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VA Anthem Common Core Formulary
Medicaid-Approved
Preferred Drug List
Effective January 1, 2019
Legend
In each class, drugs are listed alphabetically by either brand name or generic name.
Brand name drug: Uppercase in bold type
Generic drug: Lowercase in plain type
AL: Age Limit Restrictions
DO: Dose Optimization Program
GR: Gender Restriction
OTC: Over the counter medication available with a prescription. (Prescribers please indicate OTC on the prescription)
PA: Prior authorization is required. Prior authorization is the process of obtaining approval of benefits before certain prescriptions are filled.
QL: Quantity limits; certain prescription medications have specific quantity limits per prescription or per month.
SP: Specialty Pharmacy
ST: Step therapy is required. You may need to use one medication before benefits for the use of another medication can be authorized.
Drug Name Reference Notes
ALTERNATIVE THERAPY
ALTERNATIVE THERAPY
e-400 c-500 and beta carotene oral tablet OTC
glucosamine su 2kcl-chondroit oral tabletGlucosamine-Chondroitin DS
OTC
glucosamine-chondroitin complx oral capsule
OTC
kelp-lecithin-b6 oral tablet OTC
lecithin-kelp-b6 (100-8.3) oral tablet OTC
lecithin-kelp-b6 (400-20) oral tablet OTC
lecithin-kelp-b6 oral capsule OTC
super antioxidant oral capsule OTC
ANALGESIC, ANTI-INFLAMMATORY OR ANTIPYRETIC
ANALGESIC/ANTIPYRETICS, SALICYLATES
adult low dose aspirin oral tablet,delayed release (dr/ec)
OTC
antacid and pain relief oral tablet, effervescent
OTC
back and body pain reliever oral tablet OTC
butalbital-aspirin-caffeine oral capsule Fiorinal QL
choline,magnesium salicylate oral liquid
enteric coated aspirin oral tablet,delayed release (dr/ec)
OTC
lo-dose aspirin oral tablet,delayed release (dr/ec)
OTC
salsalate oral tablet Disalcid
ANALGESICS, NARCOTICS
acetaminophen-codeine oral solution 120 mg-12 mg /5 ml (5 ml), 120-12 mg/5 ml, 300 mg-30 mg /12.5 ml
QL
acetaminophen-codeine oral solution 240 mg-24 mg /10 ml (10 ml)
acetaminophen-codeine oral tablet QL
butalbital-acetaminop-caf-cod oral capsule QL
BUTRANS TRANSDERMAL PATCH WEEKLY
PA
endocet oral tablet QL
2
Drug Name Reference Notes
fentanyl transdermal patch 72 hour Duragesic QL
hydrocodone-acetaminophen oral solution Hycet QL
hydrocodone-acetaminophen oral tablet Lorcet (hydrocodone) QL
hydrocodone-ibuprofen oral tablet QL
hydromorphone oral tablet Dilaudid QL
lorcet (hydrocodone) oral tablet QL
lorcet hd oral tablet QL
lorcet plus oral tablet QL
morphine concentrate oral solution QL
morphine oral solution QL
morphine oral tablet QL
morphine oral tablet extended release MS Contin QL
oxycodone oral capsule QL
oxycodone oral solution QL
oxycodone oral tablet Roxicodone QL
oxycodone-acetaminophen oral tablet Endocet QL
tramadol oral tablet Ultram QL
verdrocet oral tablet QL
vicodin es oral tablet QL
vicodin hp oral tablet QL
vicodin oral tablet QL
xylon 10 oral tablet QL
ANALGESICS, NON-NARCOTIC
acetaminophen oral liquid OTC
acetaminophen oral tablet,disintegrating Children's Pain-Fever Relief OTC
BUTALBITAL-ACETAMINOPHEN ORAL CAPSULE
QL
butalbital-acetaminophen oral tablet Tencon QL
butalbital-acetaminophen-caff oral capsule Capacet QL
butalbital-acetaminophen-caff oral tablet Esgic QL
capacet oral capsule QL
children's acetaminophen oral suspension OTC
children's acetaminophen oral syringe OTC
feverall rectal suppository OTC
infant's non-aspirin oral drops OTC
infant's non-aspirin oral drops,suspension OTC
pre-menstrual relief oral tablet OTC
3
Drug Name Reference Notes
premsyn pms oral tablet OTC
tencon oral tablet QL
ANTI-ARTHRITIC, FOLATE ANTAGONIST AGENTS
methotrexate sodium oral tablet
ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR INHIBITOR
ENBREL MINI SUBCUTANEOUS CARTRIDGE
ENBREL SUBCUTANEOUS RECON SOLN
AL
ENBREL SUBCUTANEOUS SYRINGE AL
ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR
AL
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
AL
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
AL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
AL
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
AL
HUMIRA SUBCUTANEOUS SYRINGE KIT
AL
ANTI-INFLAMMATORY, PYRIMIDINE SYNTHESIS INHIBITOR
leflunomide oral tablet Arava
RIDAURA ORAL CAPSULE
DISEASE MODIFYING ANTI-RHEUMATOID DRUGS (DMARD)
DEPEN TITRATABS ORAL TABLET PA
hydroxychloroquine oral tablet Plaquenil
minocycline oral capsule
minocycline oral tablet
sulfasalazine oral tablet Azulfidine
sulfasalazine oral tablet,delayed release (dr/ec)
Azulfidine EN-tabs
IMMUNOSUPRESSANTS
azathioprine oral tablet Imuran
cyclosporine modified oral capsule Gengraf
4
Drug Name Reference Notes
cyclosporine modified oral solution Gengraf
cyclosporine oral capsule Sandimmune
gengraf oral capsule
gengraf oral solution
mycophenolate mofetil oral capsule CellCept
mycophenolate mofetil oral suspension for reconstitution
CellCept
mycophenolate mofetil oral tablet CellCept
SANDIMMUNE ORAL SOLUTION
NSAIDS
ALEVE ORAL CAPSULE OTC
CHILDREN'S MOTRIN ORAL SUSPENSION
OTC
ibu oral tablet
ibuprofen oral tablet IBU
ibuprofen pm oral tablet OTC
meloxicam oral tablet Mobic
MIDOL (NAPROXEN) ORAL TABLET OTC
MOTRIN IB ORAL TABLET OTC
motrin pm oral tablet OTC
naproxen oral tablet
naproxen oral tablet,delayed release (dr/ec)
EC-Naprosyn
sulindac oral tablet
ANESTHETICS
LOCAL ANESTHETICS
lidocaine hcl laryngotracheal solution LTA Pre-Attached QL
lidocaine topical ointment QL
ANORECTAL PREPARATIONS
ANORECTAL AGENTS
ANUSOL-HC TOPICAL CREAM WITH PERINEAL APPLICATOR
hydrocortisone topical cream with perineal applicator
Anusol-HC
PROCTOCORT TOPICAL CREAM
procto-med hc topical cream with perineal applicator
5
Drug Name Reference Notes
proctosol hc topical cream with perineal applicator
proctozone-hc topical cream with perineal applicator
HEMORRHOIDAL PREPARATIONS
hemorrhoid rectal ointment OTC
hemorrhoidal (phenyleph-cocoa) rectal suppository
OTC
hemorrhoidal rectal suppository OTC
lidocaine hcl-hydrocortison ac rectal cream
ANTIDOTES AND OTHER REVERSAL AGENTS
ANTIDOTES
acetylcysteine solution
CHELATING AGENTS
deferoxamine injection recon soln Desferal
DEPEN TITRATABS ORAL TABLET PA
trientine oral capsule Syprine PA; QL
MU-OPIOID RECEPTOR ANTAGONISTS, PERIPHERALLY-ACTING
MOVANTIK ORAL TABLET AL
NARCOTIC ANTAGONISTS
naloxone injection solution
naloxone injection syringe
naltrexone oral tablet
NARCAN NASAL SPRAY,NON-AEROSOL
REVIA ORAL TABLET
ANTI-INFECTIVE AGENTS
ABSORBABLE SULFONAMIDES
