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2020 STANDARD ALTERNATIVE DRUG LIST(January - March 2020)

Product Name ALTERNATIVE DRUG7TOPIC EMU Epiceram, Prumyx

ABILIFY MYCI TAB aripiprazole tab

ABSORICA CAP Claravis, Myorisan, Zenatane

ACANYA GEL adapalene, clindamycin, tretinoin

ACTOPLUS MET TAB XR metformin/ER, pioglitazone

ACUVAIL SOL ketorolac ophthalmic

ACZONE GEL adapalene, clindamycin, tretinoin

ADAZIN CRE lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

ADLYXIN INJ Byetta, Bydureon, Ozempic, Trulicity, Victoza

ADVANCED MIS AM/PM BP Vit 3 Plus

AEMCOLO TAB Xifaxan

AEROSPAN AER Asmanex, Flovent, QVAR RediHaler

AFREZZA POW Humulin/Humalog Products

ALA-QUIN CRE econazole, mupirocin, hydrocortisone valerate

ALBUTEROL AER HFA Ventolin HFA, ProAir HFA

ALCORTIN A GEL oxiconazole cream, ketoconazole, hydrocortisone valerate

ALDACTAZIDE TAB spironolactone-HCTZ, amlodipine-valsartan-HCTZ, atenolol-chlorthalidone, benazepril-HCTZ

ALEVICYN SOL DERMAL doxepin cream, triamcinolone cream, mometasone cream

The alternatives listed are suggestions based on how the drug works and the condition it treats. You should discuss your therapy with your doctor of health care provider. Some alternatives may require prior authorization or have quantity limits.

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Product Name ALTERNATIVE DRUGALLZITAL TAB butalbital/acetaminophen tablet 50-325MG

ALOCRIL SOL cromolyn, ketotifen

ALOG/PIOGLIP TAB Janumet, Janumet XR, Jentadueto

ALOG/PIOGLIT TAB Janumet, Janumet XR, Jentadueto

ALOGLIPTIN TAB Januvia, Tradjenta

ALOGLIPTIN/ TAB METFORM Janumet, Janumet XR, Jentadueto

ALOQUIN GEL oxiconazole cream, ketoconazole, econzaole

ALORA DIS estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

ALREX SUS dexamethasone ophthalmic, prednisolone ophthalmic, triamcinolone ophthalmic

ALTABAX OIN mupirocin

ALTOPREV TAB ER lovastatin

ALVESCO AER Asmanex, Flovent, QVAR RediHaler

AMICAR SOL aminocaproic acid, tranexamic acid

AMICAR TAB aminocaproic acid, tranexamic acid

AMRIX CAP cyclobenzaprine tablet

ANACAINE OIN lidocaine, lidocaine-tetracaine

ANADROL-50 TAB Procrit, Epogen

ANALPRAM E KIT hydrocortisone/pramoxine, hydrocortisone aloe

ANALPRAM KIT ADVANCED hydrocortisone/pramoxine, hydrocortisone aloe

ANALPRAM-HC LOT hydrocortisone/pramoxine, hydrocortisone aloe

ANGELIQ TAB estradiol-norethindrone acetate tablets, Jinteli tablets

ANIMI-3 CAP folbic

ANIMI-3 CAP VIT D folbic

ANTARA CAP fenofibrate, gemfibrozil

APADAZ TAB hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

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Product Name ALTERNATIVE DRUGAPAP/CAFFEIN TAB DIHYDROC butalbital-APAP-caffeine-codeine, APAP-codeine

APIDRA INJ SOLOSTAR Humulin/Humalog Products

APIDRA INJ U-100 Humulin/Humalog Products

AQUORAL AER Magic Mouthwash, Lidocaine 2%, Mouth Kote

AQUORAL SPR Magic Mouthwash, Lidocaine 2%, Mouth Kote

ARCAPTA CAP Serevent

ARIKAYCE SUS amikacin sulfate solution

ARNUITY ELPT INH Asmanex, Flovent, QVAR RediHaler

ARYMO ER TAB hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

ASTAGRAF XL CAP tacrolimus, Prograf

ASTERO GEL lidocaine 3% gel/cream/lotion

ATENDIA PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

ATOPADERM CRE Hylatopic Plus, HPR Plus, Neosalus

AUVI-Q INJ epinephrine solution auto-injector

AVAILNEX CHW Nortuss-Ex liquid

AVANDIA TAB pioglitazone

AVAR AER sulfacetamide sodium w/ sulfur foam 10-5%

AVAR LS AER sulfacetamide sodium w/ sulfur foam 10-5%

AVAR LS PAD sulfacetamide sodium w/ sulfur pad 10-4%

AVAR PAD sulfacetamide sodium w/ sulfur pad 10-4%

AZASAN TAB azathioprine, cyclosporine, mycophenolate, tacrolimus

AZASAN TAB MG azathioprine, cyclosporine, mycophenolate, tacrolimus

AZASITE SOL bacitracin ointment ophthalmic, ciprofloxacin ophthalmic

AZELEX CRE adapalene, clindamycin, tretinoin

AZENASE PAK MIS azelastine nasal spray, fluticasone nasal spray, budesonide nasal spray

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Product Name ALTERNATIVE DRUGAZESCO TAB 13-1MG Prenatal Plus, Protect Plus

