PRODUCT SELECTION CRITERIA

2

PRODUCT SELECTION CRITERIA When a new drug is considered for Formulary inclusion, an attempt will be made to examine the drug relative to similar drugs currently on Formulary. In addition, entire therapeutic classes are periodically reviewed. The class review process may result in deletion or non-Formulary (NF) status of drug(s) in a particular therapeutic class, in an effort to continually promote the most clinically useful and cost-effective agents. A central factor in successful management of the Formulary is the review and evaluation of the drug products available in the consumer market and a means to make changes to the Formulary in response to changing therapies and economic factors. The P&T Committee utilizes the following criterion in the evaluation of product selection for the Formulary: a) The drug product must demonstrate unequivocal safety for medical use. b) The drug product must be efficacious and be medically necessary for the treatment, maintenance, or prophylaxis of a medical condition. c) The drug product does not have alternative/similar agents on the Formulary that could be substituted. d) The drug product must demonstrate a therapeutic outcome. e) The medical community must accept the drug product for use. f ) The drug product must have an equitable cost ratio for the treatment of the medical condition. SIX-TIER FORMULARY CO-PAYMENT STRUCTURE This Formulary is divided into six tiers and the tier is easily identified in the second column on the Formulary. Generic drugs offer an excellent value to the consumer because they are chemically identical to brand drugs but are priced at a fraction of the cost of the corresponding brand drug. The U.S. Food and Drug Administration (FDA) requires that generic drugs provide the same effectiveness and safety as their brand name counterparts. The FDA requires drug manufacturers to show that the generic version enters the bloodstream the same way, contains the same amount of active ingredient, comes in the same dosage form and is taken the same way as the brand name drug. Members will pay the lowest co-payment for 1st tier medications. These agents can be easily identified in the Formulary as the agents with a "1" in the second column. The P&T Committee has reviewed these medications and found them to be therapeutically equivelent to their brand counterparts. Refer to your benefit materials, or call the PTI/NPS Help Desk telephone number on your ID card, to determine what level of coverage you have for your prescription drugs. OFF-LABEL USE OF MEDICATIONS The Food and Drug Administration (FDA) has required that drugs used in the United States be both safe and effective. The label information or the package insert of a medication indicates drug use only in certain "approved" doses and routes of administration for a particular condition or disease state. The use of a drug for a disease state or condition not listed on the label, or in a dose or by a route not listed on the label, is considered to be a "non-approved" or "un-labeled" or "off-label" use of the drug. A prior authorization is required when a medication is used outside of its FDA approved route of administration, dosage, or indication. Coverage will be determined in the same manner and subject to the same conditions and limitations as any other prescription drug. Prior authorizations for unlabeled uses of medications may be granted provided that: a) the medication is approved by the FDA; and b) two or more peer-reviewed professional medical journals have recognized, based on scientific medical criteria, the safety and effectiveness of the medication or combination of medications, for treatment of the indication for which the medication has been prescribed unless two articles from major peer-reviewed professional medical journals have concluded, based on scientific or medical criteria, that the drug or combination of drugs is unsafe or ineffective or the safety and effectiveness of the drug or combination of drugs cannot be determined for the treatment of the indication for which the drug or combination of drugs has been prescribed. EXPERIMENTAL MEDICATIONS Any medication or drug that has not been approved by the FDA to be both safe and effective for use in the United States will not be covered. This includes both FDA approved and non-approved medications that are in experimental or investigational trials to determine new indications, new routes of administration, or new dosage forms. PRIOR AUTHORIZATION To promote appropriate utilization, selected high-risk or high-cost medications may require prior authorization to be eligible for coverage under the member’s prescription drug benefit. The P&T Committee has established prior authorization criteria. In order for a member to receive coverage for a medication requiring prior authorization, the member’s physician should contact the customer service center at 1-800-546-5677 to obtain a prior authorization request form. Your physician may then be required to document the reason why a Formulary medication is not acceptable for treatment of your disease state or medical condition. Your physician will want to include in his/her letter your diagnosis and previous therapies that have failed. NEW DRUGS INTRODUCED INTO THE CONSUMER MARKET As the U.S. Food and Drug Administration (FDA) approves new drugs and therapies available to the consumer market after the Plan Summary Documents have been distributed, the Drug Benefit Plan reserves the right to extend or deny coverage to these medications after the printing of this document. The Drug Benefit Plan also reserves the right to assign a unique co-pay or coinsurance to these medications and/or limit the quantities of these medications. Members will receive notices regarding any Drug Benefit Plan modifications concerning drugs or therapies at such time that they present a prescription that is impacted by modifications to the Formulary. Network pharmacies are charged to communicate these updates or changes to the program which may impact a member. The P&T Committee will review new drugs approved by the FDA on a monthly basis. New products with an FDA designation of 1P (FDA priority review – therapeutic advance over currently-marketed drugs) will automatically be considered for addition to the Formulary, even if not requested by a plan. New products with an FDA designation of 1S (FDA standard review – no therapeutic gain over currently marketed drugs) will not generally be considered for addition to the Formulary, unless requested by a plan, or the drug class is currently under review by the P&T Committee. Members wanting to have newly approved therapies considered by the plan may write and/or call the company servicing the plan or may contact the plan administrator.

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STEP THERAPY Step Therapy is a program especially designed for people who take prescription drugs regularly to treat an ongoing medical condition. The program helps you get the prescription drugs you need, with safety, cost and—most importantly—your health in mind. In Step Therapy, the covered drugs you take are organized in a series of “steps,” with your doctor approving and writing your prescriptions. The program usually starts with generic drugs in the “first step.” These generics—rigorously tested and approved by the U.S. Food & Drug Administration (FDA)—allow you to begin or continue treatment with safe, effective drugs that are also affordable: Your co-payment is usually the lowest with a first-step drug. More expensive brand-name drugs are usually covered in the “second step,” even though the generics covered have been proven to be effective in treating medical conditions. Your doctor is consulted for approval and writes your prescriptions based on the list of Step Therapy drugs covered by the formulary. Step Therapy is developed under the guidance and direction of independent, licensed doctors, pharmacists and other medical experts. They review the most current research on thousands of drugs tested and approved by the Food and Drug Administration for safety and effectiveness. Then they recommend appropriate prescription drugs for the Step Therapy program. The first time you submit a prescription that isn’t for a first-step drug, your pharmacist will tell you there’s a note on the computer system indicating that our plan uses Step Therapy. This simply means that if you’d rather not pay full price for your prescription drug, your doctor needs to write you a new prescription for a first-step drug. With Step Therapy, more expensive brand-name drugs are usually covered in a later step in the program if you’ve already tried the “first-step,” generic drugs covered in the program, you can’t take the “first-step” drug (because of an allergy, for instance), or your doctor decides you need a brand-name drug, for medical reasons. If any one of these applies to you, your doctor can ask for a “prior authorization” for you to take a second-step prescription drug. Once the prior authorization is approved, you pay the appropriate co-payment for this formulary-approved drug. If the prior authorization is not approved, you will need to pay the full price for the drug. DISPENSING LIMITATION LIST The following list represents the P&T Committee recommendations for dispensing or quantity limitations per a specific amount of time. Quantity limit programming has become an acceptable pharmacy plan practice that may be appropriate to place on some medications. The intentions are to safeguard members’ health and save plan benefit dollars. This program ensures members do not receive a prescription for a quantity that exceeds recommended plan limits. Limits are set because some medications have the potential to be abused, misused, shared, or have a manufacturer’s limit on the maximum dose. These limits have been reviewed by our clinical and medical staff, and the Pharmacy and Therapeutics Committee. The quantity limits are based on FDA approved dosing schedules, current medical practices, evidence based clinical guidelines, and peer-reviewed medical literature related to that particular drug. The inclusion of a medication on this list does not imply coverage under all plans, nor does the inclusion of a dispensing limitation imply that your specific benefit plan also has the same limitation. Plans may elect their own limitations. Members should consult their prescription drug benefit manual or contact a customer service representative to determine specific coverage and/or inclusion of a medication in the dispensing limitations list, as the list is subject to change.

DRUG NAME TIER LIMITS

Analgesics Nonsteroidal Anti-inflammatory Drugs ANAPROX TAB275MG 5

ANAPROX DS TAB550MG 5

CATAFLAM TAB50MG 5

CELEBREX CAP100MG 5 QL




CLINORIL TAB200MG 5

DAYPRO TAB600MG 5

DICLOFEN POTTAB50MG 2

DICLOFENAC TAB100MG ER 2

DICLOFENAC TAB100MG ER 2

DICLOFENAC TAB25MG DR 2



DIFLUNISAL TAB500MG 2

EC-NAPROSYN TAB375MG 5

EC-NAPROSYN TAB500MG 5

ETODOLAC CAP200MG 2

ETODOLAC CAP300MG 2

ETODOLAC TAB400MG 2

ETODOLAC TAB500MG 2

ETODOLAC ER TAB400MG 2



FELDENE CAP10MG 5

FELDENE CAP20MG 5

FENOPROFEN TAB600MG 2

FLECTOR DIS1.3% 5

FLURBIPROFENTAB100MG 2

FLURBIPROFENTAB50MG 2

IBU TAB400MG 2

IBU TAB600MG 2

IBU TAB800MG 2

IBUPROFEN TAB400MG 2



INDOCIN SUS25MG/5ML 5

INDOMETHACINCAP25MG 2

INDOMETHACINCAP50MG 2

INDOMETHACINCAP75MG ER 2

KETOPROFEN CAP200MG ER 2


KETOPROFEN CAP50MG 2

KETOPROFEN CAP75MG 2

KETOROLAC TAB10MG 2 QL MECLOFEN SODCAP100MG 2

MECLOFEN SODCAP50MG 2

MEFENAM ACIDCAP250MG 2

MELOXICAM SUS7.5/5ML 2 QL

MELOXICAM TAB15MG 2 QL

MELOXICAM TAB7.5MG 2 QL

MOBIC SUS7.5/5ML 5

MOBIC TAB15MG 5

MOBIC TAB7.5MG 5 QL

NABUMETONE TAB500MG 2

NABUMETONE TAB750MG 2

NALFON CAP200MG 5

NALFON CAP400MG 5

NAPRELAN TAB375MG CR 5



NAPROSYN SUS125/5ML 5

NAPROSYN TAB250MG 5

NAPROSYN TAB375MG 5

NAPROSYN TAB500MG 5

NAPROXEN SUS125/5ML 2

NAPROXEN TAB250MG 2

NAPROXEN TAB375MG 2

NAPROXEN TAB500MG 2

NAPROXEN DR TAB375MG 2

NAPROXEN DR TAB500MG 2

NAPROXEN SODTAB275MG 2

NAPROXEN SODTAB500MG CR 3

NAPROXEN SODTAB550MG 2

OXAPROZIN TAB600MG 2

OXYCOD/IBU TAB5-400MG 2 QL

PIROXICAM CAP10MG 2

PIROXICAM CAP20MG 2

PONSTEL CAP250MG 5

SULINDAC TAB150MG 2

SULINDAC TAB200MG 2

TOLMETIN SODCAP400MG 2

TOLMETIN SODTAB200MG 2

TOLMETIN SODTAB600MG 2

VOLTAREN-XR TAB100MG 5

ZIPSOR CAP25MG 5

5


Opioid Analgesics, Long-acting ACTIQ LOZ1200MCG 6 PA QL ACTIQ LOZ1600MCG 6 PA QL ACTIQ LOZ200MCG 6 PA QL ACTIQ LOZ400MCG 6 PA QL ACTIQ LOZ600MCG 6 PA QL ACTIQ LOZ800MCG 6 PA QL AVINZA CAP120MG 5 QL AVINZA CAP30MG 5 QL AVINZA CAP45MG 5 QL AVINZA CAP60MG 5 QL AVINZA CAP75MG 5 QL AVINZA CAP90MG 5 QL BUTRANS DIS 4

BUTRANS DIS10MCG/HR 4

BUTRANS DIS10MCG/HR 4 QL BUTRANS DIS15MCG/HR 4 QL BUTRANS DIS20MCG/HR 4 QL BUTRANS DIS5MCG/HR 4 QL CONZIP CAP100MG 5

CONZIP CAP200MG 5

CONZIP CAP300MG 5

DOLOPHINE TAB10MG 5

DOLOPHINE TAB10MG 5

DOLOPHINE TAB5MG 5

DURAGESIC DIS100MCG/H 5

DURAGESIC DIS12MCG/HR 5




EMBEDA CAP100-4MG 5

EMBEDA CAP20-0.8MG 5


EMBEDA CAP50-2MG 5



EXALGO TAB12MG 5

EXALGO TAB16MG 5

EXALGO TAB32MG 5

EXALGO TAB8MG 5

FENTANYL DIS100MCG/H 3 QL

FENTANYL DIS12MCG/HR 3 QL



FENTANYL DIS75MCG/HR 3 QL FENTANYL OT LOZ1200MCG 6 PA QL


FENTANYL OT LOZ1600MCG 6 PA QL FENTANYL OT LOZ200MCG 6 PA QL FENTANYL OT LOZ400MCG 6 PA QL FENTANYL OT LOZ600MCG 6 PA QL FENTANYL OT LOZ800MCG 6 PA QL

FENTORA TAB100MCG 6 PA QL




FENTORA TAB800MCG 6 PA QL HYDROMORPHONTAB12MG ER 3

HYDROMORPHONTAB16MG ER 3



KADIAN CAP100MG CR 5 QL


KADIAN CAP10MG ER 5

KADIAN CAP130MG CR 5

KADIAN CAP150MG CR 5




KADIAN CAP40MG CR 5



KADIAN CAP70MG CR 5


LAZANDA SPR100MCG 6 PA QL

LAZANDA SPR400MCG 6 PA QL

LEVORPHANOL TAB2MG 3 QL METHADONE CON10MG/ML 3

METHADONE CON10MG/ML 3

METHADONE SOL10MG/5ML 3 QL METHADONE SOL5MG/5ML 3 QL

METHADONE TAB10MG 3 QL

METHADONE TAB5MG 3 QL

METHADOSE TAB10MG 3

METHADOSE TAB5MG 3

MORPHINE SULCAP100MG ER 3 QL MORPHINE SULCAP10MG ER 3 QL MORPHINE SULCAP120MG ER 3 QL MORPHINE SULCAP20MG ER 3 QL MORPHINE SULCAP30MG ER 3 QL MORPHINE SULCAP30MG ER 3 QL MORPHINE SULCAP45MG ER 3 QL

6


MORPHINE SULCAP50MG ER 3 QL MORPHINE SULCAP60MG ER 3 QL MORPHINE SULCAP60MG ER 3 QL MORPHINE SULCAP75MG ER 3 QL MORPHINE SULCAP80MG ER 3 QL MORPHINE SULCAP90MG ER 3 QL MORPHINE SULTAB100MG ER 3 QL MORPHINE SULTAB15MG ER 3 QL MORPHINE SULTAB200MG ER 3 QL MORPHINE SULTAB30MG ER 3 QL MORPHINE SULTAB60MG ER 3 QL

MS CONTIN TAB100MG CR 5 QL





NUCYNTA ER TAB100MG 5





ONSOLIS MIS1200MCG 6 PA





OPANA ER TAB10MG 5 QL





OXYCONTIN TAB10MG CR 4 QL






OXYCONTIN TAB80MG CR 4 QL OXYMORPHONE TAB10MG ER 3

OXYMORPHONE TAB15MG ER 3






OXYMORPHONE TAB7.5MG ER 3

RYZOLT TAB100MG 5

RYZOLT TAB200MG 5

RYZOLT TAB300MG 5

SUBSYS SPR100MCG 6 PA QL




SUBSYS SPR800MCG 6 PA QL TRAMADOL HCLCAP150MG ER 5

TRAMADOL HCLTAB100MG ER 3 QL TRAMADOL HCLTAB200MG ER 3 QL TRAMADOL HCLTAB300MG ER 3 QL

ULTRAM ER TAB100MG 5 QL



XYLON TAB10-200MG 3

Opioid Analgesics, Short-acting ABSTRAL SUB100MCG 6 PA QL

ABSTRAL SUB200MCG 6 PA QL




ABSTRAL SUB800MCG 6 PA QL BUT/APAP/CAFCAPCODEINE 2 QL BUTORPHANOL SOL10MG/ML 3 QL

CODEINE SULFTAB15MG 4



DEMEROL TAB100MG 5

DEMEROL TAB50MG 5

DILAUDID LIQ1MG/ML 5

DILAUDID TAB2MG 5

DILAUDID TAB4MG 5

DILAUDID TAB8MG 5

ENDOCET TAB2.5-325 2

HYDROMORPHONLIQ1MG/ML 3

HYDROMORPHONTAB2MG 3 QL HYDROMORPHONTAB4MG 3 QL HYDROMORPHONTAB8MG 3 QL LORCET TAB5-325MG 2 QL LORCET HD TAB10-325MG 2 QL

LORCET PLUS TAB7.5-325 2

LORTAB ELX10-300MG 3

7


LORTAB TAB10-325MG 2 QL

LORTAB TAB5-325MG 2 QL

LORTAB TAB7.5-325 2 QL MEPERIDINE SOL50MG/5ML 3

MEPERITAB TAB100MG 3

MEPERITAB TAB50MG 3

MORPHINE SULSOL10MG/5ML 3 QL MORPHINE SULSOL20MG/5ML 3 QL MORPHINE SULSOL20MG/ML 3 QL

MORPHINE SULTAB15MG 3 QL

MORPHINE SULTAB30MG 3 QL

NUCYNTA TAB100MG 5 QL



OPANA TAB10MG 5

OPANA TAB5MG 5

OXECTA TAB5MG 5

OXECTA TAB7.5MG 5

OXYCODONE TAB10MG 3 QL




OXYCODONE TAB5MG 3 QL OXYMORPHONE TABHCL 10MG 3

OXYMORPHONE TABHCL 5MG 3

ROXICODONE TAB15MG 5

ROXICODONE TAB30MG 5

ROXICODONE TAB5MG 5

TRAMADOL HCLTAB50MG 2 QL

ULTRAM TAB50MG 5

Anesthetics Local Anesthetics EMLA CRE2.5-2.5% 5

GLYDO GEL2% 3

LIDO/PRILOCNCRE2.5-2.5% 3

LIDOCAINE GEL2% 3

LIDOCAINE GEL2% JELLY 3



LIDOCAINE OIN5% 3

LIDOCAINE OIN5% 3

LIDOCAINE PAD5% 3 QL

LIDOCAINE SOL2% VISC 2

LIDOCAINE SOL4% 2


LIDODERM DIS5% 5 QL

SYNERA DIS70-70MG 5

XYLOCAINE GEL2% 5

XYLOCAINE SOL4% 5

Anti-Addiction/Substance Abuse Treatment Agents Alcohol Deterrents/Anti-craving ANTABUSE TAB250MG 5

ANTABUSE TAB500MG 5

CAMPRAL TAB333MG 5

DEPADE TAB50MG 3

DISULFIRAM TAB250MG 3

DISULFIRAM TAB500MG 3

NALTREXONE TAB50MG 3

REVIA TAB50MG 5

Opioid Antagonists BUNAVAIL MIS2.1-0.3 5 PA

BUNAVAIL MIS4.2-0.7 5 PA

BUNAVAIL MIS6.3-1MG 5 PA

BUPRENORPHINSUB2MG 3 QL

BUPRENORPHINSUB8MG 3 QL

Smoking Cessation Agents BUPROBAN TAB150MG 2 QL CHANTIX PAK0.5& 1MG 1 QL CHANTIX PAK1MG 1

CHANTIX TAB0.5MG 1

CHANTIX TAB0.5MG 1 QL CHANTIX TAB1MG 1

CHANTIX TAB1MG 1 QL NICOTROL NS SPR10MG/ML 1 PA QL

Antibacterials Aminoglycosides BETHKIS NEB300/4ML 6 PA GENOPTIC SOL0.3% OP 2

GENTAK OIN0.3% OP 2

GENTAK SOL0.3% OP 2

GENTAMICIN CRE0.1% 2

GENTAMICIN OIN0.1% 2

GENTAMICIN OIN0.3% OP 2

GENTAMICIN SOL0.3% OP 2

GENTASOL SOL0.3% OP 2

NEO-FRADIN SOL125/5ML 2

NEOMYCIN TAB500MG 3

PAROMOMYCIN CAP250MG 3

8


TOBI NEB300/5ML 6 PA QL TOBI PODHALRCAP28MG 6 PA TOBRADEX OIN0.3-0.1% 4

TOBRAMYCIN NEB300/5ML 6 PA TOBRAMYCIN SOL0.3% OP 2

TOBREX OIN0.3% OP 5

TOBREX SOL0.3% OP 5

Antibacterials, Other ACETIC ACID SOL2% OTIC 2

ALTABAX OIN1% 5

BACITRACIN OINOP 2

BACTROBAN CRE2% 5

BACTROBAN OIN2% 5

BACTROBAN OINNASAL 2% 5

CLEOCIN CAP150MG 5

CLEOCIN CAP300MG 5

CLEOCIN CAP75MG 5

CLEOCIN CRE2% VAG 5

CLEOCIN SUP100MG 5

CLEOCIN PED SOL75MG/5ML 5

CLEOCIN-T GEL1% 5

CLEOCIN-T LOT1% 5

CLEOCIN-T PAD1% 5

CLEOCIN-T SOL1% 5

CLINDACIN KITPAC 1% 3

CLINDA-DERM SOL1% 2

CLINDAMAX CRE2% VAG 2

CLINDAMAX GEL1% 3

CLINDAMAX LOT10MG/ML 3

CLINDAMYCIN AER1% 3

CLINDAMYCIN CAP150MG 2



CLINDAMYCIN CRE2% VAG 2

CLINDAMYCIN GEL1% 3

CLINDAMYCIN LOT1% 3

CLINDAMYCIN PAD1% 2

CLINDAMYCIN SOL1% 2

CLINDAMYCIN SOL75MG/5ML 2

CLINDETS PAD1% 2

EVOCLIN AER1% 5

FLAGYL CAP375MG 5

FLAGYL TAB250MG 5

FLAGYL TAB500MG 5


FLAGYL ER TAB750MG 5

FURADANTIN SUS25MG/5ML 5

HIPREX TAB1GM 5

MACROBID CAP100MG 5

MACRODANTIN CAP100MG 5



METHENAM HIPTAB1GM 3

METROCREAM CRE0.75% 5

METROGEL GEL1% 5

METROGEL-VAGGEL0.75% 5

METROGEL-VAGGEL0.75% 5

METROLOTION LOT0.75% 5

METRONIDAZOLCAP375MG 2

METRONIDAZOLCRE0.75% 3

METRONIDAZOLGEL0.75% 3

METRONIDAZOLGEL0.75%VAG 2

METRONIDAZOLGEL1% 3

METRONIDAZOLLOT0.75% 3

METRONIDAZOLTAB250MG 2

METRONIDAZOLTAB500MG 2

MONUROL PAKGRANULES 5

MUPIROCIN OIN2% 3

NITROFUR MACCAP50MG 2

NITROFURANTNCAP100MG 2

NITROFURANTNSUS25MG/5ML 2

NORITATE CRE1% 5

PRIMSOL SOL50MG/5ML 3

ROSADAN CRE0.75% 3

ROSADAN GEL0.75% 3

SIVEXTRO TAB200MG 4

SULFAMYLON CRE85MG/GM 5

SULFAMYLON PAK5% 5

TRIMETHOPRIMTAB100MG 2

UREX TAB1GM 5

VANCOCIN HCLCAP125MG 5 PA QL VANCOCIN HCLCAP250MG 5 PA QL

VANCOMYCIN CAP125MG 3 PA QL

VANCOMYCIN CAP250MG 3 PA QL

VANCOMYCIN INJ1000MG 2


VANCOMYCIN INJ10GM 2



VANDAZOLE GEL0.75% 5

XIFAXAN TAB200MG 5

9


XIFAXAN TAB550MG 5 QL ZYVOX SUS100MG/5M 4

ZYVOX TAB600MG 4 QL

Beta-lactam, Cephalosporins CEDAX CAP400MG 5

CEFACLOR CAP250MG 2

CEFACLOR CAP500MG 2

CEFACLOR SUS125/5ML 3



CEFACLOR ER TAB500MG 2

CEFADROXIL CAP500MG 2

CEFADROXIL SUS250/5ML 2

CEFADROXIL SUS500/5ML 2

CEFADROXIL TAB1GM 2

CEFAZOLIN INJ1GM 3

CEFDINIR CAP300MG 2

CEFDINIR SUS125/5ML 2

CEFDINIR SUS250/5ML 2

CEFDITOREN TAB200MG 5

CEFEPIME INJ1GM 3

CEFOTAXIME INJ1GM 3

CEFOTETAN INJ2GM/20ML 3

CEFOXITIN INJ1GM 3

CEFPODO PROXSUS100/5ML 3

CEFPODO PROXSUS50MG/5ML 3

CEFPODOXIME TAB100MG 3

CEFPODOXIME TAB200MG 3

CEFPROZIL SUS125/5ML 2

CEFPROZIL SUS250/5ML 2

CEFPROZIL TAB250MG 2

CEFPROZIL TAB500MG 2

CEFTAZIDIME/SOLD5W 1GM 3

CEFTIN SUS125/5ML 5

CEFTIN SUS250/5ML 5

CEFTIN SUS250/5ML 5

CEFTIN TAB250MG 5

CEFTIN TAB500MG 5

CEFTRIAXONE INJ10GM 3

CEFUROXIME SUS125/5ML 3

CEFUROXIME TAB250MG 2

CEFUROXIME TAB500MG 2

CEPHALEXIN CAP250MG 2

CEPHALEXIN CAP500MG 2

CEPHALEXIN SUS125/5ML 2

CEPHALEXIN SUS250/5ML 2

CEPHALEXIN TAB250MG 2

CEPHALEXIN TAB500MG 2


KEFLEX CAP250MG 5

KEFLEX CAP500MG 5

KEFLEX CAP750MG 5

SPECTRACEF TAB200MG 5

SUPRAX SUS100/5ML 5

SUPRAX SUS200/5ML 5

SUPRAX TAB400MG 5

TEFLARO INJ600MG 3

Beta-lactam, Other CAYSTON INH75MG 6 PA CAYSTON INH75MG 6 PA

Beta-lactam, Penicillins AMOX/K CLAV CHW200MG 2

AMOX/K CLAV CHW400MG 2

AMOX/K CLAV SUS200/5ML 2




AMOX/K CLAV TAB250MG 2



AMOXICILLIN CAP250MG 2

AMOXICILLIN CAP500MG 2

AMOXICILLIN CHW125MG 2

AMOXICILLIN CHW250MG 2

AMOXICILLIN SUS125/5ML 2




AMOXICILLIN TAB500MG 2



AMOXIL CAP500MG 2

AMOXIL CAP500MG 2

AMOXIL SUS125/5ML 2

AMOXIL SUS250/5ML 2

AMOX-POT CLATABER 2

AMPICILLIN CAP250MG 2

AMPICILLIN CAP500MG 2

AMPICILLIN SUS125/5ML 2

AMPICILLIN SUS250/5ML 2

AUGMENTIN SUS125/5ML 5




AUGMENTIN SUSES-600 5

AUGMENTIN TAB500MG 5

10


AUGMENTIN TAB875MG 5

AUGMENTIN XRTAB12HR 5

DICLOXACILL CAP250MG 2

DICLOXACILL CAP500MG 2

MOXATAG TAB775MG 5

NAFCILLIN INJ10GM 2 PA NAFCILLIN INJ1GM 2 PA NAFCILLIN INJ2GM 2 PA NALLPEN/DEX INJ1GM/50ML 2 PA OXACILLIN INJ10GM 3

OXACILLIN INJ2GM 3

PEN G PROC INJ600000 3

PENICILLN VKSOL125/5ML 2

PENICILLN VKSOL250/5ML 2

PENICILLN VKTAB250MG 2



PIPERACILLININJ4GM 3

TIMENTIN INJ3.1GM 3

ZOSYN INJ3-0.375G 3

Macrolides AKNE-MYCIN OIN2% 5

AZASITE SOL1% 5

AZITHROMYCINPOW1GM PAK 2

AZITHROMYCINSUS100/5ML 2 QL AZITHROMYCINSUS200/5ML 2 QL AZITHROMYCINTAB250MG 2 QL AZITHROMYCINTAB250MG 2

AZITHROMYCINTAB500MG 2

AZITHROMYCINTAB500MG 2 QL AZITHROMYCINTAB500MG 2

AZITHROMYCINTAB600MG 2 QL BIAXIN SUS250/5ML 5

BIAXIN SUS250/5ML 5

BIAXIN TAB250MG 5

BIAXIN TAB500MG 5

BIAXIN XL TAB500MG 5

BIAXIN XL TAB500MG 5

BIAXIN XL TABPAC 500 5

BIAXIN XL TABPAC 500 5

CLARITHROMYCSUS125/5ML 3

CLARITHROMYCSUS250/5ML 3

CLARITHROMYCTAB250MG 3 QL CLARITHROMYCTAB500MG 3 QL CLARITHROMYCTAB500MG ER 3

CLARITHROMYCTAB500MG ER 3 QL DIFICID TAB200MG 4 PA E.E.S. 400 TAB400MG 3


E.E.S. GRAN SUS200/5ML 5

ERY PAD2% 2

ERYPED SUS200/5ML 5

ERYPED SUS400/5ML 5

ERY-TAB TAB250MG EC 2





ERYTHRA-DERMSOL2% 2

ERYTHROCIN TAB250MG 2

ERYTHROCIN TAB250MG 2

ERYTHROM ETHTAB400MG 3

ERYTHROMYCINGEL2% 3

ERYTHROMYCINOINOP 2

ERYTHROMYCINPAD2% 2

ERYTHROMYCINSOL2% 2

ERYTHROMYCINTAB250MG BS 2

ERYTHROMYCINTAB500MG BS 2

ILOTYCIN OINOP 2

KETEK TAB300MG 5

KETEK TAB400MG 5

PCE TAB333MG EC 5

PCE TAB500MG EC 5

ROMYCIN OINOP 2

ZITHROMAX POW1GM PAK 5

ZITHROMAX SUS100/5ML 5 QL ZITHROMAX SUS200/5ML 5 QL ZITHROMAX TAB250MG 5 QL ZITHROMAX TAB500MG 5 QL ZITHROMAX TAB600MG 5

ZITHROMAX TABTRI-PAK 5 QL ZITHROMAX TABZ-PAK 5 QL ZMAX SUS2GM 5 QL

Quinolones AVELOX TAB400MG 5 QL AVELOX ABC TAB400MG 5 QL BESIVANCE SUS0.6% 5

CILOXAN OIN0.3% OP 5

CILOXAN SOL0.3% OP 5

CIPRO TAB250MG 5

CIPRO TAB500MG 5

CIPRO TAB750MG 5

CIPRO (10%) SUS500MG/5 5

CIPRO (5%) SUS250MG/5 5

CIPRO XR TAB1000MG 5

CIPRO XR TAB500MG 5

CIPROFLOXACNSOL0.3% OP 2

11


CIPROFLOXACNSUS250MG/5 3

CIPROFLOXACNSUS500MG/5 3

CIPROFLOXACNTAB1000MG 2




CIPROFLOXACNTAB500MG ER 2


FACTIVE TAB320MG 5

FLOXIN OTIC DRO0.3% 5

GATIFLOXACINSOL0.5% 2

LEVAQUIN SOL25MG/ML 5

LEVAQUIN TAB250MG 5 QL LEVAQUIN TAB500MG 5 QL LEVAQUIN TAB750MG 5 QL LEVAQUIN TABLEVA-PAK 5

LEVOFLOXACINSOL0.5% 3

LEVOFLOXACINSOL25MG/ML 3

LEVOFLOXACINTAB250MG 2 QL LEVOFLOXACINTAB500MG 2 QL LEVOFLOXACINTAB750MG 2 QL MOXEZA SOL0.5% 5

MOXIFLOXACINTAB400MG 3

NOROXIN TAB400MG 5

NOROXIN TAB400MG 5

OCUFLOX DRO0.3% OP 5

OFLOXACIN DRO0.3% OP 2

OFLOXACIN DRO0.3%OTIC 2

OFLOXACIN TAB200MG 3



VIGAMOX DRO0.5% 5

ZYMAR DRO0.3% 5

ZYMAXID SOL0.5% 5 QL

Sulfonamides BACTRIM TAB400-80MG 5

BACTRIM DS TAB800-160 5

BLEPH-10 SOL10% OP 5

BP CLEANSINGEMU10-4% 2

KLARON LOT10% 5

SEPTRA TAB400-80MG 5

SILVADENE CRE1% 5

SILVER SULFACRE1% 2

SILVER SULFACRE1% 2

SMZ/TMP DS TAB800-160 2

SMZ-TMP SUS200-40/5 2

SMZ-TMP TAB400-80MG 2

SOD SULFACETSOL10% OP 2


SSD CRE1% 2

SULFACETAMIDSUS10% 3

SULFADIAZINETAB500MG 3

SULFATRIM PDSUS200-40/5 2

Tetracyclines ADOXA CAP150MG 5

ADOXA TAB50MG 5

ADOXA TAB75MG 5

ADOXA PAK 1/TAB100MG 5

ADOXA PAK 2/TAB100MG 5

AVIDOXY TAB100MG 3

DEMECLOCYCL TAB150MG 3

DEMECLOCYCL TAB300MG 3

DORYX CAP75MG EC 5

DORYX TAB100MG 5

DORYX TAB150MG 5

DORYX TAB200MG 5

DOXYCYC MONOTAB150MG 3



DOXYCYCL HYCCAP100MG 2

DOXYCYCL HYCCAP50MG 2

DOXYCYCL HYCTAB100MG 3

DOXYCYCL HYCTAB100MG DR 3



DOXYCYCLINE CAP150MG 2

DOXYCYCLINE CAP75MG 2

DOXYCYCLINE SUS25MG/5ML 3

DOXYCYCLINE TAB20MG 3

DYNACIN CAP100MG 5

DYNACIN CAP50MG 5

DYNACIN TAB100MG 5

DYNACIN TAB50MG 5

DYNACIN TAB75MG 5

MINOCIN CAP100MG 5

MINOCIN CAP50MG 5

MINOCYCLINE CAP100MG 2



MINOCYCLINE TAB100MG 2

MINOCYCLINE TAB135MG ER 3





MONODOX CAP100MG 5

MONODOX CAP75MG 5

12


MORGIDOX CAP1X100MG 2

ORACEA CAP40MG 5

ORACEA CAP40MG 5

ORAXYL CAP20MG 5

SOLODYN TAB105MG 5

SOLODYN TAB115MG 5

SOLODYN TAB135MG 5

SOLODYN TAB45MG 5

SOLODYN TAB55MG 5

SOLODYN TAB65MG 5

SOLODYN TAB80MG 5

SOLODYN TAB90MG 5

TETRACYCLINECAP250MG 2

TETRACYCLINECAP500MG 2

VIBRAMYCIN CAP100MG 5

VIBRAMYCIN SUS25MG/5ML 5

VIBRAMYCIN SYP50MG/5ML 5

Anticonvulsants Anticonvulsants, Other FYCOMPA TAB10MG 5 QL FYCOMPA TAB12MG 5 QL FYCOMPA TAB2MG 5 QL FYCOMPA TAB4MG 5 QL FYCOMPA TAB6MG 5 QL FYCOMPA TAB8MG 5 QL KEPPRA SOL100MG/ML 5 KEPPRA TAB1000MG 5 KEPPRA TAB250MG 5 KEPPRA TAB500MG 5 KEPPRA TAB750MG 5 KEPPRA XR TAB500MG 5 QL KEPPRA XR TAB750MG 5 QL LEVETIRACETASOL100MG/ML 3 LEVETIRACETATAB1000MG 3 LEVETIRACETATAB250MG 3 LEVETIRACETATAB500MG 3 LEVETIRACETATAB500MG ER 3 QL LEVETIRACETATAB750MG 3 LEVETIRACETATAB750MG ER 3 QL MYSOLINE TAB250MG 5 MYSOLINE TAB50MG 5 POTIGA TAB200MG 5 QL POTIGA TAB300MG 5 QL POTIGA TAB400MG 5 QL POTIGA TAB50MG 5 QL PRIMIDONE TAB250MG 2 PRIMIDONE TAB50MG 2


