ANTI-INFECTIVES · Web viewcholine mag trisalicylate diflunisal SALICYLAMIDE salsalate PREFERRED...

ANTI-INFECTIVES...................................................................................................................................................................... 5

PENICILLINS.....................................................................................................................................................................................5TETRACYCLINES............................................................................................................................................................................ 5CEPHALOSPORINS........................................................................................................................................................................ 5

FIRST GENERATION CEPHALOSPORINS............................................................................................................................5SECOND GENERATION CEPHALOSPORINS.......................................................................................................................5THIRD GENERATION CEPHALOSPORINS............................................................................................................................5

ERYTHROMYCINS & OTHER MACROLIDES.............................................................................................................................5FLOUROQUINOLONES..................................................................................................................................................................6SULFA'S & RELATED AGENTS.....................................................................................................................................................6URINARY TRACT AGENTS............................................................................................................................................................6ANTIVIRALS......................................................................................................................................................................................6HIV/AIDS THERAPY........................................................................................................................................................................ 6ANTIFUNGAL AGENTS...................................................................................................................................................................7VANCOMYCIN.................................................................................................................................................................................. 7MISC. ANTI-INFECTIVES...............................................................................................................................................................7ANTIPARASITICS.............................................................................................................................................................................7ANTIMALARIALS..............................................................................................................................................................................8ANTIMYCOBACTERIALS................................................................................................................................................................8

ANTINEOPLASTIC & IMMUNOSUPPRESANT DRUGS......................................................................................................... 8

ALKYLATING AGENTS...................................................................................................................................................................8ANTIMETABOLITES........................................................................................................................................................................ 8HORMONES......................................................................................................................................................................................8ANTIESTROGENS...........................................................................................................................................................................9ANTIANDROGENS...........................................................................................................................................................................9RADIOPHARMACEUTICALS..........................................................................................................................................................9IMMUNOSUPPRESSANT DRUGS................................................................................................................................................9MISC. ANTINEOPLASTIC DRUGS................................................................................................................................................9ADJUNCTIVE AGENTS.................................................................................................................................................................10

AUTONOMIC & CNS DRUGS, NEUROLOGY & PSYCH...................................................................................................... 10

NARCOTIC ANALGESICS............................................................................................................................................................10COMBINATION NARCOTIC/ANALGESICS...............................................................................................................................11NSAIDS............................................................................................................................................................................................ 11NSAIDS-SPECIFIC COX II INHIBITORS....................................................................................................................................11SALICYLATES................................................................................................................................................................................ 11MISC. ANALGESICS......................................................................................................................................................................11NARCOTIC ANTAGONISTS.........................................................................................................................................................12HEADACHE THERAPY.................................................................................................................................................................12ANTIPARKINSONISM AGENTS...................................................................................................................................................12ANTICONVULSANTS.................................................................................................................................................................... 12MISC. NEUROLOGICAL THERAPY............................................................................................................................................13MUSCLE RELAXANTS & ANTISPASMODIC AGENTS............................................................................................................13HYPNOTIC AGENTS.....................................................................................................................................................................13TRICYCLICS................................................................................................................................................................................... 13MISC. ANTIDEPRESSANTS.........................................................................................................................................................13MAO INHIBITORS.......................................................................................................................................................................... 14SELECTIVE SEROTONIN REUPTAKE INHIBITORS...............................................................................................................14PHENOTHIAZINES........................................................................................................................................................................ 14BUTYROPHENONES.................................................................................................................................................................... 14MISC. ANTIPSYCHOTICS............................................................................................................................................................14MISCELLANEOUS PSYCHOTHERAPEUTIC AGENTS...........................................................................................................14

Updated April 1, 2018 Page

ANXIOLYTICS.................................................................................................................................................................................15

CARDIOVASCULAR, HYPERTENSION & LIPIDS................................................................................................................ 15

ANTIARRHYTHMIC AGENTS......................................................................................................................................................15CARDIAC GLYCOSIDES...............................................................................................................................................................15RAPID ACTING NITRATES..........................................................................................................................................................15LONG ACTING NITRATES...........................................................................................................................................................15ANTICOAGULANTS.......................................................................................................................................................................15ANTIPLATELET DRUGS...............................................................................................................................................................15HEPARIN......................................................................................................................................................................................... 16VITAMIN K....................................................................................................................................................................................... 16HEMOSTATICS.............................................................................................................................................................................. 16MISC. COAGULATION AGENTS.................................................................................................................................................16THIAZIDE & RELATED DIURETICS............................................................................................................................................16BETA BLOCKERS..........................................................................................................................................................................16CALCIUM CHANNEL BLOCKERS/ NON-DIHYDROPYRIDINES...........................................................................................17CALCIUM CHANNEL BLOCKERS/DIHYDROPYRIDINES.......................................................................................................17ACE INHIBITORS...........................................................................................................................................................................17ADRENERGIC ANTAGONISTS & RELATED DRUGS.............................................................................................................17AGENTS FOR PHEOCHROMOCYTOMA..................................................................................................................................17VASODILATORS............................................................................................................................................................................ 17OTHER ANTIHYPERTENSIVE COMBINATIONS.....................................................................................................................18ANGIOTENSIN II RECEPTOR BLOCKERS & RENIN INHIBITOR.........................................................................................18LIPID/CHOLESTEROL LOWERING AGENTS...........................................................................................................................18MISC. CARDIOVASCULAR AGENTS.........................................................................................................................................18

DERMATOLOGICAL/TOPICAL THERAPY............................................................................................................................ 18

TOPICAL CORTICOSTEROIDS VERY HIGH POTENCY........................................................................................................18TOPICAL CORTICOSTEROIDS HIGH POTENCY....................................................................................................................19TOPICAL CORTICOSTEROIDS MEDIUM POTENCY..............................................................................................................19TOPICAL CORTICOSTEROIDS LOW POTENCY.....................................................................................................................19TOPICAL ANESTHETICS.............................................................................................................................................................19THERAPY FOR ACNE...................................................................................................................................................................19TOPICAL ANTIBACTERIALS........................................................................................................................................................20TOPICAL ANTIFUNGALS.............................................................................................................................................................20TOPICAL ANTIVIRALS..................................................................................................................................................................20BURN THERAPY............................................................................................................................................................................20TOPICAL ENZYMES......................................................................................................................................................................20KERATOLYTICS.............................................................................................................................................................................20ANTIPSORIATICS/ANTISEBORRHEIC......................................................................................................................................20TOPICAL SCABICIDES/PEDICULICIDES..................................................................................................................................20MISC. DERMATOLOGICALS........................................................................................................................................................20

EAR, NOSE & THROAT MEDICATIONS................................................................................................................................ 21

MISCELLANEOUS OTIC PREPARATIONS...............................................................................................................................21OTIC STEROID / ANTIBIOTIC......................................................................................................................................................21MISCELLANEOUS AGENTS........................................................................................................................................................21

ENDOCRINE/DIABETES.......................................................................................................................................................... 21

ANTITHYROID AGENTS...............................................................................................................................................................21THYROID HORMONES.................................................................................................................................................................21ADRENAL HORMONES................................................................................................................................................................21ANDROGENS..................................................................................................................................................................................22OVULATORY STIMULANTS.........................................................................................................................................................22


MISCELLANEOUS AGENTS........................................................................................................................................................22GONADOTROPIN & RELATED AGENTS..................................................................................................................................22INSULIN THERAPY........................................................................................................................................................................22NON-INSULIN HYPOGLYCEMIC AGENTS..............................................................................................................................23GLUCOSE ELEVATING AGENTS...............................................................................................................................................23INSULIN SYRINGES/MISCELLANEOUS DME..........................................................................................................................23BLOOD GLUCOSE MONITORING DEVICES & SUPPLIES....................................................................................................23

GASTROENTEROLOGY.......................................................................................................................................................... 24

H2 ANTAGONISTS.........................................................................................................................................................................24PROSTAGLANDINS.......................................................................................................................................................................24OTHER ULCER THERAPY...........................................................................................................................................................24PROTON PUMP INHIBITORS......................................................................................................................................................24ANTIDIARRHEALS.........................................................................................................................................................................24ANTISPASMODICS........................................................................................................................................................................24BILE ACIDS..................................................................................................................................................................................... 24DIGESTIVE ENZYMES..................................................................................................................................................................24MISC. GASTROINTESTINAL AGENTS......................................................................................................................................24ANTIVERTIGO & ANTIEMETIC AGENTS..................................................................................................................................25BOWEL EVACUANTS....................................................................................................................................................................25

IMMUNOLOGY, VACCINES & BIOTECHNOLOGY............................................................................................................... 25

ERYTHROID STIMULANTS..........................................................................................................................................................25MYELOID STIMULANTS...............................................................................................................................................................25INTERFERONS...............................................................................................................................................................................25GROWTH HORMONES.................................................................................................................................................................25INTERLEUKINS.............................................................................................................................................................................. 26VACCINES & MISCELLANEOUS IMMUNOLOGICALS............................................................................................................26

MUSCULOSKELETAL & RHEUMATOLOGY......................................................................................................................... 26

GOUT THERAPY............................................................................................................................................................................26OTHER RHEUMATOLOGICALS..................................................................................................................................................26OSTEOPOROSIS THERAPY........................................................................................................................................................27

OBSTETRICS & GYNECOLOGY............................................................................................................................................ 27

MONOPHASIC /BIPHASIC /TRIPHASIC AGENTS...................................................................................................................27OXYTOCICS....................................................................................................................................................................................27PROGESTINS.................................................................................................................................................................................28ESTROGENS.................................................................................................................................................................................. 28ESTROGEN COMBINATIONS.....................................................................................................................................................28VAGINAL CLEANSER /ANTIINFECTIVES.................................................................................................................................28VAGINAL ANTIFUNGALS.............................................................................................................................................................28SPECIALIZED OB/GYN DRUGS..................................................................................................................................................28DIAPHRAGMS AND OTHER NON-ORAL CONTRACEPTIVES.............................................................................................28

OPHTHALMOLOGY................................................................................................................................................................. 28

BETA-BLOCKERS..........................................................................................................................................................................28CHOLINESTERASE INHIBITOR MIOTICS.................................................................................................................................28DIRECT ACTING MIOTICS...........................................................................................................................................................28OTHER GLAUCOMA DRUGS......................................................................................................................................................29ORAL DRUGS FOR GLAUCOMA................................................................................................................................................29CYCLOPLEGIC MYDRIATICS......................................................................................................................................................29NON-STEROIDAL ANTI-INFLAMMATORY AGENTS...............................................................................................................29VASOCONSTRICTOR DECONGESTANTS...............................................................................................................................29


ANTIBIOTICS.................................................................................................................................................................................. 29SULFONAMIDES............................................................................................................................................................................29STEROIDS.......................................................................................................................................................................................29STEROID-ANTIBIOTIC COMBINATIONS...................................................................................................................................30STEROID-SULFONAMIDE COMBINATIONS............................................................................................................................30SYMPATHOMIMETICS..................................................................................................................................................................30MISCELLANEOUS OPHTHALMOLOGICS.................................................................................................................................30ANTIVIRALS....................................................................................................................................................................................30

RESPIRATORY, ALLERGY, COUGH & COLD...................................................................................................................... 30

ANTIHISTAMINES..........................................................................................................................................................................30ADRENERGICS..............................................................................................................................................................................30ANTITUSSIVE COMBINATIONS..................................................................................................................................................30DECONGESTANT / ANTIHISTAMINES......................................................................................................................................31XANTHINES.................................................................................................................................................................................... 31BETA AGONISTS ORAL...............................................................................................................................................................31BETA AGONISTS INHALERS......................................................................................................................................................31INHALED CORTICOSTEROIDS...................................................................................................................................................31INTRANASAL STEROIDS.............................................................................................................................................................31MISCELLANEOUS PULMONARY AGENTS..............................................................................................................................31

UROLOGICALS........................................................................................................................................................................ 32

CHOLINERGIC STIMULANTS......................................................................................................................................................32ANTICHOLINERGICS & ANTISPASMODICS............................................................................................................................32URINARY ANESTHETICS.............................................................................................................................................................32MISCELLANEOUS UROLOGICALS............................................................................................................................................32BENIGN PROSTATIC HYPERPLASIA (BPH) THERAPY.........................................................................................................32

