Kansas State Employee Health Plan

Preferred Drug List 2018

Effective 04/01/2018

For questions or additional information, access the State of Kansas website at http://www.kdheks.gov/hcf/sehp or call the Kansas State Employees Prescription Drug Program at 1-800-294-6324.

The Preferred Drug List is subject to change. To locate covered prescriptions online, access the State of Kansas website at http://www.kdheks.gov/hcf/sehp for the most current drug list.

What is a Preferred Drug List? A Preferred Drug List is a list of safe and cost-effective drugs, chosen by a committee of physicians and pharmacists. Drug lists have been used in hospitals for many years to help ensure quality drug use. The Kansas State Employees Preferred Drug List will be continually revised to reflect the changing drug market.

Should I ask my physician to switch my current medications to a medication that is on the Preferred Drug List? Many of your medications will already be on the Preferred Drug List. However, if you have a medication that is not, ask your physician to choose a similar Preferred Drug List product for you to use.

Should I use generics? There are many medications on the market that do not come in generic form. For those drugs that do, your pharmacist should suggest safe and effective generic alternatives.

This 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.

Boldface type indicates generic availability; boldface may not apply to every strength or dosage form under the listed generic name.

ANALGESICS

NSAIDs diclofenac sodium delayed-rel diflunisal etodolac ibuprofen meloxicam nabumetone naproxen naproxen sodium oxaprozin sulindac NSAIDs, COMBINATIONS diclofenac sodium delayed-rel/misoprostol NSAIDs, TOPICAL diclofenac sodium gel (VOLTAREN) diclofenac sodium soln COX-2 INHIBITORS celecoxib GOUT allopurinol colchicine (COLCRYS) probenecid febuxostat (ULORIC) OPIOID ANALGESICS codeine/acetaminophen fentanyl transdermal fentanyl transmucosal lozenge hydrocodone/acetaminophen hydromorphone hydromorphone ext-rel methadone morphine morphine ext-rel morphine supp oxycodone caps, tabs 5 mg oxycodone concentrate 20 mg/mL oxycodone tabs 15 mg, 30 mg, soln 5 mg/5 mL oxycodone/acetaminophen 5/325 oxycodone/acetaminophen soln (ROXICET) tramadol tramadol ext-rel buprenorphine (BELBUCA) buprenorphine transdermal (BUTRANS) fentanyl citrate buccal (FENTORA) fentanyl sublingual spray (SUBSYS) hydrocodone ext-rel (HYSINGLA ER) oxycodone ext-rel (OXYCONTIN) tapentadol (NUCYNTA) tapentadol ext-rel (NUCYNTA ER) NON-OPIOID ANALGESICS butalbital/acetaminophen/caffeine tabs butalbital/aspirin/caffeine ANTI-INFECTIVES

ANTIBACTERIALS Cephalosporins First Generation cefadroxil cephalexin

Second Generation cefprozil cefuroxime axetil Third Generation cefdinir cefixime (SUPRAX) Erythromycins/Macrolides azithromycin clarithromycin clarithromycin ext-rel erythromycin delayed-rel erythromycin ethylsuccinate erythromycin stearate fidaxomicin (DIFICID) Fluoroquinolones ciprofloxacin ciprofloxacin ext-rel levofloxacin moxifloxacin Penicillins amoxicillin amoxicillin/clavulanate amoxicillin/clavulanate ext-rel ampicillin dicloxacillin penicillin VK Tetracyclines doxycycline hyclate minocycline tetracycline ANTIFUNGALS clotrimazole troches fluconazole griseofulvin ultramicrosize itraconazole nystatin terbinafine tabs voriconazole ANTIMALARIALS atovaquone/proguanil chloroquine mefloquine artemether/lumefantrine (COARTEM) ANTITUBERCULAR AGENTS ethambutol isoniazid pyrazinamide rifampin ANTIVIRALS Cytomegalovirus Agents valganciclovir Herpes Agents acyclovir caps, tabs famciclovir valacyclovir

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Influenza Agents oseltamivir zanamivir (RELENZA) MISCELLANEOUS clindamycin dapsone ivermectin metronidazole nitrofurantoin ext-rel nitrofurantoin macrocrystals nitrofurantoin susp sulfamethoxazole/trimethoprim sulfamethoxazole/trimethoprim DS tinidazole trimethoprim vancomycin mebendazole chewable (EMVERM) rifaximin 550 mg (XIFAXAN) tedizolid (SIVEXTRO) ANTINEOPLASTIC AGENTS

ALKYLATING AGENTS melphalan altretamine (HEXALEN) busulfan (MYLERAN) chlorambucil (LEUKERAN) cyclophosphamide caps ANTIMETABOLITES mercaptopurine methotrexate (TREXALL) thioguanine (TABLOID) HORMONAL ANTINEOPLASTIC AGENTS Antiandrogens bicalutamide flutamide Antiestrogens tamoxifen Aromatase Inhibitors anastrozole exemestane letrozole Progestins megestrol acetate tabs MISCELLANEOUS etoposide hydroxyurea tretinoin caps mitotane (LYSODREN) procarbazine (MATULANE) uridine triacetate (VISTOGARD) CARDIOVASCULAR

ACE INHIBITORS benazepril captopril enalapril fosinopril lisinopril perindopril

quinapril ramipril trandolapril ACE INHIBITOR/CALCIUM CHANNEL BLOCKER COMBINATIONS amlodipine/benazepril trandolapril/verapamil ext-rel ACE INHIBITOR/DIURETIC COMBINATIONS benazepril/hydrochlorothiazide captopril/hydrochlorothiazide enalapril/hydrochlorothiazide fosinopril/hydrochlorothiazide lisinopril/hydrochlorothiazide quinapril/hydrochlorothiazide ADRENOLYTICS, CENTRAL clonidine clonidine transdermal guanfacine ALDOSTERONE RECEPTOR ANTAGONISTS eplerenone spironolactone ALPHA BLOCKERS doxazosin terazosin ANGIOTENSIN II RECEPTOR ANTAGONISTS/DIURETIC COMBINATIONS candesartan candesartan/hydrochlorothiazide eprosartan irbesartan irbesartan/hydrochlorothiazide losartan losartan/hydrochlorothiazide olmesartan olmesartan/hydrochlorothiazide telmisartan telmisartan/hydrochlorothiazide valsartan valsartan/hydrochlorothiazide ANGIOTENSIN II RECEPTOR ANTAGONIST/CALCIUM CHANNEL BLOCKER COMBINATIONS amlodipine/olmesartan amlodipine/telmisartan amlodipine/valsartan ANGIOTENSIN II RECEPTOR ANTAGONIST/CALCIUM CHANNEL BLOCKER/DIURETIC COMBINATIONS amlodipine/valsartan/hydrochlorothiazide olmesartan/amlodipine/hydrochlorothiazide

ANTIARRHYTHMICS amiodarone disopyramide flecainide propafenone propafenone ext-rel sotalol dronedarone (MULTAQ) ANTILIPEMICS Bile Acid Resins cholestyramine colestipol colesevelam (WELCHOL) Cholesterol Absorption Inhibitors ezetimibe Fibrates fenofibrate fenofibric acid delayed-rel gemfibrozil HMG-CoA Reductase Inhibitors/Combinations atorvastatin ezetimibe/simvastatin fluvastatin lovastatin pravastatin rosuvastatin simvastatin Niacins niacin ext-rel Omega-3 Fatty Acids omega-3 acid ethyl esters icosapent ethyl (VASCEPA) BETA-BLOCKERS atenolol bisoprolol carvedilol carvedilol phosphate ext-rel (COREG CR) labetalol metoprolol succinate ext-rel metoprolol tartrate nadolol pindolol propranolol propranolol ext-rel nebivolol (BYSTOLIC) BETA-BLOCKER/DIURETIC COMBINATIONS atenolol/chlorthalidone bisoprolol/hydrochlorothiazide metoprolol/hydrochlorothiazide CALCIUM CHANNEL BLOCKERS Dihydropyridines amlodipine felodipine ext-rel nifedipine ext-rel

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Nondihydropyridines diltiazem ext-rel * verapamil ext-rel * Listing does not include generic CARDIZEM LA