BASAGLAR INJ Lantus, Toujeo

BECONASE AQ SUS fluticasone nasal spray

BELSOMRA TAB zolpidem, zaleplon, eszopiclone

BENSAL HP OIN ketoconazole, econzaole, topical corticosteroids

BENZHY/ACETA TAB hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

BENZIQ GEL benzoyl peroxide gel (4%, 8%)

BENZIQ LS GEL benzoyl peroxide gel (4%, 8%)

BEPREVE DRO azelastine, ketotifen, olopatadine

BESIVANCE SUS ciprfloxacin ophthalmic, ofloxacin ophthalmic

BIDIL TAB isosorbide, hydralazine

BIFERARX TAB iron asp gly/polysacch compl/ascorb CAL/b12/fa/c

BIONECT AER hyaluronate sodium 0.2% cream/gel

BIO-STATIN CAP nystatin tab

BP VIT CAP PLUS folbic

BRINTELLIX TAB paroxetine, fluoxetine, escitalopram

BROVANA NEB Serevent

B-SERENE PAD folbic, ondansetron

BUNAVAIL MIS buprenorphine/naloxone

BUPAP TAB butalbital/acetaminophen tablet 50-325MG

BUTISOL SOD TAB zolpidem, zaleplon, eszopiclone

BUTRANS DIS morphine sulfate ER

BYSTOLIC TAB atenolol, betaxolol, bisoprolol, carvedilol, metoprolol

BYVALSON TAB amlodipine/valsartan, telmisartan/amlodipine, trandolapril, verapamil

CAMPHOMEX SPR diclofenac topical

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Product Name ALTERNATIVE DRUGCAPEX SHA fluocinolone oil/solution

CAPHOSOL SOL Magic Mouthwash, Lidocaine 2%, Mouth Kote

CAPITAL/COD SUS acetaminophen/codeine sol 120-12/5

CARAFATE SUS sucralfate

CARDIZEM LA TAB diltiazem ER, Taztia XT, Cartia XT, Matzim LA, verapamil ER

CARDURA XL TAB alfuzosin, tamsulosin, doxazosin, terazosin

CENFOL TAB folbic

CEQUA SOL Restasis, Xiidra

CETACAINE AER lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

CIALIS TAB Sildenafil 25mg, 50mg, 100mg, tadalafil 2.5mg, 5mg

CIFEREX CAP Vitamin D 50,000 units and Folbic

CLIMARA PRO DIS WEEKLY estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

CLINDAGEL GEL adapalene, clindamycin, tretinoin

CLINDESSE CRE clindamycin vaginal cream, metronidazole vaginal gel

CODAR AR LIQ hydrocodone-chlorpheniramine suspension

COLY-MYCIN S SUS OTIC Cipro HC Otic

COLYTE/FLAVR SOL PACKS Gavilyte-G, Gavilyte-C, PEG-3350

COMBIGAN SOL dorzolamide/timolol ophthalmic

CONDYLOX GEL podofilox 0.5% solution

CONZIP CAP tramadol

CORDRAN TAP mometasone, triamcinolone, fluocinolone

CORDRAN CRE betamethasone dipropionate, mometasone, hydrocortisone valerate

CORDRAN LOT mometasone, triamcinolone, fluocinolone

CORDRAN OIN mometasone, triamcinolone, fluocinolone

COREMINO TAB doxycycline, minocycline

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Product Name ALTERNATIVE DRUGCORTANE-B LOT pramoxine-HC cream 1-2.5%

CORTIFOAM AER hydrocortisone, hemril-30, hydrocortisone/lidocaine, hydrocortisone/pramoxine, proctosol HC

CORTISPORIN CRE mupirocin, fluocinolone acetate

CYCLOMYDRIL SOL OP tropicamide, atropine

DEBACTEROL SOL Episil, triamcinolone oral paste

DENAVIR CRE acyclovir ointment, famciclovir, valacyclovir

DEPLIN CAP l-methylfolate tab 15mg, folbic

DERMACINRX PAK DUOPATCH lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

DERMASORB HC KIT hydrocortisone 2.5% cream, lotion

DERMASORB TA KIT triamcinolone

DESONATE GEL mometasone, hydrocortisone valerate, fluocinolone

DEXAMETHASON TAB PAK prednisone, methylprednisolone, dexamethasone

DEXILANT CAP DR omeprazole 40mg, lansoprazole 30mg pantoprazole 20, 40mg, rabeprazole 20mg

DEXPAK PAK prednisone, methylprednisolone, dexamethasone

DIALYVITE TAB 3000 Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

DIALYVITE TAB 5000 Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

DIALYVITE/ TAB ZINC Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

DICLEGIS TAB ondansetron, prochlorperzine, metoclopramide, promethazine

DICLOVIX KIT diclofenac topical

DIVIGEL GEL estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

DORYX MPC TAB DOXYCYCLINE HYCLATE TAB

DOXYCYCLINE TAB HYCL ER doxycycline hyclate, doxycycline monohydrate

DUEXIS TAB etodolac, diclofenac, ibuprofen, omeprazole 40mg, lansoprazole 30mg pantoprazole 20mg

DUOPA SUS carbidopa/levodopa

DURACHOL CAP 1-3775IU Vitamin D 50,000 units and Folbic

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Product Name ALTERNATIVE DRUGDUREZOL EMU fluorometholone susp