VITAMINS, HEMATINICS & ELECTROLYTES...................................................................................................................... 32

VITAMINS & HEMATINICS...........................................................................................................................................................32POTASSIUM....................................................................................................................................................................................34OTHER ELECTROLYTES.............................................................................................................................................................34MISCELLANEOUS NUTRITION PRODUCTS............................................................................................................................35BLOOD DERIVATIVES..................................................................................................................................................................35

DIAGNOSTICS & MISCELLANEOUS AGENTS..................................................................................................................... 35

MISCELLANEOUS AGENTS........................................................................................................................................................35SMOKING DETERRENTS.............................................................................................................................................................36ANOREXIANTS...............................................................................................................................................................................36NEUTRACEUTICALS.....................................................................................................................................................................36IRRIGATING SOLUTIONS............................................................................................................................................................36ANTIDOTES.................................................................................................................................................................................... 36


ANTI-INFECTIVES

PENICILLINSGENERIC amoxicillin amoxicillin/clavulanate er ampicillin ampicillin/sulbactam dicloxacillin sodium nafcillin dextrose nafcillin sodium oxacillin sodium penicillin g potassium penicillin g procaine penicillin g sodium penicillin v potassium piperacillin-tazobactam

PREFERRED AMOXICILLIN POWDER AUGMENTIN 125-31.25 MG/5ML BICILLIN C-R BICILLIN L-A PENICILLIN GK-ISO-OSM DEXTROSE TIMENTIN ZOSYN IV SOLUTION

NON PREFERRED AUGMENTIN ZOSYN VIAL

TETRACYCLINESGENERIC demeclocycline hcl doxycycline hyclate doxycycline monohydrate minocycline hcl minocycline hcl er ocudox

PREFERRED COREMINO DEMECLOCYCLINE HCL POWDER DOXYCYCLINE HYCLATE POWDER MINOCIN 100MG VIAL MINOCYCLINE HCL POWDER ORACEA SOLODYN ER TETRACYCLINE

NON PREFERRED DOXYCYCLINE MONOHYDRATE POWDER MINOCIN

CEPHALOSPORINS

FIRST GENERATION CEPHALOSPORINS

GENERIC cefazolin cephalexin

NON PREFERRED CEFAZOLIN/DEXTROSE KEFLEX

SECOND GENERATION CEPHALOSPORINS

GENERIC cefaclor cefoxitin cefoxitin/dextrose cefpodoxime proxetil cefprozil cefuroxime axetil cefuroxime sodium

PREFERRED CEFUROXIME 75G BULK BAG

NON PREFERRED ZINACEF

THIRD GENERATION CEPHALOSPORINS

GENERIC cefdinir cefepime cefotaxime cefotetan ceftazidime ceftibuten ceftriaxone

PREFERRED AVYCAZ CEFTAZIDIME IV PIGGYBACK FORTAZ IN ISO-OSMOTIC DEXTROSE TEFLARO ZERBAXA

NON PREFERRED CEFEPIME/DEXTROSE CEFTRIAXONE 100G BULK BAG

ERYTHROMYCINS & OTHER MACROLIDESGENERIC azithromycin clarithromycin clarithromycin er erythromycin erythromycin del rel erythromycin ethylsuccinate erythromycin stearate erythromycin/sulfisoxazole

PREFERRED AZITHROMYCIN POWDER CLARITHROMYCIN POWDER ERYTHROCIN LACTOBIONATE ERYTHROMYCIN ETHYLSUCCINATE POWDER ERYTHROMYCIN POWDER


NON PREFERRED E.E.S.200MG/5ML ORAL RECON SUSP ZITHROMAX

FLOUROQUINOLONESGENERIC ciprofloxacin ciprofloxacin er ciprofloxacin suspension ciprofloxacin/dextrose levofloxacin/d5w moxifloxacin hcl ofloxacin tablets

PREFERRED AVELOX IV LEVOFLOXACIN HEMIHYDRATE POWDER MOXIFLOXACIN HCL IV PIGGYBACK

NON PREFERRED LEVOFLOXACIN HEMIHYDRATE SOLUTION MOXIFLOXACIN HCL POWDER

SULFA'S & RELATED AGENTSGENERIC sulfadiazine sulfamethoxazole/trimethoprim

PREFERRED SULFADIAZINE POWDER

NON PREFERRED BACTRIM BACTRIM DS

URINARY TRACT AGENTSGENERIC methenamine hippurate methenamine mandelate methylene blue nitrofurantoin nitrofurantoin macrocrystal trimethoprim

PREFERRED METHENAMINE MANDELATE POWDER NITROFURANTOIN POWDER TRIMETHOPRIM POWDER

NON PREFERRED MACROBID MACRODANTIN

ANTIVIRALSGENERIC acyclovir adefovir dipivoxil amantadine hcl cidofovir entecavir famciclovir foscarnet sodium ganciclovir

oseltamivir phosphate capsule ribavirin rimantadine hcl valacyclovir valganciclovir hcl

PREFERRED AMANTADINE HCL POWDER DAKLINZA EPCLUSA MAVYRET PREVYMIS RAPIVAB RELENZA RIBAVIRIN POWDER SOVALDI TAMIFLU ORAL SUSPENSION TECHNIVIE VALACYCLOVIR POWDER VEMLIDY VICTRELIS VOSEVI ZEPATIER

NON PREFERRED CIDOFOVIR TAMIFLU CAPSULE TYZEKA VALCYTE

HIV/AIDS THERAPYGENERIC abacavir abacavir sulfate/lamivudine abacavir/lamivudine/zidovudine atazanavir sulfate capsule didanosine efavirenz fosamprenavir calcium lamivudine lamivudine hbv lamivudine/zidovudine lopinavir-ritonavir oral soln nevirapine er stavudine tenofovir disoproxil 300mg tablet zidovudine

PREFERRED APTIVUS ATRIPLA COMPLERA CRIXIVAN DESCOVY EDURANT EMTRIVA FUZEON GENVOYA INTELENCE INVIRASE ISENTRESS KALETRA TABLETS LEXIVA ORAL SUSP NORVIR ODEFSEY PREZISTA RESCRIPTOR RETROVIR VIAL REYATAZ ORAL POWDER


SELZENTRY STRIBILD TIVICAY TRIUMEQ TRUVADA VIDEX VIRACEPT VIREAD 400MG ORAL POWDER VIREAD TABLET 150MG; 200MG; 250MG

NON PREFERRED EPZICOM KALETRA ORAL SOLN LEXIVA TABLETS RETROVIR REYATAZ CAPSULE SUSTIVA VIRAMUNE VIREAD 300MG TABLET ZIAGEN

ANTIFUNGAL AGENTSGENERIC amphotericin fluconazole fluconazole in dextrose fluconazole in saline flucytosine griseofulvin griseofulvin ultramicrosize itraconazole ketoconazole nystatin terbinafine voriconazole

PREFERRED AMBISOME AMPHOTERICIN POWDER CANCIDAS CRESEMBA FLUCONAZOLE POWDER FLUCYTOSINE POWDER GRISEOFULVIN POWDER ITRACONAZOLE POWDER KETOCONAZOLE POWDER LAMISIL MYCAMINE NOXAFIL NYSTATIN SPORANOX SOLUTION TERBINAFINE VIBATIV VORICONAZOLE POWDER

NON PREFERRED FLUCONAZOLE 100MG/50ML PIGGYBACK ITRACONAZOLE 1GM POWDER KETOCONAZOLE CRYSTALS LAMISIL 250MG TABLET NYSTATIN 100MM POWDER SPORANOX CAPSULE

VANCOMYCINGENERIC vancomycin hcl

PREFERRED

VANCOMYCIN HCL

NON PREFERRED VANCOMYCIN HCL 750 VIAL W/THREADPORT

MISC. ANTI-INFECTIVESGENERIC aztreonam bacitracin clindamycin hcl clindamycin palmitate hcl clindamycin phosphate clindamycin phosphate/dextrose colistimethate dapsone daptomycin gentamicin sulfate gentamicin sulfate in ns imipenem-cilastatin kanamycin sulfate linezolid neomycin sulfate polymyxin b sulfate tobramycin sulfate tobramycin sulfate in ns

PREFERRED AMIKACIN AMIKACIN POWDER AZACTAM-ISO-OSMOTIC DEXTROSE BACITRACIN POWDER BETHKIS CAYSTON CHLORAMPHENICOL CLINDAMYCIN HCL POWDER CLINDAMYCIN PHOSPHATE COLISTIMETHATE POWDER CUBICIN RF DALVANCE DAPSONE POWDER DORIBAX GENTAMICIN SULFATE IN NS 100MG/50ML INVANZ KANAMYCIN SULFATE POWDER KITABIS PAK MEROPENEM - 0.9% NACL NEOMYCIN SULFATE POWDER POLYMYXIN B SULFATE POWDER SIVEXTRO VIAL SYNERCID TOBI PODHALER TOBRAMYCIN SULFATE POWDER TYGACIL XIFAXAN

NON PREFERRED ACZONE CUBICIN GENTAMICIN SULFATE 60MG/ML VIAL GENTAMICIN SULFATE IN NS 120MG/0.1L ORABACTIV SIVEXTRO TABLET TOBRAMYCIN SULFATE 300MG/5ML AMPUL

ANTIPARASITICSGENERIC atovaquone ivermectin


metronidazole paromomycin sulfate tinidazole

PREFERRED ALBENZA ALINIA BENZNIDAZOLE BILTRICIDE EMVERM IMPAVIDO IVERMECTIN POWDER METRONIDAZOLE POWDER NEBUPENT PAROMOMYCIN SULFATE POWDER TINIDAZOLE POWDER

NON PREFERRED FLAGYL MEPRON STROMECTOL TINDAMAX

ANTIMALARIALSGENERIC atovaquone/proguanil hcl chloroquine phosphate hydroxychloroquine sulfate mefloquine hcl quinine sulfate

PREFERRED CHLOROQUINE PHOSPHATE POWDER COARTEM DARAPRIM HYDROXYCHLOROQUINE SULFATE POWDER PRIMAQUINE QUININE SULFATE POWDER

NON PREFERRED MALARONE

ANTIMYCOBACTERIALSGENERIC ethambutol hcl isoniazid pyrazinamide rifabutin

PREFERRED CAPASTAT SULFATE ISONIAZID POWDER PRIFTIN SIRTURO STREPTOMYCIN SULFATE

NON PREFERRED PYRAZINAMIDE POWDER RIFADIN

ANTINEOPLASTIC & IMMUNOSUPPRESANT DRUGS

ALKYLATING AGENTSGENERIC

carboplatin cisplatin cyclophosphamide ifosfamide ifosfamide-mesna melphalan hcl oxaliplatin temozolomide thiotepa

PREFERRED BENDEKA BICNU BUSULFEX CEENU CISPLATIN POWDER CYCLOPHOSPHAMIDE GLEOSTINE LEUKERAN LOMUSTINE MUSTARGEN MYLERAN TEMODAR 100MG VIAL THIOTEPA POWDER TREANDA VALCHLOR ZANOSAR

NON PREFERRED ALKERAN 2MG ALKERAN 50MG TEMODAR CAPSULES

ANTIMETABOLITESGENERIC azacitidine capecitabine cytarabine decitabine floxuridine fludarabine phosphate gemcitabine hcl mercaptopurine methotrexate

PREFERRED ALIMTA ARRANON CLOLAR DEPOCYT FLOXURIDINE POWDER FOLOTYN MERCAPTOPURINE POWDER METHOTREXATE POWDER RASUVO TABLOID

NON PREFERRED FLUOROURACIL 0.005 CREAM TREXALL

HORMONESGENERIC megestrol acetate

PREFERRED


MEGESTROL ACETATE POWDER

ANTIESTROGENSGENERIC anastrozole exemestane letrozole tamoxifen citrate

PREFERRED ANASTROZOLE POWDER FARESTON FASLODEX LETROZOLE POWDER TAMOXIFEN CITRATE POWDER

NON PREFERRED ARIMIDEX AROMASIN FEMARA

ANTIANDROGENSGENERIC bicalutamide flutamide nilutamide

PREFERRED XTANDI ZYTIGA

NON PREFERRED NILANDRON

RADIOPHARMACEUTICALSPREFERRED IODOPEN XOFIGO

IMMUNOSUPPRESSANT DRUGSGENERIC azathioprine azathioprine sodium cyclosporine mycophenolate acid del rel mycophenolate mofetil mycophenolic acid del rel sirolimus tacrolimus