CALCIUM CHANNEL BLOCKER/ANTILIPEMIC COMBINATIONS amlodipine/atorvastatin DIGITALIS GLYCOSIDES digoxin 0.125 mg, 0.25 mg digoxin ped elixir DIRECT RENIN INHIBITORS/DIURETIC COMBINATIONS aliskiren (TEKTURNA) aliskiren/hydrochlorothiazide (TEKTURNA HCT) DIURETICS Carbonic Anhydrase Inhibitors acetazolamide acetazolamide ext-rel methazolamide Loop Diuretics bumetanide furosemide torsemide Potassium-sparing Diuretics amiloride Thiazides and Thiazide-like Diuretics chlorthalidone hydrochlorothiazide indapamide metolazone Diuretic Combinations amiloride/hydrochlorothiazide spironolactone/hydrochlorothiazide triamterene/hydrochlorothiazide HEART FAILURE isosorbide dinitrate/hydralazine (BIDIL) ivabradine (CORLANOR) sacubitril/valsartan (ENTRESTO) NITRATES Oral isosorbide dinitrate ext-rel tabs isosorbide dinitrate oral isosorbide mononitrate isosorbide mononitrate ext-rel Sublingual/Translingual nitroglycerin lingual spray nitroglycerin sublingual Transdermal nitroglycerin transdermal MISCELLANEOUS hydralazine methyldopa

midodrine ranolazine ext-rel (RANEXA) CENTRAL NERVOUS SYSTEM

ANTIANXIETY Benzodiazepines alprazolam clonazepam tabs diazepam lorazepam oxazepam Miscellaneous buspirone clomipramine fluvoxamine ANTICONVULSANTS carbamazepine carbamazepine ext-rel diazepam rectal gel divalproex sodium delayed-rel divalproex sodium ext-rel ethosuximide gabapentin lamotrigine lamotrigine ext-rel lamotrigine orally disintegrating tabs levetiracetam levetiracetam ext-rel oxcarbazepine phenobarbital phenytoin phenytoin sodium extended primidone tiagabine topiramate topiramate ext-rel valproic acid zonisamide lacosamide (VIMPAT) oxcarbazepine ext-rel (OXTELLAR XR) perampanel (FYCOMPA) topiramate ext-rel (TROKENDI XR) ANTIDEMENTIA donepezil galantamine galantamine ext-rel memantine rivastigmine rivastigmine transdermal memantine ext-rel (NAMENDA XR) memantine/donepezil (NAMZARIC) ANTIDEPRESSANTS Monoamine Oxidase Inhibitors (MAOIs) phenelzine tranylcypromine Selective Serotonin Reuptake Inhibitors (SSRIs) citalopram escitalopram fluoxetine fluoxetine 60 mg (FLUOXETINE) paroxetine HCl

paroxetine HCl ext-rel sertraline vilazodone (VIIBRYD) vortioxetine (TRINTELLIX) Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) desvenlafaxine ext-rel duloxetine delayed-rel venlafaxine venlafaxine ext-rel Tricyclic Antidepressants (TCAs) amitriptyline desipramine doxepin imipramine HCl nortriptyline Miscellaneous Agents bupropion bupropion ext-rel mirtazapine trazodone ANTIPARKINSONIAN AGENTS amantadine benztropine bromocriptine carbidopa/levodopa carbidopa/levodopa ext-rel carbidopa/levodopa orally disintegrating tabs carbidopa/levodopa/entacapone entacapone pramipexole pramipexole ext-rel (MIRAPEX ER) rasagiline mesylate (AZILECT) ropinirole ropinirole ext-rel selegiline trihexyphenidyl rotigotine transdermal (NEUPRO) ANTIPSYCHOTICS Atypicals aripiprazole clozapine olanzapine quetiapine quetiapine ext-rel risperidone ziprasidone aripiprazole ext-rel injection (ABILIFY MAINTENA) aripiprazole lauroxil ext-rel inj (ARISTADA) cariprazine (VRAYLAR) lurasidone (LATUDA) risperidone long-acting inj (RISPERDAL CONSTA) Miscellaneous chlorpromazine fluphenazine haloperidol perphenazine thiothixene trifluoperazine

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ATTENTION DEFICIT HYPERACTIVITY DISORDER amphetamine/dextroamphetamine mixed salts amphetamine/dextroamphetamine

mixed salts ext-rel atomoxetine dexmethylphenidate dexmethylphenidate ext-rel dextroamphetamine dextroamphetamine ext-rel guanfacine ext-rel methylphenidate methylphenidate ext-rel lisdexamfetamine (VYVANSE) methylphenidate ext-rel (APTENSIO XR) methylphenidate ext-rel susp (QUILLIVANT XR) FIBROMYALGIA milnacipran (SAVELLA) pregabalin (LYRICA) HYPNOTICS Benzodiazepines temazepam Nonbenzodiazepines eszopiclone zolpidem zolpidem ext-rel zolpidem sublingual suvorexant (BELSOMRA) Tricyclics doxepin (SILENOR) MIGRAINE Ergotamine Derivatives dihydroergotamine inj dihydroergotamine spray ergotamine/caffeine Selective Serotonin Agonists eletriptan naratriptan rizatriptan sumatriptan sumatriptan inj sumatriptan nasal spray zolmitriptan sumatriptan inj (ZEMBRACE SYMTOUCH) sumatriptan nasal powder (ONZETRA XSAIL) zolmitriptan nasal spray (ZOMIG) Selective Serotonin Agonist/Nonsteroidal Anti-inflammatory Drug (NSAID) Combinations sumatriptan/naproxen sodium (TREXIMET) MOOD STABILIZERS lithium carbonate lithium carbonate ext-rel MUSCULOSKELETAL THERAPY AGENTS baclofen carisoprodol chlorzoxazone

cyclobenzaprine dantrolene metaxalone methocarbamol orphenadrine/aspirin/caffeine tizanidine tabs MYASTHENIA GRAVIS pyridostigmine pyridostigmine ext-rel NARCOLEPSY armodafinil POSTHERPETIC NEURALGIA (PHN) gabapentin ext-rel (GRALISE) PSYCHOTHERAPEUTIC-MISCELLANEOUS Alcohol Deterrents acamprosate calcium disulfiram Opioid Antagonists naloxone inj naltrexone naloxone nasal spray (NARCAN) Partial Opioid Agonist/Opioid Antagonist Combinations buprenorphine/naloxone sublingual tabs buprenorphine/naloxone sublingual film

(SUBOXONE) buprenorphine/naloxone sublingual tabs (ZUBSOLV) Pseudobulbar Affect Agents dextromethorphan/quinidine (NUEDEXTA) Smoking Deterrents bupropion ext-rel Vasomotor Symptom Agents paroxetine mesylate ENDOCRINE AND METABOLIC

ANDROGENS testosterone cypionate testosterone enanthate testosterone gel testosterone soln testosterone gel (ANDROGEL 1.62%) testosterone transdermal (ANDRODERM) ANTIDIABETICS Alpha-glucosidase Inhibitors acarbose Amylin Analogs pramlintide (SYMLINPEN) Biguanides metformin metformin ext-rel

Biguanide/Sulfonylurea Combinations glipizide/metformin Dipeptidyl Peptidase-4 (DPP-4) Inhibitors linagliptin (TRADJENTA) sitagliptin phosphate (JANUVIA) Dipeptidyl Peptidase-4 (DPP-4) Inhibitor/Biguanide Combinations linagliptin/metformin (JENTADUETO) linagliptin/metformin ext-rel (JENTADUETO XR) sitagliptin/metformin (JANUMET) sitagliptin/metformin ext-rel (JANUMET XR) Incretin Mimetic Agents dulaglutide (TRULICITY) liraglutide (VICTOZA) Incretin Mimetic Agent/Insulin Combinations 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) insulin human (NOVOLIN R) insulin isophane human (NOVOLIN N) insulin isophane human 70%/regular 30%

(NOVOLIN 70/30) Insulin Sensitizers pioglitazone Insulin Sensitizer/Biguanide Combinations pioglitazone/metformin Insulin Sensitizer/Sulfonylurea Combinations pioglitazone/glimepiride Meglitinides nateglinide repaglinide Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors canagliflozin (INVOKANA) dapagliflozin (FARXIGA) Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor/Biguanide Combinations canagliflozin/metformin (INVOKAMET) canagliflozin/metformin ext-rel (INVOKAMET XR) dapagliflozin/metformin ext-rel (XIGDUO XR)