Calcium Channel Modifying Agents CELONTIN CAP300MG 4 ETHOSUXIMIDECAP250MG 3 ETHOSUXIMIDESOL250/5ML 3 LYRICA CAP100MG 4 QL LYRICA CAP100MG 4 LYRICA CAP150MG 4 LYRICA CAP150MG 4 QL LYRICA CAP200MG 4 QL LYRICA CAP200MG 4

LYRICA CAP225MG 4 QL

LYRICA CAP225MG 4

LYRICA CAP25MG 4 QL

LYRICA CAP25MG 4

LYRICA CAP300MG 4

LYRICA CAP300MG 4 QL

LYRICA CAP50MG 4 QL

LYRICA CAP50MG 4

LYRICA CAP75MG 4 QL

LYRICA CAP75MG 4

LYRICA SOL20MG/ML 4 QL

ZARONTIN CAP250MG 5

ZARONTIN SOL250/5ML 5

ZONEGRAN CAP100MG 5

ZONEGRAN CAP25MG 5

ZONISAMIDE CAP100MG 3



Gamma-aminobutyric Acid (GABA) Augmenting Agents DEPAKENE CAP250MG 5 DEPAKENE SYP250/5ML 5 DEPAKOTE TAB125MG DR 5 DEPAKOTE TAB250MG DR 5 DEPAKOTE TAB500MG DR 5 DEPAKOTE ER TAB250MG 5 DEPAKOTE ER TAB500MG 5 DEPAKOTE SPRCAP125MG 5 DIVALPROEX CAP125MG 3 DIVALPROEX TAB125MG DR 3 DIVALPROEX TAB250MG DR 3 DIVALPROEX TAB250MG ER 3 DIVALPROEX TAB500MG DR 3 DIVALPROEX TAB500MG ER 3 GABAPENTIN CAP100MG 3 QL

13


GABAPENTIN CAP300MG 3 QL GABAPENTIN CAP400MG 3 QL GABAPENTIN SOL250/5ML 3 QL GABAPENTIN TAB600MG 3 QL GABAPENTIN TAB800MG 3 QL GABITRIL TAB12MG 5 GABITRIL TAB16MG 5 GABITRIL TAB2MG 5 GABITRIL TAB4MG 5 GRALISE TAB300MG 5 GRALISE TAB600MG 5 GRALISE STARMIS300/600 5 NEURONTIN CAP100MG 5 ST NEURONTIN CAP300MG 5 ST NEURONTIN CAP400MG 5 ST NEURONTIN SOL250/5ML 5 ST NEURONTIN TAB600MG 5 ST NEURONTIN TAB800MG 5 ST ONFI SUS2.5MG/ML 5 PA QL SABRIL POW500MG 6 QL SABRIL TAB500MG 6 QL STAVZOR CAP125MG 5 STAVZOR CAP250MG 5 STAVZOR CAP500MG 5 TIAGABINE TAB2MG 3 TIAGABINE TAB4MG 3 VALPROIC ACDCAP250MG 2 VALPROIC ACDSYP250/5ML 2

Glutamate Reducing Agents FELBAMATE SUS600/5ML 3 FELBAMATE TAB400MG 3 FELBAMATE TAB600MG 3 FELBATOL SUS600/5ML 5 FELBATOL TAB400MG 5 FELBATOL TAB600MG 5 LAMICTAL CHW25MG 5 LAMICTAL CHW2MG 5 LAMICTAL CHW5MG 5 LAMICTAL KITSTART 35 5 LAMICTAL KITSTART 49 5 LAMICTAL KITSTART 98 5 LAMICTAL TAB100MG 5 LAMICTAL TAB150MG 5 LAMICTAL TAB200MG 5 LAMICTAL TAB25MG 5 LAMICTAL ODTKIT 5 LAMICTAL ODTKIT 5 LAMICTAL ODTKIT 5


LAMICTAL ODTTAB100MG 5 LAMICTAL ODTTAB200MG 5 LAMICTAL ODTTAB25MG 5 LAMICTAL ODTTAB50MG 5 LAMICTAL XR KIT 5 LAMICTAL XR KIT 5 LAMICTAL XR KIT 5 LAMICTAL XR TAB100MG 5 LAMICTAL XR TAB200MG 5 LAMICTAL XR TAB250MG 5 LAMICTAL XR TAB25MG 5 LAMICTAL XR TAB300MG 5 LAMICTAL XR TAB50MG 5 LAMOTRIGINE CHW25MG 3 LAMOTRIGINE CHW25MG 3 LAMOTRIGINE CHW5MG 3 LAMOTRIGINE CHW5MG 3 LAMOTRIGINE TAB100MG 3 LAMOTRIGINE TAB150MG 3 LAMOTRIGINE TAB200MG 3 LAMOTRIGINE TAB25MG 3 QUDEXY XR CAP100/24HR 5 QUDEXY XR CAP150/24HR 5 QUDEXY XR CAP200/24HR 5 QUDEXY XR CAP25/24HR 5 QUDEXY XR CAP50/24HR 5 TOPAMAX TAB100MG 5 TOPAMAX TAB200MG 5 TOPAMAX TAB25MG 5 TOPAMAX TAB50MG 5 TOPAMAX SPR CAP15MG 5 TOPAMAX SPR CAP25MG 5 TOPIRAMATE CAP15MG 3 TOPIRAMATE CAP25MG 3 TOPIRAMATE CAPER 100MG 5 TOPIRAMATE CAPER 150MG 5 TOPIRAMATE CAPER 200MG 5 TOPIRAMATE CAPER 25MG 5 TOPIRAMATE CAPER 50MG 5 TOPIRAMATE TAB100MG 2 QL TOPIRAMATE TAB200MG 2 QL TOPIRAMATE TAB25MG 2 QL TOPIRAMATE TAB50MG 2 QL

Sodium Channel Agents APTIOM TAB200MG 5 QL APTIOM TAB400MG 5 QL APTIOM TAB600MG 5 QL APTIOM TAB800MG 5 QL

14


BANZEL SUS40MG/ML 5 QL BANZEL TAB200MG 5 QL BANZEL TAB400MG 5 QL CARBAMAZEPINCAP100MG ER 2

CARBAMAZEPINCAP200MG ER 2

CARBAMAZEPINCAP300MG ER 2

CARBAMAZEPINCHW100MG 2



CARBAMAZEPINSUS100/5ML 2

CARBAMAZEPINTAB200MG 2

CARBAMAZEPINTAB200MG 2

CARBAMAZEPINTAB200MG ER 2

CARBAMAZEPINTAB400MG ER 2

CARBATROL CAP100MG 5



DILANTIN CAP100MG 5

DILANTIN CAP30MG 5

DILANTIN CHW50MG 5

EPITOL TAB200MG 2

EQUETRO CAP100MG 5 QL EQUETRO CAP200MG 5 QL EQUETRO CAP300MG 5 QL OXCARBAZEPINSUS300MG/5M 3

OXCARBAZEPINTAB150MG 3



PEGANONE TAB250MG 5

PHENYTEK CAP200MG 2

PHENYTEK CAP300MG 2

PHENYTOIN CHW50MG 2

PHENYTOIN SUS125/5ML 2

PHENYTOIN EXCAP100MG 2



TEGRETOL CHW100MG 5

TEGRETOL SUS100/5ML 5

TEGRETOL TAB200MG 5

TEGRETOL-XR TAB100MG 5



TRILEPTAL SUS300MG/5M 5

TRILEPTAL TAB150MG 5



VIMPAT SOL10MG/ML 4 QL ST VIMPAT TAB100MG 4 QL ST


VIMPAT TAB150MG 4 QL ST VIMPAT TAB200MG 4 QL ST VIMPAT TAB50MG 4 QL ST

Antidementia Agents Antidementia Agents, Other ERGOLOID MESTAB1MG ORAL 2

Cholinesterase Inhibitors ARICEPT TAB10MG 5 QL ARICEPT TAB5MG 5 QL ARICEPT ODT TAB10MG 5 ARICEPT ODT TAB5MG 5 DONEPEZIL TAB10MG 2 QL DONEPEZIL TAB10MG ODT 2 QL DONEPEZIL TAB5MG 2 QL DONEPEZIL TAB5MG ODT 2 QL EXELON CAP1.5MG 5 QL EXELON CAP3MG 5 QL EXELON CAP4.5MG 5 QL EXELON CAP6MG 5 QL EXELON DIS13.3/24 5 QL EXELON DIS4.6MG/24 5 QL EXELON DIS9.5MG/24 5 QL EXELON SOL2MG/ML 5 GALANTAMINE CAP16MG ER 3 QL GALANTAMINE CAP24MG ER 3 QL GALANTAMINE CAP8MG ER 3 QL GALANTAMINE SOL4MG/ML 3 QL GALANTAMINE TAB12MG 3 QL GALANTAMINE TAB4MG 3 QL GALANTAMINE TAB8MG 3 QL RAZADYNE SOL4MG/ML 5 RAZADYNE TAB12MG 5 RAZADYNE TAB4MG 5 RAZADYNE TAB8MG 5 RAZADYNE ER CAP16MG 5 RAZADYNE ER CAP24MG 5 RAZADYNE ER CAP8MG 5 RIVASTIGMINECAP1.5MG 3 QL RIVASTIGMINECAP3MG 3 QL RIVASTIGMINECAP4.5MG 3 QL RIVASTIGMINECAP6MG 3 QL

N-methyl-D-aspartate (NMDA) Receptor Antagonist NAMENDA SOL10MG/5ML 4 QL

NAMENDA TAB10MG 4 QL

NAMENDA TAB5-10MG 4 QL

15


NAMENDA TAB5MG 4 QL

NAMENDA XR CAP14MG 4 QL



NAMENDA XR CAP7MG 4 QL NAMENDA XR CAPTITRATIO 4 QL

Antidepressants Antidepressants, Other ABILIFY SOL1MG/ML 5 QL ABILIFY TAB10MG 5 QL ABILIFY TAB10MG 5 ABILIFY TAB15MG 5 QL ABILIFY TAB15MG 5 ABILIFY TAB20MG 5 QL ABILIFY TAB2MG 5 QL ABILIFY TAB30MG 5 ABILIFY TAB30MG 5 QL ABILIFY TAB5MG 5 QL ABILIFY DISCTAB10MG 5 QL ABILIFY DISCTAB15MG 5 QL APLENZIN TAB174MG 5 QL ST APLENZIN TAB348MG 5 QL ST APLENZIN TAB522MG 5 QL ST BUDEPRION TAB100MG SR 2 BUDEPRION TAB100MG SR 2 BUDEPRION TAB150MG SR 2 BUDEPRION TAB150MG SR 2 BUPROPION TAB100MG 2 BUPROPION TAB100MG 2 QL BUPROPION TAB100MG SR 2 QL BUPROPION TAB150MG 2 BUPROPION TAB150MG SR 2 QL BUPROPION TAB200MG SR 2 QL BUPROPION TAB75MG 2 QL BUPROPN HCL TAB150MG XL 2 BUPROPN HCL TAB150MG XL 2 QL BUPROPN HCL TAB300MG XL 2 QL FORFIVO XL TAB450MG 5 QL ST MAPROTILINE TAB25MG 2 QL MAPROTILINE TAB50MG 2 QL MAPROTILINE TAB75MG 2 MIRTAZAPINE TAB15MG 2 QL MIRTAZAPINE TAB15MG ODT 3 QL MIRTAZAPINE TAB30MG 2 QL MIRTAZAPINE TAB30MG ODT 3 QL MIRTAZAPINE TAB45MG 2 QL MIRTAZAPINE TAB45MG ODT 3 QL


MIRTAZAPINE TAB7.5MG 2 QL NEFAZODONE TAB100MG 3 QL NEFAZODONE TAB150MG 3 QL NEFAZODONE TAB200MG 3 QL NEFAZODONE TAB250MG 3 QL NEFAZODONE TAB50MG 3 QL OLEPTRO TAB24HR150 5 OLEPTRO TAB24HR300 5 REMERON TAB15MG 5 REMERON TAB30MG 5 REMERON TAB45MG 5 REMERON SLTBTAB15MG 5 REMERON SLTBTAB30MG 5 REMERON SLTBTAB45MG 5 SEROQUEL XR TAB150MG 5 SEROQUEL XR TAB150MG 5 QL SEROQUEL XR TAB200MG 5 QL SEROQUEL XR TAB300MG 5 QL SEROQUEL XR TAB400MG 5 QL SEROQUEL XR TAB50MG 5 QL TRAZODONE TAB100MG 2 TRAZODONE TAB150MG 2 TRAZODONE TAB300MG 2 TRAZODONE TAB50MG 2 VIIBRYD KIT 5 ST VIIBRYD TAB10MG 5 QL ST VIIBRYD TAB20MG 5 QL ST VIIBRYD TAB40MG 5 QL ST WELLBUTRIN TAB100MG 5 ST WELLBUTRIN TAB100MG SR 5 ST WELLBUTRIN TAB100MG SR 5 QL ST WELLBUTRIN TAB150MG SR 5 QL ST WELLBUTRIN TAB200MG SR 5 QL ST WELLBUTRIN TAB75MG 5 ST WELLBUTRIN TABXL 150MG 5 QL ST WELLBUTRIN TABXL 300MG 5 QL ST

Monoamine Oxidase Inhibitors EMSAM DIS12MG/24H 5 QL EMSAM DIS6MG/24HR 5 QL EMSAM DIS9MG/24HR 5 QL MARPLAN TAB10MG 5 NARDIL TAB15MG 5 PARNATE TAB10MG 5 PHENELZINE TAB15MG 3 TRANYLCYPROMTAB10MG 3

Serotonin/Norepinephrine Reuptake Inhibitors

16


CELEXA TAB10MG 5 QL

CELEXA TAB20MG 5 QL

CELEXA TAB40MG 5 QL

CITALOPRAM SOL10MG/5ML 2 QL

CITALOPRAM TAB10MG 2 QL



CYMBALTA CAP20MG 5 QL ST



DULOXETINE CAP20MG 3 QL



EFFEXOR XR CAP150MG 5 QL ST

EFFEXOR XR CAP37.5MG 5 QL ST

EFFEXOR XR CAP75MG 5 QL ST ESCITALOPRAMSOL5MG/5ML 2 QL

ESCITALOPRAMTAB10MG 2 QL



FLUOXETINE CAP10MG 2 QL

FLUOXETINE CAP20MG 2 QL

FLUOXETINE CAP40MG 2 QL FLUOXETINE CAP90MG DR 2 QL

FLUOXETINE SOL20MG/5ML 2 QL

FLUOXETINE TAB10MG 2 QL

FLUOXETINE TAB20MG 2 QL

FLUOXETINE TAB60MG 4

FLUVOXAMINE TAB100MG 2 QL



LEXAPRO SOL5MG/5ML 5 QL

LEXAPRO TAB10MG 5 QL

LEXAPRO TAB20MG 5 QL

LEXAPRO TAB5MG 5 QL

LUVOX CR CAP100MG 5

LUVOX CR CAP150MG 5

PAROXETIN ERTAB12.5MG 2 QL

PAROXETIN ERTAB37.5MG 2 QL

PAROXETINE SUS10MG/5ML 3

PAROXETINE TAB10MG 2 QL


PAROXETINE TAB25MG ER 2 QL




PAXIL SUS10MG/5ML 5 QL

PAXIL TAB10MG 5 QL

PAXIL TAB20MG 5 QL

PAXIL TAB30MG 5 QL

PAXIL TAB40MG 5 QL

PAXIL CR TAB12.5MG 5 QL

PAXIL CR TAB25MG 5 QL

PAXIL CR TAB37.5MG 5 QL

PEXEVA TAB10MG 5 QL

PEXEVA TAB20MG 5 QL

PEXEVA TAB30MG 5 QL

PEXEVA TAB40MG 5 QL

PRISTIQ TAB100MG 5 QL ST

PRISTIQ TAB50MG 5 QL ST

PROZAC CAP10MG 5 QL

PROZAC CAP20MG 5

PROZAC CAP40MG 5 QL PROZAC WEEKLCAP90MG 5 QL

SARAFEM TAB10MG 5 QL

SARAFEM TAB10MG 5

SARAFEM TAB20MG 5

SARAFEM TAB20MG 5 QL SERTRALINE CON20MG/ML 2 QL

SERTRALINE TAB100MG 2 QL



VENLAFAXINE CAP150MG ER 2 QL

VENLAFAXINE CAP37.5 ER 2 QL VENLAFAXINE CAP75MG ER 2 QL

VENLAFAXINE TAB100MG 2 QL

VENLAFAXINE TAB150MG ER 2 QL

VENLAFAXINE TAB225MG ER 2 QL ST


VENLAFAXINE TAB37.5 ER 2 QL

VENLAFAXINE TAB37.5MG 2 QL


VENLAFAXINE TAB75MG 2 QL VENLAFAXINE TAB75MG ER 2 QL

ZOLOFT CON20MG/ML 5

ZOLOFT TAB100MG 5 QL

ZOLOFT TAB25MG 5 QL

17


ZOLOFT TAB50MG 5 QL

Tricyclics AMITRIPTYLINTAB100MG 2

AMITRIPTYLINTAB10MG 2





AMOXAPINE TAB100MG 3

AMOXAPINE TAB150MG 3

AMOXAPINE TAB25MG 3

AMOXAPINE TAB50MG 3

ANAFRANIL CAP25MG 5

ANAFRANIL CAP50MG 5

ANAFRANIL CAP75MG 5

CLOMIPRAMINECAP25MG 2



DESIPRAMINE TAB100MG 2






DOXEPIN HCL CAP100MG 2






DOXEPIN HCL CON10MG/ML 2

IMIPRAM HCL TAB10MG 2



IMIPRAM PAM CAP100MG 2




NORPRAMIN TAB100MG 5

NORPRAMIN TAB10MG 5

NORPRAMIN TAB150MG 5

NORPRAMIN TAB25MG 5

NORPRAMIN TAB50MG 5


NORPRAMIN TAB75MG 5

NORTRIPTYLINCAP10MG 2




NORTRIPTYLINSOL10MG/5ML 3

PAMELOR CAP10MG 5

PAMELOR CAP25MG 5

PAMELOR CAP50MG 5

PAMELOR CAP75MG 5

PROTRIPTYLINTAB10MG 2

PROTRIPTYLINTAB5MG 2

SURMONTIL CAP100MG 5

SURMONTIL CAP25MG 5

SURMONTIL CAP50MG 5

TOFRANIL TAB10MG 5

TOFRANIL TAB25MG 5

TOFRANIL TAB50MG 5

TOFRANIL-PM CAP100MG 5




TRIMIPRAMINECAP100MG 2



VIVACTIL TAB10MG 5

VIVACTIL TAB5MG 5

Antiemetics Antiemetics, Other CHLORPROMAZ TAB100MG 2 CHLORPROMAZ TAB10MG 2 CHLORPROMAZ TAB200MG 2 CHLORPROMAZ TAB25MG 2 CHLORPROMAZ TAB50MG 2

COMPRO SUP25MG 2 HYDROXYZ HCLSOL10MG/5ML 2 HYDROXYZ HCLTAB10MG 2 HYDROXYZ HCLTAB25MG 2 HYDROXYZ HCLTAB50MG 2 HYDROXYZ PAMCAP100MG 2 HYDROXYZ PAMCAP25MG 2 HYDROXYZ PAMCAP50MG 2 MECLIZINE TAB25MG 3 METOCLOPRAM SOL5MG/5ML 2

18


METOCLOPRAM TAB10MG 2 METOCLOPRAM TAB5MG 2 METOZOLV ODTTAB10MG 5 METOZOLV ODTTAB5MG 5 PERPHENAZINETAB16MG 2 PERPHENAZINETAB2MG 2 PERPHENAZINETAB4MG 2 PERPHENAZINETAB8MG 2 PHENADOZ SUP12.5MG 2 PHENADOZ SUP25MG 2 PHENERGAN SUP12.5MG 2 PHENERGAN SUP25MG 2 PROCHLORPER SUP25MG 2 PROCHLORPER TAB10MG 2 PROCHLORPER TAB5MG 2 PROMETHAZINESUP12.5MG 2 PROMETHAZINESUP25MG 2 PROMETHAZINESUP50MG 2 PROMETHAZINESYP6.25/5ML 2 PROMETHAZINETAB12.5MG 2 PROMETHAZINETAB25MG 2 PROMETHAZINETAB50MG 2 PROMETHEGAN SUP12.5MG 2 PROMETHEGAN SUP25MG 2 PROMETHEGAN SUP50MG 2 REGLAN TAB10MG 5 REGLAN TAB5MG 5 TIGAN CAP300MG 5 TRANSDERM-SCDIS1.5MG 5 QL TRIMETHOBENZCAP300MG 2 VISTARIL CAP25MG 5 VISTARIL CAP50MG 5

Emetogenic Therapy Adjuncts ANZEMET TAB100MG 5 QL ANZEMET TAB50MG 5 QL CESAMET CAP1MG 5 QL DRONABINOL CAP10MG 3 QL DRONABINOL CAP2.5MG 3 QL DRONABINOL CAP5MG 3 QL EMEND CAP125MG 5 QL EMEND CAP125MG 5

EMEND CAP40MG 5 QL EMEND CAP40MG 5

EMEND CAP80MG 5 QL EMEND CAP80MG 5

EMEND PAK80 & 125 5 QL GRANISETRON TAB1MG 3 QL GRANISOL SOL2MG/10ML 3


GRANISOL SOL2MG/10ML 3

MARINOL CAP10MG 5

MARINOL CAP2.5MG 5

MARINOL CAP5MG 5

ONDANSETRON INJ4MG/2ML 3

ONDANSETRON INJ4MG/2ML 3

ONDANSETRON SOL4MG/5ML 3 QL ONDANSETRON TAB24MG 3 QL ONDANSETRON TAB4MG 2 QL ONDANSETRON TAB4MG ODT 2 QL ONDANSETRON TAB8MG 2 QL ONDANSETRON TAB8MG ODT 2 QL SANCUSO DIS3.1MG 5 QL ZOFRAN SOL4MG/5ML 5

ZOFRAN TAB4MG 5 QL ZOFRAN TAB4MG ODT 5 QL ZOFRAN TAB8MG 5 QL ZOFRAN TAB8MG ODT 5 QL

Antifungals ANCOBON CAP250MG 5

ANCOBON CAP500MG 5

CICLODAN CRE0.77% 2

CICLODAN CRE0.77% 2

CICLODAN SOL8% 2

CICLOPIROX CRE0.77% 2

CICLOPIROX GEL0.77% 2

CICLOPIROX SHA1% 2

CICLOPIROX SOL8% 2

CICLOPIROX SUS0.77% 2

CLOTRIMAZOLETRO10MG 3

DIFLUCAN SUS10MG/ML 5

DIFLUCAN SUS40MG/ML 5

DIFLUCAN TAB100MG 5

DIFLUCAN TAB150MG 5 QL DIFLUCAN TAB200MG 5

DIFLUCAN TAB50MG 5

ECONAZOLE CRE1% 2

ERTACZO CRE2% 5 ST EXELDERM CRE1% 5 ST EXELDERM SOL1% 5 ST EXTINA AER2% 5 ST FLUCONAZOLE SUS10MG/ML 2

FLUCONAZOLE SUS40MG/ML 2

FLUCONAZOLE TAB100MG 2

FLUCONAZOLE TAB150MG 2 QL FLUCONAZOLE TAB200MG 2

FLUCONAZOLE TAB50MG 2

FLUCYTOSINE CAP250MG 3

19


FLUCYTOSINE CAP500MG 3

GRIFULVIN V TAB500MG 5

GRISEOFULVINSUS125/5ML 3

GRISEOFULVINTABMICR 500 3

GRISEOFULVINTABULTR 125 3

GRISEOFULVINTABULTR 250 3

GRIS-PEG TAB125MG 5

GRIS-PEG TAB250MG 5

ITRACONAZOLECAP100MG 3 PA JUBLIA SOL10% 5 ST KERYDIN SOL5% 5 ST KETOCONAZOLEAER2% 2

KETOCONAZOLECRE2% 2

KETOCONAZOLESHA2% 2

KETOCONAZOLETAB200MG 2

KETODAN KIT2% 3

KURIC CRE2% 2

LAMISIL GRA125MG 5

LAMISIL GRA187.5MG 5

LAMISIL TAB250MG 5

LOPROX GEL0.77% 5 ST LOPROX SHA1% 5 ST MENTAX CRE1% 5 ST NAFTIN CRE1% 5 ST NAFTIN CRE2% 5 ST NAFTIN GEL1% 5 ST NATACYN SUS5% OP 5

NIZORAL SHA2% 5 ST NOXAFIL SUS40MG/ML 4 QL NOXAFIL TAB100MG 4

NYAMYC POW100000 2

NYSTATIN CRE100000 2

NYSTATIN OIN100000 2

NYSTATIN POW100000 2

NYSTATIN SUS100000 2

NYSTATIN TAB500000 2

NYSTOP POW100000 2

ORAVIG TAB50MG 5

OXISTAT CRE1% 5 ST OXISTAT LOT1% 5 ST OXISTAT LOT1% 5 ST PEDI-DRI POW100000 2

PENLAC SOL8% 5 ST SPORANOX CAP100MG 5 PA SPORANOX CAPPULSEPAK 5 PA SPORANOX SOL10MG/ML 5 PA TERAZOL 3 CRE0.8% 5 QL TERAZOL 3 SUP80MG 5


TERAZOL 7 CRE0.4% 5 QL TERBINAFINE TAB250MG 2 QL TERCONAZOLE CRE0.4% 3

TERCONAZOLE CRE0.8% 3

TERCONAZOLE SUP80MG 3 QL VFEND SUS40MG/ML 5 PA VFEND TAB200MG 5 PA VFEND TAB50MG 5 PA VORICONAZOLETAB200MG 3 PA QL VORICONAZOLETAB50MG 3 PA QL XOLEGEL GEL2% 5 ST ZAZOLE CRE0.4% 3

ZAZOLE CRE0.8% 5 QL

Antigout Agents ALLOPURINOL TAB100MG 2

ALLOPURINOL TAB300MG 2

COLCHICINE CAP0.6MG 5

COLCHICINE TAB0.6MG 3

COLCRYS TAB0.6MG 5 QL MITIGARE CAP0.6MG 5

PROBEN/COLCHTAB500-0.5 2

PROBENECID TAB500MG 2

ULORIC TAB40MG 4 QL ULORIC TAB80MG 4 QL ZYLOPRIM TAB100MG 5

ZYLOPRIM TAB300MG 5

Anti-inflammatory Agents Glucocorticoids MILLIPRED SOL10MG/5ML 3

MILLIPRED SOL10MG/5ML 3

MILLIPRED TAB5MG 3

MILLIPRED TAB5MG 3

MILLIPRED DPPAK5MG 3

MILLIPRED DPPAK5MG 3

ORAPRED SOL15MG/5ML 5

ORAPRED ODT TAB10MG 5

ORAPRED ODT TAB15MG 5

ORAPRED ODT TAB30MG 5 PRED SOD PHOSOL5MG/5ML 2 PREDNISOLONESOL15MG/5ML 2 PREDNISOLONESOL25MG/5ML 3

PRELONE SYP15MG/5ML 5

RAYOS TAB1MG 5

RAYOS TAB2MG 5

RAYOS TAB5MG 5

20


VERIPRED 20 SOL20MG/5ML 3

VERIPRED 20 SOL20MG/5ML 3

Nonsteroidal Anti-inflammatory Drugs SPRIX SPR15.75MG 5

Antimigraine Agents Ergot Alkaloids DIHYDROERGOTINJ1MG/ML 3

ERGOMAR SUB2MG 2

ERGOMAR SUB2MG 2

MIGRANAL SPR4MG/ML 4 QL

Prophylactic TIMOLOL MAL TAB10MG 2

TIMOLOL MAL TAB20MG 2

TIMOLOL MAL TAB5MG 2

Serotonin (5-HT) 1b/1d Receptor Agonists ALSUMA INJ6MG/0.5 5

AMERGE TAB1MG 5 QL AMERGE TAB2.5MG 5 QL AXERT TAB12.5MG 5 QL AXERT TAB6.25MG 5 QL FROVA TAB2.5MG 5 QL FROVA TAB2.5MG 5

IMITREX INJ4MG/0.5 5 QL IMITREX INJ6MG/0.5 5 QL IMITREX INJ6MG/0.5 5 QL IMITREX SPR20MG/ACT 5 QL IMITREX SPR5MG/ACT 5 QL IMITREX TAB100MG 5 QL IMITREX TAB25MG 5 QL IMITREX TAB50MG 5 QL MAXALT TAB10MG 5 QL MAXALT TAB5MG 5 QL MAXALT-MLT TAB10MG 5 QL MAXALT-MLT TAB5MG 5 QL NARATRIPTAN TAB1MG 3 QL NARATRIPTAN TAB2.5MG 3 QL RELPAX TAB20MG 5

RELPAX TAB40MG 5

RIZATRIPTAN TAB10MG 3 QL RIZATRIPTAN TAB10MG ODT 3 QL RIZATRIPTAN TAB5MG 3 QL SUMATRIPTAN INJ4MG/0.5 3

SUMATRIPTAN INJ6MG/0.5 3 QL SUMATRIPTAN INJ6MG/0.5 3 QL SUMATRIPTAN SPR20MG/ACT 3

SUMATRIPTAN SPR5MG/ACT 3


SUMATRIPTAN TAB100MG 3 QL SUMATRIPTAN TAB25MG 3 QL SUMATRIPTAN TAB50MG 3 QL SUMAVEL DOSEINJ4MG/0.5 5

SUMAVEL DOSEINJ6MG/0.5 5

ZOMIG TAB2.5MG 5 QL ZOMIG TAB5MG 5 QL ZOMIG NASAL SPR5MG 5 QL ZOMIG ZMT TAB2.5 MG 5 QL ZOMIG ZMT TAB5MG 5 QL

Antimyasthenic Agents Parasympathomimetics GUANIDINE TAB125MG 4

MESTINON SYP60MG/5ML 5

MESTINON TAB60MG 5

MESTINON TABTIMESPAN 5

MYTELASE TAB10MG 5

PYRIDOSTIGM TAB60MG 3

Antimycobacterials Antimycobacterials, Other

DAPSONE TAB100MG 2

DAPSONE TAB25MG 2

MYCOBUTIN CAP150MG 5

RIFABUTIN CAP150MG 3

Antituberculars CYCLOSERINE CAP250MG 3

ETHAMBUTOL TAB100MG 3

ETHAMBUTOL TAB400MG 3

ISONIAZID SYP50MG/5ML 2

ISONIAZID TAB100MG 2

ISONIAZID TAB300MG 2

MYAMBUTOL TAB400MG 5

PASER GRA4GM 3

PRIFTIN TAB150MG 5

PYRAZINAMIDETAB500MG 3

RIFADIN CAP150MG 5

RIFADIN CAP300MG 5

RIFAMATE CAP 5

RIFAMPIN CAP150MG 3

RIFAMPIN CAP300MG 3

RIFATER TAB 5

RIMACTANE CAP300MG 3

SEROMYCIN CAP250MG 3

SIRTURO TAB100MG 6

TRECATOR TAB250MG 5

21


TRECATOR TAB250MG 5

Antineoplastics Alkylating Agents CEENU CAP10MG 6 CYCLOPHOSPH TAB25MG 6 CYCLOPHOSPH TAB50MG 6

GLEOSTINE CAP100MG 6

GLEOSTINE CAP10MG 6

GLEOSTINE CAP40MG 6

LEUKERAN TAB2MG 4

LOMUSTINE CAP100MG 6

LOMUSTINE CAP10MG 6

LOMUSTINE CAP40MG 6

MATULANE CAP50MG 6

Antiangiogenic Agents POMALYST CAP1MG 6 PA QL

POMALYST CAP2MG 6 PA QL



REVLIMID CAP10MG 6 PA QL


REVLIMID CAP2.5MG 6 PA QL




THALOMID CAP100MG 6 PA QL




Antiestrogens/Modifiers EMCYT CAP140MG 6

FARESTON TAB60MG 5 QL

TAMOXIFEN TAB10MG 1

TAMOXIFEN TAB20MG 1

Antimetabolites DROXIA CAP200MG 5

DROXIA CAP300MG 5

DROXIA CAP400MG 5

HYDREA CAP500MG 5 HYDROXYUREA CAP500MG 3 MERCAPTOPUR TAB50MG 2

PURINETHOL TAB50MG 5

TABLOID TAB40MG 5


TABLOID TAB40MG 5

Antineoplastics, Other

HEXALEN CAP50MG 6 LEUCOVOR CA TAB10MG 3 LEUCOVOR CA TAB15MG 3 LEUCOVOR CA TAB25MG 3 LEUCOVOR CA TAB5MG 3

Aromatase Inhibitors, 3rd Generation ANASTROZOLE TAB1MG 2 QL

ANASTROZOLE TAB1MG 2

ARIMIDEX TAB1MG 5

ARIMIDEX TAB1MG 5 QL

ARIMIDEX TAB1MG 5

AROMASIN TAB25MG 5

EXEMESTANE TAB25MG 3 QL

FEMARA TAB2.5MG 5 QL

LETROZOLE TAB2.5MG 2 QL

Enzyme Inhibitors GILOTRIF TAB20MG 6 PA QL

GILOTRIF TAB30MG 6 PA QL

GILOTRIF TAB40MG 6 PA QL

JAKAFI TAB10MG 6 PA QL





MEKINIST TAB0.5MG 6 PA QL

MEKINIST TAB2MG 6 PA QL

TAFINLAR CAP50MG 6 PA QL

TAFINLAR CAP75MG 6 PA QL

VOTRIENT TAB200MG 6 PA QL

VOTRIENT TAB200MG 6 PA

ZYDELIG TAB150MG 6 PA QL

ZYTIGA TAB250MG 6 PA QL

Molecular Target Inhibitors AFINITOR TAB10MG 6 PA QL

AFINITOR TAB2.5MG 6 PA QL

AFINITOR TAB5MG 6 PA QL

AFINITOR TAB7.5MG 6 PA QL

AFINITOR DISTAB2MG 6 PA QL



22


CAPRELSA TAB100MG 6 PA QL

CAPRELSA TAB300MG 6 PA QL

COMETRIQ KIT100MG 6 QL



ERIVEDGE CAP150MG 6 PA QL

GLEEVEC TAB100MG 6 PA QL

GLEEVEC TAB400MG 6 PA QL

ICLUSIG TAB15MG 6 PA QL

ICLUSIG TAB45MG 6 PA

IMBRUVICA CAP140MG 6 PA QL

NEXAVAR TAB200MG 6 PA QL

SPRYCEL TAB100MG 6 PA QL






STIVARGA TAB40MG 6 PA QL

SUTENT CAP12.5MG 6 PA

SUTENT CAP12.5MG 6 PA QL

SUTENT CAP25MG 6 PA QL

SUTENT CAP25MG 6 PA

SUTENT CAP37.5MG 6 PA QL

SUTENT CAP50MG 6 PA

SUTENT CAP50MG 6 PA QL

TARCEVA TAB100MG 6 PA QL



TASIGNA CAP150MG 6 PA QL

TASIGNA CAP200MG 6 PA QL

TYKERB TAB250MG 6 PA QL

VANDETANIB TAB100MG 6 PA

VANDETANIB TAB300MG 6 PA

XALKORI CAP200MG 6 PA QL

XALKORI CAP250MG 6 PA QL

ZOLINZA CAP100MG 6 PA QL

ZOLINZA CAP100MG 6 PA

ZYDELIG TAB100MG 6 PA QL

ZYKADIA CAP150MG 6 PA QL

Monoclonal Antibodies RITUXAN INJ500MG 6 PA


Retinoids PANRETIN GEL0.1% 6

TARGRETIN CAP75MG 6

TARGRETIN GEL1% 6 QL

TRETINOIN CAP10MG 6

TRETIN-X CRE0.075% 3

Antiparasitics Anthelmintics ALBENZA TAB200MG 5

BILTRICIDE TAB600MG 5 MEBENDAZOLE CHW100MG 2

STROMECTOL TAB3MG 5

Antiprotozoals ALINIA SUS100/5ML 4 QL

ALINIA TAB500MG 4 ARALEN TAB500MG 5 ATOVAQ/PROGUTAB250-100 3 ATOVAQ/PROGUTAB62.5-25 3 ATOVAQUONE SUS750/5ML 3 CHLOROQUINE TAB250MG 2 CHLOROQUINE TAB500MG 2