sulfamethoxazole-trimethoprim oral suspension
Sulfatrim
sulfamethoxazole-trimethoprim oral tablet Bactrim
sulfatrim oral suspension
trimethoprim oral tablet
6
Drug Name Reference Notes
AMINOPENICILLINS
amoxicillin oral capsule
amoxicillin oral suspension for reconstitution
QL
amoxicillin oral tablet
amoxicillin oral tablet,chewable
amoxicillin-pot clavulanate oral suspension for reconstitution
Augmentin ES-600
amoxicillin-pot clavulanate oral tablet 250-125 mg
amoxicillin-pot clavulanate oral tablet 500-125 mg
Augmentin
amoxicillin-pot clavulanate oral tablet 875-125 mg
Augmentin QL
amoxicillin-pot clavulanate oral tablet extended release 12 hr
Augmentin XR QL
amoxicillin-pot clavulanate oral tablet,chewable
QL
ampicillin oral capsule
ANTHELMINTIC AGENTS - MACROCYCLIC LACTONES
ivermectin oral tablet Stromectol
ANTHELMINTICS
ivermectin oral tablet Stromectol
praziquantel oral tablet Biltricide
reese's pinworm medicine oral suspension OTC
ANTIBACTERIAL AGENTS, OTHER
nitrofurantoin macrocrystal oral capsule Macrodantin
nitrofurantoin monohyd/m-cryst oral capsule
Macrobid
ANTIFUNGAL ANTIBIOTICS
fluconazole oral suspension for reconstitution
Diflucan
fluconazole oral tablet Diflucan
griseofulvin microsize oral suspension
nystatin oral powder
nystatin oral tablet
terbinafine hcl oral tablet
voriconazole intravenous solution Vfend IV PA
7
Drug Name Reference Notes
ANTI-INFECTIVE AGENTS, OTHER
methenamine hippurate oral tablet Hiprex
methenamine mandelate oral tablet
ANTILEPROTIC - SULFONE AGENTS
dapsone oral tablet
ANTIMYCOBACTERIUM AGENTS
ethambutol oral tablet Myambutol
isoniazid oral solution
isoniazid oral tablet
PRIFTIN ORAL TABLET
pyrazinamide oral tablet
rifabutin oral capsule Mycobutin
rifampin oral capsule Rifadin
RIFATER ORAL TABLET
ANTIPROTOZOAL ANTIBACTERIAL AGENTS
metronidazole oral tablet Flagyl
ANTIVIRALS, GENERAL
acyclovir oral capsule Zovirax
acyclovir oral suspension 200 mg/5 ml Zovirax
acyclovir oral suspension 200 mg/5 ml (5 ml)
acyclovir oral tablet Zovirax
famciclovir oral tablet
oseltamivir oral suspension for reconstitution
Tamiflu
RELENZA DISKHALER INHALATION BLISTER WITH DEVICE
rimantadine oral tablet Flumadine
TAMIFLU ORAL CAPSULE
valacyclovir oral tablet Valtrex
valganciclovir oral recon soln Valcyte
valganciclovir oral tablet Valcyte
ANTIVIRALS, HIV SPECIFIC
abacavir oral solution Ziagen
abacavir oral tablet Ziagen
abacavir-lamivudine oral tablet Epzicom
8
Drug Name Reference Notes
abacavir-lamivudine-zidovudine oral tablet Trizivir
APTIVUS ORAL CAPSULE
APTIVUS ORAL SOLUTION
atazanavir oral capsule Reyataz
BIKTARVY ORAL TABLET
CIMDUO ORAL TABLET
CRIXIVAN ORAL CAPSULE
DESCOVY ORAL TABLET
didanosine oral capsule,delayed release(dr/ec)
Videx EC
EDURANT ORAL TABLET
EMTRIVA ORAL CAPSULE
EMTRIVA ORAL SOLUTION
EVOTAZ ORAL TABLET
FUZEON SUBCUTANEOUS RECON SOLN
PA
GENVOYA ORAL TABLET
INTELENCE ORAL TABLET
ISENTRESS HD ORAL TABLET
ISENTRESS ORAL POWDER IN PACKET
ISENTRESS ORAL TABLET
ISENTRESS ORAL TABLET,CHEWABLE
JULUCA ORAL TABLET
KALETRA ORAL TABLET
lamivudine oral solution Epivir
lamivudine oral tablet Epivir
lamivudine-zidovudine oral tablet Combivir
lopinavir-ritonavir oral solution Kaletra
nevirapine oral suspension Viramune
nevirapine oral tablet Viramune
nevirapine oral tablet extended release 24 hr
Viramune XR
NORVIR ORAL CAPSULE
NORVIR ORAL SOLUTION
PREZCOBIX ORAL TABLET
PREZISTA ORAL SUSPENSION
9
Drug Name Reference Notes
PREZISTA ORAL TABLET
RESCRIPTOR ORAL TABLET
RESCRIPTOR ORAL TABLET, DISPERSIBLE
RETROVIR INTRAVENOUS SOLUTION
REYATAZ ORAL POWDER IN PACKET
ritonavir oral tablet Norvir
SELZENTRY ORAL SOLUTION
SELZENTRY ORAL TABLET
stavudine oral capsule Zerit
STRIBILD ORAL TABLET
tenofovir disoproxil fumarate oral tablet Viread PA; QL
TIVICAY ORAL TABLET
TRIUMEQ ORAL TABLET
TROGARZO INTRAVENOUS SOLUTION
TRUVADA ORAL TABLET
VIDEX 2 GRAM PEDIATRIC ORAL RECON SOLN
VIDEX 4 GRAM PEDIATRIC ORAL RECON SOLN
VIRACEPT ORAL TABLET
VIREAD ORAL POWDER PA; QL
VIREAD ORAL TABLET PA; QL
zidovudine oral capsule Retrovir
zidovudine oral syrup Retrovir
zidovudine oral tablet
CEPHALOSPORIN ANTIBIOTICS
cefaclor oral capsule
cefadroxil oral capsule
cefadroxil oral suspension for reconstitution
cefadroxil oral tablet
cefdinir oral capsule
cefdinir oral suspension for reconstitution
cefixime oral suspension for reconstitution Suprax
cefprozil oral suspension for reconstitution
cefprozil oral tablet
10
Drug Name Reference Notes
ceftriaxone injection recon soln 1 gram, 2 gram, 250 mg, 500 mg
QL
ceftriaxone injection recon soln 10 gram
cefuroxime axetil oral suspension for reconstitution
cefuroxime axetil oral tablet
cephalexin oral capsule Keflex
cephalexin oral suspension for reconstitution
cephalexin oral tablet
HEPATITIS B TREATMENT AGENTS
adefovir oral tablet Hepsera PA
BARACLUDE ORAL SOLUTION PA
entecavir oral tablet Baraclude PA
EPIVIR HBV ORAL SOLUTION PA; QL
lamivudine oral tablet Epivir HBV PA; QL
HEPATITIS C TREATMENT AGENTS
MAVYRET ORAL TABLET PA
PEGINTRON SUBCUTANEOUS KIT
ribavirin oral capsule Ribasphere
ribavirin oral tablet Moderiba
LINCOSAMIDES
clindamycin hcl oral capsule Cleocin HCl
clindamycin palmitate hcl oral recon soln Cleocin Pediatric
clindamycin pediatric oral recon soln
MACROLIDES
azithromycin oral packet Zithromax
azithromycin oral suspension for reconstitution
Zithromax
azithromycin oral tablet Zithromax
clarithromycin oral suspension for reconstitution
clarithromycin oral tablet
e.e.s. 400 oral tablet
ERYPED 200 ORAL SUSPENSION FOR RECONSTITUTION
ery-tab oral tablet,delayed release (dr/ec) 250 mg, 333 mg
11
Drug Name Reference Notes
ERY-TAB ORAL TABLET,DELAYED RELEASE (DR/EC) 500 MG
erythrocin (as stearate) oral tablet
erythromycin oral capsule,delayed release(dr/ec)
erythromycin stearate oral tablet Erythrocin (as stearate)
PENICILLINS
dicloxacillin oral capsule
penicillin v potassium oral recon soln
penicillin v potassium oral tablet
PLASMOCIDES COMBINATION
atovaquone-proguanil oral tablet Malarone Pediatric
PLASMOCIDES
chloroquine phosphate oral tablet
hydroxychloroquine oral tablet Plaquenil
mefloquine oral tablet QL
PRIMAQUINE ORAL TABLET
QUINOLONES
ciprofloxacin hcl oral tablet
ciprofloxacin oral suspension,microcapsule recon
Cipro
levofloxacin oral tablet
SULFONAMIDE ANTIBIOTIC
sulfadiazine oral tablet
TETRACYCLINES
demeclocycline oral tablet
doxycycline monohydrate oral capsule Mondoxyne NL
doxycycline monohydrate oral suspension for reconstitution
Vibramycin
minocycline oral capsule
minocycline oral tablet
