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Health Share of Oregon/Providence (Medicaid)To help find a drug see the back of the document for an alphabetical listing

Drug Name Status* Requirements/Limits

Analgesics

8 HOUR OTC

8 HOUR PAIN RELIEF OTC

8 HOUR PAIN RELIEVER OTC

ACEPHEN (325 MG, 650 MG) OTC

ACETADRYL OTC

acetaminophen (80mg/0.8ml dropssusp, 120 mg supp.rect, 160 mg/5mloral susp, 160 mg/5ml solution, 160mg/5ml elixir, 160 mg/5ml liquid,325/10.15 solution, 325 mg tablet, 500mg tablet, 500 mg/5ml liquid,650mg/20.3 solution, 650 mg tablet er,650 mg supp.rect)

OTC

ACETAMINOPHEN PM OTC

ACETAMINOPHEN PM XTRA STRENGTH OTC

acetaminophen/diphenhydramine hcl OTC

alagesic lq Generic

ARTHRITIS PAIN OTC

ARTHRITIS PAIN RELIEF (ARTHRITIS ER650 MG CAPLT, ARTHRITIS RELF ER 650MG, ARTHRITIS RLF ER 650 MG, CVSARTHRITIS ER 650 MG, GNP ARTHRITRLF ER 650 MG, HM ARTHRITIS ER 650MG, KRO ARTHRIT RLF ER 650 MG, PUBARTHRITIS ER 650 MG, PV ARTHRITIS ER650 MG, QC ARTHRITIS ER 650 MG, RAARTHRITIS ER 650 MG, SB ARTHRITIS ER650 MG, SM ARTHRITIS ER 650 MG, SMARTHRITIS RELF ER 650)

OTC

ARTHRITIS PAIN RELIEVER OTC

aspirin (500 mg tablet dr, 600 mgsupp.rect, 650 mg tablet dr)

OTC

ATHENOL OTC

BETATEMP OTC

*Specialty medications are only available through the Providence specialty network. See introduction.^A formulary brand drug becomes non-formulary when it becomes available as a generic drug.

PA - Prior Authorization, QL - Quantity Limits, ST - Step Therapy, LA- Limited Access1 LAST UPDATE 10/2015


Drug Name Status* Requirements/Limitsbutalbital/acetaminophen Generic

butalbital/acetaminophen/caffeine(capsule, tablet)

Generic

butalbital/aspirin/caffeine Generic

capacet Generic

CHILD PAIN REL-FEVER REDUCER OTC

CHILDREN'S FEVER REDUCER OTC

CHILDREN'S FEVER REDUCING OTC

CHILDREN'S MEDI-TABS OTC

CHILDREN'S NON-ASPIRIN (CHILD NON-ASPIRIN 160 MG/5 ML, CVS CHILD NON-ASA 80 MG TB CHW, NON-ASACHILDREN'S TAB CHEW, NON-ASA PAINRELIEF TB CHEW, NON-ASPIRIN 160MG/5 ML SUSP, NON-ASPIRIN CHILD 80MG TAB, NON-ASPIRIN CHILD 120 MGSUP, NON-ASPIRIN CHILD'S DROPS, PVCHILD NON-ASA 80 MG TB CHEW, PVCHILD NON-ASPIRIN 160 MG/5, PVCHILDREN'S NON-ASA LIQ, RA NON-ASPIRIN 160 MG/5 ML)

OTC

CHILDREN'S PAIN & FEVER (CHILD PAIN& FEVER 160 MG/5 ML, CHILD PAIN-FEVER 80 MG TAB CHW, GNP CHILDPAIN-FEVER 160 MG/5, GNP CHL PAIN-FEVER 160 MG/5 ML, HM CHLD PAIN-FEVER 160 MG/5 ML, KRO CHILD PAIN-FEVER 160 MG/5, SM CHILD PAIN &FEVER 160 MG/5)

OTC

CHILDREN'S PAIN RELIEF OTC

CHILDREN'S PAIN RELIEVER (CHILD'SSUSP, EQ CHILD'S SUSP, EQL CHILD'SSUSP, SB CHILD'S SUSP, SM 80 MG TAB,SM CHEW TAB, SM CHILD'S SUSP)

OTC

CHILDREN'S Q-PAP OTC

CHILDREN'S SILAPAP OTC

CHILDREN'S TACTINAL OTC




Drug Name Status* Requirements/LimitsEAZZZE THE PAIN OTC

ED-APAP OTC

EXTRA STRENGTH NON-ASPIRIN OTC

FEVER REDUCER & PAIN RELIEVER OTC

FEVERALL (120 MG, 325 MG, 650 MG) OTC

HEADACHE PM OTC

HEADACHE PM FORMULA OTC

INFANT FEVER-PAIN RELIEVER OTC

INFANT PAIN & FEVER OTC

INFANT PAIN RELIEF OTC

INFANT'S NON-ASPIRIN OTC

INFANT'S PAIN RELIEF OTC

INFANT'S PAIN RELIEVER OTC

INFANTS' MAPAP OTC

INFANTS' PAIN & FEVER OTC

INFANTS' PAIN RELIEF OTC

INFANTS' PAIN RELIEVER OTC

LITTLE REMEDIES FEVER & PAIN OTC

MAPAP (80 MG TABLET CHEW, 160MG/5 ML ELIXIR, 160 MG/5 MLSUSPENSION, 325 MG TABLET, 500 MGTABLET, 500 MG/15 ML LIQUID, 500MG CAPLET, 500 MG GELCAP, 500 MGCAPSULE)

OTC

MAPAP ARTHRITIS PAIN OTC

MAPAP PM OTC

MASOPHEN OTC

MEDI-TABS OTC

MEDI-TABS EXTRA STRENGTH OTC

MEDI-TABS PM OTC




Drug Name Status* Requirements/LimitsNIGHT TIME PAIN MEDICINE OTC

NON-ASPIRIN (CVS NON-ASA 80 MGTABLET CHW, MEDI-FIRST NON-ASPIRIN325 MG, NON-ASPIRIN 80 MG TABCHEW, NON-ASPIRIN 160 MG/5 MLELIX, NON-ASPIRIN 325 MG TABLET, PVNON-ASPIRIN 325 MG TABLET, SB NON-ASPIRIN 80 MG TAB CHW, SB NON-ASPIRIN 325 MG TABLET, V-R NON-ASPIRIN INFANT DRPS)

OTC

NON-ASPIRIN 8 HOUR OTC

NON-ASPIRIN EXTRA STRENGTH (CVSNON-ASPIRIN 500 MG GELTAB, CVSNON-ASPIRIN 500 MG CAPLET, CVSNON-ASPIRIN 500 MG TABLET, NONASPIRIN 500 MG CAPLET, NON-ASPIRIN500 MG GELTAB, NON-ASPIRIN 500 MGGELCAP, NON-ASPIRIN 500 MGSOFTGEL, NON-ASPIRIN 500 MGTABLET, NON-ASPIRIN 500 MG CAPLET,NON-ASPIRIN X-STR 167 MG/5 ML, PVNON-ASPIRIN 500 MG SOFTGEL, RANON-ASPIRIN 500 MG CAPLET, SB NON-ASPIRIN 500 MG CAPLET, SM NON-ASPIRIN 500 MG CAPLET)

OTC

NON-ASPIRIN JR STRENGTH OTC

NON-ASPIRIN PAIN RELIEF OTC

NON-ASPIRIN PM OTC

NON-ASPIRIN PM EX-STRENGTH OTC

NORTEMP OTC

PAIN & FEVER (& 500 MG CAPLET, &500 MG TABLET)

OTC

PAIN & SLEEP OTC




Drug Name Status* Requirements/LimitsPAIN RELIEF (CVS RELIEF 500 MGGELCAP, EQL RELIEF 500 MG TABLET,EQL RELIEF 500 MG CAPLET, EQL RELIEF500 MG GELTAB, EQL RLF 160 MG/5 MLLIQ, GNP RELIEF 500 MG GELCAP, GNPRELIEF ER 650 MG CPLT, HM RELIEF 500MG CAPLET, HM RELIEF 500 MGTABLET, PUB RELIEF 500 MG TABLET,PUB RELIEF 500 MG GELTAB, PUBRELIEF 500 MG CAPLET, PV RELIEF 500MG TABLET, RELIEF 160 MG/5 MLLIQUID, RELIEF 325 MG TABLET, RELIEF500 MG GELTAB, RELIEF 500 MGCAPLET, RELIEF 500 MG CAPSULE,RELIEF 500 MG GELCAP, RELIEF 500 MGTABLET, RELIEF ER 650 MG CAPLET, SMRELIEF 500 MG GELCAP)

OTC

PAIN RELIEF ADULT OTC

PAIN RELIEF EXTRA STRENGTH (CVS 500MG CAPLET, CVS 500 MG EZ-TAB, GNP500 MG CAPLET, PV 500 MG CAPLET)

OTC

PAIN RELIEF PM OTC

PAIN RELIEVER (325 MG TABLET, CVS500 MG CPLT, EQ 500 MG CAPLET, ER650 MG CAPLET, GNP 325 MG TAB,GNP 500 MG TAB, GNP 500 MG CAPLT,HM 325 MG TABLET, HM 500 MGTABLET, SB 500 MG CAPLET, SB 500 MGGELCAP, SM 325 MG TABLET, SM 500MG GELTAB, 500 MG CAPLET, 500 MGGELCAP, 500 MG TABLET, SM 500 MGTABLET, SM 500 MG CAPLET)

OTC

PAIN RELIEVER JUNIOR STRENGTH OTC

PAIN RELIEVER PM OTC

PAIN RELIEVER-FEVER REDUCER OTC

PEDIACARE FEVER REDUCER OTC

PHARBETOL OTC

Q-PAP (80 MG/0.8 ML DROPS, 160MG/5 ML LIQUID, 160 MG/5 MLSOLUTION, 325 MG TABLET)

OTC




Drug Name Status* Requirements/LimitsQ-PAP EXTRA STRENGTH OTC

SHAKE THAT ACHE OTC

TACTINAL OTC

tencon 50-325 mg tablet Generic

TENSION HEADACHE RELIEVER OTC

TYLENOL PM EXTRA STRENGTH OTC

TYLOPHEN OTC

vanatol lq Generic

WAL-NADOL PM OTC

zebutal capsule Generic

Nonsteroidal Anti-inflammatory DrugsADULT LOW DOSE ASPIRIN EC OTC

ADVIL JR STR 100 MG TAB CHEW OTC

ALL DAY PAIN RELIEF (CVS PAIN RLF 220MG TB, EQL RLF 220 MG CAPLET, GNPPAIN RLF 220 MG TB, PAIN RELIEF 220MG TAB, PAIN RLF 220 MG CAPLET, SMRELIEF 220 MG CAPLT, SM RELIEF 220MG TAB)

OTC

ALL DAY RELIEF OTC

ASPIR 81 OTC

ASPIR-LOW OTC

ASPIR-TRIN OTC

aspirin (81 mg tab chew, 81 mg tabletdr, 300 mg supp.rect, 325 mg tablet,bayer 325 mg caplet, bayer 325 mgtablet, 325 mg tablet dr)

OTC

aspirin 975 mg tablet dr Generic

celecoxib (50 mg capsule, 100 mgcapsule, 200 mg capsule)

Generic PA, QL (2 PER DAY)

celecoxib 400 mg capsule Generic PA, QL (1 PER DAY)

CHILD IBUPROFEN OTC




Drug Name Status* Requirements/LimitsCHILDREN'S ADVIL OTC

CHILDREN'S IBUPROFEN OTC

CHILDREN'S MEDI-PROFEN OTC

CHILDREN'S PROFEN IB OTC

CHILDREN'S PROFENIB OTC

choline sal/mag salicylate 500 mg/5mlliquid

Generic

diclofenac potassium Generic

diclofenac sodium (25 mg tablet dr, 50mg tablet dr, 75 mg tablet dr, 100 mgtab er 24h)

Generic

diflunisal Generic

ECOTRIN EC 81 MG TABLET OTC

ECPIRIN OTC

etodolac (200 mg capsule, 300 mgcapsule, 400 mg tab er 24h, 400 mgtablet, 500 mg tablet, 500 mg tab er24h, 600 mg tab er 24h)

Generic

fenoprofen calcium 600 mg tablet Generic

FLANAX 220 MG TABLET OTC

flurbiprofen (50 mg tablet, 100 mgtablet)

Generic

I-PRIN OTC

IBU-DROPS OTC

ibuprofen (400 mg tablet, 600 mgtablet, 800 mg tablet)

Generic

ibuprofen (50 mg/1.25 drops susp, 100mg/5ml oral susp, 100 mg tab chew,200 mg capsule, 200 mg tablet)

OTC

INDOCIN (25 MG/5 ML SUSPENSION, 50MG SUPPOSITORY)

Brand

indomethacin (25 mg capsule, 50 mgcapsule, 75 mg capsule er)

Generic




Drug Name Status* Requirements/LimitsINFANTS IBU-DROPS OTC

INFANTS MEDI-PROFEN OTC

INFANTS PROFENIB OTC

ketoprofen (50 mg capsule, 75 mgcapsule, 200 mg cap24h pel)

Generic

ketorolac tromethamine 10 mg tablet Generic

meclofenamate sodium (50 mg capsule,100 mg capsule)

Generic

MEDI-PROFEN OTC

MEDIPROXEN OTC

meloxicam (7.5 mg tablet, 15 mgtablet)

Generic

MINIPRIN OTC

MOTRIN IB OTC

nabumetone (500 mg tablet, 750 mgtablet)

Generic

NAPRELAN CR 500 MG TABLET Brand

naproxen (125 mg/5ml oral susp, 250mg tablet, 375 mg tablet, 375 mg tabletdr, 500 mg tablet dr, 500 mg tablet)

Generic

naproxen sodium (275 mg tablet, 550mg tablet)

Generic

naproxen sodium 220 mg tablet OTC

naproxen sodium 500 mg tbmp 24hr Brand

oxaprozin Generic

piroxicam (10 mg capsule, 20 mgcapsule)

Generic

PROVIL OTC

ST. JOSEPH ASPIRIN OTC

sulindac (150 mg tablet, 200 mg tablet) Generic

tolmetin sodium Generic




Drug Name Status* Requirements/LimitsWAL-PROXEN OTC

Opioid Analgesics, Long-actingfentanyl (12 mcg/hr patch td72,25mcg/hr patch td72, 50mcg/hr patchtd72, 75mcg/hr patch td72, 100 mcg/hrpatch td72)

Generic QL (15 PER 30 DAYS)

KADIAN ER 200 MG CAPSULE Brand

methadone hcl (5 mg/5 ml solution, 5mg tablet, 10 mg/5 ml solution, 10mg/ml oral conc, 10 mg tablet, 40 mgtablet sol)

Generic

methadone intensol Generic

methadose 40 mg tablet dispr Generic

morphine sulfate (15 mg tablet er, 30mg cap er pel, 30 mg tablet er, 50 mgcap er pel, 60 mg cap er pel, 60 mgtablet er, 80 mg cap er pel, 100 mg caper pel, 100 mg tablet er, 200 mg tableter)

Generic

oxycodone hcl (10 mg tab er 12h, 20 mgtab er 12h, 40 mg tab er 12h, 80 mg taber 12h)

Brand PA, QL (90 PER 30 DAYS)

OXYCONTIN Brand PA, QL (90 PER 30 DAYS)

tramadol hcl (100 mg tbmp 24hr, 100mg tab er 24h, 200 mg tbmp 24hr, 200mg tab er 24h, 300 mg tab er 24h, 300mg tbmp 24hr)

Generic

Opioid Analgesics, Short-actingacetaminophen with codeine phosphate(120-12mg/5 solution, 300mg/12.5solution, 300mg-30mg tablet, 300mg-60mg tablet, 300mg-15mg tablet)

Generic PA (PA for ages 5 and under)

ascomp with codeine Generic PA

butalbit/acetamin/caff/codeine 50-325-30 capsule


butorphanol tartrate (1 mg/ml vial, 2mg/ml vial)

Generic PA




Drug Name Status* Requirements/Limitsbutorphanol tartrate 10 mg/ml spray Generic

co-gesic Generic

codeinephosphate/butalbital/aspirin/caffeine

Generic PA

codeine phosphate/carisoprodol/aspirin Generic PA (PA for ages 5 and under)

codeine sulfate (15 mg tablet, 30 mgtablet, 60 mg tablet)


endocet Generic

endodan Generic

hydrocodone bitartrate/acetaminophen(2.5-167/5 solution, 2.5-500 mg tablet,5 mg-325mg tablet, 5 mg-500mgtablet, 5-334mg/10 solution, 7.5-500/15 solution, 7.5-325/15 solution,7.5-325mg tablet, 7.5-750mg tablet,7.5-650 mg tablet, 7.5-500mg tablet,10mg-325mg tablet, 10-660mg tablet,10mg-650mg tablet, 10mg-500mgtablet)

Generic

hydrocodone/ibuprofen Generic

hydromorphone hcl (1 mg/ml liquid, 2mg tablet, 3 mg supp.rect, 4 mg tablet,8 mg tablet)

Generic

ibudone 5-200 mg tablet Generic

lorcet Generic

lorcet hd Generic

lorcet plus 7.5-325 mg tablet Generic

lortab (5-325 mg tablet, 5-500 tablet,7.5-325 mg tablet, 10-325 mg tablet)

Generic

meperidine hcl (50 mg tablet, 50 mg/5ml solution, 100 mg tablet)

Generic

meperitab Generic




Drug Name Status* Requirements/Limitsmorphine sulfate (5 mg supp.rect, 10mg supp.rect, 10 mg/5 ml solution, 15mg tablet, 20 mg supp.rect, 20 mg/5 mlsolution, 30 mg tablet, 30 mg supp.rect,100 mg/5ml solution)

Generic

oxycodone hcl (5 mg/5 ml solution, 5mg capsule, 5 mg tablet, 10 mg tablet,15 mg tablet, 20 mg/ml oral conc, 20mg tablet, 30 mg tablet)

Generic

oxycodone hcl/acetaminophen Generic

oxycodone hcl/aspirin Generic

oxymorphone hcl 10 mg tablet Generic PA, QL (4 PER DAY)

oxymorphone hcl 5 mg tablet Generic PA, QL (8 PER DAY)

pentazocine hcl/acetaminophen Generic

pentazocine hcl/naloxone hcl Generic

reprexain 10-200 mg tablet Generic

ROXICET 5-325 ORAL SOLUTION Brand

roxicet 5-325 tablet Generic

stagesic Generic

tramadol hcl 50 mg tablet Generic

tramadol hcl/acetaminophen Generic QL (240 PER 30 DAYS)

xylon 10 Generic

Anesthetics

Local Anestheticsglydo Generic

lidocaine 5 % oint. (g) Generic

lidocaine 5%(700mg) adh. patch Generic PA, QL (90 PER 30 DAYS)

lidocaine hcl (2 % solution, 2 % jel/pfapp, 2 % jel (ml), 4 % solution, 40mg/ml solution)

Generic

lidocaine/prilocaine (2.5 %-2.5% cream(g), 2.5 %-2.5% kit)

Generic




Drug Name Status* Requirements/Limitsrelador pak Generic

relador pak plus Generic

Anti-Addiction/Substance Abuse Treatment Agents

Alcohol Deterrents/Anti-cravingacamprosate calcium Generic

depade Generic

disulfiram (250 mg tablet, 500 mgtablet)

Generic

naltrexone hcl 50 mg tablet Generic

revia Generic

Opioid Antagonistsbuprenorphine hcl/naloxone hcl Generic

Smoking Cessation Agentsbuproban Generic

CHANTIX Brand

NICODERM CQ OTC

nicotine (7mg/24hr patch td24,14mg/24hr patch td24, 21 mg/24hrpatch td24, 22 mg/24hr patch td24)

OTC

NTS OTC

Anti-inflammatory Agents

Glucocorticoidsalclometasone dipropionate Generic

amcinonide 0.1 % cream (g) Generic

ANTI-ITCH (1% LOTION, 1% CREAM, CVS1% CREAM, EQL 1% CREAM, RA 1%CREAM)

OTC

anusol-hc 2.5% cream Generic




Drug Name Status* Requirements/Limitsapexicon e Generic

AQUANIL HC OTC

BETA HC OTC

betamethasone dipropionate (0.05 %lotion, 0.05 % gel (gram), 0.05 % cream(g), 0.05 % oint. (g))

Generic

betamethasone dipropionate/propyleneglycol (0.05 % cream (g), 0.05 % oint.(g), 0.05 % lotion)

Generic

betamethasone valerate (0.1 % cream(g), 0.1 % lotion, 0.1 % oint. (g))

Generic

clobetasol propionate (0.05 % solution,0.05 % shampoo, 0.05 % cream (g), 0.05% foam, 0.05 % oint. (g), 0.05 % gel(gram))

Generic

clobetasol propionate/emollient base Generic

clodan 0.05% shampoo Generic

cormax Generic

CORTISONE OTC

CORTIZONE-10 (1% LOTION, 1% CREME) OTC

CORTIZONE-10 PLUS OTC

DERMAREST ECZEMA OTC

desonide (0.05 % lotion, 0.05 % cream(g), 0.05 % oint. (g))

Generic

desoximetasone Generic

ECZEMA ANTI-ITCH OTC

fludrocortisone acetate 0.1 mg tablet Generic

fluocinolone acetonide (0.01 % cream(g), 0.01 % oil, 0.01 % solution, 0.025 %oint. (g), 0.025 % cream (g))

Generic

fluocinonide (0.05 % gel (gram), 0.05 %solution, 0.05 % cream (g), 0.05 % oint.(g))

Generic

fluocinonide/emollient base Generic




Drug Name Status* Requirements/Limitsfluticasone propionate (0.05 % lotion,0.05 % cream (g))

Generic

halobetasol propionate Generic

HYDRO SKIN OTC

hydrocortisone (1 % cream (g), 2.5 %lotion, 2.5 % cream (g), 2.5 % oint. (g))

Generic

hydrocortisone (1 % lotion, 1 % packet) OTC

hydrocortisone acetate 1 % cream (g) OTC

hydrocortisone butyrate 0.1 % cream(g)

Generic

HYDROCORTISONE PLUS 12 OTC

hydrocortisone/aloe vera 1 % cream (g) OTC

HYDROCREAM OTC

HYDROSKIN OTC

methylprednisolone Generic

millipred 5 mg tablet Generic

millipred dp Generic

neomycin sulfate/polymyxin bsulfate/hydrocortisone (drops susp,solution)

Generic

NEOSPORIN 1% ANTI-ITCH CREAM OTC

NOBLE FORMULA HC 1% CREAM OTC

nystatin/triamcinolone acetonide Generic

oralone Generic

prednisolone 15 mg/5 ml solution Generic

prednisolone sod phosphate (5 mg/5 mlsolution, 10 mg tab rapdis, 15 mg tabrapdis, 15 mg/5 ml solution, 30 mg tabrapdis)

Generic

prednisone (1 mg tablet, 2.5 mg tablet,5 mg tablet, 5 mg/5 ml solution, 5 mgtab ds pk, 10 mg tab ds pk, 10 mgtablet, 20 mg tablet, 50 mg tablet)

Generic




Drug Name Status* Requirements/Limitsprednisone intensol Generic

PREPARATION H HC 1% CREAM OTC

proctocream-hc Generic

RECORT PLUS OTC

SOOTHING CARE OTC

triamcinolone acetonide (0.025 %cream (g), 0.025 % oint. (g), 0.025 %lotion, 0.1 % lotion, 0.1 % oint. (g), 0.1% cream (g), 0.1 % paste (g), 0.5 % oint.(g), 0.5 % cream (g))

Generic

triderm Generic

Antibacterials

Aminoglycosidesgaramycin 0.3% eye drops Generic

gentak Generic

gentamicin sulfate (0.1 % oint. (g), 0.1% cream (g), 0.3 % oint. (g), 0.3 %drops)

Generic

neomycin sulfate 500 mg tablet Generic

TOBI PODHALER Specialty

TOBRADEX EYE OINTMENT Brand

tobramycin 0.3 % drops Generic

tobramycin in 0.225 % sodium chloride Generic LA

Antibacterials, Otheracetasol hc Generic

acetic acid 2 % solution Generic

acetic acid/aluminum acetate Generic

acetic acid/hydrocortisone Generic

ANTIBIOTIC OTC

ANTIBIOTIC + PAIN RELIEF (RA RLFOINT, RELIEF OINT)

OTC




Drug Name Status* Requirements/Limitsbacitracin (500 oint. (g), 500 packet) OTC

bacitracin zinc (500 oint. (g), 500oint.(ea))

OTC

bacitracin/polymyxin b sulfate (500-10k/g oint. (g), packet)

OTC

BACITRAYCIN PLUS 500 UNIT/GM OTC

chlorhexidine gluconate 0.12 %mouthwash

Generic

clindacin etz 1% pledget Generic

clindacin p Generic

clindamycin hcl (75 mg capsule, 150 mgcapsule, 300 mg capsule)

Generic

clindamycin palmitate hcl Generic

clindamycin phosphate (1 % foam, 1 %lotion, 1 % med. swab, 1 % gel (gram), 1% solution, 2 % cream/appl)

Generic

cycloserine 250 mg capsule Generic

erythromycinethylsuccinate/sulfisoxazole acetyl

Generic

FLAGYL ER Brand

linezolid 600 mg tablet Brand

MACRODANTIN 25 MG CAPSULE Brand

methenamine hippurate Generic

metronidazole (0.75 % gel (gram), 0.75% gel w/appl, 0.75 % lotion, 250 mgtablet, 375 mg capsule, 500 mg tablet)

Generic

MONUROL Brand

mupirocin 2 % oint. (g) Generic

nitrofurantoin 25 mg/5 ml oral susp Generic

nitrofurantoin macrocrystal (50 mgcapsule, 100 mg capsule)

Generic

nitrofurantoinmonohydrate/macrocrystals

Generic




Drug Name Status* Requirements/Limitsparoex Generic

periogard Generic

rosadan 0.75% gel Generic

SIVEXTRO 200 MG TABLET Specialty PA

tinidazole (250 mg tablet, 500 mgtablet)

Generic PA

TRI-BIOZENE OTC

trimethoprim 100 mg tablet Generic

TRIPLE ANTIBIOTIC (, CVS, EQ, GNP, HM,KRO, PUB, PV, RA, SB, SM)

OTC

TRIPLE ANTIBIOTIC EXTRA OTC

TRIPLE ANTIBIOTIC PLUS OTC

TRIPLE ANTIBIOTIC-PAIN RELIEF OTC

vancomycin hcl (125 mg capsule, 250mg capsule)

Generic

vandazole Generic

XIFAXAN 200 MG TABLET Brand PA, QL (90 PER 30 DAYS)

XIFAXAN 550 MG TABLET Brand PA, QL (60 PER 30 DAYS)

ZYVOX (100 MG/5 ML SUSPENSION,600 MG TABLET)

Brand

Beta-lactam, CephalosporinsCEDAX 90 MG/5 ML SUSPENSION Brand

cefaclor (125 mg/5ml susp recon, 250mg/5ml susp recon, 250 mg capsule,375 mg/5ml susp recon, 500 mg tab er12h, 500 mg capsule)

Generic

cefadroxil (1 g tablet, 250 mg/5ml susprecon, 500 mg capsule)

Generic

cefdinir (125 mg/5ml susp recon, 250mg/5ml susp recon, 300 mg capsule)

Generic

cefpodoxime proxetil (100 mg tablet,100 mg/5ml susp recon, 200 mg tablet)

Generic




Drug Name Status* Requirements/Limitscefprozil (125 mg/5ml susp recon, 250mg tablet, 250 mg/5ml susp recon, 500mg tablet)

Generic

ceftibuten (180 mg/5ml susp recon, 400mg capsule)

Generic

CEFTIN (125 ML ORAL SUSP, 250 MLORAL SUSP)

Brand

cefuroxime axetil Generic

cephalexin (125 mg/5ml susp recon,250 mg tablet, 250 mg capsule, 250mg/5ml susp recon, 500 mg tablet, 500mg capsule)

Generic

Beta-lactam, Penicillinsamoxicillin (125 mg tab chew, 125mg/5ml susp recon, 200 mg/5ml susprecon, 250 mg capsule, 250 mg tabchew, 250 mg/5ml susp recon, 400mg/5ml susp recon, 500 mg tablet, 500mg capsule, 875 mg tablet)

Generic

amoxicillin/potassium clavulanate (200-28.5mg tab chew, 200-28.5/5 susprecon, 250-125 mg tablet, 250-62.5/5susp recon, 400-57mg tab chew, 400-57mg/5 susp recon, 500-125 mg tablet,600-42.9/5 susp recon, 875-125 mgtablet, 1000-62.5 tab er 12h)

Generic

ampicillin trihydrate (125 mg/5ml susprecon, 250 mg capsule, 250 mg/5mlsusp recon, 500 mg capsule)

Generic

AUGMENTIN 125-31.25 MG/5 ML Brand

dicloxacillin sodium Generic

penicillin v potassium (125 mg/5ml solnrecon, 250 mg tablet, 250 mg/5ml solnrecon, 500 mg tablet)

Generic

MacrolidesAKNE-MYCIN Brand




Drug Name Status* Requirements/Limitsazithromycin (100 mg/5ml susp recon,200 mg/5ml susp recon, 250 mg tablet,500 mg tablet, 600 mg tablet)

Generic

clarithromycin (125 mg/5ml susp recon,250 mg/5ml susp recon, 250 mg tablet,500 mg tab er 24h, 500 mg tablet)

Generic

DIFICID Brand PA

E.E.S. 200 Brand

ery Generic

ERY-TAB Brand

erygel Generic

ERYPED 200 Brand

ERYPED 400 Brand

ERYTHROCIN STEARATE Brand

erythromycin base (5 mg/g oint. (g),250 mg tablet, 250 mg capsule dr, 500mg tablet)

Generic

erythromycin base/ethyl alcohol (2 %med. swab, 2 % solution, 2 % gel(gram))

Generic

erythromycin ethylsuccinate 400 mgtablet

Generic

Quinolonesciprofloxacin Generic

ciprofloxacin hcl (0.3 % drops, 100 mgtablet, 250 mg tablet, 500 mg tablet,750 mg tablet)

Generic

ciprofloxacin/ciprofloxacin hcl Generic

gatifloxacin Generic

levofloxacin (0.5 % drops, 250mg/10mlsolution, 250 mg tablet, 500 mg tablet,750 mg tablet)

Generic

moxifloxacin hcl 400 mg tablet Generic




Drug Name Status* Requirements/Limitsofloxacin (0.3 % drops, 200 mg tablet,300 mg tablet, 400 mg tablet)

Generic

Sulfonamidesbleph-10 Generic

silver sulfadiazine 1 % cream (g) Generic

sulfacetamide sodium 10 % drops Generic

sulfamethoxazole/trimethoprim (200-40mg/5 oral susp, 400mg-80mg tablet,800-160/20 oral susp, 800-160 mgtablet)

Generic

sulfamide Generic

Tetracyclinesavidoxy Generic

demeclocycline hcl Generic

doxycycline hyclate (50 mg capsule, 100mg capsule, 100 mg tablet)

Generic

doxycycline monohydrate (25 mg/5 mlsusp recon, 50 mg capsule, 50 mgtablet, 75 mg tablet, 100 mg tablet, 100mg capsule)

Generic

dynacin (50 mg tablet, 100 mg tablet) Generic

minocycline hcl (50 mg tablet, 50 mgcapsule, 75 mg capsule, 75 mg tablet,100 mg capsule, 100 mg tablet)

Generic

mondoxyne nl (nl 50 mg capsule, nl 100mg capsule)

Generic

morgidox 100 mg capsule Generic

OCUDOX Brand

tetracycline hcl (250 mg capsule, 500mg capsule)