COARTEM TAB20-120MG 4

DARAPRIM TAB25MG 5 HYDROXYCHLORTAB200MG 2

MALARONE TAB250-100 5

MALARONE TAB62.5-25 5

MEFLOQUINE TAB250MG 3

MEPRON SUS 5

PLAQUENIL TAB200MG 5

PRIMAQUINE TAB26.3MG 5

QUALAQUIN CAP324MG 5

QUININE SULFCAP324MG 3

Pediculicides/Scabicides ACTICIN CRE5% 2

EURAX CRE10% 4

EURAX LOT10% 4

LINDANE LOT1% 3

LINDANE SHA1% 3

MALATHION LOT0.5% 3

OVIDE LOT0.5% 5

PERMETHRIN CRE5% 2

SKLICE LOT0.5% 5

ULESFIA LOT5% 5

Antiparkinson Agents

23


Anticholinergics BENZTROPINE TAB0.5MG 2

BENZTROPINE TAB1MG 2

BENZTROPINE TAB2MG 2

TRIHEXYPHEN ELX0.4MG/ML 2

TRIHEXYPHEN TAB2MG 2

TRIHEXYPHEN TAB5MG 2

Antiparkinson Agents, Other AMANTADINE CAP100MG 2

AMANTADINE SYP50MG/5ML 2

AMANTADINE TAB100MG 2

COMTAN TAB200MG 5 QL

ENTACAPONE TAB200MG 3 QL

TASMAR TAB100MG 5

Dopamine Agonists APOKYN INJ10MG/ML 6 BROMOCRIPTINCAP5MG 2 BROMOCRIPTINTAB2.5MG 2 MIRAPEX TAB0.125MG 5 QL MIRAPEX TAB0.25MG 5 QL MIRAPEX TAB0.5MG 5 QL MIRAPEX TAB0.75MG 5 MIRAPEX TAB1.5MG 5 QL MIRAPEX TAB1MG 5 QL MIRAPEX ER TAB0.375MG 5 MIRAPEX ER TAB0.75MG 5 MIRAPEX ER TAB1.5MG 5 MIRAPEX ER TAB2.25MG 5 MIRAPEX ER TAB3.75MG 5 MIRAPEX ER TAB3MG 5 MIRAPEX ER TAB4.5MG 5 PARLODEL CAP5MG 5 PARLODEL TAB2.5MG 5 PRAMIPEXOLE TAB0.125MG 2 QL PRAMIPEXOLE TAB0.25MG 2 QL PRAMIPEXOLE TAB0.5MG 2 QL PRAMIPEXOLE TAB0.75MG 2 QL PRAMIPEXOLE TAB1.5MG 2 QL PRAMIPEXOLE TAB1MG 2 QL REQUIP TAB0.25MG 5 REQUIP TAB0.5MG 5 REQUIP TAB1MG 5 REQUIP TAB2MG 5 REQUIP TAB3MG 5 REQUIP TAB4MG 5 REQUIP TAB5MG 5


REQUIP XL TAB12MG 5 QL REQUIP XL TAB2MG 5 QL REQUIP XL TAB4MG 5 QL REQUIP XL TAB6MG 5 REQUIP XL TAB8MG 5 QL ROPINIROLE TAB0.25MG 2 ROPINIROLE TAB0.5MG 2 ROPINIROLE TAB12MG ER 3 ROPINIROLE TAB1MG 2 ROPINIROLE TAB2MG 2 ROPINIROLE TAB2MG ER 3 ROPINIROLE TAB3MG 2 ROPINIROLE TAB4MG 2 ROPINIROLE TAB4MG ER 3 ROPINIROLE TAB5MG 2 ROPINIROLE TAB6MG ER 3 ROPINIROLE TAB8MG ER 3

Dopamine Precursors/ L-Amino Acid Decarboxylase Inhibitors CARB/LEVO TAB10-100MG 2 CARB/LEVO TAB10-100MG 2 CARB/LEVO TAB25-100MG 2 CARB/LEVO TAB25-100MG 2 CARB/LEVO TAB25-250MG 2 CARB/LEVO TAB25-250MG 2 CARB/LEVO ERTAB25-100MG 2 CARB/LEVO ERTAB50-200MG 2 LODOSYN TAB25MG 5 PARCOPA TAB10-100MG 5 PARCOPA TAB25-100MG 5 PARCOPA TAB25-250MG 5 SINEMET TAB10-100MG 5 SINEMET TAB25-100MG 5 SINEMET TAB25-250MG 5 SINEMET CR TAB25-100MG 5 SINEMET CR TAB50-200MG 5

Monoamine Oxidase B (MAO-B) Inhibitors AZILECT TAB0.5MG 5

AZILECT TAB1MG 5

AZILECT TAB1MG 5

ELDEPRYL CAP5MG 5

SELEGILINE CAP5MG 3

SELEGILINE TAB5MG 3

ZELAPAR TAB1.25MG 5

Antipsychotics 1st Generation/Typical FLUPHENAZINECON5MG/ML 2

24


FLUPHENAZINEELX2.5/5ML 2 FLUPHENAZINETAB10MG 2 FLUPHENAZINETAB1MG 2 FLUPHENAZINETAB2.5MG 2 FLUPHENAZINETAB5MG 2 HALOPERIDOL CON2MG/ML 2 HALOPERIDOL TAB0.5MG 2 HALOPERIDOL TAB10MG 2 HALOPERIDOL TAB1MG 2 HALOPERIDOL TAB20MG 2 HALOPERIDOL TAB2MG 2 HALOPERIDOL TAB5MG 2 LOXAPINE CAP10MG 3 LOXAPINE CAP25MG 3 LOXAPINE CAP50MG 3 LOXAPINE CAP5MG 3 LOXITANE CAP10MG 5 LOXITANE CAP25MG 5 LOXITANE CAP50MG 5 LOXITANE CAP5MG 5 ORAP TAB1MG 5 ORAP TAB2MG 5 THIORIDAZINETAB100MG 2 THIORIDAZINETAB10MG 2 THIORIDAZINETAB25MG 2 THIORIDAZINETAB50MG 2 THIOTHIXENE CAP10MG 2 THIOTHIXENE CAP1MG 2 THIOTHIXENE CAP2MG 2 THIOTHIXENE CAP5MG 2 TRIFLUOPERAZTAB10MG 2 TRIFLUOPERAZTAB1MG 2 TRIFLUOPERAZTAB2MG 2 TRIFLUOPERAZTAB5MG 2

2nd Generation/Atypical FANAPT PAK 5 QL FANAPT TAB10MG 5 QL FANAPT TAB12MG 5 QL FANAPT TAB1MG 5 QL FANAPT TAB2MG 5 QL FANAPT TAB4MG 5 QL FANAPT TAB6MG 5 QL FANAPT TAB8MG 5 QL GEODON CAP20MG 5 QL GEODON CAP40MG 5 QL GEODON CAP60MG 5 QL GEODON CAP80MG 5 QL INVEGA TAB1.5MG 5 QL


INVEGA TAB3MG 5 QL INVEGA TAB6MG 5 QL INVEGA TAB9MG 5 QL LATUDA TAB120MG 5 QL LATUDA TAB20MG 5 QL LATUDA TAB40MG 5 QL LATUDA TAB60MG 5 QL LATUDA TAB80MG 5 QL OLANZAPINE TAB10MG 2 QL OLANZAPINE TAB10MG ODT 3 QL OLANZAPINE TAB15MG 2 QL OLANZAPINE TAB15MG ODT 3 QL OLANZAPINE TAB2.5MG 2 QL OLANZAPINE TAB20MG 2 QL OLANZAPINE TAB20MG ODT 3 QL OLANZAPINE TAB5MG 2 QL OLANZAPINE TAB5MG ODT 3 QL OLANZAPINE TAB7.5MG 2 QL QUETIAPINE TAB100MG 2 QL QUETIAPINE TAB200MG 2 QL QUETIAPINE TAB25MG 2 QL QUETIAPINE TAB300MG 2 QL QUETIAPINE TAB400MG 2 QL QUETIAPINE TAB50MG 2 QL RISPERDAL SOL1MG/ML 5 QL RISPERDAL TAB0.25MG 5 QL RISPERDAL TAB0.5MG 5 QL RISPERDAL TAB1MG 5 QL RISPERDAL TAB2MG 5 QL RISPERDAL TAB3MG 5 QL RISPERDAL TAB4MG 5 QL RISPERDAL M TAB0.5MG 5 QL RISPERDAL M TAB1MG 5 QL RISPERDAL M TAB2MG 5 QL RISPERDAL M TAB3MG 5 QL RISPERDAL M TAB4MG 5 QL RISPERIDONE SOL1MG/ML 2 QL RISPERIDONE TAB0.25 ODT 3 QL RISPERIDONE TAB0.25MG 2 QL RISPERIDONE TAB0.5MG 2 QL RISPERIDONE TAB0.5MG OD 3 QL RISPERIDONE TAB1MG 2 QL RISPERIDONE TAB1MG ODT 3 QL RISPERIDONE TAB2MG 2 QL RISPERIDONE TAB2MG ODT 3 QL RISPERIDONE TAB3MG 2 QL RISPERIDONE TAB3MG ODT 3 QL RISPERIDONE TAB4MG 2 QL

25


RISPERIDONE TAB4MG ODT 3 QL SAPHRIS SUB10MG 5 QL SAPHRIS SUB5MG 5 QL SEROQUEL TAB100MG 5 QL SEROQUEL TAB200MG 5 QL SEROQUEL TAB25MG 5 QL SEROQUEL TAB300MG 5 QL SEROQUEL TAB400MG 5 QL SEROQUEL TAB50MG 5 QL ZIPRASIDONE CAP20MG 3 QL ZIPRASIDONE CAP40MG 3 QL ZIPRASIDONE CAP60MG 3 QL ZIPRASIDONE CAP80MG 3 QL ZYPREXA TAB10MG 5 QL ZYPREXA TAB15MG 5 QL ZYPREXA TAB2.5MG 5 QL ZYPREXA TAB20MG 5 QL ZYPREXA TAB5MG 5 QL ZYPREXA TAB7.5MG 5 QL ZYPREXA ZYDITAB10MG 5 QL ZYPREXA ZYDITAB15MG 5 QL ZYPREXA ZYDITAB20MG 5 QL ZYPREXA ZYDITAB5MG 5 QL

Treatment-Resistant CLOZAPINE TAB100/ODT 5 QL CLOZAPINE TAB100MG 3 QL CLOZAPINE TAB12.5/ODT 5 QL CLOZAPINE TAB200MG 3 QL CLOZAPINE TAB25MG 3 QL CLOZAPINE TAB25MG ODT 5 QL CLOZAPINE TAB50MG 3 QL CLOZARIL TAB100MG 5

CLOZARIL TAB25MG 5

FAZACLO TAB100/ODT 5 QL FAZACLO TAB12.5/ODT 5 QL FAZACLO TAB150MG 5 QL FAZACLO TAB200MG 5 QL FAZACLO TAB25MG ODT 5 QL

Antispasticity Agents BACLOFEN TAB10MG 2

BACLOFEN TAB20MG 2

DANTRIUM CAP100MG 5

DANTRIUM CAP25MG 5

DANTRIUM CAP50MG 5

DANTROLENE CAP100MG 3




MYRBETRIQ TAB25MG 5 QL MYRBETRIQ TAB50MG 5 QL TIZANIDINE CAP2MG 3

TIZANIDINE CAP4MG 3

TIZANIDINE CAP6MG 3

TIZANIDINE TAB2MG 2

TIZANIDINE TAB4MG 2

ZANAFLEX CAP2MG 5

ZANAFLEX CAP4MG 5

ZANAFLEX CAP6MG 5

ZANAFLEX TAB4MG 5

Antivirals Anti-cytomegalovirus (CMV) Agents VALCYTE SOL50MG/ML 6

VALCYTE TAB450MG 6

ZIRGAN GEL0.15% 5

Antihepatitis Agents BARACLUDE SOL.05MG/ML 6 QL

BARACLUDE TAB0.5MG 6 QL

BARACLUDE TAB1MG 6 QL

ENTECAVIR TAB0.5MG 6 QL

ENTECAVIR TAB1MG 6 QL

EPIVIR HBV SOL5MG/ML 6

EPIVIR HBV TAB100MG 6

HARVONI TAB90-400MG 6 PA QL

HEPSERA TAB10MG 6

INCIVEK TAB375MG 6

INFERGEN INJ15MCG 6 PA

INTRON A INJ18MU 6 PA

INTRON A INJ50MU 6 PA

INTRON-A INJ10MU 6 PA

INTRON-A INJ10MU PEN 6 PA

INTRON-A INJ18MU 6 PA



LAMIVUDINE TAB100MG 6

MODERIBA TAB200MG 6

OLYSIO CAP150MG 6 PA QL

PEGASYS INJ 6 PA QL

PEGASYS INJPROCLICK 6 PA

PEG-INTRON KIT120 RP 6 PA QL

PEG-INTRON KIT120MCG 6 PA QL

PEG-INTRON KIT150 RP 6 PA QL


26



PEG-INTRON KIT50MCG RP 6 PA QL


PEG-INTRON KIT80MCG RP 6 PA QL

RIBAPAK PAK1000/DAY 6



RIBASPHERE CAP200MG 6

RIBASPHERE TAB200MG 6



RIBATAB PAK1000/DAY 6

RIBATAB TAB400MG 6

RIBATAB TAB600MG 6

RIBATAB TAB800/DAY 6

RIBAVIRIN CAP200MG 6

RIBAVIRIN TAB200MG 6



SOVALDI TAB400MG 6 PA QL

TYZEKA TAB600MG 6

VICTRELIS CAP200MG 6

VIREAD POW40MG/GM 6 QL

Antiherpetic Agents ACYCLOVIR CAP200MG 2

ACYCLOVIR OIN5% 3 QL

ACYCLOVIR SUS200/5ML 2

ACYCLOVIR TAB400MG 2

ACYCLOVIR TAB800MG 2

DENAVIR CRE1% 5 QL

FAMCICLOVIR TAB125MG 3 QL

FAMCICLOVIR TAB250MG 3 QL

FAMCICLOVIR TAB500MG 3 QL FAMVIR TAB125MG 5 QL FAMVIR TAB250MG 5 QL FAMVIR TAB500MG 5 QL TRIFLURIDINESOL1% OP 3

VALACYCLOVIRTAB1GM 3 QL VALACYCLOVIRTAB500MG 3 QL VALTREX TAB1GM 5 QL VALTREX TAB500MG 5 QL VIROPTIC SOL1% OP 5 ZOVIRAX CAP200MG 5 ZOVIRAX CRE5% 5 QL


ZOVIRAX OIN5% 5 QL ZOVIRAX SUS200/5ML 5 ZOVIRAX TAB400MG 5 ZOVIRAX TAB800MG 5

Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors EDURANT TAB25MG 6 QL

INTELENCE TAB100MG 6 QL



NEVIRAPINE SUS50MG/5ML 6 QL

NEVIRAPINE TAB200MG 6 QL

NEVIRAPINE TAB400MG ER 6 QL

RESCRIPTOR TAB100 MG 6 QL

RESCRIPTOR TAB200MG 6 QL

SUSTIVA CAP200MG 6 QL

SUSTIVA CAP50MG 6 QL

SUSTIVA TAB600MG 6 QL

VIRAMUNE SUS50MG/5ML 6

VIRAMUNE TAB200MG 6

VIRAMUNE XR TAB100MG 6 QL

VIRAMUNE XR TAB400MG 6

Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors ABACAV/LAMIVTAB/ZIDOVUD 6 QL ABACAVIR TAB300MG 6 QL COMBIVIR TAB150-300 6 DIDANOSINE CAP125MG 6 QL DIDANOSINE CAP200MG 6 QL DIDANOSINE CAP250MG 6 QL DIDANOSINE CAP400MG 6 QL EMTRIVA CAP200MG 6 QL EMTRIVA SOL10MG/ML 6 QL EPIVIR SOL10MG/ML 6 QL EPIVIR TAB150MG 6 EPIVIR TAB300MG 6 EPZICOM TAB600-300 6 QL LAMIVUD/ZIDOTAB150-300 6 QL LAMIVUDINE TAB150MG 6 QL LAMIVUDINE TAB300MG 6 QL RETROVIR CAP100MG 6 RETROVIR SYP50MG/5ML 6 STAVUDINE CAP15MG 6 QL STAVUDINE CAP20MG 6 QL STAVUDINE CAP30MG 6 QL

27


STAVUDINE CAP40MG 6 QL STAVUDINE SOL1MG/ML 6 QL TRIUMEQ TAB 6 QL TRIZIVIR TAB 6 QL TRUVADA TAB200-300 6 QL VIDEX SOL2GM 6 QL VIDEX EC CAP125MG 6 VIDEX EC CAP200MG 6 VIDEX EC CAP250MG 6 VIDEX EC CAP400MG 6 VIREAD TAB150MG 6 QL VIREAD TAB200MG 6 QL VIREAD TAB250MG 6 QL VIREAD TAB300MG 6 QL ZERIT CAP15MG 6 ZERIT CAP20MG 6 ZERIT CAP30MG 6 ZERIT CAP40MG 6 ZERIT SOL1MG/ML 6 ZIAGEN SOL20MG/ML 6 QL ZIAGEN TAB300MG 6 ZIDOVUDINE CAP100MG 6 QL ZIDOVUDINE SYP50MG/5ML 6 QL ZIDOVUDINE TAB300MG 6 QL

Anti-HIV Agents, Other FUZEON INJ90MG 6 PA QL

ISENTRESS CHW100MG 6 QL

ISENTRESS CHW25MG 6 QL

ISENTRESS POW100MG 6 QL

ISENTRESS TAB400MG 6 QL

SELZENTRY TAB150MG 6 QL

SELZENTRY TAB300MG 6 QL

STRIBILD TAB 6 QL

TIVICAY TAB50MG 6 QL TYBOST TAB150MG 5 QL

Anti-HIV Agents, Protease Inhibitors APTIVUS CAP250MG 6 APTIVUS CAP250MG 6 QL APTIVUS SOL 6 QL CRIXIVAN CAP200MG 6 QL CRIXIVAN CAP400MG 6 QL INVIRASE CAP200MG 6 QL INVIRASE TAB500MG 6 QL KALETRA SOL 6 QL KALETRA TAB100-25MG 6 QL KALETRA TAB200-50MG 6


KALETRA TAB200-50MG 6 QL LEXIVA SUS50MG/ML 6 QL LEXIVA TAB700MG 6 QL NORVIR CAP100MG 6 QL NORVIR SOL80MG/ML 6 QL NORVIR TAB100MG 6 QL PREZISTA SUS100MG/ML 6 QL PREZISTA TAB150MG 6 QL PREZISTA TAB400MG 6 PREZISTA TAB600MG 6 QL PREZISTA TAB75MG 6 QL REYATAZ CAP100MG 6 REYATAZ CAP150MG 6 QL REYATAZ CAP200MG 6 QL REYATAZ CAP300MG 6 QL VIRACEPT POW50MG/GM 6 VIRACEPT TAB250MG 6 QL VIRACEPT TAB625MG 6 QL

Anti-influenza Agents RELENZA MISDISKHALE 5 QL RIMANTADINE TAB100MG 2

TAMIFLU CAP30MG 4 QL TAMIFLU CAP45MG 4 QL TAMIFLU CAP75MG 4 QL TAMIFLU SUS6MG/ML 4 QL

Anxiolytics Anxiolytics, Other BUSPIRONE TAB10MG 2

BUSPIRONE TAB15MG 2

BUSPIRONE TAB30MG 2

BUSPIRONE TAB5MG 2

BUSPIRONE TAB7.5MG 2

MEPROBAMATE TAB200MG 3

MEPROBAMATE TAB400MG 3

Bipolar Agents Mood Stabilizers LITHIUM SOL8MEQ/5ML 4

LITHIUM CARBCAP150MG 2



LITHIUM CARBTAB300MG 2

LITHIUM CARBTAB300MG ER 2

LITHIUM CARBTAB450MG ER 2

LITHOBID TAB300MG CR 5

Blood Glucose Regulators Antidiabetic Agents

28


ACARBOSE TAB100MG 3 QL ACARBOSE TAB25MG 3 QL ACARBOSE TAB50MG 3 QL ACTOS TAB15MG 5 QL ACTOS TAB30MG 5 QL ACTOS TAB45MG 5 QL AMARYL TAB1MG 5 QL AMARYL TAB2MG 5 QL AMARYL TAB4MG 5 QL AVANDIA TAB2MG 5 QL AVANDIA TAB4MG 5 QL AVANDIA TAB8MG 5 QL BYDUREON INJ 4 QL ST BYDUREON INJ 4 QL ST BYETTA INJ10MCG 4 QL ST BYETTA INJ5MCG 4 QL ST CHLORPROPAM TAB100MG 2 QL CHLORPROPAM TAB250MG 2 QL CYCLOSET TAB0.8MG 5 QL DIABETA TAB1.25MG 5 QL DIABETA TAB2.5MG 5 QL DIABETA TAB5MG 5 QL FARXIGA TAB10MG 4 ST FARXIGA TAB5MG 4 ST FORTAMET TAB1000MG 5 QL FORTAMET TAB500MG 5 QL GLIMEPIRIDE TAB1MG 2 QL GLIMEPIRIDE TAB2MG 2 QL GLIMEPIRIDE TAB4MG 2 QL GLIPIZIDE TAB10MG 2 QL GLIPIZIDE TAB5MG 2 QL GLIPIZIDE ERTAB10MG 2 QL GLIPIZIDE ERTAB2.5MG 2 QL GLIPIZIDE ERTAB5MG 2 QL GLUCOPHAGE TAB1000MG 5 QL GLUCOPHAGE TAB500MG 5 QL GLUCOPHAGE TAB500MG XR 5 QL GLUCOPHAGE TAB750MG XR 5 QL GLUCOPHAGE TAB850MG 5 QL GLUCOTROL TAB10MG 5 QL GLUCOTROL TAB5MG 5 QL GLUCOTROL XLTAB10MG 5 QL GLUCOTROL XLTAB2.5MG 5 QL GLUCOTROL XLTAB5MG 5 QL GLUMETZA TAB1000MG 5 GLUMETZA TAB500MG 5 GLYBURID MCRTAB1.5MG 2 QL GLYBURID MCRTAB3MG 2 QL


GLYBURID MCRTAB6MG 2 QL GLYBURIDE TAB1.25MG 2 QL GLYBURIDE TAB2.5MG 2 QL GLYBURIDE TAB5MG 2 QL GLYNASE TAB1.5MG 5 QL GLYNASE TAB3MG 5 QL GLYNASE TAB6MG 5 QL GLYSET TAB100MG 5 QL GLYSET TAB25MG 5 QL GLYSET TAB50MG 5 QL INVOKAMET TAB150-1000 5 ST INVOKAMET TAB150-500 5 ST INVOKAMET TAB50-1000 5 ST INVOKAMET TAB50-500MG 5 ST INVOKANA TAB100MG 5 ST INVOKANA TAB300MG 5 ST JANUVIA TAB100MG 4 QL JANUVIA TAB100MG 4 JANUVIA TAB25MG 4 JANUVIA TAB25MG 4 QL JANUVIA TAB50MG 4 QL JANUVIA TAB50MG 4 JARDIANCE TAB10MG 5 QL ST JARDIANCE TAB25MG 5 QL ST METFORMIN TAB1000MG 2 QL METFORMIN TAB500MG 2 QL METFORMIN TAB500MG ER 2 QL METFORMIN TAB750MG ER 2 QL METFORMIN TAB850MG 2 QL METFORMIN ERTAB1000MG 2 QL NATEGLINIDE TAB120MG 3 QL NATEGLINIDE TAB60MG 3 QL NESINA TAB12.5MG 5 NESINA TAB25MG 5 NESINA TAB6.25MG 5 ONGLYZA TAB2.5MG 4 QL ONGLYZA TAB5MG 4 QL PIOGLITAZONETAB15MG 3 QL PIOGLITAZONETAB30MG 3 QL PIOGLITAZONETAB45MG 3 QL PRANDIN TAB0.5MG 4 QL PRANDIN TAB1MG 4 QL PRANDIN TAB2MG 4 QL PRECOSE TAB100MG 5 PRECOSE TAB25MG 5 PRECOSE TAB50MG 5 RIOMET SOL 5 STARLIX TAB120MG 5 QL

29


STARLIX TAB60MG 5 QL SYMLINPEN 60INJ1000MCG 5 PA QL SYMLNPEN 120INJ1000MCG 5 PA QL TANZEUM INJ30MG 4 ST TANZEUM INJ50MG 4 ST TOLAZAMIDE TAB250MG 2 TOLAZAMIDE TAB500MG 2 TOLBUTAMIDE TAB500MG 2 TRADJENTA TAB5MG 5 TRULICITY INJ0.75/0.5 5 ST TRULICITY INJ1.5/0.5 5 ST VICTOZA INJ18MG/3ML 5 QL ST WELCHOL PAK3.75GM 4 WELCHOL PAK3.75GM 4 WELCHOL TAB625MG 4

Glycemic Agents GLUCAGEN INJHYPOKIT 4 QL GLUCAGON KIT1MG 4 QL PROGLYCEM SUS50MG/ML 5 PROGLYCEM SUS50MG/ML 5

Insulins APIDRA INJSOLOSTAR 4 QL APIDRA INJU-100 4 QL HUMALOG INJ100/ML 4 QL HUMALOG INJ100/ML 4 QL HUMALOG MIX INJ50/50 4 QL HUMALOG MIX INJ50/50KWP 4 QL HUMALOG MIX INJ75/25KWP 4 QL HUMALOG MIX SUS75/25 4 QL HUMULIN INJ70/30 4 QL HUMULIN N INJU-100 4 QL HUMULIN R INJU-100 4 QL HUMULIN R INJU-500 4 QL LANTUS INJ100/ML 4 QL LANTUS INJSOLOSTAR 4 QL LEVEMIR INJ 4 QL LEVEMIR INJFLEXPEN 4 QL NOVOLIN INJ70/30 4 QL NOVOLIN N INJU-100 4 QL NOVOLIN R INJINNOLET 4

NOVOLIN R INJU-100 4 QL NOVOLOG INJ100/ML 4 QL NOVOLOG INJ100/ML 4

NOVOLOG INJPENFILL 4 QL NOVOLOG MIX INJ70/30 4 QL NOVOLOG MIX INJ70/30 4

NOVOLOG MIX INJFLEXPEN 4 QL


RELION 70/30INJINNOLET 4

RELION N INJINNOLET 4

Blood Products/Modifiers/ Volume Expanders Anticoagulants ARIXTRA SOL10/0.8 6 QL ARIXTRA SOL2.5/0.5 6 QL ARIXTRA SOL5.0/0.4 6 QL ARIXTRA SOL7.5/0.6 6 QL COUMADIN TAB10MG 5 COUMADIN TAB1MG 5 COUMADIN TAB2.5MG 5 COUMADIN TAB2MG 5 COUMADIN TAB3MG 5 COUMADIN TAB4MG 5 COUMADIN TAB5MG 5 COUMADIN TAB6MG 5 COUMADIN TAB7.5MG 5 ELIQUIS TAB2.5MG 5 QL ELIQUIS TAB5MG 5 QL ENOXAPARIN INJ100MG/ML 6 QL ENOXAPARIN INJ120/0.8 6 QL ENOXAPARIN INJ150MG/ML 6 QL ENOXAPARIN INJ30/0.3ML 6 QL ENOXAPARIN INJ300/3ML 6 QL ENOXAPARIN INJ40/0.4ML 6 QL ENOXAPARIN INJ60/0.6ML 6 QL ENOXAPARIN INJ80/0.8ML 6 QL FONDAPARINUXSOL10/0.8 6 QL FONDAPARINUXSOL2.5/0.5 6 QL FONDAPARINUXSOL5.0/0.4 6 QL FONDAPARINUXSOL7.5/0.6 6 QL FRAGMIN INJ10000/ML 6 FRAGMIN INJ10000/ML 6 QL FRAGMIN INJ12500UNT 6 FRAGMIN INJ12500UNT 6 QL FRAGMIN INJ15000UNT 6 QL FRAGMIN INJ18000UNT 6 QL FRAGMIN INJ2500/0.2 6 QL FRAGMIN INJ25000/ML 6 FRAGMIN INJ5000/0.2 6 QL FRAGMIN INJ7500/0.3 6 HEPARIN LOCKINJ100/ML 2 HEPARIN SOD INJ1000/ML 2 HEPARIN SOD INJ10000/ML 2 HEPARIN SOD INJ5000/ML 2 HEP-LOCK U/PINJ100/ML 2

30


JANTOVEN TAB10MG 2 JANTOVEN TAB1MG 2 JANTOVEN TAB2.5MG 2 JANTOVEN TAB2MG 2 JANTOVEN TAB3MG 2 JANTOVEN TAB4MG 2 JANTOVEN TAB5MG 2 JANTOVEN TAB6MG 2 JANTOVEN TAB7.5MG 2 LOVENOX INJ100MG/ML 6 QL LOVENOX INJ120/0.8 6 QL LOVENOX INJ150MG/ML 6 QL LOVENOX INJ30/0.3ML 6 QL LOVENOX INJ300/3ML 6 QL LOVENOX INJ40/0.4ML 6 QL LOVENOX INJ60/0.6ML 6 QL LOVENOX INJ80/0.8ML 6 QL PRADAXA CAP150MG 5 QL PRADAXA CAP75MG 5 QL WARFARIN TAB10MG 2 WARFARIN TAB1MG 2 WARFARIN TAB2.5MG 2 WARFARIN TAB2MG 2 WARFARIN TAB3MG 2 WARFARIN TAB4MG 2 WARFARIN TAB5MG 2 WARFARIN TAB6MG 2 WARFARIN TAB7.5MG 2 XARELTO TAB10MG 4 QL XARELTO TAB15MG 4 QL XARELTO TAB20MG 4 QL XARELTO STARTAB15/20MG 4 QL

Blood Formation Modifiers AGRYLIN CAP0.5MG 5

ANAGRELIDE CAP0.5MG 2

ANAGRELIDE CAP1MG 2

PROMACTA TAB12.5MG 6 PA QL

PROMACTA TAB25MG 6 PA QL



Coagulants TRANEX ACID INJ100MG/ML 2

Platelet Modifying Agents AGGRENOX CAP25-200MG 4

AGGRENOX CAP25-200MG 4 QL BRILINTA TAB90MG 5 QL


CILOSTAZOL TAB100MG 2

CILOSTAZOL TAB50MG 2

CLOPIDOGREL TAB300MG 2 QL CLOPIDOGREL TAB75MG 2 QL DIPYRIDAMOLETAB25MG 2

DIPYRIDAMOLETAB50MG 2

DIPYRIDAMOLETAB75MG 2

EFFIENT TAB10MG 4 QL EFFIENT TAB5MG 4 QL PERSANTINE TAB25MG 5

PERSANTINE TAB50MG 5

PERSANTINE TAB75MG 5

PLAVIX TAB300MG 5 QL PLAVIX TAB75MG 5 QL PLETAL TAB100MG 5

PLETAL TAB50MG 5

TICLOPIDINE TAB250MG 2 QL ZONTIVITY TAB2.08MG 5

Cardiovascular Agents Alpha-adrenergic Agonists CATAPRES TAB0.1MG 5 CATAPRES TAB0.2MG 5 CATAPRES TAB0.3MG 5 CATAPRES-TTSDIS0.1/24HR 5 QL CATAPRES-TTSDIS0.2/24HR 5 QL CATAPRES-TTSDIS0.3/24HR 5 QL CLONIDINE DIS0.1/24HR 3 QL CLONIDINE DIS0.2/24HR 3 QL CLONIDINE DIS0.3/24HR 3 QL CLONIDINE TAB0.1MG 2 CLONIDINE TAB0.2MG 2 CLONIDINE TAB0.3MG 2 GUANFACINE TAB1MG 2 GUANFACINE TAB2MG 2 METHYLDOPA TAB250MG 2 METHYLDOPA TAB500MG 2 METHYLDOPATEINJ250/5ML 3 MIDODRINE TAB10MG 3 MIDODRINE TAB2.5MG 3 MIDODRINE TAB5MG 3 TENEX TAB1MG 5 TENEX TAB2MG 5

Alpha-adrenergic Blocking Agents CARDURA TAB1MG 5 QL CARDURA TAB2MG 5 QL CARDURA TAB4MG 5 QL CARDURA TAB8MG 5 QL

31


CARDURA XL TAB4MG 5 QL CARDURA XL TAB8MG 5 QL DIBENZYLINE CAP10MG 5 DIBENZYLINE CAP10MG 5 DOXAZOSIN TAB1MG 2 QL DOXAZOSIN TAB2MG 2 QL DOXAZOSIN TAB4MG 2 QL DOXAZOSIN TAB8MG 2 QL MINIPRESS CAP1MG 5 MINIPRESS CAP2MG 5 MINIPRESS CAP5MG 5 PRAZOSIN HCLCAP1MG 2 PRAZOSIN HCLCAP2MG 2 PRAZOSIN HCLCAP5MG 2 TERAZOSIN CAP10MG 2 QL TERAZOSIN CAP1MG 2 QL TERAZOSIN CAP2MG 2 QL TERAZOSIN CAP5MG 2 QL