PREFERRED AZATHIOPRINE POWDER CELLCEPT 500MG VIAL CYCLOSPORINE POWDER NULOJIX PROGRAF 5MG/ML AMPUL RAPAMUNE SOLUTION SANDIMMUNE SOLUTION 100MG/ML SOLUTION SIMULECT SIROLIMUS POWDER TACROLIMUS POWDER ZORTRESS

NON PREFERRED

AZASAN CELLCEPT ORAL SUSP PROGRAF CAPSULES RAPAMUNE SANDIMMUNE SOLUTION

MISC. ANTINEOPLASTIC DRUGSGENERIC bleomycin cladribine dacarbazine dactinomycin daunorubicin docetaxel doxorubicin hcl doxorubicin hcl liposomal epirubicin hcl etoposide hydroxyurea idarubicin hcl imatinib mesylate irinotecan hcl leuprolide acetate mitomycin mitoxantrone octreotide acetate paclitaxel topotecan hcl tretinoin cap vinblastine sulfate

PREFERRED ABRAXANE ADCETRIS AFINITOR AFINITOR DISPERZ ALECENSA ALIQOPA ARZERRA AVASTIN BAVENCIO BESPONSA BEXXAR 14MG/ML BLINCYTO BOSULIF CAPRELSA COTELLIC CYRAMZA DARZALEX DAUNOXOME DOCEFREZ DROXIA ELIGARD ELSPAR EMCYT ERBITUX ERIVEDGE ETOPOPHOS ETOPOSIDE POWDER FIRMAGON GAZYVA GILOTRIF HALAVEN HERCEPTIN HEXALEN HYCAMTIN CAPSULES HYDROXYUREA POWDER IBRANCE ICLUSIG IDHIFA


IMBRUVICA INLYTA ISTODAX IXEMPRA JAKAFI JEVTANA KADCYLA KEYTRUDA KYMRIAH KYPROLIS LARTRUVO LENVIMA LEUPROLIDE ACETATE POWDER LONSURF LUPRON DEPOT 11.25MG LUPRON DEPOT 3.75MG LUPRON DEPOT-PED LYNPARZA LYSODREN MARQIBO MATULANE MEKINIST MITOMYCIN POWDER MYLOTARG NERLYNX NEXAVAR NINLARO ONCASPAR ONIVYDE ONTAK OPDIVO PERJETA PHOTOFRIN POMALYST PROVENGE PURIXAN REVLIMID RITUXAN RITUXAN HYCELA RUBRACA RYDAPT SANDOSTATIN KIT SANDOSTATIN LAR DEPOT SIGNIFOR SOMATULINE DEPOT SPRYCEL STIVARGA SUTENT SYLVANT SYNRIBO TAFINLAR TAGRISSO TARCEVA TARGRETIN GEL TASIGNA TECENTRIQ TENIPOSIDE THALOMID TORISEL TRELSTAR VIAL TRETINOIN POWDER TRISENOX TYKERB UNITUXIN VALSTAR VANTAS VECTIBIX VELCADE VENCLEXTA VENCLEXTA STARTER PACK VERZENIO VOTRIENT

VUMON VYXEOS LIPOSOME XALKORI XERMELO YERVOY YESCARTA YONDELIS ZALTRAP ZEJULA ZELBORAF ZEVALIN ZOLADEX ZOLINZA ZYDELIG ZYKADIA

NON PREFERRED BEXXAR HYCAMTIN 4MG VIAL LUPRON DEPOT (FOR PROSTATE CANCER) SANDOSTATIN TARGRETIN 75 CAPSULE TRELSTAR MIXJECT (LA)

ADJUNCTIVE AGENTSGENERIC amifostine calcium folinate dexrazoxane leucovorin calcium levoleucovorin calcium mesna

PREFERRED CALCIUM FOLINATE POWDER ELITEK KEPIVANCE LEUCOVORIN CALCIUM POWDER MESNEX 400MG TABLET VISTOGARD VORAXAZE XGEVA

NON PREFERRED FUSILEV MESNEX 100MG/ML VIAL

Autonomic & CNS Drugs, Neurology & Psych

NARCOTIC ANALGESICSGENERIC alfentanil hcl buprenorphine codeine sulfate fentanyl fentanyl citrate hydromorphone hcl levorphanol tartrate methadone hcl morphine sulfate morphine sulfate cr morphine sulfate er oxycodone hcl oxymorphone hcl oxymorphone hcl er remifentanil hcl


sufentil 50mcg/ml ampul

PREFERRED BUPRENORPHINE POWDER BUTRANS FENTANYL CITRATE POWDER HYDROMORPHONE HCL 1GM POWDER INFUMORPH LEVORPHANOL TARTRATE POWDER MEPERIDINE HCL POWDER METHADONE HCL POWDER MORPHINE SULFATE TABLET POWDER OXYCODONE HCL POWDER OXYCONTIN ER SUBLOCADE SUFENTIL POWDER ULTIVA

NON PREFERRED CODEINE SULFATE SOLUTION DILAUDID-HP FENTANYL FENTANYL CITRATE 100MCG/2ML FENTORA HYDROMORPHONE HCL 0.5MG/0.5ML SYRINGE meperidine hcl MORPHINE SULFATE SUFENTIL 50MCG/ML VIAL

COMBINATION NARCOTIC/ANALGESICSGENERIC acetaminophen/codeine butalbital compound butalbital compound/codeine butalbital/apap/caffeine butalbital/aspirin/caffeine butalbital/caff/apap/codeine hydrocodone/acetaminophen hydrocodone/ibuprofen oxycodone hcl/ibuprofen oxycodone w/aspirin oxycodone/acetaminophen

NON PREFERRED HYDROCODONE/ACETAMINOPHEN

NSAIDSGENERIC diclofenac potassium diclofenac sodium diclofenac sodium/misoprostol del rel etodolac etodolac er fenoprofen calcium flurbiprofen ibuprofen ibuprofen lysine indomethacin indomethacin er ketoprofen er ketorolac tromethamine meclofenamate sodium mefenamic acid meloxicam nabumetone naproxen naproxen sodium oxaprozin

piroxicam sulindac tolmetin sodium

PREFERRED DICLOFENAC SODIUM POWDER ETODOLAC POWDER FLECTOR FLURBIPROFEN POWDER IBUPROFEN POWDER INDOMETHACIN POWDER KETOPROFEN ER POWDER KETOROLAC TROMETHAMINE POWDER MECLOFENAMATE SODIUM POWDER MEFENAMIC ACID POWDER MELOXICAM POWDER MITIGARE NAPROXEN POWDER NAPROXEN SODIUM POWDER PIROXICAM POWDER SULINDAC POWDER

NON PREFERRED FENOPROFEN CALCIUM NABUMETONE POWDER NEOPROFEN ZORVOLEX

NSAIDS-SPECIFIC COX II INHIBITORSGENERIC celecoxib

PREFERRED CELECOXIB POWDER

NON PREFERRED CELEBREX

SALICYLATESGENERIC choline mag trisalicylate diflunisal SALICYLAMIDE salsalate

PREFERRED CHOLINE MAG TRISALICYLATE POWDER SALSALATE POWDER

NON PREFERRED DISALCID

MISC. ANALGESICSGENERIC acetaminophen-diphenhydramine butorphanol clonidine nalbuphine hcl pentazocine lactate tramadol hcl tramadol hcl er tramadol/acetaminophen

PREFERRED


BUTORPHANOL POWDER MONOVISC NALBUPHINE HCL POWDER NUCYNTA NUCYNTA ER OFIRMEV ORTHOVISC PRIALT QUADRAMET TRAMADOL HCL POWDER

NON PREFERRED SYNVISC SYNVISC-ONE TALWIN TRAMADOL HCL ER

NARCOTIC ANTAGONISTSGENERIC buprenorphine/naloxone naloxone hcl naltrexone hydrochloride

PREFERRED MOVANTIK NALOXONE HCL POWDER NALTREXONE HYDROCHLORIDE POWDER NARCAN SUBOXONE ZUBSOLV

NON PREFERRED SUBOXONE TABLET

HEADACHE THERAPYGENERIC dihydroergotamine mesylate eletriptan hbr ergotamine-caffeine naratriptan hcl rizatriptan rizatriptan disintegrating tablets sumatriptan succinate zolmitriptan zolmitriptan ODT

PREFERRED DIHYDROERGOTAMINE MESYLATE ISOMETHEPTENE MUCATE SUMATRIPTAN SUCCINATE POWDER VIVITROL ZOMIG SPRAY

NON PREFERRED RELPAX SUMAVEL DOSEPRO TREXIMET ZOLMITRIPTAN ZOMIG TABLET

ANTIPARKINSONISM AGENTSGENERIC benztropine benztropine mesylate carbidopa/levodopa carbidopa/levodopa er carbidopa/levodopa ODT

carbidopa/levodopa/entacapone entacapone pramipexole er rasagiline mesylate ropinirole hcl ropinirole hcl er selegiline hcl trihexyphenidyl hcl

PREFERRED APOKYN SELEGILINE HCL POWDER

NON PREFERRED AZILECT

ANTICONVULSANTSGENERIC carbamazepine carbamazepine er clonazepam clonazepam ODT diazepam diazepam rectal gel divalproex sodium divalproex sodium er ethosuximide felbamate fosphenytoin sodium gabapentin lamotrigine lamotrigine er levetiracetam levetiracetam er oxcarbazepine phenobarbital phenobarbital sodium phenytoin phenytoin sodium primidone tiagabine hcl topiramate valproate sodium valproic acid zonisamide

PREFERRED BANZEL CARBAMAZEPINE POWDER CELONTIN CLONAZEPAM POWDER DIAZEPAM POWDER DILANTIN 30MG ETHOSUXIMIDE POWDER FYCOMPA GABAPENTIN POWDER GABITRIL 12MG, 16 MG GRALISE LAMOTRIGINE POWDER LEVETIRACETAM POWDER LYRICA ONFI PEGANONE PHENOBARBITAL POWDER PHENOBARBITAL SODIUM POWDER PHENYTOIN POWDER PHENYTOIN SODIUM POWDER POTIGA PRIMIDONE POWDER


QUDEXY XR SABRIL TOPIRAMATE POWDER VALPROATE SODIUM POWDER VALPROIC ACID VIMPAT

NON PREFERRED DILANTIN GABITRIL 2MG, 4MG LAMICTAL XR OXTELLAR XR ZONISAMIDE

MISC. NEUROLOGICAL THERAPYGENERIC donepezil hcl galantamine memantine rivastigmine

PREFERRED AMPYRA GILENYA GLATOPA LEMTRADA NAMENDA XR NAMZARIC NAMZARIC THERAPY PACK NUEDEXTA OCREVUS RADICAVA SPINRAZA TECFIDERA TYSABRI

NON PREFERRED COPAXONE MEMANTINE DOSE PACK XENAZINE

MUSCLE RELAXANTS & ANTISPASMODIC AGENTSGENERIC anectine baclofen chlorzoxazone cyclobenzaprine hcl dantrolene sodium methocarbamol neostigmine methylsulfate orphenadrine citrate orphenadrine compound pyridostigmine bromide tizanidine hcl

PREFERRED BACLOFEN POWDER CYCLOBENZAPRINE HCL DANTROLENE SODIUM POWDER EDROPHONIUM CHLORIDE GABLOFEN LIORESAL MESTINON SYRUP METHOCARBAMOL POWDER NEOSTIGMINE METHYLSULFATE POWDER ORPHENADRINE CITRATE POWDER PYRIDOSTIGMINE BROMIDE POWDER

TIZANIDINE HCL POWDER

NON PREFERRED MESTINON MESTINON ER NEOSTIGMINE METHYLSULFATE ROBAXIN

HYPNOTIC AGENTSGENERIC diphenhydramine hcl flurazepam hcl seconal sodium temazepam triazolam zaleplon zolpidem tartrate zolpidem tartrate er