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Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor/Dipeptidyl Peptidase-4 (DPP-4) Inhibitor Combinations dapagliflozin/saxagliptin (QTERN) Sulfonylureas glimepiride glipizide glipizide ext-rel glyburide Supplies BD ULTRAFINE insulin syringes and needles lancets ONETOUCH ULTRA kits and test strips ONETOUCH VERIO kits and test strips ANTIOBESITY Injectable liraglutide (SAXENDA) Oral lorcaserin (BELVIQ) lorcaserin ext-rel (BELVIQ XR) naltrexone/bupropion ext-rel (CONTRAVE) CALCIUM REGULATORS Bisphosphonates alendronate ibandronate risedronate risedronate delayed-rel Calcitonins calcitonin-salmon spray CARNITINE DEFICIENCY AGENTS levocarnitine CONTRACEPTIVES EE = ethinyl estradiol ME = mestranol

Monophasic 20 mcg Estrogen drospirenone/EE 3/20 drospirenone/EE/levomefolate 3/20 and

levomefolate (BEYAZ) levonorgestrel/EE 0.1/20 - Lessina norethindrone acetate/EE 1/20 norethindrone acetate/EE 1/20 and iron norethindrone acetate/EE 1/20 and iron -

Lomedia 24 Fe norethindrone acetate/EE 1/20 and iron chewable

(MINASTRIN 24 FE) 30 mcg Estrogen desogestrel/EE 0.15/30 drospirenone/EE 3/30 levonorgestrel/EE 0.15/30 - Levora norethindrone acetate/EE 1.5/30 norethindrone acetate/EE 1.5/30 and iron norgestrel/EE 0.3/30 - Low-Ogestrel drospirenone/EE/levomefolate 3/30 and

levomefolate (SAFYRAL)

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 50 mcg Estrogen ethynodiol diacetate/EE 1/50 - Zovia 1/50 norethindrone/ME 1/50 Biphasic desogestrel/EE norethindrone acetate/EE 1/10 and EE 10 and iron

(LO LOESTRIN FE) Injectable medroxyprogesterone acetate 150 mg/mL Triphasic desogestrel/EE levonorgestrel/EE - Trivora norethindrone/EE norgestimate/EE Four Phase estradiol valerate and dienogest/estradiol valerate

(NATAZIA) Extended Cycle levonorgestrel/EE 0.1/20 and EE 10 levonorgestrel/EE 0.15/30 levonorgestrel/EE 0.15/30 and EE 10 Progestin Only norethindrone Transdermal norelgestromin/EE Vaginal etonogestrel/EE ring (NUVARING) ENDOMETRIOSIS danazol ESTROGENS Oral estradiol estropipate estrogens, conjugated (PREMARIN) Transdermal estradiol estradiol (DIVIGEL) estradiol (EVAMIST) estradiol (MINIVELLE) Vaginal estradiol vaginal crm (ESTRACE) estradiol vaginal tabs estradiol vaginal ring (ESTRING) estrogens, conjugated crm (PREMARIN) ESTROGEN/PROGESTINS Oral EE/norethindrone acetate - Jinteli

estradiol/norethindrone estrogens, conjugated/medroxyprogesterone

(PREMPHASE) estrogens, conjugated/medroxyprogesterone

(PREMPRO) Transdermal estradiol/levonorgestrel (CLIMARA PRO) estradiol/norethindrone acetate (COMBIPATCH) ESTROGEN/SELECTIVE ESTROGEN RECEPTOR MODULATOR COMBINATIONS conjugated estrogens/bazedoxifene (DUAVEE) GLUCOCORTICOIDS dexamethasone fludrocortisone hydrocortisone methylprednisolone prednisolone prednisone GLUCOSE ELEVATING AGENTS glucagon, human recombinant

(GLUCAGEN HYPOKIT) glucagon, human recombinant

(GLUCAGON EMERGENCY KIT) HYPERPARATHYROID TREATMENT, VITAMIN D ANALOGS calcitriol (1,25-D3) doxercalciferol paricalcitol PHOSPHATE BINDER AGENTS calcium acetate lanthanum carbonate sevelamer carbonate calcium acetate (PHOSLYRA) sucroferric oxyhydroxide (VELPHORO) POTASSIUM-REMOVING AGENTS patiromer sorbitex (VELTASSA) PROGESTINS Oral medroxyprogesterone acetate megestrol acetate susp norethindrone acetate progesterone, micronized SELECTIVE ESTROGEN RECEPTOR MODULATORS raloxifene ospemifene (OSPHENA) THYROID AGENTS Antithyroid Agents methimazole propylthiouracil Thyroid Supplements levothyroxine levothyroxine (SYNTHROID)

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levothyroxine - Levoxyl liothyronine VASOPRESSINS desmopressin spray, tabs MISCELLANEOUS cabergoline GASTROINTESTINAL

ANTIDIARRHEALS diphenoxylate/atropine loperamide ANTIEMETICS dronabinol granisetron meclizine metoclopramide ondansetron prochlorperazine promethazine trimethobenzamide doxylamine/pyridoxine delayed-rel (DICLEGIS) granisetron transdermal (SANCUSO) rolapitant (VARUBI) ANTISPASMODICS dicyclomine CHOLELITHOLYTICS ursodiol H2 RECEPTOR ANTAGONISTS cimetidine famotidine ranitidine INFLAMMATORY BOWEL DISEASE Oral Agents balsalazide budesonide delayed-rel caps mesalamine delayed-rel tabs (LIALDA) sulfasalazine sulfasalazine delayed-rel budesonide ext-rel (UCERIS) mesalamine ext-rel caps (APRISO) mesalamine ext-rel caps (PENTASA) Rectal Agents hydrocortisone enema mesalamine rectal susp hydrocortisone acetate foam (CORTIFOAM) mesalamine supp (CANASA) IRRITABLE BOWEL SYNDROME Irritable Bowel Syndrome with Constipation linaclotide (LINZESS) lubiprostone (AMITIZA) Irritable Bowel Syndrome with Diarrhea alosetron (LOTRONEX) eluxadoline (VIBERZI)

LAXATIVES lactulose peg 3350/electrolytes polyethylene glycol 3350 sodium sulfate/potassium sulfate/magnesium sulfate

(SUPREP) OPIOID-INDUCED CONSTIPATION naloxegol (MOVANTIK) PANCREATIC ENZYMES pancrelipase (VIOKACE) pancrelipase delayed-rel (CREON) pancrelipase delayed-rel (ZENPEP) PROSTAGLANDINS misoprostol PROTON PUMP INHIBITORS esomeprazole delayed-rel lansoprazole delayed-rel omeprazole delayed-rel pantoprazole delayed-rel dexlansoprazole delayed-rel (DEXILANT) SALIVA STIMULANTS cevimeline pilocarpine tabs STEROIDS, RECTAL hydrocortisone crm hydrocortisone acetate/pramoxine foam

(PROCTOFOAM-HC) ULCER THERAPY COMBINATIONS lansoprazole + amoxicillin + clarithromycin bismuth/metronidazole/tetracycline (PYLERA) MISCELLANEOUS sucralfate GENITOURINARY

BENIGN PROSTATIC HYPERPLASIA alfuzosin ext-rel dutasteride dutasteride/tamsulosin finasteride tamsulosin silodosin (RAPAFLO) URINARY ANTISPASMODICS darifenacin ext-rel oxybutynin oxybutynin ext-rel tolterodine tolterodine ext-rel trospium trospium ext-rel fesoterodine ext-rel (TOVIAZ) mirabegron ext-rel (MYRBETRIQ) solifenacin succinate (VESICARE) VAGINAL ANTI-INFECTIVES clindamycin crm metronidazole

terconazole MISCELLANEOUS bethanechol phenazopyridine potassium citrate ext-rel HEMATOLOGIC

ANTICOAGULANTS Injectable enoxaparin Oral warfarin apixaban (ELIQUIS) rivaroxaban (XARELTO) Synthetic Heparinoid-like Agents fondaparinux PLATELET AGGREGATION INHIBITORS clopidogrel dipyridamole dipyridamole ext-rel/aspirin prasugrel ticagrelor (BRILINTA) PLATELET SYNTHESIS INHIBITORS anagrelide MISCELLANEOUS cilostazol IMMUNOLOGIC AGENTS

ALLERGENIC EXTRACTS ragweed pollen allergen extract (RAGWITEK) timothy grass pollen allergen extract (GRASTEK) DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDs) hydroxychloroquine leflunomide methotrexate IMMUNOSUPPRESSANTS Antimetabolites azathioprine azathioprine (AZASAN) NUTRITIONAL/SUPPLEMENTS

ELECTROLYTES Potassium potassium chloride ext-rel potassium chloride liquid VITAMINS AND MINERALS Folic Acid/Combinations folic acid folic acid/vitamin B6/vitamin B12

