prescribing guide standard control 2020...4 introduction we are pleased to provide the 2020...
TRANSCRIPT
Prescribing Guide - Standard Control 2020
October
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Prescribing Guide - Standard Control 10/01/2020
INTRODUCTION....................................................................................................................................................................................................... 4 PREFACE ................................................................................................................................................................................................................. 4 PHARMACY AND THERAPEUTICS (P&T) COMMITTEE ...................................................................................................................................... 4 DRUG LIST PRODUCT DESCRIPTIONS ................................................................................................................................................................ 5 GENERIC SUBSTITUTION ...................................................................................................................................................................................... 5 SPECIALTY PHARMACY ........................................................................................................................................................................................ 6 LEGEND ................................................................................................................................................................................................................. 10 NOTICE ................................................................................................................................................................................................................... 10 ANALGESICS......................................................................................................................................................................................................... 11
ANALGESICS, OTHER ................................................................................................................................................................................ 11 NSAIDs ......................................................................................................................................................................................................... 11 NSAIDs, COMBINATIONS ........................................................................................................................................................................... 11 NSAIDs, TOPICAL ....................................................................................................................................................................................... 11 COX-2 INHIBITORS ..................................................................................................................................................................................... 11 GOUT ........................................................................................................................................................................................................... 11 OPIOID ANALGESICS ................................................................................................................................................................................. 11 NON-OPIOID ANALGESICS ........................................................................................................................................................................ 12 VISCOSUPPLEMENTS ............................................................................................................................................................................... 12
ANTI-INFECTIVES ................................................................................................................................................................................................. 12 ANTIBACTERIALS ....................................................................................................................................................................................... 13 ANTIFUNGALS ............................................................................................................................................................................................ 13 ANTIMALARIALS ......................................................................................................................................................................................... 14 ANTIRETROVIRAL AGENTS ...................................................................................................................................................................... 14 ANTITUBERCULAR AGENTS ..................................................................................................................................................................... 15 ANTIVIRALS................................................................................................................................................................................................. 15 MISCELLANEOUS ....................................................................................................................................................................................... 15
ANTINEOPLASTIC AGENTS ................................................................................................................................................................................ 16 ALKYLATING AGENTS ............................................................................................................................................................................... 16 ANTIMETABOLITES .................................................................................................................................................................................... 16 HORMONAL ANTINEOPLASTIC AGENTS ................................................................................................................................................. 16 IMMUNOMODULATORS ............................................................................................................................................................................. 16 KINASE INHIBITORS ................................................................................................................................................................................... 16 TOPOISOMERASE INHIBITORS ................................................................................................................................................................ 17 MISCELLANEOUS ....................................................................................................................................................................................... 17
CARDIOVASCULAR .............................................................................................................................................................................................. 17 ACE INHIBITORS......................................................................................................................................................................................... 17 ACE INHIBITOR/CALCIUM CHANNEL BLOCKER COMBINATIONS ........................................................................................................ 17 ACE INHIBITOR/DIURETIC COMBINATIONS ............................................................................................................................................ 17 ADRENOLYTICS, CENTRAL ....................................................................................................................................................................... 18 ALDOSTERONE RECEPTOR ANTAGONISTS .......................................................................................................................................... 18 ALPHA BLOCKERS ..................................................................................................................................................................................... 18 ANGIOTENSIN II RECEPTOR ANTAGONISTS/DIURETIC COMBINATIONS ........................................................................................... 18 ANGIOTENSIN II RECEPTOR ANTAGONIST/CALCIUM CHANNEL BLOCKER COMBINATIONS ......................................................... 18 ANGIOTENSIN II RECEPTOR ANTAGONIST/CALCIUM CHANNEL BLOCKER/DIURETIC COMBINATIONS ....................................... 18 ANTIARRHYTHMICS ................................................................................................................................................................................... 18 ANTILIPEMICS............................................................................................................................................................................................. 19 BETA-BLOCKERS ....................................................................................................................................................................................... 19 BETA-BLOCKER/DIURETIC COMBINATIONS ........................................................................................................................................... 20 CALCIUM CHANNEL BLOCKERS .............................................................................................................................................................. 20 CALCIUM CHANNEL BLOCKER/ANTILIPEMIC COMBINATIONS ............................................................................................................ 20 DIGITALIS GLYCOSIDES ............................................................................................................................................................................ 20 DIRECT RENIN INHIBITORS/DIURETIC COMBINATIONS ....................................................................................................................... 20 DIURETICS .................................................................................................................................................................................................. 20 HEART FAILURE ......................................................................................................................................................................................... 21 NITRATES .................................................................................................................................................................................................... 21 PULMONARY ARTERIAL HYPERTENSION .............................................................................................................................................. 21 MISCELLANEOUS ....................................................................................................................................................................................... 21
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CENTRAL NERVOUS SYSTEM ............................................................................................................................................................................ 22 ANTIANXIETY .............................................................................................................................................................................................. 22 ANTICONVULSANTS .................................................................................................................................................................................. 22 ANTIDEMENTIA ........................................................................................................................................................................................... 22 ANTIDEPRESSANTS .................................................................................................................................................................................. 23 ANTIPARKINSONIAN AGENTS .................................................................................................................................................................. 23 ANTIPSYCHOTICS ...................................................................................................................................................................................... 24 ATTENTION DEFICIT HYPERACTIVITY DISORDER ................................................................................................................................ 24 FIBROMYALGIA........................................................................................................................................................................................... 25 HYPNOTICS................................................................................................................................................................................................. 25 MIGRAINE .................................................................................................................................................................................................... 25 MOOD STABILIZERS .................................................................................................................................................................................. 26 MOVEMENT DISORDERS .......................................................................................................................................................................... 26 MULTIPLE SCLEROSIS AGENTS .............................................................................................................................................................. 26 MUSCULOSKELETAL THERAPY AGENTS ............................................................................................................................................... 26 MYASTHENIA GRAVIS ............................................................................................................................................................................... 26 NARCOLEPSY ............................................................................................................................................................................................. 26 POSTHERPETIC NEURALGIA (PHN) ......................................................................................................................................................... 26 PSYCHOTHERAPEUTIC-MISCELLANEOUS ............................................................................................................................................. 26
ENDOCRINE AND METABOLIC ........................................................................................................................................................................... 27 ACROMEGALY ............................................................................................................................................................................................ 27 ANDROGENS .............................................................................................................................................................................................. 27 ANTIDIABETICS .......................................................................................................................................................................................... 27 ANTIOBESITY .............................................................................................................................................................................................. 29 CALCIUM RECEPTOR ANTAGONISTS ..................................................................................................................................................... 29 CALCIUM REGULATORS ........................................................................................................................................................................... 29 CARNITINE DEFICIENCY AGENTS ........................................................................................................................................................... 29 CONTRACEPTIVES .................................................................................................................................................................................... 30 ENDOMETRIOSIS ....................................................................................................................................................................................... 31 ESTROGENS ............................................................................................................................................................................................... 31 ESTROGEN/PROGESTINS ......................................................................................................................................................................... 31 ESTROGEN/SELECTIVE ESTROGEN RECEPTOR MODULATOR COMBINATIONS ............................................................................. 31 FERTILITY REGULATORS .......................................................................................................................................................................... 31 GAUCHER DISEASE ................................................................................................................................................................................... 31 GLUCOCORTICOIDS .................................................................................................................................................................................. 32 GLUCOSE ELEVATING AGENTS ............................................................................................................................................................... 32 HEREDITARY TYROSINEMIA TYPE 1 AGENTS ....................................................................................................................................... 32 HUMAN GROWTH HORMONES ................................................................................................................................................................. 32 HYPERPARATHYROID TREATMENT, VITAMIN D ANALOGS ................................................................................................................. 32 PHENYLKETONURIA TREATMENT AGENTS ........................................................................................................................................... 32 PHOSPHATE BINDER AGENTS ................................................................................................................................................................. 32 POLYNEUROPATHY ................................................................................................................................................................................... 32 POTASSIUM-REMOVING AGENTS............................................................................................................................................................ 32 PROGESTINS .............................................................................................................................................................................................. 32 SELECTIVE ESTROGEN RECEPTOR MODULATORS ............................................................................................................................. 33 THYROID AGENTS ..................................................................................................................................................................................... 33 VASOPRESSINS ......................................................................................................................................................................................... 33 MISCELLANEOUS ....................................................................................................................................................................................... 33
GASTROINTESTINAL ........................................................................................................................................................................................... 33 ANTIDIARRHEALS ...................................................................................................................................................................................... 33 ANTIEMETICS ............................................................................................................................................................................................. 33 ANTISPASMODICS ..................................................................................................................................................................................... 33 CHOLELITHOLYTICS .................................................................................................................................................................................. 33 H2 RECEPTOR ANTAGONISTS .................................................................................................................................................................. 34 INFLAMMATORY BOWEL DISEASE .......................................................................................................................................................... 34 IRRITABLE BOWEL SYNDROME ............................................................................................................................................................... 34 LAXATIVES .................................................................................................................................................................................................. 34 OPIOID-INDUCED CONSTIPATION ........................................................................................................................................................... 34 PANCREATIC ENZYMES ............................................................................................................................................................................ 34 PROSTAGLANDINS .................................................................................................................................................................................... 34 PROTON PUMP INHIBITORS ..................................................................................................................................................................... 34 SALIVA STIMULANTS ................................................................................................................................................................................. 35 STEROIDS, RECTAL ................................................................................................................................................................................... 35 ULCER THERAPY COMBINATIONS .......................................................................................................................................................... 35 MISCELLANEOUS ....................................................................................................................................................................................... 35
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GENITOURINARY .................................................................................................................................................................................................. 35 BENIGN PROSTATIC HYPERPLASIA ........................................................................................................................................................ 35 ERECTILE DYSFUNCTION ......................................................................................................................................................................... 35 URINARY ANTISPASMODICS .................................................................................................................................................................... 35 VAGINAL ANTI-INFECTIVES ...................................................................................................................................................................... 35 MISCELLANEOUS ....................................................................................................................................................................................... 36
HEMATOLOGIC ..................................................................................................................................................................................................... 36 ANTICOAGULANTS .................................................................................................................................................................................... 36 HEMATOPOIETIC GROWTH FACTORS .................................................................................................................................................... 36 HEMOPHILIA A AGENTS ............................................................................................................................................................................ 36 HEMOPHILIA B AGENTS ............................................................................................................................................................................ 36 IDIOPATHIC THROMBOCYTOPENIC PURPURA AGENTS ...................................................................................................................... 36 PAROXYSMAL NOCTURNAL HEMOGLOBINURIA (PNH) AGENTS ........................................................................................................ 36 PLATELET AGGREGATION INHIBITORS .................................................................................................................................................. 37 PLATELET SYNTHESIS INHIBITORS ........................................................................................................................................................ 37 STEM CELL MOBILIZERS ........................................................................................................................................................................... 37 THROMBOCYTOPENIA AGENTS .............................................................................................................................................................. 37 MISCELLANEOUS ....................................................................................................................................................................................... 37
IMMUNOLOGIC AGENTS ...................................................................................................................................................................................... 37 ALLERGENIC EXTRACTS .......................................................................................................................................................................... 37 AUTOIMMUNE AGENTS ‡ ........................................................................................................................................................................... 37 DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDs) ................................................................................................................. 37 HEREDITARY ANGIOEDEMA ..................................................................................................................................................................... 37 IMMUNOMODULATORS ............................................................................................................................................................................. 38 IMMUNOSUPPRESSANTS ......................................................................................................................................................................... 38
NUTRITIONAL/SUPPLEMENTS ............................................................................................................................................................................ 38 ELECTROLYTES ......................................................................................................................................................................................... 38 VITAMINS AND MINERALS ........................................................................................................................................................................ 38
RESPIRATORY ...................................................................................................................................................................................................... 39 ANAPHYLAXIS TREATMENT AGENTS ..................................................................................................................................................... 39 ANTICHOLINERGICS .................................................................................................................................................................................. 39 ANTICHOLINERGIC/BETA AGONIST COMBINATIONS ............................................................................................................................ 39 ANTICHOLINERGIC/BETA AGONIST/STEROID INHALANT COMBINATIONS ........................................................................................ 39 ANTIHISTAMINES, LOW SEDATING.......................................................................................................................................................... 39 ANTIHISTAMINES, NONSEDATING ........................................................................................................................................................... 39 ANTIHISTAMINES, SEDATING ................................................................................................................................................................... 39 ANTIHISTAMINE/DECONGESTANT COMBINATIONS .............................................................................................................................. 40 ANTITUSSIVES............................................................................................................................................................................................ 40 ANTITUSSIVE COMBINATIONS ................................................................................................................................................................. 40 BETA AGONISTS ........................................................................................................................................................................................ 40 CYSTIC FIBROSIS ...................................................................................................................................................................................... 40 LEUKOTRIENE MODULATORS .................................................................................................................................................................. 40 MAST CELL STABILIZERS ......................................................................................................................................................................... 41 NASAL ANTIHISTAMINES .......................................................................................................................................................................... 41 NASAL STEROIDS/COMBINATIONS ......................................................................................................................................................... 41 PHOSPHODIESTERASE-4 INHIBITORS .................................................................................................................................................... 41 PULMONARY ENZYME DEFICIENCY AGENTS ........................................................................................................................................ 41 PULMONARY FIBROSIS AGENTS ............................................................................................................................................................. 41 SEVERE ASTHMA AGENTS ....................................................................................................................................................................... 41 STEROID/BETA AGONIST COMBINATIONS ............................................................................................................................................. 41 STEROID INHALANTS ................................................................................................................................................................................ 41 XANTHINES ................................................................................................................................................................................................. 41 MISCELLANEOUS ....................................................................................................................................................................................... 41
TOPICAL ................................................................................................................................................................................................................ 41 DERMATOLOGY.......................................................................................................................................................................................... 41 MOUTH/THROAT/DENTAL AGENTS ......................................................................................................................................................... 44 OPHTHALMIC .............................................................................................................................................................................................. 44 OTIC ............................................................................................................................................................................................................. 46
SPECIALTY DRUGS .............................................................................................................................................................................................. 47 WEBSITES ............................................................................................................................................................................................................. 52 INDEX ..................................................................................................................................................................................................................... 54
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INTRODUCTION
We are pleased to provide the 2020 Prescribing Guide - Standard Control as a useful reference and informational tool. The Prescribing Guide - Standard Control can assist practitioners in selecting clinically appropriate and cost-effective products for their patients.
The drugs represented have been reviewed by a National Pharmacy and Therapeutics (P&T) Committee and are approved for inclusion. The Prescribing Guide - Standard Control is reflective of current medical practice as of the date of review.
The information contained in this Prescribing Guide - Standard Control and its appendices is provided solely for the convenience of medical providers. We do not warrant or assure accuracy of such information nor is it intended to be comprehensive in nature. This Prescribing Guide - Standard Control is not intended to be a substitute for the knowledge, expertise, skill and judgment of the medical provider in his or her choice of prescription drugs. All the information in the Prescribing Guide - Standard Control is provided as a reference for drug therapy selection. Specific drug selection for an individual patient rests solely with the prescriber. The document is subject to state-specific regulations and rules, including, but not limited to, those regarding generic substitution, controlled substance schedules, preference for brands and mandatory generics whenever applicable.
We assume no responsibility for the actions or omissions of any medical provider based upon reliance, in whole or in part, on the information contained herein. The medical provider should consult the drug manufacturer's product literature or standard references for more detailed information.
National guidelines can be found on the National Guideline Clearinghouse site at https://www.ahrq.gov/gam/, on the websites listed under each therapeutic class and on the sites listed in the WEBSITES section of this publication.
PREFACE
The Prescribing Guide - Standard Control is organized by sections. Each section is divided by therapeutic drug class primarily defined by mechanism of action. Products are listed by generic name with brand name for reference only. Unless exceptions are noted, generally all applicable dosage forms and strengths of the drug cited are included in the Prescribing Guide - Standard Control. Generics should be considered the first line of prescribing.
Individual pharmacy benefit plans may impose restrictions or not reimburse some products. In addition, over-the-counter (OTC) products, with the exception of insulin and diabetes monitoring products, are usually not included in the pharmacy benefit. Pharmacy law requires a valid prescription for purchase of needles and syringes in certain states. OTC products are listed for informational purposes. If covered in the pharmacy benefit, OTC products require a valid prescription.
Drugs represented in the Prescribing Guide - Standard Control may have varying cost to the plan member. Prescription benefit plan may alter coverage of certain products or vary copay amounts based on the condition being treated. Generic medications typically are available at the lowest cost, brand-name medications on the Prescribing Guide - Standard Control will generally cost more than generics, and brand-name medications not on the list will generally cost the most.
PHARMACY AND THERAPEUTICS (P&T) COMMITTEE
The services of an independent National Pharmacy and Therapeutics Committee ("P&T Committee") are utilized to approve safe and clinically effective drug therapies. The P&T Committee is an external advisory body of clinical professionals from across the United States. The P&T Committee's voting members include physicians, pharmacists, a pharmacoeconomist and a medical ethicist, all of whom have a broad background of clinical and academic expertise regarding prescription drugs. Employees with significant clinical expertise are invited to meet with the P&T Committee, but no CVS Caremark® employee may vote on issues before the P&T Committee. Voting members of the P&T Committee must disclose any financial relationship or conflicts of interest with any pharmaceutical manufacturers.
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DRUG LIST PRODUCT DESCRIPTIONS
To assist in understanding which specific strengths and dosage forms are on the Prescribing Guide - Standard Control, examples are noted below. The general principles shown in the examples can usually be extended to other entries in the book. Any exceptions are noted. Products on the Prescribing Guide - Standard Control include all strengths and dosage forms of the cited brand-name product. cefixime Suprax Oral capsules, oral chewable tablets, oral suspension and all strengths of Suprax would be included in this listing. When a strength or dosage form is specified, only the specified strength and dosage form is on the Prescribing Guide - Standard Control. Other strengths/dosage forms of the reference product are not. acyclovir caps, tabs Zovirax The capsules and tablets of Zovirax are on the Prescribing Guide - Standard Control. From this entry, the cream and ointment cannot be assumed to be on the list unless there is a specific entry. Extended-release and delayed-release products require their own entry. sitagliptin/metformin Janumet The immediate-release product listing of Janumet alone would not include the extended-release product Janumet XR. sitagliptin/metformin ext-rel Janumet XR A separate entry for Janumet XR confirms that the extended-release product is on the Prescribing Guide - Standard Control. Dosage forms on the Prescribing Guide - Standard Control will be consistent with the category and use where listed. nystatin The above nystatin entry listed in the TOPICAL/DERMATOLOGY section is limited to the topical dosage forms. From this entry the oral formulations cannot be assumed to be on the list unless there is an entry for this product in the ANTI-INFECTIVES section of the Prescribing Guide - Standard Control.
GENERIC SUBSTITUTION
Generic substitution is a pharmacy action whereby a generic version is dispensed rather than a prescribed brand-name product. Boldface type indicates generic availability. However, not all strengths or dosage forms of the generic name in boldface type may be generically available. In addition, boldface type may indicate that the brand name cited is a generic. Examples of the latter include Levoxyl and Trivora. One way to reduce out-of-pocket cost is by requesting a generic drug. Generic drugs are usually priced lower than their brand-name equivalents. Prescription generic drugs are:
Approved by the U.S. Food and Drug Administration for safety and effectiveness, and are manufactured under the same strict standards that apply to brand-name drugs.
Tested in humans to assure the generic is absorbed into the bloodstream in a similar rate and extent compared to the brand-name drug. Generics may be different from the brand in size, color, and inactive ingredients, but this does not alter their effectiveness or ability to be absorbed just like the brand-name drug.
Manufactured in the same strength and dosage form as the brand-name drugs.
When a generic drug is substituted for a brand-name drug, you can expect the generic to produce the same clinical effect and safety profile as the brand-name drug.
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SPECIALTY PHARMACY
CVS Specialty™ is a full-service specialty pharmaceutical provider. Specialty pharmaceuticals or products are used in the management of specific chronic or genetic conditions and certain catastrophic diseases such as cancer. They are often injectable or infused medications, but may also include oral agents.
CVS Caremark offers these services combined with professional pharmaceutical care management.
