comprehensive dual eligible preferred drug list 9...2015 comprehensive dual eligible preferred drug...

2015 Comprehensive Dual Eligible Preferred Drug List (List of Covered Drugs)

WellCare of Kentucky

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Please read: This document contains information about the drugs we cover in this plan. Last updated (4/01/2015)

TESSALON 200 MG CAPSULE BENZONATATE 100 MG CAPSULE BENZONATATE 200 MG CAPSULE

DELSYM 30 MG/5 ML EXTENDED-RELEASE SUSPENSION

ROBITUSSIN PEDIATRIC COUGH SYP

DELSYM COUGH RELIEF PLUS LOZENGE

ALLANHIST PDX DROPS BROMHIST PDX DROPS BROTAPP DM LIQUID Q-TAPP DM ELIXIRBROMFED DM SYRUP ENDACOF-PD DROPS

COLD/COUGH CHILDRENS ELIXIRRYNEX DM DIMAPHEN DM ELIXIR

C-PHEN DM RONDEX-DM SYRUP DE-CHLOR DM LIQUID NOHIST-DM

PD-COF SYRUP SILDEC PE-DM SYRUP CORFEN DM TRI-DEX PE

PEDIATRIC COUGH-COLD LIQUID MESEHIST DMKIDKARE COUGH/COLD

VANACOF LIQUID

DIMETAPP LONG-ACTING COUGH LIQ ROBITUSSIN LONG ACTING LIQUID

PROMETHAZINE-DM SYRUP

DELSYM NIGHTTIME MULTI-SYMPTOM

DONATUSSIN DROPS PE-GUAI DROPS DESPEC LIQUID RESCON-GG LIQUID

NON-NARC ANTITUSS-1ST GEN. ANTIHIST-ANALGESIC COMBINATION

Chlorpheniramine/Dextromethorphan HBr

Guaifenesin/Phenylephrine HCl

Dextromethorphan HBr/Acetaminophen/Doxylamine

DECONGESTANT-EXPECTORANT COMBINATIONSEXPECTORANTS

Promethazine HCl/Dextromethorphan HBr

Kentucky Dual Eligible Cough & Cold Drug List

Preferred Drugs

Benzonatate

Non-Preferred DrugsANTITUSSIVES,NON-NARCOTIC

Dextromethorphan HBr

Dextromethorphan Polistirex

Dexchlorpheniramine/Pseudoephedrine HCl/Chlophedianol HCl

Dextromethorphan HBr/Menthol

NON-NARC ANTITUSS-1ST GEN. ANTIHISTAMINE-DECONGESTBrompheniramine/Dextromethorphan HBr/Pseudoephedrine HCl

Brophenaramine/Dextromethorphan HBr/Phenylephrine HCl

Chlorpheniramine/Dextromethorphan HBr/Phenylephrine HCl

Chlorpheniramine/Dextromethorphan HBr/Pseudoephedrine HCl

Last updated 07/31/14 Page 1 of 2

Kentucky Dual Eligible Cough & Cold Drug List

Preferred DrugsNon-Preferred Drugs

ROBAFEN CF SYRUP

DURATUSS DM ELIXIR SU-TUSS DM ELIXIR MUCUS RELIEF COUGH LIQUID DIABETIC TUSSIN DM LIQUIDSIMUC-DM ELIXIR GUAIFENESIN DM SYRUP Q-TUSSIN-DM SYRUP

EXTRA ACTION COUGH SILTUSSIN DM COUGH SYRUPREFENESEN DM SILTUSSIN DM DAS COUGH SYRUPMUCOSA DM

TUSSIONEX PENNKINETIC SUSP TUSSICAPS (min. age 6 years old) HYDROCODONE-CHLORPHENIRAMINE SUSPENSION (min. age 6 years old)

CYTUSS-HC NR SYRUP HC/PE/DBROM SYRUP PROMETH VC W/COD SYRUP PROMETHAZINE VC/COD SYRUPHC 2.5-PE 5-DBROM 1 MG SYRUP

PHENYLHISTINE DH

HYDROMET SYRUP HYDROCODONE-HOMATROPINE

HYDROCODONE-GUAIFENESIN SYRUP CHERATUSSIN AC SYRUPNARCOF SYRUP TUSSICLEAR DH SYRUP GUAIFENESIN-CODEINE SYRUP IOPHEN C-NR

CHERATUSSIN DAC SYRUPCodeine Phosphate/Guaifenesin/Pseudoephedrine HCl

Pseudoephedrine HCl/Codeine/Chlorpheniramine

NARCOTIC ANTITUSSIVE-ANTICHOLINERGIC COMBINATIONHydrocodone Bit/Homatropine

Guaifenesin/Hydrocodone Bit Codeine Phosphate/Guaifenesin

NARCOTIC ANTITUSSIVE-DECONGESTANT-EXPECTORANT COMBINATIONS

NARCOTIC ANTITUSSIVE-EXPECTORANT COMBINATION

Dextromethorphan HBr/Guaifenesin

ROBITUSSIN COUGH CHEST CONGESTION DM LIQUID

NARCOTIC ANTITUSSIVE-1ST GENERATION ANTIHISTAMINE

Codeine Phosphate/Promethazine HCl

Dexbrompheniramine/Hydrocodone Bit/Phenylephrine HCl Codeine/Phenylephrine HCl/Promethazine

NARCOTIC ANTITUSSIVE-1ST GEN. ANTIHISTAMINE-DECONGESTANTPROMETHAZINE-CODEINE SYRUP (min. age 6 years old)

Chlorpheniramine/Hydrocodone Polistirex

NON-NARCOTIC ANTITUSSIVE AND EXPECTORANT COMB.

NON-NARCOTIC DECONGESTANT-EXPECTORANT-ANTITUSSIVEGuaifenesin/Dextromethorphan HBr/Phenylephreine

Last updated 07/31/14 Page 2 of 2

This plan has a limit of 248 dosage units, unless otherwise specified through a quantity limit.

Drug Name Preference Details Coverage Details

*Alternative Medicines*

*Alternative Medicine - M's**-*Alternative Medicine - Me's***

melatonin maximum strength oral tablet 5 mg P OTC

*Analgesics - Anti-Inflammatory*

*Nonsteroidal Anti-Inflammatory Agents (Nsaids)**-*Nonsteroidal Anti-Inflammatory Agents (Nsaids)***

childrens ibuprofen oral suspension 40 mg/ml P OTC

ibuprofen oral suspension 100 mg/5ml P OTC

ibuprofen oral tablet 200 mg P OTC

*Analgesics - Nonnarcotic*

*Analgesics Other**-*Analgesics Other***

acetaminophen oral solution 160 mg/5ml P OTC

acetaminophen oral tablet 325 mg P OTC; QL (279 EA per 31 days)

acetaminophen oral tablet 500 mg P OTC; QL (186 EA per 31 days)

apap extra strength oral tablet 500 mg P OTC; QL (186 EA per 31 days)

apap oral tablet 325 mg P OTC; QL (279 EA per 31 days)

childrens non-asa pain relief oral tablet chewable80 mg

P OTC

childrens non-aspirin oral tablet chewable 80 mg P OTC

childrens pain reliever oral tablet chewable 80 mg

P OTC

childrens silapap oral liquid† 160 mg/5ml P OTC

childrens tactinal oral tablet chewable 80 mg P OTC

ed-apap oral liquid† 160 mg/5ml P OTC

infants silapap oral solution 100 mg/ml P OTC

mapap arthritis pain oral tablet extendedrelease* 650 mg

P OTC; QL (93 EA per 31 days)

P=Preferred, Dagger=N/A, Asterisk(*)=N/A, PA=Prior Authorization, ST=Step Therapy, QL=Quantity Limit, AL=Age Limit, Notes=Notes, OTC=OTC-Covered w/Rx, UPPERCASE= Brand name drugs/ lowercase italics= Generic drugs