tetracycline oral capsule
VANCOMYCIN AND DERIVATIVES
linezolid oral suspension for reconstitution Zyvox PA; QL
linezolid oral tablet Zyvox PA; QL
vancomycin oral capsule Vancocin
12
Drug Name Reference Notes
ANTINEOPLASTICS
ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS
anastrozole oral tablet Arimidex QL
bicalutamide oral tablet Casodex
DEPO-PROVERA INTRAMUSCULAR SUSPENSION
EMCYT ORAL CAPSULE PA
exemestane oral tablet Aromasin QL
flutamide oral capsule
hydroxyurea oral capsule Hydrea
imatinib oral tablet Gleevec PA; QL
IRESSA ORAL TABLET PA; QL
letrozole oral tablet Femara QL
leucovorin calcium oral tablet
megestrol oral tablet
melphalan oral tablet Alkeran
MESNEX ORAL TABLET PA
methotrexate sodium (pf) injection recon soln
methotrexate sodium (pf) injection solution
methotrexate sodium injection solution
methotrexate sodium oral tablet
MYLERAN ORAL TABLET
tamoxifen oral tablet
tretinoin (chemotherapy) oral capsule
ANTISEPTICS AND DISINFECTANTS
ANTISEPTICS, GENERAL
alcohol pads topical pads, medicated OTC
alcohol swabs topical pads, medicated Alcohol Pads OTC
alcohol wipes topical pads, medicated OTC
antiseptic skin clnsr(chlorhe) topical liquid OTC
betasept surgical scrub topical liquid OTC
chlorhexidine gluconate topical liquid Dyna-Hex OTC
curity alcohol swabs topical pads, medicated
OTC
easy touch alcohol prep pads topical pads, medicated
OTC
13
Drug Name Reference Notes
hibiclens topical liquid OTC
hydrogen peroxide solution OTC
sure comfort alcohol prep pads topical pads, medicated
OTC
webcol topical pads, medicated OTC
DISINFECTANTS - OTHER
alcoh-wipe towelette OTC
BIOLOGICALS
IMMUNE GLOBULINS
GAMUNEX-C INJECTION SOLUTION PA
OCTAGAM INTRAVENOUS SOLUTION PA
IMMUNOLOGICALS VACCINES
AFLURIA 2018-2019 (PF) INTRAMUSCULAR SYRINGE
QL
AFLURIA 2018-2019 INTRAMUSCULAR SUSPENSION
QL
AFLURIA QUAD 2018-2019 (PF) INTRAMUSCULAR SYRINGE
QL
AFLURIA QUAD 2018-2019 INTRAMUSCULAR SUSPENSION
QL
FLUAD 2018-2019 (65 YR UP)(PF) INTRAMUSCULAR SYRINGE
QL
FLUARIX QUAD 2018-2019 (PF) INTRAMUSCULAR SYRINGE
QL
FLUBLOK QUAD 2018-2019 (PF) INTRAMUSCULAR SYRINGE
QL
FLUCELVAX QUAD 2018-2019 (PF) INTRAMUSCULAR SYRINGE
FLUCELVAX QUAD 2018-2019 INTRAMUSCULAR SUSPENSION
FLULAVAL QUAD 2018-2019 (PF) INTRAMUSCULAR SYRINGE
QL
FLULAVAL QUAD 2018-2019 INTRAMUSCULAR SUSPENSION
QL
FLUMIST QUAD 2018-2019 NASAL NASAL SPRAY SYRINGE
FLUZONE HIGH-DOSE 2018-19 (PF) INTRAMUSCULAR SYRINGE
QL
FLUZONE QUAD 2018-2019 (PF) INTRAMUSCULAR SUSPENSION
QL
14
Drug Name Reference Notes
FLUZONE QUAD 2018-2019 (PF) INTRAMUSCULAR SYRINGE
QL
FLUZONE QUAD 2018-2019 INTRAMUSCULAR SUSPENSION
QL
FLUZONE QUAD PEDI 2018-19 (PF) INTRAMUSCULAR SYRINGE
QL
GARDASIL 9 (PF) INTRAMUSCULAR SUSPENSION
GARDASIL 9 (PF) INTRAMUSCULAR SYRINGE
SHINGRIX (PF) INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION
AL; QL
SYNAGIS INTRAMUSCULAR SOLUTION
PA
TWINRIX (PF) INTRAMUSCULAR SYRINGE
ZOSTAVAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION
AL; QL
CARDIOVASCULAR THERAPY AGENTS
ACE INHIBITOR/CALCIUM CHANNEL BLOCK COMBINATION
amlodipine-benazepril oral capsule
ADRENERGIC VASOPRESSOR
midodrine oral tablet
ALDOSTERONE RECEPTOR ANTAGONISTS
spironolactone oral tablet Aldactone
ALPHA/BETA-ADRENERGIC BLOCKING AGENTS
carvedilol oral tablet Coreg
labetalol oral tablet
ALPHA-ADRENERGIC BLOCKING AGENTS
doxazosin oral tablet Cardura QL
prazosin oral capsule Minipress
terazosin oral capsule QL
ANAPHYLAXIS THERAPY AGENTS
epinephrine injection auto-injector EpiPen Jr
epinephrine injection solution Adrenalin
15
Drug Name Reference Notes
ANTIARRHYTHMICS
amiodarone oral tablet 200 mg Pacerone QL
amiodarone oral tablet 400 mg Pacerone
disopyramide phosphate oral capsule Norpace
flecainide oral tablet QL
mexiletine oral capsule
pacerone oral tablet 200 mg QL
pacerone oral tablet 400 mg
propafenone oral capsule,extended release 12 hr
Rythmol SR
propafenone oral tablet
quinidine gluconate oral tablet extended release
quinidine sulfate oral tablet
sorine oral tablet
sotalol af oral tablet
sotalol oral tablet Betapace
verapamil oral tablet
BETA-ADRENERGIC BLOCKING AGENTS
atenolol oral tablet Tenormin
bisoprolol fumarate oral tablet
metoprolol succinate oral tablet extended release 24 hr
Toprol XL
metoprolol tartrate oral tablet Lopressor
propranolol oral capsule,extended release 24 hr
Inderal LA
propranolol oral solution
propranolol oral tablet
sorine oral tablet
sotalol af oral tablet
sotalol oral tablet Betapace
CALCIUM CHANNEL BLOCKING AGENTS
afeditab cr oral tablet extended release
amlodipine oral tablet Norvasc
cartia xt oral capsule,extended release 24hr
16
Drug Name Reference Notes
diltiazem hcl oral capsule,ext.rel 24h degradable
DILT-XR
diltiazem hcl oral capsule,extended release 12 hr
diltiazem hcl oral capsule,extended release 24 hr
Taztia XT
diltiazem hcl oral capsule,extended release 24hr
Cardizem CD
diltiazem hcl oral tablet Cardizem
diltiazem hcl oral tablet extended release 24 hr
Cardizem LA
dilt-xr oral capsule,ext.rel 24h degradable
nifedipine oral capsule
nifedipine oral tablet extended release Adalat CC
nifedipine oral tablet extended release 24hr
Procardia XL
taztia xt oral capsule,extended release 24 hr
verapamil oral tablet
verapamil oral tablet extended release Calan SR
DIGITALIS GLYCOSIDES
digitek oral tablet
digox oral tablet
digoxin oral solution
digoxin oral tablet Digitek
DIURETIC AGENTS, OTHER
acetazolamide oral capsule, extended release
acetazolamide oral tablet
methazolamide oral tablet
spironolactone oral tablet Aldactone
HYPOTENSIVES, ACE INHIBITORS, COMBINATIONS
benazepril oral tablet
benazepril-hydrochlorothiazide oral tablet
enalapril maleate oral tablet Vasotec
enalapril-hydrochlorothiazide oral tablet
lisinopril oral tablet Prinivil
lisinopril-hydrochlorothiazide oral tablet Zestoretic
17
Drug Name Reference Notes
ramipril oral capsule Altace
HYPOTENSIVES, ANGIOTENSIN RECEPTOR ANTAGONIST
amlodipine-valsartan oral tablet Exforge
ENTRESTO ORAL TABLET PA; AL
losartan oral tablet Cozaar
losartan-hydrochlorothiazide oral tablet Hyzaar
valsartan oral tablet Diovan
valsartan-hydrochlorothiazide oral tablet Diovan HCT
HYPOTENSIVES, MISCELLANEOUS
atenolol-chlorthalidone oral tablet Tenoretic 100
bisoprolol-hydrochlorothiazide oral tablet Ziac
CATAPRES-TTS-1 TRANSDERMAL PATCH WEEKLY
CATAPRES-TTS-2 TRANSDERMAL PATCH WEEKLY
CATAPRES-TTS-3 TRANSDERMAL PATCH WEEKLY
clonidine hcl oral tablet Catapres
guanfacine oral tablet
methyldopa oral tablet
methyldopate intravenous solution
HYPOTENSIVES, VASODILATORS