PREFERRED AMYTAL DOXYLAMINE SUCCINATE NEMBUTAL SODIUM ROZEREM

NON PREFERRED AMBIEN AMBIEN CR SONATA

TRICYCLICSGENERIC amitriptyline hcl amoxapine 150mg amoxapine 25mg clomipramine hcl desipramine hcl doxepin hcl imipramine hcl imipramine pamoate nortriptyline hcl trimipramine maleate

PREFERRED AMITRIPTYLINE HCL POWDER CLOMIPRAMINE HCL POWDER DESIPRAMINE HCL POWDER DOXEPIN HCL POWDER IMIPRAMINE HCL POWDER NORTRIPTYLINE HCL POWDER

MISC. ANTIDEPRESSANTSGENERIC amitriptyline/chlordiazepoxide bupropion er (12 hour) bupropion hcl bupropion hcl er bupropion hcl xl er bupropion sr desvenlafaxine succinate er duloxetine mirtazapine mirtazapine disintegrating perphenazine/amitriptyline trazodone hcl venlafaxine hcl


venlafaxine hcl er

PREFERRED BUPROPION HCL POWDER FETZIMA MIRTAZAPINE POWDER TRAZODONE HCL POWDER

NON PREFERRED DULOXETINE POWDER EFFEXOR XR PRISTIQ REMERON REMERON ODT

MAO INHIBITORSGENERIC phenelzine sulfate tranylcypromine sulfate

PREFERRED PHENELZINE SULFATE POWDER

SELECTIVE SEROTONIN REUPTAKE INHIBITORSGENERIC citalopram hbr escitalopram oxalate fluoxetine fluvoxamine maleate er paroxetine hcl paroxetine hcl er

PREFERRED BRISDELLE FLUOXETINE POWDER VIIBRYD

NON PREFERRED CELEXA FLUOXETINE 60MG PROZAC

PHENOTHIAZINESGENERIC chlorpromazine fluphenazine decanoate fluphenazine hcl perphenazine thioridazine hcl trifluoperazine hcl

PREFERRED CHLORPROMAZINE POWDER FLUPHENAZINE DECANOATE 2.5% THIORIDAZINE HCL POWDER

NON PREFERRED FLUPHENAZINE DECANOATE 1GM LIQUID PERPHENAZINE

BUTYROPHENONESGENERIC haloperidol haloperidol decanoate

haloperidol lactate

PREFERRED HALOPERIDOL DECANOATE POWDER HALOPERIDOL POWDER

NON PREFERRED HALDOL HALDOL DECANOATE

MISC. ANTIPSYCHOTICSGENERIC aripiprazole ODT aripiprazole tablets clozapine clozapine ODT loxapine succinate olanzapine olanzapine ODT olanzapine/fluoxetine hcl quetiapine fumarate quetiapine fumarate er risperidone thiothixene ziprasidone hcl

PREFERRED ABILIFY MAINTENA, ER ARISTADA LATUDA LOXAPINE SUCCINATE POWDER RISPERDAL CONSTA VIMIZIM

NON PREFERRED CLOZAPINE ODT RISPERDAL RISPERDAL M-TAB DISINTEGRATING

MISCELLANEOUS PSYCHOTHERAPEUTIC AGENTSGENERIC amphetamine salt combo er armodafinil atomoxetine hcl clonidine hcl er dexmethylphenidate er dextroamphetamine sulfate dextroamphetamine sulfate er ergoloid mesylates flumazenil guanfacine er guanidine hcl lithium carbonate lithium carbonate er methamphetamine hcl methylphenidate cd methylphenidate er methylphenidate hcl methylphenidate la modafinil

PREFERRED DAYTRANA ERGOLOID MESYLATES POWDER EVEKEO LITHIUM CARBONATE POWDER METHYLPHENIDATE HCL POWDER MYDAYIS


QUILLICHEW ER QUILLIVANT XR VYVANSE XYREM

NON PREFERRED FLUMAZENIL POWDER FOCALIN XR STRATTERA

ANXIOLYTICSGENERIC alprazolam alprazolam er alprazolam ODT buspirone hcl chlordiazepoxide hcl clorazepate dipotassium lorazepam midazolam hcl oxazepam

PREFERRED ALPRAZOLAM POWDER BUSPIRONE HCL POWDER LORAZEPAM POWDER MIDAZOLAM HCL POWDER

NON PREFERRED midazolam hcl XANAX XANAX XR

Cardiovascular, Hypertension & Lipids

ANTIARRHYTHMIC AGENTSGENERIC adenosine amiodarone hcl dofetilide flecainide acetate ibutilide fumarate lidocaine hcl in 7.5% dextrose mexiletine hcl procainamide hcl propafenone hcl propafenone hcl er quinidine gluconate quinidine gluconate er quinidine sulfate sotalol

PREFERRED ADENOSINE POWDER AMIODARONE HCL POWDER MEXILETINE HCL POWDER NEXTERONE PROCAINAMIDE HCL POWDER QUINIDINE SULFATE SOTALOL HCL SOTYLIZE

NON PREFERRED

BETAPACE BETAPACE AF

CARDIAC GLYCOSIDESGENERIC digoxin

PREFERRED DIGOXIN POWDER LANOXIN PEDIATRIC

NON PREFERRED LANOXIN

RAPID ACTING NITRATESGENERIC nitroglycerin nitroglycerin in d5w nitroglycerin spray nitroglycerin tablets

NON PREFERRED NITROSTAT

LONG ACTING NITRATESGENERIC isosorbide dinitrate isosorbide mononitrate isosorbide mononitrate er nitroglycerin er

PREFERRED DILATRATE-SR

NON PREFERRED NITRO-DUR

ANTICOAGULANTSGENERIC warfarin sodium

PREFERRED COUMADIN 5MG VIAL ELIQUIS REFLUDAN WARFARIN SODIUM POWDER XARELTO

NON PREFERRED ARGATROBAN COUMADIN PRADAXA

ANTIPLATELET DRUGSGENERIC aspirin / dipyridamole er cilostazol clopidogrel dipyridamole eptifibatide prasugrel hcl

PREFERRED


BRILINTA DIPYRIDAMOLE POWDER REOPRO ZONTIVITY

NON PREFERRED AGGRASTAT EFFIENT INTEGRILIN

HEPARINGENERIC enoxaparin sodium fondaparinux sodium heparin lock flush heparin sodium in 0.45% nacl heparin sodium in 5% dextrose heparin sodium syringe

PREFERRED FRAGMIN

NON PREFERRED HEPARIN SODIUM IN 0.45% NACL 12500/500

VITAMIN KPREFERRED MEPHYTON PHYTONADIONE

HEMOSTATICSGENERIC tranexamic acid

PREFERRED AMICAR HUMATE-P NOVOSEVEN RT NPLATE PROMACTA TRANEXAMIC ACID POWDER WILATE

NON PREFERRED CYKLOKAPRON LYSTEDA

MISC. COAGULATION AGENTSGENERIC bivalirudin pentoxifylline protamine sulfate

PREFERRED ADVATE ADVATE H ADVATE L ADVATE N ADVATE SH ADVATE UH ADYNOVATE AFSTYLA ALPHANATE ALPHANINE SD ALPROLIX

BEBULIN BEBULIN VH IMMUNO BENEFIX CEPROTIN COAGADEX CORIFACT FEIBA NF HELIXATE FS HEMLIBRA HEMOFIL IXINITY KOGENATE FS KOVALTRY MONOCLATE-P MONONINE NOVOEIGHT OBIZUR PENTOXIFYLLINE POWDER PROFILNINE SD PROTAMINE SULFATE POWDER RIASTAP THROMBATE III TRETTEN VONVENDI XYNTHA

NON PREFERRED ANGIOMAX ATRYN ELOCTATE KOATE-DVI RECOMBINATE XYNTHA SOLOFUSE

THIAZIDE & RELATED DIURETICSGENERIC amiloride hcl amiloride hcl w/hctz bumetanide chlorothiazide chlorothiazide sodium chlorthalidone eplerenone ethacrynate sodium furosemide hydrochlorothiazide indapamide mannitol methyclothiazide metolazone spironolactone spironolactone/hctz torsemide

PREFERRED AMILORIDE HCL POWDER FUROSEMIDE POWDER HYDROCHLOROTHIAZIDE POWDER MANNITOL POWDER RESECTISOL SPIRONOLACTONE POWDER

NON PREFERRED EDECRIN TABLET EDECRIN VIAL FUROSEMIDE 40MG/4ML SOLUTION TORSEMIDE


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

PREFERRED ACEBUTOLOL HCL POWDER ATENOLOL POWDER BYSTOLIC LABETALOL HCL POWDER METOPROLOL TARTRATE POWDER NADOLOL POWDER PROPRANOLOL HCL POWDER TIMOLOL MALEATE POWDER

NON PREFERRED COREG CR SECTRAL TENORMIN

CALCIUM CHANNEL BLOCKERS/ NON-DIHYDROPYRIDINES

GENERIC diltiazem diltiazem 24hr cd diltiazem er diltiazem er 24 hour diltiazem hcl nimodipine verapamil er verapamil er pm verapamil hcl

PREFERRED DILTIAZEM HCL POWDER VERAPAMIL HCL POWDER

NON PREFERRED NIMODIPINE POWDER

CALCIUM CHANNEL BLOCKERS/DIHYDROPYRIDINESGENERIC amlodipine besylate felodipine er isradipine nicardipine hcl

PREFERRED AMLODIPINE BESYLATE POWDER

NON PREFERRED CLEVIPREX

ACE INHIBITORSGENERIC

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

PREFERRED BENAZEPRIL HCL POWDER CAPTOPRIL POWDER ENALAPRIL MALEATE POWDER LISINOPRIL POWDER

NON PREFERRED MAVIK VASOTEC

ADRENERGIC ANTAGONISTS & RELATED DRUGSGENERIC clonidine hcl clonidine/chlorthalidone doxazosin mesylate guanfacine hcl methyldopa methyldopate hcl prazosin hcl reserpine terazosin hcl

PREFERRED CLONIDINE HCL POWDER RESERPINE POWDER

NON PREFERRED PRAZOSIN HCL POWDER

AGENTS FOR PHEOCHROMOCYTOMAGENERIC phentolamine mesylate

PREFERRED DEMSER PHENTOLAMINE MESYLATE POWDER

NON PREFERRED PHENTOLAMINE MESYLATE VIAL

VASODILATORSGENERIC epoprostenol epoprostenol diluent hydralazine hcl minoxidil papaverine hcl papaverine hcl er

PREFERRED DILUENT FOR REMODULIN HYDRALAZINE HCL POWDER MINOXIDIL POWDER PAPAVERINE HCL POWDER


REMODULIN UPTRAVI

NON PREFERRED FLOLAN

OTHER ANTIHYPERTENSIVE COMBINATIONSGENERIC amlodipine/olmesartan amlodipine/valsartan amlodipine/valsartan/hctz atenolol/chlorthalidone benazepril/hctz bisoprolol fumarate/hctz captopril/hydrochlorothiazide enalapril maleate/hctz fosinopril/hydrochlorothiazide lisinopril/hctz methyldopa/hydrochlorothiazide metoprolol/hydrochlorothiazide moexipril/hydrochlorothiazide nadolol-bendroflumethiazide olmesartan/amlodipine/hctz propranolol/hctz quinapril/hydrochlorothiazide trandolapril/verapamil er

PREFERRED BYVALSON

NON PREFERRED AZOR TARKA TRIBENZOR

ANGIOTENSIN II RECEPTOR BLOCKERS & RENIN INHIBITOR

GENERIC candesartan cilexetil candesartan/hydrochlorothiazide irbesartan irbesartan/hydrochlorothiazide losartan potassium losartan/hydrochlorothiazide olmesartan medoxomil olmesartan medoxomil/hctz valsartan valsartan/hydrochlorothiazide

PREFERRED EDARBI EDARBYCLOR TEKTURNA TEKTURNA HCT

NON PREFERRED BENICAR BENICAR HCT

LIPID/CHOLESTEROL LOWERING AGENTSGENERIC amlodipine-atorvastatin atorvastatin calcium cholestyramine cholestyramine light colestipol hcl

ezetimibe ezetimibe/simvastatin fenofibrate fenofibric acid fenofibric acid dr fluvastatin sodium gemfibrozil lovastatin niacin er omega-3-acid ethyl esters pravastatin sodium rosuvastatin simvastatin