1


MAPAP CHILDRENS ORAL SUSPENSION 160 MG/5ML

P OTC

mapap oral capsule 500 mg P OTC; QL (186 EA per 31 days)

mapap oral tablet 325 mg P OTC; QL (279 EA per 31 days)

mapap oral tablet 500 mg P OTC; QL (186 EA per 31 days)

mapap oral tablet chewable 80 mg P OTC

maxapap maximum strength oral tablet 500 mg P OTC; QL (186 EA per 31 days)

maxapap regular strength oral tablet 325 mg P OTC; QL (279 EA per 31 days)

non-aspirin extra strength oral tablet 500 mg P OTC; QL (186 EA per 31 days)

non-aspirin oral tablet 325 mg P OTC; QL (279 EA per 31 days)

non-aspirin pain relief oral tablet 325 mg P OTC; QL (279 EA per 31 days)

nortemp infants oral suspension 80 mg/0.8ml P OTC

pain & fever childrens oral solution 160 mg/5ml P OTC

pain relief extra strength oral tablet 500 mg P OTC; QL (186 EA per 31 days)

pain relief oral tablet 500 mg P OTC; QL (186 EA per 31 days)

PHARBETOL EXTRA STRENGTH ORAL TABLET 500 MG


PHARBETOL ORAL TABLET 325 MG P OTC; QL (279 EA per 31 days)

q-pap oral tablet 325 mg P OTC; QL (279 EA per 31 days)

tactinal extra strength oral tablet 500 mg P OTC; QL (186 EA per 31 days)

tactinal oral tablet 325 mg P OTC; QL (279 EA per 31 days)