hydralazine oral tablet
minoxidil oral tablet
LIPOTROPICS
atorvastatin oral tablet Lipitor
cholestyramine (with sugar) oral powder Questran
cholestyramine (with sugar) oral powder in packet
Questran
cholestyramine light oral powder
cholestyramine light oral powder in packet
colestipol oral tablet Colestid
ezetimibe oral tablet Zetia
fenofibrate nanocrystallized oral tablet Tricor
fish oil concentrate oral capsule OTC
fish oil oral capsule OTC
gemfibrozil oral tablet Lopid
18
Drug Name Reference Notes
GRAM-O-LECI ORAL TABLET,CHEWABLE
OTC
inositol oral tablet OTC
lecithin oral capsule 1,200 mg OTC
LECITHIN ORAL CAPSULE 518 MG OTC
lovastatin oral tablet
maxepa oral capsule OTC
niacin oral tablet extended release 24 hr Niaspan Extended-Release
omega-3 fatty acids oral capsule Fish Oil Concentrate OTC
pravastatin oral tablet Pravachol
prenatal dha oral capsule OTC
prevalite oral powder
prevalite oral powder in packet
rosuvastatin oral tablet Crestor
simvastatin oral tablet Zocor
super omega-3 oral capsule OTC
super twin epa-dha oral capsule OTC
vitamin e oral capsule OTC
WELCHOL ORAL TABLET
LOOP DIURETICS
bumetanide oral tablet
furosemide oral solution
furosemide oral tablet Lasix
torsemide oral tablet Demadex
PLASMA KALLIKREIN INHIBITOR AGENTS, RECOMBINANT PROTEIN
KALBITOR SUBCUTANEOUS SOLUTION
PLASMA KALLIKREIN INHIBITOR AGENTS
KALBITOR SUBCUTANEOUS SOLUTION
POTASSIUM SPARING DIURETICS
amiloride oral tablet
amiloride-hydrochlorothiazide oral tablet
spironolacton-hydrochlorothiaz oral tablet Aldactazide
triamterene-hydrochlorothiazid oral capsule
19
Drug Name Reference Notes
triamterene-hydrochlorothiazid oral tablet Maxzide-25mg
PULMONARY ANTIHYPERTENSIVE AGENTS
VENTAVIS INHALATION SOLUTION FOR NEBULIZATION
PULMONARY ARTERIAL HYPERTENSION
ADCIRCA ORAL TABLET PA
LETAIRIS ORAL TABLET PA; AL
sildenafil (antihypertensive) oral tablet Revatio PA; AL
TRACLEER ORAL TABLET PA; AL
THIAZIDE AND RELATED DIURETICS
chlorothiazide oral tablet
chlorthalidone oral tablet
hydrochlorothiazide oral capsule Microzide QL
hydrochlorothiazide oral tablet 12.5 mg QL
hydrochlorothiazide oral tablet 25 mg, 50 mg
indapamide oral tablet
metolazone oral tablet
VASODILATORS, CORONARY
isosorbide dinitrate oral tablet
isosorbide dinitrate oral tablet extended release
ISOCHRON
isosorbide mononitrate oral tablet
isosorbide mononitrate oral tablet extended release 24 hr
nitro-bid transdermal ointment
NITRO-DUR TRANSDERMAL PATCH 24 HOUR
nitroglycerin oral capsule, extended release
Nitro-Time
nitroglycerin sublingual tablet Nitrostat
nitroglycerin transdermal patch 24 hour Minitran
nitro-time oral capsule, extended release
20
Drug Name Reference Notes
CENTRAL NERVOUS SYSTEM AGENTS
ALPHA-2 RECEPTOR ANTAGONIST ANTIDEPRESSANTS
mirtazapine oral tablet Remeron
mirtazapine oral tablet,disintegrating Remeron SolTab
ANTI-ANXIETY DRUGS
alprazolam intensol oral concentrate
alprazolam oral tablet Xanax
alprazolam oral tablet,disintegrating
buspirone oral tablet
chlordiazepoxide hcl oral capsule
clonazepam oral tablet Klonopin
clorazepate dipotassium oral tablet
diazepam intensol oral concentrate
diazepam oral concentrate Diazepam Intensol
diazepam oral solution
diazepam oral tablet Valium
hydroxyzine hcl oral solution
hydroxyzine pamoate oral capsule
lorazepam oral tablet Ativan
oxazepam oral capsule
ANTICONVULSANTS
carbamazepine oral capsule, er multiphase 12 hr
Carbatrol
carbamazepine oral suspension Tegretol
carbamazepine oral tablet Epitol
carbamazepine oral tablet extended release 12 hr
Tegretol XR
carbamazepine oral tablet,chewable
clonazepam oral tablet Klonopin
DIASTAT RECTAL KIT
diazepam rectal kit Diastat AcuDial
DILANTIN EXTENDED ORAL CAPSULE
DILANTIN ORAL CAPSULE
divalproex oral capsule, delayed rel sprinkle
Depakote Sprinkles
21
Drug Name Reference Notes
divalproex oral tablet extended release 24 hr
Depakote ER
divalproex oral tablet,delayed release (dr/ec)
Depakote
epitol oral tablet
ethosuximide oral capsule Zarontin
ethosuximide oral solution Zarontin
felbamate oral suspension Felbatol
felbamate oral tablet Felbatol
gabapentin oral capsule Neurontin
gabapentin oral solution Neurontin
gabapentin oral tablet Neurontin
GABITRIL ORAL TABLET
lamotrigine oral tablet Lamictal
lamotrigine oral tablet extended release 24hr
Lamictal XR
lamotrigine oral tablet, chewable dispersible
Lamictal
levetiracetam oral solution Keppra
levetiracetam oral tablet Keppra
levetiracetam oral tablet extended release 24 hr
Keppra XR
LYRICA ORAL CAPSULE PA
oxcarbazepine oral suspension Trileptal
oxcarbazepine oral tablet Trileptal
phenobarbital oral elixir
phenobarbital oral tablet
phenytoin oral suspension Dilantin-125
phenytoin oral tablet,chewable Dilantin Infatabs
phenytoin sodium extended oral capsule Phenytek
primidone oral tablet Mysoline
ROWEEPRA ORAL TABLET
TEGRETOL XR ORAL TABLET EXTENDED RELEASE 12 HR
topiramate oral capsule, sprinkle Topamax
topiramate oral tablet Topamax
valproic acid (as sodium salt) oral solution Depakene
valproic acid oral capsule Depakene
22
Drug Name Reference Notes
VIMPAT ORAL SOLUTION
VIMPAT ORAL TABLET
VIMPAT ORAL TABLETS,DOSE PACK
zonisamide oral capsule Zonegran
ANTIDEPRESSANTS, OTHER
perphenazine-amitriptyline oral tablet
ANTIMANIA DRUGS
lithium carbonate oral capsule
lithium carbonate oral tablet
lithium carbonate oral tablet extended release
Lithobid
lithium citrate oral solution
ANTIMIGRAINE PREPARATIONS
divalproex oral tablet extended release 24 hr
Depakote ER
ergotamine-caffeine oral tablet Cafergot
isometh-dichloral-acetaminophn oral capsule
migergot rectal suppository
RELPAX ORAL TABLET
rizatriptan oral tablet Maxalt
rizatriptan oral tablet,disintegrating Maxalt-MLT
sumatriptan nasal spray,non-aerosol Imitrex
sumatriptan succinate oral tablet Imitrex
sumatriptan succinate subcutaneous cartridge
Imitrex STATdose Refill
sumatriptan succinate subcutaneous pen injector
Imitrex STATdose Pen
sumatriptan succinate subcutaneous solution
Imitrex
sumatriptan succinate subcutaneous syringe
ANTIPARKINSONISM DRUGS, ANTICHOLINERGIC
benztropine oral tablet
trihexyphenidyl oral elixir
trihexyphenidyl oral tablet
23
Drug Name Reference Notes
ANTIPARKINSONISM DRUGS, OTHER
amantadine hcl oral solution
amantadine hcl oral tablet
bromocriptine oral capsule Parlodel
bromocriptine oral tablet Parlodel
carbidopa-levodopa oral tablet Sinemet
carbidopa-levodopa oral tablet extended release
Sinemet CR
carbidopa-levodopa oral tablet,disintegrating
carbidopa-levodopa-entacapone oral tablet