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Prenatal Vitamins 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) Miscellaneous cyanocobalamin inj ergocalciferol (D2) fluoride drops, tabs multivitamins/fluoride drops, tabs multivitamins/fluoride/iron drops, tabs vitamin ADC/fluoride drops vitamin ADC/fluoride/iron drops RESPIRATORY

ANAPHYLAXIS TREATMENT AGENTS epinephrine auto-injector epinephrine auto-injector (EPIPEN) epinephrine auto-injector (EPIPEN JR.) ANTICHOLINERGICS ipratropium soln tiotropium (SPIRIVA) umeclidinium bromide (INCRUSE ELLIPTA) ANTICHOLINERGIC/BETA AGONIST COMBINATIONS Short Acting ipratropium/albuterol soln ipratropium/albuterol, CFC-free aerosol

(COMBIVENT RESPIMAT) 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, SEDATING clemastine 2.68 mg cyproheptadine hydroxyzine HCl ANTITUSSIVES benzonatate ANTITUSSIVE COMBINATIONS Opioid codeine/chlorpheniramine/pseudoephedrine

codeine/guaifenesin liquid codeine/guaifenesin/pseudoephedrine codeine/promethazine codeine/promethazine/phenylephrine hydrocodone/homatropine Non-opioid dextromethorphan/brompheniramine/

pseudoephedrine dextromethorphan/promethazine BETA AGONISTS Inhalants Short Acting albuterol soln levalbuterol tartrate, CFC-free aerosol albuterol sulfate aerosol powder breath-activated

(PROAIR RESPICLICK) albuterol sulfate, CFC-free aerosol (PROAIR HFA) 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 LEUKOTRIENE MODULATORS montelukast zafirlukast zileuton ext-rel MAST CELL STABILIZERS cromolyn soln NASAL ANTIHISTAMINES azelastine spray olopatadine spray NASAL ANTIHISTAMINE/STEROID COMBINATIONS azelastine/fluticasone spray (DYMISTA) PHOSPHODIESTERASE-4 INHIBITORS roflumilast (DALIRESP) STEROID/BETA AGONIST COMBINATIONS budesonide/formoterol (SYMBICORT) fluticasone/salmeterol (ADVAIR) fluticasone/salmeterol, CFC-free aerosol

(ADVAIR HFA) fluticasone/vilanterol (BREO ELLIPTA) STEROID INHALANTS budesonide inh susp beclomethasone, CFC-free aerosol (QVAR) budesonide (PULMICORT FLEXHALER) fluticasone (FLOVENT DISKUS)

fluticasone, CFC-free aerosol (FLOVENT HFA) mometasone (ASMANEX) XANTHINES theophylline ext-rel tabs MISCELLANEOUS ipratropium spray TOPICAL

DERMATOLOGY Acne Oral isotretinoin Topical adapalene (DIFFERIN) adapalene/benzoyl peroxide (EPIDUO) benzoyl peroxide clindamycin gel, lotion, soln clindamycin/benzoyl peroxide clindamycin/benzoyl peroxide (BENZACLIN) erythromycin gel 2% erythromycin soln erythromycin/benzoyl peroxide sulfacetamide lotion 10% tazarotene (TAZORAC) tretinoin tretinoin (ATRALIN) tretinoin - Avita tretinoin gel microsphere (RETIN-A MICRO) clindamycin/benzoyl peroxide (ACANYA) Actinic Keratosis fluorouracil crm 5%, soln 5%, soln 2% fluorouracil cream 4% (TOLAK) imiquimod (ZYCLARA) ingenol mebutate (PICATO) Antibiotics gentamicin mupirocin silver sulfadiazine Antifungals ciclopirox clotrimazole econazole ketoconazole naftifine (NAFTIN) nystatin efinaconazole (JUBLIA) luliconazole (LUZU) Antipsoriatics Oral acitretin methoxsalen oral Topical calcipotriene Antiseborrheics ketoconazole shampoo 2% selenium sulfide shampoo 2.5%

7

Atopic Dermatitis Topical tacrolimus pimecrolimus (ELIDEL) Corticosteroids Low Potency alclometasone crm, oint 0.05% desonide crm, lotion, oint 0.05% fluocinolone acetonide soln 0.01% hydrocortisone crm 2.5% hydrocortisone lotion 1% Medium Potency betamethasone valerate crm, lotion, oint 0.1% clocortolone crm 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, 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,

lotion 0.05% betamethasone dipropionate crm, lotion,

oint 0.05% desoximetasone crm, oint 0.25%, gel 0.05% diflorasone diacetate crm 0.05% fluocinonide crm, gel, oint, soln 0.05% triamcinolone acetonide crm 0.5% Very High Potency betamethasone dipropionate augmented gel, oint

0.05% clobetasol propionate crm, foam, gel, lotion, oint,

shampoo, soln diflorasone diacetate oint 0.05% halobetasol propionate crm, oint 0.05% Emollients ammonium lactate 12% Local Analgesics lidocaine patch Local Anesthetics lidocaine/prilocaine Rosacea doxycycline monohydrate (ORACEA) metronidazole crm, gel, lotion 0.75% metronidazole gel 1% azelaic acid gel (FINACEA) ivermectin (SOOLANTRA) Scabicides and Pediculicides malathion permethrin 5%

Miscellaneous Skin and Mucous Membrane imiquimod podofilox MOUTH/THROAT/DENTAL AGENTS Anesthetics - Topical Oral lidocaine viscous Steroids - Mouth/Throat triamcinolone paste OPHTHALMIC Antiallergics azelastine cromolyn sodium olopatadine alcaftadine (LASTACAFT) olopatadine (PAZEO) Anti-infectives bacitracin ciprofloxacin soln erythromycin gentamicin levofloxacin moxifloxacin neomycin/polymyxin B/gramicidin ofloxacin polymyxin B/bacitracin polymyxin B/trimethoprim sulfacetamide oint, soln 10% tobramycin besifloxacin (BESIVANCE) ciprofloxacin oint (CILOXAN) moxifloxacin (MOXEZA) Anti-infective/Anti-inflammatory Combinations neomycin/polymyxin B/bacitracin/hydrocortisone

oint neomycin/polymyxin B/dexamethasone neomycin/polymyxin B/hydrocortisone susp sulfacetamide/prednisolone phosphate

10%/0.25% tobramycin/dexamethasone susp 0.3%/0.1% tobramycin/dexamethasone oint 0.3%/0.1%

(TOBRADEX) tobramycin/dexamethasone susp 0.3%/0.05%

(TOBRADEX ST) tobramycin/loteprednol (ZYLET) Anti-inflammatories Nonsteroidal bromfenac sodium diclofenac sodium ketorolac ketorolac tromethamine (ACUVAIL) nepafenac (ILEVRO) nepafenac (NEVANAC) Steroidal dexamethasone sodium phosphate fluorometholone

prednisolone acetate 1% dexamethasone (MAXIDEX) difluprednate (DUREZOL) fluorometholone (FLAREX) fluorometholone (FML FORTE) fluorometholone (FML S.O.P.) prednisolone acetate (PRED MILD) Antivirals trifluridine Beta-blockers Nonselective levobunolol metipranolol timolol maleate timolol maleate gel timolol hemihydrate (BETIMOL) Selective betaxolol (BETOPTIC S) Carbonic Anhydrase Inhibitors Topical dorzolamide brinzolamide (AZOPT) Carbonic Anhydrase Inhibitor/Beta-blocker Combinations dorzolamide/timolol maleate Carbonic Anhydrase Inhibitor/Sympathomimetic Combinations brinzolamide/brimonidine (SIMBRINZA) Dry Eye Disease cyclosporine, emulsion (RESTASIS) lifitegrast (XIIDRA) Prostaglandins latanoprost bimatoprost (LUMIGAN) travoprost (TRAVATAN Z) Sympathomimetics brimonidine 0.15% (ALPHAGAN P) brimonidine 0.2% brimonidine 0.1% (ALPHAGAN P) Sympathomimetic/Beta-blocker Combinations brimonidine/timolol (COMBIGAN) OTIC Anti-infectives acetic acid ofloxacin otic Anti-infective/Anti-inflammatory Combinations neomycin/polymyxin B/hydrocortisone ciprofloxacin/dexamethasone (CIPRODEX)

