Comprehensive Formulary

Nappi code Drug Name Active Ingredient Strength Drug

Form

Chronic Medicine Management

Reimbursement Criteria for preferred

formulary drugs

Inhaled B2 agonists

864757 AIROMIR AUTOHALER Salbutamol 100MCG INH

821411 AIROMIR INHALER Salbutamol 100MCG INH Accepted treatment

819603 ASTHAVENT 200 DS Salbutamol 100MCG INH Accepted treatment

849332 ASTHAVENT 300 DOSE Salbutamol 100MCG INH Accepted treatment

700715 ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH Accepted treatment

878219 ASTHAVENT DP Salbutamol 200MCG CPS

706544 BEROTEC HFA 200 DOSE  Fenoterol 100MCG  INH 

791415 BRICANYL TURBOHALER Terbutaline 0.5MG INH

824623 COMBIVENT MDI Salbutamol and other drugs for obstructive airway diseases 20MCG/100MCG INH

718698 DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH

707882 DUOVENT HFA 200DOSE  Fenoterol and other drugs for obstructive airway diseases 50MCG/20MCG  INH 

775363 VENTEZE COMPLETE Salbutamol 100MCG INH Accepted treatment

711213 VENTEZE CFC FREE 200 DOSE  Salbutamol 100MCG  INH  Accepted treatment

703371 VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Accepted treatment

Long acting B2 agonists

820911 FORADIL DRY Formoterol 12MCG CPS Clinical Review

704175 FORATEC DP CAPS  Formoterol 12MCG CAP Clinical Review

710307 FORATEC HFA 120DOSE  Formoterol 12MCG INH  Clinical Review

840246 OXIS TURBUHALER Formoterol 9MCG INH Clinical Review

818496 SEREVENT ACCUHALER Salmeterol 50MCG INH

708289 SEREVENT CFC-FREE 120DOSE  Salmeterol 25MCG  INH 

787302 SEREVENT INHAL(120) Salmeterol 25MCG INH

791695 SEREVENT INHAL(60) Salmeterol 25MCG INH

Inhaled corticosteroids

705269 ALVESCO 160MCG 120 DOSE  Ciclesonide 160MCG  INH 

705267 ALVESCO 160MCG 60 DOSE  Ciclesonide 160MCG  INH 

705265 ALVESCO 80MCG 60 DOSE  Ciclesonide 80MCG  INH 

717571 ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH

717581 ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH

717572 ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH

717582 ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH

827088 BECEZE INHALER COMPLETE Beclomethasone 100MCG INH Accepted treatment

827061 BECEZE 50 200DOSE Beclomethasone 50MCG INH Accepted treatment

Special Investigations (SI) - results of recent relevant tests required before reimbursement is considered

Specialist Motivation - will require a relevant specialist motivation before reimbursement is considered

Asthma

* : these agents are only available on more comprehensive options

Specialist Script - will require a relevant specialist's prescription before reimbursement is considered

Clinical Motivation - specific clinical information required before reimbursement is considered

Clinical Review - will be authorised if the drug history or co-morbidity clearly indicates that use of the drug is indicated in the specific patient.

Accepted Treatment - will be authorised without requesting additional clinical information (unless specific concerns e.g. unusual dose requests).

Quantity/dosage and duration of authorisation may vary - depending on the requested drug.

KEY to Chronic Medicine Management Reimbursement Criteria for use of preferred formulary drugs:

Products in red are preferred formulary drugs (drugs of choice) and include information on reimbursement criteria. Products not in red i.e. products in black (non-preferred formulary drugs) are also reimbursed on the comprehensive options without a co-payment, subject to

reimbursement criteria, available funds and benefit design. However, all new treatments should, wherever possible, be commenced with preferred agents. Not only are these medicines generally the most cost-effective in their class, but they are also reimbursed unlimited on all options.

Where members have non-PMB benefits and/or where there are compelling indications, alternative agents for the treatment of CDL (Chronic Disease List) illnesses may be considered for pre-authorisation.

Please Note:

Depending on the specific scheme option, products included on this chronic medicines formulary will not attract a co-payment if authorised by Chronic Medicine Management for a disease on the CDL and obtained from the Designated Service Provider (where applicable). Reimbursement

will however be subject to the Chronic Medicine Management clinical guidelines and protocols and the Medicine Price List (MPL).

COMPREHENSIVE PMB FORMULARY

1-Nov-13

1 11/5/2013

Comprehensive Formulary

819638 BECLATE INHALER Beclomethasone 100MCG INH Accepted treatment

820083 BECLATE INHALER Beclomethasone 200MCG INH Accepted treatment

819611 BECLATE INHALER Beclomethasone 50MCG INH Accepted treatment

897469 BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH Accepted treatment

897462 BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH Accepted treatment

704176 BUDEFLAM DP CAPS  Budesonide 200MCG CAP Accepted treatment

818453 FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP

818461 FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP

818488 FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP

818445 FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP

703275 FLIXOTIDE 50 CFC FREE 120 ACT  Fluticasone 50MCG  INH 

897752 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH

897759 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH

715009 FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment

715008 FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment

715007 FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH Accepted treatment

715753 FOXAIR 25/125 120DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH Accepted treatment

715754 FOXAIR 25/250 120DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH Accepted treatment

715752 FOXAIR 25/50 120 DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH Accepted treatment

839329 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 100MCG INH Accepted treatment

839337 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 200MCG INH Accepted treatment

839310 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 50MCG INH Accepted treatment

839353 INFLAMMIDE INHALATION SYSTEM 300 DOSE Budesonide 100MCG KIT Accepted treatment

839345 INFLAMMIDE INHALATION SYSTEM 300 DOSE Budesonide 200MCG KIT Accepted treatment

704020 INFLAMMIDE 200 NOVOLIZE REFIL  Budesonide 200MCG  REF Accepted treatment

704021 INFLAMMIDE 200 NOVOLIZER COMPL  Budesonide 200MCG  INH  Accepted treatment

707879 INFLAMMIDE NOVOLIZER COMPLETE 100DOSE  Budesonide 400MCG  INH Accepted treatment

707881 INFLAMMIDE NOVOLIZER REFILL 100DOSE  Budesonide 400MCG  REF  Accepted treatment

791423 PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH

791431 PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH Accepted treatment

823791 PULMICORT TURB (100 DOSE) Budesonide 400MCG ATH

715190 SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment

715191 SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment

715189 SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment

894990 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Accepted treatment

895006 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Accepted treatment

894989 SERETIDE 25/50 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Accepted treatment

874493 SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH Accepted treatment

874507 SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH Accepted treatment

874515 SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH Accepted treatment

700173 SYMBICORD TURBO 120 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH

705984 SYMBICORD 320/9MCG PER INHALATION  Formutoterol and other anti- asthmatics 9MCG/320MCG  INH 

700172 SYMBICORD TURBO 60 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH

705986 SYMBICORD 80/4.5MCG PER INHALATION  Formutoterol and other anti- asthmatics 4.5MCG/80MCG  INH 

Oral Xanthines

782769 CHRONOPHYLLIN Theophylline 250MG CAP

725005 EUPHYLLIN RETARD Theophylline 250MG SRT

743119 MICROPHYLLIN Theophylline 125MG SRC

743127 MICROPHYLLIN Theophylline 250MG SRC

748498 NUELIN Theophylline 125MG TAB

748528 NUELIN LIQUID Theophylline 25MG/5ML SYR

748501 NUELIN SA 250 Theophylline 250MG TAB

755281 PHYLLOCONTIN Aminophylline 225MG SRT

815357 PULMOPHYLLIN SR 300 Theophylline 300MG SRT Clinical Review

788368 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT Clinical Review

788376 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT Clinical Review

770388 THEOPHEN Theophylline SYR Clinical Review

783005 THEOPLUS Theophylline 200MG SRT

783013 THEOPLUS Theophylline 300MG SRT

785105 UNIPHYL Theophylline 400MG SRT

816159 UNIPHYL Theophylline 600MG SRT

Oral Corticosteroids

716381 ADCO PREDNISOLONE Prednisolone 15MG/5ML LIQ Specialist script

714552 ASPELONE Prednisolone 15MG/5ML LIQ Specialist script

814407 CAPSOID Prednisolone 5MG TAB Specialist script

800155 LENISOLONE Prednisolone 5MG TAB Specialist script

2 11/5/2013

Comprehensive Formulary

742759 METICORTEN Prednisone 50MG TAB

742732 METICORTEN Prednisone 5MG TAB

752304 PANAFCORT Prednisone 5MG TAB Specialist script

788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Specialist script

700170 PREFLAM Prednisolone 15MG/5ML SYR Specialist script

703720 PRELONE Prednisolone 5MG TAB

805149 PRELONE Prednisolone 15MG/5ML SYR Specialist script

703603 PULMISON ORAL SOLUTION Prednisone 5MG/1ML SYR Specialist script

836826 PULMISON TABS Prednisone 20MG TAB

818267 TROLIC Prednisone 5MG TAB Specialist script

Oral Corticosteroids

716693 COVOCORT Hydrocortisone 10MG TAB Accepted treatment

726540 FLORINEF ACETATE Fludrocortisone 0.1MG TAB Accepted treatment

Mood Stabilizers

709540 ARROW LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

709541 ARROW LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

709539 ARROW LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

709537 ARROW LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

705441 ASPEN LAMOTRIGINE 100MG  Lamotrigine 100MG  TAB  Accepted treatment

705442 ASPEN LAMOTRIGINE 200MG  Lamotrigine 200MG  TAB  Accepted treatment

705436 ASPEN LAMOTRIGINE 25MG  Lamotrigine 25MG  TAB  Accepted treatment

705440 ASPEN LAMOTRIGINE 50MG  Lamotrigine 50MG  TAB  Accepted treatment

707789 AUSTELL-LAMOTRIGINE Lamotrigine 100MG  TAB  Accepted treatment

707790 AUSTELL-LAMOTRIGINE Lamotrigine 200MG  TAB  Accepted treatment

707787 AUSTELL-LAMOTRIGINE Lamotrigine 25MG  TAB  Accepted treatment

707788 AUSTELL-LAMOTRIGINE Lamotrigine 50MG  TAB  Accepted treatment

712078 CAMCOLIT Lithium 250MG TAB Accepted treatment

712086 CAMCOLIT Lithium 400MG TAB Accepted treatment

715980 CONVULEX Valproic acid 150MG CAP Accepted treatment

781541 CONVULEX Valproic acid 250MG/5ML SYR Accepted treatment

715999 CONVULEX Valproic acid 300MG CAP Accepted treatment

781568 CONVULEX Valproic acid 500MG CAP Accepted treatment

712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment

710389 DYNA-LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

710390 DYNA-LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

710387 DYNA-LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

710388 DYNA-LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

818666 EPILIM CR Valproic acid 200MG SRT Accepted treatment

818674 EPILIM CR Valproic acid 300MG SRT Accepted treatment

818682 EPILIM CR Valproic acid 500MG SRT Accepted treatment

821578 EPILIM CRUSHABLE Valproic acid 100MG TAB Accepted treatment

780545 EPILIM SUGAR FREE Valproic acid 200MG/5ML SYR Accepted treatment

718274 EPILIZINE CR Valproic acid 200MG SRT Accepted treatment

718275 EPILIZINE CR Valproic acid 300MG SRT Accepted treatment

718276 EPILIZINE CR Valproic acid 500MG SRT Accepted treatment

704381 EPITEC 100MG  Lamotrigine 100MG TAB Accepted treatment

704382 EPITEC 200MG  Lamotrigine 200MG TAB Accepted treatment

704379 EPITEC 25MG  Lamotrigine 25MG TAB Accepted treatment

704380 EPITEC 50MG  Lamotrigine 50MG TAB Accepted treatment

707361 LAMEPTIL  Lamotrigine 100MG  TAB  Accepted treatment

707362 LAMEPTIL  Lamotrigine 200MG  TAB  Accepted treatment

707359 LAMEPTIL  Lamotrigine 25MG  TAB  Accepted treatment

707360 LAMEPTIL  Lamotrigine 50MG  TAB  Accepted treatment

805521 LAMICTIN Lamotrigine 100MG TAB Accepted treatment

819034 LAMICTIN Lamotrigine 200MG TAB Accepted treatment

805505 LAMICTIN Lamotrigine 25MG TAB Accepted treatment

805513 LAMICTIN Lamotrigine 50MG TAB Accepted treatment

813907 LAMICTIN P100 Lamotrigine 100MG DSP Accepted treatment

704533 LAMICTIN P2  Lamotrigine 2MG  DSP  Accepted treatment

891716 LAMICTIN P200 Lamotrigine 200MG DSP Accepted treatment

813893 LAMICTIN P25 Lamotrigine 25MG DSP Accepted treatment

Addison's disease

Bipolar Mood Disorder

3 11/5/2013

Comprehensive Formulary

813885 LAMICTIN P5 Lamotrigine 5MG DSP Accepted treatment

891708 LAMICTIN P50 Lamotrigine 50MG DSP Accepted treatment

710887 LAMIDUS  Lamotrigine 100MG  TAB  Accepted treatment

710888 LAMIDUS  Lamotrigine 200MG  TAB  Accepted treatment

710885 LAMIDUS  Lamotrigine 50MG  TAB  Accepted treatment

704488 LAMITOR Lamotrigine 100MG TAB Accepted treatment

704486 LAMITOR Lamotrigine 25MG TAB Accepted treatment

704487 LAMITOR Lamotrigine 50MG TAB Accepted treatment

712217 LAMITOR  Lamotrigine 200MG  TAB  Accepted treatment

718465 NAVALPRO CR Valproic acid 200MG SRT Accepted treatment

718466 NAVALPRO CR Valproic acid 300MG SRT Accepted treatment

718468 NAVALPRO CR Valproic acid 500MG SRT Accepted treatment

758833 QUILONUM RETARD Lithium 450MG TAB Accepted treatment

712523 ROLAB-CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment

705597 SANDOZ CARBAMAZEPINE CR200  Carbamazepine 200MG  SRT  Accepted treatment

705602 SANDOZ CARBAMAZIPINE CR400  Carbamazepine 400MG  SRT  Accepted treatment

705248 SANDOZ LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

705249 SANDOZ LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

705251 SANDOZ LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

705250 SANDOZ LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

769398 TEGRETOL Carbamazepine 200MG TAB

779652 TEGRETOL CR Carbamazepine 200MG SRT

779660 TEGRETOL CR Carbamazepine 400MG SRT

769401 TEGRETOL S Carbamazepine 100MG/5ML SUS Accepted treatment

715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment

Antipsychotic agents

712192 ABILIFY 5MG Aripiprazole 5MG  TAB

705634 ABILIFY 10MG  Aripiprazole 10MG  TAB 

705635 ABILIFY 15MG  Aripiprazole 15MG  TAB 

705636 ABILIFY 30MG  Aripiprazole 30MG  TAB 

717082 ASPEN CLOZAPINE Clozapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717081 ASPEN CLOZAPINE Clozapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

711471

ASPEN RISPERIDONE  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711472

ASPEN RISPERIDONE  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711473

ASPEN RISPERIDONE  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711474

ASPEN RISPERIDONE  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711475

ASPEN RISPERIDONE  Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

716500 AUROPERDAL Risperidone .5MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716501 AUROPERDAL Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716502 AUROPERDAL Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716503 AUROPERDAL Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716504 AUROPERDAL Risperidone 4MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714686 AUROPIDONE Risperidone 0.5MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714687 AUROPIDONE Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714688 AUROPIDONE Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714689 AUROPIDONE Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714690 AUROPIDONE Risperidone 4MG TAB

Accepted treatment (clinical motivation

for low-cost options)

705386 BIO-SULPIRIDE  Sulpiride 200MG TAB Accepted treatment

4 11/5/2013

Comprehensive Formulary

700178

CLOMENT Clozapine 100MG TAB Accepted treatment (clinical motivation

for low-cost options)

700176

CLOMENT Clozapine 25MG TAB Accepted treatment (clinical motivation

for low-cost options)

789798 CLOPIXOL Zuclopenthixol 10MG TAB

796751 CLOPIXOL Zuclopenthixol 2MG TAB

714852 CLOPIXOL DEPOT Zuclopenthixol 200MG/1ML INJS Accepted treatment

705845

CLOZAPINE-HEXAL  Clozapine 100MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

705844

CLOZAPINE-HEXAL  Clozapine 25MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

716051 DOPAQUEL Quetiapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716052 DOPAQUEL Quetiapine 200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716050 DOPAQUEL Quetiapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716053 DOPAQUEL Quetiapine 300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

712212 DRL RISPERIDONE  Risperidone 0.5MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

712211 DRL RISPERIDONE  Risperidone 1MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

712210 DRL RISPERIDONE  Risperidone 2MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

712209 DRL RISPERIDONE  Risperidone 3MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

726656 FLUANXOL Flupentixol .5MG TAB

726664 FLUANXOL Flupentixol 1MG TAB

726672 FLUANXOL DEPOT 1ML Flupentixol 20MG/1ML INJS Accepted treatment

703465 GEODON  Ziprasidone 20MG  CAP 

703468 GEODON  Ziprasidone 40MG  CAP 

703475 GEODON  Ziprasidone 60MG  CAP 

703476 GEODON  Ziprasidone 80MG  CAP 

715666 INVEGA Paliperidone 3MG SRT

715667 INVEGA Paliperidone 6MG SRT

715668 INVEGA Paliperidone 9MG SRT

735884 LARGACTIL Chlorpromazine 100MG TAB Accepted treatment

735868 LARGACTIL Chlorpromazine 25MG TAB Accepted treatment

735876 LARGACTIL Chlorpromazine 50MG TAB Accepted treatment

736716

LEPONEX Clozapine 100MG TAB Accepted treatment (clinical motivation

for low-cost options)

736708

LEPONEX Clozapine 25MG TAB Accepted treatment (clinical motivation

for low-cost options)

712191

MYLAN RISPERIDONE Risperidone

0.5MG 

TAB Accepted treatment (clinical motivation

for low-cost options)

712190

MYLAN RISPERIDONE Risperidone

1MG 

TAB Accepted treatment (clinical motivation

for low-cost options)

712189

MYLAN RISPERIDONE Risperidone

2MG 

TAB Accepted treatment (clinical motivation

for low-cost options)

716670MYLAN QUETIAPINE

Quetiapine

100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716671MYLAN QUETIAPINE

Quetiapine

200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716668MYLAN QUETIAPINE

Quetiapine

25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716672MYLAN QUETIAPINE

Quetiapine

300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

744301 MODECATE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment

744328 MODECATE+SYRINGE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment

715996 OLEANZ Olanzapine 10MG TAB

715994 OLEANZ Olanzapine 2.5MG TAB

715995 OLEANZ Olanzapine 5MG TAB

715968 OLEANZ RAPITAB Olanzapine 10MG MLT

715967 OLEANZ RAPITAB Olanzapine 5MG MLT

715659 OLEXAR Olanzapine 10MG TAB

5 11/5/2013

Comprehensive Formulary

715657 OLEXAR Olanzapine 2.5MG TAB

715658 OLEXAR Olanzapine 5MG TAB

751073 ORAP Pimozide 1MG TAB

751081 ORAP Pimozide 4MG TAB

712617

PERIZAL Risperidone 0.5MG TAB Accepted treatment (clinical motivation

for low-cost options)

712618

PERIZAL Risperidone 1MG TAB Accepted treatment (clinical motivation

for low-cost options)

712619

PERIZAL Risperidone 2MG TAB Accepted treatment (clinical motivation

for low-cost options)

712621

PERIZAL Risperidone 3MG TAB Accepted treatment (clinical motivation

for low-cost options)

718353 PSYQUET Quetiapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718354 PSYQUET Quetiapine 200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718352 PSYQUET Quetiapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718355 PSYQUET Quetiapine 300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716636 QUETOSER

Quetiapine

100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716637 QUETOSER

Quetiapine

200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716635 QUETOSER

Quetiapine

25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716638 QUETOSER

Quetiapine

300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

715685 REDILANZ Olanzapine 10MG TAB

715683 REDILANZ Olanzapine 2.5MG TAB

715684 REDILANZ Olanzapine 5MG TAB

717996 RISNIA Risperidone .5MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717997 RISNIA Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717998 RISNIA Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717999 RISNIA Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714101 RISPACOR

Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

713967 RISPACOR

Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

713966 RISPACOR

Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

713965 RISPACOR

Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

713964 RISPACOR

Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

891523

RISPERDAL Risperidone 0.5MG TAB Accepted treatment (clinical motivation

for low-cost options)

828432

RISPERDAL Risperidone 1MG TAB Accepted treatment (clinical motivation

for low-cost options)

801860

RISPERDAL Risperidone 2MG TAB Accepted treatment (clinical motivation

for low-cost options)

801879

RISPERDAL Risperidone 3MG TAB Accepted treatment (clinical motivation

for low-cost options)

707993

RISPERDAL QUICKLET  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

707994

RISPERDAL QUICKLET  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

707995

RISPERDAL QUICKLET  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

707997

RISPERDAL QUICKLET  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

6 11/5/2013

Comprehensive Formulary

707998

RISPERDAL QUICKLET  Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

705474 RISPERDAL CONSTA  Risperidone 25MG  VIAL  Specialist motivation

705475 RISPERDAL CONSTA  Risperidone 37.5MG  VIAL  Specialist motivation

705476 RISPERDAL CONSTA  Risperidone 50MG  VIAL  Specialist motivation

710790

RISPERIDONE HEXAL  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

710791

RISPERIDONE HEXAL  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

710793

RISPERIDONE HEXAL  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711419

RISPERLET  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711420

RISPERLET  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711421

RISPERLET  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

718226 RISPEVON Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718227 RISPEVON Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718228 RISPEVON Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718229 RISPEVON Risperidone 4MG TAB

Accepted treatment (clinical motivation

for low-cost options)

711537

RISPONZ  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711534

RISPONZ  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711536

RISPONZ  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711538

RISPONZ  Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

730335 ROLAB-HALOPERIDOL Haloperidol 1.5MG TAB Accepted treatment

730327 ROLAB-HALOPERIDOL Haloperidol 5MG TAB Accepted treatment

715736 SCHIZOROL Risperidone 0.5MG TAB

Accepted treatment (clinical motivation

for low-cost options)

715737 SCHIZOROL Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

715738 SCHIZOROL Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

763411 SERENACE Haloperidol 0.5MG CAP Accepted treatment

763446 SERENACE Haloperidol 1.5MG TAB Accepted treatment

763535 SERENACE Haloperidol 10MG TAB Accepted treatment

763454 SERENACE Haloperidol 5MG TAB Accepted treatment

716652 SEREZ

Quetiapine

100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716653 SEREZ

Quetiapine

200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716651 SEREZ

Quetiapine

25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716654 SEREZ

Quetiapine

300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

850535

SEROQUEL Quetiapine 100MG TAB Accepted treatment (clinical motivation

for low-cost options)

850543

SEROQUEL Quetiapine 200MG TAB Accepted treatment (clinical motivation

for low-cost options)

850527

SEROQUEL Quetiapine 25MG TAB Accepted treatment (clinical motivation

for low-cost options)

703344

SEROQUEL Quetiapine 300MG TAB Accepted treatment (clinical motivation

for low-cost options)

713747 SEROQUEL XR Quetiapine 50MG SRT

717404 SEROQUEL XR Quetiapine 150MG SRT

713748 SEROQUEL XR Quetiapine 200MG SRT

713749 SEROQUEL XR Quetiapine 300MG SRT

713750 SEROQUEL XR Quetiapine 400MG SRT

7 11/5/2013

Comprehensive Formulary

718704 SIZONORM Quetiapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718705 SIZONORM Quetiapine 200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718674 SIZONORM Quetiapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718706 SIZONORM Quetiapine 300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

892310 SOLIAN Amisulpride 200MG TAB

892309 SOLIAN Amisulpride 50MG TAB

766410 STELAZINE Trifluoperazine 1MG TAB Accepted treatment

766437 STELAZINE Trifluoperazine 5MG TAB Accepted treatment

716647 TRUVALIN

Quetiapine

100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716648 TRUVALIN

Quetiapine

200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716646 TRUVALIN

Quetiapine

25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716649 TRUVALIN

Quetiapine

300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718469 XEPLION PREFILLED SYRINGE 0.5ML Paliperidone 50MG/.5ML INJ Specialist motivation

718470 XEPLION PREFILLED SYRINGE 0.75ML Paliperidone 75MG/.75ML INJ Specialist motivation

718472 XEPLION PREFILLED SYRINGE 1.5ML Paliperidone 150MG/1.5ML INJ Specialist motivation

718471 XEPLION PREFILLED SYRINGE 1ML Paliperidone 100MG/1ML INJ Specialist motivation

711511

ZOXADON  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711512

ZOXADON  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711513

ZOXADON  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

827517 ZYPREXA Olanzapine 10MG TAB

864188 ZYPREXA Olanzapine 2.5MG TAB

827509 ZYPREXA Olanzapine 5MG TAB

707939 ZYPREXA VELOTAB  Olanzapine 10MG  TAB 

707938 ZYPREXA VELOTAB  Olanzapine 5MG  TAB 

Antidepressants

704904 ADCO-PAROXETINE  Paroxetine 20MG  TAB 

703391 A-LENNON FLUOXETINE Fluoxetine 20MG  CAP Accepted treatment

791571 AROPAX Paroxetine 20MG TAB

703219 AROPAX 30 Paroxetine 30MG  TAB 

704647 AROPAX CR  Paroxetine 12.5MG  SRT 

704646 AROPAX CR  Paroxetine 25MG  SRT 

713583 ARROW CITALOPRAM Citalopram 20MG TAB Accepted treatment

713584 ARROW CITALOPRAM Citalopram 40MG TAB Accepted treatment

713356 AURO-CITALOPRAM Citalopram 20MG  TAB  Accepted treatment

718058 AURO PAROXETINE Paroxetine 20MG TAB

707396 AUSTELL-CITALOPRAM Citalopram 10MG  TAB  Accepted treatment

707398 AUSTELL-CITALOPRAM Citalopram 20MG  TAB  Accepted treatment

707397 AUSTELL-CITALOPRAM Citalopram 40MG  TAB  Accepted treatment

707399 AUSTELL-PAROXETINE Paroxetine 20MG  TAB 

707400 AUSTELL-PAROXETINE Paroxetine 30MG  TAB 

717094 BIO CITALOPRAM Citalopram 20MG TAB Accepted treatment

707888 CILATE  Citalopram 20MG  TAB  Accepted treatment

700157 CILIFT Citalopram 20MG TAB Accepted treatment

711988 CILORAM Citalopram 20MG TAB Accepted treatment

810622 CIPRAMIL Citalopram 20MG TAB Accepted treatment

704331 CITALOHEXAL  Citalopram 20MG TAB Accepted treatment

716521 CITALOPRAM ACTOR Citalopram 20MG  TAB  Accepted treatment

709407 CITALOPRAM-WINTHROP  Citalopram 20MG  TAB  Accepted treatment

709644 CITALOPRAM-WINTHROP  Citalopram 40MG  TAB  Accepted treatment

704792 DEPAROC  Paroxetine 20MG  TAB 

704328 DEPRAMIL 20MG  Citalopram 20MG TAB Accepted treatment

705252 DEPRAMIL  Citalopram 40MG  TAB  Accepted treatment

894303 DEPROZAN Fluoxetine 20MG CAP Accepted treatment

713445 DRL CITALOPRAM Citalopram 20MG TAB Accepted treatment

713757 DRL CITALOPRAM Citalopram 40MG TAB Accepted treatment

8 11/5/2013

Comprehensive Formulary

724661 ETHIPRAMINE Imipramine 10MG TAB Accepted treatment

724688 ETHIPRAMINE Imipramine 25MG TAB Accepted treatment

716520 FLUOXETINE ACTOR Fluoxetine 20MG  CAP  Accepted treatment

705377 FLUTINOL  Fluoxetine 20MG  CAP  Accepted treatment

717372 GLENMARK CITALOPRAM Citalopram 20MG TAB Accepted treatment

718746 GULF AMITRIPTYLINE Amitriptyline 25MG TAB Accepted treatment

707386 HEXAL-PAROXETINE  Paroxetine 20MG  TAB 

735795 LANTANON Mianserin 10MG TAB

735817 LANTANON Mianserin 30MG TAB

820016 LILLY-FLUOXETINE Fluoxetine 20MG CAP Accepted treatment

821063 LORIEN Fluoxetine 20MG CAP Accepted treatment

700877 LORIEN 20MG Fluoxetine 20MG TAB Accepted treatment

840653 NUZAK Fluoxetine 20MG CAP Accepted treatment

705186 PARAX 20  Paroxetine 20MG  TAB 

705188 PARAX 40  Paroxetine 40MG  TAB 

716745 PAROXETINE UNICORN Paroxetine 20MG TAB

704794 PAXIL 20  Paroxetine 20MG  TAB 

879282 PROHEXAL Fluoxetine 20MG CAP Accepted treatment

894243 PROHEXAL 20T Fluoxetine 20MG DSP Accepted treatment

894249 PROHEXAL 40T Fluoxetine 40MG DSP Accepted treatment

757888 PROTHIADEN Dothiepin 25MG CAP Accepted treatment

757896 PROTHIADEN Dothiepin 75MG TAB Accepted treatment

822981 PROZAC Fluoxetine 20MG TAB Accepted treatment

757969 PROZAC 20 Fluoxetine 20MG CAP Accepted treatment

704976 RAN CITALOPRAM  Citalopram 20MG  TAB  Accepted treatment

704977 RAN CITALOPRAM  Citalopram 40MG  TAB  Accepted treatment

700686 RANFLOCS Fluoxetine 20MG CAP Accepted treatment

707426 REZAK  Fluoxetine 20MG  CAP  Accepted treatment

784230 ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB Accepted treatment

820660 ROLAB-DOTHIEPIN Dothiepin 25MG CAP Accepted treatment

816515 ROLAB-DOTHIEPIN Dothiepin 75MG TAB Accepted treatment

838713 ROLAB-FLUOXETINE Fluoxetine 20MG CAP Accepted treatment

704590 SANDOZ CITALOPRAM  Citalopram 20MG  TAB  Accepted treatment

704721 SANDOZ PAROXETINE  Paroxetine 20MG  TAB 

705422 SEDARIN  Paroxetine 20MG  TAB 

705122 SERRAPRESS 20  Paroxetine 20MG  TAB 

705123 SERRAPRESS 30  Paroxetine 30MG  TAB 

707304 SIMAYLA CITALOPRAM Citalopram 20MG  TAB  Accepted treatment

702769 TALOMIL  Citalopram 20MG  TAB  Accepted treatment

717561 TEXINE Paroxetine 20MG TAB

800198 THADEN Dothiepin 25MG CAP Accepted treatment

800201 THADEN Dothiepin 75MG TAB Accepted treatment

771120 TOFRANIL Imipramine 10MG TAB Accepted treatment

771139 TOFRANIL Imipramine 25MG TAB Accepted treatment

772003 TREPILINE Amitriptyline 10MG TAB Accepted treatment

771996 TREPILINE Amitriptyline 25MG TAB Accepted treatment

705174 TRIZAC  Fluoxetine 20MG  CAP  Accepted treatment

772860 TRYPTANOL Amitriptyline 25MG TAB Accepted treatment

705633 XET 20MG  Paroxetine 20MG  TAB 

705064 ZYDUS FLUOXETINE  Fluoxetine 20MG  CAP  Accepted treatment

711911 ZYDUS-PAROXETINE  Paroxetine 20MG  TAB 

Antibiotic therapy will be evaluated on an individual basis

Inhaled B2 agonists

864757 AIROMIR AUTOHALER Salbutamol 100MCG INH

821411 AIROMIR INHALER Salbutamol 100MCG INH Accepted treatment

819603 ASTHAVENT 200 DS Salbutamol 100MCG INH Accepted treatment

849332 ASTHAVENT 300 DOSE Salbutamol 100MCG INH Accepted treatment

700715 ASTHAVENT 300D ECOHALER CFC FREE Salbutamol 100MCG INH Accepted treatment

878219 ASTHAVENT DP Salbutamol 200MCG CPS

706544 BEROTEC HFA 200 DOSE  Fenoterol 100MCG  INH 

791415 BRICANYL TURBOHALER Terbutaline 0.5MG INH

Chronic Obstructive Pulmonary Disease

Bronchiectasis

9 11/5/2013

Comprehensive Formulary

824623 COMBIVENT MDI Salbutamol and other drugs for obstructive airway diseases 20MCG/100MCG INH

718698 DUOLIN HFA 200DOSE Salbutamol and other drugs for obstructive airway diseases INH

707882 DUOVENT HFA 200DOSE  Fenoterol and other drugs for obstructive airway diseases 50MCG/20MCG  INH 

775363 VENTEZE COMPLETE Salbutamol 100MCG INH Accepted treatment

711213 VENTEZE CFC FREE 200 DOSE  Salbutamol 100MCG  INH  Accepted treatment

703371 VENTOLIN INHALER 200 CFC FREE Salbutamol 100MCG INH Accepted treatment

Long acting B2 agonists

820911 FORADIL DRY Formoterol 12MCG CPS

704175 FORATEC DP CAPS  Formoterol 12MCG CAP

710307 FORATEC HFA 120DOSE  Formoterol 12MCG INH

705116 MYLAN FORMOTEROL CLICKHALER  Formoterol 12MCG  INH 

717402 ONBREZ BREEZHALER (30 CAPS & INHALER) Indacaterol KIT

840246 OXIS TURBUHALER Formoterol 9MCG INH

818496 SEREVENT ACCUHALER Salmeterol 50MCG INH

708289 SEREVENT CFC-FREE 120DOSE  Salmeterol 25MCG  INH 

787302 SEREVENT INHAL(120) Salmeterol 25MCG INH

791695 SEREVENT INHAL(60) Salmeterol 25MCG INH

Inhaled corticosteroids

705269 ALVESCO 160MCG 120 DOSE  Ciclesonide 160MCG  INH 

705267 ALVESCO 160MCG 60 DOSE  Ciclesonide 160MCG  INH 

705265 ALVESCO 80MCG 60 DOSE  Ciclesonide 80MCG  INH 

717571 ASMANEX TWISTHALER 30 DOSE Mometasone 200MCG/1DOSE TBH

717581 ASMANEX TWISTHALER 30 DOSE Mometasone 400MCG/1DOSE TBH

717572 ASMANEX TWISTHALER 60 DOSE Mometasone 200MCG/1DOSE TBH

717582 ASMANEX TWISTHALER 60 DOSE Mometasone 400MCG/1DOSE TBH

827088 BECEZE INHALER COMPLETE Beclomethasone 100MCG INH Special Investigations (SI)

827061 BECEZE 50 200DOSE Beclomethasone 50MCG INH Special Investigations (SI)

819638 BECLATE INHALER Beclomethasone 100MCG INH Special Investigations (SI)

820083 BECLATE INHALER Beclomethasone 200MCG INH Special Investigations (SI)

819611 BECLATE INHALER Beclomethasone 50MCG INH Special Investigations (SI)

897469 BUDEFLAM CFC FREE 200MCG 300 DOSE INH Budesonide 200MCG INH Special Investigations (SI)

897462 BUDEFLAM CFC FREE 300 DOSE INH Budesonide 100MCG INH Special Investigations (SI)

704176 BUDEFLAM DP CAPS  Budesonide 200MCG CAP Special Investigations (SI)

818453 FLIXOTIDE ACCUHALER Fluticasone 100MCG CAP

818461 FLIXOTIDE ACCUHALER Fluticasone 250MCG CAP

818488 FLIXOTIDE ACCUHALER Fluticasone 500MCG CAP

818445 FLIXOTIDE ACCUHALER Fluticasone 50MCG CAP

703275 FLIXOTIDE 50 CFC FREE 120 ACT  Fluticasone 50MCG  INH 

897752 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 125MCG INH

897759 FLIXOTIDE CFC FREE (120 ACT) Fluticasone 250MCG INH

715009 FOXAIR 50/100 ACCUHALER Salmeterol/Fluticasone combinations INH Special Investigations (SI)

715008 FOXAIR 50/250 ACCUHALER Salmeterol/Fluticasone combinations INH Special Investigations (SI)

715007 FOXAIR 50/500 ACCUHALER Salmeterol/Fluticasone combinations INH Special Investigations (SI)

715753 FOXAIR 25/125 120DOSE Salmeterol and other anti-asthmatics 25MCG/125MCG INH Special Investigations (SI)

715754 FOXAIR 25/250 120DOSE Salmeterol and other anti-asthmatics 25MCG/250MCG INH Special Investigations (SI)

715752 FOXAIR 25/50 120 DOSE Salmeterol and other anti-asthmatics 25MCG/50MCG INH Special Investigations (SI)

839329 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 100MCG INH Special Investigations (SI)