Generic

VIBRAMYCIN 50 MG/5 ML SYRUP Brand





Anticonvulsants

Anticonvulsants, Otheracetazolamide (125 mg tablet, 250 mgtablet)

Generic

levetiracetam (100 mg/ml solution, 250mg tablet, 500 mg tab er 24h, 500mg/5ml solution, 500 mg tablet, 750mg tab er 24h, 750 mg tablet, 1000 mgtablet)

Generic

primidone (50 mg tablet, 250 mg tablet) Generic

Calcium Channel Modifying AgentsCELONTIN Brand

ethosuximide (250 mg/5ml solution,250 mg capsule)

Generic

LYRICA (20 MG/ML ORAL SOLUTION, 25MG CAPSULE, 50 MG CAPSULE, 75 MGCAPSULE, 100 MG CAPSULE, 150 MGCAPSULE, 200 MG CAPSULE, 225 MGCAPSULE, 300 MG CAPSULE)

Brand PA

zonisamide (25 mg capsule, 50 mgcapsule, 100 mg capsule)

Generic

Gamma-aminobutyric Acid (GABA) Augmenting AgentsDIASTAT Brand

diazepam (5-7.5-10mg kit, 12.5-15-20kit)

Generic

diazepam 2.5 mg kit Brand

gabapentin (100 mg capsule, 250mg/5ml solution, 300 mg capsule, 400mg capsule, 600 mg tablet, 800 mgtablet)

Generic

GABITRIL (12 MG TABLET, 16 MGTABLET)

Brand

ONFI (5 MG TABLET, 10 MG TABLET, 20MG TABLET)

Brand PA, QL (60 PER 30 DAYS)




Drug Name Status* Requirements/LimitsONFI 2.5 MG/ML SUSPENSION Brand PA

phenobarbital (15 mg tablet, 16.2 mgtablet, 20 mg/5 ml elixir, 30 mg tablet,32.4 mg tablet, 60 mg tablet, 64.8 mgtablet, 97.2mg tablet, 100 mg tablet)

Generic

SABRIL Brand LA

tiagabine hcl Generic

Glutamate Reducing Agentsfelbamate (400 mg tablet, 600 mgtablet, 600 mg/5ml oral susp)

Generic

topiragen Generic

topiramate (15 mg cap sprink, 25 mgcap sprink, 25 mg tablet, 50 mg tablet,100 mg tablet, 200 mg tablet)

Generic

topiramate (25 mg cap spr 24, 50 mgcap spr 24, 100 mg cap spr 24, 150 mgcap spr 24, 200 mg cap spr 24)

Generic PA

Sodium Channel AgentsAPTIOM Brand

BANZEL (40 MG/ML SUSPENSION, 200MG TABLET, 400 MG TABLET)

Brand PA

carbamazepine (100 mg cpmp 12hr,100 mg tab chew, 100 mg/5ml oralsusp, 200 mg tablet, 200 mg tab er 12h,200 mg cpmp 12hr, 300 mg cpmp 12hr,400 mg tab er 12h)

Generic

DILANTIN 30 MG CAPSULE Brand

epitol Generic

oxcarbazepine (150 mg tablet, 300 mgtablet, 300 mg/5ml oral susp, 600 mgtablet)

Generic

PEGANONE Brand

phenytoin (50 mg tab chew, 100mg/4ml oral susp, 125 mg/5ml oralsusp)

Generic




Drug Name Status* Requirements/Limitsphenytoin sodium extended Generic

TEGRETOL XR 100 MG TABLET Brand

VIMPAT (10 MG/ML SOLUTION, 50 MGTABLET, 100 MG TABLET, 150 MGTABLET, 200 MG TABLET)

Brand

Antidementia Agents

Cholinesterase Inhibitorsdonepezil hcl (5 mg tab rapdis, 5 mgtablet, 10 mg tablet, 10 mg tab rapdis)

Generic

EXELON 2 MG/ML ORAL SOLUTION Brand

galantamine hbr (4 mg tablet, 4 mg/mlsolution, 8 mg tablet, 12 mg tablet)

Generic

rivastigmine Generic

rivastigmine tartrate Generic

N-methyl-D-aspartate (NMDA) Receptor Antagonistmemantine hcl (5 mg tablet, 10 mgtablet)


memantine hcl 5 mg-10 mg tab ds pk Generic

NAMENDA 10 MG/5 ML SOLUTION Brand QL (360 ML PER 30 DAYS)

Antidepressants

Antidepressants, Otherbudeprion sr 150 mg tablet Generic

bupropion hcl 150 mg tablet er Generic

Antiemetics

Antiemetics, OtherAMBIZINE OTC

compro Generic




Drug Name Status* Requirements/LimitsDICLEGIS Brand QL (60 PER 30 DAYS)

DRAMAMINE LESS DROWSY OTC

hydroxyzine hcl (10 mg tablet, 10 mg/5ml solution, 25 mg tablet, 50 mg tablet)

Generic

hydroxyzine pamoate (25 mg capsule,50 mg capsule, 100 mg capsule)

Generic

meclizine hcl (12.5 mg tablet, 25 mgtablet)

Generic

meclizine hcl 25 mg tab chew OTC

MEDI-MECLIZINE OTC

metoclopramide hcl (5 mg tablet, 5mg/5 ml solution, 10 mg tablet, 10mg/10ml solution)

Generic

MOTION RELIEF OTC

MOTION SICKNESS (GNP SICKNES 25MG TAB, SICKNESS 25 MG TABLET, SMSICKNES 25 MG TABLET, SM SICKNESS25 MG TAB)

OTC

MOTION SICKNESS II OTC

MOTION SICKNESS RELIEF (CVS RELIEFTAB, EQ 25 MG TAB, RA RELIEF TAB, RARLF TB CHEW, RELIEF TB CHEW)

OTC

MOTION SICKNESS RELIEF II OTC

MOTION-TIME OTC

phenadoz Generic

prochlorperazine Generic

prochlorperazine maleate (5 mg tablet,10 mg tablet)

Generic

promethazine hcl (6.25mg/5ml syrup,12.5 mg supp.rect, 12.5 mg tablet, 25mg tablet, 25 mg/ml vial, 25 mgsupp.rect, 50 mg supp.rect, 50 mgtablet)

Generic

promethegan Generic




Drug Name Status* Requirements/Limitstrimethobenzamide hcl 300 mg capsule Generic

VERTICALM OTC

Emetogenic Therapy AdjunctsEMEND (80 MG CAPSULE, 125 MGCAPSULE, TRIFOLD PACK)

Brand QL (4 PER 30 DAYS)

ondansetron Generic

ondansetron hcl (4 mg/5 ml solution, 4mg tablet, 8 mg tablet, 24 mg tablet)

Generic

Antifungals

1-DAY OTC

3 DAY VAGINAL OTC

3-DAY VAGINAL CREAM OTC

ANTI-FUNGAL CREAM OTC

ANTIFUNGAL (1% CREAM, EQL 1%CREAM, GNP 1% CREAM, SM 1%CREAM)

OTC

ANTIFUNGAL CREAM (2% CREAM,CARRINGTON 2% CREAM)

OTC

ATHLETE'S FOOT (EQ 1% CREAM, 2%POWDER)

OTC

ATHLETE'S FOOT SPRAY OTC

ATHLETIC FOOT CREAM OTC

BAZA ANTIFUNGAL OTC

ciclodan 0.77% cream Generic

ciclopirox (0.77 % gel (gram), 1 %shampoo)

Generic

ciclopirox olamine (0.77 % cream (g),0.77 % suspension)

Generic

CLOTRIM ANTIFUNGAL OTC

clotrimazole (1 % cream (g), 1 %solution, 10 mg troche)

Generic




Drug Name Status* Requirements/Limitsclotrimazole (1 % cream/appl, 2 %cream/appl, 100 mg tablet)

OTC

CLOTRIMAZOLE AF OTC

CVS ANTI-FUNGAL 2% POWDER OTC

CVS ITCH RELIEF 1% CREAM OTC

DESENEX (2% POWDER, 2% SPRAYPOWDER)

OTC

econazole nitrate 1 % cream (g) Generic

fluconazole (10 mg/ml susp recon, 40mg/ml susp recon, 50 mg tablet, 100mg tablet, 150 mg tablet, 200 mgtablet)

Generic

flucytosine (250 mg capsule, 500 mgcapsule)

Generic

griseofulvin ultramicrosize Generic

griseofulvin, microsize (125 mg/5ml oralsusp, 500 mg tablet)

Generic

GYNE-LOTRIMIN OTC

GYNE-LOTRIMIN-7 OTC

INZO ANTIFUNGAL OTC

itraconazole 100 mg capsule Generic PA

JOCK ITCH (EQ 1% CREAM, 1% CREAM) OTC

JOCK ITCH RELIEF OTC

ketoconazole (2 % cream (g), 2 % foam,2 % shampoo)

Generic

ketodan 2% foam Generic

KRO ATHLETE'S FOOT CREAM OTC

LOTRIMIN AF (1% CREAM, 2% SPRAYPOWDER, 2% POWDER)

OTC

MICATIN OTC

miconazole nitrate (2 % cream (g), 2 %cream/appl, 2 % aero powd, 100 mgsupp.vag, 200 mg-2 % kit, 200 mg-2 %cmb pf crm, powder)

OTC




Drug Name Status* Requirements/Limitsmiconazole nitrate 200 mg supp.vag Generic

MICONAZORB AF OTC

MICRO-GUARD OTC

MIRANEL AF OTC

MONISTAT 3 (3 4% CREAM, 3 COMBOPACK)

OTC

NOXAFIL (40 MG/ML SUSPENSION, DR100 MG TABLET)

Brand

NUZOLE OTC

nyamyc Generic

nystatin (50mm unit powder(ea),150mm unit powder(ea), 500mm unitpowder(ea), 500k unit tablet,100000/ml oral susp, 100000/g powder,100000/g cream (g), 100000/g oint. (g))

Generic

nystop Generic

OXISTAT (1% CREAM, 1% LOTION) Brand

pedi-dri Generic

REMEDY ANTIFUNGAL (2% POWDER,2% CREAM)

OTC

REMEDY PHYTOPLEX ANTIFUNGAL 2% OTC

RINGWORM OTC

SECURA ANTIFUNGAL OTC

SPORANOX 10 MG/ML SOLUTION Brand PA

terbinafine hcl 250 mg tablet Generic

terconazole (0.4 % cream/appl, 0.8 %cream/appl, 80 mg supp.vag)

Generic

tioconazole OTC

TIOCONAZOLE 1 OTC

TIOCONAZOLE-1 OTC

tolnaftate 1 % cream (g) OTC

VAGISTAT-3 OTC




Drug Name Status* Requirements/Limitsvoriconazole (200 mg tablet, 200mg/5ml susp recon)

Generic

ZEASORB 2% POWDER OTC

Antigout Agents

allopurinol (100 mg tablet, 300 mgtablet)

Generic

colchicine 0.6 mg tablet Brand QL (60 PER 30 DAYS)

colchicine/probenecid Generic

COLCRYS Brand QL (60 PER 30 DAYS)

probenecid Generic

Antimigraine Agents

Ergot Alkaloidscafergot Generic

dihydroergotamine mesylate0.5mg/spry spray/pump

Brand QL (3.5 ML PER 30 DAYS)

ergotamine tartrate/caffeine Generic

migergot Generic

MIGRANAL Brand QL (3.5 ML PER 30 DAYS)

Prophylactictimolol maleate (5 mg tablet, 10 mgtablet, 20 mg tablet)

Generic

Serotonin (5-HT) 1b/1d Receptor Agonistsnaratriptan hcl Generic QL (18 PER 30 DAYS)

rizatriptan benzoate Generic QL (24 PER 30 DAYS)

sumatriptan (5 mg spray, 20 mg spray) Generic QL (6 PER 30 DAYS)

sumatriptan succinate (25 mg tablet, 50mg tablet, 100 mg tablet)


sumatriptan succinate (4 pen injctr, 4cartridge, 6 pen injctr, 6 syringe, 6cartridge, 6 vial)

Generic QL (2 ML PER 30 DAYS)




Drug Name Status* Requirements/Limitszolmitriptan (2.5 mg tab rapdis, 2.5 mgtablet, 5 mg tab rapdis, 5 mg tablet)


ZOMIG (2.5 MG SPRAY, 5 MG SPRAY) Brand QL (12 PER 30 DAYS)

Antimyasthenic Agents

ParasympathomimeticsMESTINON 60 MG/5 ML SYRUP Brand

pyridostigmine bromide (60 mg tablet,180 mg tablet er)

Generic

Antimycobacterials

Antimycobacterials, Otherdapsone (25 mg tablet, 100 mg tablet) Generic

rifabutin Generic

Antitubercularsethambutol hcl Generic

isoniazid (50 mg/5 ml solution, 100 mgtablet, 300 mg tablet)

Generic

pyrazinamide Generic

RIFAMATE Brand

rifampin (150 mg capsule, 300 mgcapsule)

Generic

SIRTURO Specialty LA

Antineoplastics

Alkylating AgentsALKERAN 2 MG TABLET Brand PA

CEENU Brand

CYCLOPHOSPHAMIDE CAPSULES Brand

cyclophosphamide tablets Generic




Drug Name Status* Requirements/LimitsGLEOSTINE Brand

LEUKERAN Brand

lomustine Brand

MATULANE Specialty

MYLERAN Brand

temozolomide Specialty PA

VALCHLOR Specialty LA

Antiangiogenic AgentsPOMALYST Specialty PA

REVLIMID Specialty PA, LA

THALOMID Specialty

Antiestrogens/ModifiersEMCYT Specialty

FARESTON Brand

SOLTAMOX Brand

tamoxifen citrate (10 mg tablet, 20 mgtablet)

Generic

Antimetabolitescapecitabine Generic

DROXIA Brand

hydroxyurea 500 mg capsule Generic

mercaptopurine 50 mg tablet Generic

methotrexate sodium (2.5 mg tablet, 25mg/ml vial)

Generic

methotrexate sodium/pf (1 g vial, 25mg/ml vial)

Generic

PURIXAN Brand

RHEUMATREX Brand

TABLOID Brand




Drug Name Status* Requirements/LimitsTREXALL Brand

Antineoplastics, OtherALFERON N Specialty PA

FARYDAK Specialty PA, QL (6 PER 21 DAYS)

flutamide Generic

HEXALEN Specialty

imiquimod 5 % cream pack Generic

INTRON A (6 MILLION UNIT/ML VL, 10MILLION UNIT/ML, 10 MILLION UNITSVIL, 18 MILLION UNITS VIL, 50 MILLIONUNITS VIL)

Specialty

leucovorin calcium 5 mg tablet Generic

SYLATRON Specialty PA

SYLATRON 4-PACK Specialty PA

Aromatase Inhibitors, 3rd Generationanastrozole 1 mg tablet Generic

exemestane Generic

letrozole 2.5 mg tablet Generic

Enzyme InhibitorsBOSULIF Specialty PA

etoposide 50 mg capsule Generic

GILOTRIF Specialty PA

HYCAMTIN (0.25 MG CAPSULE, 1 MGCAPSULE)

Specialty PA

IMBRUVICA Specialty PA

INLYTA Specialty PA, LA

JAKAFI Specialty PA, LA

LYNPARZA Specialty PA, LA

MEKINIST Specialty PA




Drug Name Status* Requirements/LimitsTAFINLAR Specialty PA

VOTRIENT Specialty PA

ZELBORAF Specialty PA

ZYTIGA Specialty PA

Molecular Target InhibitorsAFINITOR Specialty PA

AFINITOR DISPERZ Specialty PA

CAPRELSA Specialty PA

COMETRIQ Specialty PA, LA

ERIVEDGE Specialty PA

GLEEVEC Specialty PA

IBRANCE Specialty PA

ICLUSIG Specialty PA

LENVIMA Specialty PA, LA

NEXAVAR Specialty PA

SPRYCEL Specialty PA

STIVARGA Specialty PA

SUTENT Specialty PA

TARCEVA Specialty PA

TASIGNA Specialty PA

TYKERB Specialty PA

vandetanib Specialty PA

XALKORI Specialty PA, LA

ZOLINZA Specialty PA

ZYDELIG Specialty PA, QL (60 PER 30 DAYS)

ZYKADIA Specialty PA

Retinoidsbexarotene Specialty PA




Drug Name Status* Requirements/LimitsTARGRETIN 1% GEL Specialty PA

tretinoin 10 mg capsule Specialty PA

Antiparasitics

AnthelminticsALBENZA Brand

ivermectin 3 mg tablet Generic

Antiprotozoalsatovaquone Specialty PA

chloroquine phosphate (250 mg tablet,500 mg tablet)

Generic PA

DARAPRIM Brand PA

hydroxychloroquine sulfate 200 mgtablet

Generic

mefloquine hcl Generic PA

NEBUPENT Brand

primaquine phosphate Generic PA

Pediculicides/Scabicideselimite Generic

LICE CREAM RINSE OTC

LICE KILLING (EQ SHAMPOO, KROSHAMPOO, SM SHAMPOO, V-RSHAMPOO)

OTC

LICE TREATMENT (GNP 1% CRM RINS,HM 1% LOTION, PV PERMETHRIN, RA1% CRM RINSE, SM 1% CRM RINSE, 1%CREME RINSE, SM PERMETHRIN)

OTC

lindane Generic

permethrin 1 % liquid OTC

permethrin 5 % cream (g) Generic

ULESFIA Brand





Antiparkinson Agents

Anticholinergicsbenztropine mesylate (0.5 mg tablet, 1mg tablet, 2 mg tablet)

Generic

trihexyphenidyl hcl (2 mg/5 ml elixir, 2mg tablet, 5 mg tablet)

Generic

Antiparkinson Agents, Otheramantadine hcl (50 mg/5 ml solution,100 mg tablet, 100 mg capsule)

Generic

carbidopa/levodopa/entacapone Generic

entacapone Generic

Dopamine Agonistsbromocriptine mesylate (2.5 mg tablet,5 mg capsule)

Generic

pramipexole di-hcl (0.125 mg tablet,0.25 mg tablet, 0.5 mg tablet, 0.75 mgtablet, 1 mg tablet, 1.5 mg tablet)

Generic

ropinirole hcl (0.25 mg tablet, 0.5 mgtablet, 1 mg tablet, 2 mg tablet, 3 mgtablet, 4 mg tablet, 5 mg tablet)

Generic

Dopamine Precursors/ L-Amino Acid Decarboxylase Inhibitorscarbidopa 25 mg tablet Generic

carbidopa/levodopa (10mg-100mgtablet, 25mg-250mg tablet, 25mg-100mg tablet er, 25mg-100mg tablet,50mg-200mg tablet er)

Generic

Monoamine Oxidase B (MAO-B) InhibitorsAZILECT Brand

selegiline hcl (5 mg tablet, 5 mgcapsule)

Generic





Antispasticity Agents

baclofen (10 mg tablet, 20 mg tablet) Generic

dantrolene sodium (25 mg capsule, 50mg capsule, 100 mg capsule)

Generic

MYRBETRIQ Brand PA

tizanidine hcl (2 mg tablet, 4 mg tablet) Generic

Antivirals

Anti-HIV Agents, Non-nucleoside Reverse Transcriptase InhibitorsEDURANT Brand

INTELENCE Brand

nevirapine (50 mg/5 ml oral susp, 200mg tablet, 400 mg tab er 24h)

Generic

RESCRIPTOR 100 MG TABLET Brand

SUSTIVA Brand

VIRAMUNE XR 100 MG TABLET Brand

Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitorsabacavir sulfate Generic

abacavir sulfate/lamivudine/zidovudine Generic

COMPLERA Brand

didanosine Generic

EMTRIVA 200 MG CAPSULE Brand

EPZICOM Brand

lamivudine (10 mg/ml solution, 150 mgtablet, 300 mg tablet)

Generic

lamivudine/zidovudine Generic

stavudine (1 mg/ml soln recon, 15 mgcapsule, 20 mg capsule, 30 mg capsule,40 mg capsule)

Generic




Drug Name Status* Requirements/LimitsTRUVADA Brand

VIDEX Brand

VIREAD (150 MG TABLET, 200 MGTABLET, 250 MG TABLET, 300 MGTABLET, POWDER)

Brand

ZIAGEN 20 MG/ML SOLUTION Brand

zidovudine (10 mg/ml syrup, 100 mgcapsule, 300 mg tablet)

Generic

Anti-HIV Agents, OtherATRIPLA Brand

FUZEON Brand

ISENTRESS (100 MG POWDER PACKET,400 MG TABLET)

Brand

SELZENTRY Brand

STRIBILD Brand

TIVICAY Brand

TRIUMEQ Brand

TYBOST Brand

VITEKTA Brand

Anti-HIV Agents, Protease InhibitorsAPTIVUS 250 MG CAPSULE Brand

CRIXIVAN Brand

EVOTAZ Brand

INVIRASE Brand

KALETRA (100-25 MG TABLET, 200-50MG TABLET, 400-100/5 ML ORAL SOLU)

Brand

LEXIVA 700 MG TABLET Brand

NORVIR (80 MG/ML SOLUTION, 100 MGTABLET, 100 MG SOFTGEL CAP)

Brand

PREZCOBIX Specialty




Drug Name Status* Requirements/LimitsPREZISTA (75 MG TABLET, 100 MG/MLSUSPENSION, 150 MG TABLET, 400 MGTABLET, 600 MG TABLET, 800 MGTABLET)

Brand

REYATAZ Brand

VIRACEPT Brand

Anti-cytomegalovirus (CMV) AgentsVALCYTE 50 MG/ML SOLUTION Brand

valganciclovir hcl Generic QL (60 PER 30 DAYS)

ZIRGAN Brand

Anti-influenza AgentsRELENZA Brand

rimantadine hcl Generic

TAMIFLU (6 MG/ML SUSPENSION, 30MG CAPSULE, 45 MG CAPSULE, 75 MGCAPSULE)

Brand

Antihepatitis Agentsadefovir dipivoxil Specialty

BARACLUDE 0.05 MG/ML SOLUTION Specialty

entecavir Specialty

EPIVIR HBV 25 MG/5 ML SOLN Brand

HARVONI Specialty PA, QL (28 PER 28 DAYS)

INCIVEK Specialty

INFERGEN Specialty

lamivudine 100 mg tablet Generic

MODERIBA Specialty

OLYSIO Specialty PA, QL (28 PER 28 DAYS)

PEGASYS (180 MCG/ML VIAL, 180MCG/0.5 ML SYRINGE)

Specialty

PEGASYS PROCLICK Specialty




Drug Name Status* Requirements/LimitsPEGINTRON Specialty

PEGINTRON REDIPEN Specialty

REBETOL 40 MG/ML SOLUTION Specialty

RIBAPAK Specialty

RIBASPHERE Specialty

RIBASPHERE RIBAPAK Specialty

RIBATAB Specialty

ribavirin (200 mg capsule, 200 mgtablet, 400 mg tablet, 600 mg tablet)

Specialty

SOVALDI Specialty PA, QL (28 PER 28 DAYS)

TYZEKA Specialty

VICTRELIS Specialty PA

VIEKIRA PAK Specialty PA, QL (112 PER 28 DAYS)

Antiherpetic Agentsacyclovir (200 mg capsule, 200 mg/5mloral susp, 400 mg tablet, 800 mg tablet)

Generic

DENAVIR Brand PA

famciclovir Generic

trifluridine 1 % drops Generic

valacyclovir hcl (500 mg tablet, 1000mg tablet)

Generic

Anxiolytics

Anxiolytics, Otherclonazepam (0.125 mg tab rapdis, 0.25mg tab rapdis, 0.5 mg tablet, 0.5 mgtab rapdis, 1 mg tab rapdis, 1 mgtablet, 2 mg tab rapdis, 2 mg tablet)

Generic





Blood Glucose Regulators

Antidiabetic Agentsacarbose Generic

ACTOPLUS MET XR Brand

BYDUREON Brand ST

BYDUREON PEN Brand ST

BYETTA Brand ST

chlorpropamide Generic

FARXIGA Brand PA

glimepiride Generic

glipizide (2.5 mg tab er 24, 5 mg tablet,5 mg tab er 24, 10 mg tab er 24, 10 mgtablet)

Generic

glipizide/metformin hcl Generic

glyburide Generic

glyburide,micronized Generic

glyburide/metformin hcl Generic

GLYXAMBI Brand PA

INVOKAMET Brand PA

INVOKANA Brand PA

JANUMET Brand PA

JANUMET XR Brand PA

JANUVIA Brand PA

JARDIANCE Brand PA

JENTADUETO Brand PA

KAZANO Brand PA

KOMBIGLYZE XR Brand PA

metformin hcl (500 mg tablet, 500 mgtab er 24h, 750 mg tab er 24h, 850 mgtablet, 1000 mg tablet)

Generic




Drug Name Status* Requirements/LimitsNESINA Brand PA

ONGLYZA Brand PA

OSENI Brand PA

pioglitazone hcl Generic

pioglitazone hcl/glimepiride Generic

pioglitazone hcl/metformin hcl Generic

RIOMET Brand

SYMLINPEN 120 Brand PA

SYMLINPEN 60 Brand PA

tolazamide Generic

TRADJENTA Brand PA

VICTOZA 2-PAK Brand ST

VICTOZA 3-PAK Brand ST

XIGDUO XR Brand PA

Glycemic AgentsGLUCAGEN 1MG HYPOKIT Brand

GLUCAGON EMERGENCY KIT Brand

InsulinsAPIDRA Brand

APIDRA SOLOSTAR Brand

HUMALOG Brand

HUMALOG KWIKPEN U-100 Brand

HUMALOG KWIKPEN U-200 Brand

HUMALOG MIX 50-50 Brand

HUMALOG MIX 50-50 KWIKPEN Brand

HUMALOG MIX 75-25 Brand

HUMALOG MIX 75-25 KWIKPEN Brand

HUMULIN 70-30 OTC




Drug Name Status* Requirements/LimitsHUMULIN 70/30 KWIKPEN OTC

HUMULIN N OTC

HUMULIN N KWIKPEN OTC

HUMULIN R OTC

LANTUS Brand

LANTUS SOLOSTAR Brand

LEVEMIR Brand

LEVEMIR FLEXPEN Brand

LEVEMIR FLEXTOUCH Brand

NOVOLIN 70-30 OTC

NOVOLIN N OTC

NOVOLIN R OTC

NOVOLOG Brand

NOVOLOG FLEXPEN Brand

NOVOLOG MIX 70-30 Brand

NOVOLOG MIX 70-30 FLEXPEN Brand

TOUJEO SOLOSTAR Brand

Blood Products/Modifiers/ Volume Expanders

AnticoagulantsELIQUIS Brand

enoxaparin sodium Generic

fondaparinux sodium Generic

FRAGMIN Specialty

heparin 50 units/5 ml (10/ml) Generic

heparin sodium,porcine (10 unit/ml vial,10 unit/ml syringe, 100/ml (1) syringe,100/ml vial, 500/5 ml syringe, 1000/mlvial, 5000/ml vial, 10000/ml vial,20000/ml vial)

Generic




Drug Name Status* Requirements/Limitsheparin sodium,porcine/pf (10 unit/mlsyringe, 10 unit/ml vial, 100/ml (1) vial,500/5 ml syringe, 1000/10 ml syringe,1000/ml vial)

Generic

jantoven Generic

monoject prefill advanced (30 units/3ml (10/ml), 100 unit/10 ml (10/ml), 500unit/5 ml (100/ml), 1,000 unit/10(100/ml))

Generic

PRADAXA Brand

SAVAYSA Brand

warfarin sodium (1 mg tablet, 2 mgtablet, 2.5 mg tablet, 3 mg tablet, 4 mgtablet, 5 mg tablet, 6 mg tablet, 7.5 mgtablet, 10 mg tablet)

Generic

XARELTO Brand

Blood Formation Modifiersanagrelide hcl Generic

ARANESP Specialty PA

EPOGEN Specialty PA

GRANIX Brand

LEUKINE (250 MCG VIAL, 500 MCG/MLVIAL)

Specialty

NEULASTA Specialty

NEUMEGA Specialty

NEUPOGEN Specialty

PROCRIT Specialty PA

PROMACTA Specialty PA

Coagulantstranexamic acid 650 mg tablet Generic





Platelet Modifying AgentsAGGRENOX Brand

aspirin/dipyridamole Brand

BRILINTA 90 MG TABLET Brand

cilostazol Generic

clopidogrel bisulfate 75 mg tablet Generic

dipyridamole (25 mg tablet, 50 mgtablet, 75 mg tablet)

Generic

EFFIENT Brand

ticlopidine hcl Generic

Cardiovascular Agents

Alpha-adrenergic Agonistsclonidine Generic

clonidine hcl (0.1 mg tablet, 0.2 mgtablet, 0.3 mg tablet)

Generic

guanfacine hcl (1 mg tablet, 2 mgtablet)

Generic

methyldopa Generic

midodrine hcl (2.5 mg tablet, 5 mgtablet)

Generic

Alpha-adrenergic Blocking Agentsdoxazosin mesylate (1 mg tablet, 2 mgtablet, 4 mg tablet, 8 mg tablet)

Generic

prazosin hcl (1 mg capsule, 2 mgcapsule, 5 mg capsule)

Generic

reserpine (0.1 mg tablet, 0.25 mgtablet)

Generic

terazosin hcl Generic





Angiotensin II Receptor Antagonistscandesartan cilexetil Generic

irbesartan Generic

losartan potassium Generic

valsartan Generic

Angiotensin-converting Enzyme (ACE) Inhibitorsbenazepril hcl (5 mg tablet, 10 mgtablet, 20 mg tablet, 40 mg tablet)

Generic

captopril (12.5 mg tablet, 25 mg tablet,50 mg tablet, 100 mg tablet)

Generic

enalapril maleate (2.5 mg tablet, 5 mgtablet, 10 mg tablet, 20 mg tablet)

Generic

EPANED Brand

fosinopril sodium Generic

lisinopril (2.5 mg tablet, 5 mg tablet, 10mg tablet, 20 mg tablet, 30 mg tablet,40 mg tablet)

Generic

moexipril hcl Generic

perindopril erbumine Generic

quinapril hcl Generic

ramipril Generic

trandolapril 1 mg tablet Generic

Antiarrhythmicsamiodarone hcl (100 mg tablet, 200 mgtablet, 400 mg tablet)

Generic

disopyramide phosphate Generic

flecainide acetate Generic

mexiletine hcl (150 mg capsule, 200 mgcapsule, 250 mg capsule)

Generic

MULTAQ Brand

NORPACE CR Brand




Drug Name Status* Requirements/Limitspacerone 200 mg tablet Generic

propafenone hcl (150 mg tablet, 225mg tablet, 300 mg tablet)

Generic

quinidine gluconate 324 mg tablet er Generic

quinidine sulfate (200 mg tablet, 300mg tablet er, 300 mg tablet)

Generic

sorine Generic

sotalol hcl (80 mg tablet, 120 mg tablet,160 mg tablet, 240 mg tablet)

Generic

verapamil hcl (40 mg tablet, 80 mgtablet, 120 mg tablet)

Generic

Beta-adrenergic Blocking Agentsacebutolol hcl (200 mg capsule, 400 mgcapsule)

Generic

atenolol (25 mg tablet, 50 mg tablet,100 mg tablet)

Generic

betaxolol hcl (10 mg tablet, 20 mgtablet)

Generic

bisoprolol fumarate Generic

carvedilol Generic

COREG CR Brand

esmolol hcl Generic

INDERAL XL Brand

INNOPRAN XL Brand

labetalol hcl (100 mg tablet, 200 mgtablet, 300 mg tablet)

Generic

LEVATOL Brand

metoprolol succinate Generic

metoprolol tartrate (25 mg tablet, 50mg tablet, 100 mg tablet)

Generic

nadolol (20 mg tablet, 40 mg tablet, 80mg tablet)