Angiotensin II Receptor Antagonists ATACAND TAB16MG 5 QL ATACAND TAB32MG 5 QL ATACAND TAB4MG 5 QL ATACAND TAB8MG 5 QL AVAPRO TAB150MG 5 QL AVAPRO TAB300MG 5 QL AVAPRO TAB75MG 5 QL BENICAR TAB20MG 5 QL BENICAR TAB20MG 5 BENICAR TAB40MG 5 BENICAR TAB40MG 5 QL BENICAR TAB5MG 5 QL BENICAR TAB5MG 5 CANDESARTAN TAB16MG 2 QL CANDESARTAN TAB32MG 2 QL COZAAR TAB100MG 5 QL COZAAR TAB25MG 5 QL COZAAR TAB50MG 5 QL DIOVAN TAB160MG 5 QL DIOVAN TAB320MG 5 QL DIOVAN TAB40MG 5 QL DIOVAN TAB80MG 5 QL EDARBI TAB40MG 5 EDARBI TAB80MG 5 EPROSART MESTAB600MG 2 QL IRBESARTAN TAB150MG 2 QL IRBESARTAN TAB300MG 2 QL IRBESARTAN TAB75MG 2 QL LOSARTAN POTTAB100MG 2 QL


LOSARTAN POTTAB25MG 2 QL LOSARTAN POTTAB50MG 2 QL MICARDIS TAB20MG 5 QL MICARDIS TAB40MG 5 QL MICARDIS TAB80MG 5 QL TELMISARTAN TAB20MG 3 TELMISARTAN TAB40MG 3 TELMISARTAN TAB80MG 3 TEVETEN TAB400MG 5 TEVETEN TAB600MG 5 VALSARTAN TAB160MG 2 QL VALSARTAN TAB320MG 2 QL VALSARTAN TAB40MG 2 QL VALSARTAN TAB80MG 2 QL

Angiotensin-converting Enzyme (ACE) Inhibitors ACCUPRIL TAB10MG 5

ACCUPRIL TAB20MG 5

ACCUPRIL TAB40MG 5

ACCUPRIL TAB5MG 5

ACEON TAB4MG 5

ACEON TAB8MG 5

ALTACE CAP1.25MG 5

ALTACE CAP10MG 5

ALTACE CAP2.5MG 5

ALTACE CAP5MG 5

BENAZEPRIL TAB10MG 2



BENAZEPRIL TAB5MG 2

CAPTOPRIL TAB100MG 2

CAPTOPRIL TAB12.5MG 2

CAPTOPRIL TAB25MG 2

CAPTOPRIL TAB50MG 2

ENALAPRIL TAB10MG 2

ENALAPRIL TAB2.5MG 2

ENALAPRIL TAB20MG 2

ENALAPRIL TAB5MG 2

FOSINOPRIL TAB10MG 2



LISINOPRIL TAB10MG 2

LISINOPRIL TAB2.5MG 2


32




LISINOPRIL TAB5MG 2

LOTENSIN TAB10MG 5

LOTENSIN TAB20MG 5

LOTENSIN TAB40MG 5

MAVIK TAB1MG 5

MAVIK TAB2MG 5

MAVIK TAB4MG 5

MOEXIPRIL TAB15MG 2

MOEXIPRIL TAB7.5MG 2

PERINDOPRIL TAB2MG 2



PRINIVIL TAB10MG 5

PRINIVIL TAB20MG 5

PRINIVIL TAB40MG 5

PRINIVIL TAB5MG 5

QUINAPRIL TAB10MG 2

QUINAPRIL TAB20MG 2

QUINAPRIL TAB40MG 2

QUINAPRIL TAB5MG 2

RAMIPRIL CAP1.25MG 2 QL

RAMIPRIL CAP10MG 2 QL

RAMIPRIL CAP2.5MG 2 QL

RAMIPRIL CAP5MG 2 QL

TRANDOLAPRILTAB1MG 2 QL



VASOTEC TAB10MG 5

VASOTEC TAB2.5MG 5

VASOTEC TAB20MG 5

VASOTEC TAB5MG 5

ZESTRIL TAB10MG 5

ZESTRIL TAB2.5MG 5

ZESTRIL TAB20MG 5

ZESTRIL TAB30MG 5

ZESTRIL TAB40MG 5

ZESTRIL TAB5MG 5

Antiarrhythmics AMIODARONE TAB100MG 2 AMIODARONE TAB200MG 2 AMIODARONE TAB400MG 3


BETAPACE TAB240MG 5 BETAPACE AF TAB120MG 5 BETAPACE AF TAB160MG 5 BETAPACE AF TAB80MG 5 CORDARONE TAB200MG 5 DISOPYRAMIDECAP100MG 3 DISOPYRAMIDECAP150MG 3 FLECAINIDE TAB100MG 2 FLECAINIDE TAB150MG 2 FLECAINIDE TAB50MG 2 MEXILETINE CAP150MG 3 MEXILETINE CAP200MG 3 MEXILETINE CAP250MG 3 MULTAQ TAB400MG 5 QL NORPACE CAP100MG 5 NORPACE CAP100MG CR 5 NORPACE CAP150MG 5 NORPACE CAP150MG CR 5 PACERONE TAB100MG 2 PACERONE TAB200MG 2 PACERONE TAB400MG 3 PROCAINAMIDEINJ100MG/ML 3 PROCAINAMIDEINJ500MG/ML 3 PROPAFENONE CAP225MG ER 2 PROPAFENONE CAP325MG ER 2 PROPAFENONE CAP425MG SR 2 PROPAFENONE TAB150MG 2 PROPAFENONE TAB225MG 2 PROPAFENONE TAB300MG 2 QUINIDINE GLTAB324MG CR 3 QUINIDINE SUTAB200MG 3 QUINIDINE SUTAB300MG 3 QUINIDINE SUTAB300MG ER 3 RYTHMOL TAB150MG 5 RYTHMOL TAB225MG 5 RYTHMOL SR CAP225MG 5 RYTHMOL SR CAP325MG 5 RYTHMOL SR CAP425MG 5 SORINE TAB120MG 2 SORINE TAB160MG 2 SORINE TAB240MG 2 SORINE TAB80MG 2 SOTALOL AF TAB120MG 2 SOTALOL HCL TAB160MG 2 SOTALOL HCL TAB240MG 2 SOTALOL HCL TAB80MG 2 TAMBOCOR TAB100MG 5 TAMBOCOR TAB150MG 5

33


TAMBOCOR TAB50MG 5 TIKOSYN CAP125MCG 4 TIKOSYN CAP250MCG 4 TIKOSYN CAP500MCG 4

Beta-adrenergic Blocking Agents ACEBUTOLOL CAP200MG 3 ACEBUTOLOL CAP400MG 3 ATENOLOL TAB100MG 2 ATENOLOL TAB25MG 2 ATENOLOL TAB50MG 2 BETAXOLOL TAB10MG 2 BETAXOLOL TAB20MG 2 BISOPROL FUMTAB10MG 2 BISOPROL FUMTAB5MG 2 BYSTOLIC TAB10MG 5 BYSTOLIC TAB2.5MG 5 BYSTOLIC TAB20MG 5 BYSTOLIC TAB5MG 5 CARVEDILOL TAB12.5MG 2 QL CARVEDILOL TAB25MG 2 QL CARVEDILOL TAB3.125MG 2 QL CARVEDILOL TAB6.25MG 2 QL COREG TAB12.5MG 5 COREG TAB25MG 5 COREG TAB3.125MG 5 COREG TAB6.25MG 5 COREG CR CAP10MG 5 QL COREG CR CAP20MG 5 COREG CR CAP20MG 5 QL COREG CR CAP40MG 5 QL COREG CR CAP40MG 5 COREG CR CAP80MG 5 QL COREG CR CAP80MG 5 CORGARD TAB20MG 5 CORGARD TAB40MG 5 CORGARD TAB80MG 5 INDERAL LA CAP120MG 5 INDERAL LA CAP160MG 5 INDERAL LA CAP60MG 5 INDERAL LA CAP80MG 5 INNOPRAN XL CAP120MG 5 INNOPRAN XL CAP80MG 5 LABETALOL TAB100MG 2 LABETALOL TAB200MG 2 LABETALOL TAB300MG 2 LEVATOL TAB20MG 5 LOPRESSOR TAB100MG 5 LOPRESSOR TAB50MG 5


METOPROL TARTAB100MG 2 METOPROL TARTAB25MG 2 METOPROL TARTAB50MG 2 METOPROLOL TAB100MG ER 2 QL METOPROLOL TAB200MG ER 2 QL METOPROLOL TAB25MG ER 2 QL METOPROLOL TAB50MG ER 2 QL NADOLOL TAB20MG 2 NADOLOL TAB40MG 2 NADOLOL TAB80MG 2 PINDOLOL TAB10MG 2 PINDOLOL TAB5MG 2 PROPRANOLOL CAP120MG CR 2 PROPRANOLOL CAP120MG ER 2 PROPRANOLOL CAP160MG ER 2 PROPRANOLOL CAP160MG ER 2 PROPRANOLOL CAP60MG ER 2 PROPRANOLOL CAP60MG ER 2 PROPRANOLOL CAP80MG ER 2 PROPRANOLOL CAP80MG ER 2 PROPRANOLOL SOL20MG/5ML 2 PROPRANOLOL SOL40MG/5ML 2 PROPRANOLOL TAB10MG 2 PROPRANOLOL TAB20MG 2 PROPRANOLOL TAB40MG 2 PROPRANOLOL TAB60MG 2 PROPRANOLOL TAB80MG 2 SECTRAL CAP200MG 5 SECTRAL CAP400MG 5 TENORMIN TAB100MG 5 TENORMIN TAB25MG 5 TENORMIN TAB50MG 5 TOPROL XL TAB100MG 5 TOPROL XL TAB200MG 5 TOPROL XL TAB25MG 5 TOPROL XL TAB50MG 5 TRANDATE TAB100MG 5 TRANDATE TAB200MG 5 ZEBETA TAB10MG 5 ZEBETA TAB5MG 5

Calcium Channel Blocking Agents ADALAT CC TAB30MG ER 5 ADALAT CC TAB60MG ER 5 ADALAT CC TAB90MG ER 5 AFEDITAB TAB30MG CR 2 AFEDITAB TAB60MG CR 2 AMLODIPINE TAB10MG 2 QL AMLODIPINE TAB2.5MG 2 QL

34


AMLODIPINE TAB5MG 2 QL CALAN TAB120MG 5 CALAN TAB80MG 5 CALAN SR TAB120MG 5 CALAN SR TAB180MG 5 CALAN SR TAB240MG 5 CAPTOPRIL TAB50MG 2 CARDIZEM TAB120MG 5 CARDIZEM TAB30MG 5 CARDIZEM TAB60MG 5 CARDIZEM TAB90MG 5 CARDIZEM CD CAP120MG/24 5 CARDIZEM CD CAP180MG/24 5 CARDIZEM CD CAP240MG/24 5 CARDIZEM CD CAP300MG/24 5 CARDIZEM CD CAP360MG/24 5 CARDIZEM LA TAB120MG 5 CARDIZEM LA TAB180MG 5 CARDIZEM LA TAB240MG 5 CARDIZEM LA TAB300MG/24 5 CARDIZEM LA TAB360MG 5 CARDIZEM LA TAB420MG/24 5 CARTIA XT CAP120/24HR 2 CARTIA XT CAP180/24HR 2 CARTIA XT CAP240/24HR 2 CARTIA XT CAP300/24HR 2 COVERA-HS TAB180MG 5 COVERA-HS TAB240MG 5 DILACOR XR CAP240MG/24 5 DILT-CD CAP300MG 2 DILTIA XT CAP120MG/24 2 DILTIA XT CAP180MG/24 2 DILTIA XT CAP240MG/24 2 DILTIAZEM CAP120MG CD 2 DILTIAZEM CAP120MG ER 2 DILTIAZEM CAP120MG ER 2 DILTIAZEM CAP180MG/24 2 DILTIAZEM CAP240MG CD 2 DILTIAZEM CAP300MG ER 2 DILTIAZEM CAP360MG/24 2 DILTIAZEM CAP420MG/24 2 DILTIAZEM CAP60MG ER 2 DILTIAZEM CAP90MG ER 2 DILTIAZEM TAB120MG 2 DILTIAZEM TAB30MG 2 DILTIAZEM TAB60MG 2 DILTIAZEM TAB90MG 2 DILTIAZEM XRCAP120MG/24 2


DILT-XR CAP120MG 2 DILT-XR CAP180MG 2 DILT-XR CAP240MG 2 DILTZAC CAP120MG/24 2 DILTZAC CAP180MG/24 2 DILTZAC CAP240MG/24 2 DILTZAC CAP300MG/24 2 DYNACIRC CR TAB5MG 4 FELODIPINE TAB10MG ER 3 FELODIPINE TAB2.5MG ER 3 FELODIPINE TAB5MG ER 3 ISRADIPINE CAP2.5MG 2 ISRADIPINE CAP5MG 2 MATZIM LA TAB180MG/24 2 MATZIM LA TAB240MG/24 2 MATZIM LA TAB300MG/24 2 MATZIM LA TAB360MG/24 2 MATZIM LA TAB420MG/24 2 NICARDIPINE CAP20MG 3 NICARDIPINE CAP30MG 3 NIFEDIAC CC TAB90MG ER 2 NIFEDICAL XLTAB30MG 2 NIFEDICAL XLTAB60MG 2 NIFEDIPINE CAP10MG 3 NIFEDIPINE CAP20MG 3 NIFEDIPINE TAB30MG ER 2 NIFEDIPINE TAB60MG ER 2 NIFEDIPINE TAB60MG ER 2 NIFEDIPINE TAB90MG ER 2 NIMODIPINE CAP30MG 3 NISOLDIPINE TAB17MG ER 3 NISOLDIPINE TAB20MG 3 NISOLDIPINE TAB25.5MG 3 NISOLDIPINE TAB30MG 3 NISOLDIPINE TAB34MG ER 3 NISOLDIPINE TAB40MG 3 NISOLDIPINE TAB8.5MG ER 3 NORVASC TAB10MG 5 NORVASC TAB2.5MG 5 NORVASC TAB5MG 5 PROCARDIA CAP10MG 5 PROCARDIA XLTAB30MG CR 5 PROCARDIA XLTAB60MG CR 5 PROCARDIA XLTAB90MG CR 5 SULAR TAB17MG 5 SULAR TAB34MG 5 SULAR TAB8.5MG 5 TAZTIA XT CAP120MG/24 2

35


TAZTIA XT CAP180MG/24 2 TAZTIA XT CAP240MG/24 2 TAZTIA XT CAP300MG/24 2 TAZTIA XT CAP360MG/24 2 TIAZAC CAP120MG/24 5 TIAZAC CAP180MG/24 5 TIAZAC CAP240MG/24 5 TIAZAC CAP300MG/24 5 TIAZAC CAP360MG/24 5 TIAZAC CAP420MG/24 5 VERAPAMIL CAP100MG ER 2 VERAPAMIL CAP120MG ER 2 VERAPAMIL CAP180MG ER 2 VERAPAMIL CAP200MG ER 2 VERAPAMIL CAP240MG ER 2 VERAPAMIL CAP300MG ER 2 VERAPAMIL CAP360MG SR 2 VERAPAMIL TAB120MG 2 VERAPAMIL TAB120MG ER 2 VERAPAMIL TAB180MG ER 2 VERAPAMIL TAB240MG ER 2 VERAPAMIL TAB40MG 2 VERAPAMIL TAB80MG 2 VERELAN CAP120MG SR 5 VERELAN CAP180MG SR 5 VERELAN CAP240MG SR 5 VERELAN CAP360MG SR 5 VERELAN PM CAP100MG ER 5 VERELAN PM CAP200MG ER 5 VERELAN PM CAP300MG ER 5

Cardiovascular Agents, Other DIGOX TAB0.125MG 2 DIGOX TAB0.25MG 2 DIGOXIN SOL50MCG/ML 5 DIGOXIN TAB0.125MG 2 DIGOXIN TAB0.25MG 2 LANOXIN TAB0.0625MG 5 LANOXIN TAB0.125MG 5 LANOXIN TAB0.1875MG 5 LANOXIN TAB0.25MG 5 NORTHERA CAP100MG 6 PA QL NORTHERA CAP200MG 6 PA QL NORTHERA CAP300MG 6 PA QL PENTOXIFYLLITAB400MG ER 2 PENTOXIL TAB400MG CR 2 RANEXA TAB1000MG 4 QL RANEXA TAB500MG 4 QL TEKTURNA TAB150MG 5 QL


TEKTURNA TAB300MG 5 QL TRENTAL TAB400MG CR 5

Diuretics, Carbonic Anhydrase Inhibitors ACETAZOLAMIDCAP500MG ER 3 ACETAZOLAMIDTAB125MG 3 ACETAZOLAMIDTAB250MG 3 DIAMOX SEQUECAP500MG CR 5 METHAZOLAMIDTAB25MG 2 METHAZOLAMIDTAB50MG 2

Diuretics, Loop BUMETANIDE TAB0.5MG 2 BUMETANIDE TAB1MG 2 BUMETANIDE TAB2MG 2 DEMADEX TAB100MG 5 DEMADEX TAB10MG 5 DEMADEX TAB20MG 5 DEMADEX TAB5MG 5 EDECRIN TAB25MG 5 FUROSEMIDE SOL10MG/ML 2 FUROSEMIDE SOL8MG/ML 2 FUROSEMIDE TAB20MG 2 FUROSEMIDE TAB40MG 2 FUROSEMIDE TAB80MG 2 LASIX TAB20MG 5 LASIX TAB40MG 5 LASIX TAB80MG 5 TORSEMIDE TAB100MG 2 TORSEMIDE TAB10MG 2 TORSEMIDE TAB20MG 2 TORSEMIDE TAB5MG 2

Diuretics, Potassium-sparing ALDACTONE TAB100MG 5 ALDACTONE TAB25MG 5 ALDACTONE TAB50MG 5 AMILORIDE TAB5MG 2 DYRENIUM CAP100MG 5 DYRENIUM CAP50MG 5 EPLERENONE TAB25MG 3 EPLERENONE TAB50MG 3 INSPRA TAB25MG 5 INSPRA TAB50MG 5 SPIRONOLACT TAB100MG 2 SPIRONOLACT TAB25MG 2 SPIRONOLACT TAB50MG 2

Diuretics, Thiazide CHLOROTHIAZ TAB250MG 2 CHLOROTHIAZ TAB500MG 2

36


CHLORTHALID TAB100MG 2 CHLORTHALID TAB25MG 2 CHLORTHALID TAB50MG 2 DIURIL SUS250/5ML 5 HYDROCHLOROTCAP12.5MG 2 HYDROCHLOROTTAB12.5MG 2 HYDROCHLOROTTAB25MG 2 HYDROCHLOROTTAB50MG 3 INDAPAMIDE TAB1.25MG 2 INDAPAMIDE TAB2.5MG 2 METHYCLOTHIATAB5MG 3 METOLAZONE TAB10MG 2 METOLAZONE TAB2.5MG 2 METOLAZONE TAB5MG 2 MICROZIDE CAP12.5MG 5 THALITONE TAB15MG 5

Dyslipidemics, Fibric Acid Derivatives ANTARA CAP130MG 5 ANTARA CAP30MG 5 ANTARA CAP43MG 5 ANTARA CAP90MG 5 FENOFIBRATE CAP130MG 2 FENOFIBRATE CAP134MG 2 QL FENOFIBRATE CAP150MG 5 FENOFIBRATE CAP200MG 2 QL FENOFIBRATE CAP43MG 2 FENOFIBRATE CAP50MG 5 FENOFIBRATE CAP67MG 2 QL FENOFIBRATE TAB145MG 2 QL FENOFIBRATE TAB160MG 2 QL FENOFIBRATE TAB48MG 2 QL FENOFIBRATE TAB54MG 2 QL FENOFIBRIC TAB105MG 5 FENOFIBRIC TAB35MG 5 FENOGLIDE TAB120MG 5 FENOGLIDE TAB40MG 5 FIBRICOR TAB105MG 5 FIBRICOR TAB35MG 5 GEMFIBROZIL TAB600MG 2 LIPOFEN CAP150MG 5 LIPOFEN CAP50MG 5 LOFIBRA CAP134MG 5 LOFIBRA CAP200MG 5 LOFIBRA CAP67MG 5 LOFIBRA TAB160MG 5 LOFIBRA TAB54MG 5 LOPID TAB600MG 5 TRICOR TAB145MG 5 QL


TRICOR TAB48MG 5 QL TRIGLIDE TAB160MG 5 TRILIPIX CAP135MG 5 QL TRILIPIX CAP45MG 5 QL

Dyslipidemics, HMG CoA Reductase Inhibitors ALTOPREV TAB20MG ER 5 QL ALTOPREV TAB40MG ER 5 QL ALTOPREV TAB60MG ER 5 QL ATORVASTATINTAB10MG 2 QL ATORVASTATINTAB20MG 2 QL ATORVASTATINTAB40MG 2 QL ATORVASTATINTAB80MG 2 QL CRESTOR TAB10MG 5 QL CRESTOR TAB20MG 5 QL CRESTOR TAB40MG 5 QL CRESTOR TAB5MG 5 QL FLUVASTATIN CAP20MG 2 QL FLUVASTATIN CAP40MG 2 QL LESCOL CAP20MG 5 QL LESCOL CAP40MG 5 QL LESCOL XL TAB80MG 5 QL LIPITOR TAB10MG 5 QL LIPITOR TAB20MG 5 QL LIPITOR TAB40MG 5 QL LIPITOR TAB80MG 5 QL LIVALO TAB1MG 5 LIVALO TAB2MG 5 LIVALO TAB4MG 5 LOVASTATIN TAB10MG 2 QL LOVASTATIN TAB20MG 2 QL LOVASTATIN TAB40MG 2 QL MEVACOR TAB20MG 5 MEVACOR TAB40MG 5 PRAVACHOL TAB20MG 5 QL PRAVACHOL TAB40MG 5 QL PRAVACHOL TAB80MG 5 QL PRAVASTATIN TAB10MG 2 QL PRAVASTATIN TAB20MG 2 QL PRAVASTATIN TAB40MG 2 QL PRAVASTATIN TAB80MG 2 QL SIMVASTATIN TAB10MG 2 QL SIMVASTATIN TAB20MG 2 QL SIMVASTATIN TAB40MG 2 QL SIMVASTATIN TAB5MG 2 QL SIMVASTATIN TAB80MG 2 QL ZOCOR TAB10MG 5 QL

37


ZOCOR TAB20MG 5 QL ZOCOR TAB40MG 5 QL ZOCOR TAB5MG 5 QL ZOCOR TAB80MG 5 QL

Dyslipidemics, Other CHOLESTYRAM POW4GM LITE 2 COLESTID GRA5GM 5 COLESTID TAB1GM 5 COLESTIPOL GRA5GM 3 COLESTIPOL TAB1GM 3 JUXTAPID CAP10MG 6 PA QL JUXTAPID CAP20MG 6 PA QL JUXTAPID CAP5MG 6 PA QL LOVAZA CAP1GM 5 NIACOR TAB500MG 2 NIASPAN TAB1000 ER 5 QL NIASPAN TAB500MG ER 5 QL NIASPAN TAB750MG ER 5 QL PREVALITE POW4GM 2 QUESTRAN POW4GM 2 VASCEPA CAP1GM 5 ZETIA TAB10MG 4 QL

Vasodilators, Direct-acting Arterial HYDRALAZINE TAB100MG 2 HYDRALAZINE TAB10MG 2 HYDRALAZINE TAB25MG 2 HYDRALAZINE TAB50MG 2 MINOXIDIL TAB10MG 2 MINOXIDIL TAB2.5MG 2 RECTIV OIN0.4% 5

Vasodilators, Direct-acting Arterial/Venous DILATRATE SRCAP40MG 5

IMDUR TAB60MG ER 2

ISOCHRON TAB40MG CR 2

ISODITRATE TAB40MG ER 2

ISORDIL TAB40MG 5

ISORDIL TAB5MG 5

ISOSORB DIN SUB2.5MG 2

ISOSORB DIN SUB5MG 2

ISOSORB DIN TAB10MG 2



ISOSORB DIN TAB40MG ER 2


ISOSORB MONOTAB10MG 2

ISOSORB MONOTAB120MG ER 2

ISOSORB MONOTAB20MG 2




MINITRAN DIS0.1MG/HR 2




MONOKET TAB10MG 5

MONOKET TAB20MG 5

NITRO-BID OIN2% 2

NITRO-BID OIN2% 2

NITRO-DUR DIS0.1MG/HR 5






NITROGLYCER DIS0.1MG/HR 2 QL NITROGLYCER DIS0.2MG/HR 2 QL NITROGLYCER DIS0.4MG/HR 2 QL NITROGLYCERIDIS0.6MG/HR 2 QL NITROGLYCRN SPR0.4MG 2

NITROLINGUALSPRPUMPSPRA 5

NITROMIST AER400MCG 5

NITROSTAT SUB0.3MG 5



Central Nervous System Agents

Attention Deficit Hyperactivity Disorder Agents, Amphetamines ADDERALL TAB10MG 5 ADDERALL TAB10MG 3 ADDERALL TAB12.5MG 5 ADDERALL TAB15MG 5 ADDERALL TAB20MG 3 ADDERALL TAB30MG 3 ADDERALL TAB5MG 3 ADDERALL XR CAP10MG 5 QL ADDERALL XR CAP15MG 5 QL ADDERALL XR CAP20MG 5 QL ADDERALL XR CAP25MG 5 QL ADDERALL XR CAP30MG 5 QL ADDERALL XR CAP5MG 5 QL AMPHETAMINE CAP10MG ER 3 AMPHETAMINE CAP15MG ER 3 AMPHETAMINE CAP20MG ER 3 AMPHETAMINE CAP25MG ER 3 AMPHETAMINE CAP30MG ER 3

38


AMPHETAMINE CAP5MG ER 3 AMPHETAMINE TAB10MG 3 QL AMPHETAMINE TAB12.5MG 3 QL AMPHETAMINE TAB15MG 3 QL AMPHETAMINE TAB20MG 3 QL AMPHETAMINE TAB30MG 3 QL AMPHETAMINE TAB5MG 3 QL AMPHETAMINE TAB7.5MG 3 QL DESOXYN TAB5MG 5 DEXEDRINE CAP10MG CR 5 DEXEDRINE CAP15MG CR 5 DEXEDRINE CAP5MG CR 5 DEXEDRINE TAB10MG 3 DEXTROAMPHETCAP10MG ER 2 QL DEXTROAMPHETCAP15MG ER 2 QL DEXTROAMPHETCAP5MG ER 2 QL DEXTROAMPHETTAB10MG 3 QL DEXTROAMPHETTAB5MG 3 QL METHAMPHETAMTAB5MG 2 VYVANSE CAP20MG 4 VYVANSE CAP30MG 4 VYVANSE CAP40MG 4 VYVANSE CAP50MG 4 VYVANSE CAP60MG 4 VYVANSE CAP70MG 4 ZENZEDI TAB10MG 3 QL ZENZEDI TAB15MG 3 ZENZEDI TAB15MG 3 ZENZEDI TAB2.5MG 3 ZENZEDI TAB20MG 3 ZENZEDI TAB30MG 3 ZENZEDI TAB5MG 3 QL ZENZEDI TAB7.5MG 3

Attention Deficit Hyperactivity Disorder Agents, Non-amphetamines CONCERTA TAB18MG 5 QL CONCERTA TAB27MG 5 QL CONCERTA TAB36MG 5 QL CONCERTA TAB54MG 5 QL DAYTRANA DIS10MG/9HR 5 DAYTRANA DIS15MG/9HR 5 DAYTRANA DIS20MG/9HR 5 DAYTRANA DIS30MG/9HR 5 DEXMETHYLPH CAP15MG ER 3 DEXMETHYLPH CAP30MG ER 3 DEXMETHYLPH CAP40MG ER 3 DEXMETHYLPH TAB10MG 3 QL


DEXMETHYLPH TAB2.5MG 3 QL DEXMETHYLPH TAB5MG 3 QL FOCALIN TAB10MG 5 FOCALIN TAB2.5MG 5 FOCALIN TAB5MG 5 FOCALIN XR CAP10MG 4 QL FOCALIN XR CAP15MG 5 QL FOCALIN XR CAP20MG 4 QL FOCALIN XR CAP25MG 4 FOCALIN XR CAP30MG 5 QL FOCALIN XR CAP35MG 4 FOCALIN XR CAP40MG 5 QL FOCALIN XR CAP5MG 4 QL GUANFACINE TAB1MG ER 3 GUANFACINE TAB2MG ER 3 GUANFACINE TAB3MG ER 3 GUANFACINE TAB4MG ER 3 INTUNIV TAB1MG 5 QL INTUNIV TAB2MG 5 QL INTUNIV TAB3MG 5 QL INTUNIV TAB4MG 5 QL METADATE TAB20MG ER 3 QL METADATE CD CAP10MG 5 QL METADATE CD CAP20MG 5 QL METADATE CD CAP30MG 5 QL METADATE CD CAP40MG 5 QL METADATE CD CAP50MG 5 QL METADATE CD CAP60MG 5 QL METHYLIN CHW10MG 5 METHYLIN CHW10MG 5 METHYLIN CHW2.5MG 5 METHYLIN CHW2.5MG 5 METHYLIN CHW5MG 5 METHYLIN CHW5MG 5 METHYLIN SOL10MG/5ML 5 METHYLIN SOL5MG/5ML 5 METHYLPHENIDCAP10MG 3 METHYLPHENIDCAP20MG ER 3 METHYLPHENIDCAP30MG ER 3 QL METHYLPHENIDCAP40MG ER 3 QL METHYLPHENIDCAP50MG 3 METHYLPHENIDCAP60MG 3 METHYLPHENIDSOL10MG/5ML 3 METHYLPHENIDSOL5MG/5ML 3 METHYLPHENIDTAB10MG 3 QL METHYLPHENIDTAB10MG 3 METHYLPHENIDTAB10MG ER 3 QL METHYLPHENIDTAB18MG ER 3

39


METHYLPHENIDTAB20MG 3 METHYLPHENIDTAB20MG 3 QL METHYLPHENIDTAB20MG ER 3 METHYLPHENIDTAB20MG ER 3 QL METHYLPHENIDTAB27MG ER 3 METHYLPHENIDTAB36MG ER 3 METHYLPHENIDTAB54MG ER 3 METHYLPHENIDTAB5MG 3 METHYLPHENIDTAB5MG 3 QL QUILLIVANT SUSXR 5 RITALIN TAB10MG 5 RITALIN TAB20MG 5 RITALIN TAB20MG SR 5 RITALIN TAB5MG 5 RITALIN LA CAP10MG 5 QL RITALIN LA CAP20MG 5 QL RITALIN LA CAP30MG 5 QL RITALIN LA CAP40MG 5 QL STRATTERA CAP100MG 4 QL STRATTERA CAP10MG 4 QL STRATTERA CAP18MG 4 QL STRATTERA CAP25MG 4 QL STRATTERA CAP40MG 4 QL STRATTERA CAP40MG 4 STRATTERA CAP60MG 4 QL STRATTERA CAP60MG 4 STRATTERA CAP80MG 4 STRATTERA CAP80MG 4 QL

Central Nervous System Agents, Other HORIZANT TAB300MG 5 HORIZANT TAB600MG 5 NUEDEXTA CAP20-10MG 5 QL TENCON TAB50-325MG 2 XENAZINE TAB12.5MG 6 PA QL XENAZINE TAB25MG 6 PA QL ZEBUTAL CAP 2

Fibromyalgia Agents SAVELLA MISTITR PAK 4 QL SAVELLA TAB100MG 4 QL ST SAVELLA TAB12.5MG 4 QL ST SAVELLA TAB25MG 4 QL ST SAVELLA TAB50MG 4 QL ST

Multiple Sclerosis Agents AMPYRA TAB10MG 6 PA AUBAGIO TAB14MG 6 PA AUBAGIO TAB7MG 6 PA AVONEX KIT30MCG 6 PA QL


AVONEX PREFLKIT30MCG 6 PA QL BETASERON INJ0.3MG 6 PA QL COPAXONE INJ20MG/ML 6 PA QL COPAXONE INJ40MG/ML 6 PA QL EXTAVIA INJ0.3MG 6 PA QL GILENYA CAP0.5MG 6 PA QL REBIF INJ22/0.5 6 PA QL REBIF INJ44/0.5 6 PA QL REBIF TITRTNSOLPACK 6 PA QL TECFIDERA CAP120MG 6 PA TECFIDERA CAP240MG 6 PA TECFIDERA MISSTARTER 6 PA