839337 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 200MCG INH Special Investigations (SI)

839310 INFLAMMIDE AEROSOL COMPLETE (MAC) Budesonide 50MCG INH Special Investigations (SI)

839353 INFLAMMIDE INHALATION SYSTEM 300 DOSE Budesonide 100MCG KIT Special Investigations (SI)

839345 INFLAMMIDE INHALATION SYSTEM 300 DOSE Budesonide 200MCG KIT Special Investigations (SI)

704020 INFLAMMIDE 200 NOVOLIZE REFIL  Budesonide 200MCG  REF Special Investigations (SI)

704021 INFLAMMIDE 200 NOVOLIZER COMPL  Budesonide 200MCG  INH  Special Investigations (SI)

707879 INFLAMMIDE NOVOLIZER COMPLETE 100DOSE  Budesonide 400MCG  INH Special Investigations (SI)

707881 INFLAMMIDE NOVOLIZER REFILL 100DOSE  Budesonide 400MCG  REF  Special Investigations (SI)

791423 PULMICORT 100 TURB (200 DOSE) Budesonide 100MCG ATH

791431 PULMICORT 200 TURB (200 DOSE) Budesonide 200MCG ATH Special Investigations (SI)

823791 PULMICORT TURB (100 DOSE) Budesonide 400MCG ATH

715190 SEREFLO 25/125 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Special Investigations (SI)

715191 SEREFLO 25/250 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Special Investigations (SI)

715189 SEREFLO 25/50 HFA 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Special Investigations (SI)

894990 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/125MCG INH Special Investigations (SI)

895006 SERETIDE 120 DOSE Salmeterol/Fluticasone combinations 25MCG/250MCG INH Special Investigations (SI)

894989 SERETIDE 25/50 120 DOSE Salmeterol/Fluticasone combinations 25MCG/50MCG INH Special Investigations (SI)

874493 SERETIDE 50/100 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/100MCG INH Special Investigations (SI)

874507 SERETIDE 50/250 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/250MCG INH Special Investigations (SI)

10 11/5/2013

Comprehensive Formulary

874515 SERETIDE 50/500 ACCUHALER Salmeterol/Fluticasone combinations 50MCG/500MCG INH Special Investigations (SI)

700173 SYMBICORD TURBO 120 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH

705984 SYMBICORD 320/9MCG PER INHALATION  Formutoterol and other anti- asthmatics 9MCG/320MCG  INH 

700172 SYMBICORD TURBO 60 DOSE Formoterol/Budesonide 4.5MCG/160MCG INH

705986 SYMBICORD 80/4.5MCG PER INHALATION  Formutoterol and other anti- asthmatics 4.5MCG/80MCG  INH 

Anticholinergic inhalers (short acting)

885074 ATROVENT 40 MAC COMPL 300 DOSE Ipratropium bromide 40MCG INH Accepted treatment

706543 ATROVENT HFA 200 DOSE  Ipratropium bromide 20MCG  INH  Accepted treatment

856916 IPVENT-40 Ipratropium bromide 40MCG INH Accepted treatment

715574 IPVENT HFA 200 DOSE Ipratropium bromide 40MCG/1DOSE INH Accepted treatment

Oral Xanthines

782769 CHRONOPHYLLIN Theophylline 250MG CAP

725005 EUPHYLLIN RETARD Theophylline 250MG SRT

743119 MICROPHYLLIN Theophylline 125MG SRC

743127 MICROPHYLLIN Theophylline 250MG SRC

748498 NUELIN Theophylline 125MG TAB

748501 NUELIN SA 250 Theophylline 250MG TAB

755281 PHYLLOCONTIN Aminophylline 225MG SRT

815357 PULMOPHYLLIN SR 300 Theophylline 300MG SRT Accepted treatment

788368 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 200MG SRT Accepted treatment

788376 ROLAB-THEOPHYLLINE ANHYDROUS Theophylline 300MG SRT Accepted treatment

783005 THEOPLUS Theophylline 200MG SRT

783013 THEOPLUS Theophylline 300MG SRT

785105 UNIPHYL Theophylline 400MG SRT

816159 UNIPHYL Theophylline 600MG SRT

Oral Corticosteroids

814407 CAPSOID Prednisolone 5MG TAB Special Investigations (SI)

800155 LENISOLONE Prednisolone 5MG TAB Special Investigations (SI)

742759 METICORTEN Prednisone 50MG TAB

742732 METICORTEN Prednisone 5MG TAB

752304 PANAFCORT Prednisone 5MG TAB

788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Special Investigations (SI)

703720 PRELONE Prednisolone 5MG TAB

836826 PULMISON TABS Prednisone 20MG TAB

818267 TROLIC Prednisone 5MG TAB Special Investigations (SI)

Anticoagulants

778362 WARFARIN Warfarin 5MG TAB Accepted treatment

709906 CIPLA WARFARIN 1MG  Warfarin 1MG  TAB  Accepted treatment

712390 CIPLA-WARFARIN Warfarin 3MG TAB Accepted treatment

709905 CIPLA WARFARIN 5MG  Warfarin 5MG  TAB  Accepted treatment

Diuretics

780618 ADCO-RETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

701807 ALDACTONE Spironolactone 100MG TAB

701793 ALDACTONE Spironolactone 25MG APP Accepted treatment

702803 AMILORETIC Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment

702811 AMILORETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB Accepted treatment

807796 ARELIX Piretanide 3MG TAB

807818 ARELIX Piretanide 6MG TAB

707423 AUSTELL-FUROSEMIDE Furosemide 40MG  TAB 

808695 BETARETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

821845 BEURISES Furosemide 40MG TAB Accepted treatment

711152 BURINEX Bumetanide 1MG TAB

711160 BURINEX K Bumetanide and potassium TAB

700820 CATEXAN 2.5MG Indapamide 2.5MG TAB Accepted treatment

710313 CIPLA-INDAPAMIDE  Indapamide 2.5MG  TAB  Accepted treatment

819417 DAPAMAX Indapamide 2.5MG TAB Accepted treatment

833045 DAPTRIL Indapamide 2.5MG TAB Accepted treatment

716048 DINO-RETIC Furosemide 40MG TAB Accepted treatment

705967 DIURESIX  Furosemide 40MG  TAB  Accepted treatment

721824 DYAZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment

716962 DYNA INDAPAMIDE SR Indapamide 1.5MG SRT

890470 HEXAZIDE Hydrochlorothiazide 25MG TAB Accepted treatment

822825 HYDRO-LESS Indapamide 2.5MG TAB Accepted treatment

Cardiac failure/ Cardiomyopathy

11 11/5/2013

Comprehensive Formulary

839531 INDALIX Indapamide 2.5MG TAB Accepted treatment

735930 LASIX Furosemide 20MG TAB

735949 LASIX Furosemide 40MG TAB

735957 LASIX Furosemide 500MG TAB

839515 LASIX ORAL Furosemide 10MG/1ML SLN Clinical review

891531 LIXAMIDE Indapamide 2.5MG TAB Accepted treatment

857769 MYLAN FUROSEMIDE Furosemide 40MG TAB Accepted treatment

703329 MYLAN-INDAPAMIDE  Indapamide 2.5MG  TAB Accepted treatment

744379 MODURETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

744387 MODURETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB Accepted treatment

746002 NATRILIX Indapamide 2.5MG TAB Accepted treatment

830836 NATRILIX SR Indapamide 1.5MG SRT

758272 PURESIS Furosemide 40MG TAB

780146 RENEZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment

880949 RIDAQ Hydrochlorothiazide 25MG TAB Accepted treatment

710437 RIDAQ Hydrochlorothiazide 12.5MG TAB Accepted treatment

702951 ROLAB-AMILORIDE HCL/HYDROCHLOROTHIAZIDE Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

731668 ROLAB-FUROSEMIDE Furosemide 40MG TAB Accepted treatment

831026 ROLAB-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment

769665 ROLAB-SPIRONOLACTONE Spironolactone 25MG TAB Accepted treatment

706531 SPEC-CO-AMILORIDE  Hydrochlorothiazide and potassium-sparing agents 50MG/5MG  TAB  Accepted treatment

898937 SPIRACTIN Spironolactone 100MG TAB

765910 SPIRACTIN Spironolactone 25MG TAB Accepted treatment

707191 TORAHEXAL  Torasemide 10MG  TAB 

707189 TORAHEXAL  Torasemide 2.5MG  TAB 

707190 TORAHEXAL  Torasemide 5MG  TAB 

820369 UNAT Torasemide 2.5MG TAB

820377 UNAT Torasemide 5MG TAB

820385 UNAT Torasemide 10MG TAB

774057 URIREX-K Hydrochlorothiazide and potassium TAB Accepted treatment

Potassium supplementation

735353 KLOREF Potassium chloride 500MG EEF

755753 PLENISH K Potassium chloride 600MG TAB Accepted treatment

702947 SANDOZ K-600  Potassium chloride 600MG  TAB  Accepted treatment

764396 SLOW-K Potassium chloride 600MG TAB Accepted treatment

718911 ULTIPOT Potassium chloride 600MG TAB Accepted treatment

768227 SWISS-KAL SR Potassium chloride SRT

ACE inhibitors

708119 ACCUMAX  Quinapril 10MG  TAB  Accepted treatment

708120 ACCUMAX  Quinapril 20MG  TAB  Accepted treatment

783293 ACCUPRIL Quinapril 5MG TAB

783307 ACCUPRIL Quinapril 10MG TAB Accepted treatment

783315 ACCUPRIL Quinapril 20MG TAB Accepted treatment

853186 ACCUPRIL Quinapril 40MG TAB

715649 ACESYL Perindopril 4MG TAB

852333 BIO-CAPTOPRIL Captopril 25MG TAB Accepted treatment

714869 ACTI-PREX (GLENMARK PERINDOPRIL) Perindopril 4MG TAB

886843 ADCO-ENALAPRIL 10MG Enalapril 10MG TAB Accepted treatment

886851 ADCO-ENALAPRIL 20MG Enalapril 20MG TAB Accepted treatment

886835 ADCO-ENALAPRIL 5MG Enalapril 5MG TAB Accepted treatment

881481 ALAPREN 10 Enalapril 10MG TAB Accepted treatment

881503 ALAPREN 20 Enalapril 20MG TAB Accepted treatment

881473 ALAPREN 5 Enalapril 5MG TAB Accepted treatment

715957 APEX-RAMIPRIL Ramipril 10MG CAP

715954 APEX-RAMIPRIL Ramipril 2.5MG CAP

715955 APEX-RAMIPRIL Ramipril 5MG CAP

711159 ARROW RAMIPRIL  Ramipril 2.5MG TAB

711161 ARROW RAMIPRIL  Ramipril 5MG TAB

711162 ARROW RAMIPRIL  Ramipril 10MG TAB

715938 APEX-LISINOPRIL Lisinopril 20MG TAB Accepted treatment

714678 AURO-LISINOPRIL Lisinopril 10MG TAB Accepted treatment

714679 AURO-LISINOPRIL Lisinopril 20MG TAB Accepted treatment

714677 AURO-LISINOPRIL Lisinopril 5MG TAB Accepted treatment

716505 AURO PERINDOPRIL Perindopril 4MG  TAB 

716506 AURO PERINDOPRIL Perindopril 8MG  TAB 

704354 AUSTELL LISINOPRIL 2.5MG  Lisinopril 2.5MG  TAB  Accepted treatment

12 11/5/2013

Comprehensive Formulary

712598 AUSTELL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment

708189 AUSTELL LISINOPRIL 20MG  Lisinopril 20MG  TAB  Accepted treatment

705752 AUSTELL-RAMIPRIL 1.25MG  Ramipril 1.25MG  CAP 

705755 AUSTELL-RAMIPRIL 10MG  Ramipril 10MG  CAP 

705753 AUSTELL-RAMIPRIL 2.5MG  Ramipril 2.5MG  CAP 

705754 AUSTELL-RAMIPRIL 5MG  Ramipril 5MG  CAP 

717293 BINDACE Perindopril 4MG TAB

717294 BINDACE Perindopril 8MG TAB

795267 CAPACE Captopril 25MG TAB Accepted treatment

837628 CAPTOHEXAL Captopril 12.5MG TAB Accepted treatment

837636 CAPTOHEXAL Captopril 25MG TAB Accepted treatment

837644 CAPTOHEXAL Captopril 50MG TAB Accepted treatment

836451 CAPTOMAX Captopril 25MG TAB Accepted treatment

836478 CAPTOMAX Captopril 50MG TAB Accepted treatment

794058 CIBACE Benazepril 10MG TAB

710302 CIPLA-PERINDOPRIL  Perindopril 4MG  TAB 

710510 CIPLA-PERINDOPRIL  Perindopril 8MG  TAB 

715786 CIPLASYL Perindopril 4MG  TAB 

715795 CIPLASYL Perindopril 8MG  TAB 

894324 CIPLATEC 10 Enalapril 10MG TAB Accepted treatment

701729 CIPLATEC 20MG Enalapril 20MG TAB Accepted treatment

894316 CIPLATEC 5 Enalapril 5MG TAB Accepted treatment

785121 COVERSYL Perindopril 4MG TAB

705915 COVERSYL  Perindopril 10MG  TAB 

891279 ENAP 10MG Enalapril 10MG TAB Accepted treatment

891280 ENAP 20MG Enalapril 20MG TAB Accepted treatment

891272 ENAP 5MG Enalapril 5MG TAB Accepted treatment

712763 ENVAS Enalapril 10MG TAB Accepted treatment

712762 ENVAS Enalapril 5MG TAB Accepted treatment

701392 HEXAL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment

701394 HEXAL-LISINOPRIL Lisinopril 20MG TAB Accepted treatment

701387 HEXAL-LISINOPRIL Lisinopril 5MG TAB Accepted treatment

867853 HR-ENALAPRIL 10 Enalapril 10MG TAB Accepted treatment

867861 HR-ENALAPRIL 20 Enalapril 20MG TAB Accepted treatment

867845 HR-ENALAPRIL 5 Enalapril 5MG TAB Accepted treatment

862622 HYPACE Enalapril 5MG TAB Accepted treatment

792748 INHIBACE Cilazapril 2.5MG TAB

792756 INHIBACE Cilazapril 5MG TAB

716794 LYSIN Lisinopril 10MG TAB Accepted treatment

716792 LYSIN Lisinopril 5MG TAB Accepted treatment

805068 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 2MG CAP

805033 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 0.5MG CAP

852619 MYLAN CAPTOPRIL Captopril 25MG TAB Accepted treatment

899429 MYLAN-CAPTOPRIL Captopril 50MG TAB Accepted treatment

705450 MYLAN-FOSINOPRIL 10  Fosinopril 10MG  TAB 

705453 MYLAN-FOSINOPRIL 20  Fosinopril 20MG  TAB 

791954 MONOPRIL Fosinopril 10MG TAB

791962 MONOPRIL Fosinopril 20MG TAB

714527 PEARINDA Perindopril 4MG TAB

714528 PEARINDA Perindopril 8MG TAB

717783 PERINDOPRIL UNICORN Perindopril 4MG TAB

717784 PERINDOPRIL UNICORN Perindopril 8MG TAB

708109 PHARMAPRESS  Enalapril 5MG  TAB  Accepted treatment

868914 PHARMAPRESS Enalapril 10MG TAB Accepted treatment

868922 PHARMAPRESS Enalapril 20MG TAB Accepted treatment

703541 PREXUM Perindopril 4MG TAB

714646 PREXUM Perindopril 10MG TAB

711171 QUINACE  Quinapril 10MG  TAB  Accepted treatment

711172 QUINACE  Quinapril 20MG  TAB  Accepted treatment

708981 QUINAGEN  Quinapril 5MG  TAB 

708982 QUINAGEN  Quinapril 10MG  TAB  Accepted treatment

708983 QUINAGEN  Quinapril 20MG  TAB  Accepted treatment

708985 QUINAGEN  Quinapril 40MG  TAB 

705457 QUINASPEN 10MG  Quinapril 10MG  TAB  Accepted treatment

705447 QUINASPEN 20MG  Quinapril 20MG  TAB  Accepted treatment

704374 RAMIPRIL HEXAL  Ramipril 2.5MG TAB

13 11/5/2013

Comprehensive Formulary

704375 RAMIPRIL HEXAL  Ramipril 5MG TAB

704022 RAMIWIN Ramipril 1.25MG CAP

704023 RAMIWIN Ramipril 2.5MG CAP

704025 RAMIWIN Ramipril 5MG CAP

705426 RAMPIL 1.25MG  Ramipril 1.25MG  CAP 

705429 RAMPIL 10MG  Ramipril 10MG  CAP 

705427 RAMPIL 2.5MG  Ramipril 2.5MG  CAP 

705428 RAMPIL 5MG  Ramipril 5MG  CAP 

710611 RAN-PERINDOPRIL  Perindopril 4MG  TAB 

704975 RAN RAMIPRIL Ramipril 10MG CAP 

759783 RENITEC Enalapril 10MG TAB Accepted treatment

810355 RENITEC Enalapril 2.5MG TAB Accepted treatment

759767 RENITEC Enalapril 20MG TAB Accepted treatment

759759 RENITEC Enalapril 5MG TAB Accepted treatment

707382 RETACE  Ramipril 1.25MG  TAB 

707383 RETACE  Ramipril 2.5MG  TAB 

707385 RETACE  Ramipril 5MG  TAB 

706238 RILACE  Ramipril 2.5MG  CAP 

706237 RILACE  Ramipril 5MG  CAP 

706239 RILACE  Ramipril 10MG  CAP 

850896 ROLAB-CAPTOPRIL Captopril 25MG TAB Accepted treatment

850918 ROLAB-CAPTOPRIL Captopril 50MG TAB Accepted treatment

707311 SIMAYLA LISINOPRIL Lisinopril 10MG  TAB  Accepted treatment

707312 SIMAYLA LISINOPRIL Lisinopril 20MG  TAB  Accepted treatment

707310 SIMAYLA LISINOPRIL Lisinopril 5MG  TAB  Accepted treatment

707869 SIMAYLA RAMIPRIL  Ramipril 10MG  CAP 

700692 SINOPREN 10 Lisinopril 10MG TAB Accepted treatment

700694 SINOPREN 20 Lisinopril 20MG TAB Accepted treatment

700691 SINOPREN 5 Lisinopril 5MG TAB Accepted treatment

712615 SPEC-PERINDOPRIL Perindopril 4MG TAB

712616 SPEC-PERINDOPRIL Perindopril 8MG TAB

841579 TRITACE Ramipril 1.25MG TAB

841587 TRITACE Ramipril 2.5MG TAB

841595 TRITACE Ramipril 5MG TAB

782602 TRITACE Ramipril 10MG CAP

710297 VECTORYL  Perindopril 4MG  TAB 

710925 VECTORYL  Perindopril 8MG  TAB 

839779 ZAPTO Captopril 25MG TAB Accepted treatment

839787 ZAPTO Captopril 50MG TAB Accepted treatment

703645 ZEMAX 10  Lisinopril 10MG  TAB  Accepted treatment

705318 ZEMAX 20  Lisinopril 20MG  TAB  Accepted treatment

703646 ZEMAX 5  Lisinopril 5MG  TAB  Accepted treatment

705412 ZEPROSIL 10MG  Lisinopril 10MG  TAB  Accepted treatment

705414 ZEPROSIL 20MG  Lisinopril 20MG  TAB  Accepted treatment

705413 ZEPROSIL 5MG  Lisinopril 5MG  TAB  Accepted treatment

781703 ZESTRIL Lisinopril 10MG TAB Accepted treatment

781711 ZESTRIL Lisinopril 20MG TAB Accepted treatment

781681 ZESTRIL Lisinopril 5MG TAB Accepted treatment

862053 ZETOMAX (ZESTOMAX) 10MG Lisinopril 10MG TAB Accepted treatment

862061 ZETOMAX (ZESTOMAX) 20MG Lisinopril 20MG TAB Accepted treatment

862045 ZETOMAX (ZESTOMAX) 5MG Lisinopril 5MG TAB Accepted treatment

716680 ZYDUS PERINDOPRIL Perindopril 4MG  TAB 

ACE inhibitor and diuretic combinations

708116 ACCUMAX CO  Quinapril and diuretics 10MG/12.5MG  TAB 

708118 ACCUMAX CO  Quinapril and diuretics 20MG/12.5MG  TAB 

795755 ACCURETIC Quinapril and diuretics 10MG/12.5MG TAB

805297 ACCURETIC Quinapril and diuretics 20MG/12.5MG TAB

715651 ACESYL CO Perindopril and diuretics 1.25MG/4MG TAB

706235 ADCO-QUINARETIC 10/12.5MG  Quinapril and diuretics 10MG/12.5MG  TAB 

706236 ADCO-QUINARETIC 20/12.5MG  Quinapril and diuretics 20MG/12.5MG  TAB 

717795 ARIPREL PLUS 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB

716120 AURO-LISINOPRIL CO Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

716121 AURO-LISINOPRIL CO Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

718056 AURO QUINAPRIL CO 10MG/12.5MG Quinapril and diuretics 10MG/12.5MG TAB

718057 AURO QUINAPRIL CO 20MG/12.5MG Quinapril and diuretics 20MG/12.5MG TAB

704928 BIPRETERAX  Perindopril and diuretics 1.25MG/4MG  TAB 

14 11/5/2013

Comprehensive Formulary

788414 CAPOZIDE Captopril and diuretics 50MG/25MG TAB Accepted treatment

841137 CAPTORETIC Captopril and diuretics 50MG/25MG TAB Accepted treatment

841145 CAPTORETIC HS Captopril and diuretics 25MG/12.5MG TAB

787035 CO-RENITEC Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment

877549 COVERSYL PLUS Perindopril and diuretics TAB

710978 DIACE CO  Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

891287 ENAP-CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment

815055 INHIBACE PLUS Cilazapril and diuretics 5MG/12.5MG TAB

704703 HEXAL LISINOPRIL CO 10  Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

704704 HEXAL LISINOPRIL CO 20  Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

716943 LISINOPRIL CO UNICORN 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

716945 LISINOPRIL CO UNICORN 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

711989 LISINOZIDE Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

711990 LISINOZIDE Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

704437 LISORETIC 10/12.5 Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

704438 LISORETIC 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

707292 LISOZIDE 10MG/12.5MG  Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

707291 LISOZIDE 20MG/12.5MG  Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

714952 PEARINDA PLUS Perindopril and diuretics 1.25MG/4MG TAB

717782 PERINDOPRIL CO UNICORN 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB

885019 PHARMAPRESS CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment

704929 PREXUM PLUS Perindopril and diuretics 4MG/1.25MG TAB 

711173 QUINACE CO 10/12.5MG  Quinapril and diuretics 10MG/12.5MG  TAB 

711174 QUINACE CO 20/12.5MG  Quinapril and diuretics 20MG/12.5MG  TAB 

707550 QUINAZIDE 10/12.5  Quinapril and diuretics 10MG/12.5MG  TAB 

707551 QUINAZIDE 20/12.5  Quinapril and diuretics 20MG/12.5MG  TAB 

713763 SPEC-PERINDOPRIL PLUS Perindopril and diuretics 1.25MG/4MG TAB

718093 TRITACE PLUS 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB

718094 TRITACE PLUS 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB

718092 TRITACE PLUS 5MG/25MG Ramipril and diuretics 5MG/25MG TAB

710298 VECTORYL PLUS  Perindopril and diuretics 1.25MG/4MG  TAB 

839795 ZAPTO-CO Captopril and diuretics 50MG/25MG TAB Accepted treatment

704597 ZETOMAX CO 10/12.5 Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

704598 ZETOMAX CO 20/12.5 Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

817848 ZESTORETIC Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

797685 ZESTORETIC Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

708260 ZESTOZIDE 20  Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

717095 ZYDUS PERINDOPRIL CO 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG  TAB 

Angiotensin Receptor Blockers

718667 ADCO IRBESARTAN Irbesartan 150MG TAB

718668 ADCO IRBESARTAN Irbesartan 300MG TAB

837814 APROVEL Irbesartan 150MG TAB

837822 APROVEL Irbesartan 300MG TAB

716495 AURO LOSARTAN Losartan 100MG TAB Accepted treatment

716494 AURO LOSARTAN Losartan 50MG TAB Accepted treatment

717069 AUSTELL LOSARTAN Losartan 100MG TAB Accepted treatment

717068 AUSTELL LOSARTAN Losartan 50MG TAB Accepted treatment

818739 COZAAR Losartan 50MG TAB Accepted treatment

710079 COZAAR Losartan 100MG  TAB  Accepted treatment

716644 CIPLAZAR Losartan 100MG TAB Accepted treatment

716643 CIPLAZAR Losartan 50MG TAB Accepted treatment

709845 CIPLA-LOSARTAN  Losartan 100MG  TAB  Accepted treatment

709844 CIPLA-LOSARTAN  Losartan 50MG  TAB  Accepted treatment

717035 DIOLO Valsartan 160MG TAB

717034 DIOLO Valsartan 80MG TAB

700710 DIOVAN 160 Valsartan 160MG  TAB 

700000 DIOVAN 80 Valsartan 80MG  TAB 

717793 DYNARB Irbesartan 150MG TAB

717794 DYNARB Irbesartan 300MG TAB

712385 IRBEWIN Irbesartan 150MG TAB

712384 IRBEWIN Irbesartan 300MG TAB

718506 IRTANEL Irbesartan 150MG TAB

718507 IRTANEL Irbesartan 300MG TAB

719162 ISART Irbesartan 150MG TAB

719163 ISART Irbesartan 300MG TAB

15 11/5/2013

Comprehensive Formulary

709788 LEPITRIN  Losartan 50MG  TAB  Accepted treatment

709924 LOS-ARB  Losartan 50MG  TAB  Accepted treatment

718366 LOSARTAN UNICORN Losartan 100MG TAB Accepted treatment

718365 LOSARTAN UNICORN Losartan 50MG TAB Accepted treatment

709909 LOSARTAN-WINTHROP  Losartan 50MG  TAB  Accepted treatment

860387 MICARDIS Telmisartan 40MG TAB

860395 MICARDIS Telmisartan 80MG TAB

715569 MIGROBEN Valsartan 160MG TAB

715568 MIGROBEN Valsartan 80MG TAB

714249 PRITOR Telmisartan 40MG TAB

714250 PRITOR Telmisartan 80MG TAB

717296 RASOL Losartan 100MG TAB Accepted treatment

717295 RASOL Losartan 50MG TAB Accepted treatment

715871 RENICARD Losartan 50MG TAB Accepted treatment

713254 SPEC-LOSARTAN Losartan 100MG TAB Accepted treatment

713255 SPEC-LOSARTAN Losartan 50MG TAB Accepted treatment

704696 TAREG  Valsartan 160MG  TAB 

705060 TAREG  Valsartan 80MG  TAB 

718364 VALSARTAN UNICORN Valsartan 160MG TAB

718363 VALSARTAN UNICORN Valsartan 80MG TAB

709225 ZARTAN  Losartan 50MG  TAB  Accepted treatment

709964 ZARTAN  Losartan 100MG  TAB  Accepted treatment

715556 ZOMEVEK Valsartan 160MG TAB

715555 ZOMEVEK Valsartan 80MG TAB

Angiotensin Receptor Blockers and diuretic combinations

717070 AUSTELL LOSARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment

891353 COAPROVEL Irbesartan and diuretics 150MG/12.5MG TAB

898597 COAPROVEL Irbesartan and diuretics 300MG/12.5MG TAB

891894 CO-DIOVAN  Valsartan and diuretics 160MG/12.5MG  TAB 

839884 CO-DIOVAN  Valsartan and diuretics 80MG/12.5MG  TAB 

706051 CO-DIOVAN PLUS  Valsartan and diuretics 160MG/25MG  TAB 

712386 CO-IRBEWIN Irbesartan and diuretics 150MG/12.5MG TAB

712387 CO-IRBEWIN Irbesartan and diuretics 300MG/12.5MG TAB

894614 CO-MICARDIS 40/12.5MG Telmisartan + Hydrochlorothiazide  40MG/12.5MG TAB

894621 CO-MICARDIS 80/12.5MG Telmisartan + Hydrochlorothiazide  80MG/12.5MG TAB

716791 CO-MICARDIS 80MG/25MG Telmisartan + Hydrochlorothiazide 80MG/25MG TAB

715571 CO-MIGROBEN 160MG/12.5MG Valsartan and diuretics

715572 CO-MIGROBEN 160MG/25MG Valsartan and diuretics

715570 CO-MIGROBEN 80MG/12.5MG Valsartan and diuretics

714251 CO-PRITOR 40/12.5 MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB

714252 CO-PRITOR 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB

705068 CO-TAREG 80MG/12.5MG  Valsartan and diuretics 80MG  TAB 

715673 CO-TAREG PLUS Valsartan and diuretics 160MG/25MG  TAB 

715672 CO-TAREG 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB 

715559 CO-ZOMEVEK 160MG/12.5MG Valsartan and diuretics TAB

715558 CO-ZOMEVEK 80MG/12.5MG Valsartan and diuretics TAB

715560 CO-ZOMEVEK160MG/25MG Valsartan and diuretics TAB

828181 COZAAR COMP Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment

716613 CIPLAZAR CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716612 CIPLAZAR CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

718608 DIOLO CO 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB

718607 DIOLO CO 80MG/12.5MG Valsartan and diuretics 80MG/12.5MG TAB

887096 FORTZAAR Losartan and diuretics 100MG/25MG TAB Accepted treatment

717084 HYTENZA CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716476 HYTENZA CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

718571 ISART CO 150MG/12.5MG Irbesartan and diuretics 150MG/12.5MG TAB

718573 ISART CO 300MG/12.5MG Irbesartan and diuretics 300MG/12.5MG TAB

716059 LOHYPE FORTE PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716058 LOHYPE PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715857 LOSAAR PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

715856 LOSAAR PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

716274 LOSACAR CO 50MG/12,5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

718368 LOSARTAN CO UNICORN 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

718367 LOSARTAN CO UNICORN 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715739 LOZAAN CO 100/25 Losartan and diuretics 100MG/25MG TAB Accepted treatment

16 11/5/2013

Comprehensive Formulary

715740 LOZAAN CO 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715848 NETRASOL CO 50/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715849 NETRASOL CO 100/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

715064 SARTOC 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

716515 SARTOC 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716217 ZARTAN CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716216 ZARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