PREFERRED CHOLESTYRAMINE POWDER GEMFIBROZIL POWDER JUXTAPID LIPOFEN LIVALO PRALUENT PEN PRALUENT SYRINGE REPATHA PUSHTRONEX REPATHA SURECLICK REPATHA SYRINGE SIMVASTATIN POWDER VASCEPA WELCHOL

NON PREFERRED FENOFIBRATE SIMCOR ER VYTORIN ZETIA

MISC. CARDIOVASCULAR AGENTSGENERIC dobutamine dobutamine/dextrose dopamine hcl dopamine hcl in 5% dextrose milrinone in 5% dextrose milrinone lactate norepinephrine bitartrate phenylephrine hcl phenylephrine hcl-ns

PREFERRED ACTIVASE CATHFLO ACTIVASE CORLANOR DOPAMINE HCL POWDER ENTRESTO NATRECOR PHENYLEPHRINE HCL POWDER PHENYLEPHRINE HCL-NS RANEXA RETAVASE

NON PREFERRED LEVOPHED AMPULE/VIAL PHENYLEPHRINE HCL-NS 200MCG/5ML SYRINGE PHENYLEPHRINE HCL-NS 40MG/5ML SYRINGE


Dermatological/Topical Therapy

TOPICAL CORTICOSTEROIDS VERY HIGH POTENCYGENERIC clobetasol e clobetasol propionate diflorasone diacetate oint halobetasol propionate

PREFERRED CLOBETASOL PROPIONATE POWDER

NON PREFERRED DIPROLENE OINT

TOPICAL CORTICOSTEROIDS HIGH POTENCYGENERIC amcinonide betamethasone dipropionate augment betamethasone valerate desoximetasone diflorasone diacetate cream fluocinonide

PREFERRED BETAMETHASONE DIPROPIONATE AUGMENT POWDER BETAMETHASONE VALERATE POWDER DESOXIMETASONE POWDER FLUOCINONIDE POWDER

NON PREFERRED DIPROLENE AF CREAM DIPROLENE LOTION PSORCON CREAM

TOPICAL CORTICOSTEROIDS MEDIUM POTENCYGENERIC betamethasone valerate foam fluocinolone acetonide fluticasone propionate hydrocortisone butyrate hydrocortisone butyrate/emoll hydrocortisone valerate mometasone furoate

PREFERRED FLUOCINOLONE ACETONIDE POWDER FLUTICASONE PROPIONATE POWDER MOMETASONE FUROATE POWDER TRIAMCINOLONE ACETONIDE POWDER

NON PREFERRED FLUOCINOLONE ACETONIDE POWDER FLUTICASONE PROPIONATE 50MCG SPRAY LUXIQ

TOPICAL CORTICOSTEROIDS LOW POTENCYGENERIC alclometasone dipropionate desonide hydrocortisone hydrocortisone acetate

PREFERRED

DESONIDE POWDER HYDROCORTISONE ACETATE POWDER

NON PREFERRED DESONATE DESOWEN VERDESO

TOPICAL ANESTHETICSGENERIC bupivacaine hcl bupivacaine/epinephrine chloroprocaine cocaine hcl ethyl chloride lidocaine lidocaine hcl lidocaine hcl w/epinephrine lidocaine/prilocaine lidocaine-hc ropivacaine sensorcaine 5MG/ML VIAL

PREFERRED BENZOCAINE BUPIVACAINE HCL POWDER COCAINE HCL LIDOCAINE HCL POWDER LIDOCAINE POWDER MEPIVACAINE HCL POWDER ROPIVACAINE POWDER

NON PREFERRED BUPIVACAINE/EPINEPHRINE CARTRIDGE CARBOCAINE LIDOCAINE LIDOCAINE HCL LIDOCAINE HCL W/EPINEPHRINE LIDOCAINE-HC MEPIVACAINE HCL 30MG/ML CARTRIDGE NESACAINE SENSORCAINE 2.5MG/ML VIAL

THERAPY FOR ACNEGENERIC adapalene cream, gel benprox benzoyl peroxide clindamycin phosphate topical clindamycin phos-tretinoin clindamycin/benzoyl peroxide erythromycin solution erythromycin-benzoyl peroxide sodium sulfacetamide/sulfur tazarotene cream tretinoin tretinoin microsphere

PREFERRED ABSORICA BENZOYL PEROXIDE POWDER EPIDUO EPIDUO FORTE FINACEA MIRVASO ONEXTON


TAZORAC GEL

NON PREFERRED ADAPALENE LOTION DIFFERIN ISOTRETINOIN SODIUM SULFACETAMIDE/SULFUR GEL TAZORAC CREAM TRETIN-X ZIANA

TOPICAL ANTIBACTERIALSGENERIC bacitracin bacitracin/polymyxin ophth oint gentamicin sulfate mafenide acetate mupirocin sulfacetamide sodium

PREFERRED GENTAMICIN SULFATE POWDER MAFENIDE ACETATE POWDER MUPIROCIN POWDER SULFAMYLON CREAM SULFAMYLON PACKET

NON PREFERRED SULFACETAMIDE SODIUM

TOPICAL ANTIFUNGALSGENERIC ciclopirox clotrimazole clotrimazole/betamethasone econazole nitrate nystatin nystatin w/triamcinolone

PREFERRED CLOTRIMAZOLE POWDER ECONAZOLE NITRATE POWDER NYSTATIN

NON PREFERRED LOPROX GEL & SHAMPOO PENLAC

TOPICAL ANTIVIRALSGENERIC acyclovir 5% oint

PREFERRED ACYCLOVIR POWDER ZOVIRAX 5% CREAM

NON PREFERRED ZOVIRAX 5% OINT

BURN THERAPYGENERIC silver sulfadiazine

PREFERRED

SILVER SULFADIAZINE POWDER

NON PREFERRED SILVADENE

TOPICAL ENZYMESPREFERRED SANTYL

KERATOLYTICSGENERIC salicylic acid

PREFERRED SALICYLIC ACID

ANTIPSORIATICS/ANTISEBORRHEICGENERIC acitretin calcipotriene selenium sulfide

PREFERRED ANTHRALIN CALCIPOTRIENE POWDER COSENTYX ENSTILAR SELENIUM SULFIDE POWDER STELARA TACLONEX SUSPENSION TREMFYA

NON PREFERRED CALCITRIOL TACLONEX OINTMENT

TOPICAL SCABICIDES/PEDICULICIDESGENERIC lindane malathion permethrin spinosad

PREFERRED PERMETHRIN

NON PREFERRED ELIMITE

MISC. DERMATOLOGICALSGENERIC alphaquin hp aluminum chloride topical ammonium lactate avo cream chlorhexidine gluconate dexpanthenol eletone emulsion sb fluorouracil hpr


hpr plus hydroquinone cream hydroquinone er cream imiquimod lactic acid lustra-ultra mb hydrogel nuquin hp podofilox pruclair prumyx prutect sonafine tl-cermide urea

PREFERRED ALUMINUM CHLORIDE POWDER AMMONIUM LACTATE CARAC CHLORHEXIDINE GLUCONATE 0.2 SOLUTION DEXPANTHENOL DUPIXENT ELIDEL ETHYL ALCOHOL FLUOROURACIL POWDER HYDROQUINONE POWDER IMIQUIMOD POWDER LACTIC ACID 88 TO 92 % OXSORALEN 1% LOTION PICATO REGRANEX SOOLANTRA UREAM POWDER, BEADS

NON PREFERRED CHLORHEXIDINE GLUCONATE CONDYLOX GEL/SOLUTION ETHYL ALCOHOL 1 LIQUID PODOFILOX POWDER UREA LOTION

EAR, NOSE & THROAT MEDICATIONS

MISCELLANEOUS OTIC PREPARATIONSGENERIC acetic acid otic solution acetic acid/aluminum otic sol acetic acid/hydrocortisone otic sol antipyrine/benzocaine otic sol antipyrine/benzocaine/poly otic sol chloroxylenol/benzocaine/hc acetate otic susp ciprofloxacin hcl ofloxacin otic drops

PREFERRED CIPROFLOXACIN HCL

NON PREFERRED DERMOTIC

OTIC STEROID / ANTIBIOTICGENERIC neomycin/polymyxin/hc otic susp & soln

PREFERRED

CIPRODEX OTOVEL

NON PREFERRED CIPRO HC COLY-MYCIN S

MISCELLANEOUS AGENTSGENERIC azelastine hcl ipratropium bromide spray oxymetazoline hcl 12 hour sodium fluoride

PREFERRED BRINEURA FIRST-BXN FIRST-MOUTHWASH BLM MYALEPT OXYMETAZOLINE HCL POWDER SODIUM FLUORIDE SODIUM FLUORIDE POWDER

NON PREFERRED ATROVENT SPRAY AZELASTINE HCL POWDER

ENDOCRINE/DIABETES

ANTITHYROID AGENTSGENERIC methimazole propylthiouracil

PREFERRED METHIMAZOLE POWDER PROPYLTHIOURACIL POWDER

NON PREFERRED TAPAZOLE

THYROID HORMONESGENERIC levothyroxine sodium liothyronine sodium

PREFERRED ARMOUR THYROID LEVOTHYROXINE SODIUM LIOTHYRONINE SODIUM POWDER THYROID

NON PREFERRED CYTOMEL SYNTHROID TIROSINT

ADRENAL HORMONESGENERIC a-hydrocort cortisone acetate cosyntropin dexamethasone dexamethasone sodium phosphate


fludrocortisone acetate methylprednisolone methylprednisolone acetate methylprednisolone sod succ prednisolone prednisolone sodium phosphate prednisone veripred 20

PREFERRED ARISTOSPAN BETAMETHASONE BETAMETHASONE ACETATE BETAMETHASONE SODIUM PHOSPHATE CORTISONE ACETATE POWDER DEXAMETHASONE POWDER DEXAMETHASONE SODIUM PHOSPHATE POWDER FLUDROCORTISONE ACETATE POWDER METHYLPREDNISOLONE POWDER METHYLPREDNISOLONE SOD SUCC POWDER PREDNISOLONE POWDER PREDNISONE POWDER SOLU-CORTEF

NON PREFERRED COSYNTROPIN DEPO-MEDROL KENALOG MEDROL SOLU-MEDROL VIAL

ANDROGENSGENERIC danazol oxandrolone testosterone cypionate testosterone enanthate testosterone gel

PREFERRED ANDRODERM DANAZOL POWDER FLUOXYMESTERONE METHITEST OXANDROLONE POWDER TESTOSTERONE CYPIONATE POWDER TESTOSTERONE ENANTHATE POWDER TESTOSTERONE POWDER

NON PREFERRED AXIRON TESTOSTERONE GEL

OVULATORY STIMULANTSGENERIC clomiphene citrate

PREFERRED CLOMIPHENE CITRATE POWDER GONAL-F GONAL-F RFF GONAL-F RFF REDI-JECT MENOPUR

NON PREFERRED

BRAVELLE FOLLISTIM AQ

MISCELLANEOUS AGENTSGENERIC cabergoline calcitonin salmon nasal calcitriol desmopressin acetate doxercalciferol pamidronate disodium paricalcitol vasopressin vasopressin-ns zoledronic acid

PREFERRED ACTHREL ALDURAZYME CERDELGA CEREZYME DESMOPRESSIN ACETATE POWDER ELAPRASE ELELYSO FABRAZYME KALYDECO KUVAN LUMIZYME MEPSEVII MIACALCIN VIAL MYOZYME NAGLAZYME SAMSCA SENSIPAR SOMAVERT STIMATE SPRAY SYNAREL VPRIV ZAVESCA ZOMETA INFUSION BOTTLE