Generic




Drug Name Status* Requirements/Limitspindolol Generic

propranolol hcl (10 mg tablet, 20 mg/5ml solution, 20 mg tablet, 40 mg tablet,40mg/5ml solution, 60 mg cap sa 24h,60 mg tablet, 80 mg tablet, 80 mg capsa 24h, 120 mg cap sa 24h, 160 mg capsa 24h)

Generic

Calcium Channel Blocking Agentsafeditab cr Generic

amlodipine besylate (2.5 mg tablet, 5mg tablet, 10 mg tablet)

Generic

CARDENE SR Brand

CARDIZEM LA 120 MG TABLET Brand

cartia xt Generic

dilt-cd Generic

dilt-xr Generic

diltiazem hcl (30 mg tablet, 60 mg caper 12h, 60 mg tablet, 90 mg cap er 12h,90 mg tablet, 120 mg cap er 12h, 120mg cap er 24h, 120 mg cap er deg, 120mg capsule er, 120 mg tablet, 180 mgcap er 24h, 180 mg capsule er, 180 mgtab er 24h, 180 mg cap er deg, 240 mgtab er 24h, 240 mg cap er deg, 240 mgcap er 24h, 240 mg capsule er, 300 mgcapsule er, 300 mg cap er 24h, 360 mgcap er 24h, 360 mg capsule er, 360 mgtab er 24h, 420mg tab er 24h, 420mgcapsule er)

Generic

diltiazem hcl 300 mg tab er 24h Generic PA

diltzac er Generic

felodipine Generic

matzim la (180 mg tablet, 240 mgtablet, 360 mg tablet, 420 mg tablet)

Generic

matzim la 300 mg tablet Generic PA

nicardipine hcl (20 mg capsule, 30 mgcapsule)

Generic




Drug Name Status* Requirements/Limitsnifediac cc Generic

nifedical xl Generic

nifedipine (10 mg capsule, 20 mgcapsule, 30 mg tab er 24, 30 mg tableter, 60 mg tablet er, 60 mg tab er 24, 90mg tab er 24, 90 mg tablet er)

Generic

nimodipine 30 mg capsule Generic

nisoldipine (8.5mg tab er 24h, 17 mgtab er 24h, 25.5 mg tab er 24h, 34 mgtab er 24h)

Generic

taztia xt Generic

verapamil hcl (100 mg cap24h pct, 120mg tablet er, 120 mg cap24h pel, 180mg cap24h pel, 180 mg tablet er, 200mg cap24h pct, 240 mg cap24h pel, 240mg tablet er, 300 mg cap24h pct, 360mg cap24h pel)

Generic

Cardiovascular Agents, Otheramiloride hcl/hydrochlorothiazide Generic

amlodipine besylate/atorvastatincalcium

Generic

amlodipine besylate/benazepril hcl (5mg-40 mg capsule, 10 mg-40mgcapsule)

Generic

amlodipine besylate/valsartan Generic

atenolol/chlorthalidone Generic

benazepril hcl/hydrochlorothiazide Generic

bisoprololfumarate/hydrochlorothiazide

Generic

captopril/hydrochlorothiazide Generic

clorpres Generic

digitek Generic

digox Generic

digoxin (50 mcg/ml solution, 125 mcgtablet, 250 mcg tablet)

Generic




Drug Name Status* Requirements/Limitsenalapril maleate/hydrochlorothiazide Generic

fosinopril sodium/hydrochlorothiazide Generic

irbesartan/hydrochlorothiazide Generic

LANOXIN (62.5 MCG TABLET, 187.5MCG TABLET)

Brand

lisinopril/hydrochlorothiazide Generic

losartan potassium/hydrochlorothiazide Generic

methyldopa/hydrochlorothiazide Generic

metoprololtartrate/hydrochlorothiazide

Generic

pentoxifylline 400 mg tablet er Generic

propranolol hcl/hydrochlorothiazide Generic

quinapril hcl/hydrochlorothiazide Generic

spironolactone/hydrochlorothiazide Generic

triamterene/hydrochlorothiazide Generic

valsartan/hydrochlorothiazide Generic

Diuretics, Carbonic Anhydrase Inhibitorsacetazolamide 500 mg capsule er Generic

methazolamide (25 mg tablet, 50 mgtablet)

Generic

Diuretics, Loopbumetanide (0.5 mg tablet, 1 mg tablet,2 mg tablet)

Generic

EDECRIN Brand

ethacrynate sodium Generic

furosemide (10 mg/ml solution, 20 mgtablet, 40 mg tablet, 40mg/5mlsolution, 80 mg tablet)

Generic

torsemide (5 mg tablet, 10 mg tablet,20 mg tablet, 100 mg tablet)

Generic





Diuretics, Potassium-sparingamiloride hcl Generic

eplerenone Generic

spironolactone (25 mg tablet, 50 mgtablet, 100 mg tablet)

Generic

Diuretics, Thiazidechlorothiazide Generic

chlorthalidone Generic

hydrochlorothiazide (12.5 mg capsule,12.5 mg tablet, 25 mg tablet, 50 mgtablet)

Generic

indapamide Generic

methyclothiazide Generic

metolazone Generic

Dyslipidemics, Fibric Acid Derivativesfenofibrate (54 mg tablet, 160 mgtablet)

Generic

fenofibrate nanocrystallized Generic

fenofibrate,micronized (67 mg capsule,134mg capsule, 200 mg capsule)

Generic

fenofibric acid Generic

fenofibric acid (choline) Generic

gemfibrozil 600 mg tablet Generic

lofibra Generic

TRIGLIDE Brand

Dyslipidemics, HMG CoA Reductase Inhibitorsatorvastatin calcium Generic

CRESTOR Brand

fluvastatin sodium (20 mg capsule, 40mg capsule)

Generic




Drug Name Status* Requirements/Limitslovastatin Generic

pravastatin sodium Generic

simvastatin (5 mg tablet, 10 mg tablet,20 mg tablet, 40 mg tablet)

Generic

Dyslipidemics, Othercholestyramine (with sugar) (4 gpowder, 4 g powd pack)

Generic

cholestyramine/aspartame 4 g powdpack

Generic

COLESTID FLAVORED GRANULES Brand

colestid granules Generic

colestipol hcl (1 g tablet, 5 g packet, 5 ggranules)

Generic

ENDUR-ACIN SR 500 MG TABLET OTC

JUXTAPID Specialty PA, LA

KYNAMRO Specialty PA, LA

niacin (500 mg tablet er, 500 mg tablet,1000 mg tablet er)

OTC

niacin (inositol niacinate) 500 mg tablet OTC

omega-3 fatty acids (500 mg capsule,500 mg capsule dr, 1000 mg capsule)

OTC

omega-3 fatty acids/docosahexanoicacid/epa/fish oil (oil 250-500 mgcapsule, oil 300-1000mg capsule, oil1000 mg capsule)

OTC

omega-3 fatty acids/fish oil (oil 300-1000mg capsule, oil 300-500 mgcapsule, oil 340-1000mg capsule)

OTC

omega-3 fatty acids/vitamin e OTC

prevalite packet Generic

SLO-NIACIN 500 MG TABLET OTC

SUPER OMEGA-3 SOFTGEL OTC

ZETIA Brand PA





Vasodilators, Direct-acting Arterialhydralazine hcl (10 mg tablet, 25 mgtablet, 50 mg tablet, 100 mg tablet)

Generic

minoxidil (2.5 mg tablet, 10 mg tablet) Generic

Vasodilators, Direct-acting Arterial/Venousisochron Generic

isosorbide dinitrate Generic

isosorbide mononitrate Generic

minitran Generic

NITRO-BID Brand

NITRO-DUR (0.3 PATCH, 0.8 PATCH) Brand

nitro-time Generic

nitroglycerin (0.1mg/hr patch td24,0.2mg/hr patch td24, 0.4mg/hr patchtd24, 0.6mg/hr patch td24, 2.5 mgcapsule er, 6.5 mg capsule er, 9 mgcapsule er)

Generic

NITROSTAT Brand

Central Nervous System Agents

Attention Deficit Hyperactivity Disorder Agents, Amphetaminesdextroamphetamine sulf-saccharate/amphetamine sulf-aspartate (5 mg cap er 24h, 10 mg caper 24h, 15 mg cap er 24h, 25 mg cap er24h, 30 mg cap er 24h)

Generic QL (1 PER DAY)

dextroamphetamine sulf-saccharate/amphetamine sulf-aspartate (5 mg tablet, 7.5 mg tablet,10 mg tablet, 12.5 mg tablet, 15 mgtablet, 20 mg tablet, 30 mg tablet)

Generic

dextroamphetamine sulfate (5 mgtablet, 5 mg capsule er, 10 mg tablet,10 mg capsule er, 15 mg capsule er)

Generic




Drug Name Status* Requirements/Limitsdextroamphetamine/amphetamine 20mg cap er 24h

Generic QL (2 PER DAY)

VYVANSE Brand QL (1 PER DAY)

zenzedi (5 mg tablet, 10 mg tablet) Generic

Attention Deficit Hyperactivity Disorder Agents, Non-amphetaminesDAYTRANA Brand QL (30 PER 30 DAYS)

metadate er Generic QL (3 PER DAY)

methylphenidate hcl (10 mg cpbp 30-70, 20 mg cpbp 30-70, 30 mg cpbp 30-70, 40 mg cpbp 30-70, 50 mg cpbp 30-70, 60 mg cpbp 30-70)


methylphenidate hcl (2.5 mg tab chew,5 mg tablet, 5 mg tab chew, 10 mgtablet, 10 mg tablet er, 10 mg/5 mlsolution, 10 mg tab chew, 18 mg tab er24, 20 mg tablet, 20 mg cpbp 50-50, 27mg tab er 24, 30 mg cpbp 50-50, 36 mgtab er 24, 40 mg cpbp 50-50, 54 mg taber 24)

Generic

methylphenidate hcl 20 mg tablet er Generic QL (3 PER DAY)

RITALIN LA (10 MG CAPSULE, 60 MGCAPSULE)

Brand QL (1 PER DAY)

Central Nervous System Agents, OtherBETASERON 0.3 MG KIT Specialty PA, QL (14 PER 30 DAYS)

BETASERON 0.3 MG VIAL Specialty PA, QL (15 PER 30 DAYS)

EXTAVIA 0.3 MG KIT Specialty PA, QL (14 PER 30 DAYS)

EXTAVIA 0.3 MG VIAL Specialty PA, QL (15 PER 30 DAYS)

GILENYA Specialty PA, QL (30 PER 30 DAYS)

NUEDEXTA Brand PA

riluzole Generic

tetrabenazine Specialty PA, LA





Multiple Sclerosis AgentsAMPYRA Specialty PA, LA, QL (60 PER 30 DAYS)

AUBAGIO Specialty PA, LA, QL (30 PER 30 DAYS)

AVONEX (SYR 30 MCG, SYR 30 MCG KT) Specialty

AVONEX ADMINISTRATION PACK Specialty

AVONEX PEN Specialty

COPAXONE 20 MG/ML SYRINGE Specialty QL (30 ML PER 30 DAYS)

COPAXONE 40 MG/ML SYRINGE Specialty QL (12 ML PER 28 DAYS)

GLATOPA Specialty QL (30 ML PER 30 DAYS)

PLEGRIDY Specialty QL (1 ML PER 28 DAYS)

PLEGRIDY PEN Specialty QL (1 ML PER 28 DAYS)

REBIF (22 ML SYRINGE, 44 ML SYRINGE) Specialty QL (6 ML PER 30 DAYS)

REBIF REBIDOSE (22 ML, 44 ML) Specialty QL (6 ML PER 30 DAYS)

REBIF REBIDOSE TITRATION PACK Specialty QL (4.2 ML PER 30 DAYS)

TECFIDERA Specialty QL (60 PER 30 DAYS)

Dental and Oral Agents

ANTICAVITY FLUORIDE OTC

denta 5000 plus Generic

dentagel Generic

FLUOR-A-DAY (0.25 MG TAB CHEW, 0.5MG TAB CHEW, 1 MG TABLET CHEW)

Brand

fluoridex daily defense Generic

fluoritab (0.125 mg/drp drops, 0.5 mgtablet chew)

Generic

ludent fluoride Generic

PHOS-FLUR OTC

pilocarpine hcl (5 mg tablet, 7.5 mgtablet)

Generic

prevident 1.1% gel Generic




Drug Name Status* Requirements/Limitssf Generic

sf 5000 plus Generic

sodium fluoride (0.2 % solution,0.25(0.55) tab chew, 0.5(1.1)mg tabchew, 1mg(2.2mg) tab chew)

Generic

Dermatological Agents

ALLERGY CREAM OTC

ALLERGY RELIEF SPRAY OTC

ANTI-ITCH (2% SPRAY, CVS 2% CREAM,2% CREAM, EQ CREAM, GNP 2%CREAM, QC CREAM, RA SPRAY, SB 2%-0.1% CREAM, SM 2% CREAM, SMSPRAY)

OTC

BANOPHEN ANTI-ITCH OTC

BENADRYL ITCH STOPPING CRM OTC

DESITIN CLEAR OTC

diphenhydramine hcl 2 % cream (g) OTC

DRY SKIN THERAPY OTC

ITCH RELIEF (CREAM, CVS CREAM, CVSSPRAY)

OTC

PV ALLERGY 2% CREAM OTC

SELSUN BLUE OTC

SKIN PROTECTANT A & D OTC

VITAMIN A & D GRX OTC

vitamins a and d oint. (g) OTC

vits a & d/white pet/lanolin oint. (g) OTC

WAL-DRYL (2%-0.1% CREAM, ANTI-ITCHSPRAY)

OTC

acitretin Generic

ANTI-ITCH CREAM OTC

calcipotriene (0.005 % cream (g), 0.005% oint. (g), 0.005 % solution)

Generic




Drug Name Status* Requirements/Limitscalcitrene Generic

clotrimazole/betamethasonedipropionate (1 %-0.05 % lotion, 1 %-0.05 % cream (g))

Generic

CLOVERINE OTC

CONDYLOX 0.5% GEL Brand

cyclosporine, modified (25 mg capsule,50 mg capsule, 100 mg/ml solution)

Generic

DRITHOCREME HP Brand

ELIDEL Brand PA

gengraf (25 mg capsule, 100 mg/mlsolution, 100 mg capsule)

Generic

HYDROLATUM OTC

LOBANA BATH OIL OTC

MAPO OTC

mineral oil oil OTC

mometasone furoate (0.1 % cream (g),0.1 % oint. (g), 0.1 % solution)

Generic

petrolatum,white (jelly (g), oint pack,oint. (g))

OTC

petrolatum,white/lanolin OTC

podofilox 0.5 % solution Generic

PROTECTIVE OINTMENT OTC

REGRANEX Brand PA

SECURA PROTECTIVE OINTMENT OTC

selenium sulfide (2.25 % shampoo, 2.5% suspension)

Generic

STELARA 45 MG/0.5 ML SYRINGE Specialty QL (0.5 ML PER 90 DAYS)

STELARA 90 MG/ML SYRINGE Specialty QL (1 ML PER 90 DAYS)

tacrolimus (0.03 % oint. (g), 0.1 % oint.(g))

Generic PA

trianex Generic




Drug Name Status* Requirements/Limitsvaseline white petroleum Generic

VOLTAREN Brand

Enzyme Replacement/ Modifiers

BUPHENYL 500 MG TABLET Specialty PA

CARBAGLU Brand

CERDELGA Specialty

CREON Brand

ELELYSO Specialty

KUVAN Specialty PA, LA

ORFADIN 2 MG CAPSULE Specialty

pancrelipase 5,000 Generic

RAVICTI Specialty LA

sodium phenylbutyrate 0.94 g/g powder Specialty PA

ZENPEP (DR 3,000 CAPSULE, DR 10,000CAPSULE, DR 15,000 CAPSULE, DR20,000 CAPSULE, DR 25,000 CAPSULE,DR 40,000 CAPSULE)

Brand

Gastrointestinal Agents

Antispasmodics, GastrointestinalANTI-DIARRHEA OTC




Drug Name Status* Requirements/LimitsANTI-DIARRHEAL (ANTI-DIARRHEAL 1MG/5 ML SOLN, ANTI-DIARRHEAL 1MG/5 ML LIQ, ANTI-DIARRHEAL 2 MGCAPLET, ANTI-DIARRHEAL 2 MGTABLET, ANTI-DIARRHEAL 2 MGSOFTGEL, CVS ANTI-DIARRHEAL 2 MGSFTGEL, CVS ANTI-DIARRHEAL 2 MGCAPLET, EQ ANTI-DIARRHEAL 2 MGCAPLET, EQL ANTI-DIARRHEAL 1 MG/5ML, EQL ANTI-DIARRHEAL 2 MGCAPLET, GNP ANTI-DIARRHEAL 2 MGCAPLET, HM ANTI-DIARRHEAL 2 MGCAPLET, KRO ANTI-DIARRHEAL 2 MGCAPLET, PV ANTI-DIARRHEAL 2 MGCAPLET, QC ANTI-DIARRHEAL 2 MGCAPLET, QC ANTI-DIARRHEAL 2 MGSOFTGEL, RA ANTI DIARRHEAL 2 MGCAPLET, RA ANTI-DIARRHEAL 1 MG/5ML, RA ANTI-DIARRHEAL 2 MG CAPLET,RA ANTI-DIARRHEAL 2 MG SOFTGEL,SM ANTI-DIARRHEAL 1 MG/5 ML, SMANTI-DIARRHEAL 2 MG CAPLET, SMANTI-DIARRHEAL 2 MG SOFTGEL, V-RANTI-DIARRHEAL 2 MG CAPLET)

OTC

CUVPOSA Brand PA

DIAMODE OTC

dicyclomine hcl (10 mg capsule, 10mg/5 ml solution, 20 mg tablet)

Generic

glycopyrrolate (1 mg tablet, 2 mgtablet)

Generic

LO-PERAMIDE OTC

loperamide hcl (1 mg/5 ml liquid, 2 mgtablet)

OTC

loperamide hcl 2 mg capsule Generic

ULTRA A-D OTC

Gastrointestinal Agents, OtherACID CONTROL (150 MG TABLET, GNP150 MG TABLET)

OTC

ACID GONE OTC




Drug Name Status* Requirements/LimitsACID GONE ANTACID OTC

ACID REDUCER (CVS 150 MG TABLET,EQ 75 MG TABLET, EQ 150 MG TABLET,GNP 75 MG TABLET, HM 75 MGTABLET, PUB 75 MG TABLET, 75 MGTABLET, PV 75 MG TABLET, PV 150 MGTABLET, RA 75 MG TABLET, RA 150 MGTABLET, SB 75 MG TABLET, SB 150 MGTABLET, SM 75 MG TABLET, V-R 75 MGTABLET, 150 MG TABLET, HM 150 MGTABLET, SM 150 MG TABLET)

OTC

ACID REDUCER 150 OTC

ADVANCED ANTACID OTC

ADVANCED ANTACID-ANTIGAS OTC

ALMACONE LIQUID OTC

ALMACONE-2 OTC

aluminum hydroxide (320 oral susp, 600oral susp)

OTC

ANALPRAM HC 2.5% LOTION Brand

ANTACID & ANTIGAS OTC

ANTACID & GAS RELIEF OTC




Drug Name Status* Requirements/LimitsANTACID (EQ 500 MG CHEW TABLET,EQL 500 MG CHEW TABLET, 500 MGCHEW TABLET, 500 MG CHEWABLETABLET, 675-135 MG TAB CHEW, CVS750 MG CHEW TABLET, CVS KIDS 750MG CHEW, CVS LIQUID, CVS MAXSTRENGTH LIQ, EQ EXTRA STR TABCHEW, EQ LIQUID, EQL CHEW TAB, EQLLIQUID, EQL SUSPENSION, EX-STR 750MG TAB CHEW, EX-STR TABLET CHEW,GNP 500 MG CHEW TABLET, GNP 750MG TAB CHEW, 750 MG CHEW TB, GNPSUSPENSION, KRO 500 MG CHEWTABLET, LIQUID, PUB 500 MG CHEWTABLET, PV 675-135 MG TAB CHEW, PVSUSPENSION, QC 500 MG CHEWTABLET, QC SUSPENSION, RA 500 MGCHEW TABLET, SB 500 MG CHEWTABLET, SB SUSPENSION, SM 500 MGCHEW TABLET, SM SUSPENSION,SUSPENSION)

OTC

ANTACID ANTI-GAS DOUBLE STR OTC

ANTACID EXTRA STRENGTH (CVS XTRASTR CHEW TAB, EQ EX-STR CHEWTABLET, EQ EXTRA STR CHEW TAB, EQLXTRA STR CHEW TAB, EXTRA STRENGTHCHW TAB, GNP EXT STRGTH CHW TAB,GNP XTRA STR CHEW TAB, KRO 750 MGCHEW TABLET, PV EXTRA STRENGTHSUSP, QC XTRA STR CHEW TAB, RAXTRA STR CHEW TAB, SB XTRA STRCHEW TAB, SM EX-STR TAB CHEW, SMXTRA STR CHEW TAB, V-R XTRA STRCHEW TAB, VR X-S TAB CHEW, XTRASTRENGTH CHEW TAB)

OTC

ANTACID II PLUS SIMETHICONE OTC

ANTACID II WITH SIMETHICONE OTC

ANTACID M OTC

ANTACID MAXIMUM STRENGTH (EQTABLET CHEWABLE, MAXIMUMSTRENGTH LIQ, PV MAX STRENGTHSUSP)

OTC




Drug Name Status* Requirements/LimitsANTACID PLUS ANTI-GAS OTC

ANTACID PLUS EXTRA STRENGTH OTC

ANTACID TABLET OTC

ANTACID ULTRA STRENGTH (CVS ULTRATAB CHEW, EQ ULTRA STR TAB CHEW,KRO 1,000 MG CHEW TAB, RA ULTRATAB CHEW, ULTRA STR 1,000 MG CHW,ULTRA STR TAB CHEWABLE)

OTC

ANTACID WITH SIMETHICONE OTC

ANTACID-ANTIGAS (ANTACID ANTI-GASLIQUID, ANTACID-ANTIGAS LIQUID, CVSANTACID-ANTIGAS LIQUID, CVSANTACID-ANTIGAS MAX STR LQ, GNPANTACID ANTI-GAS LIQUID, HMANTACID ANTI-GAS SUSPENSION, HMANTACID-ANTIGAS SUSPENSION, KROANTACID-ANTIGAS LIQUID, PUBANTACID-ANTI GAS SUSP, PV ANTACID-ANTIGAS SUSPENSION, QC ANTACID-ANTIGAS MAX STR, QC ANTACID-ANTIGAS SUSPENSION, RA ANTACID-ANTIGAS LIQUID, RA ANTACID-ANTIGASSUSPENSION, SB ANTACID-ANTIGASLIQUID, SM ANTACID ANTI-GAS LIQUID,SM ANTACID-ANTIGAS LIQUID)

OTC

ANTI-GAS (CVS 180 MG, QC 180 MG,ULTRA STR, V-R 166 MG)

OTC

APRISO Brand

ASACOL HD Brand

BAN-ACID OTC

BISMATROL TABLET CHEW OTC

bismuth subsalicylate 262 mg tab chew OTC

CAL-GEST OTC

CALCI-CHEW OTC

CALCIUM ANTACID OTC




Drug Name Status* Requirements/Limitscalcium carbonate (200(500)mg tabchew, 300mg(750) tab chew, 400(1000)tab chew, 500 mg/5ml oral susp,500(1250) tab chew)

OTC

CANASA Brand

CHENODAL Specialty PA, LA

CHILDREN'S PEPTO OTC

CHILDREN'S SOOTHE OTC

CITROMA OTC

COMFORT GEL OTC

DELZICOL Brand

DIOTAME OTC

diphenoxylate hcl/atropine sulfate (2.5-.025mg tablet, 2.5-.025/5 liquid)

Generic

FLANAX ANTACID LIQUID OTC

FLAVOR CHEWS ANTACID OTC

FOAMING ANTACID (GNP LIQUID, GNPTAB CHW, LIQUID, PV CHEW TABLET,SM TABLET CHEW, TABLET CHEW)

OTC

FULYZAQ Brand PA

GAS FREE OTC




Drug Name Status* Requirements/LimitsGAS RELIEF (CVS GAS RELIEF 80 MG TABCHEW, CVS GAS RELIEF 125 MG CHEWTAB, CVS GAS RELIEF 125 MG SOFTGEL,CVS GAS RELIEF EX-STR DROPS, EQ GASRELIEF 125 MG SOFTGEL, EQL GASRELIEF 125 MG SOFTGEL, EQL GASRELIEF 180 MG SOFTGEL, EQL GASRELIEF DROPS, GAS RELIEF 20 MG/0.3ML DROPS, GAS RELIEF 40 MG/0.6 MLDROPS, GAS RELIEF 80 MG TABLETCHEW, GAS RELIEF 125 TABLET CHEW,GAS RELIEF 125 MG SOFTGEL, GASRELIEF 125 MG CHEW TABLET, GASRELIEF 180 MG SOFTGEL, GAS RELIEFDROPS, GNP GAS RELIEF 125 MG CHEWTAB, GNP GAS RELIEF 125 MG SFTG,GNP GAS RELIEF 125 MG SOFTGEL, GNPGAS RELIEF 125 TAB CHEW, GNP GASRELIEF DROPS, GS GAS RELIEF 125 MGSOFTGEL, HM GAS RELIEF 80 MG TABCHEW, HM GAS RELIEF 125 MGSOFTGEL, KRO GAS RELIEF 180 MGSOFTGEL, PUB GAS RELIEF 125 MGSOFTGEL, PUB GAS RELIEF 180 MGSOFTGEL, PV GAS RELIEF 125 MG CHEWTAB, PV GAS RELIEF 125 MG SOFTGEL,PV GAS RELIEF 180 MG SOFTGEL, QCGAS RELIEF 80 MG TAB CHEW, QC GASRELIEF 125 MG TAB CHEW, RA GASRELIEF 40 MG/0.6 ML DP, RA GASRELIEF 80 MG TAB CHEW, RA GASRELIEF 125 MG TAB CHEW, RA GASRELIEF 125 MG SOFTGEL, SB GAS RELIEF40 MG/0.6 ML DRP, SM GAS RELANTIFLATUENT 180 MG, SM GAS RELIEF125 MG SOFTGEL, V-R GAS RELIEF 80MG TAB CHEW)

OTC

GAS RELIEF 80 OTC

GAS-X EXTRA STRENGTH SOFTGEL OTC

GAS-X ULTRA STRENGTH OTC

GATTEX Specialty PA

GAVISCON 80-14.2 MG TAB CHEW OTC

GELUSIL ANTACID & ANTIGAS LIQ OTC




Drug Name Status* Requirements/LimitsGERI-LANTA OTC

GERI-MOX OTC

HEARTBURN ANTACID OTC

HEARTBURN RELIEF (CVS RELIEF CHEWTAB, EQL RELIEF 75 MG TAB, EQL RELIEF150 MG TB, EQL RLF 150 MG TAB, KRORELIEF 150 MG TB, RELIEF 75 MGTABLET, RELIEF 150 MG TABLET)

OTC

HEARTBURN RELIEF 150 OTC

INFANT GAS RELIEF OTC

INFANTS' GAS RELIEF OTC

ipecac OTC

lansoprazole/amoxicillintrihydrate/clarithromycin

Generic

LIALDA Brand

LIQUID ANTACID OTC

MAALOX MAXIMUM STRENGTH OTC

MAG-AL PLUS XS OTC

MAGLOX OTC

magnesium citrate solution OTC

MASANTI OTC

MEDI-BISMUTH OTC

mesalamine 4 g/60 ml enema Generic

MI ACID OTC

MI-ACID (MI ACID SUSPENSION, MI-ACID GAS 80 MG TAB CHEW)

OTC

MILANTEX OTC

MINTOX OTC

MINTOX MAXIMUM STRENGTH OTC

MYLANTA GAS MAXIMUM STRENGTH OTC

MYLANTEX DOUBLE-STRENGTH OTC




Drug Name Status* Requirements/LimitsMYTAB GAS OTC

MYTAB GAS MAXIMUM STRENGTH OTC

PENTASA Brand

PEP-T-MED OTC

PEPTIC RELIEF 262 MG CHEW TAB OTC

PINK BISMUTH (EQ TABLET CHEW, GNPTABLET CHEW, PV TABLET CHEW, QCTABLET CHEW, RA TABLET CHEW,TABLET CHEW)

OTC

PROCTOFOAM-HC Brand

propantheline bromide 15 mg tablet Generic

PYLERA Brand

ranitidine hcl 150 mg tablet Generic

ranitidine hcl 75 mg tablet OTC

RI-GEL OTC

RI-GEL II OTC

RI-MAG OTC

RI-MOX OTC

RI-MOX PLUS OTC

RIGINIC OTC

RULOX OTC

simethicone (40mg/0.6ml drops susp,80 mg tab chew, 125 mg tab chew, 125mg capsule, 180 mg capsule)

OTC

SMOOTH ANTACID OTC

SOOTHE 262 MG CHEWABLE TABLET OTC

STOMACH RELIEF (CVS RLF 262 MGCHEW TB, EQL RLF 262 MG CHEW TB,HM RLF 262 MG CHEW TAB, PUB RLF262 MG CHEW TB, RELIEF 262 MGCHEW TAB, SM RLF 262 MG CHEW TAB)

OTC

sulfasalazine (500 mg tablet, 500 mgtablet dr)

Generic




Drug Name Status* Requirements/Limitssulfazine Generic

sulfazine ec Generic

ULTRA STRENGTH ANTACID OTC

ursodiol (250 mg tablet, 300 mgcapsule, 500 mg tablet)

Generic

WAL-ZAN 150 OTC

WAL-ZAN 75 OTC

ZANTAC 75 OTC

Histamine2 (H2) Receptor AntagonistsACID CONTROL 20 MG TABLET OTC

ACID CONTROLLER (20 MG TABLET, CVS20 MG TAB)

OTC

ACID REDUCER (EQ 20 MG TABLET, EQ200 MG TABLET, EQL 200 MG TABLET,GNP 20 MG TABLET, KRO 200 MGTABLET, PUB 200 MG TABLET, PV 20MG TABLET, RA 20 MG TABLET, RA 200MG TABLET, SM 20 MG TABLET, 20 MGTABLET, SM 200 MG TABLET, 200 MGTABLET)

OTC

ACID RELIEF OTC

cimetidine (300 mg tablet, 400 mgtablet, 800 mg tablet)

Generic

cimetidine 200 mg tablet OTC

cimetidine hcl Generic

famotidine (20 mg tablet, 40 mg tablet) Generic

HEARTBURN PREVENTION (EQL PREVEN20 MG TAB, KRO PREVEN 20 MG TAB,PREVENTION 20 MG TAB)

OTC

HEARTBURN RELIEF (RELIEF 20 MGTABLET, RELIEF 200 MG TABLET, SMRELIEF 200 MG TAB, V-R RELF 200 MGTB)

OTC

nizatidine (150 mg capsule, 300 mgcapsule)

Generic




Drug Name Status* Requirements/LimitsPEPCID AC 20 MG TABLET OTC

ranitidine hcl (15 mg/ml syrup, 150 mgcapsule, 300 mg tablet, 300 mgcapsule)

Generic

Irritable Bowel Syndrome Agentsalosetron hcl Generic PA

LaxativesADULT GLYCERIN OTC

ALOPHEN PILLS OTC

BISA-LAX OTC

BISACODYL (5 MG TABLET DR, FLEET EC5 MG TAB, 10 MG SUPP.RECT)

OTC

BISCOLAX OTC

castor oil OTC

CHILD SUPPOSITORY OTC

CHOCOLATED LAXATIVE OTC

CITRUCEL 500 MG CAPLET OTC

CLEARLAX OTC

COL-RITE OTC

constulose Generic

CURAD ENEMA OTC

DIOCTYL OTC

DOC-Q-LACE OTC

DOC-Q-LAX OTC

DOCU LIQUID OTC

DOCU SOFT OTC

DOCUPRENE OTC

docusate calcium OTC

docusate sodium (50 mg/5 ml liquid, 60mg/15ml syrup, 100 mg tablet, 100 mgcapsule, 250 mg capsule)

