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2015 Drug FormularyFor federal employees and retirees on the Federal Employees Health Benefits Program.

EFFECTIVE OCTOBER 2015

Drug Formulary INTRODUCTION

Development of the Drug Formulary At Group Health the Drug Formulary is the cornerstone of medication therapy, quality assurance, and cost containment. It is a list of medications that are usually covered under a member’s medical coverage agreement. The Formulary is developed by the Group Health Pharmacy and Therapeutics committee (P&T), which is composed of physicians representing various medical specialties from across the Group Health system and network providers, pharmacists, and a consumer member. The P&T committee reviews the medications in all therapeutic categories and selects the most appropriate in each class based on safety, effectiveness, and cost.

The Formulary helps health care providers to offer the most effective drug therapy possible with the limited resources available. Having a formulary allows Group Health to offer the safest, most effective, and most cost-effective health care possible.

The P&T committee meets quarterly to review new and existing medications to ensure that the Formulary remains responsive to the needs of members and providers.

The Formulary is updated periodically and is subject to change. If a medication will be removed from the formulary, members who had filled the medication in the prior 3 months will be notified of the upcoming change. A formulary change notice will be posted on the member website at least 30 days prior to the effective date.

Formulary Listing and Drug Coverage Drug coverage is based on an individual’s contracted benefit and formulary status. Coverage for a specific medication is subject to each member’s medical coverage agreement. Please consult your Benefit Booklet or call Customer Service if you have questions about your drug coverage.

Group Health will only cover FDA-approved medications used for non-experimental therapies. Most plans exclude experimental and investigational drugs, over-the-counter drugs, drugs used in the treatment of sexual dysfunction disorders, medicines for anticipated illness while traveling, or drugs used for cosmetic purposes. Please consult your Benefit Booklet for limitations and exclusions.

Medications are listed by generic name if a generic is available. Brand names may be listed only to serve as a guide. Listing of a brand name does not imply coverage of a specific brand. Generic drugs are substituted when available and allowed by the prescriber. When a generic is available, the brand-name medication is generally considered non-formulary and subject to higher cost shares.

Injection medications that are typically administered by a professional in a clinical setting may not be listed on the formulary. For coverage of these drugs, refer to your Benefit Booklet.

How to Search the Formulary Medications on the formulary are listed by therapeutic class. An alphabetical index is included to assist in locating specific medications.

Generic Drugs When a drug company identifies a drug in the laboratory, that company is granted a patent on the drug for a period up to 20 years. During the life of the patent, no other manufacturer is allowed to produce or sell the same drug product without the patent-holder's approval, thus eliminating direct price competition. Patent protection allows the original drug company to recoup the cost of research and development and to make a profit. After the patent expires, other pharmaceutical manufacturers may develop, test, and market medications with the same active ingredients. These chemically identical products, “generic drugs,” contain exact quantities of the same active ingredient

in the same dosage form as the brand-name product and they are more affordable than the brand-name product.

Prior Authorization (PA) Drugs The P&T Committee determines a number of drugs require prior authorization to confirm coverage. These medications most often have alternatives drugs on the formulary, safety concerns or a high potential for inappropriate use. Prescribers do not need authorization to prescribe the drug, only to determine coverage for a patient. To request coverage for prior authorization medications, your prescriber must contact Group Health. Medications requiring Prior Authorization are listed with “PA” in the right hand column. New drugs to the market may require prior authorization until reviewed by the Pharmacy and Therapeutics Committee.

Step Therapy (ST) Drugs Step Therapy is a process where you must try a certain drug, such as a generic alternative, before receiving coverage for a similar but non-preferred medication. Instead of your prescriber contacting Group Health, we look at your prescription history and if you have tried the preferred agent, you will be automatically covered for the non-preferred agent. This makes coverage for you easier and reduces the amount of work for your prescriber. Medications requiring Step Therapy are listed with “ST” in the right hand column.

Quantity Limit (QL) Drugs Medications with quantity limits are indicated with “QL” in the right-hand column. Quantity limits align with FDA-approved indications and dosing for safe and effective use of the drug. To request exceptions to quantity limits, your prescriber must contact Group Health.

Day Supply Limit (DS) for Select Drugs Medications with day supply limit are indicated with “DS” in the right-hand column. These Medications are limited to a one month supply at a time. The 1-month limit minimizes waste of unused medications when there is a change in the prescribed drug or quantity.

Medications Limited to Select Pharmacies Some medications are limited to Group Health mail order pharmacy and/or a designated specialty pharmacy. These pharmacies work closely with patients to manage certain specialty medications to ensure you get the most from your treatment. The pharmacy works with you and your doctor to confirm your medication is working for you, reaches out to you to set up refills, and reminds you of needed labs and review the results with you. For a list of these medications, see Appendix A. To order these medications or for questions related to these medications, you can contact the Group Health Specialty Medication Pharmacy at 1-800-483-3945. Members with an out-of-network benefit may use a network pharmacy; however, they may pay a higher cost share.

Preventative Medications and Preferred Contraceptives Most plans cover Affordable Care Act (ACA) requirements for preventative care medications and contraceptives in full. Please consult your Benefit Booklet under “Preventive Services” or call Customer Service if you have questions about your coverage for these drugs.

Below is the list of the preventative medications covered in full. Aspirin 81 mg and 325 mg. Limited to 30 units per 30 days

Calcitriol (Vitamin D) 400 Units and 1000 Units

Ferrous sulfate 15 mg/mL oral drops

Folic acid 400 mg and 800 mg

Over-the-counter nicotine replacement patches, gum, and lozenge. Prior authorization required.

Sodium fluoride chewable tabs and drops

Tamoxifen generic

Raloxifene generic

In accordance with the Affordable Care Act (ACA) requirements for preventive services, most Group Health plans provide full coverage for contraceptives. If your plan offers ACA benefits, all prescribed FDA approved contraceptive methods from on the Group Health formulary list will be covered in full when obtained in-network. For plans with out-of-network (OON) benefits, contraceptives will be subject to the OON cost-share. Preferred contraceptives are listed on the formulary under “Contraception” as Tier 1 and Tier 2. If you request coverage for a non-preferred contraceptive, we will contact your provider to recommend a preferred generic or therapeutically equivalent product. If you and your provider determine that the preferred contraceptive(s) would be medically inappropriate, your provider must request a contraceptive waiver.

Please consult your Benefit Booklet under “Preventive Services” or call Customer Service if you have questions about your coverage for contraceptives.

Non-Formulary Drugs Medications not listed in this document are not on the formulary at the time of publication. The most current information is online at www.ghc.org. Non-formulary drugs are not covered unless approved by the health plan as medically necessary. The prescriber must contact Group Health to determine the medical necessity of the non-formulary medication. An alternative formulary medication will be recommended when clinically appropriate. If a medical exception is not approved, the patient is responsible for the full price of the drug.

Covered Diabetic Supplies Some diabetic supplies may be covered at Tier 1 cost share if they are filled as a prescription. These items are:

Preferred blood glucose test strips:

o One Touch Verio

o One Touch Ultra

o Prodigy – prior authorization required

o Breeze 2 – prior authorization required

o Contour Next – prior authorization required

o Freestyle – prior authorization required

Disposable insulin syringes and needles

Lancing device and lancets

Preferred blood glucose meters are covered only when filled through the mail order pharmacy.

Over-the-Counter (OTC) Drugs A few plans offer coverage for OTC drugs. For these plans, a list of covered OTC drugs can be found in Appendix B. You may contact Customer Service at 1-888-901-4636 to find if you have OTC drug coverage.

Mail Order Pharmacy Service Mail order is convenient for patients and efficiently utilizes Group Health’s resources. This service works best for drugs that must be taken on regular basis, such as birth control pills and drugs for high blood pressure, high cholesterol, or other chronic conditions.

To begin using Mail Order, ask your prescriber to send the prescription directly to the Mail Order Pharmacy. To transfer an existing prescription from a retail pharmacy, contact the Mail Order Pharmacy.

Address: Group Health Mail Order Pharmacy PO Box 34383 Seattle, WA 98124-1383

Phone: 800-245-RXRX (1-800-245-7979)

Fax: 206-901-4443, or toll-free 1-800-350-1683

Additional Information Please contact Customer Service at 1-888-901-4636 with any questions or concerns regarding information contained in this document.

The most current drug formulary is available to search at www.ghc.org.

Table of Contents

ALLERGY ...................................................................................................................................................................................... 1 ANTIEMESIS/ANTIVERTIGO..................................................................................................................................................... 2 ASTHMA ....................................................................................................................................................................................... 3 AUTONOMIC NERVOUS SYSTEM DISORDERS .................................................................................................................... 5 BEHAVIORAL HEALTH - ANTIDEPRESSANTS ..................................................................................................................... 6 BEHAVIORAL HEALTH - OTHER ............................................................................................................................................. 9 CARDIOVASCULAR DISEASE - ARRHYTHMIA .................................................................................................................. 15 CARDIOVASCULAR DISEASE - CARDIAC STIMULANT ................................................................................................... 15 CARDIOVASCULAR DISEASE - HYPERTENSION ............................................................................................................... 15 CARDIOVASCULAR DISEASE - LIPID IRREGULARITY .................................................................................................... 23 CARDIOVASCULAR DISEASE - MISCELLANEOUS AGENTS ........................................................................................... 25 CARDIOVASCULAR DISEASE - VASODILATION ............................................................................................................... 25 CONTRACEPTION/OXYTOCICS ............................................................................................................................................. 26 COUGH AND COLD ................................................................................................................................................................... 31 DERMATOLOGY - ACNE ......................................................................................................................................................... 32 DERMATOLOGY - ANTIINFECTIVE ...................................................................................................................................... 34 DERMATOLOGY - ANTIINFLAMMATORY .......................................................................................................................... 38 DERMATOLOGY - ANTIPRURITIC DRUGS .......................................................................................................................... 42 DERMATOLOGY - MISCELLANEOUS ................................................................................................................................... 42 DERMATOLOGY - PSORIASIS/ECZEMA ............................................................................................................................... 47 DIABETES ................................................................................................................................................................................... 48 EAR - GENERAL DISORDERS ................................................................................................................................................. 51 ELECTROLYTE REGULATION ................................................................................................................................................ 52 ENDOCRINE DISORDER - FERTILITY ................................................................................................................................... 54 ENDOCRINE DISORDER - OTHER .......................................................................................................................................... 54 ENDOCRINE DISORDER - THYROID ..................................................................................................................................... 56 EYE - GENERAL DISORDERS .................................................................................................................................................. 57 EYE - GLAUCOMA .................................................................................................................................................................... 60 EYE - MISCELLANEOUS .......................................................................................................................................................... 62 GOUT AND RELATED DISEASES ........................................................................................................................................... 62 HEMATOLOGICAL DISORDERS ............................................................................................................................................. 62 HORMONAL DEFICIENCY ....................................................................................................................................................... 66 IMMUNIZATION ........................................................................................................................................................................ 68 IMMUNOSUPPRESSION/MODULATION ............................................................................................................................... 68 INFECTIOUS DISEASE - BACTERIAL .................................................................................................................................... 69 INFECTIOUS DISEASE - FUNGAL .......................................................................................................................................... 73 INFECTIOUS DISEASE - MISCELLANEOUS ......................................................................................................................... 74 INFECTIOUS DISEASE - PARASITIC ...................................................................................................................................... 75 INFECTIOUS DISEASE - VIRAL .............................................................................................................................................. 76 INFLAMMATORY DISEASE .................................................................................................................................................... 80 LOCAL ANESTHESIA ............................................................................................................................................................... 85 LOWER GASTROINTESTINAL DISORDERS - BOWEL INFLAMMAT............................................................................... 85 LOWER GASTROINTESTINAL DISORDERS - OTHER ........................................................................................................ 87 MISCELLANEOUS AGENTS .................................................................................................................................................... 88 NEOPLASTIC DISEASE ............................................................................................................................................................. 88 NEUROLOGICAL DISEASE - MISCELLANEOUS ................................................................................................................. 92 ORAL/PHARYNGEAL DISORDERS ........................................................................................................................................ 94 OTHER DRUGS .......................................................................................................................................................................... 94 OTHER RESPIRATORY DISORDERS ...................................................................................................................................... 95 PAIN MANAGEMENT - ANALGESICS ................................................................................................................................... 95 PARKINSONS DISEASE .......................................................................................................................................................... 105 SEIZURE DISORDER ............................................................................................................................................................... 106 SKELETAL MUSCLE DISORDER .......................................................................................................................................... 110 UPPER GASTROINTESTINAL DISORDERS - DIGESTIVE ................................................................................................. 111 UPPER GASTROINTESTINAL DISORDERS - SPASTIC DISEASE .................................................................................... 111 UPPER GASTROINTESTINAL DISORDERS - ULCER DISEASE ....................................................................................... 112 URINARY TRACT - FUNCTIONAL DISORDERS ................................................................................................................ 114 VAGINAL DISORDERS ........................................................................................................................................................... 116 VITAMIN AND/OR MINERAL DEFICIENCY ....................................................................................................................... 116

Group Health Drug Formulary For 5-Tier Plans

UPPERCASE=brand; lowercase=generic PA=Prior Authorization; ST=Step Therapy; QL=Quantity Limit; DS=Day Supply Limit