Stalevo 50
entacapone oral tablet Comtan
pramipexole oral tablet Mirapex
ropinirole oral tablet Requip
selegiline hcl oral capsule
selegiline hcl oral tablet
ANTIPSYCHOTICS, ATYPICAL DOPAMINE AND SEROTONIN ANTAGONISTS
ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON
AL
ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING
AL
aripiprazole oral tablet Abilify
ARISTADA INITIO INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING
AL
ARISTADA INTRAMUSCULAR SUSPENSION,EXTENDED REL SYRING
AL
clozapine oral tablet Clozaril
INVEGA SUSTENNA INTRAMUSCULAR SYRINGE
AL
INVEGA TRINZA INTRAMUSCULAR SYRINGE
AL
LATUDA ORAL TABLET
olanzapine intramuscular recon soln Zyprexa AL
olanzapine oral tablet Zyprexa AL
olanzapine oral tablet,disintegrating Zyprexa Zydis
quetiapine oral tablet Seroquel AL
24
Drug Name Reference Notes
quetiapine oral tablet extended release 24 hr
Seroquel XR
RISPERDAL CONSTA INTRAMUSCULAR SYRINGE
AL
risperidone oral solution Risperdal AL
risperidone oral tablet 0.25 mg, 0.5 mg, 2 mg, 3 mg, 4 mg
Risperdal
risperidone oral tablet 1 mg Risperdal AL
risperidone oral tablet,disintegrating
ziprasidone hcl oral capsule Geodon AL
ANTIPSYCHOTICS, TYPICAL
ADASUVE INHALATION AEROSOL POWDR BREATH ACTIVATED
chlorpromazine oral tablet
fluphenazine decanoate injection solution AL
fluphenazine hcl injection solution
fluphenazine hcl oral concentrate
fluphenazine hcl oral elixir
fluphenazine hcl oral tablet
haloperidol decanoate intramuscular solution
Haldol Decanoate
haloperidol lactate injection solution Haldol
haloperidol lactate intramuscular syringe
haloperidol lactate oral concentrate
haloperidol oral tablet
loxapine succinate oral capsule
perphenazine oral tablet
prochlorperazine maleate oral tablet Compazine
thioridazine oral tablet
thiothixene oral capsule
trifluoperazine oral tablet
ATTENTION DEFICIT - HYPERACTIVITY (ADHD)/NARCOLEPSY
ADDERALL XR ORAL CAPSULE,EXTENDED RELEASE 24HR
PA; AL
atomoxetine oral capsule Strattera AL
CONCERTA ORAL TABLET EXTENDED RELEASE 24HR
AL
25
Drug Name Reference Notes
DAYTRANA TRANSDERMAL PATCH 24 HOUR
AL
dextroamphetamine oral tablet Zenzedi AL
dextroamphetamine-amphetamine oral tablet
Adderall AL
FOCALIN ORAL TABLET AL
FOCALIN XR ORAL CAPSULE,ER BIPHASIC 50-50
AL
guanfacine oral tablet extended release 24 hr
Intuniv ER
KAPVAY ORAL TABLET EXTENDED RELEASE 12 HR
AL
methylphenidate hcl oral tablet Ritalin AL
QUILLICHEW ER ORAL TABLET,CHEW,IR-ER.BIPHASIC24HR
AL
QUILLIVANT XR ORAL SUSPENSION,EXT REL 24HR,RECON
AL
VYVANSE ORAL CAPSULE AL
VYVANSE ORAL TABLET,CHEWABLE AL
ATTENTION DEFICIT-HYPERACTIVITY (ADHD)/NARCOLEPSY
caffeine citrate intravenous solution Cafcit
caffeine citrate oral solution
BENZODIAZEPINES
alprazolam intensol oral concentrate
alprazolam oral tablet Xanax
alprazolam oral tablet,disintegrating
amitriptyline-chlordiazepoxide oral tablet
chlordiazepoxide hcl oral capsule
clonazepam oral tablet Klonopin
clorazepate dipotassium oral tablet
DIASTAT RECTAL KIT
diazepam intensol oral concentrate
diazepam oral concentrate Diazepam Intensol
diazepam oral solution
diazepam oral tablet Valium
diazepam rectal kit Diastat AcuDial
lorazepam oral tablet Ativan
26
Drug Name Reference Notes
oxazepam oral capsule
temazepam oral capsule Restoril
CANNABIS AND CANNABINOID RECEPTOR AGONISTS
dronabinol oral capsule Marinol
CNS STIMULANTS
ADDERALL XR ORAL CAPSULE,EXTENDED RELEASE 24HR
PA; AL
dextroamphetamine oral tablet Zenzedi AL
dextroamphetamine-amphetamine oral tablet
Adderall AL
FIBROMYALGIA AGENTS
duloxetine oral capsule,delayed release(dr/ec)
Cymbalta
LYRICA ORAL CAPSULE PA
NOREPINEPHRINE AND DOPAMINE REUPTAKE INHIBITORS (NDRIS)
bupropion hcl oral tablet
bupropion hcl oral tablet extended release 24 hr
Wellbutrin XL
bupropion hcl oral tablet sustained-release 12 hr
Wellbutrin SR
SEDATIVE-HYPNOTICS, BARBITURATES
phenobarbital oral elixir
phenobarbital oral tablet
SEDATIVE-HYPNOTICS, NON-BARBITURATES
diphenhydramine hcl oral capsule Banophen OTC
restfully sleep oral tablet OTC
sleep aid (doxylamine) oral tablet OTC
temazepam oral capsule Restoril
zolpidem oral tablet Ambien
SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRIS)
citalopram oral solution
citalopram oral tablet Celexa
escitalopram oxalate oral tablet Lexapro
fluoxetine oral capsule Prozac
27
Drug Name Reference Notes
fluoxetine oral solution
fluvoxamine oral tablet
paroxetine hcl oral tablet Paxil
sertraline oral tablet Zoloft
SEROTONIN-2 ANTAGONIST REUPTAKE INHIBITORS (SARIS)
trazodone oral tablet
SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIS)
desvenlafaxine succinate oral tablet extended release 24 hr
Pristiq
duloxetine oral capsule,delayed release(dr/ec)
Cymbalta
venlafaxine oral capsule,extended release 24hr
Effexor XR
venlafaxine oral tablet
TRICYCLIC ANTIDEPRESSANT/BENZODIAZEPINE COMBINATIONS
amitriptyline-chlordiazepoxide oral tablet
TRICYCLIC ANTIDEPRESSANTS AND RELATED NON-SELECT REUPTAKE INHIBITORS
amitriptyline oral tablet
amoxapine oral tablet
clomipramine oral capsule Anafranil
desipramine oral tablet Norpramin
doxepin oral capsule
doxepin oral concentrate
imipramine hcl oral tablet Tofranil
imipramine pamoate oral capsule
maprotiline oral tablet
nortriptyline oral capsule Pamelor
nortriptyline oral solution
protriptyline oral tablet
trimipramine oral capsule Surmontil
28
Drug Name Reference Notes
CHEMICAL DEPENDENCY, AGENTS TO TREAT
ALCOHOL ANTAGONIST
acamprosate oral tablet,delayed release (dr/ec)
QL
disulfiram oral tablet Antabuse
VIVITROL INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON
NARCOTIC ANTAGONISTS
buprenorphine hcl sublingual tablet PA; AL
SUBOXONE SUBLINGUAL FILM AL; QL
SMOKING DETERRENT AGENTS
bupropion hcl (smoking deter) oral tablet extended release 12 hr
Zyban
bupropion hcl oral tablet sustained-release 12 hr
Wellbutrin SR
CHANTIX CONTINUING MONTH BOX ORAL TABLET
CHANTIX ORAL TABLET
CHANTIX STARTING MONTH BOX ORAL TABLETS,DOSE PACK
CHEMICALS-PHARMACEUTICAL ADJUVANTS
CHEMICALS - SOLVENTS
alcohol, rubbing solution OTC
PHARMACEUTICAL ADJUVANT
nebusal inhalation solution for nebulization
petrolatum topical ointment OTC
pulmosal inhalation solution for nebulization
sodium chloride inhalation solution for nebulization
NebuSal
COGNITIVE DISORDER THERAPY
CHOLINESTERASE INHIBITORS
donepezil oral tablet Aricept
donepezil oral tablet,disintegrating
EXELON TRANSDERMAL PATCH 24 HOUR
29
Drug Name Reference Notes
memantine oral tablet Namenda
CONTRACEPTIVES
CONTRACEPTIVES