DURLAZA CAP clopidogrel, prasugrel

DUTOPROL TAB atenolol/Chlorthalidone, bisoprolol/HCTZ, metoprolol/HCTZ

DVORAH TAB butalbital-APAP-caffeine-codeine, APAP-codeine

DXEVO PAK dexamethasone, prednisone

DYMISTA SPR azelastine nasal spray, fluticasone nasal spray, budesonide nasal spray

ECOZA AER ketoconazole, econazole

EDLUAR SUB zolpidem, zaleplon, eszopiclone

ELESTRIN GEL estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

ELFOLATE TAB PLUS l-methylfolate tab 15mg, folbic

ELIDEL CRE tacrolimus

ELIGEN B12 TAB folbic

ELMIRON CAP amitriptyline, cimetidine, hydroxyzine

EMBEDA CAP morphine sulfate ER

EMEND SUS aprepitant oral capsule/therapy pack

EMSAM DIS sertraline, escitalopram, venlafaxine ER

ENDOMETRIN SUP progesterone capsules, Crinone

ENSTILAR AER mometasone, hydrocortisone valerate, fluocinolone

ENTTY EMU SPRAY Epiceram, Prumyx

EPIDUO FORTE GEL adapalene, clindamycin, tretinoin

EPIDUO GEL adapalene, clindamycin, tretinoin

EPIFOAM AER pramoxine-HC cream 1-2.5%

EQUETRO CAP carbamazepine ER tab, risperidone, quetiapine

ERTACZO CRE oxiconazole cream, ketoconazole, econzaole

ESCAVITE D CHW TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

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Product Name ALTERNATIVE DRUGESCAVITE LQ DRO TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

ESOMEPRAZOLE CAP omeprazole 40mg, lansoprazole 30mg pantoprazole 20, 40mg, rabeprazole 20mg

ESTRACE VAG CRE estradiol tablets, Premarin vaginal cream

ESTRING MIS estradiol tablets, Premarin vaginal cream

ESTROGEL GEL estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

EURAX CRE permethrin

EURAX LOT permethrin

EVAMIST SPR estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

EXELDERM CRE oxiconazole cream, ketoconazole, econzaole

EXELDERM SOL oxiconazole cream, ketoconazole, econzaole

EZALLOR SPR CAP rosuvastatin tablets, atorvastatin tablets

FABIOR AER Claravis, Myorisan, Zenatane

FACTIVE TAB levofloxaxin, ciprofloxacin, moxifloxacin

FANAPT PAK risperidone, quetiapine, olanzapine, ziprasidone

FANAPT TAB risperidone, quetiapine, olanzapine, ziprasidone

FE 90 PLUS TAB multi-vit/iron/fluoride, vinate care

FEMRING MIS estradiol tablets, Premarin vaginal cream

FENORTHO CAP naproxen, etodolac

FERIVA TAB multi-vit/iron/fluoride, vinate care

FERIVAFA CAP multi-vit/iron/fluoride, vinate care

FERRALET TAB multi-vit/iron/fluoride, vinate care

FERRO-PLEX TAB Ferrex 150 Forte Plus

FERROTRIN CAP Ferrex 150 Forte Plus

FETZIMA CAP paroxetine, fluoxetine, escitalopram

FETZIMA CAP TITRATIO paroxetine, fluoxetine, escitalopram

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Product Name ALTERNATIVE DRUGFINACEA AER metronidazole 0.75%

FINACEA GEL metronidazole 0.75%

FLECTOR DIS meloxicam, ibuprofen, naproxen

FLORIVA CHW TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

FLORIVA DRO TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

FLOWTUSS SOL Nortuss-Ex liquid

FLUORABON DRO TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

FLUORAC CRE fluroruracil 5% cream

FLUORIDEX GEL SENSITIV fluoridex dd pst sensitive

FLUOROPLEX CRE fluorouracil cream 0.5%, 5%

FML OIN OP fluorometholone susp

FOCALGIN DSS TAB 90-1MG multi-vit/iron/fluoride, vinate care

FOLGARD OS TAB multi-vit/iron/fluoride, Virt-Gard, Folbee, Folplex, CalciFol

FOLIVANE-F CAP tri-vit/fluoride/iron, vitamins a/c/d/fluoride

FOLIXAPURE TAB 1-5000 Vitamin D 50,000 units and Folbic

FOLTRATE TAB folbic

FOLVITE-D TAB Folbic, Vitamin D 50,000 units

FORFIVO XL TAB bupriopion, bupropion SR/XL

FOSRENOL CHW Renvela tablet/packet, calcium acetate 667mg capsules, velphoro, auryxia, phoslyra, sevelamer HCL tablet, sevelamer carbonate tablet/packet

FOSRENOL POW Renvela tablet/packet, calcium acetate 667mg capsules, velphoro, auryxia, phoslyra, sevelamer HCL tablet, sevelamer carbonate tablet/packet

FOSTEUM CAP Vitamin D 50,000 units

FUSION PAK SPRINKLE Ferrex 150 Forte Plus

FUSION PLUS CAP Ferrex 150 Forte Plus

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Product Name ALTERNATIVE DRUGGATIFL-DEXAM SOL 0.5-0.1% bacitracin-neo-poly-HC

GELNIQUE GEL oxybutynin IR or ER, tolterodine IR or ER, trospium IR or ER, darifenacin hydrobromide tablet or ER, solifenacin