OTC




Drug Name Status* Requirements/LimitsDOCUSIL OTC

DOK 100 MG TABLET OTC

DOK PLUS OTC

DSS OTC

DUCODYL OTC

DULCOLAX STOOL SOFTENER OTC

ENEMA (ENEMA, ENEMA READY TOUSE, ENEMA READY-TO-USE, ENEMATWIN PACK, EQ ENEMA, EQL ENEMAREADY TO USE, GNP ENEMA READY TOUSE, HM ENEMA READY TO USE, HMENEMA READY TO USE TWIN PAK, PVENEMA, PV ENEMA READY TO USE, QCREADY TO USE ENEMA, RA ENEMATWIN PACK, SM ENEMA READY TO USE)

OTC

ENEMA DISPOSABLE OTC

enulose Generic

EQ DAILY FIBER LAXATIVE POWDER OTC

EVAC-U-GEN OTC

EX-LAX CHOCOLATE OTC

FAST RELIEF LAXATIVE OTC

FIBER (HM 500 MG CAPLET, 625 MGTABLET, HM POWDER, PUB 625 MGCAPLET, SM POWDER, TABLET)

OTC

FIBER LAX OTC

FIBER LAXATIVE (EQL 625 MG CPLT, 625MG TABLET, CVS 625 MG CPLT, KRO625 MG CPLT, PV 625 MG CAPLT, PVPOWDER, RA POWDER, SB 625 MG TAB,SM 500 MG CPLT, 625 MG CAPLET, SM625 MG TAB)

OTC

FIBER SMOOTH OTC

FIBER TABS OTC




Drug Name Status* Requirements/LimitsFIBER THERAPY (500 MG CAPLET,CAPLET, CVS 500 MG CAPLT, EQ 625MG CAPLET, EQ CAPLET, EQ POWDER,EQL 500 MG CPLT, EQL CAPLET, GNP500 MG CAPLT, POWDER, PV 500 MGCAPLET, PV POWDER)

OTC

FIBER-LAX OTC

FIBER-TABS OTC

FLEET PEDIA-LAX SUPPOSITORIES OTC

GAVILAX OTC

gavilyte-c Generic

gavilyte-g Generic

gavilyte-n Generic

generlac Generic

GENTLE LAXATIVE OTC

GENTLELAX OTC

GERI-KOT OTC

GERI-MUCIL OTC

glycerin (adult supp.rect, pediatricsupp.rect)

OTC

GLYCOLAX OTC

HEALTHYLAX OTC

HYDROCIL INSTANT PACKET OTC

INFANT GLYCERIN OTC

KAO-TIN 240 MG SOFTGEL OTC

KONSYL (ORIGINAL POWDER, PSYLLIUMPOWDER)

OTC

KONSYL EASY MIX OTC

KONSYL FIBER OTC

KONSYL FORMULA-D OTC

KONSYL-D OTC




Drug Name Status* Requirements/LimitsKRISTALOSE Brand

lactulose Generic

LAX STOOL SOFTENER WITH SENNA OTC

LAXA CLEAR OTC

LAXACIN OTC

LAXATIVE (PUB EC 5 MG TABLET, 5 MGTABLET, CVS 15 MG PILLS, EC 5 MGTABLET, EQL EC 5 MG TABLET, GNP EC 5MG TABLET, HM EC 5 MG TABLET, PV 5MG TAB, PV EC 5 MG TABLET, SMTABLET, V-R CHOCOLATE)

OTC

LAXATIVE DIETARY SUPPLEMENT OTC

LAXATIVE FEMININE OTC

LAXATIVE PEG 3350 OTC

LAXATIVE SUPPOSITORY OTC

MAGIC BULLET OTC

magnesium hydroxide (400 mg/5ml oralsusp, 2400 mg/10 oral susp)

OTC

magnesium oxide (250 mg tablet, 500mg tablet)

OTC

MEDI-LAXX OTC

MEDI-NATURAL OTC

MEDI-NATURAL SENNA STOOL SOFT OTC

METAMUCIL POWDER OTC

METAMUCIL SUGAR FREE OTC

MINERAL OIL (OIL ENEMA, OIL, HEAVY,OIL LAXATIVE)

OTC

MINERAL OIL EXTRA HEAVY OTC

MOVE IT ALONG OTC

MOVIPREP Brand

NATURAL DAILY FIBER OTC

NATURAL FIBER (EQ LAXATIVE POWD,GNP POWDER, LAX POWDER)

OTC




Drug Name Status* Requirements/LimitsNATURAL FIBER LAXATIVE OTC

NATURAL FIBER POWDER OTC

NATURAL FIBER SUPPLEMENT OTC

NATURAL SENNA LAXATIVE OTC

NATURAL VEGETABLE POWDER OTC

nulytely with flavor packs Generic

ORAL SALINE LAXATIVE OTC

ORAL SALINE LAXATIVE KIT OTC

P-COL RITE OTC

PEDIA-LAX STOOL SOFTENER OTC

peg 3350/sod sulf/sod bicarbonate/sodchloride/potassium chl

Generic

PEG3350 OTC

PHILLIPS OTC

PHILLIPS' LAXATIVE OTC

PHOSPHATE ENEMA OTC

PHOSPHATE LAXATIVE OTC

polyethylene glycol 3350 (3350 17gpowd pack, 3350 17g/dose powder)

Generic

POWDERLAX OTC

PREPARATION CLEANSING OTC

PROMOLAXIN OTC

psyllium husk/aspartame OTC

PURE & GENTLE SALINE ENEMA OTC

PURELAX (POWDER, POWDER PACKET) OTC

QC NATURAL VEG LAXATIVE TABLET OTC

READY TO USE ENEMA OTC

REGULOID (LAXATIVE POWDER,POWDER, POWDER ORANGE)

OTC

SALINE ENEMA OTC




Drug Name Status* Requirements/LimitsSEN-O-TAB OTC

SENEXON (8.8 MG/5 ML LIQUID,TABLET)

OTC

SENEXON-S OTC

SENNA (HM SENNA 8.6 MG TABLET, PVSENNA 8.6 MG TABLET, QC SENNALAXATIVE 8.6 MG TAB, RA SENNA 8.6MG TABLET, SENNA 8.6 MG TABLET,SENNA LAXATIVE 8.6 MG TAB, SENNALAXATIVE 8.6 MG TABLET, SENNA-TIME8.6 MG TABLET)

OTC

SENNA LAX OTC

SENNA LAXATIVE (CVS 8.6 MG TAB, EQL8.6 MG TAB, SM 8.6 MG TAB, TABLET)

OTC

SENNA PLUS OTC

SENNA S OTC

SENNA-S OTC

SENNA-TIME S OTC

SENNALAX-S OTC

SENNO OTC

sennosides OTC

sennosides/docusate sodium OTC

SILACE OTC

SMOOTHLAX (POWDER, POWDERPACKET)

OTC

sodium chloride/sodiumbicarbonate/potassium chloride/peg

Generic

SOF-LAX OTC

SOLUBLE FIBER OTC

sorbitol solution 70 % solution OTC

STIMULANT LAXATIVE PLUS OTC




Drug Name Status* Requirements/LimitsSTOOL SOFTENER (CVS SOFTENER 50MG SFTGL, CVS SOFTENER 100 MG CAP,CVS SOFTENER 100 MG SFTG, CVSSOFTENER 250 MG SFGL, CVSSOFTENER SOFTGEL, EQ SOFTENER 100MG CAP, EQ SOFTENER 100 MG SFTGL,EQL SOFTENER 100 MG SFGL, EQLSOFTENER TABLET, GNP SOFTENER 50MG/5 ML, GNP SOFTENER 100 MGSFGL, GNP SOFTENER 250 MG SFGL,GNP SOFTENER SYRUP, HM SOFTENER100 MG SFTGL, HM SOFTENER 250 MGSFTGL, PV SOFTENER 100 MG CAP, PVSOFTENER 100 MG SFTGL, QCSOFTENER 100 MG CAP, QC SOFTENER100 MG SFTGL, QC SOFTENER-LAXTABLET, RA SOFTENER 100 MG SFTGL,RA SOFTENER 100 MG CAP, SM NATLAX PLUS SOFTENER, SM SOFTENER 100MG SFTGL, SM SOFTENER 240 MGSFTGL, SM SOFTENER 250 MG SFTGL,SM SOFTENER TABLET, SOFTENER 50MG/5 ML LIQ, SOFTENER 100 MGTABLET, SOFTENER 100 MG SOFTGEL,SOFTENER 100 MG CAPSULE, SOFTENER240 MG CAPS, SOFTENER 240 MGSOFTGEL, SOFTENER 250 MG SOFTGEL,SOFTENER SYRUP, SOFTENER TABLET,SOFTENER-LAXATIVE TAB, V-RSOFTENER TABLET)

OTC

STOOL SOFTENER-LAXATIVE OTC

STOOL SOFTENER-STIMULANT LAX OTC

SUPPOSITORY OTC

SUPREP Brand

trilyte with flavor packets Generic

VEGETABLE LAXATIVE OTC

WAL-MUCIL 100% NATURAL FIBER OTC

WAL-MUCIL NATURAL FIBER LAX OTC

WOMAN'S LAXATIVE OTC

WOMEN'S GENTLE LAXATIVE OTC




Drug Name Status* Requirements/LimitsWOMEN'S LAXATIVE OTC

WOMENS STOOL SOFTENER OTC

ProtectantsCARAFATE 1 GM/10 ML SUSP Brand

misoprostol (100 mcg tablet, 200 mcgtablet)

Generic

sucralfate 1 g tablet Generic

Proton Pump InhibitorsACID CONTROLLER (10 MG TABLET, CVS10 MG TAB, EQ 10 MG TAB, QC 10 MGTAB)

OTC

ACID REDUCER (EQ 10 MG TABLET, GNP10 MG TABLET, PUB 10 MG TABLET, PV10 MG TABLET, RA 10 MG TABLET, SM10 MG TABLET, V-R 10 MG TABLET, 10MG TABLET)

OTC

famotidine 10 mg tablet OTC

HEARTBURN PREVENTION (EQL TAB,KRO TAB, TAB)

OTC

HEARTBURN RELIEF 10 MG TABLET OTC

HEARTBURN RELIEF 24 HOUR OTC

HEARTBURN TREATMENT 24 HOUR OTC

lansoprazole (15 mg capsule dr, 30 mgcapsule dr)

Generic

omeprazole (10 mg capsule dr, 20 mgcapsule dr, 40 mg capsule dr)

Generic

omeprazole 20 mg tablet dr OTC

omeprazole magnesium OTC

pantoprazole sodium (20 mg tablet dr,40 mg tablet dr)

Generic

PREVACID 30 MG SOLUTAB Brand

PRILOSEC OTC OTC




Drug Name Status* Requirements/LimitsPROTONIX 40 MG SUSPENSION Brand

rabeprazole sodium Generic

Genitourinary Agents

Antispasmodics, Urinaryflavoxate hcl Generic

oxybutynin chloride (5 mg/5 ml syrup, 5mg tablet, 5 mg tab er 24, 10 mg tab er24, 15 mg tab er 24)

Generic

OXYTROL Brand

tolterodine tartrate Generic

trospium chloride 20 mg tablet Generic

Benign Prostatic Hypertrophy Agentsalfuzosin hcl Generic

finasteride 5 mg tablet Generic

tamsulosin hcl Generic

Genitourinary Agents, OtherAZO OTC

AZO-TABS OTC

bethanechol chloride (5 mg tablet, 10mg tablet, 25 mg tablet, 50 mg tablet)

Generic

cytra-k oral solution Generic

ELMIRON Brand

methylergonovine maleate 0.2 mgtablet

Generic

potassium citrate/citric acid 1100-334/5solution

Generic

PROCYSBI Brand PA, LA

PV AZO DINE 95 MG TABLET OTC




Drug Name Status* Requirements/LimitsURINARY PAIN RELIEF (CVS RLF 95 MGTAB, EQ RLF 95 MG TAB, GNP RLF 95MG TAB, KRO RLF 95 MG TAB, PV RLF95 MG TAB, RELIEF 95 MG TAB, SB RLF95 MG TAB, SM RLF 95 MG TAB, V-RRLF 95 MG TAB)

OTC

URINARY TRACT OTC

URISTAT 95 MG TABLET OTC

virtrate-k Generic

Phosphate BindersAURYXIA Brand PA

calcium acetate 667 mg capsule Generic

RENAGEL Brand PA

RENVELA Brand PA

sevelamer carbonate Brand PA

Hormonal Agents, Stimulant/ Replacement/ Modifying (Adrenal)

Glucocorticoids/MineralocorticoidsANTI-ITCH (EQL 1%, RA 1%, 1%) OTC

budesonide 3 mg capdr - er Generic

CHILDREN'S NASACORT OTC PA

CORTIZONE-10 1% OINTMENT OTC

dexamethasone (0.5 mg tablet, 0.5mg/5ml elixir, 0.5 mg/5ml solution, 0.75mg tablet, 1 mg tablet, 1.5 mg tablet, 2mg tablet, 4 mg tablet, 6 mg tablet)

Generic

dexamethasone intensol Generic

dexamethasone sod phosphate 0.1 %drops

Generic

DEXPAK 13 DAY 1.5 MG TABLET Brand

diclofenac sodium 0.1 % drops Generic

EPIFOAM Brand




Drug Name Status* Requirements/LimitsFLONASE ALLERGY RELIEF OTC PA

FLOVENT DISKUS Brand

FLOVENT HFA Brand

fluocinolone acetonide oil Generic

fluorometholone Generic

fluticasone propionate 50 mcg spraysusp

Generic PA

FML FORTE Brand

FML S.O.P. Brand

HC-1% HEMORRHOID OTC

hydrocortisone (0.5 % cream (g), 0.5 %oint. (g))

OTC

hydrocortisone (1 % oint. (g), 5 mgtablet, 10 mg tablet, 20 mg tablet)

Generic

hydrocortisone acetate (0.5 % cream(g), 1 % oint. (g))

OTC

hydrocortisone butyrate (0.1 % oint. (g),0.1 % solution)

Generic

hydrocortisone valerate Generic

MEDROL 2 MG TABLET Brand

NASACORT OTC PA

prednisolone acetate Generic

Hormonal Agents, Stimulant/Replacement/Modifying (Other)

MYALEPT Specialty PA

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary)

desmopressin acetate (0.1 mg tablet,0.1 mg/ml solution, 0.2 mg tablet,10/spray spray/pump)

Generic PA

desmopressin acetate (non-refrigerated)

Generic PA




Drug Name Status* Requirements/LimitsEGRIFTA Specialty PA

GENOTROPIN Specialty PA

INCRELEX Specialty PA, LA

NUTROPIN 5 MG VIAL Specialty PA

NUTROPIN AQ (5 MG/ML VIAL, 20MG/2ML PEN CART)

Specialty PA

NUTROPIN AQ NUSPIN 20 PEN CART Specialty PA

OMNITROPE (5 ML, 10 ML) Specialty PA

OMNITROPE 5.8 MG VIAL Brand PA

SAIZEN Specialty PA

SEROSTIM (5 MG VIAL, 8.8 MG VIAL) Specialty PA

STIMATE Brand

TEV-TROPIN Specialty PA

ZOMACTON 5 MG VIAL Specialty PA

ZORBTIVE Specialty PA

Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers)

AndrogensANDRODERM Brand PA

ANDROGEL (1.62%(1.25G) GEL PCKT,1.62% GEL PUMP, 1.62%(2.5G) GELPCKT)

Brand PA

testosterone cypionate (100 mg/ml vial,200 mg/ml vial)

Generic

testosterone enanthate 200 mg/ml vial Generic

EstrogensAFTERA OTC

altavera Generic

alyacen Generic

amethia Generic




Drug Name Status* Requirements/Limitsamethia lo Generic

amethyst Generic

apri Generic

aranelle Generic

ashlyna Generic

aubra Generic

aviane Generic

azurette Generic

balziva Generic

briellyn Generic

camrese Generic

camrese lo Generic

caziant Generic

chateal Generic

cryselle Generic

cyclafem Generic

cyred Generic

dasetta Generic

daysee Generic

delyla Generic

desogestrel-ethinyl estradiol Generic

desogestrel-ethinyl estradiol/ethinylestradiol

Generic

DUAVEE Brand

ECONTRA EZ OTC

elinest Generic

emoquette Generic

enpresse Generic

enskyce Generic




Drug Name Status* Requirements/LimitsESTRACE 0.01% CREAM Brand

estradiol (.025mg/24h patch tdwk,.025mg/24h patch tdsw, .0375mg/24patch tdwk, .0375mg/24 patch tdsw,0.05mg/24h patch tdsw, 0.05mg/24hpatch tdwk, 0.06mg/24h patch tdwk,.075mg/24h patch tdwk, .075mg/24hpatch tdsw, 0.1mg/24hr patch tdwk,0.1mg/24hr patch tdsw, 0.5 mg tablet,1 mg tablet, 2 mg tablet)

Generic

estradiol/norethindrone acetate Generic

ESTRING Brand

estropipate Generic

ethinyl estradiol/drospirenone Generic

FALLBACK SOLO OTC

falmina Generic

gianvi Generic

gildagia Generic

gildess Generic

gildess 24 fe Generic

gildess fe Generic

introvale Generic

jolessa Generic

junel Generic

junel fe Generic

junel fe 24 Generic

kariva Generic

kelnor 1-35 Generic

kimidess Generic

kurvelo Generic

larin Generic

larin 24 fe Generic




Drug Name Status* Requirements/Limitslarin fe Generic

leena Generic

lessina Generic

levonest Generic

levonorgestrel 1.5 mg tablet Generic

levonorgestrel-ethinyl estradiol Generic

levonorgestrel/ethinyl estradiol andethinyl estradiol

Generic

levora-28 Generic

lomedia 24 fe Generic

lopreeza Generic

loryna Generic

low-ogestrel Generic

lutera Generic

marlissa Generic

microgestin Generic

microgestin fe Generic

mimvey Generic

mimvey lo Generic

my way Generic

myzilra Generic

necon (1-35-28 tablet, 1-50-28 tablet, 7-7-7-28 tablet, 10-11-28 tablet)

Generic

next choice one dose Generic

nikki Generic

norethindrone ac-eth estradiol 1mg-20mcg tablet

Generic

norethindrone acetate-ethinylestradiol/ferrous fumarate

Generic

norgestimate-ethinyl estradiol 7daysx328 tablet

Generic




Drug Name Status* Requirements/Limitsnortrel (1-35 tablet, 7-7-7-28 tablet) Generic

NUVARING Brand

ocella Generic

ogestrel Generic

OPCICON ONE-STEP OTC

orsythia Generic

philith Generic

pimtrea Generic

pirmella Generic

portia Generic

PREFEST Brand

PREMARIN (0.3 MG TABLET, 0.45 MGTABLET, 0.625 MG TABLET, 0.9 MGTABLET, 1.25 MG TABLET, VAGINALCREAM-APPL)

Brand

PREMPHASE Brand

PREMPRO Brand

quasense Generic

reclipsen Generic

setlakin Generic

sronyx Generic

syeda Generic

tarina fe Generic

tri-estarylla Generic

tri-linyah Generic

tri-previfem Generic

tri-sprintec Generic

trinessa Generic

trivora-28 Generic

VAGIFEM Brand




Drug Name Status* Requirements/Limitsvelivet Generic

vestura Generic

viorele Generic

vyfemla Generic

xulane Generic

zarah Generic

zenchent Generic

zovia 1-35e Generic

zovia 1-50e Generic

Progestinscamila Generic

deblitane Generic

DEPO-SUBQ PROVERA 104 Brand

errin Generic

heather Generic

jencycla Generic

jolivette Generic

levonorgestrel 0.75 mg tablet Generic

lyza Generic

medroxyprogesterone acetate (2.5 mgtablet, 5 mg tablet, 10 mg tablet)

Generic

megestrol acetate (20 mg tablet, 40 mgtablet, 400mg/10ml oral susp)

Generic

nora-be Generic

norethindrone 0.35 mg tablet Generic

norethindrone acetate 5 mg tablet Generic

norlyroc Generic

progesterone,micronized (100 mgcapsule, 200 mg capsule)

Generic




Drug Name Status* Requirements/Limitssharobel Generic

Selective Estrogen Receptor Modifying Agentsraloxifene hcl Generic

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid)

levothyroxine sodium (25 mcg tablet, 50mcg tablet, 75 mcg tablet, 88 mcgtablet, 100 mcg tablet, 112 mcg tablet,125 mcg tablet, 137 mcg tablet, 150mcg tablet, 175mcg tablet, 200 mcgtablet, 300 mcg tablet)

Generic

levoxyl Generic

liothyronine sodium (5 mcg tablet, 25mcg tablet, 50 mcg tablet)

Generic

NATPARA Specialty PA, LA, QL (2 PER 28 DAYS)

THYROLAR-1 Brand

THYROLAR-1/2 Brand

THYROLAR-1/4 Brand

THYROLAR-2 Brand

THYROLAR-3 Brand

unithroid (25 mcg tablet, 50 mcg tablet,75 mcg tablet, 88 mcg tablet, 100 mcgtablet, 112 mcg tablet, 125 mcg tablet,150 mcg tablet, 175 mcg tablet, 200mcg tablet, 300 mcg tablet)

Generic

Hormonal Agents, Suppressant (Adrenal)

LYSODREN Brand

SIGNIFOR Specialty PA, LA

Hormonal Agents, Suppressant (Parathyroid)

calcitriol (0.25 mcg capsule, 0.5 mcgcapsule, 1 mcg/ml solution)

Generic




Drug Name Status* Requirements/Limitsparicalcitol (1 mcg capsule, 2 mcgcapsule, 4mcg capsule)

Generic ST

SENSIPAR (30 MG TABLET, 60 MGTABLET)

Specialty QL (60 PER 30 DAYS)

SENSIPAR 90 MG TABLET Specialty

Hormonal Agents, Suppressant (Pituitary)

ELIGARD Brand PA

ganirelix acetate Brand PA

leuprolide acetate 1 mg/0.2ml kit Specialty PA

octreotide acetate Specialty PA

SOMAVERT Specialty PA, LA

ZOLADEX 3.6 MG IMPLANT SYRN Brand PA

Hormonal Agents, Suppressant (Sex Hormones/Modifiers)

Antiandrogensbicalutamide Generic

NILANDRON Brand

XTANDI Specialty PA

Hormonal Agents, Suppressant (Thyroid)

Antithyroid Agentsmethimazole (5 mg tablet, 10 mgtablet)

Generic

propylthiouracil 50 mg tablet Generic

Immunological Agents

Angioedema (HAE) AgentsBERINERT Specialty PA, QL (3 PER 30 DAYS)





Immune SuppressantsASTAGRAF XL Brand

azathioprine 50 mg tablet Generic

cyclosporine (25 mg capsule, 100 mgcapsule)

Generic

cyclosporine, modified 100 mg capsule Generic

ENBREL (50 MG/ML SYRINGE, 50MG/ML SURECLICK SYR)

Specialty QL (3.92 ML PER 28 DAYS)

ENBREL 25 MG KIT Specialty QL (8 PER 28 DAYS)

ENBREL 25 MG/0.5 ML SYRINGE Specialty QL (4.08 ML PER 28 DAYS)

hecoria Generic

HUMIRA (10 MG/0.2 ML SYRINGE, 20MG/0.4 ML SYRINGE)

Specialty QL (2 PER 28 DAYS)

HUMIRA (40 ML SYRINGE, 40 ML PEN) Specialty QL (1 PER 28 DAYS)

HUMIRA CROHN'S Specialty QL (1 PER 28 DAYS)

HUMIRA PEDIATRIC CROHN'S Specialty QL (1 PER 28 DAYS)

HUMIRA PSORIASIS Specialty QL (1 PER 28 DAYS)

mycophenolate mofetil (200 mg/mlsusp recon, 250 mg capsule, 500 mgtablet)

Generic

mycophenolate sodium Generic

RAPAMUNE 1 MG/ML ORAL SOLN Brand

RESTASIS Brand QL (60 PER 30 DAYS)

SIMPONI (100 MG/ML PEN INJECTOR,100 MG/ML SYRINGE)

Specialty QL (1 ML PER 30 DAYS)

SIMPONI (50 ML SYRINGE, 50 ML PENINJEC)

Specialty QL (0.5 ML PER 30 DAYS)

sirolimus (0.5 mg tablet, 1 mg tablet, 2mg tablet)

Generic

tacrolimus (0.5 mg capsule, 1 mgcapsule, 5 mg capsule)

Generic

ZORTRESS Specialty





Immunizing Agents, PassiveGAMMAKED Specialty PA

GAMUNEX-C Specialty PA

HIZENTRA (1 GRAM/5 ML VIAL, 2GRAM/10 ML VIAL, 4 GRAM/20 MLVIAL)

Specialty PA

HYQVIA Specialty PA

ImmunomodulatorsACTIMMUNE Specialty PA

FIRAZYR Specialty PA, QL (9 ML PER 30 DAYS)

leflunomide Generic

OTEZLA (28 DAY PACK, PACK) Specialty PA

OTEZLA 30 MG TABLET Specialty PA, QL (2 PER DAY)

Inflammatory Bowel Disease Agents

Aminosalicylatesbalsalazide disodium Generic

DIPENTUM Brand

Glucocorticoidscolocort Generic

hydrocortisone 100mg/60ml enema Generic

proctosol-hc Generic

proctozone-hc Generic

UCERIS 9 MG ER TABLET Brand PA

MISCELLANEOUS THERAPEUTIC AGENTS

adenosine phosphate OTC

ALTAMIST OTC

CHILDREN'S SALINE NASAL SPRAY OTC




Drug Name Status* Requirements/LimitsDEEP SEA OTC

EPSOM SALT OTC

lancets (18 each, 21 each, 25 each, 26each, 28 each, 30 each, 32 each, 33each)

OTC

LITTLE REMEDIES OTC

LITTLE REMEDIES STUFFY NOSE OTC

magnesium sulfate 100 % crystals OTC

NASAL MOISTURIZING OTC

NASAL SPRAY (0.65% SPRAY, EQ 0.65%SPRAY)

OTC

SEA SOFT OTC

sodium chloride 0.65 % spray OTC

urine acetone test,strips strip OTC

urine acetone test,tablet OTC

urine gluc-acet comb.tst,strip OTC

Metabolic Bone Disease Agents

alendronate sodium (5 mg tablet, 10mg tablet, 35 mg tablet, 40 mg tablet,70 mg/75ml solution, 70 mg tablet)

Generic

calcitonin,salmon,synthetic Generic

doxercalciferol (0.5 mcg capsule, 1 mcgcapsule, 2.5 mcg capsule)

Generic ST

etidronate disodium Generic

fortical Generic

ibandronate sodium 150 mg tablet Generic

risedronate sodium (5 mg tablet, 30 mgtablet, 35 mg tablet, 150 mg tablet)

Generic





Miscellaneous

Glucose TestingACCU-CHECK (METERS & TEST STRIPS) DME Benefit QL

LIFESCAN (METERS & TEST STRIPS) DME Benefit QL

Ophthalmic Agents

Ophthalmic Prostaglandin and Prostamide Analogsbimatoprost Generic ST, QL (2.5 ML PER 30 DAYS)

latanoprost 0.005 % drops Generic

LUMIGAN Brand ST, QL (2.5 ML PER 30 DAYS)

TRAVATAN Z Brand

Ophthalmic Agents, OtherAKWA TEARS (1.4% DROPS, OINTMENT) OTC

ARTIFICIAL TEARS (, 1.4 % DROPS, CVSDROPS, DROPS, EQ DROPS, RA DROPS)

OTC

BLEPHAMIDE Brand

BLEPHAMIDE S.O.P. Brand

CVS REDNESS RELIEF DROPS OTC

CYSTARAN Brand PA, LA, QL (60 ML PER 30 DAYS)

LIQUITEARS OTC

LUBRICANT EYE (GNP LUBRICANT 0.5%DROPS, LUBRICANT 0.5% DROPS,LUBRICANT DROPS, LUBRICANTOINTMENT, PV LUBRICANT 1.4 %DROPS, RA LUBRICANT DROPS)

OTC

LUBRICANT EYE DROPS (CVSLUBRICANT 0.5% DROPS, CVSLUBRICANT 0.6% DROPS, LUBRICANT0.6% DROPS)

OTC

LUBRICANT PLUS OTC




Drug Name Status* Requirements/LimitsLUBRICATING RELIEF OTC

LUBRIFRESH PM OTC

MOISTURIZING LUBRICANT OTC

mydfrin Generic

naphazoline hcl Generic

neo-polycin Generic

neo-polycin hc Generic

neofrin Generic

neomycin sulfate/bacitracinzinc/polymyxin b/hydrocortisone

Generic

neomycin sulfate/bacitracin/polymyxinb

Generic

neomycin sulfate/polymyxin bsulfate/gramicidin d

Generic

neomycin/polymyxin b sulf/hc 3.5-10k-10 drops susp

Generic

neomycin/polymyxin bsulfate/dexamethasone (0.1 % dropssusp, 3.5-10k-.1 oint. (g))

Generic

neosporin eye drops Generic

phenylephrine hcl (2.5 % drops, 10 %drops)

Generic

polymyxin b sulfate/trimethoprim Generic

polyvinyl alcohol 1.4 % drops OTC

RA STERILE EYE DROPS OTC

REDNESS LUBRICANT EYE DROPS OTC

REDNESS RELIEVER EYE DROPS OTC

REFRESH LACRI-LUBE OTC

RESTORE TEARS OTC

RETAINE CMC OTC

sulfacetamide sodium 10 % oint. (g) Generic




Drug Name Status* Requirements/Limitssulfacetamide sodium/prednisolonesodium phosphate

Generic

TEARS AGAIN (1.4 % DROPS, EYEOINTMENT)

OTC

TOBRADEX ST Brand

tobramycin/dexamethasone Generic

ULTRA FRESH OTC

ULTRA FRESH PM OTC

ZYLET Brand

Ophthalmic Anti-allergy AgentsALOMIDE Brand

azelastine hcl 0.05 % drops Generic

Ophthalmic Anti-inflammatoriesflurbiprofen sodium Generic

ketorolac tromethamine 0.4 % drops Generic

LOTEMAX (0.5% EYE DROPS, 0.5%OPHTHALMIC GEL, 0.5% EYEOINTMENT)

Brand

PRED MILD Brand

prednisolone sod phosphate 1 % drops Generic

VEXOL Brand

Ophthalmic Antiglaucoma AgentsAZOPT Brand

betaxolol hcl 0.5 % drops Generic

BETIMOL Brand

BETOPTIC S Brand

brimonidine tartrate (0.15 % drops, 0.2% drops)

Generic

carteolol hcl Generic

dorzolamide hcl Generic




Drug Name Status* Requirements/Limitsdorzolamide hcl/timolol maleate Generic

levobunolol hcl Generic

pilocarpine hcl (1 % drops, 2 % drops, 4% drops)

Generic

timolol maleate (0.25 % drops, 0.25 %sol-gel, 0.5 % sol-gel, 0.5 % drops)

Generic

Otic Agents

AURAPHENE-B OTC

CARBAMOXIDE OTC

CIPRODEX Brand

ciprofloxacin hcl 0.2 % droperette Generic

COLY-MYCIN S Brand

CORTISPORIN-TC Brand

EAR DROPS (CVS DROPS 6.5%, DROPS6.5%, EQL DROPS 6.5%, GNP DROPS6.5%, RA DROPS 6.5%, SM DROPS 6.5%,WAX DROPS 6.5%)