*Salicylates**-*Salicylate Combinations***

tri-buffered aspirin oral tablet 325 mg P OTC

*Salicylates**-*Salicylates***

aspirin adult low strength oral tablet delayed release 81 mg

P OTC

aspirin childrens oral tablet chewable 81 mg P OTC

aspirin ec low dose oral tablet delayed release 81 mg

P OTC

aspirin ec oral tablet delayed release 325 mg, 81 mg

P OTC

aspirin low dose oral tablet 81 mg P OTC

aspirin oral tablet 325 mg, 81 mg P OTC

aspirin oral tablet chewable 81 mg P OTC

aspirin oral tablet delayed release 81 mg P OTC

aspirin suppository 300 mg, 600 mg P OTC


2


ECPIRIN ORAL TABLET DELAYED RELEASE 325 MG

P OTC

*Antacids*

*Antacid Combinations**-*Antacid & Simethicone***

alamag plus oral tablet chewable 200-200-25 mg P OTC

ALMACONE ORAL SUSPENSION 200-200-20 MG/5ML

P OTC

antacid anti-gas max strength oral suspension400-400-40 mg/5ml

P OTC

antacid anti-gas oral suspension 200-200-20 mg/5ml

P OTC

antacid extra strength oral suspension400-400-40 mg/5ml

P OTC

antacid i oral suspension 200-200-20 mg/5ml P OTC

antacid iii oral suspension 400-400-40 mg/5ml P OTC

antacid oral suspension 200-200-20 mg/5ml P OTC

geri-lanta oral suspension 200-200-20 mg/5ml P OTC

MAALOX ADVANCED MAX ST ORAL SUSPENSION 400-400-40 MG/5ML

P OTC

MAALOX ADVANCED ORAL SUSPENSION 200-200-20 MG/5ML

P OTC

MAALOX MAX ORAL SUSPENSION 400-400-40 MG/5ML

P OTC

MAALOX MULTI SYMPTOM MAX ST ORAL SUSPENSION 400-400-40 MG/5ML

P OTC

MAALOX REGULAR STRENGTH ORAL SUSPENSION 200-200-20 MG/5ML

P OTC

milantex extra strength oral suspension400-400-40 mg/5ml

P OTC

milantex oral suspension 200-200-20 mg/5ml P OTC

MINTOX PLUS ORAL TABLET CHEWABLE 200-200-25 MG

P OTC

*Antacid Combinations**-*Antacid Combinations***

ACID GONE ORAL TABLET CHEWABLE 160-105 MG

P OTC


3


gnp foaming antacid oral tablet chewable 80-20 mg

P OTC

MI-ACID ORAL TABLET CHEWABLE 700-300 MG

P OTC

*Antacids - Aluminum Salts**-*Antacids - Aluminum Salts***

aluminum hydroxide gel oral suspension 320 mg/5ml

P OTC

*Antacids - Bicarbonate**-*Antacids - Bicarbonate***

sodium bicarbonate oral tablet 325 mg, 650 mg P OTC

*Antacids - Calcium Salts**-*Antacids - Calcium Salts***

alcalak oral tablet chewable 420 mg P OTC

antacid oral tablet chewable 420 mg, 500 mg P OTC

calcium antacid extra strength oral tablet chewable 750 mg

P OTC

calcium antacid oral tablet chewable 500 mg P OTC

calcium carbonate antacid oral tablet 648 mg P OTC

calcium carbonate antacid oral tablet chewable500 mg

P OTC

CAL-GEST ANTACID ORAL TABLET CHEWABLE 500 MG

P OTC

MAALOX ORAL TABLET CHEWABLE 600 MG

P OTC

TITRALAC ORAL TABLET CHEWABLE 420 MG

P OTC

*Antacids - Magnesium Salts**-*Antacids - Magnesium Salts***

magnesium oxide oral tablet 250 mg, 400 mg, 420 mg

P OTC

*Anthelmintics*

*Anthelmintics**-*Anthelmintics***

reeses pinworm medicine oral suspension 144 mg/ml

P OTC


4


*Antidiabetics*

*Diabetic Other**-*Diabetic Other***

BD GLUCOSE ORAL TABLET CHEWABLE 5 GM

P OTC

glucose oral tablet chewable 4 gm P OTC

*Antidiarrheals*

*Antidiarrheal Agents - Misc.**-*Antidiarrheal Agents - Misc.***

bismatrol oral suspension 262 mg/15ml P OTC

bismatrol oral tablet chewable 262 mg P OTC

bismuth oral tablet chewable 262 mg P OTC

diotame oral tablet chewable 262 mg P OTC

KAOPECTATE EXTRA STRENGTH ORAL SUSPENSION 525 MG/15ML

P OTC

KAOPECTATE ORAL SUSPENSION 262 MG/15ML

P OTC

kao-tin oral suspension 262 mg/15ml P OTC

pink bismuth oral suspension 262 mg/15ml P OTC

pink bismuth oral tablet chewable 262 mg P OTC

stomach relief oral suspension 262 mg/15ml, 527 mg/30ml

P OTC

stomach relief oral tablet chewable 262 mg P OTC

stomach relief plus oral suspension 525 mg/15ml P OTC

*Antiperistaltic Agents**-*Antiperistaltic Agents***

anti-diarrheal oral liquid† 1 mg/5ml P OTC

LOPERAMIDE A-D ORAL TABLET 2 MG P OTC

loperamide hcl oral liquid† 1 mg/5ml P OTC

*Antidotes*

*Antidotes**-*Antidotes***

ipecac oral syrup P OTC

*Antiemetics*

*Antiemetics - Anticholinergic**-*Antiemetics - Anticholinergic***

meclizine hcl oral tablet 12.5 mg, 25 mg P OTC

travel sickness oral tablet chewable 25 mg P OTC


5


*Antihistamines*

*Antihistamines - Alkylamines**-*Antihistamines - Alkylamines***

aller-chlor oral syrup 2 mg/5ml P OTC

aller-chlor oral tablet 4 mg P OTC

allergy oral tablet 4 mg P OTC

allergy relief oral tablet 4 mg P OTC

chlorhist oral tablet 4 mg P OTC

chlorphen oral tablet 4 mg P OTC

DIABETIC TUSSIN ALLERGY ORAL SYRUP 2 MG/5ML

P OTC

*Antihistamines - Ethanolamines**-*Antihistamines - Ethanolamines***

aler-cap oral capsule 25 mg P OTC

aler-dryl oral tablet 50 mg P OTC

alertab oral tablet 25 mg P OTC

allergy relief childrens oral liquid† 12.5 mg/5ml P OTC

altaryl oral elixir 12.5 mg/5ml P OTC

altaryl oral syrup 12.5 mg/5ml P OTC

anti-hist allergy oral tablet 25 mg P OTC

BANOPHEN ORAL CAPSULE 25 MG P OTC

BANOPHEN ORAL LIQUID† 12.5 MG/5ML

P OTC

BANOPHEN ORAL TABLET 25 MG P OTC

BENADRYL ALLERGY CHILDRENS ORAL LIQUID† 12.5 MG/5ML

P OTC

complete allergy medication oral tablet 25 mg P OTC

complete allergy relief oral tablet 25 mg P OTC

diphenhist oral capsule 25 mg P OTC

diphenhist oral liquid† 12.5 mg/5ml P OTC

diphenhist oral tablet 25 mg P OTC

diphenhydramine hcl oral capsule 25 mg, 50 mg P OTC

diphenhydramine hcl oral tablet 25 mg P OTC

DORMIN ORAL CAPSULE 25 MG P OTC


6


genahist oral capsule 25 mg P OTC

pharbedryl oral capsule 25 mg, 50 mg P OTC

q-dryl oral capsule 25 mg P OTC

q-dryl oral liquid† 12.5 mg/5ml P OTC

quenalin oral syrup 12.5 mg/5ml P OTC

SCOT-TUSSIN ALLERGY RELIEF ORAL LIQUID† 12.5 MG/5ML

P OTC

siladryl allergy oral liquid† 12.5 mg/5ml P OTC

silphen cough oral syrup 12.5 mg/5ml P OTC

SIMPLY ALLERGY ORAL TABLET 25 MG

P OTC

TOTAL ALLERGY MEDICINE ORAL LIQUID† 12.5 MG/5ML

P OTC

total allergy oral tablet 25 mg P OTC

*Antihistamines - Non-Sedating**-*Antihistamines - Non-Sedating***

ALLEGRA ALLERGY CHILDRENS ORAL TABLET 30 MG

P OTC

allergy oral tablet dispersible 10 mg P OTC

cetirizine hcl childrens alrgy oral syrup 1 mg/ml P OTC

cetirizine hcl childrens oral solution 1 mg/ml P OTC

cetirizine hcl oral tablet 10 mg, 5 mg P OTC

childrens loratadine oral syrup 5 mg/5ml P OTC; QL (310 ML per 31 days)

fexofenadine hcl oral tablet 180 mg, 60 mg P OTC

loratadine hives relief oral solution 5 mg/5ml P OTC; QL (300 ML per 31 days)

loratadine oral tablet 10 mg P OTC

*Antiseptics & Disinfectants*

*Chlorine Antiseptics**-*Chlorine Antiseptic Combinations***

dakins (1/2 strength) external solution 0.2-0.25 %

P OTC

dakins (1/4 strength) external solution 0.125 % P OTC

dakins external solution 0.4-0.5 % P OTC

*Chlorine Antiseptics**-*Chlorine Antiseptics***

chlorhexidine gluconate external liquid† 4 % P OTC; QL (480 ML per 31 days)


7


*Iodine Antiseptics**-*Iodine Antiseptics***

OPERAND POVIDONE-IODINE EXTERNAL SOLUTION 10 %

P OTC

povidone-iodine external solution 10 % P OTC

*Cough/Cold/Allergy*

*Cough/Cold/Allergy Combinations**-*Decongestant & Antihistamine***

ALAVERT ALLERGY/SINUS ORAL TABLET EXTENDED RELEASE 12 HR* 5-120 MG

P OTC

ALLEGRA-D ALLERGY & CONGESTION ORAL TABLET EXTENDED RELEASE 12 HR* 60-120 MG

P OTC

allergy relief/nasal decongest oral tablet extended release 24 hr* 10-240 mg

P OTC

BROTAPP ORAL LIQUID† 1-15 MG/5ML P OTC

cetirizine-pseudoephedrine er oral tablet extended release 12 hr* 5-120 mg

P OTC

fexofenadine-pseudoephed er oral tablet extended release 24 hr* 180-240 mg

P OTC

Q-TAPP ORAL ELIXIR 1-15 MG/5ML P OTC

triprolidine-pse oral tablet 2.5-60 mg P OTC

*Expectorants**-*Expectorants***

mucus relief oral tablet 400 mg P OTC

refenesen 400 oral tablet 400 mg P OTC

refenesen oral tablet 200 mg P OTC

robafen oral syrup 100 mg/5ml P OTC

*Misc. Respiratory Inhalants**-*Misc. Respiratory Inhalants***

BRONCHO SALINE INHALATION AEROSOL, SOLUTION 0.9 %

P OTC

sodium chloride inhalation nebulization solution0.9 %

P OTC

*Dermatologicals*

*Acne Products**-*Acne Products***

acne medication 5 external lotion 5 % P OTC

benzoyl peroxide external 10 %, 5 % P OTC


8


*Antibiotics - Topical**-*Antibiotic Mixtures Topical***

bacitracin-neomycin-polymyxin external ointment 400-5-5000

P OTC

double antibiotic external ointment 500-10000 unit/gm

P OTC

triple antibiotic external ointment 3.5-400-5000 , 5-400-5000

P OTC

*Antibiotics - Topical**-*Antibiotics - Topical***

bacitracin external ointment 500 unit/gm P OTC

bacitracin zinc external ointment 500 unit/gm P OTC

*Antifungals - Topical**-*Antifungals - Topical***

terbinafine hcl external cream 1 % P OTC

*Antifungals - Topical**-*Imidazole-Related Antifungals - Topical***

clotrimazole external cream 1 % P OTC

clotrimazole external solution 1 % P OTC

*Antihistamines-Topical**-*Antihistamines - Topical***

anti-itch maximum strength external cream 2 % P OTC

BENADRYL ITCH STOPPING EXTERNAL 2 %

P OTC

itch relief external cream 2 % P OTC

*Corticosteroids - Topical**-*Corticosteroids - Topical***

AVEENO ANTI-ITCH MAX ST EXTERNAL CREAM 1 %

P OTC

hydrocortisone external cream 0.5 %, 1 % P OTC

hydrocortisone external lotion 1 % P OTC

hydrocortisone external ointment 0.5 %, 1 % P OTC

hydrocortisone max st external cream 1 % P OTC

hydrocortisone max st/12 moist external cream 1 %

P OTC

HYDROSKIN EXTERNAL CREAM 1 % P OTC

kp hydrocortisone external cream 1 % P OTC


9


PREPARATION H HYDROCORTISONE EXTERNAL CREAM 1 %

P OTC

tgt anti-itch/aloe/vit e external cream 1 % P OTC

*Corticosteroids - Topical**-*Topical Steroid Combinations***

hydrocortisone-aloe external cream 1 % P OTC

sm hydrocortisone plus external cream 1 % P OTC

*Emollients**-*Emollients***

AMLACTIN EXTERNAL LOTION 12 % P OTC; QL (400 GM per 31 days)

ammonium lactate external cream 12 % P OTC; QL (400 GM per 31 days)

ammonium lactate external lotion 12 % P OTC; QL (400 GM per 31 days)

*Keratolytic/Antimitotic Agents**-*Keratolytic/Antimitotic Agents***

CLEAR AWAY 1-STEP WART REMOVER EXTERNAL PAD 40 %

P OTC

COMPOUND W EXTERNAL LIQUID† 17 %

P OTC

COMPOUND W MAXIMUM STRENGTH EXTERNAL 17 %

P OTC

FREEZONE EXTERNAL LIQUID† 17.6 % P OTC

SALACTIC FILM EXTERNAL SOLUTION 17 %

P OTC

*Local Anesthetics - Topical**-*Local Anesthetics - Topical***

capsaicin external cream 0.025 % P OTC

*Scabicides & Pediculicides**-*Scabicides & Pediculicides***

permethrin external lotion 1 % P OTC; QL (60 ML per 31 days)