Beta-blockers

786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment

786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment

703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment

703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment

704651 B-BLOCK  Atenolol 100MG  TAB  Accepted treatment

704653 B-BLOCK  Atenolol 50MG  TAB  Accepted treatment

706179 BETACOR Bisoprolol 10MG TAB Accepted treatment

706178 BETACOR Bisoprolol 5MG TAB Accepted treatment

704373 BILOCOR 10  Bisoprolol 10MG TAB Accepted treatment

704372 BILOCOR 5  Bisoprolol 5MG TAB Accepted treatment

704133 BISOHEXAL 10 Bisoprolol 10MG  TAB Accepted treatment

704132 BISOHEXAL 5 Bisoprolol 5MG  TAB Accepted treatment

707393 BISOPROLOL HEXAL Bisoprolol 10MG TAB Accepted treatment

707391 BISOPROLOL HEXAL Bisoprolol 5MG TAB Accepted treatment

716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment

716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment

704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment

704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment

704440 CARDICOR 5MG Bisoprolol 5MG  TAB Accepted treatment

818437 CONCOR Bisoprolol 10MG TAB Accepted treatment

818429 CONCOR Bisoprolol 5MG TAB Accepted treatment

715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment

715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment

806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment

806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment

732567 INDERAL Propranolol 10MG TAB Accepted treatment

732575 INDERAL Propranolol 40MG TAB Accepted treatment

732648 INDERAL LA Propranolol 80MG CAP

806552 INDOBLOK 10 Propranolol 10MG TAB Accepted treatment

806560 INDOBLOK 40 Propranolol 40MG TAB Accepted treatment

716483 LOVISPES Nebivolol 5MG TAB

700558 NEBILET 5MG Nebivolol 5MG TAB

826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment

826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment

787167 PRODOROL Propranolol 10MG TAB Accepted treatment

787175 PRODOROL Propranolol 40MG TAB Accepted treatment

758140 PURBLOKA Propranolol 10MG TAB Accepted treatment

758167 PURBLOKA Propranolol 40MG APP Accepted treatment

787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment

787892 ROLAB-ATENOLOL Atenolol 50MG TAB Accepted treatment

712604 ROLAB-PROPRANOLOL HCL Propranolol 10MG TAB Accepted treatment

712612 ROLAB-PROPRANOLOL HCL Propranolol 40MG TAB Accepted treatment

765368 SOTACOR Sotalol 160MG TAB

765341 SOTACOR Sotalol 80MG APP

828009 SOTAHEXAL Sotalol 160MG TAB

827991 SOTAHEXAL Sotalol 80MG TAB

786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment

786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment

705873 TENOPRESS  Atenolol 100MG  TAB  Accepted treatment

705872 TENOPRESS  Atenolol 25MG  TAB  Accepted treatment

705874 TENOPRESS  Atenolol 50MG  TAB  Accepted treatment

797693 TENORMIN Atenolol 25MG TAB

769576 TENORMIN Atenolol 100MG TAB Accepted treatment

769584 TENORMIN Atenolol 50MG TAB Accepted treatment

715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment

715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment

Alpha-beta blockers

17 11/5/2013

Comprehensive Formulary

710339 ASPEN CARVEDILOL  Carvedilol 12.5MG  TAB  Accepted treatment

710340 ASPEN CARVEDILOL  Carvedilol 25MG  TAB  Accepted treatment

710338 ASPEN CARVEDILOL  Carvedilol 6.25MG  TAB  Accepted treatment

897117 CARLOC Carvedilol 25MG TAB Accepted treatment

705459 CARLOC 6.25  Carvedilol 6.25MG  TAB  Accepted treatment

700168 CARLOC 12.5 Carvedilol 12.5MG TAB Accepted treatment

705770 CARVEDILOL-HEXAL  Carvedilol 12.5MG  TAB  Accepted treatment

705767 CARVEDILOL-HEXAL  Carvedilol 25MG  TAB  Accepted treatment

705749 CARVEDILOL-HEXAL  Carvedilol 6.25MG  TAB  Accepted treatment

716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB Accepted treatment

716744 CARVEDILOL UNICORN Carvedilol 25MG TAB Accepted treatment

716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB Accepted treatment

704671 CARVETREND 12.5MG  Carvedilol 12.5MG  TAB  Accepted treatment

704672 CARVETREND 25MG Carvedilol 25MG  TAB  Accepted treatment

704670 CARVETREND 6.25MG Carvedilol 6.25MG  TAB  Accepted treatment

836354 DILATREND Carvedilol 12.5MG TAB Accepted treatment

788856 DILATREND Carvedilol 25MG TAB Accepted treatment

833428 DILATREND Carvedilol 6.25MG TAB Accepted treatment

710959 VEDIBLOK  Carvedilol 12.5MG  TAB  Accepted treatment

710960 VEDIBLOK  Carvedilol 25MG  TAB  Accepted treatment

710958 VEDIBLOK  Carvedilol 6.25MG  TAB  Accepted treatment

Beta-blocker and diuretic combinations

791172 ADCO-LOTEN Atenolol and other diuretics 100MG/25MG TAB Accepted treatment

719202 BILOCOR CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB

719200 BILOCOR CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB

719201 BILOCOR CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB

718087 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 10MG Bisoprolol and thiazides 10MG/6.25MG TAB

718082 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 2.5MG Bisoprolol and thiazides 2.5MG/6.25MG TAB

718086 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 5MG Bisoprolol and thiazides 5MG/6.25MG TAB

789615 ROLAB-ATENOLOL/CHLORTHALIDONE 100/25 Atenolol and other diuretics 100MG/25MG TAB Accepted treatment

789607 ROLAB-ATENOLOL/CHLORTHALIDONE 50/12.5 Atenolol and other diuretics 50MG/12.5MG TAB Accepted treatment

786217 TENCHLOR Atenolol and other diuretics 100MG/25MG TAB Accepted treatment

807591 TENCHLOR HS Atenolol and other diuretics 50MG/12.5MG TAB Accepted treatment

852929 ZIAK Bisoprolol and thiazides 10MG/6.25MG TAB

840300 ZIAK Bisoprolol and thiazides 2.5MG/6.25MG TAB

840319 ZIAK Bisoprolol and thiazides 5MG/6.25MG TAB

717988 ZIRINAK CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB

717986 ZIRINAK CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB

717987 ZIRINAK CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB

Cardiac glycosides

735752 LANOXIN Digoxin 0.25MG TAB Accepted treatment

735744 LANOXIN PAED Digoxin 0.05MG/1ML SYR Accepted treatment

735760 LANOXIN PAED Digoxin 0.063MG TAB Accepted treatment

758280 PURGOXIN Digoxin 0.25MG TAB Accepted treatment

For diuretics and antihypertensives, refer to "Hypertension"

Calcium

828289 B-CAL Calcium products > 300MG  CHU Accepted treatment

771066 TITRALAC Calcium carbonate TAB Accepted treatment

703359 ENO TUMS ASSORTED FRUIT FLAVOURS  Calcium carbonate 500MG  CHU  Accepted treatment

703364 ENO TUMS ORANGE FLAVOUR ROLLPAC  Calcium carbonate 500MG  CHU  Accepted treatment

703361 ENO TUMS PEPPERMINT FLAVOUR ROLLPAC  Calcium carbonate 500MG  CHU  Accepted treatment

Vitamin D

711640 CALCIFEROL Ergocalciferol 50000IU TAB Accepted treatment

711853 CALCIFEROL OILY 15ML Ergocalciferol 5000U/1ML APP Accepted treatment

750654 ONE ALPHA (014050) Alfacalcidol 0.25MCG CAP Accepted treatment

750662 ONE ALPHA (014052) Alfacalcidol 1MCG CAP Accepted treatment

380380 ONE ALPHA DROPS 20ML Alfacalcidol DRP Accepted treatment

761249 ROCALTROL Calcitriol 0.25MCG CAP Accepted treatment

Oral Iron and Folic Acid supplementation

705532 AHA FERROUS SULPHATE Ferrous sulfate 30MG TAB Accepted treatment

709874 AHA FOLIC ACID  Folic acid 5MG  TAB  Accepted treatment

705531 AHA FOLIC ACID Folic acid 0.5MG TAB Accepted treatment

891329 FERROUS SULPHATE Ferrous sulfate 100MG TAB Accepted treatment

Chronic Renal Disease

18 11/5/2013

Comprehensive Formulary

877832 FERROUS SULPHATE Ferrous sulfate 30MG TAB Accepted treatment

710372 FERROUS SULPHATE  Ferrous sulfate 75MG  TAB  Accepted treatment

713558 BODY BALANCE FERROUS SULPHATE Ferrous sulfate 75MG TAB Accepted treatment

871281 FOLIC ACID Folic acid .5MG TAB Accepted treatment

711922 FOLIC ACID Folic acid 5MG TAB Accepted treatment

711922 FOLIC ACID Folic acid 5MG TAB Accepted treatment

891330 FOLIFERR Ferrous sulphate 100MG TAB Accepted treatment

727024 FOLIGLOBIN Iron vitamin B12 and folic acid TAB

897329 GULF FERROUS SULPHATE COMPOUND Ferrous sulfate TAB Accepted treatment

756571 PREGAMAL Ferrous fumarate and folic acid 200MG/100MCG TAB

768596 SYR FERRI PHOS CO Ferrous sulfate LIQ Accepted treatment

Parenteral Iron Preparations

711596 COSMOFER AMPOULE 2ML  Ferric oxide dextran complex 50MG/1ML  INJ  Clinical motivation

713080 COSMOFER AMPOULE 10ML Ferric oxide dextran complex 50MG/1ML INJ Clinical motivation

725943 FERRIMED 2ML Iron trivalent, parenteral preparations 50MG/1ML INJ Clinical motivation

873276 VENOFER 5X5ML AMP Saccharated iron oxide AMP Clinical motivation

Erythropoietin

714021 ARANESP PREFILLED SYRINGE 0.3ML Darbepoetin alfa 150MCG/.3ML INJ Specialist motivation

714019 ARANESP PREFILLED SYRINGE 0.3ML Darbepoetin alfa 30MCG/.3ML INJ Specialist motivation

714020 ARANESP PREFILLED SYRINGE 0.3ML Darbepoetin alfa 60MCG/.3ML INJ Specialist motivation

714017 ARANESP PREFILLED SYRINGE 0.4ML Darbepoetin alfa 10MCG/.4ML INJ Specialist motivation

714018 ARANESP PREFILLED SYRINGE 0.5ML Darbepoetin alfa 20MCG/.5ML INJ Specialist motivation

714022 ARANESP PREFILLED SYRINGE 0.6ML Darbepoetin alfa 300MCG/.6ML INJ Specialist motivation

715971 ARANESP PREFILLED SYRINGE 0.4ML darbepoetin alfa 40MCG/.4ML INJ Specialist motivation

715974 ARANESP PREFILLED SYRINGE 0.4ML darbepoetin alfa 80MCG/.4ML INJ Specialist motivation

715975 ARANESP PREFILLED SYRINGE 0.5ML darbepoetin alfa 100MCG/.5ML INJ Specialist motivation

715973 ARANESP PREFILLED SYRINGE 0.5ML darbepoetin alfa 50MCG/.5ML INJ Specialist motivation

839876 EPREX PREFILLED Erythropoietin 10000U/1ML INJ Specialist motivation

837318 EPREX PREFILLED Erythropoietin 2000U/.5ML INJ Specialist motivation

820741 EPREX PREFILLED Erythropoietin 4000U/.4ML INJ Specialist motivation

705487 EPREX PREFILLED  Erythropoietin 40000U/1ML  INJ  Specialist motivation

712391 EPREX PREFILLED SYRINGE 0.6ML Erythropoietin 6000U/.6ML INJ Specialist motivation

712564 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 100MCG/.3ML INJ Specialist motivation

712565 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 150MCG/.3ML INJ Specialist motivation

712567 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 200MCG/.3ML INJ Specialist motivation

712568 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 250MCG/.3ML INJ Specialist motivation

712562 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 50MCG/.3ML INJ Specialist motivation

712563 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 75MCG/.3ML INJ Specialist motivation

717045 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 120MCG/.3ML INJ Specialist motivation

717044 MIRCERA PREFILLED SYRINGE 0.3ML Methoxy polyethylene glycol-epoetin beta 30MCG/.3ML INJ Specialist motivation

717046 MIRCERA PREFILLED SYRINGE 0.6ML Methoxy polyethylene glycol-epoetin beta 360MCG/.6ML INJ Specialist motivation

839264 REPOTIN AMP 1ML Erythropoietin 2000U/1ML INJ Specialist motivation

839272 REPOTIN AMP 1ML Erythropoietin 4000U/1ML INJ Specialist motivation

809160 RECORMON 1000 Erythropoietin 1000U INJ Specialist motivation

703741 RECORMON 10000 Erythropoietin 10000IU INJ Specialist motivation

705261 RECORMON 10000 PRE-FILLED SYR  Erythropoietin 10000IU  INJ  Specialist motivation

703744 RECORMON 20000 Erythropoietin 20000IU INJ Specialist motivation

705751 RECORMON 30000 PRE-FILLED SYR  Erythropoietin 30000IU  INJ  Specialist motivation

704631 RECORMON 4000 IU/0.3ML Erythropoietin 4000IU/0.3ML  INJ  Specialist motivation

704632 RECORMON 500 IU/0.3ML  Erythropoietin 500IU/0.3ML  INJ  Specialist motivation

703747 RECORMON 50000 (10ML MULTIDOSE) Erythropoietin 50000IU INJ Specialist motivation

704630 RECORMON 6000 PRE-FILLED SYR  Erythropoietin 6000IU  INJ  Specialist motivation

Aspirin

798533 ASPIRIN (WHITE) Acetylsalicylic acid 300MG TAB Accepted treatment

704645 ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

706930 BAYER ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

862304 BAYER ASPIRIN CARDIO Acetylsalicylic acid 100MG TAB Accepted treatment

715719 COMPRAL Acetylsalicylic acid 81MG TAB Accepted treatment

714995 COPRIN 81 Acetylsalicylic acid 81MG ECT Accepted treatment

847283 DISPRIN CV Acetylsalicylic acid 100MG EEF Accepted treatment

807206 DISPRIN CV Acetylsalicylic acid 300MG EEF  Accepted treatment

720577 DISPRIN REGULAR Acetylsalicylic acid 300MG EEF Accepted treatment

823481 ECOTRIN Acetylsalicylic acid 81MG ECT Accepted treatment

Coronary Artery Disease

19 11/5/2013

Comprehensive Formulary

808261 GENPHARM CHILDREN ASPIRIN (ASPIRIN JUNIO Acetylsalicylic acid 60MG TAB Accepted treatment

700909 GULF ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

841447 JUNIOR ASPIRIN (slt) Acetylsalicylic acid 97MG TAB Accepted treatment

815160 LO-ASPIRIN (CAPRIN) Acetylsalicylic acid 125MG TAB Accepted treatment

845590 MYOPRIN Acetylsalicylic acid 100MG  EEF Accepted treatment

712608 PCH ACETYLSALICYLIC ACID CARDIO Acetylsalicylic acid 80MG DSP Accepted treatment

Nitrates

703605 ANGISED Glyceryl trinitrate 0.5MG TAB Accepted treatment

793418 ELANTAN Isosorbide mononitrate 20MG TAB Accepted treatment

860115 ELANTAN LA Isosorbide mononitrate 50MG CAP Accepted treatment

821500 IMDUR Isosorbide mononitrate 60MG SRT Accepted treatment

734055 ISMO 20 Isosorbide mononitrate 20MG TAB Accepted treatment

734381 ISORDIL Isosorbide dinitrate 10MG TAB Accepted treatment

734403 ISORDIL Isosorbide dinitrate 30MG TAB Accepted treatment

734411 ISORDIL SUBLINGUAL Isosorbide dinitrate 5MG TAB Accepted treatment

734438 ISORDIL TEMBID Isosorbide dinitrate 40MG TAB Accepted treatment

710251 MONICOR SR Isosorbide mononitrate 60MG  TAB  Accepted treatment

784206 ROLAB-ISOSORBIDE DINITRATE Isosorbide dinitrate 10MG TAB Accepted treatment

784214 ROLAB-ISOSORBIDE DINITRATE Isosorbide dinitrate 30MG TAB Accepted treatment

784192 ROLAB-ISOSORBIDE DINITRATE SUBL Isosorbide dinitrate 5MG TAB Accepted treatment

Beta-blockers

786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment

786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment

703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment

703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment

704651 B-BLOCK  Atenolol 100MG  TAB  Accepted treatment

704653 B-BLOCK  Atenolol 50MG  TAB  Accepted treatment

706179 BETACOR Bisoprolol 10MG TAB Accepted treatment

706178 BETACOR Bisoprolol 5MG TAB Accepted treatment

704373 BILOCOR 10  Bisoprolol 10MG TAB Accepted treatment

704372 BILOCOR 5  Bisoprolol 5MG TAB Accepted treatment

704133 BISOHEXAL 10 Bisoprolol 10MG  TAB Accepted treatment

704132 BISOHEXAL 5 Bisoprolol 5MG  TAB Accepted treatment

707393 BISOPROLOL HEXAL Bisoprolol 10MG TAB Accepted treatment

707391 BISOPROLOL HEXAL Bisoprolol 5MG TAB Accepted treatment

716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment

716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment

704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment

704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment

704440 CARDICOR 5MG Bisoprolol 5MG  TAB Accepted treatment

818437 CONCOR Bisoprolol 10MG TAB Accepted treatment

818429 CONCOR Bisoprolol 5MG TAB Accepted treatment

715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment

715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment

806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment

806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment

732567 INDERAL Propranolol 10MG TAB Accepted treatment

732575 INDERAL Propranolol 40MG TAB Accepted treatment

732648 INDERAL LA Propranolol 80MG CAP

806552 INDOBLOK 10 Propranolol 10MG TAB Accepted treatment

806560 INDOBLOK 40 Propranolol 40MG TAB Accepted treatment

716483 LOVISPES Nebivolol 5MG TAB

700558 NEBILET 5MG Nebivolol 5MG TAB

826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment

826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment

787167 PRODOROL Propranolol 10MG TAB Accepted treatment

787175 PRODOROL Propranolol 40MG TAB Accepted treatment

758140 PURBLOKA Propranolol 10MG TAB Accepted treatment

758167 PURBLOKA Propranolol 40MG APP Accepted treatment

787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment

787892 ROLAB-ATENOLOL Atenolol 50MG TAB Accepted treatment

712604 ROLAB-PROPRANOLOL HCL Propranolol 10MG TAB Accepted treatment

712612 ROLAB-PROPRANOLOL HCL Propranolol 40MG TAB Accepted treatment

786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment

786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment

20 11/5/2013

Comprehensive Formulary

705873 TENOPRESS  Atenolol 100MG  TAB  Accepted treatment

705872 TENOPRESS  Atenolol 25MG  TAB  Accepted treatment

705874 TENOPRESS  Atenolol 50MG  TAB  Accepted treatment

797693 TENORMIN Atenolol 25MG TAB

769576 TENORMIN Atenolol 100MG TAB Accepted treatment

769584 TENORMIN Atenolol 50MG TAB Accepted treatment

715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment

715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment

Alpha-Beta blockers

710339 ASPEN CARVEDILOL  Carvedilol 12.5MG  TAB 

710340 ASPEN CARVEDILOL  Carvedilol 25MG  TAB 

710338 ASPEN CARVEDILOL  Carvedilol 6.25MG  TAB 

897117 CARLOC Carvedilol 25MG TAB

705459 CARLOC 6.25  Carvedilol 6.25MG  TAB 

700168 CARLOC 12.5 Carvedilol 12.5MG TAB

705770 CARVEDILOL-HEXAL  Carvedilol 12.5MG  TAB 

705767 CARVEDILOL-HEXAL  Carvedilol 25MG  TAB 

705749 CARVEDILOL-HEXAL  Carvedilol 6.25MG  TAB 

716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB

716744 CARVEDILOL UNICORN Carvedilol 25MG TAB

716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB

704671 CARVETREND 12.5MG  Carvedilol 12.5MG  TAB 

704672 CARVETREND 25MG Carvedilol 25MG  TAB 

704670 CARVETREND 6.25MG Carvedilol 6.25MG  TAB 

836354 DILATREND Carvedilol 12.5MG TAB

788856 DILATREND Carvedilol 25MG APP

833428 DILATREND Carvedilol 6.25MG TAB

710959 VEDIBLOK  Carvedilol 12.5MG  TAB 

710960 VEDIBLOK  Carvedilol 25MG  TAB 

710958 VEDIBLOK  Carvedilol 6.25MG  TAB 

Calcium channel antagonists

793124 ADALAT XL Nifedipine 30MG SRT Accepted treatment

840963 ADCO-VASCARD SR Nifedipine 20MG SRC Accepted treatment

708142 ALMADIN  Amlodipine 10MG  TAB  Accepted treatment

708141 ALMADIN  Amlodipine 5MG  TAB  Accepted treatment

707278 AMLATE  Amlodipine 10MG  TAB  Accepted treatment

707277 AMLATE  Amlodipine 5MG  TAB  Accepted treatment

703917 AMLOC 10  Amlodipine 10MG  TAB Accepted treatment

703916 AMLOC 5  Amlodipine 5MG  TAB Accepted treatment

708051 AMLODAC  Amlodipine 10MG  TAB  Accepted treatment

708050 AMLODAC  Amlodipine 5MG  TAB  Accepted treatment

711374 AMLODIPINE-WINTHROP  Amlodipine 10MG  TAB  Accepted treatment

711372 AMLODIPINE-WINTHROP  Amlodipine 5MG  TAB  Accepted treatment

704621 AMLOSYN 10 Amlodipine 10MG  TAB  Accepted treatment

704620 AMLOSYN 5 Amlodipine 5MG  TAB  Accepted treatment

713972 AMTAS Amlodipine 10MG  TAB  Accepted treatment

713971 AMTAS Amlodipine 5MG  TAB  Accepted treatment

714311 AURO-AMLODIPINE Amlodipine 10MG TAB Accepted treatment

714310 AURO-AMLODIPINE Amlodipine 5MG TAB Accepted treatment

708095 AUSTELL-AMLODIPINE  Amlodipine 10MG  TAB  Accepted treatment

708094 AUSTELL-AMLODIPINE  Amlodipine 5MG  TAB  Accepted treatment

718083 BIO NIFEDIPINE XL Nifedipine 30MG SRT Accepted treatment

708040 CALBLOC  Amlodipine 10MG  TAB  Accepted treatment

708039 CALBLOC  Amlodipine 5MG  TAB  Accepted treatment

813354 CALCICARD SR Verapamil 240MG SRT Accepted treatment

864153 CIPALAT RETARD Nifedipine 20MG TAB Accepted treatment

708152 CIPLAVASC  Amlodipine 10MG  TAB  Accepted treatment

708150 CIPLAVASC  Amlodipine 5MG  TAB  Accepted treatment

707980 CORVADIL  Amlodipine 10MG  TAB  Accepted treatment

707979 CORVADIL  Amlodipine 5MG  TAB  Accepted treatment

708191 CPL ALLIANCE AMLODIPINE  Amlodipine 10MG  TAB  Accepted treatment

708190 CPL ALLIANCE AMLODIPINE  Amlodipine 5MG  TAB  Accepted treatment

818364 DILATAM Diltiazem 60MG TAB Accepted treatment

711682 FEDALOC SR Nifedipine 30MG TAB Accepted treatment

712954 GULF AMLODIPINE Amlodipine 10MG TAB Accepted treatment

712953 GULF AMLODIPINE Amlodipine 5MG TAB Accepted treatment

21 11/5/2013

Comprehensive Formulary

708648 INDO AMLODIPINE Amlodipine 5MG  TAB  Accepted treatment

734071 ISOPTIN DRAGEES Verapamil 40MG TAB Accepted treatment

734373 ISOPTIN SR Verapamil 240MG SRT Accepted treatment

712216 KEYSAL Amlodipine 10MG TAB Accepted treatment

712215 KEYSAL Amlodipine 5MG TAB Accepted treatment

708162 KLODIP  Amlodipine 5MG  TAB  Accepted treatment

708352 LOMANOR  Amlodipine 5MG  TAB  Accepted treatment

708353 LOMANOR  Amlodipine 10MG  TAB  Accepted treatment

715000 MACOREL SR Nifedipine 30MG SRT Accepted treatment

829501 NIFEDALAT 20 SR Nifedipine 20MG SRT Accepted treatment

799122 NORVASC Amlodipine 10MG TAB Accepted treatment

791245 NORVASC Amlodipine 5MG TAB Accepted treatment

710238 PHARMA DYNAMICS AMLODIPINE BESYLATE  Amlodipine 10MG  TAB  Accepted treatment

710236 PHARMA DYNAMICS AMLODIPINE BESYLATE  Amlodipine 5MG  TAB  Accepted treatment

813982 PLENDIL Felodipine 10MG SRT

805548 PLENDIL Felodipine 5MG SRT

703902 FELODIPINE HEXAL  Felodipine 10MG SRT Accepted treatment

703221 FELODIPINE HEXAL  Felodipine 5MG  SRT  Accepted treatment

819573 RAVAMIL SR Verapamil 240MG SRT Accepted treatment

820202 ROLAB-DILTIAZEM HCL Diltiazem 60MG TAB Accepted treatment

775819 ROLAB-VERAPAMIL HCL Verapamil 120MG TAB Accepted treatment

775789 ROLAB-VERAPAMIL HCL Verapamil 40MG TAB Accepted treatment

775797 ROLAB-VERAPAMIL HCL Verapamil 80MG TAB Accepted treatment

707377 SANDOZ-AMLODIPINE Amlodipine 10MG  TAB  Accepted treatment

707375 SANDOZ-AMLODIPINE Amlodipine 5MG  TAB  Accepted treatment

715002 SPEC NIFEDIPINE SR Nifedipine 30MG SRT Accepted treatment

713491 STAMLO Amlodipine 10MG TAB Accepted treatment

713490 STAMLO Amlodipine 5MG TAB Accepted treatment

813125 TILAZEM 180 CR Diltiazem 180MG SRC Accepted treatment

813133 TILAZEM 240 CR Diltiazem 240MG SRC Accepted treatment

861545 VASCARD SR Nifedipine 30MG CAP Accepted treatment

774944 VASOMIL Verapamil 40MG TAB Accepted treatment

774952 VASOMIL Verapamil 80MG TAB Accepted treatment

700071 VERAHEXAL 240 SR Verapamil 240MG SRT Accepted treatment

839183 ZILDEM Diltiazem 180MG SRC Accepted treatment

839191 ZILDEM Diltiazem 240MG SRC Accepted treatment

822213 ZILDEM 60 Diltiazem 60MG TAB Accepted treatment

824364 ZILDEM 90 BD Diltiazem 90MG TAB

Aminosalicylic acid preparations

783668 ASACOL Mesalazine 400MG TAB

709076 ASACOL  Mesalazine 800MG  TAB 

792519 DIPENTUM Olsalazine 250MG CAP

707496 MESASAL Mesalazine 500MG  TAB 

890775 PENTASA Mesalazine 500MG TAB

762008 SALAZOPYRIN Sulfasalazine 500MG TAB Accepted treatment

762016 SALAZOPYRIN E.N. Sulfasalazine 500MG ECT Accepted treatment

716333 SALOFALK Mesalazine 1000MG SAC

716331 SALOFALK Mesalazine 500MG SAC

Immunosuppressants

701252 AZAMUN Azathioprine 50MG TAB Accepted treatment

706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment

712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment

732524 IMURAN Azathioprine 50MG TAB

700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Methotrexate

782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment

782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment

712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment

825565 EMTHEXATE RTU 50-2 2ML Methotrexate 25MG/1ML INJ Accepted treatment

825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment

711328 METACHOR VIAL 2ML  Methotrexate 25MG/1ML  INJ  Accepted treatment

840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment

840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment

Crohn's Disease

22 11/5/2013

Comprehensive Formulary

742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment

Steroid preparations (oral)

814407 CAPSOID Prednisolone 5MG TAB Accepted treatment

716693 COVOCORT Hydrocortisone 10MG TAB

800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment

741124 MEDROL Methylprednisone 16MG TAB

741116 MEDROL Methylprednisone 4MG TAB

742759 METICORTEN Prednisone 50MG TAB

742732 METICORTEN Prednisone 5MG TAB

752304 PANAFCORT Prednisone 5MG TAB Accepted treatment

788783 PREDNISONE (BE-TABS) Prednisone 5mg TAB Accepted treatment

703720 PRELONE Prednisolone 5MG TAB

836826 PULMISON TABS Prednisone 20MG TAB

818267 TROLIC Prednisone 5MG TAB Accepted treatment

Steroid preparations (enemas)