Dental and Oral Agents APHTHASOL PST5% 5

CEVIMELINE CAP30MG 3

CHLORHEX GLUSOL0.12% 2

EVOXAC CAP30MG 5

PAROEX SOL0.12% 2

PAROEX SOL0.12% 2

PERIOGARD SOL0.12% 2

PILOCARPINE TAB5MG 2

PILOCARPINE TAB7.5MG 2

SALAGEN TAB5MG 5

SALAGEN TAB7.5MG 5

TRIAMCIN/ORAPST0.1% 2

Dermatological Agents 8-MOP CAP10MG 6

ABSORICA CAP10MG 5

ABSORICA CAP20MG 5

ABSORICA CAP25MG 5

ABSORICA CAP30MG 5

ABSORICA CAP35MG 5

ABSORICA CAP40MG 5

ACANYA GEL1.2-2.5% 5

ADAPALENE CRE0.1% 3

ADAPALENE GEL0.1% 3

ADAPALENE GEL0.3% 3

ALDARA CRE5% 5

AMMONIUM LACCRE12% 3

AMMONIUM LACLOT12% 3

AMNESTEEM CAP10MG 3

AMNESTEEM CAP20MG 3

AMNESTEEM CAP40MG 3

ATRALIN GEL0.05% 5

AVITA CRE0.025% 5

AVITA GEL0.025% 5

AZELEX CRE20% 5

40


CALCIPOTRIENCRE0.005% 3 QL CALCIPOTRIENOINBETAMETH 3

CALCIPOTRIENSOL0.005% 3 QL CALCITRIOL OIN3MCG/GM 4

CARAC CRE0.5% 5

CLARAVIS CAP10MG 3

CLARAVIS CAP20MG 3

CLARAVIS CAP20MG 3

CLARAVIS CAP30MG 3

CLARAVIS CAP30MG 3

CLARAVIS CAP40MG 3

CLARAVIS CAP40MG 3

CLINDAMY/BENGEL1-5% 3

CLOTRIM/BETACREDIPROP 2

CLOTRIM/BETALOTDIPROP 2

CONDYLOX GEL0.5% 5

CONDYLOX SOL0.5% 5

CORTISPORIN CRE0.5% 5

CORTISPORIN OIN1% 5

DERMATOP CRE0.1% 5

DERMATOP OIN0.1% 5

DICLOFENAC SOL1.5% 3

DIFFERIN CRE0.1% 5

DIFFERIN GEL0.1% 5

DIFFERIN GEL0.3% 5

DIFFERIN LOT0.1% 5

DOVONEX CRE0.005% 5 QL DOVONX SCALPSOL0.005% 5

EFUDEX CRE5% 5

EFUDEX SOL5% 5

EFUDEX SOL5% 5

ELIDEL CRE1% 5 QL EPIDUO GEL0.1-2.5% 5

ERYTHROMYCINGEL/BENZOYL 3

FABIOR AER0.1% 5

FINACEA GEL15% 5

FLUOROPLEX CRE1% 4

FLUOROURACILCRE5% 3

FLUOROURACILSOL2% 3

FLUOROURACILSOL5% 3

IMIQUIMOD CRE5% 3

LAC-HYDRIN CRE12% 5

LAC-HYDRIN LOT12% 5

LACLOTION LOT12% 3

LOTRISONE CRE 5 ST LOTRISONE LOT 5 ST MYORISAN CAP10MG 3

MYORISAN CAP20MG 3


MYORISAN CAP40MG 3

NYSTAT/TRIAMCRE 3

NYSTAT/TRIAMOIN 3

OXSORALEN LOT1% 6

OXSORALEN-ULCAP10MG 6

PENNSAID SOL2% 5

PHISOHEX LIQ3% 5

PICATO GEL0.015% 4

PICATO GEL0.05% 4

PODOFILOX SOL0.5% 3

PREDNICARBATCRE0.1% 2

PREDNICARBATOIN0.1% 2

PROTOPIC OIN0.03% 5 QL PROTOPIC OIN0.1% 5 QL PRUDOXIN CRE5% 5

REFISSA CRE0.05% 3

REGRANEX GEL0.01% 4

RETIN-A CRE0.025% 5

RETIN-A CRE0.05% 5

RETIN-A CRE0.1% 5

RETIN-A GEL0.01% 5

RETIN-A GEL0.025% 5

RETIN-A MICRGEL0.04% 5



SANTYL OIN250/GM 5

SANTYL OIN250/GM 5 QL SELENIUM SULLOT2.5% 2

SELENIUM SULSHA2.25% 2

SOLARAZE GEL3% W/W 5 QL SORIATANE CAP10MG 6 QL SORIATANE CAP17.5MG 6 QL SORIATANE CAP25MG 6 QL SOTRET CAP10MG 3

SOTRET CAP20MG 3

SOTRET CAP40MG 3

STELARA INJ45MG/0.5 6 PA STELARA INJ90MG/ML 6 PA STELARA INJ90MG/ML 6 PA TACLONEX OIN 5

TACLONEX SUS 5

TACROLIMUS OIN0.03% 3

TACROLIMUS OIN0.1% 3

TAZORAC CRE0.05% 5

TAZORAC CRE0.1% 5

TAZORAC GEL0.05% 5

TAZORAC GEL0.1% 5

TRETINOIN CRE0.025% 3 QL

41


TRETINOIN CRE0.05% 3 QL TRETINOIN CRE0.1% 3 QL TRETINOIN GEL0.01% 3 QL TRETINOIN GEL0.025% 3 QL TRETINOIN GEL0.1% 3

TRETIN-X CRE0.0375% 3

TRETIN-X CREKIT0.025% 3



TRETIN-X GELKIT0.01% 3

TRETIN-X GELKIT0.025% 3

VECTICAL OIN3MCG/GM 4

VELTIN GEL 5

VEREGEN OIN15% 5

VOLTAREN GEL1% 5 QL ZENATANE CAP10MG 3

ZENATANE CAP10MG 3

ZENATANE CAP20MG 3

ZENATANE CAP40MG 3

ZIANA GEL 5

ZONALON CRE5% 5

ZYCLARA CRE3.75% 5

ZYCLARA PUMPCRE2.5% 5

Enzyme Replacement/ Modifiers BUPHENYL POW 5

BUPHENYL TAB500MG 5

BUPHENYL TAB500MG 5

CARBAGLU TAB200MG 6 PA CERDELGA CAP84MG 6 PA CREON CAP12000UNT 4

CREON CAP24000UNT 4

CREON CAP3000UNIT 4

CREON CAP36000UNT 4

CREON CAP6000UNIT 4

CYSTADANE POW 4

KUVAN TAB100MG 6 PA KUVAN TAB100MG 6 PA ORFADIN CAP10MG 6

ORFADIN CAP2MG 6

ORFADIN CAP5MG 6

PANCREAZE CAP10500UNT 5



PANCREAZE CAP4200UNIT 5

PANCRELIPASECAP5000UNIT 5

PERTZYE CAP 4

PERTZYE CAP 4

PERTZYE CAP 4


RAVICTI LIQ1.1GM/ML 6 PA QL ULTRESA CAP13800UNT 5

ULTRESA CAP20700UNT 5

ULTRESA CAP23000UNT 5

ZAVESCA CAP100MG 6 PA ZENPEP CAP10000UNT 5

ZENPEP CAP15000UNT 5



ZENPEP CAP3000UNIT 5


ZENPEP CAP5000UNIT 5

Gastrointestinal Agents Antispasmodics, Gastrointestinal BENTYL CAP10MG 5 BENTYL TAB20MG 5 CANTIL TAB25MG 5 CUVPOSA SOL1MG/5ML 5 DICYCLOMINE CAP10MG 2 DICYCLOMINE SOL10MG/5ML 2 DICYCLOMINE TAB20MG 2 GLYCATE TAB1.5MG 3 GLYCOPYRROL TAB1MG 3 GLYCOPYRROL TAB2MG 3 METHSCOPOLAMTAB2.5MG 3 METHSCOPOLAMTAB5MG 3 PAMINE TAB2.5MG 5 PAMINE FORTETAB5MG 5 ROBINUL TAB1MG 5 ROBINUL FORTTAB2MG 5

Gastrointestinal Agents, Other ACTIGALL CAP300MG 5 DIPHEN/ATROPLIQ2.5/5 2 DIPHEN/ATROPTAB2.5MG 2 FULYZAQ TAB125MG 5 PA LOMOTIL TAB2.5MG 5 MOTOFEN TAB 5 RELISTOR KIT12/0.6ML 5 URSO 250 TAB250MG 5 URSO FORTE TAB500MG 5 URSODIOL CAP300MG 3 URSODIOL TAB250MG 3 URSODIOL TAB500MG 3

Histamine2 (H2) Receptor Antagonists CIMETIDINE SOL300/5ML 3 FAMOTIDINE SUS40MG/5ML 3 NIZATIDINE SOL15MG/ML 3

42


RANITIDINE SYP15MG/ML 3

Irritable Bowel Syndrome Agents AMITIZA CAP24MCG 4 QL AMITIZA CAP8MCG 4 QL AMITIZA CAP8MCG 4 LINZESS CAP145MCG 5 LINZESS CAP290MCG 5 LOTRONEX TAB0.5MG 5 QL LOTRONEX TAB1MG 5 QL

Laxatives CONSTULOSE SOL10GM/15 2 ENULOSE SOL10GM/15 2 GENERLAC SOL10GM/15 2 KRISTALOSE PAK10GM 2 KRISTALOSE PAK20GM 2 LACTULOSE SOL10GM/15 2 MOVIPREP SOL 5 PREPOPIK PAK 5 SUPREP BOWELSOLPREP 5

Protectants CARAFATE SUS1GM/10ML 5 CARAFATE TAB1GM 5 CYTOTEC TAB100MCG 5 CYTOTEC TAB200MCG 5 MISOPROSTOL TAB100MCG 3 MISOPROSTOL TAB200MCG 3 SUCRALFATE SUS1GM/10ML 5 SUCRALFATE TAB1GM 2

Proton Pump Inhibitors ACIPHEX TAB20MG 5 QL ST ACIPHEX SPR CAP10MG 5 ST ACIPHEX SPR CAP5MG 5 ST DEXILANT CAP30MG DR 5 QL ST DEXILANT CAP60MG DR 5 QL ST LANSOPRAZOLECAP30MG DR 3 QL NEXIUM CAP20MG 5 QL ST NEXIUM CAP20MG 5 QL ST NEXIUM CAP40MG 5 QL ST NEXIUM GRA10MG DR 5 QL ST NEXIUM GRA2.5MG DR 5 ST NEXIUM GRA20MG DR 5 QL ST NEXIUM GRA40MG DR 5 QL ST NEXIUM GRA5MG DR 5 ST OMEPRAZOLE CAP10MG 2 QL OMEPRAZOLE CAP40MG 2 QL PANTOPRAZOLETAB20MG 2 QL PANTOPRAZOLETAB40MG 2 QL


PREVACID CAP30MG DR 5 ST PREVACID TAB15MG STB 5 QL ST PREVACID TAB30MG STB 5 QL ST PRILOSEC CAP10MG 5 QL ST PRILOSEC CAP20MG 5 QL ST PRILOSEC CAP40MG 5 ST PROTONIX PAK 5 ST PROTONIX TAB20MG 5 QL ST PROTONIX TAB40MG 5 ST RABEPRAZOLE TAB20MG 2 QL

Genitourinary Agents Antispasmodics, Urinary DETROL TAB1MG 5 QL DETROL TAB2MG 5 QL DETROL LA CAP2MG 5 QL DETROL LA CAP4MG 5 QL DITROPAN XL TAB10MG 5 DITROPAN XL TAB15MG 5 DITROPAN XL TAB5MG 5 QL ENABLEX TAB15MG 5 QL ENABLEX TAB7.5MG 5 QL FLAVOXATE TAB100MG 2 GELNIQUE GEL10% 5 QL GELNIQUE GEL3% 5 OXYBUTYNIN SYP5MG/5ML 3 QL OXYBUTYNIN TAB10MG ER 3 QL OXYBUTYNIN TAB15MG ER 3 QL OXYBUTYNIN TAB5MG 3 QL OXYBUTYNIN TAB5MG ER 3 QL OXYTROL DIS3.9MG/24 5 QL SANCTURA XR CAP60MG 5 TOLTERODINE CAP2MG ER 3 QL TOLTERODINE CAP4MG ER 3 QL TOLTERODINE TAB1MG 3 QL TOLTERODINE TAB2MG 3 QL TOVIAZ TAB4MG 5 QL TOVIAZ TAB8MG 5 QL TROSPIUM CHLCAP60MG ER 3 VESICARE TAB10MG 4 QL VESICARE TAB5MG 4 QL

Benign Prostatic Hypertrophy Agents ALFUZOSIN TAB10MG 3 QL AVODART CAP0.5MG 5 AVODART CAP0.5MG 5 QL CIALIS TAB2.5MG 5 CIALIS TAB5MG 5 FINASTERIDE TAB5MG 2 QL

43


FLOMAX CAP0.4MG 5 PROSCAR TAB5MG 5 RAPAFLO CAP4MG 5 RAPAFLO CAP8MG 5 TAMSULOSIN CAP0.4MG 2 QL UROXATRAL TAB10MG 5 QL

Genitourinary Agents, Other BETHANECHOL TAB10MG 2 BETHANECHOL TAB25MG 2 BETHANECHOL TAB50MG 2 BETHANECHOL TAB5MG 2 CUPRIMINE CAP250MG 5 CYSTAGON CAP150MG 4 CYSTAGON CAP50MG 4 DEPEN TITRA TAB250MG 5 ELMIRON CAP100MG 4 URECHOLINE TAB10MG 5 URECHOLINE TAB25MG 5 URECHOLINE TAB50MG 5 URECHOLINE TAB5MG 5 VIAGRA TAB100MG 5 VIAGRA TAB100MG 5 VIAGRA TAB25MG 5 VIAGRA TAB50MG 5

Phosphate Binders CALC ACETATECAP667MG 3

CALC ACETATETAB667MG 3

ELIPHOS TAB667MG 3

FOSRENOL CHW1000MG 4

FOSRENOL CHW1000MG 4

FOSRENOL CHW500MG 4

FOSRENOL CHW750MG 4

FOSRENOL CHW750MG 4

PHOSLO CAP667MG 5

PHOSLYRA SOL 5

RENAGEL TAB400MG 5

RENAGEL TAB400MG 5

RENAGEL TAB800MG 5

RENVELA PAK0.8GM 5 QL RENVELA PAK2.4GM 5 QL RENVELA TAB800MG 4 QL SEVELAMER TAB800MG 5

VELPHORO CHW500MG 5

Hormonal Agents, Stimulant/ Replacement/ Modifying (Adrenal) Glucocorticoids/Mineralocorticoids ACLOVATE CRE0.05% 5


ALA SCALP LOT2% 5

ALCLOMETASONCRE0.05% 3

ALCLOMETASONOIN0.05% 3

AMCINONIDE CRE0.1% 2

AMCINONIDE LOT0.1% 2

AMCINONIDE OIN0.1% 2

APEXICON OIN0.05% 3

APEXICON E CRE0.05% 3

AUG BETAMET CRE0.05% 2

AUG BETAMET GEL0.05% 3

AUG BETAMET LOT0.05% 2

AUG BETAMET OIN0.05% 2

BAYCADRON ELX0.5/5ML 2

BETAMETH DIPCRE0.05% 2

BETAMETH DIPLOT0.05% 2

BETAMETH DIPOIN0.05% 2

BETAMETH VALCRE0.1% 2

BETAMETH VALLOT0.1% 2

BETAMETH VALOIN0.1% 2

BUDESONIDE CAP3MG/24HR 3

CAPEX SHA0.01% 5

CARMOL-HC CRE1% 5

CLOBETASOL AER0.05% 3

CLOBETASOL AER0.05% 3

CLOBETASOL GEL0.05% 3

CLOBETASOL LOT0.05% 3

CLOBETASOL OIN0.05% 3

CLOBETASOL SHA0.05% 3

CLOBETASOL SOL0.05% 3

CLOBETASOL ECRE0.05% 3

CLOBEX LOT0.05% 5

CLOBEX SHA0.05% 5

CLOBEX SPR0.05% 5

CLOCORTOLONECREPIV 0.1% 5

CLODAN SHA0.05% 3

CLODERM CRE0.1% PMP 5

CORDRAN LOT0.05% 5

CORDRAN 80X3TAP4MCG/CM 5 QL CORMAX CRE0.05% 3

CORMAX OIN0.05% 3

CORTEF TAB10MG 5

CORTEF TAB20MG 5

CORTEF TAB5MG 5

CORTISONE ACTAB25MG 2

CUTIVATE CRE0.05% 5

CUTIVATE LOT0.05% 5

CUTIVATE OIN0.005% 5

DERMA-SMOOTHOIL/FS BODY 5

44


DESONATE GEL0.05% 5

DESONIDE CRE0.05% 2

DESONIDE LOT0.05% 2

DESONIDE OIN0.05% 2

DESOWEN CRE0.05% 5

DESOWEN LOT0.05% 5

DESOXIMETAS CRE0.05% 3

DESOXIMETAS CRE0.25% 3

DESOXIMETAS GEL0.05% 3

DESOXIMETAS OIN0.05% 5

DESOXIMETAS OIN0.25% 3

DEXAMETHASONCON1MG/ML 2

DEXAMETHASONELX0.5/5ML 2

DEXAMETHASONTAB0.5MG 2



DEXAMETHASONTAB1MG 2




DEXPAK PAK10 DAY 5

DEXPAK PAK13 DAY 5

DEXPAK PAK13 DAY 5

DEXPAK PAK6 DAY 5

DIFLORASONE CRE0.05% 3

DIFLORASONE OIN0.05% 3

DIPROLENE LOT0.05% 5

DIPROLENE OIN0.05% 5

DIPROLENE AFCRE0.05% 5

ELOCON CRE0.1% 5

ELOCON LOT0.1% 5

ELOCON OIN0.1% 5

ENTOCORT EC CAP3MG/24HR 5

FLUDROCORT TAB0.1MG 2

FLUOCIN ACETCRE0.01% 2

FLUOCIN ACETCRE0.025% 2

FLUOCIN ACETOILBODY 2

FLUOCIN ACETOIN0.025% 2

FLUOCIN ACETSOL0.01% 2

FLUOCINONIDECRE0.1% 3

FLUOCINONIDECRE-E 0.05% 2

FLUOCINONIDEGEL0.05% 2

FLUOCINONIDEOIN0.05% 2

FLUOCINONIDESOL0.05% 2

FLUTICASONE CRE0.05% 2

FLUTICASONE LOT0.05% 2

FLUTICASONE OIN0.005% 2

HALOBETASOL CRE0.05% 2


HALOBETASOL OIN0.05% 2

HALOG CRE0.1% 5

HALOG OIN0.1% 5

HC BUTYRATE CRE0.1% 2

HC BUTYRATE OIN0.1% 2

HC BUTYRATE SOL0.1% 2

HC VALERATE CRE0.2% 2

HC VALERATE OIN0.2% 2

HYDROCORT CRE2.5% 2

HYDROCORT LOT2.5% 2

HYDROCORT OIN2.5% 2

HYDROCORT TAB10MG 2

HYDROCORT TAB20MG 2

HYDROCORT TAB5MG 2

KENALOG AERSPRAY 5

LOCOID LOT0.1% 5

LOCOID OIN0.1% 5

LOCOID SOL0.1% 5

LOKARA LOT0.05% 2

LUXIQ AER0.12% 5

MEDROL PAK4MG 5

MEDROL TAB16MG 5

MEDROL TAB32MG 5

MEDROL TAB4MG 5

MEDROL TAB8MG 5

METHYLPRED PAK4MG 2

METHYLPRED TAB16MG 2

METHYLPRED TAB32MG 2

METHYLPRED TAB4MG 2

METHYLPRED TAB8MG 2

MOMETASONE CRE0.1% 2

MOMETASONE OIN0.1% 2

MOMETASONE SOL0.1% 2

NASACORT AQ AER55MCG/AC 5 ST NASACORT AQ AER55MCG/AC 5 ST OLUX AER0.05% 5

PANDEL CRE0.1% 4

PREDNISONE CON5MG/ML 2

PREDNISONE PAK10MG 2

PREDNISONE PAK10MG 2

PREDNISONE PAK5MG 2

PREDNISONE PAK5MG 2

PREDNISONE SOL5MG/5ML 2

PREDNISONE TAB10MG 2


PREDNISONE TAB1MG 2

PREDNISONE TAB2.5MG 2


45



PREDNISONE TAB5MG 2

PROCTOSOL HCCRE2.5% 2

TEMOVATE CRE0.05% 5

TEMOVATE GEL0.05% 5

TEMOVATE OIN0.05% 5

TEMOVATE SOL0.05% 5

TOPICORT CRE0.05% 5

TOPICORT CRE0.25% 5

TOPICORT GEL0.05% 5

TOPICORT OIN0.05% 5

TOPICORT OIN0.25% 5

TOPICORT SPR0.25% 5

TRIAMCINOLONAER55MCG/AC 3 QL TRIAMCINOLONCRE0.025% 2

TRIAMCINOLONCRE0.1% 2

TRIAMCINOLONCRE0.5% 2

TRIAMCINOLONLOT0.025% 2

TRIAMCINOLONLOT0.1% 2

TRIAMCINOLONOIN0.025% 2



TRIDERM CRE0.1% 2

U-CORT CRE1% 2

ULTRAVATE CRE0.05% 5

ULTRAVATE OIN0.05% 5

VANOS CRE0.1% 5

VERDESO AER0.05% 5

WESTCORT OIN0.2% 5

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary) DDAVP SOL0.01% 5

DDAVP SPR0.01% 5

DDAVP TAB0.1MG 5

DDAVP TAB0.2MG 5

DESMOPRESSINSOL0.01% 3

DESMOPRESSINSPR0.01% 3

DESMOPRESSINTAB0.1MG 3

DESMOPRESSINTAB0.2MG 3

GENOTROPIN INJ0.2MG 6 PA GENOTROPIN INJ0.4MG 6 PA GENOTROPIN INJ0.6MG 6 PA GENOTROPIN INJ0.8MG 6 PA GENOTROPIN INJ1.2MG 6 PA GENOTROPIN INJ1.4MG 6 PA GENOTROPIN INJ1.4MG 6 PA GENOTROPIN INJ1.6MG 6 PA


GENOTROPIN INJ1.8MG 6 PA GENOTROPIN INJ1.8MG 6 PA GENOTROPIN INJ12MG 6 PA GENOTROPIN INJ1MG 6 PA GENOTROPIN INJ1MG 6 PA GENOTROPIN INJ2MG 6 PA GENOTROPIN INJ5MG 6 PA HUMATROPE INJ12MG 6 PA HUMATROPE INJ24MG 6 PA HUMATROPE INJ5MG 6 PA HUMATROPE INJ6MG 6 PA INCRELEX INJ40MG/4ML 6 PA MINIRIN SPRNASAL 3

NORDITROPIN INJ10/1.5ML 6 PA NORDITROPIN INJ15/1.5ML 6 PA NORDITROPIN INJ30/3ML 6 PA NORDITROPIN INJ5/1.5ML 6 PA NUTROPIN INJ10MG 6 PA NUTROPIN AQ INJ10MG/2ML 6 PA NUTROPIN AQ INJ10MG/2ML 6 PA NUTROPIN AQ INJ10MG/2ML 6 PA NUTROPIN AQ INJ20MG/2ML 6 PA NUTROPIN AQ INJNUSPIN 5 6 PA OMNITROPE INJ10/1.5ML 6 PA OMNITROPE INJ5.8MG 6 PA OMNITROPE INJ5/1.5ML 6 PA SAIZEN INJ5MG 6 PA SAIZEN INJ8.8MG 6 PA SAIZEN INJ8.8MG 6 PA SEROSTIM INJ4MG 6 PA SEROSTIM INJ5MG 6 PA SEROSTIM INJ6MG 6 PA SEROSTIM INJ8.8MG 6 PA TEV-TROPIN INJ5MG 6 PA ZORBTIVE INJ8.8MG 6 PA

Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers) Anabolic Steroids ANADROL-50 TAB50MG 5 OXANDROLONE TAB10MG 3 QL OXANDROLONE TAB2.5MG 3 QL

Androgens ANDRODERM DIS2MG/24HR 4 QL ANDRODERM DIS4MG/24HR 4 QL ANDROGEL GEL1%(50MG) 5 ANDROGEL GEL1.62% 5

46


ANDROID CAP10MG 3 ANDROXY TAB10MG 5 AXIRON SOL30MG/ACT 5 DANAZOL CAP100MG 3 DANAZOL CAP200MG 3 DANAZOL CAP50MG 3 DELATESTRYL INJ200MG/ML 5 DEPO-TESTOSTINJ100MG/ML 3 DEPO-TESTOSTINJ200MG/ML 3 FORTESTA GEL10MG/ACT 5 METHITEST TAB10MG 3 METHITEST TAB10MG 3 STRIANT MIS30MG 5 TESTIM GEL1%(50MG) 5 TESTOST CYP INJ100MG/ML 3 TESTOST CYP INJ200MG/ML 3 TESTOST ENANINJ200MG/ML 3 TESTOSTERONEGEL1%(50MG) 5 TESTRED CAP10MG 3 VOGELXO GEL1%(50MG) 5 VOGELXO GEL1%(50MG) 5

Estrogens ALORA DIS0.025MG 4 QL ALORA DIS0.05MG 4 QL ALORA DIS0.075MG 4 QL ALORA DIS0.1MG 4 QL CENESTIN TAB0.3MG 5 CENESTIN TAB0.45MG 5 CENESTIN TAB0.625MG 5 CENESTIN TAB0.9MG 5 CENESTIN TAB1.25MG 5 CLIMARA DIS0.025MG 5 QL CLIMARA DIS0.0375MG 5 QL CLIMARA DIS0.05MG 5 QL CLIMARA DIS0.06MG 5 QL CLIMARA DIS0.075MG 5 QL CLIMARA DIS0.1MG 5 QL DELESTROGEN INJ10MG/ML 5 DELESTROGEN INJ20MG/ML 5 DELESTROGEN INJ40MG/ML 5 DEPO-ESTRADIINJ5MG/ML 5 DEPO-ESTRADIINJ5MG/ML 5 DIVIGEL GEL1MG/GM 5 QL ELESTRIN GEL0.06% 5 ENJUVIA TAB0.3MG 5 ENJUVIA TAB0.45MG 5 ENJUVIA TAB0.625MG 5 ENJUVIA TAB0.9MG 5


ENJUVIA TAB1.25MG 5 ESTARYLLA TAB0.25-35 1 ESTRACE TAB0.5MG 5 ESTRACE TAB1MG 5 ESTRACE TAB2MG 5 ESTRACE VAG CRE0.1MG/GM 5 ESTRAD VAL INJ10MG/ML 3 ESTRAD VAL INJ20MG/ML 3 ESTRAD VAL INJ40MG/ML 3 ESTRADIOL DIS0.025MG 2 QL ESTRADIOL DIS0.025MG 2 ESTRADIOL DIS0.0375MG 2 QL ESTRADIOL DIS0.05MG 2 QL ESTRADIOL DIS0.06MG 2 QL ESTRADIOL DIS0.075MG 2 QL ESTRADIOL DIS0.1MG 2 QL ESTRADIOL TAB0.5MG 2 ESTRADIOL TAB1MG 2 ESTRADIOL TAB2MG 2 ESTRING MIS2MG 4 QL ESTROPIPATE TAB0.75MG 2 ESTROPIPATE TAB1.5MG 2 ESTROPIPATE TAB3MG 2 EVAMIST SPR1.53MG 5 QL FEMRING MIS0.05/24H 5 FEMRING MIS0.1MG/24 5 GILDAGIA TAB0.4-35 1 LARIN FE TAB1.5/30 1 LARIN FE TAB1/20 1 MENEST TAB0.3MG 3 MENEST TAB0.625MG 3 MENEST TAB1.25MG 3 MENEST TAB2.5MG 3 MENOSTAR DIS14MCG 5 QL MINIVELLE DIS0.025 MG 4 MINIVELLE DIS0.0375MG 4 MINIVELLE DIS0.05MG 4 MINIVELLE DIS0.075MG 4 MINIVELLE DIS0.1MG 4 MONO-LINYAH TAB0.25-35 1 OGEN TAB0.625 5 PREMARIN TAB0.3MG 4 PREMARIN TAB0.3MG 4 PREMARIN TAB0.45MG 4 PREMARIN TAB0.625MG 4 PREMARIN TAB0.625MG 4 PREMARIN TAB0.9MG 4 PREMARIN TAB1.25MG 4

47


PREMARIN TAB1.25MG 4 PREMARIN VAGCRE0.625MG 4 TRI-ESTARYLLTAB 1 VAGIFEM TAB10MCG 4 VIVELLE-DOT DIS0.025MG 4 QL VIVELLE-DOT DIS0.0375MG 4 QL VIVELLE-DOT DIS0.05MG 4 QL VIVELLE-DOT DIS0.075MG 4 QL VIVELLE-DOT DIS0.1MG 4 QL

Progestins AYGESTIN TAB5MG 5 CAMILA TAB0.35MG 1 CRINONE GEL4% VAG 6 CRINONE GEL4% VAG 6 CRINONE GEL8% VAG 6 DEBLITANE TAB0.35MG 1 DELYLA TAB0.1-0.02 1 DESO/ETHINYLTABESTRADIO 1 DESO/ETHINYLTABESTRADIO 1 ELLA TAB30MG 1 ENDOMETRIN SUP100MG 5 ENSKYCE TAB 1 ERRIN TAB0.35MG 1 FALLBACK TAB1.5MG 1 HEATHER TAB0.35MG 1 JENCYCLA TAB0.35MG 1 JOLIVETTE TAB0.35MG 5 LARIN TAB1.5/30 1 LARIN TAB1/20 1 LOMEDIA 24 TABFE 1 LYZA TAB0.35MG 1 MEDROXYPR ACTAB10MG 2 MEDROXYPR ACTAB2.5MG 2 MEDROXYPR ACTAB5MG 2 MEGACE ES SUS625/5ML 5 MEGACE ORAL SUS40MG/ML 5 MEGESTROL ACSUS40MG/ML 3 MEGESTROL ACTAB20MG 3 MEGESTROL ACTAB40MG 3 MIMVEY LO TAB0.5-0.1 2 MINASTRIN 24CHWFE 1 NIKKI TAB3-0.02MG 1 NORA-BE TAB0.35MG 5 NORETH/ETHINTAB1/20 1 NORETH/ETHINTABFE 1/20 1 NORETHIN ACETAB5MG 3 NORETHINDRONTAB0.35MG 1 NORLYROC TAB0.35MG 1


NOR-QD TAB0.35MG 5 ORTHO MICRONTAB0.35MG 5 PIMTREA TAB 1 PIRMELLA TAB1/35 1 PIRMELLA TAB7/7/7 1 PROCHIEVE GEL4% 6 PROGESTERONECAP100MG 3 PROGESTERONECAP200MG 3 PROMETRIUM CAP100MG 5 PROMETRIUM CAP200MG 5 PROVERA TAB10MG 5 PROVERA TAB2.5MG 5 PROVERA TAB5MG 5 SHAROBEL TAB0.35MG 1 TAKE ACTION TAB1.5MG 1 TARINA FE TAB1/20 1 VYFEMLA TAB0.4-35 1 WYMZYA FE CHW0.4MG-35 1 XULANE DIS150-35 1

Selective Estrogen Receptor Modifying Agents EVISTA TAB60MG 5 QL

RALOXIFENE TAB60MG 3 QL

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid) CYTOMEL TAB25MCG 5

CYTOMEL TAB50MCG 5

CYTOMEL TAB5MCG 5

LEVOTHROID TAB100MCG 2











LEVOTHYROXINTAB100MCG 2







48







LEVOXYL TAB100MCG 2

LEVOXYL TAB112MCG 2

LEVOXYL TAB125MCG 2

LEVOXYL TAB137MCG 2

LEVOXYL TAB150MCG 2

LEVOXYL TAB175MCG 2

LEVOXYL TAB200MCG 2

LEVOXYL TAB25MCG 2

LEVOXYL TAB50MCG 2

LEVOXYL TAB75MCG 2

LEVOXYL TAB88MCG 2

LIOTHYRONINETAB25MCG 2



SYNTHROID TAB100MCG 5












THYROLAR-1 TAB60MG 2

THYROLAR-1/2TAB30MG 2

THYROLAR-1/4TAB15MG 2



TIROSINT CAP100MCG 5




TIROSINT CAP13MCG 5


TIROSINT CAP25MCG 5

TIROSINT CAP50MCG 5

TIROSINT CAP75MCG 5

TIROSINT CAP88MCG 5

UNITHROID TAB100MCG 2













Hormonal Agents, Suppressant (Adrenal) LYSODREN TAB500MG 6

SIGNIFOR INJ0.3MG/ML 6 PA SIGNIFOR INJ0.6MG/ML 6 PA SIGNIFOR INJ0.9MG/ML 6 PA

Hormonal Agents, Suppressant (Parathyroid) SENSIPAR TAB30MG 6 QL SENSIPAR TAB60MG 6 QL SENSIPAR TAB90MG 6 QL

Hormonal Agents, Suppressant (Pituitary) CABERGOLINE TAB0.5MG 3

LEUPROLIDE INJ1MG/0.2 6 PA OCTREOTIDE INJ1000MCG 6 PA OCTREOTIDE INJ100MCG 6 PA OCTREOTIDE INJ200MCG 6 PA OCTREOTIDE INJ500MCG 6 PA OCTREOTIDE INJ50MCG/ML 6 PA SANDOSTATIN INJ1000MCG 6 PA SANDOSTATIN INJ100MCG 6 PA SANDOSTATIN INJ200MCG 6 PA SANDOSTATIN INJ500MCG 6 PA SANDOSTATIN INJ50MCG/ML 6 PA SOMAVERT INJ10MG 6 PA SOMAVERT INJ15MG 6 PA SOMAVERT INJ20MG 6 PA

Hormonal Agents, Suppressant (Sex Hormones/Modifiers) Antiandrogens BICALUTAMIDETAB50MG 2 QL CASODEX TAB50MG 5 QL FLUTAMIDE CAP125MG 3

NILANDRON TAB150MG 6 QL

49


Hormonal Agents, Suppressant (Thyroid) Antithyroid Agents METHIMAZOLE TAB10MG 3

METHIMAZOLE TAB5MG 3

PROPYLTHIOURTAB50MG 3

TAPAZOLE TAB10MG 5

TAPAZOLE TAB5MG 5

Immunological Agents Immune Suppressants ASTAGRAF XL CAP0.5MG 6 ASTAGRAF XL CAP1MG 6 ASTAGRAF XL CAP5MG 6 AZASAN TAB100MG 3 AZASAN TAB100MG 3 AZASAN TAB75 MG 3 AZASAN TAB75 MG 3 AZATHIOPRINETAB50MG 2 CELLCEPT CAP250MG 5 CELLCEPT SUS200MG/ML 5 CELLCEPT TAB500MG 5 CIMZIA KIT 6 PA QL CIMZIA PREFLKIT200MG/ML 6 PA QL CYCLOSPORINECAP100MG 3 CYCLOSPORINECAP100MG MD 3 CYCLOSPORINECAP25MG 3 CYCLOSPORINECAP25MG MOD 3 CYCLOSPORINECAP50MG MOD 3 CYCLOSPORINECAP50MG MOD 3 CYCLOSPORINESOLMODIFIED 3 ENBREL INJ25/0.5ML 6 PA QL ENBREL INJ25MG 6 PA QL ENBREL INJ50MG/ML 6 PA QL GENGRAF CAP100MG 3 GENGRAF CAP25MG 3 GENGRAF SOL100MG/ML 3 HECORIA CAP0.5MG 3 HECORIA CAP1MG 3 HECORIA CAP5MG 3 HUMIRA INJ10MG/0.2 6 PA QL HUMIRA INJ40MG/0.8 6 PA QL HUMIRA KIT20MG/0.4 6 PA QL HUMIRA PEN INJCROHNS 6 PA QL IMURAN TAB50MG 5 KINERET INJ 6 PA QL METHOTREXATEINJ1GM 2 METHOTREXATEINJ25MG/ML 2


METHOTREXATETAB2.5MG 2 MYCOPHENOLATCAP250MG 3 MYCOPHENOLATTAB500MG 3 MYCOPHENOLICTAB180MG DR 6 MYCOPHENOLICTAB360MG DR 6 MYFORTIC TAB180MG 6 MYFORTIC TAB360MG 6 NEORAL CAP100MG 5 NEORAL CAP25MG 5 NEORAL SOL100MG/ML 5 ORENCIA INJ250MG 6 PA PROGRAF CAP0.5MG 5 PROGRAF CAP1MG 5 PROGRAF CAP5MG 5 RAPAMUNE SOL1MG/ML 6 RAPAMUNE TAB0.5MG 6 RAPAMUNE TAB1MG 6 RAPAMUNE TAB2MG 6 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 RHEUMATREX TAB2.5MG 5 SANDIMMUNE CAP100MG 5 SANDIMMUNE CAP25MG 5 SANDIMMUNE SOL100MG/ML 5 SIMPONI INJ50/0.5ML 6 PA QL SIROLIMUS TAB0.5MG 6 TACROLIMUS CAP0.5MG 3 TACROLIMUS CAP1MG 3 TACROLIMUS CAP5MG 3 TREXALL TAB10MG 3 TREXALL TAB15MG 3 TREXALL TAB5MG 3 TREXALL TAB7.5MG 3 ZORTRESS TAB0.25MG 6 QL ZORTRESS TAB0.5MG 6 QL ZORTRESS TAB0.75MG 6 QL

Immunizing Agents, Passive THYMOGLOBULNINJ25MG 3

Immunomodulators ACTEMRA INJ162/0.9 6 PA

50


ACTIMMUNE INJ2MU/0.5 6 PA ARAVA TAB10MG 5 QL ARAVA TAB20MG 5 QL LEFLUNOMIDE TAB10MG 2 QL LEFLUNOMIDE TAB20MG 2 QL OTEZLA TAB10/20/30 6 PA QL OTEZLA TAB30MG 6 PA QL PLEGRIDY INJ 6 PA PLEGRIDY INJPEN 6 PA PLEGRIDY PENINJSTARTER 6 PA RIDAURA CAP3MG 4