GENICIN TAB VITA-D Vitamin D 50,000 units and Folbee Plus

GENICIN TAB VITA-Q Folbee, Folbee Plus, Prenatal Plus

GENICIN TAB VITA-S Folbee, Folbee Plus, Prenatal Plus

GOCOVRI CAP amantadine immediate-release

GOLYTELY SOL gavilyte-h, peg-prep, lactulose, polyethylene glycol

GORDOFILM SOL salicylic acid film forming liquid 27.5%

GORDONS UREA OIN Urea 40% cream/gel/lotion

GRALISE STAR MIS gabapentin

GRALISE TAB gabapentin

GYNAZOLE-1 CRE terconazole vaginal cream, terconazole vaginal suppository

HALOG CRE betamethasone dipropionate, mometasone furoate, fluocinonide

HALOG OIN betamethasone dipropionate, mometasone furoate, fluocinonide

HEMATOGEN FA CAP Ferrex 150 Forte Plus

HEMETAB TAB iron asp gly/polysacch compl/ascorb CAL/b12/fa/c

HORIZANT TAB gabapentin

HPR AER Nivatopic Plus, Prumyx

HPR PLUS AER Nivatopic Plus, Prumyx

HYCOFENIX SOL Promethazine-phenylephrine-codeine syrup

HYDROC/APAP hydrocodone/APAP 7.5/325/15mL

HYGEL GEL hyaluronate sodium gel 0.2%

HYLATOPIC AER PLUS Nivatopic Plus, Prumyx

HYLIRA LOT hyaluronate sodium (emollient) lotion 0.1%

ILEVRO DRO OP ketorolac ophthalmic

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Product Name ALTERNATIVE DRUGIMVEXXY SUP Premarin vaginal cream

INDERAL XL CAP 120MG propranolol ER

INNOPRAN XL CAP propranolol ER

INSULIN LISP INJ Humulin/Humalog Products

INTEGRA F CAP tri-vit/fluoride/iron, vitamins a/c/d/fluoride

INVELTYS SUS dexamethasone ophthalmic, prednisolone ophthalmic, fluorometholone ophthalmic

IROSPAN 24/6 MIS mv fe asparto gly/vit c/vit b12/ca threonate/succ

IS MIS mv fe asparto gly/vit c/vit b12/ca threonate/succ

ISORDIL TAB 40MG isosorbide dinitrate, isosorbide mononitrate

JUBLIA SOL ciclopirox

KADIAN CAP hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

KAMDOY EMU Epiceram, Prumyx

KAPSPARGO CAP metoprolol succinate ER tablets, metoprolol tartrate tablets

KAZANO TAB Janumet, Janumet XR, Jentadueto

KERALYT KIT SCALP salicylic acid shampoo 6%

KERYDIN SOL ciclopirox

KOMBIGLYZE TAB Janumet, Janumet XR, Jentadueto

KRISTALOSE PAK lactulose

LANOXIN TAB Digoxin

LASTACAFT SOL azelastine, olopatadine

LDO PLUS GEL lidocaine 3% gel/cream/lotion

LEVALBUTEROL AER Ventolin HFA, Proair HFA

LEVITRA TAB Sildenafil 25mg, 50mg, 100mg

LEVOMEFOLATE CAP /ALGAL l-methylfolate tab 15mg, folbic

LEXETTE AER halobetasol propionate cream/ointment, clotbetasol cream

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Product Name ALTERNATIVE DRUGLIDOCAINE HC CRE lidocaine 5% ointment, lidocaine 4% solution

LIDO-K LOT lidocaine 3% gel/cream/lotion

LIDOPIN CRE lidocaine 3% gel/cream/lotion

LIDO-RX CRE lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

LIDOTHOL GEL lidocaine 5% ointment, lidocaine 5% patches

LIDOTHOL PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

LIDOTRAL CRE lidocaine 3% gel/cream/lotion

LIDOVEX CRE lidocaine 3% gel/cream/lotion

LIDOVIN CRE lidocaine 3% gel/cream/lotion

LIDOZOL CRE lidocaine 3% gel/cream/lotion

LIMBREL CAP ibuprofen, naproxen, meloxicam

LITHOSTAT TAB amitriptyline, cimetidine, hydroxyzine

LIVALO TAB atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, rosuvastatin

L-METHYLFOLA CAP FORM 15 l-methylfolate tab 15mg, folbic

LOCOID LOT mometasone, hydrocortisone valerate, fluocinolone

LOCORT PAK prednisone, methylprednisolone, dexamethasone

LORTAB ELX hydrocodone/acetaminophen

LORZONE TAB chlorzoxazone

LOTEMAX GEL dexamethasone ophthalmic, prednisolone ophthalmic, triamcinolone ophthalmic

LOTEMAX SM GEL loteprednol etabonate 0.5% suspension, prednisolone opthalmic 1% suspension

LOTEMAX OIN dexamethasone ophthalmic, prednisolone ophthalmic, triamcinolone ophthalmic

LUCEMYRA TAB clonidine

LUZU CRE mometasone, hydrocortisone valerate, fluocinolone

MAFENIDE ACE PAK silver sulfadiazine cream, mupirocin

MAGNEBIND TAB calcium acetate 667mg

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Product Name ALTERNATIVE DRUGMAL PATCH PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