NON PREFERRED HECTOROL MIACALCIN AEROSOL PARICALCITOL ZEMPLAR ZOLEDRONIC ACID ZOMETA VIAL

GONADOTROPIN & RELATED AGENTSGENERIC chorionic gonadotropin

PREFERRED CHORIONIC GONADOTROPIN POWDER NOVAREL 5000 UNIT

NON PREFERRED NOVAREL 10000 UNIT PREGNYL

INSULIN THERAPYPREFERRED HUMALOG HUMALOG JUNIOR KWIKPEN HUMULIN 70/30 KWIKPEN HUMULIN N KWIKPEN


HUMULIN R 500 UNITS HUMULIN R U-500 KWIKPEN LANTUS LANTUS SOLOSTAR LEVEMIR LEVEMIR, FLEXTOUCH NOVOLIN 70-30 NOVOLIN N NOVOLIN R NOVOLOG NOVOLOG FLEXPEN NOVOLOG MIX 70-30 SOLIQUA 100-33 TOUJEO SOLOSTAR TRESIBA FLEXTOUCH U-100 TRESIBA FLEXTOUCH U-200 XULTOPHY 100-3.6

NON PREFERRED BASAGLAR KWIKPEN U-100

NON-INSULIN HYPOGLYCEMIC AGENTSGENERIC acarbose glimepiride glipizide glipizide er glyburide glyburide micronized glyburide/metformin hcl metformin hcl metformin hcl er nateglinide pioglitazone hcl pioglitazone/glimepiride pioglitazone/metformin repaglinide/metformin tolazamide tolbutamide

PREFERRED BYDUREON BYDUREON BCISE BYDUREON PEN BYETTA GLIPIZIDE POWDER GLYBURIDE POWDER GLYXAMBI INVOKAMET INVOKAMET XR INVOKANA JANUMET JANUMET XR JANUVIA JENTADUETO JENTADUETO XR JUVISYNC KOMBIGLYZE XR METFORMIN HCL POWDER ONGLYZA SYMLINPEN 120 SYMLINPEN 60 SYNJARDY SYNJARDY XR TRADJENTA TRULICITY VICTOZA XIGDUO XR

NON PREFERRED ACTOPLUS MET XR ACTOS RIOMET

GLUCOSE ELEVATING AGENTSPREFERRED GLUCAGEN PROGLYCEM

NON PREFERRED GLUCAGON

INSULIN SYRINGES/MISCELLANEOUS DMEPREFERRED 1ST CHOICE LANCETS ACCU-CHEK FASTCLIX, MULTICLIX, SOFTCLIX LANCETS ACCU-CHEK SOFTCLIX LANCETS DEVICE DEXCOM G4 METER DEXCOM G4 SENSOR DEXCOM G4 TRANSMITTER DEXCOM G5 METER DEXCOM G5 TRANSMITTER FEMCAP FORA LANCING DEVICE FREESTYLE CONTROL SOLUTION FREESTYLE FREEDOM LITE MEDISENSE MEDISENSE GLUCOSE KETONE CONTR MINIMED MINIMED RESERVOIR NOVOFINE NOVOFINE AUTOCOVER ONE TOUCH ULTRA 2 ONE TOUCH VERIO ONE TOUCH VERIO FLEX ONE TOUCH VERIO IQ ONE TOUCH VERIO SYNC PARADIGM INFUSION PARADIGM INSULIN PUMP PARADIGM SILHOUETTE POLYFIN QR PRODIGY INSULIN SYRINGE PRODIGY PEN NEEDLE QUICK RELEASE SOFT TEFLON SILHOUETTE SNAP INSULIN PUMP CONTROLLER SOF-SET SOF-SET MICRO SOFT TOUCH SOLOSITE SURE-T PARADIGM VGO 20 VGO 30 VGO 40

BLOOD GLUCOSE MONITORING DEVICES & SUPPLIESPREFERRED FREESTYLE FREEDOM KIT FREESTYLE FREEDOM LITE METER FREESTYLE INSULINX FREESTYLE INSULINX GLUCOSE SYSTEM FREESTYLE INSULINX TEST STRIPS FREESTYLE LITE METER FREESTYLE LITE TEST STRIPS FREESTYLE TEST STRIPS


ONE TOUCH ULTRA TEST STRIPS PRECISION XTRA B-KETONE STRIPS PRECISION XTRA MONITOR PRECISION XTRA TEST STRIPS

NON PREFERRED OPTIUM EZ

GASTROENTEROLOGY

H2 ANTAGONISTSGENERIC cimetidine famotidine nizatidine ranitidine hcl

PREFERRED CIMETIDINE POWDER FAMOTIDINE POWDER RANITIDINE HCL POWDER

NON PREFERRED ZANTAC RX

PROSTAGLANDINSGENERIC misoprostol

PREFERRED MISOPROSTOL POWDER

NON PREFERRED CYTOTEC

OTHER ULCER THERAPYGENERIC carafate lansoprazole/amoxicillin/clarithromycin sucralfate

PREFERRED SUCRALFATE POWDER

NON PREFERRED CARAFATE

PROTON PUMP INHIBITORSGENERIC esomeprazole lansoprazole omeprazole omeprazole sodium bicarbonate pantoprazole sodium

PREFERRED LANSOPRAZOLE POWDER NEXIUM (RX) SUSP NEXIUM 24HR

OMEPRAZOLE POWDER

NON PREFERRED NEXIUM (RX) CAPSULE NEXIUM (RX) VIAL OMEPRAZOLE SODIUM BICARBONATE

ANTIDIARRHEALSGENERIC diphenoxylate/atropine loperamide hcl opium paregoric

PREFERRED LOPERAMIDE HCL

NON PREFERRED LOMOTIL TABLET

ANTISPASMODICSGENERIC dicyclomine hcl glycopyrrolate hyoscyamine sulfate hyoscyamine sulfate disinegrating tablets hyoscyamine sulfate er

PREFERRED DICYCLOMINE HCL POWDER GLYCOPYRROLATE POWDER HYOSCYAMINE SULFATE POWDER LEVSIN 0.5MG/ML AMPUL

NON PREFERRED LEVSIN 0.125MG TABLET

BILE ACIDSGENERIC ursodiol

PREFERRED CHENODAL CHOLBAM KINEVAC URSODIOL POWDER

NON PREFERRED ACTIGALL URSO URSO FORTE

DIGESTIVE ENZYMESGENERIC pancrelipase

PREFERRED CREON SUCRAID VIOKACE ZENPEP DEL-REL

NON PREFERRED


PANCREAZE

MISC. GASTROINTESTINAL AGENTSGENERIC balsalazide disodium budesonide budesonide ec CITRA PH hydrocortisone hydrocortisone/pramoxine lactulose mesalamine metoclopramide hcl pramcort sodium bicarbonate sulfasalazine sulfasalazine dr

PREFERRED AMITIZA ASACOL HD CANASA CORTIFOAM CYSTADANE DELZICOL ENTYVIO GLUTAMENT GLUTASOLVE HYDROCORTISONE POWDER LINZESS MESALAMINE POWDER METOCLOPRAMIDE HCL POWDER OCALIVA PENTASA RECTIV RELISTOR REMICADE RENFLEXIS SODIUM BICARBONATE POWDER SULFASALAZINE POWDER UCERIS EXTENDED RELEASE VIBERZI

NON PREFERRED LIALDA LOTRONEX MESALAMINE 800MG TABLET PROCTOFOAM-HC SODIUM BICARBONATE POWDER sodium chloride/sodium bicarb UCERIS FOAM

ANTIVERTIGO & ANTIEMETIC AGENTSGENERIC aprepitant capsule, dose pack dimenhydrinate dronabinol droperidol granisetron hcl granisol meclizine hcl ondansetron hcl ondansetron ODT prochlorperazine edisylate prochlorperazine maleate trimethobenzamide hcl

PREFERRED

AKYNZEO ALOXI DIMENHYDRINATE POWDER DROPERIDOL POWDER EMEND 40MG; 125MG CAPSULE MECLIZINE HCL POWDER ONDANSETRON HCL POWDER PROCHLORPERAZINE EDISYLATE POWDER PROCHLORPERAZINE MALEATE POWDER SANCUSO SCOPOLAMINE HYDROBROMIDE TRIMETHOBENZAMIDE HCL POWDER VARUBI

NON PREFERRED EMEND 125MG/80MG DOSEPACK EMEND 80MG CAPSULE

BOWEL EVACUANTSGENERIC peg 3350-electrolyte polyethylene glycol

PREFERRED POLYETHYLENE GLYCOL PREPOPIK SUCLEAR SUPREP

NON PREFERRED POLYETHYLENE GLYCOL

IMMUNOLOGY, VACCINES & BIOTECHNOLOGY

ERYTHROID STIMULANTSPREFERRED ARANESP PROCRIT

MYELOID STIMULANTSPREFERRED GRANIX LEUKINE MOZOBIL NEULASTA NEUPOGEN ZARXIO

INTERFERONSPREFERRED ACTIMMUNE ALFERON N AVONEX BETASERON EXTAVIA INTRON A PEGASYS PEGASYS PROCLICK PLEGRIDY REBIF REBIF REBIDOSE SYLATRON


GROWTH HORMONESPREFERRED EGRIFTA GENOTROPIN HUMATROPE NORDITROPIN SEROSTIM

NON PREFERRED OMNITROPE

INTERLEUKINSPREFERRED ARCALYST ILARIS PROLEUKIN

VACCINES & MISCELLANEOUS IMMUNOLOGICALSGENERIC candin fomepizole tetanus toxoid

PREFERRED ACTHIB ADACEL AFLURIA 2017-2018 AFLURIA QUAD 2017-2018 APLISOL ATGAM BEXSERO BIOTHRAX BOOSTRIX BOTOX CERVARIX COMVAX CROFAB CYTOGAM ENGERIX-B FLUAD 2017-2018 FLUARIX FLUBLOK 2017-2018 FLUBLOK QUAD 2017-2018 FLUCELVAX QUAD 2017-2018 FLULAVAL 2017-2018 FLULAVAL QUAD 2017-2018 FLUMIST FLUVIRIN 2017-2018 FLUZONE FLUZONE HIGH-DOSE 2017-2018 FLUZONE INTRADERM QUAD 2017-18 FLUZONE QUAD 2017-2018 FLUZONE QUAD PEDI 2017-2018 GAMASTAN S-D GAMMAGARD LIQUID GAMMAGARD S-D GAMUNEX GAMUNEX-C GARDASIL 9 GRASTEK HAVRIX HEPAGAM B HIZENTRA HYPERHEP B S-D HYPERRAB S-D HYPERRHO S-D

HYPERTET S-D IMOGAM RABIES-HT IMOVAX RABIES VACCINE INFANRIX IPOL IXIARO MENACTRA MENOMUNE-A-C-Y-W-135 M-M-R II VACCINE W/DILUENT MYOBLOC ODACTRA PEDIARIX PEDVAXHIB PENTACEL PNEUMOVAX 23 PREVNAR 13 PRIVIGEN PROQUAD QUADRACEL DTAP-IPV RABAVERT RAGWITEK RECOMBIVAX HB ROTATEQ SHINGRIX STAMARIL SYNAGIS TETANUS DIPHTHERIA TOXOIDS TETANUS DIPHTHERIA TOXOIDS - PED THERACYS THYMOGLOBULIN TICE BCG TRUMENBA TUBERSOL TWINRIX TYPHIM VI VAQTA VIAL VARIVAX VACCINE VARIZIG VAXCHORA VACCINE VIVOTIF BERNA DEL REL YF-VAX

NON PREFERRED VAQTA SYRINGES

MUSCULOSKELETAL & RHEUMATOLOGY

GOUT THERAPYGENERIC allopurinol allopurinol sodium probenecid

PREFERRED ALLOPURINOL POWDER COLCHICINE POWDER COLCRYS KRYSTEXXA ULORIC

NON PREFERRED COLCHICINE

OTHER RHEUMATOLOGICALSGENERIC leflunomide


PREFERRED ACTEMRA BENLYSTA DEPEN ENBREL HUMIRA OTREXUP RIDAURA SAVELLA SIMPONI 100MG/ML XELJANZ XELJANZ XR

NON PREFERRED CUPRIMINE ORENCIA ORENCIA CLICKJECT SIMPONI 50MG/0.5ML

OSTEOPOROSIS THERAPYGENERIC alendronate sodium ibandronate ibandronate sodium risedronate dr risedronate sodium