*Gastrointestinal Agents - Misc.*

*Antiflatulents**-*Antiflatulents***

mi-acid gas relief oral tablet chewable 80 mg P OTC

mytab gas oral tablet chewable 80 mg P OTC

simethicone oral suspension 40 mg/0.6ml P OTC

simethicone oral tablet chewable 80 mg P OTC

*Genitourinary Agents - Miscellaneous*

*Urinary Analgesics**-*Urinary Analgesics***

phenazopyridine hcl oral tablet 100 mg, 200 mg P


10


*Hematopoietic Agents*

*Cobalamins**-*Cobalamins***

cyanocobalamin injection solution 1000 mcg/ml P

vitamin b-12 er oral tablet extendedrelease*1000 mcg

P OTC

vitamin b-12 oral tablet 1000 mcg, 500 mcg P OTC

vitamin b-12 sublingual tablet sublingual 1000 mcg

P OTC

*Folic Acid/Folates**-*Folic Acid/Folates***

folic acid oral tablet 1 mg, 400 mcg, 800 mcg P OTC

*Iron**-*Iron***

ferro-bob oral tablet 325 (65 fe) mg P OTC

ferrous sulfate oral elixir 220 (44 fe) mg/5ml P OTC

ferrous sulfate oral tablet 325 (65 fe) mg P OTC

ferrous sulfate oral tablet delayed release 324 (65 fe) mg, 325 (65 fe) mg

P OTC

ferrousul oral tablet 325 (65 fe) mg P OTC

iron oral tablet 325 (65 fe) mg, 90 (18 fe) mg P OTC

POLY-IRON 150 ORAL CAPSULE 150 MG P OTC

slow release iron oral tablet extendedrelease*160 (50 fe) mg

P OTC

*Hypnotics*

*Antihistamine Hypnotics**-*Antihistamine Hypnotic Combinations***

headache pm oral tablet 25-500 mg P OTC; QL (62 EA per 31 days)

mapap pm oral tablet 500-25 mg P OTC; QL (62 EA per 31 days)

pain relief pm extra strength oral tablet 500-25 mg


pain reliever pm oral tablet 500-25 mg P OTC; QL (62 EA per 31 days)

*Antihistamine Hypnotics**-*Antihistamine Hypnotics***

compoz oral capsule 50 mg P OTC

compoz oral tablet 50 mg P OTC

NYTOL ORAL TABLET 25 MG P OTC

SIMPLY SLEEP ORAL TABLET 25 MG P OTC

sleep tabs oral tablet 25 mg P OTC


11


sleep-tabs oral tablet 25 mg P OTC

SOMINEX MAXIMUM STRENGTH ORAL TABLET 50 MG

P OTC

SOMINEX ORAL TABLET 25 MG P OTC

tetra-formula nighttime sleep oral tablet 50 mg P OTC

*Laxatives*

*Bulk Laxatives**-*Bulk Laxatives***

fiber laxative oral tablet 625 mg P OTC

fiber oral tablet 625 mg P OTC

fiber therapy oral powder 58.6 % P OTC

FIBERGEN ORAL TABLET 625 MG P OTC

fiber-lax oral tablet 625 mg P OTC

KONSYL FIBER ORAL TABLET 625 MG P OTC

KONSYL ORAL PACKET 100 % P OTC

METAMUCIL MULTIHEALTH FIBER ORAL POWDER 58.6 %

P OTC

METAMUCIL ORAL POWDER 30.9 % P OTC

METAMUCIL ORAL WAFER P OTC

METAMUCIL SMOOTH TEXTURE ORAL PACKET 28 %

P OTC

METAMUCIL SMOOTH TEXTURE ORAL POWDER 28.3 %, 58.6 %

P OTC

natural fiber therapy oral powder 30.9 %, 48.57 %

P OTC

natural vegetable fiber oral powder 48.57 % P OTC

REGULOID ORAL CAPSULE 0.52 GM P OTC

*Laxative Combinations**-*Laxatives & Dss***

DOC-Q-LAX ORAL TABLET 8.6-50 MG P OTC

PERI-COLACE ORAL TABLET 8.6-50 MG P OTC

senna plus oral tablet 8.6-50 mg P OTC

senna s oral tablet 8.6-50 mg P OTC

senna-docusate sodium oral tablet 8.6-50 mg P OTC

SENNALAX-S ORAL TABLET 8.6-50 MG P OTC

senna-s oral tablet 8.6-50 mg P OTC

senna-time s oral tablet 8.6-50 mg P OTC


12


sennosides-docusate sodium oral tablet 8.6-50 mg

P OTC

*Laxatives - Miscellaneous**-*Laxatives - Miscellaneous***

sorbitol oral solution 70 % P OTC

*Saline Laxatives**-*Saline Laxative Mixtures***

enema enema 7-19 gm/118ml P OTC

sm oral saline laxative oral solution 2.7-7.2 gm/5ml

P OTC

*Saline Laxatives**-*Saline Laxatives***

citrate of magnesia oral solution 1.745 gm/30ml P OTC

CITROMA ORAL SOLUTION 1.745 GM/30ML

P OTC

DULCOLAX MILK OF MAGNESIA ORAL SUSPENSION 400 MG/5ML

P OTC

magnesium citrate oral solution 1.745 gm/30ml P OTC

milk of magnesia oral suspension 400 mg/5ml, 7.75 %

P OTC

*Stimulant Laxatives**-*Stimulant Laxatives***

BISAC-EVAC SUPPOSITORY 10 MG P OTC

biscolax suppository 10 mg P OTC

CARTERS LITTLE PILLS ORAL TABLET DELAYED RELEASE 5 MG

P OTC

correct oral tablet delayed release 5 mg P OTC

CORRECTOL ORAL TABLET DELAYED RELEASE 5 MG

P OTC

ducodyl oral tablet delayed release 5 mg P OTC

EX-LAX ORAL TABLET CHEWABLE 15 MG

P OTC

EX-LAX ULTRA ORAL TABLET DELAYED RELEASE 5 MG

P OTC

FEENAMINT ORAL TABLET DELAYED RELEASE 5 MG

P OTC

FLEET LAXATIVE ORAL TABLET DELAYED RELEASE 5 MG

P OTC

gentle laxative oral tablet delayed release 5 mg P OTC


13


laxative suppository 10 mg P OTC

natural senna laxative oral tablet 64.8-324 mg P OTC

senexon oral liquid† 8.8 mg/5ml P OTC

senexon oral tablet 8.6 mg P OTC

senna lax oral tablet 8.6 mg P OTC

senna laxative oral tablet 25 mg, 8.6 mg P OTC

senna oral syrup 8.8 mg/5ml P OTC

senna oral tablet 8.6 mg P OTC

SENNA SMOOTH ORAL TABLET 15 MG P OTC

SENNACON ORAL TABLET 8.6 MG P OTC

senna-lax oral tablet 8.6 mg P OTC

senna-tabs oral tablet 8.6 mg P OTC

senna-time oral tablet 8.6 mg P OTC

SENNO ORAL TABLET 8.6 MG P OTC

stimulant laxative oral tablet delayed release 5 mg

P OTC

womens laxative oral tablet delayed release 5 mg P OTC

*Surfactant Laxatives**-*Surfactant Laxatives***

CORRECTOL EXTRA GENTLE ORAL CAPSULE 100 MG

P OTC

d.o.s. oral capsule 250 mg P OTC

diocto oral liquid† 50 mg/5ml P OTC

diocto oral syrup 60 mg/15ml P OTC

docqlace oral capsule 100 mg P OTC

docu soft oral capsule 100 mg P OTC

docusate sodium oral tablet 100 mg P OTC

DOCUSIL ORAL CAPSULE 100 MG P OTC

dok oral capsule 100 mg, 250 mg P OTC

dok oral tablet 100 mg P OTC

dss oral capsule 100 mg, 250 mg P OTC

DULCOLAX STOOL SOFTENER ORAL CAPSULE 100 MG

P OTC

kao-tin oral capsule 240 mg P OTC

laxa basic oral capsule 100 mg P OTC

silace oral liquid† 150 mg/15ml P OTC


14


silace oral syrup 60 mg/15ml P OTC

SOF-LAX ORAL CAPSULE 100 MG P OTC

stool softener laxative dc oral capsule 240 mg P OTC

stool softener oral capsule 100 mg, 250 mg P OTC

SURFAK ORAL CAPSULE 240 MG P OTC

sur-q-lax oral capsule 240 mg P OTC

*Medical Devices*

*Respiratory Therapy Supplies**-*Respiratory Therapy Supplies***

ACE AEROSOL CLOUD ENHANCER P QL (2 EA per 365 days)