MARPLAN TAB phenelzine, tranylcypromine sulfate

MAXARON TAB FORTE Ferrex 150 Forte Plus

MAXIDEX SUS OP dexamethasone ophthalmic, prednisolone ophthalmic, triamcinolone ophthalmic

MEDROL TAB methylprednisolone, prednisone

MEDROX-RX OIN diclofenac topical

MENEST TAB estradiol tablets, estropipate tablets, estradiol weekly patches

MENOSTAR DIS estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

MENTHOCIN PAD LIDOCAIN lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

MESTINON SYP pyridostigmine tablet

METHITEST TAB methyltestosterone oral tab 10mg

METOPRO/HCTZ TAB atenolol/Chlorthalidone, bisoprolol/HCTZ, metoprolol/HCTZ

METRONIDAZOLE JELLY metronidazole 0.75%

MIGERGOT SUP sumatriptan, digydroergotamine nasal spray

MILLIPRED DP PAK prednisone, methylprednisolone, dexamethasone

MILLIPRED SOL prednisone, methylprednisolone, dexamethasone

MILLIPRED TAB prednisone, methylprednisolone, dexamethasone

MINIVELLE DIS estradiol once weekly patch, estradiol twice-weekly patch, estradiol tablets

MINOLIRA TAB minocycline immediate-release tablets and capsules

MONUROL PAK GRANULES sulfamethoxazole/trimethoprim, ciprofloxacin, nitrofurantoin

MORPHABOND TAB ER hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

MYKIDZ IRON SUS FL TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

MYRBETRIQ TAB oxybutynin IR or ER, tolterodine IR or ER, trospium IR or ER, darifenacin hydrobromide tablet or ER, solifenacin

NAFRINSE DLY SOL /NEUTRAL denta 5000 cre plu, sf 5000 plus cre 1.1%

NAFRINSE WK SOL denta 5000 cre plu, sf 5000 plus cre 1.1%

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Product Name ALTERNATIVE DRUGNAFTIN GEL oxiconazole cream, ketoconazole, econzaole

NALOCET TAB hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

NAMZARIC CAP memantine, donepezil HCl

NAPRELAN TAB CR naproxen sodium

NASCOBAL SPR cyanocobalamin vial for injection, Folbic

NATESTO GEL Androderm, testosterone topical gel

NATURE THROI TAB levothyroxine, Synthroid, Armour Thyroid

NATURE-THROI TAB levothyroxine, Synthroid, Armour Thyroid

NEOSALUS AER Nivatopic Plus, Prumyx

NEO-SYNALAR CRE mupirocin, fluocinolone acetate

NEPHRON FA TAB Ferrex 150 Forte Plus

NEPHPLEX RX TAB Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

NESINA TAB Januvia, Tradjenta

NEUPRO DIS pramipexole ER

NEUTRASAL POW Magic Mouthwash, Lidocaine 2%, Mouth Kote

NEVANAC SUS ketorolac ophthalmic

NEXIUM CAP omeprazole 40mg, lansoprazole 30mg pantoprazole 20, 40mg, rabeprazole 20mg

NEXIUM GRA DR omeprazole 40mg, lansoprazole 30mg pantoprazole 20, 40mg, rabeprazole 20mg

NICOMIDE TAB L-methylfolate tablets, niacin ER, Nicadan, Nicazel

NORITATE CRE metronidazole 0.75%

NOROXIN TAB levofloxaxin, ciprofloxacin, moxifloxacin

NORPACE CAP 100MG CR disopyramide phosphate

NOVACORT GEL pramoxine-HC cream 1-2.5%

NOVOLIN N INJ RELION Humulin/Humalog Products

NOVOLIN R INJ RELION Humulin/Humalog Products

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Product Name ALTERNATIVE DRUGNOVOLIN70/30 INJ RELION Humulin/Humalog Products

NOVOLOG INJ Humulin/Humalog Products

NOVOLOG INJ FLEXPEN Humulin/Humalog Products

NOVOLOG INJ PENFILL Humulin/Humalog Products

NOVOLOG MIX INJ Humulin/Humalog Products

NOVOLOG MIX INJ FLEXPEN Humulin/Humalog Products

NOXIFOL-D TAB Vitamin D 50,000 units and Folbic

NP THYROID TAB levothyroxine, Synthroid, Armour Thyroid

NUCORT LOT mometasone, hydrocortisone valerate, fluocinolone

NUTRIVIT LIQ Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

NUVESSA GEL clindamycin vaginal cream, metronidazole vaginal gel

OBREDON SOL Nortuss-Ex liquid

OMNARIS SPR fluticasone nasal spray

ONEXTON GEL adapalene, clindamycin, tretinoin

ONGLYZA TAB Januvia, Tradjenta

ONZETRA XSAI MIS sumatriptan

OPANA ER TAB morphine sulfate ER

ORAVIG TAB clotrimazole, fluconazole

ORTHO D CAP 1-3775IU Vitamin D 50,000 units and Folbic

ORTHO-FOLIC Vitamin D 50,000 units, Folbee, Folplex tablets

OSENI TAB Janumet, Janumet XR, Jentadueto

OSMOLEX ER TAB amantadine immediate-release

OSMOPREP TAB Gavilyte-G, Gavilyte-C, PEG-3350

OSPHENA TAB Premarin vaginal cream, estradiol tablets, estradiol patches

OTOVEL DRO ciprofloxacin

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Product Name ALTERNATIVE DRUGOVACE PLUS AER sulfacetamide sodium 10% liquid/gel/shampoo