altavera (28) oral tablet AL
alyacen 1/35 (28) oral tablet AL
alyacen 7/7/7 (28) oral tablet AL
amethia lo oral tablets,dose pack,3 month AL
amethia oral tablets,dose pack,3 month AL
amethyst oral tablet AL
apri oral tablet AL
aranelle (28) oral tablet AL
ashlyna oral tablets,dose pack,3 month AL
aubra oral tablet AL
aviane oral tablet AL
azurette (28) oral tablet AL
balziva (28) oral tablet AL
bekyree (28) oral tablet AL
blisovi 24 fe oral tablet AL
blisovi fe 1.5/30 (28) oral tablet AL
blisovi fe 1/20 (28) oral tablet AL
briellyn oral tablet AL
camila oral tablet AL
camrese lo oral tablets,dose pack,3 month AL
camrese oral tablets,dose pack,3 month AL
caziant (28) oral tablet AL
chateal oral tablet AL
cryselle (28) oral tablet AL
cyclafem 1/35 (28) oral tablet AL
cyclafem 7/7/7 (28) oral tablet AL
cyred oral tablet AL
dasetta 1/35 (28) oral tablet AL
dasetta 7/7/7 (28) oral tablet AL
daysee oral tablets,dose pack,3 month AL
deblitane oral tablet AL
delyla (28) oral tablet AL
DEPO-PROVERA INTRAMUSCULAR SUSPENSION
AL
30
Drug Name Reference Notes
desog-e.estradiol/e.estradiol oral tablet Azurette (28) AL
desogestrel-ethinyl estradiol oral tablet Apri AL
drospirenone-e.estradiol-lm.fa oral tablet Beyaz AL
drospirenone-ethinyl estradiol oral tablet Ocella AL
elinest oral tablet AL
emoquette oral tablet AL
enpresse oral tablet AL
enskyce oral tablet AL
errin oral tablet AL
estarylla oral tablet AL
ethynodiol diac-eth estradiol oral tablet Kelnor 1-50 AL
falmina (28) oral tablet AL
fayosim oral tablets,dose pack,3 month AL
femynor oral tablet AL
gianvi (28) oral tablet AL
heather oral tablet AL
introvale oral tablets,dose pack,3 month AL
isibloom oral tablet AL
jencycla oral tablet AL
jolessa oral tablets,dose pack,3 month AL
jolivette oral tablet AL
juleber oral tablet AL
junel 1.5/30 (21) oral tablet AL
junel 1/20 (21) oral tablet AL
junel fe 1.5/30 (28) oral tablet AL
junel fe 1/20 (28) oral tablet AL
junel fe 24 oral tablet AL
kaitlib fe oral tablet,chewable AL
kariva (28) oral tablet AL
kelnor 1/35 (28) oral tablet AL
kelnor 1-50 oral tablet AL
kurvelo oral tablet AL
KYLEENA INTRAUTERINE INTRAUTERINE DEVICE
l norgest/e.estradiol-e.estrad oral tablets,dose pack,3 month
Amethia AL
larin 1.5/30 (21) oral tablet AL
31
Drug Name Reference Notes
larin 1/20 (21) oral tablet AL
larin 24 fe oral tablet AL
larin fe 1.5/30 (28) oral tablet AL
larin fe 1/20 (28) oral tablet AL
larissia oral tablet AL
layolis fe oral tablet,chewable AL
leena 28 oral tablet AL
lessina oral tablet AL
levonest (28) oral tablet AL
levonorgestrel-ethinyl estrad oral tablet Aubra AL
levonorgestrel-ethinyl estrad oral tablets,dose pack,3 month
Introvale AL
levonorg-eth estrad triphasic oral tablet Enpresse AL
levora 0.15/30 (28) oral tablet AL
levora-28 oral tablet AL
LILETTA INTRAUTERINE INTRAUTERINE DEVICE
lillow oral tablet AL
loryna (28) oral tablet AL
low-ogestrel (28) oral tablet AL
lutera (28) oral tablet AL
lyza oral tablet AL
marlissa oral tablet AL
medroxyprogesterone intramuscular suspension
Depo-Provera AL
medroxyprogesterone intramuscular syringe
Depo-Provera AL
melodetta 24 fe oral tablet,chewable AL
mibelas 24 fe oral tablet,chewable AL
microgestin 1.5/30 (21) oral tablet AL
microgestin 1/20 (21) oral tablet AL
microgestin fe 1.5/30 (28) oral tablet AL
microgestin fe 1/20 (28) oral tablet AL
MIRENA INTRAUTERINE INTRAUTERINE DEVICE
mono-linyah oral tablet AL
mononessa (28) oral tablet AL
myzilra oral tablet AL
32
Drug Name Reference Notes
necon 0.5/35 (28) oral tablet AL
NEXPLANON SUBDERMAL IMPLANT
nikki (28) oral tablet AL
nora-be oral tablet AL
noreth-ethinyl estradiol-iron oral tablet,chewable
Wymzya Fe AL
norethindrone (contraceptive) oral tablet Camila AL
norethindrone ac-eth estradiol oral tablet Junel 1/20 (21) AL
norethindrone-e.estradiol-iron oral tablet Blisovi Fe 1/20 (28) AL
norethindrone-e.estradiol-iron oral tablet,chewable
Melodetta 24 Fe AL
norgestimate-ethinyl estradiol oral tablet Estarylla AL
norgestrel-ethinyl estradiol oral tablet Ogestrel (28) AL
norlyda oral tablet AL
norlyroc oral tablet AL
nortrel 0.5/35 (28) oral tablet AL
nortrel 1/35 (21) oral tablet AL
nortrel 1/35 (28) oral tablet AL
nortrel 7/7/7 (28) oral tablet AL
NUVARING VAGINAL RING AL
ocella oral tablet AL
ogestrel (28) oral tablet AL
orsythia oral tablet AL
PARAGARD T 380A INTRAUTERINE INTRAUTERINE DEVICE
philith oral tablet AL
pimtrea (28) oral tablet AL
pirmella oral tablet AL
portia oral tablet AL
previfem oral tablet AL
quasense oral tablets,dose pack,3 month AL
rajani oral tablet AL
reclipsen (28) oral tablet AL
RIVELSA ORAL TABLETS,DOSE PACK,3 MONTH
AL
setlakin oral tablets,dose pack,3 month AL
sharobel oral tablet AL
33
Drug Name Reference Notes
SKYLA INTRAUTERINE INTRAUTERINE DEVICE
sprintec (28) oral tablet AL
sronyx oral tablet AL
syeda oral tablet AL
tarina fe 1/20 (28) oral tablet AL
tarina fe 1-20 eq (28) oral tablet
tilia fe oral tablet AL
TODAY CONTRACEPTIVE SPONGE VAGINAL CONTRACEPTIVE SPONGE
OTC
tri femynor oral tablet AL
tri-estarylla oral tablet AL
tri-legest fe oral tablet AL
tri-linyah oral tablet AL
tri-lo-estarylla oral tablet AL
tri-lo-marzia oral tablet AL
tri-lo-sprintec oral tablet AL
tri-previfem (28) oral tablet AL
tri-sprintec (28) oral tablet AL
trivora (28) oral tablet AL
tri-vylibra oral tablet AL
tydemy oral tablet AL
VAGINAL CONTRACEPTIVE FILM VAGINAL FILM
OTC
vaginal contraceptive foam vaginal foam OTC
VCF CONTRACEPTIVE FILM VAGINAL FILM
OTC
velivet triphasic regimen (28) oral tablet AL
vienva oral tablet AL
viorele (28) oral tablet AL
vyfemla (28) oral tablet AL
vylibra oral tablet AL
wera (28) oral tablet AL
wymzya fe oral tablet,chewable AL
xulane transdermal patch weekly AL; QL
zarah oral tablet AL
zenchent (28) oral tablet AL
zovia 1/35e (28) oral tablet AL
34
Drug Name Reference Notes
EMERGENCY CONTRACEPTIVES
ELLA ORAL TABLET QL
DENTAL AIDS AND PREPARATIONS
ANTISEPTICS, GENERAL
chlorhexidine gluconate mucous membrane mouthwash
Paroex Oral Rinse QL
paroex oral rinse mucous membrane mouthwash
QL
periogard mucous membrane mouthwash QL
sore throat (hexylresorcinol) mucous membrane lozenge
OTC
FLUORIDE PREPARATIONS
denta 5000 plus dental cream QL
dentagel dental gel
fluoride (sodium) oral drops OTC; QL
fluoride (sodium) oral tablet,chewable Fluoritab OTC
fluoritab oral tablet,chewable OTC
flura-drops oral drops OTC
ludent fluoride oral tablet,chewable OTC
perio med dental solution OTC
sf 5000 plus dental cream QL
sf dental gel
MOUTH AND THROAT AGENTS