8

QUICK REFERENCE DRUG LIST

A ABILIFY MAINTENA, 3 acamprosate calcium, 4 ACANYA, 7 acarbose, 4 acetazolamide, 3 acetazolamide ext-rel, 3 acetic acid, 8 acitretin, 7 ACUVAIL, 8 acyclovir caps, tabs, 1 adapalene, 7 adapalene/benzoyl peroxide, 7 ADVAIR, 7 ADVAIR HFA, 7 albuterol, 7 albuterol ext-rel, 7 albuterol soln, 7 albuterol sulfate aerosol powder breath-

activated, 7 albuterol sulfate, CFC-free aerosol, 7 alcaftadine, 8 alclometasone crm, oint 0.05%, 8 alendronate, 5 alfuzosin ext-rel, 6 aliskiren, 3 aliskiren/hydrochlorothiazide, 3 allopurinol, 1 alosetron, 6 ALPHAGAN P, 8 alprazolam, 3 altretamine, 2 amantadine, 3 amiloride, 3 amiloride/hydrochlorothiazide, 3 amiodarone, 2 AMITIZA, 6 amitriptyline, 3 amlodipine, 2 amlodipine/atorvastatin, 3 amlodipine/benazepril, 2 amlodipine/olmesartan, 2 amlodipine/telmisartan, 2 amlodipine/valsartan, 2 amlodipine/valsartan/hydrochlorothiazide, 2 ammonium lactate 12%, 8 amoxicillin, 1 amoxicillin/clavulanate, 1 amoxicillin/clavulanate ext-rel, 1 amphetamine/dextroamphetamine

mixed salts, 4 amphetamine/dextroamphetamine

mixed salts ext-rel, 4 ampicillin, 1 anagrelide, 6 anastrozole, 2 ANDRODERM, 4 ANDROGEL 1.62%, 4 ANORO ELLIPTA, 7 apixaban, 6 APRISO, 6 APTENSIO XR, 4 aripiprazole, 3 aripiprazole ext-rel injection, 3 aripiprazole lauroxil ext-rel inj, 3 ARISTADA, 3 armodafinil, 4

artemether/lumefantrine, 1 ASMANEX, 7 atenolol, 2 atenolol/chlorthalidone, 2 atomoxetine, 4 atorvastatin, 2 atovaquone/proguanil, 1 ATRALIN, 7 AZASAN, 6 azathioprine, 6 azelaic acid gel, 8 azelastine, 8 azelastine spray, 7 azelastine/fluticasone spray, 7 AZILECT, 3 azithromycin, 1 AZOPT, 8

B bacitracin, 8 baclofen, 4 balsalazide, 6 BASAGLAR, 4 BD ULTRAFINE insulin syringes and needles, 5 beclomethasone, CFC-free aerosol, 7 BELBUCA, 1 BELSOMRA, 4 BELVIQ, 5 BELVIQ XR, 5 benazepril, 2 benazepril/hydrochlorothiazide, 2 BENZACLIN, 7 benzonatate, 7 benzoyl peroxide, 7 benztropine, 3 besifloxacin, 8 BESIVANCE, 8 betamethasone dipropionate augmented crm,

lotion 0.05%, 8 betamethasone dipropionate augmented gel,

oint 0.05%, 8 betamethasone dipropionate crm, lotion,

oint 0.05%, 8 betamethasone valerate crm, lotion,

oint 0.1%, 8 betaxolol, 8 bethanechol, 6 BETIMOL, 8 BETOPTIC S, 8 BEVESPI AEROSPHERE, 7 BEYAZ, 5 bicalutamide, 2 BIDIL, 3 bimatoprost, 8 bismuth/metronidazole/tetracycline, 6 bisoprolol, 2 bisoprolol/hydrochlorothiazide, 2 BREO ELLIPTA, 7 BRILINTA, 6 brimonidine 0.1%, 8 brimonidine 0.15%, 8 brimonidine 0.2%, 8 brimonidine/timolol, 8 brinzolamide, 8 brinzolamide/brimonidine, 8 bromfenac sodium, 8 bromocriptine, 3 budesonide, 7

budesonide delayed-rel caps, 6 budesonide ext-rel, 6 budesonide inh susp, 7 budesonide/formoterol, 7 bumetanide, 3 buprenorphine, 1 buprenorphine transdermal, 1 buprenorphine/naloxone sublingual film, 4 buprenorphine/naloxone sublingual tabs, 4 bupropion, 3 bupropion ext-rel, 3, 4 buspirone, 3 busulfan, 2 butalbital/acetaminophen/caffeine tabs, 1 butalbital/aspirin/caffeine, 1 BUTRANS, 1 BYSTOLIC, 2

C cabergoline, 6 calcipotriene, 7 calcitonin-salmon spray, 5 calcitriol (1,25-D3), 5 calcium acetate, 5 canagliflozin, 4 canagliflozin/metformin, 4 canagliflozin/metformin ext-rel, 4 CANASA, 6 candesartan, 2 candesartan/hydrochlorothiazide, 2 captopril, 2 captopril/hydrochlorothiazide, 2 carbamazepine, 3 carbamazepine ext-rel, 3 carbidopa/levodopa, 3 carbidopa/levodopa ext-rel, 3 carbidopa/levodopa orally disintegrating

tabs, 3 carbidopa/levodopa/entacapone, 3 cariprazine, 3 carisoprodol, 4 carvedilol, 2 carvedilol phosphate ext-rel, 2 cefadroxil, 1 cefdinir, 1 cefixime, 1 cefprozil, 1 cefuroxime axetil, 1 celecoxib, 1 cephalexin, 1 cevimeline, 6 chlorambucil, 2 chloroquine, 1 chlorpromazine, 3 chlorthalidone, 3 chlorzoxazone, 4 cholestyramine, 2 ciclopirox, 7 cilostazol, 6 CILOXAN, 8 cimetidine, 6 CIPRODEX, 8 ciprofloxacin, 1 ciprofloxacin ext-rel, 1 ciprofloxacin oint, 8 ciprofloxacin soln, 8 ciprofloxacin/dexamethasone, 8 citalopram, 3

9

CITRANATAL 90 DHA, 7 CITRANATAL ASSURE, 7 CITRANATAL B-CALM, 7 CITRANATAL DHA, 7 CITRANATAL HARMONY, 7 CITRANATAL RX, 7 clarithromycin, 1 clarithromycin ext-rel, 1 clemastine 2.68 mg, 7 CLIMARA PRO, 5 clindamycin, 2 clindamycin crm, 6 clindamycin gel, lotion, soln, 7 clindamycin/benzoyl peroxide, 7 clobetasol propionate crm, foam, gel, lotion,

oint, shampoo, soln, 8 clocortolone crm 0.1%, 8 clomipramine, 3 clonazepam tabs, 3 clonidine, 2 clonidine transdermal, 2 clopidogrel, 6 clotrimazole, 7 clotrimazole troches, 1 clozapine, 3 COARTEM, 1 codeine/acetaminophen, 1 codeine/chlorpheniramine/

pseudoephedrine, 7 codeine/guaifenesin liquid, 7 codeine/guaifenesin/pseudoephedrine, 7 codeine/promethazine, 7 codeine/promethazine/phenylephrine, 7 colchicine, 1 COLCRYS, 1 colesevelam, 2 colestipol, 2 COMBIGAN, 8 COMBIPATCH, 5 COMBIVENT RESPIMAT, 7 conjugated estrogens/bazedoxifene, 5 CONTRAVE, 5 COREG CR, 2 CORLANOR, 3 CORTIFOAM, 6 CREON, 6 cromolyn sodium, 8 cromolyn soln, 7 cyanocobalamin inj, 7 cyclobenzaprine, 4 cyclophosphamide caps, 2 cyclosporine, emulsion, 8 cyproheptadine, 7