OVACE PLUS CRE sulfacetamide sodium 10% liquid/gel/shampoo

OVACE PLUS LOT sulfacetamide sodium 10% liquid/gel/shampoo

OXAYDO TAB hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

OXISTAT LOT oxiconazole cream, ketoconazole, econzaole

OXYTROL DIS oxybutynin IR or ER, tolterodine IR or ER, trospium IR or ER, darifenacin hydrobromide tablet or ER, solifenacin

PAIN RELIEF PAD PATCH lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

PANDEL CRE mometasone, hydrocortisone valerate, fluocinolone

PANLOR TAB butalbital-APAP-caffeine-codeine, APAP-codeine

PAXIL SUS paroxetine, fluoxetine, escitalopram

PAZEO DRO azelastine, olopatadine

PCP KIT Gavilyte-G, Gavilyte-C, PEG-3350

PEDIADERM HC KIT hydrocortisone 2.5% cream, lotion

PEDIADERM TA KIT triamcinolone

PENNSAID SOL meloxicam, ibuprofen, naproxen

PERFOROMIST NEB Serevent

PERMAVAN PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

PHLAG SPR Epiceram, Prumyx

PICATO GEL fluorouracil, imiquimod

PLEXION CLTH PAD sulfacetamide sodium w/ sulfur pad 10-4%

PLIXDA PAD SWAB adapalene 0.1% cream, clindamycin/benzoyl peroxide gel 1.2-5%

POLY-VI-FLOR CHW multi-vit/iron/fluoride, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

POLY-VI-FLOR MIS FS multi-vit/iron/fluoride, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

POLY-VI-FLOR SUS multi-vit/iron/fluoride, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

PRADAXA CAP Xarelto

17

Product Name ALTERNATIVE DRUGPRAMOSONE CRE hydrocortisone acetate/pramoxine

PRAMOSONE E CRE pramoxine-HC cream 1-2.5%

PRAMOSONE LOT pramoxine-HC cream 1-2.5%

PRAMOSONE OIN pramoxine-HC cream 1-2.5%

PRED-GATI SUS bacitracin-neo-poly-HC

PREDN GATI SOL bacitracin-neo-poly-HC

PRE-FOLIC TAB Prenatabs Rx

PREGENNA TAB Prental Plus, Prenate

PRENA 1 TRUE MIS Mynatal Plus tablets, Virt-PN DHA, Prenatal 19 CHW, Citranaral, Duet DHA 400, Prefera OB

PREPOPIK PAK gavilyte-h, peg-prep, lactulose, polyethylene glycol

PRESERA AER Nivatopic Plus, Prumyx

PRESTALIA TAB Lisinopril - Amlodipine as separate agents

PRILOSEC POW omeprazole 40mg, lansoprazole 30mg pantoprazole 20, 40mg, rabeprazole 20mg

PRIMLEV TAB hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

PROCORT CRE hydrocortisone acetate/pramoxine

PROFERRIN- TAB FORTE Ferrex 150 Forte Plus

PROLENSA SOL bromfenac 0.09%

PROTECTIRON TAB Ferrex 150 Forte Plus

PROVENTIL AER HFA Ventolin HFA, Proair HFA

PSORCON CRE diflorasone diacetate cream 0.05%

PULMICORT INH Asmanex, Flovent, QVAR RediHaler

PUREFOLIX TAB Vitamin D 50,000 units and Folbic

PYLERA CAP amoxicillin-clarithromycin-lansoprazole therapy pack

QBRELIS SOL captopril, enalapril, lisinopril, quinapril

QBREXZA PAD Drysol, Xerac AC

18

Product Name ALTERNATIVE DRUGQMIIZ ODT TAB meloxicam, diclofenac

QNASL AER fluticasone nasal spray

QNASL CHILD SPR fluticasone nasal spray

QUFLORA FE CHW TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

RAYOS TAB prednisone, methylprednisolone, dexamethasone

RECTIV OIN hydrocortisone acetate/pramoxine

RECURA CRE oxiconazole cream, ketoconazole, econzaole

RELENZA MIS DISKHALE oseltamivir

RELION R INJ 100/ML Humulin/Humalog Products

RELPAX TAB sumatriptan, rizatriptan

REMATEX CRE diclofenac topical

REMAXAZON PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

RENATABS MIS IRON Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

RENATABS TAB Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

RENOVO LIDO5 CRE lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

RENUU PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

RESCULA SOL latanoprost, Travatan Z

RESTORA RX CAP Folbic

RESTORA SPRI PAK Folbic

RETIN-A MICR GEL adapalene, clindamycin, tretinoin

REXAPHENAC CRE Ibuprofen, diclofenac, meloxicam

REZESOL LOT sodium sulfacetamide-sulfer suspension/lotion, salicylic acid 6% cream

REZIRA SOL Promethazine-phenylephrine-codeine syrup

RIAX AER benzoyl peroxide foam (9.8%), benzoyl peroxide liquid (7%)

RIFAMATE CAP isoniazid tablet and rifampin capsule

19

Product Name ALTERNATIVE DRUGRIFATER TAB isoniazid tablet and rifampin capsule and pyrazinamide tablet