IN-CHECK DIAL FLOW TRAINER DEVICE

P QL (2 EA per 365 days)

PFLEX P QL (2 EA per 365 days)

THRESHOLD IMT P QL (2 EA per 365 days)

THRESHOLD PEP DEVICE P QL (2 EA per 365 days)

WINDMILL TRAINER P QL (2 EA per 365 days)

*Respiratory Therapy Supplies**-*Spacer/Aerosol-Holding Chambers & Supplies***

AEROCHAMBER MV P QL (2 EA per 365 days)

AEROCHAMBER PLUS FLO-VU P QL (2 EA per 365 days)

AEROCHAMBER PLUS FLO-VU LARGE P QL (2 EA per 365 days)

AEROCHAMBER PLUS FLO-VU SMALL P QL (2 EA per 365 days)

AEROCHAMBER PLUS FLO-VU W/MASK


AEROCHAMBER W/FLOWSIGNAL P QL (2 EA per 365 days)

AEROCHAMBER Z-STAT PLUS P QL (2 EA per 365 days)

AEROCHAMBER Z-STAT PLUS CHAMBR


EASIVENT P QL (2 EA per 365 days)

MICROCHAMBER P QL (2 EA per 365 days)

MICROSPACER P QL (2 EA per 365 days)

OPTICHAMBER ADVANTAGE P QL (2 EA per 365 days)

OPTIHALER P QL (2 EA per 365 days)

OPTIHALER DEVICE P QL (2 EA per 365 days)

POCKET CHAMBER DEVICE P QL (2 EA per 365 days)


15


POCKET SPACER DEVICE P QL (2 EA per 365 days)

WATCHHALER DEVICE P QL (2 EA per 365 days)

*Minerals & Electrolytes*

*Calcium**-*Calcium Combinations***

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

calcium 600-d oral tablet 600-400 mg-unit P OTC

calcium carbonate-vitamin d oral tablet 500-400 mg-unit, 600-400 mg-unit

P OTC

calcium high potency/vitamin d oral tablet600-200 mg-unit

P OTC

calcium oral tablet 500-125 mg-unit P OTC

calcium-carb 600 + d oral tablet 600-125 mg-unit

P OTC

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

P OTC

CALTRATE 600+D ORAL TABLET 600-800 MG-UNIT

P OTC

liquid calcium/vitamin d oral capsule 600-200 mg-unit

P OTC

OYSCO 500+D ORAL TABLET 500-200 MG-UNIT

P OTC

OYSCO D ORAL TABLET 250-125 MG-UNIT

P OTC

oyst-cal d oral tablet 250-125 mg-unit P OTC

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

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

P OTC

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

P OTC

oyster shell calcium/d oral tablet 250-125 mg-unit, 500-200 mg-unit

P OTC

oyster shell calcium/vitamin d oral tablet500-200 mg-unit

P OTC

oyster shell/vitamin d oral tablet 600-125 mg-unit

P OTC

*Calcium**-*Calcium***

calcarb 600 oral tablet 1500 mg P OTC


16


CAL-CARB FORTE ORAL TABLET 1250 MG

P OTC

CALCI-CHEW ORAL TABLET CHEWABLE 1250 MG

P OTC

calcium 600 oral tablet 600 mg P OTC

calcium carbonate oral suspension 1250 mg/5ml P OTC

calcium carbonate oral tablet 1250 mg, 600 mg P OTC

calcium high potency oral tablet 600 mg P OTC

calcium lactate oral tablet 648 mg P OTC

calcium oral tablet 600 mg P OTC

calcium oyster shell oral tablet 1250 mg P OTC

calcium-carb 600 oral tablet 600 mg P OTC

cal-lac oral capsule 500 mg P OTC

CALTRATE 600 ORAL TABLET 1500 MG P OTC

OYSCO 500 ORAL TABLET 500 MG P OTC

OYSTERCAL ORAL TABLET 500 MG P OTC

*Electrolyte Mixtures**-*Electrolytes Oral***

ORALYTE ORAL SOLUTION P OTC; QL (4000 ML per 31 days)

*Magnesium**-*Magnesium***

MAG64 ORAL TABLET EXTENDEDRELEASE* 535 (64 MG) MG

P OTC

mag-delay oral tablet extendedrelease* 535 (64 mg) mg

P OTC

magnacaps oral capsule 100 mg P OTC

magnesium oral tablet 250 mg P OTC

magnesium oxide oral tablet 400 (240 mg) mg P OTC

MAGNESIUM-OXIDE ORAL TABLET 400 (241.3 MG) MG

P OTC

mag-sr oral tablet extendedrelease* 535 (64 mg) mg

P OTC

MAG-TAB SR ORAL TABLET EXTENDEDRELEASE* 84 MG (7MEQ)