SIMPONI INJ100MG/ML 6 PA QL XELJANZ TAB5MG 6 PA

Inflammatory Bowel Disease Agents Aminosalicylates APRISO CAP0.375GM 5 QL ASACOL TAB400MG DR 4 ASACOL HD TAB800MG 4 QL BALSALAZIDE CAP750MG 3 CANASA SUP1000MG 5 COLAZAL CAP750MG 5 DELZICOL CAP400MG 4 DIPENTUM CAP250MG 5 GIAZO TAB1.1GM 5 LIALDA TAB1.2GM 4 MESALAMINE KIT4GM 3 PENTASA CAP250MG CR 4 PENTASA CAP500MG CR 4 PENTASA CAP500MG CR 4 SFROWASA ENE4GM 5

Glucocorticoids ANUSOL-HC CRE2.5% 5

COLOCORT ENE100MG 3

CORTENEMA ENE100MG 5

HYDROCORT CRE2.5% 2

HYDROCORT ENE100MG 3 PROCTOCREAM CREHC 2.5% 2

PROCTO-KIT CRE2.5% 2

PROCTO-PAK CRE1% 2

PROCTOZONE CRE-HC 2.5% 2

Sulfonamides AZULFIDINE TAB500MG 5

AZULFIDINE TAB500MG EN 5

SULFASALAZINTAB500MG 3

SULFAZINE TAB500MG 3


SULFAZINE ECTAB500MG 3

Metabolic Bone Disease Agents ACTONEL TAB150MG 5 QL

ACTONEL TAB30MG 4

ACTONEL TAB30MG 4 QL

ACTONEL TAB35MG 4

ACTONEL TAB35MG 4

ACTONEL TAB35MG 4

ACTONEL TAB35MG 4 QL

ACTONEL TAB5MG 4 QL

ACTONEL TAB5MG 4

ALENDRONATE TAB10MG 2 QL





ATELVIA TAB 4

BONIVA TAB150MG 5

CALCITONIN SPR200/ACT 3

CALCITRIOL CAP0.25MCG 2

CALCITRIOL CAP0.5MCG 2

CALCITRIOL SOL1MCG/ML 2

DIDRONEL TAB400MG 5

DOXERCALCIF CAP0.5MCG 3

DOXERCALCIF CAP1MCG 3

DOXERCALCIF CAP2.5MCG 3

ETIDRON DISDTAB200MG 3

ETIDRON DISDTAB400MG 3

FORTEO SOL600/2.4 6 PA QL

FORTICAL SPR200/ACT 5

FOSAMAX TAB70MG 5 QL

FOSAMAX + D TAB70-2800 5 QL

FOSAMAX + D TAB70-5600 5 QL

FOSAMAX + D TAB70-5600 5

HECTOROL CAP0.5MCG 5

HECTOROL CAP1MCG 5

HECTOROL CAP2.5MCG 5

IBANDRONATE TAB150MG 2 QL

MIACALCIN INJ200/ML 5

MIACALCIN SPR200/ACT 5

RISEDRONATE TAB150MG 3

ROCALTROL CAP0.25MCG 5

ROCALTROL CAP0.5MCG 5

51


ROCALTROL SOL1MCG/ML 5

SKELID TAB200MG 5

ZEMPLAR CAP1MCG 6

ZEMPLAR CAP2MCG 6

ZEMPLAR CAP4MCG 6

Ophthalmic Agents

Ophthalmic Prostaglandin and Prostamide Analogs LATANOPROST SOL0.005% 2 QL

LUMIGAN SOL0.01% 4 QL ST

LUMIGAN SOL0.03% 4 ST

TRAVATAN Z DRO0.004% 5 QL ST

XALATAN SOL0.005% 5 QL ST

Ophthalmic Agents, Other ALCAINE SOL0.5% OP 5 CYSTARAN SOL0.44% 6 LACRISERT MIS5MG OP 5 PA NAPHAZOLINE SOL0.1% OP 2 NAPHAZOLINE SOL0.1% OP 2 OPHTHETIC SOL0.5% OP 5 PARCAINE SOL0.5% OP 3 PROPARACAINESOL0.5% OP 3 RESTASIS EMU0.05% 4 QL TROPICAMIDE SOL0.5% OP 3

Ophthalmic Anti-allergy Agents ALAMAST DRO0.1% 4 ALOCRIL SOL2% 4 ALOMIDE SOL0.1% OP 4 AZELASTINE DRO0.05% 2 BEPREVE DRO1.5% 4 CROMOLYN SODSOL4% OP 2 ELESTAT DRO0.05% 5 EMADINE SOL0.05% OP 4 EPINASTINE DRO0.05% 3 LASTACAFT SOL0.25% 5 OPTIVAR DRO0.05% 5 PATADAY SOL0.2% 5 PATANOL SOL0.1% OP 4

Ophthalmic Antiglaucoma Agents ALPHAGAN P SOL0.1% 4 ALPHAGAN P SOL0.15% 5 APRACLONIDINSOL0.5% OP 3 AZOPT SUS1% OP 5 BETAGAN SOL0.5% OP 5 BETAXOLOL SOL0.5% OP 2


BETIMOL SOL0.25% 5 BETIMOL SOL0.5% 5 BETOPTIC-S SUS0.25% OP 5 BRIMONIDINE SOL0.15% 3 BRIMONIDINE SOL0.2% OP 3 CARTEOLOL SOL1% OP 2 COMBIGAN SOL0.2/0.5% 5 COSOPT SOL2-0.5%OP 5 DORZOL/TIMOLSOL2-0.5%OP 2 DORZOLAMIDE SOL2% OP 2 IOPIDINE SOL0.5% OP 5 IOPIDINE SOL1% OP 5 ISOPTO CARP SOL1% OP 5 ISOPTO CARP SOL2% OP 5 ISOPTO CARP SOL4% OP 5 ISTALOL SOL0.5% OP 5 LEVOBUNOLOL SOL0.5% OP 2 METIPRANOLOLSOL0.3% OPH 2 OPTIPRANOLOLSOL0.3% OP 5 PHOSPHOLINE SOL0.125%OP 4 PILOCARPINE SOL1% OP 2 PILOCARPINE SOL2% OP 2 PILOCARPINE SOL4% OP 2 PILOPINE HS GEL4% OP 5 PROPINE SOL0.1% OP 5 SIMBRINZA SUS1-0.2% 5 TIMOLOL GEL SOL0.25% OP 2 TIMOLOL GEL SOL0.5% OP 2 TIMOLOL MAL SOL0.25% OP 2 TIMOLOL MAL SOL0.5% OP 2 TIMOPTIC OCUSOL0.25% OP 5 TIMOPTIC OCUSOL0.5% OP 5 TIMOPTIC-XE SOL0.25% OP 5 TIMOPTIC-XE SOL0.5% OP 5 TRUSOPT SOL2% OP 5 ZIOPTAN DRO0.0015% 5 ST

Ophthalmic Anti-inflammatories ACULAR SOL0.5% OP 5

ACULAR LS SOL0.4% 5

ACUVAIL SOL0.45% 5

ALREX SUS0.2% 4

BROMDAY SOL0.09% 5

BROMFENAC SOL0.09% OP 3

DEXAMETH PHOSOL0.1% OP 2

DICLOFENAC SOL0.1% OP 2

DUREZOL EMU0.05% 5

DUREZOL EMU0.05% 5

FLAREX SUS0.1% OP 5

52


FLUOROMETHOLSUS0.1% OP 3

FLURBIPROFENSOL0.03% OP 2

FML OIN0.1% OP 4

FML FORTE SUS0.25% OP 4

FML LIQUIFLMSUS0.1% OP 5

ILEVRO DRO0.3% OP 5

KETOROLAC SOL0.4% 2

KETOROLAC SOL0.5% 2

LOTEMAX GEL0.5% 4

LOTEMAX OIN0.5% 4

LOTEMAX SUS0.5% 4

MAXIDEX SUS0.1% OP 5

NEVANAC SUS0.1% 5

OCUFEN SOL0.03% OP 5

OMNIPRED SUS1% OP 5

PRED MILD SUS0.12% OP 5

PRED SOD PHOSOL1% OP 2

VEXOL SUS1% OP 5

VOLTAREN SOL0.1% OP 5

Otic Agents ACETASOL HC SOLOTIC 2

CIPRO HC SUSOTIC 4

CIPRODEX SUS0.3-0.1% 4

COLY-MYCIN SSUSOTIC 5

CORTISPORIN SOL1% OTIC 2

CORTISPORIN SUS-TC OTIC 5

CORTOMYCIN SUS1% OTIC 2

DERMOTIC OIL0.01% 5

FLUOCIN ACETOIL0.01% 2

HC/ACET ACIDSOLOTIC 2

NEO/POLY/HC SOL1% OTIC 2

NEO/POLY/HC SUS1% OTIC 2

Respiratory Tract Agents Antihistamines ARBINOXA SOL4MG/5ML 2 ARBINOXA TAB4MG 2 ASTELIN NASASPR137MCG 5 QL ASTEPRO SPR0.15% 5 ASTEPRO SPR0.15% 5 ASTEPRO SPR0.15% 5 QL AZELASTINE SPR0.1% 2 QL AZELASTINE SPR0.15% 2 CARBINOXAMINSOL4MG/5ML 2 CARBINOXAMINTAB4MG 2 CLARINEX TAB5MG 5 QL CLARINEX RDTTAB2.5MG 5 CLEMASTINE SYP0.5/5ML 2


CLEMASTINE TAB2.68MG 2 CYPROHEPTAD SYP2MG/5ML 3 CYPROHEPTAD TAB4MG 2 DESLORATADINTAB2.5 ODT 3 DESLORATADINTAB5MG 3 DESLORATADINTAB5MG ODT 3 DEXCHLORPHENSYP2MG/5ML 3 LEVOCETIRIZISOL2.5/5ML 3 LEVOCETIRIZITAB5MG 3 QL OLOPATADINE SPR0.6% 3 PALGIC SOL4MG/5ML 2 PALGIC TAB4MG 5 PATANASE SPR0.6% 5 QL XYZAL SOL2.5/5ML 5 XYZAL TAB5MG 5 QL

Anti-inflammatories, Inhaled Corticosteroids AEROBID AER250MCG 5 AEROBID AER250MCG 5 AEROSPAN AER80MCG 5 ALVESCO AER160MCG 5 QL ALVESCO AER160MCG 5 ALVESCO AER80MCG 5 QL ASMANEX 120 AER220MCG 5 QL ASMANEX 14 AER220MCG 5 ASMANEX 30 AER110MCG 5 QL ASMANEX 30 AER220MCG 5 QL ASMANEX 60 AER220MCG 5 QL ASMANEX 7 AER110MCG 5 ASMANEX HFA AER100 MCG 5 ASMANEX HFA AER200 MCG 5 BECONASE AQ SUS0.042% 5 QL ST BREO ELLIPTAINH100-25 4 QL BUDESONIDE SUS0.25MG/2 3 QL BUDESONIDE SUS0.5MG/2 3 QL BUDESONIDE SUS32MCG 3 FLONASE SPR0.05% 5 ST FLOVENT DISKAER100MCG 4 FLOVENT DISKAER100MCG 4 QL FLOVENT DISKAER250MCG 4 QL FLOVENT DISKAER50MCG 4 QL FLOVENT HFA AER110MCG 4 QL FLOVENT HFA AER220MCG 4 QL FLOVENT HFA AER44MCG 4 QL FLUNISOLIDE SPR0.025% 2 QL FLUTICASONE SPR50MCG 2 QL NASONEX SPR50MCG/AC 4 QL ST

53


OMNARIS SPR 5 QL ST PULMICORT INH180MCG 4 QL PULMICORT INH90MCG 4 QL PULMICORT SUS0.25MG/2 5 PULMICORT SUS0.5MG/2 5 PULMICORT SUS1MG/2ML 4 QNASL AER80MCG 5 ST QVAR AER40MCG 4 QVAR AER40MCG 4 QL QVAR AER80MCG 4 QVAR AER80MCG 4 QL QVAR AER80MCG 4 RHINOCORT SUSAQUA 5 QL ST RHINOCORT SUSAQUA 5 ST VERAMYST SPR27.5MCG 5 QL ST ZETONNA AER37MCG 5 ST

Antileukotrienes ACCOLATE TAB10MG 5 QL ACCOLATE TAB20MG 5 QL MONTELUKAST CHW4MG 2 QL MONTELUKAST CHW5MG 2 QL MONTELUKAST GRA4MG 2 QL MONTELUKAST TAB10MG 2 QL SINGULAIR CHW4MG 5 QL SINGULAIR CHW5MG 5 QL SINGULAIR GRA4MG 5 QL SINGULAIR TAB10MG 5 QL ZAFIRLUKAST TAB10MG 3 QL ZAFIRLUKAST TAB20MG 3 QL ZYFLO CR TAB600MG 5 QL

Bronchodilators, Anticholinergic ANORO ELLIPTAER62.5-25 4 ANORO ELLIPTAER62.5-25 4 ATROVENT HFAAER17MCG 4 QL ATROVENT NASSOL0.03% 5 QL ATROVENT NASSOL0.06% 5 QL IPRATROPIUM SOL0.02%INH 3 IPRATROPIUM SPR0.03% 2 QL IPRATROPIUM SPR0.06% 2 QL SPIRIVA CAPHANDIHLR 4 QL SPIRIVA SPRRESPIMAT 4 QL SPIRIVA SPRRESPIMAT 4 TUDORZA PRESAER400/ACT 5 QL

Bronchodilators, Phosphodiesterase Inhibitors (Xanthines) AMINOPHYLLININJ25MG/ML 3 ELIXOPHYLLINELX80/15ML 3


LUFYLLIN TAB200MG 3 LUFYLLIN TAB400MG 3 THEOCHRON TAB100MG CR 2 THEOCHRON TAB200MG CR 2 THEOCHRON TAB300MG CR 2 THEOPHYLLINETAB100MG CR 2 THEOPHYLLINETAB200MG CR 2 THEOPHYLLINETAB300MG ER 2 THEOPHYLLINETAB400MG ER 2 THEOPHYLLINETAB450MG ER 2 THEOPHYLLINETAB600MG ER 2

Bronchodilators, Sympathomimetic ACCUNEB NEB0.63MG/3 5 ACCUNEB NEB1.25MG/3 5 ADRENACLICK INJ0.15MG 5 ADRENACLICK INJ0.3MG 5 ALBUTEROL NEB0.083% 2 QL ALBUTEROL NEB0.5% 2 QL ALBUTEROL NEB0.63MG/3 2 QL ALBUTEROL NEB1.25MG/3 2 QL ALBUTEROL SYP2MG/5ML 2 ALBUTEROL TAB2MG 2 ALBUTEROL TAB4MG 2 ALBUTEROL TAB4MG ER 2 ALBUTEROL TAB8MG ER 2 ARCAPTA CAP75MCG 5 QL AUVI-Q INJ0.15MG 5 AUVI-Q INJ0.3MG 5 BROVANA NEB15MCG 5 EPINEPHRINE INJ0.15MG 5 EPINEPHRINE INJ0.1MG/ML 3 EPINEPHRINE INJ0.3MG 5 EPIPEN 2-PAKINJ0.3MG 4 QL EPIPEN-JR INJ2-PAK 4 QL FORADIL CAPAEROLIZE 4 QL LEVALBUTEROLNEB0.31MG 3 QL LEVALBUTEROLNEB0.63MG 3 QL LEVALBUTEROLNEB1.25/0.5 3 QL MAXAIR AUTOHAER200MCG 4 METAPROTERENSYP10MG/5ML 2 METAPROTERENTAB10MG 2 METAPROTERENTAB20MG 2 PERFOROMIST NEB20MCG 5 PROAIR HFA AER 4 QL PROVENTIL AERHFA 5 QL SEREVENT DISAER50MCG 4 SEREVENT DISAER50MCG 4 QL STRIVERDI AERRESPIMAT 4

54


TERBUTALINE TAB2.5MG 2 TERBUTALINE TAB5MG 2 VENTOLIN HFAAER 5 VENTOLIN HFAAER 5 QL VOSPIRE ER TAB4MG 2 VOSPIRE ER TAB8MG 2 XOPENEX NEB0.31MG 5 XOPENEX NEB0.63MG 5 XOPENEX NEB1.25/3ML 5 XOPENEX HFA AER 5 XOPENEX HFA AER 5 QL

Mast Cell Stabilizers CROMOLYN SODCON100/5ML 2 CROMOLYN SODNEB20MG/2ML 3 QL GASTROCROM CON100/5ML 5

Pulmonary Antihypertensives ADCIRCA TAB20MG 6 PA QL ADEMPAS TAB0.5MG 6 PA QL ADEMPAS TAB1.5MG 6 PA QL ADEMPAS TAB1MG 6 PA QL ADEMPAS TAB2.5MG 6 PA QL ADEMPAS TAB2MG 6 PA QL LETAIRIS TAB10MG 6 PA QL LETAIRIS TAB5MG 6 PA QL OPSUMIT TAB10MG 6 PA QL ORENITRAM TAB0.125MG 6 PA ORENITRAM TAB0.25MG 6 PA ORENITRAM TAB1MG 6 PA ORENITRAM TAB2.5MG 6 PA REVATIO SUS10MG/ML 5 REVATIO TAB20MG 5 QL SILDENAFIL TAB20MG 2 QL TRACLEER TAB125MG 6 PA QL TRACLEER TAB62.5MG 6 PA QL VENTAVIS SOL10MCG/ML 6 PA

Respiratory Tract Agents, Other ACETYLCYST SOL10% 3

ACETYLCYST SOL20% 3

DALIRESP TAB500MCG 5 QL GRASTEK SUB2800BAU 5

KALYDECO TAB150MG 6 PA QL TYZINE SOL0.1% 3

TYZINE PED DRO0.05% 3

Skeletal Muscle Relaxants AMRIX CAP15MG 5

AMRIX CAP30MG 5

CARISOPRODOLTAB250MG 2


CARISOPRODOLTAB350MG 2

CHLORZOXAZONTAB500MG 2

CYCLOBENZAPRCAP15MG ER 3

CYCLOBENZAPRCAP30MG ER 3

CYCLOBENZAPRTAB10MG 2

CYCLOBENZAPRTAB5MG 2

CYCLOBENZAPRTAB7.5MG 2

FEXMID TAB7.5MG 5

LORZONE TAB375MG 2

LORZONE TAB750MG 2

METAXALONE TAB800MG 3

METHOCARBAM TAB500MG 2

METHOCARBAM TAB750MG 2

ORPHENADRINETAB100MG ER 2

ORPHENADRINETAB100MG ER 2

PARAFON FORTTAB500MG 5

ROBAXIN-750 TAB750MG 5

SKELAXIN TAB800MG 5

SOMA TAB250MG 5

SOMA TAB350MG 5

Sleep Disorder Agents GABA Receptor Modulators AMBIEN TAB10MG 5 QL AMBIEN TAB5MG 5 QL AMBIEN CR TAB12.5MG 5 QL AMBIEN CR TAB6.25MG 5 QL EDLUAR SUB10MG 5 QL EDLUAR SUB5MG 5 QL ESZOPICLONE TAB1MG 3 ESZOPICLONE TAB2MG 3 ESZOPICLONE TAB3MG 3 INTERMEZZO SUB1.75MG 5 INTERMEZZO SUB3.5MG 5 LUNESTA TAB1MG 5 QL LUNESTA TAB2MG 5 QL LUNESTA TAB3MG 5 QL SONATA CAP10MG 5 QL SONATA CAP5MG 5 QL ZALEPLON CAP10MG 2 QL ZALEPLON CAP5MG 2 QL ZOLPIDEM TAB10MG 2 QL ZOLPIDEM TAB5MG 2 QL ZOLPIDEM ER TAB12.5MG 3 QL ZOLPIDEM ER TAB6.25MG 3 QL

Sleep Disorders, Other HETLIOZ CAP20MG 6 PA QL MODAFINIL TAB100MG 3 PA QL

55


MODAFINIL TAB200MG 3 PA QL NUVIGIL TAB150MG 5 PA NUVIGIL TAB150MG 5 PA NUVIGIL TAB200MG 5 PA NUVIGIL TAB200MG 5 PA NUVIGIL TAB250MG 5 PA NUVIGIL TAB250MG 5 PA NUVIGIL TAB50MG 5 PA NUVIGIL TAB50MG 5 PA PROVIGIL TAB100MG 5 PA QL PROVIGIL TAB200MG 5 PA QL ROZEREM TAB8MG 5 QL ROZEREM TAB8MG 5

SILENOR TAB3MG 5

SILENOR TAB6MG 5

XYREM SOL500MG/ML 6 PA QL

Therapeutic Nutrients/ Minerals/ Electrolytes Electrolyte/Mineral Modifiers CHEMET CAP100MG 5 EXJADE TAB125MG 6 PA EXJADE TAB250MG 6 PA EXJADE TAB500MG 6 PA FERRIPROX TAB500MG 6 PA KAYEXALATE POW 5 KIONEX POW 2 SAMSCA TAB15MG 5 PA QL


SAMSCA TAB30MG 5 PA QL SOD POLY SULSUS15GM/60 2 SYPRINE CAP250MG 5

Electrolyte/Mineral Replacement KLOR-CON 10 TAB10MEQ ER 2

KLOR-CON 8 TAB8MEQ ER 2

KLOR-CON M15TAB 2

KLOR-CON M20TAB20MEQ ER 2

K-TAB TAB10MEQ CR 5

K-TAB TAB20MEQ 2

OSMOPREP TAB1.5GM 5

PHYSIOLYTE SOL 5

PHYSIOSOL SOLIRRIGAT 5

POT CHLORIDECAP10MEQ ER 2

POT CHLORIDECAP8MEQ ER 2

POT CHLORIDETAB8MEQ ER 2

POT CITRATE TAB1080MG 3

POT CITRATE TAB1620MG 3

POT CITRATE TAB540MG ER 3

POT CL MICROTAB10MEQ ER 2

POT CL MICROTAB20MEQ ER 2

UROCIT-K 10 TAB 5

UROCIT-K 15 TAB 5

UROCIT-K 5 TAB 5

VISICOL TAB1.5GM 5

56

Index of Drugs UTherapeutic Classes and Categories Therapeutic Categories are listed in Bold Therapeutic Classes are also listed in Bold

1

1st Generation/Typical ....................................................... 23

2

2nd Generation/Atypical ..................................................... 24

A

ABACAV/LAMIVTAB/ZIDOVUD ............................................ 26 ABILIFY DISCTAB10MG ...................................................... 15 ABILIFY DISCTAB15MG ...................................................... 15 ACETASOL HC SOLOTIC .................................................... 52 ACETAZOLAMIDCAP500MG ER .......................................... 35 ACETAZOLAMIDTAB125MG ................................................ 35 ACETAZOLAMIDTAB250MG ................................................ 35 ACETIC ACID SOL2% OTIC ................................................... 8 ACIPHEX SPR CAP10MG .................................................... 42 ACIPHEX SPR CAP5MG ...................................................... 42 ADDERALL XR CAP10MG ................................................... 37 ADDERALL XR CAP15MG ................................................... 37 ADDERALL XR CAP20MG ................................................... 37 ADDERALL XR CAP25MG ................................................... 37 ADDERALL XR CAP30MG ................................................... 37 ADDERALL XR CAP5MG ..................................................... 37 ADOXA PAK 1/TAB100MG ................................................... 11 ADOXA PAK 2/TAB100MG ................................................... 11 ADRENACLICK INJ0.15MG .................................................. 53 ADRENACLICK INJ0.3MG ................................................... 53 AFINITOR DISTAB2MG ....................................................... 21 AFINITOR DISTAB3MG ....................................................... 21 AFINITOR DISTAB5MG ....................................................... 21 ALAMAST DRO0.1% ........................................................... 51 ALCLOMETASONCRE0.05% ............................................... 43 ALCLOMETASONOIN0.05% ................................................ 43 Alcohol Deterrents/Anti-craving ........................................... 7 ALENDRONATE TAB10MG .................................................. 50 ALENDRONATE TAB35MG .................................................. 50 ALENDRONATE TAB40MG .................................................. 50 ALENDRONATE TAB5MG ................................................... 50 ALENDRONATE TAB70MG .................................................. 50 Alkylating Agents ............................................................... 21 ALLOPURINOL TAB100MG ................................................. 19 ALLOPURINOL TAB300MG ................................................. 19 Alpha-adrenergic Agonists ................................................. 30 Alpha-adrenergic Blocking Agents ..................................... 30 Aminoglycosides ................................................................. 7

AMINOPHYLLININJ25MG/ML .............................................. 53 Aminosalicylates ............................................................... 50 AMITRIPTYLINTAB100MG .................................................. 17 AMITRIPTYLINTAB10MG .................................................... 17 AMITRIPTYLINTAB150MG .................................................. 17 AMITRIPTYLINTAB25MG .................................................... 17 AMITRIPTYLINTAB50MG .................................................... 17 AMITRIPTYLINTAB75MG .................................................... 17 AMMONIUM LACCRE12% ................................................... 39 AMMONIUM LACLOT12% ................................................... 39 AMOX/K CLAV CHW200MG .................................................. 9 AMOX/K CLAV CHW400MG .................................................. 9 AMOX/K CLAV SUS200/5ML ................................................. 9 AMOX/K CLAV SUS250/5ML ................................................. 9 AMOX/K CLAV SUS400/5ML ................................................. 9 AMOX/K CLAV SUS600/5ML ................................................. 9 AMOX/K CLAV TAB250MG .................................................... 9 AMOX/K CLAV TAB500MG .................................................... 9 AMOX/K CLAV TAB875MG .................................................... 9 AMOXICILLIN CAP250MG ..................................................... 9 AMOXICILLIN CAP500MG ..................................................... 9 AMOXICILLIN CHW125MG .................................................... 9 AMOXICILLIN CHW250MG .................................................... 9 AMOXICILLIN SUS125/5ML ................................................... 9 AMOXICILLIN SUS200/5ML ................................................... 9 AMOXICILLIN SUS250/5ML ................................................... 9 AMOXICILLIN SUS400/5ML ................................................... 9 AMOXICILLIN TAB500MG ..................................................... 9 AMOXICILLIN TAB775MG ..................................................... 9 AMOXICILLIN TAB875MG ..................................................... 9 AMOX-POT CLATABER ........................................................ 9 AMPHETAMINE CAP10MG ER ............................................ 37 AMPHETAMINE CAP15MG ER ............................................ 37 AMPHETAMINE CAP20MG ER ............................................ 37 AMPHETAMINE CAP25MG ER ............................................ 37 AMPHETAMINE CAP30MG ER ............................................ 37 AMPHETAMINE CAP5MG ER .............................................. 38 AMPHETAMINE TAB10MG .................................................. 38 AMPHETAMINE TAB12.5MG ............................................... 38 AMPHETAMINE TAB15MG .................................................. 38 AMPHETAMINE TAB20MG .................................................. 38 AMPHETAMINE TAB30MG .................................................. 38 AMPHETAMINE TAB5MG ................................................... 38 AMPHETAMINE TAB7.5MG ................................................. 38 Anabolic Steroids .............................................................. 45 Analgesics .......................................................................... 4 ANASTROZOLE TAB1MG ................................................... 21 Androgens ........................................................................ 45 Anesthetics ......................................................................... 7

57

Angiotensin II Receptor Antagonists .................................. 31 Angiotensin-converting Enzyme (ACE) Inhibitors ............... 31 ANORO ELLIPTAER62.5-25 ................................................. 53 Anthelmintics ..................................................................... 22 Anti-Addiction/Substance Abuse Treatment Agents ............. 7 Antiandrogens ................................................................... 48 Antiangiogenic Agents ....................................................... 21 Antiarrhythmics ................................................................. 32 Antibacterials ................................................................... 7, 8 Antibacterials, Other ............................................................ 8 Anticholinergics ................................................................. 23 Anticoagulants ................................................................... 29 Anticonvulsants ................................................................. 12 Anticonvulsants, Other ...................................................... 12 Anti-cytomegalovirus (CMV) Agents ................................... 25 Antidementia Agents .......................................................... 14 Antidementia Agents, Other ............................................... 14 Antidepressants ................................................................. 15 Antidepressants, Other ...................................................... 15 Antidiabetic Agents ............................................................ 27 Antiemetics ........................................................................ 17 Antiemetics, Other ............................................................. 17 Antiestrogens/Modifiers ..................................................... 21 Antifungals ........................................................................ 18 Antigout Agents ................................................................. 19 Antihepatitis Agents .......................................................... 25 Antiherpetic Agents ........................................................... 26 Antihistamines ................................................................... 52 Anti-HIV Agents, Non-nucleoside Reverse Transcriptase

Inhibitors ...................................................................... 26 Anti-HIV Agents, Nucleoside and Nucleotide Reverse

Transcriptase Inhibitors ................................................ 26 Anti-HIV Agents, Other ....................................................... 27 Anti-HIV Agents, Protease Inhibitors .................................. 27 Anti-inflammatories, Inhaled Corticosteroids ...................... 52 Anti-inflammatory Agents .................................................. 19 Anti-influenza Agents ......................................................... 27 Antileukotrienes ................................................................. 53 Antimetabolites .................................................................. 21 Antimigraine Agents .......................................................... 20 Antimyasthenic Agents ...................................................... 20 Antimycobacterials ............................................................ 20 Antimycobacterials, Other .................................................. 20 Antineoplastics .................................................................. 21 Antineoplastics, Other ....................................................... 21 Antiparasitics ..................................................................... 22 Antiparkinson Agents .................................................. 22, 23 Antiparkinson Agents, Other .............................................. 23 Antiprotozoals ................................................................... 22 Antipsychotics ................................................................... 23 Antispasmodics, Gastrointestinal....................................... 41 Antispasmodics, Urinary .................................................... 42 Antispasticity Agents ......................................................... 25 Antithyroid Agents ............................................................. 49 Antituberculars .................................................................. 20 Antivirals ........................................................................... 25 Anxiolytics ......................................................................... 27 Anxiolytics, Other .............................................................. 27 APRACLONIDINSOL0.5% OP .............................................. 51

ARICEPT ODT TAB10MG .................................................... 14 ARICEPT ODT TAB5MG ..................................................... 14 Aromatase Inhibitors, 3rd Generation ................................ 21 ASMANEX 120 AER220MCG ............................................... 52 ASMANEX HFA AER100 MCG ............................................. 52 ASMANEX HFA AER200 MCG ............................................. 52 ASTAGRAF XL CAP0.5MG .................................................. 49 ASTAGRAF XL CAP1MG ..................................................... 49 ASTAGRAF XL CAP5MG ..................................................... 49 ASTELIN NASASPR137MCG ............................................... 52 ATORVASTATINTAB10MG ................................................. 36 ATORVASTATINTAB20MG ................................................. 36 ATORVASTATINTAB40MG ................................................. 36 ATORVASTATINTAB80MG ................................................. 36 ATOVAQ/PROGUTAB250-100 ............................................. 22 ATOVAQ/PROGUTAB62.5-25 .............................................. 22 ATROVENT HFAAER17MCG ............................................... 53 ATROVENT NASSOL0.03% ................................................. 53 ATROVENT NASSOL0.06% ................................................. 53 Attention Deficit Hyperactivity Disorder Agents,

Amphetamines ............................................................. 37 Attention Deficit Hyperactivity Disorder Agents, Non-

amphetamines ............................................................. 38 AUG BETAMET CRE0.05% ................................................. 43 AUG BETAMET GEL0.05% .................................................. 43 AUG BETAMET LOT0.05% .................................................. 43 AUG BETAMET OIN0.05% .................................................. 43 AUGMENTIN XRTAB12HR .................................................. 10 AVONEX PREFLKIT30MCG ................................................ 39 AZATHIOPRINETAB50MG .................................................. 49 AZITHROMYCINPOW1GM PAK ........................................... 10 AZITHROMYCINSUS100/5ML .............................................. 10 AZITHROMYCINSUS200/5ML .............................................. 10 AZITHROMYCINTAB250MG ................................................ 10 AZITHROMYCINTAB500MG ................................................ 10 AZITHROMYCINTAB600MG ................................................ 10

B

BALSALAZIDE CAP750MG ................................................. 50 BECONASE AQ SUS0.042% ............................................... 52 Benign Prostatic Hypertrophy Agents ................................ 42 BENZTROPINE TAB0.5MG ................................................. 23 BENZTROPINE TAB1MG .................................................... 23 BENZTROPINE TAB2MG .................................................... 23 Beta-adrenergic Blocking Agents ...................................... 33 Beta-lactam, Cephalosporins ............................................... 9 Beta-lactam, Other ............................................................... 9 Beta-lactam, Penicillins ....................................................... 9 BETAMETH DIPCRE0.05% ................................................. 43 BETAMETH DIPLOT0.05% .................................................. 43 BETAMETH DIPOIN0.05% ................................................... 43 BETAMETH VALCRE0.1% ................................................... 43 BETAMETH VALLOT0.1% ................................................... 43 BETAMETH VALOIN0.1% .................................................... 43 BETAPACE AF TAB120MG ................................................. 32 BETAPACE AF TAB160MG ................................................. 32 BETAPACE AF TAB80MG ................................................... 32 BETHANECHOL TAB10MG ................................................. 43

58

BETHANECHOL TAB25MG .................................................. 43 BETHANECHOL TAB50MG .................................................. 43 BETHANECHOL TAB5MG ................................................... 43 BICALUTAMIDETAB50MG ................................................... 48 Bipolar Agents ................................................................... 27 BISOPROL FUMTAB10MG .................................................. 33 BISOPROL FUMTAB5MG .................................................... 33 Blood Formation Modifiers ................................................. 30 Blood Glucose Regulators ................................................. 27 Blood Products/Modifiers/ Volume Expanders .................... 29 BP CLEANSINGEMU10-4% ................................................. 11 BREO ELLIPTAINH100-25 ................................................... 52 BRIMONIDINE SOL0.15% .................................................... 51 BRIMONIDINE SOL0.2% OP ................................................ 51 BROMOCRIPTINCAP5MG ................................................... 23 BROMOCRIPTINTAB2.5MG ................................................. 23 Bronchodilators, Anticholinergic ........................................ 53 Bronchodilators, Phosphodiesterase Inhibitors (Xanthines)

..................................................................................... 53 Bronchodilators, Sympathomimetic ................................... 53 BUPRENORPHINSUB2MG .................................................... 7 BUPRENORPHINSUB8MG .................................................... 7 BUPROPN HCL TAB150MG XL ............................................ 15 BUPROPN HCL TAB300MG XL ............................................ 15 BUT/APAP/CAFCAPCODEINE ............................................... 6 BUTORPHANOL SOL10MG/ML .............................................. 6

C

CABERGOLINE TAB0.5MG .................................................. 48 CALC ACETATECAP667MG ................................................ 43 CALC ACETATETAB667MG ................................................. 43 CALCIPOTRIENCRE0.005% ................................................ 40 CALCIPOTRIENOINBETAMETH ........................................... 40 CALCIPOTRIENSOL0.005% ................................................. 40 Calcium Channel Blocking Agents ..................................... 33 Calcium Channel Modifying Agents .................................... 12 CANDESARTAN TAB16MG ................................................. 31 CANDESARTAN TAB32MG ................................................. 31 CARB/LEVO ERTAB25-100MG ............................................ 23 CARB/LEVO ERTAB50-200MG ............................................ 23 CARBAMAZEPINCAP100MG ER .......................................... 14 CARBAMAZEPINCAP200MG ER .......................................... 14 CARBAMAZEPINCAP300MG ER .......................................... 14 CARBAMAZEPINCHW100MG .............................................. 14 CARBAMAZEPINSUS100/5ML ............................................. 14 CARBAMAZEPINTAB200MG ............................................... 14 CARBAMAZEPINTAB200MG ER .......................................... 14 CARBAMAZEPINTAB400MG ER .......................................... 14 CARBINOXAMINSOL4MG/5ML ............................................ 52 CARBINOXAMINTAB4MG .................................................... 52 Cardiovascular Agents ................................................. 30, 35 Cardiovascular Agents, Other ............................................ 35 CARDIZEM CD CAP120MG/24 ............................................. 34 CARDIZEM CD CAP180MG/24 ............................................. 34 CARDIZEM CD CAP240MG/24 ............................................. 34 CARDIZEM CD CAP300MG/24 ............................................. 34 CARDIZEM CD CAP360MG/24 ............................................. 34