OTC

EAR HEALTH PLUS OTC

EAR SYSTEM OTC

EAR WAX REMOVAL OTC

EARWAX TREATMENT OTC

MURINE EAR WAX REMOVAL SYSTEM OTC

Respiratory Tract Agents

Anti-inflammatories, Inhaled CorticosteroidsAEROSPAN Brand

ALVESCO Brand

ARNUITY ELLIPTA Brand

ASMANEX Brand

ASMANEX HFA Brand




Drug Name Status* Requirements/LimitsBREO ELLIPTA 100-25 MCG INH Brand

budesonide (0.25mg/2ml ampul-neb,0.5 mg/2ml ampul-neb, 1 mg/2 mlampul-neb)

Generic

flunisolide 29mcg spray Generic PA

PULMICORT FLEXHALER Brand

QVAR Brand

AntihistaminesALAVERT OTC PA

ALER-CAP OTC

ALER-TAB OTC

ALKA-SELTZER PLUS ALLERGY OTC

ALL DAY ALLERGY (1 MG/ML SYRUP,EQL 10 MG TAB, GNP 10 MG TAB, HM10 MG TAB, KRO 10 MG TAB, KRO 10MG SFGL, SM 1 MG/ML SYR, 10 MGCHEW TAB, PV 10 MG SFTGL, 10 MGTABLET, QC 10 MG TAB, SM 10 MGTAB)

OTC PA

ALL DAY ALLERGY RELIEF OTC PA

ALLER-EASE OTC PA

ALLER-FEX OTC PA

ALLER-G-TIME OTC

ALLER-TEC OTC PA

ALLERCLEAR OTC PA

ALLERCLEAR D-12HR OTC PA

ALLERGY & CONGESTION OTC PA

ALLERGY & CONGESTION RELIEF (& RLFTAB, KRO & TAB)

OTC PA




Drug Name Status* Requirements/LimitsALLERGY (KRO 4 MG TABLET, 4 MGTABLET, CVS 25 MG CAPSULE, EQL 4MG TABLET, GNP 4 MG TABLET, 12.5MG/5 ML LIQ, CVS 12.5 MG/5 ML LIQ,CVS 25 MG TABLET, EQL 25 MG TABLET,EQL 25 MG CAPSULE, GNP 25 MGTABLET, GNP 25 MG CAPSULE, HM 25MG TABLET, HM 25 MG CAPSULE, KRO25 MG CAPSULE, PUB 12.5 MG/5 MLLIQ, 25 MG SOFTGEL, CVS 25 MGSOFTGEL, EQL 12.5 MG/5 ML LIQ, 25MG CAPSULE, GNP 25 MG SOFTGEL,KRO 25 MG TABLET, PUB 25 MGCAPSULE, RA 25 MG TABLET, 25 MGTABLET, PUB 25 MG TABLET)

OTC

ALLERGY (SB 10 MG TABLET, 10 MGTABLET)

OTC PA

ALLERGY 4-HOUR OTC

ALLERGY MEDICATION OTC

ALLERGY MEDICINE (MEDICINE 25 MGTABLET, PV MEDICINE 25 MG CAP, RAMED 25 MG TABLET, SB 12.5 MG/5 MLELIXIR, SB MED 25 MG TABLET, SBMEDICINE 25 MG CAP)

OTC

ALLERGY RELIEF (CVS 25 MG/10 ML LIQ,CVS 50 MG/20 ML LIQ, CVS RELIEF 4MG TABLET, EQ RELIEF 25 MG CAP, EQRELIEF 25 MG TABLET, HM RELIEF 4 MGTABLET, RA RELIEF 25 MG TABLET,RELIEF 4 MG TABLET, RELIEF 25 MGSOFTGEL, RELIEF 25 MG CAPSULE,RELIEF 25 MG TABLET, SM RELIEF 1.34MG TAB, SM RELIEF 12.5 MG/5 ML, SMRELIEF 25 MG CAP, SM RELIEF 25 MGSFTGEL, SM RELIEF 25 MG TABLET)

OTC




Drug Name Status* Requirements/LimitsALLERGY RELIEF (CVS RELIEF 5 MG/5ML, CVS RELIEF 10 MG TAB, CVS RELIEF10 MG SFTGL, CVS RELIEF 10 MG ODT,CVS RELIEF 60 MG TAB, CVS RELIEF 180MG TAB, EQ RELIEF 1 MG/ML SOLN, EQRELIEF 10 MG TABLET, EQ RELIEF 180MG TAB, EQL RELIEF 10 MG TAB, EQLRELIEF 10 MG ODT, GNP RELF 5 MG/5ML SLN, GNP RELIEF 10 MG ODT, GNPRELIEF 180 MG TAB, GS RELIEF 10 MGTABLET, HM RELIEF 10 MG TABLET, HMRELIEF 10 MG ODT, KRO RELIEF 10 MGTAB, KRO RELIEF 60 MG TAB, KRORELIEF 180 MG TAB, PUB RELIEF 10 MGTAB, PUB RELIEF 180 MG TAB, PVRELIEF 10 MG TABLET, PV RELIEF 10 MGODT, PV RELIEF 180 MG TAB, QC RELIEF10 MG ODT, RA RELIEF 10 MG TABLET,RA RELIEF 180 MG TAB, RELIEF 5 MG/5ML SOLN, RELIEF 10 MG TABLET, RELIEF10 MG ODT, RELIEF 180 MG TABLET,RELIEF SYRUP, SM RELIEF 10 MG ODT,SW RELIEF 10 MG TAB)

OTC PA

ALLERGY RELIEF D (12-HOUR TAB, CVSTABLET)

OTC PA

ALLERGY RELIEF D12 OTC PA

ALLERGY RELIEF-D 12 HOUR TAB OTC PA

ALLERGY-TIME OTC

ALLERHIST-1 OTC

ANIMAL SHAPES PLUS IRON OTC

ANTIHIST OTC

ANTIHISTAMINE OTC

BANOPHEN (12.5 MG/5 ML ELIXIR,ALLERGY 12.5 MG/5 ML, 25 MGCAPSULE, 25 MG TABLET, 50 MGCAPSULE)

OTC

BENADRYL ALLERGY (25 MG ULTRATB,25 MG KAPGELS)

OTC

cetirizine hcl (5 mg/5 ml solution, 5 mgtablet, 5 mg tab chew, 10 mg tab chew,10 mg tablet)

OTC PA




Drug Name Status* Requirements/Limitscetirizine hcl 1 mg/ml solution Generic PA

CHEWABLE MULTIVITAMIN W-IRON OTC

CHILD CHEW + IRON OTC

CHILD'S VITAMIN WITH IRON OTC

CHILD'S WAL-DRYL 12.5 MG/5 ML OTC

CHILDREN'S ALL DAY ALLERGY OTC PA

CHILDREN'S ALLER-TEC OTC PA

CHILDREN'S ALLERGY (CHILD 12.5 MLLIQ, CHILD'S 12.5 ML, CVS CHILD 12.5ML, EQL CHILD 12.5 ML, HM CHILD 12.5ML, PV CHILD 12.5 ML, QC CHILD 12.5ML, 12.5 ML ELIXIR)

OTC

CHILDREN'S ALLERGY COMPLETE OTC PA

CHILDREN'S ALLERGY RELIEF (CHILD REL12.5 MG/5 ML, CHILD RLF 12.5 MG/5ML, CHILD'S 12.5 MG/5ML, EQ CHILD12.5 MG/5 ML, KRO CHILD 12.5 MG/5ML, RA CHILD 12.5 MG/5 ML, SM CHILD12.5 MG/5 ML)

OTC

CHILDREN'S ALLERGY RELIEF (CVS 10MG CHW TB, CVS RELF 1 MG/ML, CVSRELF 1MG/ML, CVS RLF 30 MG/5, EQRELF 1 MG/ML, EQ RELIEF SOLN, KRORELIEF SOLN, RA RELF 1 MG/ML)

OTC PA

CHILDREN'S MULTIVITAMIN-IRON OTC

CHILDREN'S VITAMIN-IRON OTC

CHILDREN'S VITAMINS WITH IRON OTC

CHILDREN'S WAL-FEX OTC PA

CHILDREN'S WAL-ZYR (CHILD 1 MG/MLSOLUTION, CHILD'S 10 MG CHEW TAB)

OTC PA

CHILDREN'S ZYRTEC ALLERGY OTC PA

CHLD ALLEGRA ALLERGY 30 MG ODT OTC PA

CHLOR HIST OTC

chlorpheniramine maleate 4 mg tablet OTC




Drug Name Status* Requirements/LimitsCHLORTABS OTC

CLARITIN 10 MG LIQUI-GEL CAP OTC PA

clemastine fumarate (0.67mg/5mlsyrup, 2.68 mg tablet)

Generic

clemastine fumarate 1.34 mg tablet OTC

COMPLETE ALLERGY (COMPLETE 12.5MG/5 ML, COMPLETE 25 MG TAB,COMPLETE 25 MG CAP, COMPLT MED25 MG CP, PV COMPLETE 25 MG SFGL,PV COMPLETE 25 MG TAB, QCCOMPLETE 25 MG CAP, QC COMPLETE25 MG CPLT, RA COMPLETE MED CPT,RA COMPLETE SOFTGEL)

OTC

COMPOZ OTC

CVS SPECTRAVITE TABLET CHEW OTC

cyproheptadine hcl (2 mg/5 ml syrup, 4mg tablet)

Generic

DAILYHIST-1 OTC

DAYHIST OTC

DAYHIST ALLERGY OTC

dimenhydrinate 50 mg tablet OTC

DIPHEDRYL (12.5 MG/5 ML ELIXIR,ALLERGY CAPSULE, GNP 12.5 MG/5 MLELX, GNP 25 MG TABLET, GNP ALLERGYCAP, RA 12.5 MG/5 ML ELIX, 25 MGTABLET)

OTC

DIPHEDRYL ALLERGY OTC

DIPHENHIST (12.5 MG/5 ML SOLN, 25MG CAPTAB, 25 MG CAPLET, 50 MGTABLET)

OTC

diphenhydramine hcl (12.5mg/5mlliquid, 12.5mg/5ml syrup, 25 mg tablet,25 mg capsule, 50 mg capsule, 50 mgtablet)

OTC

diphenhydramine hcl 12.5mg/5ml elixir Generic

DRIMINATE OTC




Drug Name Status* Requirements/LimitsED CHLORPED JR OTC

ED-CHLORTAN OTC

fexofenadine hcl (30 mg/5 ml oral susp,60 mg tablet, 180 mg tablet)

OTC PA

GERI-DRYL OTC

levocetirizine dihydrochloride (2.5mg/5ml solution, 5 mg tablet)

Generic PA

LITTLE ANIMALS WITH IRON OTC

LORADAMED OTC PA

loratadine (5 mg/5 ml solution, 10 mgtablet, 10 mg tab rapdis)

OTC PA

LORATADINE D OTC PA

LORATADINE-D (GNP 12 HOUR TAB, 12HOUR TABLET)

OTC PA

MEDI-PHEDRYL (12.5 MG/5 ML ELIX, 25MG CAPSULE)

OTC

MOTION SICKNESS (50 MG TABLET, CVS50 MG TAB, PV 50 MG TAB, SB 50 MGTAB)

OTC

MOTION SICKNESS RELIEF (GNP 50 MGTAB, HM 50 MG TAB, RA 50 MG TAB,SM 50 MG TAB)

OTC

MUCINEX ALLERGY OTC PA

NIGHTTIME ALLERGY RELIEF OTC

NIGHTTIME SLEEP AID (CVS NIGHTTIMEAID CAPLET, EQ NIGHTTIME 25 MGCPLT, EQL NIGHTTIME AID CAPLET, GNPNIGHTTIME AID CAPLET, GNPNIGHTTIME AID CPLT, KRO NIGHTTIME25 MG CPLT, NIGHT TIME 25 MGCAPLET, NIGHTTIME AID 25 MG CPLT,NIGHTTIME AID CPLT, QC NIGHTTIME25 MG TAB, RA NIGHTTIME 25 MG TAB,RA NIGHTTIME AID CPLT)

OTC

NON-DROWSY ALLERGY OTC PA

NYT-TIME SLEEP OTC




Drug Name Status* Requirements/LimitsNYTOL QUICKCAPS OTC

PHARBECHLOR OTC

PHARBEDRYL OTC

PUB CHILDREN'S ALLERGY 1 MG/ML OTC PA

PV KID'S VIT + IRON TAB CHEW OTC

Q-DRYL (12.5 MG/5 ML LIQUID, 25 MGCAPSULE)

OTC

QUENALIN OTC

REST SIMPLY OTC

RESTFULLY SLEEP OTC

SILADRYL OTC

SILPHEN OTC

SIMPLY SLEEP OTC

SLEEP AID (CVS 25 MG TABLET, CVSCAPLET, EQL 25 MG CAPLET, PV 25 MGCAPLET, 25 MG TABLET, PV TABLET, RA25 MG CAPLET, 25 MG CAPLET, SMNIGHT TIME CAPLET, TABLET)

OTC

SLEEP II OTC

SLEEP TABLET OTC

SLEEP TABS OTC

TOTAL ALLERGY OTC

TRAVEL SICKNESS (50 MG TABLET, RA50 MG TAB)

OTC

V-R PEDIA RELIEF INF DROPS OTC

V-R VALUDRYL 12.5 MG/5 ML ELX OTC

VALU-DRYL ALLERGY MEDICINE OTC

VICKS QLEARQUIL ALLERGY OTC PA

VICKS QLEARQUIL NIGHT 25 MG OTC

VITALETS OTC

WAL-DRAM OTC




Drug Name Status* Requirements/LimitsWAL-DRYL (25 MG MINITAB, 25 MGCAPSULE, 25 MG SOFTGEL)

OTC

WAL-DRYL ALLERGY 12.5 MG/5 ML OTC

WAL-FEX ALLERGY OTC PA

WAL-FEX D 24 HOUR OTC PA

WAL-FINATE OTC

WAL-ITIN (CHILD 5 MG/5 ML SYRUP, 5MG/5 ML SYRUP, 10 MG TABLET, 10MG ODT)

OTC PA

WAL-ITIN D 12 HOUR OTC PA

WAL-ZYR (10 MG SOFTGEL, 10 MGTABLET, SOLUTION)

OTC PA

ZYRTEC 10 MG ODT OTC PA

Antileukotrienesmontelukast sodium (4 mg gran pack, 4mg tab chew, 5 mg tab chew, 10 mgtablet)

Generic PA

zafirlukast Generic QL (60 PER 30 DAYS)

Bronchodilators, AnticholinergicATROVENT HFA Brand

INCRUSE ELLIPTA Brand

ipratropium bromide 0.2 mg/mlsolution

Generic

SPIRIVA Brand

SPIRIVA RESPIMAT INHAL SPRAY Brand

Bronchodilators, Phosphodiesterase Inhibitors (Xanthines)ELIXOPHYLLIN Brand

THEO-24 ER 300 MG CAPSULE Brand

theochron Generic




Drug Name Status* Requirements/Limitstheophylline anhydrous (80 mg/15mlelixir, 80 mg/15ml solution, 100 mg taber 12h, 200 mg tab er 12h, 300 mg taber 12h, 450 mg tab er 12h)

Generic

Bronchodilators, SympathomimeticADVAIR DISKUS Brand

ADVAIR HFA Brand

albuterol sulfate (0.63mg/3ml vial-neb,1.25mg/3ml vial-neb, 2 mg/5 ml syrup,2 mg tablet, 2.5 mg/3ml vial-neb, 4 mgtab er 12h, 4 mg tablet, 5 mg/mlsolution, 8 mg tab er 12h)

Generic

ANORO ELLIPTA Brand

BREO ELLIPTA 200-25 MCG INH Brand

COMBIVENT Brand QL (14.7 GM PER 30 DAYS)

COMBIVENT RESPIMAT Brand QL (4 GM PER 30 DAYS)

EPIPEN 2-PAK Brand

EPIPEN JR 2-PAK Brand

FORADIL Brand

ipratropium bromide/albuterol sulfate Generic

metaproterenol sulfate (10 mg tablet,10 mg/5 ml syrup, 20 mg tablet)

Generic

proair hfa Generic QL (17 GM PER 30 DAYS)

proair respiclick Generic QL (2 PER 30 DAYS)

SEREVENT DISKUS Brand

SYMBICORT Brand

terbutaline sulfate (2.5 mg tablet, 5 mgtablet)

Generic

ventolin hfa Generic QL (36 GM PER 30 DAYS)

XOPENEX HFA Brand





Mast Cell Stabilizerscromolyn sodium 20 mg/2 ml ampul-neb

Generic

Pulmonary AntihypertensivesADCIRCA Specialty PA, QL (60 PER 30 DAYS)

ADEMPAS Specialty PA

LETAIRIS Specialty PA

OPSUMIT Specialty PA, LA

ORENITRAM ER Specialty PA, LA

REVATIO 10 MG/ML ORAL SUSP Specialty PA

sildenafil citrate 20 mg tablet Specialty PA, QL (90 PER 30 DAYS)

TRACLEER Specialty PA, LA

VENTAVIS Specialty PA

Respiratory Tract Agents, Other12 HOUR COLD RELIEF OTC

12 HOUR DECONGESTANT OTC

60PSE-400GFN OTC

ADLT WAL-TUSSIN COUGH-COLD CF OTC

ADULT ROBITUSSIN PEAK COLD OTC

ADULT ROBITUSSIN PEAK COLD M-S OTC

ADULT TUSSIN CHEST CONGESTION OTC

ADULT TUSSIN COUGH CONGEST DM OTC

ADULT TUSSIN DM OTC

ADULT TUSSIN MULTI-SYMP COLD OTC

ADULT WAL-TUSSIN OTC

ADULT WAL-TUSSIN DM OTC

ALLERCLEAR D-24HR OTC PA

ALLERGY RELIEF D-24 OTC PA




Drug Name Status* Requirements/LimitsALLERGY RELIEF-NASAL DECONGEST OTC PA

ALLERGY-CONGESTION RELIEF OTC PA

ALLERGY-CONGESTION RELIEF-D OTC PA

AMBITUSSIN AC OTC PA (PA for ages 5 and under)

ANTITUSSIVE DM OTC

APRODINE OTC

benzonatate Generic

BIO-S-PRES DX OTC

BIOCOTRON OTC

BIOGIL OTC

bromfed dm Generic

BRONTUSS SF OTC

CHERATUSSIN AC OTC PA (PA for ages 5 and under)

CHERATUSSIN DAC OTC PA (PA for ages 5 and under)

CHEST CONGESTION RELIEF D OTC

CHILD MUCINEX CHEST CONGESTION OTC

CHILDREN'S CHEST CONGESTION OTC

CHILDREN'S COLD & ALLERGY ELXR OTC

CHILDREN'S MUCUS RELIEF OTC

CLARITIN 5 MG REDITABS OTC PA

CONGEST-EZE OTC

CONGESTAC OTC

COUGH OTC

COUGH & COLD SYRUP OTC

COUGH AND COLD MULTI-SYMPTOM OTC

COUGH CONTROL CF OTC

COUGH CONTROL DM OTC

COUGH FORMULA DM OTC




Drug Name Status* Requirements/LimitsCOUGH SYRUP OTC

COUGH SYRUP DM OTC

COUGH-HEAD CONGESTION RELIEF OTC

COUGHTAB OTC

CREO-TERPIN OTC

d-methorphan hb/p-epd hcl/bpm 10-30-2/5 syrup

OTC

DAY TIME LIQUID CAPSULE OTC

DESGEN DM OTC

DESPEC DM OTC

DESPEC EDA COUGH & COLD DROPS OTC

DIABETIC SILTUSSIN DAS-NA OTC

DIABETIC SILTUSSIN-DM OTC

DIABETIC TUSSIN DM LIQUID OTC

DIABETIC TUSSIN EX OTC

DOMETUSS-DMX OTC

ED A-HIST PSE OTC

ESBRIET Specialty PA, LA

EXEFEN IR OTC

EXPECTORANT (100 MG/5 ML SYRUP,200 MG TABLET, RA COUGH SYRUP)

OTC

EXPECTORANT COUGH SYRUP OTC

EXPECTORANT DM COUGH SYRUP OTC

EXTRA ACTION COUGH OTC

G-TRON LIQUID OTC

GERI-TUSSIN OTC

GERI-TUSSIN DM OTC

GRASTEK Brand PA

GUAIASORB DM OTC




Drug Name Status* Requirements/LimitsGUAIATUSSIN AC OTC PA (PA for ages 5 and under)

guaifenesin (100 mg/5ml liquid, 200 mgtablet, 600 mg tab er 12h)

OTC

GUAIFENESIN AC OTC PA (PA for ages 5 and under)

GUAIFENESIN DAC OTC PA (PA for ages 5 and under)

guaifenesin/codeine phosphate OTC PA (PA for ages 5 and under)

guaifenesin/dextromethorphan hbr(liquid, syrup)

OTC

hydrocodone bitartrate/homatropinemethylbromide (5 mg-1.5mg tablet, 5-1.5 mg/5 syrup)

Generic

hydromet Generic

HYPER-SAL 3.5% VIAL Brand

INTENSE COUGH OTC

INTENSE COUGH RELIEVER OTC

IOPHEN DM-NR OTC

IOPHEN NR OTC

IOPHEN-C NR OTC PA (PA for ages 5 and under)

KALYDECO Specialty PA, LA, QL (60 PER 30 DAYS)

KRO ALLERGY & CONGEST RLF TAB OTC PA

LOHIST-D OTC

LONG ACTING NASAL DECONGESTANT OTC

LORATA-D OTC PA

LORATA-DINE D OTC PA

LORATADINE-D (24HR TABLET, CVS24HR TABLET, GNP 24HR TABLET, QC24HR TABLET)

OTC PA

LORTUSS EX OTC PA (PA for ages 5 and under)

MEDI-PHEDRINE OTC

MEDI-TUSSIN OTC

MEDI-TUSSIN DM OTC




Drug Name Status* Requirements/LimitsMEDI-TUSSIN DM DIABETIC OTC

MEDIFIN EXPECTORANT MUCUS RLF OTC

MUCINEX D OTC

MUCINEX DM ER 600-30 MG TABLET OTC

MUCUS DM OTC

MUCUS ER OTC

MUCUS RELIEF (ER 600 MG TABLET, RAER 600 MG TAB, SB 200 MG TABLET)

OTC

MUCUS-ER OTC

NASAL & SINUS DECONGESTANT OTC

NASAL DECONGEST-ANTIHISTAMINE OTC

NASAL DECONGESTANT (CVSDECONGEST 30 MG TAB,DECONGESTANT 30 MG TAB, EQLDECONGEST 30 MG TAB, GNPDECONGEST 30 MG TAB, HMDECONGEST 30 MG TAB, HMDECONGEST ER 120 MG, KRODECONGEST 30 MG TAB, PUBDECONGEST 30 MG TAB, PUBDECONGEST ER 120 MG, PVDECONGEST 30 MG TAB, SMDECONGEST 30 MG TAB, SWDECONGESTANT 30 MG TB)

OTC

NASAL DECONGESTANT-ANTIHIST OTC

NON-DRYING SINUS OTC

OFEV Specialty PA

ORALAIR Specialty PA, LA

ORGAN-I NR OTC

PEDIA RELIEF INFANT OTC

PEDIATRIC COUGH-COLD SYRUP OTC

phenylephrine hcl/promethazine hcl Generic

promethazine hcl/codeine Generic PA (PA for ages 5 and under)

promethazine hcl/dextromethorphanhbr

Generic




Drug Name Status* Requirements/Limitspromethazine/phenylephrinehcl/codeine


pseudoephedrine hcl (30 mg/5 ml liquid,30 mg tablet, 60 mg tablet, 120 mgtablet er)

OTC

PUB ALLERGY RELIEF D TABLET OTC PA

pulmosal Generic

PULMOZYME Specialty

PV COLD & COUGH SOFTGEL OTC

PV SINUS & ALLERGY 120 MG CPLT OTC

Q-TAPP OTC

Q-TUSSIN OTC

Q-TUSSIN DM OTC

RAGWITEK Brand PA

REFENESEN 200 MG TABLET OTC

RI-TUSSIN OTC

RI-TUSSIN DM OTC

ROBAFEN OTC

ROBAFEN CF OTC

ROBAFEN DM COUGH OTC

ROBAFEN-DM OTC

RYNEX PSE OTC

SAFETUSSIN DM OTC

SB COUGH CONTROL SYRUP OTC

SILTUSSIN DM OTC

SILTUSSIN DM DAS COUGH FORMULA OTC

SILTUSSIN SA OTC

SINUS 12-HOUR OTC

SM COLD & ALLERGY TABLET OTC

SM DAY TIME COLD-FLU REL SFTGL OTC




Drug Name Status* Requirements/Limitssodium chloride for inhalation 7 % vial-neb

Generic

SORBUGEN NR OTC

SUDOGEST OTC

SUPHEDRIN (GNP 30 MG TABLET, 30MG TABLET)

OTC

SUPHEDRIN 12-HOUR OTC

SUPHEDRINE OTC

SUPHEDRINE 12-HOUR OTC

SUPHEDRINE SINUS CONGESTION OTC

TRIACTING EXPECTORANT OTC

TUSNEL C OTC PA (PA for ages 5 and under)

TUSNEL DIABETIC OTC

TUSNEL PEDIATRIC DROPS OTC

tussigon Generic

TUSSIN (CVS 100 MG/5 ML LIQUID, EQL100 MG/5 ML LIQUID, GNP 100 MG/5ML SYRUP, KRO 200 MG/10 ML SYRUP,PUB 100 MG/5 ML SYRUP, PV 100MG/5 ML LIQUID, SM 100 MG/5 MLLIQUID, 100 MG/5 ML SYRUP, QC 100MG/5 ML LIQUID, RA 100 MG/5 MLSYRUP)

OTC

TUSSIN CF OTC

TUSSIN CHEST CONGESTION OTC

TUSSIN COLD SEVERE CONGESTION OTC

TUSSIN COUGH (CVS LIQUID, RALIQUID)

OTC

TUSSIN COUGH DM OTC

TUSSIN COUGH-CHEST CONGESTION OTC




Drug Name Status* Requirements/LimitsTUSSIN DM (CLEAR LIQUID, COUGH &CHEST SYRUP, COUGH SYRUP, CVSLIQUID, EQ COUGH-CHEST SYR, EQLCOUGH-CHEST SYR, EQL SYRUP, GNPSYRUP, KRO LIQUID, LIQUID, PUBLIQUID, PV LIQUID, PV SYRUP, QCSYRUP, RA SYRUP, SM SYRUP, SYRUP)

OTC

TUSSIN DM CLEAR OTC

TUSSIN DM COUGH OTC

TUSSIN DM COUGH & CHEST LIQUID OTC

TUSSIN DM COUGH-CHEST CONGEST OTC

TUSSIN DM MAX (LIQUID, PV LIQUID) OTC

TUSSIN HONEY OTC

TUSSIN MUCUS-CHEST CONGESTION OTC

TYLENOL COLD SEVERE CONGESTION OTC

ULTRA DM FREE & CLEAR OTC

ULTRA TUSS OTC

V-R TUSSIN PE SYRUP OTC

VALU-TAPP OTC

VALU-TAPP DECONGESTANT OTC

VIRTUSSIN AC OTC PA (PA for ages 5 and under)

VIRTUSSIN DAC OTC PA (PA for ages 5 and under)

WAL-ACT D COLD & ALLERGY OTC

WAL-ITIN D OTC PA

WAL-PHED 12 HOUR OTC

WAL-PHED 30 MG TABLET OTC

WAL-TUSSIN COUGH & COLD CF OTC

WAL-TUSSIN DM OTC

WAL-TUSSIN SYRUP OTC





Skeletal Muscle Relaxants

carisoprodol (250 mg tablet, 350 mgtablet)

Generic

carisoprodol/aspirin Generic

chlorzoxazone Generic

cyclobenzaprine hcl (5 mg tablet, 7.5mg tablet, 10 mg tablet)

Generic

metaxalone 800 mg tablet Generic

methocarbamol (500 mg tablet, 750 mgtablet)

Generic

orphenadrine citrate 100 mg tablet er Generic

orphenadrine/aspirin/caffeine 50-770-60 tablet

Generic

Sleep Disorder Agents

GABA Receptor Modulatorsflurazepam hcl Generic

temazepam (7.5 mg capsule, 15 mgcapsule, 30 mg capsule)

Generic

triazolam Generic

Sleep Disorders, OtherSLEEP AID (EQ 25 MG TABLET, GS 25MG TABLET)

OTC

WAL-SOM 25 MG TABLET OTC

XYREM Specialty PA, LA, QL (540 ML PER 30 DAYS)

Therapeutic Nutrients/ Minerals/ Electrolytes

Electrolyte/Mineral ModifiersCARNITOR SF Brand

EXJADE Specialty




Drug Name Status* Requirements/Limitskionex powder Generic

levocarnitine (with sugar) Generic

levocarnitine 330 mg tablet Generic

marlexate Generic

sodium polystyrene sulfonate(50g/200ml enema, powder)

Generic

Electrolyte/Mineral ReplacementA THRU Z ADVANCED FORMULA OTC

A THRU Z ADVANCED FORMULA TAB OTC

A THRU Z SELECT OTC

A THRU Z SELECT 50+ FORMULA OTC

A-G PRO OTC

ABC PLUS OTC

ADULTS' 50+ DAILY FORMULA OTC

ADULTS' DAILY FORMULA OTC

amino acids capsule OTC

AMINO ACTION OTC

ANIMAL CHEWS OTC

ANIMAL SHAPES OTC

ANIMAL SHAPES VITAMINS OTC

ANTIOXIDANT FORM SOFTGEL CAP OTC

ANTIOXIDANT SOFTGEL OTC

ANTIOXIDANT VITAMIN OTC

ANTIOXIDANT VITAMINS OTC

ascorbate calcium 500 mg tablet OTC

ascorbic acid (250 mg tab chew, 250 mgtablet, 500 mg tab chew, 500 mg tablet,500 mg tablet er, 500 mg wafer, 1000mg tab chew)

OTC

ascorbic acid/ascorbate sodium 500 mgwafer

OTC




Drug Name Status* Requirements/LimitsB COMPLETE OTC

b complex with vitamin c tablet OTC

B-12 DOTS OTC

b-plex Generic

BAL B-100 OTC

BAL B-50 OTC

BALANCE B-100 OTC

BALANCE B-50 OTC

BALANCED B-100 TABLET OTC

BALANCED B-150 OTC

BALANCED B-50 (RA TABLET, SMTABLET, TABLET, V-R TABLET)

OTC

BEE-ZEE OTC

BIOPETIT OTC

biotin 5 mg capsule OTC

BIOVOL OTC

C 500 MG TIMED RELEASED OTC

C COMPLEX 500 MG TABLET SA OTC

ca/d3/mag ox/zinc/cop/mang/bor 600mg-800 tablet

OTC

CALCIDOL OTC

CALCITRATE OTC

calcium acetate 667 mg tablet Generic

calcium carbonate (500(1250) tablet,600 mg tablet)

OTC

calcium carbonate,citrate/magnesiumoxide,aspartate/vit d3

OTC




Drug Name Status* Requirements/Limitscalcium carbonate/cholecalciferol(vitamin d3) (250 mg-125 tablet, 500mg-200 tablet, 500 mg-100 tab chew,500 mg-400 tablet, 500 mg-600 tablet,600 mg-125 tablet, 600 mg-200 tablet,600 mg-400 tablet, 600 mg-800 tablet)

OTC

calcium carbonate/ergocalciferol(vitamin d2)

OTC

calcium citrate 200(950)mg tablet OTC

calcium citrate/ergocalciferol (vitamind2)