D DALIRESP, 7 danazol, 5 dantrolene, 4 dapagliflozin, 4 dapagliflozin/metformin ext-rel, 4 dapagliflozin/saxagliptin, 5 dapsone, 2 darifenacin ext-rel, 6 desipramine, 3 desmopressin spray, tabs, 6 desogestrel/EE, 5 desogestrel/EE 0.15/30, 5 desonide crm, lotion, oint 0.05%, 8 desoximetasone crm, oint 0.05%, 8 desoximetasone crm, oint 0.25%, gel 0.05%, 8 desvenlafaxine ext-rel, 3

dexamethasone, 5, 8 dexamethasone sodium phosphate, 8 DEXILANT, 6 dexlansoprazole delayed-rel, 6 dexmethylphenidate, 4 dexmethylphenidate ext-rel, 4 dextroamphetamine, 4 dextroamphetamine ext-rel, 4 dextromethorphan/brompheniramine/

pseudoephedrine, 7 dextromethorphan/promethazine, 7 dextromethorphan/quinidine, 4 diazepam, 3 diazepam rectal gel, 3 DICLEGIS, 6 diclofenac sodium, 8 diclofenac sodium delayed-rel, 1 diclofenac sodium delayed-rel/misoprostol, 1 diclofenac sodium gel, 1 diclofenac sodium soln, 1 dicloxacillin, 1 dicyclomine, 6 DIFFERIN, 7 DIFICID, 1 diflorasone diacetate crm 0.05%, 8 diflorasone diacetate oint 0.05%, 8 diflunisal, 1 difluprednate, 8 digoxin 0.125 mg, 0.25 mg, 3 digoxin ped elixir, 3 dihydroergotamine inj, 4 dihydroergotamine spray, 4 diltiazem ext-rel, 3 diphenoxylate/atropine, 6 dipyridamole, 6 dipyridamole ext-rel/aspirin, 6 disopyramide, 2 disulfiram, 4 divalproex sodium delayed-rel, 3 divalproex sodium ext-rel, 3 DIVIGEL, 5 donepezil, 3 dorzolamide, 8 dorzolamide/timolol maleate, 8 doxazosin, 2 doxepin, 3, 4 doxercalciferol, 5 doxycycline hyclate, 1 doxycycline monohydrate, 8 doxylamine/pyridoxine delayed-rel, 6 dronabinol, 6 dronedarone, 2 drospirenone/EE 3/20, 5 drospirenone/EE 3/30, 5 drospirenone/EE/levomefolate 3/20 and

levomefolate, 5 drospirenone/EE/levomefolate 3/30 and

levomefolate, 5 DUAVEE, 5 dulaglutide, 4 duloxetine delayed-rel, 3 DUREZOL, 8 dutasteride, 6 dutasteride/tamsulosin, 6 DYMISTA, 7

E econazole, 7 EE/norethindrone acetate - Jinteli, 5 efinaconazole, 7 eletriptan, 4

ELIDEL, 8 ELIQUIS, 6 eluxadoline, 6 EMVERM, 2 enalapril, 2 enalapril/hydrochlorothiazide, 2 enoxaparin, 6 entacapone, 3 ENTRESTO, 3 EPIDUO, 7 epinephrine auto-injector, 7 EPIPEN, 7 EPIPEN JR., 7 eplerenone, 2 eprosartan, 2 ergocalciferol (D2), 7 ergotamine/caffeine, 4 erythromycin, 8 erythromycin delayed-rel, 1 erythromycin ethylsuccinate, 1 erythromycin gel 2%, 7 erythromycin soln, 7 erythromycin stearate, 1 erythromycin/benzoyl peroxide, 7 escitalopram, 3 esomeprazole delayed-rel, 6 ESTRACE, 5 estradiol, 5 estradiol vaginal crm, 5 estradiol vaginal ring, 5 estradiol vaginal tabs, 5 estradiol valerate and dienogest/

estradiol valerate, 5 estradiol/levonorgestrel, 5 estradiol/norethindrone, 5 estradiol/norethindrone acetate, 5 ESTRING, 5 estrogens, conjugated, 5 estrogens, conjugated crm, 5 estrogens, conjugated/medroxyprogesterone, 5 estropipate, 5 eszopiclone, 4 ethambutol, 1 ethosuximide, 3 ethynodiol diacetate/EE 1/35 - Zovia 1/35, 5 ethynodiol diacetate/EE 1/50 - Zovia 1/50, 5 etodolac, 1 etonogestrel/EE ring, 5 etoposide, 2 EVAMIST, 5 exemestane, 2 ezetimibe, 2 ezetimibe/simvastatin, 2

F famciclovir, 1 famotidine, 6 FARXIGA, 4 febuxostat, 1 felodipine ext-rel, 2 fenofibrate, 2 fenofibric acid delayed-rel, 2 fentanyl citrate buccal, 1 fentanyl sublingual spray, 1 fentanyl transdermal, 1 fentanyl transmucosal lozenge, 1 FENTORA, 1 fesoterodine ext-rel, 6 FIASP, 4 fidaxomicin, 1 FINACEA, 8

10

finasteride, 6 FLAREX, 8 flecainide, 2 FLOVENT DISKUS, 7 FLOVENT HFA, 7 fluconazole, 1 fludrocortisone, 5 fluocinolone acetonide crm, oint 0.025%, 8 fluocinolone acetonide soln 0.01%, 8 fluocinonide crm, gel, oint, soln 0.05%, 8 fluoride drops, tabs, 7 fluorometholone, 8 fluorouracil cream 4%, 7 fluorouracil crm 5%, soln 5%, soln 2%, 7 fluoxetine, 3 FLUOXETINE, 3 fluoxetine 60 mg, 3 fluphenazine, 3 flutamide, 2 fluticasone, 7 fluticasone propionate crm, lotion 0.05%,

oint 0.005%, 8 fluticasone, CFC-free aerosol, 7 fluticasone/salmeterol, 7 fluticasone/salmeterol, CFC-free aerosol, 7 fluticasone/umeclidinium/vilanterol, 7 fluticasone/vilanterol, 7 fluvastatin, 2 fluvoxamine, 3 FML FORTE, 8 FML S.O.P., 8 folic acid, 6 folic acid/vitamin B6/vitamin B12, 6 fondaparinux, 6 formoterol inhalation soln, 7 fosinopril, 2 fosinopril/hydrochlorothiazide, 2 furosemide, 3 FYCOMPA, 3

G gabapentin, 3 gabapentin ext-rel, 4 galantamine, 3 galantamine ext-rel, 3 gemfibrozil, 2 gentamicin, 7, 8 glimepiride, 5 glipizide, 5 glipizide ext-rel, 5 glipizide/metformin, 4 GLUCAGEN HYPOKIT, 5 GLUCAGON EMERGENCY KIT, 5 glucagon, human recombinant, 5 glyburide, 5 glycopyrrolate/formoterol, 7 GRALISE, 4 granisetron, 6 granisetron transdermal, 6 GRASTEK, 6 griseofulvin ultramicrosize, 1 guanfacine, 2 guanfacine ext-rel, 4

H halobetasol propionate crm, oint 0.05%, 8 haloperidol, 3 HEXALEN, 2 HUMULIN R U-500, 4 hydralazine, 3 hydrochlorothiazide, 3

hydrocodone ext-rel, 1 hydrocodone/acetaminophen, 1 hydrocodone/homatropine, 7 hydrocortisone, 5 hydrocortisone acetate foam, 6 hydrocortisone acetate/pramoxine foam, 6 hydrocortisone butyrate crm, oint,

soln 0.1%, 8 hydrocortisone crm, 6 hydrocortisone crm 2.5%, 8 hydrocortisone enema, 6 hydrocortisone lotion 1%, 8 hydrocortisone valerate crm, oint 0.2%, 8 hydromorphone, 1 hydromorphone ext-rel, 1 hydroxychloroquine, 6 hydroxyurea, 2 hydroxyzine HCl, 7 HYSINGLA ER, 1

I ibandronate, 5 ibuprofen, 1 icosapent ethyl, 2 ILEVRO, 8 imipramine HCl, 3 imiquimod, 7, 8 INCRUSE ELLIPTA, 7 indapamide, 3 ingenol mebutate, 7 insulin aspart, 4 insulin aspart protamine 70%/

insulin aspart 30%, 4 insulin degludec, 4 insulin detemir, 4 insulin glargine, 4 insulin human, 4 insulin isophane human, 4 insulin isophane human 70%/regular 30%, 4 INVOKAMET, 4 INVOKAMET XR, 4 INVOKANA, 4 ipratropium soln, 7 ipratropium spray, 7 ipratropium/albuterol soln, 7 ipratropium/albuterol, CFC-free aerosol, 7 irbesartan, 2 irbesartan/hydrochlorothiazide, 2 isoniazid, 1 isosorbide dinitrate ext-rel tabs, 3 isosorbide dinitrate oral, 3 isosorbide dinitrate/hydralazine, 3 isosorbide mononitrate, 3 isosorbide mononitrate ext-rel, 3 isotretinoin, 7 itraconazole, 1 ivabradine, 3 ivermectin, 2, 8