Medications distributed through CVS Specialty program are listed below. A member's specific prescription benefit plan may have different coverage or copayments for specific specialty products.
Medications Available through CVS Specialty (Alpha List)
abacavir tab (ZIAGEN)1 abacavir/lamivudine (EPZICOM)1 abacavir/lamivudine/ zidovudine tab (TRIZIVIR)1 abiraterone acetate (ZYTIGA)1 Actemra Acthar H.P. Gel Actimmune Adakveo Adcetris Adcirca adefovir (HEPSERA)1 Adempas Advate Adynovate Afinitor Afstyla Aimovig Ajovy Aldurazyme Alecensa Alferon N Alphanate AlphaNine SD Alprolix Alunbrig alyq (ADCIRCA, tadalafil)1 ambrisentan (LETAIRIS)1 Ampyra Apokyn Aptivus Aralast NP Aranesp Arcalyst Arzerra Asceniv Asparlas Astagraf XL atazanavir sulfate (REYATAZ)1 Atripla Aubagio Austedo Avastin Aveed Avonex Avsola
azacitidine (VIDAZA)1 Baraclude Bavencio Bebulin Beleodaq Belrapzo Bendamustine Hydrochloride Bendeka BeneFIX Benlysta Beovu Berinert Besponsa Betaseron Bethkis bexarotene (TARGRETIN)1 Biktarvy Bivigam Blincyto Bortezomib bosentan (TRACLEER)1 Bosulif Botox Buphenyl Bynfezia Pen Cabometyx capecitabine (XELODA)1 Cayston CellCept Ceprotin Cerdelga Cerezyme Cetrotide Chorionic Gonadotropin Cimduo Cimzia cinacalcet hydrochloride (SENSIPAR)1 Cinqair Cinryze Coagadex Combivir Cometriq Complera Copaxone Corifact Cosentyx
Cotellic Crixivan Crysvita Cuvitru cyclosporine (gengraf, NEORAL, SANDIMMUNE)1 Cyramza Cystagon Cytogam Dacogen dalfampridine ER (AMPYRA)1 Darzalex Darzalex Faspro Daurismo decitabine (DACOGEN)1 deferasirox (EXJADE, JADENU)1 deferoxamine (DESFERAL)1 Delstrigo Descovy Desferal didanosine (VIDEX, VIDEX EC)1 dofetilide (TIKOSYN)1 Doptelet Dovato Dupixent Durolane Durysta Dysport Edurant efavirenz (SUSTIVA)1 Egrifta Elaprase Elelyso Eligard Eloctate Emgality Empliciti Emtriva Enbrel Enhertu entecavir (BARACLUDE)1 Entyvio Envarsus XR Epclusa
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Epidiolex Epivir Epivir HBV Epogen epoprostenol sodium (FLOLAN, VELETRI)1 Epzicom Erbitux Erivedge Erleada erlotinib hydrochloride (TARCEVA)1 Esbriet Esperoct Euflexxa Evenity everolimus (AFINITOR)1 everolimus (ZORTRESS)1 Evomela Evotaz Exjade Extavia Eylea Fabrazyme Farydak Fasenra Feiba Fibryga Firazyr Firmagon Flolan Follistim AQ Folotyn Forteo fosamprenavir (LEXIVA)1 Fulphila Fusilev Fuzeon GamaSTAN GamaSTAN S/D Gamifant Gammagard Liquid Gammagard S/D Gammaked Gammaplex Gamunex C Ganirelix acetate Gattex Gazyva Gel-One Gelsyn-3 gengraf1 Genotropin Genvisc 850 Genvoya Gilenya Glassia
glatiramer acetate (COPAXONE, glatopa)1 Gleevec Gonal-F Granix H.P. Acthar Gel Haegarda Halaven Harvoni Helixate FS Hemlibra Hemofil M HepaGam B Hepsera Herceptin Herceptin Hylecta Herzuma Hizentra Humate-P Humatrope Humira Hyalgan Hycamtin hydroxyprogesterone capro (MAKENA)1 Hymovis HyperHEP B HyperRHO S/D HyQvia Ibrance icatibant acetate (FIRAZYR)1 Idelvion Idhifa Ilaris Ilumya Iluvien imatinib mesylate (GLEEVEC)1 Imfinzi Inbrija Increlex Inflectra Inlyta Inrebic Intelence Intron A Invirase Iressa Isentress Istodax Ixempra Ixinity Jadenu Jakafi Jevtana Jivi Juluca Kadcyla
Kalbitor Kaletra Kanjinti Kanuma Kevzara Keytruda Khapzory Kisqali Kisqali Femara Kitabis Pak Koate Koate-DVI Kogenate FS Kovaltry Krystexxa Kuvan Kyleena Kynmobi Kyprolis lamivudine (EPIVIR, EPIVIR HBV)1 lamivudine/zidovudine (COMBIVIR)1 Ledipasvir/Sofosbuvir Lemtrada Lenvima Letairis Leukine leuprolide acetate (LUPRON)1 Levoleucovorin Lexiva Liletta Lonsurf lopinavir/ritonavir soln (KALETRA)1 Lorbrena Lucentis Lumizyme Lumoxiti Lupaneta Pack Lupron Lupron Depot Lynparza Macrilen Macugen Makena Mavenclad Mavyret Mayzent Mekinist Menopur MICRhoGAM miglustat1 Mirena mitoxantrone hcl1 Moderiba Mononine
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Monovisc Mozobil Mugard Mulpleta Mvasi mycophenolate mofetil (CELLCEPT)1 mycophenolic acid dr (MYFORTIC)1 Myfortic Mylotarg Myobloc Nabi-HB Naglazyme Natpara Neoral Nerlynx Neulasta Neupogen nevirapine (VIRAMUNE)1 Nexavar Nexplanon Ninlaro Nivestym Norditropin Northera Norvir Nourianz Novarel Novoeight NovoSeven RT Nplate Nubeqa Nucala Nulojix Nuplazid Nutropin Nuwiq Nuzyra Obizur Ocaliva Ocrevus Octagam octreotide acetate (SANDOSTATIN)1 Odefsey Odomzo Ofev Ogivri Olumiant Omnitrope Oncaspar Onpattro Ontruzant Opdivo Opsumit Oralair
Orencia Orenitram Orthovisc Otezla Otrexup Ovidrel Oxbryta Ozurdex Padcev Palforzia Palynziq Panzyga Parsabiv Pegasys PegIntron Perjeta Pifeltro Piqray Plegridy Polivy Pomalyst Portrazza Poteligeo Pregnyl Prezcobix Prezista Privigen Probuphine Implant Kit Procrit Profilnine Profilnine SD Prograf Proleukin Prolia Promacta Pulmozyme Purixan Radicava Rapamune Rasuvo Ravicti Rebetol Rebif Rebinyn Reblozyl Reclast Recombinate Remicade Remodulin Renflexis Rescriptor Retacrit Retevmo Retisert Retrovir Retrovir inj Revatio
Revlimid Reyataz RhoGAM Rhophylac RiaSTAP ribasphere1 Ribasphere Ribapak ribavirin caps (ribasphere, REBETOL)1 ribavirin tabs (ribasphere, MODERIBA)1 Rinvoq ritonavir (NORVIR)1 Rituxan Rituxan Hycela Rixubis Romidepsin Rozlytrek Rubraca Ruconest Ruxience Rydapt Sabril pwd Sabril tabs Saizen Samsca Sandimmune Sandostatin Sandostatin LAR Sarclisa Selzentry Sensipar Serostim sildenafil citrate (REVATIO)1 Siliq Simponi Simponi ARIA sirolimus tab (RAPAMUNE)1 Skyla Skyrizi Sodium Hyaluronate sodium phenylbutyrate (BUPHENYL)1 Sofosbuvir/Velpatasvir Solesta Soliris Somatuline Depot Somavert Sovaldi Spravato Sprycel stavudine (ZERIT)1 Stelara Stimate Stivarga Stribild Supartz
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Supprelin LA Sustiva Sutent Sylvant Symfi Symfi Lo Symtuza Synagis Synvisc Tabrecta tacrolimus (PROGRAF)1 tadalafil (ADCIRCA, alyq)1 Tafinlar Tagrisso Takhzyro Taltz Talzenna Tarceva Targretin Tasigna Tecentriq Tecfidera Temixys Temodar temozolomide (TEMODAR)1 temsirolimus (TORISEL)1 tenofovir disoproxil fumarate (VIREAD)1 Tepadina Tepezza Teriparatide tetrabenazine (XENAZINE)1 Thalomid Thyrogen Tikosyn Tivicay TOBI TOBI Podhaler tobramycin nebulizer (TOBI)1 tolvaptan (SAMSCA)1 Torisel Tracleer Trazimera Treanda Trelstar Tremfya
treprostinil sodium (REMODULIN)1 Tretten Triluron Triumeq Trivisc Trizivir Trogarzo Truvada Truxima Tybost Tykerb Tymlos Tysabri Tyvaso Udenyca Ultomiris Uptravi valrubicin (VALSTAR)1 Valstar Vantas Varizig Vectibix Velcade Veletri Vemlidy Ventavis Verzenio Vidaza Videx Videx EC Viekira Pak vigabatrin pwd (SABRIL PWD)1 vigabatrin tabs (SABRIL TABS)1 Vimizim Viracept Viramune Viramune XR Viread Visco-3 Visudyne Vitrakvi Vivitrol Vizimpro Vonvendi Vosevi
Votrient VPRIV Vumerity Vyndamax Vyndaqel Wakix Wilate WinRho SDF Xalkori Xeljanz Xeloda Xembify Xenazine Xenleta Xeomin Xgeva Xolair Xtandi Xyntha Yervoy Yondelis Yonsa Zaltrap Zarxio Zelboraf Zemaira Zepatier Zeposia Zerit Ziagen zidovudine (RETROVIR)1 Ziextenzo Zirabev Zoladex zoledronic acid (RECLAST)1 Zolinza Zomacton Zorbtive Zortress Zulresso Zydelig Zykadia Zytiga
1 Bold lowercase type indicates generic name and availability; nonbold lowercase type within parentheses indicates trademark
generics. Products in all capital letters within parentheses indicate brand names of generic products. This list is current as of July 2020. Products distributed by CVS Caremark and therapies may change. To learn more about how CVS Specialty can help you or your patients, please visit our website https://www.CVSspecialty.com or call 1-800-237-2767.
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LEGEND
OTC Over the counter boldface Indicates generic availability; boldface may not apply to every strength or dosage form
under the listed generic name delayed-rel Delayed-release (also known as enteric-coated), refer to the reference brand listed for
clarification ext-rel Extended-release (also known as sustained-release), refer to the reference brand listed for
clarification NOTICE
The information contained in this document is proprietary. The information may not be copied in whole or in part without written permission. ©2020 CVS Caremark. All rights reserved.
This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark. CVS Caremark does not operate the websites/organizations listed here, nor is it responsible for the availability or reliability of the websites' content. These listings do not imply or constitute an endorsement, sponsorship or recommendation by CVS Caremark.
When viewing the Prescribing Guide - Standard Control via the Internet, please be advised that the Prescribing Guide - Standard Control is updated periodically and changes may appear prior to their effective date to allow for client notification.
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ANALGESICS
Practice guidelines of pain management are available at: https://www.asahq.org ANALGESICS, OTHER Treatment recommendations for osteoarthritis are available at: https://www.rheumatology.org OTC acetaminophen (generic of TYLENOL) NSAIDs diclofenac sodium delayed-rel diflunisal etodolac ibuprofen OTC ibuprofen (generic of ADVIL) meloxicam nabumetone OTC naproxen sodium (generic of ALEVE) naproxen sodium tabs naproxen tabs oxaprozin sulindac NSAIDs, COMBINATIONS diclofenac sodium delayed-rel/misoprostol NSAIDs, TOPICAL * diclofenac sodium gel 1% diclofenac sodium soln * Listing does not include NDC 69499031866. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size. COX-2 INHIBITORS celecoxib GOUT allopurinol colchicine probenecid OPIOID ANALGESICS Practice Guidelines for Cancer Pain Management (includes WHO analgesic ladder) are available at: https://www.asahq.org https://www.nccn.org Opioid guidelines in the management of chronic non-malignant pain are available at: https://www.asipp.org/ASIPP-Guidelines.html buprenorphine (BELBUCA) buprenorphine transdermal codeine/acetaminophen fentanyl sublingual spray (SUBSYS) fentanyl transdermal fentanyl transmucosal lozenge hydrocodone ext-rel hydrocodone/acetaminophen
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hydromorphone hydromorphone ext-rel methadone morphine morphine ext-rel morphine supp oxycodone caps 5 mg oxycodone concentrate 20 mg/mL oxycodone ext-rel (XTAMPZA ER) oxycodone soln 5 mg/5 mL oxycodone tabs 5 mg, 15 mg, 30 mg oxycodone/acetaminophen 5/325 tapentadol (NUCYNTA) tapentadol ext-rel (NUCYNTA ER) * tramadol tramadol ext-rel * Listing does not include NDC 52817019610. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size. NON-OPIOID ANALGESICS butalbital/acetaminophen/caffeine tabs butalbital/aspirin/caffeine VISCOSUPPLEMENTS sodium hyaluronate (DUROLANE) sodium hyaluronate (GEL-ONE) sodium hyaluronate (GELSYN-3) sodium hyaluronate (SUPARTZ FX) sodium hyaluronate (VISCO-3) ANTI-INFECTIVES
Practice guidelines and statements developed and endorsed by the Infectious Diseases Society of America are available at: https://www.idsociety.org Hepatitis: CDC recommendations on the treatment of hepatitis are available at: https://www.cdc.gov/hepatitis/Resources/ Guidelines for the management of chronic hepatitis by the American Association for the Study of Liver Disease are available at: https://www.aasld.org HIV/AIDS: Guidelines for the treatment of HIV patients by the U.S. Department of Health and Human Services are available at: https://www.aidsinfo.nih.gov Infective Endocarditis: American Heart Association recommendations for the prevention of bacterial endocarditis are available at: https://professional.heart.org Influenza: Recommendations of the Advisory Committee on Immunization Practices are available at: https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html
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International Travel: CDC recommendations for international travel are available at: https://wwwnc.cdc.gov/travel Respiratory Tract Infection/Antibiotic Use/Community Acquired Pneumonia/Other: Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infection in adults are available at: https://www.cdc.gov/pneumonia/management-prevention-guidelines.html Sexually Transmitted Diseases: CDC Sexually Transmitted Diseases Guidelines are available at: https://www.cdc.gov/std/treatment/default.htm ANTIBACTERIALS Cephalosporins First Generation cefadroxil cephalexin (generic of KEFLEX) Second Generation cefprozil cefuroxime axetil Third Generation cefdinir cefixime (generic of SUPRAX) Erythromycins/Macrolides azithromycin (generic of ZITHROMAX) clarithromycin clarithromycin ext-rel erythromycin delayed-rel erythromycin ethylsuccinate erythromycin stearate fidaxomicin (DIFICID) Fluoroquinolones ciprofloxacin (generic of CIPRO) levofloxacin (generic of LEVAQUIN) moxifloxacin (generic of AVELOX) Penicillins amoxicillin amoxicillin/clavulanate (generic of AUGMENTIN) amoxicillin/clavulanate ext-rel ampicillin dicloxacillin penicillin VK Tetracyclines doxycycline hyclate (generic of VIBRAMYCIN) doxycycline hyclate 20 mg minocycline tetracycline ANTIFUNGALS clotrimazole troches fluconazole (generic of DIFLUCAN) griseofulvin ultramicrosize itraconazole nystatin
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terbinafine tabs voriconazole (generic of VFEND) ANTIMALARIALS atovaquone/proguanil (generic of MALARONE) chloroquine mefloquine ANTIRETROVIRAL AGENTS Antiretroviral Combinations abacavir/dolutegravir/lamivudine (TRIUMEQ) abacavir/lamivudine (generic of EPZICOM) atazanavir/cobicistat (EVOTAZ) bictegravir/emtricitabine/tenofovir alafenamide (BIKTARVY) darunavir/cobicistat (PREZCOBIX) darunavir/cobicistat/emtricitabine/tenofovir alafenamide (SYMTUZA) dolutegravir/lamivudine (DOVATO) efavirenz/emtricitabine/tenofovir disoproxil fumarate (ATRIPLA) efavirenz/lamivudine/tenofovir disoproxil fumarate (generic of SYMFI) efavirenz/lamivudine/tenofovir disoproxil fumarate (generic of SYMFI LO) elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (GENVOYA) elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (STRIBILD) emtricitabine/rilpivirine/tenofovir alafenamide (ODEFSEY) emtricitabine/rilpivirine/tenofovir disoproxil fumarate (COMPLERA) emtricitabine/tenofovir alafenamide (DESCOVY) emtricitabine/tenofovir disoproxil fumarate (TRUVADA) lamivudine/tenofovir disoproxil fumarate (CIMDUO) lamivudine/tenofovir disoproxil fumarate (TEMIXYS) lamivudine/zidovudine (generic of COMBIVIR) Fusion Inhibitors enfuvirtide (FUZEON) Integrase Inhibitors dolutegravir (TIVICAY) raltegravir (ISENTRESS) Non-nucleoside Reverse Transcriptase Inhibitors efavirenz etravirine (INTELENCE) nevirapine nevirapine ext-rel rilpivirine (EDURANT) Nucleoside Reverse Transcriptase Inhibitors abacavir tabs (generic of ZIAGEN) didanosine delayed-rel emtricitabine (generic of EMTRIVA) lamivudine (generic of EPIVIR) stavudine zidovudine (generic of RETROVIR) Nucleotide Reverse Transcriptase Inhibitors tenofovir disoproxil fumarate (generic of VIREAD) Protease Inhibitors atazanavir darunavir (PREZISTA)
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lopinavir/ritonavir soln (generic of KALETRA) lopinavir/ritonavir tabs (KALETRA) ritonavir (generic of NORVIR) ANTITUBERCULAR AGENTS ethambutol (generic of MYAMBUTOL) isoniazid pyrazinamide rifampin (generic of RIFADIN) ANTIVIRALS Cytomegalovirus Agents valganciclovir Hepatitis Agents Hepatitis B entecavir soln (BARACLUDE) entecavir tabs lamivudine tenofovir alafenamide (VEMLIDY) Hepatitis C † ledipasvir/sofosbuvir (HARVONI) ribavirin † sofosbuvir/velpatasvir (EPCLUSA) † sofosbuvir/velpatasvir/voxilaprevir (VOSEVI) † HARVONI only for genotypes 1, 4, 5, and 6 EPCLUSA for genotypes 1, 2, 3, 4, 5, 6 VOSEVI for use in patients previously treated with an HCV regimen containing an NS5A inhibitor (for genotypes 1-6) or sofosbuvir without an NS5A inhibitor (for genotypes 1a or 3). Herpes Agents acyclovir caps, tabs (generic of ZOVIRAX) famciclovir valacyclovir Influenza Agents oseltamivir zanamivir (RELENZA) MISCELLANEOUS clindamycin (generic of CLEOCIN) dapsone ivermectin (generic of STROMECTOL) linezolid mebendazole chewable (EMVERM) metronidazole (generic of FLAGYL) nitrofurantoin ext-rel (generic of MACROBID) nitrofurantoin macrocrystals nitrofurantoin susp rifaximin 550 mg (XIFAXAN) sulfamethoxazole/trimethoprim sulfamethoxazole/trimethoprim DS tinidazole trimethoprim vancomycin caps (generic of VANCOCIN)
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ANTINEOPLASTIC AGENTS
Clinical practice guidelines in oncology are available at: https://www.asco.org https://www.nccn.org ALKYLATING AGENTS busulfan (MYLERAN) chlorambucil (LEUKERAN) cyclophosphamide caps melphalan (generic of ALKERAN) temozolomide (generic of TEMODAR) ANTIMETABOLITES capecitabine (generic of XELODA) mercaptopurine methotrexate (TREXALL) thioguanine (TABLOID) HORMONAL ANTINEOPLASTIC AGENTS Antiandrogens abiraterone abiraterone (YONSA) apalutamide (ERLEADA) bicalutamide (generic of CASODEX) darolutamide (NUBEQA) enzalutamide (XTANDI) flutamide Antiestrogens tamoxifen Aromatase Inhibitors anastrozole (generic of ARIMIDEX) exemestane (generic of AROMASIN) letrozole (generic of FEMARA) Luteinizing Hormone-Releasing Hormone (LHRH) Agonists leuprolide acetate leuprolide acetate (ELIGARD) leuprolide acetate (LUPRON DEPOT) Progestins megestrol acetate tabs IMMUNOMODULATORS lenalidomide (REVLIMID) pomalidomide (POMALYST) thalidomide (THALOMID) KINASE INHIBITORS bosutinib (BOSULIF) cabozantinib (CABOMETYX) dasatinib (SPRYCEL) duvelisib (COPIKTRA) erlotinib everolimus (generic of AFINITOR) gefitinib (IRESSA) imatinib mesylate