1

ALLERGY

Drug Name Dosage Form Tier Limit

arbinoxa LIQUID 1

arbinoxa TABLET 1

ASTEPRO SPRAY/PUMP 3

azelastine hcl 137 MCG SPRAY/PUMP 1

azelastine hcl 205.5MCG SPRAY/PUMP 3

BECONASE AQ SPRAY 3

budesonide SPRAY/PUMP 3

carbinoxamine maleate LIQUID 1

carbinoxamine maleate TABLET 1

cetirizine hcl SOLUTION 3

CLARINEX SYRUP 3

CLARINEX TABLET 3

CLARINEX-D 12 HOUR TBMP 12HR 3

clemastine fumarate SYRUP 1

clemastine fumarate TABLET 1

cyproheptadine hcl SYRUP 1

cyproheptadine hcl TABLET 1

desloratadine TAB RAPDIS 1

desloratadine TABLET 1

DICOPANOL SUSP RECON 3

diphenhydramine hcl ELIXIR 3

DYMISTA SPRAY/PUMP 3

fexofenadine hcl TABLET 3

fexofenadine-pse er TAB ER 24H 3

flunisolide SPRAY 1

fluticasone propionate SPRAY SUSP 1

hydroxyzine hcl SYRUP 1

hydroxyzine hcl TABLET 1

HYDROXYZINE PAMOATE CAPSULE 3

hydroxyzine pamoate CAPSULE 1

KARBINAL ER SUS ER 12H 3

levocetirizine dihydrochloride SOLUTION 1

levocetirizine dihydrochloride TABLET 1

NASONEX SPRAY/PUMP 3



2


olopatadine hcl SPRAY/PUMP 3

OMNARIS SPRAY/PUMP 3

PATANASE SPRAY/PUMP 3

promethazine hcl SYRUP 1

promethazine hcl TABLET 1

QNASL HFA AER AD 3

QNASL CHILDREN HFA AER AD 3

RHINOCORT AQUA SPRAY/PUMP 3

SEMPREX-D CAPSULE 3

triamcinolone acetonide SPRAY 3

VERAMYST SPRAY SUSP 3

VISTARIL CAPSULE 3

XYZAL SOLUTION 3

XYZAL TABLET 3

ZETONNA HFA AER AD 3

ANTIEMESIS/ANTIVERTIGO


AKYNZEO CAPSULE 3

ANTIVERT TABLET 3

ANZEMET TABLET 3

CESAMET CAPSULE 3

COMPAZINE SUPP.RECT 3

COMPAZINE TABLET 3

compro SUPP.RECT 1

DICLEGIS TABLET DR 3

dronabinol CAPSULE 1

EMEND CAP DS PK 2

EMEND 125 MG CAPSULE 2



granisetron hcl TABLET 3

MARINOL CAPSULE 3

meclizine hcl TABLET 3

ondansetron hcl SOLUTION 1

ondansetron hcl TABLET 1



3


ondansetron odt TAB RAPDIS 1

phenadoz SUPP.RECT 1

PHENERGAN SUPP.RECT 3

prochlorperazine maleate SUPP.RECT 1

prochlorperazine maleate TABLET 1

promethazine hcl SUPP.RECT 1

promethegan SUPP.RECT 1

SANCUSO PATCH TDWK 3

TIGAN CAPSULE 3

TRANSDERM-SCOP PATCH TD72 3

trimethobenzamide hcl CAPSULE 3

ZOFRAN SOLUTION 3

ZOFRAN TABLET 3

ZOFRAN ODT TAB RAPDIS 3

ZUPLENZ FILM 3

ASTHMA


ACCOLATE TABLET 3

ADVAIR DISKUS 100-50 MCG BLST W/DEV 2 PA



ADVAIR HFA 115-21MCG HFA AER AD 2 PA



AEROSPAN HFA AER AD 3

albuterol sulfate SOLUTION 1

albuterol sulfate SYRUP 1

albuterol sulfate TAB ER 12H 3

albuterol sulfate TABLET 1

albuterol sulfate 0.63MG/3ML VIAL-NEB 3

albuterol sulfate 1.25MG/3ML VIAL-NEB 3

albuterol sulfate 2.5 MG/0.5 VIAL-NEB 1

albuterol sulfate 2.5 MG/3ML VIAL-NEB 1

ALVESCO HFA AER AD 3

ARCAPTA NEOHALER CAP W/DEV 3



4


ASMANEX AER POW BA 2 ST

ASMANEX HFA HFA AER AD 2 ST

ATROVENT HFA HFA AER AD 2

BROVANA VIAL-NEB 3

budesonide AMPUL-NEB 1

caffeine citrate SOLUTION 1

COMBIVENT RESPIMAT MIST INHAL 2

cromolyn sodium AMPUL-NEB 1

cromolyn sodium SOLUTION 3

DALIRESP TABLET 3

DULERA HFA AER AD 2 PA

elixophyllin ELIXIR 3

FLOVENT DISKUS 100 MCG BLST W/DEV 2 PA



FLOVENT HFA AER W/ADAP 2

FLOVENT HFA 110 MCG AER W/ADAP 2 PA

FLOVENT HFA 220 MCG AER W/ADAP 2 PA

FORADIL CAP W/DEV 3

GASTROCROM SOLUTION 3

ipratropium bromide SOLUTION 1

ipratropium-albuterol AMPUL-NEB 1

levalbuterol concentrate VIAL-NEB 3

levalbuterol hcl VIAL-NEB 3

LUFYLLIN TABLET 3

metaproterenol sulfate SYRUP 1

metaproterenol sulfate TABLET 1

montelukast sodium GRAN PACK 1

montelukast sodium TAB CHEW 1

montelukast sodium TABLET 1

PERFOROMIST VIAL-NEB 3

PROAIR HFA 90 MCG HFA AER AD 2 QL

PROVENTIL HFA 90 MCG HFA AER AD 3 QL

PULMICORT 0.25MG/2ML AMPUL-NEB 3

PULMICORT 0.5 MG/2ML AMPUL-NEB 3

PULMICORT 1 MG/2 ML AMPUL-NEB 3

PULMICORT FLEXHALER AER POW BA 3



5


QVAR AER W/ADAP 2

SEREVENT DISKUS BLST W/DEV 2

SINGULAIR GRAN PACK 3

SINGULAIR TAB CHEW 3

SINGULAIR TABLET 3

SPIRIVA CAP W/DEV 2

SPIRIVA RESPIMAT MIST INHAL 2

STRIVERDI RESPIMAT MIST INHAL 3

SYMBICORT 160-4.5MCG HFA AER AD 3 PA

SYMBICORT 80-4.5 MCG HFA AER AD 3 PA

terbutaline sulfate TABLET 1

terbutaline sulfate VIAL 3

THEO-24 CAP ER 24H 3

theochron TAB ER 12H 1

theophylline SOLUTION 1

theophylline TABLET ER 1

theophylline anhydrous TAB ER 12H 1

TUDORZA PRESSAIR AER POW BA 3

VENTOLIN HFA 90 MCG HFA AER AD 3 QL

VOSPIRE ER TAB ER 12H 3

XOPENEX VIAL-NEB 3

XOPENEX CONCENTRATE VIAL-NEB 3

XOPENEX HFA 45 MCG HFA AER AD 3 QL

zafirlukast TABLET 3

ZYFLO TABLET 3

ZYFLO CR TBMP 12HR 3

AUTONOMIC NERVOUS SYSTEM DISORDERS


ARICEPT TABLET 3

donepezil hcl 10 MG TABLET 1



donepezil hcl odt TAB RAPDIS 3

EXELON CAPSULE 3

EXELON PATCH TD24 3



6


galantamine hbr CAP24H PEL 1

galantamine hbr TABLET 1

galantamine hydrobromide SOLUTION 1

Memantine TABLET 1

MESTINON SYRUP 2

MESTINON TABLET 3

MESTINON TABLET ER 3

NAMENDA SOLUTION 2

NAMENDA TAB DS PK 3

NAMENDA TABLET 3

NAMENDA XR CAP SPR 24 3

NAMENDA XR CAP24 DSPK 3

pyridostigmine bromide TABLET 1

RAZADYNE TABLET 3

RAZADYNE ER CAP24H PEL 3

rivastigmine CAPSULE 1

BEHAVIORAL HEALTH - ANTIDEPRESSANTS


amitriptyline hcl TABLET 1

amoxapine TABLET 1

ANAFRANIL CAPSULE 3

APLENZIN TAB ER 24H 3

BRINTELLIX 10 MG TABLET 3 ST,DS



BRISDELLE CAPSULE 3

bupropion hcl TABLET 1

bupropion hcl sr TABLET ER 1

bupropion xl TAB ER 24H 1

CELEXA TABLET 3

chlordiazepoxide-amitriptyline TABLET 3

citalopram hbr SOLUTION 1

citalopram hbr TABLET 1

clomipramine hcl CAPSULE 1

CYMBALTA CAPSULE DR 3



7


desipramine hcl TABLET 1

DESVENLAFAXINE ER 100 MG TAB ER 24H 3 PA

DESVENLAFAXINE ER 50 MG TAB ER 24H 3 PA

desvenlafaxine er 100 MG TAB ER 24 3 PA

desvenlafaxine er 50 MG TAB ER 24 3 PA

DESVENLAFAXINE FUMARATE ER 100 MG TAB ER 24 3 PA

DESVENLAFAXINE FUMARATE ER 50 MG TAB ER 24 3 PA

doxepin hcl CAPSULE 1

doxepin hcl ORAL CONC 1

duloxetine hcl CAPSULE DR 1

EFFEXOR XR CAP ER 24H 3

escitalopram oxalate SOLUTION 1

escitalopram oxalate TABLET 1

FETZIMA 120 MG CAP SA 24H 3 ST




FETZIMA 20-40MG CAP24HDSPK 3 ST

fluoxetine dr CAPSULE DR 3

FLUOXETINE HCL TABLET 3

fluoxetine hcl CAPSULE 1

fluoxetine hcl SOLUTION 1

fluoxetine hcl TABLET 1

fluvoxamine maleate TABLET 1

fluvoxamine maleate er CAP ER 24H 3

FORFIVO XL 450 MG TAB ER 24H 3 ST

imipramine hcl TABLET 1

imipramine pamoate CAPSULE 3

KHEDEZLA 100 MG TAB ER 24 3 PA

KHEDEZLA 50 MG TAB ER 24 3 PA

LEXAPRO SOLUTION 3

LEXAPRO TABLET 3

maprotiline hcl TABLET 1

MARPLAN TABLET 3

mirtazapine TAB RAPDIS 1

mirtazapine TABLET 1

NARDIL TABLET 3



8


nefazodone hcl TABLET 3

NORPRAMIN TABLET 3

nortriptyline hcl CAPSULE 1

nortriptyline hcl SOLUTION 1

OLEPTRO ER TAB ER 24H 3

PAMELOR CAPSULE 3

PARNATE TABLET 3

paroxetine hcl TAB ER 24H 3

paroxetine hcl TABLET 1

PAXIL ORAL SUSP 2

PAXIL TABLET 3

PAXIL CR TAB ER 24H 3

perphenazine-amitriptyline TABLET 1

PEXEVA TABLET 3

phenelzine sulfate TABLET 1

PRISTIQ ER 100 MG TAB ER 24H 3 PA

PRISTIQ ER 50 MG TAB ER 24H 3 PA

protriptyline hcl TABLET 1

PROZAC CAPSULE 3

PROZAC WEEKLY CAPSULE DR 3

REMERON TAB RAPDIS 3

REMERON TABLET 3

SARAFEM TABLET 3

sertraline hcl ORAL CONC 1

sertraline hcl TABLET 1

SURMONTIL CAPSULE 3

TOFRANIL TABLET 3

TOFRANIL-PM CAPSULE 3

tranylcypromine sulfate TABLET 1

trazodone hcl TABLET 1

venlafaxine hcl TABLET 1

VENLAFAXINE HCL ER TAB ER 24 3

venlafaxine hcl er CAP ER 24H 1

venlafaxine hcl er TAB ER 24 3

VIIBRYD 10-20-40MG TAB DS PK 3 ST

VIIBRYD 10 MG TABLET 3 ST




9



WELLBUTRIN TABLET 3

WELLBUTRIN SR TABLET ER 3

WELLBUTRIN XL TAB ER 24H 3

ZOLOFT ORAL CONC 3

ZOLOFT TABLET 3

BEHAVIORAL HEALTH - OTHER


ABILIFY 1 MG/ML SOLUTION 3 PA

ABILIFY 10 MG TABLET 3 PA






ABILIFY DISCMELT 10 MG TAB RAPDIS 3 PA

ABILIFY DISCMELT 15 MG TAB RAPDIS 3 PA

ABILIFY MAINTENA 300 MG SUSER SYR 5 ST,DS

ABILIFY MAINTENA 400 MG SUSER SYR 5 ST,DS

ABILIFY MAINTENA 300 MG SUSER VIAL 5 ST,DS

ABILIFY MAINTENA 400 MG SUSER VIAL 5 ST,DS

acamprosate calcium TABLET DR 1

ADDERALL TABLET 3

ADDERALL XR CAP ER 24H 1

alprazolam TABLET 1

alprazolam er TAB ER 24H 3

ALPRAZOLAM INTENSOL ORAL CONC 3

alprazolam odt TAB RAPDIS 3

alprazolam xr TAB ER 24H 3

AMBIEN TABLET 3

AMBIEN CR TAB MPHASE 1

amphetamine salt combo TABLET 1

ANTABUSE TABLET 3

aripiprazole 10MG TABLET 1 PA




10






ATIVAN TABLET 3

BELSOMRA TABLET 3 PA

buspirone hcl 10 MG TABLET 1




buspirone hcl 7.5 MG TABLET 3

BUTISOL SODIUM TABLET 3

chlordiazepoxide hcl CAPSULE 1

chlorpromazine hcl TABLET 1

clonidine hcl er TAB ER 12H 3

clorazepate dipotassium TABLET 1

clozapine 100 MG TABLET 1




clozapine odt TAB RAPDIS 3

CLOZARIL TABLET 3

CONCERTA TAB ER 24 3

DAYTRANA PATCH TD24 3

depade TABLET 1

DESOXYN TABLET 3

DEXEDRINE CAPSULE ER 3 QL

dexmethylphenidate hcl TABLET 1 QL

dexmethylphenidate hcl er CPBP 50-50 3 QL

dextroamphetamine sulfate SOLUTION 3 QL

dextroamphetamine sulfate TABLET 1 QL

dextroamphetamine sulfate er CAPSULE ER 1 QL

diazepam ORAL CONC 3

diazepam SOLUTION 3

diazepam TABLET 1

disulfiram TABLET 1



11


EDLUAR TAB SUBL 3

EMSAM PATCH TD24 3

EQUETRO CPMP 12HR 3

estazolam TABLET 3

eszopiclone TABLET 1

EVEKEO 10 MG TABLET 3 PA

EVEKEO 5 MG TABLET 3 PA

FANAPT 1-2-4-6MG TAB DS PK 3 ST

FANAPT 1 MG TABLET 3 ST







FAZACLO TAB RAPDIS 3

fluphenazine hcl ELIXIR 1

fluphenazine hcl ORAL CONC 1

fluphenazine hcl TABLET 1

flurazepam hcl CAPSULE 1

FOCALIN TABLET 3

FOCALIN XR CPBP 50-50 3 QL

GEODON CAPSULE 3

guanfacine hcl er TAB ER 24H 3

HALCION TABLET 3

haloperidol TABLET 1

haloperidol lactate ORAL CONC 1

HETLIOZ 20 MG CAPSULE 5 PA,DS

INTERMEZZO TAB SUBL 3

INTUNIV TAB ER 24H 2

INVEGA 1.5 MG TAB ER 24 3 ST

INVEGA 3 MG TAB ER 24 3 ST



INVEGA SUSTENNA 117MG/0.75 SYRINGE 5 ST

INVEGA SUSTENNA 156 MG/ML SYRINGE 5 ST




12



INVEGA SUSTENNA 78MG/0.5ML SYRINGE 5 ST

KAPVAY TAB ER 12H 3

LATUDA 120 MG TABLET 3 ST





lithium SOLUTION 1

lithium carbonate CAPSULE 1

lithium carbonate TABLET 1

lithium carbonate er TABLET ER 1

LITHOBID TABLET ER 3

lorazepam ORAL CONC 1

lorazepam TABLET 1

lorazepam intensol ORAL CONC 1

loxapine CAPSULE 1

LUNESTA TABLET 3

meprobamate TABLET 3

METADATE CD CPBP 30-70 3 QL

METADATE ER TABLET ER 3 QL

methamphetamine hcl TABLET 3

METHYLIN SOLUTION 3

METHYLIN TAB CHEW 3

methylphenidate er CPBP 50-50 3 QL

methylphenidate er TAB ER 24 1 QL

methylphenidate er TABLET ER 1 QL

methylphenidate hcl SOLUTION 3 QL

methylphenidate hcl TABLET 1 QL

methylphenidate hcl cd CPBP 30-70 1 QL

methylphenidate la CPBP 50-50 3 QL

midazolam hcl SYRUP 3

modafinil 100 MG TABLET 1 ST

modafinil 200 MG TABLET 1 ST

naltrexone hcl TABLET 1

NUVIGIL 150 MG TABLET 3 ST




13




olanzapine TABLET 1

olanzapine odt TAB RAPDIS 3

olanzapine-fluoxetine hcl CAPSULE 3

ORAP TABLET 2

oxazepam CAPSULE 1

perphenazine TABLET 1

phenobarbital ELIXIR 1

phenobarbital TABLET 1

PROCENTRA SOLUTION 3

PROVIGIL 100 MG TABLET 3 ST

PROVIGIL 200 MG TABLET 3 ST

quetiapine fumarate TABLET 1

QUILLIVANT XR SU ER RC24 3

RESTORIL CAPSULE 3

REVIA TABLET 3

RISPERDAL SOLUTION 3

RISPERDAL TABLET 3

RISPERDAL M-TAB TAB RAPDIS 3

risperidone SOLUTION 1

risperidone TAB RAPDIS 3

risperidone TABLET 1

risperidone odt TAB RAPDIS 3

RITALIN TABLET 3 QL

RITALIN LA CPBP 50-50 3 QL

ROZEREM TABLET 3

SAPHRIS 10 MG TAB SUBL 3 ST

SAPHRIS 5 MG TAB SUBL 3 ST

SECONAL SODIUM CAPSULE 2

SEROQUEL TABLET 3

SEROQUEL XR 150 MG TAB ER 24H 3 ST





SILENOR TABLET 3



14


SONATA CAPSULE 3

STRATTERA 10 MG CAPSULE 2 ST







SYMBYAX CAPSULE 3

temazepam 15 MG CAPSULE 1

temazepam 22.5 MG CAPSULE 3

temazepam 30 MG CAPSULE 1

temazepam 7.5 MG CAPSULE 1

thioridazine hcl TABLET 3

thiothixene CAPSULE 1

TRANXENE T-TAB TABLET 3

triazolam TABLET 1

trifluoperazine hcl TABLET 1

VALIUM TABLET 3

VERSACLOZ ORAL SUSP 3

VYVANSE CAPSULE 3 PA,QL

XANAX TABLET 3

XANAX XR TAB ER 24H 3

XYREM 500 MG/ML SOLUTION 5 PA,DS

zaleplon CAPSULE 1

zenzedi TABLET 1

ziprasidone hcl CAPSULE 1

zolpidem TABLET 1

zolpidem tartrate TABLET 1

zolpidem tartrate er TAB MPHASE 1

ZOLPIMIST SPRAY/PUMP 3

ZYPREXA TABLET 3

ZYPREXA RELPREVV 210 MG VIAL 3 ST



ZYPREXA ZYDIS TAB RAPDIS 3



15

CARDIOVASCULAR DISEASE - ARRHYTHMIA


amiodarone hcl 100 MG TABLET 3



CORDARONE TABLET 3

disopyramide phosphate CAPSULE 1

flecainide acetate TABLET 1

mexiletine hcl CAPSULE 1

MULTAQ TABLET 3

NORPACE CAPSULE 3

NORPACE CR CAPSULE ER 2

pacerone 100 MG TABLET 3



propafenone hcl TABLET 1

propafenone hcl er CAP ER 12H 3

quinidine gluconate TABLET ER 1

quinidine sulfate TABLET 1

quinidine sulfate TABLET ER 1

RYTHMOL TABLET 3

RYTHMOL SR CAP ER 12H 3

TIKOSYN CAPSULE 3

CARDIOVASCULAR DISEASE - CARDIAC STIMULANT


digitek TABLET 1

digox TABLET 1

DIGOXIN SOLUTION 2

digoxin TABLET 1

LANOXIN TABLET 3

CARDIOVASCULAR DISEASE - HYPERTENSION


ACCUPRIL TABLET 3



16


ACCURETIC TABLET 3

acebutolol hcl CAPSULE 1

ACEON TABLET 3

ADALAT CC TABLET ER 3

ADCIRCA 20 MG TABLET 5 PA,DS

ADEMPAS 0.5 MG TABLET 5 PA,DS

ADEMPAS 1 MG TABLET 5 PA,DS


ADEMPAS 2 MG TABLET 5 PA,DS


afeditab cr TABLET ER 3

ALDACTAZIDE 25 MG-25MG TABLET 3

ALDACTAZIDE 50 MG-50MG TABLET 2

ALDACTONE TABLET 3

ALTACE CAPSULE 3

amiloride hcl TABLET 1

amiloride-hydrochlorothiazide TABLET 1

amlodipine besylate TABLET 1

amlodipine besylate-benazepril CAPSULE 1

amlodipine-valsartan 10MG-160MG TABLET 3 ST




amlodipine-valsartan-hctz TABLET 3

AMTURNIDE 150-5-12.5 TABLET 3 ST

AMTURNIDE 300-10-25 TABLET 3 ST

AMTURNIDE 300-5-12.5 TABLET 3 ST

AMTURNIDE 300-5-25MG TABLET 3 ST

AMTURNIDE 300MG-10MG TABLET 3 ST

ATACAND TABLET 3

ATACAND HCT TABLET 3

atenolol TABLET 1

atenolol-chlorthalidone TABLET 1

AVALIDE TABLET 3

AVAPRO TABLET 3

AZOR 10 MG-20MG TABLET 3 ST

AZOR 10 MG-40MG TABLET 3 ST



17


AZOR 5 MG-20 MG TABLET 3 ST

AZOR 5 MG-40 MG TABLET 3 ST

benazepril hcl TABLET 1

benazepril-hydrochlorothiazide TABLET 1

BENICAR 20 MG TABLET 3 ST



BENICAR HCT 20-12.5 MG TABLET 3 ST

BENICAR HCT 40 MG-25MG TABLET 3 ST

BENICAR HCT 40-12.5 MG TABLET 3 ST

BETAPACE TABLET 3

BETAPACE AF TABLET 3

betaxolol hcl TABLET 1

BIDIL TABLET 3

bisoprolol fumarate TABLET 1

bisoprolol-hydrochlorothiazide TABLET 1

bumetanide TABLET 1

BYSTOLIC TABLET 3

CALAN TABLET 3

CALAN SR TABLET ER 3

candesartan cilexetil TABLET 3

candesartan-hydrochlorothiazid TABLET 3

captopril TABLET 1

captopril-hydrochlorothiazide TABLET 1

CARDENE SR CAPSULE ER 3

CARDIZEM TABLET 3

CARDIZEM CD CAP ER 24H 3

CARDIZEM LA TAB ER 24H 3

CARDURA TABLET 3

CARDURA XL TAB ER 24 3

cartia xt CAP ER 24H 1

carvedilol TABLET 1

CATAPRES TABLET 3

CATAPRES-TTS 1 PATCH TDWK 3



chlorothiazide TABLET 1



18


chlorthalidone TABLET 1

clonidine PATCH TDWK 1

clonidine hcl TABLET 1

clorpres TABLET 3

COREG TABLET 3

COREG CR CPMP 24HR 3

CORGARD TABLET 3

CORZIDE TABLET 3

COZAAR TABLET 3

DEMADEX TABLET 3

DEMSER CAPSULE 3

DIBENZYLINE CAPSULE 2

dilt-xr CAP ER DEG 1

diltiazem 12hr er CAP ER 12H 1

diltiazem 24hr cd CAP ER 24H 1

diltiazem 24hr er CAP ER 24H 1

diltiazem er CAP ER DEG 1

diltiazem er CAPSULE ER 3

diltiazem er TAB ER 24H 3

diltiazem hcl TABLET 1

DIOVAN TABLET 3

DIOVAN HCT TABLET 3

DIURIL ORAL SUSP 2

doxazosin mesylate TABLET 1

DUTOPROL TAB ER 24H 3

DYAZIDE CAPSULE 3

DYRENIUM CAPSULE 2

EDARBI 40 MG TABLET 3 ST

EDARBI 80 MG TABLET 3 ST

EDARBYCLOR 40 MG-25MG TABLET 3 ST

EDARBYCLOR 40-12.5 MG TABLET 3 ST

EDECRIN TABLET 2

enalapril maleate TABLET 1

enalapril-hydrochlorothiazide TABLET 1

EPANED SOLN RECON 3

eplerenone TABLET 1

eprosartan mesylate 600 MG TABLET 3 ST



19


EXFORGE 10MG-160MG TABLET 3 ST




EXFORGE HCT TABLET 3

felodipine er TAB ER 24H 1

fosinopril sodium TABLET 1

fosinopril-hydrochlorothiazide TABLET 1

furosemide SOLUTION 1

furosemide TABLET 1

guanfacine hcl TABLET 1

HEMANGEOL 4.28 MG/ML SOLUTION 3 PA

hydralazine hcl TABLET 1

hydrochlorothiazide CAPSULE 1

hydrochlorothiazide TABLET 1

HYZAAR TABLET 3

indapamide TABLET 1

INDERAL LA CAP SA 24H 3

INDERAL XL CAP ER 24H 3

INNOPRAN XL CAP ER 24H 3

INSPRA TABLET 3

irbesartan TABLET 1

irbesartan-hydrochlorothiazide TABLET 1

isradipine CAPSULE 1

labetalol hcl TABLET 1

LASIX TABLET 3

LETAIRIS 10 MG TABLET 4 PA,DS

LETAIRIS 5 MG TABLET 4 PA,DS

LEVATOL TABLET 3

lisinopril TABLET 1

lisinopril-hydrochlorothiazide TABLET 1

LOPRESSOR TABLET 3

LOPRESSOR HCT TABLET 3

losartan potassium TABLET 1

losartan-hydrochlorothiazide TABLET 1

LOTENSIN TABLET 3

LOTENSIN HCT TABLET 3



20


LOTREL CAPSULE 3

matzim la TAB ER 24H 3

MAVIK TABLET 3

MAXZIDE TABLET 3

MAXZIDE-25 MG TABLET 3

methyclothiazide TABLET 1

methyldopa TABLET 1

methyldopa-hydrochlorothiazide TABLET 3

metolazone TABLET 1

metoprolol succinate TAB ER 24H 1

metoprolol tartrate TABLET 1

metoprolol-hydrochlorothiazide TABLET 1

MICARDIS TABLET 3

MICARDIS HCT TABLET 3

MICROZIDE CAPSULE 3

MINIPRESS CAPSULE 3

minoxidil TABLET 1

moexipril hcl TABLET 1

moexipril-hydrochlorothiazide TABLET 1

nadolol TABLET 1

nadolol-bendroflumethiazide TABLET 3

nicardipine hcl CAPSULE 1

nifedical xl TAB ER 24 1

nifedipine CAPSULE 1

nifedipine er TAB ER 24 1

nifedipine er TABLET ER 3

nimodipine CAPSULE 1

nisoldipine TAB ER 24H 3

NORVASC TABLET 3

NYMALIZE 60 MG/20ML SOLUTION 5 DS

OPSUMIT 10 MG TABLET 4 PA,DS

ORENITRAM ER 0.125 MG TABLET ER 3 PA,DS


ORENITRAM ER 1 MG TABLET ER 5 PA,DS


perindopril erbumine TABLET 1

pindolol TABLET 1



21


prazosin hcl CAPSULE 1

PRINIVIL TABLET 3

PROCARDIA CAPSULE 3

PROCARDIA XL TAB ER 24 3

propranolol hcl SOLUTION 1

propranolol hcl TABLET 1

propranolol hcl er CAP SA 24H 1

propranolol-hydrochlorothiazid TABLET 1

quinapril hcl TABLET 1

quinapril-hydrochlorothiazide TABLET 1

ramipril CAPSULE 1

reserpine TABLET 3

REVATIO 10 MG/ML SUSP RECON 3 PA

REVATIO 20 MG TABLET 5 PA

SECTRAL CAPSULE 3

sildenafil 20 MG TABLET 4 PA

sorine TABLET 1

sotalol TABLET 1

sotalol af TABLET 1

SOTYLIZE SOLUTION 3

spironolactone TABLET 1

spironolactone-hctz TABLET 1

SULAR TAB ER 24H 3

TARKA TBMP 24HR 3

taztia xt CAPSULE ER 3

TEKAMLO 150 MG-5MG TABLET 3 ST

TEKAMLO 150MG-10MG TABLET 3 ST



TEKTURNA 150 MG TABLET 3 ST

TEKTURNA 300 MG TABLET 3 ST

TEKTURNA HCT 150-12.5MG TABLET 3 ST

TEKTURNA HCT 150MG-25MG TABLET 3 ST

TEKTURNA HCT 300-12.5MG TABLET 3 ST

TEKTURNA HCT 300MG-25MG TABLET 3 ST

telmisartan TABLET 3

telmisartan-amlodipine TABLET 3



22


telmisartan-hydrochlorothiazid TABLET 3

TENEX TABLET 3

TENORETIC 100 TABLET 3

TENORETIC 50 TABLET 3

TENORMIN TABLET 3

terazosin hcl CAPSULE 1

TEVETEN 600 MG TABLET 3 ST

TEVETEN HCT 600-12.5MG TABLET 3 ST

TEVETEN HCT 600-25MG TABLET 3 ST

TIAZAC CAPSULE ER 3

timolol maleate TABLET 1

TOPROL XL TAB ER 24H 3

torsemide TABLET 1

TRACLEER 125 MG TABLET 4 PA,DS

TRACLEER 62.5 MG TABLET 4 PA,DS

TRANDATE TABLET 3

trandolapril TABLET 1

trandolapril-verapamil er TBMP 24HR 3

triamterene-hydrochlorothiazid CAPSULE 3

triamterene-hydrochlorothiazid TABLET 1

TRIBENZOR 20-5-12.5 TABLET 3 ST


TRIBENZOR 40-10-25MG TABLET 3 ST


TRIBENZOR 40-5-25 MG TABLET 3 ST

TWYNSTA TABLET 3

TYVASO 1.74MG/2.9 AMPUL-NEB 4 PA,DS

valsartan TABLET 3

valsartan-hydrochlorothiazide TABLET 3

VASERETIC TABLET 3

VASOTEC TABLET 3

VECAMYL TABLET 5

VENTAVIS 10 MCG/ML AMPUL-NEB 4 PA,DS

VENTAVIS 20 MCG/ML AMPUL-NEB 4 PA,DS

verapamil er CAP24H PEL 1

verapamil er TABLET ER 1

verapamil er pm CAP24H PCT 3



23


verapamil hcl CAP24H PEL 1

verapamil hcl TABLET 1

verapamil sr CAP24H PEL 1

VERELAN CAP24H PEL 3

VERELAN PM CAP24H PCT 3

ZEBETA TABLET 3

ZESTORETIC TABLET 3

ZESTRIL TABLET 3

ZIAC TABLET 3

CARDIOVASCULAR DISEASE - LIPID IRREGULARITY


ADVICOR TBMP 24HR 3

ALTOPREV TAB ER 24H 3

ANTARA CAPSULE 3

atorvastatin calcium TABLET 1

cholestyramine POWD PACK 1

cholestyramine POWDER 1

cholestyramine light POWD PACK 3

cholestyramine light POWDER 1

COLESTID GRANULES 3

COLESTID PACKET 3

COLESTID TABLET 3

colestipol hcl GRANULES 1

colestipol hcl PACKET 1

colestipol hcl TABLET 1

CRESTOR 10 MG TABLET 3 PA




fenofibrate 130 MG CAPSULE 1

fenofibrate 134MG CAPSULE 1







24



fenofibrate 145MG TABLET 3

fenofibrate 160 MG TABLET 1



fenofibric acid CAPSULE DR 3

fenofibric acid TABLET 1

FENOGLIDE TABLET 3

FIBRICOR TABLET 3

fluvastatin sodium CAPSULE 3

gemfibrozil TABLET 1

JUXTAPID 10 MG CAPSULE 5 QL,PA,DS



KYNAMRO 200 MG/ML SYRINGE 5 QL,PA,DS

LESCOL CAPSULE 3

LESCOL XL TAB ER 24H 3

LIPITOR TABLET 3

LIPOCHOL PLUS TABLET 3

LIPOFEN CAPSULE 3

LIPTRUZET 10 MG-10MG TABLET 3 PA,DS




LIVALO TABLET 3

LOFIBRA CAPSULE 3

LOFIBRA TABLET 3

LOPID TABLET 3

lovastatin TABLET 1

LOVAZA CAPSULE 3

niacin er TAB ER 24H 1

niacor TABLET 3

NIASPAN TAB ER 24H 1

omega-3 acid ethyl esters CAPSULE 3



25


PRAVACHOL TABLET 3

pravastatin sodium TABLET 1

prevalite POWD PACK 3

prevalite POWDER 1

QUESTRAN POWD PACK 3

QUESTRAN POWDER 3

QUESTRAN LIGHT POWDER 3

SIMCOR TBMP 24HR 3

simvastatin TABLET 1

TRICOR TABLET 3

TRIGLIDE TABLET 3

TRILIPIX CAPSULE DR 3

VASCEPA CAPSULE 3

VYTORIN 10 MG-10MG TABLET 3 PA




WELCHOL POWD PACK 3

WELCHOL TABLET 3

ZETIA 10 MG TABLET 3 PA

ZOCOR TABLET 3

CARDIOVASCULAR DISEASE - MISCELLANEOUS AGENTS


amlodipine-atorvastatin TABLET 3

CADUET TABLET 3

midodrine hcl TABLET 1

RANEXA TAB ER 12H 3

CARDIOVASCULAR DISEASE - VASODILATION


DILATRATE-SR CAPSULE ER 3