J JANUMET, 4 JANUMET XR, 4 JANUVIA, 4 JENTADUETO, 4 JENTADUETO XR, 4 JUBLIA, 7

K ketoconazole, 7 ketoconazole shampoo 2%, 7 ketorolac, 8

ketorolac tromethamine, 8

L labetalol, 2 lacosamide, 3 lactulose, 6 lamotrigine, 3 lamotrigine ext-rel, 3 lamotrigine orally disintegrating tabs, 3 lancets, 5 lansoprazole + amoxicillin + clarithromycin, 6 lansoprazole delayed-rel, 6 lanthanum carbonate, 5 LASTACAFT, 8 latanoprost, 8 LATUDA, 3 leflunomide, 6 letrozole, 2 LEUKERAN, 2 levalbuterol tartrate, CFC-free aerosol, 7 LEVEMIR, 4 levetiracetam, 3 levetiracetam ext-rel, 3 levobunolol, 8 levocarnitine, 5 levofloxacin, 1, 8 levonorgestrel/EE - Trivora, 5 levonorgestrel/EE 0.1/20 - Lessina, 5 levonorgestrel/EE 0.1/20 and EE 10, 5 levonorgestrel/EE 0.15/30, 5 levonorgestrel/EE 0.15/30 - Levora, 5 levonorgestrel/EE 0.15/30 and EE 10, 5 levothyroxine, 5 levothyroxine - Levoxyl, 6 LIALDA, 6 lidocaine patch, 8 lidocaine viscous, 8 lidocaine/prilocaine, 8 lifitegrast, 8 linaclotide, 6 linagliptin, 4 linagliptin/metformin, 4 linagliptin/metformin ext-rel, 4 LINZESS, 6 liothyronine, 6 liraglutide, 4, 5 lisdexamfetamine, 4 lisinopril, 2 lisinopril/hydrochlorothiazide, 2 lithium carbonate, 4 lithium carbonate ext-rel, 4 lixisenatide/insulin glargine, 4 LO LOESTRIN FE, 5 loperamide, 6 lorazepam, 3 lorcaserin, 5 lorcaserin ext-rel, 5 losartan, 2 losartan/hydrochlorothiazide, 2 LOTRONEX, 6 lovastatin, 2 lubiprostone, 6 luliconazole, 7 LUMIGAN, 8 lurasidone, 3 LUZU, 7 LYRICA, 4 LYSODREN, 2

M malathion, 8

11

MATULANE, 2 MAXIDEX, 8 mebendazole chewable, 2 meclizine, 6 medroxyprogesterone acetate, 5 medroxyprogesterone acetate 150 mg/mL, 5 mefloquine, 1 megestrol acetate susp, 5 megestrol acetate tabs, 2 meloxicam, 1 melphalan, 2 memantine, 3 memantine ext-rel, 3 memantine/donepezil, 3 mercaptopurine, 2 mesalamine delayed-rel tabs, 6 mesalamine ext-rel caps, 6 mesalamine rectal susp, 6 mesalamine supp, 6 metaxalone, 4 metformin, 4 metformin ext-rel, 4 methadone, 1 methazolamide, 3 methimazole, 5 methocarbamol, 4 methotrexate, 2, 6 methoxsalen oral, 7 methyldopa, 3 methylphenidate, 4 methylphenidate ext-rel, 4 methylphenidate ext-rel susp, 4 methylprednisolone, 5 metipranolol, 8 metoclopramide, 6 metolazone, 3 metoprolol succinate ext-rel, 2 metoprolol tartrate, 2 metoprolol/hydrochlorothiazide, 2 metronidazole, 2, 6 metronidazole crm, gel, lotion 0.75%, 8 metronidazole gel 1%, 8 midodrine, 3 milnacipran, 4 MINASTRIN 24 FE, 5 MINIVELLE, 5 minocycline, 1 mirabegron ext-rel, 6 MIRAPEX ER, 3 mirtazapine, 3 misoprostol, 6 mitotane, 2 mometasone, 7 mometasone crm, lotion, oint 0.1%, 8 montelukast, 7 morphine, 1 morphine ext-rel, 1 morphine supp, 1 MOVANTIK, 6 MOXEZA, 8 moxifloxacin, 1, 8 MULTAQ, 2 multivitamins/fluoride drops, tabs, 7 multivitamins/fluoride/iron drops, tabs, 7 mupirocin, 7 MYLERAN, 2 MYRBETRIQ, 6

N nabumetone, 1 nadolol, 2

naftifine, 7 NAFTIN, 7 naloxegol, 6 naloxone inj, 4 naloxone nasal spray, 4 naltrexone, 4 naltrexone/bupropion ext-rel, 5 NAMENDA XR, 3 NAMZARIC, 3 naproxen, 1 naproxen sodium, 1 naratriptan, 4 NARCAN, 4 NATAZIA, 5 nateglinide, 4 nebivolol, 2 neomycin/polymyxin B/

bacitracin/hydrocortisone oint, 8 neomycin/polymyxin B/dexamethasone, 8 neomycin/polymyxin B/gramicidin, 8 neomycin/polymyxin B/hydrocortisone, 8 neomycin/polymyxin B/hydrocortisone

susp, 8 nepafenac, 8 NEUPRO, 3 NEVANAC, 8 niacin ext-rel, 2 nifedipine ext-rel, 2 nitrofurantoin ext-rel, 2 nitrofurantoin macrocrystals, 2 nitrofurantoin susp, 2 nitroglycerin lingual spray, 3 nitroglycerin sublingual, 3 nitroglycerin transdermal, 3 norelgestromin/EE, 5 norethindrone, 5 norethindrone acetate, 5 norethindrone acetate/EE 1.5/30, 5 norethindrone acetate/EE 1.5/30 and iron, 5 norethindrone acetate/EE 1/10 and EE 10 and

iron, 5 norethindrone acetate/EE 1/20, 5 norethindrone acetate/EE 1/20 and iron, 5 norethindrone acetate/EE 1/20 and iron -

Lomedia 24 Fe, 5 norethindrone acetate/EE 1/20 and iron

chewable, 5 norethindrone/EE, 5 norethindrone/EE 0.5/35, 5 norethindrone/EE 1/35, 5 norethindrone/ME 1/50, 5 norgestimate/EE, 5 norgestimate/EE 0.25/35, 5 norgestrel/EE 0.3/30 - Low-Ogestrel, 5 nortriptyline, 3 NOVOLIN 70/30, 4 NOVOLIN N, 4 NOVOLIN R, 4 NOVOLOG, 4 NOVOLOG MIX 70/30, 4 NUCYNTA, 1 NUCYNTA ER, 1 NUEDEXTA, 4 NUVARING, 5 nystatin, 1, 7

O ofloxacin, 8 ofloxacin otic, 8 olanzapine, 3 olmesartan, 2

olmesartan/amlodipine/ hydrochlorothiazide, 2

olmesartan/hydrochlorothiazide, 2 olodaterol, CFC-free aerosol, 7 olopatadine, 8 olopatadine spray, 7 omega-3 acid ethyl esters, 2 omeprazole delayed-rel, 6 ondansetron, 6 ONETOUCH ULTRA kits and test strips, 5 ONETOUCH VERIO kits and test strips, 5 ONZETRA XSAIL, 4 ORACEA, 8 orphenadrine/aspirin/caffeine, 4 oseltamivir, 2 ospemifene, 5 OSPHENA, 5 oxaprozin, 1 oxazepam, 3 oxcarbazepine, 3 oxcarbazepine ext-rel, 3 OXTELLAR XR, 3 oxybutynin, 6 oxybutynin ext-rel, 6 oxycodone caps, tabs 5 mg, 1 oxycodone concentrate 20 mg/mL, 1 oxycodone ext-rel, 1 oxycodone tabs 15 mg, 30 mg,

soln 5 mg/5 mL, 1 oxycodone/acetaminophen 5/325, 1 oxycodone/acetaminophen soln, 1 OXYCONTIN, 1

P pancrelipase, 6 pancrelipase delayed-rel, 6 pantoprazole delayed-rel, 6 paricalcitol, 5 paroxetine HCl, 3 paroxetine HCl ext-rel, 3 paroxetine mesylate, 4 patiromer sorbitex, 5 PAZEO, 8 peg 3350/electrolytes, 6 penicillin VK, 1 PENTASA, 6 perampanel, 3 PERFOROMIST, 7 perindopril, 2 permethrin 5%, 8 perphenazine, 3 phenazopyridine, 6 phenelzine, 3 phenobarbital, 3 phenytoin, 3 phenytoin sodium extended, 3 PHOSLYRA, 5 PICATO, 7 pilocarpine tabs, 6 pimecrolimus, 8 pindolol, 2 pioglitazone, 4 pioglitazone/glimepiride, 4 pioglitazone/metformin, 4 podofilox, 8 polyethylene glycol 3350, 6 polymyxin B/bacitracin, 8 polymyxin B/trimethoprim, 8 potassium chloride ext-rel, 6 potassium chloride liquid, 6 potassium citrate ext-rel, 6