OTC

CALPHRON OTC

CENTAMIN OTC

CENTAVITE A-Z WITH MINERALS OTC

CENTRAL VITE OTC

CENTRAL VITE FOR SENIORS OTC

CENTRAL-VITE (EQL TABLET, RA TABLET) OTC

CENTRAL-VITE SELECT OTC

CENTRAL-VITE SENIOR OTC

CENTRAL-VITE WOMEN'S UNDER 50 OTC

CENTRAM-CARE OTC

CENTRAVITES 50 PLUS OTC

CENTRUM COMPLETE OTC

CENTRUM MULTIVIT-MINERAL LIQ OTC

CENTRUM SILVER TABLET OTC

CENTRUM SILVER ULTRA WOMEN'S OTC

CENTURY OTC

CENTURY ADVANCED FORMULA OTC

CENTURY MATURE OTC

CENTURY ULTIMATE WOMEN'S OTC

CEROVITE JR OTC




Drug Name Status* Requirements/LimitsCERTAVITE-ANTIOXIDANT (LIQUID,TABLET)

OTC

CHEWABLE MULTI VITAMIN OTC

CHILD CHEW VITAMIN OTC

CHILD VITAMIN WITH MINERALS OTC

CHILD'S VITAMIN WITH VITAMIN C OTC

CHILDREN'S CHEW MULTIVIT-IRON OTC

CHILDREN'S CHEWABLE COMPLETE OTC

CHILDREN'S CHEWABLE VITAMIN OTC

CHILDREN'S IRON OTC

CHILDREN'S MULTIVIT W-EXTRA C OTC

CHILDREN'S MULTIVIT-MINERALS OTC

cholecalciferol (vitamin d3) (400 unittablet, 400/ml drops, 400 unit capsule,1000 unit capsule, 1000 unit tablet,2000 unit tablet, 2000 unit capsule,5000 unit capsule, 5000 unit tablet)

OTC

COMPLETE (ADVANCED TABLET,TABLET)

OTC

COMPLETE 50+ OTC

COMPLETE MULTI OTC

COMPLETE MULTI 50+ OTC

COMPLETE MULTI-VIT-MINERAL OTC

COMPLETE MULTIVITAMIN OTC

COMPLETE PREMIUM VITAMIN OTC

COMPLETE SENIOR OTC

completenate Generic

CVS IRON 27 MG TABLET OTC

CVS SPECTRAVITE ADULT 50+ TABS OTC

CVS SPECTRAVITE LIQUID OTC




Drug Name Status* Requirements/Limitscyanocobalamin (vitamin b-12) (100mcg tablet, 500 mcg tablet, 1000 mcgtablet, 1000 mcg tab subl, 1000 mcgtablet er)

OTC

cyanocobalamin (vitamin b-12)1000mcg/ml vial

Generic

D-VI-SOL OTC

D-VITA OTC

D3 DOTS OTC

D3-2000 OTC

DAILY MULTIPLE (CVS DAILY TABLET,DAILY TABLET)

OTC

DAILY MULTIPLE VITAMIN OTC

DAILY MULTIVITAMIN WITH IRON OTC

DAILY MULTIVITAMIN-IRON OTC

DAILY TEEN MULTI-VITAMIN OTC

DAILY VALUE OTC

DAILY VITAMIN OTC

DAILY VITAMIN + IRON OTC

DAILY VITAMIN FORMULA OTC

DAILY VITAMIN FORMULA + IRON OTC

DAILY VITAMIN FORMULA-MINERALS OTC

DAILY VITE TABLET OTC

DECUBI VITE OTC

DELTA D3 OTC

dialyvite Generic

DIALYVITE 800 OTC

DIALYVITE VITAMIN D OTC

DIALYVITE ZINC Brand

DINO-LIFE OTC




Drug Name Status* Requirements/LimitsDINO-LIFE WITH EXTRA C OTC

EAR CARE OTC

EAR HEALTH FORMULA OTC

ELDERCAPS Brand

ELDERTONIC OTC

eliphos Generic

ELLIS TONIC OTC

ENDUR-ACIN SR 250 MG TABLET OTC

ENFALYTE OTC

EQL CENTRAL-VITE PERFORMANCE OTC

EQL ONE DAILY MEN'S TABLET OTC

ergocalciferol (vitamin d2) (400 unittablet, 8000/ml drops)

OTC

ergocalciferol (vitamin d2) 50000 unitcapsule

Generic

ESSENTIA OTC

FARBEE W-C OTC

FEOSOL 65 MG TABLET OTC

FER-IRON OTC

FERATE 27 MG TABLET OTC

FERGON OTC

FEROSUL (220 MG/5 ML ELIXIR, 325 MGTABLET)

OTC

FERREX 150 OTC

ferrex 150 forte plus Generic

FERRIC X-150 OTC

FERRO-TIME OTC

ferrous gluconate (240(27)mg tablet,324(38)mg tablet, 324(36)mg tablet,324(37.5) tablet, 325 mg tablet,325(36)mg tablet)

OTC




Drug Name Status* Requirements/Limitsferrous sulfate (15 mg/ml drops, 47.5iron tablet er, 134mg tablet, 142(45)mgtablet er, 143(45) mg tablet er,220(44)/5 solution, 324(65)mg tabletdr, 325(65) mg tablet dr, 325(65) mgtablet)

OTC

FERROUSUL OTC

FERUS OTC

FLINTSTONES COMPLETE TABLET OTC

FLINTSTONES EXTRA C TAB CHEW OTC

FLINTSTONES PLUS CALCIUM OTC

FLINTSTONES TABLET CHEWABLE OTC

FLINTSTONES WITH IRON OTC

fluoride/iron/vitamins a,c,and d Generic

flura-drops Generic

folbee plus Generic

folic acid (0.4 mg tablet, 0.8 mg tablet) OTC

folic acid 1 mg tablet Generic

folic acid/vitamin b complex & c/ricebran

OTC

FOSFREE OTC

FRUIT C-500 OTC

FRUITY CHEWS OTC

FULL SPECTRUM B OTC

GERAVIM OTC

GERIATON OTC

GERITOL COMPLETE OTC

GERITOL TONIC OTC

GUMMI BEAR MULTIVITAMIN OTC

GUMMY SWIRLS OTC

HAIR VITAMIN OTC




Drug Name Status* Requirements/LimitsHAIR, SKIN & NAILS (CVS SKIN &TABLET, HM SKIN & CAPLET, PV SKIN &TABLET, SKIN & CAPLET, SM SKIN &CAPLET)

OTC

HAIR,SKIN & NAILS OTC

HEALTHY EYES OTC

HI B COMPLEX OTC

HIGH POTENCY CALCIUM OTC

HIGH POTENCY IRON OTC

HIGH POTENCY MULTIVITAMIN OTC

HIGH PROTEIN OTC

HONEY BEARS OTC

ICAPS PLUS OTC

IFEREX 150 OTC

inatal advance Generic

iron asp gly&ps cmplx/ascorb.cal/vitb12/fa/ca-thr/succ.acid

Generic

k-sol 10% (20 meq/15 ml) liq Generic

KENWOOD THERAPEUTIC OTC

KID'S GUMMY BEAR VITAMINS OTC

KID'S VITAMINS OTC

KID'S VITAMINS + EXTRA C OTC

KID'S VITAMINS COMPLETE OTC

klor-con 10 Generic

klor-con 8 Generic

klor-con m10 Generic



klor-con sprinkle Generic

MACUVITE OTC




Drug Name Status* Requirements/LimitsMACUVITE EYE CARE OTC

MAG DELAY OTC

MAG64 OTC

magnesium 250 mg tablet OTC

magnesium oxide (400 mg tablet, 500mg capsule)

OTC

MEGA MULTI W-CHELATED MINERALS OTC

MEGA MULTIVITAMIN WITH MINERAL OTC

MEN'S DAILY MULTIVIT-MINERAL OTC

MEN'S MULTI-VITAMIN OTC

MEPHYTON Brand

MG-PLUS-PROTEIN OTC

MGO OTC

MILLTRIUM SENIOR OTC

MULTI COMPLETE-IRON OTC

MULTI-DAY PLUS IRON OTC

MULTI-DELYN LIQUID OTC

MULTI-VITAMIN DAILY OTC

MULTI-VITE OTC

MULTI-VITE 50 & OVER OTC

multivit with calcium, iron, and otherminerals

OTC

MULTIVITAL OTC

MULTIVITAL PERFORMANCE OTC

MULTIVITAL PLATINUM OTC

multivitamin OTC

multivitamin w-minerals/ferrousgluconate

OTC

multivitamin with minerals OTC

multivitamins with iron OTC




Drug Name Status* Requirements/Limitsmultivitamins,ther w-minerals OTC

MY FAVORITE MULTIPLE OTC

MYFERON 150 OTC

mynatal advance Generic

mynephrocaps Generic

MYVITALIFE OTC

natal-v rx Generic

NATURAL B-100 OTC

niacin (50 mg tablet, 100 mg tablet, 125mg capsule er, 250 mg capsule er, 250mg tablet er, 250 mg tablet, 400 mgcapsule er, 500 mg capsule er, 750 mgtablet er)

OTC

niva-plus Generic

OCUTABS OTC

OCUVITE WITH LUTEIN OTC

omega-3 fatty acids 300 mg capsule OTC

omega-3 fatty acids/dha/epa/otheromega-3s/fish oil (oil 360-1200mgcapsule, oil 720-1200mg capsule)

OTC

omega-3 fatty acids/docosahexanoicacid/epa/fish oil (oil 60 mg-90mgcapsule, oil 120-180 mg capsule)

OTC

omega-3 fatty acids/fish oil (oil capsule,oil capsule dr)

OTC

ONCE DAILY OTC

ONCOVITE OTC

ONE DAILY (DAILY TABLET, GNP DAILYTABLET, RA DAILY MULTI-VITAMIN TAB,RA DAILY TABLET)

OTC

ONE DAILY 50 PLUS OTC

ONE DAILY ESSENTIAL (DAILY TABLET,EQL DAILY TABLET, GNP DAILY TABLET)

OTC




Drug Name Status* Requirements/LimitsONE DAILY FOR MEN OTC

ONE DAILY FOR WOMEN OTC

ONE DAILY FOR WOMEN 50+ ADV OTC

ONE DAILY MAXIMUM (DAILY TABLET,GNP DAILY TABLET, RA DAILY TABLET)

OTC

ONE DAILY MEN'S HEALTH OTC

ONE DAILY MULTIVITAMIN (DAILY TAB,DAILY TABLET)

OTC

ONE DAILY MULTIVITAMIN-IRON OTC

ONE DAILY PLUS IRON OTC

ONE DAILY PLUS MINERALS OTC

ONE DAILY WITH CALCIUM-IRON OTC

ONE DAILY WITH IRON OTC

ONE DAILY WOMEN'S OTC

ONE DAILY WOMEN'S 50+ OTC

ONE DAILY WOMEN'S HEALTH OTC

ONE-A-DAY ESSENTIAL OTC

ONE-A-DAY MAXIMUM FORMULA OTC

ONE-A-DAY TEEN ADVANTAGE OTC

ONE-A-DAY WOMEN'S OTC

OPTI-VITAMIN OTC

ORALYTE OTC

OS-CAL 500+D3 OTC

OYSCO 500+D OTC

OYSCO-500 OTC

OYSTERCAL-D OTC

PARVA-CAL 500 OTC




Drug Name Status* Requirements/LimitsPEDIATRIC ELECTROLYTE (CVSPEDIATRIC POPS, CVS PEDIATRIC SOLN,EQL PEDIATRIC SOLN, GNP PEDIATRICSOLN, HEB PEDIATRIC SOLN, HMPEDIATRIC SOLN, PEDI FREEZER POP,PEDIATRIC SOLN, PEDIATRIC SOLUTION,PV PEDI FREEZE POP, PV PEDIATRICSOLN, RA PEDIATRIC SOLN, SBPEDIATRIC SOLN, SM PEDIATRIC SOLN)

OTC

PEDIATRIC FREEZER POPS OTC

pediatric multivitamin combinationno.2/sodium fluoride

Generic

pediatric multivitamin combono.45/fluoride/ferrous sulfate

Generic

pediatric multivitamin combono.75/fluoride/ferrous sulfate

Generic

pediatric multivitamins a,c,& d3 no.21 OTC

pediatric multivitamins a,c,& d3 no.21with sodium fluoride

Generic

pediatric multivitamins no.16 withsodium fluoride

Generic


Generic


Generic

PHARMACIST FAVORITE MULTI-VITE OTC

pnv 29-1 Generic

pnv-vp-u Generic

POLY-IRON OTC

POLY-VI-SOL OTC

POLY-VI-SOL WITH IRON OTC

POLY-VITA OTC

POLY-VITA WITH IRON OTC

POLY-VITAMIN DROPS OTC




Drug Name Status* Requirements/LimitsPOLYSACCHARIDE IRON OTC

POLYVITAMIN WITH IRON (W-IRONDROPS, WITH IRON TAB CHEW)

OTC

potassium chloride (8 meq capsule er, 8meq tablet er, 10 meq tablet er, 10 meqtab er prt, 10 meq capsule er,20meq/15ml liquid, 20 meq tablet er,20 meq tab er prt)

Generic

potassium chloride/potassiumbicarbonate/citric acid

Generic

potassium citrate (5 tablet er, 10 tableter, 15 tablet er)

Generic

PRE PROTEIN OTC

prenaplus Generic

prenatal vit w-ca,fe,fa(<1 mg) OTC

PRENATAL VITAMIN OTC

prenatal vitaminno.15/iron,carbonyl/folic acid/docusatesod

Generic

prenatal vitamins comb no.115/ironfumarate/folic acid

Generic

prenatal vitamins comb no.115/ironfumarate/folic acid/dss

Generic

prenatal vitamins comb no.119/ironfumarate/folic acid/dss

OTC

prenatal vitamins combo no.60/ferrousfumarate/folic acid

Generic

prenatal vitamins with calcium/ferrousfumarate/folic acid

OTC

prenatal vits with calcium #72/ferrousfumarate/folic acid

Generic

prenatal vits with calcium#72/iron,carbonyl/folic acid

Generic


Generic




Drug Name Status* Requirements/Limitsprenatal vits with calcium #95/ferrousfumarate/folic acid

OTC


OTC

prenatal vits with calcium#118/ferrousfumarate/folic acid

OTC

prenatal vits without calc no5/ferrousfumarate/folic acid

Generic

preplus Generic

PROSIGHT OTC

PROTEIN OTC

PROTEINEX TABLET OTC

PV B-100 COMPLEX OTC

PV B-50 COMPLEX OTC

PV KIDS VITAMINS+IRON TAB CHEW OTC

pyridoxine hcl 50 mg tablet OTC

QC CHILDREN'S CHEWABLE TABLET OTC

QUFLORA (0.25 MG/ML DROP, 0.5MG/ML DROP)

Brand

RA HI-CAL PLUS VITAMIN D TAB OTC

RA ONE DAILY ENERGY TABLET OTC

RA ONE DAILY MEN'S 50+ TABLET OTC

RENA-VITE OTC

rena-vite rx Generic

renal caps Generic

reno caps Generic

RIGHT STEP PRENATAL VITAMINS OTC

RISANOID PLUS OTC

salmon oil/omega-3 fatty acids 500-100mg capsule

OTC

SCOOBY-DOO ONE A DAY TABLET OTC




Drug Name Status* Requirements/Limitsse-natal 19 Generic

SENIOR TABS OTC

SENTRY OTC

SENTRY SENIOR OTC

sodium fluoride 0.5 mg/ml drops Generic

SOOTHING PUREWAY-C OTC

SPECTRAVITE ADVANCED FORM OTC

SPECTRAVITE ADVANCED FORMULA OTC

SPECTRAVITE PERFORMANCE OTC

SPECTRAVITE SENIOR OTC

SPECTRAVITE ULTRA WOMEN OTC

STRESS 500 OTC

STRESS 500 PLUS ZINC OTC

STRESS B OTC

STRESS B WITH ZINC OTC

STRESS FORMULA (CVS TABLET,TABLET)

OTC

STRESS FORMULA WITH ZINC OTC

STRESS-C OTC

STUART PRENATAL OTC

SUPER AMINO ACIDS OTC

SUPER B COMPLEX-VITAMIN C OTC

SUPER B-50 COMPLEX OTC

SUPER B-50 COMPLEX PLUS OTC

SUPER CALCIUM OTC

SUPER MULTIPLE VIT-MINERAL TAB OTC

SUPER QUINTS B-50 TABLETS OTC

SUPER THERAVITE-M OTC

SUPERPLEX-T OTC




Drug Name Status* Requirements/LimitsSV FISH OIL EC 1,200 MG SOFTGL OTC

TAB-A-VITE OTC

TAB-A-VITE WITH IRON OTC

TAB-A-VITE-MINERALS OTC

THERA OTC

THERA-D (RAPID REPLETION TABLET,SPORT 2,000 UNIT TAB, 2000 TABLET)

OTC

THERA-M CAPLET OTC

THERA-TABS OTC

THERADEX M OTC

THERAMILL FORTE OTC

therapeutic hematinic Generic

THERAPEUTIC M (STABLET, TABLET) OTC

THERAPEUTIC-M (, GNP) OTC

THERATRUM COMPLETE OTC

THERATRUM COMPLETE 50 PLUS OTC

THEREMS OTC

THEREMS-M OTC

thiamine hcl 100 mg tablet OTC

thiamine mononitrate OTC

thrivite 19 Generic

TL FOLATE Brand

tl-fluorivite Generic

TOTAL B WITH C OTC

TRI-VITA OTC

triadvance Generic

TRICARE Brand

trinatal gt Generic

trinatal rx 1 Generic




Drug Name Status* Requirements/Limitstriphrocaps Generic

triveen-u Generic

ULTRA B-100 COMPLEX (TAB, TABLET) OTC

v-c forte Generic

vic-forte Generic

vinate gt Generic

vinate one Generic

vinate pn care Generic

vinate-m Generic

virt nate Generic

virt-advance Generic

virt-caps Generic

virt-nate Generic

virt-vite gt Generic

VISION OTC

VISION FORMULA OTC

VISION PLUS LUTEIN OTC

VISION VITAMINS OTC

vit b complex/vit c/folic acid/ferrousfumarate/vit e acet

OTC

vitamin a 10000 unit capsule OTC

vitamin a palmitate 10000 unit capsule OTC

vitamin b complex (capsule, talet) OTC

VITAMIN B-100 COMPLEX OTC

vitamin e (100 unit capsul, 200 unitcapsul, 400 unit capsul)

OTC

vitamin e (dl-alpha tocopheryl acetate)((dl,tocophryl act) 200 unit capsul,(dl,tocophryl act) 400 unit capsul)

OTC

vitamin e acetate (actat200 unit capsul,actat400 unit capsul, actat600 unitcapsul)

OTC




Drug Name Status* Requirements/Limitsvitamin e acid succinate 200 unit tablet OTC

vitamin e mixed (mixd 200 unit tablt,mixd 400 unit capsul)

OTC

VITRUM SENIOR OTC

vol-care rx Generic

vol-nate Generic

vol-plus Generic

vol-tab rx Generic

vp-vite rx Generic

WOMEN'S 50+ DAILY FORMULA TAB OTC

WOMEN'S DAILY FORMULA OTC

WOMEN'S ONE DAILY OTC

YELETS OTC

ZOO CHEWS OTC

Uncategorized

Unclassifiedblade lancet, safety OTC

lancets (17 gauge each, 23 gauge each,31 gauge each, each)