ergoloid mesylates TABLET 3

ISOCHRON TABLET ER 3

ISORDIL TABLET 2



26


ISORDIL TITRADOSE TABLET 3

isosorbide dinitrate TABLET 1

isosorbide dinitrate TABLET ER 3

isosorbide mononitrate TABLET 1

isosorbide mononitrate er TAB ER 24H 1

isoxsuprine hcl TABLET 3

minitran PATCH TD24 1

NITRO-BID OINT. (G) 2

NITRO-DUR 0.1MG/HR PATCH TD24 3


NITRO-DUR 0.3 MG/HR PATCH TD24 2




nitro-time CAPSULE ER 1

nitroglycerin CAPSULE ER 1

nitroglycerin SPRAY 3

nitroglycerin patch PATCH TD24 1

NITROLINGUAL SPRAY 3

NITROMIST SPRAY 3

NITROSTAT TAB SUBL 2

CONTRACEPTION/OXYTOCICS


altavera TABLET 1

alyacen TABLET 1

amethia TBDSPK 3MO 3

amethia lo TBDSPK 3MO 3

AMETHYST TABLET 3

apri TABLET 1

aranelle TABLET 1

aubra TABLET 1

aviane TABLET 1

azurette TABLET 3

balziva TABLET 1

BEYAZ TABLET 3



27


brevicon TABLET 1

briellyn TABLET 1

camila TABLET 1

camrese TBDSPK 3MO 3

camrese lo TBDSPK 3MO 3

caziant TABLET 1

CERVIDIL INSERT ER 2

chateal TABLET 1

cryselle TABLET 1

cyclafem TABLET 1

CYCLESSA TABLET 3

dasetta TABLET 1

daysee TBDSPK 3MO 3

deblitane TABLET 1

delyla TABLET 1

DEPO-PROVERA 150 MG/ML SYRINGE 3 QL

DEPO-PROVERA 150 MG/ML VIAL 3 QL


DEPO-SUBQ PROVERA 104 SYRINGE 3

DESOGEN TABLET 3

desogestr-eth estrad eth estra TABLET 3

desogestrel-ethinyl estradiol TABLET 1

drospirenone-ethinyl estradiol TABLET 1

elinest TABLET 1

ELLA TABLET 2

emoquette TABLET 1

enpresse TABLET 1

enskyce TABLET 1

errin TABLET 1

estarylla TABLET 1

ESTROSTEP FE TABLET 3

falmina TABLET 1

FEMCON FE TAB CHEW 3

GENERESS FE TAB CHEW 3

gianvi TABLET 3

gildagia TABLET 1

gildess TABLET 1



28


gildess 24 fe TABLET 3

gildess fe TABLET 1

heather TABLET 1

introvale TBDSPK 3MO 3

jencycla TABLET 1

jolessa TBDSPK 3MO 3

jolivette TABLET 1

junel TABLET 1

junel fe TABLET 1

kariva TABLET 3

kelnor 1-35 TABLET 1

kurvelo TABLET 1

larin TABLET 1

larin fe TABLET 1

leena TABLET 1

lessina TABLET 1

levonest TABLET 1

levonorg-eth estrad eth estrad TBDSPK 3MO 3

levonorgestrel TABLET 1

levonorgestrel-eth estradiol TABLET 1

levonorgestrel-eth estradiol TBDSPK 3MO 3

levora-28 TABLET 1

LO LOESTRIN FE TABLET 3

LOESTRIN TABLET 3

LOESTRIN FE TABLET 3

lomedia 24 fe TABLET 3

loryna TABLET 3

LOSEASONIQUE TBDSPK 3MO 3

low-ogestrel TABLET 1

lutera TABLET 1

lyza TABLET 1

marlissa TABLET 1

methylergonovine maleate TABLET 1

microgestin TABLET 1

microgestin fe TABLET 1

MINASTRIN 24 FE TAB CHEW 3

MIRCETTE TABLET 3



29


MODICON TABLET 3

mono-linyah TABLET 1

mononessa TABLET 1

myzilra TABLET 1

NATAZIA TABLET 3

necon TABLET 1

nikki TABLET 3

NOR-Q-D TABLET 3

nora-be TABLET 1

norethin-eth estra ferrous fum 1MG-20(21) TABLET 1

norethin-eth estra ferrous fum 1MG-20(24) TABLET 3

norethindron-ethinyl estradiol TABLET 1

norethindrone TABLET 1

norgestimate-ethinyl estradiol TABLET 1

norinyl 1+35 TABLET 3

NORINYL 1+50 TABLET 3

norlyroc TABLET 1

nortrel TABLET 1

NUVARING VAG RING 2

ocella TABLET 1

ogestrel TABLET 1

orsythia TABLET 1

ORTHO EVRA PATCH TDWK 2

ORTHO MICRONOR TABLET 3

ORTHO TRI-CYCLEN TABLET 3

ORTHO TRI-CYCLEN LO TABLET 3

ORTHO-CEPT TABLET 3

ORTHO-CYCLEN TABLET 3

ORTHO-NOVUM TABLET 3

OVCON-35 TABLET 3

philith TABLET 1

pimtrea TABLET 3

pirmella TABLET 1

PLAN B ONE-STEP TABLET 1

portia TABLET 1

PREPIDIL GEL/PF APP 2

previfem TABLET 1



30


PROSTIN E2 VAGINAL SUPPOSITORY SUPP.VAG 2

QUARTETTE TBDSPK 3MO 3

quasense TBDSPK 3MO 3

reclipsen TABLET 1

SAFYRAL TABLET 3

SEASONIQUE TBDSPK 3MO 3

sharobel TABLET 1

sprintec TABLET 1

sronyx TABLET 1

syeda TABLET 1

tarina fe TABLET 1

tilia fe TABLET 3

tri-estarylla TABLET 1

tri-legest fe TABLET 3

tri-linyah TABLET 1

TRI-NORINYL TABLET 1

tri-previfem TABLET 1

tri-sprintec TABLET 1

trinessa TABLET 1

trivora-28 TABLET 1

velivet TABLET 1

vestura TABLET 3

viorele TABLET 3

vyfemla TABLET 1

wera TABLET 1

wymzya fe TAB CHEW 3

xulane PATCH TDWK 1

YASMIN 28 TABLET 3

YAZ TABLET 3

zarah TABLET 1

zenchent TABLET 1

zenchent fe TAB CHEW 3

zeosa TAB CHEW 3

zovia 1-35e TABLET 1

zovia 1-50e TABLET 1



31

COUGH AND COLD


ADRENALIN CHLORIDE SOLUTION 3

benzonatate CAPSULE 1

bpm-dm-phen LIQUID 3

bromfed dm SYRUP 3

brompheniramine-pseudoephed-dm SYRUP 3

centergy DROPS 3

centergy dm DROPS 3

hydrocod-cpm-pseudoephedrine SOLUTION 3

hydrocodone bt-homatropine mbr TABLET 1

hydrocodone-chlorpheniramne er SUS ER 12H 3

hydrocodone-homatropine mbr SYRUP 1

hydromet SYRUP 1

HYSINGA TABLET 3 PA,QL

lohist-dm LIQUID 3

OBREDON SOLUTION 3

promethazine vc SYRUP 1

promethazine vc-codeine SYRUP 1

promethazine-codeine SYRUP 1

promethazine-dm SYRUP 1

respa a.r. TAB ER 12H 3

REZIRA SOLUTION 3

TESSALON PERLE CAPSULE 3

TUSNEL PEDIATRIC LIQUID 3

TUSSICAPS CAP ER 12H 3

TUSSIGON TABLET 3

TUSSIONEX SUS ER 12H 3

TYZINE DROPS 3

TYZINE SPRAY 3

VITUZ SOLUTION 3

ZONATUSS CAPSULE 3

ZUTRIPRO SOLUTION 3



32

DERMATOLOGY - ACNE


ABSORICA CAPSULE 3

ACANYA GEL W/PUMP 3

ACZONE GEL (GRAM) 3

adapalene CREAM (G) 1

adapalene GEL (GRAM) 1

adapalene GEL W/PUMP 1

ALA-QUIN CREAM (G) 3

ALCORTIN A GEL PACKET 3

ALOQUIN GEL (GRAM) 3

amnesteem CAPSULE 1

ATRALIN GEL (GRAM) 3

avita CREAM (G) 1

avita GEL (GRAM) 1

AZELEX CREAM (G) 2

BENZACLIN GEL (GRAM) 3

BENZACLIN GEL W/PUMP 3

claravis CAPSULE 1

clindamycin phos-benzoyl perox GEL (GRAM) 3

clindamycin-benzoyl peroxide GEL (GRAM) 1

DERMASORB AF CREAM (G) 3

dermazene CREAM (G) 3

DIFFERIN CREAM (G) 1

DIFFERIN 0.10% GEL (GRAM) 1

DIFFERIN 0.30% GEL (GRAM) 3

DIFFERIN GEL W/PUMP 2

DIFFERIN LOTION 2

DUAC GEL (GRAM) 3

EPIDUO GEL (GRAM) 3

EPIDUO GEL W/PUMP 3

FABIOR FOAM 3

FINACEA GEL (GRAM) 2

hydrocortisone-iodoquinol CREAM (G) 3

IODOFLEX MED. PAD 3

IODOSORB GEL (GRAM) 2

KLARON SUSPENSION 3



33


lugols SOLUTION 3

METROCREAM CREAM (G) 3

METROGEL GEL (GRAM) 3

METROGEL GEL W/PUMP 3

METROLOTION LOTION 3

metronidazole CREAM (G) 1

metronidazole 0.75% GEL (GRAM) 1

metronidazole 1% GEL (GRAM) 3

metronidazole GEL W/PUMP 3

metronidazole LOTION 3

MIRVASO GEL (GRAM) 3

myorisan CAPSULE 1

neuac GEL (GRAM) 3

NORITATE CREAM (G) 3

ONEXTON GEL W/PUMP 3

RETIN-A CREAM (G) 1

RETIN-A GEL (GRAM) 1

RETIN-A MICRO GEL (GRAM) 1

RETIN-A MICRO PUMP GEL W/PUMP 1

ROSADAN GEL (GRAM) 3

ROSADAN KIT CL&CRM 3

ROSADAN KIT CL&GEL 3

rosadan CREAM (G) 1

silver nitrate OINT. (G) 3

silver nitrate SOLUTION 3

sodium sulfacetamide SUSPENSION 1

SOOLANTRA CREAM (G) 3

sulfacetamide sodium SUSPENSION 1

TRETIN-X CREAM (G) 3

tretinoin CREAM (G) 1

tretinoin GEL (GRAM) 1

tretinoin microsphere GEL (GRAM) 1

tretinoin microsphere GEL W/PUMP 1

VANOXIDE-HC SUSPENSION 3

VELTIN GEL (GRAM) 3

zenatane CAPSULE 1

ZIANA GEL (GRAM) 3



34

DERMATOLOGY - ANTIINFECTIVE


acyclovir OINT. (G) 3

ALINIA SUSP RECON 2

ALINIA TABLET 2

ALTABAX OINT. (G) 3

AVAR CLEANSER 3

AVAR LS CLEANSER 3

AVAR-E CREAM (G) 3

AVAR-E GREEN CREAM (G) 3

AVAR-E LS CREAM (G) 3

BACTROBAN CREAM (G) 3

BACTROBAN OINT. (G) 3

BENZAMYCIN GEL (GRAM) 3

BENZAMYCINPAK GEL (EA) 3

bp 10-1 CLEANSER 3

CENTANY OINT. (G) 3

CENTANY AT KIT 3

CICLODAN CREAM (G) 3

CICLODAN SOLUTION 3

ciclopirox CREAM (G) 1

ciclopirox GEL (GRAM) 1

ciclopirox SHAMPOO 3

ciclopirox SOLUTION 1

ciclopirox SUSPENSION 1

CLARIFOAM EF FOAM 3

CLARIS CLEANSER 3

cleansing wash CLEANSER 3

CLEOCIN T GEL (GRAM) 3

CLEOCIN T LOTION 3

CLEOCIN T MED. SWAB 3

CLEOCIN T SOLUTION 3

CLINDACIN ETZ KIT 3

CLINDACIN ETZ MED. SWAB 3

CLINDACIN P MED. SWAB 3

CLINDACIN PAC KIT 3



35


CLINDAGEL GEL (ML) 3

clindamycin phosphate FOAM 3

clindamycin phosphate GEL (GRAM) 1

clindamycin phosphate LOTION 1

clindamycin phosphate MED. SWAB 1

clindamycin phosphate SOLUTION 1

clotrimazole CREAM (G) 3

clotrimazole SOLUTION 3

clotrimazole-betamethasone CREAM (G) 1

clotrimazole-betamethasone LOTION 1

CNL 8 KIT 3

DENAVIR CREAM (G) 3

econazole nitrate CREAM (G) 1

ECOZA FOAM 3

ELIMITE CREAM (G) 3

ERTACZO CREAM (G) 3

ery MED. SWAB 3

ERYGEL GEL (GRAM) 3

erythromycin GEL (GRAM) 1

erythromycin MED. SWAB 3

erythromycin SOLUTION 1

erythromycin-benzoyl peroxide GEL (GRAM) 1

EURAX CREAM (G) 2

EURAX LOTION 2

EVOCLIN FOAM 3

EXELDERM CREAM (G) 3

EXELDERM SOLUTION 3

exoderm LOTION 3

EXTINA FOAM 3

gentamicin sulfate CREAM (G) 1

gentamicin sulfate OINT. (G) 1

JUBLIA SOL W/APPL 3

KERYDIN SOL W/APPL 3

ketoconazole CREAM (G) 1

ketoconazole SHAMPOO 1

KETODAN FOAM 3

LIDOVIR OINT. (G) 3



36


lindane LOTION 3

lindane SHAMPOO 3

LOPROX SHAMPOO 3

LOTRISONE CREAM (G) 3

LUZU CREAM (G) 3

LYCELLE GEL (ML) 3

malathion LOTION 3

MENTAX CREAM (G) 3

mupirocin CREAM (G) 1

mupirocin OINT. (G) 1

NAFTIN CREAM (G) 3

NAFTIN GEL (GRAM) 3

NATROBA SUSPENSION 3

NIZORAL SHAMPOO 3

nyamyc POWDER 1

nystatin CREAM (G) 1

nystatin OINT. (G) 1

nystatin POWDER 1

nystatin-triamcinolone CREAM (G) 1

nystatin-triamcinolone OINT. (G) 1

nystop POWDER 1

OVIDE LOTION 3

OXISTAT CREAM (G) 3

OXISTAT LOTION 3

PEDIADERM AF CREAM (G) 3

PENLAC SOLUTION 3

permethrin CREAM (G) 1

PLEXION CLEANSER 3

PLEXION CREAM (G) 3

PLEXION LOTION 3

PLEXION MED. PAD 3

ROSANIL CLEANSER 3

ROSULA CLEANSER 3

SILVADENE CREAM (G) 3

silver sulfadiazine CREAM (G) 1

SKLICE LOTION 3

sodium sulfacetamide-sulfur 10 %-2 % CLEANSER 3



37


sodium sulfacetamide-sulfur 10%-5%-10% CLEANSER 1

sodium sulfacetamide-sulfur 10-5%(W/W) CLEANSER 1

sodium sulfacetamide-sulfur 9 %-4 % CLEANSER 3

sodium sulfacetamide-sulfur 9 %-4.5 % CLEANSER 3

sodium sulfacetamide-sulfur 9.8%-4.8% CLEANSER 3

sodium sulfacetamide-sulfur CREAM (G) 3

sodium sulfacetamide-sulfur FOAM 3

sodium sulfacetamide-sulfur GEL (GRAM) 3

sodium sulfacetamide-sulfur KIT 3

sodium sulfacetamide-sulfur 10-5%(W/V) LOTION 1

sodium sulfacetamide-sulfur 10-5%(W/W) LOTION 1

sodium sulfacetamide-sulfur 9.8%-4.8% LOTION 3

sodium sulfacetamide-sulfur MED. PAD 3

sodium sulfacetamide-sulfur SUSPENSION 3

spinosad SUSPENSION 3

SS 10-2 CLEANSER 3

ssd CREAM (G) 1

sss 10-5 CREAM (G) 3

sss 10-5 FOAM 3

sulfacleanse 8-4 SUSPENSION 3

SULFAMYLON CREAM (G) 3

SULFAMYLON PACKET 3

SUMADAN CLEANSER 3

SUMADAN KIT 3

SUMAXIN CLEANSER 3

SUMAXIN MED. PAD 3

SUMAXIN CP KIT 3

SUMAXIN TS SUSPENSION 3

THERMAZENE CREAM (G) 3

triple dye MED. SWAB 3

ULESFIA LOTION 2

VEREGEN OINT. (G) 3

virti-sulf CREAM (G) 3

VUSION OINT. (G) 3

XERESE CREAM (G) 3

XOLEGEL GEL (GRAM) 3

ZENCIA CLEANSER 3



38


ZOVIRAX CREAM (G) 3

ZOVIRAX OINT. (G) 3

DERMATOLOGY - ANTIINFLAMMATORY


ala-cort CREAM (G) 3

ala-scalp LOTION 3

alclometasone dipropionate CREAM (G) 3

alclometasone dipropionate OINT. (G) 3

amcinonide CREAM (G) 3

amcinonide LOTION 3

amcinonide OINT. (G) 3

APEXICON E CREAM (G) 3

AQUA GLYCOLIC HC COMBO. PKG 3

betamethasone dipropionate CREAM (G) 1

betamethasone dipropionate GEL (GRAM) 1

betamethasone dipropionate LOTION 1

betamethasone dipropionate OINT. (G) 1

betamethasone valerate CREAM (G) 1

betamethasone valerate FOAM 3

betamethasone valerate LOTION 1

betamethasone valerate OINT. (G) 1

CAPEX SHAMPOO SHAMPOO 2

clobetasol emollient CREAM (G) 1

clobetasol emollient FOAM 3

clobetasol emulsion FOAM 3

clobetasol propionate CREAM (G) 1

clobetasol propionate FOAM 3

clobetasol propionate GEL (GRAM) 1

clobetasol propionate LOTION 3

clobetasol propionate OINT. (G) 1

clobetasol propionate SHAMPOO 3

clobetasol propionate SOLUTION 1

clobetasol propionate SPRAY 3

CLOBEX LOTION 3

CLOBEX SHAMPOO 3



39


CLOBEX SPRAY 3

clocortolone pivalate CREAM (G) 3

CLODAN KT SHM CLN 3

CLODAN SHAMPOO 3

CLODERM CREAM (G) 3

CORDRAN CREAM (G) 3

CORDRAN LOTION 3

CORDRAN MED. TAPE 2

CORDRAN OINT. (G) 3

cormax SOLUTION 1

CORTISPORIN CREAM (G) 3

CORTISPORIN OINT. (G) 2

CUTIVATE CREAM (G) 3

CUTIVATE LOTION 3

DERMA-SMOOTHE-FS OIL 3

DERMASORB HC CMB CLN LT 3

DERMASORB TA CREAM (G) 3

DERMATOP CREAM (G) 3

DERMATOP OINT. (G) 3

DESONATE GEL (GRAM) 3

desonide CREAM (G) 1

desonide LOTION 1

desonide OINT. (G) 1

DESOWEN CREAM (G) 3

DESOWEN LOTION 3

desoximetasone CREAM (G) 1

desoximetasone GEL (GRAM) 1

desoximetasone OINT. (G) 1

diclofenac sodium 1.50% DROPS 3

diflorasone diacetate CREAM (G) 3

diflorasone diacetate OINT. (G) 3

DIPROLENE LOTION 3

DIPROLENE OINT. (G) 3

DIPROLENE AF CREAM (G) 3

ELOCON CREAM (G) 3

ELOCON OINT. (G) 3

ELOCON SOLUTION 3



40


FIRST-HYDROCORTISONE GEL (GRAM) 3

FLECTOR PATCH TD12 3

fluocinolone acetonide CREAM (G) 1

fluocinolone acetonide OIL 1

fluocinolone acetonide OINT. (G) 1

fluocinolone acetonide SOLUTION 1

fluocinonide 0.05% CREAM (G) 1

fluocinonide 0.10% CREAM (G) 3

fluocinonide GEL (GRAM) 1

fluocinonide OINT. (G) 1

fluocinonide SOLUTION 1

fluocinonide-e CREAM (G) 1

fluticasone propionate CREAM (G) 3

fluticasone propionate LOTION 3

fluticasone propionate OINT. (G) 3

halobetasol propionate CREAM (G) 1

halobetasol propionate OINT. (G) 1

HALOG CREAM (G) 3

HALOG OINT. (G) 3

hydrocortisone 1% CREAM (G) 3

hydrocortisone 2.50% CREAM (G) 1

hydrocortisone LOTION 1

hydrocortisone 1% OINT. (G) 1

hydrocortisone 1% OINT. (G) 3

hydrocortisone 2.50% OINT. (G) 1

hydrocortisone butyrate CREAM (G) 1

hydrocortisone butyrate OINT. (G) 1

hydrocortisone butyrate SOLUTION 1

hydrocortisone valerate CREAM (G) 1

hydrocortisone valerate OINT. (G) 1

KENALOG AEROSOL 3

LOCOID CREAM (G) 3

LOCOID LOTION 3

LOCOID OINT. (G) 3

LOCOID SOLUTION 3

LOCOID LIPOCREAM CREAM (G) 3

LUXIQ FOAM 3



41


mometasone furoate CREAM (G) 1

mometasone furoate OINT. (G) 1

mometasone furoate SOLUTION 1

NEO-SYNALAR CREAM (G) 3

NUCORT LOTION 3

OLUX FOAM 3

OLUX-E FOAM 3

PANDEL CREAM (G) 3

PEDIADERM HC KT LOTN CE 3

PEDIADERM TA CREAM (G) 3

PENNSAID DROPS 3

PENNSAID SOL MD PMP 3

prednicarbate CREAM (G) 3

prednicarbate OINT. (G) 3

SCALACORT LOTION 3

SCALACORT DK COMBO. PKG 3

SYNALAR CMB ONT CR 3

SYNALAR CREAM (G) 3

SYNALAR OINT. (G) 3

SYNALAR SOLUTION 3

SYNALAR TS KIT 3

TEMOVATE CREAM (G) 3

TEMOVATE OINT. (G) 3

TEMOVATE EMOLLIENT CREAM (G) 3

TEXACORT SOLUTION 3

TOPICORT CREAM (G) 3

TOPICORT GEL (GRAM) 3

TOPICORT OINT. (G) 3

TOPICORT SPRAY 3

triamcinolone acetonide CREAM (G) 1

triamcinolone acetonide LOTION 1

triamcinolone acetonide OINT. (G) 1

trianex OINT. (G) 3

triderm CREAM (G) 1

u-cort CREAM (G) 3

ULTRAVATE CREAM (G) 3

ULTRAVATE OINT. (G) 3



42


ULTRAVATE X CMB ONT CR 3

ULTRAVATE X COMBO. PKG 3

VANOS CREAM (G) 3

VERDESO FOAM 3

VOLTAREN GEL (GRAM) 3

DERMATOLOGY - ANTIPRURITIC DRUGS


PRUDOXIN CREAM (G) 3

ZONALON CREAM (G) 3

DERMATOLOGY - MISCELLANEOUS


ADAZIN CREAM (G) 3

ALUVEA CREAM (G) 3

ANACAINE OINT. (G) 3

ATRAPRO DERMAL SPRAY SPRAY 3

BENSAL HP OINT. (G) 3

BENZEFOAM FOAM 3

BENZEFOAM ULTRA FOAM 3

benzepro FOAM 3

benzoyl peroxide CLEANSER 3

benzoyl peroxide FOAM 3

BETADINE SOLUTION 3

BIONECT CREAM (G) 3

BIONECT GEL (GRAM) 3

BIONECT SPRAY 3

bp foam FOAM 3

bp-50% urea EMULSN(G) 3

bpo GEL (GRAM) 3

bpo KIT 3

bpo TOWELETTE 3

captracin ADH. PATCH 3

CARAC 0.50% CREAM (G) 2 DS

cem-urea GEL/PF APP 3



43


CETACAINE SPRAY 3

CETACAINE ANESTHETIC LIQUID 3

cocaine hcl SOLUTION 3

CONDYLOX GEL (GRAM) 2

CONDYLOX SOLUTION 3

DERMASORB XM CREAM (G) 3

diclofenac sodium GEL (GRAM) 3

EFUDEX 5% CREAM (G) 3 DS

elenzapatch ADH. PATCH 3

EMLA CREAM (G) 3

EPIFOAM FOAM 3

ethyl chloride SPRAY 3

FLUOROPLEX 1% CREAM (G) 2 DS

fluorouracil 0.50% CREAM (G) 1 DS

fluorouracil 5% CREAM (G) 1 DS

fluorouracil 2% SOLUTION 1 DS

fluorouracil 5% SOLUTION 1 DS

GORDO-UREA OINT. (G) 3

granulex SPRAY 3

HYDRO 35 FOAM 3

HYDRO 40 FOAM 3

hydrocortisone-pramoxine hcl CREAM (G) 1

INOVA COMBO. PKG 3

INOVA 4-1 COMBO. PKG 3

INOVA 8-2 COMBO. PKG 3

KERAFOAM FOAM 3

KERALAC CREAM (G) 3

KERALYT GEL (GRAM) 3

KERALYT SCALP KT SHM GEL 3

latrix SUSPENSION 3

latrix xm EML MD PMP 3

lidocaine ADH. PATCH 1

lidocaine OINT. (G) 3

lidocaine hcl CREAM (G) 3

lidocaine hcl LOTION 3

lidocaine hcl SOLUTION 3

lidocaine-hydrocortisone CREAM (G) 3



44


lidocaine-prilocaine CREAM (G) 1

lidocaine-prilocaine KIT 1

LIDODERM ADH. PATCH 3

LIDODEXTRAPINE ADH. PATCH 3

LIDOPIN CREAM (G) 3

LIDORX GEL W/PUMP 3

LORENZA ADH. PATCH 3

MAC ADH. PATCH 3

NEUVAXIN ADH. PATCH 3

NOVACORT GEL (GRAM) 3

NUOX GEL (GRAM) 3

OVACE CLEANSER 3

OVACE PLUS CLEANSR ER 3

OVACE PLUS CREAM (G) 3

OVACE PLUS SHAMPOO 3

OVACE PLUS WASH CLNSGEL ER 3

OXALIS OINT. (G) 3

PACNEX CLEANSER 3

PACNEX HP MED. PAD 3

PACNEX LP MED. PAD 3

PACNEX MX CLEANSER 3

PAIN EASE SPRAY 3

PAIN RELIEF ADH. PATCH 3

PANRETIN 0.10% GEL (GRAM) 5 DS

PICATO 0.02% GEL (EA) 2

PICATO 0.05% GEL (EA) 2

podocon-25 LIQUID 3

podofilox SOLUTION 1

PONTOCAINE SOLUTION 3

potassium hydroxide SOLUTION 3

pr cream CREAM (G) 3

PRAMOSONE CREAM (G) 3

PRAMOSONE LOTION 2

PRAMOSONE OINT. (G) 2

PRAMOSONE E CREAM (G) 2

PRE-ATTACHED LTA KIT SOLUTION 3

PROMISEB CREAM (G) 3



45


PROVENZA ADH. PATCH 3

QROXIN ADH. PATCH 3

QUTENZA KIT 3

RADIAPLEXRX GEL (GRAM) 3

REA LO 39 CREAM (G) 3

REA LO 40 CREAM (G) 3

REA LO 40 LOTION 3

RECIPHEXAMINE ADH. PATCH 3

REGENECARE GEL (GRAM) 3

REGENECARE GEL (ML) 3

remeven CREAM (G) 3

RENOVO ADH. PATCH 3

SALACYN CREAM (G) 3

salacyn LOTION 3

SALEX COMBO. PKG 3

SALEX KIT CLCMER 3

SALEX SHAMPOO 3

salicylic acid COMBO. PKG 3

salicylic acid CREAM (G) 3

salicylic acid CRM ER (G) 3

salicylic acid FOAM 3

salicylic acid GEL (GRAM) 3

salicylic acid KIT CLCMER 3

salicylic acid LIQ-FILM 3

salicylic acid LIQUID 3

salicylic acid LOTION 3

salicylic acid LOTION ER 3

salicylic acid SHAMPOO 3

SALKERA FOAM 3

salkera FOAM 3

salvax FOAM 3

SALVAX DUO PLUS FOAM 3

SANTYL OINT. (G) 2

seb-prev CLEANSER 3

selenium sulfide SHAMPOO 3

selenium sulfide SUSPENSION 1

SELRX SHAMPOO 3



46


silver nitrate SOLUTION 3

silver nitrate applicator STICK (EA) 3

SINELEE ADH. PATCH 3

sodium sulfacetamide CLEANSER 3

sodium sulfacetamide SHAMPOO 1

SOLARAZE GEL (GRAM) 3

SPRAY AND STRETCH SPRAY 3

sulfacetamide sodium CLNSGEL ER 3

SYNERA M.HT PATCH 3

SYNVEXIA ADH. PATCH 3

TARGRETIN 1% GEL (GRAM) 3 DS

TERSI FOAM FOAM 3

TETRIX CREAM (G) 3

UMECTA EMULSN(G) 3

UMECTA FOAM 3

UMECTA NL FM SUSP 3

UMECTA NLFMSUSAPP 3

UMECTA SUSPENSION 3

UMECTA PD EMUL ADHES 3

UMECTA PD SUSP ADHES 3

URAMAXIN CREAM (G) 3

URAMAXIN FOAM 3

URAMAXIN GEL (ML) 3

URAMAXIN LOTION 3

URAMAXIN GT GEL/PF APP 3

urea 39% CREAM (G) 3





urea EMULSN(G) 3

urea FOAM 3

urea GEL (ML) 3

urea KIT 3

urea LOTION 3

urea NL FM SUSP 3

urea SOL/PF APP 3



47


urea SUSPENSION 3

UTOPIC CREAM (G) 3

VALCHLOR 0.02% GEL (GRAM) 5 PA,DS

vasolex OINT. (G) 3

VIRASAL LIQ-FILM 3

X-VIATE GEL (ML) 3

x-viate CREAM (G) 1

x-viate LOTION 3

ZERUVIA ADH. PATCH 3

DERMATOLOGY - PSORIASIS/ECZEMA


8-MOP 10 MG CAPSULE 5 DS

acitretin CAPSULE 4

calcipotriene CREAM (G) 1

calcipotriene OINT. (G) 1

calcipotriene SOLUTION 1

calcipotriene-betamethasone dp OINT. (G) 3

calcitrene OINT. (G) 1

calcitriol OINT. (G) 1

DOVONEX CREAM (G) 3

DRITHOCREME HP CREAM (G) 2

ELIDEL CREAM (G) 2

GORDO-UREA OINT. (G) 3

methoxsalen 10 MG CAPSULE 4 DS

OXSORALEN-ULTRA 10 MG CAPSULE 5 DS

PROTOPIC OINT. (G) 3

PYROGALLIC ACID OINT. (G) 3

SORIATANE CAPSULE 5

SORILUX FOAM 3

TACLONEX OINT. (G) 3

TACLONEX SUSPENSION 3

tacrolimus OINT. (G) 1

TAZORAC CREAM (G) 2

TAZORAC GEL (GRAM) 2

VECTICAL OINT. (G) 1



48


ZITHRANOL SHAMPOO(G) 3

ZITHRANOL-RR CRM RR (G) 3

DIABETES


acarbose TABLET 1

ACTOPLUS MET TABLET 3

ACTOPLUS MET XR TBMP 24HR 3

ACTOS 15 MG TABLET 1



AFREZZA INHALATION 3 PA

AMARYL TABLET 3

APIDRA VIAL 3

APIDRA SOLOSTAR INSULN PEN 3

AVANDAMET TABLET 3

AVANDARYL TABLET 3

AVANDIA TABLET 3

BYDUREON 2 MG VIAL 3 ST

BYDUREON PEN 2MG/0.65ML PEN INJCTR 3 ST

BYETTA 10MCG/0.04 PEN INJCTR 3 ST

BYETTA 5MCG/0.02 PEN INJCTR 3 ST

chlorpropamide TABLET 3

CYCLOSET 0.8 MG TABLET 3 ST

DIABETA TABLET 2

DUETACT TABLET 3

FARXIGA 10 MG TABLET 3 PA

FARXIGA 5 MG TABLET 3 PA

FORTAMET TAB ER 24 3

glimepiride TABLET 1

glipizide TABLET 1

glipizide er TAB ER 24 1

glipizide xl TAB ER 24 1

glipizide-metformin TABLET 3

GLUCOPHAGE TABLET 3

GLUCOPHAGE XR TAB ER 24H 3



49


GLUCOTROL TABLET 3

GLUCOTROL XL TAB ER 24 3

GLUCOVANCE TABLET 3

GLUMETZA TABERGR24H 3

glyburide TABLET 1

glyburide micronized TABLET 3

glyburide-metformin hcl TABLET 3

GLYNASE TABLET 3

GLYSET TABLET 3

GLYXAMBI 10 MG-5 MG TABLET 3 PA

GLYXAMBI 25 MG-5 MG TABLET 3 PA

HUMALOG CARTRIDGE 2

HUMALOG INSULN PEN 2

HUMALOG VIAL 2

HUMALOG MIX 50-50 INSULN PEN 3

HUMALOG MIX 50-50 VIAL 3

HUMALOG MIX 75-25 INSULN PEN 3

HUMALOG MIX 75-25 VIAL 3

HUMULIN 70-30 VIAL 1

HUMULIN 70/30 KWIKPEN INSULN PEN 1

HUMULIN N VIAL 1

HUMULIN N KWIKPEN INSULN PEN 1

HUMULIN R 100/ML VIAL 1

HUMULIN R 500/ML VIAL 2

INVOKAMET 150-1000MG TABLET 3 ST

INVOKAMET 150-500 MG TABLET 3 ST

INVOKAMET 50-1000 MG TABLET 3 ST

INVOKAMET 50MG-500MG TABLET 3 ST

INVOKANA 100 MG TABLET 3 PA

INVOKANA 300 MG TABLET 3 PA

JANUMET 50-1000 MG TABLET 3 PA

JANUMET 50MG-500MG TABLET 3 PA

JANUMET XR 100-1000MG TBMP 24HR 3 PA

JANUMET XR 50-1000 MG TBMP 24HR 3 PA

JANUMET XR 50MG-500MG TBMP 24HR 3 PA

JANUVIA 100 MG TABLET 3 PA




50



JARDIANCE 10 MG TABLET 3 ST

JARDIANCE 25 MG TABLET 3 ST