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lapatinib (TYKERB) midostaurin (RYDAPT) palbociclib (IBRANCE) pazopanib (VOTRIENT) ribociclib (KISQALI) ribociclib + letrozole (KISQALI FEMARA CO-PACK) sunitinib (SUTENT) TOPOISOMERASE INHIBITORS topotecan caps (HYCAMTIN) MISCELLANEOUS bexarotene caps (generic of TARGRETIN) etoposide hydroxyurea (generic of HYDREA) mitotane (LYSODREN) niraparib (ZEJULA) olaparib (LYNPARZA) procarbazine (MATULANE) rucaparib (RUBRACA) sonidegib (ODOMZO) tretinoin caps uridine triacetate (VISTOGARD) vorinostat (ZOLINZA) CARDIOVASCULAR
The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure is available at: https://jamanetwork.com/journals/jama/fullarticle/1791497 Guidelines for the evaluation and management of cardiovascular diseases in adults are available at: https://www.acc.org https://professional.heart.org ACE INHIBITORS Guidelines for the use of ACE inhibitors are available at: https://jamanetwork.com/journals/jama/fullarticle/1791497 https://professional.diabetes.org https://www.acc.org https://professional.heart.org benazepril (generic of LOTENSIN) captopril enalapril (generic of VASOTEC) fosinopril lisinopril (generic of ZESTRIL) perindopril quinapril (generic of ACCUPRIL) ramipril (generic of ALTACE) trandolapril ACE INHIBITOR/CALCIUM CHANNEL BLOCKER COMBINATIONS amlodipine/benazepril (generic of LOTREL) trandolapril/verapamil ext-rel (generic of TARKA) ACE INHIBITOR/DIURETIC COMBINATIONS benazepril/hydrochlorothiazide (generic of LOTENSIN HCT) captopril/hydrochlorothiazide
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enalapril/hydrochlorothiazide (generic of VASERETIC) fosinopril/hydrochlorothiazide lisinopril/hydrochlorothiazide (generic of ZESTORETIC) quinapril/hydrochlorothiazide (generic of ACCURETIC) ADRENOLYTICS, CENTRAL clonidine (generic of CATAPRES) clonidine transdermal (generic of CATAPRES-TTS) guanfacine ALDOSTERONE RECEPTOR ANTAGONISTS eplerenone (generic of INSPRA) spironolactone (generic of ALDACTONE) ALPHA BLOCKERS Guidelines for the use of alpha blockers in various patient populations are available at: https://jamanetwork.com/journals/jama/fullarticle/1791497 doxazosin (generic of CARDURA) terazosin ANGIOTENSIN II RECEPTOR ANTAGONISTS/DIURETIC COMBINATIONS Guidelines for the use of angiotensin II receptor antagonists in various patient populations are available at: https://jamanetwork.com/journals/jama/fullarticle/1791497 https://professional.diabetes.org candesartan candesartan/hydrochlorothiazide irbesartan irbesartan/hydrochlorothiazide losartan (generic of COZAAR) losartan/hydrochlorothiazide (generic of HYZAAR) olmesartan olmesartan/hydrochlorothiazide telmisartan (generic of MICARDIS) telmisartan/hydrochlorothiazide (generic of MICARDIS HCT) valsartan valsartan/hydrochlorothiazide ANGIOTENSIN II RECEPTOR ANTAGONIST/CALCIUM CHANNEL BLOCKER COMBINATIONS amlodipine/olmesartan (generic of AZOR) amlodipine/telmisartan amlodipine/valsartan ANGIOTENSIN II RECEPTOR ANTAGONIST/CALCIUM CHANNEL BLOCKER/DIURETIC COMBINATIONS amlodipine/valsartan/hydrochlorothiazide olmesartan/amlodipine/hydrochlorothiazide (generic of TRIBENZOR) ANTIARRHYTHMICS Guidelines for the use of antiarrhythmics and cardiac glycosides in various patient populations are available at: https://www.acc.org amiodarone disopyramide (generic of NORPACE) disopyramide ext-rel (NORPACE CR) dofetilide (generic of TIKOSYN) dronedarone (MULTAQ) flecainide
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propafenone propafenone ext-rel (generic of RYTHMOL SR) sotalol ANTILIPEMICS The 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol is available at: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625 Bile Acid Resins cholestyramine (generic of QUESTRAN/QUESTRAN LIGHT) colesevelam colestipol (generic of COLESTID) Cholesterol Absorption Inhibitors ezetimibe Fibrates * fenofibrate fenofibrate (ANTARA) fenofibrate (generic of LIPOFEN) fenofibric acid delayed-rel (generic of TRILIPIX) gemfibrozil (generic of LOPID) * Listing does not include fenofibrate tablet 120 mg. HMG-CoA Reductase Inhibitors/Combinations atorvastatin ezetimibe/simvastatin (generic of VYTORIN) fluvastatin lovastatin pravastatin (generic of PRAVACHOL) rosuvastatin simvastatin (generic of ZOCOR) Niacins niacin ext-rel (generic of NIASPAN) Omega-3 Fatty Acids icosapent ethyl (VASCEPA) omega-3 acid ethyl esters (generic of LOVAZA) PCSK9 Inhibitors alirocumab (PRALUENT) BETA-BLOCKERS Guidelines for the use of beta-blockers and beta-blocker combinations in various patient populations are available at: https://jamanetwork.com/journals/jama/fullarticle/1791497 https://www.acc.org atenolol bisoprolol carvedilol (generic of COREG) carvedilol phosphate ext-rel labetalol metoprolol succinate ext-rel metoprolol tartrate (generic of LOPRESSOR) nadolol (generic of CORGARD)
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nebivolol (BYSTOLIC) pindolol propranolol propranolol ext-rel BETA-BLOCKER/DIURETIC COMBINATIONS Guidelines for the use of beta-blockers and diuretic combinations in various patient populations are available at: https://jamanetwork.com/journals/jama/fullarticle/1791497 https://www.acc.org atenolol/chlorthalidone bisoprolol/hydrochlorothiazide (generic of ZIAC) metoprolol/hydrochlorothiazide (generic of LOPRESSOR HCT) CALCIUM CHANNEL BLOCKERS Dihydropyridines amlodipine felodipine ext-rel nifedipine ext-rel nifedipine ext-rel (generic of PROCARDIA XL) Nondihydropyridines * diltiazem ext-rel diltiazem ext-rel (generic of TIAZAC) verapamil ext-rel (generic of CALAN SR) * Listing does not include generics for CARDIZEM LA. CALCIUM CHANNEL BLOCKER/ANTILIPEMIC COMBINATIONS amlodipine/atorvastatin (generic of CADUET) DIGITALIS GLYCOSIDES digoxin 0.0625 mg, 0.1875 mg (LANOXIN) digoxin 0.125 mg, 0.25 mg digoxin ped elixir DIRECT RENIN INHIBITORS/DIURETIC COMBINATIONS aliskiren aliskiren/hydrochlorothiazide (TEKTURNA HCT) DIURETICS Carbonic Anhydrase Inhibitors acetazolamide acetazolamide ext-rel methazolamide Loop Diuretics bumetanide furosemide (generic of LASIX) torsemide Potassium-sparing Diuretics amiloride triamterene Thiazides and Thiazide-like Diuretics chlorthalidone hydrochlorothiazide
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indapamide metolazone Diuretic Combinations amiloride/hydrochlorothiazide spironolactone/hydrochlorothiazide (generic of ALDACTAZIDE) triamterene/hydrochlorothiazide (generic of DYAZIDE) triamterene/hydrochlorothiazide (generic of MAXZIDE) HEART FAILURE isosorbide dinitrate/hydralazine (BIDIL) ivabradine (CORLANOR) sacubitril/valsartan (ENTRESTO) NITRATES Oral isosorbide dinitrate isosorbide mononitrate isosorbide mononitrate ext-rel Sublingual/Translingual nitroglycerin lingual spray (generic of NITROLINGUAL) nitroglycerin sublingual (generic of NITROSTAT) Transdermal nitroglycerin transdermal nitroglycerin transdermal (generic of NITRO-DUR) PULMONARY ARTERIAL HYPERTENSION Endothelin Receptor Antagonists ambrisentan bosentan macitentan (OPSUMIT) Phosphodiesterase Inhibitors sildenafil (generic of REVATIO) tadalafil Prostacyclin Receptor Agonists selexipag (UPTRAVI) Prostaglandin Vasodilators epoprostenol sodium (generic of FLOLAN) treprostinil ext-rel (ORENITRAM) Soluble Guanylate Cyclase Stimulators riociguat (ADEMPAS) MISCELLANEOUS hydralazine methyldopa midodrine ranolazine ext-rel
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CENTRAL NERVOUS SYSTEM
Practice guidelines for psychiatric disorders are available at: https://www.psychiatry.org ANTIANXIETY Benzodiazepines alprazolam clonazepam (generic of KLONOPIN) diazepam (generic of VALIUM) lorazepam (generic of ATIVAN) oxazepam Miscellaneous buspirone clomipramine (generic of ANAFRANIL) fluvoxamine ANTICONVULSANTS Practice guidelines for the treatment of epilepsy are available at: https://www.aan.com carbamazepine (generic of TEGRETOL) carbamazepine ext-rel carbamazepine ext-rel (generic of CARBATROL) clobazam diazepam rectal gel (generic of DIASTAT) divalproex sodium delayed-rel (generic of DEPAKOTE) divalproex sodium ext-rel (generic of DEPAKOTE ER) ethosuximide (generic of ZARONTIN) gabapentin (generic of NEURONTIN) lacosamide (VIMPAT) lamotrigine lamotrigine ext-rel lamotrigine orally disintegrating tabs levetiracetam (generic of KEPPRA) levetiracetam ext-rel (generic of KEPPRA XR) oxcarbazepine (generic of TRILEPTAL) oxcarbazepine ext-rel (OXTELLAR XR) perampanel (FYCOMPA) phenobarbital phenytoin (generic of DILANTIN INFATABS) phenytoin sodium extended (generic of DILANTIN) primidone (generic of MYSOLINE) tiagabine topiramate (generic of TOPAMAX) topiramate ext-rel topiramate ext-rel (TROKENDI XR) valproic acid vigabatrin zonisamide ANTIDEMENTIA Practice guidelines for the management of dementia are available at: https://www.aan.com donepezil (generic of ARICEPT) galantamine (generic of RAZADYNE) galantamine ext-rel (generic of RAZADYNE ER)
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memantine (generic of NAMENDA) memantine ext-rel memantine/donepezil (NAMZARIC) rivastigmine rivastigmine transdermal (generic of EXELON) ANTIDEPRESSANTS Although these agents are primarily indicated for depression, some of these are also approved for other indications, including bipolar disorder, obsessive-compulsive disorder, panic disorder and premenstrual dysphoric disorder. Guidelines for the evaluation and management of bipolar and depressive disorders are available at: https://www.psychiatry.org Monoamine Oxidase Inhibitors (MAOIs) phenelzine (generic of NARDIL) tranylcypromine (generic of PARNATE) Selective Serotonin Reuptake Inhibitors (SSRIs) citalopram (generic of CELEXA) escitalopram * fluoxetine paroxetine HCl (generic of PAXIL) paroxetine HCl ext-rel (generic of PAXIL CR) sertraline (generic of ZOLOFT) vilazodone (VIIBRYD) vortioxetine (TRINTELLIX) * Listing does not include fluoxetine tablet 60 mg, fluoxetine tablet (generics for SARAFEM). Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) desvenlafaxine ext-rel duloxetine delayed-rel venlafaxine venlafaxine ext-rel Tricyclic Antidepressants (TCAs) amitriptyline desipramine (generic of NORPRAMIN) doxepin imipramine HCl nortriptyline (generic of PAMELOR) Miscellaneous Agents bupropion bupropion ext-rel (generic of WELLBUTRIN SR) bupropion ext-rel (generic of WELLBUTRIN XL) mirtazapine (generic of REMERON) trazodone ANTIPARKINSONIAN AGENTS Practice guidelines for the diagnosis and treatment of Parkinson's disease are available at: https://www.aan.com amantadine benztropine bromocriptine (generic of PARLODEL) carbidopa/levodopa (generic of SINEMET) carbidopa/levodopa ext-rel
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carbidopa/levodopa orally disintegrating tabs carbidopa/levodopa/entacapone (generic of STALEVO) entacapone (generic of COMTAN) pramipexole (generic of MIRAPEX) pramipexole ext-rel rasagiline ropinirole ropinirole ext-rel (generic of REQUIP XL) rotigotine transdermal (NEUPRO) selegiline trihexyphenidyl ANTIPSYCHOTICS Atypicals aripiprazole aripiprazole ext-rel inj (ABILIFY MAINTENA) aripiprazole lauroxil ext-rel inj (ARISTADA) aripiprazole lauroxil ext-rel inj (ARISTADA INITIO) cariprazine (VRAYLAR) clozapine (generic of CLOZARIL) lurasidone (LATUDA) olanzapine (generic of ZYPREXA) quetiapine (generic of SEROQUEL) quetiapine ext-rel risperidone (generic of RISPERDAL) risperidone long-acting injection (RISPERDAL CONSTA) ziprasidone Miscellaneous chlorpromazine fluphenazine haloperidol perphenazine thiothixene trifluoperazine ATTENTION DEFICIT HYPERACTIVITY DISORDER Guidelines for the evaluation and management of attention deficit disorder are available at: https://www.aacap.org https://www.aap.org amphetamine/dextroamphetamine mixed salts ^ amphetamine/dextroamphetamine mixed salts ext-rel amphetamine/dextroamphetamine mixed salts ext-rel (MYDAYIS) atomoxetine (generic of STRATTERA) dexmethylphenidate (generic of FOCALIN) dexmethylphenidate ext-rel (generic of FOCALIN XR) dextroamphetamine dextroamphetamine ext-rel (generic of DEXEDRINE SPANSULE) guanfacine ext-rel lisdexamfetamine (VYVANSE) methylphenidate (generic of METHYLIN) methylphenidate (generic of RITALIN) ^ methylphenidate ext-rel ^ Listing does not include certain NDCs. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size.
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FIBROMYALGIA pregabalin HYPNOTICS Practice parameters for the treatment of sleep disorders and clinical guidelines for the evaluation and management of chronic insomnia in adults are available at: https://aasm.org Benzodiazepines temazepam (generic of RESTORIL) Nonbenzodiazepines eszopiclone ramelteon suvorexant (BELSOMRA) zolpidem (generic of AMBIEN) zolpidem ext-rel (generic of AMBIEN CR) zolpidem sublingual Tricyclics doxepin MIGRAINE Guidelines for prevention and management of migraine headaches are available at: https://www.aan.com Acute Migraine Agents Ergotamine Derivatives dihydroergotamine inj (generic of D.H.E. 45) Newer Agents lasmiditan (REYVOW) rimegepant (NURTEC ODT) ubrogepant (UBRELVY) Triptans eletriptan (generic of RELPAX) naratriptan rizatriptan (generic of MAXALT) sumatriptan (generic of IMITREX) sumatriptan inj (generic of IMITREX) sumatriptan inj (ZEMBRACE SYMTOUCH) sumatriptan nasal powder (ONZETRA XSAIL) sumatriptan nasal spray (generic of IMITREX) zolmitriptan (generic of ZOMIG) zolmitriptan nasal spray (ZOMIG) Miscellaneous OTC acetaminophen/aspirin/caffeine (generic of EXCEDRIN MIGRAINE) Preventive Migraine Agents Monoclonal Antibodies erenumab-aooe (AIMOVIG) fremanezumab-vfrm (AJOVY) galcanezumab-gnlm (EMGALITY)
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MOOD STABILIZERS lithium carbonate lithium carbonate ext-rel tabs 300 mg (generic of LITHOBID) lithium carbonate ext-rel tabs 450 mg MOVEMENT DISORDERS deutetrabenazine (AUSTEDO) tetrabenazine valbenazine (INGREZZA) MULTIPLE SCLEROSIS AGENTS Practice guidelines for multiple sclerosis are available at: https://www.aan.com dimethyl fumarate delayed-rel (generic of TECFIDERA) diroximel fumarate delayed-rel (VUMERITY) fingolimod (GILENYA) glatiramer (generic of COPAXONE) interferon beta-1a (REBIF) interferon beta-1b (BETASERON) natalizumab (TYSABRI) siponimod (MAYZENT) teriflunomide (AUBAGIO) MUSCULOSKELETAL THERAPY AGENTS baclofen carisoprodol * chlorzoxazone 500 mg ** cyclobenzaprine dantrolene (generic of DANTRIUM) metaxalone (generic of SKELAXIN) *** methocarbamol (generic of ROBAXIN) tizanidine tabs (generic of ZANAFLEX) * Listing does not include NDC 73007001303. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size. ** Listing does not include cyclobenzaprine tablet 7.5 mg. *** Listing does not include NDCs 69036093090 and 70868090190. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size. MYASTHENIA GRAVIS pyridostigmine pyridostigmine ext-rel NARCOLEPSY armodafinil solriamfetol (SUNOSI) POSTHERPETIC NEURALGIA (PHN) gabapentin ext-rel (GRALISE) PSYCHOTHERAPEUTIC-MISCELLANEOUS Alcohol Deterrents acamprosate calcium disulfiram (generic of ANTABUSE)
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Opioid Antagonists naloxone inj naloxone nasal spray (NARCAN) naltrexone Partial Opioid Agonist/Opioid Antagonist Combinations buprenorphine/naloxone sublingual buprenorphine/naloxone sublingual tabs (ZUBSOLV) Pseudobulbar Affect Agents dextromethorphan/quinidine (NUEDEXTA) Smoking Deterrents Treating Tobacco Use and Dependence: 2008 Update-Clinical Practice Guideline is available at: https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/index.html bupropion ext-rel OTC nicotine polacrilex gum (generic of NICORETTE) OTC nicotine polacrilex lozenge (NICORETTE) OTC nicotine transdermal (generic of NICODERM CQ) varenicline (CHANTIX) Vasomotor Symptom Agents paroxetine mesylate ENDOCRINE AND METABOLIC
ACROMEGALY lanreotide acetate (SOMATULINE DEPOT) pegvisomant (SOMAVERT) ANDROGENS Clinical practice guidelines for the treatment of hypogonadism are available at: https://www.aace.com testosterone cypionate testosterone enanthate * testosterone gel testosterone soln testosterone transdermal (ANDRODERM) * Listing does not include the authorized generics for TESTIM and VOGELXO. ANTIDIABETICS Guidelines of treatment and management of diabetes are available at: https://professional.diabetes.org Alpha-glucosidase Inhibitors acarbose (generic of PRECOSE) Amylin Analogs pramlintide (SYMLINPEN) Biguanides metformin * metformin ext-rel * Listing does not include generics for FORTAMET and GLUMETZA.