824593 ENTOCORD ENEMAS Budesonide 2.3MG ENE Accepted treatment

Insulin

733512 INSU ACTRAPH HMGE 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

816213 INSU ACTRAPH HMGE PENSET 3ML Insulin (human) 100IU/1ML INJD

714977 INSU ACTRAPHANE HM (GE) FLEXPEN 3ML Insulin (human) 100IU/1ML INJD

706039 INSU APIDRA CARTIDGES  Insulin glulisine 100IU/1ML  INJD Accepted treatment

706040 INSU APIDRA  Insulin glulisine 100IU/1ML  INJD Accepted treatment

710367 INSU APIDRA L OPTISET PENSET 3ML  Insulin glulisine 100IU/1ML  INJD Accepted treatment

709861 INSU APIDRA SOLOSTAR DISPOSABLE PENS 3ML  Insulin glulisine 100IU/1ML  INJD Accepted treatment

712767 INSU BIOSULIN R CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

712769 INSU BIOSULIN L CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

712768 INSU BIOSULIN N CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

712770 INSU BIOSULIN 30-70 CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

819468 INSU HUMALOG Insulin lispro 100IU/1ML INJD Accepted treatment

862355 INSU HUMALOG INJ 3.0ML CART Insulin lispro INJD Accepted treatment

853437 INSU HUMALOG MIX 25 10ML VIAL Insulin lispro 100IU/1ML INJD Accepted treatment

861782 INSU HUMALOG MIX 25 CART 3ML Insulin lispro INJD Accepted treatment

853461 INSU HUMALOG MIX 25 PEN 3ML Insulin lispro 100IU/1ML INJD Accepted treatment

705074 INSU HUMALOG MIX 50 CART  Insulin lispro 3ML  INJD Accepted treatment

853445 INSU HUMALOG PEN 3ML Insulin lispro 100IU/1ML INJD Accepted treatment

783811 INSU HUMULIN 30/70 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

863572 INSU HUMULIN 30/70 3ML Insulin (human) INJD Accepted treatment

704456 INSU HUMULIN 30/70 PEN 3ML DISP Insulin (human) 100IU/1ML INJD Accepted treatment

733458 INSU HUMULIN N 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

863556 INSU HUMULIN N 3.0ML CART 5 Insulin (human) INJD Accepted treatment

853453 INSU HUMULIN N PEN 3ML Insulin (human) 100IU/1ML INJD Accepted treatment

733431 INSU HUMULIN R 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

863564 INSU HUMULIN R 3.0ML CARTRIDGE Insulin (human) INJD Accepted treatment

704457 INSU HUMULIN R PEN 3ML DISP Insulin (human) 100IU/1ML INJD Accepted treatment

710299 INSU INSUMAN COMB 30/70 PEN 3ML  Insulin (human) 100IU/1ML INJD Accepted treatment

709860 INSU LANTUS SOLOSTAR DISPOSABLE PENS 3ML  Insulin glargine  100IU/1ML  INJ 

700308 INSU LANTUS CARTRIDGE 3ML Insulin glargine INJD

705312 INSU LEVEMIR 3ML FLEXPEN PREFILLED Insulin detemir 100MG/1ML  INJ 

705313 INSU LEVEMIR 3ML PREFILLED CARTRIDGE Insulin detemir 100MG/1ML  INJ 

706761 INSU MIRIO PEN HUMALOG MIX 25  Insulin lispro INJD Accepted treatment

706762 INSU MIRIO PEN HUMALOG MIX 50  Insulin lispro INJD Accepted treatment

706760 INSU MIRIO PEN HUMALOG  Insulin lispro INJD Accepted treatment

702086 INSU NOVOMIX 30 FLEXPEN 3ML Combinations INJD Accepted treatment

702089 INSU NOVOMIX 30 PENFILL 3ML Combinations INJD Accepted treatment

897775 INSU NOVORAPID 3ML SOLUTION FOR I Insulin aspart 100U INJD Accepted treatment

897767 INSU NOVORAPID FLEXPEN 3ML PENS Insulin aspart INJD Accepted treatment

707927 INSU NOVORAPID 10ML  Insulin aspart 100IU/1ML  INJ  Accepted treatment

733482 INSU PROTAPH HMGE 10 ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

700183 INSU PROTAPH FLEXPEN 3ML  Insulin (human) 100IU/1ML INJD

Applicances

Accepted treatment

Diabetes Mellitus Type 1

Diabetes Mellitus Type 2

Diabetic strips, needles and lancets

23 11/5/2013

Comprehensive Formulary

Biguanides

714427 ACCORD METFORMIN Metformin 500MG TAB Accepted treatment

714426 ACCORD METFORMIN Metformin 850MG TAB Accepted treatment

707670 APEX-METFORMIN  Metformin 500MG  TAB  Accepted treatment

707669 APEX-METFORMIN FORTE  Metformin 850MG  TAB  Accepted treatment

706672 ARROW METFORMIN  Metformin 500MG  TAB  Accepted treatment

706673 ARROW METFORMIN  Metformin 850MG  TAB  Accepted treatment

714683 AURO-METFORMIN Metformin 1000MG TAB Accepted treatment

714680 AURO-METFORMIN Metformin 500MG TAB Accepted treatment

714681 AURO-METFORMIN Metformin 850MG TAB Accepted treatment

705757 AUSTELL-METFORMIN 500MG  Metformin 500MG  TAB  Accepted treatment

705758 AUSTELL-METFORMIN 850MG  Metformin 850MG  TAB  Accepted treatment

708281 BIGSENS  Metformin 500MG  TAB  Accepted treatment

708282 BIGSENS  Metformin 850MG  TAB  Accepted treatment

709172 BIGSENS  Metformin 1000MG  TAB  Accepted treatment

705358 DIABETMIN  Metformin 850MG  TAB  Accepted treatment

715936 DIAFORMIN Metformin 500MG TAB Accepted treatment

715937 DIAFORMIN FORTE Metformin 850MG TAB Accepted treatment

714186 DIAMIN Metformin 500MG TAB Accepted treatment

714187 DIAMIN Metformin 850MG TAB Accepted treatment

708009 FORMINAL  Metformin 500MG  TAB  Accepted treatment

708010 FORMINAL  Metformin 850MG  TAB  Accepted treatment

714525 GLUCONORM Metformin 500MG TAB Accepted treatment

714526 GLUCONORM Metformin 850MG  TAB  Accepted treatment

729159 GLUCOPHAGE Metformin 500MG TAB Accepted treatment

703909 GLUCOPHAGE  Metformin 1000MG  TAB  Accepted treatment

729167 GLUCOPHAGE FORTE Metformin 850MG TAB Accepted treatment

710196 GLUCOPHAGE XR  Metformin 500MG  SRT  Accepted treatment

709338 INDO METFORMIN FC Metformin 500MG  TAB  Accepted treatment

709339 INDO METFORMIN FC Metformin 850MG  TAB  Accepted treatment

718828 METFORMIN ALKEM Metformin 500MG TAB Accepted treatment

718827 METFORMIN ALKEM Metformin 850MG TAB Accepted treatment

897957 MYLAN-METFORMIN Metformin 500MG TAB Accepted treatment

897957 MYLAN-METFORMIN Metformin 850MG TAB Accepted treatment

718231 METCHEK Metformin 500MG TAB Accepted treatment

718232 METCHEK Metformin 850MG TAB Accepted treatment

702385 METFORAL 500 Metformin 500MG TAB Accepted treatment

702363 METFORAL 850 Metformin 850MG TAB Accepted treatment

711773 METORED  Metformin 1000MG  TAB  Accepted treatment

711636 METORED  Metformin 500MG  TAB  Accepted treatment

711638 METORED  Metformin 850MG  TAB  Accepted treatment

709246 METPHAGE  Metformin 500MG TAB Accepted treatment

709247 METPHAGE  Metformin 850MG TAB Accepted treatment

719285 ROLAB-METFORMIN HCL Metformin 500MG TAB Accepted treatment

719293 ROLAB-METFORMIN HCL Metformin 850MG TAB Accepted treatment

815225 ROLAB-METFORMIN HCL 500 FC Metformin 500MG TAB Accepted treatment

815233 ROLAB-METFORMIN HCL 850 FC Metformin 850MG TAB Accepted treatment

Sulphonylureas

716714 ACCORD GLIMEPIRIDE Glimepiride 1MG  TAB 

716715 ACCORD GLIMEPIRIDE Glimepiride 2MG  TAB 

707587 ALEMBIC GLICLAZIDE  Gliclazide 80MG  TAB  Accepted treatment

709538 ARROW GLICLAZIDE  Gliclazide 80MG  TAB  Accepted treatment

831557 AMARYL Glimepiride 1MG TAB

831565 AMARYL Glimepiride 2MG TAB

714854 ASPEN GLIMEPIRIDE Glimepiride 1MG TAB

714855 ASPEN GLIMEPIRIDE Glimepiride 2MG TAB

705759 AUSTELL-GLICLAZIDE  Gliclazide 40MG  TAB  Accepted treatment

705760 AUSTELL-GLICLAZIDE  Gliclazide 80MG  TAB  Accepted treatment

717076 AUSTELL GLIMEPIRIDE Glimepiride 1MG TAB

717077 AUSTELL GLIMEPIRIDE Glimepiride 2MG TAB

717452 DAONIL Glibenclamide 5MG TAB Accepted treatment

708005 DIAGLIM  Glimepiride 1MG  TAB 

708006 DIAGLIM  Glimepiride 2MG  TAB 

894502 DIACARE Glibenclamide 5MG TAB Accepted treatment

868906 DIAGLUCIDE Gliclazide 80MG TAB Accepted treatment

714582 DIAGLUCIDE MR Gliclazide 30MG TAB

24 11/5/2013

Comprehensive Formulary

718247 DIAGLUCIDE MR Gliclazide 60MG SRT

719463 DIAMICRON Gliclazide 80MG TAB Accepted treatment

702923 DIAMICRON MR Gliclazide 30MG TAB

718245 DIAMICRON MR Gliclazide 60MG SRT

714909 DIARAN MR Gliclazide 30MG SRT

716953 DYNA GLICLAZIDE SR Gliclazide 30MG SRT

710207 EUGLIM  Glimepiride 1MG  TAB 

710208 EUGLIM  Glimepiride 2MG  TAB 

704362 GLAMARYL 1MG  Glimepiride 1MG TAB

704363 GLAMARYL 2MG  Glimepiride 2MG TAB

707388 GLIMEHEXAL  Glimepiride 1MG  TAB 

707389 GLIMEHEXAL  Glimepiride 2MG  TAB 

834599 GLUCOMED Gliclazide 80MG TAB Accepted treatment

729361 GLYCOMIN Glibenclamide 5MG TAB Accepted treatment

838209 GLYCRON Gliclazide 80MG TAB Accepted treatment

700717 GLYGARD Gliclazide 80MG TAB Accepted treatment

700639 MYLAN-GLICLAZIDE Gliclazide 80MG TAB Accepted treatment

709984 MYLAN-GLIMEPIRIDE Glimepiride 1MG  TAB 

709985 MYLAN-GLIMEPIRIDE Glimepiride 2MG  TAB 

827053 NORTON-GLIBENCLAMIDE Glibenclamide 5MG TAB Accepted treatment

781258 ROLAB-GLIBENCLAMIDE Glibenclamide 5MG TAB Accepted treatment

834866 ROLAB-GLICLAZIDE Gliclazide 80MG TAB Accepted treatment

704673 SANDOZ GLIMEPIRIDE  Glimepiride 1MG  TAB 

704674 SANDOZ GLIMEPIRIDE  Glimepiride 2MG  TAB 

710904 SULPHONUR  Glimepiride 1MG  TAB 

710905 SULPHONUR  Glimepiride 2MG  TAB 

711908 ZYDUS-GLIMEPIRIDE  Glimepiride 1MG  TAB 

711909 ZYDUS-GLIMEPIRIDE  Glimepiride 2MG  TAB 

Combination products

718106 AMARYL COMBI 2MG/500MG Metformin and sulfonamides 2MG/500MG TAB

701109 GLUCOVANCE 250/1,25 Metformin/Glibenclamide 250MG/1.25MG TAB

701111 GLUCOVANCE 500/2.5 Metformin/Glibenclamide 500MG/2.5MG TAB

701112 GLUCOVANCE 500/5 Metformin/Glibenclamide 500MG/5MG TAB

Thiazolidines

718148 ACCORD PIOGLITAZONE Pioglitazone 15MG TAB Specialist motivation/SI

718150 ACCORD PIOGLITAZONE Pioglitazone 30MG TAB Specialist motivation/SI

718151 ACCORD PIOGLITAZONE Pioglitazone 45MG TAB Specialist motivation/SI

878243 ACTOS 15MG Pioglitazone 15MG TAB Specialist motivation/SI

878251 ACTOS 30MG Pioglitazone 30MG TAB Specialist motivation/SI

707974 CIPLA PIOGLITAZONE 15  Pioglitazone 15MG  TAB  Specialist motivation/SI

707981 CIPLA PIOGLITAZONE 30  Pioglitazone 30MG  TAB  Specialist motivation/SI

Insulin

733512 INSU ACTRAPH HMGE 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

816213 INSU ACTRAPH HMGE PENSET 3ML Insulin (human) 100IU/1ML INJD

714977 INSU ACTRAPHANE HM (GE) FLEXPEN 3ML Insulin (human) 100IU/1ML INJD

706039 INSU APIDRA CARTIDGES  Insulin glulisine 100IU/1ML  INJD Accepted treatment

706040 INSU APIDRA  Insulin glulisine 100IU/1ML  INJD Accepted treatment

710367 INSU APIDRA L OPTISET PENSET 3ML  Insulin glulisine 100IU/1ML  INJD Accepted treatment

709861 INSU APIDRA SOLOSTAR DISPOSABLE PENS 3ML  Insulin glulisine 100IU/1ML  INJD Accepted treatment

712767 INSU BIOSULIN R CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

712769 INSU BIOSULIN L CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

712768 INSU BIOSULIN N CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

712770 INSU BIOSULIN 30-70 CARTRIDGE 3ML Insulin (human) 100IU/1ML INJ Accepted treatment

819468 INSU HUMALOG Insulin lispro 100IU/1ML INJD Accepted treatment

862355 INSU HUMALOG INJ 3.0ML CART Insulin lispro INJD Accepted treatment

853437 INSU HUMALOG MIX 25 10ML VIAL Insulin lispro 100IU/1ML INJD Accepted treatment

861782 INSU HUMALOG MIX 25 CART 3ML Insulin lispro INJD Accepted treatment

853461 INSU HUMALOG MIX 25 PEN 3ML Insulin lispro 100IU/1ML INJD Accepted treatment

705074 INSU HUMALOG MIX 50 CART  Insulin lispro 3ML  INJ  Accepted treatment

853445 INSU HUMALOG PEN 3ML Insulin lispro 100IU/1ML INJD Accepted treatment

783811 INSU HUMULIN 30/70 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

863572 INSU HUMULIN 30/70 3ML Insulin (human) INJD Accepted treatment

704456 INSU HUMULIN 30/70 PEN 3ML DISP Insulin (human) 100IU/1ML INJD Accepted treatment

733458 INSU HUMULIN N 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

863556 INSU HUMULIN N 3.0ML CART 5 Insulin (human) INJD Accepted treatment

853453 INSU HUMULIN N PEN 3ML Insulin (human) 100IU/1ML INJD Accepted treatment

25 11/5/2013

Comprehensive Formulary

733431 INSU HUMULIN R 10ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

863564 INSU HUMULIN R 3.0ML CARTRIDGE Insulin (human) INJD Accepted treatment

704457 INSU HUMULIN R PEN 3ML DISP Insulin (human) 100IU/1ML INJD Accepted treatment

710299 INSU INSUMAN COMB 30/70 PEN 3ML  Insulin (human) 100IU/1ML INJD Accepted treatment

709860 INSU LANTUS SOLOSTAR DISPOSABLE PENS 3ML  Insulin glargine  100IU/1ML  INJ 

700308 INSU LANTUS CARTRIDGE 3ML Insulin glargine INJD

705312 INSU LEVEMIR 3ML FLEXPEN PREFILLED Insulin detemir 100MG/1ML  INJ 

705313 INSU LEVEMIR 3ML PREFILLED CARTRIDGE Insulin detemir 100MG/1ML  INJ 

706761 INSU MIRIO PEN HUMALOG MIX 25  Insulin lispro INJD Accepted treatment

706762 INSU MIRIO PEN HUMALOG MIX 50  Insulin lispro INJD Accepted treatment

706760 INSU MIRIO PEN HUMALOG  Insulin lispro INJD Accepted treatment

702086 INSU NOVOMIX 30 FLEXPEN 3ML Combinations INJD Accepted treatment

702089 INSU NOVOMIX 30 PENFILL 3ML Combinations INJD Accepted treatment

897775 INSU NOVORAPID 3ML SOLUTION FOR I Insulin aspart 100U INJD Accepted treatment

897767 INSU NOVORAPID FLEXPEN 3ML PENS Insulin aspart INJD Accepted treatment

707927 INSU NOVORAPID 10ML  Insulin aspart 100IU/1ML  INJ  Accepted treatment

733482 INSU PROTAPH HMGE 10 ML VIAL Insulin (human) 100IU/1ML INJD Accepted treatment

700183 INSU PROTAPH FLEXPEN 3ML  Insulin (human) 100IU/1ML INJD

Applicances

Clinical review

Desmopressin

837563 DDAVP Desmopressin 0.1MG TAB Special investigations

703639 DDAVP Desmopressin 0.2MG TAB Special investigations

837555 DDAVP 5ML Desmopressin 0.1MG/1ML NAS Special investigations

717746 DDAVP INTRANASAL SOLUTION Desmopressin 0.1MG/1ML NOD Special investigations

Anticoagulants

778362 WARFARIN Warfarin 5MG TAB Accepted treatment

709906 CIPLA WARFARIN 1MG  Warfarin 1MG  TAB  Accepted treatment

712390 CIPLA-WARFARIN Warfarin 3MG TAB Accepted treatment

709905 CIPLA WARFARIN 5MG  Warfarin 5MG  TAB  Accepted treatment

Antiplatelet agents

798533 ASPIRIN (WHITE) Acetylsalicylic acid 300MG TAB Accepted treatment

704645 ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

706930 BAYER ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

862304 BAYER ASPIRIN CARDIO Acetylsalicylic acid 100MG TAB Accepted treatment

715719 COMPRAL Acetylsalicylic acid 81MG TAB Accepted treatment

714995 COPRIN 81 Acetylsalicylic acid 81MG ECT Accepted treatment

847283 DISPRIN CV Acetylsalicylic acid 100MG EEF Accepted treatment

807206 DISPRIN CV Acetylsalicylic acid 300MG EEF  Accepted treatment

720577 DISPRIN REGULAR Acetylsalicylic acid 300MG EEF Accepted treatment

823481 ECOTRIN Acetylsalicylic acid 81MG ECT Accepted treatment

808261 GENPHARM CHILDREN ASPIRIN (ASPIRIN JUNIO Acetylsalicylic acid 60MG TAB Accepted treatment

700909 GULF ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

841447 JUNIOR ASPIRIN (slt) Acetylsalicylic acid 97MG TAB Accepted treatment

815160 LO-ASPIRIN (CAPRIN) Acetylsalicylic acid 125MG TAB Accepted treatment

845590 MYOPRIN Acetylsalicylic acid 100MG  EEF Accepted treatment

712608 PCH ACETYLSALICYLIC ACID CARDIO Acetylsalicylic acid 80MG DSP Accepted treatment

Beta-blockers

786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment

786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment

703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment

703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment

704651 B-BLOCK  Atenolol 100MG  TAB  Accepted treatment

704653 B-BLOCK  Atenolol 50MG  TAB  Accepted treatment

706179 BETACOR Bisoprolol 10MG TAB Accepted treatment

706178 BETACOR Bisoprolol 5MG TAB Accepted treatment

704373 BILOCOR 10  Bisoprolol 10MG TAB Accepted treatment

704372 BILOCOR 5  Bisoprolol 5MG TAB Accepted treatment

704133 BISOHEXAL 10 Bisoprolol 10MG  TAB Accepted treatment

704132 BISOHEXAL 5 Bisoprolol 5MG  TAB Accepted treatment

Dysrhythmias

Diabetes Insipidus

Diabetic strips, needles and lancets

26 11/5/2013

Comprehensive Formulary

707393 BISOPROLOL HEXAL Bisoprolol 10MG TAB Accepted treatment

707391 BISOPROLOL HEXAL Bisoprolol 5MG TAB Accepted treatment

716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment

716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment

704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment

704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment

704440 CARDICOR 5MG Bisoprolol 5MG  TAB Accepted treatment

818437 CONCOR Bisoprolol 10MG TAB Accepted treatment

818429 CONCOR Bisoprolol 5MG TAB Accepted treatment

715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment

715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment

806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment

806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment

732567 INDERAL Propranolol 10MG TAB Accepted treatment

732575 INDERAL Propranolol 40MG TAB Accepted treatment

732648 INDERAL LA Propranolol 80MG CAP

806552 INDOBLOK 10 Propranolol 10MG TAB Accepted treatment

806560 INDOBLOK 40 Propranolol 40MG TAB Accepted treatment

716483 LOVISPES Nebivolol 5MG TAB

700558 NEBILET 5MG Nebivolol 5MG TAB

826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment

826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment

787167 PRODOROL Propranolol 10MG TAB Accepted treatment

787175 PRODOROL Propranolol 40MG TAB Accepted treatment

758140 PURBLOKA Propranolol 10MG TAB Accepted treatment

758167 PURBLOKA Propranolol 40MG APP Accepted treatment

787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment

787892 ROLAB-ATENOLOL Atenolol 50MG TAB Accepted treatment

712604 ROLAB-PROPRANOLOL HCL Propranolol 10MG TAB Accepted treatment

712612 ROLAB-PROPRANOLOL HCL Propranolol 40MG TAB Accepted treatment

765368 SOTACOR Sotalol 160MG TAB

765341 SOTACOR Sotalol 80MG APP

828009 SOTAHEXAL Sotalol 160MG TAB Specialist script

827991 SOTAHEXAL Sotalol 80MG TAB Specialist script

786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment

786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment

705873 TENOPRESS  Atenolol 100MG  TAB  Accepted treatment

705872 TENOPRESS  Atenolol 25MG  TAB  Accepted treatment

705874 TENOPRESS  Atenolol 50MG  TAB  Accepted treatment

797693 TENORMIN Atenolol 25MG TAB

769576 TENORMIN Atenolol 100MG TAB Accepted treatment

769584 TENORMIN Atenolol 50MG TAB Accepted treatment

715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment

715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment

Alpha-Beta blockers

710339 ASPEN CARVEDILOL  Carvedilol 12.5MG  TAB 

710340 ASPEN CARVEDILOL  Carvedilol 25MG  TAB 

710338 ASPEN CARVEDILOL  Carvedilol 6.25MG  TAB 

897117 CARLOC Carvedilol 25MG TAB

705459 CARLOC 6.25  Carvedilol 6.25MG  TAB 

700168 CARLOC 12.5 Carvedilol 12.5MG TAB

705770 CARVEDILOL-HEXAL  Carvedilol 12.5MG  TAB 

705767 CARVEDILOL-HEXAL  Carvedilol 25MG  TAB 

705749 CARVEDILOL-HEXAL  Carvedilol 6.25MG  TAB 

716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB

716744 CARVEDILOL UNICORN Carvedilol 25MG TAB

716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB

704671 CARVETREND 12.5MG  Carvedilol 12.5MG  TAB 

704672 CARVETREND 25MG Carvedilol 25MG  TAB 

704670 CARVETREND 6.25MG Carvedilol 6.25MG  TAB 

836354 DILATREND Carvedilol 12.5MG TAB

788856 DILATREND Carvedilol 25MG APP

833428 DILATREND Carvedilol 6.25MG TAB

710959 VEDIBLOK  Carvedilol 12.5MG  TAB 

710960 VEDIBLOK  Carvedilol 25MG  TAB 

710958 VEDIBLOK  Carvedilol 6.25MG  TAB 

27 11/5/2013

Comprehensive Formulary

Cardiac glycosides

735752 LANOXIN Digoxin 0.25MG TAB Accepted treatment

735744 LANOXIN PAED Digoxin 0.05MG/1ML SYR Accepted treatment

735760 LANOXIN PAED Digoxin 0.063MG TAB Accepted treatment

758280 PURGOXIN Digoxin 0.25MG TAB Accepted treatment

Calcium channel antagonists

813354 CALCICARD SR Verapamil 240MG SRT Accepted treatment

818364 DILATAM Diltiazem 60MG TAB Accepted treatment

734071 ISOPTIN DRAGEES Verapamil 40MG TAB Accepted treatment

734373 ISOPTIN SR Verapamil 240MG SRT Accepted treatment

819573 RAVAMIL SR Verapamil 240MG SRT Accepted treatment

820202 ROLAB-DILTIAZEM HCL Diltiazem 60MG TAB Accepted treatment

775819 ROLAB-VERAPAMIL HCL Verapamil 120MG TAB Accepted treatment

775789 ROLAB-VERAPAMIL HCL Verapamil 40MG TAB Accepted treatment

775797 ROLAB-VERAPAMIL HCL Verapamil 80MG TAB Accepted treatment

813125 TILAZEM 180 CR Diltiazem 180MG SRC Accepted treatment

813133 TILAZEM 240 CR Diltiazem 240MG SRC Accepted treatment

774944 VASOMIL Verapamil 40MG TAB Accepted treatment

774952 VASOMIL Verapamil 80MG TAB Accepted treatment

700071 VERAHEXAL 240 SR Verapamil 240MG SRT Accepted treatment

839183 ZILDEM Diltiazem 180MG SRC Accepted treatment

839191 ZILDEM Diltiazem 240MG SRC Accepted treatment

822213 ZILDEM 60 Diltiazem 60MG TAB Accepted treatment

824364 ZILDEM 90 BD Diltiazem 90MG TAB

Anti-arrhythmics

703515 ARYCOR Amiodarone 100MG TAB Accepted treatment

703513 ARYCOR Amiodarone 200MG TAB Accepted treatment

707851 BIO-AMIODARONE Amiodarone 200MG  TAB  Accepted treatment

800554 CORDARONE X Amiodarone 100MG TAB

716111 CORDARONE X Amiodarone 200MG TAB

863157 HEXARONE 100MG Amiodarone 100MG TAB Accepted treatment

863165 HEXARONE 200MG Amiodarone 200MG TAB Accepted treatment

754803 ADCO-PHENOBARB VITALET ELIXIR Phenobarbital 100ML SYR Accepted treatment

710242 ADCO-TOPIRAMATE  Topiramate 100MG  TAB  Specialist motivation

710243 ADCO-TOPIRAMATE  Topiramate 200MG  TAB  Specialist motivation

710240 ADCO-TOPIRAMATE  Topiramate 25MG  TAB  Specialist motivation

710241 ADCO-TOPIRAMATE  Topiramate 50MG  TAB  Specialist motivation

709540 ARROW LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

709541 ARROW LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

709539 ARROW LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

709537 ARROW LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

705441 ASPEN LAMOTRIGINE 100MG  Lamotrigine 100MG  TAB  Accepted treatment

705442 ASPEN LAMOTRIGINE 200MG  Lamotrigine 200MG  TAB  Accepted treatment

705436 ASPEN LAMOTRIGINE 25MG  Lamotrigine 25MG  TAB  Accepted treatment

705440 ASPEN LAMOTRIGINE 50MG  Lamotrigine 50MG  TAB  Accepted treatment

707789 AUSTELL-LAMOTRIGINE Lamotrigine 100MG  TAB  Accepted treatment

707790 AUSTELL-LAMOTRIGINE Lamotrigine 200MG  TAB  Accepted treatment

707787 AUSTELL-LAMOTRIGINE Lamotrigine 25MG  TAB  Accepted treatment

707788 AUSTELL-LAMOTRIGINE Lamotrigine 50MG  TAB  Accepted treatment

715980 CONVULEX Valproic acid 150MG CAP Accepted treatment

781541 CONVULEX Valproic acid 250MG/5ML SYR Accepted treatment

715999 CONVULEX Valproic acid 300MG CAP Accepted treatment

781568 CONVULEX Valproic acid 500MG CAP Accepted treatment

712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment

710389 DYNA-LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

710390 DYNA-LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

710387 DYNA-LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

710388 DYNA-LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

718486 DYNA LEVETIRACETAM Levetiracetam 250MG TAB Accepted treatment

718485 DYNA LEVETIRACETAM Levetiracetam 500MG TAB Accepted treatment

718484 DYNA LEVETIRACETAM Levetiracetam 750MG TAB Accepted treatment

723525 EPANUTIN Phenytoin 100MG APP Accepted treatment

723533 EPANUTIN FORTE Phenytoin 125MG/5ML SUS Accepted treatment

Epilepsy

28 11/5/2013

Comprehensive Formulary

723568 EPANUTIN INFATABS Phenytoin 50MG TAB Accepted treatment

818666 EPILIM CR Valproic acid 200MG SRT Accepted treatment

818674 EPILIM CR Valproic acid 300MG SRT Accepted treatment

818682 EPILIM CR Valproic acid 500MG SRT Accepted treatment

821578 EPILIM CRUSHABLE Valproic acid 100MG TAB Accepted treatment

780545 EPILIM SUGAR FREE Valproic acid 200MG/5ML SYR Accepted treatment

718274 EPILIZINE CR Valproic acid 200MG SRT Accepted treatment

718275 EPILIZINE CR Valproic acid 300MG SRT Accepted treatment

718276 EPILIZINE CR Valproic acid 500MG SRT Accepted treatment

704381 EPITEC 100MG  Lamotrigine 100MG TAB Accepted treatment

704382 EPITEC 200MG  Lamotrigine 200MG TAB Accepted treatment

704379 EPITEC 25MG  Lamotrigine 25MG TAB Accepted treatment

704380 EPITEC 50MG  Lamotrigine 50MG TAB Accepted treatment

710901 EPITOZ  Topiramate 100MG  TAB  Specialist motivation

710899 EPITOZ  Topiramate 25MG  TAB  Specialist motivation

710900 EPITOZ  Topiramate 50MG  TAB  Specialist motivation

707622 EPLEPTIN  Gabapentin 100MG  CAP  Specialist motivation

707623 EPLEPTIN  Gabapentin 300MG  CAP  Specialist motivation

707624 EPLEPTIN  Gabapentin 400MG  CAP  Specialist motivation

700958 KEPPRA 250MG Levetiracetam 250MG TAB Accepted treatment

703165 KEPPRA  Levetiracetam 750MG  TAB  Accepted treatment

714166 KEPPRA Levetiracetam 100MG/1ML SOL Accepted treatment

707361 LAMEPTIL  Lamotrigine 100MG  TAB  Accepted treatment

707362 LAMEPTIL  Lamotrigine 200MG  TAB  Accepted treatment

707359 LAMEPTIL  Lamotrigine 25MG  TAB  Accepted treatment

707360 LAMEPTIL  Lamotrigine 50MG  TAB  Accepted treatment

805521 LAMICTIN Lamotrigine 100MG TAB Accepted treatment

819034 LAMICTIN Lamotrigine 200MG TAB Accepted treatment

805505 LAMICTIN Lamotrigine 25MG TAB Accepted treatment

805513 LAMICTIN Lamotrigine 50MG TAB Accepted treatment

813907 LAMICTIN P100 Lamotrigine 100MG DSP Accepted treatment

704533 LAMICTIN P2  Lamotrigine 2MG  DSP  Accepted treatment

891716 LAMICTIN P200 Lamotrigine 200MG DSP Accepted treatment

813893 LAMICTIN P25 Lamotrigine 25MG DSP Accepted treatment

813885 LAMICTIN P5 Lamotrigine 5MG DSP Accepted treatment

891708 LAMICTIN P50 Lamotrigine 50MG DSP Accepted treatment

710887 LAMIDUS  Lamotrigine 100MG  TAB  Accepted treatment

710888 LAMIDUS  Lamotrigine 200MG  TAB  Accepted treatment

710885 LAMIDUS  Lamotrigine 50MG  TAB  Accepted treatment

704488 LAMITOR Lamotrigine 100MG TAB Accepted treatment

704486 LAMITOR Lamotrigine 25MG TAB Accepted treatment

704487 LAMITOR Lamotrigine 50MG TAB Accepted treatment

712217 LAMITOR  Lamotrigine 200MG  TAB  Accepted treatment

737844 LETHYL Phenobarbital 30MG TAB Accepted treatment

717226 MYLAN OXCARBAZEPINE Oxcarbazepine 300MG TAB  Specialist motivation

717227 MYLAN OXCARBAZEPINE Oxcarbazepine 600MG TAB  Specialist motivation

718465 NAVALPRO CR Valproic acid 200MG SRT Accepted treatment

718466 NAVALPRO CR Valproic acid 300MG SRT Accepted treatment

718468 NAVALPRO CR Valproic acid 500MG SRT Accepted treatment

708949 NEUREXAL  Gabapentin 100MG  CAP  Specialist motivation

708994 NEUREXAL  Gabapentin 300MG  CAP  Specialist motivation

708995 NEUREXAL  Gabapentin 400MG  CAP  Specialist motivation

807443 NEURONTIN Gabapentin 100MG CAP Specialist motivation

807451 NEURONTIN Gabapentin 300MG CAP Specialist motivation

807478 NEURONTIN Gabapentin 400MG CAP Specialist motivation

755060 NORSTAN-PHENYTOIN SODIUM Phenytoin 100MG TAB Accepted treatment

754870 PHENYTOIN SOD Phenytoin 100MG  TAB  Accepted treatment

716468 PAMIRAM Topiramate 100MG  TAB  Specialist motivation

716482 PAMIRAM Topiramate 200MG  TAB  Specialist motivation

716000 PAMIRAM Topiramate 25MG  TAB  Specialist motivation

716001 PAMIRAM Topiramate 50MG  TAB  Specialist motivation

709361 PIRAMAX  Topiramate 100MG  TAB  Specialist motivation

