALANCE FIBER COOKIE ORAL OTC

NUTRA BALANCE PROTEIN COOKIE ORAL

OTC

OA 1 ORAL POWDER OTC

OA 2 ORAL POWDER OTC

ORGANIC PEDIA SMART ORAL POWDER OTC

OS 2 ORAL POWDER OTC

PERIFLEX ADVANCE ORAL POWDER OTC

PERIFLEX JUNIOR ORAL POWDER OTC

PFD 1 ORAL POWDER OTC

PFD 2 ORAL POWDER OTC

PHENEX-1 ORAL POWDER OTC

PHENEX-2 ORAL POWDER OTC

PHENYLADE DRINK MIX ORAL POWDER OTC

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Drug Name Reference Notes

PHENYLADE ESSENTIAL DRINK MIX ORAL PACKET

OTC

PHENYLADE ESSENTIAL DRINK MIX ORAL POWDER

OTC

PHENYLADE ESSENTIAL MIX/FIBER ORAL PACKET

OTC

PHENYLADE ESSENTIAL MIX/FIBER ORAL POWDER

OTC

PHENYLADE60 DRINK MIX ORAL PACKET

OTC

PHENYLADE60 DRINK MIX ORAL POWDER

OTC

PHENYL-FREE 2 ORAL POWDER OTC

PHENYL-FREE 2HP ORAL POWDER OTC

PKU 2 ORAL POWDER OTC

PKU 3 ORAL POWDER OTC

PROPIMEX-2 ORAL POWDER OTC

PROSOURCE ORAL POWDER OTC

PROTEIN FORTIFIED COOKIE ORAL OTC

RE/GEN PROTEIN COOKIE ORAL OTC

RENASTART ORAL POWDER OTC

SCANDICAL ORAL POWDER OTC

SCANDISHAKE (ASPARTAME) ORAL PACKET

OTC

SCANDISHAKE ORAL OTC

SCANDISHAKE ORAL PACKET OTC

SCANDISHAKE ORAL POWDER OTC

sol carb oral powder Acerflex OTC

THICK-IT CHICKEN A LA KING ORAL OTC

THICK-IT MIXED FRUIT/BERRY ORAL OTC

THICK-IT PUREES BEEF LASAGNA ORAL

OTC

THICK-IT PUREES CHICKEN PATTY ORAL

OTC

THICK-IT PUREES FRENCH TOAST ORAL

OTC

THICK-IT PUREES SWEET CORN ORAL OTC

TYR COOLER ORAL LIQUID OTC

TYREX-2 ORAL POWDER OTC

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Drug Name Reference Notes

TYROS 2 ORAL POWDER OTC

UCD 2 ORAL POWDER OTC

UCD ANAMIX JUNIOR ORAL POWDER OTC

ucd trio oral powder Acerflex OTC

ultramino soy protein oral powder Acerflex OTC

WND 2 ORAL POWDER OTC

XLEU MAXAMAID ORAL POWDER OTC

XLEU MAXAMUM ORAL POWDER OTC

XLYS-XTRP MAXAMAID ORAL POWDER OTC

XLYS-XTRP MAXAMUM ORAL POWDER OTC

XMET MAXAMAID ORAL POWDER OTC

XMET MAXAMUM ORAL POWDER OTC

XMTVI MAXAMAID ORAL POWDER OTC

XMTVI MAXAMUM ORAL POWDER OTC

XPHE MAXAMAID ORAL POWDER OTC

XPHE-XTYR MAXAMAID ORAL POWDER OTC

*DIGESTIVE AIDS*

CREON ORAL CAPSULE DELAYED RELEASE PARTICLES 12000 UNIT, 24000-76000 UNIT, 6000 UNIT

QL

CREON ORAL CAPSULE DELAYED RELEASE PARTICLES 3000-9500 UNIT, 36000 UNIT

cvs dairy relief fast acting oral tablet Lactaid Fast Act OTC

cvs lactase oral tablet Lac-Dose OTC

dairy relief oral tablet Lac-Dose OTC

gnp dairy relief oral tablet Lac-Dose OTC

gnp fast acting dairy relief oral tablet chewable

Lactaid Fast Act OTC

kls fast acting lactase oral tablet Lactaid Fast Act OTC

LAC-DOSE ORAL TABLET OTC

lactase enzyme oral tablet Lac-Dose OTC

lactase fast acting oral tablet Lactaid Fast Act OTC

lactase oral tablet Lac-Dose OTC

lactose fast acting relief oral tablet Lactaid Fast Act OTC

lactose fast acting relief oral tablet chewable Lactaid Fast Act OTC

px dairy digestive oral tablet Lactaid Fast Act OTC

ra dairy aid oral tablet Lac-Dose OTC

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Drug Name Reference Notes

ra dairy relief fast acting oral tablet chewable Lactaid Fast Act OTC

sb lactase oral tablet Lac-Dose OTC

sm ultra dairy digestive oral tablet Lactaid Fast Act OTC

surelac oral tablet Lac-Dose OTC

tgt dairy digestive aid oral tablet Lactaid Fast Act OTC

*DIURETICS*

acetazolamide er oral capsule extended release 12 hour

acetazolamide oral tablet

amiloride hcl oral tablet

amiloride-hydrochlorothiazide oral tablet

bumetanide oral tablet Bumex

chlorothiazide oral tablet

chlorthalidone oral tablet

furosemide oral solution

furosemide oral tablet Lasix

hydrochlorothiazide oral capsule QL

hydrochlorothiazide oral tablet 12.5 mg QL

hydrochlorothiazide oral tablet 25 mg, 50 mg

indapamide oral tablet

methazolamide oral tablet

metolazone oral tablet

spironolactone oral tablet Aldactone

spironolactone-hctz oral tablet Aldactazide

torsemide oral tablet

triamterene-hctz oral capsule Dyazide

triamterene-hctz oral tablet Maxzide-25

*ENDOCRINE AND METABOLIC AGENTS - MISC.*

alendronate sodium oral solution QL

alendronate sodium oral tablet QL

cabergoline oral tablet QL

calcitonin (salmon) nasal solution Miacalcin

calcitriol oral capsule Rocaltrol PA

calcitriol oral solution Rocaltrol PA

clomiphene citrate oral tablet AL; QL

DDAVP RHINAL TUBE NASAL SOLUTION

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Drug Name Reference Notes

desmopressin ace spray refrig nasal solution

desmopressin acetate oral tablet DDAVP QL

desmopressin acetate spray nasal solution DDAVP

levocarnitine oral tablet Carnitor

octreotide acetate injection solution SandoSTATIN PA; SP

raloxifene hcl oral tablet Evista

sodium phenylbutyrate oral powder Buphenyl PA; SP; QL

sodium phenylbutyrate oral tablet Buphenyl PA; SP; QL

ZOMACTON SUBCUTANEOUS SOLUTION RECONSTITUTED

PA; SP; QL

*ESTROGENS*

AMABELZ ORAL TABLET

estradiol oral tablet Estrace

estradiol transdermal patch weekly Climara QL

estradiol-norethindrone acet oral tablet Amabelz

FYAVOLV ORAL TABLET

JINTELI ORAL TABLET

LOPREEZA ORAL TABLET

MIMVEY ORAL TABLET

norethindrone-eth estradiol oral tablet Fyavolv

PREMARIN ORAL TABLET QL

PREMPHASE ORAL TABLET

PREMPRO ORAL TABLET

*FLUOROQUINOLONES*

ciprofloxacin hcl oral tablet QL

levofloxacin oral solution QL

levofloxacin oral tablet Levaquin QL

ofloxacin oral tablet QL

*GASTROINTESTINAL AGENTS - MISC.*

balsalazide disodium oral capsule Colazal QL

BICARSIM FORTE ORAL TABLET OTC

calcium acetate (phos binder) oral capsule PhosLo

calcium acetate (phos binder) oral tablet Calphron

calcium acetate oral tablet Calphron

CALPHRON ORAL TABLET PA; OTC

cvs gas relief drops ex st oral liquid Gas-X Infant Drops OTC

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Drug Name Reference Notes

cvs gas relief extra strength oral capsule Gas-X Extra Strength OTC

cvs gas relief extra strength oral tablet chewable

Phazyme OTC

cvs gas relief infants oral suspensionLittle Remedies for Tummys

OTC

cvs gas relief oral capsule Gas-X Extra Strength OTC

cvs gas relief oral tablet chewable Gas-X OTC

cvs gas relief ultra strength oral capsule Gas-X Ultra Strength OTC

cvs infants gas relief oral suspensionLittle Remedies for Tummys

OTC

drxchoice gas relief oral tablet chewable Gas-X OTC

enulose oral solution QL

eq gas relief extra strength oral tablet chewable

Phazyme OTC

eq gas relief oral capsule Gas-X Extra Strength OTC

eq gas relief oral tablet chewable Phazyme OTC

eq infants gas relief oral suspensionLittle Remedies for Tummys

OTC

eql gas gone oral tablet chewable Phazyme OTC

eql gas relief oral capsule Gas-X Extra Strength OTC

eql gas relief ultra strength oral capsule Gas-X Ultra Strength OTC

eql infants gas relief oral suspensionLittle Remedies for Tummys

OTC

gas relief drops infants oral suspensionLittle Remedies for Tummys

OTC

gas relief extra strength oral capsule Gas-X Extra Strength OTC

gas relief extra strength oral tablet chewable Phazyme OTC

gas relief infants oral liquid Gas-X Infant Drops OTC

gas relief infants oral suspensionLittle Remedies for Tummys

OTC

gas relief oral capsule Gas-X Ultra Strength OTC

gas relief oral liquid Gas-X Infant Drops OTC

gas relief oral suspensionLittle Remedies for Tummys

OTC

gas relief oral tablet chewable Gas-X OTC

gas relief ultra strength oral capsule Gas-X Ultra Strength OTC

GAS-X EXTRA STRENGTH ORAL CAPSULE

OTC

GAS-X INFANT DROPS ORAL LIQUID OTC

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Drug Name Reference Notes

generlac oral solution QL

gnp anti-gas oral capsule Gas-X Ultra Strength OTC

gnp gas relief extra strength oral capsule Gas-X Extra Strength OTC

gnp gas relief extra strength oral tablet chewable

Phazyme OTC

gnp gas relief max st oral tablet chewable Phazyme OTC

gnp gas relief oral tablet chewable Gas-X OTC

gnp infant gas relief oral suspensionLittle Remedies for Tummys

OTC

gnp infants gas relief oral suspensionLittle Remedies for Tummys

OTC

goodsense gas relief oral tablet chewable Phazyme OTC

hm gas relief extra strength oral capsule Gas-X Extra Strength OTC

hm gas relief infants drops oral suspensionLittle Remedies for Tummys

OTC

hm gas relief oral tablet chewable Gas-X OTC

infants gas relief oral suspensionLittle Remedies for Tummys

OTC

infants simethicone oral suspensionLittle Remedies for Tummys

OTC

lactulose encephalopathy oral solution QL

lanthanum carbonate oral tablet chewable Fosrenol

LITTLE REMEDIES FOR TUMMYS ORAL SUSPENSION

OTC

LITTLE TUMMYS GAS RELIEF ORAL SUSPENSION

OTC

mesalamine er oral capsule extended release 24 hour

Apriso QL

mesalamine rectal enema QL

mesalamine-cleanser rectal kit Rowasa QL

metoclopramide hcl oral solution

metoclopramide hcl oral tablet Reglan

mi-acid gas relief oral tablet chewable Gas-X OTC

MOMMY'S BLISS GAS RELIEF DROPS ORAL SUSPENSION

OTC

mytab gas oral tablet chewable Gas-X OTC

PEDIACARE INFANTS GAS RELIEF ORAL SUSPENSION

OTC

PHAZYME ORAL TABLET CHEWABLE OTC

px gas relief extra strength oral capsule Gas-X Extra Strength OTC

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Drug Name Reference Notes

px gas relief infants oral suspensionLittle Remedies for Tummys

OTC

px gas relief ultra strength oral capsule Gas-X Ultra Strength OTC

qc anti-gas oral capsule Gas-X Ultra Strength OTC

qc gas relief extra strength oral tablet chewable

Phazyme OTC

qc gas relief oral capsule Gas-X Extra Strength OTC

qc gas relief oral tablet chewable Gas-X OTC

ra gas relief extra strength oral capsule Gas-X Extra Strength OTC

ra gas relief extra strength oral tablet chewable

Phazyme OTC

ra gas relief maximum strength oral tablet chewable

Phazyme OTC

ra gas relief oral capsule Gas-X Extra Strength OTC

ra gas relief oral suspensionLittle Remedies for Tummys

OTC

ra gas relief oral tablet chewable Gas-X OTC

ra gas relief/infants oral suspensionLittle Remedies for Tummys

OTC

sb gas relief oral suspensionLittle Remedies for Tummys

OTC

sb gas relief oral tablet chewable Phazyme OTC

sevelamer carbonate oral packet Renvela

sevelamer carbonate oral tablet Renvela QL

simeped oral suspensionLittle Remedies for Tummys

OTC

simethicone extra strength oral capsule Gas-X Extra Strength OTC

simethicone oral capsule Gas-X Ultra Strength OTC

simethicone oral suspensionLittle Remedies for Tummys

OTC

simethicone oral tablet chewable Phazyme OTC

sm gas relief antiflatuent oral capsule Gas-X Ultra Strength OTC

sm gas relief extra strength oral capsule Gas-X Extra Strength OTC

sm gas relief infants drops oral suspensionLittle Remedies for Tummys

OTC

sm gas relief infants oral suspensionLittle Remedies for Tummys

OTC

sm gas relief oral tablet chewable Gas-X OTC

sulfasalazine oral tablet Azulfidine QL

sulfasalazine oral tablet delayed release Azulfidine EN-tabs QL

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Drug Name Reference Notes

tgt gas relief extra strength oral capsule Gas-X Extra Strength OTC

tgt gas relief extra strength oral tablet chewable

Phazyme OTC

tgt gas relief infants oral liquid Gas-X Infant Drops OTC

ursodiol oral capsule Actigall

ursodiol oral tablet Urso 250

*GENITOURINARY AGENTS - MISCELLANEOUS*

alfuzosin hcl er oral tablet extended release 24 hour

Uroxatral QL

ARGYLE STERILE SALINE IRRIGATION SOLUTION

cvs urinary pain relief oral tablet AZO Urinary Pain Relief OTC

cytra k crystals oral packet Taron-Crystals

cytra-2 oral solution OTC

CYTRA-3 ORAL SYRUP OTC

cytra-k oral solution OTC

eq urinary pain relief oral tablet AZO Urinary Pain Relief OTC

finasteride oral tablet Proscar QL

gnp urinary pain relief oral tablet AZO Urinary Pain Relief OTC

PHENAZO ORAL TABLET

potassium citrate er oral tablet extended release

Urocit-K 10

potassium citrate-citric acid oral solution

ra urinary pain relief oral tablet AZO Urinary Pain Relief OTC

sm urinary pain relief oral tablet AZO Urinary Pain Relief OTC

sod citrate-citric acid oral solution

sodium chloride irrigation solution Argyle Sterile Saline

tamsulosin hcl oral capsule Flomax QL

TARON-CRYSTALS ORAL PACKET

tricitrates oral solution

urinary pain relief oral tablet AZO Urinary Pain Relief OTC

*GLYCOPEPTIDES***

vancomycin hcl oral capsule Vancocin HCl PA

*GOUT AGENTS*

allopurinol oral tablet Zyloprim

colchicine-probenecid oral tablet

probenecid oral tablet

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Drug Name Reference Notes

*HEMATOLOGICAL AGENTS - MISC.*

anagrelide hcl oral capsule Agrylin

BERINERT INTRAVENOUS KIT PA; SP; QL

cilostazol oral tablet

clopidogrel bisulfate oral tablet 300 mg

clopidogrel bisulfate oral tablet 75 mg Plavix QL

dipyridamole oral tablet

HAEGARDA SUBCUTANEOUS SOLUTION RECONSTITUTED

PA; SP; QL

icatibant acetate subcutaneous solution Firazyr PA; SP; QL

KALBITOR SUBCUTANEOUS SOLUTION PA; SP; QL

pentoxifylline er oral tablet extended release

RUCONEST INTRAVENOUS SOLUTION RECONSTITUTED

PA; SP; QL

*HEMATOPOIETIC AGENTS*

ABATRON AF ORAL TABLET OTC

AIRAVITE ORAL TABLET

ARANESP (ALBUMIN FREE) INJECTION SOLUTION

PA; SP; QL

ARANESP (ALBUMIN FREE) INJECTION SOLUTION PREFILLED SYRINGE 10 MCG/0.4ML, 100 MCG/0.5ML, 200 MCG/0.4ML, 25 MCG/0.42ML, 300 MCG/0.6ML, 40 MCG/0.4ML, 60 MCG/0.3ML