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pramipexole, 3 pramipexole ext-rel, 3 pramlintide, 4 prasugrel, 6 pravastatin, 2 PRED MILD, 8 prednisolone, 5 prednisolone acetate, 8 prednisolone acetate 1%, 8 prednisone, 5 pregabalin, 4 PREMARIN, 5 PREMPHASE, 5 PREMPRO, 5 prenatal vitamins, 7 prenatal vitamins/DHA/docusate/folic acid, 7 prenatal vitamins/docusate/folic acid, 7 prenatal vitamins/docusate/folic acid + DHA, 7 prenatal vitamins/folic acid + pyridoxine, 7 primidone, 3 PROAIR HFA, 7 PROAIR RESPICLICK, 7 probenecid, 1 procarbazine, 2 prochlorperazine, 6 PROCTOFOAM-HC, 6 progesterone, micronized, 5 promethazine, 6 propafenone, 2 propafenone ext-rel, 2 propranolol, 2 propranolol ext-rel, 2 propylthiouracil, 5 PULMICORT FLEXHALER, 7 PYLERA, 6 pyrazinamide, 1 pyridostigmine, 4 pyridostigmine ext-rel, 4

Q QTERN, 5 quetiapine, 3 quetiapine ext-rel, 3 QUILLIVANT XR, 4 quinapril, 2 quinapril/hydrochlorothiazide, 2 QVAR, 7

R ragweed pollen allergen extract, 6 RAGWITEK, 6 raloxifene, 5 ramipril, 2 RANEXA, 3 ranitidine, 6 ranolazine ext-rel, 3 RAPAFLO, 6 rasagiline mesylate, 3 RELENZA, 2 repaglinide, 4 RESTASIS, 8 RETIN-A MICRO, 7 rifampin, 1 rifaximin 550 mg, 2 risedronate, 5 risedronate delayed-rel, 5 RISPERDAL CONSTA, 3 risperidone, 3 risperidone long-acting inj, 3 rivaroxaban, 6 rivastigmine, 3

rivastigmine transdermal, 3 rizatriptan, 4 roflumilast, 7 rolapitant, 6 ropinirole, 3 ropinirole ext-rel, 3 rosuvastatin, 2 rotigotine transdermal, 3 ROXICET, 1

S sacubitril/valsartan, 3 SAFYRAL, 5 salmeterol xinafoate, 7 SANCUSO, 6 SAVELLA, 4 SAXENDA, 5 selegiline, 3 selenium sulfide shampoo 2.5%, 7 SEREVENT, 7 sertraline, 3 sevelamer carbonate, 5 SILENOR, 4 silodosin, 6 silver sulfadiazine, 7 SIMBRINZA, 8 simvastatin, 2 sitagliptin phosphate, 4 sitagliptin/metformin, 4 sitagliptin/metformin ext-rel, 4 SIVEXTRO, 2 sodium sulfate/potassium sulfate/

magnesium sulfate, 6 solifenacin succinate, 6 SOLIQUA, 4 SOOLANTRA, 8 sotalol, 2 SPIRIVA, 7 spironolactone, 2 spironolactone/hydrochlorothiazide, 3 STIOLTO RESPIMAT, 7 STRIVERDI RESPIMAT, 7 SUBOXONE, 4 SUBSYS, 1 sucralfate, 6 sucroferric oxyhydroxide, 5 sulfacetamide lotion 10%, 7 sulfacetamide oint, soln 10%, 8 sulfacetamide/prednisolone phosphate

10%/0.25%, 8 sulfamethoxazole/trimethoprim, 2 sulfamethoxazole/trimethoprim DS, 2 sulfasalazine, 6 sulfasalazine delayed-rel, 6 sulindac, 1 sumatriptan, 4 sumatriptan inj, 4 sumatriptan nasal powder, 4 sumatriptan nasal spray, 4 sumatriptan/naproxen sodium, 4 SUPRAX, 1 SUPREP, 6 suvorexant, 4 SYMBICORT, 7 SYMLINPEN, 4 SYNTHROID, 5

T TABLOID, 2 tacrolimus, 8 tamoxifen, 2

tamsulosin, 6 tapentadol, 1 tapentadol ext-rel, 1 tazarotene, 7 TAZORAC, 7 tedizolid, 2 TEKTURNA, 3 TEKTURNA HCT, 3 telmisartan, 2 telmisartan/hydrochlorothiazide, 2 temazepam, 4 terazosin, 2 terbinafine tabs, 1 terbutaline, 7 terconazole, 6 testosterone cypionate, 4 testosterone enanthate, 4 testosterone gel, 4 testosterone soln, 4 testosterone transdermal, 4 tetracycline, 1 theophylline ext-rel tabs, 7 thioguanine, 2 thiothixene, 3 tiagabine, 3 ticagrelor, 6 timolol hemihydrate, 8 timolol maleate, 8 timolol maleate gel, 8 timothy grass pollen allergen extract, 6 tinidazole, 2 tiotropium, 7 tiotropium/olodaterol, 7 tizanidine tabs, 4 TOBRADEX, 8 TOBRADEX ST, 8 tobramycin, 8 tobramycin/dexamethasone oint 0.3%/0.1%, 8 tobramycin/dexamethasone susp 0.3%/0.05%, 8 tobramycin/dexamethasone

susp 0.3%/0.1%, 8 tobramycin/loteprednol, 8 TOLAK, 7 tolterodine, 6 tolterodine ext-rel, 6 topiramate, 3 topiramate ext-rel, 3 torsemide, 3 TOVIAZ, 6 TRADJENTA, 4 tramadol, 1 tramadol ext-rel, 1 trandolapril, 2 trandolapril/verapamil ext-rel, 2 tranylcypromine, 3 TRAVATAN Z, 8 travoprost, 8 trazodone, 3 TRELEGY ELLIPTA, 7 TRESIBA, 4 tretinoin, 7 tretinoin - Avita, 7 tretinoin caps, 2 tretinoin gel microsphere, 7 TREXALL, 2 TREXIMET, 4 triamcinolone acetonide crm 0.5%, 8 triamcinolone acetonide crm, lotion 0.025%, 8 triamcinolone acetonide crm, lotion,

oint 0.1%, 8 triamcinolone paste, 8

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triamterene/hydrochlorothiazide, 3 trifluoperazine, 3 trifluridine, 8 trihexyphenidyl, 3 trimethobenzamide, 6 trimethoprim, 2 TRINTELLIX, 3 TROKENDI XR, 3 trospium, 6 trospium ext-rel, 6 TRULICITY, 4

U UCERIS, 6 ULORIC, 1 umeclidinium bromide, 7 umeclidinium/vilanterol, 7 uridine triacetate, 2 ursodiol, 6

V valacyclovir, 1 valganciclovir, 1 valproic acid, 3 valsartan, 2 valsartan/hydrochlorothiazide, 2

vancomycin, 2 VARUBI, 6 VASCEPA, 2 VELPHORO, 5 VELTASSA, 5 venlafaxine, 3 venlafaxine ext-rel, 3 verapamil ext-rel, 3 VESICARE, 6 VIBERZI, 6 VICTOZA, 4 VIIBRYD, 3 vilazodone, 3 VIMPAT, 3 VIOKACE, 6 VISTOGARD, 2 vitamin ADC/fluoride drops, 7 vitamin ADC/fluoride/iron drops, 7 VOLTAREN, 1 voriconazole, 1 vortioxetine, 3 VRAYLAR, 3 VYVANSE, 4

W warfarin, 6

WELCHOL, 2

X XARELTO, 6 XIFAXAN, 2 XIGDUO XR, 4 XIIDRA, 8

Z zafirlukast, 7 zanamivir, 2 ZEMBRACE SYMTOUCH, 4 ZENPEP, 6 zileuton ext-rel, 7 ziprasidone, 3 zolmitriptan, 4 zolmitriptan nasal spray, 4 zolpidem, 4 zolpidem ext-rel, 4 zolpidem sublingual, 4 ZOMIG, 4 zonisamide, 3 ZUBSOLV, 4 ZYCLARA, 7 ZYLET, 8

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