709362 PIRAMAX  Topiramate 200MG  TAB  Specialist motivation

709360 PIRAMAX  Topiramate 25MG  TAB  Specialist motivation

710525 RAN-GABAPENTIN  Gabapentin 100MG CAP Specialist motivation

710526 RAN-GABAPENTIN  Gabapentin 300MG CAP Specialist motivation

29 11/5/2013

Comprehensive Formulary

710527 RAN-GABAPENTIN  Gabapentin 400MG CAP Specialist motivation

714662 REDILEV Levetiracetam 250MG TAB Accepted treatment

714663 REDILEV Levetiracetam 500MG TAB Accepted treatment

714664 REDILEV Levetiracetam 750MG TAB Accepted treatment

761079 RIVOTRIL Clonazepam 0.5MG TAB Accepted treatment

835129 RIVOTRIL Clonazepam 2.5MG/1ML DRP Accepted treatment

761087 RIVOTRIL Clonazepam 2MG TAB Accepted treatment

712523 ROLAB-CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment

705597 SANDOZ CARBAMAZEPINE CR200  Carbamazepine 200MG  SRT  Accepted treatment

705602 SANDOZ CARBAMAZIPINE CR400  Carbamazepine 400MG  SRT  Accepted treatment

705248 SANDOZ LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

705249 SANDOZ LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

705251 SANDOZ LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

705250 SANDOZ LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

709286 SANDOZ TOPIRAMATE  Topiramate 100MG  TAB  Specialist motivation

709287 SANDOZ TOPIRAMATE  Topiramate 200MG  TAB  Specialist motivation

709284 SANDOZ TOPIRAMATE  Topiramate 25MG  TAB  Specialist motivation

709285 SANDOZ TOPIRAMATE  Topiramate 50MG  TAB  Specialist motivation

814946 SEDABARB Phenobarbital 30MG TAB Accepted treatment

769398 TEGRETOL Carbamazepine 200MG TAB

779652 TEGRETOL CR Carbamazepine 200MG SRT

779660 TEGRETOL CR Carbamazepine 400MG SRT

769401 TEGRETOL S Carbamazepine 100MG/5ML SUS Accepted treatment

715981 TOPALEX Topiramate 100MG TAB Specialist motivation

715978 TOPALEX Topiramate 25MG TAB Specialist motivation

715979 TOPALEX Topiramate 50MG TAB Specialist motivation

822531 TOPAMAX Topiramate 100MG TAB Specialist motivation

836753 TOPAMAX Topiramate 200MG TAB Specialist motivation

822515 TOPAMAX Topiramate 25MG TAB Specialist motivation

822523 TOPAMAX Topiramate 50MG TAB Specialist motivation

878014 TOPAMAX SC SPRINKLE Topiramate 15MG CAP Specialist motivation

878022 TOPAMAX SC SPRINKLE Topiramate 25MG CAP Specialist motivation

890728 TOPAMAX SC SPRINKLE Topiramate 50MG CAP Specialist motivation

718290 TOPIROL Topiramate 50MG TAB Specialist motivation

708389 TOPLEP Topiramate 25MG TAB  Specialist motivation

708390 TOPLEP Topiramate 50MG TAB  Specialist motivation

708391 TOPLEP Topiramate 100MG TAB  Specialist motivation

708392 TOPLEP Topiramate 200MG TAB  Specialist motivation

892484 TRILEPTAL FCT Oxcarbazepine 300MG TAB  Specialist motivation

892491 TRILEPTAL FCT Oxcarbazepine 600MG TAB  Specialist motivation

779105 ZARONTIN Ethosuximide 250MG/5ML SYR Accepted treatment

715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment

Sympathomimetics

837121 ALPHAGAN Brimonidine 1.32MG/1ML OPD Clinical review

709410 ALPHAGAN PURITE 5ML  Brimonidine 1.5MG/1ML  OPD  Clinical review

Parasympathomimetics

734284 ISOPTO CARPINE 15ML Pilocarpine 10MG/1ML APP Accepted treatment

734179 ISOPTO CARPINE 15ML Pilocarpine 20MG/1ML OPD Accepted treatment

734195 ISOPTO CARPINE 15ML Pilocarpine 40MG/1ML OPD Accepted treatment

755389 PILOGEL GEL 5G Pilocarpine 40MG/1G EYO

Carbonic anhydrase inhibitor

701523 AZOPTIC EYE DROP Brinzolamide 10MG/1ML OPD Clinical review

819832 TRUSOPT 5ML Dorzolamide 20MG/1ML DRP Clinical review

Beta-blockers

816728 BETA-OPTHIOLE 5ML Metipranolol 0.003 OPD

816736 BETA-OPTHIOLE 5ML Metipranolol 0.006 OPD

708445 BETOPTIC 5ML Betaxolol 5MG/1ML OPD

836052 BETOPTIC S 5ML Betaxolol 2.5MG/1ML OPD

821624 GLAUCOSAN 0.5 % 5ML Timolol 5MG/1ML OPD Accepted treatment

702142 NYOGEL EYE GEL 5G Timolol 0.001 OPD Accepted treatment

770833 TIMOPTOL 5ML Timolol 2.5MG/1ML OPD Accepted treatment

770841 TIMOPTOL 5ML Timolol 5MG/1ML OPD Accepted treatment

819816 TIMOPTOL-XE 0.25% 2.5ML Timolol 2.5MG/1ML DRP Accepted treatment

819824 TIMOPTOL-XE 0.50 % 2.5ML Timolol 5MG/1ML DRP Accepted treatment

Glaucoma

30 11/5/2013

Comprehensive Formulary

Combination products

717260 AZARGA 5ML Timolol, combinations OPD  Accepted treatment

709863 COMBIGAN 2MG/5MG 5ML  Timolol, combinations OPD  Accepted treatment

860379 COSOPT 5ML Timolol, combinations 0.005 OPD Accepted treatment

708877 DUOTRAV 2.5ML  Timolol, combinations OPD  Accepted treatment

714110 GANFORT 3ML Timolol, combinations 0.3MG/5MG OPD Accepted treatment

702983 XALACOM 2.5ML Timolol, combinations 50MCG/5MG OPD

Prostaglandin derivatives

703666 LUMIGAN 3ML Bimatoprost 0.3MG/1ML OPD Clinical review

716754 LUMIGAN Bimatoprost 0.01% OPD Clinical review

715961 OCUPROST 3ML Latanoprost 50MCG/1ML OPD Clinical review

702534 TRAVATAN 2.5ML Travoprost OPD Clinical review

833223 XALATAN 2.5ML Latanoprost 50MCG/1ML OPD Clinical review

Acetazolamide

789771 AZOMID Acetazolamide 250MG TAB Clinical review

719471 DIAMOX Acetazolamide 250MG TAB Clinical review

Tranexamic Acid

717134 CYKLOKAPRON Tranexamic acid 500MG TAB Accepted treatment (intermittent use)

714722 TRANEXAMIC ACID MEDWICH Tranexamic acid 500MG TAB Accepted treatment (intermittent use)

716276 TRANIC Tranexamic acid 500MG TAB Accepted treatment (intermittent use)

Desmopressin

837563 DDAVP Desmopressin 0.1MG TAB Accepted treatment (intermittent use)

703639 DDAVP Desmopressin 0.2MG TAB Accepted treatment (intermittent use)

837555 DDAVP 5ML Desmopressin 0.1MG/1ML NAS Accepted treatment (intermittent use)

717746 DDAVP INTRANASAL SOLUTION Desmopressin 0.1MG/1ML NOD Accepted treatment (intermittent use)

Analgesics

792101 ACTAMOL Paracetamol 120MG/5ML SYR Accepted treatment

717725 ACTAMOL Paracetamol 500MG TAB Accepted treatment

704093 ACTAMOL RED (UN-BOXED) Paracetamol 120MG/5ML SYR Accepted treatment

716045 ADCO-NAPAMOL Paracetamol 500MG TAB Accepted treatment

894281 ADCO-PARACETAMOL Paracetamol 120MG/5ML SYR Accepted treatment

805467 ANTALGIC 500 Paracetamol 500MG TAB Accepted treatment

713153 AUSTELL-PARACETAMOL Paracetamol 500MG TAB Accepted treatment

717187 BARRS PARACETAMOL Paracetamol 120MG/5ML SYR Accepted treatment

789526 BRUNOMOL Paracetamol 120MG/5ML SYR Accepted treatment

711993 CALPOL Paracetamol 120MG/5ML SUS Accepted treatment

714499 CLICKS PARACETAMOL Paracetamol 500MG TAB Accepted treatment

897124 CO CODAMOL Paracetamol and codeine 500MG/8MG EFF Accepted treatment

837652 DINO-COD (BEI) Paracetamol and codeine TAB Accepted treatment

720860 DOLOROL Paracetamol 500MG TAB Accepted treatment

720879 DOLOROL FORTE Paracetamol and codeine TAB Accepted treatment

798045 DYNA-DOL Paracetamol 120MG/5ML SYR Accepted treatment

798053 DYNA-DOL Paracetamol 500MG TAB Accepted treatment

784575 ENTALGIC Paracetamol 120MG/5ML SYR Accepted treatment

784567 ENTALGIC Paracetamol 500MG TAB Accepted treatment

702871 FABU PARACETAMOL ALC Paracetamol 120MG/5ML SYR Accepted treatment

726176 FEVAMOL P AL+SU FREE Paracetamol 120MG/5ML SYR Accepted treatment

863742 FEVERPAIN Paracetamol 120MG/5ML SYR Accepted treatment

824992 GENCETAMOL Paracetamol 500MG TAB Accepted treatment

895199 GO-PAIN P Paracetamol 120mg/5ml SYR Accepted treatment

715112 GRAYS PARACETAMOL Paracetamol 500MG TAB Accepted treatment

715111 GRAYS PARACETAMOL Paracetamol 120MG/5ML SYR Accepted treatment

867950 GULF PARACETAMOL Paracetamol 500MG TAB Accepted treatment

894212 JP PARACETAMOL Paracetamol 500MG TAB Accepted treatment

715280 LENNON PARACETAMOL Paracetamol 500MG TAB Accepted treatment

706192 MICROGESIC Paracetamol 120MG/5ML SYR Accepted treatment

745707 NAPACOD Paracetamol and codeine TAB Accepted treatment

745715 NAPAMOL Paracetamol 120MG/5ML SYR Accepted treatment

745723 NAPAMOL Paracetamol 500MG TAB Accepted treatment

825034 PACIMOL Paracetamol 500MG TAB Accepted treatment

752118 PAINAMOL Paracetamol 120MG/5ML SYR Accepted treatment

707562 PAINAMOL (GLASS BOTTLE) Paracetamol 120MG/5ML SYR Accepted treatment

799629 PAINAMOL (GREEN) Paracetamol 500MG TAB Accepted treatment

Haemophilia

31 11/5/2013

Comprehensive Formulary

707910 PAINAMOL PLUS (BETACOD) Paracetamol and codeine TAB Accepted treatment

752142 PAINAMOL WHITE Paracetamol 500MG TAB Accepted treatment

889772 PAINBLOK Paracetamol 120MG/5ML SYR Accepted treatment

867969 PAINBLOK Paracetamol 500MG TAB Accepted treatment

895030 PAINCODEIN Paracetamol and codeine 500MG/8MG TAB Accepted treatment

704450 PAINOGESIC  Paracetamol 120MG/5ML  SYR  Accepted treatment

704465 PAINOGESIC  Paracetamol 500MG  TAB  Accepted treatment

752274 PANADO Paracetamol 500MG CAP Accepted treatment

752274 PANADO Paracetamol 500MG TAB Accepted treatment

708432 PANADO CHILDRENS  Paracetamol 125MG  MLT Accepted treatment

708438 PANADO  Paracetamol 500MG  MLT Accepted treatment

788953 PANADO ( ALCO/SUGAR FREE) Paracetamol 120MG/5ML SYR Accepted treatment

815306 PANADO EFFERVESCENT Paracetamol 500MG EEF Accepted treatment

752282 PANADO PAED SYRUP Paracetamol 120MG/5ML SYR Accepted treatment

703118 PANADO PAEDIATRIC SYRUP STRAWBERRY Paracetamol 120MG/5ML SYR Accepted treatment

704719 PARACET  Paracetamol 500MG  TAB  Accepted treatment

818372 PARACETAMOL Paracetamol 500MG TAB Accepted treatment

799378 PARACETAMOL ELIXIR {Brunel} Paracetamol 120MG/5ML SYR Accepted treatment

707583 PARACETAMOL ELIXIR SAD (ALCOHOL FREE)  Paracetamol 120MG/5ML  SYR  Accepted treatment

784443 PARAMED Paracetamol 500MG TAB Accepted treatment

752878 PARAPANE Paracetamol 500MG TAB Accepted treatment

757403 PROLIEF Paracetamol 500MG TAB Accepted treatment

714708 PYNGESIC S Paracetamol 120MG/5ML SYR Accepted treatment

714707 PYNGESIC T Paracetamol 500MG TAB Accepted treatment

797480 PYRADOL Paracetamol 120MG/5ML SYR Accepted treatment

758558 PYRALEN Paracetamol 120MG/5ML SYR Accepted treatment

761303 ROCODIN Paracetamol and codeine TAB Accepted treatment

765635 SPECTRAPAIN Paracetamol and codeine CAP Accepted treatment

826588 THERA-PAIN Paracetamol 500MG TAB Accepted treatment

713688 VARI-COCODAMOL 8MG/500MG Paracetamol and codeine 8MG/500MG TAB Accepted treatment

701140 VARIPAN Paracetamol 500MG TAB Accepted treatment

885863 VON PARACETAMOL Paracetamol 500MG TAB Accepted treatment

783943 WINPAIN (BRUNEL) Paracetamol 120MG/5ML SYR Accepted treatment

710452 WOODWARD'S PARACETAMOL  Paracetamol 120MG/5ML  SYR  Accepted treatment

710211 ZYDUS-PARACETAMOL  Paracetamol 500MG  TAB  Accepted treatment

Statins

718073 ADCO ATORVASTATIN Atorvastatin 10MG TAB  Special investigations

718074 ADCO ATORVASTATIN Atorvastatin 20MG TAB  Special investigations

718075 ADCO ATORVASTATIN Atorvastatin 40MG TAB  Special investigations

701276 ADCO-SIMVASTATIN Simvastatin 10MG TAB Special investigations

701279 ADCO-SIMVASTATIN Simvastatin 20MG TAB Special investigations

701281 ADCO-SIMVASTATIN Simvastatin 40MG TAB Special investigations

707089 ARROW SIMVASTATIN  Simvastatin 10MG  TAB  Special investigations

707090 ARROW SIMVASTATIN  Simvastatin 20MG  TAB  Special investigations

707091 ARROW SIMVASTATIN  Simvastatin 40MG  TAB  Special investigations

708121 ASPAVOR  Atorvastatin 10MG  TAB  Special investigations

708122 ASPAVOR  Atorvastatin 20MG  TAB  Special investigations

710912 ASPAVOR  Atorvastatin 40MG  TAB  Special investigations

706714 ASPEN SIMVASTATIN  Simvastatin 10MG  TAB  Special investigations

706715 ASPEN SIMVASTATIN  Simvastatin 20MG  TAB  Special investigations

706716 ASPEN SIMVASTATIN  Simvastatin 40MG  TAB  Special investigations

719185 ASTOR Atorvastatin 10MG TAB Special investigations

719186 ASTOR Atorvastatin 20MG TAB Special investigations

719187 ASTOR Atorvastatin 40MG TAB Special investigations

719189 ASTOR Atorvastatin 80MG TAB Special investigations

714336 ARROW PRAVASTATIN Pravastatin 10MG TAB

714337 ARROW PRAVASTATIN Pravastatin 20MG TAB

714338 ARROW PRAVASTATIN Pravastatin 40MG TAB

705212 ASPEN PRAVASTATIN  Pravastatin 10MG  TAB 

705213 ASPEN PRAVASTATIN  Pravastatin 20MG  TAB 

705214 ASPEN PRAVASTATIN  Pravastatin 40MG  TAB 

714370 ATOLIP Atorvastatin 10MG TAB Special investigations

714371 ATOLIP Atorvastatin 20MG TAB Special investigations

Hyperlipidaemia

32 11/5/2013

Comprehensive Formulary

714372 ATOLIP Atorvastatin 40MG TAB Special investigations

714373 ATOLIP Atorvastatin 80MG TAB

711621 ATORVASTATIN UNICORN Atorvastatin 10MG TAB Special investigations

712170 ATORVASTATIN UNICORN Atorvastatin 20MG TAB Special investigations

713522 ATORVASTATIN UNICORN Atorvastatin 40MG TAB Special investigations

716615 ATORVASTATIN WINTHROP Atorvastatin 10MG TAB

716616 ATORVASTATIN WINTHROP Atorvastatin 20MG TAB

716617 ATORVASTATIN WINTHROP Atorvastatin 40MG TAB

717073 AUSTELL PRAVASTATIN Pravastatin 10MG TAB

717074 AUSTELL PRAVASTATIN Pravastatin 20MG TAB

717075 AUSTELL PRAVASTATIN Pravastatin 40MG TAB

705464 AUSTELL-SIMVASTATIN 10MG  Simvastatin 10MG  TAB  Special investigations

705465 AUSTELL-SIMVASTATIN 20MG  Simvastatin 20MG  TAB  Special investigations

705467 AUSTELL-SIMVASTATIN 40MG  Simvastatin 40MG  TAB  Special investigations

709668 BIOVAC SIMVASTATIN  Simvastatin 10MG  TAB  Special investigations

709822 BIOVAC SIMVASTATIN  Simvastatin 20MG  TAB  Special investigations

709823 BIOVAC SIMVASTATIN  Simvastatin 40MG  TAB  Special investigations

714705 CHOLESTE Simvastatin 20MG TAB Special investigations

714706 CHOLESTE Simvastatin 40MG TAB Special investigations

708307 CIPLA-SIMVASTATIN  Simvastatin 10MG  TAB  Special investigations

708308 CIPLA-SIMVASTATIN  Simvastatin 20MG  TAB  Special investigations

710511 CIPLA-SIMVASTATIN  Simvastatin 40MG  TAB  Special investigations

710513 CIPLA-SIMVASTATIN  Simvastatin 80MG  TAB  Special investigations

710974 COLITE  Pravastatin 10MG  TAB 

710975 COLITE  Pravastatin 20MG  TAB 

710976 COLITE  Pravastatin 40MG  TAB 

710977 COLITE  Pravastatin 80MG  TAB 

718218 DYNATOR Atorvastatin 10MG TAB Special investigations

718219 DYNATOR Atorvastatin 20MG TAB Special investigations

718220 DYNATOR Atorvastatin 40MG TAB Special investigations

718221 DYNATOR Atorvastatin 80MG TAB

700963 LESCOL XL Fluvastatin 80MG ECT

705076 LIPIDEX  Simvastatin 10MG  TAB  Special investigations

705077 LIPIDEX  Simvastatin 20MG  TAB  Special investigations

831484 LIPITOR Atorvastatin 10MG TAB

831492 LIPITOR Atorvastatin 20MG TAB

886015 LIPITOR Atorvastatin 40MG TAB

704186 LIPITOR  Atorvastatin 80MG TAB

714071 LIPOGEN Atorvastatin 10MG TAB Special investigations

714072 LIPOGEN Atorvastatin 20MG TAB Special investigations

714073 LIPOGEN Atorvastatin 40MG TAB Special investigations

714074 LIPOGEN Atorvastatin 80MG TAB

705382 MYLAN-SIMVASTATIN 20MG  Simvastatin 20MG  TAB  Special investigations

710868 MICHOL  Simvastatin 10MG  TAB  Special investigations

710869 MICHOL  Simvastatin 20MG  TAB  Special investigations

710870 MICHOL  Simvastatin 40MG  TAB  Special investigations

710871 MICHOL  Simvastatin 80MG  TAB  Special investigations

712952 NOVALES Pravastatin 20MG TAB

704583 PRANALIP 10 Pravastatin 10MG  TAB 

704584 PRANALIP 20 Pravastatin 20MG  TAB 

704585 PRANALIP 40 Pravastatin 40MG  TAB 

787345 PRAVA Pravastatin 10MG TAB

787353 PRAVA Pravastatin 20MG TAB

839655 PRAVA Pravastatin 40MG TAB

715709 PRAVACOR Pravastatin 10MG TAB

715710 PRAVACOR Pravastatin 20MG TAB

715711 PRAVACOR Pravastatin 40MG TAB

714075 RAN-ATORVASTATIN Atorvastatin 10MG TAB

714076 RAN-ATORVASTATIN Atorvastatin 20MG TAB

714077 RAN-ATORVASTATIN Atorvastatin 40MG TAB

714078 RAN-ATORVASTATIN Atorvastatin 80MG TAB

711232 REDICOR  Simvastatin 10MG TAB Special investigations

711234 REDICOR  Simvastatin 20MG TAB Special investigations

711235 REDICOR  Simvastatin 40MG TAB Special investigations

705901 SANDOZ PRAVASTATIN 10  Pravastatin 10MG  TAB 

705902 SANDOZ PRAVASTATIN 20  Pravastatin 20MG  TAB 

33 11/5/2013

Comprehensive Formulary

705903 SANDOZ PRAVASTATIN 40  Pravastatin 40MG  TAB 

707870 SIMAYLA SIMVASTATIN  Simvastatin 10MG  TAB  Special investigations

707871 SIMAYLA SIMVASTATIN  Simvastatin 20MG  TAB  Special investigations

707873 SIMAYLA SIMVASTATIN  Simvastatin 40MG  TAB  Special investigations

705281 SIMCARD  Simvastatin 10MG  TAB  Special investigations

705282 SIMCARD  Simvastatin 20MG  TAB  Special investigations

704174 SIMCARD 40  Simvastatin 40MG TAB Special investigations

706566 SIMCARD  Simvastatin 80MG  TAB  Special investigations

700519 SIMVACOR 10 Simvastatin 10MG TAB Special investigations

700520 SIMVACOR 20 Simvastatin 20MG TAB Special investigations

708463 SIMVACOR  Simvastatin 40MG  TAB  Special investigations

703525 SIMVOTIN 10  Simvastatin 10MG  TAB  Special investigations

703526 SIMVOTIN 20  Simvastatin 20MG  TAB  Special investigations

703527 SIMVOTIN 40  Simvastatin 40MG  TAB  Special investigations

713487 SIMZOR Simvastatin 10MG  TAB  Special investigations

713488 SIMZOR Simvastatin 20MG  TAB  Special investigations

713489 SIMZOR Simvastatin 40MG  TAB  Special investigations

718933 VASTOR Atorvastatin 10MG TAB Special investigations

718934 VASTOR Atorvastatin 20MG TAB Special investigations

718935 VASTOR Atorvastatin 40MG TAB Special investigations

718936 VASTOR Atorvastatin 80MG TAB

718208 VATICOL XL Fluvastatin 80MG TAB

783951 ZOCOR Simvastatin 10MG TAB Special investigations

783978 ZOCOR Simvastatin 20MG TAB Special investigations

836265 ZOCOR Simvastatin 40MG TAB Special investigations

710826 ZYSIM  Simvastatin 10MG  TAB  Special investigations

710827 ZYSIM  Simvastatin 20MG  TAB  Special investigations

710828 ZYSIM  Simvastatin 40MG  TAB  Special investigations

710829 ZYSIM  Simvastatin 80MG  TAB  Special investigations

Fibrates

710337 BEZACHOLE SR Bezafibrate 400MG TAB Special investigations

708453 BEZALIP Bezafibrate 200MG TAB Special investigations

779644 BEZALIP RETARD Bezafibrate 400MG TAB Special investigations

710122 DYNA-BEZAFIBRATE SR  Bezafibrate 400MG  SRT  Special investigations

705708 LIPANTHYL  Fenofibrate 200MG  CAP 

788627 LOPID Gemfibrozil 600MG TAB

828300 ROLAB-BEZAFIBRATE Bezafibrate 400MG TAB Special investigations

Nicotinic Acid

818518 NICOTINIC ACID Nicotinic acid 100MG CAP Special investigations

891322 NICOTINIC ACID Nicotinic acid 20MG TAB Special investigations

883028 NICOTINIC ACID Nicotinic acid 30MG TAB Special investigations

Sympathetic Nervous System Blockers

760048 RESERPINE Reserpine .25MG TAB Accepted treatment

Alpha-aderenergic blockers

701626 ADCO-DOXAZASIN Doxazosin 1MG TAB Clinical review

701628 ADCO-DOXAZASIN Doxazosin 2MG TAB Clinical review

701631 ADCO-DOXAZASIN Doxazosin 4MG TAB Clinical review

785512 CARDURA Doxazosin 1MG TAB Clinical review

869856 CARDURA XL Doxazosin 4MG TAB

869864 CARDURA XL Doxazosin 8MG TAB

714292 CARZIN XL Doxazosin 4MG TAB

806358 HYTRIN Terazosin 1MG TAB

806366 HYTRIN Terazosin 2MG TAB

701425 CARDUGEN WAS MERCK DOXAZOSIN Doxazosin 1MG TAB Clinical review

701426 CARDUGEN WAS MERCK DOXAZOSIN Doxazosin 4MG TAB Clinical review

782122 PRATSIOL Prazosin 1MG TAB Clinical review

782130 PRATSIOL Prazosin 2MG TAB Clinical review

782149 PRATSIOL Prazosin 5MG TAB Clinical review

Arterial Vasodilators

731714 HYPERPHEN Hydralazine 10MG TAB Clinical review

731722 HYPERPHEN Hydralazine 50MG TAB Clinical review

761400 ROLAB-HYDRALAZINE HCL Hydralazine 25MG TAB Clinical review

761419 ROLAB-HYDRALAZINE HCL Hydralazine 50MG TAB Clinical review

Hypertension

34 11/5/2013

Comprehensive Formulary

Diuretics

780618 ADCO-RETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

701807 ALDACTONE Spironolactone 100MG TAB

701793 ALDACTONE Spironolactone 25MG APP Accepted treatment

702803 AMILORETIC Hydrochlorothiazide and potassium-sparing agents 50MG/5MG TAB Accepted treatment

702811 AMILORETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB Accepted treatment

807796 ARELIX Piretanide 3MG TAB

807818 ARELIX Piretanide 6MG TAB

707423 AUSTELL-FUROSEMIDE Furosemide 40MG  TAB 

808695 BETARETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

821845 BEURISES Furosemide 40MG TAB

711152 BURINEX Bumetanide 1MG TAB

711160 BURINEX K Bumetanide and potassium TAB

700820 CATEXAN 2.5MG Indapamide 2.5MG TAB Accepted treatment

710313 CIPLA-INDAPAMIDE  Indapamide 2.5MG  TAB  Accepted treatment

819417 DAPAMAX Indapamide 2.5MG TAB Accepted treatment

833045 DAPTRIL Indapamide 2.5MG TAB Accepted treatment

716048 DINO-RETIC Furosemide 40MG TAB Accepted treatment

705967 DIURESIX  Furosemide 40MG  TAB  Accepted treatment

721824 DYAZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment

716962 DYNA INDAPAMIDE SR Indapamide 1.5MG SRT

890470 HEXAZIDE Hydrochlorothiazide 25MG TAB Accepted treatment

822825 HYDRO-LESS Indapamide 2.5MG TAB Accepted treatment

839531 INDALIX Indapamide 2.5MG TAB Accepted treatment

735930 LASIX Furosemide 20MG TAB

735949 LASIX Furosemide 40MG TAB

735957 LASIX Furosemide 500MG TAB

839515 LASIX ORAL Furosemide 10MG/1ML SLN Clinical review

891531 LIXAMIDE Indapamide 2.5MG TAB Accepted treatment

857769 MYLAN FUROSEMIDE Furosemide 40MG TAB Accepted treatment

703329 MYLAN-INDAPAMIDE  Indapamide 2.5MG  TAB Accepted treatment

744379 MODURETIC Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

744387 MODURETIC HS Hydrochlorothiazide and potassium-sparing agents 2.5MG/25MG TAB Accepted treatment

746002 NATRILIX Indapamide 2.5MG TAB Accepted treatment

830836 NATRILIX SR Indapamide 1.5MG SRT

758272 PURESIS Furosemide 40MG TAB

780146 RENEZIDE Hydrochlorothiazide and potassium-sparing agents 25MG/50MG TAB Accepted treatment

880949 RIDAQ Hydrochlorothiazide 25MG TAB Accepted treatment

710437 RIDAQ Hydrochlorothiazide 12.5MG TAB Accepted treatment

702951 ROLAB-AMILORIDE HCL/HYDROCHLOROTHIAZIDE Hydrochlorothiazide and potassium-sparing agents 5MG/50MG TAB Accepted treatment

731668 ROLAB-FUROSEMIDE Furosemide 40MG TAB

831026 ROLAB-INDAPAMIDE Indapamide 2.5MG TAB Accepted treatment

769665 ROLAB-SPIRONOLACTONE Spironolactone 25MG TAB Accepted treatment

706531 SPEC-CO-AMILORIDE  Hydrochlorothiazide and potassium-sparing agents 50MG/5MG  TAB  Accepted treatment

898937 SPIRACTIN Spironolactone 100MG TAB

765910 SPIRACTIN Spironolactone 25MG TAB Accepted treatment

774057 URIREX-K Hydrochlorothiazide and potassium TAB Accepted treatment

Beta-blockers

786586 ADCO-ATENOLOL Atenolol 100MG TAB Accepted treatment

786578 ADCO-ATENOLOL Atenolol 50MG TAB Accepted treatment

703914 ADCO BISOCOR 10MG Bisoprolol 10MG TAB Accepted treatment

703913 ADCO BISOCOR 5MG Bisoprolol 5MG TAB Accepted treatment

704651 B-BLOCK  Atenolol 100MG  TAB  Accepted treatment

704653 B-BLOCK  Atenolol 50MG  TAB  Accepted treatment

706179 BETACOR Bisoprolol 10MG TAB Accepted treatment

706178 BETACOR Bisoprolol 5MG TAB Accepted treatment

704373 BILOCOR 10  Bisoprolol 10MG TAB Accepted treatment

704372 BILOCOR 5  Bisoprolol 5MG TAB Accepted treatment

704133 BISOHEXAL 10 Bisoprolol 10MG  TAB Accepted treatment

704132 BISOHEXAL 5 Bisoprolol 5MG  TAB Accepted treatment

707393 BISOPROLOL HEXAL Bisoprolol 10MG TAB Accepted treatment

707391 BISOPROLOL HEXAL Bisoprolol 5MG TAB Accepted treatment

716166 BISOPROLOL UNICORN Bisoprolol 10MG TAB Accepted treatment

716167 BISOPROLOL UNICORN Bisoprolol 5MG TAB Accepted treatment

704441 CARDICOR 10MG Bisoprolol 10MG TAB Accepted treatment

704439 CARDICOR 2.5MG Bisoprolol 2.5MG TAB Accepted treatment

35 11/5/2013

Comprehensive Formulary

704440 CARDICOR 5MG Bisoprolol 5MG  TAB Accepted treatment

818437 CONCOR Bisoprolol 10MG TAB Accepted treatment

818429 CONCOR Bisoprolol 5MG TAB Accepted treatment

715626 GULF ATENOLOL Atenolol 100MG TAB Accepted treatment

715625 GULF ATENOLOL Atenolol 50MG TAB Accepted treatment

806897 HEXA-BLOK Atenolol 100MG TAB Accepted treatment

806889 HEXA-BLOK Atenolol 50MG TAB Accepted treatment

732567 INDERAL Propranolol 10MG TAB Accepted treatment

732575 INDERAL Propranolol 40MG TAB Accepted treatment

732648 INDERAL LA Propranolol 80MG CAP

806552 INDOBLOK 10 Propranolol 10MG TAB Accepted treatment

806560 INDOBLOK 40 Propranolol 40MG TAB Accepted treatment

716483 LOVISPES Nebivolol 5MG TAB

700558 NEBILET 5MG Nebivolol 5MG TAB

826901 NORTON-ATENOLOL Atenolol 100MG TAB Accepted treatment

826898 NORTON-ATENOLOL Atenolol 50MG TAB Accepted treatment

787167 PRODOROL Propranolol 10MG TAB Accepted treatment

787175 PRODOROL Propranolol 40MG TAB Accepted treatment

758140 PURBLOKA Propranolol 10MG TAB Accepted treatment

758167 PURBLOKA Propranolol 40MG APP Accepted treatment

787914 ROLAB-ATENOLOL Atenolol 100MG TAB Accepted treatment

787892 ROLAB-ATENOLOL Atenolol 50MG TAB Accepted treatment

712604 ROLAB-PROPRANOLOL HCL Propranolol 10MG TAB Accepted treatment

712612 ROLAB-PROPRANOLOL HCL Propranolol 40MG TAB Accepted treatment

786195 TEN-BLOKA Atenolol 100MG TAB Accepted treatment

786187 TEN-BLOKA Atenolol 50MG TAB Accepted treatment

705873 TENOPRESS  Atenolol 100MG  TAB  Accepted treatment

705872 TENOPRESS  Atenolol 25MG  TAB  Accepted treatment

705874 TENOPRESS  Atenolol 50MG  TAB  Accepted treatment

797693 TENORMIN Atenolol 25MG TAB

769576 TENORMIN Atenolol 100MG TAB Accepted treatment

769584 TENORMIN Atenolol 50MG TAB Accepted treatment

715276 ZIAPRO Bisoprolol 10MG TAB Accepted treatment

715274 ZIAPRO Bisoprolol 5MG TAB Accepted treatment

Alpha-beta blockers

710339 ASPEN CARVEDILOL  Carvedilol 12.5MG  TAB 

710340 ASPEN CARVEDILOL  Carvedilol 25MG  TAB 

710338 ASPEN CARVEDILOL  Carvedilol 6.25MG  TAB 

897117 CARLOC Carvedilol 25MG TAB

705459 CARLOC 6.25  Carvedilol 6.25MG  TAB 

700168 CARLOC 12.5 Carvedilol 12.5MG TAB

705770 CARVEDILOL-HEXAL  Carvedilol 12.5MG  TAB 

705767 CARVEDILOL-HEXAL  Carvedilol 25MG  TAB 

705749 CARVEDILOL-HEXAL  Carvedilol 6.25MG  TAB 

716743 CARVEDILOL UNICORN Carvedilol 12.5MG TAB

716744 CARVEDILOL UNICORN Carvedilol 25MG TAB

716742 CARVEDILOL UNICORN Carvedilol 6.25MG TAB

704671 CARVETREND 12.5MG  Carvedilol 12.5MG  TAB 

704672 CARVETREND 25MG Carvedilol 25MG  TAB 

704670 CARVETREND 6.25MG Carvedilol 6.25MG  TAB 

836354 DILATREND Carvedilol 12.5MG TAB

788856 DILATREND Carvedilol 25MG APP

833428 DILATREND Carvedilol 6.25MG TAB

710959 VEDIBLOK  Carvedilol 12.5MG  TAB 

710960 VEDIBLOK  Carvedilol 25MG  TAB 

710958 VEDIBLOK  Carvedilol 6.25MG  TAB 

Beta-blocker and diuretic combinations

791172 ADCO-LOTEN Atenolol and other diuretics 100MG/25MG TAB Accepted treatment

719202 BILOCOR CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB

719200 BILOCOR CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB

719201 BILOCOR CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB

718087 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 10M Bisoprolol and thiazides 10MG/6.25MG TAB

718082 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 2.5 Bisoprolol and thiazides 2.5MG/6.25MG TAB