PA; SP

ARANESP (ALBUMIN FREE) INJECTION SOLUTION PREFILLED SYRINGE 150 MCG/0.3ML, 500 MCG/ML

PA; SP; QL

B-12 DOTS ORAL TABLET DISPERSIBLE OTC

b-12 oral tablet OTC

b-12 oral tablet extended release OTC

b-12 sublingual tablet sublingual OTC

b-12 tr oral tablet extended release OTC

b-12-sl sublingual tablet sublingual OTC

bp vit 3 oral capsule Taliva

BPROTECTED PEDIA IRON ORAL SOLUTION

OTC

CENTRATEX ORAL CAPSULE QL

cvs b-12 oral liquid OTC

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Drug Name Reference Notes

cvs b-12 oral tablet OTC

cvs b12 quick dissolve oral lozenge OTC

cvs b-12 sublingual tablet sublingual OTC

cvs folic acid oral tablet FA-8 OTC

cvs iron oral tablet FeroSul OTC; QL

cvs slow release iron oral tablet extended release

OTC

cvs vitamin b12 oral tablet OTC

cvs vitamin b-12 oral tablet OTC

cvs vitamin b12 oral tablet extended release OTC

cvs vitamin b-12 oral tablet extended release OTC

cvs vitamin b-12 sublingual tablet sublingual OTC

cyanocobalamin injection solution

cyanocobalamin sublingual tablet sublingual OTC

DROXIA ORAL CAPSULE

EPOGEN INJECTION SOLUTION PA; SP

eq slow-release iron oral tablet extended release

OTC

eql b-12 oral tablet OTC

eql carbonyl iron oral tablet Feosol Natural Release OTC

eql iron supplement therapy oral tablet FeroSul OTC; QL

eql slow release iron oral tablet extended release

OTC

eql vitamin b-12 oral tablet OTC

eql vitamin b-12 tr oral tablet extended release

OTC

FA-8 ORAL TABLET OTC

fabb oral tablet Virt-Gard

fa-vitamin b-6-vitamin b-12 oral tablet

fe c tab oral tablet Icar-C OTC

fe c tab plus oral tablet Icar-C Plus OTC; QL

fe tabs oral tablet delayed release OTC

FERATE ORAL TABLET OTC; QL

FERGON ORAL TABLET OTC; QL

FEROSUL ORAL TABLET OTC; QL

ferraplus 90 oral tablet

ferretts oral tablet OTC

ferrex 150 oral capsule Nu-Iron OTC

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Drug Name Reference Notes

ferric x-150 oral capsule Nu-Iron OTC

FERROCITE ORAL TABLET OTC

ferrotabs oral tablet Ferate OTC; QL

ferrous fumarate oral tablet Ferrocite OTC

ferrous gluconate oral tablet Ferate OTC; QL

ferrous sulfate er oral tablet extended release

OTC

ferrous sulfate iron oral tablet Feosol OTC; QL

ferrous sulfate oral elixir OTC

ferrous sulfate oral solution BProtected Pedia Iron OTC

ferrous sulfate oral tablet 27 mg OTC

ferrous sulfate oral tablet 325 (65 fe) mg FeroSul OTC; QL

ferrous sulfate oral tablet delayed release OTC; QL

ferrousul oral tablet FeroSul OTC; QL

folate oral tablet OTC

folbee oral tablet Airavite

folic acid injection solution

folic acid oral tablet 1 mg

folic acid oral tablet 400 mcg OTC

folic acid oral tablet 800 mcg FA-8 OTC

FOLIVANE-F ORAL CAPSULE

FOLIVANE-PLUS ORAL CAPSULE

folplex 2.2 oral tablet

FOLTABS 800 ORAL TABLET OTC

FULPHILA SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

gentle iron oral capsule OTC

gnp b-12 sublingual tablet sublingual OTC

gnp folic acid oral tablet OTC

gnp iron oral tablet FeroSul OTC; QL

gnp iron oral tablet extended release Slow Fe OTC

gnp slow release iron oral tablet extended release

OTC

gnp vitamin b-12 oral tablet OTC

gnp vitamin b-12 oral tablet extended release

OTC

gnp vitamin b-12 tr oral tablet extended release

OTC

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Drug Name Reference Notes

GOODSENSE IRON ORAL TABLET OTC; QL

HEMATOGEN FA ORAL CAPSULE

HEMAX ORAL TABLET OTC

hm folic acid oral tablet OTC

hm iron oral tablet Feosol OTC; QL

hm iron slow release oral tablet extended release

Slow Fe OTC

hm slow release iron oral tablet extended release

OTC

hm vitamin b12 oral tablet OTC

hm vitamin b-12 oral tablet OTC

hm vitamin b12 oral tablet extended release OTC

hm vitamin b-12 tr oral tablet extended release

OTC

hydroxocobalamin acetate intramuscular solution

iron (ferrous sulfate) oral tablet extended release

Slow Fe OTC

iron 100 plus oral tablet Icar-C Plus OTC; QL

iron 100/c oral tablet Icar-C OTC

iron 27 oral tablet Ferate OTC; QL

iron complex oral capsule Chromagen OTC

iron high-potency oral tablet FeroSul OTC; QL

iron high-potency oral tablet extended release

Slow Fe OTC

iron oral tablet FeroSul OTC; QL

iron slow release oral tablet extended release

OTC

iron supplement childrens oral solution BProtected Pedia Iron OTC

iron supplement oral elixir OTC

kp ferrous gluconate oral tablet OTC; QL

kp ferrous sulfate oral tablet FeroSul OTC; QL

kp folic acid oral tablet FA-8 OTC

kp vitamin b-12 oral tablet OTC

meijer ferrous sulfate oral tablet FeroSul OTC; QL

MILLGUARD ORAL TABLET OTC

MULTIGEN FOLIC ORAL TABLET

MULTIGEN ORAL TABLET

MULTIGEN PLUS ORAL TABLET

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Drug Name Reference Notes

myferon 150 oral capsule Nu-Iron OTC

na ferric gluc cplx in sucrose intravenous solution

Ferrlecit

nat-rul iron oral tablet FeroSul OTC; QL

NEULASTA ONPRO SUBCUTANEOUS PREFILLED SYRINGE KIT

PA; SP; QL

NEULASTA SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

NUFOL ORAL TABLET

NU-IRON ORAL CAPSULE OTC

pa vitamin b-12 tr oral tablet extended release

OTC

POLY-IRON 150 ORAL CAPSULE OTC

polysaccharide iron complex oral capsule Nu-Iron OTC

px folic acid oral tablet OTC

px iron oral tablet 200 (65 fe) mg Feosol OTC; QL

px iron oral tablet 27 mg OTC

qc ferrous sulfate oral tablet FeroSul OTC; QL

qc folic acid oral tablet FA-8 OTC

qc vitamin b12 oral tablet OTC

qc vitamin b12 oral tablet extended release OTC

qc vitamin b12 sublingual tablet sublingual OTC

ra folic acid oral tablet OTC

ra high potency iron oral tablet OTC

ra iron oral tablet 27 mg OTC

ra iron oral tablet 325 (65 fe) mg FeroSul OTC; QL

ra slow release iron oral tablet extended release

OTC

ra vitamin b-12 oral tablet OTC

ra vitamin b12 oral tablet extended release OTC

ra vitamin b-12 oral tablet extended release OTC

ra vitamin b-12 tr oral tablet extended release

OTC

RETACRIT INJECTION SOLUTION PA; SP

slow iron oral tablet extended release OTC

slow release iron oral tablet extended release

OTC

sm folic acid oral tablet OTC

sm iron oral tablet FeroSul OTC; QL

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Drug Name Reference Notes

sm iron slow release oral tablet extended release

OTC

sm slow release iron oral tablet extended release

Slow Fe OTC

sm vitamin b-12 oral tablet OTC

sm vitamin b12 tr oral tablet extended release

OTC

sv vitamin b-12 er oral tablet extended release

OTC

TALIVA ORAL CAPSULE

taron forte oral capsule

VIRT-GARD ORAL TABLET

VITAMEZ ORAL CAPSULE

vitamin b 12 oral tablet OTC

vitamin b-12 er oral tablet extended release OTC

vitamin b-12 oral liquid OTC

vitamin b-12 oral lozenge OTC

vitamin b12 oral tablet OTC

vitamin b-12 oral tablet OTC

vitamin b12 oral tablet extended release OTC

vitamin b12 sublingual liquid OTC

vitamin b-12 sublingual liquid OTC

vitamin b-12 sublingual tablet sublingual OTC

vitamin b12 tr oral tablet extended release OTC

wee care oral suspension Icar OTC; QL

yl folic acid oral tablet OTC

ZARXIO INJECTION SOLUTION PREFILLED SYRINGE

PA; SP

*HEMOSTATICS*

aminocaproic acid oral solution Amicar OTC

aminocaproic acid oral tablet Amicar QL

tranexamic acid oral tablet Lysteda QL

*HEPATITIS C AGENT - COMBINATIONS***

MAVYRET ORAL TABLET PA; SP; QL

sofosbuvir-velpatasvir oral tablet Epclusa PA; SP; QL

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Drug Name Reference Notes

*HYPNOTICS*

acetaminophen pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

acetaminophen pm oral tabletHealthy Mama eaZZZe the Pain

OTC

compoz oral tablet Nytol Maximum Strength OTC

cvs ibuprofen pm oral tablet Motrin PM OTC

cvs non-aspirin headache pm oral tablet Excedrin PM OTC

cvs pain relief pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

cvs sleep aid nighttime oral capsule Unisom Sleepgels OTC

cvs sleep aid nighttime oral tablet Nytol OTC

cvs sleep aid oral tablet Nytol OTC

cvs sleep-aid nighttime oral tablet Unisom SleepTabs OTC

cvs ultra sleep oral tablet Unisom SleepTabs OTC

diphenhydramine hcl (sleep) oral tablet Nytol Maximum Strength OTC

eq acetaminophen pm oral tabletHealthy Mama eaZZZe the Pain

OTC

eq ibuprofen pm oral tablet Motrin PM OTC

eq nighttime sleep aid max st oral capsule Unisom Sleepgels OTC

eq nighttime sleep aid oral tablet Nytol OTC

eql acetaminophen pm oral tabletHealthy Mama eaZZZe the Pain

OTC

eql ibuprofen pm oral tablet Motrin PM OTC

eql nighttime sleep aid oral tablet Nytol OTC

eql pain relief pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

eql sleep aid oral capsule Unisom Sleepgels OTC

eql sleep aid oral tablet Unisom SleepTabs OTC

estazolam oral tablet

flurazepam hcl oral capsule QL

gnp headache pm oral tabletHealthy Mama eaZZZe the Pain

OTC

gnp ibuprofen pm oral tablet Motrin PM OTC

gnp nighttime sleep aid oral tablet Nytol OTC

gnp pain relief pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

gnp sleep aid oral tablet Unisom SleepTabs OTC

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Drug Name Reference Notes

goodsense headache pm oral tabletHealthy Mama eaZZZe the Pain

OTC

goodsense ibuprofen pm oral tablet Motrin PM OTC

goodsense pain relief pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

headache pm oral tabletHealthy Mama eaZZZe the Pain

OTC

headache relief pm oral tablet Excedrin PM OTC

hm acetaminophen pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

hm ibuprofen pm oral tablet Motrin PM OTC

hm nighttime sleep aid oral tablet Nytol OTC

hm pain reliever pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

hm sleep aid oral tablet Unisom SleepTabs OTC

ibuprofen pm oral tablet Motrin PM OTC

kls sleep aid oral tablet Unisom SleepTabs OTC

mapap pm oral tabletHealthy Mama eaZZZe the Pain

OTC

MOTRIN PM ORAL TABLET OTC

night time sleep aid oral tablet Nytol OTC

nighttime sleep aid oral tablet Nytol OTC

NYTOL ORAL TABLET OTC

ormir oral capsule Unisom Sleepgels OTC

pain relief pm extra strength oral tabletHealthy Mama eaZZZe the Pain

OTC

pain reliever pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

pain reliever pm oral tabletHealthy Mama eaZZZe the Pain

OTC

phenobarbital oral elixir

phenobarbital oral solution

phenobarbital oral tablet 100 mg, 15 mg, 16.2 mg, 60 mg, 64.8 mg, 97.2 mg

phenobarbital oral tablet 30 mg, 32.4 mg QL

px pain relief pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

qc headache relief pm oral tablet Excedrin PM OTC

qc rest simply oral tablet Nytol OTC

qc sleep aid max st oral capsule Unisom Sleepgels OTC

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Drug Name Reference Notes

ra acetaminophen pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

ra ibuprofen pm oral tablet Motrin PM OTC

ra night sleep aid oral tablet Unisom SleepTabs OTC

ra nighttime sleep aid oral tablet Nytol OTC

ra pain reliever pm oral tablet Excedrin PM OTC

ra sleep aid (diphenhydramine) oral tablet Nytol OTC

ra sleep aid oral capsule Unisom Sleepgels OTC

ra sleep aid oral tablet Unisom SleepTabs OTC

sb non-aspirin nighttime oral tabletHealthy Mama eaZZZe the Pain

OTC

sb sleep oral tablet Nytol OTC

SIMPLY SLEEP ORAL TABLET OTC

sleep aid (diphenhydramine) oral tablet Nytol OTC

sleep aid oral tablet Unisom SleepTabs OTC

sleep ii oral tablet Nytol OTC

sleep tabs oral tablet Nytol OTC

sleep-tabs oral tablet Nytol OTC

sm headache relief pm oral tablet Excedrin PM OTC

sm ibuprofen pm oral tablet Motrin PM OTC

sm nighttime sleep aid oral tablet Nytol OTC

sm pain reliever pm ex st oral tabletHealthy Mama eaZZZe the Pain

OTC

sm sleep aid oral tablet Unisom SleepTabs OTC

temazepam oral capsule Restoril QL

tetra-formula nighttime sleep oral tablet Nytol Maximum Strength OTC

tgt ibuprofen pm oral tablet Motrin PM OTC

tgt nighttime sleep aid oral tablet Nytol OTC

tgt sleep aid max strength oral capsule Unisom Sleepgels OTC

triazolam oral tablet Halcion QL

wal-som maximum strength oral capsule Unisom Sleepgels OTC

wal-som oral tablet Unisom SleepTabs OTC

zaleplon oral capsule QL

zolpidem tartrate oral tablet Ambien QL

*LAXATIVES*

ALOPHEN ORAL TABLET DELAYED RELEASE

OTC; QL

bisacodyl ec oral tablet delayed release Alophen OTC; QL

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Drug Name Reference Notes

bisacodyl laxative rectal suppository The Magic Bullet OTC

bisacodyl rectal suppository The Magic Bullet OTC

chocolated laxative oral tablet chewable OTC

citrate of magnesia oral solution Citroma OTC

CITROMA ORAL SOLUTION OTC

clear fiber powder oral powder OTC

CLEARLAX ORAL POWDER OTC

COLACE 2-IN-1 ORAL TABLET OTC

constulose oral solution QL

correct oral tablet delayed release Alophen OTC; QL

CORRECTOL ORAL TABLET DELAYED RELEASE

OTC; QL

cvs bisacodyl oral tablet delayed release Alophen OTC; QL

cvs bisacodyl rectal suppository The Magic Bullet OTC

cvs chocolate laxative pieces oral tablet chewable

OTC

cvs citrate of magnesia oral solution Citroma OTC

cvs c-lax laxative oral tablet delayed release Alophen OTC; QL

cvs easy fiber oral powder OTC

cvs enema disposable rectal enema Pure & Gentle Enema OTC

cvs enema ready-to-use rectal enema Pure & Gentle Enema OTC

cvs epsom salt oral granules OTC

cvs fiber laxative oral tablet FiberCon OTC

cvs fiber oral capsule Reguloid OTC

cvs gentle laxative oral tablet delayed release

Alophen OTC; QL

cvs gentle laxative rectal suppository The Magic Bullet OTC

cvs gentle laxative womens oral tablet delayed release

Alophen OTC; QL

cvs glycerin adult rectal suppository OTC

cvs glycerin child rectal suppository Pedia-Lax OTC

cvs laxative dietary supplemnt oral tablet Phillips OTC

cvs laxative pills oral tablet OTC; QL

cvs magnesium citrate oral solution Citroma OTC

cvs milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

cvs mineral oil enema rectal enema Fleet Oil OTC

cvs mineral oil oral oil OTC

cvs natural fiber supplement oral packet OTC

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Drug Name Reference Notes

CVS PURELAX ORAL PACKET OTC; QL

CVS PURELAX ORAL POWDER OTC

cvs senna oral tabletDr Edwards Olive Laxative

OTC

cvs senna plus oral tablet Colace 2-IN-1 OTC

cvs senna-extra oral tablet Senokot Extra Strength OTC

cvs soluble fiber therapy oral tablet Citrucel OTC

cvs stool softener oral capsule 100 mg Docusil OTC; QL

cvs stool softener oral capsule 240 mg Kao-Tin OTC

cvs stool softener oral capsule 250 mg DOK OTC

cvs stool softener oral capsule 50 mg Colace Clear OTC

cvs stool softener/laxative oral tablet Colace 2-IN-1 OTC

daily fiber oral powder Reguloid OTC

diocto oral liquid OTC

diocto oral syrup OTC

docqlace oral capsule Docusil OTC; QL

DOC-Q-LAX ORAL TABLET OTC

docu oral liquid OTC

docu soft oral capsule Docusil OTC; QL

docuprene oral tablet DOK OTC

docusate calcium oral capsule Kao-Tin OTC

docusate mini rectal enema DocuSol Mini OTC

docusate sodium oral capsule 100 mg Docusil OTC; QL

docusate sodium oral capsule 250 mg DOK OTC

docusate sodium oral liquid OTC

docusate sodium oral syrup OTC

docusate sodium oral tablet DOK OTC

DOCUSIL ORAL CAPSULE OTC; QL

docuzen oral tablet Colace 2-IN-1 OTC

DOK ORAL CAPSULE 100 MG OTC; QL

DOK ORAL CAPSULE 250 MG OTC

DOK ORAL TABLET OTC

DOK PLUS ORAL TABLET OTC

DOVER ENEMA BAG AND TUBE 24FR RECTAL KIT

OTC

DR EDWARDS OLIVE LAXATIVE ORAL TABLET

OTC

dss oral capsule DOK OTC

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Drug Name Reference Notes

ducodyl oral tablet delayed release Alophen OTC; QL

DULCOLAX MILK OF MAGNESIA ORAL SUSPENSION

OTC

DULCOLAX STOOL SOFTENER ORAL CAPSULE

OTC; QL

easy-lax oral capsule Docusil OTC; QL

easy-lax plus oral tablet Colace 2-IN-1 OTC

enema disposable rectal enema Pure & Gentle Enema OTC

enema mineral oil rectal enema Fleet Oil OTC

enema ready-to-use rectal enema Pure & Gentle Enema OTC

enema rectal enema Pure & Gentle Enema OTC

epsom salt oral granules OTC

EQ CLEARLAX ORAL POWDER OTC

eq daily fiber oral capsule Reguloid OTC

eq enema rectal enema Pure & Gentle Enema OTC

eq fiber supplement oral tablet chewable Fiber Select Gummies OTC

eq fiber therapy oral capsule Reguloid OTC

eq fiber therapy oral tablet Citrucel OTC

eq gentle laxative oral tablet delayed release Alophen OTC; QL

eq laxative maximum strength oral tablet OTC; QL

eq laxative oral tablet chewable OTC

eq magnesium citrate oral solution Citroma OTC

eq mineral oil oral oil OTC

eq natural laxative oral tabletDr Edwards Olive Laxative

OTC

eq natural vegetable laxative oral tabletDr Edwards Olive Laxative

OTC

eq senna-s oral tablet Colace 2-IN-1 OTC

eq stool softener oral capsule 100 mg Docusil OTC; QL

eq stool softener oral capsule 250 mg DOK OTC

eq stool softener/laxative oral tablet Colace 2-IN-1 OTC

eq vegetable laxative oral tabletDr Edwards Olive Laxative

OTC

eq womens laxative oral tablet delayed release

Alophen OTC; QL

EQL CLEARLAX ORAL POWDER OTC

eql epsom salt granules OTC; QL

eql fiber supplement oral powder OTC

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Drug Name Reference Notes

eql fiber therapy oral tablet Citrucel OTC

eql gentle laxative oral tablet delayed release

Alophen OTC; QL

eql laxative maximum strength oral tablet OTC; QL

eql laxative oral tablet OTC; QL

eql laxative oral tablet chewable OTC

eql laxative oral tablet delayed release Alophen OTC; QL

eql magnesium citrate oral solution Citroma OTC

eql milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

eql ready-to-use enema rectal enema Pure & Gentle Enema OTC

eql senna laxative oral tabletDr Edwards Olive Laxative

OTC

eql senna-s oral tablet Colace 2-IN-1 OTC

eql smooth texture fiber oral powder Reguloid OTC

eql stool softener oral capsule Docusil OTC; QL

eql stool softener/stimulant oral tablet Colace 2-IN-1 OTC

EVAC-U-GEN ORAL TABLET OTC

EX-LAX ULTRA ORAL TABLET DELAYED RELEASE

OTC; QL

FEENAMINT ORAL TABLET DELAYED RELEASE

OTC; QL

fiber (corn dextrin) oral powder OTC

fiber laxative oral tablet FiberCon OTC

fiber oral powder SolFiber OTC

fiber oral tablet FiberCon OTC

fiber therapy oral powder Reguloid OTC

fiber therapy oral tablet Citrucel OTC

fiber-lax oral tablet FiberCon OTC

gavilax oral powder ClearLax OTC

GAVILYTE-C ORAL SOLUTION RECONSTITUTED

QL

GAVILYTE-G ORAL SOLUTION RECONSTITUTED

QL

GAVILYTE-N WITH FLAVOR PACK ORAL SOLUTION RECONSTITUTED

QL

gentle laxative oral tablet delayed release Alophen OTC; QL

gentle laxative rectal suppository The Magic Bullet OTC

gentlelax oral powder ClearLax OTC

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Drug Name Reference Notes

geri-kot oral tabletDr Edwards Olive Laxative

OTC

glycerin (adult) rectal suppository OTC

glycerin (infants & children) rectal suppository

Pedia-Lax OTC

glycerin (pediatric) rectal suppository Pedia-Lax OTC

glycerin adult rectal suppository OTC

glycerin childrens rectal suppository Pedia-Lax OTC

GLYCOLAX ORAL POWDER OTC

GNP BISA-LAX ORAL TABLET DELAYED RELEASE

OTC; QL

GNP CLEARLAX ORAL PACKET OTC; QL

GNP CLEARLAX ORAL POWDER OTC

gnp enema rectal enema Pure & Gentle Enema OTC

gnp epsom salt oral granules OTC

gnp fiber therapy oral tablet Citrucel OTC

gnp fiber-caps oral tablet FiberCon OTC

gnp gentle laxative oral tablet delayed release

Alophen OTC; QL

gnp gentle laxative rectal suppository The Magic Bullet OTC

gnp glycerin (adult) rectal suppository OTC

gnp glycerin child rectal suppository OTC

gnp laxative oral tablet delayed release Alophen OTC; QL

gnp laxative pills oral tablet OTC; QL

gnp laxative rectal suppository The Magic Bullet OTC

gnp magnesium citrate oral solution Citroma OTC

gnp milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

gnp natural fiber oral capsule Reguloid OTC

gnp natural fiber oral powder Reguloid OTC

gnp senna lax oral tabletDr Edwards Olive Laxative

OTC

gnp senna plus oral tablet Colace 2-IN-1 OTC

gnp senna-lax oral tabletDr Edwards Olive Laxative

OTC

gnp stool softener oral capsule 100 mg Docusil OTC; QL

gnp stool softener oral capsule 250 mg DOK OTC

gnp stool softener oral liquid OTC

gnp stool softener oral syrup OTC

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Drug Name Reference Notes

gnp stool softener/laxative oral tablet Colace 2-IN-1 OTC

gnp womens gentle laxative oral tablet delayed release

Alophen OTC; QL

gnp womens laxative oral tablet delayed release

Alophen OTC; QL

goodsense bisacodyl ec oral tablet delayed release

Alophen OTC; QL

GOODSENSE CLEARLAX ORAL POWDER

OTC

goodsense enema rectal enema Pure & Gentle Enema OTC

goodsense fiber oral tablet Citrucel OTC

goodsense laxative pills oral tablet OTC; QL

goodsense magnesium citrate oral solution Citroma OTC

goodsense mineral oil oral oil OTC

goodsense psyllium fiber oral powder Reguloid OTC

goodsense senna laxative oral tabletDr Edwards Olive Laxative

OTC

goodsense stimulant laxative oral tablet Colace 2-IN-1 OTC

goodsense womens laxative oral tablet delayed release

Alophen OTC

HEALTHYLAX ORAL PACKET OTC; QL

HM CLEARLAX ORAL PACKET OTC; QL

HM CLEARLAX ORAL POWDER OTC

hm enema mineral oil rectal enema Fleet Oil OTC

hm enema rectal enema Pure & Gentle Enema OTC

hm fiber oral capsule Reguloid OTC

hm fiber oral powder Reguloid OTC

hm fiber oral tablet Citrucel OTC

hm fiber powder oral powder Reguloid OTC

hm laxative oral tablet delayed release Alophen OTC; QL

hm laxative rectal suppository The Magic Bullet OTC

hm magnesium citrate oral solution Citroma OTC