JENTADUETO 2.5-1000MG TABLET 3 ST

JENTADUETO 2.5-500 MG TABLET 3 ST

JENTADUETO 2.5-850 MG TABLET 3 ST

KAZANO 12.5-1000 TABLET 3 PA

KAZANO 12.5-500MG TABLET 3 PA

KOMBIGLYZE XR 2.5-1000MG TBMP 24HR 3 PA

KOMBIGLYZE XR 5 MG-500MG TBMP 24HR 3 PA

KOMBIGLYZE XR 5MG-1000MG TBMP 24HR 3 PA

KORLYM 300 MG TABLET 5 QL,PA,DS

LANTUS 100/ML VIAL 2 PA

LANTUS SOLOSTAR 100/ML (3) INSULN PEN 2 PA

LEVEMIR 100/ML VIAL 2 PA

LEVEMIR FLEXTOUCH 100/ML (3) INSULN PEN 2 PA

metformin hcl TABLET 1

metformin hcl er TAB ER 24 3

metformin hcl er TAB ER 24H 1

nateglinide TABLET 3

NESINA 12.5 MG TABLET 3 PA

NESINA 25 MG TABLET 3 PA

NESINA 6.25 MG TABLET 3 PA

NOVOLIN 70-30 VIAL 1

NOVOLIN N VIAL 1

NOVOLIN R VIAL 1

NOVOLOG CARTRIDGE 3

NOVOLOG VIAL 3

NOVOLOG FLEXPEN INSULN PEN 3

NOVOLOG MIX 70-30 VIAL 3

NOVOLOG MIX 70-30 FLEXPEN INSULN PEN 3

ONGLYZA 2.5 MG TABLET 3 PA

ONGLYZA 5 MG TABLET 3 PA

OSENI 12.5-15 MG TABLET 3 PA





51


OSENI 25 MG-15MG TABLET 3 PA



pioglitazone hcl 15 MG TABLET 1



pioglitazone-glimepiride TABLET 3

pioglitazone-metformin TABLET 3

PRANDIMET TABLET 3

PRANDIN TABLET 3

PRECOSE TABLET 3

PROGLYCEM ORAL SUSP 2

REGRANEX GEL (GRAM) 3

repaglinide TABLET 3

RIOMET SOLUTION 2

STARLIX TABLET 3

SYMLINPEN 120 PEN INJCTR 3

SYMLINPEN 60 PEN INJCTR 3

TANZEUM 30MG/0.5ML PEN INJCTR 3 ST

TANZEUM 50MG/0.5ML PEN INJCTR 3 ST

tolazamide TABLET 1

tolbutamide TABLET 1

TRADJENTA 5 MG TABLET 3 ST

VICTOZA 2-PAK 0.6MG/0.1 PEN INJCTR 3 ST

VICTOZA 3-PAK 0.6MG/0.1 PEN INJCTR 3 ST

XIGDUO TABLET 3 PA

EAR - GENERAL DISORDERS


acetasol hc DROPS 3

acetic acid SOLUTION 1

acetic acid-aluminum DROPS 3

antipyrine-benzocaine 5.4 %-1.4% DROPS 1

antipyrine-benzocaine 5.5 %-1.4% DROPS 3

auroguard DROPS 1

CETRAXAL DROPERETTE 3



52


CIPRO HC DROPS SUSP 2

CIPRODEX DROPS SUSP 2

ciprofloxacin hcl DROPERETTE 3

COLY-MYCIN S DROPS SUSP 3

CORTANE-B LOTION 3

cortane-b DROPS 3

CORTISPORIN SOLUTION 3

CORTISPORIN-TC DROPS SUSP 3

DERMOTIC DROPS 3

exotic-hc DROPS 3

fluocinolone acetonide oil DROPS 3

hydrocortisone-acetic acid DROPS 3

neomycin-polymyxin-hc 3.5-10K-1 DROPS SUSP 1

neomycin-polymyxin-hydrocort SOLUTION 1

ofloxacin DROPS 1

OTIC CARE DROPS 3

OTICIN DROPS 3

OTICIN HC DROPS 3

oto-end 10 DROPS 3

otomax-hc DROPS 3

OTOZIN DROPS 3

pinnacaine DROPS 3

TRIOXIN DROPS SUSP 3

ELECTROLYTE REGULATION


AURYXIA 210MG IRON TABLET 5 DS

calcium acetate CAPSULE 1

calcium acetate TABLET 1

EFFER-K TABLET EFF 3

effer-k TABLET EFF 3

eliphos TABLET 3

FOSRENOL TAB CHEW 3

k effervescent TABLET EFF 3

K-SOL 20MEQ/15ML LIQUID 3

K-SOL 40MEQ/15ML LIQUID 2



53


K-TAB ER 10 MEQ TABLET ER 1

K-TAB ER 20 MEQ TABLET ER 2

KAYEXALATE POWDER 3

kionex ORAL SUSP 1

kionex POWDER 1

KLOR-CON 20 MEQ PACKET 2

KLOR-CON 25 MEQ PACKET 3

KLOR-CON 10 TABLET ER 3

KLOR-CON 8 TABLET ER 2

klor-con m10 TAB ER PRT 1



KLOR-CON-EF TABLET EFF 3

magnebind 400 rx TABLET 3

marlexate POWDER 1

PHOSLO CAPSULE 3

PHOSLYRA SOLUTION 3

potassium bicarbonate TABLET EFF 3

potassium chloride CAPSULE ER 1

potassium chloride LIQUID 1

potassium chloride PACKET 1

potassium chloride TAB ER PRT 1

potassium chloride TABLET EFF 3

potassium chloride TABLET ER 1

RENAGEL TABLET 2

RENVELA POWD PACK 2

RENVELA TABLET 2

SAMSCA 15 MG TABLET 5 PA,DS

SAMSCA 30 MG TABLET 3 PA,DS

sodium polystyrene sulfonate ENEMA 3

sodium polystyrene sulfonate ORAL SUSP 1

sodium polystyrene sulfonate POWDER 1

SPS ENEMA 3

sps ORAL SUSP 1

VELPHORO 500MG IRON TAB CHEW 5 PA,DS



54

ENDOCRINE DISORDER - FERTILITY


CIALIS TABLET 3

CRINONE GEL/PF APP 3

ENDOCRINE DISORDER - OTHER


ACTONEL TABLET 2

alendronate sodium SOLUTION 1

alendronate sodium TABLET 1

ATELVIA TABLET DR 3

BINOSTO TABLET EFF 3

BONIVA TABLET 3

cabergoline TABLET 1

calcitonin-salmon SPRAY/PUMP 3

danazol CAPSULE 1

DDAVP SOLUTION 3

DDAVP SPRAY/PUMP 3

DDAVP TABLET 3

desmopressin acetate SOLUTION 1

desmopressin acetate SPRAY/PUMP 1

desmopressin acetate TABLET 1

doxercalciferol CAPSULE 3

EGRIFTA 1 MG VIAL 5 DS

EGRIFTA 2 MG VIAL 5 DS

ELIGARD SYRINGE 3

etidronate disodium TABLET 1

EVISTA 60 MG TABLET 3 PA

FORTEO 20MCG/DOSE PEN INJCTR 5 DS

FORTICAL SPRAY/PUMP 1

FOSAMAX TABLET 3

FOSAMAX PLUS D TABLET 3

GENOTROPIN 12 MG/ML CARTRIDGE 5 PA,DS

GENOTROPIN 5 MG/ML CARTRIDGE 5 PA,DS

GENOTROPIN 0.2MG/0.25 SYRINGE 5 PA,DS




55








GENOTROPIN 1MG/0.25ML SYRINGE 5 PA,DS

GENOTROPIN 2MG/0.25ML SYRINGE 3 PA,DS

H.P. ACTHAR 80 UNIT/ML VIAL 4 PA,DS

HECTOROL CAPSULE 3

HUMATROPE 12 MG CARTRIDGE 5 PA,DS



HUMATROPE 5 MG VIAL 5 PA,DS

ibandronate sodium TABLET 3

INCRELEX 10 MG/ML VIAL 5 PA,DS

leuprolide acetate KIT 1

LUPRON DEPOT SYRINGEKIT 2

MIACALCIN SPRAY/PUMP 3

MYALEPT FNL 5MG/ML VIAL 5 PA,DS

NORDITROPIN FLEXPRO 10MG/1.5ML PEN INJCTR 5 PA,DS

NORDITROPIN FLEXPRO 15MG/1.5ML PEN INJCTR 5 PA,DS

NORDITROPIN FLEXPRO 5 MG/1.5ML PEN INJCTR 5 PA,DS

NORDITROPIN NORDIFLEX 30 MG/3 ML PEN INJCTR 5 PA,DS

NUTROPIN AQ 10 MG/2 ML CARTRIDGE 5 PA,DS

NUTROPIN AQ 20 MG/2 ML CARTRIDGE 5 PA,DS

NUTROPIN AQ NUSPIN 10 MG/2 ML CARTRIDGE 5 PA,DS



OMNITROPE 10MG/1.5ML CARTRIDGE 4 PA,DS

OMNITROPE 5 MG/1.5ML CARTRIDGE 4 PA,DS

OMNITROPE 5.8 MG VIAL 4 PA,DS

OSPHENA 60 MG TABLET 3 PA

paricalcitol CAPSULE 3

raloxifene hcl 60 MG TABLET 1 PA

risedronate sodium TABLET 1

SAIZEN 8.8 MG/1.5 CARTRIDGE 5 PA,DS



56


SAIZEN 5 MG VIAL 5 PA,DS

SAIZEN 8.8 MG VIAL 5 PA,DS

SENSIPAR 30 MG TABLET 3 ST



SEROSTIM 4 MG VIAL 5 PA,DS



SOMAVERT 10 MG VIAL 5 PA,DS





STIMATE SPRAY/PUMP 2

SYNAREL 2 MG/ML SPRAY 3 DS

TEV-TROPIN 5 MG VIAL 5 PA,DS

ZEMPLAR CAPSULE 3

ZORBTIVE 8.8 MG VIAL 5 PA,DS

ENDOCRINE DISORDER - THYROID


ARMOUR THYROID TABLET 3

CYTOMEL TABLET 3

levothyroxine sodium TABLET 1

LEVOXYL TABLET 3

liothyronine sodium TABLET 1

lugols SOLUTION 3

methimazole TABLET 1

nature-throid TABLET 3

np thyroid TABLET 3

propylthiouracil TABLET 1

sski SOLUTION 1

strong iodine SOLUTION 3

SYNTHROID TABLET 3

TAPAZOLE TABLET 3

THYROLAR-1 TABLET 3



57


THYROLAR-1/2 TABLET 3

THYROLAR-1/4 TABLET 3

THYROLAR-2 TABLET 3

THYROLAR-3 TABLET 3

TIROSINT CAPSULE 3

UNITHROID TABLET 3

westhroid TABLET 3

wp thyroid TABLET 3

EYE - GENERAL DISORDERS


ACULAR DROPS 3

ACULAR LS DROPS 3

ACUVAIL DROPERETTE 3

ak-poly-bac OINT. (G) 1

AKTEN GEL (ML) 3

alcaine DROPS 3

ALOCRIL DROPS 3

ALOMIDE DROPS 2

ALREX DROPS SUSP 3

altafluor DROPS 3

AZASITE DROPS 3

azelastine hcl DROPS 1

bacitracin OINT. (G) 1

bacitracin-polymyxin OINT. (G) 1

BEPREVE DROPS 3

BESIVANCE DROPS SUSP 3

BLEPH-10 DROPS 3

BLEPHAMIDE DROPS SUSP 2

BLEPHAMIDE S.O.P. OINT. (G) 2

bromfenac sodium DROPS 3

CILOXAN DROPS 3

CILOXAN OINT. (G) 2

ciprofloxacin hcl DROPS 1

cromolyn sodium DROPS 1

dexamethasone sodium phosphate DROPS 1



58


diclofenac sodium 0.10% DROPS 1

DUREZOL DROPS 2

ELESTAT DROPS 3

EMADINE DROPS 3

epinastine hcl DROPS 3

erythromycin OINT. (G) 1

FLAREX DROPS SUSP 3

flucaine DROPS 3

FLUORESCEIN-BENOXINATE DROPS 3

fluorescein-proparacaine DROPS 3

fluorometholone DROPS SUSP 1

flurbiprofen sodium DROPS 1

FLUROX DROPS 3

FML DROPS SUSP 3

FML FORTE DROPS SUSP 3

FML S.O.P. OINT. (G) 2

GARAMYCIN DROPS 3

gatifloxacin DROPS 1

gentak OINT. (G) 1

gentamicin sulfate DROPS 1

gentamicin sulfate OINT. (G) 1

goniovisc DROPS 3

ILEVRO DROPS SUSP 3

ILOTYCIN OINT. (G) 3

ketorolac tromethamine DROPS 1

LASTACAFT DROPS 3

levofloxacin DROPS 3

LOTEMAX DROPS GEL 3

LOTEMAX DROPS SUSP 3

LOTEMAX OINT. (G) 3

MAXIDEX DROPS SUSP 3

MAXITROL DROPS SUSP 3

MAXITROL OINT. (G) 3

MOXEZA DROPS VISC 2

naphazoline hcl DROPS 3

NATACYN DROPS SUSP 3

neo-polycin OINT. (G) 3



59


neo-polycin hc OINT. (G) 1

neomycin-bacitracin-poly-hc OINT. (G) 1

neomycin-bacitracin-polymyxin OINT. (G) 3

neomycin-polymyxin-dexameth DROPS SUSP 1

neomycin-polymyxin-dexameth 3.5-10K-.1 OINT. (G) 1

neomycin-polymyxin-dexameth 3.5-10K-.1 OINT. (G) 3

neomycin-polymyxin-gramicidin DROPS 1

neomycin-polymyxin-hc 3.5-10K-10 DROPS SUSP 3

NEOSPORIN DROPS 3

NEVANAC DROPS SUSP 3

OCUFEN DROPS 3

OCUFLOX DROPS 3

ofloxacin DROPS 1

OMNIPRED DROPS SUSP 3

PATADAY DROPS 3

PATANOL DROPS 2

PAZEO DROPS 3

phenylephrine hcl DROPS 1

polycin OINT. (G) 1

polymyxin b sul-trimethoprim DROPS 1

POLYTRIM DROPS 3

PRED FORTE DROPS SUSP 3

PRED MILD DROPS SUSP 2

PRED-G DROPS SUSP 2

PRED-G OINT. (G) 2

prednisolone acetate DROPS SUSP 1

prednisolone sodium phosphate DROPS 3

PROLENSA DROPS 3

proparacaine hcl DROPS 3

RESTASIS DROPERETTE 2 PA

sulfacetamide sodium DROPS 1

sulfacetamide sodium OINT. (G) 1

sulfacetamide-prednisolone DROPS 1

TETCAINE DROPS 3

tetracaine hcl DROPS 3

TETRAVISC DROPR VISC 3

TETRAVISC DROPS VISC 3



60


TETRAVISC FORTE DRPR HPVIS 3

TETRAVISC FORTE DRPS HPVIS 3

TOBRADEX DROPS SUSP 3

TOBRADEX OINT. (G) 2

TOBRADEX ST DROPS SUSP 3

tobramycin DROPS 1

tobramycin-dexamethasone DROPS SUSP 1

TOBREX DROPS 3

TOBREX OINT. (G) 2

trifluridine DROPS 1

VEXOL DROPS SUSP 2

VIGAMOX DROPS 2

VIROPTIC DROPS 3

ZIRGAN GEL (GRAM) 3

ZYLET DROPS SUSP 3

ZYMAXID DROPS 1

EYE - GLAUCOMA


acetazolamide CAPSULE ER 1

acetazolamide TABLET 1

ALPHAGAN P DROPS 3

apraclonidine hcl DROPS 3

atropine sulfate DROPS 1

atropine sulfate OINT. (G) 1

AZOPT DROPS SUSP 2

BETAGAN DROPS 3

betaxolol hcl DROPS 1

BETIMOL DROPS 3

BETOPTIC S DROPS SUSP 2

brimonidine tartrate 0.15% DROPS 3

brimonidine tartrate 0.20% DROPS 1

carteolol hcl DROPS 1

COMBIGAN DROPS 3

COSOPT DROPS 3

COSOPT PF DROPERETTE 3



61


CYCLOGYL 0.50% DROPS 2

CYCLOGYL 1% DROPS 3

CYCLOGYL 2% DROPS 3

CYCLOMYDRIL DROPS 3

cyclopentolate hcl DROPS 1

DIAMOX SEQUELS CAPSULE ER 3

dorzolamide hcl DROPS 1

dorzolamide-timolol DROPS 1

homatropaire DROPS 1

homatropine hydrobromide DROPS 1

IOPIDINE DROPERETTE 3

IOPIDINE DROPS 3

ISOPTO ATROPINE DROPS 3

ISOPTO CARPINE DROPS 3

ISTALOL DROP DAILY 3

latanoprost DROPS 1

levobunolol hcl DROPS 1

LUMIGAN DROPS 2

methazolamide TABLET 1

metipranolol DROPS 1

MYDRIACYL DROPS 3

NEPTAZANE TABLET 3

PAREMYD DROPS 3

PHOSPHOLINE IODIDE DROPS 3

pilocarpine hcl DROPS 1

RESCULA DROPS 3

SIMBRINZA DROPS SUSP 3

timolol maleate DROPS 1

timolol maleate SOL-GEL 1

TIMOPTIC DROPS 3

TIMOPTIC OCUDOSE DROPERETTE 3

TIMOPTIC-XE SOL-GEL 3

TRAVATAN Z DROPS 2

travoprost DROPS 1

tropicamide DROPS 1

TRUSOPT DROPS 3



62


XALATAN DROPS 3

ZIOPTAN DROPERETTE 3

EYE - MISCELLANEOUS


CYSTARAN DROPS 5

GELFILM EACH 3

LACRISERT INSERT 2

GOUT AND RELATED DISEASES


allopurinol TABLET 1

colchicine CAPSULE 1

colchicine TABLET 1

COLCRYS TABLET 2

MITIGARE CAPSULE 3

probenecid TABLET 1

probenecid-colchicine TABLET 1

ULORIC TABLET 3

ZYLOPRIM TABLET 3

HEMATOLOGICAL DISORDERS


AGGRENOX CPMP 12HR 2

AGRYLIN CAPSULE 3

aminocaproic acid SOLUTION 1

aminocaproic acid 1000 MG TABLET 3

aminocaproic acid 500 MG TABLET 1

anagrelide hcl CAPSULE 1

ARANESP 100MCG/0.5 SYRINGE 5 DS







63


ARANESP 40 MCG/0.4 SYRINGE 5 DS

ARANESP 500 MCG/ML SYRINGE 5 DS


ARANESP 100 MCG/ML VIAL 5 DS

ARANESP 150MCG/.75 VIAL 5 DS





ARANESP 60MCG/ML VIAL 5 DS

ARIXTRA 10MG/0.8ML SYRINGE 5 DS

ARIXTRA 2.5 MG/0.5 SYRINGE 5 DS

ARIXTRA 5MG/0.4ML SYRINGE 5 DS

ARIXTRA 7.5MG/0.6 SYRINGE 5 DS

ASTRINGYN SOLN(GRAM) 3

AVITENE POWD PACK 2

AVITENE POWDER 2

AVITENE SHEET 2

BRILINTA TABLET 2

cilostazol TABLET 1

clopidogrel TABLET 1

COUMADIN TABLET 3

dipyridamole TABLET 1

DROXIA CAPSULE 2

EFFIENT TABLET 2

ELIQUIS 2.5 MG TABLET 3 PA

ELIQUIS 5 MG TABLET 3 PA

ENDO-AVITENE SHEET 2

enoxaparin sodium 100 MG/ML SYRINGE 1 DS

enoxaparin sodium 120MG/.8ML SYRINGE 1 DS

enoxaparin sodium 150 MG/ML SYRINGE 1 DS

enoxaparin sodium 30MG/0.3ML SYRINGE 1 DS




enoxaparin sodium 300MG/3ML VIAL 1 DS

EPOGEN 10000/ML VIAL 4 DS



64



EPOGEN 20000/2ML VIAL 4 DS




fondaparinux sodium 10MG/0.8ML SYRINGE 4 DS

fondaparinux sodium 2.5 MG/0.5 SYRINGE 4 DS

fondaparinux sodium 5MG/0.4ML SYRINGE 4 DS

fondaparinux sodium 7.5MG/0.6 SYRINGE 4 DS

FRAGMIN 10000/ML SYRINGE 5 DS

FRAGMIN 12500/0.5 SYRINGE 5 DS



FRAGMIN 2500/0.2ML SYRINGE 5 DS

FRAGMIN 5000/0.2ML SYRINGE 5 DS

GELFOAM SPONGE 3

GELFOAM COMPRESSED SPONGE 3

IPRIVASK VIAL 3

jantoven TABLET 1

LOVENOX 100 MG/ML SYRINGE 1 DS

LOVENOX 120MG/.8ML SYRINGE 1 DS

LOVENOX 150 MG/ML SYRINGE 1 DS

LOVENOX 30MG/0.3ML SYRINGE 1 DS




LOVENOX 300MG/3ML VIAL 1 DS

LYSTEDA 650 MG TABLET 3 QL

MEPHYTON TABLET 2

monsels SOL W/APPL 3

NEULASTA 6MG/0.6ML SYR W/ INJ 5 DS

NEULASTA 6MG/0.6ML SYRINGE 5 DS

NEUMEGA 5 MG VIAL 5 DS

NEUPOGEN 300MCG/0.5 SYRINGE 4 DS

NEUPOGEN 480MCG/0.8 SYRINGE 4 DS

NEUPOGEN 300 MCG/ML VIAL 4 DS

NEUPOGEN 480MCG/1.6 VIAL 4 DS



65


pentoxifylline TABLET ER 1

PERSANTINE TABLET 3

PLAVIX TABLET 3

PLETAL TABLET 3

PRADAXA 150 MG CAPSULE 3 PA

PRADAXA 75 MG CAPSULE 3 PA

PROCRIT 10000/ML VIAL 4 DS


PROCRIT 20000/2ML VIAL 4 DS





PROMACTA 12.5 MG TABLET 5 PA,DS

PROMACTA 25 MG TABLET 5 PA,DS



RECOTHROM VIAL 3

SYRINGE AVITENE POWDER 2

TACHOSIL ADH. PATCH 3

thrombi-gel MED. PAD 3

thrombi-pad MED. PAD 3

thrombin-jmi NAS SP SYR 3

thrombin-jmi SPRAY 1

thrombin-jmi 20000 UNIT SPRAY SYRN 1

thrombin-jmi 5000 UNIT SPRAY SYRN 3

thrombin-jmi 20000 UNIT VIAL 1

thrombin-jmi 5000 UNIT VIAL 3

ticlopidine hcl TABLET 1

TISSEEL VHSD KIT 3

TISSEEL VHSD SYRINGE 3

tranexamic acid 650 MG TABLET 1 QL

warfarin sodium TABLET 1

XARELTO 15 MG-20MG TAB DS PK 3 PA

XARELTO 10 MG TABLET 3 PA




66



ZONTIVITY TABLET 3

HORMONAL DEFICIENCY


ACTIVELLA TABLET 3

ALORA PATCH TDSW 3

ANADROL-50 TABLET 3

ANDRODERM PATCH TD24 2 PA,QL

ANDROGEL GEL MD PMP 3 PA,QL

ANDROGEL GEL PACKET 3 PA,QL

ANDROID CAPSULE 2

ANGELIQ TABLET 3

AXIRON SOL MD PMP 3

AYGESTIN TABLET 3

CLIMARA PATCH TDWK 1

CLIMARA PRO PATCH TDWK 3

COMBIPATCH PATCH TDSW 3

covaryx TABLET 1

covaryx h.s. TABLET 1

CRINONE GEL/PF APP 3



DEPO-TESTOSTERONE 100 MG/ML VIAL 3 PA,QL

DEPO-TESTOSTERONE 200 MG/ML VIAL 1 PA,QL

DIVIGEL GEL PACKET 3

DUAVEE TABLET 3

eemt TABLET 1

eemt h.s. TABLET 1

ELESTRIN GEL MD PMP 3

ENJUVIA TABLET 3

ESTRACE TABLET 3

estradiol PATCH TDSW 1

estradiol PATCH TDWK 1

estradiol TABLET 1

estradiol-norethindrone acetat TABLET 3



67


ESTROGEL GEL MD PMP 3

estrogen & methyltestosterone TABLET 1

estrogen-methyltestosterone TABLET 1

estropipate TABLET 1

EVAMIST SPRAY 3

FEMHRT TABLET 3

FIRST-TESTOSTERONE OINT. (G) 3 PA,QL

FIRST-TESTOSTERONE MC CREAM (G) 3 PA,QL

FORTESTA GEL MD PMP 3 PA,QL

jinteli TABLET 3

lopreeza TABLET 3

medroxyprogesterone acetate TABLET 1

MENEST TABLET 3

MENOSTAR PATCH TDWK 2

METHITEST TABLET 2

mimvey TABLET 3

mimvey lo TABLET 3

MINIVELLE PATCH TDSW 3

norethindrone acetate TABLET 1

OXANDRIN TABLET 3

oxandrolone TABLET 3

PREFEST TABLET 3

PREMARIN TABLET 2

PREMPHASE TABLET 3

PREMPRO TABLET 3

progesterone CAPSULE 1

PROMETRIUM CAPSULE 3

PROVERA TABLET 3

STRIANT MUC ER 12H 3 PA,QL

TESTIM GEL (GRAM) 3 PA,QL

testosterone GEL (GRAM) 3 PA,QL

testosterone GEL MD PMP 3 PA,QL

testosterone GEL PACKET 3 PA,QL

testosterone cypionate VIAL 1 PA,QL

testosterone enanthate VIAL 1 PA,QL

TESTRED CAPSULE 2 PA,QL

VIVELLE-DOT PATCH TDSW 3



68

IMMUNIZATION


HIZENTRA 1 G/5 ML VIAL 4 PA,DS




IMMUNOSUPPRESSION/MODULATION


ACTIMMUNE 100MCG/0.5 VIAL 5 DS

ALDARA CREAM PACK 3

ASTAGRAF XL CAP ER 24H 3

AZASAN TABLET 3

azathioprine TABLET 1

CELLCEPT CAPSULE 3

CELLCEPT SUSP RECON 2

CELLCEPT TABLET 3

cyclosporine CAPSULE 1

cyclosporine SOLUTION 1

cyclosporine modified 100 MG CAPSULE 1



gengraf CAPSULE 1

gengraf SOLUTION 1

imiquimod CREAM PACK 1

IMURAN TABLET 3

INTRON A 10MM UNIT VIAL 4 DS

INTRON A 10MM/ML VIAL 4 DS



INTRON A 6MMUNIT/ML VIAL 4 DS

mycophenolate mofetil CAPSULE 1

mycophenolate mofetil SUSP RECON 1

mycophenolate mofetil TABLET 1

mycophenolic acid TABLET DR 1



69


MYFORTIC TABLET DR 2

NEORAL CAPSULE 3

NEORAL SOLUTION 3

PROGRAF CAPSULE 3

RAPAMUNE SOLUTION 2

RAPAMUNE TABLET 3

SANDIMMUNE CAPSULE 3

SANDIMMUNE SOLUTION 3

sirolimus TABLET 1

tacrolimus CAPSULE 1

ZORTRESS 0.25 MG TABLET 5 DS



ZYCLARA CREAM PACK 3

ZYCLARA CRM MD PMP 3

INFECTIOUS DISEASE - BACTERIAL


ACTICLATE TABLET 3

ADOXA CAPSULE 3

amox tr-potassium clavulanate SUSP RECON 1

amox tr-potassium clavulanate TAB CHEW 1

amox tr-potassium clavulanate TABLET 1

amoxicillin CAPSULE 1

amoxicillin SUSP RECON 1

amoxicillin TAB CHEW 1

amoxicillin 500 MG TABLET 3

amoxicillin 875 MG TABLET 1

amoxicillin er TBMP 24HR 3

amoxicillin-clavulanate er TAB ER 12H 3

ampicillin trihydrate CAPSULE 1

ampicillin trihydrate SUSP RECON 3

AUGMENTIN SUSP RECON 3

AUGMENTIN TABLET 3

AUGMENTIN ES-600 SUSP RECON 3

AUGMENTIN XR TAB ER 12H 3



70


AVELOX TABLET 3

AVELOX ABC PACK TABLET 3

AVIDOXY TABLET 3

azithromycin PACKET 1

azithromycin SUSP RECON 1

azithromycin TABLET 1

BACTRIM TABLET 3

BACTRIM DS TABLET 3

BIAXIN SUSP RECON 3

BIAXIN TABLET 3

CAYSTON 75 MG/ML VIAL-NEB 5 PA,DS

CEDAX CAPSULE 3

CEDAX SUSP RECON 3

cefaclor CAPSULE 3

cefaclor SUSP RECON 3

cefaclor er TAB ER 12H 3

cefadroxil CAPSULE 1

cefadroxil SUSP RECON 1

cefadroxil TABLET 1

cefdinir CAPSULE 1

cefdinir SUSP RECON 1

cefditoren pivoxil TABLET 3

cefpodoxime proxetil SUSP RECON 3

cefpodoxime proxetil TABLET 3

cefprozil SUSP RECON 1

cefprozil TABLET 3

ceftibuten CAPSULE 3

ceftibuten SUSP RECON 3

CEFTIN SUSP RECON 2

CEFTIN TABLET 3

cefuroxime TABLET 1

cephalexin 250 MG CAPSULE 1



cephalexin SUSP RECON 1

cephalexin TABLET 3

CIPRO SUS MC REC 3



71


CIPRO TABLET 3

CIPRO XR TBMP 24HR 3

ciprofloxacin SUS MC REC 1

ciprofloxacin er TBMP 24HR 3

ciprofloxacin hcl TABLET 1

clarithromycin SUSP RECON 3

clarithromycin TABLET 1

clarithromycin er TAB ER 24H 3

demeclocycline hcl TABLET 3

dicloxacillin sodium CAPSULE 1

DIFICID 200 MG TABLET 3 PA

DORYX TABLET DR 3

doxycycline hyclate CAPSULE 1

doxycycline hyclate TABLET 1

doxycycline hyclate TABLET DR 3

doxycycline ir-dr CAP IR DR 3

doxycycline monohydrate CAPSULE 1

doxycycline monohydrate SUSP RECON 3

doxycycline monohydrate TABLET 1

e.e.s. 200 SUSP RECON 1

e.e.s. 400 TABLET 1

ERY-TAB TABLET DR 2

ery-tab TABLET DR 1

ERYPED 200 SUSP RECON 2

ERYPED 400 SUSP RECON 2

erythrocin stearate TABLET 3

erythromycin CAPSULE DR 3

erythromycin TABLET 1

erythromycin ethylsuccinate TABLET 1

FACTIVE TABLET 3

FURADANTIN ORAL SUSP 3

HIPREX TABLET 3

hyophen TABLET 3

KEFLEX CAPSULE 3

KETEK TABLET 3

LEVAQUIN SOLUTION 3

LEVAQUIN TABLET 3



72


levofloxacin SOLUTION 1

levofloxacin TABLET 1

MACROBID CAPSULE 3

MACRODANTIN 100 MG CAPSULE 3



methenamine hippurate TABLET 1

methenamine mandelate TABLET 3

MINOCIN CAPSULE 3

minocycline hcl CAPSULE 1

minocycline hcl 135 MG TAB ER 24H 3 PA



minocycline hcl TABLET 3

MONODOX CAPSULE 3

MONUROL PACKET 3

MORGIDOX CAPSULE 3

MOXATAG TBMP 24HR 3

moxifloxacin hcl TABLET 1

nitrofurantoin CAPSULE 1

nitrofurantoin ORAL SUSP 1

nitrofurantoin mono-macro CAPSULE 1

ofloxacin TABLET 3

ORACEA CAP IR DR 3

PCE TAB PART 3

penicillin v potassium SOLN RECON 1

penicillin v potassium TABLET 1

PHOSPHASAL TABLET 2

PRIMSOL SOLUTION 2

PROSED-DS TABLET 3

SIVEXTRO 200 MG TABLET 4 DS

SOLODYN 105 MG TAB ER 24H 3 PA

SOLODYN 115MG TAB ER 24H 3 PA




SPECTRACEF TABLET 3



73


sulfamethoxazole-trimethoprim ORAL SUSP 1

sulfamethoxazole-trimethoprim TABLET 1

sulfatrim ORAL SUSP 1

SUPRAX CAPSULE 2

SUPRAX SUSP RECON 3

SUPRAX TAB CHEW 3

tetracycline hcl CAPSULE 3

trimethoprim TABLET 1

ur n-c TABLET 1

URELLE TABLET 3

URETRON D-S TABLET 2

URIBEL CAPSULE 3

urimar-t TABLET 3

URIN D.S. TABLET 2

uro-blue TABLET 3

uro-l TABLET 3

uro-mp CAPSULE 3

urogesic-blue TABLET 3

URYL TABLET 3

ustell CAPSULE 3

UTA CAPSULE 3

VIBRAMYCIN CAPSULE 3

VIBRAMYCIN SUSP RECON 3

VIBRAMYCIN SYRUP 3

ZITHROMAX PACKET 3

ZITHROMAX SUSP RECON 3

ZITHROMAX TABLET 3

ZITHROMAX TRI-PAK TABLET 3

ZMAX SUS ER REC 3

ZYVOX SUSP RECON 4

ZYVOX TABLET 5

INFECTIOUS DISEASE - FUNGAL


ANCOBON CAPSULE 3

DIFLUCAN SUSP RECON 3



74


DIFLUCAN TABLET 3

fluconazole SUSP RECON 1

fluconazole TABLET 1

flucytosine CAPSULE 1

GRIFULVIN V TABLET 3

GRIS-PEG TABLET 3

griseofulvin ORAL SUSP 1

griseofulvin TABLET 1

griseofulvin ultramicrosize TABLET 1

itraconazole CAPSULE 1

ketoconazole TABLET 1

LAMISIL GRAN PACK 3

LAMISIL TABLET 3

NOXAFIL ORAL SUSP 3

NOXAFIL TABLET DR 3

nystatin ORAL SUSP 1

nystatin POWDER(EA) 3

nystatin TABLET 1

ONMEL TABLET 3

ORAVIG MA BUC TAB 3

SPORANOX CAPSULE 3

SPORANOX SOLUTION 2

terbinafine hcl TABLET 1

VFEND SUSP RECON 5

VFEND TABLET 5

voriconazole SUSP RECON 4

voriconazole TABLET 4

INFECTIOUS DISEASE - MISCELLANEOUS


BETHKIS 300 MG/4ML AMPUL-NEB 5 PA,DS

CLEOCIN HCL CAPSULE 3

CLEOCIN PALMITATE SOLN RECON 3

clindamycin hcl CAPSULE 1

clindamycin palmitate hcl SOLN RECON 1

clindamycin pediatric SOLN RECON 1



75


cycloserine CAPSULE 3

dapsone TABLET 1

ethambutol hcl TABLET 1

isoniazid SOLUTION 1

isoniazid TABLET 1

KITABIS PAK 300 MG/5ML AMPUL-NEB 5 PA,DS

MYAMBUTOL TABLET 3

MYCOBUTIN CAPSULE 2

neomycin sulfate TABLET 1

PASER GRANPKT DR 3

PRIFTIN 150 MG TABLET 2 PA

pyrazinamide TABLET 1

rifabutin CAPSULE 1

RIFADIN CAPSULE 3

RIFAMATE CAPSULE 3

rifampin CAPSULE 1

RIFATER TABLET 3