718086 BISOPROLOL HYDROCHLOROTHIAZIDE ZYDUS 5MG Bisoprolol and thiazides 5MG/6.25MG TAB

789615 ROLAB-ATENOLOL/CHLORTHALIDONE 100/25 Atenolol and other diuretics 100MG/25MG TAB Accepted treatment

789607 ROLAB-ATENOLOL/CHLORTHALIDONE 50/12.5 Atenolol and other diuretics 50MG/12.5MG TAB Accepted treatment

36 11/5/2013

Comprehensive Formulary

786217 TENCHLOR Atenolol and other diuretics 100MG/25MG TAB Accepted treatment

807591 TENCHLOR HS Atenolol and other diuretics 50MG/12.5MG TAB Accepted treatment

852929 ZIAK Bisoprolol and thiazides 10MG/6.25MG TAB

840300 ZIAK Bisoprolol and thiazides 2.5MG/6.25MG TAB

840319 ZIAK Bisoprolol and thiazides 5MG/6.25MG TAB

717988 ZIRINAK CO 10MG/6.25MG Bisoprolol and thiazides 10MG/6.25MG TAB

717986 ZIRINAK CO 2.5MG/6.25MG Bisoprolol and thiazides 2.5MG/6.25MG TAB

717987 ZIRINAK CO 5MG/6.25MG Bisoprolol and thiazides 5MG/6.25MG TAB

Calcium channel antagonists

793124 ADALAT XL Nifedipine 30MG SRT Accepted treatment

840963 ADCO-VASCARD SR Nifedipine 20MG SRC Accepted treatment

708142 ALMADIN  Amlodipine 10MG  TAB  Accepted treatment

708141 ALMADIN  Amlodipine 5MG  TAB  Accepted treatment

707278 AMLATE  Amlodipine 10MG  TAB  Accepted treatment

707277 AMLATE  Amlodipine 5MG  TAB  Accepted treatment

703917 AMLOC 10  Amlodipine 10MG  TAB Accepted treatment

703916 AMLOC 5  Amlodipine 5MG  TAB Accepted treatment

708051 AMLODAC  Amlodipine 10MG  TAB  Accepted treatment

708050 AMLODAC  Amlodipine 5MG  TAB  Accepted treatment

711374 AMLODIPINE-WINTHROP  Amlodipine 10MG  TAB  Accepted treatment

711372 AMLODIPINE-WINTHROP  Amlodipine 5MG  TAB  Accepted treatment

704621 AMLOSYN 10 Amlodipine 10MG  TAB  Accepted treatment

704620 AMLOSYN 5 Amlodipine 5MG  TAB  Accepted treatment

713972 AMTAS Amlodipine 10MG  TAB  Accepted treatment

713971 AMTAS Amlodipine 5MG  TAB  Accepted treatment

714311 AURO-AMLODIPINE Amlodipine 10MG TAB Accepted treatment

714310 AURO-AMLODIPINE Amlodipine 5MG TAB Accepted treatment

708095 AUSTELL-AMLODIPINE  Amlodipine 10MG  TAB  Accepted treatment

708094 AUSTELL-AMLODIPINE  Amlodipine 5MG  TAB  Accepted treatment

718083 BIO NIFEDIPINE XL Nifedipine 30MG SRT Accepted treatment

708040 CALBLOC  Amlodipine 10MG  TAB  Accepted treatment

708039 CALBLOC  Amlodipine 5MG  TAB  Accepted treatment

813354 CALCICARD SR Verapamil 240MG SRT Accepted treatment

864153 CIPALAT RETARD Nifedipine 20MG TAB Accepted treatment

708152 CIPLAVASC  Amlodipine 10MG  TAB  Accepted treatment

708150 CIPLAVASC  Amlodipine 5MG  TAB  Accepted treatment

707980 CORVADIL  Amlodipine 10MG  TAB  Accepted treatment

707979 CORVADIL  Amlodipine 5MG  TAB  Accepted treatment

708191 CPL ALLIANCE AMLODIPINE  Amlodipine 10MG  TAB  Accepted treatment

708190 CPL ALLIANCE AMLODIPINE  Amlodipine 5MG  TAB  Accepted treatment

818364 DILATAM Diltiazem 60MG TAB Accepted treatment

711682 FEDALOC SR Nifedipine 30MG TAB Accepted treatment

712954 GULF AMLODIPINE Amlodipine 10MG TAB Accepted treatment

712953 GULF AMLODIPINE Amlodipine 5MG TAB Accepted treatment

708648 INDO AMLODIPINE Amlodipine 5MG  TAB  Accepted treatment

734071 ISOPTIN DRAGEES Verapamil 40MG TAB Accepted treatment

734373 ISOPTIN SR Verapamil 240MG SRT Accepted treatment

712216 KEYSAL Amlodipine 10MG TAB Accepted treatment

712215 KEYSAL Amlodipine 5MG TAB Accepted treatment

708162 KLODIP  Amlodipine 5MG  TAB  Accepted treatment

708352 LOMANOR  Amlodipine 5MG  TAB  Accepted treatment

708353 LOMANOR  Amlodipine 10MG  TAB  Accepted treatment

715000 MACOREL SR Nifedipine 30MG SRT Accepted treatment

829501 NIFEDALAT 20 SR Nifedipine 20MG SRT Accepted treatment

799122 NORVASC Amlodipine 10MG TAB Accepted treatment

791245 NORVASC Amlodipine 5MG TAB Accepted treatment

710238 PHARMA DYNAMICS AMLODIPINE BESYLATE  Amlodipine 10MG  TAB  Accepted treatment

710236 PHARMA DYNAMICS AMLODIPINE BESYLATE  Amlodipine 5MG  TAB  Accepted treatment

813982 PLENDIL Felodipine 10MG SRT

805548 PLENDIL Felodipine 5MG SRT

703902 FELODIPINE HEXAL  Felodipine 10MG SRT Accepted treatment

703221 FELODIPINE HEXAL  Felodipine 5MG  SRT  Accepted treatment

819573 RAVAMIL SR Verapamil 240MG SRT Accepted treatment

820202 ROLAB-DILTIAZEM HCL Diltiazem 60MG TAB Accepted treatment

775819 ROLAB-VERAPAMIL HCL Verapamil 120MG TAB Accepted treatment

775789 ROLAB-VERAPAMIL HCL Verapamil 40MG TAB Accepted treatment

37 11/5/2013

Comprehensive Formulary

775797 ROLAB-VERAPAMIL HCL Verapamil 80MG TAB Accepted treatment

707377 SANDOZ-AMLODIPINE Amlodipine 10MG  TAB  Accepted treatment

707375 SANDOZ-AMLODIPINE Amlodipine 5MG  TAB  Accepted treatment

715002 SPEC NIFEDIPINE SR Nifedipine 30MG SRT Accepted treatment

713491 STAMLO Amlodipine 10MG TAB Accepted treatment

713490 STAMLO Amlodipine 5MG TAB Accepted treatment

813125 TILAZEM 180 CR Diltiazem 180MG SRC

813133 TILAZEM 240 CR Diltiazem 240MG SRC

861545 VASCARD SR Nifedipine 30MG CAP Accepted treatment

774944 VASOMIL Verapamil 40MG TAB Accepted treatment

774952 VASOMIL Verapamil 80MG TAB Accepted treatment

700071 VERAHEXAL 240 SR Verapamil 240MG SRT Accepted treatment

839183 ZILDEM Diltiazem 180MG SRC

839191 ZILDEM Diltiazem 240MG SRC

822213 ZILDEM 60 Diltiazem 60MG TAB

824364 ZILDEM 90 BD Diltiazem 90MG TAB

ACE inhibitors

708119 ACCUMAX  Quinapril 10MG  TAB  Accepted treatment

708120 ACCUMAX  Quinapril 20MG  TAB  Accepted treatment

783293 ACCUPRIL Quinapril 5MG TAB

783307 ACCUPRIL Quinapril 10MG TAB Accepted treatment

783315 ACCUPRIL Quinapril 20MG TAB Accepted treatment

853186 ACCUPRIL Quinapril 40MG TAB

715649 ACESYL Perindopril 4MG TAB

852333 BIO-CAPTOPRIL Captopril 25MG TAB Accepted treatment

714869 ACTI-PREX (GLENMARK PERINDOPRIL) Perindopril 4MG TAB

886843 ADCO-ENALAPRIL 10MG Enalapril 10MG TAB Accepted treatment

886851 ADCO-ENALAPRIL 20MG Enalapril 20MG TAB Accepted treatment

886835 ADCO-ENALAPRIL 5MG Enalapril 5MG TAB Accepted treatment

881481 ALAPREN 10 Enalapril 10MG TAB Accepted treatment

881503 ALAPREN 20 Enalapril 20MG TAB Accepted treatment

881473 ALAPREN 5 Enalapril 5MG TAB Accepted treatment

715957 APEX-RAMIPRIL Ramipril 10MG CAP

715954 APEX-RAMIPRIL Ramipril 2.5MG CAP

715955 APEX-RAMIPRIL Ramipril 5MG CAP

711159 ARROW RAMIPRIL  Ramipril 2.5MG TAB

711161 ARROW RAMIPRIL  Ramipril 5MG TAB

711162 ARROW RAMIPRIL  Ramipril 10MG TAB

715938 APEX-LISINOPRIL Lisinopril 20MG TAB Accepted treatment

714678 AURO-LISINOPRIL Lisinopril 10MG TAB Accepted treatment

714679 AURO-LISINOPRIL Lisinopril 20MG TAB Accepted treatment

714677 AURO-LISINOPRIL Lisinopril 5MG TAB Accepted treatment

716505 AURO PERINDOPRIL Perindopril 4MG  TAB 

716506 AURO PERINDOPRIL Perindopril 8MG  TAB 

704354 AUSTELL LISINOPRIL 2.5MG  Lisinopril 2.5MG  TAB  Accepted treatment

712598 AUSTELL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment

708189 AUSTELL LISINOPRIL 20MG  Lisinopril 20MG  TAB  Accepted treatment

705752 AUSTELL-RAMIPRIL 1.25MG  Ramipril 1.25MG  CAP 

705755 AUSTELL-RAMIPRIL 10MG  Ramipril 10MG  CAP 

705753 AUSTELL-RAMIPRIL 2.5MG  Ramipril 2.5MG  CAP 

705754 AUSTELL-RAMIPRIL 5MG  Ramipril 5MG  CAP 

717293 BINDACE Perindopril 4MG TAB

717294 BINDACE Perindopril 8MG TAB

795267 CAPACE Captopril 25MG TAB Accepted treatment

837628 CAPTOHEXAL Captopril 12.5MG TAB Accepted treatment

837636 CAPTOHEXAL Captopril 25MG TAB Accepted treatment

837644 CAPTOHEXAL Captopril 50MG TAB Accepted treatment

836451 CAPTOMAX Captopril 25MG TAB Accepted treatment

836478 CAPTOMAX Captopril 50MG TAB Accepted treatment

794058 CIBACE Benazepril 10MG TAB

710302 CIPLA-PERINDOPRIL  Perindopril 4MG  TAB 

710510 CIPLA-PERINDOPRIL  Perindopril 8MG  TAB 

715786 CIPLASYL Perindopril 4MG  TAB 

715795 CIPLASYL Perindopril 8MG  TAB 

894324 CIPLATEC 10 Enalapril 10MG TAB Accepted treatment

701729 CIPLATEC 20MG Enalapril 20MG TAB Accepted treatment

38 11/5/2013

Comprehensive Formulary

894316 CIPLATEC 5 Enalapril 5MG TAB Accepted treatment

785121 COVERSYL Perindopril 4MG TAB

705915 COVERSYL  Perindopril 10MG  TAB 

891279 ENAP 10MG Enalapril 10MG TAB Accepted treatment

891280 ENAP 20MG Enalapril 20MG TAB Accepted treatment

891272 ENAP 5MG Enalapril 5MG TAB Accepted treatment

712763 ENVAS Enalapril 10MG TAB Accepted treatment

712762 ENVAS Enalapril 5MG TAB Accepted treatment

701392 HEXAL-LISINOPRIL Lisinopril 10MG TAB Accepted treatment

701394 HEXAL-LISINOPRIL Lisinopril 20MG TAB Accepted treatment

701387 HEXAL-LISINOPRIL Lisinopril 5MG TAB Accepted treatment

867853 HR-ENALAPRIL 10 Enalapril 10MG TAB Accepted treatment

867861 HR-ENALAPRIL 20 Enalapril 20MG TAB Accepted treatment

867845 HR-ENALAPRIL 5 Enalapril 5MG TAB Accepted treatment

862622 HYPACE Enalapril 5MG TAB Accepted treatment

792748 INHIBACE Cilazapril 2.5MG TAB

792756 INHIBACE Cilazapril 5MG TAB

716794 LYSIN Lisinopril 10MG TAB Accepted treatment

716792 LYSIN Lisinopril 5MG TAB Accepted treatment

708279 MAVIK  Trandolapril 4MG  CAP 

805068 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 2MG CAP

805033 MAVIK (PREVIOUSLY GOPTEN) Trandolapril 0.5MG CAP

852619 MYLAN CAPTOPRIL Captopril 25MG TAB Accepted treatment

899429 MYLAN-CAPTOPRIL Captopril 50MG TAB Accepted treatment

705450 MYLAN-FOSINOPRIL 10  Fosinopril 10MG  TAB 

705453 MYLAN-FOSINOPRIL 20  Fosinopril 20MG  TAB 

791954 MONOPRIL Fosinopril 10MG TAB

791962 MONOPRIL Fosinopril 20MG TAB

714527 PEARINDA Perindopril 4MG TAB

714528 PEARINDA Perindopril 8MG TAB

717783 PERINDOPRIL UNICORN Perindopril 4MG TAB

717784 PERINDOPRIL UNICORN Perindopril 8MG TAB

708109 PHARMAPRESS  Enalapril 5MG  TAB  Accepted treatment

868914 PHARMAPRESS Enalapril 10MG TAB Accepted treatment

868922 PHARMAPRESS Enalapril 20MG TAB Accepted treatment

703541 PREXUM Perindopril 4MG TAB

714646 PREXUM Perindopril 10MG TAB

711171 QUINACE  Quinapril 10MG  TAB  Accepted treatment

711172 QUINACE  Quinapril 20MG  TAB  Accepted treatment

708981 QUINAGEN  Quinapril 5MG  TAB 

708982 QUINAGEN  Quinapril 10MG  TAB  Accepted treatment

708983 QUINAGEN  Quinapril 20MG  TAB  Accepted treatment

708985 QUINAGEN  Quinapril 40MG  TAB 

705457 QUINASPEN 10MG  Quinapril 10MG  TAB  Accepted treatment

705447 QUINASPEN 20MG  Quinapril 20MG  TAB  Accepted treatment

704374 RAMIPRIL HEXAL  Ramipril 2.5MG TAB

704375 RAMIPRIL HEXAL  Ramipril 5MG TAB

704022 RAMIWIN Ramipril 1.25MG CAP

704023 RAMIWIN Ramipril 2.5MG CAP

704025 RAMIWIN Ramipril 5MG CAP

705426 RAMPIL 1.25MG  Ramipril 1.25MG  CAP 

705429 RAMPIL 10MG  Ramipril 10MG  CAP 

705427 RAMPIL 2.5MG  Ramipril 2.5MG  CAP 

705428 RAMPIL 5MG  Ramipril 5MG  CAP 

710611 RAN-PERINDOPRIL  Perindopril 4MG  TAB 

704975 RAN RAMIPRIL Ramipril 10MG CAP 

759783 RENITEC Enalapril 10MG TAB Accepted treatment

810355 RENITEC Enalapril 2.5MG TAB

759767 RENITEC Enalapril 20MG TAB Accepted treatment

759759 RENITEC Enalapril 5MG TAB Accepted treatment

707382 RETACE  Ramipril 1.25MG  TAB 

707383 RETACE  Ramipril 2.5MG  TAB 

707385 RETACE  Ramipril 5MG  TAB 

706238 RILACE  Ramipril 2.5MG  CAP 

706237 RILACE  Ramipril 5MG  CAP 

706239 RILACE  Ramipril 10MG  CAP 

39 11/5/2013

Comprehensive Formulary

850896 ROLAB-CAPTOPRIL Captopril 25MG TAB Accepted treatment

850918 ROLAB-CAPTOPRIL Captopril 50MG TAB Accepted treatment

707311 SIMAYLA LISINOPRIL Lisinopril 10MG  TAB  Accepted treatment

707312 SIMAYLA LISINOPRIL Lisinopril 20MG  TAB  Accepted treatment

707310 SIMAYLA LISINOPRIL Lisinopril 5MG  TAB  Accepted treatment

707869 SIMAYLA RAMIPRIL  Ramipril 10MG  CAP 

700692 SINOPREN 10 Lisinopril 10MG TAB Accepted treatment

700694 SINOPREN 20 Lisinopril 20MG TAB Accepted treatment

700691 SINOPREN 5 Lisinopril 5MG TAB Accepted treatment

712615 SPEC-PERINDOPRIL Perindopril 4MG TAB

712616 SPEC-PERINDOPRIL Perindopril 8MG TAB

841579 TRITACE Ramipril 1.25MG TAB

841587 TRITACE Ramipril 2.5MG TAB

841595 TRITACE Ramipril 5MG TAB

782602 TRITACE Ramipril 10MG CAP

710297 VECTORYL  Perindopril 4MG  TAB 

710925 VECTORYL  Perindopril 8MG  TAB 

839779 ZAPTO Captopril 25MG TAB Accepted treatment

839787 ZAPTO Captopril 50MG TAB Accepted treatment

703645 ZEMAX 10  Lisinopril 10MG  TAB  Accepted treatment

705318 ZEMAX 20  Lisinopril 20MG  TAB  Accepted treatment

703646 ZEMAX 5  Lisinopril 5MG  TAB  Accepted treatment

705412 ZEPROSIL 10MG  Lisinopril 10MG  TAB  Accepted treatment

705414 ZEPROSIL 20MG  Lisinopril 20MG  TAB  Accepted treatment

705413 ZEPROSIL 5MG  Lisinopril 5MG  TAB  Accepted treatment

781703 ZESTRIL Lisinopril 10MG TAB Accepted treatment

781711 ZESTRIL Lisinopril 20MG TAB Accepted treatment

781681 ZESTRIL Lisinopril 5MG TAB Accepted treatment

862053 ZETOMAX (ZESTOMAX) 10MG Lisinopril 10MG TAB Accepted treatment

862061 ZETOMAX (ZESTOMAX) 20MG Lisinopril 20MG TAB Accepted treatment

862045 ZETOMAX (ZESTOMAX) 5MG Lisinopril 5MG TAB Accepted treatment

716680 ZYDUS PERINDOPRIL Perindopril 4MG  TAB 

ACE inhibitor and diuretic combinations

708116 ACCUMAX CO  Quinapril and diuretics 10MG/12.5MG  TAB 

708118 ACCUMAX CO  Quinapril and diuretics 20MG/12.5MG  TAB 

795755 ACCURETIC Quinapril and diuretics 10MG/12.5MG TAB

805297 ACCURETIC Quinapril and diuretics 20MG/12.5MG TAB

706235 ADCO-QUINARETIC 10/12.5MG  Quinapril and diuretics 10MG/12.5MG  TAB 

706236 ADCO-QUINARETIC 20/12.5MG  Quinapril and diuretics 20MG/12.5MG  TAB 

715651 ACESYL CO Perindopril and diuretics 1.25MG/4MG TAB

717795 ARIPREL PLUS 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB

716120 AURO-LISINOPRIL CO Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

716121 AURO-LISINOPRIL CO Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

718056 AURO QUINAPRIL CO 10MG/12.5MG Quinapril and diuretics 10MG/12.5MG TAB

718057 AURO QUINAPRIL CO 20MG/12.5MG Quinapril and diuretics 20MG/12.5MG TAB

788414 CAPOZIDE Captopril and diuretics 50MG/25MG TAB Accepted treatment

841137 CAPTORETIC Captopril and diuretics 50MG/25MG TAB Accepted treatment

841145 CAPTORETIC HS Captopril and diuretics 25MG/12.5MG TAB

787035 CO-RENITEC Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment

877549 COVERSYL PLUS Perindopril and diuretics TAB

710978 DIACE CO  Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

891287 ENAP-CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment

815055 INHIBACE PLUS Cilazapril and diuretics 5MG/12.5MG TAB

704703 HEXAL LISINOPRIL CO 10  Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

704704 HEXAL LISINOPRIL CO 20  Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

716943 LISINOPRIL CO UNICORN 10MG/12.5MG Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

716945 LISINOPRIL CO UNICORN 20MG/12.5MG Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

711989 LISINOZIDE Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

711990 LISINOZIDE Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

704437 LISORETIC 10/12.5 Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

704438 LISORETIC 20/12.5 Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

707292 LISOZIDE 10MG/12.5MG  Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

707291 LISOZIDE 20MG/12.5MG  Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

714952 PEARINDA PLUS Perindopril and diuretics 1.25MG/4MG TAB

717782 PERINDOPRIL CO UNICORN 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB

40 11/5/2013

Comprehensive Formulary

885019 PHARMAPRESS CO Enalapril and diuretics 20MG/12.5MG TAB Accepted treatment

704929 PREXUM PLUS Perindopril and diuretics 4MG/1.25MG TAB 

711173 QUINACE CO 10/12.5MG  Quinapril and diuretics 10MG/12.5MG  TAB 

711174 QUINACE CO 20/12.5MG  Quinapril and diuretics 20MG/12.5MG  TAB 

707550 QUINAZIDE 10/12.5  Quinapril and diuretics 10MG/12.5MG  TAB 

707551 QUINAZIDE 20/12.5  Quinapril and diuretics 20MG/12.5MG  TAB 

713763 SPEC-PERINDOPRIL PLUS Perindopril and diuretics 1.25MG/4MG TAB

718093 TRITACE PLUS 10MG/12.5MG Ramipril and diuretics 10MG/12.5MG TAB

718094 TRITACE PLUS 5MG/12.5MG Ramipril and diuretics 5MG/12.5MG TAB

718092 TRITACE PLUS 5MG/25MG Ramipril and diuretics 5MG/25MG TAB

710298 VECTORYL PLUS  Perindopril and diuretics 1.25MG/4MG  TAB 

839795 ZAPTO-CO Captopril and diuretics 50MG/25MG TAB Accepted treatment

704597 ZETOMAX CO 10/12.5 Lisinopril and diuretics 10MG/12.5MG  TAB  Accepted treatment

704598 ZETOMAX CO 20/12.5 Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

817848 ZESTORETIC Lisinopril and diuretics 10MG/12.5MG TAB Accepted treatment

797685 ZESTORETIC Lisinopril and diuretics 20MG/12.5MG TAB Accepted treatment

708260 ZESTOZIDE 20  Lisinopril and diuretics 20MG/12.5MG  TAB  Accepted treatment

717095 ZYDUS PERINDOPRIL CO 4MG/1.25MG Perindopril and diuretics 1.25MG/4MG TAB

Angiotensin Receptor Blockers

718667 ADCO IRBESARTAN Irbesartan 150MG TAB

718668 ADCO IRBESARTAN Irbesartan 300MG TAB

837814 APROVEL Irbesartan 150MG TAB

837822 APROVEL Irbesartan 300MG TAB

716495 AURO LOSARTAN Losartan 100MG TAB Accepted treatment

716494 AURO LOSARTAN Losartan 50MG TAB Accepted treatment

717069 AUSTELL LOSARTAN Losartan 100MG TAB Accepted treatment

717068 AUSTELL LOSARTAN Losartan 50MG TAB Accepted treatment

818739 COZAAR Losartan 50MG TAB Accepted treatment

710079 COZAAR Losartan 100MG TAB Accepted treatment

716644 CIPLAZAR Losartan 100MG TAB Accepted treatment

716643 CIPLAZAR Losartan 50MG TAB Accepted treatment

709845 CIPLA-LOSARTAN  Losartan 100MG  TAB  Accepted treatment

709844 CIPLA-LOSARTAN  Losartan 50MG  TAB  Accepted treatment

717035 DIOLO Valsartan 160MG TAB

717034 DIOLO Valsartan 80MG TAB

700710 DIOVAN 160 Valsartan 160MG  TAB 

700000 DIOVAN 80 Valsartan 80MG  TAB 

717793 DYNARB Irbesartan 150MG TAB

717794 DYNARB Irbesartan 300MG TAB

712385 IRBEWIN Irbesartan 150MG TAB 

712384 IRBEWIN Irbesartan 300MG TAB 

718506 IRTANEL Irbesartan 150MG TAB

718507 IRTANEL Irbesartan 300MG TAB

719162 ISART Irbesartan 150MG TAB

719163 ISART Irbesartan 300MG TAB

709788 LEPITRIN  Losartan 50MG  TAB  Accepted treatment

709924 LOS-ARB  Losartan 50MG  TAB  Accepted treatment

718366 LOSARTAN UNICORN Losartan 100MG TAB Accepted treatment

718365 LOSARTAN UNICORN Losartan 50MG TAB Accepted treatment

709909 LOSARTAN-WINTHROP  Losartan 50MG  TAB  Accepted treatment

860387 MICARDIS Telmisartan 40MG TAB

860395 MICARDIS Telmisartan 80MG TAB

714249 PRITOR Telmisartan 40MG TAB

714250 PRITOR Telmisartan 80MG TAB

717296 RASOL Losartan 100MG TAB Accepted treatment

717295 RASOL Losartan 50MG TAB Accepted treatment

715871 RENICARD Losartan 50MG TAB Accepted treatment

713254 SPEC-LOSARTAN Losartan 100MG TAB Accepted treatment

713255 SPEC-LOSARTAN Losartan 50MG TAB Accepted treatment

704696 TAREG  Valsartan 160MG  TAB 

705060 TAREG  Valsartan 80MG  TAB 

718364 VALSARTAN UNICORN Valsartan 160MG TAB

718363 VALSARTAN UNICORN Valsartan 80MG TAB

709225 ZARTAN  Losartan 50MG  TAB  Accepted treatment

709964 ZARTAN  Losartan 100MG  TAB  Accepted treatment

41 11/5/2013

Comprehensive Formulary

Angiotensin Receptor Blockers and diuretic combinations

717070 AUSTELL LOSARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment

891353 COAPROVEL Irbesartan and diuretics 150MG/12.5MG TAB

898597 COAPROVEL Irbesartan and diuretics 300MG/12.5MG TAB

891894 CO-DIOVAN  Valsartan and diuretics 160MG/12.5MG  TAB 

839884 CO-DIOVAN  Valsartan and diuretics 80MG/12.5MG  TAB 

706051 CO-DIOVAN PLUS  Valsartan and diuretics 160MG/25MG  TAB 

712386 CO-IRBEWIN Irbesartan and diuretics 150MG/12.5MG TAB 

712387 CO-IRBEWIN Irbesartan and diuretics 300MG/12.5MG TAB 

894614 CO-MICARDIS 40/12.5MG Telmisartan + Hydrochlorothiazide  40MG/12.5MG TAB

894621 CO-MICARDIS 80/12.5MG Telmisartan + Hydrochlorothiazide  80MG/12.5MG TAB

716791 CO-MICARDIS 80MG/25MG Telmisartan + Hydrochlorothiazide 80MG/25MG TAB

715571 CO-MIGROBEN 160MG/12.5MG Valsartan and diuretics

715572 CO-MIGROBEN 160MG/25MG Valsartan and diuretics

715570 CO-MIGROBEN 80MG/12.5MG Valsartan and diuretics

714251 CO-PRITOR 40/12.5 MG Telmisartan + Hydrochlorothiazide 40MG/12.5MG TAB

714252 CO-PRITOR 80/12.5MG Telmisartan + Hydrochlorothiazide 80MG/12.5MG TAB

705068 CO-TAREG 80MG/12.5MG  Valsartan and diuretics 80MG  TAB 

715673 CO-TAREG PLUS Valsartan and diuretics 160MG/25MG  TAB 

715672 CO-TAREG 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB 

715559 CO-ZOMEVEK 160MG/12.5MG Valsartan and diuretics TAB

715558 CO-ZOMEVEK 80MG/12.5MG Valsartan and diuretics TAB

715560 CO-ZOMEVEK160MG/25MG Valsartan and diuretics TAB

828181 COZAAR COMP Losartan and diuretics 50MG/12.5 MG TAB Accepted treatment

716613 CIPLAZAR CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716612 CIPLAZAR CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

718608 DIOLO CO 160MG/12.5MG Valsartan and diuretics 160MG/12.5MG TAB

718607 DIOLO CO 80MG/12.5MG Valsartan and diuretics 80MG/12.5MG TAB

887096 FORTZAAR Losartan and diuretics 100MG/25MG TAB Accepted treatment

717084 HYTENZA CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716476 HYTENZA CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

718571 ISART CO 150MG/12.5MG Irbesartan and diuretics 150MG/12.5MG TAB

718573 ISART CO 300MG/12.5MG Irbesartan and diuretics 300MG/12.5MG TAB

716059 LOHYPE FORTE PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716058 LOHYPE PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715857 LOSAAR PLUS 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

715856 LOSAAR PLUS 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

716274 LOSACAR CO 50MG/12,5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

718368 LOSARTAN CO UNICORN 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

718367 LOSARTAN CO UNICORN 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715739 LOZAAN CO 100/25 Losartan and diuretics 100MG/25MG TAB Accepted treatment

715740 LOZAAN CO 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715848 NETRASOL CO 50/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

715849 NETRASOL CO 100/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

715064 SARTOC 50/12.5 Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

716515 SARTOC 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716217 ZARTAN CO 100MG/25MG Losartan and diuretics 100MG/25MG TAB Accepted treatment

716216 ZARTAN CO 50MG/12.5MG Losartan and diuretics 50MG/12.5MG TAB Accepted treatment

Combination antihypertensives

717633 CO EXFORGE 10MG/160MG/12.5MG valsartan, amlodipine and hydrochlorothiazide TAB

717634 CO EXFORGE 10MG/160MG/25MG valsartan, amlodipine and hydrochlorothiazide TAB

717631 CO EXFORGE 5MG/160MG/12.5MG valsartan, amlodipine and hydrochlorothiazide TAB

717632 CO EXFORGE 5MG/160MG/25MG valsartan, amlodipine and hydrochlorothiazide TAB

711254 EXFORGE  Valsartan and Amlodipine 10MG/160MG  TAB 

711253 EXFORGE  Valsartan and Amlodipine 5MG/160MG  TAB 

862207 TRI-PLEN Ramipril and calcium channel blockers 2.5MG/2.5MG TAB

717367 TWYNSTA 40MG/10MG telmisartan and amlodipine 40MG/10MG TAB

717366 TWYNSTA 40MG/5MG telmisartan and amlodipine 40MG/5MG TAB

717369 TWYNSTA 80MG/10MG telmisartan and amlodipine 80MG/10MG TAB

717368 TWYNSTA 80MG/5MG telmisartan and amlodipine 80MG/5MG TAB

711444 ZANERIL Enalapril and Lercanidipine 10MG/10MG  TAB 

Hypothyroidism

42 11/5/2013

Comprehensive Formulary

722944 ELTROXIN Levothyroxine sodium 0.05MG TAB Accepted treatment

722952 ELTROXIN Levothyroxine sodium 0.1MG TAB Accepted treatment

713169 EUTHYROX Levothyroxine sodium 100MCG TAB Accepted treatment

713172 EUTHYROX Levothyroxine sodium 25MCG TAB Accepted treatment

713168 EUTHYROX Levothyroxine sodium 50MCG TAB Accepted treatment

716576 SYNTHROID Levothyroxine sodium 100MCG TAB Accepted treatment

716577 SYNTHROID Levothyroxine sodium 112MCG TAB Accepted treatment

716571 SYNTHROID Levothyroxine sodium 25MCG TAB Accepted treatment

716574 SYNTHROID Levothyroxine sodium 50MCG TAB Accepted treatment

716575 SYNTHROID Levothyroxine sodium 88MCG TAB Accepted treatment

Anticholinergics

720658 DITROPAN Oxybutynin 5MG TAB Accepted treatment

872253 LENDITRO Oxybutynin 5MG TAB Accepted treatment

701893 MYLAN OXYBUTYNIN CHLORIDE 5 Oxybutynin 5MG TAB Accepted treatment

883721 ROLAB-OXYBUTYNIN HCI 5 Oxybutynin 5MG TAB Accepted treatment

701170 URIHEXAL 5MG Oxybutynin 5MG TAB Accepted treatment

Immunosuppressants

782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment

782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment

701252 AZAMUN Azathioprine 50MG TAB Accepted treatment

706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment

712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment

712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment

825565 EMTHEXATE RTU 50-2 2ML Methotrexate 25MG/1ML INJ Accepted treatment

825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment

711328 METACHOR VIAL 2ML  Methotrexate 25MG/1ML  INJ  Accepted treatment

723274 ENDOXAN Cyclophosphamide 50MG TAB Accepted treatment

732524 IMURAN Azathioprine 50MG TAB Accepted treatment

840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment

840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment

742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment

700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Muscle relaxants

738344 LIORESAL Baclofen 10MG TAB Accepted treatment

865567 BIO-BACLOFEN Baclofen 10MG TAB Accepted treatment

712607 TEVA BACLOFEN Baclofen 10MG TAB Accepted treatment

Tricyclic Antidepressants

724661 ETHIPRAMINE Imipramine 10MG TAB Accepted treatment

724688 ETHIPRAMINE Imipramine 25MG TAB Accepted treatment

718746 GULF AMITRIPTYLINE Amitriptyline 25MG TAB Accepted treatment

757888 PROTHIADEN Dothiepin 25MG CAP Accepted treatment

757896 PROTHIADEN Dothiepin 75MG TAB Accepted treatment

784230 ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB Accepted treatment

820660 ROLAB-DOTHIEPIN Dothiepin 25MG CAP Accepted treatment

816515 ROLAB-DOTHIEPIN Dothiepin 75MG TAB Accepted treatment

800198 THADEN Dothiepin 25MG CAP Accepted treatment

800201 THADEN Dothiepin 75MG TAB Accepted treatment

771120 TOFRANIL Imipramine 10MG TAB Accepted treatment

771139 TOFRANIL Imipramine 25MG TAB Accepted treatment

772003 TREPILINE Amitriptyline 10MG TAB Accepted treatment

771996 TREPILINE Amitriptyline 25MG TAB Accepted treatment

772860 TRYPTANOL Amitriptyline 25MG TAB Accepted treatment

Carbamazepine

712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment

712523 ROLAB-CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment

769398 TEGRETOL Carbamazepine 200MG TAB

779652 TEGRETOL CR Carbamazepine 200MG SRT

779660 TEGRETOL CR Carbamazepine 400MG SRT

715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment

Analgesics

717725 ACTAMOL Paracetamol 500MG TAB Accepted treatment

716045 ADCO-NAPAMOL Paracetamol 500MG TAB Accepted treatment

805467 ANTALGIC 500 Paracetamol 500MG TAB Accepted treatment

Multiple sclerosis

43 11/5/2013

Comprehensive Formulary

713153 AUSTELL-PARACETAMOL Paracetamol 500MG TAB Accepted treatment

714499 CLICKS PARACETAMOL Paracetamol 500MG TAB Accepted treatment

897124 CO CODAMOL Paracetamol combinations payable by PBM 500MG/8MG EFF Accepted treatment

837652 DINO-COD (BEI) Paracetamol and codeine TAB Accepted treatment

720860 DOLOROL Paracetamol 500MG TAB Accepted treatment

720879 DOLOROL FORTE Paracetamol combinations payable by PBM TAB Accepted treatment

798053 DYNA-DOL Paracetamol 500MG TAB Accepted treatment

784567 ENTALGIC Paracetamol 500MG TAB Accepted treatment

824992 GENCETAMOL Paracetamol 500MG TAB Accepted treatment

715112 GRAYS PARACETAMOL Paracetamol 500MG TAB Accepted treatment

867950 GULF PARACETAMOL Paracetamol 500MG TAB Accepted treatment

894212 JP PARACETAMOL Paracetamol 500MG TAB Accepted treatment

715280 LENNON PARACETAMOL Paracetamol 500MG TAB Accepted treatment

745707 NAPACOD Paracetamol combinations payable by PBM TAB Accepted treatment

745723 NAPAMOL Paracetamol 500MG TAB Accepted treatment

825034 PACIMOL Paracetamol 500MG TAB Accepted treatment

799629 PAINAMOL (GREEN) Paracetamol 500MG TAB Accepted treatment

707910 PAINAMOL PLUS (BETACOD) Paracetamol combinations payable by PBM TAB Accepted treatment

752142 PAINAMOL WHITE Paracetamol 500MG TAB Accepted treatment

867969 PAINBLOK Paracetamol 500MG TAB Accepted treatment

752126 PAINCOD Acetylsalicylic acid comb. excl. psycholeptics TAB Accepted treatment

895030 PAINCODEIN Paracetamol combinations payable by PBM 500MG/8MG TAB Accepted treatment

704465 PAINOGESIC  Paracetamol 500MG  TAB  Accepted treatment

752274 PANADO Paracetamol 500MG CAP Accepted treatment

752274 PANADO Paracetamol 500MG TAB Accepted treatment

708432 PANADO CHILDRENS  Paracetamol 125MG  MLT Accepted treatment

708438 PANADO  Paracetamol 500MG  MLT Accepted treatment

815306 PANADO EFFERVESCENT Paracetamol 500MG EEF Accepted treatment

704719 PARACET  Paracetamol 500MG  TAB  Accepted treatment

818372 PARACETAMOL Paracetamol 500MG TAB Accepted treatment

784443 PARAMED Paracetamol 500MG TAB Accepted treatment

752878 PARAPANE Paracetamol 500MG TAB Accepted treatment

757403 PROLIEF Paracetamol 500MG TAB Accepted treatment

714707 PYNGESIC T Paracetamol 500MG TAB Accepted treatment

761303 ROCODIN Paracetamol and codeine TAB Accepted treatment

765635 SPECTRAPAIN Paracetamol combinations payable by PBM CAP Accepted treatment

826588 THERA-PAIN Paracetamol 500MG TAB Accepted treatment

713688 VARI-COCODAMOL 8MG/500MG Paracetamol combinations payable by PBM 8MG/500MG TAB Accepted treatment

701140 VARIPAN Paracetamol 500MG TAB Accepted treatment

885863 VON PARACETAMOL Paracetamol 500MG TAB Accepted treatment

710211 ZYDUS-PARACETAMOL  Paracetamol 500MG  TAB  Accepted treatment

Non-steroidal anti-inflammatories

786594 ADCO-DICLOFENAC Diclofenac 25MG TAB Accepted treatment

788597 ADCO-DICLOFENAC Diclofenac 50MG TAB Accepted treatment

780596 ADCO-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment

701106 ADCO-INDOMETHACIN Indometacin 25MG CAP Accepted treatment

883102 ADCO-MEFENAMIC ACID Mefenamic acid 250MG CAP

705376 ADCO-MELOXICAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705375 ADCO-MELOXICAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