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Biguanide/Sulfonylurea Combinations glipizide/metformin Dipeptidyl Peptidase-4 (DPP-4) Inhibitors sitagliptin phosphate (JANUVIA) Dipeptidyl Peptidase-4 (DPP-4) Inhibitor/Biguanide Combinations sitagliptin/metformin (JANUMET) sitagliptin/metformin ext-rel (JANUMET XR) Incretin Mimetic Agents dulaglutide (TRULICITY) liraglutide (VICTOZA) semaglutide (OZEMPIC) semaglutide (RYBELSUS) Incretin Mimetic Agent/Insulin Combinations liraglutide/insulin degludec (XULTOPHY) lixisenatide/insulin glargine (SOLIQUA) Insulins insulin aspart (FIASP) insulin aspart (NOVOLOG) insulin aspart protamine 70%/insulin aspart 30% (NOVOLOG MIX 70/30) insulin degludec (TRESIBA) insulin detemir (LEVEMIR) insulin glargine (BASAGLAR) insulin human (HUMULIN R U-500) OTC insulin human (NOVOLIN R) OTC insulin isophane human (NOVOLIN N) OTC insulin isophane human 70%/regular 30% (NOVOLIN 70/30) Insulin Sensitizers pioglitazone Insulin Sensitizer/Biguanide Combinations pioglitazone/metformin (generic of ACTOPLUS MET) Insulin Sensitizer/Sulfonylurea Combinations pioglitazone/glimepiride (generic of DUETACT) Meglitinides nateglinide repaglinide Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors dapagliflozin (FARXIGA) empagliflozin (JARDIANCE) Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor/Biguanide Combinations dapagliflozin/metformin ext-rel (XIGDUO XR) empagliflozin/metformin (SYNJARDY) empagliflozin/metformin ext-rel (SYNJARDY XR) Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor/Dipeptidyl Peptidase-4 (DPP-4) Inhibitor Combinations empagliflozin/linagliptin (GLYXAMBI)
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Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor/Dipeptidyl Peptidase-4 (DPP-4) Inhibitor/Biguanide Combinations empagliflozin/linagliptin/metformin ext-rel (TRIJARDY XR) Sulfonylureas glimepiride (generic of AMARYL) glipizide (generic of GLUCOTROL) glipizide ext-rel (generic of GLUCOTROL XL) Supplies blood glucose continuous monitoring receivers, sensors, transmitters
(DEXCOM CONTINUOUS GLUCOSE MONITORING SYSTEM) blood glucose monitoring kits, test strips (ACCU-CHEK AVIVA PLUS kits and test strips) blood glucose monitoring kits, test strips (ACCU-CHEK COMPACT PLUS kits and test strips) blood glucose monitoring kits, test strips (ACCU-CHEK GUIDE kits and test strips) blood glucose monitoring kits, test strips (ACCU-CHEK SMARTVIEW kits and test strips) insulin infusion disposable pump (OMNIPOD INSULIN INFUSION PUMP) insulin infusion disposable pump (V-GO INSULIN INFUSION PUMP) OTC insulin syringes, needles (BD ULTRAFINE insulin syringes and needles) OTC lancets ANTIOBESITY Guidelines of treatment and management of obesity are available at: https://www.aace.com https://www.nhlbi.nih.gov/health-topics/managing-overweight-obesity-in-adults liraglutide (SAXENDA) CALCIUM RECEPTOR ANTAGONISTS cinacalcet CALCIUM REGULATORS Guidelines of treatment and management of osteoporosis are available at: https://www.aace.com https://www.nof.org Bisphosphonates alendronate (generic of FOSAMAX) ibandronate (generic of BONIVA) risedronate (generic of ACTONEL) risedronate delayed-rel (generic of ATELVIA) Calcitonins calcitonin-salmon spray Parathyroid Hormones teriparatide (FORTEO) abaloparatide (TYMLOS) Miscellaneous denosumab (PROLIA) CARNITINE DEFICIENCY AGENTS levocarnitine
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CONTRACEPTIVES EE = ethinyl estradiol ME = mestranol Monophasic 20 mcg Estrogen drospirenone/EE 3/20 drospirenone/EE/levomefolate 3/20 and levomefolate levonorgestrel/EE 0.1/20 - Lessina norethindrone acetate/EE 1/20 (generic of LOESTRIN 1/20) norethindrone acetate/EE 1/20 and iron (generic of LOESTRIN FE 1/20) norethindrone acetate/EE 1/20 and iron chewable 30 mcg Estrogen desogestrel/EE 0.15/30 drospirenone/EE 3/30 (generic of YASMIN) drospirenone/EE/levomefolate 3/30 and levomefolate levonorgestrel/EE 0.15/30 - Levora norethindrone acetate/EE 1.5/30 (generic of LOESTRIN 1.5/30) norethindrone acetate/EE 1.5/30 and iron (generic of LOESTRIN FE 1.5/30) norgestrel/EE 0.3/30 - Low-Ogestrel 35 mcg Estrogen ethynodiol diacetate/EE 1/35 - Zovia 1/35 norethindrone/EE 0.5/35 norethindrone/EE 1/35 norgestimate/EE 0.25/35 Biphasic desogestrel/EE (generic of MIRCETTE) norethindrone acetate/EE 1/10 and EE 10 and iron (LO LOESTRIN FE) Triphasic desogestrel/EE levonorgestrel/EE - Trivora norethindrone/EE (generic of ORTHO-NOVUM 7/7/7) norgestimate/EE Extended Cycle levonorgestrel/EE 0.1/20 and EE 10 (generic of LOSEASONIQUE) levonorgestrel/EE 0.15/30 levonorgestrel/EE 0.15/30 and EE 10 (generic of SEASONIQUE) Progestin Only norethindrone norethindrone (generic of ORTHO MICRONOR) Injectable medroxyprogesterone acetate 150 mg/mL (generic of DEPO-PROVERA) Progestin Intrauterine Devices levonorgestrel releasing IUD (KYLEENA) levonorgestrel releasing IUD (MIRENA) levonorgestrel releasing IUD (SKYLA) Transdermal norelgestromin/EE
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Vaginal etonogestrel/EE ring ENDOMETRIOSIS danazol elagolix (ORILISSA) ESTROGENS Guidelines of treatment and management of hormone therapy and menopause are available at: https://www.menopause.org https://www.aace.com/files/menopause.pdf Oral estradiol (generic of ESTRACE) estrogens, conjugated (PREMARIN) Transdermal estradiol estradiol (generic of CLIMARA) estradiol (DIVIGEL) estradiol (EVAMIST) Vaginal estradiol vaginal crm estradiol vaginal ring (ESTRING) estradiol vaginal tabs (generic of VAGIFEM) estrogens, conjugated crm (PREMARIN) ESTROGEN/PROGESTINS Oral estradiol/norethindrone estrogens, conjugated/medroxyprogesterone (PREMPHASE) estrogens, conjugated/medroxyprogesterone (PREMPRO) EE/norethindrone acetate - Jinteli Transdermal estradiol/levonorgestrel (CLIMARA PRO) estradiol/norethindrone acetate (COMBIPATCH) ESTROGEN/SELECTIVE ESTROGEN RECEPTOR MODULATOR COMBINATIONS conjugated estrogens/bazedoxifene (DUAVEE) FERTILITY REGULATORS GNRH/LHRH Antagonists cetrorelix (CETROTIDE) ganirelix acetate Ovulation Stimulants, Gonadotropins choriogonadotropin alfa (OVIDREL) follitropin alfa (GONAL-F) Ovulation Stimulants, Synthetic clomiphene GAUCHER DISEASE eliglustat (CERDELGA) imiglucerase (CEREZYME)
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GLUCOCORTICOIDS dexamethasone fludrocortisone hydrocortisone (generic of CORTEF) methylprednisolone (generic of MEDROL) prednisolone prednisone GLUCOSE ELEVATING AGENTS glucagon nasal powder (BAQSIMI) glucagon subcutaneous soln (GVOKE) glucagon, human recombinant (GLUCAGEN HYPOKIT) glucagon, human recombinant (GLUCAGON EMERGENCY KIT) HEREDITARY TYROSINEMIA TYPE 1 AGENTS nitisinone (generic of ORFADIN) HUMAN GROWTH HORMONES Guidelines for use of growth hormone are available at: https://www.aace.com/publications/guidelines somatropin (GENOTROPIN) somatropin (HUMATROPE) HYPERPARATHYROID TREATMENT, VITAMIN D ANALOGS calcitriol (1,25-D3) (generic of ROCALTROL) doxercalciferol (generic of HECTOROL) paricalcitol (generic of ZEMPLAR) PHENYLKETONURIA TREATMENT AGENTS sapropterin (KUVAN) PHOSPHATE BINDER AGENTS calcium acetate calcium acetate (PHOSLYRA) sevelamer carbonate sucroferric oxyhydroxide (VELPHORO) POLYNEUROPATHY inotersen (TEGSEDI) POTASSIUM-REMOVING AGENTS patiromer sorbitex (VELTASSA) sodium zirconium cyclosilicate (LOKELMA) PROGESTINS Oral medroxyprogesterone acetate (generic of PROVERA) megestrol acetate susp (generic of MEGACE ES) norethindrone acetate (generic of AYGESTIN) progesterone, micronized (generic of PROMETRIUM) Vaginal progesterone gel (CRINONE) progesterone vaginal inserts (ENDOMETRIN)
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SELECTIVE ESTROGEN RECEPTOR MODULATORS ospemifene (OSPHENA) raloxifene (generic of EVISTA) THYROID AGENTS Antithyroid Agents methimazole (generic of TAPAZOLE) propylthiouracil Thyroid Supplements levothyroxine levothyroxine (generic of SYNTHROID) levothyroxine - Levoxyl liothyronine (generic of CYTOMEL) VASOPRESSINS desmopressin spray, tabs (generic of DDAVP) MISCELLANEOUS cabergoline GASTROINTESTINAL
Guidelines for the treatment and management of various gastrointestinal diseases/conditions are available at: https://gi.org https://www.gastro.org ANTIDIARRHEALS diphenoxylate/atropine (generic of LOMOTIL) loperamide OTC loperamide (generic of IMODIUM A-D) ANTIEMETICS doxylamine/pyridoxine delayed-rel dronabinol (generic of MARINOL) granisetron granisetron transdermal (SANCUSO) meclizine metoclopramide (generic of REGLAN) ondansetron (generic of ZOFRAN) prochlorperazine promethazine rolapitant (VARUBI) scopolamine transdermal trimethobenzamide (generic of TIGAN) ANTISPASMODICS dicyclomine (generic of BENTYL) hyoscyamine sulfate (generic of LEVSIN) hyoscyamine sulfate ext-rel (generic of LEVBID) hyoscyamine sulfate ext-rel caps hyoscyamine sulfate orally disintegrating tabs CHOLELITHOLYTICS ursodiol (generic of ACTIGALL) ursodiol (generic of URSO)
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H2 RECEPTOR ANTAGONISTS cimetidine OTC cimetidine (generic of TAGAMET HB 200) famotidine (generic of PEPCID) OTC famotidine (generic of PEPCID AC) INFLAMMATORY BOWEL DISEASE Oral Agents balsalazide budesonide delayed-rel caps budesonide ext-rel mesalamine delayed-rel caps mesalamine delayed-rel tabs mesalamine ext-rel caps mesalamine ext-rel caps (PENTASA) sulfasalazine (generic of AZULFIDINE) sulfasalazine delayed-rel (generic of AZULFIDINE EN-TABS) Rectal Agents hydrocortisone acetate foam (CORTIFOAM) hydrocortisone enema mesalamine supp mesalamine susp (generic of ROWASA) IRRITABLE BOWEL SYNDROME Irritable Bowel Syndrome with Constipation linaclotide (LINZESS) lubiprostone (AMITIZA) Irritable Bowel Syndrome with Diarrhea alosetron eluxadoline (VIBERZI) LAXATIVES lactulose soln peg 3350/electrolytes (generic of GOLYTELY) peg 3350/electrolytes (generic of NULYTELY) OTC polyethylene glycol 3350 (generic of MIRALAX) sodium sulfate/potassium sulfate/magnesium sulfate (SUPREP) OPIOID-INDUCED CONSTIPATION naldemedine (SYMPROIC) naloxegol (MOVANTIK) PANCREATIC ENZYMES pancrelipase (VIOKACE) pancrelipase delayed-rel (CREON) pancrelipase delayed-rel (ZENPEP) PROSTAGLANDINS misoprostol (generic of CYTOTEC) PROTON PUMP INHIBITORS dexlansoprazole delayed-rel (DEXILANT) esomeprazole delayed-rel lansoprazole delayed-rel omeprazole delayed-rel (generic of PRILOSEC)
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OTC omeprazole magnesium delayed-rel (generic of PRILOSEC OTC) pantoprazole delayed-rel SALIVA STIMULANTS cevimeline (generic of EVOXAC) pilocarpine tabs (generic of SALAGEN) STEROIDS, RECTAL hydrocortisone acetate/pramoxine foam (PROCTOFOAM-HC) hydrocortisone crm (generic of ANUSOL-HC) ULCER THERAPY COMBINATIONS bismuth/metronidazole/tetracycline (PYLERA) lansoprazole + amoxicillin + clarithromycin MISCELLANEOUS sucralfate tablet GENITOURINARY
BENIGN PROSTATIC HYPERPLASIA Guidelines for the management of BPH are available at: https://www.auanet.org/guidelines alfuzosin ext-rel dutasteride (generic of AVODART) dutasteride/tamsulosin finasteride (generic of PROSCAR) silodosin tamsulosin (generic of FLOMAX) ERECTILE DYSFUNCTION Guidelines for the management of erectile dysfunction are available at: https://www.auanet.org/guidelines Alprostadil Agents alprostadil supp (MUSE) Phosphodiesterase Inhibitors sildenafil tadalafil URINARY ANTISPASMODICS darifenacin ext-rel fesoterodine ext-rel (TOVIAZ) mirabegron ext-rel (MYRBETRIQ) oxybutynin oxybutynin ext-rel (generic of DITROPAN XL) solifenacin tolterodine (generic of DETROL) tolterodine ext-rel trospium trospium ext-rel VAGINAL ANTI-INFECTIVES clindamycin crm (generic of CLEOCIN) OTC clotrimazole (generic of GYNE-LOTRIMIN) metronidazole OTC miconazole (generic of MONISTAT)
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terconazole OTC tioconazole (generic of VAGISTAT-1) MISCELLANEOUS bethanechol (generic of URECHOLINE) OTC phenazopyridine potassium citrate ext-rel (generic of UROCIT-K) HEMATOLOGIC
Guidelines of treatment and management of hemophilia are available at: https://www.hemophilia.org ANTICOAGULANTS CHEST guidelines are available at: https://www.chestnet.org/Guidelines-and-Resources/CHEST-Guideline-Topic-Areas/Pulmonary-Vascular Injectable dalteparin (FRAGMIN) enoxaparin Oral apixaban (ELIQUIS) rivaroxaban (XARELTO) warfarin Synthetic Heparinoid-like Agents fondaparinux (generic of ARIXTRA) HEMATOPOIETIC GROWTH FACTORS Guidelines for the management of neutropenia are available at: https://www.asco.org Guidelines for the management of anemia associated with chronic kidney disease are available at: https://www.kidney.org/professionals/guidelines#guidelines darbepoetin alfa (ARANESP) epoetin alfa-epbx (RETACRIT) filgrastim-aafi (NIVESTYM) pegfilgrastim (NEULASTA) pegfilgrastim-cbqv (UDENYCA) HEMOPHILIA A AGENTS antihemophilic factor (recombinant) (KOGENATE FS) antihemophilic factor (recombinant) (KOVALTRY) antihemophilic factor (recombinant) (NOVOEIGHT) antihemophilic factor (recombinant) pegylated (ADYNOVATE) antihemophilic factor (recombinant) pegylated-aucl (JIVI) human coagulation factor VIII (rDNA) simoctocog alfa (NUWIQ) HEMOPHILIA B AGENTS coagulation factor IX (recombinant) glycopegylated (REBINYN) IDIOPATHIC THROMBOCYTOPENIC PURPURA AGENTS eltrombopag (PROMACTA) PAROXYSMAL NOCTURNAL HEMOGLOBINURIA (PNH) AGENTS eculizumab (SOLIRIS)
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PLATELET AGGREGATION INHIBITORS OTC aspirin clopidogrel dipyridamole dipyridamole ext-rel/aspirin (generic of AGGRENOX) prasugrel ticagrelor (BRILINTA) PLATELET SYNTHESIS INHIBITORS anagrelide (generic of AGRYLIN) STEM CELL MOBILIZERS plerixafor (MOZOBIL) THROMBOCYTOPENIA AGENTS lusutrombopag (MULPLETA) MISCELLANEOUS cilostazol IMMUNOLOGIC AGENTS
Guidelines for the management of rheumatic diseases are available at: https://www.rheumatology.org ALLERGENIC EXTRACTS grass mixed pollen allergen extract (ORALAIR) ragweed pollen allergen extract (RAGWITEK) timothy grass pollen allergen extract (GRASTEK) AUTOIMMUNE AGENTS ‡ adalimumab (HUMIRA) apremilast (OTEZLA) etanercept (ENBREL) guselkumab (TREMFYA) risankizumab-rzaa (SKYRIZI) secukinumab (COSENTYX) tofacitinib (XELJANZ) tofacitinib ext-rel (XELJANZ XR) upadacitinib (RINVOQ) ustekinumab (STELARA SUBCUTANEOUS) ‡ Coverage may be altered or copay amounts may vary based on the condition being treated (e.g., psoriasis). DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDs) hydroxychloroquine (generic of PLAQUENIL) leflunomide (generic of ARAVA) methotrexate methotrexate auto-injector (RASUVO) HEREDITARY ANGIOEDEMA C1 esterase inhibitor, recombinant (RUCONEST) icatibant (generic of FIRAZYR) lanadelumab-flyo (TAKHZYRO)
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IMMUNOMODULATORS CDC recommendations on the treatment of hepatitis are available at: https://www.cdc.gov/hepatitis/Resources/ Guidelines for the management of hepatitis are available at: https://www.aasld.org Interferons interferon alfa-2b (INTRON A) peginterferon alfa-2a (PEGASYS) peginterferon alfa-2b (SYLATRON) Miscellaneous canakinumab (ILARIS) IMMUNOSUPPRESSANTS Antimetabolites azathioprine (AZASAN) azathioprine (generic of IMURAN) mycophenolate mofetil mycophenolate sodium delayed-rel Calcineurin Inhibitors cyclosporine cyclosporine, modified tacrolimus Rapamycin Derivatives everolimus sirolimus NUTRITIONAL/SUPPLEMENTS
ELECTROLYTES Potassium potassium chloride ext-rel potassium chloride liquid Miscellaneous OTC electrolyte soln, oral (generic of PEDIALYTE) VITAMINS AND MINERALS Folic Acid/Combinations folic acid folic acid/vitamin B6/vitamin B12 Prenatal Vitamins prenatal vitamins/DHA/docusate/folic acid (CITRANATAL 90 DHA) prenatal vitamins/DHA/docusate/folic acid (CITRANATAL DHA) prenatal vitamins/DHA/docusate/folic acid (CITRANATAL HARMONY) prenatal vitamins/docusate/folic acid (CITRANATAL RX) prenatal vitamins/docusate/folic acid + DHA (CITRANATAL ASSURE) prenatal vitamins/folic acid + pyridoxine (CITRANATAL B-CALM) prenatal vitamins Miscellaneous OTC calcium carbonate cyanocobalamin inj ergocalciferol (D2)
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OTC ferrous sulfate (generic of FEOSOL) fluoride drops fluoride tabs multivitamins/fluoride drops, tabs multivitamins/fluoride/iron drops, tabs OTC multivitamins/minerals (generic of CENTRUM) vitamin ADC/fluoride drops vitamin ADC/fluoride/iron drops RESPIRATORY
Guidelines to the management, prevention, or treatment of COPD and asthma are available at: https://www.aaaai.org https://ginasthma.org https://goldcopd.org https://www.nhlbi.nih.gov The Allergy Report and guidelines for allergy-related conditions are available at: https://www.aaaai.org ANAPHYLAXIS TREATMENT AGENTS epinephrine (SYMJEPI) epinephrine auto-injector epinephrine auto-injector (generic of EPIPEN) epinephrine auto-injector (generic of EPIPEN JR.) ANTICHOLINERGICS ipratropium soln revefenacin inhalation soln (YUPELRI) tiotropium (SPIRIVA) umeclidinium bromide (INCRUSE ELLIPTA) ANTICHOLINERGIC/BETA AGONIST COMBINATIONS Short Acting ipratropium/albuterol soln Long Acting glycopyrrolate/formoterol (BEVESPI AEROSPHERE) tiotropium/olodaterol (STIOLTO RESPIMAT) umeclidinium/vilanterol (ANORO ELLIPTA) ANTICHOLINERGIC/BETA AGONIST/STEROID INHALANT COMBINATIONS fluticasone/umeclidinium/vilanterol (TRELEGY ELLIPTA) ANTIHISTAMINES, LOW SEDATING OTC cetirizine (generic of ZYRTEC) levocetirizine ANTIHISTAMINES, NONSEDATING OTC fexofenadine (generic of ALLEGRA) OTC loratadine (generic of CLARITIN) ANTIHISTAMINES, SEDATING OTC chlorpheniramine 4 mg (generic of CHLOR-TRIMETON ALLERGY) OTC clemastine 1.34 mg clemastine 2.68 mg cyproheptadine OTC diphenhydramine (generic of BENADRYL) hydroxyzine HCl