hm milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

hm mineral oil oral oil OTC

hm senna oral tabletDr Edwards Olive Laxative

OTC

hm senna-s oral tablet Colace 2-IN-1 OTC

hm stool softener oral capsule 100 mg Docusil OTC; QL

hm stool softener oral capsule 250 mg DOK OTC

136

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Drug Name Reference Notes

hm stool softener oral tablet DOK OTC

hm stool softener/laxative oral tablet Colace 2-IN-1 OTC

KAO-TIN ORAL CAPSULE OTC

kls fiber-tabs oral tablet FiberCon OTC

KLS LAXACLEAR ORAL POWDER OTC

konsyl daily fiber oral powder Reguloid OTC

kp bisacodyl oral tablet delayed release Alophen OTC; QL

kp senna oral tabletDr Edwards Olive Laxative

OTC

ks stool softener oral capsule Docusil OTC; QL

lactulose oral solution QL

laxacin oral tablet Colace 2-IN-1 OTC

laxative max str oral tablet OTC; QL

laxative oral tablet delayed release Alophen OTC; QL

laxative pills oral tablet 15 mg Medi-Lax OTC

laxative pills oral tablet 25 mg OTC; QL

laxative rectal suppository The Magic Bullet OTC

laxative regular strength oral tablet Medi-Lax OTC

magnesium citrate oral solution Citroma OTC

MEDI-LAX ORAL TABLET OTC

medi-laxx oral capsule OTC

medi-natural oral tabletDr Edwards Olive Laxative

OTC

medi-natural plus oral tablet Colace 2-IN-1 OTC

milk of magnesia concentrate oral suspension

OTC

milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

mineral oil oral oil OTC

mm stool softener laxative oral capsule Docusil OTC; QL

natural fiber therapy oral powder Reguloid OTC

natural senna laxative oral tabletDr Edwards Olive Laxative

OTC

peg 3350 oral packet CVS Purelax OTC; QL

peg 3350 oral powder ClearLax OTC

peg 3350-kcl-na bicarb-nacl oral solution reconstituted

GaviLyte-N with Flavor Pack

QL

peg-3350/electrolytes oral solution reconstituted

GaviLyte-G QL

137

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Drug Name Reference Notes

PHILLIPS MILK OF MAGNESIA ORAL SUSPENSION

OTC

polyethylene glycol 3350 oral packet CVS Purelax OTC; QL

polyethylene glycol 3350 oral powder ClearLax OTC

PROMOLAXIN ORAL TABLET OTC

PURE & GENTLE ENEMA RECTAL ENEMA

OTC

px docusate sodium oral capsule Docusil OTC; QL

px fiber oral capsule Reguloid OTC

px fiber oral tablet FiberCon OTC

px glycerin rectal suppository OTC

px laxative oral tablet delayed release Alophen OTC; QL

px milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

px vegetable laxative oral tabletDr Edwards Olive Laxative

OTC

qc enema rectal enema Pure & Gentle Enema OTC

qc fiber laxative oral capsule Reguloid OTC

qc fiber therapy oral tablet Citrucel OTC

qc gentle laxative oral tablet delayed release Alophen OTC; QL

qc gentle laxative rectal suppository The Magic Bullet OTC

qc laxative oral tablet OTC; QL

qc magnesium citrate oral solution Citroma OTC

qc milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

qc mineral oil heavy oral oil OTC

qc natural vegetable laxative oral tabletDr Edwards Olive Laxative

OTC

qc natural vegetable oral powder Hydrocil OTC

qc senna oral tabletDr Edwards Olive Laxative

OTC

qc senna-s oral tablet Colace 2-IN-1 OTC

qc stool softener pls laxative oral tablet Colace 2-IN-1 OTC

ra col-rite oral capsule 100 mg Docusil OTC; QL

ra col-rite oral capsule 250 mg DOK OTC

ra col-rite oral capsule 50 mg Colace Clear OTC

ra enema rectal enema Pure & Gentle Enema OTC

ra epsom salt granules OTC; QL

ra epsom salt oral granules OTC

ra fast relief laxative rectal suppository The Magic Bullet OTC

138

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Drug Name Reference Notes

ra fiber laxative oral powder Reguloid OTC

ra fiber oral capsule Reguloid OTC

ra fiber oral powder Reguloid OTC

ra fiber supplement oral powder Reguloid OTC

ra fiber therapy oral capsule Reguloid OTC

ra glycerin adult rectal suppository OTC

ra glycerin child rectal suppository OTC

ra laxative & stool softener oral tablet Colace 2-IN-1 OTC

ra laxative extra strength oral tablet Senokot Extra Strength OTC

ra laxative maximum strength oral tablet OTC; QL

ra laxative oral packet CVS Purelax OTC; QL

ra laxative oral powder ClearLax OTC

ra laxative oral tablet OTC; QL

ra laxative oral tablet chewable OTC

ra laxative oral tablet delayed release Alophen OTC; QL

ra magnesium citrate oral solution Citroma OTC

ra milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

ra mineral oil oral oil OTC

ra p col-rite oral tablet Colace 2-IN-1 OTC

ra saline enema rectal enema Pure & Gentle Enema OTC

ra senna oral capsule OTC

ra senna oral tabletDr Edwards Olive Laxative

OTC

ra senna plus oral tablet Colace 2-IN-1 OTC

ra soluble fiber oral tablet Citrucel OTC

ra stimulant laxative rectal suppository The Magic Bullet OTC

ra stool softener oral capsule Docusil OTC; QL

ra womens laxative oral tablet delayed release

Alophen OTC; QL

REGULOID ORAL CAPSULE OTC

REGULOID ORAL POWDER OTC

sb bisacodyl laxative ec oral tablet delayed release

Alophen OTC; QL

sb docusate sodium oral capsule Docusil OTC; QL

sb docusate sodium/senna oral tablet Colace 2-IN-1 OTC

sb gentle lax-women oral tablet delayed release

Alophen OTC; QL

sb glycerin adult rectal suppository OTC

139

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Drug Name Reference Notes

sb laxative rectal suppository The Magic Bullet OTC

sb magnesium citrate oral solution Citroma OTC

sb milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

sb senna-lax oral tabletDr Edwards Olive Laxative

OTC

SENEXON-S ORAL TABLET OTC

senna lax oral tabletDr Edwards Olive Laxative

OTC

senna laxative oral tablet 25 mg OTC; QL

senna laxative oral tablet 8.6 mgDr Edwards Olive Laxative

OTC

senna oral capsule OTC

senna oral liquid OTC

senna oral syrup OTC

senna oral tabletDr Edwards Olive Laxative

OTC

senna plus oral capsule OTC

senna plus oral tablet Colace 2-IN-1 OTC

senna s oral tablet Colace 2-IN-1 OTC

SENNA SMOOTH ORAL TABLET OTC

senna-docusate sodium oral tablet Colace 2-IN-1 OTC

senna-grx oral syrup OTC

senna-lax oral tabletDr Edwards Olive Laxative

OTC

senna-plus oral tablet Colace 2-IN-1 OTC

senna-s oral tablet Colace 2-IN-1 OTC

senna-tabs oral tabletDr Edwards Olive Laxative

OTC

senna-time oral tabletDr Edwards Olive Laxative

OTC

senna-time s oral tablet Colace 2-IN-1 OTC

sennazon oral syrup OTC

SENNO ORAL TABLET OTC

sennosides-docusate sodium oral tablet Colace 2-IN-1 OTC

silace oral liquid OTC

silace oral syrup OTC

SM CLEARLAX ORAL POWDER OTC

sm docusate calcium oral capsule Kao-Tin OTC

sm enema rectal enema Pure & Gentle Enema OTC

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Drug Name Reference Notes

sm epsom salt oral granules OTC

sm fiber laxative oral tablet Citrucel OTC

sm fiber oral capsule Reguloid OTC

sm fiber oral powder Reguloid OTC

sm fiber oral tablet FiberCon OTC

sm fiber powder oral powder Reguloid OTC

sm gentle laxative oral tablet delayed release

Alophen OTC; QL

sm glycerin pediatric rectal suppository OTC

sm laxative maximum strength oral tablet OTC; QL

sm laxative rectal suppository The Magic Bullet OTC

sm magnesium citrate oral solution Citroma OTC

sm milk of magnesia oral suspension Dulcolax Milk of Magnesia OTC

sm mineral oil oral oil OTC

sm natural laxative/stool soft oral tablet Colace 2-IN-1 OTC

sm senna laxative oral tabletDr Edwards Olive Laxative

OTC

sm senna-s oral tablet Colace 2-IN-1 OTC

sm stool softener oral capsule 100 mg Docusil OTC; QL

sm stool softener oral capsule 240 mg Kao-Tin OTC

sm stool softener oral capsule 250 mg DOK OTC

sm stool softener oral tablet Colace 2-IN-1 OTC

sm stool softener/laxative oral tablet Colace 2-IN-1 OTC

SMOOTH LAX ORAL PACKET OTC; QL

SMOOTH LAX ORAL POWDER OTC

SOLUBLE FIBER THERAPY ORAL POWDER

OTC

stimulant laxative oral tablet Colace 2-IN-1 OTC

stimulant laxative oral tablet delayed release Alophen OTC; QL

stool softener laxative oral capsule 100 mg Docusil OTC; QL

stool softener laxative oral capsule 250 mg DOK OTC

stool softener laxative oral tablet Colace 2-IN-1 OTC

stool softener oral capsule 100 mg Docusil OTC; QL

stool softener oral capsule 240 mg Kao-Tin OTC

stool softener oral capsule 250 mg DOK OTC

stool softener oral liquid OTC

stool softener oral tablet DOK OTC

stool softener plus laxative oral tablet Colace 2-IN-1 OTC

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Drug Name Reference Notes

stool softener/laxative oral capsule OTC

stool softener/laxative oral tablet Colace 2-IN-1 OTC

SURFAK ORAL CAPSULE OTC

tgt fiber therapy oral powder Reguloid OTC

tgt gentle laxative oral tablet delayed release Alophen OTC; QL

tgt laxative pills max st oral tablet OTC; QL

tgt natural laxative pills oral tablet OTC; QL

TGT POWDERLAX ORAL PACKET OTC; QL

tgt psyllium fiber oral capsule Reguloid OTC

tgt saline laxative rectal enema Pure & Gentle Enema OTC

tgt senna laxative oral tablet Colace 2-IN-1 OTC

tgt senna oral tabletDr Edwards Olive Laxative

OTC

tgt stool softener & stimulant oral tablet Colace 2-IN-1 OTC

tgt womens laxative oral tablet delayed release

Alophen OTC; QL

THE MAGIC BULLET RECTAL SUPPOSITORY

OTC

TRILYTE ORAL SOLUTION RECONSTITUTED

QL

vegetable lax+stool softener oral tablet Colace 2-IN-1 OTC

veracolate oral tablet delayed release Alophen OTC; QL

WAL-MUCIL ORAL CAPSULE OTC

WAL-MUCIL ORAL POWDER OTC

womans laxative oral tablet delayed release Alophen OTC; QL

womens laxative oral tablet delayed release Alophen OTC; QL

*LYMPHOCYTE FUNCTION-ASSOCIATED ANTIGEN-1 (LFA-1) ANTAG***

XIIDRA OPHTHALMIC SOLUTION PA; QL

*MACROLIDES*

azithromycin oral packet Zithromax QL

azithromycin oral suspension reconstituted Zithromax QL

azithromycin oral tablet Zithromax QL

clarithromycin er oral tablet extended release 24 hour

clarithromycin oral suspension reconstituted

clarithromycin oral tablet

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Drug Name Reference Notes

E.E.S. 400 ORAL TABLET

ERY-TAB ORAL TABLET DELAYED RELEASE

ERYTHROCIN STEARATE ORAL TABLET

erythromycin base oral capsule delayed release particles

erythromycin base oral tablet

erythromycin base oral tablet delayed release

Ery-Tab

erythromycin ethylsuccinate oral tablet E.E.S. 400

erythromycin oral tablet delayed release Ery-Tab

*MEDICAL DEVICES*

1st tier unilet comfortouchAgaMatrix Ultra-Thin Lancets

OTC; QL

ACCU-CHEK AVIVA IN VITRO SOLUTION OTC

ACCU-CHEK COMPACT PLUS CONTROL IN VITRO SOLUTION

OTC

ACCU-CHEK GUIDE CONTROL IN VITRO LIQUID

OTC

ACCU-CHEK SMARTVIEW CONTROL IN VITRO LIQUID

OTC

ACCU-CHEK SPIRIT ADAPTER KIT OTC

ACCU-CHEK SPIRIT BATTERY KIT

ACCU-CHEK TENDER 1 INFUSION KIT

ACCU-CHEK ULTRAFLEX INF SET

ACCUTREND GLUCOSE CONTROL IN VITRO SOLUTION

OTC

acti-lance 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

acti-lance lite lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

acti-lance special lancets 17gAgaMatrix Ultra-Thin Lancets

OTC; QL

acti-lance universal 23gAgaMatrix Ultra-Thin Lancets

OTC; QL

adjustable lancing device Advocate Lancing Device OTC; QL

ADVANCE INTUITION CONTROL IN VITRO LIQUID

OTC

ADVANCE MICRO-DRAW CONTROL IN VITRO LIQUID

OTC

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Drug Name Reference Notes

ADVANCE MICRO-DRAW NORMAL IN VITRO LIQUID

OTC

advanced mobile lancetAgaMatrix Ultra-Thin Lancets

OTC; QL

ADVOCATE CONTROL SOLUTION IN VITRO LIQUID

OTC

ADVOCATE LANCING DEVICE OTC; QL

ADVOCATE RAPID-SAFE LANCING OTC; QL

ADVOCATE REDI-CODE+ CONTROL IN VITRO SOLUTION

OTC

AGAMATRIX CONTROL IN VITRO SOLUTION

OTC

AGAMATRIX CONTROL LEVEL 2 IN VITRO SOLUTION

OTC

AGAMATRIX CONTROL LEVEL 4 IN VITRO SOLUTION

OTC

AGAMATRIX ULTRA-THIN LANCETS OTC; QL

aimsco twist lancets 32gAgaMatrix Ultra-Thin Lancets

OTC; QL

AIMSCO TWIST LANCETS 33G OTC; QL

alcohol prep padBD Swabs Single Use Butterfly

OTC

alternate site lancing device Advocate Lancing Device OTC; QL

aqua lance adjustable lancing device Advocate Lancing Device OTC; QL

ARGYLE TRACHEOSTOMY CARE TRAY KIT

ASSURE 3 CONTROL IN VITRO LIQUID OTC

ASSURE 4 CONTROL LEVEL 1 & 2 IN VITRO LIQUID

OTC

ASSURE DOSE CONTROL IN VITRO SOLUTION

OTC

ASSURE DOSE NORM/HIGH CONTROL IN VITRO SOLUTION

OTC

ASSURE HAEMOLANCE PLUS HIGH OTC; QL

ASSURE HAEMOLANCE PLUS LOW OTC; QL

ASSURE HAEMOLANCE PLUS MICRO OTC; QL

ASSURE HAEMOLANCE PLUS NORMAL OTC; QL

ASSURE HAEMOLANCE PLUS PED OTC; QL

ASSURE II CONTROL IN VITRO LIQUID OTC

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Drug Name Reference Notes

ASSURE II CONTROL LEVEL 1 & 2 IN VITRO LIQUID

OTC

ASSURE LANCE LANCETS OTC; QL

ASSURE LANCE LANCETS 21G OTC; QL

ASSURE LANCE PLUS SAFETY 25G OTC; QL

ASSURE LANCE PLUS SAFETY 30G OTC; QL

ASSURE LANCE SAFETY LANCET 28G OTC; QL

ASSURE PRISM CONTROL LEVEL 1&2 IN VITRO SOLUTION

OTC

ASSURE PRO CONTROL LEVEL 1 & 2 IN VITRO LIQUID

OTC

aurora lancet super thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

aurora lancet thin 23gAgaMatrix Ultra-Thin Lancets

OTC; QL

AUTO-LANCET MINI OTC; QL

AUTOLET PLUS OTC; QL

BD AUTOSHIELD OTC; QL

BD AUTOSHIELD DUO OTC; QL

BD INSULIN SYR ULTRAFINE II QL

BD INSULIN SYRINGE QL

BD INSULIN SYRINGE MICROFINE QL

BD INSULIN SYRINGE U/F QL

BD INSULIN SYRINGE U/F 1/2UNIT QL

BD INSULIN SYRINGE U-500 QL

BD INSULIN SYRINGE ULTRAFINE QL

BD PEN NEEDLE MICRO U/F OTC; QL

BD PEN NEEDLE MINI U/F OTC; QL

BD PEN NEEDLE NANO 2ND GEN OTC; QL

BD PEN NEEDLE NANO U/F QL

BD PEN NEEDLE ORIGINAL U/F OTC; QL

BD PEN NEEDLE SHORT U/F OTC; QL

BD SAFETYGLIDE INSULIN SYRINGE QL

BD SAFETY-LOK INSULIN SYRINGE QL

BD SWABS SINGLE USE BUTTERFLY PAD

OTC

BD VEO INSULIN SYRINGE U/F QL

careone advanced lancing dev Advocate Lancing Device OTC; QL

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Drug Name Reference Notes

careone lancet thin 23gAgaMatrix Ultra-Thin Lancets

OTC; QL

careone lancet ultra thin 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

CARESENS CONTROL A IN VITRO SOLUTION

OTC

CARESENS LANCETS OTC; QL

CARETOUCH LANCING/EJECTOR OTC; QL

CLEAN START VAPORIZER TABLET SOLUBLE

OTC

CLEANLET LANCETS 28G OTC; QL

CLEVER CHOICE GLUCOSE CONTROL IN VITRO LIQUID

OTC

comfort assured lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

comfort assured lancets 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

comfort lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

COMPAT ENTERAL FEEDING PUMP OTC

COMPAT SELECT FLO BAGGLE CASE OTC

COMPAT SELECT FLO PUMP OTC

COMPAT SELECT TRANSPORT CASE OTC

COMPAT YSET OTC

CONTOUR CONTROL IN VITRO LIQUID OTC

CONTOUR NEXT CONTROL IN VITRO SOLUTION

OTC

control in vitro solution Advance Intuition Control OTC

COOL CONTROL A IN VITRO SOLUTION OTC

COOL CONTROL B IN VITRO SOLUTION OTC

CPR MICROSHIELD OTC; QL

CURITY ALCOHOL PREPS PAD OTC

CURITY BURN DRESSING PAD OTC

cvs alcohol prep pads padBD Swabs Single Use Butterfly

OTC

cvs arthritis heatwrapsSoftHeat Heating Wrap Ultra

OTC

cvs hearing aid batteriesDuracell Hearing Aid Batteries

OTC

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Drug Name Reference Notes

cvs heat therapy/backSoftHeat Heating Wrap Ultra

OTC

cvs heatwrapsSoftHeat Heating Wrap Ultra

OTC

cvs heatwraps/back/hipSoftHeat Heating Wrap Ultra

OTC

cvs lancets 21gAgaMatrix Ultra-Thin Lancets

OTC; QL

cvs lancets micro thin 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

cvs lancets originalAgaMatrix Ultra-Thin Lancets

OTC; QL

cvs lancets thin 26gAgaMatrix Ultra-Thin Lancets

OTC; QL

cvs lancets ultra thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

cvs lancets ultra-thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

cvs max hearing aid batteriesDuracell Hearing Aid Batteries

OTC

cvs moist heat pain reliefSoftHeat Heating Wrap Ultra

OTC

cvs prep padBD Swabs Single Use Butterfly

OTC

cvs procedural mask CPR Microshield OTC; QL

cvs ultra thin lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

DESENEX FOOT/SNEAKER SPRAY EXTERNAL AEROSOL

OTC

diathrive glucose control soln in vitro liquid Accu-Chek Aviva OTC

diathrive lancet ultra thin 30AgaMatrix Ultra-Thin Lancets

OTC; QL

diathrive lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

diatrue control level 1 in vitro solution Advocate Control Solution OTC

diatrue control level 2 in vitro solution Advance Intuition Control OTC

diatrue control level 3 in vitro solution Advocate Control Solution OTC

DROPLET LANCETS ULTRA THIN 30G OTC; QL

DROPLET LANCING DEVICE OTC; QL

drug mart lancets thin 26gAgaMatrix Ultra-Thin Lancets

OTC; QL

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Drug Name Reference Notes

DRUG MART LANCING DEVICE OTC; QL

DRUG MART ON-THE-GO LANCET 30G OTC; QL

DRUG MART UNILET LANCETS 28G OTC; QL

DRUG MART UNILET LANCETS 30G OTC; QL

DRUG MART UNILET LANCETS 33G OTC; QL

DUO-CARE CONTROL SOLUTION IN VITRO LIQUID

OTC

DURACELL HEARING AID BATTERIES OTC

ear-loop mask small CPR Microshield OTC; QL

easy mini eject lancing device Advocate Lancing Device OTC; QL

easy mini lancing device Advocate Lancing Device OTC; QL

easy plus ii control in vitro solution Advocate Control Solution OTC

EASY STEP CONTROL IN VITRO SOLUTION

OTC

easy talk control in vitro solution Advocate Control Solution OTC

EASY TOUCH ALCOHOL PREP MEDIUM PAD

OTC

EASY TOUCH CONTROL HIGH & LOW IN VITRO SOLUTION

OTC

EASY TOUCH LANCETS 21G OTC; QL

EASY TOUCH LANCETS 23G OTC; QL

EASY TOUCH LANCETS 26G OTC; QL

EASY TOUCH LANCETS 28G OTC; QL

EASY TOUCH LANCETS 28G/TWIST OTC; QL

EASY TOUCH LANCETS 30G OTC; QL

EASY TOUCH LANCETS 32G OTC; QL

EASY TOUCH LANCETS 32G/TWIST OTC; QL

EASY TOUCH LANCING DEVICE OTC; QL

EASY TOUCH SAFETY LANCETS 21G OTC; QL

EASY TOUCH SAFETY LANCETS 23G OTC; QL

EASY TOUCH SAFETY LANCETS 26G OTC; QL

EASY TOUCH SAFETY LANCETS 28G OTC; QL

easy trak control in vitro solution Advance Intuition Control OTC

EASYGLUCO CONTROL IN VITRO SOLUTION

OTC

EASYGLUCO PLUS LEVEL 1 IN VITRO SOLUTION

OTC

EASYMAX 15 LEVEL 1 CONTROL IN VITRO SOLUTION

OTC

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Drug Name Reference Notes

EASYMAX 15 LEVEL 1-2 CONTROL IN VITRO SOLUTION

OTC

EASYMAX 15 LEVEL 2 CONTROL IN VITRO SOLUTION

OTC

EASYMAX CONTROL IN VITRO SOLUTION

OTC

EASYMAX CONTROL NORMAL/LOW IN VITRO SOLUTION

OTC

element compact control 2 in vitro solution Accu-Chek Aviva OTC

element compact control 3 in vitro solution Accu-Chek Aviva OTC

ELEMENT CONTROL IN VITRO LIQUID OTC

EMBRACE CONTROL IN VITRO SOLUTION

OTC

EMBRACE EVO CONTROL LEVEL 1 IN VITRO LIQUID

OTC

EMBRACE EVO CONTROL LEVEL 2 IN VITRO LIQUID

OTC

EMBRACE GLUCOSE CONTROL IN VITRO LIQUID

OTC

EMBRACE PRO GLUCOSE CONTROL IN VITRO LIQUID

OTC

EMBRACE TALK GLUCOSE CONTROL IN VITRO SOLUTION

OTC

eq hot/cold compression sleeveGood2Go Hot/Cold Pack/Mitten

OTC

eql color lancets 21gAgaMatrix Ultra-Thin Lancets

OTC; QL

eql color lancets micro 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

eql heat wrapsSoftHeat Heating Wrap Ultra

OTC

eql heat wraps back/hipSoftHeat Heating Wrap Ultra

OTC

eql super thin lancets 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

eql thin lancets 26gAgaMatrix Ultra-Thin Lancets

OTC; QL

EVENCARE CONTROL LOW/HIGH IN VITRO LIQUID

OTC

EVENCARE G2 LOW/HIGH CONTROL IN VITRO SOLUTION

OTC

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Drug Name Reference Notes

EVENCARE G3 LOW/HIGH CONTROL IN VITRO SOLUTION

OTC

EVENCARE MINI CONTROL IN VITRO SOLUTION

OTC

EVOLUTION CONTROL IN VITRO SOLUTION

OTC

E-Z JECT LANCET MICRO-THIN 33G OTC; QL

E-Z JECT LANCET SUPER THIN 30G OTC; QL

E-Z JECT LANCETS OTC; QL

E-Z JECT LANCETS 21G OTC; QL

E-Z JECT LANCETS THIN 26G OTC; QL

EZ SMART BLOOD GLUCOSE LANCETS OTC; QL

EZ-LETS LANCETS 21G OTC; QL

EZ-LETS LANCETS 26G OTC; QL

EZ-LETS LANCETS 28G OTC; QL

EZ-LETS LANCETS 30G OTC; QL

face mask earloop-style CPR Microshield OTC; QL

face mask resp n-100 part CPR Microshield QL

face mask respirator r-95 part CPR Microshield QL

FIFTY50 ALCOHOL PREP PAD OTC

FIFTY50 SAFETY SEAL LANCETS OTC; QL

FIFTY50 UNILET LANCETS 33G OTC; QL

FINE 30 OTC; QL

FORA CONTROL IN VITRO SOLUTION OTC

FORA LANCETS OTC; QL

FORA LANCING DEVICE OTC; QL

FORACARE GDH CONTROL IN VITRO SOLUTION

OTC

FORTISCARE CONTROL IN VITRO SOLUTION

OTC

freds pharmacy autolet lancing Advocate Lancing Device OTC; QL

freds pharmacy unilet lanc 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

freds pharmacy unilet lanc 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

FREESTYLE CONTROL SOLUTION IN VITRO LIQUID

OTC

FREESTYLE UNISTICK II LANCETS OTC; QL

ge100 control in vitro solution Advance Intuition Control OTC

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Drug Name Reference Notes

GENTEEL BUTTERFLY TOUCH LANCET OTC; QL

GENTLE-LET GP LANCETS OTC; QL

GENTLE-LET LANCETS OTC; QL

global lancing device Advocate Lancing Device OTC; QL

GLUCOCARD 01 CONTROL IN VITRO LIQUID

OTC

GLUCOCARD 01 CONTROL IN VITRO SOLUTION

OTC

GLUCOCARD EXPRESSION CONTROL IN VITRO SOLUTION

OTC

GLUCOCARD SHINE CONTROL IN VITRO SOLUTION

OTC

GLUCOCARD X-SENSOR CONTROL IN VITRO SOLUTION

OTC

GLUCOCOM CONTROL IN VITRO LIQUID OTC

GLUCOCOM LANCETS 28G OTC; QL

GLUCOCOM LANCETS 30G OTC; QL

GLUCOCOM LANCETS 33G OTC; QL

glucose control in vitro solution Accu-Chek Aviva OTC

gnp alcohol swabs padBD Swabs Single Use Butterfly

OTC

GNP EASY TOUCH CONT HIGH/LOW IN VITRO SOLUTION

OTC

gnp heatwrapsSoftHeat Heating Wrap Ultra

OTC

gnp lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