785245 ADCO-NAPROXEN Naproxen 250MG TAB Accepted treatment

785253 ADCO-PIROXICAM Piroxicam 10MG CAP Accepted treatment

785261 ADCO-PIROXICAM Piroxicam 20MG CAP Accepted treatment

892302 ADVIL LIQUI GEL Ibuprofen 200MG CAP Accepted treatment

716004 ADVIL LIQUI GEL Ibuprofen 400MG CAP Accepted treatment

893390 A-LENNON DICLOFENAC Diclofenac 25MG TAB Accepted treatment

893391 A-LENNON DICLOFENAC Diclofenac 50MG TAB Accepted treatment

701891 AMDOCIN Indometacin 25MG CAP Accepted treatment

707668 APEX-MELOXICAM Meloxicam 15MG TAB Accepted treatment

707667 APEX-MELOXICAM Meloxicam 7.5MG TAB Accepted treatment

711325 ARROW MELOXICAM  Meloxicam 15MG  TAB  Accepted treatment

711324 ARROW MELOXICAM  Meloxicam 7.5MG  TAB  Accepted treatment

704725 ARTHREXIN Indometacin 25MG APP Accepted treatment

704741 ARTHREXIN Indometacin 100MG SUP Accepted treatment

707374 ARTHROCOX  Meloxicam 15MG  TAB  Accepted treatment

707373 ARTHROCOX  Meloxicam 7.5MG  TAB  Accepted treatment

813044 ARTHROTEC Diclofenac, combinations 50MG/200MCG ECT

44 11/5/2013

Comprehensive Formulary

869805 ARTHROTEC Diclofenac, combinations 75MG/200mcg ECT

799459 BE-TABS NAPROXEN Naproxen 250MG TAB Accepted treatment

787833 BETACIN Indometacin 25MG CAP Accepted treatment

708186 BETAGESIC Ibuprofen 200MG TAB Accepted treatment

787426 BETAPROFEN Ibuprofen 200MG TAB Accepted treatment

701975 BETAPROFEN 400 FC  Ibuprofen 400MG TAB Accepted treatment

715831 BIO-NAPROXEN Naproxen 250MG TAB Accepted treatment

708290 BREN  Ibuprofen 400MG  TAB  Accepted treatment

800724 BREXECAM Piroxicam 20MG TAB Accepted treatment

710822 BRUFEN Ibuprofen 200MG TAB Accepted treatment

710830 BRUFEN Ibuprofen 400MG TAB Accepted treatment

710849 BRUFEN Ibuprofen 600MG TAB

899070 COXFLAM Meloxicam 15MG TAB Accepted treatment

899066 COXFLAM Meloxicam 7.5MG TAB Accepted treatment

841153 DICLOHEXAL Diclofenac 50MG TAB Accepted treatment

853240 DICLOHEXAL 25T Diclofenac 25MG TAB Accepted treatment

718479 DICLOFENAC BIOTECH Diclofenac 25MG TAB Accepted treatment

718480 DICLOFENAC SR BIOTECH Diclofenac 100MG SRT Accepted treatment

706314 DIFEN SR  Diclofenac 100MG  TAB  Accepted treatment

798185 DYNOFEN Ibuprofen 200mg TAB Accepted treatment

807729 FAMETHACIN Indometacin 25MG CAP Accepted treatment

797707 FENAMIN Mefenamic acid 250MG CAP

797715 FENAMIN Mefenamic acid 500MG TAB

813478 FLAMARET Indometacin 25MG CAP Accepted treatment

717092 FLAMARYX Meloxicam 15MG  TAB  Accepted treatment

717091 FLAMARYX Meloxicam 7.5MG  TAB  Accepted treatment

726389 FLAMECID Indometacin 25MG CAP Accepted treatment

704828 FLEXOCAM  Meloxicam 15MG  TAB  Accepted treatment

704829 FLEXOCAM  Meloxicam 7.5MG  TAB  Accepted treatment

791547 FORTFEN SR Diclofenac 100MG SRC Accepted treatment

718305 GLENMARK MELOXICAM Meloxicam 15MG TAB Accepted treatment

718306 GLENMARK MELOXICAM Meloxicam 7.5MG TAB Accepted treatment

868213 GULF INDOMETHACIN Indometacin 25MG CAP Accepted treatment

895196 IBOFLAM Ibuprofen 200MG TAB Accepted treatment

705940 IBU Ibuprofen 200MG TAB Accepted treatment

704781 IBUGESIC  Ibuprofen 100MG/5ML  SUS  Accepted treatment

700316 IBUMAX Ibuprofen 200MG TAB Accepted treatment

700318 IBUMAX Ibuprofen 400MG TAB Accepted treatment

809268 IBUMED Ibuprofen 200MG CAP Accepted treatment

868221 IBUNATE Ibuprofen 200MG TAB Accepted treatment

733741 INZA Ibuprofen 200MG TAB Accepted treatment

733768 INZA Ibuprofen 400MG TAB Accepted treatment

822205 KETOFLAM SR Ketoprofen 200MG SRC Accepted treatment

868469 LENAFEN Ibuprofen 200MG TAB Accepted treatment

701522 LOXIFLAM 15 Meloxicam 15MG TAB Accepted treatment

701520 LOXIFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment

705177 M-CAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705176 M-CAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

788996 MEDIFLEX Indometacin 25MG CAP Accepted treatment

718382 MEDOXICAM Meloxicam 15MG TAB Accepted treatment

718381 MEDOXICAM Meloxicam 7.5MG TAB Accepted treatment

705297 MELFLAM 15  Meloxicam 15MG  TAB  Accepted treatment

705296 MELFLAM 7.5  Meloxicam 7.5MG  TAB  Accepted treatment

716169 MELOXICAM UNICORN Meloxicam 15MG TAB Accepted treatment

716168 MELOXICAM UNICORN Meloxicam 7.5MG TAB Accepted treatment

786012 MYLAN DICLOFENAC (ARCANAFENAC) Diclofenac 25MG TAB Accepted treatment

786020 MYLAN DICLOFENAC SOD (ARCANAFENAC) Diclofenac 50MG TAB Accepted treatment

810185 MYLAN NAPROXEN (ARCANA-NAPROXEN) Naproxen 250MG TAB Accepted treatment

814393 METHOCAPS Indometacin 25MG CAP Accepted treatment

818615 MOBIC Meloxicam 7.5MG TAB Accepted treatment

842052 MOBIC 15MG Meloxicam 15MG TAB Accepted treatment

815934 MYPROFLAM SRC Ketoprofen 200MG SRC Accepted treatment

812625 NAFASOL EC-250 Naproxen 250MG ECT

812633 NAFASOL EC-500 Naproxen 500MG ECT

806447 NAPFLAM Naproxen 250MG TAB Accepted treatment

808474 NAPFLAM Naproxen 500MG TAB Accepted treatment

45 11/5/2013

Comprehensive Formulary

805238 NAPROSCRIPT Naproxen 250MG TAB Accepted treatment

805246 NAPROSCRIPT Naproxen 500MG TAB Accepted treatment

789410 NISAID 25 Indometacin 25MG CAP Accepted treatment

863394 NORFLAM-T Ibuprofen 200MG TAB Accepted treatment

748560 NUROFEN Ibuprofen 200MG TAB Accepted treatment

711948 NUROFEN (CAPLETS)  Ibuprofen 200MG  CAP  Accepted treatment

897984 NUROFEN EXTRA STRENGTH Ibuprofen 400MG TAB Accepted treatment

751472 ORUVAIL 200 Ketoprofen 200MG SRC Accepted treatment

897060 PAINIL Ibuprofen 200MG TAB Accepted treatment

752398 PANAMOR AT-50 Diclofenac 50MG TAB Accepted treatment

827592 PANAMOR SR Diclofenac 100MG TAB Accepted treatment

827584 PANAMOR SR Diclofenac 75MG TAB Accepted treatment

752371 PANAMOR-25 Diclofenac 25MG TAB Accepted treatment

716517 PIROXICAM ACTOR DT Piroxicam 20MG DSP Accepted treatment

827428 PIXICAM Piroxicam 20MG DSP Accepted treatment

796433 PONAC Mefenamic acid 250MG CAP

756148 PONSTAN Mefenamic acid 250MG CAP

756156 PONSTAN Mefenamic acid 50MG/5ML SUS

756164 PONSTAN FORTE Mefenamic acid 500MG TAB

812250 PONSTEL 250 Mefenamic acid 250MG CAP

810371 PONSTEL FORTE Mefenamic acid 500MG TAB

799432 PYROCAPS Piroxicam 20MG CAP Accepted treatment

824852 RANFEN Ibuprofen 200MG TAB Accepted treatment

701654 RANFEN 400 Ibuprofen 400MG TAB Accepted treatment

759600 RELIFEN 500 Nabumetone 500MG TAB

797456 RELISAN Nabumetone 500MG TAB

793027 RELITONE Nabumetone 500MG TAB

821144 RHEUGESIC Piroxicam 20MG DSP Accepted treatment

719811 ROLAB-DICLOFENAC SODIUM Diclofenac 25MG TAB Accepted treatment

719838 ROLAB-DICLOFENAC SODIUM Diclofenac 50MG TAB Accepted treatment

834327 ROLAB-DICLOFENAC SR Diclofenac 100MG TAB Accepted treatment

703966 ROLAB-IBUPROFEN Ibuprofen 200MG TAB Accepted treatment

703974 ROLAB-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment

782807 ROLAB-IBUPROFEN Ibuprofen 600MG TAB

704776 ROLAB-INDOMETHACIN Indometacin 25MG CAP Accepted treatment

741167 ROLAB-MEFENAMIC ACID Mefenamic acid 250MG CAP

781207 ROLAB-NAPROXEN Naproxen 250MG TAB Accepted treatment

840335 ROLAB-NAPROXEN Naproxen 500MG TAB Accepted treatment

812102 ROLAB-PIROXICAM DISP Piroxicam 20MG DSP Accepted treatment

701072 ROXIFEN Piroxicam 20MG CAP Accepted treatment

704589 SANDOZ MELOXICAM  Meloxicam 15MG  TAB  Accepted treatment

704588 SANDOZ MELOXICAM  Meloxicam 7.5MG  TAB  Accepted treatment

787272 VELTEX CR Diclofenac 100MG SRC Accepted treatment

793663 VELTEX CR Diclofenac 75MG SRC Accepted treatment

718724 VIMOVO 500/20MG naproxen and esomeprazole TAB

718854 VOLTAREN ACTI-GO SOFT GEL CAPSULES Diclofenac 25MG CAP Accepted treatment

778206 VOLTAREN Diclofenac 25MG TAB Accepted treatment

789240 VOLTAREN 75 Diclofenac 75MG TAB Accepted treatment

835218 VOLTAREN DROPS Diclofenac 15MG/1ML DRP

778222 VOLTAREN GT Diclofenac 50MG TAB Accepted treatment

778230 VOLTAREN SR Diclofenac 100MG TAB Accepted treatment

860654 XEFO Lornoxicam 4MG TAB

860662 XEFO Lornoxicam 8MG TAB

717776 XEFO RAPID Lornoxicam 8MG TAB

797030 XYCAM Piroxicam 20MG CAP Accepted treatment

797049 XYCAM DISPERS Piroxicam 20MG DSP Accepted treatment

705230 ZYDUS-MELOXICAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705229 ZYDUS-MELOXICAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

Levodopa combinations

824321 CARBILEV Levodopa and decarboxylase inhibitor 25MG/100MG TAB Accepted treatment

824348 CARBILEV Levodopa and decarboxylase inhibitor 25MG/250MG TAB Accepted treatment

739928 MADOPAR Levodopa and decarboxylase inhibitor 50MG/200MG TAB Accepted treatment

828483 MADOPAR HBS Levodopa and decarboxylase inhibitor 25MG/100MG CAP Accepted treatment

Parkinson's Disease

46 11/5/2013

Comprehensive Formulary

764078 SINEMET Levodopa and decarboxylase inhibitor 25MG/100MG TAB Accepted treatment

764086 SINEMET Levodopa and decarboxylase inhibitor 25MG/250MG TAB Accepted treatment

794635 SINEMET CR Levodopa and decarboxylase inhibitor 50MG/200MG SRT Accepted treatment

710286 TEVA CARBI-LEVO 25/100 Levodopa and decarboxylase inhibitor 25MG/100MG TAB Accepted treatment

710468 TEVA CARBI-LEVO 25/250 Levodopa and decarboxylase inhibitor 25MG/250MG TAB Accepted treatment

Dopamine agonists and other

701491 AKINETON Biperiden 2MG TAB Accepted treatment

713209 LENNON-BIPERIDEN Biperiden 2MG TAB Accepted treatment

704593 ASPEN BROMOCRIPTINE Bromocriptine 2.5MG  TAB  Clinical review

713210 BENZHEXOL Trihexyphenidyl 2MG TAB Accepted treatment

720542 DISIPAL Orphenadrine (chloride) 50MG TAB Accepted treatment

781282 ELDEPRYL Selegiline 5MG TAB Accepted treatment

706712 PARKILYNE  Selegiline 5MG  TAB  Accepted treatment

752959 PARLODEL Bromocriptine 2.5MG TAB Clinical review

752967 PARLODEL Bromocriptine 5MG CAP Clinical review

898836 PEXOLA .125MG Pramipexole 0.125MG TAB

898848 PEXOLA .25MG Pramipexole 0.25MG TAB

898828 PEXOLA 1MG Pramipexole 1MG TAB

718253 PEXOLA ER Pramipexole .375MG SRT

718255 PEXOLA ER Pramipexole .75MG SRT

718256 PEXOLA ER Pramipexole 1.5MG SRT

718257 PEXOLA ER Pramipexole 3MG SRT

718258 PEXOLA ER Pramipexole 4.5MG SRT

717741 PRAMIOLA Pramipexole .125MG TAB

717742 PRAMIOLA Pramipexole .25MG TAB

700647 REQUIP 0.25MG Ropinirole 0.25MG TAB Specialist motivation

700650 REQUIP 0.5MG Ropinirole 0.5MG TAB Specialist motivation

700652 REQUIP 1MG Ropinirole 1MG TAB Specialist motivation

700655 REQUIP 2MG Ropinirole 2MG TAB Specialist motivation

700658 REQUIP 5MG Ropinirole 5MG TAB Specialist motivation

711090 REQUIP XL  Ropinirole 2MG  SRT  Specialist motivation

711091 REQUIP XL  Ropinirole 4MG  SRT  Specialist motivation

711092 REQUIP XL  Ropinirole 8MG  SRT  Specialist motivation

715081 RESURE Ropinirole 0.25MG TAB Specialist motivation

715082 RESURE Ropinirole 0.5MG TAB Specialist motivation

715083 RESURE Ropinirole 1MG TAB Specialist motivation

715084 RESURE Ropinirole 2MG TAB Specialist motivation

715086 RESURE Ropinirole 5MG TAB Specialist motivation

700500 SYMADIN (WAS FLUSTOP) Amantadine 100MG CAP Accepted treatment

768243 SYMMETREL Amantadine 100MG CAP Accepted treatment

Disease modifying agents

782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment

782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment

898171 ARAVA Leflunomide 10MG TAB Specialist motivation

898175 ARAVA Leflunomide 20MG TAB Specialist motivation

712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment

825565 EMTHEXATE RTU 50-2 2ML Methotrexate 25MG/1ML INJ Accepted treatment

825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment

711328 METACHOR VIAL 2ML  Methotrexate 25MG/1ML  INJ  Accepted treatment

742317 METALCAPTASE Penicillamine 300MG TAB Specialist script

840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment

840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment

742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment

878790 MIRQUIN Chloroquine 50MG/5ML SYR

747297 NIVAQUINE Chloroquine 200MG TAB Accepted treatment

794333 PLASMOQUINE Chloroquine 200MG CAP Accepted treatment

760501 RIDAURA Auranofin 3MG TAB Specialist motivation

762008 SALAZOPYRIN Sulfasalazine 500MG TAB Accepted treatment

762016 SALAZOPYRIN E.N. Sulfasalazine 500MG ECT Accepted treatment

Immunosuppressants

701252 AZAMUN Azathioprine 50MG TAB Accepted treatment

706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment

Rheumatoid arthritis

47 11/5/2013

Comprehensive Formulary

712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment

732524 IMURAN Azathioprine 50MG TAB

700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Alkylating agents

723274 ENDOXAN Cyclosphosphamide 50MG TAB Specialist motivation

737887 LEUKERAN Chlorambucil 2MG TAB Specialist motivation

Non-steroidal anti-inflammatories

786594 ADCO-DICLOFENAC Diclofenac 25MG TAB Accepted treatment

788597 ADCO-DICLOFENAC Diclofenac 50MG TAB Accepted treatment

780596 ADCO-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment

701106 ADCO-INDOMETHACIN Indometacin 25MG CAP Accepted treatment

883102 ADCO-MEFENAMIC ACID Mefenamic acid 250MG CAP

875643 ADCO-MEFENAMIC SUS Mefenamic acid 50MG/5ML SUS

705376 ADCO-MELOXICAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705375 ADCO-MELOXICAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

785245 ADCO-NAPROXEN Naproxen 250MG TAB Accepted treatment

785253 ADCO-PIROXICAM Piroxicam 10MG CAP Accepted treatment

785261 ADCO-PIROXICAM Piroxicam 20MG CAP Accepted treatment

892302 ADVIL LIQUI GEL Ibuprofen 200MG CAP Accepted treatment

716004 ADVIL LIQUI GEL Ibuprofen 400MG CAP Accepted treatment

703490 ADVIL PAEDIATRIC SUSPENSION Ibuprofen 100MG/5ML SUS Accepted treatment

893390 A-LENNON DICLOFENAC Diclofenac 25MG TAB Accepted treatment

893391 A-LENNON DICLOFENAC Diclofenac 50MG TAB Accepted treatment

701891 AMDOCIN Indometacin CAP Accepted treatment

707668 APEX-MELOXICAM Meloxicam 15MG TAB Accepted treatment

707667 APEX-MELOXICAM Meloxicam 7.5MG TAB Accepted treatment

711325 ARROW MELOXICAM  Meloxicam 15MG  TAB  Accepted treatment

711324 ARROW MELOXICAM  Meloxicam 7.5MG  TAB  Accepted treatment

704725 ARTHREXIN Indometacin 25MG APP Accepted treatment

704741 ARTHREXIN Indometacin 100MG SUP Accepted treatment

707374 ARTHROCOX  Meloxicam 15MG  TAB  Accepted treatment

707373 ARTHROCOX  Meloxicam 7.5MG  TAB  Accepted treatment

813044 ARTHROTEC Diclofenac, combinations 50MG/200MCG ECT

869805 ARTHROTEC Diclofenac, combinations 75MG/200mcg ECT

799459 BE-TABS NAPROXEN Naproxen 250MG TAB Accepted treatment

787833 BETACIN Indometacin 25MG CAP Accepted treatment

708186 BETAGESIC Ibuprofen 200MG TAB Accepted treatment

787426 BETAPROFEN Ibuprofen 200MG TAB Accepted treatment

701975 BETAPROFEN 400 FC  Ibuprofen 400MG TAB Accepted treatment

715831 BIO-NAPROXEN Naproxen 250MG TAB Accepted treatment

708290 BREN  Ibuprofen 400MG  TAB  Accepted treatment

800724 BREXECAM Piroxicam 20MG TAB Accepted treatment

710822 BRUFEN Ibuprofen 200MG TAB Accepted treatment

710830 BRUFEN Ibuprofen 400MG TAB Accepted treatment

710849 BRUFEN Ibuprofen 600MG TAB

710857 BRUFEN PAED SUSP Ibuprofen 100MG/5ML SUS Accepted treatment

899070 COXFLAM Meloxicam 15MG TAB Accepted treatment

899066 COXFLAM Meloxicam 7.5MG TAB Accepted treatment

841153 DICLOHEXAL Diclofenac 50MG TAB Accepted treatment

853240 DICLOHEXAL 25T Diclofenac 25MG TAB Accepted treatment

718479 DICLOFENAC BIOTECH Diclofenac 25MG TAB Accepted treatment

718480 DICLOFENAC SR BIOTECH Diclofenac 100MG SRT Accepted treatment

706314 DIFEN SR  Diclofenac 100MG  TAB  Accepted treatment

798185 DYNOFEN Ibuprofen 200mg TAB Accepted treatment

807729 FAMETHACIN Indometacin 25MG CAP Accepted treatment

797707 FENAMIN Mefenamic acid 250MG CAP

797715 FENAMIN Mefenamic acid 500MG TAB

797014 FENAMIN Mefenamic acid 50MG/5ML SUS

813478 FLAMARET Indometacin 25MG CAP Accepted treatment

717092 FLAMARYX Meloxicam 15MG  TAB  Accepted treatment

717091 FLAMARYX Meloxicam 7.5MG  TAB  Accepted treatment

726389 FLAMECID Indometacin 25MG CAP Accepted treatment

704828 FLEXOCAM  Meloxicam 15MG  TAB  Accepted treatment

704829 FLEXOCAM  Meloxicam 7.5MG  TAB  Accepted treatment

791547 FORTFEN SR Diclofenac 100MG SRC Accepted treatment

718305 GLENMARK MELOXICAM Meloxicam 15MG TAB Accepted treatment

48 11/5/2013

Comprehensive Formulary

718306 GLENMARK MELOXICAM Meloxicam 7.5MG TAB Accepted treatment

868213 GULF INDOMETHACIN Indometacin 25MG CAP Accepted treatment

895196 IBOFLAM Ibuprofen 200MG TAB Accepted treatment

705940 IBU Ibuprofen 200MG TAB Accepted treatment

704781 IBUGESIC  Ibuprofen 100MG/5ML  SUS  Accepted treatment

700316 IBUMAX Ibuprofen 200MG TAB Accepted treatment

700318 IBUMAX Ibuprofen 400MG TAB Accepted treatment

700315 IBUMAX PAEDIATRIC Ibuprofen 100MG/5ML SUS Accepted treatment

809268 IBUMED Ibuprofen 200MG CAP Accepted treatment

868221 IBUNATE Ibuprofen 200MG TAB Accepted treatment

733741 INZA Ibuprofen 200MG TAB Accepted treatment

733768 INZA Ibuprofen 400MG TAB Accepted treatment

822205 KETOFLAM SR Ketoprofen 200MG SRC Accepted treatment

868469 LENAFEN Ibuprofen 200MG TAB Accepted treatment

701522 LOXIFLAM 15 Meloxicam 15MG TAB Accepted treatment

701520 LOXIFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment

705177 M-CAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705176 M-CAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

788996 MEDIFLEX Indometacin 25MG CAP Accepted treatment

718382 MEDOXICAM Meloxicam 15MG TAB Accepted treatment

718381 MEDOXICAM Meloxicam 7.5MG TAB Accepted treatment

705297 MELFLAM 15  Meloxicam 15MG  TAB  Accepted treatment

705296 MELFLAM 7.5  Meloxicam 7.5MG  TAB  Accepted treatment

716169 MELOXICAM UNICORN Meloxicam 15MG TAB Accepted treatment

716168 MELOXICAM UNICORN Meloxicam 7.5MG TAB Accepted treatment

786012 MYLAN DICLOFENAC (ARCANAFENAC) Diclofenac 25MG TAB Accepted treatment

786020 MYLAN DICLOFENAC SOD (ARCANAFENAC) Diclofenac 50MG TAB Accepted treatment

810185 MYLAN NAPROXEN (ARCANA-NAPROXEN) Naproxen 250MG TAB Accepted treatment

814393 METHOCAPS Indometacin 25MG CAP Accepted treatment

818615 MOBIC Meloxicam 7.5MG TAB Accepted treatment

842052 MOBIC 15MG Meloxicam 15MG TAB Accepted treatment

815934 MYPROFLAM SRC Ketoprofen 200MG SRC Accepted treatment

812625 NAFASOL EC-250 Naproxen 250MG ECT

812633 NAFASOL EC-500 Naproxen 500MG ECT

806447 NAPFLAM Naproxen 250MG TAB Accepted treatment

808474 NAPFLAM Naproxen 500MG TAB Accepted treatment

805238 NAPROSCRIPT Naproxen 250MG TAB Accepted treatment

805246 NAPROSCRIPT Naproxen 500MG TAB Accepted treatment

789410 NISAID 25 Indometacin 25MG CAP Accepted treatment

863394 NORFLAM-T Ibuprofen 200MG TAB Accepted treatment

748560 NUROFEN Ibuprofen 200MG TAB Accepted treatment

711948 NUROFEN (CAPLETS)  Ibuprofen 200MG  CAP  Accepted treatment

897984 NUROFEN EXTRA STRENGTH Ibuprofen 400MG TAB Accepted treatment

700695 NUROFEN FOR CHILDREN SUGAR FREE Ibuprofen 100MG/5ML SUS Accepted treatment

712683 NUROFEN FOR CHILDREN STRAWBERRY Ibuprofen 100MG/5ML SUS Accepted treatment

751472 ORUVAIL 200 Ketoprofen 200MG SRC Accepted treatment

897060 PAINIL Ibuprofen 200MG TAB Accepted treatment

752398 PANAMOR AT-50 Diclofenac 50MG TAB Accepted treatment

827592 PANAMOR SR Diclofenac 100MG TAB Accepted treatment

827584 PANAMOR SR Diclofenac 75MG TAB Accepted treatment

752371 PANAMOR-25 Diclofenac 25MG TAB Accepted treatment

716517 PIROXICAM ACTOR DT Piroxicam 20MG DSP Accepted treatment

827428 PIXICAM Piroxicam 20MG DSP Accepted treatment

796433 PONAC Mefenamic acid 250MG CAP

793264 PONAC Mefenamic acid 50MG/5ML SUS

756148 PONSTAN Mefenamic acid 250MG CAP

756156 PONSTAN Mefenamic acid 50MG/5ML SUS

756164 PONSTAN FORTE Mefenamic acid 500MG TAB

812250 PONSTEL 250 Mefenamic acid 250MG CAP

810371 PONSTEL FORTE Mefenamic acid 500MG TAB

810398 PONSTEL S Mefenamic acid 50MG/5ML SUS

799432 PYROCAPS Piroxicam 20MG CAP Accepted treatment

824852 RANFEN Ibuprofen 200MG TAB Accepted treatment

701654 RANFEN 400 Ibuprofen 400MG TAB Accepted treatment

759600 RELIFEN 500 Nabumetone 500MG TAB

797456 RELISAN Nabumetone 500MG TAB

49 11/5/2013

Comprehensive Formulary

793027 RELITONE Nabumetone 500MG TAB

821144 RHEUGESIC Piroxicam 20MG DSP Accepted treatment

719811 ROLAB-DICLOFENAC SODIUM Diclofenac 25MG TAB Accepted treatment

719838 ROLAB-DICLOFENAC SODIUM Diclofenac 50MG TAB Accepted treatment

834327 ROLAB-DICLOFENAC SR Diclofenac 100MG TAB Accepted treatment

703966 ROLAB-IBUPROFEN Ibuprofen 200MG TAB Accepted treatment

703974 ROLAB-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment

782807 ROLAB-IBUPROFEN Ibuprofen 600MG TAB

704776 ROLAB-INDOMETHACIN Indometacin 25MG CAP Accepted treatment

741167 ROLAB-MEFENAMIC ACID Mefenamic acid 250MG CAP

781207 ROLAB-NAPROXEN Naproxen 250MG TAB Accepted treatment

840335 ROLAB-NAPROXEN Naproxen 500MG TAB Accepted treatment

812102 ROLAB-PIROXICAM DISP Piroxicam 20MG DSP Accepted treatment

701072 ROXIFEN Piroxicam 20MG CAP Accepted treatment

704589 SANDOZ MELOXICAM  Meloxicam 15MG  TAB  Accepted treatment

704588 SANDOZ MELOXICAM  Meloxicam 7.5MG  TAB  Accepted treatment

787272 VELTEX CR Diclofenac 100MG SRC Accepted treatment

793663 VELTEX CR Diclofenac 75MG SRC Accepted treatment

718724 VIMOVO 500/20MG naproxen and esomeprazole TAB

718854 VOLTAREN ACTI-GO SOFT GEL CAPSULES Diclofenac 25MG CAP Accepted treatment

778206 VOLTAREN Diclofenac 25MG TAB Accepted treatment

789240 VOLTAREN 75 Diclofenac 75MG TAB Accepted treatment

835218 VOLTAREN DROPS Diclofenac 15MG/1ML DRP

778222 VOLTAREN GT Diclofenac 50MG TAB Accepted treatment

778230 VOLTAREN SR Diclofenac 100MG TAB Accepted treatment

860654 XEFO Lornoxicam 4MG TAB

860662 XEFO Lornoxicam 8MG TAB

717776 XEFO RAPID Lornoxicam 8MG TAB

797030 XYCAM Piroxicam 20MG CAP Accepted treatment

797049 XYCAM DISPERS Piroxicam 20MG DSP Accepted treatment

705230 ZYDUS-MELOXICAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705229 ZYDUS-MELOXICAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

Oral Corticosteroids

716381 ADCO PREDNISOLONE Prednisolone 15MG/5ML LIQ Accepted treatment

714552 ASPELONE Prednisolone 15MG/5ML LIQ Accepted treatment

814407 CAPSOID Prednisolone 5MG TAB Accepted treatment

800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment

742759 METICORTEN Prednisone 50MG TAB

742732 METICORTEN Prednisone 5MG TAB

752304 PANAFCORT Prednisone 5MG TAB Accepted treatment

788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Accepted treatment

700170 PREFLAM Prednisolone 15MG/5ML SYR Accepted treatment

703720 PRELONE Prednisolone 5MG TAB

805149 PRELONE Prednisolone 15MG/5ML SYR Accepted treatment

703603 PULMISON ORAL SOLUTION Prednisone 5MG/1ML SYR Accepted treatment

836826 PULMISON TABS Prednisone 20MG TAB

818267 TROLIC Prednisone 5MG TAB Accepted treatment

Antipsychotic agents

712192 ABILIFY 5MG Aripiprazole 5MG  TAB

705634 ABILIFY 10MG  Aripiprazole 10MG  TAB 

705635 ABILIFY 15MG  Aripiprazole 15MG  TAB 

705636 ABILIFY 30MG  Aripiprazole 30MG  TAB 

717082 ASPEN CLOZAPINE Clozapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717081 ASPEN CLOZAPINE Clozapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

711471

ASPEN RISPERIDONE  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711472

ASPEN RISPERIDONE  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711473

ASPEN RISPERIDONE  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

Schizophrenia

50 11/5/2013

Comprehensive Formulary

711474

ASPEN RISPERIDONE  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711475

ASPEN RISPERIDONE  Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

716500 AUROPERDAL Risperidone .5MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716501 AUROPERDAL Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716502 AUROPERDAL Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716503 AUROPERDAL Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716504 AUROPERDAL Risperidone 4MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714686 AUROPIDONE Risperidone 0.5MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714687 AUROPIDONE Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714688 AUROPIDONE Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714689 AUROPIDONE Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714690 AUROPIDONE Risperidone 4MG TAB