CARDIZEM LA TAB120MG .................................................. 34 CARDIZEM LA TAB180MG .................................................. 34 CARDIZEM LA TAB240MG .................................................. 34 CARDIZEM LA TAB300MG/24 ............................................. 34 CARDIZEM LA TAB360MG .................................................. 34 CARDIZEM LA TAB420MG/24 ............................................. 34 CARISOPRODOLTAB250MG .............................................. 54 CARISOPRODOLTAB350MG .............................................. 54 CATAPRES-TTSDIS0.1/24HR .............................................. 30 CATAPRES-TTSDIS0.2/24HR .............................................. 30 CATAPRES-TTSDIS0.3/24HR .............................................. 30 CEFACLOR ER TAB500MG ................................................... 9 CEFPODO PROXSUS100/5ML .............................................. 9 CEFPODO PROXSUS50MG/5ML ........................................... 9 CEFPODOXIME TAB100MG .................................................. 9 CEFPODOXIME TAB200MG .................................................. 9 CEFTAZIDIME/SOLD5W 1GM ............................................... 9 CEFTRIAXONE INJ10GM ...................................................... 9 Central Nervous System Agents .................................. 37, 39 Central Nervous System Agents, Other .............................. 39 CHLORHEX GLUSOL0.12% ................................................ 39 CHLOROQUINE TAB250MG ............................................... 22 CHLOROQUINE TAB500MG ............................................... 22 CHLOROTHIAZ TAB250MG ................................................ 35 CHLOROTHIAZ TAB500MG ................................................ 35 CHLORPROMAZ TAB100MG .............................................. 17 CHLORPROMAZ TAB10MG ................................................ 17 CHLORPROMAZ TAB200MG .............................................. 17 CHLORPROMAZ TAB25MG ................................................ 17 CHLORPROMAZ TAB50MG ................................................ 17 CHLORPROPAM TAB100MG .............................................. 28 CHLORPROPAM TAB250MG .............................................. 28 CHLORTHALID TAB100MG ................................................. 36 CHLORTHALID TAB25MG ................................................... 36 CHLORTHALID TAB50MG ................................................... 36 CHLORZOXAZONTAB500MG .............................................. 54 CHOLESTYRAM POW4GM LITE ......................................... 37 Cholinesterase Inhibitors ................................................... 14 CIMZIA PREFLKIT200MG/ML .............................................. 49 CIPRO (10%) SUS500MG/5 ................................................. 10 CIPROFLOXACNSOL0.3% OP ............................................ 10 CIPROFLOXACNSUS250MG/5 ............................................ 11 CIPROFLOXACNSUS500MG/5 ............................................ 11 CIPROFLOXACNTAB1000MG ............................................. 11 CIPROFLOXACNTAB100MG ............................................... 11 CIPROFLOXACNTAB250MG ............................................... 11 CIPROFLOXACNTAB500MG ............................................... 11 CIPROFLOXACNTAB500MG ER .......................................... 11 CIPROFLOXACNTAB750MG ............................................... 11 CLARINEX RDTTAB2.5MG .................................................. 52 CLARITHROMYCSUS125/5ML ............................................ 10 CLARITHROMYCSUS250/5ML ............................................ 10 CLARITHROMYCTAB250MG ............................................... 10 CLARITHROMYCTAB500MG ............................................... 10 CLARITHROMYCTAB500MG ER ......................................... 10 CLEOCIN PED SOL75MG/5ML .............................................. 8 CLINDA-DERM SOL1% ......................................................... 8 CLINDAMY/BENGEL1-5% ................................................... 40

59

CLINDAMYCIN AER1% ......................................................... 8 CLINDAMYCIN CAP150MG ................................................... 8 CLINDAMYCIN CAP300MG ................................................... 8 CLINDAMYCIN CAP75MG ..................................................... 8 CLINDAMYCIN CRE2% VAG ................................................. 8 CLINDAMYCIN GEL1% .......................................................... 8 CLINDAMYCIN LOT1% .......................................................... 8 CLINDAMYCIN PAD1% ......................................................... 8 CLINDAMYCIN SOL1% .......................................................... 8 CLINDAMYCIN SOL75MG/5ML .............................................. 8 CLOBETASOL ECRE0.05% ................................................. 43 CLOCORTOLONECREPIV 0.1% .......................................... 43 CLOMIPRAMINECAP25MG ................................................. 17 CLOMIPRAMINECAP50MG ................................................. 17 CLOMIPRAMINECAP75MG ................................................. 17 CLOPIDOGREL TAB300MG ................................................. 30 CLOPIDOGREL TAB75MG ................................................... 30 CLOTRIM/BETACREDIPROP ............................................... 40 CLOTRIM/BETALOTDIPROP ............................................... 40 CLOTRIMAZOLETRO10MG ................................................. 18 Coagulants ........................................................................ 30 CODEINE SULFTAB15MG ..................................................... 6 CODEINE SULFTAB30MG ..................................................... 6 CODEINE SULFTAB60MG ..................................................... 6 COLY-MYCIN SSUSOTIC .................................................... 52 CORDRAN 80X3TAP4MCG/CM ............................................ 43 CORTISONE ACTAB25MG .................................................. 43 CORTISPORIN CRE0.5% .................................................... 40 CORTISPORIN OIN1% ........................................................ 40 CORTISPORIN SOL1% OTIC ............................................... 52 CORTISPORIN SUS-TC OTIC .............................................. 52 CROMOLYN SODCON100/5ML ............................................ 54 CROMOLYN SODNEB20MG/2ML ......................................... 54 CROMOLYN SODSOL4% OP ............................................... 51 CYCLOBENZAPRCAP15MG ER ........................................... 54 CYCLOBENZAPRCAP30MG ER ........................................... 54 CYCLOBENZAPRTAB10MG ................................................ 54 CYCLOBENZAPRTAB5MG .................................................. 54 CYCLOBENZAPRTAB7.5MG................................................ 54 CYCLOPHOSPH TAB25MG ................................................. 21 CYCLOPHOSPH TAB50MG ................................................. 21 CYCLOSERINE CAP250MG ................................................. 20 CYCLOSPORINECAP100MG ............................................... 49 CYCLOSPORINECAP100MG MD ......................................... 49 CYCLOSPORINECAP25MG ................................................. 49 CYCLOSPORINECAP25MG MOD ........................................ 49 CYCLOSPORINECAP50MG MOD ........................................ 49 CYCLOSPORINESOLMODIFIED .......................................... 49 CYPROHEPTAD SYP2MG/5ML ............................................ 52 CYPROHEPTAD TAB4MG ................................................... 52

D

DELATESTRYL INJ200MG/ML ............................................. 46 DELESTROGEN INJ10MG/ML.............................................. 46 DELESTROGEN INJ20MG/ML.............................................. 46 DELESTROGEN INJ40MG/ML.............................................. 46 DEMECLOCYCL TAB150MG ............................................... 11

DEMECLOCYCL TAB300MG ............................................... 11 Dental and Oral Agents ...................................................... 39 DEPAKOTE ER TAB250MG ................................................. 12 DEPAKOTE ER TAB500MG ................................................. 12 DEPAKOTE SPRCAP125MG ............................................... 12 DEPEN TITRA TAB250MG .................................................. 43 DEPO-ESTRADIINJ5MG/ML ................................................ 46 DEPO-TESTOSTINJ100MG/ML ........................................... 46 DEPO-TESTOSTINJ200MG/ML ........................................... 46 DERMA-SMOOTHOIL/FS BODY .......................................... 43 Dermatological Agents ...................................................... 39 DESIPRAMINE TAB100MG ................................................. 17 DESIPRAMINE TAB10MG ................................................... 17 DESIPRAMINE TAB150MG ................................................. 17 DESIPRAMINE TAB25MG ................................................... 17 DESIPRAMINE TAB50MG ................................................... 17 DESIPRAMINE TAB75MG ................................................... 17 DESLORATADINTAB2.5 ODT .............................................. 52 DESLORATADINTAB5MG ................................................... 52 DESLORATADINTAB5MG ODT ........................................... 52 DESMOPRESSINSOL0.01% ................................................ 45 DESMOPRESSINSPR0.01% ............................................... 45 DESMOPRESSINTAB0.1MG ............................................... 45 DESMOPRESSINTAB0.2MG ............................................... 45 DESO/ETHINYLTABESTRADIO ........................................... 47 DESOXIMETAS CRE0.05% ................................................. 44 DESOXIMETAS CRE0.25% ................................................. 44 DESOXIMETAS GEL0.05% ................................................. 44 DESOXIMETAS OIN0.05% .................................................. 44 DESOXIMETAS OIN0.25% .................................................. 44 DEXAMETH PHOSOL0.1% OP ............................................ 51 DEXAMETHASONCON1MG/ML ........................................... 44 DEXAMETHASONELX0.5/5ML ............................................ 44 DEXAMETHASONTAB0.5MG .............................................. 44 DEXAMETHASONTAB0.75MG ............................................ 44 DEXAMETHASONTAB1.5MG .............................................. 44 DEXAMETHASONTAB1MG ................................................. 44 DEXAMETHASONTAB2MG ................................................. 44 DEXAMETHASONTAB4MG ................................................. 44 DEXAMETHASONTAB6MG ................................................. 44 DEXCHLORPHENSYP2MG/5ML .......................................... 52 DEXMETHYLPH CAP15MG ER ........................................... 38 DEXMETHYLPH CAP30MG ER ........................................... 38 DEXMETHYLPH CAP40MG ER ........................................... 38 DEXMETHYLPH TAB10MG ................................................. 38 DEXMETHYLPH TAB2.5MG ................................................ 38 DEXMETHYLPH TAB5MG ................................................... 38 DEXTROAMPHETCAP10MG ER .......................................... 38 DEXTROAMPHETCAP15MG ER .......................................... 38 DEXTROAMPHETCAP5MG ER ........................................... 38 DEXTROAMPHETTAB10MG ............................................... 38 DEXTROAMPHETTAB5MG ................................................. 38 DIAMOX SEQUECAP500MG CR .......................................... 35 DIBENZYLINE CAP10MG .................................................... 31 DICLOFEN POTTAB50MG .................................................... 4 DICLOXACILL CAP250MG .................................................. 10 DICLOXACILL CAP500MG .................................................. 10 DICYCLOMINE CAP10MG ................................................... 41

60

DICYCLOMINE SOL10MG/5ML ............................................ 41 DICYCLOMINE TAB20MG ................................................... 41 DIFLORASONE CRE0.05% .................................................. 44 DIFLORASONE OIN0.05% ................................................... 44 DIHYDROERGOTINJ1MG/ML .............................................. 20 DILATRATE SRCAP40MG ................................................... 37 DILTIAZEM XRCAP120MG/24 .............................................. 34 DIPHEN/ATROPLIQ2.5/5 ..................................................... 41 DIPHEN/ATROPTAB2.5MG .................................................. 41 DIPROLENE AFCRE0.05% .................................................. 44 DIPYRIDAMOLETAB25MG .................................................. 30 DIPYRIDAMOLETAB50MG .................................................. 30 DIPYRIDAMOLETAB75MG .................................................. 30 DISOPYRAMIDECAP100MG ................................................ 32 DISOPYRAMIDECAP150MG ................................................ 32 DITROPAN XL TAB10MG .................................................... 42 DITROPAN XL TAB15MG .................................................... 42 DITROPAN XL TAB5MG ...................................................... 42 Diuretics, Carbonic Anhydrase Inhibitors ........................... 35 Diuretics, Loop .................................................................. 35 Diuretics, Potassium-sparing ............................................. 35 Diuretics, Thiazide ............................................................. 35 Dopamine Agonists ............................................................ 23 Dopamine Precursors/ L-Amino Acid Decarboxylase

Inhibitors ...................................................................... 23 DORZOL/TIMOLSOL2-0.5%OP ............................................ 51 DORZOLAMIDE SOL2% OP ................................................. 51 DOVONX SCALPSOL0.005% ............................................... 40 DOXEPIN HCL CAP100MG .................................................. 17 DOXEPIN HCL CAP10MG .................................................... 17 DOXEPIN HCL CAP150MG .................................................. 17 DOXEPIN HCL CAP25MG .................................................... 17 DOXEPIN HCL CAP50MG .................................................... 17 DOXEPIN HCL CAP75MG .................................................... 17 DOXEPIN HCL CON10MG/ML .............................................. 17 DOXERCALCIF CAP0.5MCG ............................................... 50 DOXERCALCIF CAP1MCG .................................................. 50 DOXERCALCIF CAP2.5MCG ............................................... 50 DOXYCYC MONOTAB150MG .............................................. 11 DOXYCYC MONOTAB50MG ................................................ 11 DOXYCYC MONOTAB75MG ................................................ 11 DOXYCYCL HYCCAP100MG ............................................... 11 DOXYCYCL HYCCAP50MG ................................................. 11 DOXYCYCL HYCTAB100MG ............................................... 11 DOXYCYCL HYCTAB100MG DR .......................................... 11 DOXYCYCL HYCTAB150MG DR .......................................... 11 DOXYCYCL HYCTAB75MG DR ............................................ 11 DOXYCYCLINE CAP150MG ................................................. 11 DOXYCYCLINE CAP75MG .................................................. 11 DOXYCYCLINE SUS25MG/5ML ........................................... 11 DOXYCYCLINE TAB20MG ................................................... 11 DYNACIRC CR TAB5MG ..................................................... 34 Dyslipidemics, Fibric Acid Derivatives ............................... 36 Dyslipidemics, HMG CoA Reductase Inhibitors .................. 36 Dyslipidemics, Other .......................................................... 37

E

E.E.S. GRAN SUS200/5ML .................................................. 10 EC-NAPROSYN TAB375MG .................................................. 4 EC-NAPROSYN TAB500MG .................................................. 4 Electrolyte/Mineral Modifiers ............................................. 55 Electrolyte/Mineral Replacement ........................................ 55 ELIXOPHYLLINELX80/15ML ................................................ 53 Emetogenic Therapy Adjuncts ........................................... 18 ENTOCORT EC CAP3MG/24HR .......................................... 44 Enzyme Inhibitors .............................................................. 21 Enzyme Replacement/ Modifiers ........................................ 41 EPINEPHRINE INJ0.15MG .................................................. 53 EPINEPHRINE INJ0.1MG/ML ............................................... 53 EPINEPHRINE INJ0.3MG .................................................... 53 EPIPEN 2-PAKINJ0.3MG ..................................................... 53 EPROSART MESTAB600MG ............................................... 31 ERGOLOID MESTAB1MG ORAL ......................................... 14 Ergot Alkaloids .................................................................. 20 ERYTHRA-DERMSOL2% .................................................... 10 ERYTHROM ETHTAB400MG ............................................... 10 ERYTHROMYCINGEL/BENZOYL ......................................... 40 ERYTHROMYCINGEL2% .................................................... 10 ERYTHROMYCINOINOP ..................................................... 10 ERYTHROMYCINPAD2% .................................................... 10 ERYTHROMYCINSOL2% .................................................... 10 ERYTHROMYCINTAB250MG BS ......................................... 10 ERYTHROMYCINTAB500MG BS ......................................... 10 ESCITALOPRAMSOL5MG/5ML ........................................... 16 ESCITALOPRAMTAB10MG ................................................. 16 ESCITALOPRAMTAB20MG ................................................. 16 ESCITALOPRAMTAB5MG ................................................... 16 ESTRACE VAG CRE0.1MG/GM ........................................... 46 Estrogens .......................................................................... 46 ESTROPIPATE TAB0.75MG ................................................ 46 ESTROPIPATE TAB1.5MG .................................................. 46 ESTROPIPATE TAB3MG ..................................................... 46 ESZOPICLONE TAB1MG .................................................... 54 ESZOPICLONE TAB2MG .................................................... 54 ESZOPICLONE TAB3MG .................................................... 54 ETHOSUXIMIDECAP250MG................................................ 12 ETHOSUXIMIDESOL250/5ML .............................................. 12 ETIDRON DISDTAB200MG ................................................. 50 ETIDRON DISDTAB400MG ................................................. 50 ETODOLAC ER TAB400MG .................................................. 4 ETODOLAC ER TAB500MG .................................................. 4 ETODOLAC ER TAB600MG .................................................. 4

F

FAMCICLOVIR TAB125MG ................................................. 26 FAMCICLOVIR TAB250MG ................................................. 26 FAMCICLOVIR TAB500MG ................................................. 26 FENOFIBRATE CAP130MG ................................................. 36 FENOFIBRATE CAP134MG ................................................. 36 FENOFIBRATE CAP150MG ................................................. 36 FENOFIBRATE CAP200MG ................................................. 36 FENOFIBRATE CAP43MG .................................................. 36

61

FENOFIBRATE CAP50MG ................................................... 36 FENOFIBRATE CAP67MG ................................................... 36 FENOFIBRATE TAB145MG ................................................. 36 FENOFIBRATE TAB160MG ................................................. 36 FENOFIBRATE TAB48MG ................................................... 36 FENOFIBRATE TAB54MG ................................................... 36 FENTANYL OT LOZ1200MCG ................................................ 5 FENTANYL OT LOZ1600MCG ................................................ 5 FENTANYL OT LOZ200MCG ................................................. 5 FENTANYL OT LOZ400MCG ................................................. 5 FENTANYL OT LOZ600MCG ................................................. 5 FENTANYL OT LOZ800MCG ................................................. 5 Fibromyalgia Agents .......................................................... 39 FINASTERIDE TAB5MG ...................................................... 42 FLOVENT DISKAER100MCG ............................................... 52 FLOVENT DISKAER250MCG ............................................... 52 FLOVENT DISKAER50MCG ................................................. 52 FLOVENT HFA AER110MCG ............................................... 52 FLOVENT HFA AER220MCG ............................................... 52 FLOVENT HFA AER44MCG ................................................. 52 FLOXIN OTIC DRO0.3% ...................................................... 11 FLUCONAZOLE SUS10MG/ML ............................................ 18 FLUCONAZOLE SUS40MG/ML ............................................ 18 FLUCONAZOLE TAB100MG ................................................ 18 FLUCONAZOLE TAB150MG ................................................ 18 FLUCONAZOLE TAB200MG ................................................ 18 FLUCONAZOLE TAB50MG .................................................. 18 FLUCYTOSINE CAP250MG ................................................. 18 FLUCYTOSINE CAP500MG ................................................. 19 FLUNISOLIDE SPR0.025% .................................................. 52 FLUOCIN ACETCRE0.01% .................................................. 44 FLUOCIN ACETCRE0.025% ................................................ 44 FLUOCIN ACETOIL0.01% .................................................... 52 FLUOCIN ACETOILBODY .................................................... 44 FLUOCIN ACETOIN0.025% ................................................. 44 FLUOCIN ACETSOL0.01% ................................................... 44 FLUOCINONIDECRE0.1% ................................................... 44 FLUOCINONIDECRE-E 0.05% ............................................. 44 FLUOCINONIDEGEL0.05% .................................................. 44 FLUOCINONIDEOIN0.05% ................................................... 44 FLUOCINONIDESOL0.05% .................................................. 44 FLUOROMETHOLSUS0.1% OP ........................................... 52 FLUOROURACILCRE5% ..................................................... 40 FLUOROURACILSOL2% ..................................................... 40 FLUOROURACILSOL5% ..................................................... 40 FLUPHENAZINECON5MG/ML .............................................. 23 FLUPHENAZINEELX2.5/5ML ............................................... 24 FLUPHENAZINETAB10MG .................................................. 24 FLUPHENAZINETAB1MG .................................................... 24 FLUPHENAZINETAB2.5MG ................................................. 24 FLUPHENAZINETAB5MG .................................................... 24 FLURBIPROFENSOL0.03% OP ............................................ 52 FLURBIPROFENTAB100MG .................................................. 4 FLURBIPROFENTAB50MG .................................................... 4 FLUTICASONE CRE0.05% .................................................. 44 FLUTICASONE LOT0.05% ................................................... 44 FLUTICASONE OIN0.005% .................................................. 44 FLUTICASONE SPR50MCG ................................................. 52

FLUVASTATIN CAP20MG ................................................... 36 FLUVASTATIN CAP40MG ................................................... 36 FLUVOXAMINE TAB100MG ................................................ 16 FLUVOXAMINE TAB25MG .................................................. 16 FLUVOXAMINE TAB50MG .................................................. 16 FML LIQUIFLMSUS0.1% OP................................................ 52 FONDAPARINUXSOL10/0.8 ................................................ 29 FONDAPARINUXSOL2.5/0.5 ............................................... 29 FONDAPARINUXSOL5.0/0.4 ............................................... 29 FONDAPARINUXSOL7.5/0.6 ............................................... 29 FOSAMAX + D TAB70-2800 ................................................ 50 FOSAMAX + D TAB70-5600 ................................................ 50

G

GABA Receptor Modulators ............................................... 54 GALANTAMINE CAP16MG ER ............................................ 14 GALANTAMINE CAP24MG ER ............................................ 14 GALANTAMINE CAP8MG ER .............................................. 14 GALANTAMINE SOL4MG/ML .............................................. 14 GALANTAMINE TAB12MG .................................................. 14 GALANTAMINE TAB4MG .................................................... 14 GALANTAMINE TAB8MG .................................................... 14 Gamma-aminobutyric Acid (GABA) Augmenting Agents .... 12 Gastrointestinal Agents ..................................................... 41 Gastrointestinal Agents, Other .......................................... 41 GATIFLOXACINSOL0.5% .................................................... 11 GEMFIBROZIL TAB600MG .................................................. 36 Genitourinary Agents .................................................. 42, 43 Genitourinary Agents, Other .............................................. 43 GLIMEPIRIDE TAB1MG ...................................................... 28 GLIMEPIRIDE TAB2MG ...................................................... 28 GLIMEPIRIDE TAB4MG ...................................................... 28 GLIPIZIDE ERTAB10MG ..................................................... 28 GLIPIZIDE ERTAB2.5MG .................................................... 28 GLIPIZIDE ERTAB5MG ....................................................... 28 Glucocorticoids ..................................................... 19, 43, 50 Glucocorticoids/Mineralocorticoids ................................... 43 GLUCOTROL XLTAB10MG ................................................. 28 GLUCOTROL XLTAB2.5MG ................................................ 28 GLUCOTROL XLTAB5MG ................................................... 28 Glutamate Reducing Agents .............................................. 13 GLYBURID MCRTAB1.5MG ................................................. 28 GLYBURID MCRTAB3MG ................................................... 28 GLYBURID MCRTAB6MG ................................................... 28 Glycemic Agents ............................................................... 29 GLYCOPYRROL TAB1MG ................................................... 41 GLYCOPYRROL TAB2MG ................................................... 41 GRALISE STARMIS300/600 ................................................ 13 GRANISETRON TAB1MG ................................................... 18 GRIFULVIN V TAB500MG ................................................... 19 GRISEOFULVINSUS125/5ML .............................................. 19 GRISEOFULVINTABMICR 500 ............................................ 19 GRISEOFULVINTABULTR 125 ............................................ 19 GRISEOFULVINTABULTR 250 ............................................ 19

62

H

HALOBETASOL CRE0.05% ................................................. 44 HALOBETASOL OIN0.05% .................................................. 44 HALOPERIDOL CON2MG/ML .............................................. 24 HALOPERIDOL TAB0.5MG .................................................. 24 HALOPERIDOL TAB10MG ................................................... 24 HALOPERIDOL TAB1MG ..................................................... 24 HALOPERIDOL TAB20MG ................................................... 24 HALOPERIDOL TAB2MG ..................................................... 24 HALOPERIDOL TAB5MG ..................................................... 24 HC BUTYRATE CRE0.1% .................................................... 44 HC BUTYRATE OIN0.1% ..................................................... 44 HC BUTYRATE SOL0.1% .................................................... 44 HC VALERATE CRE0.2% .................................................... 44 HC VALERATE OIN0.2% ..................................................... 44 HC/ACET ACIDSOLOTIC ..................................................... 52 HEPARIN LOCKINJ100/ML .................................................. 29 HEPARIN SOD INJ1000/ML ................................................. 29 HEPARIN SOD INJ10000/ML ............................................... 29 HEPARIN SOD INJ5000/ML ................................................. 29 HEP-LOCK U/PINJ100/ML ................................................... 29 Histamine2 (H2) Receptor Antagonists ............................... 41 Hormonal Agents, Stimulant/ Replacement/ Modifying

(Adrenal) ...................................................................... 43 Hormonal Agents, Stimulant/Replacement/Modifying

(Pituitary) ...................................................................... 45 Hormonal Agents, Stimulant/Replacement/Modifying (Sex

Hormones/Modifiers) .................................................... 45 Hormonal Agents, Stimulant/Replacement/Modifying

(Thyroid) ....................................................................... 47 Hormonal Agents, Suppressant (Adrenal) .......................... 48 Hormonal Agents, Suppressant (Parathyroid)..................... 48 Hormonal Agents, Suppressant (Pituitary) .......................... 48 Hormonal Agents, Suppressant (Sex Hormones/Modifiers) . 48 Hormonal Agents, Suppressant (Thyroid) ........................... 49 HUMALOG MIX INJ50/50 ..................................................... 29 HUMALOG MIX INJ50/50KWP .............................................. 29 HUMALOG MIX INJ75/25KWP .............................................. 29 HUMALOG MIX SUS75/25 ................................................... 29 HYDRALAZINE TAB100MG ................................................. 37 HYDRALAZINE TAB10MG ................................................... 37 HYDRALAZINE TAB25MG ................................................... 37 HYDRALAZINE TAB50MG ................................................... 37 HYDROCHLOROTCAP12.5MG ............................................ 36 HYDROCHLOROTTAB12.5MG ............................................. 36 HYDROCHLOROTTAB25MG ............................................... 36 HYDROCHLOROTTAB50MG ............................................... 36 HYDROMORPHONLIQ1MG/ML .............................................. 6 HYDROMORPHONTAB12MG ER ........................................... 5 HYDROMORPHONTAB16MG ER ........................................... 5 HYDROMORPHONTAB2MG .................................................. 6 HYDROMORPHONTAB32MG ER ........................................... 5 HYDROMORPHONTAB4MG .................................................. 6 HYDROMORPHONTAB8MG .............................................. 5, 6 HYDROMORPHONTAB8MG ER ............................................. 5 HYDROXYCHLORTAB200MG .............................................. 22 HYDROXYUREA CAP500MG ............................................... 21 HYDROXYZ HCLSOL10MG/5ML .......................................... 17

HYDROXYZ HCLTAB10MG ................................................. 17 HYDROXYZ HCLTAB25MG ................................................. 17 HYDROXYZ HCLTAB50MG ................................................. 17 HYDROXYZ PAMCAP100MG .............................................. 17 HYDROXYZ PAMCAP25MG ................................................ 17 HYDROXYZ PAMCAP50MG ................................................ 17

I

IBANDRONATE TAB150MG ................................................ 50 IMIPRAM HCL TAB10MG .................................................... 17 IMIPRAM HCL TAB25MG .................................................... 17 IMIPRAM HCL TAB50MG .................................................... 17 IMIPRAM PAM CAP100MG ................................................. 17 IMIPRAM PAM CAP125MG ................................................. 17 IMIPRAM PAM CAP150MG ................................................. 17 IMIPRAM PAM CAP75MG ................................................... 17 Immune Suppressants ....................................................... 49 Immunizing Agents, Passive .............................................. 49 Immunological Agents ....................................................... 49 Immunomodulators ........................................................... 49 INDOMETHACINCAP25MG ................................................... 4 INDOMETHACINCAP50MG ................................................... 4 INDOMETHACINCAP75MG ER .............................................. 4 Inflammatory Bowel Disease Agents .................................. 50 INNOPRAN XL CAP120MG ................................................. 33 INNOPRAN XL CAP80MG ................................................... 33 Insulins ............................................................................. 29 IPRATROPIUM SOL0.02%INH ............................................. 53 IPRATROPIUM SPR0.03% .................................................. 53 IPRATROPIUM SPR0.06% .................................................. 53 Irritable Bowel Syndrome Agents....................................... 42 ISOPTO CARP SOL1% OP .................................................. 51 ISOPTO CARP SOL2% OP .................................................. 51 ISOPTO CARP SOL4% OP .................................................. 51 ISOSORB DIN SUB2.5MG ................................................... 37 ISOSORB DIN SUB5MG ...................................................... 37 ISOSORB DIN TAB10MG .................................................... 37 ISOSORB DIN TAB20MG .................................................... 37 ISOSORB DIN TAB30MG .................................................... 37 ISOSORB DIN TAB40MG ER ............................................... 37 ISOSORB DIN TAB5MG ...................................................... 37 ISOSORB MONOTAB10MG ................................................. 37 ISOSORB MONOTAB120MG ER ......................................... 37 ISOSORB MONOTAB20MG ................................................. 37 ISOSORB MONOTAB30MG ER ........................................... 37 ISOSORB MONOTAB60MG ER ........................................... 37 ITRACONAZOLECAP100MG ............................................... 19

K

KETOCONAZOLEAER2% ................................................... 19 KETOCONAZOLECRE2% ................................................... 19 KETOCONAZOLESHA2% ................................................... 19 KETOCONAZOLETAB200MG .............................................. 19 KLOR-CON 10 TAB10MEQ ER ............................................ 55 KLOR-CON M15TAB ........................................................... 55 KLOR-CON M20TAB20MEQ ER .......................................... 55

63

L

LAMICTAL ODTKIT ............................................................. 13 LAMICTAL ODTTAB100MG ................................................. 13 LAMICTAL ODTTAB200MG ................................................. 13 LAMICTAL ODTTAB25MG ................................................... 13 LAMICTAL ODTTAB50MG ................................................... 13 LAMICTAL XR KIT ............................................................... 13 LAMICTAL XR TAB100MG ................................................... 13 LAMICTAL XR TAB200MG ................................................... 13 LAMICTAL XR TAB250MG ................................................... 13 LAMICTAL XR TAB25MG ..................................................... 13 LAMICTAL XR TAB300MG ................................................... 13 LAMICTAL XR TAB50MG ..................................................... 13 LAMIVUD/ZIDOTAB150-300 ................................................. 26 LAMOTRIGINE CHW25MG .................................................. 13 LAMOTRIGINE CHW5MG .................................................... 13 LAMOTRIGINE TAB100MG .................................................. 13 LAMOTRIGINE TAB150MG .................................................. 13 LAMOTRIGINE TAB200MG .................................................. 13 LAMOTRIGINE TAB25MG .................................................... 13 LANSOPRAZOLECAP30MG DR ........................................... 42 LATANOPROST SOL0.005% ............................................... 51 Laxatives ........................................................................... 42 LEFLUNOMIDE TAB10MG ................................................... 50 LEFLUNOMIDE TAB20MG ................................................... 50 LEUCOVOR CA TAB10MG .................................................. 21 LEUCOVOR CA TAB15MG .................................................. 21 LEUCOVOR CA TAB25MG .................................................. 21 LEUCOVOR CA TAB5MG .................................................... 21 LEVALBUTEROLNEB0.31MG .............................................. 53 LEVALBUTEROLNEB0.63MG .............................................. 53 LEVALBUTEROLNEB1.25/0.5 .............................................. 53 LEVETIRACETASOL100MG/ML ........................................... 12 LEVETIRACETATAB1000MG ............................................... 12 LEVETIRACETATAB250MG ................................................. 12 LEVETIRACETATAB500MG ................................................. 12 LEVETIRACETATAB500MG ER ........................................... 12 LEVETIRACETATAB750MG ................................................. 12 LEVETIRACETATAB750MG ER ........................................... 12 LEVOBUNOLOL SOL0.5% OP.............................................. 51 LEVOCETIRIZISOL2.5/5ML .................................................. 52 LEVOCETIRIZITAB5MG ...................................................... 52 LEVOFLOXACINSOL0.5% ................................................... 11 LEVOFLOXACINSOL25MG/ML ............................................ 11 LEVOFLOXACINTAB250MG ................................................ 11 LEVOFLOXACINTAB500MG ................................................ 11 LEVOFLOXACINTAB750MG ................................................ 11 LEVORPHANOL TAB2MG ..................................................... 5 LEVOTHYROXINTAB100MCG ............................................. 47 LEVOTHYROXINTAB112MCG ............................................. 47 LEVOTHYROXINTAB125MCG ............................................. 47 LEVOTHYROXINTAB137MCG ............................................. 47 LEVOTHYROXINTAB150MCG ............................................. 47 LEVOTHYROXINTAB175MCG ............................................. 47 LEVOTHYROXINTAB200MCG ............................................. 47 LEVOTHYROXINTAB25MCG ............................................... 48 LEVOTHYROXINTAB300MCG ............................................. 48

LEVOTHYROXINTAB50MCG ............................................... 48 LEVOTHYROXINTAB75MCG ............................................... 48 LEVOTHYROXINTAB88MCG ............................................... 48 LIDO/PRILOCNCRE2.5-2.5% ................................................. 7 LIOTHYRONINETAB25MCG ................................................ 48 LIOTHYRONINETAB50MCG ................................................ 48 LIOTHYRONINETAB5MCG ................................................. 48 LITHIUM CARBCAP150MG ................................................. 27 LITHIUM CARBCAP300MG ................................................. 27 LITHIUM CARBCAP600MG ................................................. 27 LITHIUM CARBTAB300MG .................................................. 27 LITHIUM CARBTAB300MG ER ............................................ 27 LITHIUM CARBTAB450MG ER ............................................ 27 Local Anesthetics ................................................................ 7 LORCET PLUS TAB7.5-325 ................................................... 6 LOSARTAN POTTAB100MG ............................................... 31 LOSARTAN POTTAB25MG ................................................. 31 LOSARTAN POTTAB50MG ................................................. 31