ROCKLATAN DRO bimatoprost, latanoprost, travoprost, Lumigan 0.01%

RIOMET SOL metformin, metformin ER

ROSULA LIQ sulfacetamide sodium w/ sulfur wash 9-4%

ROXIFOL-D TAB Vitamin D 50,000 units and Folbic

ROXYBOND TAB hydrocodone/APAP, oxycodone, oxycodone/APAP, morphine sulfate ER

ROZEREM TAB zolpidem, zaleplon, eszopiclone

RYNODERM CRE Urea Cream (39%, 40%, 41%, 45%, 47%, 50%)

RYTARY CAP carbodopa/levodopa ER

SALIVAMAX POW Magic Mouthwash, Lidocaine 2%, Mouth Kote

SANCUSO DIS ondansetron oral solution, tablet, odt

SAPHRIS SUB risperidone, quetiapine, olanzapine, ziprasidone

SAVAYSA TAB Xarelto

SAVELLA MIS TITR PAK duloxetine

SAVELLA TAB duloxetine

SCAR PATCH PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

SCAR PATCH PAD PREMIUM lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

SECONAL SOD CAP zolpidem, zaleplon, eszopiclone

SELRX SHA selenium sulfide-pyrthione zinc in urea shampoo 2.25%

SERNIVO SPR betamethasone dipropionate, mometasone furoate, fluocinonide

SEYSARA TAB doxycycline immediate-release tablets/capsules, minocycline immediate-release tablets/capsules

SIKLOS TAB hydroxyurea

SILENOR TAB doxepin

SILMANIX CRE diclofenac topical

SILVERA PAIN PAD RELIEF lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

20

Product Name ALTERNATIVE DRUGSIMBRINZA SUS brimonidine

SITAVIG TAB acyclovir ointment, acyclovir tablets and capsules, valacyclovir tablets

SKLICE LOT permethrin

SODIUM SULFA LIQ WASH sulfacetamide sodium 10% liquid/gel/shampoo

SOLMARA PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

SOOLANTRA CRE metronidazole 0.75%

SOOTHEE PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

SORILUX AER calcipotriene cream/ointment

SPRIX SPR ketorolac

STAXYN TAB Sildenafil 25mg, 50mg, 100mg

STENDRA TAB Sildenafil 25mg, 50mg, 100mg

STRIANT MIS Androderm, testosterone topical gel

STRIVERDI AER Serevent

SUCLEAR KIT Gavilyte-G, Gavilyte-C, PEG-3350

SULFAMYLON CRE silver sulfadiazine cream

SUMAVEL DOSE INJ sumatriptan

SUPERVITE EC TAB Dialyvite tablets, Dialyvite Supreme D, Triphrocaps, Virt-Caps

SUPREP BOWEL SOL PREP gavilyte-h, peg-prep, lactulose, polyethylene glycol

SUVICORT EMU Epiceram, Prumyx

SYMPAZAN MIS clobazam suspension, clobazam tablets

SYNERA DIS lidocaine-tetracaine cream

SYNERDERM EMU Epiceram, Prumyx

SYNVEXIA TC CRE lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

TACLONEX SUS calcipotriene, topical corticosteroids

21

Product Name ALTERNATIVE DRUGTALIVA CAP Folbee, Folbic

TAPERDEX PAK prednisone, methylprednisolone, dexamethasone

TARGADOX TAB doxycycline, minocycline

TARON FORTE CAP Ferrex 150 Forte Plus

TAYTULLA CAP Microgestin 1/20, Larin 1/20, Junel 1/20

TEKTURNA HCT TAB losartan HCTZ, valsartan HCTZ

TERSI FOAM AER selenium sulfide lotion 2.5%

TETRAMEX SPR lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

TETRAVEX GEL lidocaine 5% ointment, lidocaine 4% solution

TEXACORT SOL hydrocortisone 2.5% cream, lotion

TEXAVITE LQ LIQ TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

THEO-24 CAP CR theophylline ER 12 hr 100mg

THEO-24 CAP ER theophylline ER 12 hr 100mg

TIMOPTIC OCU SOL OP timolol ophthalmic

TIROSINT CAP levothyroxine, Synthroid, Armour Thyroid

TIROSINT-SOL SOL levothyroxine, Synthroid, Armour Thyroid

TIVORBEX CAP indomethacin

TL G-FOL OS TAB multi-vit/iron/fluoride, Virt-Gard, Folbee, Folplex, CalciFol

TOBRADEX OIN tobramcyin/dexamethasone

TOBREX OIN OP tobramycin, gentamicin

TOLAK CRE fluorouracil cream 0.5%, 5%

TOLSURA CAP itraconazole capsules/oral solution

TOPICORT SPR betamethasone dipropionate, mometasone furoate, fluocinonide

TOVIAZ TAB oxybutynin IR or ER, tolterodine IR or ER, trospium IR or ER, darifenacin hydrobromide tablet or ER, solifenacin

TRAMADOL HCL CAP ER tramadol

22

Product Name ALTERNATIVE DRUGTRETIN-X CRE adapalene, clindamycin, tretinoin (generic Retin-A)

TREXIMET TAB sumatriptan, rizatriptan

TRIANEX OIN mometasone, hydrocortisone valerate, fluocinolone

TRICARE CHW PRENATAL Mynatal Plus tablets, Virt-PN DHA, Prenatal 19 CHW, Citranaral, Duet DHA 400, Prefera OB