Accepted treatment (clinical motivation

for low-cost options)

705386 BIO-SULPIRIDE  Sulpiride 200MG TAB Accepted treatment

700178

CLOMENT Clozapine 100MG TAB Accepted treatment (clinical motivation

for low-cost options)

700176

CLOMENT Clozapine 25MG TAB Accepted treatment (clinical motivation

for low-cost options)

789798 CLOPIXOL Zuclopenthixol 10MG TAB

796751 CLOPIXOL Zuclopenthixol 2MG TAB

714852 CLOPIXOL DEPOT Zuclopenthixol 200MG/1ML INJS Accepted treatment

705845

CLOZAPINE-HEXAL  Clozapine 100MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

705844

CLOZAPINE-HEXAL  Clozapine 25MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

716051 DOPAQUEL Quetiapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716052 DOPAQUEL Quetiapine 200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716050 DOPAQUEL Quetiapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716053 DOPAQUEL Quetiapine 300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

712212 DRL RISPERIDONE  Risperidone 0.5MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

712211 DRL RISPERIDONE  Risperidone 1MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

712210 DRL RISPERIDONE  Risperidone 2MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

712209 DRL RISPERIDONE  Risperidone 3MG  TAB 

Accepted treatment (clinical motivation

for low-cost options)

726656 FLUANXOL Flupentixol .5MG TAB

726664 FLUANXOL Flupentixol 1MG TAB

726672 FLUANXOL DEPOT 1ML Flupentixol 20MG/1ML INJS Accepted treatment

703465 GEODON  Ziprasidone 20MG  CAP 

703468 GEODON  Ziprasidone 40MG  CAP 

703475 GEODON  Ziprasidone 60MG  CAP 

703476 GEODON  Ziprasidone 80MG  CAP 

715666 INVEGA Paliperidone 3MG SRT

715667 INVEGA Paliperidone 6MG SRT

715668 INVEGA Paliperidone 9MG SRT

735884 LARGACTIL Chlorpromazine 100MG TAB Accepted treatment

735868 LARGACTIL Chlorpromazine 25MG TAB Accepted treatment

735876 LARGACTIL Chlorpromazine 50MG TAB Accepted treatment

51 11/5/2013

Comprehensive Formulary

736716

LEPONEX Clozapine 100MG TAB Accepted treatment (clinical motivation

for low-cost options)

736708

LEPONEX Clozapine 25MG TAB Accepted treatment (clinical motivation

for low-cost options)

712191

MYLAN RISPERIDONE Risperidone

0.5MG 

TAB Accepted treatment (clinical motivation

for low-cost options)

712190

MYLAN RISPERIDONE Risperidone

1MG 

TAB Accepted treatment (clinical motivation

for low-cost options)

712189

MYLAN RISPERIDONE Risperidone

2MG 

TAB Accepted treatment (clinical motivation

for low-cost options)

716670 MYLAN QUETIAPINE Quetiapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716671 MYLAN QUETIAPINE Quetiapine 200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716668 MYLAN QUETIAPINE Quetiapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716672 MYLAN QUETIAPINE Quetiapine 300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

744301 MODECATE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment

744328 MODECATE+SYRINGE 1ML Fluphenazine 25MG/1ML INJS Accepted treatment

715996 OLEANZ Olanzapine 10MG TAB

715994 OLEANZ Olanzapine 2.5MG TAB

715995 OLEANZ Olanzapine 5MG TAB

715968 OLEANZ RAPITAB Olanzapine 10MG MLT

715967 OLEANZ RAPITAB Olanzapine 5MG MLT

715659 OLEXAR Olanzapine 10MG TAB

715657 OLEXAR Olanzapine 2.5MG TAB

715658 OLEXAR Olanzapine 5MG TAB

751073 ORAP Pimozide 1MG TAB

751081 ORAP Pimozide 4MG TAB

712617

PERIZAL Risperidone 0.5MG TAB Accepted treatment (clinical motivation

for low-cost options)

712618

PERIZAL Risperidone 1MG TAB Accepted treatment (clinical motivation

for low-cost options)

712619

PERIZAL Risperidone 2MG TAB Accepted treatment (clinical motivation

for low-cost options)

712621

PERIZAL Risperidone 3MG TAB Accepted treatment (clinical motivation

for low-cost options)

718353 PSYQUET Quetiapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718354 PSYQUET Quetiapine 200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718352 PSYQUET Quetiapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718355 PSYQUET Quetiapine 300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

715685 REDILANZ Olanzapine 10MG TAB

715683 REDILANZ Olanzapine 2.5MG TAB

715684 REDILANZ Olanzapine 5MG TAB

717996 RISNIA Risperidone .5MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717997 RISNIA Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717998 RISNIA Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

717999 RISNIA Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

714101 RISPACOR

Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

713967 RISPACOR

Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

713966 RISPACOR

Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

713965 RISPACOR

Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

52 11/5/2013

Comprehensive Formulary

713964 RISPACOR

Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

891523

RISPERDAL Risperidone 0.5MG TAB Accepted treatment (clinical motivation

for low-cost options)

828432

RISPERDAL Risperidone 1MG TAB Accepted treatment (clinical motivation

for low-cost options)

801860

RISPERDAL Risperidone 2MG TAB Accepted treatment (clinical motivation

for low-cost options)

801879

RISPERDAL Risperidone 3MG TAB Accepted treatment (clinical motivation

for low-cost options)

707993

RISPERDAL QUICKLET  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

707994

RISPERDAL QUICKLET  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

707995

RISPERDAL QUICKLET  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

707997

RISPERDAL QUICKLET  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

707998

RISPERDAL QUICKLET  Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

705474 RISPERDAL CONSTA  Risperidone 25MG  VIAL  Specialist motivation

705475 RISPERDAL CONSTA  Risperidone 37.5MG  VIAL  Specialist motivation

705476 RISPERDAL CONSTA  Risperidone 50MG  VIAL  Specialist motivation

710790

RISPERIDONE HEXAL  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

710791

RISPERIDONE HEXAL  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

710793

RISPERIDONE HEXAL  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711419

RISPERLET  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711420

RISPERLET  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711421

RISPERLET  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

718226 RISPEVON Risperidone 1MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718227 RISPEVON Risperidone 2MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718228 RISPEVON Risperidone 3MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718229 RISPEVON Risperidone 4MG TAB

Accepted treatment (clinical motivation

for low-cost options)

711537

RISPONZ  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711534

RISPONZ  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711536

RISPONZ  Risperidone 3MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711538

RISPONZ  Risperidone 4MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

730335 ROLAB-HALOPERIDOL Haloperidol 1.5MG TAB Accepted treatment

730327 ROLAB-HALOPERIDOL Haloperidol 5MG TAB Accepted treatment

715736 SCHIZOROL Risperidone 0.5MG TAB Accepted treatment (clinical motivation

for low-cost options)715737 SCHIZOROL Risperidone 1MG TAB Accepted treatment (clinical motivation

for low-cost options)715738 SCHIZOROL Risperidone 2MG TAB Accepted treatment (clinical motivation

for low-cost options)763411 SERENACE Haloperidol 0.5MG CAP Accepted treatment

763446 SERENACE Haloperidol 1.5MG TAB Accepted treatment

763535 SERENACE Haloperidol 10MG TAB Accepted treatment

763454 SERENACE Haloperidol 5MG TAB Accepted treatment

716652 SEREZ

Quetiapine

100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716653 SEREZ

Quetiapine

200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

53 11/5/2013

Comprehensive Formulary

716651 SEREZ

Quetiapine

25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

716654 SEREZ

Quetiapine

300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

850535

SEROQUEL Quetiapine 100MG TAB Accepted treatment (clinical motivation

for low-cost options)

850543

SEROQUEL Quetiapine 200MG TAB Accepted treatment (clinical motivation

for low-cost options)

850527

SEROQUEL Quetiapine 25MG TAB Accepted treatment (clinical motivation

for low-cost options)

703344

SEROQUEL Quetiapine 300MG TAB Accepted treatment (clinical motivation

for low-cost options)

713747 SEROQUEL XR Quetiapine 50MG SRT

717404 SEROQUEL XR Quetiapine 150MG SRT

713748 SEROQUEL XR Quetiapine 200MG SRT

713749 SEROQUEL XR Quetiapine 300MG SRT

713750 SEROQUEL XR Quetiapine 400MG SRT

718704 SIZONORM Quetiapine 100MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718705 SIZONORM Quetiapine 200MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718674 SIZONORM Quetiapine 25MG TAB

Accepted treatment (clinical motivation

for low-cost options)

718706 SIZONORM Quetiapine 300MG TAB

Accepted treatment (clinical motivation

for low-cost options)

892310 SOLIAN Amisulpride 200MG TAB

892309 SOLIAN Amisulpride 50MG TAB

766410 STELAZINE Trifluoperazine 1MG TAB Accepted treatment

766437 STELAZINE Trifluoperazine 5MG TAB Accepted treatment

718469 XEPLION PREFILLED SYRINGE 0.5ML Paliperidone 50MG/.5ML INJ Specialist motivation

718470 XEPLION PREFILLED SYRINGE 0.75ML Paliperidone 75MG/.75ML INJ Specialist motivation

718472 XEPLION PREFILLED SYRINGE 1.5ML Paliperidone 150MG/1.5ML INJ Specialist motivation

718471 XEPLION PREFILLED SYRINGE 1ML Paliperidone 100MG/1ML INJ Specialist motivation

711511

ZOXADON  Risperidone 0.5MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711512

ZOXADON  Risperidone 1MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

711513

ZOXADON  Risperidone 2MG  TAB  Accepted treatment (clinical motivation

for low-cost options)

827517 ZYPREXA Olanzapine 10MG TAB

864188 ZYPREXA Olanzapine 2.5MG TAB

827509 ZYPREXA Olanzapine 5MG TAB

707939 ZYPREXA VELOTAB  Olanzapine 10MG  TAB 

707938 ZYPREXA VELOTAB  Olanzapine 5MG  TAB 

Antidepressants

724661 ETHIPRAMINE Imipramine 10MG TAB Accepted treatment

724688 ETHIPRAMINE Imipramine 25MG TAB Accepted treatment

718746 GULF AMITRIPTYLINE Amitriptyline 25MG TAB Accepted treatment

757888 PROTHIADEN Dothiepin 25MG CAP Accepted treatment

757896 PROTHIADEN Dothiepin 75MG TAB Accepted treatment

784230 ROLAB-AMITRIPTYLINE HCL Amitriptyline 25MG TAB Accepted treatment

820660 ROLAB-DOTHIEPIN Dothiepin 25MG CAP Accepted treatment

816515 ROLAB-DOTHIEPIN Dothiepin 75MG TAB Accepted treatment

800198 THADEN Dothiepin 25MG CAP Accepted treatment

800201 THADEN Dothiepin 75MG TAB Accepted treatment

771120 TOFRANIL Imipramine 10MG TAB Accepted treatment

771139 TOFRANIL Imipramine 25MG TAB Accepted treatment

772003 TREPILINE Amitriptyline 10MG TAB Accepted treatment

771996 TREPILINE Amitriptyline 25MG TAB Accepted treatment

772860 TRYPTANOL Amitriptyline 25MG TAB Accepted treatment

Mood Stabilisers

709540 ARROW LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

709541 ARROW LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

709539 ARROW LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

709537 ARROW LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

54 11/5/2013

Comprehensive Formulary

705441 ASPEN LAMOTRIGINE 100MG  Lamotrigine 100MG  TAB  Accepted treatment

705442 ASPEN LAMOTRIGINE 200MG  Lamotrigine 200MG  TAB  Accepted treatment

705436 ASPEN LAMOTRIGINE 25MG  Lamotrigine 25MG  TAB  Accepted treatment

705440 ASPEN LAMOTRIGINE 50MG  Lamotrigine 50MG  TAB  Accepted treatment

707789 AUSTELL-LAMOTRIGINE Lamotrigine 100MG  TAB  Accepted treatment

707790 AUSTELL-LAMOTRIGINE Lamotrigine 200MG  TAB  Accepted treatment

707787 AUSTELL-LAMOTRIGINE Lamotrigine 25MG  TAB  Accepted treatment

707788 AUSTELL-LAMOTRIGINE Lamotrigine 50MG  TAB  Accepted treatment

715980 CONVULEX Valproic acid 150MG CAP Accepted treatment

715999 CONVULEX Valproic acid 300MG CAP Accepted treatment

781568 CONVULEX Valproic acid 500MG CAP Accepted treatment

712493 DEGRANOL Carbamazepine 200MG TAB Accepted treatment

710389 DYNA-LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

710390 DYNA-LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

710387 DYNA-LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

710388 DYNA-LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

818666 EPILIM CR Valproic acid 200MG SRT Accepted treatment

818674 EPILIM CR Valproic acid 300MG SRT Accepted treatment

818682 EPILIM CR Valproic acid 500MG SRT Accepted treatment

821578 EPILIM CRUSHABLE Valproic acid 100MG TAB Accepted treatment

718274 EPILIZINE CR Valproic acid 200MG SRT Accepted treatment

718275 EPILIZINE CR Valproic acid 300MG SRT Accepted treatment

718276 EPILIZINE CR Valproic acid 500MG SRT Accepted treatment

704381 EPITEC 100MG  Lamotrigine 100MG TAB Accepted treatment

704382 EPITEC 200MG  Lamotrigine 200MG TAB Accepted treatment

704379 EPITEC 25MG  Lamotrigine 25MG TAB Accepted treatment

704380 EPITEC 50MG  Lamotrigine 50MG TAB Accepted treatment

707361 LAMEPTIL  Lamotrigine 100MG  TAB  Accepted treatment

707362 LAMEPTIL  Lamotrigine 200MG  TAB  Accepted treatment

707359 LAMEPTIL  Lamotrigine 25MG  TAB  Accepted treatment

707360 LAMEPTIL  Lamotrigine 50MG  TAB  Accepted treatment

805521 LAMICTIN Lamotrigine 100MG TAB Accepted treatment

819034 LAMICTIN Lamotrigine 200MG TAB Accepted treatment

805505 LAMICTIN Lamotrigine 25MG TAB Accepted treatment

805513 LAMICTIN Lamotrigine 50MG TAB Accepted treatment

813907 LAMICTIN P100 Lamotrigine 100MG DSP Accepted treatment

704533 LAMICTIN P2  Lamotrigine 2MG  DSP  Accepted treatment

891716 LAMICTIN P200 Lamotrigine 200MG DSP Accepted treatment

813893 LAMICTIN P25 Lamotrigine 25MG DSP Accepted treatment

813885 LAMICTIN P5 Lamotrigine 5MG DSP Accepted treatment

891708 LAMICTIN P50 Lamotrigine 50MG DSP Accepted treatment

710887 LAMIDUS  Lamotrigine 100MG  TAB  Accepted treatment

710888 LAMIDUS  Lamotrigine 200MG  TAB  Accepted treatment

710885 LAMIDUS  Lamotrigine 50MG  TAB  Accepted treatment

704488 LAMITOR Lamotrigine 100MG TAB Accepted treatment

704486 LAMITOR Lamotrigine 25MG TAB Accepted treatment

704487 LAMITOR Lamotrigine 50MG TAB Accepted treatment

712217 LAMITOR  Lamotrigine 200MG  TAB  Accepted treatment

718465 NAVALPRO CR Valproic acid 200MG SRT Accepted treatment

718466 NAVALPRO CR Valproic acid 300MG SRT Accepted treatment

718468 NAVALPRO CR Valproic acid 500MG SRT Accepted treatment

712523 ROLAB-CARBAMAZEPINE Carbamazepine 200MG TAB Accepted treatment

705597 SANDOZ CARBAMAZEPINE CR200  Carbamazepine 200MG  SRT  Accepted treatment

705602 SANDOZ CARBAMAZIPINE CR400  Carbamazepine 400MG  SRT  Accepted treatment

705248 SANDOZ LAMOTRIGINE  Lamotrigine 100MG  TAB  Accepted treatment

705249 SANDOZ LAMOTRIGINE  Lamotrigine 200MG  TAB  Accepted treatment

705251 SANDOZ LAMOTRIGINE  Lamotrigine 25MG  TAB  Accepted treatment

705250 SANDOZ LAMOTRIGINE  Lamotrigine 50MG  TAB  Accepted treatment

769398 TEGRETOL Carbamazepine 200MG TAB

779652 TEGRETOL CR Carbamazepine 200MG SRT

779660 TEGRETOL CR Carbamazepine 400MG SRT

715962 ZEPTOL Carbamazepine 200MG TAB Accepted treatment

Non-steroidal anti-inflammatories

786594 ADCO-DICLOFENAC Diclofenac 25MG TAB Accepted treatment

Systemic Lupus Erythematosus

55 11/5/2013

Comprehensive Formulary

788597 ADCO-DICLOFENAC Diclofenac 50MG TAB Accepted treatment

780596 ADCO-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment

701106 ADCO-INDOMETHACIN Indometacin 25MG CAP Accepted treatment

883102 ADCO-MEFENAMIC ACID Mefenamic acid 250MG CAP

705376 ADCO-MELOXICAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705375 ADCO-MELOXICAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

785245 ADCO-NAPROXEN Naproxen 250MG TAB Accepted treatment

785261 ADCO-PIROXICAM Piroxicam 20MG CAP Accepted treatment

892302 ADVIL LIQUI GEL Ibuprofen 200MG CAP Accepted treatment

716004 ADVIL LIQUI GEL Ibuprofen 400MG CAP Accepted treatment

893390 A-LENNON DICLOFENAC Diclofenac 25MG TAB Accepted treatment

893391 A-LENNON DICLOFENAC Diclofenac 50MG TAB Accepted treatment

701891 AMDOCIN Indometacin CAP Accepted treatment

707668 APEX-MELOXICAM Meloxicam 15MG TAB Accepted treatment

707667 APEX-MELOXICAM Meloxicam 7.5MG TAB Accepted treatment

711325 ARROW MELOXICAM  Meloxicam 15MG  TAB  Accepted treatment

711324 ARROW MELOXICAM  Meloxicam 7.5MG  TAB  Accepted treatment

704725 ARTHREXIN Indometacin 25MG APP Accepted treatment

704741 ARTHREXIN Indometacin 100MG SUP Accepted treatment

707374 ARTHROCOX  Meloxicam 15MG  TAB  Accepted treatment

707373 ARTHROCOX  Meloxicam 7.5MG  TAB  Accepted treatment

813044 ARTHROTEC Diclofenac, combinations 50MG/200MCG ECT

869805 ARTHROTEC Diclofenac, combinations 75MG/200mcg ECT

799459 BE-TABS NAPROXEN Naproxen 250MG TAB Accepted treatment

787833 BETACIN Indometacin 25MG CAP Accepted treatment

708186 BETAGESIC Ibuprofen 200MG TAB Accepted treatment

787426 BETAPROFEN Ibuprofen 200MG TAB Accepted treatment

701975 BETAPROFEN 400 FC  Ibuprofen 400MG TAB Accepted treatment

715831 BIO-NAPROXEN Naproxen 250MG TAB

708290 BREN  Ibuprofen 400MG  TAB  Accepted treatment

800724 BREXECAM Piroxicam 20MG TAB Accepted treatment

710822 BRUFEN Ibuprofen 200MG TAB Accepted treatment

710830 BRUFEN Ibuprofen 400MG TAB Accepted treatment

710849 BRUFEN Ibuprofen 600MG TAB

899070 COXFLAM Meloxicam 15MG TAB Accepted treatment

899066 COXFLAM Meloxicam 7.5MG TAB Accepted treatment

841153 DICLOHEXAL Diclofenac 50MG TAB Accepted treatment

853240 DICLOHEXAL 25T Diclofenac 25MG TAB Accepted treatment

718479 DICLOFENAC BIOTECH Diclofenac 25MG TAB Accepted treatment

718480 DICLOFENAC SR BIOTECH Diclofenac 100MG SRT Accepted treatment

706314 DIFEN SR  Diclofenac 100MG  TAB  Accepted treatment

798185 DYNOFEN Ibuprofen 200mg TAB Accepted treatment

807729 FAMETHACIN Indometacin 25MG CAP Accepted treatment

797707 FENAMIN Mefenamic acid 250MG CAP

797715 FENAMIN Mefenamic acid 500MG TAB

797014 FENAMIN Mefenamic acid 50MG/5ML SUS

813478 FLAMARET Indometacin 25MG CAP Accepted treatment

717092 FLAMARYX Meloxicam 15MG  TAB  Accepted treatment

717091 FLAMARYX Meloxicam 7.5MG  TAB  Accepted treatment

726389 FLAMECID Indometacin 25MG CAP Accepted treatment

704828 FLEXOCAM  Meloxicam 15MG  TAB  Accepted treatment

704829 FLEXOCAM  Meloxicam 7.5MG  TAB  Accepted treatment

791547 FORTFEN SR Diclofenac 100MG SRC Accepted treatment

718305 GLENMARK MELOXICAM Meloxicam 15MG TAB Accepted treatment

718306 GLENMARK MELOXICAM Meloxicam 7.5MG TAB Accepted treatment

868213 GULF INDOMETHACIN Indometacin 25MG CAP Accepted treatment

895196 IBOFLAM Ibuprofen 200MG TAB Accepted treatment

705940 IBU Ibuprofen 200MG TAB Accepted treatment

704781 IBUGESIC  Ibuprofen 100MG/5ML  SUS  Accepted treatment

700316 IBUMAX Ibuprofen 200MG TAB Accepted treatment

700318 IBUMAX Ibuprofen 400MG TAB Accepted treatment

700315 IBUMAX PAEDIATRIC Ibuprofen 100MG/5ML SUS Accepted treatment

809268 IBUMED Ibuprofen 200MG CAP Accepted treatment

868221 IBUNATE Ibuprofen 200MG TAB Accepted treatment

733741 INZA Ibuprofen 200MG TAB Accepted treatment

733768 INZA Ibuprofen 400MG TAB Accepted treatment

56 11/5/2013

Comprehensive Formulary

822205 KETOFLAM SR Ketoprofen 200MG SRC Accepted treatment

868469 LENAFEN Ibuprofen 200MG TAB Accepted treatment

701522 LOXIFLAM 15 Meloxicam 15MG TAB Accepted treatment

701520 LOXIFLAM 7.5 Meloxicam 7.5MG TAB Accepted treatment

705177 M-CAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705176 M-CAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

788996 MEDIFLEX Indometacin 25MG CAP Accepted treatment

718382 MEDOXICAM Meloxicam 15MG TAB Accepted treatment

718381 MEDOXICAM Meloxicam 7.5MG TAB Accepted treatment

705297 MELFLAM 15  Meloxicam 15MG  TAB  Accepted treatment

705296 MELFLAM 7.5  Meloxicam 7.5MG  TAB  Accepted treatment

716169 MELOXICAM UNICORN Meloxicam 15MG TAB Accepted treatment

716168 MELOXICAM UNICORN Meloxicam 7.5MG TAB Accepted treatment

786012 MYLAN DICLOFENAC (ARCANAFENAC) Diclofenac 25MG TAB Accepted treatment

786020 MYLAN DICLOFENAC SOD (ARCANAFENAC) Diclofenac 50MG TAB Accepted treatment

810185 MYLAN NAPROXEN (ARCANA-NAPROXEN) Naproxen 250MG TAB Accepted treatment

814393 METHOCAPS Indometacin 25MG CAP Accepted treatment

818615 MOBIC Meloxicam 7.5MG TAB Accepted treatment

842052 MOBIC 15MG Meloxicam 15MG TAB Accepted treatment

815934 MYPROFLAM SRC Ketoprofen 200MG SRC Accepted treatment

812625 NAFASOL EC-250 Naproxen 250MG ECT

812633 NAFASOL EC-500 Naproxen 500MG ECT

806447 NAPFLAM Naproxen 250MG TAB Accepted treatment

808474 NAPFLAM Naproxen 500MG TAB Accepted treatment

805238 NAPROSCRIPT Naproxen 250MG TAB Accepted treatment

805246 NAPROSCRIPT Naproxen 500MG TAB Accepted treatment

789410 NISAID 25 Indometacin 25MG CAP Accepted treatment

863394 NORFLAM-T Ibuprofen 200MG TAB Accepted treatment

748560 NUROFEN Ibuprofen 200MG TAB Accepted treatment

711948 NUROFEN (CAPLETS)  Ibuprofen 200MG  CAP  Accepted treatment

897984 NUROFEN EXTRA STRENGTH Ibuprofen 400MG TAB Accepted treatment

751472 ORUVAIL 200 Ketoprofen 200MG SRC Accepted treatment

897060 PAINIL Ibuprofen 200MG TAB Accepted treatment

752398 PANAMOR AT-50 Diclofenac 50MG TAB Accepted treatment

827592 PANAMOR SR Diclofenac 100MG TAB Accepted treatment

827584 PANAMOR SR Diclofenac 75MG TAB Accepted treatment

752371 PANAMOR-25 Diclofenac 25MG TAB Accepted treatment

716517 PIROXICAM ACTOR DT Piroxicam 20MG DSP Accepted treatment

827428 PIXICAM Piroxicam 20MG DSP Accepted treatment

796433 PONAC Mefenamic acid 250MG CAP

756148 PONSTAN Mefenamic acid 250MG CAP

756164 PONSTAN FORTE Mefenamic acid 500MG TAB

812250 PONSTEL 250 Mefenamic acid 250MG CAP

810371 PONSTEL FORTE Mefenamic acid 500MG TAB

799432 PYROCAPS Piroxicam 20MG CAP Accepted treatment

824852 RANFEN Ibuprofen 200MG TAB Accepted treatment

701654 RANFEN 400 Ibuprofen 400MG TAB Accepted treatment

759600 RELIFEN 500 Nabumetone 500MG TAB

797456 RELISAN Nabumetone 500MG TAB

793027 RELITONE Nabumetone 500MG TAB

821144 RHEUGESIC Piroxicam 20MG DSP Accepted treatment

719811 ROLAB-DICLOFENAC SODIUM Diclofenac 25MG TAB Accepted treatment

719838 ROLAB-DICLOFENAC SODIUM Diclofenac 50MG TAB Accepted treatment

834327 ROLAB-DICLOFENAC SR Diclofenac 100MG TAB Accepted treatment

703966 ROLAB-IBUPROFEN Ibuprofen 200MG TAB Accepted treatment

703974 ROLAB-IBUPROFEN Ibuprofen 400MG TAB Accepted treatment

782807 ROLAB-IBUPROFEN Ibuprofen 600MG TAB

704776 ROLAB-INDOMETHACIN Indometacin 25MG CAP Accepted treatment

741167 ROLAB-MEFENAMIC ACID Mefenamic acid 250MG CAP

781207 ROLAB-NAPROXEN Naproxen 250MG TAB Accepted treatment

840335 ROLAB-NAPROXEN Naproxen 500MG TAB Accepted treatment

812102 ROLAB-PIROXICAM DISP Piroxicam 20MG DSP Accepted treatment

701072 ROXIFEN Piroxicam 20MG CAP Accepted treatment

704589 SANDOZ MELOXICAM  Meloxicam 15MG  TAB  Accepted treatment

704588 SANDOZ MELOXICAM  Meloxicam 7.5MG  TAB  Accepted treatment

787272 VELTEX CR Diclofenac 100MG SRC Accepted treatment

57 11/5/2013

Comprehensive Formulary

793663 VELTEX CR Diclofenac 75MG SRC Accepted treatment

718724 VIMOVO 500/20MG naproxen and esomeprazole TAB

718854 VOLTAREN ACTI-GO SOFT GEL CAPSULES Diclofenac 25MG CAP Accepted treatment

778206 VOLTAREN Diclofenac 25MG TAB Accepted treatment

789240 VOLTAREN 75 Diclofenac 75MG TAB Accepted treatment

778222 VOLTAREN GT Diclofenac 50MG TAB Accepted treatment

778230 VOLTAREN SR Diclofenac 100MG TAB Accepted treatment

860654 XEFO Lornoxicam 4MG TAB

860662 XEFO Lornoxicam 8MG TAB

717776 XEFO RAPID Lornoxicam 8MG TAB

797030 XYCAM Piroxicam 20MG CAP Accepted treatment

797049 XYCAM DISPERS Piroxicam 20MG DSP Accepted treatment

705230 ZYDUS-MELOXICAM 15MG  Meloxicam 15MG  TAB  Accepted treatment

705229 ZYDUS-MELOXICAM 7.5MG  Meloxicam 7.5MG  TAB  Accepted treatment

Oral Corticosteroids

814407 CAPSOID Prednisolone 5MG TAB Accepted treatment

800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment

742759 METICORTEN Prednisone 50MG TAB

742732 METICORTEN Prednisone 5MG TAB

752304 PANAFCORT Prednisone 5MG TAB Accepted treatment

788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Accepted treatment

703720 PRELONE Prednisolone 5MG TAB

836826 PULMISON TABS Prednisone 20MG TAB

818267 TROLIC Prednisone 5MG TAB Accepted treatment

Anticoagulants

798533 ASPIRIN (WHITE) Acetylsalicylic acid 300MG TAB Accepted treatment

704645 ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

706930 BAYER ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

862304 BAYER ASPIRIN CARDIO Acetylsalicylic acid 100MG TAB Accepted treatment

715719 COMPRAL Acetylsalicylic acid 81MG TAB Accepted treatment

714995 COPRIN 81 Acetylsalicylic acid 81MG ECT Accepted treatment

847283 DISPRIN CV Acetylsalicylic acid 100MG EEF Accepted treatment

807206 DISPRIN CV Acetylsalicylic acid 300MG EEF  Accepted treatment

720577 DISPRIN REGULAR Acetylsalicylic acid 300MG EEF Accepted treatment

823481 ECOTRIN Acetylsalicylic acid 81MG ECT Accepted treatment

808261 GENPHARM CHILDREN ASPIRIN (ASPIRIN JUNIO Acetylsalicylic acid 60MG TAB Accepted treatment

700909 GULF ASPIRIN Acetylsalicylic acid 300MG TAB Accepted treatment

841447 JUNIOR ASPIRIN (slt) Acetylsalicylic acid 97MG TAB Accepted treatment

815160 LO-ASPIRIN (CAPRIN) Acetylsalicylic acid 125MG TAB Accepted treatment

845590 MYOPRIN Acetylsalicylic acid 100MG  EEF Accepted treatment

712608 PCH ACETYLSALICYLIC ACID CARDIO Acetylsalicylic acid 80MG DSP Accepted treatment

Disease modifying agents

782556 ABITREXATE-20ML Methotrexate 500MG/20ML INJ Accepted treatment

782548 ABITREXATE-2ML Methotrexate 50MG INJ Accepted treatment

712504 EMTHEXATE Methotrexate 2.5MG TAB Accepted treatment

825565 EMTHEXATE RTU 50-2 2ML Methotrexate 25MG/1ML INJ Accepted treatment

825557 EMTHEXATE RTU 500-20 20ML Methotrexate 25MG/1ML INJ Accepted treatment

711328 METACHOR VIAL 2ML  Methotrexate 25MG/1ML  INJ  Accepted treatment

840815 METHOTREXATE CSV 2ML (P&U) Methotrexate 50MG/2ML INJ Accepted treatment

840807 METHOTREXATE CSV 20ML (P&U) Methotrexate 500MG/20ML INJ Accepted treatment

742465 METHOTREXATE Methotrexate 2.5MG TAB Accepted treatment

Immunosuppressants

701252 AZAMUN Azathioprine 50MG TAB Accepted treatment

706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment

712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment

732524 IMURAN Azathioprine 50MG TAB

700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Alkylating agents

723274 ENDOXAN Cyclosphosphamide 50MG TAB Specialist Motivation

Aminosalicylic acid preparations

783668 ASACOL Mesalazine 400MG TAB

709076 ASACOL  Mesalazine 800MG  TAB 

Ulcerative colitis

58 11/5/2013

Comprehensive Formulary

792519 DIPENTUM Olsalazine 250MG CAP

707496 MESASAL Mesalazine 500MG  TAB 

890775 PENTASA Mesalazine 500MG TAB

762008 SALAZOPYRIN Sulfasalazine 500MG TAB Accepted treatment

762016 SALAZOPYRIN E.N. Sulfasalazine 500MG ECT Accepted treatment

716333 SALOFALK Mesalazine 1000MG SAC

716331 SALOFALK Mesalazine 500MG SAC

Immunosuppressants

701252 AZAMUN Azathioprine 50MG TAB Accepted treatment

706108 AZAPRESS Azathioprine 50MG TAB Accepted treatment

712609 AZATHIOPRINE PCH Azathioprine 50MG TAB Accepted treatment

732524 IMURAN Azathioprine 50MG TAB

700777 ZAPRINE 50MG Azathioprine 50MG TAB Accepted treatment

Steroid preparations (oral)

814407 CAPSOID Prednisolone 5MG TAB Accepted treatment

716693 COVOCORT Hydrocortisone 10MG TAB

800155 LENISOLONE Prednisolone 5MG TAB Accepted treatment

741124 MEDROL Methylprednisone 16MG TAB

741116 MEDROL Methylprednisone 4MG TAB

742759 METICORTEN Prednisone 50MG TAB

742732 METICORTEN Prednisone 5MG TAB

752304 PANAFCORT Prednisone 5MG TAB Accepted treatment

788783 PREDNISONE (BE-TABS) Prednisone 5MG TAB Accepted treatment

703720 PRELONE Prednisolone 5MG TAB

836826 PULMISON TABS Prednisone 20MG TAB

818267 TROLIC Prednisone 5MG TAB Accepted treatment

Steroid preparations (enemas)

824593 ENTOCORD ENEMAS Budesonide 2.3MG ENE Accepted treatment

59 11/5/2013