SIRTURO 100 MG TABLET 5 PA,DS

THALOMID 100 MG CAPSULE 2 PA,DS




TOBI 300 MG/5ML AMPUL-NEB 5 DS

TOBI PODHALER 28 MG CAP W/DEV 5 DS

TOBI PODHALER 28 MG CAPSULE 5 DS

tobramycin 300 MG/5ML AMPUL-NEB 4 DS

TRECATOR TABLET 3

VANCOCIN HCL CAPSULE 3

vancomycin hcl CAPSULE 1

XIFAXAN 200 MG TABLET 5 PA

XIFAXAN 550 MG TABLET 5 PA

INFECTIOUS DISEASE - PARASITIC


ALBENZA TABLET 2

atovaquone ORAL SUSP 4



76


BILTRICIDE TABLET 2

FLAGYL CAPSULE 3

FLAGYL TABLET 3

FLAGYL ER TABLET ER 3

hydroxychloroquine sulfate TABLET 1

ivermectin TABLET 3

MEPRON ORAL SUSP 5

metronidazole CAPSULE 3

metronidazole TABLET 1

NEBUPENT VIAL-NEB 2

paromomycin sulfate CAPSULE 3

PLAQUENIL TABLET 3

STROMECTOL TABLET 3

TINDAMAX TABLET 3

tinidazole TABLET 3

INFECTIOUS DISEASE - VIRAL


abacavir TABLET 1

abacavir-lamivudine-zidovudine 150-300MG TABLET 4 DS

acyclovir CAPSULE 1

acyclovir ORAL SUSP 1

acyclovir TABLET 1

adefovir dipivoxil 10 MG TABLET 1 DS

APTIVUS 250 MG CAPSULE 4 DS

APTIVUS 100 MG/ML SOLUTION 5 DS

ATRIPLA 600-200MG TABLET 4 DS

BARACLUDE 0.05MG/ML SOLUTION 5 DS

BARACLUDE 0.5 MG TABLET 5 DS

BARACLUDE 1 MG TABLET 5 DS

COMBIVIR TABLET 3

COMPLERA 200-25-300 TABLET 4 DS

COPEGUS 200 MG TABLET 3 DS

CRIXIVAN CAPSULE 2

didanosine CAPSULE DR 1

EDURANT 25 MG TABLET 2 ST



77


EMTRIVA CAPSULE 2

EMTRIVA SOLUTION 2

entecavir 0.5 MG TABLET 4 DS

entecavir 1 MG TABLET 4 DS

EPIVIR SOLUTION 3

EPIVIR TABLET 3

EPIVIR HBV SOLUTION 3

EPIVIR HBV TABLET 3

EPZICOM 600-300MG TABLET 4 DS

famciclovir TABLET 3

FAMVIR TABLET 3

FLUMADINE TABLET 3

FUZEON 90 MG VIAL 5 DS

HARVONI 90MG-400MG TABLET 4 PA,DS

HEPSERA 10 MG TABLET 3 DS

INTELENCE TABLET 2

INVIRASE CAPSULE 2

INVIRASE TABLET 2

ISENTRESS POWD PACK 3

ISENTRESS TAB CHEW 2

ISENTRESS TABLET 2

KALETRA SOLUTION 2

KALETRA TABLET 2

lamivudine SOLUTION 1

lamivudine TABLET 1

lamivudine hbv TABLET 1

lamivudine-zidovudine TABLET 1

LEXIVA 50 MG/ML ORAL SUSP 4 DS

LEXIVA 700 MG TABLET 4 DS

MODERIBA 200-400(7) TAB DS PK 3 DS




MODERIBA 200 MG TABLET 3 DS

nevirapine ORAL SUSP 1

nevirapine TABLET 1

nevirapine er TAB ER 24H 1



78


NORVIR CAPSULE 2

NORVIR SOLUTION 2

NORVIR TABLET 2

OLYSIO 150 MG CAPSULE 5 PA,DS

PEGASYS 180MCG/0.5 SYRINGE 4 DS

PEGASYS 180MCG/ML VIAL 4 DS

PEGASYS PROCLICK 135MCG/0.5 PEN INJCTR 4 DS

PEGASYS PROCLICK 180MCG/0.5 PEN INJCTR 4 DS

PEGINTRON 120MCG/0.5 KIT 4 DS


PEGINTRON 50 MCG/0.5 KIT 4 DS


PEGINTRON REDIPEN 120MCG/0.5 PEN IJ KIT 4 DS


PEGINTRON REDIPEN 50 MCG/0.5 PEN IJ KIT 4 DS


PREZCOBIX TABLET 4 PA,DS,QL

PREZISTA 100 MG/ML ORAL SUSP 4 DS

PREZISTA 150 MG TABLET 4 DS





REBETOL 200 MG CAPSULE 3 DS

REBETOL 40 MG/ML SOLUTION 2 DS

RELENZA BLST W/DEV 2

RESCRIPTOR TAB DISPER 2

RESCRIPTOR TABLET 2

RETROVIR CAPSULE 3

RETROVIR SYRUP 3

REYATAZ 150 MG CAPSULE 4 DS



REYATAZ 50 MG POWD PACK 4 DS

ribapak 200-400(7) TAB DS PK 3 DS

ribapak 200-400MG TAB DS PK 3 DS



79


ribapak 400-400 MG TAB DS PK 3 DS






ribasphere 200 MG CAPSULE 1 DS

ribasphere 200 MG TABLET 1 DS



RIBATAB 400-400 MG TAB DS PK 3 DS



ribavirin 200 MG CAPSULE 1 DS

ribavirin 200 MG TABLET 1 DS

rimantadine hcl TABLET 1

SELZENTRY 150 MG TABLET 4 DS

SELZENTRY 300 MG TABLET 4 DS

SITAVIG MA BUC TAB 3

SOVALDI 400 MG TABLET 4 PA,DS

stavudine CAPSULE 1

stavudine SOLN RECON 1

STRIBILD 150-200 MG TABLET 4 ST,DS

SUSTIVA CAPSULE 2

SUSTIVA TABLET 2

TAMIFLU CAPSULE 2

TAMIFLU SUSP RECON 2

TIVICAY 50 MG TABLET 4 DS

TRIUMEQ 600-50-300 TABLET 5 DS

TRIZIVIR 150-300MG TABLET 5 DS

TRUVADA 200-300 MG TABLET 4 DS

TYBOST 150 MG TABLET 2 PA

TYZEKA 600 MG TABLET 5 DS

valacyclovir TABLET 1

VALCYTE 50 MG/ML SOLN RECON 4 DS

VALCYTE 450 MG TABLET 5 DS

valganciclovir hcl 450 MG TABLET 4 DS



80


VALTREX TABLET 3

VIDEX SOLN RECON 2

VIDEX EC CAPSULE DR 3

VIEKIRA PAK 12.5-75-50 TAB DS PK 5 PA,DS

VIRACEPT TABLET 2

VIRAMUNE ORAL SUSP 3

VIRAMUNE TABLET 3

VIRAMUNE XR TAB ER 24H 3

VIRAZOLE VIAL-NEB 3

VIREAD 40MG/SCOOP POWDER 2 DS

VIREAD 150 MG TABLET 2 DS




VITEKTA 150 MG TABLET 5 PA,DS

VITEKTA 85 MG TABLET 3 PA,DS

ZERIT CAPSULE 3

ZERIT SOLN RECON 3

ZIAGEN SOLUTION 2

ZIAGEN TABLET 3

zidovudine CAPSULE 1

zidovudine SYRUP 1

zidovudine TABLET 1

ZOVIRAX CAPSULE 3

ZOVIRAX ORAL SUSP 3

ZOVIRAX TABLET 3

INFLAMMATORY DISEASE


ACTEMRA 162 MG/0.9 SYRINGE 5 QL,PA,DS

ANAPROX TABLET 3

ANAPROX DS TABLET 3

ARAVA TABLET 3

ARCALYST 220 MG VIAL 5 PA,DS

ARTHROTEC 50 TAB IR DR 3



81


ARTHROTEC 75 TAB IR DR 3

BERINERT 500(10 ML) KIT 4 QL,PA,DS

BERINERT 500(10 ML) VIAL 4 QL,PA,DS

budesonide ec CAPDR - ER 5

CELEBREX CAPSULE 3

celecoxib CAPSULE 3

CINRYZE 500 (5 ML) VIAL 5 QL,PA,DS

CORTEF TABLET 3

COSENTYX SYRINGE $ QL,PA,DS

cortisone acetate TABLET 1

CUPRIMINE 250 MG CAPSULE 4 DS

DAYPRO TABLET 3

DEPEN 250 MG TABLET 4 DS

dexamethasone ELIXIR 1

dexamethasone SOLUTION 1

dexamethasone TABLET 1

DEXAMETHASONE INTENSOL DROPS 2

DEXPAK TAB DS PK 3

diclofenac potassium TABLET 1

diclofenac sodium TABLET DR 1

diclofenac sodium er 100MG TAB ER 24H 1

diclofenac sodium-misoprostol TAB IR DR 3

DUEXIS TABLET 3

EC-NAPROSYN TABLET DR 3

ENBREL 50 MG/ML PEN INJCTR 4 QL,PA,DS

ENBREL 25MG/0.5ML SYRINGE 4 QL,PA,DS

ENBREL 50 MG/ML SYRINGE 4 QL,PA,DS

ENBREL 25 MG VIAL 4 QL,PA,DS

ENTOCORT EC CAPDR - ER 5

etodolac CAPSULE 1

etodolac TABLET 1



82


etodolac er TAB ER 24H 3

FELDENE CAPSULE 3

FENOPROFEN CALCIUM CAPSULE 3

fenoprofen calcium TABLET 3

FIRAZYR 30 MG/3 ML SYRINGE 4 QL,DS

FLO-PRED ORAL SUSP 3

fludrocortisone acetate TABLET 1

flurbiprofen TABLET 1

HUMIRA 40MG/0.8ML PEN IJ KIT 4 QL,PA,DS

HUMIRA 10MG/0.2ML SYRINGEKIT 4 QL,PA,DS



HUMIRA PEDIATRIC CROHNS 40MG/0.8ML SYRINGEKIT 4 QL,PA,DS

hydrocortisone TABLET 1

ibuprofen ORAL SUSP 3

ibuprofen TABLET 1

INDOCIN ORAL SUSP 3

INDOCIN SUPP.RECT 3

indomethacin CAPSULE 1

indomethacin CAPSULE ER 3

ketoprofen CAP24H PEL 3

ketoprofen CAPSULE 3

ketorolac tromethamine TABLET 3

KINERET 100MG/0.67 SYRINGE 5 QL,PA,DS

leflunomide TABLET 1

meclofenamate sodium CAPSULE 1

MEDROL TAB DS PK 3

MEDROL 16 MG TABLET 3





mefenamic acid CAPSULE 3



83


meloxicam ORAL SUSP 3

meloxicam TABLET 1

methylprednisolone TAB DS PK 1

methylprednisolone TABLET 1

MILLIPRED SOLUTION 3

MILLIPRED TABLET 3

MILLIPRED DP TAB DS PK 3

MOBIC ORAL SUSP 3

MOBIC TABLET 3

nabumetone TABLET 1

NALFON CAPSULE 3

NAPRELAN TBMP 24HR 3

NAPROSYN ORAL SUSP 3

NAPROSYN TABLET 3

naproxen ORAL SUSP 1

naproxen TABLET 1

naproxen TABLET DR 3

naproxen sodium TABLET 1

ORAPRED ODT TAB RAPDIS 3

ORENCIA 125 MG/ML SYRINGE 4 QL,PA,DS

OTEZLA 10-20-30MG TAB DS PK 3 PA,DS

OTEZLA 10-20-30MG TAB DS PK 5 PA,DS

OTEZLA 30 MG TABLET 4 PA,DS

OTREXUP 10MG/0.4ML AUTO INJCT 3 PA




oxaprozin TABLET 3

PEDIAPRED SOLUTION 3

piroxicam CAPSULE 1

PONSTEL CAPSULE 3

prednisolone SOLUTION 1

prednisolone sodium phosphate SOLUTION 1

prednisolone sodium phosphate TAB RAPDIS 3

prednisone SOLUTION 1

prednisone TAB DS PK 1



84


prednisone TABLET 1

PREDNISONE INTENSOL ORAL CONC 3

RASUVO 10MG/0.2ML AUTO INJCT 2 PA

RASUVO 12.5/0.25 AUTO INJCT 2 PA








RASUVO 7.5MG/0.15 AUTO INJCT 2 PA

RAYOS TABLET DR 3

RHEUMATREX TAB DS PK 3

RIDAURA CAPSULE 2

RUCONEST 2100 UNIT VIAL 5 QL,PA,DS

SIMPONI 100 MG/ML PEN INJCTR 5 QL,PA,DS

SIMPONI 50MG/0.5ML PEN INJCTR 5 QL,PA,DS

SIMPONI 100 MG/ML SYRINGE 5 QL,PA,DS

SIMPONI 50MG/0.5ML SYRINGE 5 QL,PA,DS

SPRIX SPRAY 3

STELARA 45MG/0.5ML SYRINGE 4 QL,PA

STELARA 90 MG/ML SYRINGE 4 QL,PA

sulindac TABLET 1

tolmetin sodium CAPSULE 1

tolmetin sodium 200 MG TABLET 1

tolmetin sodium 600 MG TABLET 3

UCERIS 9 MG TABDR & ER 5 DS

VERIPRED 20 SOLUTION 3

VIMOVO TAB IR DR 3

VOLTAREN-XR TAB ER 24H 3

XELJANZ 5 MG TABLET 5 QL,PA



85


ZIPSOR CAPSULE 3

ZORVOLEX CAPSULE 3

LOCAL ANESTHESIA


lidocaine hcl JEL (ML) 1

lidocaine hcl JEL/PF APP 1

lidocaine hcl SOLUTION 3

lidocaine hcl viscous SOLUTION 1

LOWER GASTROINTESTINAL DISORDERS - BOWEL INFLAMMAT


ANALPRAM E KT CRM TWL 3

ANALPRAM HC 1 %-1 % CREAM/APPL 3

ANALPRAM HC 2.5 %-1 % CREAM/APPL 3

ANALPRAM HC 2.5-1%(4G) CREAM/APPL 3

ANALPRAM HC LOTION 2

anucort-hc SUPP.RECT 1

ANUSOL-HC CREAM (G) 3

ANUSOL-HC SUPP.RECT 3

APRISO CAP ER 24H 3

ASACOL HD TABLET DR 2

AZULFIDINE TABLET 3

AZULFIDINE TABLET DR 3

balsalazide disodium CAPSULE 1

CANASA SUPP.RECT 2

CIMZIA 400 MG KIT 5 QL,PA,DS

CIMZIA 400MG/2ML SYRINGEKIT 5 QL,PA,DS

COLAZAL CAPSULE 3

colocort ENEMA 1

CORTENEMA ENEMA 3

CORTIFOAM FOAM/APPL 2

DELZICOL CAPSULE DR 3

DIPENTUM CAPSULE 3



86


GIAZO TABLET 3

grx hicort 25 SUPP.RECT 1

hydrocortisone ENEMA 1

hydrocortisone acetate SUPP.RECT 1

hydrocortisone-pramoxine CREAM/APPL 1

hydrocortisone-pramoxine KT CRM TWL 3

LIALDA TABLET DR 2

lidocaine-hydrocortisone CREAM (G) 3

lidocaine-hydrocortisone CREAM/APPL 3

lidocaine-hydrocortisone GEL W/APPL 3

lidocaine-hydrocortisone KIT 3

LINZESS 145 MCG CAPSULE 3 PA

LINZESS 290 MCG CAPSULE 3 PA

mesalamine ENEMA 1

mesalamine ENEMA KIT 3

PENTASA CAPSULE ER 2

PRAMCORT CREAM/APPL 2

PROCORT CREAM/APPL 3

procto-pak CREAM (G) 3

PROCTOCORT CREAM (G) 3

PROCTOCORT SUPP.RECT 3

PROCTOFOAM-HC FOAM 2

proctosol-hc CREAM/APPL 1

proctozone-hc CREAM/APPL 1

RECTACORT-HC SUPP.RECT 3

RECTIV OINT. (G) 2

ROWASA ENEMA KIT 3

SFROWASA ENEMA 3

sulfadiazine TABLET 3

sulfasalazine TABLET 1

sulfasalazine dr TABLET DR 1

sulfazine TABLET 1

sulfazine ec TABLET DR 1

UCERIS FOAM/APPL 3

ZYPRAM KT CRM TWL 3



87

LOWER GASTROINTESTINAL DISORDERS - OTHER


ACTIGALL CAPSULE 3

AMITIZA 24MCG CAPSULE 3 PA

AMITIZA 8 MCG CAPSULE 3 PA

BUPHENYL POWDER 5

BUPHENYL 500 MG TABLET 5 DS

CARBAGLU 200 MG TAB DISPER 5 PA,DS

CHENODAL TABLET 5

COLYTE WITH FLAVOR PACKETS SOLN RECON 3

COLYTE WITH FLAVOR PACKS SOLN RECON 3

constulose SOLUTION 1

diphenoxylate-atropine LIQUID 1

diphenoxylate-atropine TABLET 1

ENTEREG CAPSULE 3

enulose SOLUTION 1

FULYZAQ TABLET DR 3

GATTEX 5 MG KIT 5 QL,PA,DS

gavilyte-c SOLN RECON 1

gavilyte-g SOLN RECON 3

gavilyte-n SOLN RECON 3

generlac SOLUTION 1

GOLYTELY POWD PACK 2

GOLYTELY SOLN RECON 3

KRISTALOSE PACKET 3

lactulose SOLUTION 1

LITHOSTAT TABLET 3

LOMOTIL TABLET 3

loperamide CAPSULE 1

LOTRONEX TABLET 3

MOTOFEN TABLET 3

MOVIPREP POWD PACK 3

MOVANTIK TABLET 3 PA

NULYTELY WITH FLAVOR PACKS SOLN RECON 3

opium tincture TINCTURE 1

OSMOPREP TABLET 3

paregoric LIQUID 3



88


peg 3350-electrolyte SOLN RECON 1

peg-3350 SOLN RECON 3

peg-3350 and electrolytes SOLN RECON 3

peg-3350 with flavor packs SOLN RECON 3

polyethylene glycol 3350 POWD PACK 1

polyethylene glycol 3350 POWDER 1

PREPOPIK POWD PACK 3

RAVICTI 1.1GRAM/ML LIQUID 5 PA,DS

RELISTOR SYRINGE 2

RELISTOR VIAL 2

sodium phenylbutyrate POWDER 5

SUCLEAR SOLN RC SQ 3

SUPREP SOLN RECON 3

trilyte with flavor packets SOLN RECON 3

URSO TABLET 3

URSO FORTE TABLET 3

ursodiol CAPSULE 1

ursodiol TABLET 1

MISCELLANEOUS AGENTS


ADRENACLICK AUTO INJCT 3

EPIPEN 2-PAK AUTO INJCT 2

EPIPEN JR 2-PAK AUTO INJCT 2

NEOPLASTIC DISEASE


AFINITOR 10 MG TABLET 2 PA,DS

AFINITOR 2.5 MG TABLET 2 PA,DS

AFINITOR 5 MG TABLET 2 PA,DS

AFINITOR 7.5 MG TABLET 2 PA,DS

AFINITOR DISPERZ 2 MG TAB SUSP 2 PA,DS



ALKERAN 2 MG TABLET 2 DS



89


anastrozole TABLET 1

ARIMIDEX TABLET 3

AROMASIN TABLET 3

bicalutamide TABLET 1

BOSULIF 100 MG TABLET 3 PA,DS

BOSULIF 500 MG TABLET 3 PA,DS

capecitabine 150 MG TABLET 1 PA,DS

capecitabine 500 MG TABLET 1 PA,DS

CAPRELSA 100 MG TABLET 3 PA,DS

CAPRELSA 300 MG TABLET 3 PA,DS

CASODEX TABLET 3

COMETRIQ 100 MG/DAY CAPSULE 3 PA,DS



CYCLOPHOSPHAMIDE CAPSULE 2

EMCYT 140 MG CAPSULE 3 DS

ERIVEDGE 150 MG CAPSULE 3 PA,DS

etoposide 50 MG CAPSULE 1 DS

exemestane TABLET 3

FARESTON TABLET 3

FARYDAK CAPSULE 5 PA,DS

FEMARA TABLET 3

flutamide CAPSULE 1

GILOTRIF 20 MG TABLET 3 PA,DS



GLEEVEC 100 MG TABLET 2 PA,DS

GLEEVEC 400 MG TABLET 2 PA,DS

GLEOSTINE CAPSULE 3

HEXALEN 50 MG CAPSULE 3 DS

HYCAMTIN 0.25 MG CAPSULE 3 DS

HYCAMTIN 1 MG CAPSULE 3 DS

HYDREA CAPSULE 3

hydroxyurea CAPSULE 1

IBRANCE CAPSULE 5 PA,DS

ICLUSIG 15 MG TABLET 3 PA,DS

ICLUSIG 45 MG TABLET 3 PA,DS



90


IMBRUVICA 140 MG CAPSULE 2 PA,DS

INLYTA 1 MG TABLET 3 PA,DS

INLYTA 5 MG TABLET 3 PA,DS

JAKAFI 10 MG TABLET 3 PA,DS





LANPARZA CAPSULE 5 PA,DS

LENVIMA 10 MG/DAY CAPSULE 3 PA,DS




letrozole TABLET 1

leucovorin calcium TABLET 1

LEUKERAN TABLET 2

LEVULAN 20% SOL W/APPL 2 DS

lomustine CAPSULE 1

LYSODREN 500 MG TABLET 3 PA

MATULANE 50 MG CAPSULE 2 DS

megestrol acetate TABLET 1

MEKINIST 0.5 MG TABLET 2 PA,DS

MEKINIST 2 MG TABLET 2 PA,DS

mercaptopurine TABLET 1

MESNEX TABLET 2

methotrexate TABLET 1

MYLERAN 2 MG TABLET 2 DS

NEXAVAR 200 MG TABLET 2 PA,DS

NILANDRON TABLET 3

POMALYST 1 MG CAPSULE 3 PA,DS




PURINETHOL TABLET 3

PURIXAN 20 MG/ML ORAL SUSP 3 PA

REVLIMID 10 MG CAPSULE 2 PA,DS




91


REVLIMID 2.5 MG CAPSULE 2 PA,DS




SOLTAMOX SOLUTION 3

SPRYCEL 100 MG TABLET 2 PA,DS






STIVARGA 40 MG TABLET 3 PA,DS

SUTENT 12.5 MG CAPSULE 2 PA,DS

SUTENT 25 MG CAPSULE 2 PA,DS

SUTENT 37.5 MG CAPSULE 2 PA,DS

SUTENT 50 MG CAPSULE 2 PA,DS

SYLATRON 200 MCG KIT 5 DS



SYLATRON 4-PACK 200 MCG KIT 5 DS

SYLATRON 4-PACK 300 MCG KIT 5 DS

TABLOID TABLET 2

TAFINLAR 50 MG CAPSULE 2 PA,DS

TAFINLAR 75 MG CAPSULE 2 PA,DS

tamoxifen citrate TABLET 1

TARCEVA 100 MG TABLET 2 PA,DS



TARGRETIN 75 MG CAPSULE 3 DS

TASIGNA 150 MG CAPSULE 3 PA,DS

TASIGNA 200 MG CAPSULE 3 PA,DS

TEMODAR 100 MG CAPSULE 3 DS





temozolomide 100 MG CAPSULE 1 DS



92







tretinoin 10 MG CAPSULE 1 DS

TREXALL TABLET 3

TYKERB 250 MG TABLET 2 PA,DS

VOTRIENT 200 MG TABLET 2 PA,DS

XALKORI 200 MG CAPSULE 3 PA,DS

XALKORI 250 MG CAPSULE 3 PA,DS

XELODA 150 MG TABLET 3 PA,DS

XELODA 500 MG TABLET 3 PA,DS

XTANDI 40 MG CAPSULE 2 PA,DS

ZELBORAF 240 MG TABLET 3 PA,DS

ZOLINZA 100 MG CAPSULE 3 PA,DS

ZYDELIG 100 MG TABLET 4 PA,DS

ZYDELIG 150 MG TABLET 4 PA,DS

ZYKADIA 150 MG CAPSULE 5 PA,DS

ZYTIGA 250 MG TABLET 2 PA,DS

NEUROLOGICAL DISEASE - MISCELLANEOUS


AMPYRA 10 MG TAB ER 12H 5 PA,DS

AUBAGIO 14 MG TABLET 5 QL,PA,DS

AUBAGIO 7 MG TABLET 5 QL,PA,DS

AVONEX 30MCG/.5ML SYRINGE 4 QL,DS

AVONEX 30MCG/.5ML SYRINGEKIT 4 QL,DS

AVONEX ADMINISTRATION PACK 30 MCG KIT 4 QL,DS

AVONEX PEN 30MCG/.5ML PEN IJ KIT 4 QL,DS

AVONEX PEN 30MCG/.5ML PEN INJCTR 4 QL,DS

BETASERON 0.3 MG KIT 5 QL,DS

BETASERON 0.3 MG VIAL 5 QL,DS

COPAXONE 20 MG/ML SYRINGE 4 QL,DS



93


COPAXONE 40 MG/ML SYRINGE 5 QL,PA,DS

EXTAVIA 0.3 MG KIT 2 QL,DS

EXTAVIA 0.3 MG VIAL 2 QL,DS

GILENYA 0.5 MG CAPSULE 4 QL,PA,DS

glatopa 20 MG/ML SYRINGE 1 QL,DS

GRALISE TAB ER 24H 3

HORIZANT TABLET ER 3

NUEDEXTA CAPSULE 3

PLEGRIDY 125MCG/0.5 SYRINGE 5 PA,DS

PLEGRIDY 63-94 MCG SYRINGE 5 PA,DS

PLEGRIDY PEN 125MCG/0.5 PEN INJCTR 5 PA,DS

PLEGRIDY PEN 63-94 MCG PEN INJCTR 5 PA,DS

REBIF 22MCG/.5ML SYRINGE 4 QL,PA,DS

REBIF 44MCG/.5ML SYRINGE 4 QL,PA,DS

REBIF 8.8-22(6) SYRINGE 4 QL,PA,DS

REBIF REBIDOSE 22MCG/.5ML PEN INJCTR 4 QL,PA,DS

REBIF REBIDOSE 44MCG/.5ML PEN INJCTR 4 QL,PA,DS

REBIF REBIDOSE 8.8-22(6) PEN INJCTR 4 QL,PA,DS

RILUTEK 50 MG TABLET 3 DS

riluzole 50 MG TABLET 1 DS

SAVELLA 12.5-25-50 TAB DS PK 3 ST

SAVELLA 100 MG TABLET 3 ST

SAVELLA 12.5 MG TABLET 3 ST



TECFIDERA 120 MG CAPSULE DR 5 QL,PA,DS

TECFIDERA 120-240 MG CAPSULE DR 5 QL,PA,DS

TECFIDERA 240 MG CAPSULE DR 5 QL,PA,DS



94


XENAZINE 12.5 MG TABLET 5 QL,PA,DS

XENAZINE 25 MG TABLET 5 QL,PA,DS

ORAL/PHARYNGEAL DISORDERS


ARESTIN CARTRIDGE 3

ATROVENT SPRAY 3

BACTROBAN NASAL OINT. (G) 3

ipratropium bromide SPRAY 1

OTHER DRUGS


CARNITOR SOLUTION 3

CARNITOR TABLET 3

CARNITOR SF SOLUTION 3

CERDELGA 84 MG CAPSULE 4 PA,DS

CHEMET CAPSULE 5

CYSTADANE POWDER 3

EXJADE 125 MG TAB DISPER 5 PA,DS



FERRIPROX 500 MG TABLET 3 PA,DS

GALZIN CAPSULE 3

KUVAN 100 MG POWD PACK 5 DS

KUVAN 100 MG TABLET SOL 5 DS

levocarnitine SOLUTION 1

levocarnitine TABLET 1

MEGACE ORAL SUSP 3

MEGACE ES ORAL SUSP 3

megestrol acetate ORAL SUSP 1

MIFEPREX TABLET 3

mucotrol WAFER 3

ORFADIN 10 MG CAPSULE 5 DS




95



RADIOGARDASE CAPSULE 3

SIGNIFOR 0.3 MG/ML AMPUL 5 QL,PA,DS

SIGNIFOR 0.6 MG/ML AMPUL 5 QL,PA,DS

SIGNIFOR 0.9 MG/ML AMPUL 5 PA, QL,DS

SOMATULINE DEPOT SYRINGE 5 PA,QL,DS

SYNAPRYN SUSP RECON 3

SYPRINE 250 MG CAPSULE 5 PA,DS

ZAVESCA 100 MG CAPSULE 5 DS

OTHER RESPIRATORY DISORDERS


ESBRIET 267 MG CAPSULE 5 DS

KALYDECO 150 MG TABLET 4 PA,QL,DS

OFEV 100 MG CAPSULE 5 DS

OFEV 150 MG CAPSULE 5 DS

PAIN MANAGEMENT - ANALGESICS


ABSTRAL 100 MCG TAB SUBL 5 PA,DS






acetaminophen-butalbital TABLET 3

acetaminophen-codeine 120-12MG/5 SOLUTION 1 QL

acetaminophen-codeine 300MG/12.5 SOLUTION 1 QL

acetaminophen-codeine 300MG-15MG TABLET 1 QL



ACTIQ 1200 MCG LOZENGE HD 5 PA,DS



96







alagesic lq SOLUTION 3

ALSUMA 6 MG/0.5ML PEN INJCTR 3 QL

AMERGE TABLET 3

ascomp with codeine CAPSULE 3

aspirin-caffeine-dihydrocodein CAPSULE 3

AVINZA 120 MG CPMP 24HR 3 QL






AXERT 12.5 MG TABLET 3 QL,ST

AXERT 6.25 MG TABLET 3 QL,ST

belladonna-opium SUPP.RECT 1

BUNAVAIL 2.1-0.3 MG FILM 3 PA

BUNAVAIL 4.2-0.7 MG FILM 3 PA

BUNAVAIL 6.3MG-1MG FILM 3 PA

BUPAP TABLET 3

buprenorphine hcl TAB SUBL 1

buprenorphine-naloxone TAB SUBL 1

butalb-acetaminoph-caff-codein CAPSULE 3

butalb-caff-acetaminoph-codein 50-325-30 CAPSULE 3 QL

butalbital compound-codeine CAPSULE 3

butalbital-acetaminophen-caffe CAPSULE 3

butalbital-acetaminophen-caffe TABLET 1

butalbital-aspirin-caffeine CAPSULE 1

butorphanol tartrate SPRAY 3

BUTRANS 10 MCG/HR PATCH TDWK 3 PA




BUTRANS 7.5 MCG/HR PATCH TDWK 3 PA



97


CAFERGOT TABLET 2

CAMBIA POWD PACK 3

capacet CAPSULE 3

CAPITAL W-CODEINE 120-12MG/5 ORAL SUSP 3 QL

carisoprodol compound-codeine TABLET 3

carisoprodol-aspirin-codeine TABLET 3

choline mag trisalicylate LIQUID 1

CODEINE SULFATE SOLUTION 3

codeine sulfate TABLET 1

CONZIP 300 MG CPBP 17-83 3 QL



DEMEROL TABLET 3

diflunisal TABLET 1

dihydroergotamine mesylate SPRAY/PUMP 4

DILAUDID LIQUID 1

DILAUDID TABLET 3

DISALCID TABLET 2

DISKETS 40 MG TABLET SOL 3 QL

DOLOPHINE HCL 10 MG TABLET 3 QL

DOLOPHINE HCL 5 MG TABLET 3 QL

DURAGESIC 100 MCG/HR PATCH TD72 3 QL

DURAGESIC 12 MCG/HR PATCH TD72 3 QL

DURAGESIC 25MCG/HR PATCH TD72 3 QL



endocet 10MG-325MG TABLET 1 QL

endocet 2.5-325MG TABLET 1 QL

endocet 5 MG-325MG TABLET 1 QL

endocet 7.5-325MG TABLET 1 QL

endodan TABLET 1

ERGOMAR TAB SUBL 2

ESGIC CAPSULE 3

ESGIC TABLET 3

EXALGO 12 MG TAB ER 24H 3 QL





98



fentanyl 100 MCG/HR PATCH TD72 1 QL

fentanyl 12 MCG/HR PATCH TD72 1 QL

fentanyl 25MCG/HR PATCH TD72 1 QL

fentanyl 37.5MCG/HR PATCH TD72 3 QL





fentanyl citrate 1200 MCG LOZENGE HD 5 PA,DS






FENTORA 100 MCG TABLET EFF 5 PA,DS





FIORICET CAPSULE 3

FIORICET WITH CODEINE CAPSULE 3

FIORINAL CAPSULE 3

FIORINAL WITH CODEINE #3 CAPSULE 3

FROVA 2.5 MG TABLET 3 QL,ST

HYCET 7.5-325/15 SOLUTION 3 QL

hydrocodone-acetaminophen 10-325/15 SOLUTION 3 QL

hydrocodone-acetaminophen 2.5-167/5 SOLUTION 1 QL

hydrocodone-acetaminophen 5-163/7.5 SOLUTION 3 QL



hydrocodone-acetaminophen 10MG-300MG TABLET 3 QL


hydrocodone-acetaminophen 2.5-325MG TABLET 3 QL

hydrocodone-acetaminophen 5 MG-325MG TABLET 1 QL





99



hydrocodone-ibuprofen TABLET 3

hydromorphone er 12 MG TAB ER 24H 3 QL




hydromorphone hcl LIQUID 1

hydromorphone hcl SUPP.RECT 1

hydromorphone hcl TABLET 1

IBUDONE TABLET 3

IMITREX 4 MG/0.5ML CARTRIDGE 3 QL

IMITREX 6 MG/0.5ML CARTRIDGE 3 QL

IMITREX 4 MG/0.5ML PEN INJCTR 3 QL

IMITREX 6 MG/0.5ML PEN INJCTR 3 QL

IMITREX 20 MG SPRAY 3 QL

IMITREX 5 MG SPRAY 3 QL

IMITREX 100 MG TABLET 3 QL



IMITREX 6 MG/0.5ML VIAL 3 QL

isomethept-caff-acetaminophen TABLET 3

isomethept-dichloralp-acetamin CAPSULE 1

KADIAN 10 MG CAP ER PEL 3 QL,ST









LAZANDA 100MCG/SPR SPRAY/PUMP 5 PA,DS

LAZANDA 400MCG/SPR SPRAY/PUMP 5 PA,DS

LEVACET TABLET 3

levorphanol tartrate TABLET 1

lorcet 5 MG-325MG TABLET 1 QL

lorcet hd 10MG-325MG TABLET 1 QL



100


lorcet plus 7.5-325MG TABLET 1 QL

LORTAB 10-300/15 SOLUTION 3 QL

LORTAB 10MG-325MG TABLET 3 QL

LORTAB 5 MG-325MG TABLET 3 QL

LORTAB 7.5-325MG TABLET 3 QL

margesic CAPSULE 3

marten-tab TABLET 3

MAXALT 10 MG TABLET 3 QL

MAXALT 5 MG TABLET 3 QL

MAXALT MLT 10 MG TAB RAPDIS 3 QL

MAXALT MLT 5 MG TAB RAPDIS 3 QL

meperidine hcl SOLUTION 3

meperidine hcl TABLET 3

meperitab TABLET 3

methadone hcl 10 MG/ML ORAL CONC 1 QL

methadone hcl 10 MG/5 ML SOLUTION 1 QL

methadone hcl 5 MG/5 ML SOLUTION 1 QL

methadone hcl 10 MG TABLET 1 QL

methadone hcl 5 MG TABLET 1 QL

methadone hcl 40 MG TABLET SOL 3 QL

methadone intensol 10 MG/ML ORAL CONC 1 QL

METHADOSE 10 MG/ML ORAL CONC 3 QL

methadose 40 MG TABLET SOL 3 QL

MIGERGOT SUPP.RECT 2

migragesic ida CAPSULE 1

MIGRANAL SPRAY/PUMP 4

MORPHINE SULFATE 15 MG TABLET 1




morphine sulfate SOLUTION 1

morphine sulfate SUPP.RECT 1

morphine sulfate er 10 MG CAP ER PEL 3 QL,ST







101




morphine sulfate er 120 MG CPMP 24HR 3 QL






morphine sulfate er 100 MG TABLET ER 1 QL





MS CONTIN 100 MG TABLET ER 3 QL





naratriptan 1 MG TABLET 1 QL

naratriptan 2.5 MG TABLET 1 QL

naratriptan hcl 1 MG TABLET 1 QL

naratriptan hcl 2.5 MG TABLET 1 QL

nodolor CAPSULE 1

NORCO 10MG-325MG TABLET 3 QL