OTC

ring OTC



Alphabetical Listing

11-DAY 25

12 HOUR COLD RELIEF 101

12 HOUR DECONGESTANT 101

33 DAY VAGINAL 25

3-DAY VAGINAL CREAM 25

660PSE-400GFN 101

88 HOUR 1

8 HOUR PAIN RELIEF 1

8 HOUR PAIN RELIEVER 1

AA THRU Z 110

A THRU Z ADVANCED FORMULA 110

A THRU Z SELECT 110

A THRU Z SELECT 50+ FORMULA 110

A-G PRO 110

abacavir sulfate 35

abacavir sulfate/lamivudine/zidovudine 35

ABC PLUS 110

acamprosate calcium 12

acarbose 39

acebutolol hcl 45

ACEPHEN 1

ACETADRYL 1

acetaminophen 1

ACETAMINOPHEN PM 1

ACETAMINOPHEN PM XTRA STRENGTH 1

acetaminophen with codeine phosphate 9

acetaminophen/diphenhydramine hcl 1

acetasol hc 15

acetazolamide 21,48

acetic acid 15

acetic acid/aluminum acetate 15

acetic acid/hydrocortisone 15

ACID CONTROL 57,65

ACID CONTROLLER 65,73

ACID GONE 57

ACID GONE ANTACID 58

ACID REDUCER 58,65,73

ACID REDUCER 150 58

ACID RELIEF 65

acitretin 54

ACTIMMUNE 86

ACTOPLUS MET XR 39

acyclovir 38

ADCIRCA 101

adefovir dipivoxil 37

ADEMPAS 101

adenosine phosphate 86

ADLT WAL-TUSSIN COUGH-COLD CF 101

ADULT GLYCERIN 66

ADULT LOW DOSE ASPIRIN EC 6

ADULT ROBITUSSIN PEAK COLD 101

ADULT ROBITUSSIN PEAK COLD M-S 101

ADULT TUSSIN CHEST CONGESTION 101

ADULT TUSSIN COUGH CONGEST DM 101

ADULT TUSSIN DM 101

ADULT TUSSIN MULTI-SYMP COLD 101

ADULT WAL-TUSSIN 101

ADULT WAL-TUSSIN DM 101

ADULTS' 50+ DAILY FORMULA 110

ADULTS' DAILY FORMULA 110

ADVAIR DISKUS 100

ADVAIR HFA 100

ADVANCED ANTACID 58

ADVANCED ANTACID-ANTIGAS 58

ADVIL 6

AEROSPAN 91

afeditab cr 46

AFINITOR 32

AFINITOR DISPERZ 32

AFTERA 77

AGGRENOX 43

AKNE-MYCIN 18

128

AKWA TEARS 88

alagesic lq 1

ALAVERT 92

ALBENZA 33

albuterol sulfate 100

alclometasone dipropionate 12

alendronate sodium 87

ALER-CAP 92

ALER-TAB 92

ALFERON N 31

alfuzosin hcl 74

ALKA-SELTZER PLUS ALLERGY 92

ALKERAN 29

ALL DAY ALLERGY 92

ALL DAY ALLERGY RELIEF 92

ALL DAY PAIN RELIEF 6

ALL DAY RELIEF 6

ALLER-EASE 92

ALLER-FEX 92

ALLER-G-TIME 92

ALLER-TEC 92

ALLERCLEAR 92

ALLERCLEAR D-12HR 92

ALLERCLEAR D-24HR 101

ALLERGY 54,93

ALLERGY & CONGESTION 92

ALLERGY & CONGESTION RELIEF 92,104

ALLERGY 4-HOUR 93

ALLERGY CREAM 54

ALLERGY MEDICATION 93

ALLERGY MEDICINE 93

ALLERGY RELIEF 93,94

ALLERGY RELIEF D 94,106

ALLERGY RELIEF D-24 101

ALLERGY RELIEF D12 94

ALLERGY RELIEF SPRAY 54

ALLERGY RELIEF-D 94

ALLERGY RELIEF-NASAL DECONGEST 102

ALLERGY-CONGESTION RELIEF 102

ALLERGY-CONGESTION RELIEF-D 102

ALLERGY-TIME 94

ALLERHIST-1 94

allopurinol 28

ALMACONE 58

ALMACONE-2 58

ALOMIDE 90

ALOPHEN PILLS 66

alosetron hcl 66

ALTAMIST 86

altavera 77

aluminum hydroxide 58

ALVESCO 91

alyacen 77

amantadine hcl 34

AMBITUSSIN AC 102

AMBIZINE 23

amcinonide 12

amethia 77

amethia lo 78

amethyst 78

amiloride hcl 49

amiloride hcl/hydrochlorothiazide 47

amino acids 110

AMINO ACTION 110

amiodarone hcl 44

amlodipine besylate 46

amlodipine besylate/atorvastatin calcium 47

amlodipine besylate/benazepril hcl 47

amlodipine besylate/valsartan 47

amoxicillin 18

amoxicillin/potassium clavulanate 18

ampicillin trihydrate 18

AMPYRA 53

anagrelide hcl 42

ANALPRAM HC 58

anastrozole 31

ANDRODERM 77

ANDROGEL 77

ANIMAL CHEWS 110

ANIMAL SHAPES 110

ANIMAL SHAPES PLUS IRON 94

ANIMAL SHAPES VITAMINS 110

129

ANORO ELLIPTA 100

ANTACID 59

ANTACID & ANTIGAS 58

ANTACID & GAS RELIEF 58

ANTACID ANTI-GAS DOUBLE STR 59

ANTACID EXTRA STRENGTH 59

ANTACID II PLUS SIMETHICONE 59

ANTACID II WITH SIMETHICONE 59

ANTACID M 59

ANTACID MAXIMUM STRENGTH 59

ANTACID PLUS ANTI-GAS 60

ANTACID PLUS EXTRA STRENGTH 60

ANTACID TABLET 60

ANTACID ULTRA STRENGTH 60

ANTACID WITH SIMETHICONE 60

ANTACID-ANTIGAS 60

ANTI-DIARRHEA 56

ANTI-DIARRHEAL 57

ANTI-FUNGAL 26

ANTI-FUNGAL CREAM 25

ANTI-GAS 60

ANTI-ITCH 12,54,75

ANTI-ITCH CREAM 54

ANTIBIOTIC 15

ANTIBIOTIC + PAIN RELIEF 15

ANTICAVITY FLUORIDE 53

ANTIFUNGAL 25

ANTIFUNGAL CREAM 25

ANTIHIST 94

ANTIHISTAMINE 94

ANTIOXIDANT 110

ANTIOXIDANT FORMULA 110

ANTIOXIDANT VITAMIN 110

ANTIOXIDANT VITAMINS 110

ANTITUSSIVE DM 102

anusol-hc 12

apexicon e 13

APIDRA 40

APIDRA SOLOSTAR 40

apri 78

APRISO 60

APRODINE 102

APTIOM 22

APTIVUS 36

AQUANIL HC 13

aranelle 78

ARANESP 42

ARNUITY ELLIPTA 91

ARTHRITIS PAIN 1

ARTHRITIS PAIN RELIEF 1

ARTHRITIS PAIN RELIEVER 1

ARTIFICIAL TEARS 88

ASACOL HD 60

ascomp with codeine 9

ascorbate calcium 110

ascorbic acid 110

ascorbic acid/ascorbate sodium 110

ashlyna 78

ASMANEX 91

ASMANEX HFA 91

ASPIR 81 6

ASPIR-LOW 6

ASPIR-TRIN 6

aspirin 1,6

aspirin/dipyridamole 43

ASTAGRAF XL 85

atenolol 45

atenolol/chlorthalidone 47

ATHENOL 1

ATHLETE'S FOOT 25

ATHLETE'S FOOT CREAM 26

ATHLETE'S FOOT SPRAY 25

ATHLETIC FOOT CREAM 25

atorvastatin calcium 49

atovaquone 33

ATRIPLA 36

ATROVENT HFA 99

AUBAGIO 53

aubra 78

AUGMENTIN 18

AURAPHENE-B 91

AURYXIA 75

130

aviane 78

avidoxy 20

AVONEX 53

AVONEX ADMINISTRATION PACK 53

AVONEX PEN 53

azathioprine 85

azelastine hcl 90

AZILECT 34

azithromycin 19

AZO 74

AZO DINE 74

AZO-TABS 74

AZOPT 90

azurette 78

BB COMPLETE 111

b complex with vitamin c 111

B-100 COMPLEX 123

B-12 DOTS 111

B-50 COMPLEX 123

b-plex 111

bacitracin 16

bacitracin zinc 16

bacitracin/polymyxin b sulfate 16

BACITRAYCIN PLUS 16

baclofen 35

BAL B-100 111

BAL B-50 111

BALANCE B-100 111

BALANCE B-50 111

BALANCED B-100 111

BALANCED B-150 111

BALANCED B-50 111

balsalazide disodium 86

balziva 78

BAN-ACID 60

BANOPHEN 94

BANOPHEN ANTI-ITCH 54

BANZEL 22

BARACLUDE 37

BAZA ANTIFUNGAL 25

BEE-ZEE 111

BENADRYL ALLERGY 94

BENADRYL ITCH STOPPING 54

benazepril hcl 44

benazepril hcl/hydrochlorothiazide 47

benzonatate 102

benztropine mesylate 34

BERINERT 84

BETA HC 13

betamethasone dipropionate 13

betamethasone dipropionate/propylene glycol 13

betamethasone valerate 13

BETASERON 52

BETATEMP 1

betaxolol hcl 45,90

bethanechol chloride 74

BETIMOL 90

BETOPTIC S 90

bexarotene 32

bicalutamide 84

bimatoprost 88

BIO-S-PRES DX 102

BIOCOTRON 102

BIOGIL 102

BIOPETIT 111

biotin 111

BIOVOL 111

BISA-LAX 66

bisacodyl 66

BISCOLAX 66

BISMATROL 60

bismuth subsalicylate 60

bisoprolol fumarate 45

bisoprolol fumarate/hydrochlorothiazide 47

blade lancet, safety 127

bleph-10 20

BLEPHAMIDE 88

BLEPHAMIDE S.O.P. 88

blood sugar diagnostic 88

BOSULIF 31

131

BREO ELLIPTA 92,100

briellyn 78

BRILINTA 43

brimonidine tartrate 90

bromfed dm 102

bromocriptine mesylate 34

BRONTUSS SF 102

budeprion sr 23

budesonide 75,92

bumetanide 48

BUPHENYL 56

buprenorphine hcl/naloxone hcl 12

buproban 12

bupropion hcl 23

butalbital/acetaminophen 2

butalbital/acetaminophen/caffeine 2

butalbital/acetaminophen/caffeine/codeine phosphate 9

butalbital/aspirin/caffeine 2

butorphanol tartrate 9,10

BYDUREON 39

BYDUREON PEN 39

BYETTA 39

CC 500 MG TIMED RELEASED 111

C COMPLEX 111

cafergot 28

CAL-GEST 60

CALCI-CHEW 60

CALCIDOL 111

calcipotriene 54

calcitonin,salmon,synthetic 87

CALCITRATE 111

calcitrene 55

calcitriol 83

calcium acetate 75,111

CALCIUM ANTACID 60

calcium carbonate 61,111

calcium carbonate,citrate/magnesium

oxide,aspartate/vit d3 111

calcium carbonate/cholecalciferol (vitamin d3) 112

calcium carbonate/ergocalciferol (vitamin d2) 112

calcium carbonate/vit d3/mag

ox/zinc/copper/manganese/boron 111

calcium citrate 112

calcium citrate/ergocalciferol (vitamin d2) 112

CALPHRON 112

camila 82

camrese 78

camrese lo 78

CANASA 61

candesartan cilexetil 44

capacet 2

capecitabine 30

CAPRELSA 32

captopril 44

captopril/hydrochlorothiazide 47

CARAFATE 73

CARBAGLU 56

carbamazepine 22

CARBAMOXIDE 91

carbidopa 34

carbidopa/levodopa 34

carbidopa/levodopa/entacapone 34

CARDENE SR 46

CARDIZEM LA 46

carisoprodol 109

carisoprodol/aspirin 109

CARNITOR SF 109

carteolol hcl 90

cartia xt 46

carvedilol 45

castor oil 66

caziant 78

CEDAX 17

CEENU 29

cefaclor 17

cefadroxil 17

cefdinir 17

cefpodoxime proxetil 17

cefprozil 18

ceftibuten 18

132

CEFTIN 18

cefuroxime axetil 18

celecoxib 6

CELONTIN 21

CENTAMIN 112

CENTAVITE A-Z WITH MINERALS 112

CENTRAL VITE 112

CENTRAL VITE FOR SENIORS 112

CENTRAL-VITE 112

CENTRAL-VITE PERFORMANCE 115

CENTRAL-VITE SELECT 112

CENTRAL-VITE SENIOR 112

CENTRAL-VITE WOMEN'S UNDER 50 112

CENTRAM-CARE 112

CENTRAVITES 50 PLUS 112

CENTRUM 112

CENTRUM COMPLETE 112

CENTRUM SILVER 112

CENTRUM SILVER ULTRA WOMEN'S 112

CENTURY 112

CENTURY ADVANCED FORMULA 112

CENTURY MATURE 112

CENTURY ULTIMATE WOMEN'S 112

cephalexin 18

CERDELGA 56

CEROVITE JR 112

CERTAVITE-ANTIOXIDANT 113

cetirizine hcl 94,95

CHANTIX 12

chateal 78

CHENODAL 61

CHERATUSSIN AC 102

CHERATUSSIN DAC 102

CHEST CONGESTION RELIEF D 102

CHEWABLE MULTI VITAMIN 113

CHEWABLE MULTIVITAMIN W-IRON 95

CHILD CHEW + IRON 95

CHILD CHEW VITAMIN 113

CHILD IBUPROFEN 6

CHILD MUCINEX CHEST CONGESTION 102

CHILD PAIN REL-FEVER REDUCER 2

CHILD SUPPOSITORY 66

CHILD VITAMIN WITH MINERALS 113

CHILD'S VITAMIN WITH IRON 95

CHILD'S VITAMIN WITH VITAMIN C 113

CHILDREN'S ADVIL 7

CHILDREN'S ALL DAY ALLERGY 95

CHILDREN'S ALLEGRA ALLERGY 95

CHILDREN'S ALLER-TEC 95

CHILDREN'S ALLERGY 95,98

CHILDREN'S ALLERGY COMPLETE 95

CHILDREN'S ALLERGY RELIEF 95

CHILDREN'S CHEST CONGESTION 102

CHILDREN'S CHEW MULTIVIT-IRON 113

CHILDREN'S CHEWABLE 123

CHILDREN'S CHEWABLE COMPLETE 113

CHILDREN'S CHEWABLE VITAMIN 113

CHILDREN'S COLD & ALLERGY 102

CHILDREN'S FEVER REDUCER 2

CHILDREN'S FEVER REDUCING 2

CHILDREN'S IBUPROFEN 7

CHILDREN'S IRON 113

CHILDREN'S MEDI-PROFEN 7

CHILDREN'S MEDI-TABS 2

CHILDREN'S MUCUS RELIEF 102

CHILDREN'S MULTIVIT W-EXTRA C 113

CHILDREN'S MULTIVIT-MINERALS 113

CHILDREN'S MULTIVITAMIN-IRON 95

CHILDREN'S NASACORT 75

CHILDREN'S NON-ASPIRIN 2

CHILDREN'S PAIN & FEVER 2

CHILDREN'S PAIN RELIEF 2

CHILDREN'S PAIN RELIEVER 2

CHILDREN'S PEPTO 61

CHILDREN'S PROFEN IB 7

CHILDREN'S PROFENIB 7

CHILDREN'S Q-PAP 2

CHILDREN'S SALINE NASAL SPRAY 86

CHILDREN'S SILAPAP 2

CHILDREN'S SOOTHE 61

CHILDREN'S TACTINAL 2

CHILDREN'S VITAMIN-IRON 95

133

CHILDREN'S VITAMINS WITH IRON 95

CHILDREN'S WAL-DRYL ALLERGY 95

CHILDREN'S WAL-FEX 95

CHILDREN'S WAL-ZYR 95

CHILDREN'S ZYRTEC ALLERGY 95

CHLOR HIST 95

chlorhexidine gluconate 16

chloroquine phosphate 33

chlorothiazide 49

chlorpheniramine maleate 95

chlorpropamide 39

CHLORTABS 96

chlorthalidone 49

chlorzoxazone 109

CHOCOLATED LAXATIVE 66

cholecalciferol (vitamin d3) 113

cholestyramine (with sugar) 50

cholestyramine/aspartame 50

choline salicylate/magnesium salicylate 7

ciclodan 25

ciclopirox 25

ciclopirox olamine 25

cilostazol 43

cimetidine 65

cimetidine hcl 65

CIPRODEX 91

ciprofloxacin 19

ciprofloxacin hcl 19,91

ciprofloxacin/ciprofloxacin hcl 19

CITROMA 61

CITRUCEL 66

clarithromycin 19

CLARITIN 96,102

CLEARLAX 66

clemastine fumarate 96

clindacin etz 16

clindacin p 16

clindamycin hcl 16

clindamycin palmitate hcl 16

clindamycin phosphate 16

clobetasol propionate 13

clobetasol propionate/emollient base 13

clodan 13

clonazepam 38

clonidine 43

clonidine hcl 43

clopidogrel bisulfate 43

clorpres 47

CLOTRIM ANTIFUNGAL 25

clotrimazole 25,26

CLOTRIMAZOLE AF 26

clotrimazole/betamethasone dipropionate 55

CLOVERINE 55

co-gesic 10

codeine phosphate/butalbital/aspirin/caffeine 10

codeine phosphate/carisoprodol/aspirin 10

codeine sulfate 10

COL-RITE 66

colchicine 28

colchicine/probenecid 28

COLCRYS 28

COLD & ALLERGY 106

COLD & COUGH 106

COLESTID 50

colestid 50

colestipol hcl 50

colocort 86

COLY-MYCIN S 91

COMBIVENT 100

COMBIVENT RESPIMAT 100

COMETRIQ 32

COMFORT GEL 61

COMPLERA 35

COMPLETE 113

COMPLETE 50+ 113

COMPLETE ALLERGY 96

COMPLETE MULTI 113

COMPLETE MULTI 50+ 113

COMPLETE MULTI-VIT-MINERAL 113

COMPLETE MULTIVITAMIN 113

COMPLETE PREMIUM VITAMIN 113

COMPLETE SENIOR 113

134

completenate 113

COMPOZ 96

compro 23

CONDYLOX 55

CONGEST-EZE 102

CONGESTAC 102

constulose 66

COPAXONE 53

COREG CR 45

cormax 13

CORTISONE 13

CORTISPORIN-TC 91

CORTIZONE-10 13,75

CORTIZONE-10 PLUS 13

COUGH 102

COUGH & COLD 102

COUGH AND COLD MULTI-SYMPTOM 102

COUGH CONTROL 106

COUGH CONTROL CF 102

COUGH CONTROL DM 102

COUGH FORMULA DM 102

COUGH SYRUP 103

COUGH SYRUP DM 103

COUGH-HEAD CONGESTION RELIEF 103

COUGHTAB 103

CREO-TERPIN 103

CREON 56

CRESTOR 49

CRIXIVAN 36

cromolyn sodium 101

cryselle 78

CURAD ENEMA 66

CUVPOSA 57

cyanocobalamin (vitamin b-12) 114

cyclafem 78

cyclobenzaprine hcl 109

CYCLOPHOSPHAMIDE CAPSULES 29

cyclophosphamide tablets 29

cycloserine 16

cyclosporine 85

cyclosporine, modified 55,85

cyproheptadine hcl 96

cyred 78

CYSTARAN 88

cytra-k 74

DD-VI-SOL 114

D-VITA 114

D3 DOTS 114

D3-2000 114

DAILY FIBER 67

DAILY MULTIPLE 114

DAILY MULTIPLE VITAMIN 114

DAILY MULTIVITAMIN WITH IRON 114

DAILY MULTIVITAMIN-IRON 114

DAILY TEEN MULTI-VITAMIN 114

DAILY VALUE 114

DAILY VITAMIN 114

DAILY VITAMIN + IRON 114

DAILY VITAMIN FORMULA 114

DAILY VITAMIN FORMULA + IRON 114

DAILY VITAMIN FORMULA-MINERALS 114

DAILY VITE 114

DAILYHIST-1 96

dantrolene sodium 35

dapsone 29

DARAPRIM 33

dasetta 78

DAY TIME COLD-FLU RELIEF 106

DAYHIST 96

DAYHIST ALLERGY 96

daysee 78

DAYTIME 103

DAYTRANA 52

deblitane 82

DECUBI VITE 114

DEEP SEA 87

DELTA D3 114

delyla 78

DELZICOL 61

demeclocycline hcl 20

135

DENAVIR 38

denta 5000 plus 53

dentagel 53

depade 12

DEPO-SUBQ PROVERA 104 82

DERMAREST ECZEMA 13

DESENEX 26

DESGEN DM 103

DESITIN CLEAR 54

desmopressin acetate 76

desmopressin acetate (non-refrigerated) 76

desogestrel-ethinyl estradiol 78

desogestrel-ethinyl estradiol/ethinyl estradiol 78

desonide 13

desoximetasone 13

DESPEC 103

DESPEC DM 103

dexamethasone 75

dexamethasone intensol 75

dexamethasone sod phosphate 75

DEXPAK 75

dextroamphetamine sulf-saccharate/amphetamine sulf-

aspartate 51,52

dextroamphetamine sulfate 51

dextromethorphan hbr/pseudoephedrine

hcl/brompheniramine 103

DIABETIC SILTUSSIN DAS-NA 103

DIABETIC SILTUSSIN-DM 103

DIABETIC TUSSIN DM 103

DIABETIC TUSSIN EX 103

dialyvite 114

DIALYVITE 800 114

DIALYVITE VITAMIN D 114

DIALYVITE ZINC 114

DIAMODE 57

DIASTAT 21

diazepam 21

DICLEGIS 24

diclofenac potassium 7

diclofenac sodium 7,75

dicloxacillin sodium 18

dicyclomine hcl 57

didanosine 35

DIFICID 19

diflunisal 7

digitek 47

digox 47

digoxin 47

dihydroergotamine mesylate 28

DILANTIN 22

dilt-cd 46

dilt-xr 46

diltiazem hcl 46

diltzac er 46

dimenhydrinate 96

DINO-LIFE 114

DINO-LIFE WITH EXTRA C 115

DIOCTYL 66

DIOTAME 61

DIPENTUM 86

DIPHEDRYL 96

DIPHEDRYL ALLERGY 96

DIPHENHIST 96

diphenhydramine hcl 54,96

diphenoxylate hcl/atropine sulfate 61

dipyridamole 43

disopyramide phosphate 44

disulfiram 12

DOC-Q-LACE 66

DOC-Q-LAX 66

DOCU LIQUID 66

DOCU SOFT 66

DOCUPRENE 66

docusate calcium 66

docusate sodium 66

DOCUSIL 67

DOK 67

DOK PLUS 67

DOMETUSS-DMX 103

donepezil hcl 23

dorzolamide hcl 90

dorzolamide hcl/timolol maleate 91

136

doxazosin mesylate 43

doxercalciferol 87

doxycycline hyclate 20

doxycycline monohydrate 20

DRAMAMINE LESS DROWSY 24

DRIMINATE 96

DRITHOCREME HP 55

DROXIA 30

DRY SKIN THERAPY 54

DSS 67

DUAVEE 78

DUCODYL 67

DULCOLAX STOOL SOFTENER 67

dynacin 20

EE.E.S. 200 19

EAR CARE 115

EAR DROPS 91

EAR HEALTH FORMULA 115

EAR HEALTH PLUS 91

EAR SYSTEM 91

EAR WAX REMOVAL 91

EARWAX TREATMENT 91

EAZZZE THE PAIN 3

econazole nitrate 26

ECONTRA EZ 78

ECOTRIN 7

ECPIRIN 7

ECZEMA ANTI-ITCH 13

ED A-HIST PSE 103

ED CHLORPED JR 97

ED-APAP 3

ED-CHLORTAN 97

EDECRIN 48

EDURANT 35

EFFIENT 43

EGRIFTA 77

ELDERCAPS 115

ELDERTONIC 115

ELELYSO 56

ELIDEL 55

ELIGARD 84

elimite 33

elinest 78

eliphos 115

ELIQUIS 41

ELIXOPHYLLIN 99

ELLIS TONIC 115

ELMIRON 74

EMCYT 30

EMEND 25

emoquette 78

EMTRIVA 35

enalapril maleate 44

enalapril maleate/hydrochlorothiazide 48

ENBREL 85

endocet 10

endodan 10

ENDUR-ACIN 50,115

ENEMA 67

ENEMA DISPOSABLE 67

ENFALYTE 115

enoxaparin sodium 41

enpresse 78

enskyce 78

entacapone 34

entecavir 37

enulose 67

EPANED 44

EPIFOAM 75

EPIPEN 2-PAK 100

EPIPEN JR 2-PAK 100

epitol 22

EPIVIR HBV 37

eplerenone 49

EPOGEN 42

EPSOM SALT 87

EPZICOM 35

ergocalciferol (vitamin d2) 115

ergotamine tartrate/caffeine 28

ERIVEDGE 32

137

errin 82

ery 19

ERY-TAB 19

erygel 19

ERYPED 200 19

ERYPED 400 19

ERYTHROCIN STEARATE 19

erythromycin base 19

erythromycin base/ethyl alcohol 19

erythromycin ethylsuccinate 19

erythromycin ethylsuccinate/sulfisoxazole acetyl 16

ESBRIET 103

esmolol hcl 45

ESSENTIA 115

ESTRACE 79

estradiol 79

estradiol/norethindrone acetate 79

ESTRING 79

estropipate 79

ethacrynate sodium 48

ethambutol hcl 29

ethinyl estradiol/drospirenone 79

ethosuximide 21

etidronate disodium 87

etodolac 7

etoposide 31

EVAC-U-GEN 67

EVOTAZ 36

EX-LAX 67

EXEFEN IR 103

EXELON 23

exemestane 31

EXJADE 109

EXPECTORANT 103

EXPECTORANT COUGH SYRUP 103

EXPECTORANT DM 103

EXTAVIA 52

EXTRA ACTION COUGH 103

EXTRA STRENGTH NON-ASPIRIN 3

FFALLBACK SOLO 79

falmina 79

famciclovir 38

famotidine 65,73

FARBEE W-C 115

FARESTON 30

FARXIGA 39

FARYDAK 31

FAST RELIEF LAXATIVE 67

felbamate 22

felodipine 46

fenofibrate 49

fenofibrate nanocrystallized 49

fenofibrate,micronized 49

fenofibric acid 49

fenofibric acid (choline) 49

fenoprofen calcium 7

fentanyl 9

FEOSOL 115

FER-IRON 115

FERATE 115

FERGON 115

FEROSUL 115

FERREX 150 115

ferrex 150 forte plus 115

FERRIC X-150 115

FERRO-TIME 115

ferrous gluconate 115

ferrous sulfate 116

FERROUSUL 116

FERUS 116

FEVER REDUCER & PAIN RELIEVER 3

FEVERALL 3

fexofenadine hcl 97

FIBER 67

FIBER LAX 67

FIBER LAXATIVE 67

FIBER SMOOTH 67

FIBER TABS 67

138

FIBER THERAPY 68

FIBER-LAX 68

FIBER-TABS 68

finasteride 74

FIRAZYR 86

FISH OIL 125

FLAGYL ER 16

FLANAX 7,61

FLAVOR CHEWS ANTACID 61

flavoxate hcl 74

flecainide acetate 44

FLINTSTONES 116

FLINTSTONES COMPLETE 116

FLINTSTONES PLUS CALCIUM 116

FLINTSTONES WITH EXTRA C 116

FLINTSTONES WITH IRON 116

FLONASE ALLERGY RELIEF 76

FLOVENT DISKUS 76

FLOVENT HFA 76

fluconazole 26

flucytosine 26

fludrocortisone acetate 13

flunisolide 92

fluocinolone acetonide 13

fluocinolone acetonide oil 76

fluocinonide 13

fluocinonide/emollient base 13

FLUOR-A-DAY 53

fluoride/iron/vitamins a,c,and d 116

fluoridex daily defense 53

fluoritab 53

fluorometholone 76

flura-drops 116

flurazepam hcl 109

flurbiprofen 7

flurbiprofen sodium 90

flutamide 31

fluticasone propionate 14,76

fluvastatin sodium 49

FML FORTE 76

FML S.O.P. 76

FOAMING ANTACID 61

folbee plus 116

folic acid 116

folic acid/vitamin b complex & c/rice bran 116

fondaparinux sodium 41

FORADIL 100

fortical 87

FOSFREE 116

fosinopril sodium 44

fosinopril sodium/hydrochlorothiazide 48

FRAGMIN 41

FRUIT C-500 116

FRUITY CHEWS 116

FULL SPECTRUM B 116

FULYZAQ 61

furosemide 48

FUZEON 36

GG-TRON 103

gabapentin 21

GABITRIL 21

galantamine hbr 23

GAMMAKED 86

GAMUNEX-C 86

ganirelix acetate 84

garamycin 15

GAS FREE 61

GAS RELIEF 62

GAS RELIEF 80 62

GAS-X 62

GAS-X ULTRA STRENGTH 62

gatifloxacin 19

GATTEX 62

GAVILAX 68

gavilyte-c 68

gavilyte-g 68

gavilyte-n 68

GAVISCON 62

GELUSIL 62

gemfibrozil 49

139

generlac 68

gengraf 55

GENOTROPIN 77

gentak 15

gentamicin sulfate 15

GENTLE LAXATIVE 68

GENTLELAX 68

GERAVIM 116

GERI-DRYL 97

GERI-KOT 68

GERI-LANTA 63

GERI-MOX 63

GERI-MUCIL 68

GERI-TUSSIN 103

GERI-TUSSIN DM 103

GERIATON 116

GERITOL COMPLETE 116

GERITOL TONIC 116

gianvi 79

gildagia 79

gildess 79

gildess 24 fe 79

gildess fe 79

GILENYA 52

GILOTRIF 31

GLATOPA 53

GLEEVEC 32

GLEOSTINE 30

glimepiride 39

glipizide 39

glipizide/metformin hcl 39

GLUCAGEN 1MG HYPOKIT 40

GLUCAGON EMERGENCY KIT 40

glyburide 39

glyburide,micronized 39

glyburide/metformin hcl 39

glycerin 68

GLYCOLAX 68

glycopyrrolate 57

glydo 11

GLYXAMBI 39

GRANIX 42

GRASTEK 103

griseofulvin ultramicrosize 26

griseofulvin, microsize 26

GUAIASORB DM 103

GUAIATUSSIN AC 104

guaifenesin 104

GUAIFENESIN AC 104

GUAIFENESIN DAC 104

guaifenesin/codeine phosphate 104

guaifenesin/dextromethorphan hbr 104

guanfacine hcl 43

GUMMI BEAR MULTIVITAMIN 116

GUMMY SWIRLS 116

GYNE-LOTRIMIN 26

GYNE-LOTRIMIN-7 26

HHAIR VITAMIN 116

HAIR, SKIN & NAILS 117

HAIR,SKIN & NAILS 117

halobetasol propionate 14

HARVONI 37

HC-1% HEMORRHOID 76

HEADACHE PM 3

HEADACHE PM FORMULA 3

HEALTHY EYES 117

HEALTHYLAX 68

HEARTBURN ANTACID 63

HEARTBURN PREVENTION 65,73

HEARTBURN RELIEF 63,65,73

HEARTBURN RELIEF 150 63

HEARTBURN RELIEF 24 HOUR 73

HEARTBURN TREATMENT 24 HOUR 73

heather 82

hecoria 85

heparin sodium,porcine 41

heparin sodium,porcine/pf 42

HEXALEN 31

HI B COMPLEX 117

HI-CAL 123

140

HIGH POTENCY CALCIUM 117

HIGH POTENCY IRON 117

HIGH POTENCY MULTIVITAMIN 117

HIGH PROTEIN 117

HIZENTRA 86

HONEY BEARS 117

HUMALOG 40

HUMALOG KWIKPEN U-100 40

HUMALOG KWIKPEN U-200 40

HUMALOG MIX 50-50 40

HUMALOG MIX 50-50 KWIKPEN 40

HUMALOG MIX 75-25 40

HUMALOG MIX 75-25 KWIKPEN 40

HUMIRA 85

HUMIRA CROHN'S 85

HUMIRA PEDIATRIC CROHN'S 85

HUMIRA PSORIASIS 85

HUMULIN 70-30 40

HUMULIN 70/30 KWIKPEN 41

HUMULIN N 41

HUMULIN N KWIKPEN 41

HUMULIN R 41

HYCAMTIN 31

hydralazine hcl 51

HYDRO SKIN 14

hydrochlorothiazide 49

HYDROCIL INSTANT 68

hydrocodone bitartrate/acetaminophen 10

hydrocodone bitartrate/homatropine methylbromide 104

hydrocodone/ibuprofen 10

hydrocortisone 14,76,86

hydrocortisone acetate 14,76

hydrocortisone butyrate 14,76

HYDROCORTISONE PLUS 12 14

hydrocortisone valerate 76

hydrocortisone/aloe vera 14

HYDROCREAM 14

HYDROLATUM 55

hydromet 104

hydromorphone hcl 10

HYDROSKIN 14

hydroxychloroquine sulfate 33

hydroxyurea 30

hydroxyzine hcl 24

hydroxyzine pamoate 24

HYPER-SAL 104

HYQVIA 86

II-PRIN 7

ibandronate sodium 87

IBRANCE 32

IBU-DROPS 7

ibudone 10

ibuprofen 7

ICAPS PLUS 117

ICLUSIG 32

IFEREX 150 117

IMBRUVICA 31

imiquimod 31

inatal advance 117

INCIVEK 37

INCRELEX 77

INCRUSE ELLIPTA 99

indapamide 49

INDERAL XL 45

INDOCIN 7

indomethacin 7

INFANT FEVER-PAIN RELIEVER 3

INFANT GAS RELIEF 63

INFANT GLYCERIN 68

INFANT PAIN & FEVER 3

INFANT PAIN RELIEF 3

INFANT'S NON-ASPIRIN 3

INFANT'S PAIN RELIEF 3

INFANT'S PAIN RELIEVER 3

INFANTS IBU-DROPS 8

INFANTS MEDI-PROFEN 8

INFANTS PROFENIB 8

INFANTS' GAS RELIEF 63

INFANTS' MAPAP 3

INFANTS' PAIN & FEVER 3

141

INFANTS' PAIN RELIEF 3

INFANTS' PAIN RELIEVER 3

INFERGEN 37

INLYTA 31

INNOPRAN XL 45

INTELENCE 35

INTENSE COUGH 104

INTENSE COUGH RELIEVER 104

INTRON A 31

introvale 79

INVIRASE 36

INVOKAMET 39

INVOKANA 39

INZO ANTIFUNGAL 26

IOPHEN DM-NR 104

IOPHEN NR 104

IOPHEN-C NR 104

ipecac 63

ipratropium bromide 99

ipratropium bromide/albuterol sulfate 100

irbesartan 44

irbesartan/hydrochlorothiazide 48

IRON 113

iron asp gly&ps cmplx/ascorb.cal/vit b12/fa/ca-

thr/succ.acid 117

ISENTRESS 36

isochron 51

isoniazid 29

isosorbide dinitrate 51

isosorbide mononitrate 51

ITCH RELIEF 26,54

itraconazole 26

ivermectin 33

JJAKAFI 31

jantoven 42

JANUMET 39

JANUMET XR 39

JANUVIA 39

JARDIANCE 39

jencycla 82

JENTADUETO 39

JOCK ITCH 26

JOCK ITCH RELIEF 26

jolessa 79

jolivette 82

junel 79

junel fe 79

junel fe 24 79

JUXTAPID 50

Kk-sol 117

KADIAN 9

KALETRA 36

KALYDECO 104

KAO-TIN 68

kariva 79

KAZANO 39

kelnor 1-35 79

KENWOOD THERAPEUTIC 117

ketoconazole 26

ketodan 26

ketoprofen 8

ketorolac tromethamine 8,90

KID'S GUMMY BEAR VITAMINS 117

KID'S VITAMINS 117

KID'S VITAMINS + EXTRA C 117

KID'S VITAMINS + IRON 98,123

KID'S VITAMINS COMPLETE 117

kimidess 79

kionex 110

klor-con 10 117

klor-con 8 117

klor-con m10 117

klor-con m15 117

klor-con m20 117

klor-con sprinkle 117

KOMBIGLYZE XR 39

KONSYL 68

KONSYL EASY MIX 68

142

KONSYL FIBER 68

KONSYL FORMULA-D 68

KONSYL-D 68

KRISTALOSE 69

kurvelo 79

KUVAN 56

KYNAMRO 50

Llabetalol hcl 45

lactulose 69

lamivudine 35,37

lamivudine/zidovudine 35

lancets 87,127

LANOXIN 48

lansoprazole 73

lansoprazole/amoxicillin trihydrate/clarithromycin 63

LANTUS 41

LANTUS SOLOSTAR 41

larin 79

larin 24 fe 79

larin fe 80

latanoprost 88

LAX STOOL SOFTENER WITH SENNA 69

LAXA CLEAR 69

LAXACIN 69

LAXATIVE 69

LAXATIVE DIETARY SUPPLEMENT 69

LAXATIVE FEMININE 69

LAXATIVE PEG 3350 69

LAXATIVE SUPPOSITORY 69

leena 80

leflunomide 86

LENVIMA 32

lessina 80

LETAIRIS 101

letrozole 31

leucovorin calcium 31

LEUKERAN 30

LEUKINE 42

leuprolide acetate 84

LEVATOL 45

LEVEMIR 41

LEVEMIR FLEXPEN 41

LEVEMIR FLEXTOUCH 41

levetiracetam 21

levobunolol hcl 91

levocarnitine 110

levocarnitine (with sugar) 110

levocetirizine dihydrochloride 97

levofloxacin 19

levonest 80

levonorgestrel 80,82

levonorgestrel-ethinyl estradiol 80

levonorgestrel/ethinyl estradiol and ethinyl estradiol 80

levora-28 80

levothyroxine sodium 83

levoxyl 83

LEXIVA 36

LIALDA 63

LICE CREAM RINSE 33

LICE KILLING 33

LICE TREATMENT 33

lidocaine 11

lidocaine hcl 11

lidocaine/prilocaine 11

lindane 33

linezolid 16

liothyronine sodium 83

LIQUID ANTACID 63

LIQUITEARS 88

lisinopril 44