cherry cough drops mucous membrane lozenge
OTC
cherry menthol mucous membrane lozenge
OTC
cough drops (with eucalyptus) mucous membrane lozenge
OTC
honey lemon mucous membrane lozenge OTC
lidocaine hcl mucous membrane jelly
lidocaine hcl mucous membrane solution QL
lidocaine viscous mucous membrane solution
QL
medikoff drops mucous membrane lozenge
OTC
menthol drops mucous membrane lozenge
OTC
35
Drug Name Reference Notes
nystatin oral suspension
oralone dental paste
pilocarpine hcl oral tablet Salagen (pilocarpine) QL
sore throat relief (pectin) mucous membrane lozenge on a handle
OTC
throat drops mucous membrane lozenge OTC
throat lozenges mucous membrane lozenge
OTC
triamcinolone acetonide dental paste Oralone
zinc with vitamins a and c oral lozenge OTC
DERMATOLOGICAL
ACNE AGENTS, SYSTEMIC
amnesteem oral capsule PA
claravis oral capsule PA
isotretinoin oral capsule Absorica PA
MYORISAN ORAL CAPSULE 10 MG, 30 MG
PA
myorisan oral capsule 20 mg, 40 mg PA
zenatane oral capsule PA
ACNE AGENTS, TOPICAL
acne medication topical lotion AL; OTC
advanced acne wash topical cleanser,extended release
OTC
bp gel topical gel OTC
bp wash topical cleanser OTC
CLEAR PORE CLEANSER-MASK TOPICAL CLEANSER
OTC
clindamycin phosphate topical solution Cleocin T AL
clindamycin phosphate topical swab Cleocin T PA; AL
clindamycin-benzoyl peroxide topical gel Duac PA; AL
erythromycin with ethanol topical solution AL
METROCREAM TOPICAL CREAM
METROLOTION TOPICAL LOTION
NEUTROGENA ON THE SPOT TOPICAL CREAM
OTC
OC8 TOPICAL GEL OTC
ANTIPSORIATIC AGENTS
calcipotriene scalp solution
36
Drug Name Reference Notes
calcipotriene topical cream Dovonex
calcipotriene topical ointment Calcitrene
HAIR GROWTH AGENTS
finasteride oral tablet Propecia
ROSACEA AGENTS, TOPICAL
METROGEL TOPICAL GEL
METROGEL TOPICAL GEL WITH PUMP
SCABICIDE AND PEDICULICIDES
complete lice treatment topical kit OTC; QL
lice complete kit 1-2-3 topical kit OTC; QL
lice solution topical kit OTC; QL
permethrin topical cream Elimite QL
rid complete lice elim kit topical kit OTC; QL
spinosad topical suspension Natroba
TOPICAL AGENTS, MISCELLANEOUS
alphabath topical oil OTC
ameriphor topical ointment OTC
ammonium lactate topical cream Geri-Hydrolac OTC
ammonium lactate topical lotion AmLactin OTC
aqua glycolic face topical cream OTC
aqua glycolic topical shampoo OTC
aqua lube topical lubricant OTC
arthricream rub topical cream OTC
bath oil topical oil OTC
beta care topical cream OTC
beta care topical lotion OTC
calamine topical lotion OTC
calamine-zinc oxide-phenol topical suspension
OTC
cam topical lotion OTC
capsaicin topical liquid Capzasin OTC
CAPZASIN TOPICAL LIQUID OTC
CAPZASIN-P TOPICAL CREAM OTC
CERAVE PM TOPICAL LOTION,EXTENDED RELEASE
OTC
CERAVE SUNSCREEN TOPICAL LOTION
OTC
37
Drug Name Reference Notes
CERAVE TOPICAL CLEANSER OTC
CERAVE TOPICAL CREAM OTC
CUTTER BACKWOODS TOPICAL AEROSOL,SPRAY
OTC; QL
CUTTER SKINSATIONS TOPICAL SPRAY,NON-AEROSOL
OTC; QL
daily moisturizing lotion topical lotion OTC
dermabase topical cream OTC
dermaphor topical ointment OTC
dermavantage topical lotion OTC
diaper rash topical ointment OTC
dry skin care topical lotion OTC
dry skin therapy moisturizing topical lotion OTC
dry skin therapy topical cream OTC
emollient topical cream Aqua Glycolic Face OTC
eucerin original topical lotion OTC
excel-gel topical gel OTC
finger cream topical cream OTC
glycerin topical liquid OTC
high potency capsaicin topical cream OTC
hydrocerin topical lotion OTC
HYPERCARE TOPICAL LIQUID OTC
insect repellent (picaridin) topical spray with pump
OTC; QL
lan-o-soothe topical cream OTC
lidocaine hcl mucous membrane jelly
lidocaine hcl topical cream Lidopin
lidocaine hcl topical lotion Lido-K
lidocaine topical adhesive patch,medicated
Lidoderm
lidocaine topical ointment QL
lubriderm daily moisture (pet) topical lotion OTC
lubriderm skin nourishing topical lotion OTC
lubrisilk topical lotion OTC
lubrisoft topical lotion OTC
mapo bath topical oil OTC
medicated heat patch topical adhesive patch,medicated
OTC
38
Drug Name Reference Notes
mineral freez topical gel OTC
mineral oil light topical oil OTC
mineral oil topical oil Lobana Bath OTC
minerin topical lotion OTC
NATRAPEL TOPICAL AEROSOL,SPRAY
OTC; QL
natural oatmeal bath treatment topical packet
OTC
nivatopic plus topical cream
oatmeal bath regular topical packet OTC
OFF ACTIVE TOPICAL AEROSOL,SPRAY
OTC; QL
OFF DEEP WOODS DRY TOPICAL AEROSOL POWDER
OTC; QL
OFF DEEP WOODS TOPICAL AEROSOL,SPRAY
OTC; QL
OFF FAMILYCARE (WITH DEET) TOPICAL AEROSOL POWDER
OTC; QL
pediatric oint (cod liver oil) topical ointment
OTC
petrolatum topical ointment OTC
podofilox topical solution
prumyx topical cream
REPEL SPORTSMEN DRY TOPICAL AEROSOL,SPRAY
OTC; QL
REPEL SPORTSMEN MAX TOPICAL AEROSOL,SPRAY
OTC; QL
REPEL SPORTSMEN TOPICAL AEROSOL,SPRAY
OTC; QL
salactic film topical liquid OTC
salicylic acid er-ceramides topical kit,cleanser and cream er
Salex
salicylic acid topical cream Salimez
salicylic acid topical cream,extended release
salicylic acid topical film forming liquid w/appl
Virasal
salicylic acid topical foam Salvax
salicylic acid topical gel Keralyt Rx
salicylic acid topical liquid
39
Drug Name Reference Notes
salicylic acid topical lotion
salicylic acid topical lotion,extended release
salicylic acid topical shampoo Salex
SALONPAS-HOT TOPICAL ADHESIVE PATCH,MEDICATED
OTC
salvax topical foam
scar topical gel OTC
selenium sulfide topical lotion
selenium sulfide topical shampoo
silver sulfadiazine topical cream Silvadene
sorbidon hydrate topical cream OTC
special care lotion topical lotion OTC
ssd topical cream
sween cream topical cream OTC
sween topical cream OTC
thera bath topical oil OTC
thera-derm topical lotion OTC
unscented cold cream topical cream OTC
urea topical cream
urea topical gel CEM-Urea
urea topical lotion Uramaxin
vanicream topical cream OTC
vitamin a and d topical ointment OTC
vitamin e plus topical cream OTC
vitamin e-vitamins a and d topical cream OTC
VOLTAREN TOPICAL GEL
x-seb t pearl topical shampoo OTC
zinc oxide diaper cream topical cream OTC
TOPICAL ANESTHETICS
hydrocortisone-pramoxine topical cream Pramosone
lidocaine hcl-hydrocortison ac topical cream
lidocaine-prilocaine topical cream QL
TOPICAL ANTIBIOTICS
double antibiotic (b.tracn zn) topical ointment
OTC
gentamicin topical cream
40
Drug Name Reference Notes
gentamicin topical ointment
mupirocin topical ointment Centany
wal-sporin topical ointment OTC
TOPICAL ANTIFUNGALS
antifungal topical liquid OTC