gnp lancets 21gAgaMatrix Ultra-Thin Lancets

OTC; QL

gnp lancets micro thin 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

gnp lancets super thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

gnp lancets thinAgaMatrix Ultra-Thin Lancets

OTC; QL

gnp lancets thin 26gAgaMatrix Ultra-Thin Lancets

OTC; QL

gnp micro thin lancets 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

gnp super thin lancets 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

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Drug Name Reference Notes

GOJJI CONTROL IN VITRO SOLUTION OTC

goodsense color lancets 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

goodsense lancets 26g univAgaMatrix Ultra-Thin Lancets

OTC; QL

goodsense lancets 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

goodsense lancets 30g univAgaMatrix Ultra-Thin Lancets

OTC; QL

goodsense lancets 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

goodsense lancets 33g univAgaMatrix Ultra-Thin Lancets

OTC; QL

HAEMOLANCE OTC; QL

HAEMOLANCE LOW FLOW LANCETS OTC; QL

HAEMOLANCE PLUS OTC; QL

HAEMOLANCE PLUS HIGH FLOW OTC; QL

HAEMOLANCE PLUS LOW FLOW OTC; QL

HAEMOLANCE PLUS MAX FLOW OTC; QL

HAEMOLANCE PLUS PEDIATRIC FLOW OTC; QL

healthy accents lancing device Advocate Lancing Device OTC; QL

healthy accents unilet lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

hearing aid batteriesDuracell Hearing Aid Batteries

OTC

hearing aid batteryDuracell Hearing Aid Batteries

OTC

heat therapy patchesSoftHeat Heating Wrap Ultra

OTC

heat wraps back/hipSoftHeat Heating Wrap Ultra

OTC

heatwraps back/hipSoftHeat Heating Wrap Ultra

OTC

heatwraps neck/shoulder/wristSoftHeat Heating Wrap Ultra

OTC

h-e-b incontrol adv lancing Advocate Lancing Device OTC; QL

h-e-b incontrol lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

h-e-b incontrol lancets 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

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Drug Name Reference Notes

h-e-b incontrol lancets 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

hm heat wrapsSoftHeat Heating Wrap Ultra

OTC

hm heat wraps back/hipSoftHeat Heating Wrap Ultra

OTC

hm sterile alcohol prep padBD Swabs Single Use Butterfly

OTC

HYPOLANCE AST LANCING KIT OTC

HY-VEE LANCETS OTC; QL

hy-vee thin lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

IN TOUCH GLUCOSE CONTROL IN VITRO SOLUTION

OTC

IN TOUCH STERILE LANCETS 30G OTC; QL

INFINITY CONTROL IN VITRO SOLUTION OTC

INFINITY VOICE IN VITRO LIQUID OTC

J & J GERM FILTER MASK OTC; QL

JOHNSONS FOOT SPRAY EXTERNAL AEROSOL

OTC

kinney lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

kinney thin lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

KROGER HEALTHPRO CONTROL HI/LO IN VITRO LIQUID

OTC

KROGER HEALTHPRO LANCET 26G OTC; QL

KROGER HEALTHPRO LANCET 30G OTC; QL

KROGER HEALTHPRO LANCET 33G OTC; QL

kroger lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

kroger lancets 21gAgaMatrix Ultra-Thin Lancets

OTC; QL

kroger lancets micro thin 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

kroger lancets super thinAgaMatrix Ultra-Thin Lancets

OTC; QL

kroger lancets thinAgaMatrix Ultra-Thin Lancets

OTC; QL

kroger lancets thin 26gAgaMatrix Ultra-Thin Lancets

OTC; QL

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Drug Name Reference Notes

kroger lancets ultrathin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

kroger lancing device Advocate Lancing Device OTC; QL

lancet device with ejector Advocate Lancing Device OTC; QL

lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

lancets 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

lancets micro thin 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

lancets super thin 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

lancets thinAgaMatrix Ultra-Thin Lancets

OTC; QL

LANCETS ULTRA FINE OTC; QL

LANCETS ULTRA THIN OTC; QL

lancets ultra thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

lancing device Advocate Lancing Device OTC; QL

LANZO OTC; QL

leader advanced lancing device Advocate Lancing Device OTC; QL

LIBERTY GLUCOSE CONTROL IN VITRO LIQUID

OTC

LIBERTY GLUCOSE CONTROL IN VITRO SOLUTION

OTC

LIBERTY GLUCOSE CONTROL MID IN VITRO SOLUTION

OTC

light shield CPR Microshield OTC; QL

LIGHT SHIELD DELUXE SLEEP MASK OTC; QL

lite touch lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

LITE TOUCH LANCING PEN OTC; QL

LITETOUCH LANCETS OTC; QL

live better adv lancing device Advocate Lancing Device OTC; QL

live better lancet super thinAgaMatrix Ultra-Thin Lancets

OTC; QL

live better lancet ultra thinAgaMatrix Ultra-Thin Lancets

OTC; QL

154

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Drug Name Reference Notes

longs lancets standardAgaMatrix Ultra-Thin Lancets

OTC; QL

longs lancets thinAgaMatrix Ultra-Thin Lancets

OTC; QL

longs lancets ultra thinAgaMatrix Ultra-Thin Lancets

OTC; QL

mask pediatric size 1" CPR Microshield OTC; QL

mask pediatric size 3" CPR Microshield OTC; QL

MAXI-MASK OTC; QL

medichoice safety lancetAgaMatrix Ultra-Thin Lancets

OTC; QL

medichoice safety lancet extraAgaMatrix Ultra-Thin Lancets

OTC; QL

medichoice safety lancet normAgaMatrix Ultra-Thin Lancets

OTC; QL

MEDISENSE GLUCOSE KETONE CONTR IN VITRO LIQUID

OTC

MEDISENSE HI/MID/LOW CONTROL IN VITRO LIQUID

OTC

MEDISENSE HIGH/LOW CONTROL IN VITRO LIQUID

OTC

MEDISENSE MID CONTROL IN VITRO LIQUID

OTC

MEDLANCE EXTRA 21G OTC; QL

MEDLANCE LITE 25G OTC; QL

MEDLANCE PLUS EXTRA 21G OTC; QL

MEDLANCE PLUS LANCETS OTC; QL

MEDLANCE PLUS LITE 25G OTC; QL

MEDLANCE PLUS SPECIAL 0.8MM OTC; QL

MEDLANCE PLUS SUPERLITE 30G OTC; QL

MEDLANCE PLUS UNIVERSAL 21G OTC; QL

MEDLANCE UNIVERSAL 21G OTC; QL

MEIJER LANCETS OTC; QL

MEIJER LANCETS THIN OTC; QL

MEIJER LANCETS UNIVERSAL 21G OTC; QL

MEIJER LANCETS UNIVERSAL 30G OTC; QL

MEIJER LANCETS UNIVERSAL 33G OTC; QL

MEIJER SUPER THIN LANCETS OTC; QL

MICROCHAMBER DEVICE QL

155

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Drug Name Reference Notes

MICRODOT CONTROL HIGH/LOW IN VITRO SOLUTION

OTC

MICROLET NEXT LANCING DEVICE OTC; QL

mini lancing device Advocate Lancing Device OTC; QL

MINILINK REAL-TIME REPLACEMENT KIT

PA

MINILINK REAL-TIME TRANSMITTER

MINILINK-REAL-TIME STARTER KIT PA

MM LANCING DEVICE OTC; QL

MM TWIST LANCETS OTC; QL

MONOLET LANCETS OTC; QL

MONOLET OPD LANCETS OTC; QL

MONOLETTOR SAFETY LANCETS OTC; QL

mpd safety lancet 21gAgaMatrix Ultra-Thin Lancets

OTC; QL

mpd safety lancet 23gAgaMatrix Ultra-Thin Lancets

OTC; QL

mpd safety lancet 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

mpd safety lancet 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

MULTI-LANCET DEVICE 2 KIT OTC

MYGLUCOHEALTH CONTROL IN VITRO SOLUTION

OTC

MYGLUCOHEALTH LANCETS 30G OTC; QL

NEUTEK 2TEK CONTROL IN VITRO SOLUTION

OTC

NEXCARE ALL PURPOSE MASK OTC; QL

NEXCARE EARLOOP MASK OTC; QL

NOVA MAX PLUS GLU/KET CONTROL IN VITRO LIQUID

OTC

NOVA SAFETY LANCETS 23G OTC; QL

NOVA SAFETY LANCETS 28G OTC; QL

NOVA SUREFLEX LANCETS OTC; QL

NOVA SUREFLEX LANCING DEVICE OTC; QL

OMNIPOD 5 PACK

OMNIPOD STARTER KIT

ON CALL EXPRESS GLUCOSE CONTR IN VITRO SOLUTION

OTC

156

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Drug Name Reference Notes

ON CALL LANCETS OTC; QL

ON CALL LANCING DEVICE OTC; QL

ON CALL PLUS GLUCOSE CONTROL IN VITRO SOLUTION

OTC

ON CALL PLUS LANCETS OTC; QL

ON CALL PLUS LANCING DEVICE OTC; QL

ON CALL VIVID GLUCOSE CONTROL IN VITRO SOLUTION

OTC

ONETOUCH ULTRA CONTROL IN VITRO SOLUTION

OTC

ONETOUCH VERIO IN VITRO SOLUTION OTC

OPTUMRX GLUCOSE CONTROL IN VITRO SOLUTION

OTC

PARADIGM PUMP REMOTE PROGRAM PA; OTC

pc lancets super thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

pediatric medium mask CPR Microshield OTC; QL

pediatric small mask CPR Microshield OTC; QL

PERFECT LANCETS 28G OTC; QL

PERFECT LANCETS 30G OTC; QL

PHARMACY COUNTER LANCETS OTC; QL

pip lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

pip lancets 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

POCKETCHEM EZ CONTROL IN VITRO SOLUTION

OTC

PRECISION GLUCOSE CONTROL IN VITRO LIQUID

OTC

PRECISION GLUCOSE CONTROL SOLN IN VITRO SOLUTION

OTC

PRECISION GLUCOSE KETONE CONTR IN VITRO LIQUID

OTC

PRECISION GLUCOSE/KETONE CONTR IN VITRO LIQUID

OTC

PRECISION THINS GP LANCETS OTC; QL

preferred plus lancets coloredAgaMatrix Ultra-Thin Lancets

OTC; QL

preferred plus lancets thinAgaMatrix Ultra-Thin Lancets

OTC; QL

157

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Drug Name Reference Notes

premium hearing aid batteriesDuracell Hearing Aid Batteries

OTC

pressure activat safety lancetAgaMatrix Ultra-Thin Lancets

OTC; QL

PRODIGY CONTROL SOLUTION IN VITRO SOLUTION

OTC

PRODIGY LANCING DEVICE OTC; QL

PSS SELECT GP LANCETS OTC; QL

PSS SELECT SAFETY LANCETS OTC; QL

pump remote programmerAccu-Chek Spirit Battery Kit

PA; OTC

push button safety lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

push button safety lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

px advanced lancing device Advocate Lancing Device OTC; QL

px heatwraps back/hipSoftHeat Heating Wrap Ultra

OTC

px lancets ultra thinAgaMatrix Ultra-Thin Lancets

OTC; QL

px lancets ultra thin 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

qc alcohol swabs padBD Swabs Single Use Butterfly

OTC

qc lancets super thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

qc lancets ultra thinAgaMatrix Ultra-Thin Lancets

OTC; QL

qc unilet lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

qc unilet lancets micro thinAgaMatrix Ultra-Thin Lancets

OTC; QL

QUICKTEK CONTROL SOLUTION IN VITRO LIQUID

OTC

QUINTET CONTROL HIGH/NORMAL IN VITRO SOLUTION

OTC

ra ear-loop mask CPR Microshield OTC; QL

RA E-ZJECT COLOR LANCETS 33G OTC; QL

RA E-ZJECT LANCETS 28G OTC; QL

RA E-ZJECT LANCETS THIN 26G OTC; QL

RA E-ZJECT LANCETS THIN 28G OTC; QL

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Drug Name Reference Notes

RA E-ZJECT LANCETS ULTRA THIN OTC; QL

ra hearing aid batteries s 312Duracell Hearing Aid Batteries

OTC

ra hearing aid batteries sz 10Duracell Hearing Aid Batteries

OTC

ra hearing aid batteries sz 13Duracell Hearing Aid Batteries

OTC

ra heat therapy patches/backSoftHeat Heating Wrap Ultra

OTC

ra heatwrapsSoftHeat Heating Wrap Ultra

OTC

ra heatwraps back/hipSoftHeat Heating Wrap Ultra

OTC

ra instant heat therapy/backSoftHeat Heating Wrap Ultra

OTC

ra instant heat therapy/neckSoftHeat Heating Wrap Ultra

OTC

ra pin point heat therapySoftHeat Heating Wrap Ultra

OTC

ra siesta mask CPR Microshield OTC; QL

READYLANCE SAFETY LANCETS OTC; QL

reality lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

reality trigger lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

REFUAH PLUS GLUCOSE CONTROL IN VITRO SOLUTION

OTC

RELION ALCOHOL SWABS PAD OTC

RELION LANCETS MICRO-THIN 33G OTC; QL

RELION LANCETS STANDARD 21G OTC; QL

RELION LANCETS THIN 26G OTC; QL

RELION LANCETS ULTRA-THIN 30G OTC; QL

RELION ULTRA THIN LANCETS 30G OTC; QL

RELION ULTRA THIN PLUS LANCETS OTC; QL

RESTORE BARRIER CREAM OTC

REXALL LANCETS ULTRA THIN 30G OTC; QL

RIGHTEST GC300 CONTROL IN VITRO LIQUID

OTC

RIGHTEST GD500 LANCING DEVICE OTC; QL

RIGHTEST GL300 LANCETS OTC; QL

159

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Drug Name Reference Notes

SAFE-T-LANCE OTC; QL

SAFE-T-LANCE PLUS OTC; QL

safety lancet 21g/pressure actAgaMatrix Ultra-Thin Lancets

OTC; QL

safety lancet 28g/pressure actAgaMatrix Ultra-Thin Lancets

OTC; QL

SAFETY LANCETS 21G OTC; QL

safety lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

SAFETY SEAL LANCETS OTC; QL

sb lancets thinAgaMatrix Ultra-Thin Lancets

OTC; QL

sb lancets ultra thinAgaMatrix Ultra-Thin Lancets

OTC; QL

SHIELD-SECURE FULL FACE SHIELD OTC; QL

SHOPKO AUTOLET LANCING DEVICE OTC; QL

SHOPKO ON-THE-GO LANCETS 30G OTC; QL

SHOPKO UNILET LANCETS 28G OTC; QL

SHOPKO UNILET LANCETS 30G OTC; QL

side button safety lancetAgaMatrix Ultra-Thin Lancets

OTC; QL

SIESTA MASK OTC; QL

SIMPLE DIAGNOSTICS LANCING DEV OTC; QL

skin conditioning cream Restore Barrier OTC

sm alcohol prep padBD Swabs Single Use Butterfly

OTC

sm heatwraps back/hip padSoftHeat Heating Wrap Ultra

OTC

sm lancets 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

sm vaporizer cleaning tablet soluble Clean Start Vaporizer OTC

SMART DIABETES VANTAGE LANCING OTC; QL

SMART SENSE COLOR LANCETS 33G OTC; QL

SMART SENSE STANDARD LANCETS OTC; QL

SMART SENSE SUPER THIN LANCETS OTC; QL

SMART SENSE THIN LANCETS 26G OTC; QL

SMARTEST CONTROL MEDIUM IN VITRO SOLUTION

OTC

SMARTEST LANCETS 28G OTC; QL

160

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Drug Name Reference Notes

SOFTHEAT HEATING WRAP ULTRA OTC

SOLARTEK GLUCOSE CONTROL IN VITRO LIQUID

OTC

SOLUS V2 CONTROL IN VITRO SOLUTION

OTC

STERILANCE PA OTC

STERILANCE TL OTC; QL

super thin lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

supreme ii high/low control in vitro liquid Accu-Chek Aviva OTC

sure comfort lancing pen Advocate Lancing Device OTC; QL

SURE-LANCE FLAT LANCETS OTC; QL

SURE-LANCE LANCETS 26G OTC; QL

SURE-LANCE THIN LANCETS 28G OTC; QL

SURE-LANCE ULTRA THIN LANCETS OTC; QL

SURELITE LANCETS OTC; QL

SURESTEP GLUCOSE CONTROL IN VITRO SOLUTION

OTC

SURESTEP PRO HIGH GLUCOSE IN VITRO LIQUID

OTC

SURESTEP PRO LOW GLUCOSE IN VITRO LIQUID

OTC

SURESTEP PRO NORMAL GLUCOSE IN VITRO LIQUID

OTC

SURE-TOUCH LANCETS UNIVERSAL OTC; QL

TAI DOC CONTROL IN VITRO SOLUTION OTC

TECHLITE AST LANCETS OTC; QL

TECHLITE LANCETS OTC; QL

TECHLITE LANCETS 30G OTC; QL

TELCARE GLUCOSE CONTROL IN VITRO SOLUTION

OTC

tens therapy replace back pads Cefaly Electrode OTC

tens therapy replace body pads Cefaly Electrode OTC

tgt alcohol swabs padBD Swabs Single Use Butterfly

OTC

tgt lancet micro thin 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

tgt lancet thin 26gAgaMatrix Ultra-Thin Lancets

OTC; QL

161

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Drug Name Reference Notes

tgt lancet ultra thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

THERMACARE OTC

THERMACARE ARTHRITIS HAND OTC

THERMACARE ARTHRITIS KNEE/ELBW OTC

THERMACARE ARTHRITIS NECK OTC

THERMACARE BACK/HIP OTC

THERMACARE JOINT PAIN THERAPY OTC

THERMACARE KNEE/ELBOW OTC

THERMACARE MENSTRUAL OTC

THERMACARE MUSCLE/JOINT OTC

THINLETS GP LANCETS OTC; QL

todays health lancing device Advocate Lancing Device OTC; QL

todays health thin lancets 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

todays health thin lancets 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

topcare lancets micro-thin 33gAgaMatrix Ultra-Thin Lancets

OTC; QL

travel lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

TRAVEL LANCETS ADVANCED 28G OTC; QL

true comfort alcohol prep pads padBD Swabs Single Use Butterfly

OTC

TRUE METRIX AIR GLUCOSE METER KIT OTC

TRUE METRIX LEVEL 1 IN VITRO SOLUTION

OTC

TRUE METRIX LEVEL 2 IN VITRO SOLUTION

OTC

TRUE METRIX LEVEL 3 IN VITRO SOLUTION

OTC

TRUECONTROL GLUCOSE CONT LEV 0 IN VITRO LIQUID

OTC

TRUECONTROL GLUCOSE CONT LEV 1 IN VITRO LIQUID

OTC

TRUEDRAW LANCING DEVICE OTC; QL

TRUEPLUS LANCETS 26G OTC; QL

TRUEPLUS LANCETS 28G OTC; QL

TRUEPLUS LANCETS 30G OTC; QL

TRUEPLUS LANCETS 33G OTC; QL

162

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Drug Name Reference Notes

TRUEPLUS SAFETY LANCETS 28G OTC; QL

ULTICARE ALCOHOL SWABS PAD OTC

ULTI-LANCE AUTOMATIC OTC; QL

ULTRA-THIN II LANCETS OTC; QL

ULTRATRAK PRO CONTROL IN VITRO SOLUTION

OTC

ULTRATRAK ULTIMATE CONTROL IN VITRO SOLUTION

OTC

UNILET COMFORTOUCH LANCET OTC; QL

UNILET EXCELITE OTC; QL

UNILET EXCELITE II OTC; QL

UNILET G.P. LANCET OTC; QL

UNILET G.P. SUPERLITE LANCET OTC; QL

UNILET GP 28 ULTRA THIN OTC; QL

UNILET LANCET OTC; QL

UNILET MICRO-THIN 33G OTC; QL

UNILET SUPERLITE LANCET OTC; QL

UNILET SUPER-THIN 30G OTC; QL

UNILET ULTRA-THIN 28G OTC; QL

UNISTIK 2 NORMAL OTC

UNISTIK 2 SUPER OTC

UNISTIK 3 COMFORT OTC

UNISTIK 3 EXTRA OTC

UNISTIK 3 GENTLE OTC; QL

UNISTIK 3 NEONATAL OTC

UNISTIK 3 NORMAL OTC

UNISTIK CZT COMFORT OTC

UNISTIK CZT NORMAL OTC

UNISTIK PRO SAFETY LANCET OTC; QL

UNISTIK SAFETY LANCETS 28G OTC; QL

UNISTIK SAFETY LANCETS 30G OTC; QL

UNISTIK TOUCH SAFETY LANC 21G OTC; QL

UNISTIK TOUCH SAFETY LANC 23G OTC; QL

UNISTIK TOUCH SAFETY LANC 28G OTC; QL

UNISTIK TOUCH SAFETY LANC 30G OTC; QL

UNISTRIP CONTROL IN VITRO SOLUTION

OTC

UNIVERSAL 1 LANCETS THIN 26G OTC; QL

163

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Drug Name Reference Notes

UNIVERSAL 1 LANCETS THIN 33G OTC; QL

UNIVERSAL 1 LANCETS ULTRA THIN OTC; QL

value plus lancet standard 21gAgaMatrix Ultra-Thin Lancets

OTC; QL

value plus lancets super thinAgaMatrix Ultra-Thin Lancets

OTC; QL

value plus lancets thin 26gAgaMatrix Ultra-Thin Lancets

OTC; QL

value plus lancing device Advocate Lancing Device OTC; QL

valumark lancet super thin 30gAgaMatrix Ultra-Thin Lancets

OTC; QL

valumark lancet ultra thin 28gAgaMatrix Ultra-Thin Lancets

OTC; QL

verasens glucose control in vitro liquid Accu-Chek Aviva OTC

V-GO 20 KIT

V-GO 30 KIT

V-GO 40 KIT

VICTORY CONTROL LEVEL 1/2 IN VITRO SOLUTION

OTC

VIDA MIA AUTOLET LANCING DEV OTC; QL

VIDA MIA UNILET LANCETS 28G OTC; QL

VIDA MIA UNILET LANCETS 30G OTC; QL

VIVAGUARD INO CONTROL SOLUTION IN VITRO LIQUID

OTC

VIVAGUARD LANCETS OTC; QL

walgreens adv travel lancetsAgaMatrix Ultra-Thin Lancets

OTC; QL

WALGREENS LANCETS OTC; QL

walgreens lancets micro thinAgaMatrix Ultra-Thin Lancets

OTC; QL

walgreens lancets super thinAgaMatrix Ultra-Thin Lancets

OTC; QL

WALGREENS THIN LANCETS OTC; QL

WALGREENS ULTRA THIN LANCETS OTC; QL

WEBCOL ALCOHOL PREP LARGE PAD OTC

WEBCOL ALCOHOL PREP MEDIUM PAD OTC

WIDE-SEAL DIAPHRAGM 60 VAGINAL DIAPHRAGM

WIDE-SEAL DIAPHRAGM 65 VAGINAL DIAPHRAGM

164

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Drug Name Reference Notes

WIDE-SEAL DIAPHRAGM 70 VAGINAL DIAPHRAGM

WIDE-SEAL DIAPHRAGM 75 VAGINAL DIAPHRAGM

WIDE-SEAL DIAPHRAGM 80 VAGINAL DIAPHRAGM

WIDE-SEAL DIAPHRAGM 85 VAGINAL DIAPHRAGM

WIDE-SEAL DIAPHRAGM 90 VAGINAL DIAPHRAGM

WIDE-SEAL DIAPHRAGM 95 VAGINAL DIAPHRAGM

*MIGRAINE PRODUCTS*

ergotamine-caffeine oral tablet Cafergot

MIGERGOT RECTAL SUPPOSITORY

naratriptan hcl oral tablet Amerge QL

sumatriptan nasal solution Imitrex PA; QL

sumatriptan succinate oral tablet Imitrex QL

sumatriptan succinate refill subcutaneous solution cartridge

Imitrex STATdose Refill PA; QL

sumatriptan succinate subcutaneous solution

Imitrex PA; QL

sumatriptan succinate subcutaneous solution auto-injector

Imitrex STATdose System PA; QL

sumatriptan succinate subcutaneous solution prefilled syringe

QL

*MINERALS & ELECTROLYTES*

ADVANTAGE CARE ELECTROLYTE PED ORAL SOLUTION

OTC; QL

CALCITRATE ORAL TABLET OTC

calcitrate plus d oral tablet OTC

calcium + d oral tablet OTC

calcium + d3 oral tablet OTC

calcium + vitamin d3 oral tablet chewable OTC

calcium 500 + d oral tablet OTC

calcium 500 + d3 oral tablet Os-Cal Calcium + D3 OTC

calcium 500 +d oral tablet Oystercal-D OTC

calcium 500/d oral tablet RA Hi Cal OTC

calcium 500/d oral tablet chewable OTC

165

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Drug Name Reference Notes

calcium 500/vitamin d oral tablet OTC

calcium 500+d high potency oral tablet OTC

calcium 500+d oral tablet Os-Cal Calcium + D3 OTC

calcium 500+d3 oral tablet Oystercal-D OTC

calcium 600 + d oral tablet OTC

calcium 600 + minerals oral tablet OTC

calcium 600 high potency oral tablet High Potency Calcium OTC

calcium 600 oral tablet High Potency Calcium OTC

calcium 600/vitamin d oral tablet OTC; QL

calcium 600/vitamin d oral tablet chewable OTC; QL

calcium 600/vitamin d3 oral tablet Caltrate 600+D3 OTC; QL

calcium 600+d high potency oral tablet OTC; QL

calcium 600+d oral tablet 600-200 mg-unit OTC

calcium 600+d oral tablet 600-400 mg-unit OTC; QL

calcium 600+d plus minerals oral tablet OTC; QL

calcium 600+d plus minerals oral tablet chewable

OTC; QL

calcium 600+d3 oral tablet 600-200 mg-unit OTC

calcium 600+d3 oral tablet 600-400 mg-unit OTC; QL

calcium 600-d oral tablet OTC; QL

calcium carbonate oral tablet 1250 (500 ca) mg

OTC; QL

calcium carbonate oral tablet 1500 (600 ca) mg

Caltrate 600 OTC

calcium carbonate oral tablet 600 mg High Potency Calcium OTC

calcium carbonate-vitamin d oral capsule OTC; QL

calcium carbonate-vitamin d oral tablet 500-400 mg-unit

OTC

calcium carbonate-vitamin d oral tablet 600-400 mg-unit

OTC; QL

calcium citrate + d oral tablet OTC

calcium citrate + d3 oral tablet OTC

calcium citrate + oral tablet OTC

calcium citrate oral tablet OTC

calcium citrate plus/magnesium oral tabletAdvanced Calcium/D/Magnesium

OTC

calcium citrate-vitamin d oral tablet OTC

calcium creamies oral tablet chewable OTC; QL

166

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Drug Name Reference Notes

calcium for women oral tablet chewable OTC

calcium high potency oral tablet High Potency Calcium OTC

calcium high potency/vitamin d oral tablet OTC

calcium oral tablet OTC

calcium oral tablet chewable OTC; QL

calcium oyster shell oral tablet OTC; QL

calcium plus vitamin d3 oral tablet Caltrate 600+D3 OTC; QL

calcium/c/d oral tablet chewable OTC; QL

calcium+d3 gradual release oral tablet extended release 24 hour

Citracal Slow Release OTC

calcium-folic acid plus d oral wafer

calcium-magnesium oral tablet Cal-Mag OTC