PREFERRED FORTEO TYMLOS

NON PREFERRED ACTONEL BONIVA FOSAMAX

OBSTETRICS & GYNECOLOGY

MONOPHASIC /BIPHASIC /TRIPHASIC AGENTSGENERIC altavera alyacen amethia amethia lo amethyst apri aranelle aubra aviane azurette balziva briellyn camrese camrese lo caziant chateal cryselle cyclafem dasetta daysee drospirenone/eth estra/levomef elinest emoquette enpresse enskyce estarylla falmina

gianvi gildagia gildess gildess fe introvale jolessa junel junel fe kariva kelnor 1-35 kurvelo leena lessina levonorgestrel levora loryna low-ogestrel lutera marlissa microgestin microgestin fe mono-linyah mononessa myzilra necon norethindrone/eth estradiol/iron norethindrone/ethinyl estradiol norethin-eth estra ferrous fum nortrel ocella ogestrel orsythia philith pirmella portia quasense reclipsen sprintec sronyx syeda tilia fe tri-estarylla tri-legest fe tri-linyah trinessa trivora velivet vestura viorele wera wymzya fe zarah zenchent zenchent fe zeosa zovia

PREFERRED LO LOESTRIN FE NATAZIA SAFYRAL TAYTULLA

NON PREFERRED BEYAZ MINASTRIN 24 FE

OXYTOCICSGENERIC


methylergonovine maleate oxytocin

PREFERRED ERGONOVINE MALEATE HEMABATE OXYTOCIN POWDER

NON PREFERRED METHYLERGONOVINE MALEATE

PROGESTINSGENERIC errin heather jencycla jolivette lyza medroxyprogesterone acetate nora-be norethindrone acetate progesterone in oil progesterone micronized

PREFERRED CALDOLOR CRINONE DEPO-PROVERA 400 MG/ML MAKENA NORETHINDRONE ACETATE POWDER PROGESTERONE MICRONIZED POWDER

NON PREFERRED DEPO-PROVERA ENDOMETRIN MEDROXYPROGESTERONE ACETATE POWDER

ESTROGENSGENERIC estradiol patch estradiol tablet/cream estradiol valerate estropipate yuvafem

PREFERRED DEPO-ESTRADIOL DIVIGEL ESTRADIOL VALERATE POWDER ESTRING MINIVELLE PREMARIN PREMARIN CREAM

NON PREFERRED ENJUVIA ESTRACE CREAM ESTRACE TABLET FEMRING

ESTROGEN COMBINATIONSGENERIC

estradiol/norethindrone acetate estrogen/methyltestosterone

PREFERRED COMBIPATCH DUAVEE PREMPHASE PREMPRO

VAGINAL CLEANSER /ANTIINFECTIVESGENERIC clindamycin phosphate vaginal

VAGINAL ANTIFUNGALSGENERIC miconazole 1 terconazole

PREFERRED MICONAZOLE 1

SPECIALIZED OB/GYN DRUGSGENERIC isoxsuprine hcl

PREFERRED ISOXSUPRINE HCL POWDER

NON PREFERRED OSPHENA

DIAPHRAGMS AND OTHER NON-ORAL CONTRACEPTIVES

PREFERRED IMPLANON KYLEENA MIRENA NEXPLANON NUVARING ORTHO-DIAPHRAGM SKYLA TODAY CONTRACEPTIVE SPONGE

OPHTHALMOLOGY

BETA-BLOCKERSGENERIC betaxolol ophth solution carteolol hcl levobunolol hcl drops metipranolol drops

NON PREFERRED BETAGAN BETOPTIC S

CHOLINESTERASE INHIBITOR MIOTICSPREFERRED PHOSPHOLINE IODIDE DROPS


DIRECT ACTING MIOTICSGENERIC pilocarpine hcl

PREFERRED PILOCARPINE HCL POWDER PILOPINE HS

NON PREFERRED ISOPTO CARPINE

OTHER GLAUCOMA DRUGSGENERIC bimatoprost dorzolamide hcl dorzolamide/timolol latanoprost drops physostigmine salicylate travoprost

PREFERRED CARBACHOL COMBIGAN ISOPTO CARBACHOL 0.015 PHYSOSTIGMINE SALICYLATE TRAVATAN Z

NON PREFERRED ISOPTO CARBACHOL 0.03 LATANOPROST DROPS 1GM OIL LUMIGAN

ORAL DRUGS FOR GLAUCOMAGENERIC acetazolamide acetazolamide er methazolamide

PREFERRED ACETAZOLAMIDE POWDER METHAZOLAMIDE POWDER

NON PREFERRED DIAMOX SEQUELS

CYCLOPLEGIC MYDRIATICSGENERIC atropine sulfate cyclopentolate ophth solution homatropine hydrobromide tropicamide

PREFERRED ATROPINE SULFATE POWDER CYCLOPENTOLATE POWDER HOMATROPINE HYDROBROMIDE TROPICAMIDE POWDER

NON PREFERRED CYCLOGYL MYDRIACYL

NON-STEROIDAL ANTI-INFLAMMATORY AGENTSGENERIC bromfenac ophth flurbiprofen sodium ketorolac tromethamine drops

PREFERRED ILEVRO NEVANAC PROLENSA

NON PREFERRED BROMFENAC POWDER

VASOCONSTRICTOR DECONGESTANTSGENERIC naphazoline hcl

PREFERRED NAPHAZOLINE HCL POWDER

ANTIBIOTICSGENERIC ciprofloxacin ophth solution erythromycin ointment gatifloxacin gentasol levofloxacin hemihydrate neomycin/polymyxin/gramicidin ofloxacin tobramycin sulfate drops

PREFERRED AZASITE MOXEZA NATACYN TOBRAMYCIN SULFATE POWDER

NON PREFERRED BESIVANCE OCUFLOX TOBREX VIGAMOX

SULFONAMIDESGENERIC sulfacetamide sodium

NON PREFERRED BLEPH-10

STEROIDSGENERIC dexamethasone sod phos ophth fluorometholone prednisolone acetate prednisolone sodium phosphate drops

PREFERRED ALREX FLUOROMETHOLONE POWDER LOTEMAX PREDNISOLONE ACETATE POWDER


PREDNISOLONE SODIUM PHOSPHATE DROPS POWDER

NON PREFERRED FML S.O.P. PRED MILD

STEROID-ANTIBIOTIC COMBINATIONSGENERIC neomycin/bacitracin/poly/hc tobramycin/dexamethasone

PREFERRED TOBRADEX OINTMENT TOBRADEX ST ZYLET

NON PREFERRED TOBRADEX SUSPENSION

STEROID-SULFONAMIDE COMBINATIONSGENERIC sulfacetamide w/prednisolone

NON PREFERRED BLEPHAMIDE S.O.P.

SYMPATHOMIMETICSGENERIC apraclonidine ophth solution brimonidine ophth solution

PREFERRED ALPHAGAN P 0.001% BRIMONIDINE POWDER

NON PREFERRED ALPHAGAN P 0.0015%

MISCELLANEOUS OPHTHALMOLOGICSGENERIC azelastine hcl ophth solution balanced salt ophth irrigation cromolyn sodium epinastine hcl olopatadine hcl (ophthalmic) proparacaine hcl proparacaine/fluorescein sodium chloride drops tetcaine drops

PREFERRED BEPREVE CYSTARAN EYLEA FLUORESCEIN SODIUM JETREA LUCENTIS LUXTURNA PAZEO PROPARACAINE HCL POWDER RESTASIS RESTASIS MULTIDOSE

VISUDYNE XIIDRA

NON PREFERRED ELESTAT PATADAY PATANOL

ANTIVIRALSGENERIC trifluridine

PREFERRED TRIFLURIDINE POWDER

NON PREFERRED VIROPTIC

RESPIRATORY, ALLERGY, COUGH & COLD

ANTIHISTAMINESGENERIC arbinoxa carbinoxamine cetirizine syrup clemastine fumarate cyproheptadine hcl desloratadine desloratadine disintegrating tablets dexchlorpheniramine maleate er diphenhydramine hydroxyzine hcl hydroxyzine pamoate levocetirizine dihydrochloride promethazine hcl promethegan

PREFERRED CLEMASTINE FUMARATE POWDER CYPROHEPTADINE HCL POWDER DIPHENHYDRAMINE POWDER HYDROXYZINE HCL POWDER HYDROXYZINE PAMOATE POWDER LEVOCETIRIZINE DIHYDROCHLORIDE POWDER PROMETHAZINE HCL POWDER PROMETHAZINE HCL TABLETS POWDER

NON PREFERRED CYPROHEPTADINE HCL 4MG/10ML SYRUP HYDROXYZINE HCL 50MG/25ML SOLUTION VISTARIL

ADRENERGICSGENERIC epinephrine ampule/vial

PREFERRED EPINEPHRINE AUTO-INJECTOR EPINEPHRINE POWDER EPIPEN EPIPEN JR.

NON PREFERRED


EPINEPHRINE 1MG/ML AMPUL EPINEPHRINE AUTO-INJECTOR

ANTITUSSIVE COMBINATIONSGENERIC benzonatate chlorphen/pse/dm tannate D-CHLORPHENIRA/PSE/CHLOPHEDIAN 12.5CPD-1DCPM-30PSE dihydrocodeine/aspirin/caffeine dihydrocodeine/bpm/pe DM/PHENYLEPH/CHLORPHENIRAMINE 10PEH-4CPM-20DM guaifenesin/codeine hydrocodone/chlorpheniramine er hydrocodone/homatropine promethazine vc/codeine promethazine w/codeine promethazine/dextromethorphan

PREFERRED DEXTROMETHORPHAN HBR

NON PREFERRED GUAIFENESIN/CODEINE HYDROCODONE/HOMATROPINE PSEUDOEPH/CHLOPHEDIANOL/GG 12.5CPD-100GFN-30PSE TUSSICAPS

DECONGESTANT / ANTIHISTAMINESGENERIC brompheniramine/pseudoephedrine phenylephrine/chlorpheniramine 10peh-4cpm pseudoephedrine hcl pseudoephedrine hcl er

PREFERRED PSEUDOEPHEDRINE HCL

NON PREFERRED pseudoephedrine sulfate er

XANTHINESGENERIC aminophylline caffeine/sodium benzoate difil-g theophylline anhydrous drops er 12 hr theophylline anhydrous er

PREFERRED AMINOPHYLLINE POWDER THEOPHYLLINE ANHYDROUS POWDER

NON PREFERRED AMINOPHYLLINE 500MG/20ML AMPUL

BETA AGONISTS ORALGENERIC albuterol sulfate ephedrine sulfate metaproterenol sulfate terbutaline sulfate

PREFERRED ALBUTEROL ALBUTEROL SULFATE POWDER

EPHEDRINE SULFATE POWDER METAPROTERENOL SULFATE POWDER TERBUTALINE SULFATE POWDER

NON PREFERRED VOSPIRE ER

BETA AGONISTS INHALERSGENERIC levalbuterol hcl

PREFERRED ARCAPTA NEOHALER LEVALBUTEROL HCL POWDER PERFOROMIST PROAIR HFA PROAIR RESPICLICK SEREVENT DISKUS STRIVERDI RESPIMAT VENTOLIN HFA

INHALED CORTICOSTEROIDSGENERIC budesonide

PREFERRED ARMONAIR RESPICLICK ASMANEX, HFA BUDESONIDE POWDER FLOVENT DISKUS FLOVENT HFA PULMICORT FLEXHALER QVAR QVAR REDIHALER

NON PREFERRED ALVESCO

INTRANASAL STEROIDSGENERIC flunisolide nasal spray fluticasone nasal spray mometasone furoate nasal triamcinolone acetonide