TRINTELLIX TAB paroxetine, fluoxetine, escitalopram

TRI-VI-FLORO SUS TRI-VIT/FL DRO 0.25MG, MVC-Fluoride CHW, Floriva Plus, Vitamax Pediatric

TROKENDI XR CAP topiramate

TUDORZA PRES AER Spiriva

TUSSICAPS CAP hydrocodone-chlorpheniramine suspension

TUZISTRA XR SUS hydrocodone-chlorpheniramine suspension

UCERIS AER BUDESONIDE (SYSTEMIC)

ULESFIA LOT malathion

ULTRAVATE LOT betamethasone dipropionate, mometasone furoate, fluocinonide

ULTRAVATE X KIT halobetasol propionate

UMECTA PD EMU Urea 40% cream/gel/lotion

URALISS CRE Urea 40% cream/gel/lotion

UREA NAIL MIS urea emu 50%

UREVAZ CRE Urea Cream (39%, 40%, 41%, 45%, 47%, 50%)

VANOXIDE-HC LOT benzoyl peroxide gel (4%, 8%), benzoyl peroxide cloth (6%, 9%)

VASCEPA CAP omega 3 fatty acid

VAYARIN CAP vitamins

VELMA PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

VELTIN GEL adapalene, clindamycin, tretinoin

VERAMYST SPR fluticasone nasal spray

VERDESO AER mometasone, hydrocortisone valerate, fluocinolone

23

Product Name ALTERNATIVE DRUGVEREGEN OIN fluorouracil, imiquimod 5%

VERIPRED SOL prednisone, methylprednisolone, dexamethasone

VEXA PAD lidocaine, lidocaine-tetracaine, lidocaine-prilocaine

VIBRAMYCIN SYP DOXYCYCLINE HYCLATE TAB

VIIBRYD KIT paroxetine, fluoxetine, escitalopram

VIIBRYD KIT STARTER paroxetine, fluoxetine, escitalopram

VIIBRYD TAB paroxetine, fluoxetine, escitalopram

VIMOVO TAB naproxen, omeprazole 40 mg

VITAL-D RX TAB Dialyvite tablets, Dialyvite Supreme D, Nephronex, Triphrocaps, Virt-Caps

VITAMEZ CAP Folbee, Folbic

VITATRUE MIS Mynatal Plus tablets, Virt-PN DHA, Prenatal 19 CHW, Citranaral, Duet DHA 400, Prefera OB

VIVLODEX CAP meloxicam, diclofenac

VOPAC MDS KIT meloxicam, ibuprofen, naproxen

VP-GSTN CAP Vitamin D 50,000 units

VRAYLAR CAP risperidone, quetiapine, olanzapine, ziprasidone

VUSION OIN nystatin

WESTHROID TAB levothyroxine, Synthroid, Armour Thyroid

WP THYROID TAB levothyroxine, Synthroid, Armour Thyroid

XAQUIL XR TAB l-methylfolate tab 15mg

XELPROS EMU 0.005% latanoprost, Travatan Z, bimatoprost

XEPI CRE mupirocin 2% cream or ointment

XERESE CRE acyclovir ointment, famciclovir, valacyclovir

XIMINO CAP doxycycline, minocycline

XOLEGEL GEL ketoconazole cream/foam/shampoo

XOPENEX HFA AER Ventolin HFA, ProAir HFA

24

Product Name ALTERNATIVE DRUGYOSPRALA TAB aspirin, omeprazole 40 mg

YUPELRI SOL Lonhala Magnair, Incurse Ellipta, Spiriva Handihaler/Respimat

ZAVARA CAP Vitamin D 50,000 units and Folbic

ZECUITY PAD sumatriptan, rizatriptan

ZEMBRACE SYM INJ sumatriptan

ZETONNA AER fluticasone nasal spray

ZILEUTON ER TAB montelukast, zafirlukast

ZINBRYTA INJ Avonex, Copaxone or Tecfidera

ZIOPTAN DRO latanoprost, Travatan Z

ZIPSOR CAP diclofenac

ZODEX PAK prednisone, methylprednisolone, dexamethasone

ZOLATE CAP Vitamin D 50,000 units and Folbic

ZOMIG NASAL SPR sumatriptan nasal spray

ZOMIG SPR sumatriptan nasal spray

ZONACORT PAK prednisone, methylprednisolone, dexamethasone

ZORVOLEX CAP diclofenac

ZOVIRAX CRE acyclovir ointment, famciclovir, valacyclovir

ZTLIDO PAD lidocaine 5% patch, gabapentin, nortripyline

ZUBSOLV SUB buprenorphine/naloxone

ZUPLENZ MIS ondansetron oral solution, tablet, odt

ZURAMPIC TAB allopurinol, colchicine

ZYCLARA CRE fluorouracil, imiquimod 5%

ZYCLARA PUMP CRE fluorouracil, imiquimod 5%

ZYFLO CR TAB montelukast

ZYFLO TAB montelukast

25

Product Name ALTERNATIVE DRUGZYLET SUS tobramcyin/dexamethasone

This document is updated quarterly. It is provided as a reference and is subject to change. Please check the website www.optimahealth.com for updates. Sentara Health Care Pharmacy Services, January 1, 2020 Revised: 12/17/2019