M

MACRODANTIN CAP100MG ................................................. 8 MACRODANTIN CAP25MG ................................................... 8 MACRODANTIN CAP50MG ................................................... 8 Macrolides ........................................................................ 10 MAPROTILINE TAB25MG ................................................... 15 MAPROTILINE TAB50MG ................................................... 15 MAPROTILINE TAB75MG ................................................... 15 Mast Cell Stabilizers .......................................................... 54 MAXAIR AUTOHAER200MCG ............................................. 53 MEBENDAZOLE CHW100MG .............................................. 22 MECLOFEN SODCAP100MG ................................................ 4 MECLOFEN SODCAP50MG .................................................. 4 MEDROXYPR ACTAB10MG ................................................ 47 MEDROXYPR ACTAB2.5MG ............................................... 47 MEDROXYPR ACTAB5MG .................................................. 47 MEFENAM ACIDCAP250MG ................................................. 4 MEGACE ORAL SUS40MG/ML ............................................ 47 MEGESTROL ACSUS40MG/ML ........................................... 47 MEGESTROL ACTAB20MG ................................................. 47 MEGESTROL ACTAB40MG ................................................. 47 MEPROBAMATE TAB200MG .............................................. 27 MEPROBAMATE TAB400MG .............................................. 27 MERCAPTOPUR TAB50MG ................................................ 21 Metabolic Bone Disease Agents ........................................ 50 METADATE CD CAP10MG .................................................. 38 METADATE CD CAP20MG .................................................. 38 METADATE CD CAP30MG .................................................. 38 METADATE CD CAP40MG .................................................. 38 METADATE CD CAP50MG .................................................. 38 METADATE CD CAP60MG .................................................. 38 METAPROTERENSYP10MG/5ML ........................................ 53 METAPROTERENTAB10MG ............................................... 53 METAPROTERENTAB20MG ............................................... 53 METFORMIN ERTAB1000MG .............................................. 28 METHAMPHETAMTAB5MG ................................................. 38 METHAZOLAMIDTAB25MG ................................................. 35 METHAZOLAMIDTAB50MG ................................................. 35

64

METHENAM HIPTAB1GM ...................................................... 8 METHIMAZOLE TAB10MG ................................................... 49 METHIMAZOLE TAB5MG .................................................... 49 METHOCARBAM TAB500MG ............................................... 54 METHOCARBAM TAB750MG ............................................... 54 METHOTREXATEINJ1GM ................................................... 49 METHOTREXATEINJ25MG/ML ............................................ 49 METHOTREXATETAB2.5MG ............................................... 49 METHSCOPOLAMTAB2.5MG .............................................. 41 METHSCOPOLAMTAB5MG ................................................. 41 METHYCLOTHIATAB5MG ................................................... 36 METHYLDOPATEINJ250/5ML .............................................. 30 METHYLPHENIDCAP10MG ................................................. 38 METHYLPHENIDCAP20MG ER ............................................ 38 METHYLPHENIDCAP30MG ER ............................................ 38 METHYLPHENIDCAP40MG ER ............................................ 38 METHYLPHENIDCAP50MG ................................................. 38 METHYLPHENIDCAP60MG ................................................. 38 METHYLPHENIDSOL10MG/5ML .......................................... 38 METHYLPHENIDSOL5MG/5ML ............................................ 38 METHYLPHENIDTAB10MG ................................................. 38 METHYLPHENIDTAB10MG ER ............................................ 38 METHYLPHENIDTAB18MG ER ............................................ 38 METHYLPHENIDTAB20MG ................................................. 39 METHYLPHENIDTAB20MG ER ............................................ 39 METHYLPHENIDTAB27MG ER ............................................ 39 METHYLPHENIDTAB36MG ER ............................................ 39 METHYLPHENIDTAB54MG ER ............................................ 39 METHYLPHENIDTAB5MG ................................................... 39 METIPRANOLOLSOL0.3% OPH ........................................... 51 METOCLOPRAM SOL5MG/5ML ........................................... 17 METOCLOPRAM TAB10MG ................................................. 18 METOCLOPRAM TAB5MG .................................................. 18 METOPROL TARTAB100MG ............................................... 33 METOPROL TARTAB25MG ................................................. 33 METOPROL TARTAB50MG ................................................. 33 METOZOLV ODTTAB10MG ................................................. 18 METOZOLV ODTTAB5MG ................................................... 18 METROGEL-VAGGEL0.75% .................................................. 8 METROLOTION LOT0.75% .................................................... 8 METRONIDAZOLCAP375MG ................................................. 8 METRONIDAZOLCRE0.75% .................................................. 8 METRONIDAZOLGEL0.75% ................................................... 8 METRONIDAZOLGEL0.75%VAG ............................................ 8 METRONIDAZOLGEL1% ....................................................... 8 METRONIDAZOLLOT0.75% ................................................... 8 METRONIDAZOLTAB250MG ................................................. 8 METRONIDAZOLTAB500MG ................................................. 8 MILLIPRED DPPAK5MG ...................................................... 19 MINASTRIN 24CHWFE ........................................................ 47 MINOCYCLINE CAP100MG ................................................. 11 MINOCYCLINE CAP50MG ................................................... 11 MINOCYCLINE CAP75MG ................................................... 11 MINOCYCLINE TAB100MG .................................................. 11 MINOCYCLINE TAB135MG ER ............................................ 11 MINOCYCLINE TAB45MG ER .............................................. 11 MINOCYCLINE TAB50MG ................................................... 11 MINOCYCLINE TAB75MG ................................................... 11

MINOCYCLINE TAB90MG ER .............................................. 11 MIRTAZAPINE TAB15MG .................................................... 15 MIRTAZAPINE TAB15MG ODT ............................................ 15 MIRTAZAPINE TAB30MG .................................................... 15 MIRTAZAPINE TAB30MG ODT ............................................ 15 MIRTAZAPINE TAB45MG .................................................... 15 MIRTAZAPINE TAB45MG ODT ............................................ 15 MIRTAZAPINE TAB7.5MG ................................................... 15 MISOPROSTOL TAB100MCG.............................................. 42 MISOPROSTOL TAB200MCG.............................................. 42 Molecular Target Inhibitors ................................................ 21 Monoamine Oxidase B (MAO-B) Inhibitors ......................... 23 Monoamine Oxidase Inhibitors .......................................... 15 Monoclonal Antibodies ...................................................... 22 MONO-LINYAH TAB0.25-35 ................................................ 46 MONTELUKAST CHW4MG ................................................. 53 MONTELUKAST CHW5MG ................................................. 53 MONTELUKAST GRA4MG .................................................. 53 MONTELUKAST TAB10MG ................................................. 53 Mood Stabilizers ................................................................ 27 MORPHINE SULCAP100MG ER ............................................ 5 MORPHINE SULCAP10MG ER .............................................. 5 MORPHINE SULCAP120MG ER ............................................ 5 MORPHINE SULCAP20MG ER .............................................. 5 MORPHINE SULCAP30MG ER .............................................. 5 MORPHINE SULCAP45MG ER .............................................. 5 MORPHINE SULCAP50MG ER .............................................. 6 MORPHINE SULCAP60MG ER .............................................. 6 MORPHINE SULCAP75MG ER .............................................. 6 MORPHINE SULCAP80MG ER .............................................. 6 MORPHINE SULCAP90MG ER .............................................. 6 MORPHINE SULSOL10MG/5ML ............................................ 7 MORPHINE SULSOL20MG/5ML ............................................ 7 MORPHINE SULSOL20MG/ML .............................................. 7 MORPHINE SULTAB100MG ER ............................................ 6 MORPHINE SULTAB15MG ................................................ 6, 7 MORPHINE SULTAB15MG ER .............................................. 6 MORPHINE SULTAB200MG ER ............................................ 6 MORPHINE SULTAB30MG ................................................ 6, 7 MORPHINE SULTAB30MG ER .............................................. 6 MORPHINE SULTAB60MG ER .............................................. 6 MOXIFLOXACINTAB400MG ................................................ 11 Multiple Sclerosis Agents .................................................. 39 MYCOPHENOLATCAP250MG ............................................. 49 MYCOPHENOLATTAB500MG ............................................. 49 MYCOPHENOLICTAB180MG DR ......................................... 49 MYCOPHENOLICTAB360MG DR ......................................... 49

N

NALLPEN/DEX INJ1GM/50ML ............................................. 10 NAPHAZOLINE SOL0.1% OP .............................................. 51 NAPROXEN DR TAB375MG .................................................. 4 NAPROXEN DR TAB500MG .................................................. 4 NAPROXEN SODTAB275MG ................................................ 4 NAPROXEN SODTAB500MG CR ........................................... 4 NAPROXEN SODTAB550MG ................................................ 4 NARATRIPTAN TAB1MG .................................................... 20

65

NARATRIPTAN TAB2.5MG .................................................. 20 NASACORT AQ AER55MCG/AC .......................................... 44 NATEGLINIDE TAB120MG ................................................... 28 NATEGLINIDE TAB60MG .................................................... 28 NEO/POLY/HC SOL1% OTIC ............................................... 52 NEO/POLY/HC SUS1% OTIC ............................................... 52 NICARDIPINE CAP20MG ..................................................... 34 NICARDIPINE CAP30MG ..................................................... 34 NICOTROL NS SPR10MG/ML ................................................ 7 NIFEDIAC CC TAB90MG ER ................................................ 34 NIFEDICAL XLTAB30MG ..................................................... 34 NIFEDICAL XLTAB60MG ..................................................... 34 NISOLDIPINE TAB17MG ER ................................................ 34 NISOLDIPINE TAB20MG ..................................................... 34 NISOLDIPINE TAB25.5MG ................................................... 34 NISOLDIPINE TAB30MG ..................................................... 34 NISOLDIPINE TAB34MG ER ................................................ 34 NISOLDIPINE TAB40MG ..................................................... 34 NISOLDIPINE TAB8.5MG ER ............................................... 34 NITROFUR MACCAP50MG .................................................... 8 NITROFURANTNCAP100MG ................................................. 8 NITROFURANTNSUS25MG/5ML ............................................ 8 NITROGLYCER DIS0.1MG/HR ............................................. 37 NITROGLYCER DIS0.2MG/HR ............................................. 37 NITROGLYCER DIS0.4MG/HR ............................................. 37 NITROGLYCERIDIS0.6MG/HR ............................................. 37 NITROGLYCRN SPR0.4MG ................................................. 37 NITROLINGUALSPRPUMPSPRA ......................................... 37 N-methyl-D-aspartate (NMDA) Receptor Antagonist ............ 14 Nonsteroidal Anti-inflammatory Drugs ........................... 4, 20 NORDITROPIN INJ10/1.5ML ................................................ 45 NORDITROPIN INJ15/1.5ML ................................................ 45 NORDITROPIN INJ30/3ML ................................................... 45 NORDITROPIN INJ5/1.5ML .................................................. 45 NORETH/ETHINTAB1/20 ..................................................... 47 NORETH/ETHINTABFE 1/20 ................................................ 47 NORETHIN ACETAB5MG .................................................... 47 NORETHINDRONTAB0.35MG .............................................. 47 NORTRIPTYLINCAP10MG ................................................... 17 NORTRIPTYLINCAP25MG ................................................... 17 NORTRIPTYLINCAP50MG ................................................... 17 NORTRIPTYLINCAP75MG ................................................... 17 NORTRIPTYLINSOL10MG/5ML ............................................ 17 NOVOLOG MIX INJ70/30 ..................................................... 29 NOVOLOG MIX INJFLEXPEN .............................................. 29 NUTROPIN AQ INJ10MG/2ML .............................................. 45 NUTROPIN AQ INJ20MG/2ML .............................................. 45 NUTROPIN AQ INJNUSPIN 5 ............................................... 45 NYSTAT/TRIAMCRE ........................................................... 40 NYSTAT/TRIAMOIN ............................................................ 40

O

OLOPATADINE SPR0.6% .................................................... 52 ONDANSETRON INJ4MG/2ML ............................................. 18 ONDANSETRON SOL4MG/5ML ........................................... 18 ONDANSETRON TAB24MG ................................................. 18 ONDANSETRON TAB4MG ................................................... 18

ONDANSETRON TAB4MG ODT .......................................... 18 ONDANSETRON TAB8MG .................................................. 18 ONDANSETRON TAB8MG ODT .......................................... 18 Ophthalmic Agents ............................................................ 51 Ophthalmic Agents, Other ................................................. 51 Ophthalmic Anti-allergy Agents ......................................... 51 Ophthalmic Antiglaucoma Agents ..................................... 51 Ophthalmic Anti-inflammatories ........................................ 51 Opioid Analgesics, Long-acting ........................................... 5 Opioid Analgesics, Short-acting .......................................... 6 Opioid Antagonists .............................................................. 7 OPTIPRANOLOLSOL0.3% OP ............................................. 51 ORAPRED ODT TAB10MG .................................................. 19 ORAPRED ODT TAB15MG .................................................. 19 ORAPRED ODT TAB30MG .................................................. 19 ORPHENADRINETAB100MG ER ......................................... 54 ORTHO MICRONTAB0.35MG .............................................. 47 Otic Agents ....................................................................... 52 OXANDROLONE TAB10MG ................................................ 45 OXANDROLONE TAB2.5MG ............................................... 45 OXCARBAZEPINSUS300MG/5M ......................................... 14 OXCARBAZEPINTAB150MG ............................................... 14 OXCARBAZEPINTAB300MG ............................................... 14 OXCARBAZEPINTAB600MG ............................................... 14 OXSORALEN-ULCAP10MG ................................................. 40 OXYMORPHONE TAB10MG ER ............................................ 6 OXYMORPHONE TAB15MG ER ............................................ 6 OXYMORPHONE TAB20MG ER ............................................ 6 OXYMORPHONE TAB30MG ER ............................................ 6 OXYMORPHONE TAB40MG ER ............................................ 6 OXYMORPHONE TAB5MG ER .............................................. 6 OXYMORPHONE TAB7.5MG ER ........................................... 6 OXYMORPHONE TABHCL 10MG .......................................... 7 OXYMORPHONE TABHCL 5MG ............................................ 7

P

PAMINE FORTETAB5MG .................................................... 41 PANCRELIPASECAP5000UNIT ........................................... 41 PANTOPRAZOLETAB20MG ................................................ 42 PANTOPRAZOLETAB40MG ................................................ 42 PARAFON FORTTAB500MG ............................................... 54 Parasympathomimetics ..................................................... 20 PAROMOMYCIN CAP250MG ................................................ 7 PAROXETIN ERTAB12.5MG ............................................... 16 PAROXETIN ERTAB37.5MG ............................................... 16 Pediculicides/Scabicides ................................................... 22 PENICILLN VKSOL125/5ML ................................................ 10 PENICILLN VKSOL250/5ML ................................................ 10 PENICILLN VKTAB250MG ................................................... 10 PENICILLN VKTAB500MG ................................................... 10 PENTOXIFYLLITAB400MG ER ............................................ 35 PERFOROMIST NEB20MCG ............................................... 53 PERINDOPRIL TAB2MG ..................................................... 32 PERINDOPRIL TAB4MG ..................................................... 32 PERINDOPRIL TAB8MG ..................................................... 32 PERPHENAZINETAB16MG ................................................. 18 PERPHENAZINETAB2MG ................................................... 18

66

PERPHENAZINETAB4MG ................................................... 18 PERPHENAZINETAB8MG ................................................... 18 PHENYTOIN EXCAP100MG ................................................. 14 PHENYTOIN EXCAP200MG ................................................. 14 PHENYTOIN EXCAP300MG ................................................. 14 Phosphate Binders ............................................................ 43 PHOSPHOLINE SOL0.125%OP............................................ 51 PILOCARPINE SOL1% OP ................................................... 51 PILOCARPINE SOL2% OP ................................................... 51 PILOCARPINE SOL4% OP ................................................... 51 PILOCARPINE TAB5MG ...................................................... 39 PILOCARPINE TAB7.5MG ................................................... 39 PILOPINE HS GEL4% OP .................................................... 51 PIOGLITAZONETAB15MG ................................................... 28 PIOGLITAZONETAB30MG ................................................... 28 PIOGLITAZONETAB45MG ................................................... 28 PIPERACILLININJ4GM ........................................................ 10 Platelet Modifying Agents .................................................. 30 PLEGRIDY PENINJSTARTER .............................................. 50 POT CHLORIDECAP10MEQ ER ........................................... 55 POT CHLORIDECAP8MEQ ER ............................................ 55 POT CHLORIDETAB8MEQ ER ............................................. 55 POT CITRATE TAB1080MG ................................................. 55 POT CITRATE TAB1620MG ................................................. 55 POT CITRATE TAB540MG ER ............................................. 55 POT CL MICROTAB10MEQ ER ............................................ 55 POT CL MICROTAB20MEQ ER ............................................ 55 PRAMIPEXOLE TAB0.125MG .............................................. 23 PRAMIPEXOLE TAB0.25MG ................................................ 23 PRAMIPEXOLE TAB0.5MG .................................................. 23 PRAMIPEXOLE TAB0.75MG ................................................ 23 PRAMIPEXOLE TAB1.5MG .................................................. 23 PRAMIPEXOLE TAB1MG..................................................... 23 PRAVASTATIN TAB10MG ................................................... 36 PRAVASTATIN TAB20MG ................................................... 36 PRAVASTATIN TAB40MG ................................................... 36 PRAVASTATIN TAB80MG ................................................... 36 PRAZOSIN HCLCAP1MG .................................................... 31 PRAZOSIN HCLCAP2MG .................................................... 31 PRAZOSIN HCLCAP5MG .................................................... 31 PRED SOD PHOSOL1% OP ................................................ 52 PRED SOD PHOSOL5MG/5ML ............................................ 19 PREDNICARBATCRE0.1% .................................................. 40 PREDNICARBATOIN0.1% ................................................... 40 PREDNISOLONESOL15MG/5ML .......................................... 19 PREDNISOLONESOL25MG/5ML .......................................... 19 PREMARIN VAGCRE0.625MG ............................................. 47 PROBEN/COLCHTAB500-0.5 ............................................... 19 PROCAINAMIDEINJ100MG/ML ............................................ 32 PROCAINAMIDEINJ500MG/ML ............................................ 32 PROCARDIA XLTAB30MG CR ............................................. 34 PROCARDIA XLTAB60MG CR ............................................. 34 PROCARDIA XLTAB90MG CR ............................................. 34 PROCHLORPER SUP25MG ................................................. 18 PROCHLORPER TAB10MG ................................................. 18 PROCHLORPER TAB5MG ................................................... 18 PROCTOCREAM CREHC 2.5% ............................................ 50 PROCTOSOL HCCRE2.5% .................................................. 45

PROGESTERONECAP100MG ............................................. 47 PROGESTERONECAP200MG ............................................. 47 Progestins ......................................................................... 47 PROMETHAZINESUP12.5MG .............................................. 18 PROMETHAZINESUP25MG ................................................ 18 PROMETHAZINESUP50MG ................................................ 18 PROMETHAZINESYP6.25/5ML ............................................ 18 PROMETHAZINETAB12.5MG .............................................. 18 PROMETHAZINETAB25MG ................................................. 18 PROMETHAZINETAB50MG ................................................. 18 PROMETHEGAN SUP12.5MG ............................................. 18 PROMETHEGAN SUP25MG ................................................ 18 PROMETHEGAN SUP50MG ................................................ 18 PROPAFENONE CAP225MG ER ......................................... 32 PROPAFENONE CAP325MG ER ......................................... 32 PROPAFENONE CAP425MG SR ......................................... 32 PROPAFENONE TAB150MG ............................................... 32 PROPAFENONE TAB225MG ............................................... 32 PROPAFENONE TAB300MG ............................................... 32 PROPARACAINESOL0.5% OP ............................................ 51 Prophylactic ...................................................................... 20 PROPRANOLOL CAP120MG CR ......................................... 33 PROPRANOLOL CAP120MG ER ......................................... 33 PROPRANOLOL CAP160MG ER ......................................... 33 PROPRANOLOL CAP60MG ER ........................................... 33 PROPRANOLOL CAP80MG ER ........................................... 33 PROPRANOLOL SOL20MG/5ML ......................................... 33 PROPRANOLOL SOL40MG/5ML ......................................... 33 PROPRANOLOL TAB10MG ................................................. 33 PROPRANOLOL TAB20MG ................................................. 33 PROPRANOLOL TAB40MG ................................................. 33 PROPRANOLOL TAB60MG ................................................. 33 PROPRANOLOL TAB80MG ................................................. 33 PROPYLTHIOURTAB50MG ................................................. 49 Protectants ........................................................................ 42 Proton Pump Inhibitors ..................................................... 42 PROTRIPTYLINTAB10MG ................................................... 17 PROTRIPTYLINTAB5MG ..................................................... 17 PROZAC WEEKLCAP90MG ................................................ 16 Pulmonary Antihypertensives ............................................ 54 PYRAZINAMIDETAB500MG ................................................ 20 PYRIDOSTIGM TAB60MG ................................................... 20

Q

QUINIDINE GLTAB324MG CR ............................................. 32 QUINIDINE SUTAB200MG .................................................. 32 QUINIDINE SUTAB300MG .................................................. 32 QUINIDINE SUTAB300MG ER ............................................. 32 QUININE SULFCAP324MG ................................................. 22 Quinolones ........................................................................ 10

R

RABEPRAZOLE TAB20MG ................................................. 42 RAZADYNE ER CAP16MG .................................................. 14 RAZADYNE ER CAP24MG .................................................. 14 RAZADYNE ER CAP8MG .................................................... 14

67

REBIF TITRTNSOLPACK ..................................................... 39 RELION 70/30INJINNOLET .................................................. 29 REMERON SLTBTAB15MG ................................................. 15 REMERON SLTBTAB30MG ................................................. 15 REMERON SLTBTAB45MG ................................................. 15 Respiratory Tract Agents ............................................. 52, 54 Respiratory Tract Agents, Other ......................................... 54 RETIN-A MICRGEL0.04% .................................................... 40 RETIN-A MICRGEL0.08% .................................................... 40 RETIN-A MICRGEL0.1% ...................................................... 40 Retinoids ........................................................................... 22 RIMANTADINE TAB100MG .................................................. 27 RISEDRONATE TAB150MG ................................................. 50 RISPERDAL M TAB0.5MG ................................................... 24 RISPERDAL M TAB1MG ...................................................... 24 RISPERDAL M TAB2MG ...................................................... 24 RISPERDAL M TAB3MG ...................................................... 24 RISPERDAL M TAB4MG ...................................................... 24 RISPERIDONE SOL1MG/ML ................................................ 24 RISPERIDONE TAB0.25 ODT .............................................. 24 RISPERIDONE TAB0.25MG ................................................. 24 RISPERIDONE TAB0.5MG ................................................... 24 RISPERIDONE TAB0.5MG OD ............................................. 24 RISPERIDONE TAB1MG ..................................................... 24 RISPERIDONE TAB1MG ODT .............................................. 24 RISPERIDONE TAB2MG ..................................................... 24 RISPERIDONE TAB2MG ODT .............................................. 24 RISPERIDONE TAB3MG ..................................................... 24 RISPERIDONE TAB3MG ODT .............................................. 24 RISPERIDONE TAB4MG ............................................... 24, 25 RISPERIDONE TAB4MG ODT .............................................. 25 RIVASTIGMINECAP1.5MG .................................................. 14 RIVASTIGMINECAP3MG ..................................................... 14 RIVASTIGMINECAP4.5MG .................................................. 14 RIVASTIGMINECAP6MG ..................................................... 14 RIZATRIPTAN TAB10MG ..................................................... 20 RIZATRIPTAN TAB10MG ODT ............................................. 20 RIZATRIPTAN TAB5MG ...................................................... 20 ROBAXIN-750 TAB750MG ................................................... 54 ROBINUL FORTTAB2MG..................................................... 41

S

SANCTURA XR CAP60MG .................................................. 42 SANDOSTATIN INJ1000MCG .............................................. 48 SANDOSTATIN INJ100MCG ................................................ 48 SANDOSTATIN INJ200MCG ................................................ 48 SANDOSTATIN INJ500MCG ................................................ 48 SANDOSTATIN INJ50MCG/ML ............................................. 48 Selective Estrogen Receptor Modifying Agents .................. 47 SELENIUM SULLOT2.5% ..................................................... 40 SELENIUM SULSHA2.25% .................................................. 40 SEREVENT DISAER50MCG ................................................ 53 SEROQUEL XR TAB150MG ................................................. 15 SEROQUEL XR TAB200MG ................................................. 15 SEROQUEL XR TAB300MG ................................................. 15 SEROQUEL XR TAB400MG ................................................. 15 SEROQUEL XR TAB50MG ................................................... 15

Serotonin (5-HT) 1b/1d Receptor Agonists ......................... 20 Serotonin/Norepinephrine Reuptake Inhibitors .................. 15 SILVER SULFACRE1% ....................................................... 11 SIMVASTATIN TAB10MG .................................................... 36 SIMVASTATIN TAB20MG .................................................... 36 SIMVASTATIN TAB40MG .................................................... 36 SIMVASTATIN TAB5MG ...................................................... 36 SIMVASTATIN TAB80MG .................................................... 36 Skeletal Muscle Relaxants ................................................. 54 Sleep Disorder Agents ....................................................... 54 Sleep Disorders, Other ...................................................... 54 Smoking Cessation Agents.................................................. 7 SOD POLY SULSUS15GM/60 .............................................. 55 SOD SULFACETSOL10% OP .............................................. 11 Sodium Channel Agents .................................................... 13 SOTALOL HCL TAB160MG ................................................. 32 SOTALOL HCL TAB240MG ................................................. 32 SOTALOL HCL TAB80MG ................................................... 32 SPIRONOLACT TAB100MG ................................................ 35 SPIRONOLACT TAB25MG .................................................. 35 SPIRONOLACT TAB50MG .................................................. 35 SULFACETAMIDSUS10% ................................................... 11 SULFADIAZINETAB500MG ................................................. 11 SULFASALAZINTAB500MG ................................................. 50 SULFATRIM PDSUS200-40/5 .............................................. 11 SULFAZINE ECTAB500MG ................................................. 50 Sulfonamides .............................................................. 11, 50 SUMATRIPTAN INJ4MG/0.5 ................................................ 20 SUMATRIPTAN INJ6MG/0.5 ................................................ 20 SUMATRIPTAN SPR20MG/ACT .......................................... 20 SUMATRIPTAN SPR5MG/ACT ............................................ 20 SUMATRIPTAN TAB100MG ................................................ 20 SUMATRIPTAN TAB25MG .................................................. 20 SUMATRIPTAN TAB50MG .................................................. 20 SUMAVEL DOSEINJ4MG/0.5 ............................................... 20 SUMAVEL DOSEINJ6MG/0.5 ............................................... 20 SUPREP BOWELSOLPREP ................................................ 42 SYMLINPEN 60INJ1000MCG ............................................... 29 SYMLNPEN 120INJ1000MCG .............................................. 29

T

TAKE ACTION TAB1.5MG ................................................... 47 TEGRETOL-XR TAB100MG ................................................. 14 TEGRETOL-XR TAB200MG ................................................. 14 TEGRETOL-XR TAB400MG ................................................. 14 TELMISARTAN TAB20MG ................................................... 31 TELMISARTAN TAB40MG ................................................... 31 TELMISARTAN TAB80MG ................................................... 31 TERBINAFINE TAB250MG .................................................. 19 TERBUTALINE TAB2.5MG .................................................. 54 TERBUTALINE TAB5MG ..................................................... 54 TERCONAZOLE CRE0.4% .................................................. 19 TERCONAZOLE CRE0.8% .................................................. 19 TERCONAZOLE SUP80MG ................................................. 19 TESTOST CYP INJ100MG/ML ............................................. 46 TESTOST CYP INJ200MG/ML ............................................. 46 TESTOST ENANINJ200MG/ML ............................................ 46

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TESTOSTERONEGEL1%(50MG) ......................................... 46 TETRACYCLINECAP250MG ................................................ 12 TETRACYCLINECAP500MG ................................................ 12 Tetracyclines ..................................................................... 11 THEOPHYLLINETAB100MG CR ........................................... 53 THEOPHYLLINETAB200MG CR ........................................... 53 THEOPHYLLINETAB300MG ER ........................................... 53 THEOPHYLLINETAB400MG ER ........................................... 53 THEOPHYLLINETAB450MG ER ........................................... 53 THEOPHYLLINETAB600MG ER ........................................... 53 Therapeutic Nutrients/ Minerals/ Electrolytes ..................... 55 THIORIDAZINETAB100MG .................................................. 24 THIORIDAZINETAB10MG .................................................... 24 THIORIDAZINETAB25MG .................................................... 24 THIORIDAZINETAB50MG .................................................... 24 THIOTHIXENE CAP10MG .................................................... 24 THIOTHIXENE CAP1MG ...................................................... 24 THIOTHIXENE CAP2MG ...................................................... 24 THIOTHIXENE CAP5MG ...................................................... 24 THYMOGLOBULNINJ25MG ................................................. 49 THYROLAR-1/2TAB30MG .................................................... 48 THYROLAR-1/4TAB15MG .................................................... 48 TICLOPIDINE TAB250MG .................................................... 30 TIMOLOL GEL SOL0.25% OP .............................................. 51 TIMOLOL GEL SOL0.5% OP ................................................ 51 TIMOLOL MAL SOL0.25% OP .............................................. 51 TIMOLOL MAL SOL0.5% OP ................................................ 51 TIMOLOL MAL TAB10MG .................................................... 20 TIMOLOL MAL TAB20MG .................................................... 20 TIMOLOL MAL TAB5MG ...................................................... 20 TIMOPTIC OCUSOL0.25% OP ............................................. 51 TIMOPTIC OCUSOL0.5% OP ............................................... 51 TIMOPTIC-XE SOL0.25% OP ............................................... 51 TIMOPTIC-XE SOL0.5% OP ................................................. 51 TOBI PODHALRCAP28MG .................................................... 8 TOFRANIL-PM CAP100MG .................................................. 17 TOFRANIL-PM CAP125MG .................................................. 17 TOFRANIL-PM CAP150MG .................................................. 17 TOFRANIL-PM CAP75MG .................................................... 17 TOLBUTAMIDE TAB500MG ................................................. 29 TOLMETIN SODCAP400MG .................................................. 4 TOLMETIN SODTAB200MG ................................................... 4 TOLMETIN SODTAB600MG ................................................... 4 TOLTERODINE CAP2MG ER ............................................... 42 TOLTERODINE CAP4MG ER ............................................... 42 TOLTERODINE TAB1MG ..................................................... 42 TOLTERODINE TAB2MG ..................................................... 42 TOPAMAX SPR CAP15MG .................................................. 13 TOPAMAX SPR CAP25MG .................................................. 13 TRAMADOL HCLCAP150MG ER ............................................ 6 TRAMADOL HCLTAB100MG ER ............................................ 6 TRAMADOL HCLTAB200MG ER ............................................ 6 TRAMADOL HCLTAB300MG ER ............................................ 6 TRAMADOL HCLTAB50MG ................................................... 7 TRANDOLAPRILTAB1MG .................................................... 32 TRANDOLAPRILTAB2MG .................................................... 32 TRANDOLAPRILTAB4MG .................................................... 32 TRANEX ACID INJ100MG/ML .............................................. 30

TRANSDERM-SCDIS1.5MG ................................................ 18 TRANYLCYPROMTAB10MG ............................................... 15 Treatment-Resistant .......................................................... 25 TRETIN-X CREKIT0.025% ................................................... 41 TRETIN-X CREKIT0.05% ..................................................... 41 TRETIN-X CREKIT0.1% ...................................................... 41 TRETIN-X GELKIT0.01% ..................................................... 41 TRETIN-X GELKIT0.025% ................................................... 41 TRIAMCIN/ORAPST0.1% .................................................... 39 TRIAMCINOLONAER55MCG/AC ......................................... 45 TRIAMCINOLONCRE0.025% ............................................... 45 TRIAMCINOLONCRE0.1% .................................................. 45 TRIAMCINOLONCRE0.5% .................................................. 45 TRIAMCINOLONLOT0.025% ............................................... 45 TRIAMCINOLONLOT0.1% ................................................... 45 TRIAMCINOLONOIN0.025% ................................................ 45 TRIAMCINOLONOIN0.1% ................................................... 45 TRIAMCINOLONOIN0.5% ................................................... 45 Tricyclics .......................................................................... 17 TRI-ESTARYLLTAB ............................................................ 47 TRIFLUOPERAZTAB10MG .................................................. 24 TRIFLUOPERAZTAB1MG ................................................... 24 TRIFLUOPERAZTAB2MG ................................................... 24 TRIFLUOPERAZTAB5MG ................................................... 24 TRIFLURIDINESOL1% OP .................................................. 26 TRIHEXYPHEN ELX0.4MG/ML ............................................ 23 TRIHEXYPHEN TAB2MG .................................................... 23 TRIHEXYPHEN TAB5MG .................................................... 23 TRIMETHOBENZCAP300MG ............................................... 18 TRIMETHOPRIMTAB100MG ................................................. 8 TRIMIPRAMINECAP100MG ................................................. 17 TRIMIPRAMINECAP25MG .................................................. 17 TRIMIPRAMINECAP50MG .................................................. 17 TROPICAMIDE SOL0.5% OP ............................................... 51 TROSPIUM CHLCAP60MG ER ............................................ 42 TUDORZA PRESAER400/ACT ............................................. 53

U

UROCIT-K 10 TAB .............................................................. 55 UROCIT-K 15 TAB .............................................................. 55

V

VALACYCLOVIRTAB1GM ................................................... 26 VALACYCLOVIRTAB500MG ................................................ 26 VALPROIC ACDCAP250MG ................................................ 13 VALPROIC ACDSYP250/5ML .............................................. 13 VANCOCIN HCLCAP125MG .................................................. 8 VANCOCIN HCLCAP250MG .................................................. 8 Vasodilators, Direct-acting Arterial .................................... 37 Vasodilators, Direct-acting Arterial/Venous ........................ 37 VENLAFAXINE CAP150MG ER ............................................ 16 VENLAFAXINE CAP37.5 ER ................................................ 16 VENLAFAXINE CAP75MG ER ............................................. 16 VENLAFAXINE TAB100MG ................................................. 16 VENLAFAXINE TAB150MG ER ............................................ 16 VENLAFAXINE TAB225MG ER ............................................ 16

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VENLAFAXINE TAB25MG .................................................... 16 VENLAFAXINE TAB37.5 ER ................................................. 16 VENLAFAXINE TAB37.5MG ................................................. 16 VENLAFAXINE TAB50MG .................................................... 16 VENLAFAXINE TAB75MG .................................................... 16 VENLAFAXINE TAB75MG ER .............................................. 16 VENTOLIN HFAAER ............................................................ 54 VERIPRED 20 SOL20MG/5ML ............................................. 20 VIRAMUNE XR TAB100MG .................................................. 26 VIRAMUNE XR TAB400MG .................................................. 26 VIVELLE-DOT DIS0.025MG ................................................. 47 VIVELLE-DOT DIS0.0375MG ............................................... 47 VIVELLE-DOT DIS0.05MG ................................................... 47 VIVELLE-DOT DIS0.075MG ................................................. 47 VIVELLE-DOT DIS0.1MG ..................................................... 47 VOLTAREN-XR TAB100MG ................................................... 4 VORICONAZOLETAB200MG ............................................... 19 VORICONAZOLETAB50MG ................................................. 19

X

XARELTO STARTAB15/20MG ............................................. 30 XOPENEX HFA AER ........................................................... 54

Z

ZAFIRLUKAST TAB10MG ................................................... 53 ZAFIRLUKAST TAB20MG ................................................... 53 ZIPRASIDONE CAP20MG ................................................... 25 ZIPRASIDONE CAP40MG ................................................... 25 ZIPRASIDONE CAP60MG ................................................... 25 ZIPRASIDONE CAP80MG ................................................... 25 ZOLPIDEM ER TAB12.5MG ................................................. 54 ZOLPIDEM ER TAB6.25MG ................................................. 54 ZOMIG NASAL SPR5MG ..................................................... 20 ZYCLARA PUMPCRE2.5% .................................................. 41 ZYPREXA ZYDITAB10MG ................................................... 25 ZYPREXA ZYDITAB15MG ................................................... 25 ZYPREXA ZYDITAB20MG ................................................... 25 ZYPREXA ZYDITAB5MG ..................................................... 25

PRODUCT SELECTION CRITERIA

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