PREFERRED DYMISTA FLUNISOLIDE POWDER QNASL

NON PREFERRED BECONASE AQ NASONEX VERAMYST

MISCELLANEOUS PULMONARY AGENTSGENERIC acetylcysteine cromolyn sodium ipratropium bromide ipratropium/albuterol nebulization montelukast sodium sildenafil citrate sodium chloride


zafirlukast

PREFERRED ACETYLCYSTEINE POWDER ADCIRCA ADEMPAS ADVAIR DISKUS ADVAIR HFA ANORO ELLIPTA ARNUITY ELLIPTA BERINERT BEVESPI AEROSPHERE BREO ELLIPTA CINRYZE COMBIVENT RESPIMAT CROMOLYN SODIUM POWDER DALIRESP DULERA ESBRIET FASENRA FIRAZYR INCRUSE ELLIPTA IPRATROPIUM BROMIDE POWDER LETAIRIS MONTELUKAST SODIUM POWDER NUCALA OPSUMIT ORKAMBI PULMOZYME SEEBRI NEOHALER SILDENAFIL CITRATE POWDER SPIRIVA RESPIMAT STIOLTO RESPIMAT SYMBICORT TRACLEER TRELEGY ELLIPTA TUDORZA PRESSAIR TYVASO UTIBRON NEOHALER VENTAVIS XOLAIR

NON PREFERRED ACCOLATE KALBITOR REVATIO

UROLOGICALS

CHOLINERGIC STIMULANTSGENERIC bethanechol chloride

PREFERRED BETHANECHOL CHLORIDE POWDER

ANTICHOLINERGICS & ANTISPASMODICSGENERIC darifenacin er flavoxate hcl oxybutynin chloride oxybutynin chloride er tolterodine tartrate trospium chloride er

PREFERRED

GELNIQUE MYRBETRIQ ER 24 HR OXYBUTYNIN CHLORIDE POWDER TOVIAZ VESICARE

NON PREFERRED DITROPAN XL ENABLEX

URINARY ANESTHETICSGENERIC phenazopyridine hcl phenazopyridine plus

PREFERRED PHENAZOPYRIDINE HCL POWDER

MISCELLANEOUS UROLOGICALSGENERIC alprostadil glycine hyophen phosphasal potassium citrate er sildenafil citrate tablet tricitrates uretron d-s urimar-t urin d.s. urogesic ustell

PREFERRED ALPROSTADIL POWDER AMINOACETIC ACID AMMONIUM CHLORIDE CAVERJECT CIALIS CYSTAGON ELMIRON GLYCINE POWDER K-PHOS ORIGINAL MUSE RENACIDIN

NON PREFERRED AMINOACETIC ACID POWDER VIAGRA

BENIGN PROSTATIC HYPERPLASIA (BPH) THERAPYGENERIC alfuzosin hcl er finasteride tamsulosin hcl er 24 hr

PREFERRED FINASTERIDE POWDER RAPAFLO

NON PREFERRED


FLOMAX PROSCAR

VITAMINS, HEMATINICS & ELECTROLYTES

VITAMINS & HEMATINICSGENERIC advanced am/pm ascorbic acid bal-care dha b-complex cavan-alpha kit cavan-ec sod dha centratex choice-ob + dha choice-tabs complete natal dha corvita dailyvite dexferrum dialyvite 800 elite ob elite-ob elite-ob 400 fabb fe 90 plus fe c ferocon ferotrinsic ferraplus 90 ferrex 150 forte ferrex 150 forte plus ferrex 28 ferrocite plus ferrogels forte folbecal folbee folbee plus folbic folcaps folcaps omega-3 folic acid folic acid/cyancobal/pyridoxine folivane-f folivane-ob folivane-plus folivane-prx dha nf folplex 2.2 foltanx hematinic plus hematinic with folic acid hematogen hematogen fa hematogen forte hemenatal ob hemenatal ob + dha hemetab hydroxocobalamin iferex 150 forte inatal advance inatal gt inatal ultra infed l-mefolate-pyridox-mecobalamin l-methyl-b6-b12 l-methylfolate calcium m.v.i. adult

macnatal cn dha mefolate-pyridox-mecobalamin metafolbic methyl-b6-b12 multigen multigen folic multigen plus multivitamin w/fluoride & iron multivitamin with fluoride mynatal mynatal advance mynatal caps mynatal plus mynatal-z mynate 90 plus er mynephrocaps natal-v rx natalvirt 90 dha natalvirt ca natalvirt flt nephplex rx nephro-vite rx nutri-tab ob obstetrix dha pnv ob+dha pnv-dha pnv-first pnv-omega pnv-select pnv-total poly-iron 150 forte polysaccharide iron forte pr natal 400 pr natal 400 ec pr natal 430 pr natal 430 ec prefol-dha prena1 prena1 chew prena1 plus prenaissance prenaissance 90 dha prenaissance balance prenaissance dha prenaissance harmony dha prenaissance next prenaissance plus prenaplus prenatabs fa prenatabs rx prenatal ad prenatal low iron prenatal plus prenatal-u pyridoxine hcl relnate dha renal caps renalpren rena-vite rx reno caps se-natal 19 se-tan dha prenatal se-tan plus setonet setonet ec strovite taron forte taron prenatal taron-bc taron-c dha taron-duo ec therapeutic hematinic


therapeutic vitamin/minerals thiamine hcl tl gard rx tl g-fol os tl icon tl-care dha tl-fol 500 er tl-hem 150 er 24 hr tl-select tri rx triadvance tricon trigels-f forte trinatal gt trinatal rx 1 trinatal ultra trinate triphrocaps triveen-duo dha triveen-one triveen-prx rnf triveen-ten triveen-u trust natal dha ultimate ob dha ultimatecare one ultimatecare one nf v-c forte vemavite-prx 2 vena-bal dha venatal complete dha venatal-fa vinacal vinate az vinate c vinate calcium vinate dha vinate gt vinate ic vinate ii vinate one vinate ultra vinate-m virt-bal dha virt-bal dha plus virt-pn virt-pn dha virt-pn plus virt-select virt-vite virt-vite forte vitacirc-b vitafol-pn vitamin a v-natal vol-care rx vol-nate vol-plus vol-tab rx vp-ch plus vp-ch-pnv vp-era ob plus vp-ggr-b6 vp-heme one zatean-ch zatean-pn zatean-pn dha zatean-pn plus zingiber

PREFERRED

AQUASOL A ASCORBIC ACID FERAHEME FOLIC ACID POWDER HYDROXOCOBALAMIN POWDER INFUVITE LEVOMEFOLATE DHA L-METHYLFOLATE CALCIUM POWEDER M.V.I. PEDIATRIC M.V.I.-12 NASCOBAL PYRIDOXINE HCL THIAMINE HCL POWDER TROPHAMINE VENOFER VITAMIN A

NON PREFERRED B-COMPLEX CENOLATE CONCEPTION XR MOTILITY DIALYVITE 800 DULEEK-MET NEW folbic rf FOLIC ACID 20MG CAP FOLIC ACID-VIT B12 PYRIDOXINE HCL 500MG TABLETS STUART ONE THIAMINE HCL VITAFOL-OB VITAMIN A vitaspire vynatal-fa

POTASSIUMGENERIC pot chloride/dextrose/ns potassium acetate potassium bicarbonate potassium chloride potassium chloride/dextrose

PREFERRED POTASSIUM ACETATE POTASSIUM BICARBONATE POTASSIUM CHLORIDE

OTHER ELECTROLYTESGENERIC calcium acetate calcium chloride calcium gluconate chromium chloride copper chloride eliphos k-phos neutral magnesium chloride magnesium sulfate manganese manganese sulfate multitrace-4 nutrilyte nutrilyte ii potassium chl-normal saline ringers selenium sodium acetate sodium chloride sodium lactate


zinc chloride zinc sulfate

PREFERRED ADDAMEL N CALCIUM ACETATE POWDER CALCIUM CHLORIDE CALCIUM GLUCONATE 61MG CALCIUM GLUCONATE POWDER CUPRIC SULFATE GLYCOPHOS MAGNESIUM CHLORIDE MAGNESIUM SULFATE MAGNESIUM SULFATE IN DEXTROSE MANGANESE SULFATE POWDER MULTITRACE-4 MULTITRACE-5 NEUT NORMOSOL-R AND DEXTROSE PEDITRACE PHOSLYRA SODIUM ACETATE POWDER SODIUM LACTATE TPN ELECTROLYTES 18-18-5MEQ TRACE ELEMENTS ZINC CHLORIDE ZINC SULFATE

NON PREFERRED CALCIUM ACETATE CALCIUM GLUCONATE 50MG CUPRIC SULFATE MAGNESIUM SULFATE 100MG CAPSULE SELENIUM TPN ELECTROLYTES 35-20-5MEQ

MISCELLANEOUS NUTRITION PRODUCTSGENERIC amino acid freamine iii hetastarch w/sodium chloride intralipid l-methylfolate-mecobalamin-nac metafolbic plus premasol travasol vp-zel

PREFERRED AMINOSYN BAL IN OIL CLINIMIX CLINIMIX E FREAMINE HBC FREAMINE III HEPATAMINE HEPATASOL IONOSOL B WITH DEXTROSE 5% ISOLYTE S NEPHRAMINE NORMOSOL-M AND DEXTROSE NORMOSOL-R PH 7.4 PLASMA-LYTE 148 PREMASOL PROCALAMINE PROSOL

NON PREFERRED

AMINO ACID 700MG TABLETS INTRALIPID METHYLFOLATE MECOBALAMIN-NAC 6-600-2MG

BLOOD DERIVATIVESGENERIC albumin

NON PREFERRED ALBUMIN

DIAGNOSTICS & MISCELLANEOUS AGENTS

MISCELLANEOUS AGENTSGENERIC acamprosate calcium acetic acid irrigation anagrelide hydrochloride bupivacaine/dextrose caffeine citrated cevimeline hcl citric acid deferoxamine delflex w/dextrose dextrose in lactated ringers dextrose in water dextrose with sodium chloride disulfiram etidronate disodium etomidate ketamine hcl lanthanum carbonate levocarnitine md-gastroview midodrine hcl pilocarpine hcl propofol riluzole sevelamer carbonate sodium chloride sodium phenylbutyrate sodium phosphate 3mmol/ml vial sodium polystyrene sulfonate sodium thiosulfate water water intravenous solution water solution; irrigation

PREFERRED ACETIC ACID ADAGEN AMMONUL ARALAST NP BREVITAL BROMHEXINE HYDROCHLORIDE CAFFEINE CITRATED POWDER CARBAGLU CHEMET CITRIC ACID POWDER DISULFIRAM POWDER EOVIST ETHAMOLIN ETOMIDATE POWDER EXJADE EXTRANEAL ICODEXTRIN DIALYSIS FERRIPROX


FOSRENOL ORAL POWDER HEXTEND LACTATED ELECTROLYTE INCRELEX JADENU JADENU SPRINKLE KANUMA KETAMINE HCL POWDER LEVOCARNITINE POWDER LEXISCAN NATPARA NITYR OMNIPAQUE ORFADIN PANHEMATIN PROLASTIN C RAVICTI SEROTONIN HCL SODIUM PHOSPHATE SODIUM THIOSULFATE SOLIRIS SOTRADECOL STRENSIQ THYROGEN TRYPSIN VELPHORO VELTASSA WATER XIAFLEX XURIDEN ZEMAIRA

NON PREFERRED BUPHENYL DELFLEX W/DEXTROSE FOSRENOL CHEW TABLET ISOVUE ISOVUE-M KALEXATE KETAMINE HCL 50MG/ML SYRINGE MAGNEVIST PROHANCE PROSTAMEN RENVELA SODIUM POLYSTYRENE SULFONATE THALLOUS CHLORIDE TL-201 VISIPAQUE

SMOKING DETERRENTSGENERIC BUPROBAN

PREFERRED CHANTIX

NON PREFERRED ZYBAN

ANOREXIANTSGENERIC benzphetamine hcl diethylpropion hcl phendimetrazine tartrate phendimetrazine tartrate er phentermine hcl

PREFERRED

DIETHYLPROPION HCL POWDER PHENTERMINE HCL POWDER

NEUTRACEUTICALSPREFERRED UVA URSI LEAF FLUID EXTRACT

IRRIGATING SOLUTIONSGENERIC neomycin-polymyxin b ringers irrigation

ANTIDOTESPREFERRED PROTOPAM CHLORIDE

NON PREFERRED ATROPEN


ANTI-INFECTIVES · Web viewcholine mag trisalicylate diflunisal SALICYLAMIDE salsalate PREFERRED...

Documents

Transcript of ANTI-INFECTIVES · Web viewcholine mag trisalicylate diflunisal SALICYLAMIDE salsalate PREFERRED...