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ANTIHISTAMINE/DECONGESTANT COMBINATIONS OTC cetirizine/pseudoephedrine ext-rel (generic of ZYRTEC-D 12 Hour) OTC dexbrompheniramine/pseudoephedrine ext-rel 6 mg/120 mg (generic of DRIXORAL) OTC loratadine/pseudoephedrine ext-rel (generic of CLARITIN-D) ANTITUSSIVES Clinical practice guidelines are available at: https://journal.chestnet.org/article/S0012-3692(15)52856-0/pdf * benzonatate (generic of TESSALON) * Listing does not include NDCs 69336012615 and 69499032915. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size. ANTITUSSIVE COMBINATIONS Opioid codeine/guaifenesin liquid codeine/guaifenesin/pseudoephedrine codeine/promethazine codeine/promethazine/phenylephrine hydrocodone/homatropine Non-opioid dextromethorphan/brompheniramine/pseudoephedrine OTC dextromethorphan/guaifenesin (generic of ROBITUSSIN-DM) dextromethorphan/promethazine BETA AGONISTS Inhalants Short Acting albuterol soln albuterol sulfate, CFC-free aerosol levalbuterol tartrate, CFC-free aerosol Long Acting Hand-held Active Inhalation olodaterol, CFC-free aerosol (STRIVERDI RESPIMAT) salmeterol xinafoate (SEREVENT) Nebulized Passive Inhalation formoterol inhalation soln (PERFOROMIST) Oral Agents albuterol albuterol ext-rel terbutaline CYSTIC FIBROSIS dornase alfa (PULMOZYME) tobramycin inhalation soln tobramycin inhalation soln (BETHKIS) LEUKOTRIENE MODULATORS montelukast zafirlukast zileuton ext-rel
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MAST CELL STABILIZERS cromolyn soln NASAL ANTIHISTAMINES azelastine spray olopatadine spray (generic of PATANASE) NASAL STEROIDS/COMBINATIONS azelastine/fluticasone spray (generic of DYMISTA) flunisolide spray fluticasone spray mometasone spray PHOSPHODIESTERASE-4 INHIBITORS roflumilast (DALIRESP) PULMONARY ENZYME DEFICIENCY AGENTS alpha-1 proteinase inhibitor (PROLASTIN-C) PULMONARY FIBROSIS AGENTS nintedanib (OFEV) pirfenidone (ESBRIET) SEVERE ASTHMA AGENTS benralizumab (FASENRA) dupilumab (DUPIXENT) mepolizumab (NUCALA) omalizumab (XOLAIR) STEROID/BETA AGONIST COMBINATIONS budesonide/formoterol (generic of SYMBICORT) fluticasone/salmeterol (ADVAIR DISKUS) fluticasone/salmeterol, CFC-free aerosol (ADVAIR HFA) fluticasone/vilanterol (BREO ELLIPTA) STEROID INHALANTS beclomethasone breath-activated aerosol (QVAR REDIHALER) budesonide (PULMICORT FLEXHALER) budesonide inhalation susp (generic of PULMICORT RESPULES) fluticasone (ARNUITY ELLIPTA) fluticasone (FLOVENT DISKUS) fluticasone, CFC-free aerosol (FLOVENT HFA) XANTHINES theophylline ext-rel tabs MISCELLANEOUS ipratropium spray TOPICAL
DERMATOLOGY Acne Guidelines for the care and treatment of acne vulgaris are available at: https://www.aad.org/practicecenter/quality/clinical-guidelines Oral isotretinoin
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Topical adapalene adapalene/benzoyl peroxide (generic of EPIDUO) adapalene/benzoyl peroxide (EPIDUO FORTE) OTC benzoyl peroxide benzoyl peroxide (generic of BENZAC AC) * clindamycin gel clindamycin gel, lotion, soln (generic of CLEOCIN T) clindamycin/benzoyl peroxide clindamycin/benzoyl peroxide (ONEXTON) erythromycin gel 2% erythromycin soln erythromycin/benzoyl peroxide (generic of BENZAMYCIN) sulfacetamide lotion 10% (generic of KLARON) tazarotene (generic of TAZORAC) tretinoin tretinoin (generic of RETIN-A) tretinoin - Avita tretinoin gel microsphere * Listing does not include NDC 68682046275. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size. Actinic Keratosis fluorouracil crm 4% (TOLAK) fluorouracil crm 5%, soln 5%, soln 2% imiquimod (generic of ZYCLARA) ingenol mebutate (PICATO) Antibiotics OTC bacitracin gentamicin mupirocin oint OTC neomycin/polymyxin B/bacitracin (generic of NEOSPORIN) OTC polymyxin B/bacitracin (generic of POLYSPORIN) silver sulfadiazine (generic of SILVADENE) Antifungals ciclopirox (generic of LOPROX) clotrimazole OTC clotrimazole (generic of LOTRIMIN AF) econazole ketoconazole crm 2% luliconazole OTC miconazole (generic of MICATIN) naftifine (generic of NAFTIN) nystatin OTC terbinafine (LAMISIL AT) OTC tolnaftate (generic of TINACTIN) Antipsoriatics Guidelines of care for the management and treatment of psoriasis with topical therapies are available at: https://www.aad.org Oral acitretin (generic of SORIATANE) methoxsalen oral (generic of OXSORALEN-ULTRA)
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Topical calcipotriene oint, soln 0.005% Antiseborrheics ketoconazole shampoo 2% (generic of NIZORAL) selenium sulfide lotion 2.5% Atopic Dermatitis Guidelines for the treatment of atopic dermatitis are available at: https://www.aad.org/practicecenter/quality/clinical-guidelines Injectable dupilumab (DUPIXENT) Topical crisaborole (EUCRISA) pimecrolimus tacrolimus Corticosteroids Low Potency alclometasone crm, oint 0.05% desonide crm, lotion, oint 0.05% (generic of DESOWEN) fluocinolone acetonide soln 0.01% hydrocortisone crm 2.5% OTC hydrocortisone crm, oint 0.5%, 1% (generic of CORTIZONE) hydrocortisone lotion 1% Medium Potency betamethasone valerate crm, lotion, oint 0.1% desoximetasone crm, oint 0.05% fluocinolone acetonide crm, oint 0.025% fluticasone propionate crm, lotion 0.05%, oint 0.005% hydrocortisone butyrate crm, lotion, oint, soln 0.1% hydrocortisone valerate crm, oint 0.2% mometasone crm, lotion, oint 0.1% triamcinolone acetonide crm, lotion 0.025% triamcinolone acetonide crm, lotion, oint 0.1% High Potency betamethasone dipropionate augmented crm 0.05% (generic of DIPROLENE AF) betamethasone dipropionate augmented lotion 0.05% (generic of DIPROLENE) betamethasone dipropionate crm, lotion, oint 0.05% desoximetasone crm, oint 0.25%, gel 0.05% fluocinonide crm, gel, oint, soln 0.05% halobetasol propionate lotion 0.01% (BRYHALI) triamcinolone acetonide crm 0.5% Very High Potency betamethasone dipropionate augmented gel, oint 0.05% (generic of DIPROLENE) clobetasol propionate crm, gel, oint, soln 0.05% (generic of TEMOVATE) clobetasol propionate foam 0.05% clobetasol propionate lotion, shampoo 0.05% (generic of CLOBEX) halobetasol propionate crm, oint 0.05% (generic of ULTRAVATE) Emollients ammonium lactate 12%
44
Local Analgesics lidocaine patch (generic of LIDODERM) Local Anesthetics OTC lidocaine (generic of LMX-4) lidocaine/prilocaine Rosacea azelaic acid foam (FINACEA FOAM) azelaic acid gel doxycycline monohydrate delayed-rel caps ivermectin (SOOLANTRA) metronidazole crm 0.75% (generic of METROCREAM) metronidazole gel 0.75% metronidazole gel 1% (generic of METROGEL) metronidazole lotion 0.75% (generic of METROLOTION) Scabicides and Pediculicides malathion (generic of OVIDE) permethrin 5% OTC permethrin creme rinse 1% (generic of NIX) OTC pyrethrins/piperonyl butoxide shampoo 4% (generic of A-200) OTC pyrethrins/piperonyl butoxide shampoo 4% (generic of RID) Miscellaneous Skin and Mucous Membrane imiquimod podofilox (generic of CONDYLOX) OTC salicylic acid 17%/collodion (generic of DUOFILM) MOUTH/THROAT/DENTAL AGENTS Anesthetics - Topical Oral lidocaine viscous Protectants - Mouth/Throat benzyl alcohol/carbomer 941/glycerin (MUGARD) soy phospholipid/glycerol dioleate (EPISIL) Steroids - Mouth/Throat triamcinolone paste OPHTHALMIC Preferred Practice Pattern Guidelines for the treatment of various ophthalmic conditions are available at: https://one.aao.org Antiallergics alcaftadine (LASTACAFT) azelastine cromolyn sodium OTC ketotifen (generic of ZADITOR) olopatadine OTC olopatadine (generic of PATADAY) olopatadine (PAZEO) Anti-infectives bacitracin besifloxacin (BESIVANCE) ciprofloxacin oint (CILOXAN) ciprofloxacin soln (generic of CILOXAN)
45
erythromycin gentamicin levofloxacin moxifloxacin moxifloxacin (generic of VIGAMOX) neomycin/polymyxin B/gramicidin ofloxacin (generic of OCUFLOX) polymyxin B/bacitracin polymyxin B/trimethoprim (generic of POLYTRIM) sulfacetamide oint 10% sulfacetamide soln 10% (generic of BLEPH-10) tobramycin (generic of TOBREX) Anti-infective/Anti-inflammatory Combinations neomycin/polymyxin B/bacitracin/hydrocortisone oint neomycin/polymyxin B/dexamethasone (generic of MAXITROL) neomycin/polymyxin B/hydrocortisone susp sulfacetamide/prednisolone phosphate 10%/0.25% tobramycin/dexamethasone oint 0.3%/0.1% (TOBRADEX) tobramycin/dexamethasone susp 0.3%/0.05% (TOBRADEX ST) tobramycin/dexamethasone susp 0.3%/0.1% (generic of TOBRADEX) Anti-inflammatories Nonsteroidal bromfenac sodium diclofenac sodium ketorolac (generic of ACULAR) ketorolac tromethamine (ACUVAIL) nepafenac (ILEVRO) nepafenac (NEVANAC) Steroidal dexamethasone (MAXIDEX) dexamethasone sodium phosphate difluprednate (DUREZOL) fluorometholone fluorometholone (FML FORTE) fluorometholone (FML S.O.P.) loteprednol prednisolone acetate (PRED MILD) prednisolone acetate 1% prednisolone phosphate 1% Antivirals trifluridine Beta-blockers Nonselective levobunolol timolol hemihydrate (BETIMOL) timolol maleate (generic of TIMOPTIC) timolol maleate gel Selective betaxolol (BETOPTIC S)
46
Carbonic Anhydrase Inhibitors Topical brinzolamide (AZOPT) dorzolamide (generic of TRUSOPT) Carbonic Anhydrase Inhibitor/Beta-blocker Combinations dorzolamide/timolol maleate (generic of COSOPT) Carbonic Anhydrase Inhibitor/Sympathomimetic Combinations brinzolamide/brimonidine (SIMBRINZA) Dry Eye Disease cyclosporine, emulsion (RESTASIS) lifitegrast (XIIDRA) Prostaglandins bimatoprost 0.01% (LUMIGAN) latanoprost (generic of XALATAN) travoprost Retinal Disorders aflibercept (EYLEA) ranibizumab (LUCENTIS) Rho Kinase Inhibitors netarsudil (RHOPRESSA) Rho Kinase Inhibitor/Prostaglandin Combinations netarsudil/latanoprost (ROCKLATAN) Sympathomimetics brimonidine (generic of ALPHAGAN P) brimonidine 0.2% Sympathomimetic/Beta-blocker Combinations brimonidine/timolol (COMBIGAN) OTIC Clinical practice guidelines for the treatment of otitis media are available at: https://www.aap.org Anti-infectives acetic acid ofloxacin otic Anti-infective/Anti-inflammatory Combinations ciprofloxacin/dexamethasone (generic of CIPRODEX) neomycin/polymyxin B/hydrocortisone Miscellaneous OTC carbamide peroxide 6.5% (generic of DEBROX)
47
SPECIALTY DRUGS
CVS Specialty is a leading provider of specialty pharmaceuticals to individuals with chronic or genetic conditions throughout the United States. CVS Specialty is dedicated to helping individuals by providing services for the following: ACROMEGALY Bynfezia Pen octreotide acetate (SANDOSTATIN)1 Sandostatin Sandostatin LAR Somatuline Depot Somavert ALCOHOL/OPIOID DEPENDENCY Probuphine Implant Kit Vivitrol ALLERGEN IMMUNOTHERAPY Oralair Palforzia ALPHA-1 ANTITRYPSIN DEFICIENCY Aralast NP Glassia Zemaira AMYLOIDOSIS Onpattro Vyndamax Vyndaqel ANEMIA Aranesp Epogen Procrit Reblozyl Retacrit ASTHMA Cinqair Dupixent Fasenra Nucala Xolair ATOPIC DERMATITIS Dupixent BOTULINUM TOXINS Botox Dysport Myobloc Xeomin
CARDIAC DISORDERS dofetilide (TIKOSYN)1 Tikosyn COAGULATION DISORDERS Ceprotin CONTRACEPTIVES Kyleena Liletta Mirena Nexplanon Skyla CRYOPYRIN-ASSOCIATED PERIODIC SYNDROMES Arcalyst Ilaris CYSTIC FIBROSIS Bethkis Cayston Kitabis Pak Pulmozyme TOBI TOBI Podhaler tobramycin nebulizer (TOBI)1 ELECTROLYTE DISORDERS Samsca tolvaptan (SAMSCA)1 GASTROINTESTINAL DISORDERS-OTHER Gattex Ocaliva Solesta GOUT Krystexxa GROWTH HORMONE & RELATED DISORDERS Growth Hormone Disorders Genotropin Humatrope Macrilen Norditropin Nutropin AQ Omnitrope Saizen
Serostim Zomacton Zorbtive GROWTH HORMONE & RELATED DISORDERS IGF-1 Deficiency Increlex HEMATOPOIETICS Mozobil HEMOPHILIA, VON WILLEBRAND DISEASE & RELATED BLEEDING DISORDERS Advate Adynovate Afstyla Alphanate AlphaNine SD Alprolix Bebulin BeneFIX Coagadex Corifact Eloctate Esperoct Feiba Fibryga Helixate FS Hemlibra Hemofil M Humate-P Idelvion Ixinity Jivi Koate Koate-DVI Kogenate FS Kovaltry Mononine Novoeight NovoSeven RT Nuwiq Obizur Profilnine Profilnine SD Rebinyn Recombinate RiaSTAP Rixubis
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Stimate Tretten Vonvendi Wilate Xyntha HEPATITIS adefovir dipivoxil (HEPSERA)1 Baraclude entecavir (BARACLUDE)1 Epclusa Epivir Epivir HBV Harvoni Hepsera Intron A lamivudine (EPIVIR, EPIVIR HBV)1 Ledipasvir/Sofosbuvir Mavyret Moderiba Pegasys PegIntron Rebetol ribasphere1 Ribasphere Ribapak ribavirin caps (ribasphere, REBETOL)1 ribavirin tabs (ribasphere, MODERIBA)1 Sofosbuvir/Velpatasvir Sovaldi tenofovir disoproxil fumarate (VIREAD)1 Vemlidy Viekira Pak Viread Vosevi Zepatier HEREDITARY ANGIOEDEMA Berinert Cinryze Firazyr Haegarda icatibant acetate (FIRAZYR)1 Kalbitor Ruconest Takhzyro HIV MEDICATIONS abacavir tab (ZIAGEN)1 abacavir/lamivudine (EPZICOM)1 abacavir/lamivudine/ zidovudine tab (TRIZIVIR)1 Aptivus atazanavir sulfate (REYATAZ)1 Atripla
Biktarvy Cimduo Combivir Complera Crixivan Delstrigo Descovy didanosine (VIDEX, VIDEX EC)1 Dovato Edurant efavirenz (SUSTIVA)1 Egrifta Emtriva Epivir Epzicom Evotaz fosamprenavir (LEXIVA)1 Fuzeon Genvoya Intelence Invirase Isentress Juluca Kaletra lamivudine (EPIVIR)1 lamivudine/zidovudine (COMBIVIR)1 Lexiva lopinavir/ritonavir soln (KALETRA)1 nevirapine (VIRAMUNE, VIRAMUNE XR)1 Norvir Odefsey Pifeltro Prezcobix Prezista Rescriptor Retrovir Retrovir Injectable Reyataz ritonavir (NORVIR)1 Selzentry stavudine (ZERIT)1 Stribild Sustiva Symfi Symfi Lo Symtuza Temixys tenofovir disoproxil fumarate (VIREAD)1 Tivicay Triumeq Trizivir Trogarzo
Truvada Tybost Videx Videx EC Viracept Viramune Viramune XR Viread Zerit Ziagen zidovudine (RETROVIR)1 HORMONAL THERAPIES Aveed Eligard Firmagon leuprolide acetate (LUPRON)1 Lupaneta Pack Lupron Lupron Depot Natpara Supprelin LA Trelstar Vantas Zoladex IMMUNE DEFICIENCIES & RELATED DISORDERS Asceniv Bivigam Cuvitru Cytogam GamaSTAN GamaSTAN S/D Gammagard Liquid Gammagard S/D Gammaked Gammaplex Gamunex C HepaGam B Hizentra HyperHEP B HyperRHO S/D HyQvia MICRhoGAM Nabi-HB Octagam Panzyga Privigen RhoGAM Rhophylac Varizig WinRho SDF Xembify
49
INFECTIOUS DISEASE - OTHER Actimmune Alferon N Nuzyra Xenleta INFERTILITY Cetrotide Chorionic Gonadotropin Follistim AQ Ganirelix acetate Gonal-F Menopur Novarel Ovidrel Pregnyl INFLAMMATORY BOWEL DISEASE Avsola Cimzia Entyvio Humira Inflectra Remicade Renflexis Simponi Stelara Tysabri Xeljanz IRON OVERLOAD deferasirox (EXJADE, JADENU)1 deferoxamine (DESFERAL)1 Desferal Exjade Jadenu LYSOSOMAL STORAGE DISORDERS Aldurazyme Cerdelga Cerezyme Cystagon Elaprase Elelyso Fabrazyme Kanuma Lumizyme miglustat1 Naglazyme Vimizim VPRIV MENTAL HEALTH CONDITIONS Spravato Zulresso
MIGRAINE Aimovig Ajovy Emgality MOVEMENT DISORDERS Apokyn Austedo Inbrija Kynmobi Northera Nourianz Nuplazid Radicava Soliris tetrabenazine (XENAZINE)1 Xenazine MULTIPLE SCLEROSIS Ampyra Aubagio Avonex Betaseron Copaxone dalfampridine ER (AMPYRA)1 Extavia Gilenya glatiramer acetate (COPAXONE, glatopa)1 Lemtrada Mavenclad Mayzent mitoxantrone hcl1 Ocrevus Plegridy Rebif2 Tecfidera Tysabri Vumerity Zeposia NEUTROPENIA Fulphila Granix Leukine Neulasta Neupogen Nivestym Udenyca Zarxio Ziextenzo OCULAR DISORDERS Beovu Durysta Eylea Iluvien
Lucentis Macugen Ozurdex Retisert Tepezza Visudyne ONCOLOGY - INJECTABLE2 Adcetris Arzerra Asparlas Avastin azacitidine (VIDAZA)1 Bavencio Beleodaq Belrapzo Bendamustine Hydrochloride Bendeka Besponsa Blincyto Bortezomib Cyramza Dacogen Darzalex Darzalex Faspro decitabine (DACOGEN)1 Empliciti Enhertu Erbitux Evomela Folotyn Fusilev Gazyva Halaven Herceptin Herceptin Hylecta Herzuma Imfinzi Intron A Istodax Ixempra Jevtana Kadcyla Kanjinti Keytruda Khapzory Kyprolis Levoleucovorin Lumoxiti mitoxantrone hcl1 Mvasi Mylotarg Ogivri Oncaspar Ontruzant Opdivo Padcev
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Perjeta Polivy Portrazza Poteligeo Proleukin Rituxan Rituxan Hycela Romidepsin Ruxience Sarclisa Sylvant Tecentriq Temodar temsirolimus (TORISEL)1 Tepadina Thyrogen Torisel Trazimera Treanda Truxima valrubicin (VALSTAR)1 Valstar Vectibix Velcade Vidaza Xgeva Yervoy Yondelis Zaltrap Zirabev zoledronic acid1 ONCOLOGY - ORAL/TOPICAL abiraterone acetate (ZYTIGA)1 Afinitor Alecensa Alunbrig bexarotene (TARGRETIN)1 Bosulif Cabometyx capecitabine (XELODA)1 Cometriq Cotellic Daurismo Erivedge Erleada erlotinib hydrochloride (TARCEVA)1 everolimus (AFINITOR)1 Farydak Gleevec Hycamtin Ibrance Idhifa imatinib mesylate (GLEEVEC)1 Inlyta Inrebic
Iressa Jakafi Kisqali Kisqali Femara Lenvima Lonsurf Lorbrena Lynparza Mekinist Mugard Nerlynx Nexavar Ninlaro Nubeqa Odomzo Piqray Pomalyst Purixan Retevmo Revlimid Rozlytrek Rubraca Rydapt Sprycel Stivarga Sutent Tabrecta Tafinlar Tagrisso Talzenna Tarceva Targretin Tasigna Temodar temozolomide (TEMODAR)1 Thalomid Tykerb Verzenio Vitrakvi Vizimpro Votrient Xalkori Xeloda Xtandi Yonsa Zelboraf Zolinza Zydelig Zykadia Zytiga OSTEOARTHRITIS Durolane Euflexxa Gel-One Gelsyn-3 Genvisc 850
Hyalgan Hymovis Monovisc Orthovisc Sodium Hyaluronate Supartz Synvisc Synvisc-One Triluron Trivisc Visco-3 OSTEOPOROSIS Evenity Forteo Prolia Reclast Teriparatide Tymlos zoledronic acid (RECLAST)1 PAROXYSMAL NOCTURNAL HEMOGLOBINURIA Soliris Ultomiris PHENYLKETONURIA Kuvan Palynziq PRE-TERM BIRTH hydroxyprogesterone capro (MAKENA)1 Makena PSORIASIS Avsola Cimzia Cosentyx Enbrel Humira Ilumya Inflectra Otezla Otrexup Rasuvo Remicade Renflexis Siliq Skyrizi Stelara Taltz Tremfya Xeljanz
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PULMONARY ARTERIAL HYPERTENSION Adcirca Adempas ambrisentan (LETAIRIS)1 bosentan (TRACLEER)1 epoprostenol sodium (FLOLAN, VELETRI)1 Flolan Letairis Opsumit Orenitram Remodulin Revatio sildenafil citrate (REVATIO)1 tadalafil (ADCIRCA, alyq)1 Tracleer treprostinil sodium (REMODULIN)1 Tyvaso Uptravi Veletri Ventavis PULMONARY DISORDERS-OTHER Esbriet Ofev RARE DISORDERS - OTHER Crysvita Gamifant RENAL DISEASE cinacalcet hydrochloride (SENSIPAR)1 Parsabiv Sensipar
RESPIRATORY SYNCYTIAL VIRUS Synagis RHEUMATOID ARTHRITIS Actemra Avsola Cimzia Enbrel Humira Inflectra Kevzara Olumiant Orencia Otrexup Rasuvo Remicade Renflexis Rinvoq Rituxan Simponi Simponi ARIA Xeljanz SEIZURE DISORDERS Epidiolex H.P. Acthar Gel Sabril pwd Sabril tabs vigabatrin pwd (SABRIL PWD)1 vigabatrin tabs (SABRIL TABS)1 SICKLE CELL DISEASE Adakveo Oxbryta SLEEP DISORDERS Wakix
SYSTEMIC LUPUS ERYTHEMATOSUS Benlysta THROMBOCYTOPENIA Doptelet Mulpleta Nplate Promacta TRANSPLANT Astagraf XL CellCept CellCept injectable cyclosporine (gengraf, NEORAL, SANDIMMUNE)1 Envarsus XR everolimus (ZORTRESS)1 mycophenolate mofetil (CELLCEPT, CELLCEPT INJECTABLE)1 mycophenolic acid dr (MYFORTIC)1 Myfortic Neoral Nulojix Prograf Prograf injectable Rapamune Sandimmune sirolimus tab (RAPAMUNE)1 tacrolimus (PROGRAF)1 Zortress UREA CYCLE DISORDERS Buphenyl Ravicti sodium phenylbutyrate (BUPHENYL)1
1 Bold lowercase type indicates generic name and availability; nonbold lowercase type within parentheses indicates trademark
generics. Products in all capital letters within parentheses indicate brand names of generic products. 2 Call CVS Caremark for specific medications available through CVS Specialty.