calcium-magnesium-zinc oral tablet OTC

calcium-vitamin d oral tablet 500-125 mg-unit, 600-200 mg-unit

OTC

calcium-vitamin d oral tablet 500-200 mg-unit

Os-Cal Calcium + D3 OTC

calcium-vitamin d oral tablet 500-400 mg-unit

Oystercal-D OTC

calcium-vitamin d oral tablet 600-400 mg-unit

OTC; QL

calcium-vitamin d3 oral capsule OTC; QL

calcium-vitamin d3 oral tablet 250-125 mg-unit, 600-400 mg-unit

OTC; QL

calcium-vitamin d3 oral tablet 500-400 mg-unit

Oystercal-D OTC

calcium-vitamin d-minerals oral tablet chewable

OTC; QL

CAL-MAG ORAL TABLET OTC

cal-mag-zinc-d oral tabletAdvanced Calcium/D/Magnesium

OTC

CALTRATE 600 ORAL TABLET OTC

CERALYTE 70 ORAL SOLUTION OTC; QL

chelated zinc oral tablet OTC; QL

chewable calcium oral tablet chewable OTC

citrus calcium/vitamin d oral tablet Citracal Petites/Vitamin D OTC

cvs calcium 600 + d/minerals oral tabletCaltrate 600+D Plus Minerals

OTC

cvs calcium carbonate oral tablet OTC; QL

167

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Drug Name Reference Notes

cvs calcium-magnesium-zinc oral tablet OTC

cvs electrolyte solution oral solutionAdvantage Care Electrolyte Ped

OTC; QL

cvs magnesium oral tablet OTC

cvs magnesium oxide oral tablet OTC

cvs oyster shell calcium-vit d oral tablet OTC

cvs ped electrolyte freeze pop oral solutionAdvantage Care Electrolyte Ped

OTC; QL

cvs pediatric electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

cvs potassium gluconate oral tablet OTC; QL

cvs zinc oral tablet OTC; QL

eq calcium 500+d oral tablet Os-Cal Calcium + D3 OTC

eq calcium 600+d oral tablet Caltrate 600+D3 OTC; QL

eq calcium 600+d+minerals oral tabletCaltrate 600+D Plus Minerals

OTC

eql calcium citrate/vitamin d oral tablet Calcitrate OTC

eql calcium soft chews oral tablet chewable OTC

eql calcium/vitamin d oral tablet OTC; QL

eql calcium/vitamin d3 oral tablet Caltrate 600+D3 OTC; QL

eql natural zinc oral tablet OTC; QL

fluoritab oral solution NaFrinse Drops

fluoritab oral tablet chewable Ludent

FLURA-DROPS ORAL SOLUTION

gnp calcium 500 +d3 oral tablet Os-Cal Extra D3 OTC

gnp calcium 500/d oral tablet RA Hi Cal OTC

gnp calcium 600 +d/minerals oral tabletCaltrate 600+D Plus Minerals

OTC

gnp calcium 600 +d3 oral tablet Caltrate 600+D3 OTC; QL

gnp calcium 600 +d3/minerals oral tablet chewable

Caltrate 600+D Plus Minerals

OTC

gnp calcium 600 plus d/mineral oral tablet OTC; QL

gnp calcium 600/d oral tablet OTC; QL

gnp calcium citrate +d3 oral tablet Calcitrate OTC

gnp calcium oral tablet High Potency Calcium OTC

gnp calcium plus 600 +d oral tablet OTC

gnp calcium/vitamin d/minerals oral tablet chewable

OTC; QL

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Drug Name Reference Notes

gnp pediatric electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

gnp potassium gluconate oral tablet OTC; QL

gnp zinc chelated oral tablet OTC; QL

gnp zinc oral tablet OTC; QL

h-e-b oral electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

HIGH POTENCY CALCIUM ORAL TABLET OTC

hm calcium citrate+vitamin d oral tablet Calcitrate OTC

hm calcium-vitamin d oral tablet 500-200 mg-unit

Os-Cal Calcium + D3 OTC

hm calcium-vitamin d oral tablet 600-400 mg-unit

OTC; QL

hm calcium-vitamin d oral tablet 600-800 mg-unit

Caltrate 600+D3 OTC; QL

hm calcium-vitamin d-minerals oral tablet OTC; QL

hm pediatric electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

hm potassium oral tablet OTC; QL

hm zinc oral tablet OTC; QL

KLOR-CON 10 ORAL TABLET EXTENDED RELEASE

KLOR-CON M10 ORAL TABLET EXTENDED RELEASE

KLOR-CON M15 ORAL TABLET EXTENDED RELEASE

KLOR-CON M20 ORAL TABLET EXTENDED RELEASE

KLOR-CON ORAL PACKET

KLOR-CON ORAL TABLET EXTENDED RELEASE

kp mag-oxide magnesium oral tablet Mag-Oxide OTC

K-PRIME ORAL TABLET EFFERVESCENT

K-TAB ORAL TABLET EXTENDED RELEASE

liquid calcium with d3 oral capsule OTC

liquid calcium/vitamin d oral capsule OTC; QL

LUDENT ORAL TABLET CHEWABLE

MAGDELAY ORAL TABLET DELAYED RELEASE

OTC; QL

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Drug Name Reference Notes

mag-g oral tablet OTC

magnesium gluconate oral tablet OTC

magnesium oral capsule OTC

magnesium oral tablet 200 mg, 250 mg OTC

magnesium oral tablet 400 mg OTC; QL

magnesium oxide -mg supplement oral tablet

OTC

magnesium oxide oral capsule OTC

magnesium oxide oral tablet 400 (240 mg) mg

OTC; QL

magnesium oxide oral tablet 400 (241.3 mg) mg

MAGnesium-Oxide OTC; QL

magnesium oxide oral tablet 500 mg OTC

MAGNESIUM-OXIDE ORAL TABLET OTC; QL

MAG-OXIDE ORAL TABLET OTC

mgo oral tablet MAGnesium-Oxide OTC; QL

NAFRINSE DROPS ORAL SOLUTION

NAFRINSE ORAL TABLET CHEWABLE

natrul magnesium oral tablet OTC

nat-rul oyster calcium+vit d oral tablet OTC

oral electrolyte freezer pops oral solutionAdvantage Care Electrolyte Ped

OTC; QL

oral electrolytes oral solutionAdvantage Care Electrolyte Ped

OTC; QL

ORALYTE FREEZER POPS ORAL SOLUTION

OTC; QL

ORALYTE ORAL SOLUTION OTC; QL

oscal 500/200 d-3 oral tablet RA Hi Cal OTC

OS-CAL CALCIUM + D3 ORAL TABLET OTC

OYSCO 500 ORAL TABLET OTC; QL

OYSCO 500+D ORAL TABLET OTC

oyster calcium + d oral tablet 250-125 mg-unit

OTC; QL

oyster calcium + d oral tablet 500-125 mg-unit

OTC

oyster calcium/d3 oral tablet Os-Cal Calcium + D3 OTC

oyster shell calcium + d oral tablet Os-Cal Calcium + D3 OTC

oyster shell calcium + d3 oral tablet Oystercal-D OTC

oyster shell calcium 250+d oral tablet OTC; QL

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Drug Name Reference Notes

oyster shell calcium 500 + d oral tablet OTC

oyster shell calcium 500+d oral tablet chewable

OTC

oyster shell calcium oral tablet 500 mg Oysco 500 OTC; QL

oyster shell calcium oral tablet 500-400 mg-unit

Oystercal-D OTC

oyster shell calcium plus d oral tablet OTC

oyster shell calcium/d oral tablet 250-125 mg-unit

OTC; QL

oyster shell calcium/d oral tablet 500-200 mg-unit

RA Hi Cal OTC

oyster shell calcium/d oral tablet 500-400 mg-unit

OTC

oyster shell calcium/d oral tablet 500-5 mg-mcg

Os-Cal Calcium + D3 OTC

oyster shell calcium/d3 oral tablet OTC

oyster shell calcium/vitamin d oral tablet 250-125 mg-unit

OTC; QL

oyster shell calcium/vitamin d oral tablet 500-200 mg-unit

Os-Cal Calcium + D3 OTC

OYSTERCAL ORAL TABLET OTC; QL

OYSTERCAL-D ORAL TABLET OTC

pa oyster shell calcium oral tablet RA Hi Cal OTC

ped electrolyte freeze pops oral solutionAdvantage Care Electrolyte Ped

OTC; QL

ped electrolyte freezer pops oral solutionAdvantage Care Electrolyte Ped

OTC; QL

PEDIA VANCE ORAL SOLUTION OTC; QL

pediatric electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

pediatric electrolyte-zinc oral solutionAdvantage Care Electrolyte Ped

OTC; QL

pot bicarb-pot chloride oral tablet effervescent

potassium bicarbonate oral tablet effervescent

K-Prime

potassium chloride crys er oral tablet extended release

Klor-Con M20

potassium chloride er oral capsule extended release

Klor-Con Sprinkle

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Drug Name Reference Notes

potassium chloride er oral tablet extended release

Klor-Con 10

potassium chloride oral packet Klor-Con

potassium chloride oral solution

potassium gluconate oral tablet OTC; QL

px calcium&d oral tablet OTC; QL

qc calcium 600 +d3/minerals oral tablet chewable

Caltrate 600+D Plus Minerals

OTC

qc calcium fast dissolution oral tablet High Potency Calcium OTC

qc calcium/minerals/vitamin d oral tablet OTC; QL

qc potassium oral tablet OTC; QL

qc zinc oral tablet OTC; QL

ra ca/mg/zn/cu oral tablet Colamine OTC

ra calcium 600 oral tablet High Potency Calcium OTC

ra calcium 600/vit d/minerals oral tablet OTC

ra calcium 600/vit d/minerals oral tablet chewable

OTC; QL

ra calcium 600/vitamin d-3 oral tablet OTC; QL

ra calcium cit plus vit d-3 oral tablet Calcitrate OTC

ra calcium citrate plus vit d oral tablet OTC

ra calcium cit-vit d-3 petites oral tablet Citracal Petites/Vitamin D OTC

ra calcium plus vitamin d oral tablet OTC; QL

ra calcium soft chews oral tablet chewable OTC

ra calcium/minerals/vitamin d oral tablet OTC; QL

RA HI CAL ORAL TABLET OTC

RA HI-CAL ORAL TABLET OTC; QL

RA HI-CAL PLUS VITAMIN D ORAL TABLET

OTC

ra magnesium oral capsule OTC

ra oyster shell calcium oral tablet Oysco 500 OTC; QL

ra oyster shell calcium/d oral tablet 250-125 mg-unit

OTC; QL

ra oyster shell calcium/d oral tablet 500-200 mg-unit

RA Hi Cal OTC

ra ped electrolyte freezer pop oral solutionAdvantage Care Electrolyte Ped

OTC; QL

ra pediatric electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

ra potassium gluconate oral tablet OTC; QL

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Drug Name Reference Notes

ra zinc oral tablet OTC; QL

REHYDRALYTE ORAL SOLUTION OTC; QL

risacal-d oral tablet OTC

sb oyster shell calcium oral tablet Oysco 500 OTC; QL

sb pediatric electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

sm calcium 500/vitamin d3 oral tablet OTC

sm calcium 600/vitamin d oral tablet OTC; QL

sm calcium citrate w/vit d3 oral tablet Calcitrate OTC

sm calcium citrate-vit d oral tablet OTC

sm calcium soft chews oral tablet chewable OTC

sm calcium/vitamin d oral tablet 500-200 mg-unit

Os-Cal Calcium + D3 OTC

sm calcium/vitamin d oral tablet 600-800 mg-unit

Caltrate 600+D3 OTC; QL

sm calcium/vitamin d3 oral tabletCaltrate 600+D Plus Minerals

OTC

sm calcium-magnesium-zinc oral tablet OTC

sm calcium-vitamin d oral tablet 500-200 mg-unit

Os-Cal Calcium + D3 OTC

sm calcium-vitamin d oral tablet 600-400 mg-unit

OTC; QL

sm magnesium oral tablet OTC

sm magnesium oxide oral tablet OTC

sm oyster shell calcium/vit d oral tablet OTC

sm oyster shell calcium/vit d3 oral tablet Oystercal-D OTC

sm pediatric electrolyte oral solutionAdvantage Care Electrolyte Ped

OTC; QL

sm potassium oral tablet OTC; QL

sm zinc oral tablet OTC; QL

sodium fluoride oral solution QL

sodium fluoride oral tablet chewable Ludent

super calcium 600 + d 400 oral tablet OTC; QL

super calcium 600 + d3 oral tablet OTC; QL

super calcium oral tablet High Potency Calcium OTC

tgt calcium dietary supplement oral tablet chewable

OTC; QL

zinc chelated oral tablet OTC; QL

zinc gluconate oral tablet 100 mg, 30 mg OTC

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Drug Name Reference Notes

zinc gluconate oral tablet 50 mg OTC; QL

zinc oral tablet 100 mg, 30 mg OTC

zinc oral tablet 50 mg OTC; QL

zinc sulfate oral capsule Orazinc OTC

zinc sulfate oral tablet OTC

zinc-220 oral capsule Orazinc OTC

*MOUTH/THROAT/DENTAL AGENTS*

CAVAREST DENTAL GEL

cherry cough drops mouth/throat lozenge Dentiva OTC

CHLORASEPTIC KIDS MOUTH/THROAT LIQUID

OTC

CHLORASEPTIC MOUTH/THROAT LIQUID

OTC

CHLORASEPTIC MOUTH/THROAT LOZENGE

OTC

CHLORASEPTIC SORE THROAT MOUTH/THROAT LOZENGE

OTC

chlorhexidine gluconate mouth/throat solution

Paroex QL

clotrimazole mouth/throat lozenge QL

clotrimazole mouth/throat troche QL

cough drops mouth/throat lozenge OTC

cvs cherry menthol drops mouth/throat lozenge

Dentiva OTC

cvs honey lemon drops mouth/throat lozenge

Dentiva OTC

cvs menthol drops mouth/throat lozenge Dentiva OTC

cvs sore throat relief pops mouth/throat lozenge on a handle

OTC

gnp cough drops mouth/throat lozenge OTC

gnp sore throat mouth/throat lozenge Chloraseptic OTC

gnp throat drops mouth/throat lozenge Ludens Throat Drops OTC

lidocaine hcl mouth/throat solution QL

lidocaine viscous hcl mouth/throat solution QL

medikoff drops mouth/throat lozenge OTC

neutral sodium fluoride mouth/throat solution PreviDent

nystatin mouth/throat suspension

ORALONE MOUTH/THROAT PASTE

PAROEX MOUTH/THROAT SOLUTION QL

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Drug Name Reference Notes

PERIOGARD MOUTH/THROAT SOLUTION

QL

PERIOMED MOUTH/THROAT CONCENTRATE

OTC

pilocarpine hcl oral tablet Salagen QL

ra cough drops mouth/throat lozenge OTC

ra throat lozenges mouth/throat lozenge Chloraseptic OTC

sm cough drops mouth/throat lozenge OTC

sore throat lozenges mouth/throat lozenge Chloraseptic OTC

sore throat mouth/throat lozenge Chloraseptic OTC

tgt lozenges mouth/throat lozenge Chloraseptic OTC

tgt throat drops mouth/throat lozenge Ludens Throat Drops OTC

triamcinolone acetonide mouth/throat paste Oralone

ultra throat mouth/throat lozenge Chloraseptic OTC

zinc w/a&c mouth/throat lozenge Dentiva OTC

*MULTIVITAMINS*

a thru z select 50+ advanced oral tablet Vitacel OTC; QL

a thru z select advanced oral tablet Vitacel OTC; QL

a thru z select ultimate women oral tablet Vitacel OTC; QL

ABC PLUS SENIOR ADULTS 50+ ORAL TABLET

OTC; QL

actical oral capsule VIC-Forte OTC; QL

ALIVE GUMMIES FOR CHILDREN ORAL TABLET CHEWABLE

OTC

ALIVE MULTI-VITAMIN CHILDRENS ORAL TABLET CHEWABLE

OTC; QL

ALIVE PRENATAL ORAL TABLET CHEWABLE

AL; OTC

animal chews oral tablet chewable Animal Shapes OTC

ANIMAL SHAPES ORAL TABLET CHEWABLE

OTC

animal shapes/iron oral tablet chewable Cerovite Jr OTC

antioxidant a/c/e/selenium oral tablet Vitacel OTC; QL

anti-oxidant oral tablet One Daily Essential OTC; QL

APETIGEN-PLUS ORAL SOLUTION OTC

ATABEX ORAL TABLET CHEWABLE OTC

b complete oral tablet Big 100 OTC; QL

b complex 100 tr oral tablet extended release

Endur-B OTC

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Drug Name Reference Notes

b complex formula 1 oral tablet OTC

b complex oral capsule OTC

b complex oral tablet OTC

b complex plus oral tablet OTC

b complex vitamins oral capsule OTC

b complex-biotin-fa oral tablet Big 100 OTC; QL

b complex-c oral tablet Allbee/C OTC; QL

b complex-c-biotin-e-fa oral tablet OTC

b complex-c-folic acid oral tablet OTC; QL

b-100 b-complex oral tablet Big 100 OTC; QL

b-100 complex cr oral tablet extended release

Endur-B OTC

b-100 cr oral tablet extended release OTC

b-100 tr oral tablet extended release Endur-B OTC

b-50 complex oral tablet extended release Endur-B OTC

b50 complex tr oral tablet extended release Endur-B OTC

balance b-100 oral tablet Lipoflavovit AL; OTC; QL

balance b-50 oral tablet Big 100 OTC; QL

balanced b complex oral tablet Big 100 OTC; QL

balanced b-100 complex cr oral tablet extended release

OTC

balanced b-100 oral tablet Lipoflavovit AL; OTC; QL

balanced b-100 oral tablet extended release Endur-B OTC

balanced b-50 complex oral tablet Lipoflavovit AL; OTC; QL

balanced b-50 oral tablet Lipoflavovit AL; OTC; QL

b-compleet-100 oral tablet Big 100 OTC; QL

b-compleet-50 oral tablet Big 100 OTC; QL

b-complex balanced oral tablet OTC; QL

b-complex oral tablet Big 100 OTC

b-complex/b-12 oral tablet OTC

b-complex/vitamin c oral tablet OTC; QL

b-complex-c oral tablet Allbee/C OTC; QL

benfotiamine multi-b oral capsule OTC

BIG 100 ORAL TABLET OTC; QL

BPROTECTED PEDIA POLY-VITE ORAL SOLUTION

OTC

BPROTECTED PEDIA POLY-VITE/FE ORAL SOLUTION

OTC

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Drug Name Reference Notes

BPROTECTED PEDIA TRI-VITE ORAL SOLUTION

OTC

BRAINSTRONG PRENATAL ORAL OTC; QL

c complex oral tablet extended release Ascocid-1000 OTC

cadeau dha oral capsule OTC; QL

calna oral tablet OTC

centamin oral liquid Lysiplex Plus OTC; QL

centravites 50 plus oral tablet Vitacel OTC; QL

CENTRUM SPECIALIST PRENATAL ORAL

OTC

CEROVITE ADVANCED FORMULA ORAL TABLET

OTC; QL

CEROVITE SENIOR ORAL TABLET OTC; QL

certa plus oral tablet Vitacel OTC; QL

CERTAVITE SENIOR/ANTIOXIDANT ORAL TABLET

OTC; QL

CERTAVITE/ANTIOXIDANTS ORAL TABLET

OTC; QL

chewable vite childrens oral tablet chewable Animal Shapes OTC

child chewable vitamins/iron oral tablet chewable

Flintstones Plus Iron OTC

childrens chewable vitamins oral tablet chewable

Animal Shapes OTC

childrens gummies oral tablet chewableAlive Gummies for Children

OTC

classic prenatal oral tablet AL; OTC; QL

CLINICAL NUTRIENTS PRENATAL ORAL TABLET

OTC

companion oral tablet Vitacel OTC; QL

COMPETE ORAL TABLET OTC; QL

complete multi-vitamin oral tablet chewableAlive Gummies for Children

OTC

complete oral tablet Vitacel OTC; QL

complete senior oral tablet Vitacel OTC; QL

complex b-100 oral tablet extended release OTC

complex b-50 prolonged release oral tablet extended release

Endur-B OTC

CORVITA ORAL TABLET

cvs b complex plus c oral tablet Allbee/C OTC; QL

cvs daily multiple for men oral tablet Vitacel OTC; QL

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Drug Name Reference Notes

cvs daily multiple women 50+ oral tablet Vitacel OTC; QL

cvs gummy dinos oral tablet chewableAlive Gummies for Children

OTC

cvs gummy multivitamin kids oral tablet chewable

Alive Gummies for Children

OTC

cvs hair/skin/nails oral tablet Allerwell Allergy Formula OTC; QL

cvs niacin flush free oral capsule OTC

cvs one daily womens formula oral tablet Vitacel OTC; QL

cvs prenatal gummy oral tablet chewable 0.4-113.5 mg

OTC

cvs prenatal gummy oral tablet chewable 0.4-25 mg

Alive Prenatal AL; OTC

cvs prenatal multi+dha oral capsule OTC; QL

cvs prenatal oral tablet NeoNatal Vitamin AL; OTC; QL

cvs spectravite advanced oral tablet Vitacel OTC; QL

cvs spectravite senior oral tablet Vitacel OTC; QL

cvs spectravite ultra mens oral tablet Vitacel OTC; QL

cvs spectravite ultra women oral tablet Vitacel OTC; QL

cvs spectravite womens senior oral tablet Vitacel OTC; QL

cvs super b complex/c oral tablet Allbee/C OTC; QL

cvs womens prenatal+dha oral AL; OTC; QL

daily combo multi vitamins oral tablet Vitacel OTC; QL

daily multiple vitamins oral tablet One Daily Essential OTC; QL

daily value multivitamin oral tablet One Daily Essential OTC; QL

daily vitamin formula+iron oral tablet OTC; QL

daily vitamin formula+minerals oral tablet Vitacel OTC; QL

daily vitamin oral tablet One Daily Essential OTC; QL

daily vitamins oral tablet One Daily Essential OTC; QL

daily vite multivitamin/iron oral tablet OTC; QL

daily vite oral tablet One Daily Essential OTC; QL

daily vites oral tablet One Daily Essential OTC; QL

daily-vitamin oral tablet One Daily Essential OTC; QL

daily-vite oral tablet One Daily Essential OTC; QL

daily-vite/iron/beta-carotene oral tablet OTC; QL

DIALYVITE 800 ORAL TABLET OTC

DIALYVITE/ZINC ORAL TABLET

DINO-LIFE ORAL TABLET CHEWABLE OTC

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Drug Name Reference Notes

DINO-LIFE W/EXTRA C ORAL TABLET CHEWABLE

OTC

DINO-LIFE W/IRON-ZINC ORAL TABLET CHEWABLE

OTC; QL

disney cars gummies oral tablet chewableAlive Gummies for Children

OTC

disney princess gummies oral tablet chewable

Alive Gummies for Children

OTC

ear health formula oral tablet Lipoflavovit AL; OTC; QL

ear health plus oral tablet Lipoflavovit AL; OTC; QL

ELDERTONIC ORAL LIQUID OTC; QL

ENDUR-B ORAL TABLET EXTENDED RELEASE

OTC

ENFAMIL EXPECTA ORAL OTC

eq complete multivitamin-adult oral tablet Vitacel OTC; QL

eq multivitamin gummies oral tablet chewable

Alive Gummies for Children

OTC

eq multivitamins gummy child oral tablet chewable

Alive Gummies for Children

OTC

eql b complex 50 oral tablet Big 100 OTC; QL

eql b-100 complex oral tablet extended release

Endur-B OTC

eql century mature adults 50+ oral tablet Vitacel OTC; QL

eql century mature oral tablet Vitacel OTC; QL

eql century oral tablet Vitacel OTC; QL

eql gummies childrens oral tablet chewableAlive Gummies for Children

OTC

eql one daily mens health oral tablet Vitacel OTC; QL

eql one daily womens oral tabletHM Vita-Mini Multi Complete

OTC; QL

eql prenatal formula oral tablet AL; OTC; QL

eql super b complex/vitamin c oral tablet OTC; QL

eql vision formula oral tablet Vitacel OTC; QL

ESSENTIA ORAL TABLET OTC; QL

extress oral tablet Big 100 OTC; QL

extress-super oral tablet Big 100 OTC; QL

ezfe forte oral capsule OTC

FLINTSTONES GUMMIES BONE BUILD ORAL TABLET CHEWABLE

OTC; QL

FOLBEE PLUS CZ ORAL TABLET

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Drug Name Reference Notes

folbee plus oral tablet Dexifol

FOSFREE ORAL TABLET OTC; QL

full spectrum b/vitamin c oral tablet Dialyvite 800 OTC

geriaton oral liquid Eldertonic OTC; QL

gnp b-100 complex oral tablet extended release

Endur-B OTC

gnp b-50 balanced oral tablet Big 100 OTC; QL

gnp b-50 complex oral tablet extended release

Endur-B OTC

gnp b-complex plus vitamin c oral tablet OTC

gnp century cardio health oral tablet Vitacel OTC; QL

gnp century oral tablet Vitacel OTC; QL

gnp century ultimate womens oral tablet Vitacel OTC; QL

gnp childrens chewables/ex c oral tablet chewable

Dino-Life w/Extra C OTC

gnp childrens chewables/iron oral tablet chewable

Flintstones Plus Iron OTC

gnp daily prenatal oralOne-A-Day Womens Prenatal

AL; OTC; QL

gnp essential one daily oral tablet One Daily Essential OTC; QL

gnp healthy eyes oral tablet Vitacel OTC; QL

gnp healthy eyes supervision oral capsule VIC-Forte OTC; QL

gnp little ones childrens oral tablet chewable Animal Shapes OTC

gnp mega multi for men oral tablet Vitacel OTC; QL

gnp mega multi for women oral tablet Vitacel OTC; QL

gnp niacin flush free oral capsule OTC

gnp one daily maximum oral tablet Vitacel OTC; QL

gnp one daily mens health 50+ oral tablet Vitacel OTC; QL

gnp one daily mens/lycopene oral tablet Vitacel OTC; QL

gnp one daily plus iron oral tablet OTC; QL

gnp one daily womens health oral tabletHM Vita-Mini Multi Complete

OTC; QL

gnp prenatal oral tablet AL; OTC; QL

gnp therapeutic-m oral tablet Vitacel OTC; QL

gnp zoochews gummies oral tablet chewable

Alive Gummies for Children

OTC

goodsense prenatal vitamins oral tablet AL; OTC; QL