NORCO 5 MG-325MG TABLET 3 QL

NORCO 7.5-325MG TABLET 3 QL

NUCYNTA TABLET 3

NUCYNTA ER 100 MG TAB ER 12H 3 QL,ST





OPANA TABLET 3

OPANA ER 10 MG TAB ER 12H 3 QL,ST






102




OPANA ER 7.5 MG TAB ER 12H 3 QL,ST

OXECTA TABLET ORL 3

oxycodone hcl CAPSULE 3

oxycodone hcl ORAL CONC 1

oxycodone hcl SOLUTION 1

oxycodone hcl TABLET 1

oxycodone hcl er 10 MG TAB ER 12H 1 QL,ST




oxycodone hcl-aspirin TABLET 1

oxycodone hcl-ibuprofen TABLET 3

oxycodone-acetaminophen 10MG-325MG TABLET 1 QL

oxycodone-acetaminophen 2.5-325MG TABLET 1 QL

oxycodone-acetaminophen 5 MG-325MG TABLET 1 QL

oxycodone-acetaminophen 7.5-325MG TABLET 1 QL

OXYCONTIN 10 MG TAB ER 12H 2 QL,ST







oxymorphone hcl TABLET 3

oxymorphone hcl er 10 MG TAB ER 12H 3 QL,ST






oxymorphone hcl er 7.5 MG TAB ER 12H 3 QL,ST

pentazocine-naloxone hcl TABLET 3

PERCOCET 10MG-325MG TABLET 3 QL

PERCOCET 2.5-325MG TABLET 3 QL

PERCOCET 5 MG-325MG TABLET 3 QL



103


PERCOCET 7.5-325MG TABLET 3 QL

PERCODAN TABLET 3

PRIMLEV 10MG-300MG TABLET 3 QL

PRIMLEV 5MG-300MG TABLET 3 QL

PRIMLEV 7.5-300MG TABLET 3 QL

prodrin TABLET 3

RELPAX 20 MG TABLET 3 QL,ST

RELPAX 40 MG TABLET 3 QL,ST

reprexain TABLET 3

rizatriptan 10 MG TAB RAPDIS 1 QL

rizatriptan 5 MG TAB RAPDIS 1 QL

rizatriptan 10 MG TABLET 1 QL

rizatriptan 5 MG TABLET 1 QL

roxicet 5-325/5ML SOLUTION 1 QL

roxicet 5 MG-325MG TABLET 1 QL

ROXICODONE TABLET 3

salsalate TABLET 1

SUBOXONE FILM 3

SUBSYS 100MCG/SPR SPRAY 5 PA,DS

SUBSYS 1200 MCG SPRAY 5 PA,DS



SUBSYS 400MCG/SPR SPRAY 5 PA,DS



sumatriptan 20 MG SPRAY 1 QL

sumatriptan 5 MG SPRAY 1 QL

sumatriptan succinate 4 MG/0.5ML CARTRIDGE 1 QL

sumatriptan succinate 6 MG/0.5ML CARTRIDGE 1 QL

sumatriptan succinate 4 MG/0.5ML PEN INJCTR 1 QL

sumatriptan succinate 6 MG/0.5ML PEN INJCTR 1 QL

sumatriptan succinate 6 MG/0.5ML SYRINGE 1 QL

sumatriptan succinate 100 MG TABLET 1 QL



sumatriptan succinate 6 MG/0.5ML VIAL 1 QL

SUMAVEL DOSEPRO 4 MG/0.5ML NDL FR INJ 3 QL



104


SUMAVEL DOSEPRO 6 MG/0.5ML NDL FR INJ 3 QL

SYNALGOS-DC CAPSULE 3

tencon TABLET 3

tramadol hcl TABLET 1

tramadol hcl er CPBP 25-75 3

tramadol hcl er 100 MG TAB ER 24H 3 QL



tramadol hcl er 100 MG TBMP 24HR 3 QL



tramadol hcl-acetaminophen 37.5-325MG TABLET 1 QL

TREXIMET 85MG-500MG TABLET 3 QL,ST

TREZIX CAPSULE 3

TYLENOL-CODEINE NO.3 300MG-30MG TABLET 3 QL

TYLENOL-CODEINE NO.4 300MG-60MG TABLET 3 QL

ULTRACET 37.5-325MG TABLET 3 QL

ULTRAM TABLET 3

ULTRAM ER 100 MG TAB ER 24H 3 QL



vicodin 5MG-300MG TABLET 3 QL

vicodin es 7.5-300MG TABLET 3 QL

vicodin hp 10MG-300MG TABLET 3 QL

VICOPROFEN TABLET 3

XARTEMIS XR 7.5-325MG TAB IR ERO 3 ST

XODOL 10-300 10MG-300MG TABLET 3 QL

XODOL 5-300 5MG-300MG TABLET 3 QL

XODOL 7.5-300 7.5-300MG TABLET 3 QL

xylon 10 TABLET 3

zebutal CAPSULE 3

ZOHYDRO ER 10 MG CAP ER 12H 3 QL,PA








105


zolmitriptan 2.5 MG TABLET 1 QL

zolmitriptan 5 MG TABLET 1 QL

zolmitriptan odt 2.5 MG TAB RAPDIS 1 QL

zolmitriptan odt 5 MG TAB RAPDIS 1 QL

ZOMIG 2.5 MG SPRAY 3 QL

ZOMIG 5 MG SPRAY 3 QL

ZOMIG 2.5 MG TABLET 3 QL

ZOMIG 5 MG TABLET 3 QL

ZOMIG ZMT 2.5 MG TAB RAPDIS 3 QL

ZOMIG ZMT 5 MG TAB RAPDIS 3 QL

ZUBSOLV TAB SUBL 3

PARKINSONS DISEASE


amantadine CAPSULE 1

amantadine SYRUP 1

amantadine TABLET 1

APOKYN 10 MG/ML CARTRIDGE 5 DS

AZILECT TABLET 2

benztropine mesylate TABLET 1

bromocriptine mesylate CAPSULE 1

bromocriptine mesylate TABLET 1

carbidopa TABLET 1

carbidopa-levodopa TAB RAPDIS 3

carbidopa-levodopa TABLET 1

carbidopa-levodopa er TABLET ER 1

carbidopa-levodopa-entacapone TABLET 1

COMTAN TABLET 1

DUOPA SUSPENSION 4 PA,DS,QL

ELDEPRYL CAPSULE 3

entacapone TABLET 1

LODOSYN TABLET 3

MIRAPEX TABLET 3

MIRAPEX ER TAB ER 24H 3

NEUPRO PATCH TD24 3



106


PARLODEL CAPSULE 3

PARLODEL TABLET 3

pramipexole dihydrochloride TABLET 1

pramipexole er TAB ER 24H 3

REQUIP TABLET 3

REQUIP XL TAB ER 24H 3

ropinirole hcl TAB ER 24H 3

ropinirole hcl TABLET 1

RYTARY CAPSULE ER 3 PA

selegiline hcl CAPSULE 1

selegiline hcl TABLET 1

SINEMET 10-100 TABLET 3



SINEMET CR TABLET ER 3

STALEVO 100 TABLET 3




STALEVO 50 TABLET 3

STALEVO 75 TABLET 3

TASMAR TABLET 3

trihexyphenidyl hcl ELIXIR 1

trihexyphenidyl hcl TABLET 1

ZELAPAR TAB RAPDIS 3

SEIZURE DISORDER


APTIOM 200 MG TABLET 5 PA,DS




BANZEL ORAL SUSP 3

BANZEL TABLET 3

carbamazepine CPMP 12HR 1

carbamazepine ORAL SUSP 1



107


carbamazepine TAB CHEW 1

carbamazepine TABLET 1

carbamazepine er TAB ER 12H 1

carbamazepine xr TAB ER 12H 1

CARBATROL CPMP 12HR 2

CELONTIN CAPSULE 2

clonazepam TAB RAPDIS 3

clonazepam TABLET 1

DEPAKENE CAPSULE 3

DEPAKENE SOLUTION 3

DEPAKOTE TABLET DR 3

DEPAKOTE ER TAB ER 24H 3

DEPAKOTE SPRINKLE CAP SPRINK 3

DIASTAT KIT 1

DIASTAT ACUDIAL KIT 3

diazepam KIT 3

diazapem 5mg/5ml SOLUTION 1

DILANTIN 100 MG CAPSULE 3

DILANTIN 30 MG CAPSULE 2

DILANTIN TAB CHEW 3

DILANTIN-125 ORAL SUSP 3

divalproex sodium CAP SPRINK 1

divalproex sodium TABLET DR 1

divalproex sodium er TAB ER 24H 1

epitol TABLET 1

ethosuximide CAPSULE 1

ethosuximide SOLUTION 1

FANATREX ORAL SUSP 3

felbamate ORAL SUSP 3

felbamate TABLET 3

FELBATOL ORAL SUSP 3

FELBATOL TABLET 3

FYCOMPA 10 MG TABLET 3 ST,DS







108



gabapentin CAPSULE 1

gabapentin SOLUTION 3

gabapentin TABLET 1

GABITRIL TABLET 3

KEPPRA SOLUTION 3

KEPPRA TABLET 3

KEPPRA XR TAB ER 24H 3

KLONOPIN TABLET 3

LAMICTAL TABLET 3

LAMICTAL TB CHW DSP 3

LAMICTAL (BLUE) TAB DS PK 3

LAMICTAL (GREEN) TAB DS PK 3

LAMICTAL (ORANGE) TAB DS PK 3

LAMICTAL ODT TAB RAPDIS 3

LAMICTAL ODT (BLUE) TB RD DSPK 3

LAMICTAL ODT (GREEN) TB RD DSPK 3

LAMICTAL ODT (ORANGE) TB RD DSPK 3

LAMICTAL XR TAB ER 24 3

LAMICTAL XR (BLUE) TB ER DSPK 3

LAMICTAL XR (GREEN) TB ER DSPK 3

LAMICTAL XR (ORANGE) TB ER DSPK 3

lamotrigine TAB DS PK 3

lamotrigine TABLET 1

lamotrigine TB CHW DSP 1

lamotrigine er TAB ER 24 3

lamotrigine odt TAB RAPDIS 3

levetiracetam 100 MG/ML SOLUTION 1

levetiracetam 500 MG/5ML SOLUTION 1

levetiracetam 500 MG/5ML SOLUTION 3

levetiracetam TABLET 1

levetiracetam er TAB ER 24H 1

LYRICA 100 MG CAPSULE 3 QL,PA







109





LYRICA 20 MG/ML SOLUTION 3 QL,PA

MYSOLINE TABLET 3

NEURONTIN CAPSULE 3

NEURONTIN SOLUTION 3

NEURONTIN TABLET 3

ONFI ORAL SUSP 3

ONFI TABLET 3

oxcarbazepine ORAL SUSP 1

oxcarbazepine TABLET 1

OXTELLAR XR TAB ER 24H 3

PEGANONE TABLET 3

PHENYTEK CAPSULE 3

phenytoin ORAL SUSP 1

phenytoin TAB CHEW 1

phenytoin sodium extended 100 MG CAPSULE 1



POTIGA TABLET 3

primidone TABLET 1

QUDEXY XR CAP SPR 24 3

SABRIL POWD PACK 5

SABRIL TABLET 5

TEGRETOL ORAL SUSP 3

TEGRETOL TABLET 3

TEGRETOL XR 100 MG TAB ER 12H 2



tiagabine hcl TABLET 3

TOPAMAX CAP SPRINK 3

TOPAMAX TABLET 3

topiragen TABLET 1

topiramate CAP SPRINK 1

topiramate TABLET 1

topiramate er CAP SPR 24 3



110


TRILEPTAL ORAL SUSP 3

TRILEPTAL TABLET 3

TROKENDI XR CAP ER 24H 3

valproic acid CAPSULE 1

valproic acid SOLUTION 1

VIMPAT SOLUTION 3

VIMPAT TABLET 3

ZARONTIN CAPSULE 3

ZARONTIN SOLUTION 3

ZONEGRAN CAPSULE 3

zonisamide CAPSULE 1

SKELETAL MUSCLE DISORDER


AMRIX CAP ER 24H 3

baclofen TABLET 1

carisoprodol TABLET 3

carisoprodol compound TABLET 3

carisoprodol-aspirin TABLET 3

chlorzoxazone TABLET 3

cyclobenzaprine hcl 10 MG TABLET 1

cyclobenzaprine hcl 5 MG TABLET 1

cyclobenzaprine hcl 7.5 MG TABLET 3

DANTRIUM CAPSULE 3

dantrolene sodium CAPSULE 1

FEXMID TABLET 3

LORZONE TABLET 3

metaxalone TABLET 3

methocarbamol TABLET 1

orphenadrine citrate TABLET ER 1

PARAFON FORTE DSC TABLET 3

ROBAXIN TABLET 3

ROBAXIN-750 TABLET 3

SKELAXIN TABLET 3

SOMA TABLET 3

tizanidine hcl CAPSULE 3



111


tizanidine hcl TABLET 1

ZANAFLEX CAPSULE 3

ZANAFLEX TABLET 3

UPPER GASTROINTESTINAL DISORDERS - DIGESTIVE


CREON CAPSULE DR 2

PANCREAZE CAPSULE DR 3

pancrelipase 5,000 CAPSULE DR 1

PERTZYE CAPSULE DR 3

SUCRAID SOLUTION 5

ULTRESA CAPSULE DR 3

VIOKACE TABLET 3

ZENPEP 10-34-55K CAPSULE DR 2




ZENPEP 3K-10K-16K CAPSULE DR 2

ZENPEP 40K-136K CAPSULE DR 2

ZENPEP 5K-17K-27K CAPSULE DR 3

UPPER GASTROINTESTINAL DISORDERS - SPASTIC DISEASE


ANASPAZ TAB RAPDIS 3

BENTYL CAPSULE 3

BENTYL TABLET 3

dicyclomine hcl CAPSULE 1

dicyclomine hcl SOLUTION 1

dicyclomine hcl TABLET 1

DONNATAL ELIXIR 3

DONNATAL TABLET 3

ed-spaz TAB RAPDIS 3

hyoscyamine sulfate DROPS 3

hyoscyamine sulfate ELIXIR 3

hyoscyamine sulfate TAB RAPDIS 3



112


hyoscyamine sulfate TAB SUBL 3

hyoscyamine sulfate TABLET 3

hyoscyamine sulfate er TAB ER 12H 3

hyoscyamine sulfate sr TAB ER 12H 3

hyosyne DROPS 3

hyosyne ELIXIR 3

LEVBID TAB ER 12H 3

LEVSIN TABLET 3

LEVSIN-SL TAB SUBL 3

methscopolamine bromide TABLET 3

NULEV TAB RAPDIS 3

oscimin TAB RAPDIS 3

oscimin TABLET 3

oscimin sl TAB SUBL 3

oscimin sr TAB ER 12H 3

SYMAX TAB RAPDIS 3

SYMAX DUOTAB TAB MPHASE 3

SYMAX-SL TAB SUBL 3

SYMAX-SR TAB ER 12H 3

UPPER GASTROINTESTINAL DISORDERS - ULCER DISEASE


ACIPHEX TABLET DR 3

ACIPHEX SPRINKLE 10 MG CAP DR SPR 3 PA

ACIPHEX SPRINKLE 5 MG CAP DR SPR 3 PA

CANTIL TABLET 3

CARAFATE ORAL SUSP 2

CARAFATE TABLET 3

chlordiazepoxide-clidinium CAPSULE 1

cimetidine SOLUTION 1

cimetidine TABLET 1

CUVPOSA SOLUTION 3

CYTOTEC TABLET 3

DEPRIZINE SUSP RECON 3

DEXILANT 30 MG CAP DR BP 3 PA

DEXILANT 60 MG CAP DR BP 3 PA



113


ESOMEPRAZOLE STRONTIUM 49.3 MG CAPSULE DR 1 PA

esomeprazole strontium 49.3 MG CAPSULE DR 1 PA

famotidine ORAL SUSP 1

famotidine TABLET 1

FIRST-LANSOPRAZOLE SUSP RECON 3

FIRST-OMEPRAZOLE SUSP RECON 2

glycopyrrolate TABLET 1

lansoprazol-amoxicil-clarithro COMBO. PKG 3

lansoprazole CAPSULE DR 1

LIBRAX CAPSULE 3

metoclopramide hcl SOLUTION 1

metoclopramide hcl TABLET 1

METOZOLV ODT TAB RAPDIS 3

misoprostol TABLET 1

nizatidine CAPSULE 3

nizatidine SOLUTION 3

OMECLAMOX-PAK COMBO. PKG 3

omeprazole 10 MG CAPSULE DR 1



omeprazole+syrspend sf alka SUSP RECON 1

omeprazole-sodium bicarbonate CAPSULE 3

pantoprazole sodium TABLET DR 1

PEPCID ORAL SUSP 3

PEPCID TABLET 3

PREVACID CAPSULE DR 3

PREVACID TAB RAP DR 3

PREVPAC COMBO. PKG 3

PRILOSEC CAPSULE DR 3

PRILOSEC SUSPDR PKT 3

propantheline bromide TABLET 1

PROTONIX GRANPKT DR 3

PROTONIX TABLET DR 3

PYLERA CAPSULE 2

rabeprazole sodium TABLET DR 1

ranitidine hcl CAPSULE 3

ranitidine hcl SYRUP 1



114


ranitidine hcl TABLET 1

REGLAN TABLET 3

ROBINUL TABLET 3

ROBINUL FORTE TABLET 3

sucralfate ORAL SUSP 1

sucralfate TABLET 1

ZANTAC TABLET 3

ZEGERID CAPSULE 3

ZEGERID PACKET 2

URINARY TRACT - FUNCTIONAL DISORDERS


alfuzosin hcl er TAB ER 24H 1

AVODART CAPSULE 3

CYSTAGON 150 MG CAPSULE 2 PA

CYSTAGON 50 MG CAPSULE 2 PA

cytra-2 SOLUTION 1

cytra-3 SOLUTION 1

cytra-k PACKET 1

cytra-k SOLUTION 1

DETROL TABLET 3

DETROL LA CAP ER 24H 3

DITROPAN XL TAB ER 24 3

ELMIRON CAPSULE 2

ENABLEX 15 MG TAB ER 24H 3 ST

ENABLEX 7.5 MG TAB ER 24H 3 ST

finasteride TABLET 1

flavoxate hcl TABLET 1

FLOMAX CAP ER 24H 3

GELNIQUE 28MG/0.92G GEL MD PMP 3 ST

GELNIQUE 10% GEL PACKET 3 ST

JALYN CPMP 24HR 3

K-PHOS NEUTRAL TABLET 3

K-PHOS NO.2 TABLET 3

K-PHOS ORIGINAL TABLET SOL 3

MYRBETRIQ 25 MG TAB ER 24H 3 ST



115


MYRBETRIQ 50 MG TAB ER 24H 3 ST

ORACIT SOLUTION 2

oxybutynin chloride SYRUP 1

oxybutynin chloride TABLET 1

oxybutynin chloride er TAB ER 24 1

OXYTROL 3.9MG/24HR PATCH TDSW 3 ST

phenazopyridine hcl TABLET 1

phospha 250 neutral TABLET 1

potass cit-sod cit-citric acid SOLUTION 1

potassium citrate er 10 MEQ TABLET ER 1



potassium citrate-citric acid PACKET 3

potassium citrate-citric acid SOLUTION 1

PROCYSBI 25 MG CAP DR SPR 5 PA,DS

PROCYSBI 75 MG CAP DR SPR 5 PA,DS

PROSCAR TABLET 3

PYRIDIUM TABLET 3

RAPAFLO CAPSULE 3

SHOHLS MODIFIED SOLUTION 3

sodium citrate & citric acid SOLUTION 1

tamsulosin hcl CAP ER 24H 1

taron-crystals PACKET 3

THIOLA TABLET 3

tolterodine tartrate TABLET 1

tolterodine tartrate er CAP ER 24H 1

TOVIAZ 4 MG TAB ER 24H 3 ST

TOVIAZ 8 MG TAB ER 24H 3 ST

tricitrates SOLUTION 3

trospium chloride TABLET 1

trospium chloride er CAP ER 24H 1

UROCIT-K TABLET ER 3

UROQID-ACID NO.2 TABLET 3

UROXATRAL TAB ER 24H 3

VESICARE 10 MG TABLET 3 ST

VESICARE 5 MG TABLET 3 ST



116


virt-phos 250 neutral TABLET 1

virtrate-3 SOLUTION 1

VAGINAL DISORDERS


AVC CREAM/APPL 3

CLEOCIN CREAM/APPL 3

CLEOCIN SUPP.VAG 3

clindamycin phosphate CREAM/APPL 1

CLINDESSE CRM ER (G) 3

ESTRACE CREAM/APPL 2

ESTRING VAG RING 2

FEM PH JELLY/APPL 3

FEMRING VAG RING 3

GYNAZOLE 1 CRM/PF APP 3

METROGEL-VAGINAL GEL W/APPL 3

metronidazole GEL W/APPL 1

miconazole 3 SUPP.VAG 3

PREMARIN CREAM/APPL 2

RELAGARD JELLY/APPL 3

TERAZOL 7 CREAM/APPL 3

terconazole CREAM/APPL 3

terconazole SUPP.VAG 3

VAGIFEM TABLET 2

VANDAZOLE GEL W/APPL 3

VITAMIN AND/OR MINERAL DEFICIENCY


DRISDOL CAPSULE 3

folic acid TABLET 1

sodium fluoride DROPS 1

sodium fluoride TAB CHEW 1

vitamin d2 CAPSULE 1



117

8

8-MOP 47

A

abacavir 76 abacavir-lamivudine-zidovudine 76 ABILIFY 9 ABILIFY DISCMELT 9 ABILIFY MAINTENA 9 ABSORICA 31 ABSTRAL 95 acamprosate calcium 9 ACANYA 31 acarbose 47 ACCOLATE 3 ACCUPRIL 15 ACCURETIC 15 acebutolol hcl 15 ACEON 15 acetaminophen-butalbital 95 acetaminophen-codeine 95 acetasol hc 51 acetazolamide 60 acetic acid 51 acetic acid-aluminum 51 ACIPHEX 112 ACIPHEX SPRINKLE 112 acitretin 47 ACTEMRA 80 ACTICLATE 69 ACTIGALL 86 ACTIMMUNE 68 ACTIQ 95 ACTIVELLA 65 ACTONEL 53 ACTOPLUS MET 48 ACTOPLUS MET XR 48 ACTOS 48 ACULAR 57 ACULAR LS 57 ACUVAIL 57 acyclovir 33, 76 ACZONE 31 ADALAT CC 15 adapalene 31 ADAZIN 42 ADCIRCA 15 ADDERALL 9 ADDERALL XR 9 adefovir dipivoxil 76 ADEMPAS 15, 16 ADOXA 69 ADRENACLICK 88 ADRENALIN CHLORIDE 30 ADVAIR DISKUS 3

ADVAIR HFA 3 ADVICOR 23 AEROSPAN 3 afeditab cr 16 AFINITOR 88 AFINITOR DISPERZ 88 AFREZZA 53 AGGRENOX 62 AGRYLIN 62 ak-poly-bac 57 AKTEN 57 AKYNZEO 2 ala-cort 37 alagesic lq 95 ALA-QUIN 31 ala-scalp 37 ALBENZA 75 albuterol sulfate 3 alcaine 57 alclometasone dipropionate 37, 38 ALCORTIN A 31 ALDACTAZIDE 16 ALDACTONE 16 ALDARA 68 alendronate sodium 54 alfuzosin hcl er 113 ALINIA 33 ALKERAN 88 allopurinol 62 ALOCRIL 57 ALOMIDE 57 ALOQUIN 32 ALORA 65 ALPHAGAN P 60 alprazolam 9 alprazolam er 9 ALPRAZOLAM INTENSOL 9 alprazolam odt 9 alprazolam xr 9 ALREX 57 ALSUMA 95 ALTABAX 33 ALTACE 16 altafluor 57 altavera 26 ALTOPREV 23 ALUVEA 42 ALVESCO 3 alyacen 26 amantadine 104 AMARYL 48 AMBIEN 9 AMBIEN CR 9 amcinonide 38 AMERGE 95 amethia 26 amethia lo 26 AMETHYST 26 amiloride hcl 16 amiloride-hydrochlorothiazide 16



118

aminocaproic acid 62 amiodarone hcl 14 AMITIZA 86 amitriptyline hcl 6 amlodipine besylate 16 amlodipine besylate-benazepril 16 amlodipine-atorvastatin 25 amlodipine-valsartan 16 amlodipine-valsartan-hctz 16 amnesteem 32 amox tr-potassium clavulanate 69 amoxapine 6 amoxicillin 69 amoxicillin er 69 amoxicillin-clavulanate er 69 amphetamine salt combo 9 ampicillin trihydrate 69 AMPYRA 92 AMRIX 109 AMTURNIDE 16 ANACAINE 42 ANADROL-50 65 ANAFRANIL 6 anagrelide hcl 62 ANALPRAM E 84 ANALPRAM HC 85 ANAPROX 80 ANAPROX DS 80 ANASPAZ 111 anastrozole 88 ANCOBON 73 ANDRODERM 65 ANDROGEL 65 ANDROID 66 ANGELIQ 66 ANTABUSE 9 ANTARA 23 antipyrine-benzocaine 51 ANTIVERT 2 anucort-hc 85 ANUSOL-HC 85 ANZEMET 2 APEXICON E 38 APIDRA 48 APIDRA SOLOSTAR 48 APLENZIN 6 APOKYN 104 apraclonidine hcl 60 apri 26 APRISO 85 APTIOM 106 APTIVUS 76 AQUA GLYCOLIC HC 38 aranelle 26 ARANESP 62 ARAVA 80 arbinoxa 1 ARCALYST 80 ARCAPTA NEOHALER 3 ARESTIN 93

ARICEPT 5 ARIMIDEX 88 ARIXTRA 62, 63 ARMOUR THYROID 56 AROMASIN 88 ARTHROTEC 50 80 ARTHROTEC 75 80 ASACOL HD 85 ascomp with codeine 95 ASMANEX 4 ASMANEX HFA 4 aspirin-caffeine-dihydrocodein 95 ASTAGRAF XL 68 ASTEPRO 1 ASTRINGYN 63 ATACAND 16 ATACAND HCT 16 ATELVIA 54 atenolol 16 atenolol-chlorthalidone 16 ATIVAN 9 atorvastatin calcium 23 atovaquone 75 ATRALIN 32 ATRAPRO DERMAL SPRAY 42 ATRIPLA 76 atropine sulfate 60 ATROVENT 4, 93 ATROVENT HFA 4 AUBAGIO 92 aubra 26 AUGMENTIN 69 AUGMENTIN ES-600 69 AUGMENTIN XR 69 auroguard 51 AURYXIA 52 AVALIDE 16 AVANDAMET 48 AVANDARYL 48 AVANDIA 48 AVAPRO 16 AVAR 33, 34 AVAR LS 33 AVAR-E 34 AVAR-E GREEN 34 AVAR-E LS 34 AVC 115 AVELOX 69 AVELOX ABC PACK 69 aviane 26 AVIDOXY 69 AVINZA 95 avita 32 AVITENE 63 AVODART 113 AVONEX 92 AVONEX ADMINISTRATION PACK 92 AVONEX PEN 92 AXERT 95 AXIRON 66



119

AYGESTIN 66 AZASAN 68 AZASITE 57 azathioprine 68 azelastine hcl 1, 57 AZELEX 32 AZILECT 104 azithromycin 69 AZOPT 60 AZOR 16 AZULFIDINE 85 azurette 26

B

bacitracin 57 bacitracin-polymyxin 57 baclofen 109 BACTRIM 69 BACTRIM DS 69 BACTROBAN 34, 93 BACTROBAN NASAL 93 balsalazide disodium 85 balziva 26 BANZEL 106 BARACLUDE 76 BECONASE AQ 1 belladonna-opium 95 BELSOMRA 14 benazepril hcl 16 benazepril-hydrochlorothiazide 16 BENICAR 16, 17 BENICAR HCT 16, 17 BENSAL HP 42 BENTYL 111 BENZACLIN 32 BENZAMYCIN 34 BENZAMYCINPAK 34 BENZEFOAM 42 BENZEFOAM ULTRA 42 benzepro 42 benzonatate 30 benzoyl peroxide 42 benztropine mesylate 104 BEPREVE 57 BERINERT 80 BESIVANCE 57 BETADINE 42 BETAGAN 60 betamethasone dipropionate 38 betamethasone valerate 38 BETAPACE 17 BETAPACE AF 17 BETASERON 92 betaxolol hcl 17, 60 BETHKIS 74 BETIMOL 60 BETOPTIC S 60 BEYAZ 26

BIAXIN 69, 70 bicalutamide 88 BIDIL 17 BILTRICIDE 75 BINOSTO 54 BIONECT 42 bisoprolol fumarate 17 bisoprolol-hydrochlorothiazide 17 bleph-10 57 BLEPHAMIDE 57 BLEPHAMIDE S.O.P. 57 BONIVA 54 BOSULIF 88 bp 10-1 34 bp foam 42 bp-50% urea 42 bpm-dm-phen 30 bpo 42 brevicon 26 briellyn 26 BRILINTA 63 brimonidine tartrate 60 BRINTELLIX 6 BRISDELLE 6 bromfed dm 30 bromfenac sodium 57 bromocriptine mesylate 105 brompheniramine-pseudoephed-dm 30 BROVANA 4 budesonide 1, 4, 80 budesonide ec 80 bumetanide 17 BUNAVAIL 95, 96 BUPAP 96 BUPHENYL 86 buprenorphine hcl 96 buprenorphine-naloxone 96 bupropion hcl 6 bupropion hcl sr 6 bupropion xl 6 buspirone hcl 9, 10 butalb-acetaminoph-caff-codein 96 butalb-caff-acetaminoph-codein 96 butalbital compound-codeine 96 butalbital-acetaminophen-caffe 96 butalbital-aspirin-caffeine 96 BUTISOL SODIUM 10 butorphanol tartrate 96 BUTRANS 96 BYDUREON 48 BYDUREON PEN 48 BYETTA 48 BYSTOLIC 17

C

cabergoline 54 CADUET 25 CAFERGOT 96



120

caffeine citrate 4 CALAN 17 CALAN SR 17 calcipotriene 47 calcipotriene-betamethasone dp 47 calcitonin-salmon 54 calcitrene 47 calcitriol 47 calcium acetate 52 CAMBIA 96 camila 26 camrese 26 camrese lo 26 CANASA 85 candesartan cilexetil 17 candesartan-hydrochlorothiazid 17 CANTIL 112 capacet 96 capecitabine 88 CAPEX SHAMPOO 38 CAPITAL W-CODEINE 96 CAPRELSA 88 captopril 17 captopril-hydrochlorothiazide 17 captracin 42 CARAC 42 CARAFATE 112 CARBAGLU 86 carbamazepine 106 carbamazepine er 106 carbamazepine xr 106 CARBATROL 106 carbidopa 105 carbidopa-levodopa 105 carbidopa-levodopa er 105 carbidopa-levodopa-entacapone 105 carbinoxamine maleate 1 CARDENE SR 17 CARDIZEM 17 CARDIZEM CD 17 CARDIZEM LA 17 CARDURA 17 CARDURA XL 17 carisoprodol 96, 109 carisoprodol compound 96, 109 carisoprodol compound-codeine 96 carisoprodol-aspirin 96, 109 carisoprodol-aspirin-codeine 96 CARNITOR 93 CARNITOR SF 93 carteolol hcl 60 cartia xt 17 carvedilol 17 CASODEX 88 CATAPRES 17 CATAPRES-TTS 1 17 CATAPRES-TTS 2 17 CATAPRES-TTS 3 17 CAYSTON 70 caziant 26

CEDAX 70 cefaclor 70 cefaclor er 70 cefadroxil 70 cefdinir 70 cefditoren pivoxil 70 cefpodoxime proxetil 70 cefprozil 70 ceftibuten 70 CEFTIN 70 cefuroxime 70 CELEBREX 80 celecoxib 80 CELEXA 6 CELLCEPT 68 CELONTIN 106 cem-urea 42 CENTANY 34 CENTANY AT 34 centergy 31 centergy dm 31 cephalexin 70 CERDELGA 93 CERVIDIL 26 CESAMET 2 CETACAINE 42 CETACAINE ANESTHETIC 42 cetirizine hcl 1 CETRAXAL 51 chateal 27 CHEMET 93 CHENODAL 86 chlordiazepoxide hcl 10 chlordiazepoxide-amitriptyline 6 chlordiazepoxide-clidinium 112 chlorothiazide 17 chlorpromazine hcl 10 chlorpropamide 48 chlorthalidone 17 chlorzoxazone 109 cholestyramine 23 cholestyramine light 23 choline mag trisalicylate 96 CIALIS 53 CICLODAN 34 ciclopirox 34 cilostazol 63 CILOXAN 57 cimetidine 112 CIMZIA 85 CINRYZE 80 CIPRO 51, 70 CIPRO HC 51 CIPRO XR 70 CIPRODEX 51 ciprofloxacin 51, 57, 70 ciprofloxacin er 70 ciprofloxacin hcl 51, 57, 70 citalopram hbr 6 claravis 32



121

CLARIFOAM EF 34 CLARINEX 1 CLARINEX-D 12 HOUR 1 CLARIS 34 clarithromycin 70 clarithromycin er 70 cleansing wash 34 clemastine fumarate 1 CLEOCIN 34, 74, 115 CLEOCIN HCL 74 CLEOCIN PALMITATE 74 CLEOCIN T 34 CLIMARA 66 CLIMARA PRO 66 CLINDACIN ETZ 34 CLINDACIN P 34 CLINDACIN PAC 34 CLINDAGEL 34 clindamycin hcl 74 clindamycin palmitate hcl 74 clindamycin pediatric 74 clindamycin phos-benzoyl perox 32 clindamycin phosphate 34, 115 clindamycin-benzoyl peroxide 32 CLINDESSE 115 clobetasol emollient 38 clobetasol emulsion 38 clobetasol propionate 38 CLOBEX 38 clocortolone pivalate 38 CLODAN 38 CLODERM 38 clomipramine hcl 6 clonazepam 106 clonidine 10, 17 clonidine hcl 10, 17 clonidine hcl er 10 clopidogrel 63 clorazepate dipotassium 10 clorpres 17 clotrimazole 34, 35 clotrimazole-betamethasone 34, 35 clozapine 10 clozapine odt 10 CLOZARIL 10 CNL 8 35 cocaine hcl 42 codeine sulfate 96 CODEINE SULFATE 96 COLAZAL 85 colchicine 62 COLCRYS 62 COLESTID 23 colestipol hcl 23 colocort 85 COLY-MYCIN S 51 COLYTE WITH FLAVOR PACKETS 86 COLYTE WITH FLAVOR PACKS 86 COMBIGAN 60 COMBIPATCH 66