P OTC

*Zinc**-*Zinc***

ORAZINC ORAL CAPSULE 220 MG P OTC

zinc sulfate oral capsule 220 mg P OTC

zinc sulfate oral tablet 220 (50 zn) mg P OTC


17


zinc-220 oral capsule 220 mg P OTC

*Multivitamins*

*B-Complex W/ C**-*B-Complex W/ C***

vitamin b complex-c oral capsule P OTC

*B-Complex W/ Folic Acid**-*B-Complex W/ C & Folic Acid***

NEPHRONEX ORAL TABLET P

RENAL ORAL CAPSULE 1 MG P

rena-vite rx oral tablet 1 mg P

reno caps oral capsule 1 mg P

*Multiple Vitamins W/ Minerals**-*Multiple Vitamins W/ Minerals***

centamin oral liquid† P OTC

centavite a-z complete-mineral oral tablet P OTC

centavite oral liquid† P OTC

CEROVITE ADVANCED FORMULA ORAL TABLET

P OTC

CERTAVITE/ANTIOXIDANTS ORAL LIQUID†

P OTC

formula twenty-one oral tablet P OTC

gerivite complete oral tablet P OTC

multivitamin & mineral oral liquid† P OTC

SUPER NU-THERA ORAL TABLET P OTC

thera vital m oral tablet P OTC

therabasic-m oral tablet P OTC

therapeutic liquid oral solution P OTC

therapeutic-m oral tablet P OTC

TOTAL FORMULA 3 ORAL TABLET P OTC

*Multivitamins**-*Multivitamins***

daily multiple vitamins oral tablet P OTC

daily vite oral tablet P OTC

daily vites oral tablet P OTC

multi-day oral tablet P OTC

multi-vitamin oral tablet P OTC

multi-vitamins oral tablet P OTC

once daily oral tablet P OTC


18


one-daily multi vitamins oral tablet P OTC

THERA ORAL TABLET P OTC

THERA/BETA-CAROTENE ORAL TABLET

P OTC

therapeutic oral tablet P OTC

thera-tabs oral tablet P OTC

*Ped Mv W/ Fluoride**-*Ped Mv W/ Fluoride***

multi-vit/fluoride oral solution 0.25 mg/ml, 0.5 mg/ml

P

multivitamin/fluoride oral tablet chewable 0.25 mg, 0.5 mg, 1 mg

P

multi-vitamin/fluoride oral tablet chewable 0.5 mg

P

multivitamins/fluoride oral tablet chewable 0.25 mg

P

*Ped Mv W/ Iron**-*Ped Mv W/ Iron***

polyvitamin/iron oral solution 10 mg/ml P OTC

*Pediatric Multiple Vitamins**-*Pediatric Multiple Vitamins W/ C***

polyvitamin oral solution 35 mg/ml P OTC

*Pediatric Vitamins**-*Pediatric Vitamins A & D W/ C***

tri-vitamin oral solution 1500-400-35 P OTC

*Prenatal Vitamins**-*Prenatal Mv & Min W/Fe-Fa***

prenatal low iron oral tablet 27-0.8 mg P OTC

*Specialty Vitamins Products**-*Specialty Vitamins Products***

vitamins for hair oral tablet P OTC

*Nasal Agents - Systemic And Topical*

*Nasal Agents - Misc.**-*Nasal Agents - Misc.***

altamist spray nasal solution 0.65 % P OTC

AYR NASAL SOLUTION 0.65 % P OTC

deep sea nasal spray nasal solution 0.65 % P OTC

HUMIST NASAL SOLUTION 0.65 % P OTC


19


LITTLE NOSES SALINE NASAL SOLUTION 0.65 %

P OTC

NASAL MOIST NASAL SOLUTION 0.65 % P OTC

na-zone nasal solution 0.65 % P OTC

OCEAN FOR KIDS NASAL SOLUTION 0.65 %

P OTC

saline mist spray nasal solution 0.65 % P OTC

saline nasal spray nasal solution 0.65 % P OTC

sea soft nasal mist nasal solution 0.65 % P OTC

*Nasal Antiallergy**-*Nasal Mast Cell Stabilizers***

cromolyn sodium nasal aerosol, solution 5.2 mg/act

P OTC

*Sympathomimetic Decongestants**-*Systemic Decongestants***

pseudoephedrine hcl oral tablet 30 mg, 60 mg P OTC

*Ophthalmic Agents*

*Artificial Tears And Lubricants**-*Artificial Tear And Lubricant Combinations***

artificial tears ophthalmic ointment 83-15 % P OTC

HYPOTEARS OPHTHALMIC SOLUTION 1-1 %

P OTC

*Artificial Tears And Lubricants**-*Artificial Tear Ointments***

tears again ophthalmic ointment P OTC

ULTRA FRESH PM OPHTHALMIC OINTMENT

P OTC

*Artificial Tears And Lubricants**-*Artificial Tear Solutions***

tears again ophthalmic solution P OTC

*Artificial Tears And Lubricants**-*Artificial Tears And Lubricants***

artificial tears ophthalmic solution 1.4 % P OTC; QL (15 ML per 31 days)

liquitears ophthalmic solution 1.4 % P OTC; QL (15 ML per 31 Days)

polyvinyl alcohol ophthalmic solution 1.4 % P OTC; QL (15 ML per 31 Days)


20


*Ophthalmics - Misc.**-*Ophthalmic Antiallergic***

ALAWAY OPHTHALMIC SOLUTION 0.025 %

P OTC

ketotifen fumarate ophthalmic solution 0.025 % P OTC

*Otic Agents*

*Otic Agents - Miscellaneous**-*Otic Agents - Miscellaneous***

auraphene-b otic solution 6.5 % P OTC

AURO EARDROPS OTIC SOLUTION 6.5 %

P OTC

ear drops earwax aid otic solution 6.5 % P OTC

earwax treatment drops otic solution 6.5 % P OTC

E-R-O EAR DROPS OTIC SOLUTION 6.5 %

P OTC

E-R-O EAR WAX REMOVAL SYSTEM OTIC SOLUTION 6.5 %

P OTC

MURINE EAR OTIC SOLUTION 6.5 % P OTC

MURINE EAR WAX REMOVAL SYSTEM OTIC SOLUTION 6.5 %

P OTC

OTIX OTIC SOLUTION 6.5 % P OTC

thera-ear otic solution 6.5 % P OTC

*Psychotherapeutic And Neurological Agents - Misc.*

*Smoking Deterrents**-*Smoking Deterrents***

nicotine polacrilex mouth/throat gum 2 mg, 4 mg POTC; QL (4032 EA per 365 days)

nicotine transdermal patch 24 hr 14 mg/24hr, 21 mg/24hr, 7 mg/24hr


*Ulcer Drugs*

*H-2 Antagonists**-*H-2 Antagonists***

acid reducer oral tablet 75 mg P OTC

cimetidine oral tablet 200 mg P OTC

famotidine oral tablet 10 mg P OTC


21


*Proton Pump Inhibitors**-*Proton Pump Inhibitors***

omeprazole oral tablet delayed release 20 mg P OTC

*Vaginal Products*

*Vaginal Anti-Infectives**-*Imidazole-Related Antifungals***

GYNE-LOTRIMIN 3 VAGINAL CREAM 2 %

P OTC

miconazole 3 combo pack vaginal kit 200-2 mg-% (9gm)

P OTC

miconazole nitrate vaginal cream 2 % P OTC

miconazole nitrate vaginal suppository 100 mg P OTC

MONISTAT 3 VAGINAL CREAM 4 % P OTC

*Vitamins*

*Oil Soluble Vitamins**-*Vitamin A***

vitamin a oral capsule 10000 unit, 8000 unit P OTC

*Oil Soluble Vitamins**-*Vitamin D***

CALCIFEROL ORAL SOLUTION 8000 UNIT/ML

P OTC

vitamin d (ergocalciferol) oral capsule 50000 unit


vitamin d oral capsule 1000 unit, 400 unit P OTC

vitamin d oral tablet 400 unit P OTC

vitamin d3 oral capsule 2000 unit P OTC

vitamin d3 oral tablet 1000 unit, 400 unit P OTC

vitamin d3 oral tablet chewable 400 unit P OTC

vitamin d-400 oral tablet 400 unit P OTC

*Oil Soluble Vitamins**-*Vitamin E***

vitamin e oral capsule 400 unit P OTC

vitamin e oral tablet chewable 400 unit P OTC

*Oil Soluble Vitamins**-*Vitamin K***

vitamin k (phytonadione) oral tablet 100 mcg P OTC

*Water Soluble Vitamins**-*Vitamin B-1***

vitamin b-1 oral tablet 100 mg, 250 mg, 50 mg P OTC


vitamin b-2 oral tablet 100 mg P OTC


22



niacin er oral capsule extended release* 250 mg P OTC

niacin er oral tablet extendedrelease* 250 mg P OTC

niacin oral tablet 100 mg, 250 mg, 50 mg, 500 mg

P OTC


vitamin b-6 er oral tablet extendedrelease* 200 mg

P OTC

vitamin b-6 oral tablet 100 mg, 25 mg, 250 mg, 50 mg, 500 mg

P OTC

*Water Soluble Vitamins**-*Vitamin C***

ascorbic acid oral tablet 1000 mg, 250 mg, 500 mg

P OTC

ascorbic acid oral tablet chewable 250 mg P OTC

c-500 oral tablet chewable 500 mg P OTC

vitamin c oral syrup 500 mg/5ml P OTC

vitamin c oral tablet 100 mg, 1000 mg, 250 mg, 500 mg

P OTC

vitamin c oral tablet chewable 100 mg, 250 mg P OTC


23


24

Index

Index

ACE AEROSOL CLOUD ENHANCER .................................................. 15acetaminophen .................................................... 1ACID GONE ..................................................... 3acid reducer ......................................................... 21acne medication 5 ........................................... 8AEROCHAMBER MV .................. 15AEROCHAMBER PLUS FLO-VU ................................................................. 15AEROCHAMBER PLUS FLO-VU LARGE .................................... 15AEROCHAMBER PLUS FLO-VU SMALL .................................... 15AEROCHAMBER PLUS FLO-VU W/MASK ............................... 15AEROCHAMBER W/FLOWSIGNAL ................................ 15AEROCHAMBER Z-STAT PLUS ........................................................................... 15AEROCHAMBER Z-STAT PLUS CHAMBR ...................................... 15alamag plus ............................................................. 3ALAVERT ALLERGY/SINUS................................................................................................... 8ALAWAY ........................................................... 21alcalak ............................................................................ 4aler-cap ......................................................................... 6aler-dryl ........................................................................ 6alertab ............................................................................ 6ALLEGRA ALLERGY CHILDRENS .................................................... 7ALLEGRA-D ALLERGY & CONGESTION .............................................. 8aller-chlor .................................................................. 6allergy ..................................................................... 6, 7allergy relief ........................................................... 6allergy relief childrens .............................. 6allergy relief/nasal decongest .......... 8ALMACONE .................................................... 3altamist spray ................................................... 19altaryl .............................................................................. 6aluminum hydroxide gel ......................... 4AMLACTIN .................................................... 10ammonium lactate ...................................... 10antacid .................................................................... 3, 4antacid anti-gas ................................................. 3antacid anti-gas max strength ....... 3antacid extra strength ............................... 3antacid i ........................................................................ 3antacid iii .................................................................... 3