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WEBSITES
Agency for Healthcare Research and Quality https://www.ahrq.gov Alzheimer's Association https://www.alz.org American Academy of Allergy, Asthma and Immunology https://www.aaaai.org American Academy of Child & Adolescent Psychiatry https://www.aacap.org American Academy of Dermatology https://www.aad.org American Academy of Neurology https://www.aan.com American Academy of Ophthalmology https://www.aao.org American Academy of Pediatrics https://www.aap.org American Association for the Study of Liver Disease https://www.aasld.org American Association of Clinical Endocrinologists https://www.aace.com American Association of Diabetes Educators https://www.diabeteseducator.org American Cancer Society https://www.cancer.org American College of Allergy, Asthma and Immunology https://www.acaai.org American College of Cardiology https://www.acc.org American College of Chest Physicians https://www.chestnet.org American College of Gastroenterology https://gi.org American College of Physicians https://www.acponline.org American College of Rheumatology https://www.rheumatology.org
American Congress of Obstetricians and Gynecologists https://www.acog.org American Diabetes Association http://www.diabetes.org American Gastroenterological Association https://www.gastro.org American Headache Society Committee for Headache Education https://americanheadachesociety.org American Heart Association https://professional.heart.org American Lung Association https://www.lung.org American Medical Association https://www.ama-assn.org American Psychiatric Association https://www.psychiatry.org American Society of Anesthesiologists https://www.asahq.org American Society of Clinical Oncology https://www.asco.org American Society of Interventional Pain Physicians https://www.asipp.org American Urological Association https://www.auanet.org Centers for Disease Control and Prevention https://www.cdc.gov Centers for Disease Control and Prevention Guideline topics: AIDS https://www.cdc.gov/hiv/default.html Centers for Disease Control and Prevention Guideline topics: Sexually Transmitted Diseases https://www.cdc.gov/std/treatment/default.htm CVS Caremark https://www.caremark.com The Food and Drug Administration https://www.fda.gov
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Global Initiative for Asthma https://ginasthma.org Infectious Diseases Society of America https://www.idsociety.org Institute for Safe Medication Practices https://www.ismp.org Johns Hopkins AIDS Service https://www.thebody.com/content/art12096.html Juvenile Diabetes Research Foundation International https://www.jdrf.org MedWatch https://www.fda.gov/Safety/MedWatch/default.htm National Agricultural Library https://www.nal.usda.gov National Cancer Institute https://www.cancer.gov/about-cancer National Comprehensive Cancer Network https://www.nccn.org
National Foundation for Infectious Diseases http://www.nfid.org National Guideline Clearinghouse https://www.ahrq.gov National Heart, Lung and Blood Institute https://www.nhlbi.nih.gov National Institutes of Health https://www.nih.gov National Kidney Foundation https://www.kidney.org National Osteoporosis Foundation https://www.nof.org North American Menopause Society https://www.menopause.org United States Department of Health and Human Services https://www.hhs.gov World Health Organization https://www.who.int
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INDEX
A A-200, 44 abacavir tabs, 14 abacavir/dolutegravir/lamivudine, 14 abacavir/lamivudine, 14 abaloparatide, 29 ABILIFY MAINTENA, 24 abiraterone, 16 acamprosate calcium, 26 acarbose, 27 ACCU-CHEK AVIVA PLUS kits and test strips, 29 ACCU-CHEK COMPACT PLUS kits and test strips, 29 ACCU-CHEK GUIDE kits and test strips, 29 ACCU-CHEK SMARTVIEW kits and test strips, 29 ACCUPRIL, 17 ACCURETIC, 18 acetaminophen, 11 acetaminophen/aspirin/caffeine, 25 acetazolamide, 20 acetazolamide ext-rel, 20 acetic acid, 46 acitretin, 42 ACTIGALL, 33 ACTONEL, 29 ACTOPLUS MET, 28 ACULAR, 45 ACUVAIL, 45 acyclovir caps, tabs, 15 adalimumab, 37 adapalene, 42 adapalene/benzoyl peroxide, 42 ADEMPAS, 21 ADVAIR DISKUS, 41 ADVAIR HFA, 41 ADVIL, 11 ADYNOVATE, 36 AFINITOR, 16 aflibercept, 46 AGGRENOX, 37 AGRYLIN, 37 AIMOVIG, 25 AJOVY, 25 albuterol, 40 albuterol ext-rel, 40 albuterol soln, 40 albuterol sulfate, CFC-free aerosol, 40 alcaftadine, 44 alclometasone crm, oint 0.05%, 43 ALDACTAZIDE, 21 ALDACTONE, 18 alendronate, 29 ALEVE, 11 alfuzosin ext-rel, 35 alirocumab, 19 aliskiren, 20 aliskiren/hydrochlorothiazide, 20 ALKERAN, 16 ALLEGRA, 39 allopurinol, 11 alosetron, 34 alpha-1 proteinase inhibitor, 41 ALPHAGAN P, 46
alprazolam, 22 alprostadil supp, 35 ALTACE, 17 amantadine, 23 AMARYL, 29 AMBIEN, 25 AMBIEN CR, 25 ambrisentan, 21 amiloride, 20 amiloride/hydrochlorothiazide, 21 amiodarone, 18 AMITIZA, 34 amitriptyline, 23 amlodipine, 20 amlodipine/atorvastatin, 20 amlodipine/benazepril, 17 amlodipine/olmesartan, 18 amlodipine/telmisartan, 18 amlodipine/valsartan, 18 amlodipine/valsartan/hydrochlorothiazide, 18 ammonium lactate 12%, 43 amoxicillin, 13 amoxicillin/clavulanate, 13 amoxicillin/clavulanate ext-rel, 13 amphetamine/dextroamphetamine mixed salts, 24 amphetamine/dextroamphetamine mixed salts ext-rel, 24 ampicillin, 13 ANAFRANIL, 22 anagrelide, 37 anastrozole, 16 ANDRODERM, 27 ANORO ELLIPTA, 39 ANTABUSE, 26 ANTARA, 19 antihemophilic factor (recombinant), 36 antihemophilic factor (recombinant) pegylated, 36 antihemophilic factor (recombinant) pegylated-aucl, 36 ANUSOL-HC, 35 apalutamide, 16 apixaban, 36 apremilast, 37 ARANESP, 36 ARAVA, 37 ARICEPT, 22 ARIMIDEX, 16 aripiprazole, 24 aripiprazole ext-rel inj, 24 aripiprazole lauroxil ext-rel inj, 24 ARISTADA, 24 ARISTADA INITIO, 24 ARIXTRA, 36 armodafinil, 26 ARNUITY ELLIPTA, 41 AROMASIN, 16 aspirin, 37 atazanavir, 14 atazanavir/cobicistat, 14 ATELVIA, 29 atenolol, 19 atenolol/chlorthalidone, 20 ATIVAN, 22 atomoxetine, 24 atorvastatin, 19
55
atovaquone/proguanil, 14 ATRIPLA, 14 AUBAGIO, 26 AUGMENTIN, 13 AUSTEDO, 26 AVELOX, 13 AVODART, 35 AYGESTIN, 32 AZASAN, 38 azathioprine, 38 azelaic acid foam, 44 azelaic acid gel, 44 azelastine, 44 azelastine spray, 41 azelastine/fluticasone spray, 41 azithromycin, 13 AZOPT, 46 AZOR, 18 AZULFIDINE, 34 AZULFIDINE EN-TABS, 34
B bacitracin, 42, 44 baclofen, 26 balsalazide, 34 BAQSIMI, 32 BARACLUDE, 15 BASAGLAR, 28 BD ULTRAFINE insulin syringes and needles, 29 beclomethasone breath-activated aerosol, 41 BELBUCA, 11 BELSOMRA, 25 BENADRYL, 39 benazepril, 17 benazepril/hydrochlorothiazide, 17 benralizumab, 41 BENTYL, 33 BENZAC AC, 42 BENZAMYCIN, 42 benzonatate, 40 benzoyl peroxide, 42 benztropine, 23 benzyl alcohol/carbomer 941/glycerin, 44 besifloxacin, 44 BESIVANCE, 44 betamethasone dipropionate augmented crm 0.05%, 43 betamethasone dipropionate augmented gel, oint 0.05%, 43 betamethasone dipropionate augmented lotion 0.05%, 43 betamethasone dipropionate crm, lotion, oint 0.05%, 43 betamethasone valerate crm, lotion, oint 0.1%, 43 BETASERON, 26 betaxolol, 45 bethanechol, 36 BETHKIS, 40 BETIMOL, 45 BETOPTIC S, 45 BEVESPI AEROSPHERE, 39 bexarotene caps, 17 bicalutamide, 16 bictegravir/emtricitabine/tenofovir alafenamide, 14 BIDIL, 21 BIKTARVY, 14 bimatoprost 0.01%, 46 bismuth/metronidazole/tetracycline, 35 bisoprolol, 19 bisoprolol/hydrochlorothiazide, 20
BLEPH-10, 45 blood glucose continuous monitoring receivers, sensors,
transmitters, 29 blood glucose monitoring kits, test strips, 29 BONIVA, 29 bosentan, 21 BOSULIF, 16 bosutinib, 16 BREO ELLIPTA, 41 BRILINTA, 37 brimonidine, 46 brimonidine 0.2%, 46 brimonidine/timolol, 46 brinzolamide, 46 brinzolamide/brimonidine, 46 bromfenac sodium, 45 bromocriptine, 23 BRYHALI, 43 budesonide, 41 budesonide delayed-rel caps, 34 budesonide ext-rel, 34 budesonide inhalation susp, 41 budesonide/formoterol, 41 bumetanide, 20 buprenorphine, 11 buprenorphine transdermal, 11 buprenorphine/naloxone sublingual, 27 buprenorphine/naloxone sublingual tabs, 27 bupropion, 23 bupropion ext-rel, 23, 27 buspirone, 22 busulfan, 16 butalbital/acetaminophen/caffeine tabs, 12 butalbital/aspirin/caffeine, 12 BYSTOLIC, 20
C C1 esterase inhibitor, recombinant, 37 cabergoline, 33 CABOMETYX, 16 cabozantinib, 16 CADUET, 20 CALAN SR, 20 calcipotriene oint, soln 0.005%, 43 calcitonin-salmon spray, 29 calcitriol (1,25-D3), 32 calcium acetate, 32 calcium carbonate, 38 canakinumab, 38 candesartan, 18 candesartan/hydrochlorothiazide, 18 capecitabine, 16 captopril, 17 captopril/hydrochlorothiazide, 17 carbamazepine, 22 carbamazepine ext-rel, 22 carbamide peroxide 6.5%, 46 CARBATROL, 22 carbidopa/levodopa, 23 carbidopa/levodopa ext-rel, 23 carbidopa/levodopa orally disintegrating tabs, 24 carbidopa/levodopa/entacapone, 24 CARDURA, 18 cariprazine, 24 carisoprodol, 26 carvedilol, 19
56
carvedilol phosphate ext-rel, 19 CASODEX, 16 CATAPRES, 18 CATAPRES-TTS, 18 cefadroxil, 13 cefdinir, 13 cefixime, 13 cefprozil, 13 cefuroxime axetil, 13 celecoxib, 11 CELEXA, 23 CENTRUM, 39 cephalexin, 13 CERDELGA, 31 CEREZYME, 31 cetirizine, 39 cetirizine/pseudoephedrine ext-rel, 40 cetrorelix, 31 CETROTIDE, 31 cevimeline, 35 CHANTIX, 27 chlorambucil, 16 chloroquine, 14 chlorpheniramine 4 mg, 39 chlorpromazine, 24 chlorthalidone, 20 CHLOR-TRIMETON ALLERGY, 39 chlorzoxazone 500 mg, 26 cholestyramine, 19 choriogonadotropin alfa, 31 ciclopirox, 42 cilostazol, 37 CILOXAN, 44 CIMDUO, 14 cimetidine, 34 cinacalcet, 29 CIPRO, 13 CIPRODEX, 46 ciprofloxacin, 13 ciprofloxacin oint, 44 ciprofloxacin soln, 44 ciprofloxacin/dexamethasone, 46 citalopram, 23 CITRANATAL 90 DHA, 38 CITRANATAL ASSURE, 38 CITRANATAL B-CALM, 38 CITRANATAL DHA, 38 CITRANATAL HARMONY, 38 CITRANATAL RX, 38 clarithromycin, 13 clarithromycin ext-rel, 13 CLARITIN, 39 CLARITIN-D, 40 clemastine 1.34 mg, 39 clemastine 2.68 mg, 39 CLEOCIN, 15, 35 CLEOCIN T, 42 CLIMARA, 31 CLIMARA PRO, 31 clindamycin, 15 clindamycin crm, 35 clindamycin gel, 42 clindamycin gel, lotion, soln, 42 clindamycin/benzoyl peroxide, 42 clobazam, 22 clobetasol propionate crm, gel, oint, soln 0.05%, 43
clobetasol propionate foam 0.05%, 43 clobetasol propionate lotion, shampoo 0.05%, 43 CLOBEX, 43 clomiphene, 31 clomipramine, 22 clonazepam, 22 clonidine, 18 clonidine transdermal, 18 clopidogrel, 37 clotrimazole, 35, 42 clotrimazole troches, 13 clozapine, 24 CLOZARIL, 24 coagulation factor IX (recombinant) glycopegylated, 36 codeine/acetaminophen, 11 codeine/guaifenesin liquid, 40 codeine/guaifenesin/pseudoephedrine, 40 codeine/promethazine, 40 codeine/promethazine/phenylephrine, 40 colchicine, 11 colesevelam, 19 COLESTID, 19 colestipol, 19 COMBIGAN, 46 COMBIPATCH, 31 COMBIVIR, 14 COMPLERA, 14 COMTAN, 24 CONDYLOX, 44 conjugated estrogens/bazedoxifene, 31 COPAXONE, 26 COPIKTRA, 16 COREG, 19 CORGARD, 19 CORLANOR, 21 CORTEF, 32 CORTIFOAM, 34 CORTIZONE, 43 COSENTYX, 37 COSOPT, 46 COZAAR, 18 CREON, 34 CRINONE, 32 crisaborole, 43 cromolyn sodium, 44 cromolyn soln, 41 cyanocobalamin inj, 38 cyclobenzaprine, 26 cyclophosphamide caps, 16 cyclosporine, 38 cyclosporine, emulsion, 46 cyclosporine, modified, 38 cyproheptadine, 39 CYTOMEL, 33 CYTOTEC, 34
D D.H.E. 45, 25 DALIRESP, 41 dalteparin, 36 danazol, 31 DANTRIUM, 26 dantrolene, 26 dapagliflozin, 28 dapagliflozin/metformin ext-rel, 28 dapsone, 15
57
darbepoetin alfa, 36 darifenacin ext-rel, 35 darolutamide, 16 darunavir, 14 darunavir/cobicistat, 14 darunavir/cobicistat/emtricitabine/tenofovir alafenamide, 14 dasatinib, 16 DDAVP, 33 DEBROX, 46 denosumab, 29 DEPAKOTE, 22 DEPAKOTE ER, 22 DEPO-PROVERA, 30 DESCOVY, 14 desipramine, 23 desmopressin spray, tabs, 33 desogestrel/EE, 30 desogestrel/EE 0.15/30, 30 desonide crm, lotion, oint 0.05%, 43 DESOWEN, 43 desoximetasone crm, oint 0.05%, 43 desoximetasone crm, oint 0.25%, gel 0.05%, 43 desvenlafaxine ext-rel, 23 DETROL, 35 deutetrabenazine, 26 dexamethasone, 32, 45 dexamethasone sodium phosphate, 45 dexbrompheniramine/pseudoephedrine ext-rel 6 mg/120 mg, 40 DEXCOM CONTINUOUS GLUCOSE MONITORING SYSTEM, 29 DEXEDRINE SPANSULE, 24 DEXILANT, 34 dexlansoprazole delayed-rel, 34 dexmethylphenidate, 24 dexmethylphenidate ext-rel, 24 dextroamphetamine, 24 dextroamphetamine ext-rel, 24 dextromethorphan/brompheniramine/pseudoephedrine, 40 dextromethorphan/guaifenesin, 40 dextromethorphan/promethazine, 40 dextromethorphan/quinidine, 27 DIASTAT, 22 diazepam, 22 diazepam rectal gel, 22 diclofenac sodium, 45 diclofenac sodium delayed-rel, 11 diclofenac sodium delayed-rel/misoprostol, 11 diclofenac sodium gel 1%, 11 diclofenac sodium soln, 11 dicloxacillin, 13 dicyclomine, 33 didanosine delayed-rel, 14 DIFICID, 13 DIFLUCAN, 13 diflunisal, 11 difluprednate, 45 digoxin 0.0625 mg, 0.1875 mg, 20 digoxin 0.125 mg, 0.25 mg, 20 digoxin ped elixir, 20 dihydroergotamine inj, 25 DILANTIN, 22 DILANTIN INFATABS, 22 diltiazem ext-rel, 20 dimethyl fumarate delayed-rel, 26 diphenhydramine, 39 diphenoxylate/atropine, 33 DIPROLENE, 43