COMBIVENT RESPIMAT 4 COMBIVIR 76 COMETRIQ 88 COMPAZINE 2 COMPLERA 76 compro 2 COMTAN 105 CONCERTA 10 CONDYLOX 42 constulose 86 CONZIP 96 COPAXONE 92 COPEGUS 76 CORDARONE 14 CORDRAN 38 COREG 17 COREG CR 17 CORGARD 17 cormax 39 cortane-b 51 CORTANE-B 51 CORTEF 80 CORTENEMA 85 CORTIFOAM 85 cortisone acetate 80 CORTISPORIN 39, 51 CORTISPORIN-TC 51 CORZIDE 17 COSOPT 60 COSOPT PF 60 COUMADIN 63 covaryx 66 covaryx h.s. 66 COZAAR 18 CREON 110 CRESTOR 23 CRINONE 53, 66 CRIXIVAN 76 cromolyn sodium 4, 57 cryselle 27 CUPRIMINE 81 CUTIVATE 39 CUVPOSA 112 cyclafem 27 CYCLESSA 27 cyclobenzaprine hcl 109 CYCLOGYL 60 CYCLOMYDRIL 60 cyclopentolate hcl 60 CYCLOPHOSPHAMIDE 89 cycloserine 74 CYCLOSET 48 cyclosporine 68 cyclosporine modified 68 CYMBALTA 6 cyproheptadine hcl 1 CYSTADANE 94 CYSTAGON 113 CYSTARAN 61 CYTOMEL 56



122

CYTOTEC 112 cytra-2 113 cytra-3 113 cytra-k 113

D

DALIRESP 4 danazol 54 DANTRIUM 110 dantrolene sodium 110 dapsone 74 dasetta 27 DAYPRO 81 daysee 27 DAYTRANA 10 DDAVP 54 deblitane 27 delyla 27 DELZICOL 85 DEMADEX 18 demeclocycline hcl 70 DEMEROL 96 DEMSER 18 DENAVIR 35 depade 10 DEPAKENE 106 DEPAKOTE 106 DEPAKOTE ER 106 DEPAKOTE SPRINKLE 106 DEPEN 81 DEPO-PROVERA 27, 66 DEPO-SUBQ PROVERA 104 27 DEPO-TESTOSTERONE 66 DEPRIZINE 112 DERMA-SMOOTHE-FS 39 DERMASORB AF 32 DERMASORB HC 39 DERMASORB TA 39 DERMASORB XM 42 DERMATOP 39 dermazene 32 DERMOTIC 51 desipramine hcl 6 desloratadine 1 desmopressin acetate 54 DESOGEN 27 desogestrel-ethinyl estradiol 27 desogestr-eth estrad eth estra 27 DESONATE 39 desonide 39 DESOWEN 39 desoximetasone 39 DESOXYN 10 desvenlafaxine er 7 DESVENLAFAXINE ER 7 DESVENLAFAXINE FUMARATE ER 7 DETROL 114 DETROL LA 114

dexamethasone 57, 81 DEXAMETHASONE INTENSOL 81 dexamethasone sodium phosphate 57 DEXEDRINE 10 DEXILANT 112 dexmethylphenidate hcl 10 dexmethylphenidate hcl er 10 DEXPAK 81 dextroamphetamine sulfate 10 dextroamphetamine sulfate er 10 DIABETA 48 DIAMOX SEQUELS 60 DIASTAT 106 DIASTAT ACUDIAL 106 diazepam 10, 106 DIBENZYLINE 18 DICLEGIS 2 diclofenac potassium 81 diclofenac sodium 39, 42, 57, 81 diclofenac sodium er 81 diclofenac sodium-misoprostol 81 dicloxacillin sodium 71 DICOPANOL 1 dicyclomine hcl 111 didanosine 76 DIFFERIN 32 DIFICID 71 diflorasone diacetate 39 DIFLUCAN 73 diflunisal 96 digitek 15 digox 15 digoxin 15 DIGOXIN 15 dihydroergotamine mesylate 96 DILANTIN 106 DILANTIN-125 106 DILATRATE-SR 25 DILAUDID 96 diltiazem 12hr er 18 diltiazem 24hr cd 18 diltiazem 24hr er 18 diltiazem er 18 diltiazem hcl 18 dilt-xr 18 DIOVAN 18 DIOVAN HCT 18 DIPENTUM 85 diphenhydramine hcl 1 diphenoxylate-atropine 86 DIPROLENE 39 DIPROLENE AF 39 dipyridamole 63 DISALCID 96 DISKETS 96 disopyramide phosphate 14 disulfiram 10 DITROPAN XL 114 DIURIL 18 divalproex sodium 106



123

divalproex sodium er 106 DIVIGEL 66 DOLOPHINE HCL 96 donepezil hcl 5 donepezil hcl odt 5 DONNATAL 111 DORYX 71 dorzolamide hcl 60 dorzolamide-timolol 60 DOVONEX 47 doxazosin mesylate 18 doxepin hcl 7 doxercalciferol 54 doxycycline hyclate 71 doxycycline ir-dr 71 doxycycline monohydrate 71 DRISDOL 116 DRITHOCREME HP 47 dronabinol 2 drospirenone-ethinyl estradiol 27 DROXIA 63 DUAC 32 DUAVEE 66 DUETACT 48 DUEXIS 81 DULERA 4 duloxetine hcl 7 DURAGESIC 97 DUREZOL 57 DUTOPROL 18 DYAZIDE 18 DYMISTA 1 DYRENIUM 18

E

e.e.s. 200 71 e.e.s. 400 71 EC-NAPROSYN 81 econazole nitrate 35 ECOZA 35 EDARBI 18 EDARBYCLOR 18 EDECRIN 18 EDLUAR 10 ed-spaz 111 EDURANT 76 eemt 66 eemt h.s. 66 effer-k 52 EFFER-K 52 EFFEXOR XR 7 EFFIENT 63 EFUDEX 43 EGRIFTA 54 ELDEPRYL 105 elenzapatch 43 ELESTAT 57 ELESTRIN 66

ELIDEL 47 ELIGARD 54 ELIMITE 35 elinest 27 eliphos 52 ELIQUIS 63 elixophyllin 4 ELLA 27 ELMIRON 114 ELOCON 39 EMADINE 57 EMCYT 89 EMEND 2 EMLA 43 emoquette 27 EMSAM 10 EMTRIVA 76 ENABLEX 114 enalapril maleate 18 enalapril-hydrochlorothiazide 18 ENBREL 81 ENDO-AVITENE 63 endocet 97 endodan 97 ENJUVIA 66 enoxaparin sodium 63 enpresse 27 enskyce 27 entacapone 105 entecavir 76 ENTEREG 87 ENTOCORT EC 81 enulose 87 EPANED 18 EPIDUO 32 EPIFOAM 43 epinastine hcl 57 EPIPEN 2-PAK 88 EPIPEN JR 2-PAK 88 epitol 107 EPIVIR 76 EPIVIR HBV 76 eplerenone 18 EPOGEN 63 eprosartan mesylate 18 EPZICOM 76 EQUETRO 10 ergoloid mesylates 25 ERGOMAR 97 ERIVEDGE 89 errin 27 ERTACZO 35 ery 35, 71 ERYGEL 35 ERYPED 200 71 ERYPED 400 71 ery-tab 71 ERY-TAB 71 erythrocin stearate 71 erythromycin 35, 57, 71



124

erythromycin ethylsuccinate 71 erythromycin-benzoyl peroxide 35 ESBRIET 94 escitalopram oxalate 7 ESGIC 97 esomeprazole strontium 112 ESOMEPRAZOLE STRONTIUM 112 estarylla 27 estazolam 10 ESTRACE 66, 115 estradiol 66 estradiol-norethindrone acetat 66 ESTRING 115 ESTROGEL 66 estrogen & methyltestosterone 66 estrogen-methyltestosterone 66 estropipate 66 ESTROSTEP FE 27 eszopiclone 10 ethambutol hcl 74 ethosuximide 107 ethyl chloride 43 etidronate disodium 54 etodolac 81 etodolac er 81 etoposide 89 EURAX 35 EVAMIST 66 EVEKEO 10 EVISTA 54 EVOCLIN 35 EXALGO 97 EXELDERM 35 EXELON 5 exemestane 89 EXFORGE 18 EXFORGE HCT 18 EXJADE 94 exoderm 35 exotic-hc 52 EXTAVIA 92 EXTINA 35

F

FABIOR 32 FACTIVE 71 falmina 27 famciclovir 77 famotidine 112 FAMVIR 77 FANAPT 10, 11 FANATREX 107 FARESTON 89 FARXIGA 48 FARYDAK 94 FAZACLO 11 felbamate 107 FELBATOL 107

FELDENE 81 felodipine er 18 FEM PH 115 FEMARA 89 FEMCON FE 27 FEMHRT 66 FEMRING 115 fenofibrate 23 fenofibric acid 23 FENOGLIDE 24 fenoprofen calcium 81 FENOPROFEN CALCIUM 81 fentanyl 97 fentanyl citrate 97 FENTORA 97 FERRIPROX 94 FETZIMA 7 FEXMID 110 fexofenadine hcl 1 fexofenadine-pse er 1 FIBRICOR 24 FINACEA 32 finasteride 114 FIORICET 97, 98 FIORICET WITH CODEINE 98 FIORINAL 98 FIORINAL WITH CODEINE #3 98 FIRAZYR 81 FIRST-HYDROCORTISONE 39 FIRST-LANSOPRAZOLE 112 FIRST-OMEPRAZOLE 112 FIRST-TESTOSTERONE 66 FIRST-TESTOSTERONE MC 66 FLAGYL 75 FLAGYL ER 75 FLAREX 57 flavoxate hcl 114 flecainide acetate 14 FLECTOR 39 FLOMAX 114 FLO-PRED 81 FLOVENT DISKUS 4 FLOVENT HFA 4 flucaine 57 fluconazole 73 flucytosine 73 fludrocortisone acetate 81 FLUMADINE 77 flunisolide 1 fluocinolone acetonide 39, 52 fluocinolone acetonide oil 52 fluocinonide 39, 40 fluocinonide-e 40 FLUORESCEIN-BENOXINATE 57 fluorescein-proparacaine 57 fluorometholone 58 FLUOROPLEX 43 fluorouracil 43 fluoxetine dr 7 fluoxetine hcl 7



125

FLUOXETINE HCL 7 fluphenazine hcl 11 flurazepam hcl 11 flurbiprofen 58, 81 flurbiprofen sodium 58 FLUROX 58 flutamide 89 fluticasone propionate 1, 40 fluvastatin sodium 24 fluvoxamine maleate 7 fluvoxamine maleate er 7 FML 58 FML FORTE 58 FML S.O.P. 58 FOCALIN 11 FOCALIN XR 11 folic acid 116 fondaparinux sodium 63 FORADIL 4 FORFIVO XL 7 FORTAMET 48 FORTEO 54 FORTESTA 66 FORTICAL 54 FOSAMAX 54 FOSAMAX PLUS D 54 fosinopril sodium 18 fosinopril-hydrochlorothiazide 18 FOSRENOL 52 FRAGMIN 63, 64 FROVA 98 FULYZAQ 87 FURADANTIN 71 furosemide 19 FUZEON 77 FYCOMPA 107

G

gabapentin 107 GABITRIL 107 galantamine hbr 6 galantamine hydrobromide 6 GALZIN 94 GARAMYCIN 58 GASTROCROM 4 gatifloxacin 58 GATTEX 87 gavilyte-c 87 gavilyte-g 87 gavilyte-n 87 GELFILM 61 GELFOAM 64 GELFOAM COMPRESSED 64 GELNIQUE 114 gemfibrozil 24 GENERESS FE 27 generlac 87 gengraf 68

GENOTROPIN 54 gentak 58 gentamicin sulfate 35, 58 GEODON 11 gianvi 27 GIAZO 85 gildagia 27 gildess 27 gildess 24 fe 27 gildess fe 27 GILENYA 92 GILOTRIF 89 GLEEVEC 89 GLEOSTINE 89 glimepiride 48 glipizide 48 glipizide er 48 glipizide xl 48 glipizide-metformin 48 GLUCOPHAGE 48 GLUCOPHAGE XR 48 GLUCOTROL 48 GLUCOTROL XL 48 GLUCOVANCE 48 GLUMETZA 48 glyburide 48 glyburide micronized 48 glyburide-metformin hcl 48 glycopyrrolate 112 GLYNASE 48 GLYSET 49 GLYXAMBI 49 GOLYTELY 87 goniovisc 58 GORDO-UREA 43, 47 GRALISE 92 granisetron hcl 2 granulex 43 GRIFULVIN V 73 griseofulvin 73 griseofulvin ultramicrosize 73 GRIS-PEG 73 grx hicort 25 85 guanfacine hcl 11, 19 guanfacine hcl er 11 GYNAZOLE 1 115

H

H.P. ACTHAR 54 HALCION 11 halobetasol propionate 40 HALOG 40 haloperidol 11 haloperidol lactate 11 HARVONI 77 heather 27 HECTOROL 55 HEMANGEOL 19



126

HEPSERA 77 HETLIOZ 11 HEXALEN 89 HIPREX 71 HIZENTRA 67 homatropaire 60 homatropine hydrobromide 60 HORIZANT 92 HUMALOG 49 HUMALOG MIX 50-50 49 HUMALOG MIX 75-25 49 HUMATROPE 55 HUMIRA 81, 82 HUMULIN 70/30 KWIKPEN 49 HUMULIN 70-30 49 HUMULIN N 49 HUMULIN N KWIKPEN 49 HUMULIN R 49 HYCAMTIN 89 HYCET 98 hydralazine hcl 19 HYDREA 89 HYDRO 35 43 HYDRO 40 43 hydrochlorothiazide 19 hydrocod-cpm-pseudoephedrine 31 hydrocodone bt-homatropine mbr 31 hydrocodone-acetaminophen 98 hydrocodone-chlorpheniramne er 31 hydrocodone-homatropine mbr 31 hydrocodone-ibuprofen 98 hydrocortisone 32, 40, 43, 52, 82, 85 hydrocortisone acetate 85 hydrocortisone butyrate 40 hydrocortisone valerate 40 hydrocortisone-acetic acid 52 hydrocortisone-iodoquinol 32 hydrocortisone-pramoxine 43, 85 hydrocortisone-pramoxine hcl 43 hydromet 31 hydromorphone er 98 hydromorphone hcl 98 hydroxychloroquine sulfate 75 hydroxyurea 89 hydroxyzine hcl 1 hydroxyzine pamoate 1 HYDROXYZINE PAMOATE 1 hyophen 71 hyoscyamine sulfate 111 hyoscyamine sulfate er 111 hyoscyamine sulfate sr 111 hyosyne 111 HYZAAR 19

I

ibandronate sodium 55 IBRANCE 94 IBUDONE 98

ibuprofen 82 ICLUSIG 89 ILEVRO 58 ILOTYCIN 58 IMBRUVICA 89 imipramine hcl 7 imipramine pamoate 7 imiquimod 68 IMITREX 98 IMURAN 68 INCRELEX 55 indapamide 19 INDERAL LA 19 INDERAL XL 19 INDOCIN 82 indomethacin 82 INLYTA 89 INNOPRAN XL 19 INOVA 43 INOVA 4-1 43 INOVA 8-2 43 INSPRA 19 INTELENCE 77 INTERMEZZO 11 INTRON A 68 introvale 27 INTUNIV 11 INVEGA 11 INVEGA SUSTENNA 11 INVIRASE 77 INVOKAMET 49 INVOKANA 49 IODOFLEX 32 IODOSORB 32 IOPIDINE 61 ipratropium bromide 4, 93 ipratropium-albuterol 4 IPRIVASK 64 irbesartan 19 irbesartan-hydrochlorothiazide 19 ISENTRESS 77 ISOCHRON 25 isomethept-caff-acetaminophen 98 isomethept-dichloralp-acetamin 99 isoniazid 74 ISOPTO ATROPINE 61 ISOPTO CARPINE 61 ISORDIL 25 ISORDIL TITRADOSE 25 isosorbide dinitrate 25 isosorbide mononitrate 25 isosorbide mononitrate er 25 isoxsuprine hcl 25 isradipine 19 ISTALOL 61 itraconazole 74 ivermectin 75



127

J

JAKAFI 89 JALYN 114 jantoven 64 JANUMET 49 JANUMET XR 49 JANUVIA 49 JARDIANCE 49 jencycla 27 JENTADUETO 49 jinteli 66 jolessa 27 jolivette 27 JUBLIA 35 junel 28 junel fe 28 JUXTAPID 24

K

k effervescent 52 KADIAN 99 KALETRA 77 KALYDECO 94 KAPVAY 11 KARBINAL ER 1 kariva 28 KAYEXALATE 52 KAZANO 49 KEFLEX 71 kelnor 1-35 28 KENALOG 40 KEPPRA 107 KEPPRA XR 107 KERAFOAM 43 KERALAC 43 KERALYT 43 KERALYT SCALP 43 KERYDIN 35 KETEK 71 ketoconazole 35, 74 KETODAN 35 ketoprofen 82 ketorolac tromethamine 58, 82 KHEDEZLA 7 KINERET 82 kionex 52 KITABIS PAK 74 KLARON 32 KLONOPIN 107 KLOR-CON 52, 53 KLOR-CON 10 52 KLOR-CON 8 52 klor-con m10 53 klor-con m15 53 klor-con m20 53 KLOR-CON-EF 53

KOMBIGLYZE XR 50 KORLYM 50 K-PHOS NEUTRAL 114 K-PHOS NO.2 114 K-PHOS ORIGINAL 114 KRISTALOSE 87 K-SOL 52 K-TAB ER 52 kurvelo 28 KUVAN 94 KYNAMRO 24

L

labetalol hcl 19 LACRISERT 61 lactulose 87 LAMICTAL 107 LAMICTAL (BLUE) 107 LAMICTAL (GREEN) 107 LAMICTAL (ORANGE) 107 LAMICTAL ODT 107 LAMICTAL ODT (BLUE) 107 LAMICTAL ODT (GREEN) 107 LAMICTAL ODT (ORANGE) 107 LAMICTAL XR 107 LAMICTAL XR (BLUE) 107 LAMICTAL XR (GREEN) 107 LAMICTAL XR (ORANGE) 107 LAMISIL 74 lamivudine 77 lamivudine hbv 77 lamivudine-zidovudine 77 lamotrigine 107, 108 lamotrigine er 108 lamotrigine odt 108 LANOXIN 15 LANPARZA 94 lansoprazol-amoxicil-clarithro 112 lansoprazole 112 LANTUS 50 LANTUS SOLOSTAR 50 larin 28 larin fe 28 LASIX 19 LASTACAFT 58 latanoprost 61 latrix 43 latrix xm 43 LATUDA 11 LAZANDA 99 leena 28 leflunomide 82 LENVIMA 89 LESCOL 24 LESCOL XL 24 lessina 28 LETAIRIS 19 letrozole 89



128

leucovorin calcium 89 LEUKERAN 89 leuprolide acetate 55 LEVACET 99 levalbuterol concentrate 4 levalbuterol hcl 4 LEVAQUIN 71 LEVATOL 19 LEVBID 111 LEVEMIR 50 LEVEMIR FLEXTOUCH 50 levetiracetam 108 levetiracetam er 108 levobunolol hcl 61 levocarnitine 94 levocetirizine dihydrochloride 1 levofloxacin 58, 71 levonest 28 levonorgestrel 28 levonorgestrel-eth estradiol 28 levonorg-eth estrad eth estrad 28 levora-28 28 levorphanol tartrate 99 levothyroxine sodium 56 LEVOXYL 56 LEVSIN 111 LEVSIN-SL 111 LEVULAN 89 LEXAPRO 7 LEXIVA 77 LIALDA 85 LIBRAX 112 lidocaine 43, 84, 85 lidocaine hcl 43, 84 lidocaine hcl viscous 84 lidocaine-hydrocortisone 43, 85 lidocaine-prilocaine 43 LIDODERM 43 LIDODEXTRAPINE 43 LIDOPIN 43 LIDORX 43 LIDOVIR 35 lindane 35 LINZESS 85 liothyronine sodium 56 LIPITOR 24 LIPOCHOL PLUS 24 LIPOFEN 24 LIPTRUZET 24 lisinopril 19 lisinopril-hydrochlorothiazide 19 lithium 11, 12 lithium carbonate 12 lithium carbonate er 12 LITHOBID 12 LITHOSTAT 87 LIVALO 24 LO LOESTRIN FE 28 LOCOID 40 LOCOID LIPOCREAM 40

LODOSYN 105 LOESTRIN 28 LOESTRIN FE 28 LOFIBRA 24 lohist-dm 31 lomedia 24 fe 28 LOMOTIL 87 lomustine 90 loperamide 87 LOPID 24 lopreeza 66 LOPRESSOR 19 LOPRESSOR HCT 19 LOPROX 35 lorazepam 12 lorazepam intensol 12 lorcet 99 lorcet hd 99 lorcet plus 99 LORENZA 43 LORTAB 99 loryna 28 LORZONE 110 losartan potassium 19 losartan-hydrochlorothiazide 19 LOSEASONIQUE 28 LOTEMAX 58 LOTENSIN 19 LOTENSIN HCT 19 LOTREL 19 LOTRISONE 35 LOTRONEX 87 lovastatin 24 LOVAZA 24 LOVENOX 64 low-ogestrel 28 loxapine 12 LUFYLLIN 4 LUMIGAN 61 LUNESTA 12 LUPRON DEPOT 55 lutera 28 LUXIQ 40 LUZU 35 LYCELLE 35 LYRICA 108 LYSODREN 90 LYSTEDA 64 lyza 28

M

MAC 44 MACROBID 71 MACRODANTIN 71 magnebind 400 rx 53 malathion 35 maprotiline hcl 7 margesic 99



129

MARINOL 2 marlexate 53 marlissa 28 MARPLAN 7 marten-tab 99 MATULANE 90 matzim la 19 MAVIK 19 MAXALT 99 MAXALT MLT 99 MAXIDEX 58 MAXITROL 58 MAXZIDE 19 MAXZIDE-25 MG 19 meclizine hcl 2 meclofenamate sodium 82 MEDROL 82 medroxyprogesterone acetate 66 mefenamic acid 82 MEGACE 94 MEGACE ES 94 megestrol acetate 90, 94 MEKINIST 90 meloxicam 82 memantine 6 MENEST 67 MENOSTAR 67 MENTAX 35 meperidine hcl 99 meperitab 99 MEPHYTON 64 meprobamate 12 MEPRON 75 mercaptopurine 90 mesalamine 85, 86 MESNEX 90 MESTINON 6 METADATE CD 12 METADATE ER 12 metaproterenol sulfate 4 metaxalone 110 metformin hcl 50 metformin hcl er 50 methadone hcl 99 methadone intensol 99 methadose 100 METHADOSE 100 methamphetamine hcl 12 methazolamide 61 methenamine hippurate 71 methenamine mandelate 71 methimazole 56 METHITEST 67 methocarbamol 110 methotrexate 90 methoxsalen 47 methscopolamine bromide 111 methyclothiazide 19 methyldopa 19 methyldopa-hydrochlorothiazide 19

methylergonovine maleate 28 METHYLIN 12 methylphenidate er 12 methylphenidate hcl 12 methylphenidate hcl cd 12 methylphenidate la 12 methylprednisolone 82 metipranolol 61 metoclopramide hcl 112 metolazone 20 metoprolol succinate 20 metoprolol tartrate 20 metoprolol-hydrochlorothiazide 20 METOZOLV ODT 112 METROCREAM 32 METROGEL 32, 115 METROGEL-VAGINAL 115 METROLOTION 32 metronidazole 32, 75, 115 mexiletine hcl 15 MIACALCIN 55 MICARDIS 20 MICARDIS HCT 20 miconazole 3 115 microgestin 28 microgestin fe 28 MICROZIDE 20 midazolam hcl 12 midodrine hcl 25 MIFEPREX 94 MIGERGOT 100 migragesic ida 100 MIGRANAL 100 MILLIPRED 82 MILLIPRED DP 82 mimvey 67 mimvey lo 67 MINASTRIN 24 FE 28 MINIPRESS 20 minitran 25 MINIVELLE 67 MINOCIN 71 minocycline hcl 72 minoxidil 20 MIRAPEX 105 MIRAPEX ER 105 MIRCETTE 28 mirtazapine 7 MIRVASO 33 misoprostol 112 MITIGARE 62 MOBIC 82 modafinil 12 MODERIBA 77 MODICON 28 moexipril hcl 20 moexipril-hydrochlorothiazide 20 mometasone furoate 40 MONODOX 72 mono-linyah 28



130

mononessa 28 montelukast sodium 4 MONUROL 72 MORGIDOX 72 morphine sulfate 100 MORPHINE SULFATE 100 morphine sulfate er 100 MOTOFEN 87 MOVIPREP 87 MOXATAG 72 MOXEZA 58 moxifloxacin hcl 72 MS CONTIN 100 mucotrol 94 MULTAQ 15 mupirocin 35, 36 MYALEPT 55 MYAMBUTOL 74 MYCOBUTIN 74 mycophenolate mofetil 68 mycophenolic acid 68 MYDRIACYL 61 MYFORTIC 68 MYLERAN 90 myorisan 33 MYRBETRIQ 114 MYSOLINE 108 myzilra 28

N

nabumetone 82 nadolol 20 nadolol-bendroflumethiazide 20 NAFTIN 36 NALFON 82 naltrexone hcl 12 NAMENDA 6 NAMENDA XR 6 naphazoline hcl 58 NAPRELAN 82 NAPROSYN 82, 83 naproxen 83 naproxen sodium 83 naratriptan 100, 101 naratriptan hcl 100, 101 NARDIL 7 NASONEX 1 NATACYN 58 NATAZIA 28 nateglinide 50 NATROBA 36 nature-throid 56 NEBUPENT 76 necon 28 nefazodone hcl 7 neomycin sulfate 74 neomycin-bacitracin-poly-hc 58 neomycin-bacitracin-polymyxin 58

neomycin-polymyxin-dexameth 58 neomycin-polymyxin-gramicidin 58 neomycin-polymyxin-hc 52, 58 neomycin-polymyxin-hydrocort 52 neo-polycin 58 neo-polycin hc 58 NEORAL 68 NEOSPORIN 58 NEO-SYNALAR 40 NEPTAZANE 61 NESINA 50 neuac 33 NEULASTA 64 NEUMEGA 64 NEUPOGEN 64 NEUPRO 105 NEURONTIN 108 NEUVAXIN 44 NEVANAC 58 nevirapine 77 nevirapine er 77 NEXAVAR 90 niacin er 24 niacor 24 NIASPAN 24 nicardipine hcl 20 nifedical xl 20 nifedipine 20 nifedipine er 20 nikki 28 NILANDRON 90 nimodipine 20 nisoldipine 20 NITRO-BID 26 NITRO-DUR 26 nitrofurantoin 72 nitrofurantoin mono-macro 72 nitroglycerin 26 nitroglycerin patch 26 NITROLINGUAL 26 NITROMIST 26 NITROSTAT 26 nitro-time 26 nizatidine 112 NIZORAL 36 nodolor 101 nora-be 29 NORCO 101 NORDITROPIN FLEXPRO 55 NORDITROPIN NORDIFLEX 55 norethindrone 29, 67 norethindrone acetate 67 norethindron-ethinyl estradiol 29 norethin-eth estra ferrous fum 29 norgestimate-ethinyl estradiol 29 norinyl 1+35 29 NORINYL 1+50 29 NORITATE 33 norlyroc 29 NORPACE 15



131

NORPACE CR 15 NORPRAMIN 8 NOR-Q-D 29 nortrel 29 nortriptyline hcl 8 NORVASC 20 NORVIR 77 NOVACORT 44 NOVOLIN 70-30 50 NOVOLIN N 50 NOVOLIN R 50 NOVOLOG 50 NOVOLOG FLEXPEN 50 NOVOLOG MIX 70-30 50 NOVOLOG MIX 70-30 FLEXPEN 50 NOXAFIL 74 np thyroid 56 NUCORT 40 NUCYNTA 101 NUCYNTA ER 101 NUEDEXTA 92 NULEV 111 NULYTELY WITH FLAVOR PACKS 87 NUOX 44 NUTROPIN AQ 55 NUTROPIN AQ NUSPIN 55 NUVARING 29 NUVIGIL 12 nyamyc 36 NYMALIZE 20 nystatin 36, 74 nystatin-triamcinolone 36 nystop 36

O

OBREDON 31 ocella 29 OCUFEN 59 OCUFLOX 59 OFEV 94 ofloxacin 52, 59, 72 ogestrel 29 olanzapine 12 olanzapine odt 12 olanzapine-fluoxetine hcl 12 OLEPTRO ER 8 olopatadine hcl 2 OLUX 40 OLUX-E 40 OLYSIO 77 OMECLAMOX-PAK 112 omega-3 acid ethyl esters 24 omeprazole 112, 113 omeprazole+syrspend sf alka 112 omeprazole-sodium bicarbonate 113 OMNARIS 2 OMNIPRED 59 OMNITROPE 55

ondansetron hcl 2 ondansetron odt 3 ONEXTON 33 ONFI 108 ONGLYZA 50 ONMEL 74 OPANA 101 OPANA ER 101 opium tincture 87 OPSUMIT 20 ORACEA 72 ORACIT 114 ORAP 12 ORAPRED ODT 83 ORAVIG 74 ORENCIA 83 ORENITRAM ER 20 ORFADIN 94 orphenadrine citrate 110 orsythia 29 ORTHO EVRA 29 ORTHO MICRONOR 29 ORTHO TRI-CYCLEN 29 ORTHO TRI-CYCLEN LO 29 ORTHO-CEPT 29 ORTHO-CYCLEN 29 ORTHO-NOVUM 29 oscimin 111 oscimin sl 111 oscimin sr 111 OSENI 50 OSMOPREP 87 OSPHENA 55 OTEZLA 83 OTIC CARE 52 OTICIN 52 OTICIN HC 52 oto-end 10 52 otomax-hc 52 OTOZIN 52 OTREXUP 83 OVACE 44 OVACE PLUS 44 OVACE PLUS WASH 44 OVCON-35 29 OVIDE 36 OXALIS 44 OXANDRIN 67 oxandrolone 67 oxaprozin 83 oxazepam 12 oxcarbazepine 108 OXECTA 101 OXISTAT 36 OXSORALEN-ULTRA 47 OXTELLAR XR 108 oxybutynin chloride 114 oxybutynin chloride er 114 oxycodone hcl 101 oxycodone hcl er 101



132

oxycodone hcl-aspirin 101 oxycodone hcl-ibuprofen 101 oxycodone-acetaminophen 101 OXYCONTIN 101, 102 oxymorphone hcl 102 oxymorphone hcl er 102 OXYTROL 114