lisinopril/hydrochlorothiazide 48

LITTLE ANIMALS WITH IRON 97

LITTLE REMEDIES 87

LITTLE REMEDIES FEVER & PAIN 3

LITTLE REMEDIES STUFFY NOSE 87

LO-PERAMIDE 57

LOBANA BATH OIL 55

lofibra 49

LOHIST-D 104

lomedia 24 fe 80

143

lomustine 30

LONG ACTING NASAL DECONGESTANT 104

loperamide hcl 57

lopreeza 80

LORADAMED 97

LORATA-D 104

LORATA-DINE D 104

loratadine 97

LORATADINE D 97

LORATADINE-D 97,104

lorcet 10

lorcet hd 10

lorcet plus 10

lortab 10

LORTUSS EX 104

loryna 80

losartan potassium 44

losartan potassium/hydrochlorothiazide 48

LOTEMAX 90

LOTRIMIN AF 26

lovastatin 50

low-ogestrel 80

LUBRICANT EYE 88

LUBRICANT EYE DROPS 88

LUBRICANT PLUS 88

LUBRICATING RELIEF 89

LUBRIFRESH PM 89

ludent fluoride 53

LUMIGAN 88

lutera 80

LYNPARZA 31

LYRICA 21

LYSODREN 83

lyza 82

MMAALOX MAXIMUM STRENGTH 63

MACRODANTIN 16

MACUVITE 117

MACUVITE EYE CARE 118

MAG DELAY 118

MAG-AL PLUS XS 63

MAG64 118

MAGIC BULLET 69

MAGLOX 63

magnesium 118

magnesium citrate 63

magnesium hydroxide 69

magnesium oxide 69,118

magnesium sulfate 87

MAPAP 3

MAPAP ARTHRITIS PAIN 3

MAPAP PM 3

MAPO 55

marlexate 110

marlissa 80

MASANTI 63

MASOPHEN 3

MATULANE 30

matzim la 46

meclizine hcl 24

meclofenamate sodium 8

MEDI-BISMUTH 63

MEDI-LAXX 69

MEDI-MECLIZINE 24

MEDI-NATURAL 69

MEDI-NATURAL SENNA STOOL SOFT 69

MEDI-PHEDRINE 104

MEDI-PHEDRYL 97

MEDI-PROFEN 8

MEDI-TABS 3

MEDI-TABS EXTRA STRENGTH 3

MEDI-TABS PM 3

MEDI-TUSSIN 104

MEDI-TUSSIN DM 104

MEDI-TUSSIN DM DIABETIC 105

MEDIFIN EXPECTORANT MUCUS RLF 105

MEDIPROXEN 8

MEDROL 76

medroxyprogesterone acetate 82

mefloquine hcl 33

MEGA MULTI W-CHELATED MINERALS 118

144

MEGA MULTIVITAMIN WITH MINERAL 118

megestrol acetate 82

MEKINIST 31

meloxicam 8

memantine hcl 23

MEN'S DAILY MULTIVIT-MINERAL 118

MEN'S MULTI-VITAMIN 118

MEN'S ONE DAILY 115

meperidine hcl 10

meperitab 10

MEPHYTON 118

mercaptopurine 30

mesalamine 63

MESTINON 29

metadate er 52

METAMUCIL 69

METAMUCIL SUGAR FREE 69

metaproterenol sulfate 100

metaxalone 109

metformin hcl 39

methadone hcl 9

methadone intensol 9

methadose 9

methazolamide 48

methenamine hippurate 16

methimazole 84

methocarbamol 109

methotrexate sodium 30

methotrexate sodium/pf 30

methyclothiazide 49

methyldopa 43

methyldopa/hydrochlorothiazide 48

methylergonovine maleate 74

methylphenidate hcl 52

methylprednisolone 14

metoclopramide hcl 24

metolazone 49

metoprolol succinate 45

metoprolol tartrate 45

metoprolol tartrate/hydrochlorothiazide 48

metronidazole 16

mexiletine hcl 44

MG-PLUS-PROTEIN 118

MGO 118

MI ACID 63

MI-ACID 63

MICATIN 26

miconazole nitrate 26,27

MICONAZORB AF 27

MICRO-GUARD 27

microgestin 80

microgestin fe 80

midodrine hcl 43

migergot 28

MIGRANAL 28

MILANTEX 63

millipred 14

millipred dp 14

MILLTRIUM SENIOR 118

mimvey 80

mimvey lo 80

mineral oil 55

MINERAL OIL 69

MINERAL OIL EXTRA HEAVY 69

MINIPRIN 8

minitran 51

minocycline hcl 20

minoxidil 51

MINTOX 63

MINTOX MAXIMUM STRENGTH 63

MIRANEL AF 27

misoprostol 73

MODERIBA 37

moexipril hcl 44

MOISTURIZING LUBRICANT 89

mometasone furoate 55

mondoxyne nl 20

MONISTAT 3 27

monoject prefill 41

monoject prefill advanced 42

montelukast sodium 99

MONUROL 16

145

morgidox 20

morphine sulfate 9,11

MOTION RELIEF 24

MOTION SICKNESS 24,97

MOTION SICKNESS II 24

MOTION SICKNESS RELIEF 24,97

MOTION SICKNESS RELIEF II 24

MOTION-TIME 24

MOTRIN IB 8

MOVE IT ALONG 69

MOVIPREP 69

moxifloxacin hcl 19

MUCINEX ALLERGY 97

MUCINEX D 105

MUCINEX DM 105

MUCUS DM 105

MUCUS ER 105

MUCUS RELIEF 105

MUCUS-ER 105

MULTAQ 44

MULTI COMPLETE-IRON 118

MULTI-DAY PLUS IRON 118

MULTI-DELYN 118

MULTI-VITAMIN DAILY 118

MULTI-VITE 118

MULTI-VITE 50 & OVER 118

multivit with calcium, iron, and other minerals 118

MULTIVITAL 118

MULTIVITAL PERFORMANCE 118

MULTIVITAL PLATINUM 118

multivitamin 118

multivitamin w-minerals/ferrous gluconate 118

multivitamin with minerals 118

multivitamins with iron 118

multivitamins,ther w-minerals 119

mupirocin 16

MURINE EAR WAX REMOVAL SYSTEM 91

MY FAVORITE MULTIPLE 119

my way 80

MYALEPT 76

mycophenolate mofetil 85

mycophenolate sodium 85

mydfrin 89

MYFERON 150 119

MYLANTA GAS MAXIMUM STRENGTH 63

MYLANTEX DOUBLE-STRENGTH 63

MYLERAN 30

mynatal advance 119

mynephrocaps 119

MYRBETRIQ 35

MYTAB GAS 64

MYTAB GAS MAXIMUM STRENGTH 64

MYVITALIFE 119

myzilra 80

Nnabumetone 8

nadolol 45

naltrexone hcl 12

NAMENDA 23

naphazoline hcl 89

NAPRELAN 8

naproxen 8

naproxen sodium 8

naratriptan hcl 28

NASACORT 76

NASAL & SINUS DECONGESTANT 105

NASAL DECONGEST-ANTIHISTAMINE 105

NASAL DECONGESTANT 105

NASAL DECONGESTANT-ANTIHIST 105

NASAL MOISTURIZING 87

NASAL SPRAY 87

natal-v rx 119

NATPARA 83

NATURAL B-100 119

NATURAL DAILY FIBER 69

NATURAL FIBER 69

NATURAL FIBER LAXATIVE 70

NATURAL FIBER POWDER 70

NATURAL FIBER SUPPLEMENT 70

NATURAL SENNA LAXATIVE 70

NATURAL VEGETABLE LAXATIVE 70

146

NATURAL VEGETABLE POWDER 70

NEBUPENT 33

necon 80

neo-polycin 89

neo-polycin hc 89

neofrin 89

neomycin sulfate 15

neomycin sulfate/bacitracin zinc/polymyxin

b/hydrocortisone 89

neomycin sulfate/bacitracin/polymyxin b 89

neomycin sulfate/polymyxin b sulfate/gramicidin d 89

neomycin sulfate/polymyxin b

sulfate/hydrocortisone 14,89

neomycin/polymyxin b sulfate/dexamethasone 89

NEOSPORIN 14

neosporin 89

NESINA 40

NEULASTA 42

NEUMEGA 42

NEUPOGEN 42

nevirapine 35

NEXAVAR 32

next choice one dose 80

niacin 50,119

niacin (inositol niacinate) 50

nicardipine hcl 46

NICODERM CQ 12

nicotine 12

nifediac cc 47

nifedical xl 47

nifedipine 47

NIGHT TIME PAIN MEDICINE 4

NIGHTTIME ALLERGY RELIEF 97

NIGHTTIME SLEEP AID 97

nikki 80

NILANDRON 84

nimodipine 47

nisoldipine 47

NITRO-BID 51

NITRO-DUR 51

nitro-time 51

nitrofurantoin 16

nitrofurantoin macrocrystal 16

nitrofurantoin monohydrate/macrocrystals 16

nitroglycerin 51

NITROSTAT 51

niva-plus 119

nizatidine 65

NOBLE FORMULA HC 14

NON-ASPIRIN 4

NON-ASPIRIN 8 HOUR 4

NON-ASPIRIN EXTRA STRENGTH 4

NON-ASPIRIN JR STRENGTH 4

NON-ASPIRIN PAIN RELIEF 4

NON-ASPIRIN PM 4

NON-ASPIRIN PM EX-STRENGTH 4

NON-DROWSY ALLERGY 97

NON-DRYING SINUS 105

nora-be 82

norethindrone 82

norethindrone acetate 82

norethindrone acetate-ethinyl estradiol 80

norethindrone acetate-ethinyl estradiol/ferrous

fumarate 80

norgestimate-ethinyl estradiol 80

norlyroc 82

NORPACE CR 44

NORTEMP 4

nortrel 81

NORVIR 36

NOVOLIN 70-30 41

NOVOLIN N 41

NOVOLIN R 41

NOVOLOG 41

NOVOLOG FLEXPEN 41

NOVOLOG MIX 70-30 41

NOVOLOG MIX 70-30 FLEXPEN 41

NOXAFIL 27

NTS 12

NUEDEXTA 52

nulytely with flavor packs 70

NUTROPIN 77

147

NUTROPIN AQ 77

NUTROPIN AQ NUSPIN 77

NUVARING 81

NUZOLE 27

nyamyc 27

nystatin 27

nystatin/triamcinolone acetonide 14

nystop 27

NYT-TIME SLEEP 97

NYTOL QUICKCAPS 98

Oocella 81

octreotide acetate 84

OCUDOX 20

OCUTABS 119

OCUVITE WITH LUTEIN 119

OFEV 105

ofloxacin 20

ogestrel 81

OLYSIO 37

omega-3 fatty acids 50,119

omega-3 fatty acids/dha/epa/other omega-3s/fish

oil 119

omega-3 fatty acids/docosahexanoic acid/epa/fish

oil 50,119

omega-3 fatty acids/fish oil 50,119

omega-3 fatty acids/vitamin e 50

omeprazole 73

omeprazole magnesium 73

OMNITROPE 77

ONCE DAILY 119

ONCOVITE 119

ondansetron 25

ondansetron hcl 25

ONE DAILY 119

ONE DAILY 50 PLUS 119

ONE DAILY ENERGY 123

ONE DAILY ESSENTIAL 119

ONE DAILY FOR MEN 120

ONE DAILY FOR WOMEN 120

ONE DAILY FOR WOMEN 50+ ADV 120

ONE DAILY MAXIMUM 120

ONE DAILY MEN'S 50+ 123

ONE DAILY MEN'S HEALTH 120

ONE DAILY MULTIVITAMIN 120

ONE DAILY MULTIVITAMIN-IRON 120

ONE DAILY PLUS IRON 120

ONE DAILY PLUS MINERALS 120

ONE DAILY WITH CALCIUM-IRON 120

ONE DAILY WITH IRON 120

ONE DAILY WOMEN'S 120

ONE DAILY WOMEN'S 50+ 120

ONE DAILY WOMEN'S HEALTH 120

ONE-A-DAY ESSENTIAL 120

ONE-A-DAY MAXIMUM FORMULA 120

ONE-A-DAY TEEN ADVANTAGE 120

ONE-A-DAY WOMEN'S 120

ONFI 21,22

ONGLYZA 40

OPCICON ONE-STEP 81

OPSUMIT 101

OPTI-VITAMIN 120

ORAL SALINE LAXATIVE 70

ORAL SALINE LAXATIVE KIT 70

ORALAIR 105

oralone 14

ORALYTE 120

ORENITRAM ER 101

ORFADIN 56

ORGAN-I NR 105

orphenadrine citrate 109

orphenadrine citrate/aspirin/caffeine 109

orsythia 81

OS-CAL 500+D3 120

OSENI 40

OTEZLA 86

oxaprozin 8

oxcarbazepine 22

OXISTAT 27

oxybutynin chloride 74

oxycodone hcl 9,11

148

oxycodone hcl/acetaminophen 11

oxycodone hcl/aspirin 11

OXYCONTIN 9

oxymorphone hcl 11

OXYTROL 74

OYSCO 500+D 120

OYSCO-500 120

OYSTERCAL-D 120

PP-COL RITE 70

pacerone 45

PAIN & FEVER 4

PAIN & SLEEP 4

PAIN RELIEF 5

PAIN RELIEF ADULT 5

PAIN RELIEF EXTRA STRENGTH 5

PAIN RELIEF PM 5

PAIN RELIEVER 5

PAIN RELIEVER JUNIOR STRENGTH 5

PAIN RELIEVER PM 5

PAIN RELIEVER-FEVER REDUCER 5

pancrelipase 5,000 56

pantoprazole sodium 73

paricalcitol 84

paroex 17

PARVA-CAL 500 120

pedi-dri 27

PEDIA RELIEF 98

PEDIA RELIEF INFANT 105

PEDIA-LAX 68

PEDIA-LAX STOOL SOFTENER 70

PEDIACARE FEVER REDUCER 5

PEDIATRIC COUGH-COLD 105

PEDIATRIC ELECTROLYTE 121

PEDIATRIC FREEZER POPS 121

pediatric multivitamin combination no.2/sodium

fluoride 121

pediatric multivitamin combo no.45/fluoride/ferrous

sulfate 121

pediatric multivitamin combo no.75/fluoride/ferrous

sulfate 121

pediatric multivitamins a,c,& d3 no.21 121

pediatric multivitamins a,c,& d3 no.21 with sodium

fluoride 121

pediatric multivitamins no.16 with sodium fluoride 121



peg 3350/sod sulf/sod bicarbonate/sod

chloride/potassium chl 70

PEG3350 70

PEGANONE 22

PEGASYS 37

PEGASYS PROCLICK 37

PEGINTRON 38

PEGINTRON REDIPEN 38

penicillin v potassium 18

PENTASA 64

pentazocine hcl/acetaminophen 11

pentazocine hcl/naloxone hcl 11

pentoxifylline 48

PEP-T-MED 64

PEPCID AC 66

PEPTIC RELIEF 64

perindopril erbumine 44

periogard 17

permethrin 33

petrolatum,white 55

petrolatum,white/lanolin 55

PHARBECHLOR 98

PHARBEDRYL 98

PHARBETOL 5

PHARMACIST FAVORITE MULTI-VITE 121

phenadoz 24

phenobarbital 22

phenylephrine hcl 89

phenylephrine hcl/promethazine hcl 105

phenytoin 22

phenytoin sodium extended 23

philith 81

PHILLIPS 70

149

PHILLIPS' LAXATIVE 70

PHOS-FLUR 53

PHOSPHATE ENEMA 70

PHOSPHATE LAXATIVE 70

pilocarpine hcl 53,91

pimtrea 81

pindolol 46

PINK BISMUTH 64

pioglitazone hcl 40

pioglitazone hcl/glimepiride 40

pioglitazone hcl/metformin hcl 40

pirmella 81

piroxicam 8

PLEGRIDY 53

PLEGRIDY PEN 53

pnv 29-1 121

pnv-vp-u 121

podofilox 55

POLY-IRON 121

POLY-VI-SOL 121

POLY-VI-SOL WITH IRON 121

POLY-VITA 121

POLY-VITA WITH IRON 121

POLY-VITAMIN 121

polyethylene glycol 3350 70

polymyxin b sulfate/trimethoprim 89

POLYSACCHARIDE IRON 122

polyvinyl alcohol 89

POLYVITAMIN WITH IRON 122

POMALYST 30

portia 81

potassium chloride 122

potassium chloride/potassium bicarbonate/citric

acid 122

potassium citrate 122

potassium citrate/citric acid 74

POWDERLAX 70

PRADAXA 42

pramipexole di-hcl 34

pravastatin sodium 50

prazosin hcl 43

PRE PROTEIN 122

PRED MILD 90

prednisolone 14

prednisolone acetate 76

prednisolone sod phosphate 14,90

prednisone 14

prednisone intensol 15

PREFEST 81

PREMARIN 81

PREMPHASE 81

PREMPRO 81

prenaplus 122

prenatal vit w-ca,fe,fa(<1 mg) 122

PRENATAL VITAMIN 122

prenatal vitamin no.15/iron,carbonyl/folic acid/docusate

sod 122

prenatal vitamins comb no.115/iron fumarate/folic

acid 122


acid/dss 122


acid/dss 122

prenatal vitamins combo no.60/ferrous fumarate/folic

acid 122

prenatal vitamins with calcium/ferrous fumarate/folic

acid 122

prenatal vits with calcium #72/ferrous fumarate/folic

acid 122

prenatal vits with calcium #72/iron,carbonyl/folic

acid 122


acid 122


acid 123


acid 123

prenatal vits with calcium#118/ferrous fumarate/folic

acid 123

prenatal vits without calc no5/ferrous fumarate/folic

acid 123

PREPARATION CLEANSING 70

150

PREPARATION H 15

preplus 123

PREVACID 73

prevalite 50

prevident 53

PREZCOBIX 36

PREZISTA 37

PRILOSEC OTC 73

primaquine phosphate 33

primidone 21

proair hfa 100

proair respiclick 100

probenecid 28

prochlorperazine 24

prochlorperazine maleate 24

PROCRIT 42

proctocream-hc 15

PROCTOFOAM-HC 64

proctosol-hc 86

proctozone-hc 86

PROCYSBI 74

progesterone,micronized 82

PROMACTA 42

promethazine hcl 24

promethazine hcl/codeine 105

promethazine hcl/dextromethorphan hbr 105

promethazine/phenylephrine hcl/codeine 106

promethegan 24

PROMOLAXIN 70

propafenone hcl 45

propantheline bromide 64

propranolol hcl 46

propranolol hcl/hydrochlorothiazide 48

propylthiouracil 84

PROSIGHT 123

PROTECTIVE OINTMENT 55

PROTEIN 123

PROTEINEX 123

PROTONIX 74

PROVIL 8

pseudoephedrine hcl 106

psyllium husk/aspartame 70

PULMICORT FLEXHALER 92

pulmosal 106

PULMOZYME 106

PURE & GENTLE SALINE ENEMA 70

PURELAX 70

PURIXAN 30

PYLERA 64

pyrazinamide 29

pyridostigmine bromide 29

pyridoxine hcl 123

QQ-DRYL 98

Q-PAP 5

Q-PAP EXTRA STRENGTH 6

Q-TAPP 106

Q-TUSSIN 106

Q-TUSSIN DM 106

quasense 81

QUENALIN 98

QUFLORA 123

quinapril hcl 44

quinapril hcl/hydrochlorothiazide 48

quinidine gluconate 45

quinidine sulfate 45

QVAR 92

Rrabeprazole sodium 74

RAGWITEK 106

raloxifene hcl 83

ramipril 44

ranitidine hcl 64,66

RAPAMUNE 85

RAVICTI 56

READY TO USE ENEMA 70

REBETOL 38

REBIF 53

REBIF REBIDOSE 53

reclipsen 81

151

RECORT PLUS 15

REDNESS LUBRICANT EYE DROPS 89

REDNESS RELIEF 88

REDNESS RELIEVER EYE DROPS 89

REFENESEN 106

REFRESH LACRI-LUBE 89

REGRANEX 55

REGULOID 70

relador pak 12

relador pak plus 12

RELENZA 37

REMEDY ANTIFUNGAL 27

REMEDY PHYTOPLEX ANTIFUNGAL 27

RENA-VITE 123

rena-vite rx 123

RENAGEL 75

renal caps 123

reno caps 123

RENVELA 75

reprexain 11

RESCRIPTOR 35

reserpine 43

REST SIMPLY 98

RESTASIS 85

RESTFULLY SLEEP 98

RESTORE TEARS 89

RETAINE CMC 89

REVATIO 101

revia 12

REVLIMID 30

REYATAZ 37

RHEUMATREX 30

RI-GEL 64

RI-GEL II 64

RI-MAG 64

RI-MOX 64

RI-MOX PLUS 64

RI-TUSSIN 106

RI-TUSSIN DM 106

RIBAPAK 38

RIBASPHERE 38

RIBASPHERE RIBAPAK 38

RIBATAB 38

ribavirin 38

rifabutin 29

RIFAMATE 29

rifampin 29

RIGHT STEP PRENATAL VITAMINS 123

RIGINIC 64

riluzole 52

rimantadine hcl 37

ring 127

RINGWORM 27

RIOMET 40

RISANOID PLUS 123

risedronate sodium 87

RITALIN LA 52

rivastigmine 23

rivastigmine tartrate 23

rizatriptan benzoate 28

ROBAFEN 106

ROBAFEN CF 106

ROBAFEN DM COUGH 106

ROBAFEN-DM 106

ropinirole hcl 34

rosadan 17

ROXICET 11

roxicet 11

RULOX 64

RYNEX PSE 106

SSABRIL 22

SAFETUSSIN DM 106

SAIZEN 77

SALINE ENEMA 70

salmon oil/omega-3 fatty acids 123

SAVAYSA 42

SCOOBY-DOO 123

se-natal 19 124

SEA SOFT 87

SECURA ANTIFUNGAL 27

152

SECURA PROTECTIVE 55

selegiline hcl 34

selenium sulfide 55

SELSUN BLUE 54

SELZENTRY 36

SEN-O-TAB 71

SENEXON 71

SENEXON-S 71

SENIOR TABS 124

SENNA 71

SENNA LAX 71

SENNA LAXATIVE 71

SENNA PLUS 71

SENNA S 71

SENNA-S 71

SENNA-TIME S 71

SENNALAX-S 71

SENNO 71

sennosides 71

sennosides/docusate sodium 71

SENSIPAR 84

SENTRY 124

SENTRY SENIOR 124

SEREVENT DISKUS 100

SEROSTIM 77

setlakin 81

sevelamer carbonate 75

sf 54

sf 5000 plus 54

SHAKE THAT ACHE 6

sharobel 83

SIGNIFOR 83

SILACE 71

SILADRYL 98

sildenafil citrate 101

SILPHEN 98

SILTUSSIN DM 106

SILTUSSIN DM DAS COUGH FORMULA 106

SILTUSSIN SA 106

silver sulfadiazine 20

simethicone 64

SIMPLY SLEEP 98

SIMPONI 85

simvastatin 50

SINUS & ALLERGY 106

SINUS 12-HOUR 106

sirolimus 85

SIRTURO 29

SIVEXTRO 17

SKIN PROTECTANT A & D 54

SLEEP AID 98,109

SLEEP II 98

SLEEP TABLET 98

SLEEP TABS 98

SLO-NIACIN 50

SMOOTH ANTACID 64

SMOOTHLAX 71

sodium chloride 87

sodium chloride for inhalation 107

sodium chloride/sodium bicarbonate/potassium

chloride/peg 71

sodium fluoride 54,124

sodium phenylbutyrate 56

sodium polystyrene sulfonate 110

SOF-LAX 71

SOLTAMOX 30

SOLUBLE FIBER 71

SOMAVERT 84

SOOTHE 64

SOOTHING CARE 15

SOOTHING PUREWAY-C 124

sorbitol solution 71

SORBUGEN NR 107

sorine 45

sotalol hcl 45

SOVALDI 38

SPECTRAVITE 96,113

SPECTRAVITE ADULT 50+ 113

SPECTRAVITE ADVANCED FORM 124

SPECTRAVITE ADVANCED FORMULA 124

SPECTRAVITE PERFORMANCE 124

SPECTRAVITE SENIOR 124

153

SPECTRAVITE ULTRA WOMEN 124

SPIRIVA 99

SPIRIVA RESPIMAT 99

spironolactone 49

spironolactone/hydrochlorothiazide 48

SPORANOX 27

SPRYCEL 32

sronyx 81

ST. JOSEPH ASPIRIN 8

stagesic 11

stavudine 35

STELARA 55

STERILE EYE DROPS 89

STIMATE 77

STIMULANT LAXATIVE PLUS 71

STIVARGA 32

STOMACH RELIEF 64

STOOL SOFTENER 72

STOOL SOFTENER-LAXATIVE 72

STOOL SOFTENER-STIMULANT LAX 72

STRESS 500 124

STRESS 500 PLUS ZINC 124

STRESS B 124

STRESS B WITH ZINC 124

STRESS FORMULA 124

STRESS FORMULA WITH ZINC 124

STRESS-C 124

STRIBILD 36

STUART PRENATAL 124

sucralfate 73

SUDOGEST 107

sulfacetamide sodium 20,89

sulfacetamide sodium/prednisolone sodium

phosphate 90

sulfamethoxazole/trimethoprim 20

sulfamide 20

sulfasalazine 64

sulfazine 65

sulfazine ec 65

sulindac 8

sumatriptan 28

sumatriptan succinate 28

SUPER AMINO ACIDS 124

SUPER B COMPLEX-VITAMIN C 124

SUPER B-50 COMPLEX 124

SUPER B-50 COMPLEX PLUS 124

SUPER CALCIUM 124

SUPER MULTIPLE 124

SUPER OMEGA-3 50

SUPER QUINTS 124

SUPER THERAVITE-M 124

SUPERPLEX-T 124

SUPHEDRIN 107

SUPHEDRIN 12-HOUR 107

SUPHEDRINE 107

SUPHEDRINE 12-HOUR 107

SUPHEDRINE SINUS CONGESTION 107

SUPPOSITORY 72

SUPREP 72

SUSTIVA 35

SUTENT 32

syeda 81

SYLATRON 31

SYLATRON 4-PACK 31

SYMBICORT 100

SYMLINPEN 120 40

SYMLINPEN 60 40

TTAB-A-VITE 125

TAB-A-VITE WITH IRON 125

TAB-A-VITE-MINERALS 125

TABLOID 30

tacrolimus 55,85

TACTINAL 6

TAFINLAR 32

TAMIFLU 37

tamoxifen citrate 30

tamsulosin hcl 74

TARCEVA 32

TARGRETIN 33

tarina fe 81

154

TASIGNA 32

taztia xt 47

TEARS AGAIN 90

TECFIDERA 53

TEGRETOL XR 23

temazepam 109

temozolomide 30

tencon 6

TENSION HEADACHE RELIEVER 6

terazosin hcl 43

terbinafine hcl 27

terbutaline sulfate 100

terconazole 27

testosterone cypionate 77

testosterone enanthate 77

tetrabenazine 52

tetracycline hcl 20

TEV-TROPIN 77

THALOMID 30

THEO-24 99

theochron 99

theophylline anhydrous 100

THERA 125

THERA-D 125

THERA-M 125

THERA-TABS 125

THERADEX M 125

THERAMILL FORTE 125

therapeutic hematinic 125

THERAPEUTIC M 125

THERAPEUTIC-M 125

THERATRUM COMPLETE 125

THERATRUM COMPLETE 50 PLUS 125

THEREMS 125

THEREMS-M 125

thiamine hcl 125

thiamine mononitrate 125

thrivite 19 125

THYROLAR-1 83

THYROLAR-1/2 83

THYROLAR-1/4 83

THYROLAR-2 83

THYROLAR-3 83

tiagabine hcl 22

ticlopidine hcl 43

timolol maleate 28,91

tinidazole 17

tioconazole 27

TIOCONAZOLE 1 27

TIOCONAZOLE-1 27

TIVICAY 36

tizanidine hcl 35

TL FOLATE 125

tl-fluorivite 125

TOBI PODHALER 15

TOBRADEX 15

TOBRADEX ST 90

tobramycin 15

tobramycin in 0.225 % sodium chloride 15

tobramycin/dexamethasone 90

tolazamide 40

tolmetin sodium 8

tolnaftate 27

tolterodine tartrate 74

topiragen 22

topiramate 22

torsemide 48

TOTAL ALLERGY 98

TOTAL B WITH C 125

TOUJEO SOLOSTAR 41

TRACLEER 101

TRADJENTA 40

tramadol hcl 9,11

tramadol hcl/acetaminophen 11

trandolapril 44

tranexamic acid 42

TRAVATAN Z 88

TRAVEL SICKNESS 98

tretinoin 33

TREXALL 31

TRI-BIOZENE 17

tri-estarylla 81

155

tri-linyah 81

tri-previfem 81

tri-sprintec 81

TRI-VITA 125

TRIACTING EXPECTORANT 107

triadvance 125

triamcinolone acetonide 15

triamterene/hydrochlorothiazide 48

trianex 55

triazolam 109

TRICARE 125

triderm 15

trifluridine 38

TRIGLIDE 49

trihexyphenidyl hcl 34

trilyte with flavor packets 72

trimethobenzamide hcl 25

trimethoprim 17

trinatal gt 125

trinatal rx 1 125

trinessa 81

triphrocaps 126

TRIPLE ANTIBIOTIC 17

TRIPLE ANTIBIOTIC EXTRA 17

TRIPLE ANTIBIOTIC PLUS 17

TRIPLE ANTIBIOTIC-PAIN RELIEF 17

TRIUMEQ 36

triveen-u 126

trivora-28 81

trospium chloride 74

TRUVADA 36

TUSNEL C 107

TUSNEL DIABETIC 107

TUSNEL PEDIATRIC 107

tussigon 107

TUSSIN 107

TUSSIN CF 107

TUSSIN CHEST CONGESTION 107

TUSSIN COLD SEVERE CONGESTION 107

TUSSIN COUGH 107

TUSSIN COUGH DM 107

TUSSIN COUGH-CHEST CONGESTION 107

TUSSIN DM 108

TUSSIN DM CLEAR 108

TUSSIN DM COUGH 108

TUSSIN DM COUGH & CHEST 108

TUSSIN DM COUGH-CHEST CONGEST 108

TUSSIN DM MAX 108

TUSSIN HONEY 108

TUSSIN MUCUS-CHEST CONGESTION 108

TUSSIN PE 108

TYBOST 36

TYKERB 32

TYLENOL COLD SEVERE CONGESTION 108

TYLENOL PM EXTRA STRENGTH 6

TYLOPHEN 6

TYZEKA 38

UUCERIS 86

ULESFIA 33

ULTRA A-D 57

ULTRA B-100 COMPLEX 126

ULTRA DM FREE & CLEAR 108

ULTRA FRESH 90

ULTRA FRESH PM 90

ULTRA STRENGTH ANTACID 65

ULTRA TUSS 108

unithroid 83

URINARY PAIN RELIEF 75

URINARY TRACT 75

urine acetone test,strips 87

urine acetone test,tablet 87

urine gluc-acet comb.tst,strip 87

URISTAT 75

ursodiol 65

Vv-c forte 126

VAGIFEM 81

VAGISTAT-3 27

valacyclovir hcl 38

156

VALCHLOR 30

VALCYTE 37

valganciclovir hcl 37

valsartan 44

valsartan/hydrochlorothiazide 48

VALU-DRYL 98

VALU-DRYL ALLERGY MEDICINE 98

VALU-TAPP 108

VALU-TAPP DECONGESTANT 108

vanatol lq 6

vancomycin hcl 17

vandazole 17

vandetanib 32

vaseline white petroleum 56

VEGETABLE LAXATIVE 72

velivet 82

VENTAVIS 101

ventolin hfa 100

verapamil hcl 45,47

VERTICALM 25

vestura 82

VEXOL 90

VIBRAMYCIN 20

vic-forte 126

VICKS QLEARQUIL ALLERGY 98

VICKS QLEARQUIL NIGHTTIME 98

VICTOZA 2-PAK 40

VICTOZA 3-PAK 40

VICTRELIS 38

VIDEX 36

VIEKIRA PAK 38

VIMPAT 23

vinate gt 126

vinate one 126

vinate pn care 126

vinate-m 126

viorele 82

VIRACEPT 37

VIRAMUNE XR 35

VIREAD 36

virt nate 126

virt-advance 126

virt-caps 126

virt-nate 126

virt-vite gt 126

virtrate-k 75

VIRTUSSIN AC 108

VIRTUSSIN DAC 108

VISION 126

VISION FORMULA 126

VISION PLUS LUTEIN 126

VISION VITAMINS 126

vit b complex/vit c/folic acid/ferrous fumarate/vit e

acet 126

VITALETS 98

vitamin a 126

VITAMIN A & D GRX 54

vitamin a palmitate 126

vitamin b complex 126

VITAMIN B-100 COMPLEX 126

vitamin e 126

vitamin e (dl-alpha tocopheryl acetate) 126

vitamin e acetate 126

vitamin e acid succinate 127

vitamin e mixed 127

vitamins a & d/white petrolatum/lanolin 54

vitamins a and d 54

VITEKTA 36

VITRUM SENIOR 127

vol-care rx 127

vol-nate 127

vol-plus 127

vol-tab rx 127

VOLTAREN 56

voriconazole 28

VOTRIENT 32

vp-vite rx 127

vyfemla 82

VYVANSE 52

WWAL-ACT D COLD & ALLERGY 108

157

WAL-DRAM 98

WAL-DRYL 54,99

WAL-DRYL ALLERGY 99

WAL-FEX ALLERGY 99

WAL-FEX D 24 HOUR 99

WAL-FINATE 99

WAL-ITIN 99

WAL-ITIN D 108

WAL-ITIN D 12 HOUR 99

WAL-MUCIL 72

WAL-MUCIL NATURAL FIBER LAX 72

WAL-NADOL PM 6

WAL-PHED 108

WAL-PHED 12 HOUR 108

WAL-PROFEN 9

WAL-PROXEN 9

WAL-SOM 109

WAL-TUSSIN 108

WAL-TUSSIN COUGH & COLD CF 108

WAL-TUSSIN DM 108

WAL-ZAN 150 65

WAL-ZAN 75 65

WAL-ZYR 99

warfarin sodium 42

WOMAN'S LAXATIVE 72

WOMEN'S 50+ DAILY FORMULA 127

WOMEN'S DAILY FORMULA 127

WOMEN'S GENTLE LAXATIVE 72

WOMEN'S LAXATIVE 73

WOMEN'S ONE DAILY 127

WOMENS STOOL SOFTENER 73

XXALKORI 32

XARELTO 42

XIFAXAN 17

XIGDUO XR 40

XOPENEX HFA 100

XTANDI 84

xulane 82

xylon 10 11

XYREM 109

YYELETS 127

Zzafirlukast 99

ZANTAC 75 65

zarah 82

ZEASORB 28

zebutal 6

ZELBORAF 32

zenchent 82

ZENPEP 56

zenzedi 52

ZETIA 50

ZIAGEN 36

zidovudine 36

ZIRGAN 37

ZOLADEX 84

ZOLINZA 32

zolmitriptan 29

ZOMACTON 77

ZOMIG 29

zonisamide 21

ZOO CHEWS 127

ZORBTIVE 77

ZORTRESS 85

zovia 1-35e 82

zovia 1-50e 82

ZYDELIG 32

ZYKADIA 32

ZYLET 90

ZYRTEC 99

ZYTIGA 32

ZYVOX 17

158

Category ListingAnalgesics 1

Anesthetics 11

Anti-Addiction/Substance Abuse Treatment Agents 12

Anti-inflammatory Agents 12

Antibacterials 15

Anticonvulsants 21

Antidementia Agents 23

Antidepressants 23

Antiemetics 23

Antifungals 25

Antigout Agents 28

Antimigraine Agents 28

Antimyasthenic Agents 29

Antimycobacterials 29

Antineoplastics 29

Antiparasitics 33

Antiparkinson Agents 34

Antispasticity Agents 35

Antivirals 35

Anxiolytics 38

Blood Glucose Regulators 39

Blood Products/Modifiers/ Volume Expanders 41

Cardiovascular Agents 43

Central Nervous System Agents 51

Dental and Oral Agents 53

Dermatological Agents 54

Enzyme Replacement/ Modifiers 56

Gastrointestinal Agents 56

Genitourinary Agents 74

Hormonal Agents, Stimulant/ Replacement/ Modifying (Adrenal) 75

Hormonal Agents, Stimulant/Replacement/Modifying (Other) 76

Hormonal Agents, Stimulant/Replacement/Modifying (Pituitary) 76

Hormonal Agents, Stimulant/Replacement/Modifying (Sex Hormones/Modifiers) 77

Hormonal Agents, Stimulant/Replacement/Modifying (Thyroid) 83

Hormonal Agents, Suppressant (Adrenal) 83

Hormonal Agents, Suppressant (Parathyroid) 83

Hormonal Agents, Suppressant (Pituitary) 84

Hormonal Agents, Suppressant (Sex Hormones/Modifiers) 84

Hormonal Agents, Suppressant (Thyroid) 84

Immunological Agents 84

Inflammatory Bowel Disease Agents 86

Metabolic Bone Disease Agents 87

Miscellaneous 88

MISCELLANEOUS THERAPEUTIC AGENTS 86

Ophthalmic Agents 88

159

Otic Agents 91

Respiratory Tract Agents 91

Skeletal Muscle Relaxants 109

Sleep Disorder Agents 109

Therapeutic Nutrients/ Minerals/ Electrolytes 109

Uncategorized 127

160

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