GUMMI BEAR MULTIVITAMIN/MIN ORAL TABLET CHEWABLE

OTC

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Drug Name Reference Notes

healthy eyes oral tablet Vitacel OTC; QL

healthy hair/skin/nails oral tablet One Daily Essential OTC; QL

HEALTHY KIDS OVERALL HEALTH ORAL TABLET CHEWABLE

OTC

HEALTHY MAMA BE WELL ROUNDED ORAL THERAPY PACK

OTC

hm antioxidant vitamins oral tablet Vitacel OTC; QL

hm complete 50+ oral tablet Vitacel OTC; QL

hm complete 50+ women ultimate oral tablet Vitacel OTC; QL

hm complete oral tablet Vitacel OTC; QL

hm complete women oral tablet Vitacel OTC; QL

hm hair/skin/nails oral tablet Vitacel OTC; QL

hm one daily essential oral tabletHM Vita-Mini Multi Complete

OTC; QL

hm one daily prenatal oralOne-A-Day Womens Prenatal

AL; OTC; QL

hm one daily womens oral tablet Vitacel OTC; QL

hm one daily/iron oral tablet OTC; QL

hm prenatal oral tablet AL; OTC; QL

hm super vitamin b complex/c oral tablet OTC; QL

hm vitamin b complex/vitamin c oral tablet OTC; QL

hm vitamin b100 complex oral tablet Big 100 OTC; QL

hm vitamin b50 complex oral tablet Big 100 OTC; QL

HONEY BEARS ORAL TABLET CHEWABLE

OTC

HONEY BEARS W/IRON-ZINC ORAL TABLET CHEWABLE

OTC; QL

ICAPS ORAL CAPSULE OTC; QL

inner ear plus oral tablet Lipoflavovit OTC

i-vite oral tablet Vitacel OTC; QL

i-vite protect oral tablet Vitacel OTC; QL

kobee oral tablet OTC

kp adults 50+ daily formula oral tablet Vitacel OTC; QL

kp adults daily formula oral tablet Vitacel OTC; QL

kp mens 50+ daily formula oral tablet Vitacel OTC; QL

kp prenatal multivitamins oral tablet AL; OTC; QL

kp womens daily formula oral tablet Vitacel OTC; QL

kpn prenatal oral tablet AL; OTC; QL

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Drug Name Reference Notes

LIPOFLAVOVIT ORAL TABLET AL; OTC; QL

LYSIPLEX PLUS ORAL LIQUID OTC; QL

M.V.I. ADULT INTRAVENOUS INJECTABLE

MACUVITE EYE CARE ORAL TABLET OTC; QL

magnum-75 oral tablet extended release Endur-VM OTC; QL

MEGA MULTI MEN ORAL TABLET OTC; QL

mega multiple/chelated mineral oral tablet Lipoflavovit AL; OTC; QL

mega multivitamin for men oral tablet Vitacel OTC; QL

mega multivitamin for women oral tablet Vitacel OTC; QL

mega-marathon 100 tr oral tablet extended release

Endur-VM OTC; QL

MILLTRIUM SENIOR ORAL TABLET OTC; QL

multi complete/iron oral tablet Vitacel OTC; QL

multi for her oral tablet Vitacel OTC; QL

multi prenatal oral tablet NeoNatal Vitamin AL; OTC; QL

multi vitamin daily oral tablet One Daily Essential OTC; QL

multi vitamin mens oral tablet One Daily Essential OTC; QL

multi-day oral tablet One Daily Essential OTC; QL

multi-day plus iron oral tablet OTC; QL

multi-delyn oral liquidNovaMV Pediatric Multi-Vitamin

OTC

multi-delyn/iron oral liquid OTC

multilex oral tablet Vitacel OTC; QL

multilex-t&m oral tablet Vitacel OTC; QL

multiple vit/minerals/no iron oral tablet Vitacel OTC; QL

multiple vitamin-folic acid oral tablet One Daily Essential OTC; QL

multiple vitamins essential oral tablet One Daily Essential OTC; QL

multiple vitamins oral tablet One Daily Essential OTC; QL

multiple vitamins/iron oral tablet OTC; QL

multi-vit/iron/fluoride oral solution

multivitamin & mineral oral liquid Lysiplex Plus OTC; QL

multi-vitamin daily oral tablet One Daily Essential OTC; QL

multi-vitamin hp/minerals oral capsule OTC

multivitamin iron-free oral tablet One Daily Essential OTC; QL

multi-vitamin oral tablet One Daily Essential OTC; QL

multivitamin/fluoride oral solution Floriva Plus

multi-vitamin/fluoride oral solution Floriva Plus

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Drug Name Reference Notes

multivitamin/fluoride oral tablet chewable MVC-Fluoride

multivitamin/fluoride/iron oral solution

multi-vitamin/fluoride/iron oral solution

multi-vitamin/minerals oral tablet Vitacel OTC; QL

multivitamins oral capsule Chlorocaps OTC

multi-vitamins oral tablet One Daily Essential OTC; QL

multivitamins/fluoride oral tablet chewable MVC-Fluoride

MVC-FLUORIDE ORAL TABLET CHEWABLE

MVW COMPLETE FORMULATION D3000 ORAL TABLET CHEWABLE

OTC

MVW COMPLETE FORMULATION D5000 ORAL TABLET CHEWABLE

OTC

mynephrocaps oral capsule Mynephron

MYNEPHRON ORAL CAPSULE

my-vitalife oral capsule VIC-Forte OTC; QL

NEONATAL VITAMIN ORAL TABLET AL; OTC; QL

NEPHPLEX RX ORAL TABLET

NEPHRONEX ORAL LIQUID OTC

NESTABS ORAL TABLET AL; QL

niacin flush free oral capsule OTC

no iron mult vitamin-minerals oral tablet Vitacel OTC; QL

NOVAMV PEDIATRIC MULTI-VITAMIN ORAL LIQUID

OTC

OBTREX ORAL TABLET AL; OTC; QL

ocutabs oral tablet Vitacel OTC; QL

ocutabs-lutein oral tablet Vitacel OTC; QL

once daily oral tablet One Daily Essential OTC; QL

once daily/iron oral tablet OTC; QL

ONE A DAY PRENATAL ORAL TABLET CHEWABLE

AL; OTC

one daily calcium/iron oral tablet Vitacel OTC; QL

one daily complete oral tablet Vitacel OTC; QL

ONE DAILY ESSENTIAL ORAL TABLET OTC; QL

one daily for men 50+ advanced oral tablet Vitacel OTC; QL

one daily for men/lycopene oral tablet Vitacel OTC; QL

one daily for women 50+ adv oral tablet Vitacel OTC; QL

one daily for women oral tablet Vitacel OTC; QL

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Drug Name Reference Notes

one daily maximum oral tablet Vitacel OTC; QL

one daily multivitamin/iron oral tablet OTC; QL

one daily oral tablet One Daily Essential OTC; QL

ONE DAILY PLUS IRON ORAL TABLET OTC; QL

one daily plus minerals oral tablet Vitacel OTC; QL

one daily womens 50 plus oral tablet Vitacel OTC; QL

one daily/minerals oral tablet Vitacel OTC; QL

ONE-A-DAY TEEN ADVANTAGE/HER ORAL TABLET

OTC; QL

ONE-A-DAY TEEN ADVANTAGE/HIM ORAL TABLET

OTC; QL

ONE-A-DAY WOMENS PRENATAL 1 ORAL CAPSULE

OTC

ONE-A-DAY WOMENS PRENATAL ORAL28-0.8 & 223 MG

OTC

ONE-A-DAY WOMENS PRENATAL ORAL28-0.8 & 440 MG

AL; OTC; QL

one-daily multi vitamins oral tablet One Daily Essential OTC; QL

one-daily multi-vitamin oral tablet One Daily Essential OTC; QL

OPTIVITE P.M.T. ORAL TABLET OTC; QL

pa b-complex with b-12 oral tablet OTC

pa prenatal formula oral tablet OTC

PEDIAVIT ORAL LIQUID OTC

PERRY PRENATAL ORAL CAPSULE AL; OTC; QL

poly vitamin oral tablet chewable Animal Shapes OTC

POLY-VI-SOL ORAL SOLUTION OTC

POLY-VI-SOL/IRON ORAL SOLUTION OTC

polyvitamin oral solutionBProtected Pedia Poly-Vite

OTC

poly-vite pediatric oral solutionBProtected Pedia Poly-Vite

OTC

POTEN B-150 CR ORAL TABLET EXTENDED RELEASE

OTC

prenatabs fa oral tablet Co-Natal FA AL; OTC; QL

prenatal + complete multi oral therapy pack OTC

prenatal adult gummy/dha/fa oral tablet chewable

Alive Prenatal AL; OTC

prenatal complete oral tablet AL; OTC; QL

prenatal formula a-free oral tablet OTC

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Drug Name Reference Notes

prenatal formula oral capsule OTC

pre-natal formula oral tablet AL; OTC; QL

prenatal forte oral tablet AL; OTC; QL

prenatal gummies/dha & fa oral tablet chewable

OTC

prenatal low iron oral tablet NeoNatal Vitamin AL; OTC; QL

prenatal multi +dha oral capsule 27-0.8-200 mg, 27-0.8-228 mg

OTC

prenatal multi +dha oral capsule 27-0.8-250 mg

OTC; QL

PRENATAL MULTIVITAMIN + DHA ORAL OTC

prenatal multivitamin plus dha oral capsule OTC

prenatal one daily oral tablet NeoNatal Vitamin AL; OTC; QL

prenatal oral tablet 27-0.8 mg NeoNatal Vitamin AL; OTC; QL

prenatal oral tablet 28-0.8 mg AL; OTC; QL

prenatal oral tablet 6.75-0.2 mg OTC

prenatal vitamin and mineral oral tablet AL; OTC; QL

prenatal vitamin oral tablet NeoNatal Vitamin AL; OTC; QL

prenatal vitamins oral tablet AL; OTC; QL

prenatal/iron oral tablet AL; OTC; QL

prenatal/omega-3/fa/iron oral capsule Your Life Multi Prenatal OTC

prenatal+dha oral AL; OTC; QL

PROSIGHT ORAL TABLET OTC; QL

px complete senior multivits oral tablet Vitacel OTC; QL

px prenatal multivitamins oral tablet AL; OTC; QL

qc b50 prolonged release oral tablet extended release

Endur-B OTC

qc b-complex/vitamin c oral tablet OTC

qc daily multivit/multimineral oral tablet Vitacel OTC; QL

qc essentials oral tablet One Daily Essential OTC; QL

qc prenatal oral tablet AL; OTC; QL

quin b strong b-25 oral tablet Big 100 OTC; QL

ra balanced b-100 cr oral tablet extended release

Endur-B OTC

ra balanced b-100 oral tablet Big 100 OTC; QL

ra balanced b-50 oral tablet Big 100 OTC; QL

ra balanced b-50 tr oral tablet extended release

Endur-B OTC

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Drug Name Reference Notes

ra b-complex oral tablet OTC

ra b-complex with b-12 oral tablet OTC

ra b-complex/vitamin c cr oral tablet extended release

OTC; QL

RA CENTRAL-VITE ORAL TABLET OTC; QL

ra central-vite performance oral tablet Allerwell Allergy Formula OTC; QL

ra central-vite under 50 mens oral tablet Vitacel OTC; QL

ra central-vite under 50 women oral tablet Vitacel OTC; QL

ra ear care oral tablet Allerwell Allergy Formula OTC; QL

ra gummy vitamins & minerals oral tablet chewable

Alive Gummies for Children

OTC

ra one daily energy formula oral tablet Vitacel OTC; QL

ra one daily essential oral tablet One Daily Essential OTC; QL

ra one daily maximum oral tablet Vitacel OTC; QL

ra one daily multi-vit plus fe oral tablet OTC; QL

ra one daily multi-vitamin oral tablet One Daily Essential OTC; QL

ra one daily oralOne-A-Day Womens Prenatal

AL; OTC; QL

ra one daily womens oral tablet Vitacel OTC; QL

ra prenatal formula oral tablet AL; OTC; QL

ra prenatal oral tablet AL; OTC; QL

ra therapeutic m plus beta car oral tablet Vitacel OTC; QL

ra vision vite plus zinc oral tablet Vitacel OTC; QL

ra vitamin c cr oral tablet extended release Ascocid-1000 OTC

RENAL ORAL CAPSULE

rena-vite oral tablet Dialyvite 800 OTC

reno caps oral capsule Mynephron

RIGHT STEP PRENATAL ORAL TABLET AL; OTC; QL

risanoid plus oral tablet Lipoflavovit AL; OTC; QL

SEA BUDDIES DAILY MULTIPLE ORAL TABLET CHEWABLE

OTC; QL

senior tabs oral tablet Vitacel OTC; QL

sentry adult oral tablet Vitacel OTC; QL

sentry oral tablet Vitacel OTC; QL

sentry senior oral tablet Vitacel OTC; QL

SIGTAB ORAL TABLET OTC; QL

SIMILAC PRENATAL EARLY SHIELD ORAL

OTC

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Drug Name Reference Notes

sm b super vitamin complex oral tablet OTC; QL

sm b100 complex oral tablet Big 100 OTC; QL

sm balanced b-100 oral tablet OTC

sm balanced b-50 oral tablet OTC

sm b-complex oral tablet Big 100 OTC; QL

sm b-complex/vitamin c oral tablet OTC; QL

sm complete 50+ oral tablet Vitacel OTC; QL

sm complete 50+ ultimate women oral tablet Vitacel OTC; QL

sm complete oral tablet Vitacel OTC; QL

sm complete senior formula oral tablet Vitacel OTC; QL

sm hair/skin/nails oral tablet Vitacel OTC; QL

sm multiple vitamins essential oral tablet One Daily Essential OTC; QL

sm multiple vitamins/iron oral tablet OTC; QL

sm one daily prenatal oralOne-A-Day Womens Prenatal

AL; OTC; QL

sm opti-vitamins oral tablet Vitacel OTC; QL

sm prenatal vitamins oral tablet AL; OTC; QL

sm super b complex/c oral tablet Allbee/C OTC; QL

SMARTY PANTS KIDS COMPLETE ORAL TABLET CHEWABLE

OTC

SPIDER-MAN COMPLETE MULTI-VIT ORAL TABLET CHEWABLE

OTC

SPONGEBOB SQUAREPANTS GUMMIES ORAL TABLET CHEWABLE

OTC

stress b/zinc oral tablet OTC; QL

stress formula oral tablet OTC; QL

stress formula/iron oral tablet OTC; QL

stress formula/zinc oral tablet OTC; QL

STRESSTABS ADVANCED ORAL TABLET

OTC; QL

STRESSTABS ENERGY ORAL TABLET OTC; QL

STUART ONE ORAL CAPSULE OTC

SUNVITE ADVANCED ORAL TABLET OTC; QL

super antioxidant oral capsule VIC-Forte OTC; QL

super b complex maxi oral tablet OTC

super b complex/fa/vit c oral tablet OTC; QL

super b/c oral capsule OTC; QL

super b-100 oral tablet Big 100 OTC; QL

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Drug Name Reference Notes

super b-50 oral tablet Big 100 OTC; QL

super b-complex oral tablet Big 100 OTC; QL

super b-complex/vit c/fa oral tablet OTC; QL

SUPER DEC B-100 ORAL TABLET OTC; QL

super natrul-100 oral tablet extended release

Endur-VM OTC; QL

SUPER QUINTS B-50 ORAL TABLET OTC; QL

super stress b-complex cr oral tablet extended release

OTC

super thera vite m oral tablet Vitacel OTC; QL

superior 35 oral tablet extended release Endur-VM OTC; QL

support oral liquid Lysiplex Plus QL

TAB-A-VITE ORAL TABLET OTC; QL

TAB-A-VITE/BETA CAROTENE ORAL TABLET

OTC; QL

tab-a-vite/iron oral tablet OTC; QL

THERA M PLUS ORAL TABLET OTC; QL

THERA ORAL TABLET OTC; QL

thera-m oral tablet Vitacel OTC; QL

thera-mill oral tablet One Daily Essential OTC; QL

THERANATAL COMPLETE ORAL OTC

THERANATAL CORE NUTRITION ORAL TABLET

AL; OTC; QL

THERANATAL ONE ORAL CAPSULE OTC

therapeutic oral tablet One Daily Essential OTC; QL

therapeutic-m/lutein oral tablet Vitacel OTC; QL

thera-tabs m oral tablet Vitacel OTC; QL

thera-tabs oral tablet One Daily Essential OTC; QL

THERATRUM COMPLETE 50 PLUS ORAL TABLET

OTC; QL

THERATRUM COMPLETE ORAL TABLET OTC; QL

THEREMS ORAL TABLET OTC; QL

THEREMS-M ORAL TABLET OTC; QL

total b/c oral tablet Allbee/C OTC; QL

totalday multiple oral tablet extended release Endur-VM OTC; QL

triphrocaps oral capsule Mynephron

tri-vitamin/fluoride oral solution

tri-vite pediatric oral solution BProtected Pedia Tri-Vite OTC

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Drug Name Reference Notes

tri-vite/fluoride oral solution

ultra-mega oral tablet extended release Endur-VM OTC; QL

unicomplex-m oral tablet Vitacel OTC; QL

urosex oral tablet Allerwell Allergy Formula QL

v-c forte oral capsule VIC-Forte QL

VIC-FORTE ORAL CAPSULE QL

VINATE CARE ORAL TABLET CHEWABLE

AL; OTC; QL

vit e-vit c-beta carotene oral tablet One Daily Essential OTC; QL

VITACEL ORAL TABLET QL

vitachew multiple vitamin oral tablet chewable

Alive Gummies for Children

OTC

vitalee oral tablet One Daily Essential OTC; QL

vitamin b complex oral tablet OTC

vitamin b complex-c oral capsule OTC; QL

vitamin b50 complex oral tablet extended release

Endur-B OTC

vitamin b-complex oral tablet OTC

vitamin c oral tablet chewable OTC; QL

vitamin-b complex oral tablet OTC

vitamins acd-fluoride oral solution

vitamins for hair oral tablet Allerwell Allergy Formula OTC; QL

vitamins/minerals oral tablet Vitacel OTC; QL

vitatrum oral tablet Vitacel OTC; QL

VITRUM SENIOR ORAL TABLET OTC; QL

wegmans complete prenatal+dha oral AL; OTC; QL

womens daily form/fa/ca/fe oral tablet Vitacel OTC; QL

womens one daily oral tablet Vitacel OTC; QL

YELETS TEENAGE FORMULA ORAL TABLET

OTC; QL

yl balanced b-100 oral tablet Big 100 OTC; QL

YOUR LIFE MULTI PRENATAL ORAL CAPSULE

OTC

zinc oral lozenge OTC

zoo friends gummies plus d oral tablet chewable

Alive Gummies for Children

OTC

ZOO FRIENDS MULTI GUMMIES ORAL TABLET CHEWABLE

OTC

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Drug Name Reference Notes

zoo friends oral tablet chewableAlive Gummies for Children

OTC; QL

zoo friends plus iron oral tablet chewable Flintstones Plus Iron OTC

*MUSCULOSKELETAL THERAPY AGENTS*

baclofen oral tablet

carisoprodol oral tablet Soma QL

carisoprodol-aspirin oral tablet QL

carisoprodol-aspirin-codeine oral tablet AL; QL

chlorzoxazone oral tablet

cyclobenzaprine hcl oral tablet 10 mg QL

cyclobenzaprine hcl oral tablet 5 mg

dantrolene sodium oral capsule Dantrium

EUFLEXXA INTRA-ARTICULAR SOLUTION PREFILLED SYRINGE

PA; SP

GELSYN-3 INTRA-ARTICULAR SOLUTION PREFILLED SYRINGE

PA; SP

methocarbamol oral tablet QL

orphenadrine citrate er oral tablet extended release 12 hour

QL

SUPARTZ FX INTRA-ARTICULAR SOLUTION PREFILLED SYRINGE

PA; SP

tizanidine hcl oral tablet QL

*NASAL AGENTS - SYSTEMIC AND TOPICAL*

12 hour decongestant oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

12 hour nasal decongestant oral tablet extended release 12 hour

Shopko Nasal Decongestant

AL; OTC

AFRIN SALINE NASAL MIST NASAL SOLUTION

AL; OTC

allergy relief nasal suspension ClariSpray OTC; QL

allergy spray 24 hour nasal aerosol Nasacort Allergy 24HR OTC; QL

allergy spray 24 hour nasal suspension ClariSpray OTC; QL

altamist spray nasal solution Afrin Saline Nasal Mist AL; OTC

AYR NASAL SOLUTION AL; OTC

AYR SALINE NASAL DROPS NASAL SOLUTION

OTC

azelastine hcl nasal solution QL

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Drug Name Reference Notes

BABY AYR SALINE NASAL SOLUTION AL; OTC

budesonide nasal suspension Rhinocort Allergy OTC; QL

CLARISPRAY NASAL SUSPENSION OTC; QL

cromolyn sodium nasal aerosol solution NasalCrom OTC

cvs 12 hour nasal decongestant oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

cvs budesonide nasal suspension Rhinocort Allergy OTC; QL

cvs fluticasone propionate nasal suspension ClariSpray OTC; QL

cvs nasal allergy spray nasal aerosol Nasacort Allergy 24HR OTC; QL

cvs nasal decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

cvs nasal mist nasal aerosol solution Simply Saline OTC

cvs saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

decongestant 12hour max st oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

deep sea nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

eq allergy relief nasal suspension ClariSpray OTC; QL

eq budesonide nasal nasal suspension Rhinocort Allergy OTC; QL

eq nasal allergy nasal aerosol Nasacort Allergy 24HR OTC; QL

eq saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

eq suphedrine oral tabletShopko Nasal Decongestant Max

AL; OTC

eql fluticasone childrens nasal suspension ClariSpray OTC; QL

eql fluticasone propionate nasal suspension ClariSpray OTC; QL

eql nasal decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

eql saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

fluticasone propionate nasal suspension ClariSpray OTC; QL

genaphed oral tabletShopko Nasal Decongestant Max

AL; OTC

gnp 24 hour nasal allergy nasal aerosol Nasacort Allergy 24HR OTC; QL

gnp budesonide nasal spray nasal suspension

Rhinocort Allergy OTC; QL

gnp fluticasone propionate chl nasal suspension

ClariSpray OTC; QL

gnp fluticasone propionate nasal suspension ClariSpray OTC; QL

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Drug Name Reference Notes

gnp nasal decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

gnp nasal moisturizing nasal solution Afrin Saline Nasal Mist AL; OTC

gnp pseudoephedrine hcl 12 hr oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

gnp suphedrin oral liquid Sudafed Childrens OTC

goodsense nasal allergy spray nasal aerosol Nasacort Allergy 24HR OTC; QL

hm allergy relief nasal suspension ClariSpray OTC; QL

hm nasal decongestant 12 hour oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

hm nasal decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

hm saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

ipratropium bromide nasal solution

KLS ALLER-FLO NASAL SUSPENSION OTC; QL

kp pseudoephedrine hcl oral tabletShopko Nasal Decongestant Max

AL; OTC

LITTLE NOSES SALINE NASAL SOLUTION

AL; OTC

LITTLE NOSES STUFFY NOSE KIT NASAL SOLUTION

AL; OTC

meijer nasal decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

meijer saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

nasal allergy 24 hour nasal aerosol Nasacort Allergy 24HR OTC; QL

nasal decongestant 12hr oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

nasal decongestant max st oral tabletShopko Nasal Decongestant Max

AL; OTC

nasal decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

NASAL MOIST NASAL SOLUTION AL; OTC

nasal moisturizing spray nasal solution Afrin Saline Nasal Mist AL; OTC

OCEAN FOR KIDS NASAL SOLUTION AL; OTC

OCEAN NASAL SPRAY NASAL SOLUTION

AL; OTC

pseudoephedrine hcl er oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

pseudoephedrine hcl oral tabletShopko Nasal Decongestant Max

AL; OTC

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Drug Name Reference Notes

px nasal decongestant oral tabletShopko Nasal Decongestant Max

AL; OTC

px nasal decongestant oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

px saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

qc allergy relief nasal suspension ClariSpray OTC; QL

qc fluticasone propionate nasal suspension ClariSpray OTC; QL

qc saline nasal relief nasal solution Afrin Saline Nasal Mist AL; OTC

qc suphedrine maximum strength oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

ra budesonide nasal suspension Rhinocort Allergy OTC; QL

ra nasal allergy nasal aerosol Nasacort Allergy 24HR OTC; QL

ra saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

ra sterile saline nasal mist nasal solution Simply Saline OTC

ra suphedrine oral tabletShopko Nasal Decongestant Max

AL; OTC

ra suphedrine oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

RHINOCORT ALLERGY NASAL SUSPENSION

OTC; QL

saline mist spray nasal solution Afrin Saline Nasal Mist AL; OTC

saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

sb saline nose nasal solution Afrin Saline Nasal Mist AL; OTC

SHOPKO NASAL DECONGESTANT MAX ORAL TABLET

AL; OTC

SHOPKO NASAL DECONGESTANT ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC

sinus 12 hour oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

sm allergy relief nasal suspension ClariSpray OTC; QL

sm nasal decongestant max st oral tabletShopko Nasal Decongestant Max

AL; OTC

sm nasal decongestant oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

sm nasal spray saline nasal solution Afrin Saline Nasal Mist AL; OTC

SUDAFED 12 HOUR ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC

SUDAFED SINUS CONGESTION 12HR ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC

193

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Drug Name Reference Notes

sudogest 12 hour oral tablet extended release 12 hour

Shopko Nasal Decongestant

OTC

SUDOGEST MAXIMUM STRENGTH ORAL TABLET

AL; OTC

SUDOGEST ORAL TABLET 30 MG AL; OTC

SUDOGEST ORAL TABLET 60 MG OTC

tgt nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

tgt saline nasal spray nasal solution Afrin Saline Nasal Mist AL; OTC

triamcinolone acetonide nasal aerosol Nasacort Allergy 24HR OTC; QL

WAL-PHED 12 HOUR ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC

WAL-PHED D ORAL TABLET EXTENDED RELEASE 12 HOUR

OTC

WAL-PHED ORAL TABLET AL; OTC

*NEUROMUSCULAR AGENTS*

riluzole oral tablet Rilutek PA; SP

*NUTRIENTS*

cvs lecithin oral capsule OTC

GERBER GOOD START WATER ORAL SOLUTION

OTC

GOOD START 5% GLUCOSE WATER ORAL SOLUTION

OTC

gram-o-leci oral tablet chewable OTC

inositol oral tablet OTC

kelp-b6-lecithin-vinegar oral capsule OTC

lecithin 3500 oral capsule OTC

lecithin oral capsule OTC

lecithin-19 oral capsule OTC

omega-3 fish oil oral capsule Ovega-3 OTC

PHENYLADE40 DRINK MIX ORAL PACKET

OTC

PRE PROTEIN ORAL POWDER OTC

prenatal dha oral capsule OTC

PROCEL 100 ORAL POWDER OTC

prosynminic oral powder Pre Protein OTC

protein oral powder OTC

pyridoxine-kelp-lect-vinegar oral tablet OTC

RENAMENT ORAL POWDER OTC

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Drug Name Reference Notes

SIMILAC GLUCOSE WATER ORAL SOLUTION

OTC

sm fish oil oral capsule Super Omega-3 OTC

sm soya lecithin oral capsule OTC

soya lecithin oral capsule OTC

SUPER OMEGA-3 ORAL CAPSULE OTC

SUPER TWIN EPA/DHA ORAL CAPSULE OTC

UNJURY ORAL POWDER OTC

whey protein oral powder Pre Protein OTC

*OPHTHALMIC AGENTS*

ak-poly-bac ophthalmic ointment Polycin

AKWA TEARS OPHTHALMIC OINTMENT OTC

ALAWAY CHILDRENS ALLERGY OPHTHALMIC SOLUTION

OTC; QL

ALAWAY OPHTHALMIC SOLUTION OTC; QL

ALTAFRIN OPHTHALMIC SOLUTION

apraclonidine hcl ophthalmic solution

artificial tears ophthalmic solution GenTeal Tears OTC

atropine sulfate ophthalmic solution Isopto Atropine QL

azelastine hcl ophthalmic solution QL

bacitracin ophthalmic ointment QL

bacitracin-polymyxin b ophthalmic ointment Polycin

bacitra-neomycin-polymyxin-hc ophthalmic ointment

Neo-Polycin HC

betaxolol hcl ophthalmic solution

brimonidine tartrate ophthalmic solution Alphagan P QL

carteolol hcl ophthalmic solution

ciprofloxacin hcl ophthalmic solution Ciloxan

CLARITIN EYE OPHTHALMIC SOLUTION OTC; QL

cromolyn sodium ophthalmic solution QL

cvs allergy eye drops ophthalmic solution Alaway OTC; QL

cvs artificial tears ophthalmic solution Moisture Eyes OTC

cvs dry eye relief ophthalmic solution Visine Dry Eye OTC

cvs eye allergy relief ophthalmic solution Opcon-A OTC

cvs eye drops ophthalmic solution 0.05 % OTC; QL

cvs eye drops ophthalmic solution 0.05-0.1-1-1 %

Visine Advanced Relief OTC

cvs eye itch relief ophthalmic solution Alaway OTC; QL

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Drug Name Reference Notes

cvs eye lubricant ophthalmic ointment Puralube OTC

cvs lubricant eye drops ophthalmic solution Ultra Fresh OTC

cvs redness relief ophthalmic solution OTC

dexamethasone sodium phosphate ophthalmic solution

diclofenac sodium ophthalmic solution

dorzolamide hcl ophthalmic solution Trusopt QL

dorzolamide hcl-timolol mal ophthalmic solution

Cosopt QL

epinastine hcl ophthalmic solution QL

eq artificial tears ophthalmic solution Moisture Eyes OTC

eq eye allergy relief ophthalmic solution Opcon-A OTC

eq eye drops ophthalmic solution OTC; QL

eql advanced relief ophthalmic solution Visine Advanced Relief OTC

eql eye drops ophthalmic solution OTC; QL

erythromycin ophthalmic ointment

eye allergy relief ophthalmic solution 0.025-0.3 %

Naphcon-A OTC; QL

eye allergy relief ophthalmic solution 0.027-0.315 %

Opcon-A OTC

eye drops advanced relief ophthalmic solution

Visine Advanced Relief OTC

eye drops allergy relief ophthalmic solution Visine-AC OTC; QL

eye drops maximum relief ophthalmic solution

Visine Advanced Relief OTC

eye drops ophthalmic solution 0.012-0.2 % OTC

eye drops ophthalmic solution 0.05 % OTC; QL

eye itch relief ophthalmic solution Alaway OTC; QL

eye lubricant ophthalmic ointment Puralube OTC

fluorometholone ophthalmic suspension FML Liquifilm

flurbiprofen sodium ophthalmic solution

for sty relief ophthalmic ointment Puralube OTC

gatifloxacin ophthalmic solution Zymaxid

GENTAK OPHTHALMIC OINTMENT QL

gentamicin sulfate ophthalmic solution QL

gnp eye drops ophthalmic solution 0.05 % OTC; QL

gnp eye drops ophthalmic solution 0.05-0.1-1-1 %

Visine Advanced Relief OTC

gnp eye itch relief ophthalmic solution Alaway OTC; QL

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Drug Name Reference Notes

gnp itchy eye ophthalmic solution Alaway OTC; QL

goodsense eye drops ophthalmic solution 0.05 %

OTC; QL

goodsense eye drops ophthalmic solution 0.05-0.1-1-1 %

Visine Advanced Relief OTC

goodsense relief eye drops ophthalmic solution

Visine-AC OTC; QL

hm eye drops advanced relief ophthalmic solution

Visine Advanced Relief OTC

hm eye drops ophthalmic solution OTC; QL

hm eye itch relief ophthalmic solution Alaway OTC; QL

ketotifen fumarate ophthalmic solution Alaway OTC; QL

kp ketotifen fumarate ophthalmic solution Alaway OTC; QL

latanoprost ophthalmic solution Xalatan QL

levobunolol hcl ophthalmic solution

levofloxacin ophthalmic solution

liquitears ophthalmic solution OTC

lubricant eye drops ophthalmic solution Ultra Fresh OTC

lubricant eye nighttime ophthalmic ointment Puralube OTC

lubricant eye ophthalmic ointment Puralube OTC

lubrifresh p.m. ophthalmic ointment Puralube OTC

MOISTURE EYES OPHTHALMIC SOLUTION

OTC

moxifloxacin hcl ophthalmic solution Vigamox QL

neomycin-bacitracin zn-polymyx ophthalmic ointment

Neo-Polycin QL

neomycin-polymyxin-dexameth ophthalmic ointment

Maxitrol

neomycin-polymyxin-dexameth ophthalmic suspension

Maxitrol

neomycin-polymyxin-gramicidin ophthalmic solution

QL

neomycin-polymyxin-hc ophthalmic suspension

NEO-POLYCIN HC OPHTHALMIC OINTMENT

NEO-POLYCIN OPHTHALMIC OINTMENT QL

ofloxacin ophthalmic solution Ocuflox QL

phenylephrine hcl ophthalmic solution Altafrin

pilocarpine hcl ophthalmic solution Isopto Carpine

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Drug Name Reference Notes

POLYCIN OPHTHALMIC OINTMENT

polymyxin b-trimethoprim ophthalmic solution

Polytrim QL

polyvinyl alcohol ophthalmic solution OTC

prednisolone acetate ophthalmic suspension Pred Forte

prednisolone sodium phosphate ophthalmic solution

PURALUBE OPHTHALMIC OINTMENT OTC

px sterile eye drops ophthalmic solution OTC; QL

ra antihistamine eye drops ophthalmic solution

Alaway OTC; QL

ra artificial tears ophthalmic solution Moisture Eyes OTC

ra eye allergy relief ophthalmic solution Opcon-A OTC

ra eye itch relief ophthalmic solution Alaway OTC; QL

ra lubricant eye ophthalmic solution Moisture Eyes OTC

ra sterile eye drops ophthalmic solution OTC

redness reliever eye drops ophthalmic solution

OTC; QL

sm eye drops ophthalmic solution 0.05 % OTC; QL

sm eye drops ophthalmic solution 0.05-0.1-1-1 %

Visine Advanced Relief OTC

sm eye itch relief ophthalmic solution Alaway OTC; QL

sulfacetamide sodium ophthalmic ointment QL

sulfacetamide sodium ophthalmic solution Bleph-10 QL

sulfacetamide-prednisolone ophthalmic solution

QL

TEARS AGAIN OPHTHALMIC OINTMENT OTC

tears pure ophthalmic solution GenTeal Tears OTC

tgt eye allergy relief ophthalmic solution Opcon-A OTC

tgt lubricant eye drops ophthalmic solution 0.4-0.3 %

Systane OTC; QL

tgt lubricant eye drops ophthalmic solution 1-0.3 %

Moisture Eyes OTC

tgt lubricant eye nighttime ophthalmic ointment

Puralube OTC

tgt redness reliever ophthalmic solution OTC

THERATEARS ALLERGY OPHTHALMIC SOLUTION

OTC; QL

timolol maleate ophthalmic gel forming solution

Timoptic-XE QL

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Drug Name Reference Notes

timolol maleate ophthalmic solution 0.25 % Timoptic QL

timolol maleate ophthalmic solution 0.5 % Timoptic

tobramycin ophthalmic solution Tobrex QL

tobramycin-dexamethasone ophthalmic suspension

TobraDex QL

trifluridine ophthalmic solution QL

ULTRA FRESH OPHTHALMIC SOLUTION OTC

*OTIC AGENTS*

acetic acid otic solution

auraphene-b otic solutionClearcanal Earwax Softener

OTC

ciprofloxacin hcl otic solution Cetraxal QL

CLEARCANAL EARWAX SOFTENER OTIC SOLUTION

OTC

CORTIC-ND OTIC SOLUTION

cvs ear drops otic solutionClearcanal Earwax Softener

OTC

cvs ear wax removal system otic solutionClearcanal Earwax Softener

OTC

cvs earwax removal kit otic solutionClearcanal Earwax Softener

OTC

ear drops earwax aid otic solutionClearcanal Earwax Softener

OTC

ear drops otic solutionClearcanal Earwax Softener

OTC

ear wax removal drops otic solutionClearcanal Earwax Softener

OTC

ear wax removal kit otic solutionClearcanal Earwax Softener

OTC

ear wax removal system otic solutionClearcanal Earwax Softener

OTC

earwax removal kit otic solutionClearcanal Earwax Softener

OTC

earwax removal otic solutionClearcanal Earwax Softener

OTC

earwax treatment drops otic solutionClearcanal Earwax Softener

OTC

eq ear wax removal aid otic solutionClearcanal Earwax Softener

OTC

gnp ear drops otic solutionClearcanal Earwax Softener

OTC

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Drug Name Reference Notes

gnp ear systems otic solutionClearcanal Earwax Softener

OTC

gnp earwax removal drops otic solutionClearcanal Earwax Softener

OTC

gnp earwax removal kit otic solutionClearcanal Earwax Softener

OTC

goodsense ear wax kit otic solutionClearcanal Earwax Softener

OTC

goodsense ear wax removal otic solutionClearcanal Earwax Softener

OTC

hm earwax removal aid otic solutionClearcanal Earwax Softener

OTC

hm earwax removal kit otic solutionClearcanal Earwax Softener

OTC

MURINE EAR OTIC SOLUTION OTC

MURINE EAR WAX REMOVAL SYSTEM OTIC SOLUTION

OTC

neomycin-polymyxin-hc otic solution

neomycin-polymyxin-hc otic suspension

ofloxacin otic solution QL

OTICIN HC NR OTIC SOLUTION

OTIX OTIC SOLUTION OTC

qc ear wax removal otic solutionClearcanal Earwax Softener

OTC

qc earwax removal otic solutionClearcanal Earwax Softener

OTC

ra ear drops otic solutionClearcanal Earwax Softener

OTC

ra earwax removal kit otic solutionClearcanal Earwax Softener

OTC

sm ear drops otic solutionClearcanal Earwax Softener

OTC

*OXYTOCICS*

methylergonovine maleate injection solution

methylergonovine maleate oral tablet Methergine

*PA ENDONUCLEASE INHIBITORS***

XOFLUZA (40 MG DOSE) ORAL TABLET THERAPY PACK

QL

XOFLUZA (80 MG DOSE) ORAL TABLET THERAPY PACK

QL

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Drug Name Reference Notes

*PASSIVE IMMUNIZING AGENTS*

GAMUNEX-C INJECTION SOLUTION PA; SP

OCTAGAM INTRAVENOUS SOLUTION PA; SP

SYNAGIS INTRAMUSCULAR SOLUTION PA; SP

*PCSK9 INHIBITORS***

REPATHA PUSHTRONEX SYSTEM SUBCUTANEOUS SOLUTION CARTRIDGE

PA; QL

REPATHA SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; QL

REPATHA SURECLICK SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; QL

*PENICILLINS*

amoxicillin oral capsule

amoxicillin oral suspension reconstituted QL

amoxicillin oral tablet

amoxicillin oral tablet chewable

amoxicillin-pot clavulanate er oral tablet extended release 12 hour

QL

amoxicillin-pot clavulanate oral suspension reconstituted

Augmentin ES-600

amoxicillin-pot clavulanate oral tablet

amoxicillin-pot clavulanate oral tablet chewable

ampicillin oral capsule

dicloxacillin sodium oral capsule

penicillin v potassium oral solution reconstituted

penicillin v potassium oral tablet

*PHARMACEUTICAL ADJUVANTS*

cvs petroleum jelly external gelRA Tugaboos Petroleum Jelly

OTC

gnp petroleum jelly gelRA Tugaboos Petroleum Jelly

OTC

GRX WHITE PETROLATUM EXTERNAL OINTMENT

OTC

hm petroleum jelly gelRA Tugaboos Petroleum Jelly

OTC

petrolatum external ointment OTC

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Drug Name Reference Notes

petroleum jelly external gelRA Tugaboos Petroleum Jelly

OTC

petroleum jelly external ointment OTC

petroleum jelly gelRA Tugaboos Petroleum Jelly

OTC

ra petroleum jelly external ointment OTC

ra petroleum jelly gelRA Tugaboos Petroleum Jelly

OTC

RA TUGABOOS PETROLEUM JELLY GEL OTC

RESOURCE THICKENUP ORAL PACKET OTC

RESOURCE THICKENUP ORAL POWDER OTC

SIMPLYTHICK EASY MIX ORAL GEL OTC

SIMPLYTHICK ORAL GEL OTC

sm petroleum jelly gelRA Tugaboos Petroleum Jelly

OTC

sterile water for injection injection solution

sterile water for injection intravenous solution

THICK & EASY ORAL PACKET OTC

THICK NOW ORAL POWDER OTC

THICK-IT #2 ORAL PACKET OTC

THICK-IT #2 ORAL POWDER OTC

THICK-IT ORAL PACKET OTC

THICK-IT ORAL POWDER OTC

THIK & CLEAR ORAL POWDER OTC

white petrolatum external ointment GRX White Petrolatum OTC

white petroleum jelly external gelRA Tugaboos Petroleum Jelly

OTC

yellow petrolatum external ointment OTC

*PLASMA KALLIKREIN INHIBITORS - MONOCLONAL ANTIBODIES***

TAKHZYRO SUBCUTANEOUS SOLUTION PA; SP; QL

*POTASSIUM REMOVING AGENTS***

sodium polystyrene sulfonate oral suspension

SPS

sodium polystyrene sulfonate rectal suspension

SPS ORAL SUSPENSION

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Drug Name Reference Notes

*PRENATAL MV & MIN W/FE-FA & COENZYME Q10***

THERANATAL OVAVITE ORAL THERAPY PACK

OTC

*PRENATAL MV & MINERALS W/ FA WITHOUT IRON***

cvs prenatal gummy oral tablet chewable OTC

*PRENATAL MV & MINERALS W/ FA-OMEGA FATTY ACIDS W/O IRON***

cvs prenatal gummy oral tablet chewable OTC

*PRENATAL MV & MINERALS W/FA WITHOUT IRON***

ALIVE PRENATAL ORAL TABLET CHEWABLE

AL; OTC

cvs prenatal gummy oral tablet chewable Alive Prenatal AL; OTC

ONE A DAY PRENATAL ORAL TABLET CHEWABLE

AL; OTC

prenatal + complete multi oral therapy pack OTC

prenatal adult gummy/dha/fa oral tablet chewable

Alive Prenatal AL; OTC

prenatal gummies/dha & fa oral tablet chewable

OTC

*PROGESTINS*

hydroxyprogesterone caproate intramuscular oil

Makena PA; SP; QL

MAKENA SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; SP; QL

medroxyprogesterone acetate oral tablet Provera QL

norethindrone acetate oral tablet Aygestin

progesterone micronized oral capsule Prometrium QL

*PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC.*

acamprosate calcium oral tablet delayed release

QL

AUBAGIO ORAL TABLET PA; SP; QL

AVONEX PEN INTRAMUSCULAR AUTO-INJECTOR KIT

PA; SP; QL

AVONEX PREFILLED INTRAMUSCULAR PREFILLED SYRINGE KIT

PA; SP; QL

BETASERON SUBCUTANEOUS KIT PA; SP; QL

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Drug Name Reference Notes

bupropion hcl er (smoking det) oral tablet extended release 12 hour

QL

CHANTIX CONTINUING MONTH PAK ORAL TABLET

AL; QL

CHANTIX ORAL TABLET AL; QL

CHANTIX STARTING MONTH PAK ORAL TABLET

QL

chlordiazepoxide-amitriptyline oral tablet

cvs nicotine mouth/throat gum KLS Quit2 OTC; QL

cvs nicotine mouth/throat lozenge KLS Quit2 OTC; QL

cvs nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

cvs nicotine polacrilex mouth/throat lozenge KLS Quit2 OTC; QL

cvs nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL

disulfiram oral tablet Antabuse

donepezil hcl oral tablet 10 mg, 5 mg Aricept QL

donepezil hcl oral tablet 23 mg Aricept PA; QL

donepezil hcl oral tablet dispersible QL

eq nicotine mouth/throat gum KLS Quit4 OTC; QL

eq nicotine mouth/throat lozenge KLS Quit4 OTC; QL

eq nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

eq nicotine polacrilex mouth/throat lozenge KLS Quit2 OTC; QL

eq nicotine step 3 transdermal patch 24 hour Nicoderm CQ OTC; QL

eq nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL

eql nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

eql nicotine polacrilex mouth/throat lozenge KLS Quit2 OTC; QL

EXTAVIA SUBCUTANEOUS KIT PA; SP; QL

fluoxetine hcl (pmdd) oral tablet Sarafem QL

galantamine hydrobromide er oral capsule extended release 24 hour

Razadyne ER

galantamine hydrobromide oral solution

galantamine hydrobromide oral tablet QL

glatiramer acetate subcutaneous solution prefilled syringe

Glatopa PA; SP; QL

GLATOPA SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

gnp nicotine mini mouth/throat lozenge KLS Quit2 OTC; QL

gnp nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

gnp nicotine polacrilex mouth/throat lozenge KLS Quit2 OTC; QL

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Drug Name Reference Notes

gnp nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL

goodsense nicotine mouth/throat gum KLS Quit4 OTC; QL

goodsense nicotine mouth/throat lozenge KLS Quit2 OTC; QL

hm nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

hm nicotine polacrilex mouth/throat lozenge KLS Quit4 OTC; QL

hm nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL

KLS QUIT2 MOUTH/THROAT GUM OTC; QL

KLS QUIT2 MOUTH/THROAT LOZENGE OTC; QL

KLS QUIT4 MOUTH/THROAT GUM OTC; QL

KLS QUIT4 MOUTH/THROAT LOZENGE OTC; QL

memantine hcl oral solution

memantine hcl oral tablet Namenda QL

NAMENDA TITRATION PAK ORAL TABLET

QL

NICORELIEF MOUTH/THROAT GUM OTC; QL

nicotine mini mouth/throat lozenge KLS Quit2 OTC; QL

nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

nicotine polacrilex mouth/throat lozenge KLS Quit2 OTC; QL

nicotine step 1 transdermal patch 24 hour Nicoderm CQ OTC; QL

nicotine step 2 transdermal patch 24 hour Nicoderm CQ OTC; QL

nicotine step 3 transdermal patch 24 hour Nicoderm CQ OTC; QL

nicotine transdermal kit OTC

nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL

NICOTROL INHALATION INHALER

NICOTROL NS NASAL SOLUTION

perphenazine-amitriptyline oral tablet

pimozide oral tablet PA

px stop smoking aid mouth/throat gum KLS Quit2 OTC; QL

px stop smoking aid mouth/throat lozenge KLS Quit2 OTC; QL

ra mini nicotine mouth/throat lozenge KLS Quit2 OTC; QL

ra nicotine gum mouth/throat gum KLS Quit2 OTC; QL

ra nicotine mouth/throat gum KLS Quit2 OTC; QL

ra nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

ra nicotine polacrilex mouth/throat lozenge KLS Quit2 OTC; QL

ra nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL

REBIF REBIDOSE SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; SP

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Drug Name Reference Notes

REBIF REBIDOSE TITRATION PACK SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; SP

REBIF SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP

REBIF TITRATION PACK SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP

rivastigmine tartrate oral capsule

sm nicotine mouth/throat gum KLS Quit4 OTC; QL

sm nicotine mouth/throat lozenge KLS Quit2 OTC; QL

sm nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

sm nicotine polacrilex mouth/throat lozenge KLS Quit4 OTC; QL

sm nicotine transdermal patch 24 hour Nicoderm CQ OTC; QL

sr nicotine mouth/throat gum KLS Quit2 OTC; QL

tgt nicotine mouth/throat gum KLS Quit2 OTC; QL

tgt nicotine polacrilex mouth/throat gum KLS Quit2 OTC; QL

tgt nicotine polacrilex mouth/throat lozenge KLS Quit4 OTC; QL

tgt nicotine step one transdermal patch 24 hour

Nicoderm CQ OTC; QL

tgt nicotine step three transdermal patch 24 hour

Nicoderm CQ OTC; QL

tgt nicotine step two transdermal patch 24 hour

Nicoderm CQ OTC; QL

THRIVE MOUTH/THROAT GUM OTC; QL

*RESPIRATORY AGENTS - MISC.*

PULMOZYME INHALATION SOLUTION PA; SP; QL

*SEROTONIN MODULATORS***

nefazodone hcl oral tablet

trazodone hcl oral tablet

*SODIUM-GLUCOSE CO-TRANSPORTER 2 INHIBITOR-BIGUANIDE COMB***

SYNJARDY ORAL TABLET PA; QL

SYNJARDY XR ORAL TABLET EXTENDED RELEASE 24 HOUR

PA; QL

*STEROIDS - MOUTH/THROAT/DENTAL***

ORALONE MOUTH/THROAT PASTE

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Drug Name Reference Notes

triamcinolone acetonide mouth/throat paste Oralone

*SULFONAMIDES*

sulfadiazine oral tablet

*TETRACYCLINES*

demeclocycline hcl oral tablet

doxycycline monohydrate oral capsule 100 mg

Mondoxyne NL QL

doxycycline monohydrate oral capsule 150 mg

doxycycline monohydrate oral capsule 50 mg

QL

doxycycline monohydrate oral capsule 75 mg

Mondoxyne NL

doxycycline monohydrate oral suspension reconstituted

Vibramycin

minocycline hcl oral capsule Minocin

minocycline hcl oral tablet

tetracycline hcl oral capsule

*THYROID AGENTS*

EUTHYROX ORAL TABLET

LEVO-T ORAL TABLET

levothyroxine sodium oral tablet Euthyrox

LEVOXYL ORAL TABLET

liothyronine sodium oral tablet Cytomel

methimazole oral tablet Tapazole

propylthiouracil oral tablet

SYNTHROID ORAL TABLET

UNITHROID ORAL TABLET

*ULCER DRUGS*

acid control maximum strength oral tablet Pepcid OTC; QL

acid controller complete oral tablet chewable Duo Fusion OTC

acid controller max st oral tablet Pepcid OTC; QL

acid controller oral tablet Pepcid AC OTC; QL

acid reducer complete oral tablet chewable Duo Fusion OTC

acid reducer maximum strength oral tablet Pepcid OTC; QL

acid reducer oral capsule delayed release OTC; QL

acid reducer oral tablet Pepcid AC OTC; QL

cvs acid controller max st oral tablet Pepcid OTC; QL

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Drug Name Reference Notes

cvs acid controller oral tablet Pepcid AC OTC; QL

cvs dual action complete oral tablet chewable

Duo Fusion OTC

cvs esomeprazole magnesium oral capsule delayed release

GoodSense Esomeprazole

OTC; QL

cvs lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

cvs omeprazole oral capsule delayed release

OTC; QL

cvs omeprazole oral tablet delayed release OTC; QL

cvs omeprazole oral tablet delayed release dispersible

OTC

cvs omeprazole-sod bicarbonate oral capsule

Zegerid OTC OTC; QL

dicyclomine hcl oral capsule

dicyclomine hcl oral solution

dicyclomine hcl oral tablet

eq acid reducer complete oral tablet chewable

Duo Fusion OTC

eq acid reducer max st oral tablet Pepcid OTC; QL

eq acid reducer oral tablet Pepcid AC OTC; QL

eq lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

eq omeprazole magnesium oral capsule delayed release

OTC; QL

eq omeprazole oral tablet delayed release OTC; QL

eq omeprazole oral tablet delayed release dispersible

OTC

eql dual action complete oral tablet chewable

Duo Fusion OTC

eql heartburn prevention oral tablet Pepcid AC OTC; QL

eql lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

eql omeprazole oral tablet delayed release OTC; QL

esomeprazole magnesium capsule delayed release 20 mg oral (otc)

GoodSense Esomeprazole

QL

esomeprazole magnesium capsule delayed release 20 mg oral (otc)