DIPROLENE AF, 43 dipyridamole, 37 dipyridamole ext-rel/aspirin, 37 diroximel fumarate delayed-rel, 26 disopyramide, 18 disopyramide ext-rel, 18 disulfiram, 26 DITROPAN XL, 35 divalproex sodium delayed-rel, 22 divalproex sodium ext-rel, 22 DIVIGEL, 31 dofetilide, 18 dolutegravir, 14 dolutegravir/lamivudine, 14 donepezil, 22 dornase alfa, 40 dorzolamide, 46 dorzolamide/timolol maleate, 46 DOVATO, 14 doxazosin, 18 doxepin, 23, 25 doxercalciferol, 32 doxycycline hyclate, 13 doxycycline hyclate 20 mg, 13 doxycycline monohydrate delayed-rel caps, 44 doxylamine/pyridoxine delayed-rel, 33 DRIXORAL, 40 dronabinol, 33 dronedarone, 18 drospirenone/EE 3/20, 30 drospirenone/EE 3/30, 30 drospirenone/EE/levomefolate 3/20 and levomefolate, 30 drospirenone/EE/levomefolate 3/30 and levomefolate, 30 DUAVEE, 31 DUETACT, 28 dulaglutide, 28 duloxetine delayed-rel, 23 DUOFILM, 44 dupilumab, 41, 43 DUPIXENT, 41, 43 DUREZOL, 45 DUROLANE, 12 dutasteride, 35 dutasteride/tamsulosin, 35 duvelisib, 16 DYAZIDE, 21 DYMISTA, 41
E econazole, 42 eculizumab, 36 EDURANT, 14 EE/norethindrone acetate - Jinteli, 31 efavirenz, 14 efavirenz/emtricitabine/tenofovir disoproxil fumarate, 14 efavirenz/lamivudine/tenofovir disoproxil fumarate, 14 elagolix, 31 electrolyte soln, oral, 38 eletriptan, 25 ELIGARD, 16 eliglustat, 31 ELIQUIS, 36 eltrombopag, 36 eluxadoline, 34 elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, 14 elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate, 14
58
EMGALITY, 25 empagliflozin, 28 empagliflozin/linagliptin, 28 empagliflozin/linagliptin/metformin ext-rel, 29 empagliflozin/metformin, 28 empagliflozin/metformin ext-rel, 28 emtricitabine, 14 emtricitabine/rilpivirine/tenofovir alafenamide, 14 emtricitabine/rilpivirine/tenofovir disoproxil fumarate, 14 emtricitabine/tenofovir alafenamide, 14 emtricitabine/tenofovir disoproxil fumarate, 14 EMTRIVA, 14 EMVERM, 15 enalapril, 17 enalapril/hydrochlorothiazide, 18 ENBREL, 37 ENDOMETRIN, 32 enfuvirtide, 14 enoxaparin, 36 entacapone, 24 entecavir soln, 15 entecavir tabs, 15 ENTRESTO, 21 enzalutamide, 16 EPCLUSA, 15 EPIDUO, 42 EPIDUO FORTE, 42 epinephrine, 39 epinephrine auto-injector, 39 EPIPEN, 39 EPIPEN JR., 39 EPISIL, 44 EPIVIR, 14 eplerenone, 18 epoetin alfa-epbx, 36 epoprostenol sodium, 21 EPZICOM, 14 erenumab-aooe, 25 ergocalciferol (D2), 38 ERLEADA, 16 erlotinib, 16 erythromycin, 45 erythromycin delayed-rel, 13 erythromycin ethylsuccinate, 13 erythromycin gel 2%, 42 erythromycin soln, 42 erythromycin stearate, 13 erythromycin/benzoyl peroxide, 42 ESBRIET, 41 escitalopram, 23 esomeprazole delayed-rel, 34 ESTRACE, 31 estradiol, 31 estradiol vaginal crm, 31 estradiol vaginal ring, 31 estradiol vaginal tabs, 31 estradiol/levonorgestrel, 31 estradiol/norethindrone, 31 estradiol/norethindrone acetate, 31 ESTRING, 31 estrogens, conjugated, 31 estrogens, conjugated crm, 31 estrogens, conjugated/medroxyprogesterone, 31 eszopiclone, 25 etanercept, 37 ethambutol, 15
ethosuximide, 22 ethynodiol diacetate/EE 1/35 - Zovia 1/35, 30 etodolac, 11 etonogestrel/EE ring, 31 etoposide, 17 etravirine, 14 EUCRISA, 43 EVAMIST, 31 everolimus, 16, 38 EVISTA, 33 EVOTAZ, 14 EVOXAC, 35 EXCEDRIN MIGRAINE, 25 EXELON, 23 exemestane, 16 EYLEA, 46 ezetimibe, 19 ezetimibe/simvastatin, 19
F famciclovir, 15 famotidine, 34 FARXIGA, 28 FASENRA, 41 felodipine ext-rel, 20 FEMARA, 16 fenofibrate, 19 fenofibric acid delayed-rel, 19 fentanyl sublingual spray, 11 fentanyl transdermal, 11 fentanyl transmucosal lozenge, 11 FEOSOL, 39 ferrous sulfate, 39 fesoterodine ext-rel, 35 fexofenadine, 39 FIASP, 28 fidaxomicin, 13 filgrastim-aafi, 36 FINACEA FOAM, 44 finasteride, 35 fingolimod, 26 FIRAZYR, 37 FLAGYL, 15 flecainide, 18 FLOLAN, 21 FLOMAX, 35 FLOVENT DISKUS, 41 FLOVENT HFA, 41 fluconazole, 13 fludrocortisone, 32 flunisolide spray, 41 fluocinolone acetonide crm, oint 0.025%, 43 fluocinolone acetonide soln 0.01%, 43 fluocinonide crm, gel, oint, soln 0.05%, 43 fluoride drops, 39 fluoride tabs, 39 fluorometholone, 45 fluorouracil crm 4%, 42 fluorouracil crm 5%, soln 5%, soln 2%, 42 fluoxetine, 23 fluphenazine, 24 flutamide, 16 fluticasone, 41 fluticasone propionate crm, lotion 0.05%, oint 0.005%, 43 fluticasone spray, 41 fluticasone, CFC-free aerosol, 41
59
fluticasone/salmeterol, 41 fluticasone/salmeterol, CFC-free aerosol, 41 fluticasone/umeclidinium/vilanterol, 39 fluticasone/vilanterol, 41 fluvastatin, 19 fluvoxamine, 22 FML FORTE, 45 FML S.O.P., 45 FOCALIN, 24 FOCALIN XR, 24 folic acid, 38 folic acid/vitamin B6/vitamin B12, 38 follitropin alfa, 31 fondaparinux, 36 formoterol inhalation soln, 40 FORTEO, 29 FOSAMAX, 29 fosinopril, 17 fosinopril/hydrochlorothiazide, 18 FRAGMIN, 36 fremanezumab-vfrm, 25 furosemide, 20 FUZEON, 14 FYCOMPA, 22
G gabapentin, 22 gabapentin ext-rel, 26 galantamine, 22 galantamine ext-rel, 22 galcanezumab-gnlm, 25 ganirelix acetate, 31 gefitinib, 16 GEL-ONE, 12 GELSYN-3, 12 gemfibrozil, 19 GENOTROPIN, 32 gentamicin, 42, 45 GENVOYA, 14 GILENYA, 26 glatiramer, 26 glimepiride, 29 glipizide, 29 glipizide ext-rel, 29 glipizide/metformin, 28 GLUCAGEN HYPOKIT, 32 GLUCAGON EMERGENCY KIT, 32 glucagon nasal powder, 32 glucagon subcutaneous soln, 32 glucagon, human recombinant, 32 GLUCOTROL, 29 GLUCOTROL XL, 29 glycopyrrolate/formoterol, 39 GLYXAMBI, 28 GOLYTELY, 34 GONAL-F, 31 GRALISE, 26 granisetron, 33 granisetron transdermal, 33 grass mixed pollen allergen extract, 37 GRASTEK, 37 griseofulvin ultramicrosize, 13 guanfacine, 18 guanfacine ext-rel, 24 guselkumab, 37 GVOKE, 32
GYNE-LOTRIMIN, 35
H halobetasol propionate crm, oint 0.05%, 43 halobetasol propionate lotion 0.01%, 43 haloperidol, 24 HARVONI, 15 HECTOROL, 32 human coagulation factor VIII (rDNA) simoctocog alfa, 36 HUMATROPE, 32 HUMIRA, 37 HUMULIN R U-500, 28 HYCAMTIN, 17 hydralazine, 21 HYDREA, 17 hydrochlorothiazide, 20 hydrocodone ext-rel, 11 hydrocodone/acetaminophen, 11 hydrocodone/homatropine, 40 hydrocortisone, 32 hydrocortisone acetate foam, 34 hydrocortisone acetate/pramoxine foam, 35 hydrocortisone butyrate crm, lotion, oint, soln 0.1%, 43 hydrocortisone crm, 35 hydrocortisone crm 2.5%, 43 hydrocortisone crm, oint 0.5%, 1%, 43 hydrocortisone enema, 34 hydrocortisone lotion 1%, 43 hydrocortisone valerate crm, oint 0.2%, 43 hydromorphone, 12 hydromorphone ext-rel, 12 hydroxychloroquine, 37 hydroxyurea, 17 hydroxyzine HCl, 39 hyoscyamine sulfate, 33 hyoscyamine sulfate ext-rel, 33 hyoscyamine sulfate ext-rel caps, 33 hyoscyamine sulfate orally disintegrating tabs, 33 HYZAAR, 18
I ibandronate, 29 IBRANCE, 17 ibuprofen, 11 icatibant, 37 icosapent ethyl, 19 ILARIS, 38 ILEVRO, 45 imatinib mesylate, 16 imiglucerase, 31 imipramine HCl, 23 imiquimod, 42, 44 IMITREX, 25 IMODIUM A-D, 33 IMURAN, 38 INCRUSE ELLIPTA, 39 indapamide, 21 ingenol mebutate, 42 INGREZZA, 26 inotersen, 32 INSPRA, 18 insulin aspart, 28 insulin aspart protamine 70%/insulin aspart 30%, 28 insulin degludec, 28 insulin detemir, 28 insulin glargine, 28 insulin human, 28
60
insulin infusion disposable pump, 29 insulin isophane human, 28 insulin isophane human 70%/regular 30%, 28 insulin syringes, needles, 29 INTELENCE, 14 interferon alfa-2b, 38 interferon beta-1a, 26 interferon beta-1b, 26 INTRON A, 38 ipratropium soln, 39 ipratropium spray, 41 ipratropium/albuterol soln, 39 irbesartan, 18 irbesartan/hydrochlorothiazide, 18 IRESSA, 16 ISENTRESS, 14 isoniazid, 15 isosorbide dinitrate, 21 isosorbide dinitrate/hydralazine, 21 isosorbide mononitrate, 21 isosorbide mononitrate ext-rel, 21 isotretinoin, 41 itraconazole, 13 ivabradine, 21 ivermectin, 15, 44
J JANUMET, 28 JANUMET XR, 28 JANUVIA, 28 JARDIANCE, 28 JIVI, 36
K KALETRA, 15 KEFLEX, 13 KEPPRA, 22 KEPPRA XR, 22 ketoconazole crm 2%, 42 ketoconazole shampoo 2%, 43 ketorolac, 45 ketorolac tromethamine, 45 ketotifen, 44 KISQALI, 17 KISQALI FEMARA CO-PACK, 17 KLARON, 42 KLONOPIN, 22 KOGENATE FS, 36 KOVALTRY, 36 KUVAN, 32 KYLEENA, 30
L labetalol, 19 lacosamide, 22 lactulose soln, 34 LAMISIL AT, 42 lamivudine, 14, 15 lamivudine/tenofovir disoproxil fumarate, 14 lamivudine/zidovudine, 14 lamotrigine, 22 lamotrigine ext-rel, 22 lamotrigine orally disintegrating tabs, 22 lanadelumab-flyo, 37 lancets, 29 LANOXIN, 20 lanreotide acetate, 27
lansoprazole + amoxicillin + clarithromycin, 35 lansoprazole delayed-rel, 34 lapatinib, 17 LASIX, 20 lasmiditan, 25 LASTACAFT, 44 latanoprost, 46 LATUDA, 24 ledipasvir/sofosbuvir, 15 leflunomide, 37 lenalidomide, 16 letrozole, 16 LEUKERAN, 16 leuprolide acetate, 16 levalbuterol tartrate, CFC-free aerosol, 40 LEVAQUIN, 13 LEVBID, 33 LEVEMIR, 28 levetiracetam, 22 levetiracetam ext-rel, 22 levobunolol, 45 levocarnitine, 29 levocetirizine, 39 levofloxacin, 13, 45 levonorgestrel releasing IUD, 30 levonorgestrel/EE - Trivora, 30 levonorgestrel/EE 0.1/20 - Lessina, 30 levonorgestrel/EE 0.1/20 and EE 10, 30 levonorgestrel/EE 0.15/30, 30 levonorgestrel/EE 0.15/30 - Levora, 30 levonorgestrel/EE 0.15/30 and EE 10, 30 levothyroxine, 33 levothyroxine - Levoxyl, 33 LEVSIN, 33 lidocaine, 44 lidocaine patch, 44 lidocaine viscous, 44 lidocaine/prilocaine, 44 LIDODERM, 44 lifitegrast, 46 linaclotide, 34 linezolid, 15 LINZESS, 34 liothyronine, 33 LIPOFEN, 19 liraglutide, 28, 29 liraglutide/insulin degludec, 28 lisdexamfetamine, 24 lisinopril, 17 lisinopril/hydrochlorothiazide, 18 lithium carbonate, 26 lithium carbonate ext-rel tabs 300 mg, 26 lithium carbonate ext-rel tabs 450 mg, 26 LITHOBID, 26 lixisenatide/insulin glargine, 28 LMX-4, 44 LO LOESTRIN FE, 30 LOESTRIN 1.5/30, 30 LOESTRIN 1/20, 30 LOESTRIN FE 1.5/30, 30 LOESTRIN FE 1/20, 30 LOKELMA, 32 LOMOTIL, 33 loperamide, 33 LOPID, 19 lopinavir/ritonavir soln, 15
61
lopinavir/ritonavir tabs, 15 LOPRESSOR, 19 LOPRESSOR HCT, 20 LOPROX, 42 loratadine, 39 loratadine/pseudoephedrine ext-rel, 40 lorazepam, 22 losartan, 18 losartan/hydrochlorothiazide, 18 LOSEASONIQUE, 30 LOTENSIN, 17 LOTENSIN HCT, 17 loteprednol, 45 LOTREL, 17 LOTRIMIN AF, 42 lovastatin, 19 LOVAZA, 19 lubiprostone, 34 LUCENTIS, 46 luliconazole, 42 LUMIGAN, 46 LUPRON DEPOT, 16 lurasidone, 24 lusutrombopag, 37 LYNPARZA, 17 LYSODREN, 17
M macitentan, 21 MACROBID, 15 MALARONE, 14 malathion, 44 MARINOL, 33 MATULANE, 17 MAXALT, 25 MAXIDEX, 45 MAXITROL, 45 MAXZIDE, 21 MAYZENT, 26 mebendazole chewable, 15 meclizine, 33 MEDROL, 32 medroxyprogesterone acetate, 32 medroxyprogesterone acetate 150 mg/mL, 30 mefloquine, 14 MEGACE ES, 32 megestrol acetate susp, 32 megestrol acetate tabs, 16 meloxicam, 11 melphalan, 16 memantine, 23 memantine ext-rel, 23 memantine/donepezil, 23 mepolizumab, 41 mercaptopurine, 16 mesalamine delayed-rel caps, 34 mesalamine delayed-rel tabs, 34 mesalamine ext-rel caps, 34 mesalamine supp, 34 mesalamine susp, 34 metaxalone, 26 metformin, 27 metformin ext-rel, 27 methadone, 12 methazolamide, 20 methimazole, 33
methocarbamol, 26 methotrexate, 16, 37 methotrexate auto-injector, 37 methoxsalen oral, 42 methyldopa, 21 METHYLIN, 24 methylphenidate, 24 methylphenidate ext-rel, 24 methylprednisolone, 32 metoclopramide, 33 metolazone, 21 metoprolol succinate ext-rel, 19 metoprolol tartrate, 19 metoprolol/hydrochlorothiazide, 20 METROCREAM, 44 METROGEL, 44 METROLOTION, 44 metronidazole, 15, 35 metronidazole crm 0.75%, 44 metronidazole gel 0.75%, 44 metronidazole gel 1%, 44 metronidazole lotion 0.75%, 44 MICARDIS, 18 MICARDIS HCT, 18 MICATIN, 42 miconazole, 35, 42 midodrine, 21 midostaurin, 17 minocycline, 13 mirabegron ext-rel, 35 MIRALAX, 34 MIRAPEX, 24 MIRCETTE, 30 MIRENA, 30 mirtazapine, 23 misoprostol, 34 mitotane, 17 mometasone crm, lotion, oint 0.1%, 43 mometasone spray, 41 MONISTAT, 35 montelukast, 40 morphine, 12 morphine ext-rel, 12 morphine supp, 12 MOVANTIK, 34 moxifloxacin, 13, 45 MOZOBIL, 37 MUGARD, 44 MULPLETA, 37 MULTAQ, 18 multivitamins/fluoride drops, tabs, 39 multivitamins/fluoride/iron drops, tabs, 39 multivitamins/minerals, 39 mupirocin oint, 42 MUSE, 35 MYAMBUTOL, 15 mycophenolate mofetil, 38 mycophenolate sodium delayed-rel, 38 MYDAYIS, 24 MYLERAN, 16 MYRBETRIQ, 35 MYSOLINE, 22
N nabumetone, 11 nadolol, 19
62