Index

anti-diarrheal ........................................................ 5anti-hist allergy .................................................. 6anti-itch maximum strength ............. 9apap ................................................................................... 1apap extra strength ...................................... 1artificial tears ................................................... 20ascorbic acid ....................................................... 23aspirin ............................................................................. 2aspirin adult low strength ..................... 2aspirin childrens ................................................ 2aspirin ec ..................................................................... 2aspirin ec low dose ......................................... 2aspirin low dose ................................................. 2auraphene-b ......................................................... 21AURO EARDROPS ........................... 21AVEENO ANTI-ITCH MAX ST ......................................................................................... 9AYR ............................................................................. 19bacitracin ................................................................... 9bacitracin zinc ..................................................... 9bacitracin-neomycin-polymyxin................................................................................................... 9BANOPHEN ...................................................... 6BD GLUCOSE ................................................ 5BENADRYL ALLERGY CHILDRENS .................................................... 6BENADRYL ITCH STOPPING ........................................................... 9benzoyl peroxide .............................................. 8BISAC-EVAC ................................................ 13biscolax ..................................................................... 13bismatrol ..................................................................... 5bismuth .......................................................................... 5BRONCHO SALINE ............................ 8BROTAPP .............................................................. 8c-500 .............................................................................. 23calcarb 600 ........................................................... 16CAL-CARB FORTE .......................... 17CALCI-CHEW ............................................ 17CALCIFEROL ............................................ 22calcium ............................................................ 16, 17calcium + d3 ....................................................... 16calcium 600 .......................................................... 17calcium 600-d .................................................... 16calcium antacid .................................................. 4calcium antacid extra strength ..... 4calcium carbonate ....................................... 17calcium carbonate antacid .................. 4calcium carbonate-vitamin d ........ 16calcium high potency .............................. 17

Index

calcium high potency/vitamin d............................................................................................... 16calcium lactate ................................................ 17calcium oyster shell ................................... 17calcium-carb 600 .......................................... 17calcium-carb 600 + d .............................. 16calcium-vitamin d ........................................ 16CAL-GEST ANTACID ..................... 4cal-lac .......................................................................... 17CALTRATE 600 ....................................... 17CALTRATE 600+D ............................ 16capsaicin .................................................................. 10CARTERS LITTLE PILLS ...... 13centamin ................................................................... 18centavite ................................................................... 18centavite a-z complete-mineral............................................................................................... 18CEROVITE ADVANCED FORMULA ...................................................... 18CERTAVITE/ANTIOXIDANTS .......................................................................................... 18cetirizine hcl ........................................................... 7cetirizine hcl childrens .............................. 7cetirizine hcl childrens alrgy ............ 7cetirizine-pseudoephedrine er .......... 8childrens ibuprofen ........................................ 1childrens loratadine ...................................... 7childrens non-asa pain relief ............. 1childrens non-aspirin ................................... 1childrens pain reliever ............................... 1childrens silapap ............................................... 1childrens tactinal .............................................. 1chlorhexidine gluconate .......................... 7chlorhist ........................................................................ 6chlorphen .................................................................... 6cimetidine ............................................................... 21citrate of magnesia .................................... 13CITROMA ......................................................... 13CLEAR AWAY 1-STEP WART REMOVER ....................................................... 10clotrimazole ............................................................ 9complete allergy medication ............. 6complete allergy relief .............................. 6COMPOUND W ...................................... 10COMPOUND W MAXIMUM STRENGTH .................................................... 10compoz ....................................................................... 11correct ......................................................................... 13CORRECTOL .............................................. 13


25

Index

CORRECTOL EXTRA GENTLE .............................................................. 14cromolyn sodium .......................................... 20cyanocobalamin ............................................. 11d.o.s. .............................................................................. 14daily multiple vitamins ......................... 18daily vite .................................................................. 18daily vites ................................................................ 18dakins .............................................................................. 7dakins (1/2 strength) ................................. 7dakins (1/4 strength) ................................. 7deep sea nasal spray ................................. 19DIABETIC TUSSIN ALLERGY ............................................................ 6diocto ............................................................................ 14diotame .......................................................................... 5diphenhist ................................................................... 6diphenhydramine hcl ................................... 6docqlace .................................................................... 14DOC-Q-LAX .................................................. 12docu soft ................................................................... 14docusate sodium ............................................ 14DOCUSIL ........................................................... 14dok ................................................................................... 14DORMIN ................................................................ 6double antibiotic ............................................... 9dss ..................................................................................... 14ducodyl ....................................................................... 13DULCOLAX MILK OF MAGNESIA .................................................... 13DULCOLAX STOOL SOFTENER ..................................................... 14ear drops earwax aid .............................. 21earwax treatment drops ...................... 21EASIVENT ........................................................ 15ECPIRIN .................................................................. 3ed-apap .......................................................................... 1enema ........................................................................... 13E-R-O EAR DROPS ........................... 21E-R-O EAR WAX REMOVAL SYSTEM ............................................................... 21EX-LAX ................................................................. 13EX-LAX ULTRA .................................... 13famotidine .............................................................. 21FEENAMINT ............................................... 13ferro-bob .................................................................. 11ferrous sulfate ................................................... 11ferrousul ................................................................... 11fexofenadine hcl ................................................ 7fexofenadine-pseudoephed er .......... 8fiber ................................................................................ 12fiber laxative ...................................................... 12

Index

fiber therapy ....................................................... 12FIBERGEN ...................................................... 12fiber-lax .................................................................... 12FLEET LAXATIVE ............................ 13folic acid .................................................................. 11formula twenty-one ................................... 18FREEZONE .................................................... 10genahist ......................................................................... 7gentle laxative .................................................. 13geri-lanta .................................................................... 3gerivite complete ........................................... 18glucose ............................................................................ 5gnp foaming antacid .................................... 4GYNE-LOTRIMIN 3 ....................... 22headache pm ....................................................... 11HUMIST ............................................................... 19hydrocortisone ..................................................... 9hydrocortisone max st .............................. 9hydrocortisone max st/12 moist................................................................................................... 9hydrocortisone-aloe .................................. 10HYDROSKIN .................................................. 9HYPOTEARS ............................................... 20ibuprofen ..................................................................... 1IN-CHECK DIAL FLOW TRAINER .......................................................... 15infants silapap ...................................................... 1ipecac ............................................................................... 5iron .................................................................................. 11itch relief ..................................................................... 9KAOPECTATE ............................................. 5KAOPECTATE EXTRA STRENGTH ....................................................... 5kao-tin ................................................................. 5, 14ketotifen fumarate ...................................... 21KONSYL .............................................................. 12KONSYL FIBER ..................................... 12kp hydrocortisone ........................................... 9laxa basic ................................................................ 14laxative ...................................................................... 14liquid calcium/vitamin d ..................... 16liquitears .................................................................. 20LITTLE NOSES SALINE .......... 20LOPERAMIDE A-D ............................. 5loperamide hcl ..................................................... 5loratadine ................................................................... 7loratadine hives relief ................................. 7MAALOX ............................................................... 4MAALOX ADVANCED ................ 3MAALOX ADVANCED MAX ST ......................................................................................... 3MAALOX MAX .......................................... 3