P

pacerone 15 PACNEX 44 PACNEX HP 44 PACNEX LP 44 PACNEX MX 44 PAIN EASE 44 PAIN RELIEF 44 PAMELOR 8 PANCREAZE 110 pancrelipase 5,000 110 PANDEL 40 PANRETIN 44 pantoprazole sodium 113 PARAFON FORTE DSC 110 paregoric 87 PAREMYD 61 paricalcitol 55 PARLODEL 105 PARNATE 8 paromomycin sulfate 76 paroxetine hcl 8 PASER 75 PATADAY 59 PATANASE 2 PATANOL 59 PAXIL 8 PAXIL CR 8 PAZEO 59 PCE 72 PEDIADERM AF 36 PEDIADERM HC 40 PEDIADERM TA 41 PEDIAPRED 83 peg 3350-electrolyte 87 peg-3350 87 peg-3350 and electrolytes 87 peg-3350 with flavor packs 87 PEGANONE 108 PEGASYS 77 PEGASYS PROCLICK 77 PEGINTRON 77, 78 PEGINTRON REDIPEN 78 penicillin v potassium 72 PENLAC 36 PENNSAID 41 PENTASA 86 pentazocine-naloxone hcl 102 pentoxifylline 64 PEPCID 113

PERCOCET 102 PERCODAN 102 PERFOROMIST 4 perindopril erbumine 20 permethrin 36 perphenazine 8, 12 perphenazine-amitriptyline 8 PERSANTINE 64 PERTZYE 110 PEXEVA 8 phenadoz 3 phenazopyridine hcl 114 phenelzine sulfate 8 PHENERGAN 3 phenobarbital 12, 13 phenylephrine hcl 59 PHENYTEK 108 phenytoin 108 phenytoin sodium extended 108 philith 29 PHOSLO 53 PHOSLYRA 53 phospha 250 neutral 114 PHOSPHASAL 72 PHOSPHOLINE IODIDE 61 PICATO 44 pilocarpine hcl 61 pimtrea 29 pindolol 20 pinnacaine 52 pioglitazone hcl 50 pioglitazone-glimepiride 50 pioglitazone-metformin 50 pirmella 29 piroxicam 83 PLAN B ONE-STEP 29 PLAQUENIL 76 PLAVIX 64 PLEGRIDY 92 PLEGRIDY PEN 92 PLETAL 64 PLEXION 36 podocon-25 44 podofilox 44 polycin 59 polyethylene glycol 3350 87 polymyxin b sul-trimethoprim 59 POLYTRIM 59 POMALYST 90 PONSTEL 83 PONTOCAINE 44 portia 29 potass cit-sod cit-citric acid 114 potassium bicarbonate 53 potassium chloride 53 potassium citrate er 114 potassium citrate-citric acid 114 potassium hydroxide 44 POTIGA 108 pr cream 44



133

PRADAXA 64 PRAMCORT 86 pramipexole dihydrochloride 105 pramipexole er 105 PRAMOSONE 44 PRAMOSONE E 44 PRANDIMET 51 PRANDIN 51 PRAVACHOL 24 pravastatin sodium 24 prazosin hcl 20 PRE-ATTACHED LTA KIT 44 PRECOSE 51 PRED FORTE 59 PRED MILD 59 PRED-G 59 prednicarbate 41 prednisolone 59, 83 prednisolone acetate 59 prednisolone sodium phosphate 59, 83 prednisone 83 PREDNISONE INTENSOL 83 PREFEST 67 PREMARIN 67, 115 PREMPHASE 67 PREMPRO 67 PREPIDIL 29 PREPOPIK 87 PREVACID 113 prevalite 24 previfem 29 PREVPAC 113 PREZISTA 78 PRIFTIN 75 PRILOSEC 113 primidone 108 PRIMLEV 102 PRIMSOL 72 PRINIVIL 20 PRISTIQ ER 8 PROAIR HFA 4 probenecid 62 probenecid-colchicine 62 PROCARDIA 20 PROCARDIA XL 20 PROCENTRA 13 prochlorperazine maleate 3 PROCORT 86 PROCRIT 64, 65 PROCTOCORT 86 PROCTOFOAM-HC 86 procto-pak 86 proctosol-hc 86 proctozone-hc 86 PROCYSBI 114 prodrin 102 progesterone 67 PROGLYCEM 51 PROGRAF 68 PROLENSA 59

PROMACTA 65 promethazine hcl 2, 3 promethazine vc 31 promethazine vc-codeine 31 promethazine-codeine 31 promethazine-dm 31 promethegan 3 PROMETRIUM 67 PROMISEB 44 propafenone hcl 15 propafenone hcl er 15 propantheline bromide 113 proparacaine hcl 59 propranolol hcl 20 propranolol hcl er 20 propranolol-hydrochlorothiazid 20 propylthiouracil 56 PROSCAR 114 PROSED-DS 72 PROSTIN E2 VAGINAL SUPPOSITORY 29 PROTONIX 113 PROTOPIC 47 protriptyline hcl 8 PROVENTIL HFA 4 PROVENZA 44 PROVERA 67 PROVIGIL 13 PROZAC 8 PROZAC WEEKLY 8 PRUDOXIN 42 PULMICORT 4 PULMICORT FLEXHALER 4 PURINETHOL 90 PURIXAN 90 PYLERA 113 pyrazinamide 75 PYRIDIUM 114 pyridostigmine bromide 6 PYROGALLIC ACID 47

Q

QNASL 2 QNASL CHILDREN 2 QROXIN 44 QUARTETTE 29 quasense 29 QUDEXY XR 108 QUESTRAN 24 QUESTRAN LIGHT 24 quetiapine fumarate 13 QUILLIVANT XR 13 quinapril hcl 21 quinapril-hydrochlorothiazide 21 quinidine gluconate 15 quinidine sulfate 15 QUTENZA 44 QVAR 5



134

R

rabeprazole sodium 113 RADIAPLEXRX 44 RADIOGARDASE 94 raloxifene hcl 55 ramipril 21 RANEXA 25 ranitidine hcl 113 RAPAFLO 114 RAPAMUNE 68 RASUVO 83 RAVICTI 87 RAYOS 83 RAZADYNE 6 RAZADYNE ER 6 REA LO 39 44 REA LO 40 44 REBETOL 78 REBIF 92, 93 REBIF REBIDOSE 93 RECIPHEXAMINE 45 reclipsen 29 RECOTHROM 65 RECTACORT-HC 86 RECTIV 86 REGENECARE 45 REGLAN 113 REGRANEX 51 RELAGARD 115 RELENZA 78 RELISTOR 87 RELPAX 102 REMERON 8 remeven 45 RENAGEL 53 RENOVO 45 RENVELA 53 repaglinide 51 reprexain 102 REQUIP 105 REQUIP XL 105 RESCRIPTOR 78 RESCULA 61 reserpine 21 respa a.r. 31 RESTASIS 59 RESTORIL 13 RETIN-A 33 RETIN-A MICRO 33 RETIN-A MICRO PUMP 33 RETROVIR 78 REVATIO 21 REVIA 13 REVLIMID 90 REYATAZ 78 REZIRA 31 RHEUMATREX 84 RHINOCORT AQUA 2 ribapak 78

ribasphere 78 RIBATAB 78, 79 ribavirin 79 RIDAURA 84 rifabutin 75 RIFADIN 75 RIFAMATE 75 rifampin 75 RIFATER 75 RILUTEK 93 riluzole 93 rimantadine hcl 79 RIOMET 51 risedronate sodium 55 RISPERDAL 13 RISPERDAL M-TAB 13 risperidone 13 risperidone odt 13 RITALIN 13 RITALIN LA 13 rivastigmine 6 rizatriptan 102 ROBAXIN 110 ROBAXIN-750 110 ROBINUL 113 ROBINUL FORTE 113 ropinirole hcl 105 rosadan 33 ROSADAN 33 ROSANIL 36 ROSULA 36 ROWASA 86 roxicet 102 ROXICODONE 102 ROZEREM 13 RUCONEST 84 RYTARY 105 RYTHMOL 15 RYTHMOL SR 15

S

SABRIL 108, 109 SAFYRAL 29 SAIZEN 55 salacyn 45 SALACYN 45 SALEX 45 salicylic acid 45 salkera 45 SALKERA 45 salsalate 102 salvax 45 SALVAX DUO PLUS 45 SAMSCA 53 SANCUSO 3 SANDIMMUNE 68 SANTYL 45 SAPHRIS 13



135

SARAFEM 8 SAVELLA 93 SCALACORT 41 SCALACORT DK 41 SEASONIQUE 29 seb-prev 45 SECONAL SODIUM 13 SECTRAL 21 selegiline hcl 105 selenium sulfide 45 SELRX 45 SELZENTRY 79 SEMPREX-D 2 SENSIPAR 55 SEREVENT DISKUS 5 SEROQUEL 13 SEROQUEL XR 13 SEROSTIM 55 sertraline hcl 8 SFROWASA 86 sharobel 29 SIGNIFOR 94 sildenafil 21 SILENOR 13 SILVADENE 36 silver nitrate 33, 45 silver nitrate applicator 45 silver sulfadiazine 36 SIMBRINZA 61 SIMCOR 25 SIMPONI 84 simvastatin 25 SINELEE 45 SINEMET 10-100 105 SINEMET 25-100 105 SINEMET 25-250 105 SINEMET CR 105 SINGULAIR 5 sirolimus 68 SIRTURO 75 SITAVIG 79 SIVEXTRO 72 SKELAXIN 110 SKLICE 36 sodium citrate & citric acid 114 sodium fluoride 116 sodium phenylbutyrate 87 sodium polystyrene sulfonate 53 sodium sulfacetamide 33, 36, 37, 45 sodium sulfacetamide-sulfur 36, 37 SOLARAZE 45 SOLODYN 72 SOLTAMOX 90 SOMA 110 SOMATULINE DEPOT 94 SOMAVERT 55, 56 SONATA 13 SOOLANTRA 33 SORIATANE 47 SORILUX 47

sorine 21 sotalol 21 sotalol af 21 SOTYLIZE 21 SOVALDI 79 SPECTRACEF 72 spinosad 37 SPIRIVA 5 SPIRIVA RESPIMAT 5 spironolactone 21 spironolactone-hctz 21 SPORANOX 74 SPRAY AND STRETCH 45 sprintec 30 SPRIX 84 SPRYCEL 90 sps 53 SPS 53 sronyx 30 SS 10-2 37 ssd 37 sski 56 sss 10-5 37 STALEVO 100 105 STALEVO 125 105 STALEVO 150 105 STALEVO 200 105 STALEVO 50 105 STALEVO 75 105 STARLIX 51 stavudine 79 STELARA 84 STIMATE 56 STIVARGA 90 STRATTERA 13 STRIANT 67 STRIBILD 79 STRIVERDI RESPIMAT 5 STROMECTOL 76 strong iodine 56 SUBOXONE 102 SUBSYS 102, 103 SUCLEAR 87 SUCRAID 110 sucralfate 113 SULAR 21 sulfacetamide sodium 33, 46, 59 sulfacetamide-prednisolone 59 sulfacleanse 8-4 37 sulfadiazine 86 sulfamethoxazole-trimethoprim 72 SULFAMYLON 37 sulfasalazine 86 sulfasalazine dr 86 sulfatrim 72 sulfazine 86 sulfazine ec 86 sulindac 84 SUMADAN 37 sumatriptan 103



136

sumatriptan succinate 103 SUMAVEL DOSEPRO 103 SUMAXIN 37 SUMAXIN CP 37 SUMAXIN TS 37 SUPRAX 72 SUPREP 87 SURMONTIL 8 SUSTIVA 79 SUTENT 90 syeda 30 SYLATRON 90, 91 SYLATRON 4-PACK 91 SYMAX 111 SYMAX DUOTAB 111 SYMAX-SL 111 SYMAX-SR 111 SYMBICORT 5 SYMBYAX 13 SYMLINPEN 120 51 SYMLINPEN 60 51 SYNALAR 41 SYNALAR TS 41 SYNALGOS-DC 103 SYNAPRYN 94 SYNAREL 56 SYNERA 46 SYNTHROID 56 SYNVEXIA 46 SYPRINE 94 SYRINGE AVITENE 65

T

TABLOID 91 TACHOSIL 65 TACLONEX 47 tacrolimus 47, 69 TAFINLAR 91 TAMIFLU 79 tamoxifen citrate 91 tamsulosin hcl 115 TANZEUM 51 TAPAZOLE 56 TARCEVA 91 TARGRETIN 46, 91 tarina fe 30 TARKA 21 taron-crystals 115 TASIGNA 91 TASMAR 105 TAZORAC 47 taztia xt 21 TECFIDERA 93 TEGRETOL 109 TEGRETOL XR 109 TEKAMLO 21 TEKTURNA 21 TEKTURNA HCT 21

telmisartan 21 telmisartan-amlodipine 21 telmisartan-hydrochlorothiazid 21 temazepam 14 TEMODAR 91 TEMOVATE 41 TEMOVATE EMOLLIENT 41 temozolomide 91 tencon 103 TENEX 21 TENORETIC 100 21 TENORETIC 50 21 TENORMIN 21 TERAZOL 7 115 terazosin hcl 21 terbinafine hcl 74 terbutaline sulfate 5 terconazole 116 TERSI FOAM 46 TESSALON PERLE 31 TESTIM 67 testosterone 67 testosterone cypionate 67 testosterone enanthate 67 TESTRED 67 TETCAINE 59 tetracaine hcl 59 tetracycline hcl 72 TETRAVISC 59 TETRAVISC FORTE 59 TETRIX 46 TEVETEN 21, 22 TEVETEN HCT 21, 22 TEV-TROPIN 56 TEXACORT 41 THALOMID 75 THEO-24 5 theochron 5 theophylline 5 theophylline anhydrous 5 THERMAZENE 37 THIOLA 115 thioridazine hcl 14 thiothixene 14 thrombi-gel 65 thrombin-jmi 65 thrombi-pad 65 THYROLAR-1 56 THYROLAR-1/2 56 THYROLAR-1/4 56 THYROLAR-2 56 THYROLAR-3 56 tiagabine hcl 109 TIAZAC 22 ticlopidine hcl 65 TIGAN 3 TIKOSYN 15 tilia fe 30 timolol maleate 22, 61 TIMOPTIC 61



137

TIMOPTIC OCUDOSE 61 TIMOPTIC-XE 61 TINDAMAX 76 tinidazole 76 TIROSINT 56 TISSEEL VHSD 65 TIVICAY 79 tizanidine hcl 110 TOBI 75 TOBI PODHALER 75 TOBRADEX 59 TOBRADEX ST 59 tobramycin 59, 75 tobramycin-dexamethasone 59 TOBREX 59 TOFRANIL 8 TOFRANIL-PM 8 tolazamide 51 tolbutamide 51 tolmetin sodium 84 tolterodine tartrate 115 tolterodine tartrate er 115 TOPAMAX 109 TOPICORT 41 topiragen 109 topiramate 109 topiramate er 109 TOPROL XL 22 torsemide 22 TOVIAZ 115 TRACLEER 22 TRADJENTA 51 tramadol hcl 103 tramadol hcl er 103 tramadol hcl-acetaminophen 103 TRANDATE 22 trandolapril 22 trandolapril-verapamil er 22 tranexamic acid 65 TRANSDERM-SCOP 3 TRANXENE T-TAB 14 tranylcypromine sulfate 8 TRAVATAN Z 61 travoprost 61 trazodone hcl 8 TRECATOR 75 tretinoin 33, 91 tretinoin microsphere 33 TRETIN-X 33 TREXALL 91 TREXIMET 103 TREZIX 103 triamcinolone acetonide 2, 41 triamterene-hydrochlorothiazid 22 trianex 41 triazolam 14 TRIBENZOR 22 tricitrates 115 TRICOR 25 triderm 41

tri-estarylla 30 trifluoperazine hcl 14 trifluridine 59 TRIGLIDE 25 trihexyphenidyl hcl 105, 106 tri-legest fe 30 TRILEPTAL 109 tri-linyah 30 TRILIPIX 25 trilyte with flavor packets 87 trimethobenzamide hcl 3 trimethoprim 72 trinessa 30 TRI-NORINYL 30 TRIOXIN 52 triple dye 37 tri-previfem 30 tri-sprintec 30 TRIUMEQ 79 trivora-28 30 TRIZIVIR 79 TROKENDI XR 109 tropicamide 61 trospium chloride 115 trospium chloride er 115 TRUSOPT 61 TRUVADA 79 TUDORZA PRESSAIR 5 TUSNEL PEDIATRIC 31 TUSSICAPS 31 TUSSIGON 31 TUSSIONEX 31 TWYNSTA 22 TYBOST 79 TYKERB 91 TYLENOL-CODEINE NO.3 103 TYLENOL-CODEINE NO.4 103 TYVASO 22 TYZEKA 79 TYZINE 31

U

UCERIS 84, 86 u-cort 41 ULESFIA 37 ULORIC 62 ULTRACET 103 ULTRAM 103 ULTRAM ER 103 ULTRAVATE 41 ULTRAVATE X 41 ULTRESA 110 UMECTA 46 UMECTA PD 46 UNITHROID 56 ur n-c 72 URAMAXIN 46 URAMAXIN GT 46



138

urea 46 URELLE 73 URETRON D-S 73 URIBEL 73 urimar-t 73 URIN D.S. 73 uro-blue 73 UROCIT-K 115 urogesic-blue 73 uro-l 73 uro-mp 73 UROQID-ACID NO.2 115 UROXATRAL 115 URSO 88 URSO FORTE 88 ursodiol 88 URYL 73 ustell 73 UTA 73 UTOPIC 46

V

VAGIFEM 116 valacyclovir 79 VALCHLOR 46 VALCYTE 79 valganciclovir hcl 79 VALIUM 14 valproic acid 109 valsartan 22 valsartan-hydrochlorothiazide 22 VALTREX 79 VANCOCIN HCL 75 vancomycin hcl 75 VANDAZOLE 116 VANOS 41 VANOXIDE-HC 33 VASCEPA 25 VASERETIC 22 vasolex 46 VASOTEC 22 VECAMYL 22 VECTICAL 47 velivet 30 VELPHORO 53 VELTIN 33 venlafaxine hcl 8 venlafaxine hcl er 8 VENLAFAXINE HCL ER 8 VENTAVIS 22 VENTOLIN HFA 5 VERAMYST 2 verapamil er 22 verapamil er pm 22 verapamil hcl 22 verapamil sr 22 VERDESO 41 VEREGEN 37

VERELAN 22 VERELAN PM 22 VERIPRED 20 84 VERSACLOZ 14 VESICARE 115 vestura 30 VEXOL 60 VFEND 74 VIBRAMYCIN 73 vicodin 104 vicodin es 104 vicodin hp 104 VICOPROFEN 104 VICTOZA 2-PAK 51 VICTOZA 3-PAK 51 VIDEX 79 VIDEX EC 79 VIEKIRA PAK 79 VIGAMOX 60 VIIBRYD 8 VIMOVO 84 VIMPAT 109 VIOKACE 110 viorele 30 VIRACEPT 79 VIRAMUNE 79 VIRAMUNE XR 79 VIRASAL 46 VIRAZOLE 79 VIREAD 79, 80 VIROPTIC 60 virti-sulf 37 virt-phos 250 neutral 115 virtrate-3 115 VISTARIL 2 vitamin d2 116 VITEKTA 80 VITUZ 31 VIVELLE-DOT 67 VOLTAREN 41, 84 VOLTAREN-XR 84 voriconazole 74 VOSPIRE ER 5 VOTRIENT 91 VUSION 37 vyfemla 30 VYTORIN 25 VYVANSE 14

W

warfarin sodium 65 WELCHOL 25 WELLBUTRIN 9 WELLBUTRIN SR 9 WELLBUTRIN XL 9 wera 30 westhroid 56 wp thyroid 56



139

wymzya fe 30

X

XALATAN 61 XALKORI 91 XANAX 14 XANAX XR 14 XARELTO 65 XARTEMIS XR 104 XELJANZ 84 XELODA 91 XENAZINE 93 XERESE 37 XIFAXAN 75 XODOL 10-300 104 XODOL 5-300 104 XODOL 7.5-300 104 XOLEGEL 37 XOPENEX 5 XOPENEX CONCENTRATE 5 XOPENEX HFA 5 XTANDI 91 xulane 30 x-viate 46, 47 X-VIATE 46 xylon 10 104 XYREM 14 XYZAL 2

Y

YASMIN 28 30 YAZ 30

Z

zafirlukast 5 zaleplon 14 ZANAFLEX 110 ZANTAC 113 zarah 30 ZARONTIN 109 ZAVESCA 94 ZEBETA 22 zebutal 104 ZEGERID 113 ZELAPAR 106 ZELBORAF 91 ZEMPLAR 56 zenatane 33 zenchent 30 zenchent fe 30 ZENCIA 37 ZENPEP 110 zenzedi 14

zeosa 30 ZERIT 80 ZERUVIA 47 ZESTORETIC 22 ZESTRIL 23 ZETIA 25 ZETONNA 2 ZIAC 23 ZIAGEN 80 ZIANA 33 zidovudine 80 ZIOPTAN 61 ziprasidone hcl 14 ZIPSOR 84 ZIRGAN 60 ZITHRANOL 47 ZITHRANOL-RR 47 ZITHROMAX 73 ZITHROMAX TRI-PAK 73 ZMAX 73 ZOCOR 25 ZOFRAN 3 ZOFRAN ODT 3 ZOHYDRO ER 104 ZOLINZA 91 zolmitriptan 104 zolmitriptan odt 104 ZOLOFT 9 zolpidem 14 zolpidem tartrate 14 zolpidem tartrate er 14 ZOLPIMIST 14 ZOMIG 104 ZOMIG ZMT 104 ZONALON 42 ZONATUSS 31 ZONEGRAN 109 zonisamide 109 ZONTIVITY 65 ZORBTIVE 56 ZORTRESS 69 ZORVOLEX 84 zovia 1-35e 30 zovia 1-50e 30 ZOVIRAX 37, 80 ZUBSOLV 104 ZUPLENZ 3 ZUTRIPRO 31 ZYCLARA 69 ZYDELIG 91, 92 ZYFLO 5 ZYFLO CR 5 ZYKADIA 92 ZYLET 60 ZYLOPRIM 62 ZYMAXID 60 ZYPRAM 86 ZYPREXA 14 ZYPREXA RELPREVV 14 ZYPREXA ZYDIS 14



140

ZYTIGA 92 ZYVOX 73



141

OVER-THE-COUNTER (OTC) MEDICATION

BENEFIT LIST The medications listed below are covered only for members who have purchased a special benefit offered through Group Health called the

Over-the-Counter Pharmacy Benefit.

***Typically, if a generic product is available for a drug, the Brand Name product may not be covered.***

Generic Product Name ***Brand Name*** Forms ALLERGY COUGH AND COLD Antihistamines CHLORPHENIRAMINE CHLOR-TRIMETON® Tab, Liquid

CLEMASTINE TAVIST® Tab, Liquid

DIPHENHYDRAMINE BENADRYL® Cap, Liquid

LORATADINE CLARITIN® Tab, Liquid

Decongestants

OXYMETAZOLINE NASAL SPRAY AFRIN® Spray

PHENYLEPHRINE NASAL SPRAY NEO-SYNEPHRINE® Spray

PSEUDOEPHEDRINE SUDAFED® Tablet

Antihistamine/Decongestant Combinations

TRIPROLIDINE/PSEUDOEPHEDRINE ACTIFED® Tablet

BROMPHENIRAMINE/PSEUDOEPHEDRINE DIMETAPP® Liquid

Expectorants/Cough Agents

GUAIFENESIN ROBITUSSIN® Liquid

GUAIFENESIN/DEXTROMETHORPHAN ROBITUSSIN-DM® Liquid

DEXTROMETHORPHAN ROBITUSSIN COUGH® Liquid

DEXTROMETHORPHAN EXTEND RELEASE DELSYM® Liquid

AUTONOMICS AND CNS

Analgesics, Miscellaneous ACETAMINOPHEN TYLENOL® Tab, Chew, Supp,

Liquid

Non-Steroidal Anti-Inflammatories

IBUPROFEN MOTRIN®, ADVIL® Tab, Liquid

Salicylates

ASPIRIN BAYER®, ASCRIPTIN® Tab, Supp

DERMATOLOGICAL/ TOPICAL AGENTS

Acne/Psoriasis, Topical BENZOYL PEROXIDE 5%, 10% BENZAC® Gel, Wash, Lotion

COAL TAR Solution

Anesthetic Agents, Topical

BENZOCAINE HURRICAINE® Gel

PRAMOXINE ANUSOL® Ointment

Antifungals, Topical CLOTRIMAZOLE 1% LOTRIMIN® Cream, Solution

MICONAZOLE 2% MICATIN®, DESENEX® Cream, Powder

Anti-Infectives, Topical



142

BACITRACIN BACIGUENT® Ointment

BACITRACIN, POLYMIXIN B POLYSPORIN® Ointment

BACITRACIN, NEOMYCIN, POLYMYXIN B NEOSPORIN® Ointment

OATMEAL, COLLOIDAL AVEENO® BATH POWDER Powder

Anti-Itch, Topical CALAMINE CALAMINE Lotion

CAMPHOR/ MENTHOL SARNA® Lotion

CAPSAICIN ZOSTRIX®, ZOSTRIX-HP® Cream

Anti-Virals, Topical

DOCOSANOL 10% ABREVA® Cream

Corticosteroids, Topical, Low Potency HYDROCORTISONE 0.5%, 1% CORTIZONE® Cream, Oint,

Lotion Keratolytics

SALICYLIC ACID 17% DUOFILM® Liquid

SALICYLIC ACID 40% MEDIPLAST® Plaster

UREA 10%, 20% UREACIN®, CARMOL® 20 Cream, Lotion

Dermatologics, Miscellaneous

ALUMINUM ACETATE BUROWS® Liquid

AMMONIUM LACTATE 12% AMLACTIN® Cream, Lotion

HYDROGEN PEROXIDE HYDROGEN PEROXIDE Liquid

VITAMIN A&D A AND D® OINTMENT Ointment

WITCH HAZEL TUCKS® Solution, Pads

ZINC OXIDE, COD LIVER OIL & LANOLIN DESITIN® Oint, Paste

ZINC OXIDE 20% BALMEX® Ointment

Scabicides PERMETHRIN NIX® Rinse

PYRETHRINS, PIPERONYL BUTOXIDE RID®, R & C® Shampoo

Skin Protectants

LANOLIN, HYDROUS LANOLIN Ointment

PETROLATUM, GLYCERIN,BENZYL ALC MOISTUREL® Lotion

PETROLATUM, MINERAL OIL/WAX, ETC. AQUAPHOR®, EUCERIN® Ointment

EYE, EAR, NOSE AND THROAT

Otics

CARBAMIDE DEBROX® Solution

Nasal Agents

CROMOLYN NASALCROM® Spray

Ophthalmics

ARTIFICIAL TEARS HYOPTEARS®, PURALUBE® Drops, Ointment

CARBOXYMETHYLCELLULOSE CELLUVISC®, REFRESH PLUS® Drops

HYDROXYPROPYL METHYLCELLULOSE TEARS NATURALE II® Drops

KETOTIFEN FUMARATE 0.025% ZADITOR® Drops

NAPHAZOLINE/ PHENIRAMINE OPCON-A® Drops

POLYVINYL ALCOHOL, POVIDONE REFRESH® PF Drops

SODIUM CHLORIDE 5% MURO®-128 Drops, Ointment

Throat and Mouth Agents CETYLPYRIDINIUM CL, BENZYL ALCOHOL CEPACOL® Lozenge

GASTROINTESTINAL AGENTS

Antacids/Adsorbents

CHARCOAL, ACTIVATED W/O SORBITOL ACTIDOSE Liquid

ALUMINUM/ MAGNESIUM MAALOX® Tablet, Liquid



143

ALUMINUM/ MAGNESIUM/ SIMETHICONE MINTOX® PLUS, MI-ACID Tablet, Liquid

ALUM/ MAGN/TRISILIS/ALG AC/SOD BICAR GAVISCON®, GENATON Tablet

ALUMINUM HYDROXIDE ALTERNAGEL®, AMPHOGEL® Liquid

MAGNESIUM OXIDE MAG-OX® Tablet

Antidiarrheals

BISMUTH SUBSALICYLATE PEPTO BISMOL® Tablet, Liquid

LOPERAMIDE IMMODIUM® Tablet, Liquid

Antinauseants

DIMENHYDRINATE DRAMAMINE® Tablet, Liquid

MECLIZINE BONINE®, ANTIVERT® Tablet

Laxatives/Cathartics

BISACODYL DULCOLAX® Tablet, Supp

DOCUSATE SODIUM COLACE® Tablet, Liquid

GLYCERIN GLYCERIN Liquid, Supp

MAGNESIUM CITRATE CITRO-MAG® Liquid

MILK OF MAGNESIA MILK OF MAGNESIA Liquid

MINERAL OIL FLEET® MINERAL OIL Liquid

PSYLLIUM METAMUCIL® Powder

POLYETHYLENE GLYCOL MIRALAX® Powder

SENNA SENOKOT® Tablet, Liquid

Histamine H2 Blockers

RANITIDINE ZANTAC® Tablet

Gastrointestinal, Miscellaneous

SIMETHICONE MYLICON® Tablet

LACTOBACILLUS BACID® Capsule

SHARK LIVER OIL, COCOA BUTTER, PHENYLEPHRINE

HEMORRHOIDAL SUPPOSITORIES

Supp

Proton Pump Inhibitors

OMEPRAZOLE PRILOSEC OTC Tablet

GENITOURINARY

Overactive bladder treatment

OXYBUTYNIN OXYTROL® PATCH Patch

HORMONES

Contraceptive

LEVONORGESTROL PLAN B ONE STEP Tablet

LIPID LOWERING AGENTS

Non-Prescription Agents

NIACIN NIACIN Tablet

NIACIN EXTENDED-RELEASE SLO-NIACIN® Tablet

FISH OILS SEA-OMEGA®-50 Capsule

NUTRITIONALS AND SUPPLEMENTS

Vitamins/Dietary Supplements

ACETYLCYSTEINE NAC® Capsule

ASCORBIC ACID (VIT C) Tablet

CYANOCOBALAMIN (VIT B12) Tablet

CHOLECALCIFEROL (VIT D) Tablet

FOLIC ACID Tablet

NIACINAMIDE (VIT B3) Tablet

PRENATAL VITAMINS W/ FOLIC ACID Tablet

PYRIDOXINE (VIT B6) Tablet



144

THIAMINE (VIT B1) Tablet

VITAMIN A Capsule

VITAMIN B COMPLEX Tablet

VITAMIN B COMPLEX W/C Tablet

VITAMIN E Capsule

Electrolytes, Iron, & Minerals

CALCIUM CARBONATE TUMS® Chew tabs, Liquid

CALCIUM CITRATE CAL-CITRATE® Tablet

CALCIUM CITRATE w/VITAMIN D CITRACAL® Tablet

ELECTROLYTE ORAL PEDIALYTE® Liquid

FERROUS GLUCONATE FERGON® Tablet

FERROUS SULFATE FER-IN-SOL® Tablet, Liquid

MAGNESIUM OXIDE URO-MAG® Capsule

SODIUM BICARBONATE Tablet

ZINC SULFATE ZINCATE® Capsule

VAGINAL PREPARATIONS

Vaginal Anti-Infectives

POVIDONE-IODINE BETADINE® Douche

Vaginal Antifungals

CLOTRIMAZOLE MYCELEX®-7, GYNE-LOTRIMIN®-3

Cream, Vag tabs

MICONAZOLE MONISTAT® Cream

Miscellaneous

LUBRICATING JELLY K-Y JELLY® JELLY

2015 drug formulary - kaiser permanente · 2015 drug formulary ... test, and market medications...

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