GoodSense Esomeprazole

OTC; QL

famotidine intravenous solution

famotidine oral suspension reconstituted PA

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Drug Name Reference Notes

famotidine oral tablet 10 mg Pepcid AC OTC; QL

famotidine oral tablet 20 mg, 40 mg Pepcid QL

glycopyrrolate oral tablet 1 mg, 2 mg

glycopyrrolate oral tablet 1.5 mg Glycate PA

gnp acid reducer max st oral tablet Pepcid OTC; QL

gnp acid reducer oral tablet Pepcid AC OTC; QL

gnp dual action complete oral tablet chewable

Duo Fusion OTC

gnp lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

gnp omeprazole oral tablet delayed release OTC; QL

gnp omeprazole oral tablet delayed release dispersible

OTC

GOODSENSE ESOMEPRAZOLE ORAL CAPSULE DELAYED RELEASE

OTC; QL

goodsense lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

heartburn relief max st oral tablet Pepcid OTC; QL

heartburn relief oral tablet Pepcid AC OTC; QL

heartburn treatment 24 hour oral capsule delayed release

Prevacid 24HR OTC; QL

hm esomeprazole magnesium dr oral capsule delayed release

GoodSense Esomeprazole

OTC; QL

hm famotidine oral tablet Pepcid AC OTC; QL

hm lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

hm omeprazole oral tablet delayed release OTC; QL

hyosyne oral elixir

hyosyne oral solution

kls acid controller max st oral tablet Pepcid OTC; QL

kls esomeprazole magnesium oral capsule delayed release

GoodSense Esomeprazole

OTC; QL

kls lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

kls omeprazole oral tablet delayed release OTC; QL

kp omeprazole magnesium oral capsule delayed release

OTC; QL

lansoprazole oral capsule delayed release Prevacid 24HR OTC; QL

misoprostol oral tablet Cytotec

mm famotidine oral tablet Pepcid OTC; QL

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Drug Name Reference Notes

NEXIUM 24HR ORAL TABLET DELAYED RELEASE

OTC; QL

nizatidine oral capsule

nizatidine oral solution PA

omeprazole magnesium oral capsule delayed release

OTC; QL

omeprazole oral capsule delayed release PA; QL

omeprazole oral tablet delayed release OTC; QL

omeprazole oral tablet delayed release dispersible

OTC

omeprazole-sodium bicarbonate oral capsule

Zegerid OTC PA; OTC; QL

PREVACID 24HR ORAL CAPSULE DELAYED RELEASE

OTC; QL

PRILOSEC OTC ORAL TABLET DELAYED RELEASE

OTC; QL

propantheline bromide oral tablet

px acid reducer max st oral tablet Pepcid OTC; QL

px acid reducer oral tablet Pepcid AC OTC; QL

px dual action oral tablet chewable Duo Fusion OTC

px omeprazole oral tablet delayed release OTC; QL

qc acid controller max st oral tablet Pepcid OTC; QL

qc acid controller oral tablet Pepcid AC OTC; QL

qc omeprazole magnesium oral capsule delayed release

OTC; QL

ra acid reducer max st oral tablet Pepcid OTC; QL

ra acid reducer oral tablet Pepcid AC OTC; QL

ra dual action complete oral tablet chewable Duo Fusion OTC

ra esomeprazole magnesium oral capsule delayed release

GoodSense Esomeprazole

OTC; QL

ra lansoprazole oral capsule delayed release Prevacid 24HR OTC; QL

ra omeprazole oral tablet delayed release OTC; QL

ra omeprazole-sodium bicarb oral capsule Zegerid OTC OTC; QL

sb acid controller max st oral tablet Pepcid OTC; QL

sb acid controller oral tablet Pepcid AC OTC; QL

sb acid reducer oral tablet Pepcid AC OTC; QL

sb omeprazole oral tablet delayed release OTC; QL

sm acid reducer max st oral tablet Pepcid OTC; QL

sm acid reducer oral tablet Pepcid AC OTC; QL

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Drug Name Reference Notes

sm esomeprazole magnesium oral capsule delayed release

GoodSense Esomeprazole

OTC; QL

sm lansoprazole oral capsule delayed release

Prevacid 24HR OTC; QL

sm omeprazole oral tablet delayed release OTC; QL

sucralfate oral suspension Carafate

sucralfate oral tablet Carafate

tgt omeprazole oral tablet delayed release OTC; QL

ZEGERID OTC ORAL CAPSULE OTC; QL

*URINARY ANTI-INFECTIVES*

methenamine hippurate oral tablet Hiprex

nitrofurantoin macrocrystal oral capsule Macrodantin

nitrofurantoin monohyd macro oral capsule Macrobid

*URINARY ANTISPASMODICS*

bethanechol chloride oral tablet

darifenacin hydrobromide er oral tablet extended release 24 hour

Enablex

flavoxate hcl oral tablet

oxybutynin chloride er oral tablet extended release 24 hour 10 mg

Ditropan XL

oxybutynin chloride er oral tablet extended release 24 hour 15 mg

oxybutynin chloride er oral tablet extended release 24 hour 5 mg

Ditropan XL QL

oxybutynin chloride oral syrup

oxybutynin chloride oral tablet

OXYTROL FOR WOMEN TRANSDERMAL PATCH TWICE WEEKLY

OTC

tolterodine tartrate er oral capsule extended release 24 hour

Detrol LA

tolterodine tartrate oral tablet Detrol

trospium chloride er oral capsule extended release 24 hour

trospium chloride oral tablet

*VACCINES*

AFLURIA QUADRIVALENT INTRAMUSCULAR SUSPENSION

QL

AFLURIA QUADRIVALENT INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

QL

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Drug Name Reference Notes

FLUAD INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

QL

FLUARIX QUADRIVALENT INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

QL

FLUBLOK QUADRIVALENT INTRAMUSCULAR SOLUTION PREFILLED SYRINGE

QL

FLUCELVAX QUADRIVALENT INTRAMUSCULAR SUSPENSION

QL

FLULAVAL QUADRIVALENT INTRAMUSCULAR SUSPENSION

QL

FLULAVAL QUADRIVALENT INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

QL

FLUZONE HIGH-DOSE INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

QL

FLUZONE QUADRIVALENT INTRAMUSCULAR SUSPENSION

QL

FLUZONE QUADRIVALENT INTRAMUSCULAR SUSPENSION PREFILLED SYRINGE

QL

PREVNAR 13 INTRAMUSCULAR SUSPENSION

SHINGRIX INTRAMUSCULAR SUSPENSION RECONSTITUTED

AL

ZOSTAVAX SUBCUTANEOUS SUSPENSION RECONSTITUTED

AL

*VAGINAL PRODUCTS*

3 day vaginal vaginal cream Gyne-Lotrimin 3 OTC

CLEOCIN VAGINAL SUPPOSITORY

clindamycin phosphate vaginal cream Cleocin

clotrimazole 3 vaginal cream Gyne-Lotrimin 3 OTC

clotrimazole vaginal cream Gyne-Lotrimin OTC

clotrimazole-7 vaginal cream Gyne-Lotrimin OTC

cvs clotrimazole 3 vaginal cream Gyne-Lotrimin 3 OTC

cvs miconazole 1 combo pack vaginal kit Monistat 1 Combo Pack OTC

cvs miconazole 3 combo pack vaginal kit Vagistat-3 OTC

cvs miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

cvs tioconazole 1 vaginal ointment Monistat 1-Day OTC

eq miconazole 1 vaginal kit Monistat 1 Combo Pack OTC

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Drug Name Reference Notes

eq miconazole 3 combo pack vaginal kit Vagistat-3 OTC

eq miconazole 7 day treatment vaginal cream

Monistat 7 Simply Cure OTC

eq miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

eql miconazole 3 vaginal kit Vagistat-3 OTC

eql miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

eql tioconazole-1 vaginal ointment Monistat 1-Day OTC

estradiol vaginal tablet Yuvafem

gnp clotrimazole 3 vaginal cream Gyne-Lotrimin 3 OTC

gnp miconazole 3 vaginal kit Vagistat-3 OTC

gnp miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

goodsense miconazole 1 vaginal kit Monistat 1 Combo Pack OTC

metronidazole vaginal gel Vandazole

miconazole 1 vaginal kit Monistat 1 Combo Pack OTC

miconazole 3 applicator vaginal kitMonistat 3 Combo Pack App

OTC

miconazole 3 combo pack app vaginal kitMonistat 3 Combo Pack App

OTC

miconazole 3 combo pack vaginal kit Vagistat-3 OTC

miconazole 3 vaginal suppository

miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

miconazole 7 vaginal suppository OTC

miconazole nitrate vaginal cream Monistat 7 Simply Cure OTC

PREMARIN VAGINAL CREAM PA

px miconazole 3-day combo vaginal kit Vagistat-3 OTC

qc 3 day vaginal cream Monistat 3 OTC

qc miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

ra clotrimazole 3 vaginal cream Gyne-Lotrimin 3 OTC

ra clotrimazole 7 vaginal cream Gyne-Lotrimin OTC

ra miconazole 3 combo pack app vaginal kitMonistat 3 Combo Pack App

OTC

ra miconazole 3 combo pack vaginal kit Vagistat-3 OTC

ra miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

ra tioconazole 1 vaginal ointment Monistat 1-Day OTC

sm 3-day vaginal vaginal cream Gyne-Lotrimin 3 OTC

sm clotrimazole vaginal vaginal cream Gyne-Lotrimin OTC

sm miconazole 3 applicator vaginal kitMonistat 3 Combo Pack App

OTC

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Drug Name Reference Notes

sm miconazole 3 vaginal kit Vagistat-3 OTC

sm miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

sm miconazole 7 vaginal suppository OTC

sm tioconazole-1 vaginal ointment Monistat 1-Day OTC

terconazole vaginal cream 0.4 %

terconazole vaginal cream 0.8 % QL

terconazole vaginal suppository QL

tgt miconazole 1 vaginal kit Monistat 1 Combo Pack OTC

tgt miconazole 3 combo pack vaginal kit Vagistat-3 OTC

tgt miconazole 7 vaginal cream Monistat 7 Simply Cure OTC

tioconazole-1 vaginal ointment Monistat 1-Day OTC

TODAY SPONGE VAGINAL OTC

VAGISTAT-3 VAGINAL KIT OTC

VANDAZOLE VAGINAL GEL

VCF VAGINAL CONTRACEPTIVE VAGINAL FILM

OTC

VCF VAGINAL CONTRACEPTIVE VAGINAL FOAM

OTC

YUVAFEM VAGINAL TABLET

*VASOPRESSORS*

epinephrine injection solution auto-injector EpiPen Jr 2-Pak QL

midodrine hcl oral tablet

SYMJEPI INJECTION SOLUTION PREFILLED SYRINGE

QL

*VITAMINS*

ACEROLA C 500 ORAL WAFER OTC

acerola c-500 oral tablet chewable Sunkist Vitamin C OTC; QL

alph-e oral capsule Ester-E OTC

alph-e-mixed oral capsule Ester-E OTC

aqueous vitamin d oral liquid BProtected Pedia D-Vite OTC; QL

aqueous vitamin e oral solution SoluVita E OTC

ascorbic acid injection solution

ascorbic acid oral tablet 1000 mg OTC

ascorbic acid oral tablet 250 mg OTC; QL

ascorbic acid oral tablet 500 mg PureWay-C OTC; QL

ascorbic acid oral tablet chewable OTC

asco-tabs-1000 oral tablet OTC

b-1 high potency oral tablet OTC

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Drug Name Reference Notes

b-1 oral tablet OTC

b2 oral tablet OTC

b-2 oral tablet OTC

b6 natural oral tablet OTC

b-6 oral tablet OTC

biotin 5000 oral capsule Meribin OTC

biotin maximum strength oral capsule Meribin OTC

biotin oral capsule Meribin OTC

biotin oral tablet OTC

BPROTECTED PEDIA D-VITE ORAL LIQUID

OTC; QL

BPROTECTED VITAMIN C ORAL LIQUID OTC

c 1000 oral tablet OTC

c 250 oral tablet OTC; QL

c 250 oral tablet chewable OTC

c 500 oral tablet PureWay-C OTC; QL

c 500 oral tablet chewable Sunkist Vitamin C OTC; QL

c 500/rose hips oral tablet PureWay-C OTC; QL

c-1000 oral tablet OTC

c-1000 oral tablet extended release Endur-C OTC

c-1000 sr oral tablet extended release Endur-C OTC

c-1000/rose hips oral tablet OTC

c-1000/rose hips sr oral tablet extended release

Endur-C OTC

c-1500/rose hips sr oral tablet extended release

OTC

c-250 oral tablet OTC; QL

c-250 oral tablet chewable OTC

c-500 non-acid oral tablet OTC; QL

c-500 oral tablet PureWay-C OTC; QL

c-500 oral tablet chewable Sunkist Vitamin C OTC; QL

c-500 oral tablet extended release Endur-C OTC

c-500 sr oral capsule extended release OTC

c-500 sr oral tablet extended release Endur-C OTC

c-500/rose hips oral tablet PureWay-C OTC; QL

CALCIDOL ORAL SOLUTION OTC

calcium ascorbate oral tablet OTC; QL

calcium pantothenate oral tablet OTC

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Drug Name Reference Notes

c-chewable oral tablet chewable Sunkist Vitamin C OTC; QL

chew-c oral tablet chewable Sunkist Vitamin C OTC; QL

CRUSH VITAMIN C DROPS MOUTH/THROAT LOZENGE

OTC

c-time oral capsule extended release OTC

cvs b-1 oral tablet OTC

cvs b6 oral tablet OTC

cvs biotin high potency oral tablet OTC

cvs biotin oral capsule Meribin OTC

cvs chewable c with rose hips oral tablet chewable

Sunkist Vitamin C OTC; QL

cvs d3 oral capsule 10 mcg (400 unit) OTC

cvs d3 oral capsule 125 mcg (5000 ut) Dialyvite Vitamin D 5000 OTC; QL

cvs d3 oral capsule 25 mcg (1000 ut) Pronutrients Vitamin D3 OTC

cvs d3 oral capsule 50 mcg (2000 ut) OTC; QL

cvs vitamin b-2 oral tablet OTC

cvs vitamin c oral tablet 1000 mg OTC

cvs vitamin c oral tablet 250 mg OTC; QL

cvs vitamin c oral tablet 500 mg PureWay-C OTC; QL

cvs vitamin c-rose hips oral tablet 1000 mg OTC

cvs vitamin c-rose hips oral tablet 500 mg PureWay-C OTC; QL

cvs vitamin d3 oral capsule Decara OTC

cvs vitamin d3 oral tablet chewableKids First Vitamin D3 Gummies

OTC

cvs vitamin e oral capsule Ester-E OTC

d 1000 oral capsule Pronutrients Vitamin D3 OTC

d 1000 oral tablet Vitamin D-1000 Max St OTC

d 1000 oral tablet chewableKids First Vitamin D3 Gummies

OTC

d 10000 oral capsule Decara OTC

d 400 oral tablet OTC; QL

d 400 oral tablet chewable Healthy Kids Vitamin D3 OTC

d 5000 oral capsule Dialyvite Vitamin D 5000 OTC; QL

d 5000 oral tabletRadiance Platinum Vitamin D3

OTC

d-1000 extra strength oral tablet Vitamin D-1000 Max St OTC

d-1000 oral tablet Vitamin D-1000 Max St OTC

d-2000 maximum strength oral tablet Thera-D 2000 OTC

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Drug Name Reference Notes

d2000 ultra strength oral capsule OTC; QL

d3 adult oral tablet chewableKids First Vitamin D3 Gummies

OTC

d3 high potency oral capsule 125 mcg (5000 ut)

Dialyvite Vitamin D 5000 OTC

d3 high potency oral capsule 25 mcg (1000 ut)

Pronutrients Vitamin D3 OTC

d3 high potency oral capsule 50 mcg (2000 ut)

OTC; QL

d3 high potency oral tablet OTC; QL

d3 maximum strength oral capsule Dialyvite Vitamin D 5000 OTC; QL

d3 maximum strength oral liquid OTC

d3 super strength oral capsule OTC; QL

d3-1000 oral capsule Pronutrients Vitamin D3 OTC

d3-1000 oral tablet Vitamin D-1000 Max St OTC

d-3-5 oral capsule Dialyvite Vitamin D 5000 OTC; QL

D3-50 ORAL CAPSULE OTC

d-400 oral tablet OTC; QL

d-5000 oral tabletRadiance Platinum Vitamin D3

OTC

DECARA ORAL CAPSULE OTC

delta d3 oral tablet OTC; QL

DIALYVITE VITAMIN D 5000 ORAL CAPSULE

OTC; QL

DIALYVITE VITAMIN D3 MAX ORAL TABLET

OTC

d-vite pediatric oral liquid BProtected Pedia D-Vite OTC; QL

e400 mixed oral capsule Ester-E OTC

e400 oral capsule Ester-E OTC

e-400 oral capsule Ester-E OTC

e-400-clear oral capsule Ester-E OTC

e-400-mixed oral capsule Ester-E OTC

e600 oral capsule OTC

ENDUR-C ORAL TABLET EXTENDED RELEASE

OTC

eql b-6 oral tablet OTC

eql vitamin c oral tablet 1000 mg OTC

eql vitamin c oral tablet 500 mg PureWay-C OTC; QL

eql vitamin c/rose hips oral tablet 1000 mg OTC

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Drug Name Reference Notes

eql vitamin c/rose hips oral tablet 500 mg PureWay-C OTC; QL

eql vitamin d3 gummies oral tablet chewableKids First Vitamin D3 Gummies

OTC

eql vitamin d3 oral capsule 10 mcg (400 unit)

OTC

eql vitamin d3 oral capsule 125 mcg (5000 ut)

Dialyvite Vitamin D 5000 OTC; QL

eql vitamin d3 oral capsule 25 mcg (1000 ut) Pronutrients Vitamin D3 OTC

eql vitamin d3 oral capsule 50 mcg (2000 ut) OTC; QL

eql vitamin e oral capsule Ester-E OTC

ergocalciferol oral capsule Drisdol

ergocalciferol oral solution Calcidol OTC

ESTER-E ORAL CAPSULE OTC

fruit c 500 oral tablet chewable Sunkist Vitamin C OTC; QL

fruity c oral tablet chewable OTC

gnp biotin oral capsule Meribin OTC

gnp d 1000 oral capsule Pronutrients Vitamin D3 OTC

gnp d 2000 oral tablet chewableKids First Vitamin D3 Gummies

OTC

gnp niacin oral tablet OTC

gnp vitamin b1 oral tablet OTC

gnp vitamin b-1 oral tablet OTC

gnp vitamin b-6 oral tablet OTC

gnp vitamin c cr oral tablet extended release Endur-C OTC

gnp vitamin c drops mouth/throat lozenge Crush Vitamin C Drops OTC

gnp vitamin c oral tablet 1000 mg OTC

gnp vitamin c oral tablet 250 mg OTC; QL

gnp vitamin c oral tablet 500 mg PureWay-C OTC; QL

gnp vitamin c oral tablet chewable Sunkist Vitamin C OTC; QL

gnp vitamin c oral tablet extended release Endur-C OTC

gnp vitamin c w/rose hips oral tablet PureWay-C OTC; QL

gnp vitamin c/rose hips oral tablet OTC

gnp vitamin c/rose hips tr oral tablet extended release

Endur-C OTC

gnp vitamin d maximum strength oral tablet Thera-D 2000 OTC

gnp vitamin d oral tablet Vitamin D-1000 Max St OTC

gnp vitamin d super strength oral tabletRadiance Platinum Vitamin D3

OTC

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Drug Name Reference Notes

gnp vitamin d3 extra strength oral tablet Vitamin D-1000 Max St OTC

gnp vitamin d-400 oral tablet OTC; QL

gnp vitamin e oral capsule Ester-E OTC

hm e vitamin oral capsule Ester-E OTC

hm niacin oral tablet extended release Endur-Acin OTC

hm niacin tr oral tablet extended release Endur-Acin OTC

hm vitamin b1 oral tablet OTC

hm vitamin b6 oral tablet OTC

hm vitamin c oral tablet 1000 mg OTC

hm vitamin c oral tablet 500 mg PureWay-C OTC; QL

hm vitamin c oral tablet chewable Sunkist Vitamin C OTC; QL

hm vitamin c tr oral tablet extended release Endur-C OTC

hm vitamin c/rose hips oral tablet 1000 mg OTC

hm vitamin c/rose hips oral tablet 500 mg PureWay-C OTC; QL

hm vitamin d oral tablet 10 mcg (400 unit) OTC; QL

hm vitamin d oral tablet 25 mcg (1000 ut) Vitamin D-1000 Max St OTC

hm vitamin d3 oral capsule 100 mcg (4000 ut)

OTC

hm vitamin d3 oral capsule 50 mcg (2000 ut) OTC; QL

hm vitamin e oral capsule Ester-E OTC

JUST D ORAL LIQUID OTC; QL

k 100 oral tablet OTC

KIDS FIRST VITAMIN D3 GUMMIES ORAL TABLET CHEWABLE

OTC

kp niacin oral tablet OTC

kp vitamin b-6 oral tablet OTC

kp vitamin d oral capsule Pronutrients Vitamin D3 OTC

kp vitamin d3 oral capsule 25 mcg (1000 ut) Pronutrients Vitamin D3 OTC

kp vitamin d3 oral capsule 50 mcg (2000 ut) OTC; QL

kp vitamin e oral capsule OTC

meijer c oral tablet PureWay-C OTC; QL

nat-rul vitamin d oral tablet Vitamin D-1000 Max St OTC

natural c/rose hips oral tablet 1000 mg OTC

natural c/rose hips oral tablet 500 mg PureWay-C OTC; QL

natural vitamin d-3 oral tabletRadiance Platinum Vitamin D3

OTC

natural vitamin e oral capsule Ester-E OTC

neuro-k-250 vitamin b6 oral tablet OTC

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Drug Name Reference Notes

neuro-k-50 oral tablet OTC

niacin er oral capsule extended release OTC; QL

niacin er oral tablet extended release Endur-Acin OTC

niacin oral tablet OTC

niacin-50 oral tablet OTC

niacinamide oral tablet OTC

OPTIMAL-D ORAL CAPSULE OTC

pa biotin oral capsule Meribin OTC

pa biotin oral tablet OTC

pa vitamin d-3 oral capsule OTC; QL

pa vitamin d-3 oral tablet Vitamin D-1000 Max St OTC

pa vitamin e oral capsule Ester-E OTC

phytonadione injection solution

phytonadione oral tablet Mephyton

plain niacin oral tablet OTC

PRONUTRIENTS VITAMIN D3 ORAL CAPSULE

OTC

pure c 500 oral capsule extended release OTC

PUREWAY-C ORAL TABLET OTC; QL

px niacin oral tablet OTC

px vitamin c oral tablet PureWay-C OTC; QL

px vitamin e oral capsule Ester-E OTC

pyridoxine hcl injection solution

pyridoxine hcl oral tablet OTC

qc biotin oral tablet OTC

qc niacin oral tablet OTC

qc vitamin b1 oral tablet OTC

qc vitamin b6 oral tablet OTC

qc vitamin c oral tablet 1000 mg OTC

qc vitamin c oral tablet 500 mg PureWay-C OTC; QL

qc vitamin c oral tablet chewable Sunkist Vitamin C OTC; QL

qc vitamin c with rose hips oral tablet PureWay-C OTC; QL

qc vitamin d3 oral capsule 25 mcg (1000 ut) Pronutrients Vitamin D3 OTC

qc vitamin d3 oral capsule 50 mcg (2000 ut) OTC; QL

qc vitamin d3 oral tablet 10 mcg (400 unit) OTC; QL

qc vitamin d3 oral tablet 125 mcg (5000 ut)Radiance Platinum Vitamin D3

OTC

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Drug Name Reference Notes

qc vitamin d3 oral tablet 25 mcg (1000 ut) Vitamin D-1000 Max St OTC

qc vitamin d3 oral tablet 50 mcg (2000 ut) Thera-D 2000 OTC

qc vitamin e oral capsule Ester-E OTC

ra biotin oral capsule Hard Nails OTC

ra biotin oral tablet OTC

ra natural vitamin e oral capsule Ester-E OTC

ra niacin oral tablet OTC

ra vitamin b-1 oral tablet OTC

ra vitamin b-6 oral tablet OTC

ra vitamin c cr oral tablet extended release Endur-C OTC

ra vitamin c drops mouth/throat lozenge Crush Vitamin C Drops OTC

ra vitamin c oral tablet PureWay-C OTC; QL

ra vitamin c oral tablet chewable 250 mg OTC

ra vitamin c oral tablet chewable 500 mg Sunkist Vitamin C OTC; QL

ra vitamin c/acerola oral tablet chewable Sunkist Vitamin C OTC; QL

ra vitamin c/rose hips cr oral tablet extended release

Endur-C OTC

ra vitamin c/rose hips oral tablet 1000 mg OTC

ra vitamin c/rose hips oral tablet 500 mg PureWay-C OTC; QL

ra vitamin d-3 oral capsule OTC; QL

ra vitamin d-3 oral tablet Vitamin D-1000 Max St OTC

ra vitamin e blend oral capsule Ester-E OTC

ra vitamin e oral capsule Ester-E OTC

RADIANCE PLATINUM VITAMIN D3 ORAL TABLET

REPLESTA ORAL WAFER OTC

sb vitamin c oral tablet PureWay-C OTC; QL

SLO-NIACIN ORAL TABLET EXTENDED RELEASE

OTC

sm chewable c oral tablet chewable Sunkist Vitamin C OTC; QL

sm chewable vitamin c oral tablet chewable Sunkist Vitamin C OTC; QL

sm vit c/rose hips oral tablet OTC

sm vitamin b1 oral tablet OTC

sm vitamin b6 oral tablet OTC

sm vitamin b-6 oral tablet OTC

sm vitamin c cr oral tablet extended release Endur-C OTC

sm vitamin c oral tablet 1000 mg OTC

sm vitamin c oral tablet 250 mg OTC; QL

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Drug Name Reference Notes

sm vitamin c oral tablet 500 mg PureWay-C OTC; QL

sm vitamin c oral tablet chewable Sunkist Vitamin C OTC; QL

sm vitamin c/rose hips oral tablet PureWay-C OTC; QL

sm vitamin d oral tablet OTC; QL

sm vitamin d3 oral capsule 100 mcg (4000 ut)

OTC

sm vitamin d3 oral capsule 125 mcg (5000 ut)

Dialyvite Vitamin D 5000 OTC; QL

sm vitamin d3 oral capsule 50 mcg (2000 ut) OTC; QL

sm vitamin d3 oral tablet Vitamin D-1000 Max St OTC

sm vitamin e oral capsule Ester-E OTC

SUNKIST VITAMIN C ORAL TABLET CHEWABLE

OTC; QL

super biotin oral capsule Meribin OTC

tgt vitamin c drops mouth/throat lozenge Crush Vitamin C Drops OTC

THERA-D 2000 ORAL TABLET OTC

THERA-D RAPID REPLETION ORAL TABLET

OTC

thiamine hcl injection solution

thiamine hcl oral tablet OTC

vita-c oral crystals OTC

VITAJOY DAILY D GUMMIES ORAL TABLET CHEWABLE

OTC

vitamin a oral capsule OTC

vitamin b1 oral tablet OTC

vitamin b-1 oral tablet OTC

vitamin b-2 oral tablet OTC

vitamin b6 oral tablet OTC

vitamin b-6 oral tablet OTC

vitamin c drops mouth/throat lozenge Crush Vitamin C Drops OTC

vitamin c er oral capsule extended release OTC

vitamin c er oral tablet extended release OTC

vitamin c immune health oral tablet chewable

Sunkist Vitamin C OTC; QL

vitamin c oral liquid BProtected Vitamin C OTC

vitamin c oral powder Ascocid OTC

vitamin c oral tablet 100 mg, 1000 mg OTC

vitamin c oral tablet 250 mg OTC; QL

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Page 223: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

vitamin c oral tablet 500 mg PureWay-C OTC; QL

vitamin c oral tablet chewable 250 mg OTC

vitamin c oral tablet chewable 500 mg Sunkist Vitamin C OTC; QL

vitamin c plus wild rose hips oral tablet chewable

Sunkist Vitamin C OTC; QL

vitamin c/bioflavonoids/rosehp oral tablet PureWay-C OTC; QL

vitamin c/rose hips oral tablet PureWay-C OTC; QL

vitamin c/rose hips tr oral tablet extended release

Endur-C OTC

vitamin c-acerola oral tablet PureWay-C OTC; QL

vitamin c-acerola oral tablet chewable Sunkist Vitamin C OTC; QL

vitamin c-rose hips er oral tablet extended release

Endur-C OTC

vitamin c-rose hips oral tablet 1000 mg OTC

vitamin c-rose hips oral tablet 500 mg PureWay-C OTC; QL

vitamin c-rose hips oral tablet chewable Sunkist Vitamin C OTC; QL

vitamin c-rose hips tr oral tablet extended release

Endur-C OTC

vitamin d (cholecalciferol) oral capsule 10 mcg (400 unit)

OTC

vitamin d (cholecalciferol) oral capsule 25 mcg (1000 ut)

Pronutrients Vitamin D3 OTC

vitamin d (cholecalciferol) oral capsule 50 mcg (2000 ut)

vitamin d (cholecalciferol) oral tablet 10 mcg (400 unit)

OTC; QL

vitamin d (cholecalciferol) oral tablet 25 mcg (1000 ut)

Vitamin D-1000 Max St OTC

vitamin d (ergocalciferol) oral capsule Drisdol

vitamin d high potency oral capsule Pronutrients Vitamin D3 OTC

vitamin d infant oral liquid BProtected Pedia D-Vite OTC; QL

vitamin d oral capsule OTC; QL

vitamin d oral liquid BProtected Pedia D-Vite OTC; QL

vitamin d oral tablet Thera-D 2000 OTC

VITAMIN D-1000 MAX ST ORAL TABLET OTC

vitamin d2 oral tablet OTC

vitamin d3 adult gummies oral tablet chewable

Kids First Vitamin D3 Gummies

OTC

vitamin d3 gummies adult oral tablet chewable

Kids First Vitamin D3 Gummies

OTC

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Page 224: Medicaid-Approved Preferred Drug List - MMITfm.formularynavigator.com/FBO/4/Western_New_York_Medicaid_PDL_English.pdf · Western New York Medicaid-Approved Preferred Drug List. Effective

Drug Name Reference Notes

vitamin d3 gummies oral tablet chewableKids First Vitamin D3 Gummies

OTC

vitamin d3 maximum strength oral capsule Dialyvite Vitamin D 5000 OTC; QL

vitamin d-3 oral capsule Pronutrients Vitamin D3 OTC

vitamin d3 oral capsule 1.25 mg (50000 ut) D3-50 OTC

vitamin d3 oral capsule 10 mcg (400 unit) OTC

vitamin d3 oral capsule 125 mcg (5000 ut) Dialyvite Vitamin D 5000 OTC; QL

vitamin d3 oral capsule 25 mcg (1000 ut) Pronutrients Vitamin D3 OTC

vitamin d3 oral capsule 250 mcg (10000 ut) Decara OTC

vitamin d3 oral capsule 50 mcg (2000 ut) OTC; QL

vitamin d3 oral liquid 10 mcg/ml BProtected Pedia D-Vite OTC; QL

vitamin d3 oral liquid 125 mcg/ml OTC

vitamin d-3 oral tabletRadiance Platinum Vitamin D3

OTC

vitamin d3 oral tablet 1.25 mg (50000 ut) Dialyvite Vitamin D3 Max OTC

vitamin d3 oral tablet 10 mcg (400 unit) OTC; QL

vitamin d3 oral tablet 125 mcg (5000 ut)Radiance Platinum Vitamin D3

OTC

vitamin d3 oral tablet 25 mcg (1000 ut) Vitamin D-1000 Max St OTC

vitamin d3 oral tablet 50 mcg (2000 ut) Thera-D 2000 OTC

vitamin d3 oral tablet chewable Healthy Kids Vitamin D3 OTC

vitamin d3 super strength oral tablet Thera-D 2000 OTC

vitamin d3 ultra potency oral tablet Dialyvite Vitamin D3 Max OTC

vitamin d-400 oral tablet OTC; QL

vitamin e blend oral capsule Ester-E OTC

vitamin e complex oral capsule Ester-E OTC

vitamin e high potency oral capsule Ester-E OTC

vitamin e oral capsule Ester-E OTC

vitamin e water soluble oral capsule Ester-E OTC

vitamin e/d-alpha natural oral capsule Ester-E OTC

vitamin e/d-alpha oral capsule OTC

vitamin e-200 oral capsule OTC

vitamin e-400 oral capsule Ester-E OTC

vitamin k (phytonadione) oral tablet OTC

vitamin k oral tablet OTC

vitamin k1 injection solution

WEEKLY-D ORAL CAPSULE OTC

yl vitamin b-6 oral tablet OTC

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Drug Name Reference Notes

yl vitamin c oral tablet 1000 mg OTC

yl vitamin c oral tablet 500 mg PureWay-C OTC; QL

yl vitamin c-rose hips oral tablet 1000 mg OTC

yl vitamin c-rose hips oral tablet 500 mg PureWay-C OTC; QL

yl vitamin e oral capsule Ester-E OTC

225