Index

MAALOX MULTI SYMPTOM MAX ST .................................................................... 3MAALOX REGULAR STRENGTH ....................................................... 3MAG64 .................................................................... 17mag-delay .............................................................. 17magnacaps ............................................................ 17magnesium ............................................................ 17magnesium citrate ...................................... 13magnesium oxide .................................. 4, 17MAGNESIUM-OXIDE ................ 17mag-sr ......................................................................... 17MAG-TAB SR .............................................. 17mapap .............................................................................. 2mapap arthritis pain .................................... 1MAPAP CHILDRENS ....................... 2mapap pm ............................................................... 11maxapap maximum strength ........... 2maxapap regular strength ................... 2meclizine hcl ........................................................... 5melatonin maximum strength ......... 1METAMUCIL ............................................. 12METAMUCIL MULTIHEALTH FIBER .......... 12METAMUCIL SMOOTH TEXTURE ......................................................... 12MI-ACID ................................................................. 4mi-acid gas relief .......................................... 10miconazole 3 combo pack ................ 22miconazole nitrate ...................................... 22MICROCHAMBER ............................ 15MICROSPACER ..................................... 15milantex ....................................................................... 3milantex extra strength .......................... 3milk of magnesia .......................................... 13MINTOX PLUS ............................................ 3MONISTAT 3 ............................................... 22mucus relief ............................................................. 8multi-day ................................................................. 18multi-vit/fluoride ........................................... 19multi-vitamin ..................................................... 18multivitamin & mineral ........................ 18multivitamin/fluoride .............................. 19multi-vitamin/fluoride ............................ 19multi-vitamins .................................................. 18multivitamins/fluoride ........................... 19MURINE EAR ........................................... 21MURINE EAR WAX REMOVAL SYSTEM ...................... 21mytab gas ............................................................... 10NASAL MOIST ......................................... 20natural fiber therapy ............................... 12


26

Index

natural senna laxative ........................... 14natural vegetable fiber .......................... 12na-zone ....................................................................... 20NEPHRONEX ............................................. 18niacin ............................................................................ 23niacin er .................................................................... 23nicotine ...................................................................... 21nicotine polacrilex ...................................... 21non-aspirin ................................................................ 2non-aspirin extra strength ................... 2non-aspirin pain relief ............................... 2nortemp infants .................................................. 2NYTOL ................................................................... 11OCEAN FOR KIDS ............................ 20omeprazole ........................................................... 22once daily ................................................................ 18one-daily multi vitamins ..................... 19OPERAND POVIDONE-IODINE .......................... 8OPTICHAMBER ADVANTAGE ............................................ 15OPTIHALER ................................................. 15ORALYTE ......................................................... 17ORAZINC .......................................................... 17OTIX ........................................................................... 21OYSCO 500 ....................................................... 17OYSCO 500+D ............................................ 16OYSCO D ............................................................ 16oyst-cal d ................................................................. 16oyster calcium + d ...................................... 16oyster shell calcium + d ...................... 16oyster shell calcium 500 + d ......... 16oyster shell calcium/d ............................. 16oyster shell calcium/vitamin d .... 16oyster shell/vitamin d .............................. 16OYSTERCAL ............................................... 17pain & fever childrens ................................ 2pain relief ................................................................... 2pain relief extra strength ...................... 2pain relief pm extra strength ........ 11pain reliever pm .............................................. 11PERI-COLACE .......................................... 12permethrin ............................................................. 10PFLEX ..................................................................... 15pharbedryl ................................................................. 7PHARBETOL ................................................... 2PHARBETOL EXTRA STRENGTH ....................................................... 2phenazopyridine hcl .................................. 10pink bismuth ........................................................... 5POCKET CHAMBER ..................... 15POCKET SPACER ............................... 16

Index

POLY-IRON 150 ...................................... 11polyvinyl alcohol ........................................... 20polyvitamin .......................................................... 19polyvitamin/iron ............................................ 19povidone-iodine .................................................. 8prenatal low iron .......................................... 19PREPARATION H HYDROCORTISONE .................... 10pseudoephedrine hcl ................................. 20q-dryl ................................................................................ 7q-pap ................................................................................. 2Q-TAPP ...................................................................... 8quenalin ........................................................................ 7reeses pinworm medicine ....................... 4refenesen ...................................................................... 8refenesen 400 ......................................................... 8REGULOID .................................................... 12RENAL ................................................................... 18rena-vite rx ........................................................... 18reno caps .................................................................. 18robafen ........................................................................... 8SALACTIC FILM .................................. 10saline mist spray ........................................... 20saline nasal spray ......................................... 20SCOT-TUSSIN ALLERGY RELIEF ...................................................................... 7sea soft nasal mist ....................................... 20senexon ...................................................................... 14senna ............................................................................. 14senna lax .................................................................. 14senna laxative ................................................... 14senna plus ............................................................... 12senna s ........................................................................ 12SENNA SMOOTH ................................ 14SENNACON .................................................. 14senna-docusate sodium ......................... 12senna-lax ................................................................. 14SENNALAX-S ............................................. 12senna-s ........................................................................ 12senna-tabs .............................................................. 14senna-time ............................................................. 14senna-time s ......................................................... 12SENNO ................................................................... 14sennosides-docusate sodium .......... 13silace .................................................................. 14, 15siladryl allergy .................................................... 7silphen cough ......................................................... 7simethicone ........................................................... 10SIMPLY ALLERGY ............................. 7SIMPLY SLEEP ........................................ 11sleep tabs ................................................................. 11sleep-tabs ................................................................ 12

Index

slow release iron ............................................ 11sm hydrocortisone plus ......................... 10sm oral saline laxative .......................... 13sodium bicarbonate ....................................... 4sodium chloride .................................................. 8SOF-LAX ............................................................. 15SOMINEX .......................................................... 12SOMINEX MAXIMUM STRENGTH .................................................... 12sorbitol ....................................................................... 13stimulant laxative ........................................ 14stomach relief ....................................................... 5stomach relief plus ......................................... 5stool softener ..................................................... 15stool softener laxative dc .................. 15SUPER NU-THERA ......................... 18SURFAK .............................................................. 15sur-q-lax ................................................................... 15tactinal ........................................................................... 2tactinal extra strength .............................. 2tears again ............................................................. 20terbinafine hcl ...................................................... 9tetra-formula nighttime sleep ...... 12tgt anti-itch/aloe/vit e ............................. 10THERA ................................................................... 19thera vital m ........................................................ 18THERA/BETA-CAROTENE............................................................................................... 19therabasic-m ....................................................... 18thera-ear .................................................................. 21therapeutic ............................................................ 19therapeutic liquid ......................................... 18therapeutic-m .................................................... 18thera-tabs ............................................................... 19THRESHOLD IMT ............................. 15THRESHOLD PEP .............................. 15TITRALAC .......................................................... 4total allergy ............................................................. 7TOTAL ALLERGY MEDICINE .......................................................... 7TOTAL FORMULA 3 .................... 18travel sickness ...................................................... 5tri-buffered aspirin ........................................ 2triple antibiotic ................................................... 9triprolidine-pse .................................................... 8tri-vitamin .............................................................. 19ULTRA FRESH PM .......................... 20vitamin a .................................................................. 22vitamin b complex-c ................................. 18vitamin b-1 ............................................................ 22vitamin b-12 ........................................................ 11vitamin b-12 er ................................................ 11


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Index

vitamin b-2 ............................................................ 22vitamin b-6 ............................................................ 23vitamin b-6 er .................................................... 23vitamin c .................................................................. 23vitamin d .................................................................. 22vitamin d (ergocalciferol) ............... 22vitamin d3 .............................................................. 22vitamin d-400 .................................................... 22vitamin e .................................................................. 22vitamin k (phytonadione) ................ 22vitamins for hair ............................................ 19WATCHHALER ...................................... 16WINDMILL TRAINER .............. 15womens laxative ............................................ 14zinc sulfate ............................................................ 17zinc-220 ..................................................................... 18


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comprehensive dual eligible preferred drug list 9...2015 comprehensive dual eligible preferred drug...

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