naftifine, 42 NAFTIN, 42 naldemedine, 34 naloxegol, 34 naloxone inj, 27 naloxone nasal spray, 27 naltrexone, 27 NAMENDA, 23 NAMZARIC, 23 naproxen sodium, 11 naproxen sodium tabs, 11 naproxen tabs, 11 naratriptan, 25 NARCAN, 27 NARDIL, 23 natalizumab, 26 nateglinide, 28 nebivolol, 20 neomycin/polymyxin B/bacitracin, 42 neomycin/polymyxin B/bacitracin/hydrocortisone oint, 45 neomycin/polymyxin B/dexamethasone, 45 neomycin/polymyxin B/gramicidin, 45 neomycin/polymyxin B/hydrocortisone, 46 neomycin/polymyxin B/hydrocortisone susp, 45 NEOSPORIN, 42 nepafenac, 45 netarsudil, 46 netarsudil/latanoprost, 46 NEULASTA, 36 NEUPRO, 24 NEURONTIN, 22 NEVANAC, 45 nevirapine, 14 nevirapine ext-rel, 14 niacin ext-rel, 19 NIASPAN, 19 NICODERM CQ, 27 NICORETTE, 27 nicotine polacrilex gum, 27 nicotine polacrilex lozenge, 27 nicotine transdermal, 27 nifedipine ext-rel, 20 nintedanib, 41 niraparib, 17 nitisinone, 32 NITRO-DUR, 21 nitrofurantoin ext-rel, 15 nitrofurantoin macrocrystals, 15 nitrofurantoin susp, 15 nitroglycerin lingual spray, 21 nitroglycerin sublingual, 21 nitroglycerin transdermal, 21 NITROLINGUAL, 21 NITROSTAT, 21 NIVESTYM, 36 NIX, 44 NIZORAL, 43 norelgestromin/EE, 30 norethindrone, 30 norethindrone acetate, 32 norethindrone acetate/EE 1.5/30, 30 norethindrone acetate/EE 1.5/30 and iron, 30 norethindrone acetate/EE 1/10 and EE 10 and iron, 30 norethindrone acetate/EE 1/20, 30 norethindrone acetate/EE 1/20 and iron, 30 norethindrone acetate/EE 1/20 and iron chewable, 30
norethindrone/EE, 30 norethindrone/EE 0.5/35, 30 norethindrone/EE 1/35, 30 norgestimate/EE, 30 norgestimate/EE 0.25/35, 30 norgestrel/EE 0.3/30 - Low-Ogestrel, 30 NORPACE, 18 NORPACE CR, 18 NORPRAMIN, 23 nortriptyline, 23 NORVIR, 15 NOVOEIGHT, 36 NOVOLIN 70/30, 28 NOVOLIN N, 28 NOVOLIN R, 28 NOVOLOG, 28 NOVOLOG MIX 70/30, 28 NUBEQA, 16 NUCALA, 41 NUCYNTA, 12 NUCYNTA ER, 12 NUEDEXTA, 27 NULYTELY, 34 NURTEC ODT, 25 NUWIQ, 36 nystatin, 13, 42
O OCUFLOX, 45 ODEFSEY, 14 ODOMZO, 17 OFEV, 41 ofloxacin, 45 ofloxacin otic, 46 olanzapine, 24 olaparib, 17 olmesartan, 18 olmesartan/amlodipine/hydrochlorothiazide, 18 olmesartan/hydrochlorothiazide, 18 olodaterol, CFC-free aerosol, 40 olopatadine, 44 olopatadine spray, 41 omalizumab, 41 omega-3 acid ethyl esters, 19 omeprazole delayed-rel, 34 omeprazole magnesium delayed-rel, 35 OMNIPOD INSULIN INFUSION PUMP, 29 ondansetron, 33 ONEXTON, 42 ONZETRA XSAIL, 25 OPSUMIT, 21 ORALAIR, 37 ORENITRAM, 21 ORFADIN, 32 ORILISSA, 31 ORTHO MICRONOR, 30 ORTHO-NOVUM 7/7/7, 30 oseltamivir, 15 ospemifene, 33 OSPHENA, 33 OTEZLA, 37 OVIDE, 44 OVIDREL, 31 oxaprozin, 11 oxazepam, 22 oxcarbazepine, 22
63
oxcarbazepine ext-rel, 22 OXSORALEN-ULTRA, 42 OXTELLAR XR, 22 oxybutynin, 35 oxybutynin ext-rel, 35 oxycodone caps 5 mg, 12 oxycodone concentrate 20 mg/mL, 12 oxycodone ext-rel, 12 oxycodone soln 5 mg/5 mL, 12 oxycodone tabs 5 mg, 15 mg, 30 mg, 12 oxycodone/acetaminophen 5/325, 12 OZEMPIC, 28
P palbociclib, 17 PAMELOR, 23 pancrelipase, 34 pancrelipase delayed-rel, 34 pantoprazole delayed-rel, 35 paricalcitol, 32 PARLODEL, 23 PARNATE, 23 paroxetine HCl, 23 paroxetine HCl ext-rel, 23 paroxetine mesylate, 27 PATADAY, 44 PATANASE, 41 patiromer sorbitex, 32 PAXIL, 23 PAXIL CR, 23 PAZEO, 44 pazopanib, 17 PEDIALYTE, 38 peg 3350/electrolytes, 34 PEGASYS, 38 pegfilgrastim, 36 pegfilgrastim-cbqv, 36 peginterferon alfa-2a, 38 peginterferon alfa-2b, 38 pegvisomant, 27 penicillin VK, 13 PENTASA, 34 PEPCID, 34 PEPCID AC, 34 perampanel, 22 PERFOROMIST, 40 perindopril, 17 permethrin 5%, 44 permethrin creme rinse 1%, 44 perphenazine, 24 phenazopyridine, 36 phenelzine, 23 phenobarbital, 22 phenytoin, 22 phenytoin sodium extended, 22 PHOSLYRA, 32 PICATO, 42 pilocarpine tabs, 35 pimecrolimus, 43 pindolol, 20 pioglitazone, 28 pioglitazone/glimepiride, 28 pioglitazone/metformin, 28 pirfenidone, 41 PLAQUENIL, 37 plerixafor, 37
podofilox, 44 polyethylene glycol 3350, 34 polymyxin B/bacitracin, 42, 45 polymyxin B/trimethoprim, 45 POLYSPORIN, 42 POLYTRIM, 45 pomalidomide, 16 POMALYST, 16 potassium chloride ext-rel, 38 potassium chloride liquid, 38 potassium citrate ext-rel, 36 PRALUENT, 19 pramipexole, 24 pramipexole ext-rel, 24 pramlintide, 27 prasugrel, 37 PRAVACHOL, 19 pravastatin, 19 PRECOSE, 27 PRED MILD, 45 prednisolone, 32 prednisolone acetate, 45 prednisolone acetate 1%, 45 prednisolone phosphate 1%, 45 prednisone, 32 pregabalin, 25 PREMARIN, 31 PREMPHASE, 31 PREMPRO, 31 prenatal vitamins, 38 prenatal vitamins/DHA/docusate/folic acid, 38 prenatal vitamins/docusate/folic acid, 38 prenatal vitamins/docusate/folic acid + DHA, 38 prenatal vitamins/folic acid + pyridoxine, 38 PREZCOBIX, 14 PREZISTA, 14 PRILOSEC, 34 PRILOSEC OTC, 35 primidone, 22 probenecid, 11 procarbazine, 17 PROCARDIA XL, 20 prochlorperazine, 33 PROCTOFOAM-HC, 35 progesterone gel, 32 progesterone vaginal inserts, 32 progesterone, micronized, 32 PROLASTIN-C, 41 PROLIA, 29 PROMACTA, 36 promethazine, 33 PROMETRIUM, 32 propafenone, 19 propafenone ext-rel, 19 propranolol, 20 propranolol ext-rel, 20 propylthiouracil, 33 PROSCAR, 35 PROVERA, 32 PULMICORT FLEXHALER, 41 PULMICORT RESPULES, 41 PULMOZYME, 40 PYLERA, 35 pyrazinamide, 15 pyrethrins/piperonyl butoxide shampoo 4%, 44 pyridostigmine, 26
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pyridostigmine ext-rel, 26
Q QUESTRAN/QUESTRAN LIGHT, 19 quetiapine, 24 quetiapine ext-rel, 24 quinapril, 17 quinapril/hydrochlorothiazide, 18 QVAR REDIHALER, 41
R ragweed pollen allergen extract, 37 RAGWITEK, 37 raloxifene, 33 raltegravir, 14 ramelteon, 25 ramipril, 17 ranibizumab, 46 ranolazine ext-rel, 21 rasagiline, 24 RASUVO, 37 RAZADYNE, 22 RAZADYNE ER, 22 REBIF, 26 REBINYN, 36 REGLAN, 33 RELENZA, 15 RELPAX, 25 REMERON, 23 repaglinide, 28 REQUIP XL, 24 RESTASIS, 46 RESTORIL, 25 RETACRIT, 36 RETIN-A, 42 RETROVIR, 14 REVATIO, 21 revefenacin inhalation soln, 39 REVLIMID, 16 REYVOW, 25 RHOPRESSA, 46 ribavirin, 15 ribociclib, 17 ribociclib + letrozole, 17 RID, 44 RIFADIN, 15 rifampin, 15 rifaximin 550 mg, 15 rilpivirine, 14 rimegepant, 25 RINVOQ, 37 riociguat, 21 risankizumab-rzaa, 37 risedronate, 29 risedronate delayed-rel, 29 RISPERDAL, 24 RISPERDAL CONSTA, 24 risperidone, 24 risperidone long-acting injection, 24 RITALIN, 24 ritonavir, 15 rivaroxaban, 36 rivastigmine, 23 rivastigmine transdermal, 23 rizatriptan, 25 ROBAXIN, 26 ROBITUSSIN-DM, 40
ROCALTROL, 32 ROCKLATAN, 46 roflumilast, 41 rolapitant, 33 ropinirole, 24 ropinirole ext-rel, 24 rosuvastatin, 19 rotigotine transdermal, 24 ROWASA, 34 RUBRACA, 17 rucaparib, 17 RUCONEST, 37 RYBELSUS, 28 RYDAPT, 17 RYTHMOL SR, 19
S sacubitril/valsartan, 21 SALAGEN, 35 salicylic acid 17%/collodion, 44 salmeterol xinafoate, 40 SANCUSO, 33 sapropterin, 32 SAXENDA, 29 scopolamine transdermal, 33 SEASONIQUE, 30 secukinumab, 37 selegiline, 24 selenium sulfide lotion 2.5%, 43 selexipag, 21 semaglutide, 28 SEREVENT, 40 SEROQUEL, 24 sertraline, 23 sevelamer carbonate, 32 sildenafil, 21, 35 silodosin, 35 SILVADENE, 42 silver sulfadiazine, 42 SIMBRINZA, 46 simvastatin, 19 SINEMET, 23 siponimod, 26 sirolimus, 38 sitagliptin phosphate, 28 sitagliptin/metformin, 28 sitagliptin/metformin ext-rel, 28 SKELAXIN, 26 SKYLA, 30 SKYRIZI, 37 sodium hyaluronate, 12 sodium sulfate/potassium sulfate/magnesium sulfate, 34 sodium zirconium cyclosilicate, 32 sofosbuvir/velpatasvir, 15 sofosbuvir/velpatasvir/voxilaprevir, 15 solifenacin, 35 SOLIQUA, 28 SOLIRIS, 36 solriamfetol, 26 somatropin, 32 SOMATULINE DEPOT, 27 SOMAVERT, 27 sonidegib, 17 SOOLANTRA, 44 SORIATANE, 42 sotalol, 19
65
soy phospholipid/glycerol dioleate, 44 SPIRIVA, 39 spironolactone, 18 spironolactone/hydrochlorothiazide, 21 SPRYCEL, 16 STALEVO, 24 stavudine, 14 STELARA SUBCUTANEOUS, 37 STIOLTO RESPIMAT, 39 STRATTERA, 24 STRIBILD, 14 STRIVERDI RESPIMAT, 40 STROMECTOL, 15 SUBSYS, 11 sucralfate tablet, 35 sucroferric oxyhydroxide, 32 sulfacetamide lotion 10%, 42 sulfacetamide oint 10%, 45 sulfacetamide soln 10%, 45 sulfacetamide/prednisolone phosphate 10%/0.25%, 45 sulfamethoxazole/trimethoprim, 15 sulfamethoxazole/trimethoprim DS, 15 sulfasalazine, 34 sulfasalazine delayed-rel, 34 sulindac, 11 sumatriptan, 25 sumatriptan inj, 25 sumatriptan nasal powder, 25 sumatriptan nasal spray, 25 sunitinib, 17 SUNOSI, 26 SUPARTZ FX, 12 SUPRAX, 13 SUPREP, 34 SUTENT, 17 suvorexant, 25 SYLATRON, 38 SYMBICORT, 41 SYMFI, 14 SYMFI LO, 14 SYMJEPI, 39 SYMLINPEN, 27 SYMPROIC, 34 SYMTUZA, 14 SYNJARDY, 28 SYNJARDY XR, 28 SYNTHROID, 33
T TABLOID, 16 tacrolimus, 38, 43 tadalafil, 21, 35 TAGAMET HB 200, 34 TAKHZYRO, 37 tamoxifen, 16 tamsulosin, 35 TAPAZOLE, 33 tapentadol, 12 tapentadol ext-rel, 12 TARGRETIN, 17 TARKA, 17 tazarotene, 42 TAZORAC, 42 TECFIDERA, 26 TEGRETOL, 22 TEGSEDI, 32
TEKTURNA HCT, 20 telmisartan, 18 telmisartan/hydrochlorothiazide, 18 temazepam, 25 TEMIXYS, 14 TEMODAR, 16 TEMOVATE, 43 temozolomide, 16 tenofovir alafenamide, 15 tenofovir disoproxil fumarate, 14 terazosin, 18 terbinafine, 42 terbinafine tabs, 14 terbutaline, 40 terconazole, 36 teriflunomide, 26 teriparatide, 29 TESSALON, 40 testosterone cypionate, 27 testosterone enanthate, 27 testosterone gel, 27 testosterone soln, 27 testosterone transdermal, 27 tetrabenazine, 26 tetracycline, 13 thalidomide, 16 THALOMID, 16 theophylline ext-rel tabs, 41 thioguanine, 16 thiothixene, 24 tiagabine, 22 TIAZAC, 20 ticagrelor, 37 TIGAN, 33 TIKOSYN, 18 timolol hemihydrate, 45 timolol maleate, 45 timolol maleate gel, 45 TIMOPTIC, 45 timothy grass pollen allergen extract, 37 TINACTIN, 42 tinidazole, 15 tioconazole, 36 tiotropium, 39 tiotropium/olodaterol, 39 TIVICAY, 14 tizanidine tabs, 26 TOBRADEX, 45 TOBRADEX ST, 45 tobramycin, 45 tobramycin inhalation soln, 40 tobramycin/dexamethasone oint 0.3%/0.1%, 45 tobramycin/dexamethasone susp 0.3%/0.05%, 45 tobramycin/dexamethasone susp 0.3%/0.1%, 45 TOBREX, 45 tofacitinib, 37 tofacitinib ext-rel, 37 TOLAK, 42 tolnaftate, 42 tolterodine, 35 tolterodine ext-rel, 35 TOPAMAX, 22 topiramate, 22 topiramate ext-rel, 22 topotecan caps, 17 torsemide, 20
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TOVIAZ, 35 tramadol, 12 tramadol ext-rel, 12 trandolapril, 17 trandolapril/verapamil ext-rel, 17 tranylcypromine, 23 travoprost, 46 trazodone, 23 TRELEGY ELLIPTA, 39 TREMFYA, 37 treprostinil ext-rel, 21 TRESIBA, 28 tretinoin, 42 tretinoin - Avita, 42 tretinoin caps, 17 tretinoin gel microsphere, 42 TREXALL, 16 triamcinolone acetonide crm 0.5%, 43 triamcinolone acetonide crm, lotion 0.025%, 43 triamcinolone acetonide crm, lotion, oint 0.1%, 43 triamcinolone paste, 44 triamterene, 20 triamterene/hydrochlorothiazide, 21 TRIBENZOR, 18 trifluoperazine, 24 trifluridine, 45 trihexyphenidyl, 24 TRIJARDY XR, 29 TRILEPTAL, 22 TRILIPIX, 19 trimethobenzamide, 33 trimethoprim, 15 TRINTELLIX, 23 TRIUMEQ, 14 TROKENDI XR, 22 trospium, 35 trospium ext-rel, 35 TRULICITY, 28 TRUSOPT, 46 TRUVADA, 14 TYKERB, 17 TYLENOL, 11 TYMLOS, 29 TYSABRI, 26
U UBRELVY, 25 ubrogepant, 25 UDENYCA, 36 ULTRAVATE, 43 umeclidinium bromide, 39 umeclidinium/vilanterol, 39 upadacitinib, 37 UPTRAVI, 21 URECHOLINE, 36 uridine triacetate, 17 UROCIT-K, 36 URSO, 33 ursodiol, 33 ustekinumab, 37
V VAGIFEM, 31 VAGISTAT-1, 36 valacyclovir, 15 valbenazine, 26 valganciclovir, 15
VALIUM, 22 valproic acid, 22 valsartan, 18 valsartan/hydrochlorothiazide, 18 VANCOCIN, 15 vancomycin caps, 15 varenicline, 27 VARUBI, 33 VASCEPA, 19 VASERETIC, 18 VASOTEC, 17 VELPHORO, 32 VELTASSA, 32 VEMLIDY, 15 venlafaxine, 23 venlafaxine ext-rel, 23 verapamil ext-rel, 20 VFEND, 14 V-GO INSULIN INFUSION PUMP, 29 VIBERZI, 34 VIBRAMYCIN, 13 VICTOZA, 28 vigabatrin, 22 VIGAMOX, 45 VIIBRYD, 23 vilazodone, 23 VIMPAT, 22 VIOKACE, 34 VIREAD, 14 VISCO-3, 12 VISTOGARD, 17 vitamin ADC/fluoride drops, 39 vitamin ADC/fluoride/iron drops, 39 voriconazole, 14 vorinostat, 17 vortioxetine, 23 VOSEVI, 15 VOTRIENT, 17 VRAYLAR, 24 VUMERITY, 26 VYTORIN, 19 VYVANSE, 24
W warfarin, 36 WELLBUTRIN SR, 23 WELLBUTRIN XL, 23
X XALATAN, 46 XARELTO, 36 XELJANZ, 37 XELJANZ XR, 37 XELODA, 16 XIFAXAN, 15 XIGDUO XR, 28 XIIDRA, 46 XOLAIR, 41 XTAMPZA ER, 12 XTANDI, 16 XULTOPHY, 28
Y YASMIN, 30 YONSA, 16 YUPELRI, 39
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Z ZADITOR, 44 zafirlukast, 40 ZANAFLEX, 26 zanamivir, 15 ZARONTIN, 22 ZEJULA, 17 ZEMBRACE SYMTOUCH, 25 ZEMPLAR, 32 ZENPEP, 34 ZESTORETIC, 18 ZESTRIL, 17 ZIAC, 20 ZIAGEN, 14 zidovudine, 14 zileuton ext-rel, 40 ziprasidone, 24 ZITHROMAX, 13
ZOCOR, 19 ZOFRAN, 33 ZOLINZA, 17 zolmitriptan, 25 zolmitriptan nasal spray, 25 ZOLOFT, 23 zolpidem, 25 zolpidem ext-rel, 25 zolpidem sublingual, 25 ZOMIG, 25 zonisamide, 22 ZOVIRAX, 15 ZUBSOLV, 27 ZYCLARA, 42 ZYPREXA, 24 ZYRTEC, 39 ZYRTEC-D 12 Hour, 40
The 2020 Prescribing Guide - Standard Control is intended to be a useful reference and informational tool for medical providers. It is intended to assist practitioners in selecting clinically appropriate and cost-effective products for their patients. CVS Caremark does not warrant or assure the accuracy of such information, nor is the Prescribing Guide - Standard Control intended to be comprehensive in nature. This Prescribing Guide - Standard Control is not intended to be a substitute for the knowledge, expertise, skill, and judgment of the medical provider in their choice of prescription drugs. All the information in the Prescribing Guide - Standard Control is provided as a reference for drug therapy selection. Specifi c drug selection for an individual patient rests solely with the prescriber.
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