ATHLETE'S FOOT (TERBINAFINE) TOPICAL CREAM
OTC
baza cream hospital care pack topical combo pack
OTC
CICLODAN TOPICAL SOLUTION
ciclopirox topical solution Ciclodan
clotrimazole topical cream Antifungal (clotrimazole) OTC
ELON DUAL DEFENSE TOPICAL SOLUTION
OTC
EQ TERBINAFINE 1% CREAM Antifungal (terbinafine) OTC
GORDOCHOM TOPICAL SOLUTION OTC
HONGO CURA SPRAY TOPICAL AEROSOL,SPRAY
OTC
JOCK ITCH (TERBINAFINE) TOPICAL CREAM
OTC
ketoconazole topical cream
ketoconazole topical shampoo Nizoral
lotrimin af topical aerosol,spray OTC
MYCO NAIL A TOPICAL SOLUTION OTC
MYCO NAIL TOPICAL LIQUID OTC
nyamyc topical powder
nystatin topical cream
nystatin topical ointment
nystatin topical powder Nyamyc
nystop topical powder
terbinafine 1% cream Antifungal (terbinafine) OTC
TERBINAFINE 1% CREAM Antifungal (terbinafine) OTC
tinactin topical cream OTC
UNDELENIC TOPICAL TINCTURE OTC
TOPICAL ANTI-INFLAMMATORY STEROIDAL AGENTS
ala-cort topical cream 1 %
ala-cort topical cream 2.5 % QL
41
Drug Name Reference Notes
alclometasone topical cream
alclometasone topical ointment
ANUSOL-HC TOPICAL CREAM WITH PERINEAL APPLICATOR
betamethasone valerate topical cream
betamethasone valerate topical lotion
betamethasone valerate topical ointment
clobetasol scalp solution Cormax
clobetasol topical cream Temovate
clobetasol topical gel
clobetasol topical ointment Temovate
clobetasol-emollient topical cream
cormax scalp solution
cortisone with aloe topical cream OTC
fluocinonide topical solution
fluticasone topical cream Cutivate
fluticasone topical ointment
halobetasol propionate topical cream Ultravate
halobetasol propionate topical ointment Ultravate
hydrocortisone 1% ointment (rx) Anti-Itch (HC) OTC
hydrocortisone 1% ointment (rx) Anti-Itch (HC) OTC
hydrocortisone acetate topical cream OTC
hydrocortisone acetate topical ointment OTC
hydrocortisone butyrate topical lotion Locoid
hydrocortisone butyr-emollient topical cream
Locoid Lipocream
hydrocortisone topical cream 1 % Ala-Cort OTC; QL
hydrocortisone topical cream 2.5 % Ala-Cort
hydrocortisone topical cream with perineal applicator
Anusol-HC
hydrocortisone topical lotion
hydrocortisone topical ointment 2.5 %
hydrocortisone-aloe vera topical cream Cortisone with Aloe OTC
hydrocortisone-pramoxine topical cream Pramosone
mometasone topical cream Elocon
mometasone topical ointment Elocon
mometasone topical solution
PROCTOCORT TOPICAL CREAM
42
Drug Name Reference Notes
procto-med hc topical cream with perineal applicator
proctosol hc topical cream with perineal applicator
proctozone-hc topical cream with perineal applicator
scalacort topical lotion
triamcinolone acetonide topical cream Triderm
triamcinolone acetonide topical lotion
triamcinolone acetonide topical ointment
triderm topical cream
TOPICAL ANTINEOPLASTIC AND PREMALIGNANT
fluorouracil topical cream Efudex QL
fluorouracil topical solution QL
TOPICAL ANTIPARASITICS
CUTTER BACKWOODS TOPICAL AEROSOL,SPRAY
OTC; QL
CUTTER SKINSATIONS TOPICAL SPRAY,NON-AEROSOL
OTC; QL
insect repellent (picaridin) topical spray with pump
OTC; QL
NATRAPEL TOPICAL AEROSOL,SPRAY
OTC; QL
OFF ACTIVE TOPICAL AEROSOL,SPRAY
OTC; QL
OFF DEEP WOODS DRY TOPICAL AEROSOL POWDER
OTC; QL
OFF DEEP WOODS TOPICAL AEROSOL,SPRAY
OTC; QL
OFF FAMILYCARE (WITH DEET) TOPICAL AEROSOL POWDER
OTC; QL
REPEL SPORTSMEN DRY TOPICAL AEROSOL,SPRAY
OTC; QL
REPEL SPORTSMEN MAX TOPICAL AEROSOL,SPRAY
OTC; QL
REPEL SPORTSMEN TOPICAL AEROSOL,SPRAY
OTC; QL
TOPICAL ANTIVIRALS
ABREVA TOPICAL CREAM OTC
43
Drug Name Reference Notes
ZOVIRAX TOPICAL CREAM
TOPICAL IMMUNOMODULATORS
ELIDEL TOPICAL CREAM AL
imiquimod topical cream in packet Aldara PA; QL
VITAMIN A DERIVATIVES
RETIN-A TOPICAL CREAM AL
RETIN-A TOPICAL GEL AL
DIAGNOSTIC AGENTS
DIAGNOSTIC - MULTIPLE URINE TESTS
AZO TEST STRIPS STRIP OTC
URINARY TRACT INF.TEST (WBCS) STRIP
OTC
DIAGNOSTIC DRUGS - GASTROINTESTINAL RADIOLOGICAL ADJUNCT
GLUCAGEN DIAGNOSTIC KIT INJECTION RECON SOLN
QL
DIAGNOSTIC DRUGS
dipyridamole intravenous solution
DRUGS TO TREAT MULTIPLE SCLEROSIS
DRUGS TO TREAT MULTIPLE SCLEROSIS
AVONEX (WITH ALBUMIN) INTRAMUSCULAR KIT
AVONEX INTRAMUSCULAR PEN INJECTOR KIT
AVONEX INTRAMUSCULAR SYRINGE KIT
BETASERON SUBCUTANEOUS KIT
COPAXONE SUBCUTANEOUS SYRINGE
GILENYA ORAL CAPSULE
REBIF (WITH ALBUMIN) SUBCUTANEOUS SYRINGE
REBIF REBIDOSE SUBCUTANEOUS PEN INJECTOR
44
Drug Name Reference Notes
REBIF TITRATION PACK SUBCUTANEOUS SYRINGE
EATING DISORDER THERAPY
ANTI-OBESITY AGENTS
ALLI ORAL CAPSULE PA; OTC; QL
APPETITE STIMULANT AGENTS
dronabinol oral capsule Marinol
megestrol oral suspension
ELECTROLYTE BALANCE-NUTRITIONAL PRODUCTS
AMINO ACIDS
levocarnitine oral tablet Carnitor OTC
BIOFLAVONOID COMBINATIONS
ear care oral tablet OTC
ear health formula oral tablet OTC
CALCIUM REPLACEMENT
bone meal-vitamin d2 oral tablet OTC
ca-d3-mag ox-zinc-cop-mang-bor oral tablet
Calcium 600-D3 Plus OTC
ca-d3-mag ox-zinc-cop-mang-bor oral tablet,chewable
OTC
CA-D3-MAG-ZINC-COP-MANG-BOR ORAL TABLET
OTC
calcium 500 oral tablet OTC
calcium 600 + minerals oral tablet OTC
calcium carb and citrate-vitd3 oral tablet extended release
Citracal + D Slow Release OTC
calcium carbonate oral tablet OTC
calcium carbonate-vit d3-min oral tablet Calcium 600 + Minerals OTC
CALCIUM CARBONATE-VITAMIN D3 ORAL TABLET,CHEWABLE
OTC
calcium citrate-vitamin d2 oral tablet OTC
calcium for women oral tablet,chewable OTC
calcium gluconate oral tablet OTC
calcium lactate oral tablet OTC
calcium magnesium oral tablet OTC
calcium soft chew oral tablet,chewable OTC
calcium-folic acid-vitamin d oral wafer OTC
45
Drug Name Reference Notes
calcium-magnesium-zinc oral tablet OTC
calcium-vitamin d3-vitamin k oral tablet,chewable
Calcium Soft Chew OTC
oyst-cal-500 oral tablet OTC
oyster shell calcium-vit d2 oral tablet OTC
risacal-d oral tablet OTC
tl g-fol os oral tablet
DIETARY PRODUCTS
hair, skin and nails advanced oral tablet OTC
FOLIC ACID PREPARATIONS
elfolate oral tablet OTC
fabb oral tablet OTC
folbee oral tablet OTC
folbic oral tablet OTC
folic acid injection solution
folic acid oral tablet OTC
folic acid-vit b6-vit b12 oral tablet Folplex 2.2 OTC
folplex 2.2 oral tablet OTC
levomefolate calcium oral tablet Elfolate OTC
l-methylfolate oral tablet OTC
tl gard rx oral tablet OTC
virt-gard oral tablet OTC
virt-vite oral tablet OTC
IRON REPLACEMENT
centratex oral capsule OTC
chewable iron oral tablet,chewable OTC
corvita 150 oral tablet OTC
duofer oral tablet OTC
fe c plus oral tablet OTC; QL
ferocon oral capsule OTC
ferraplus 90 oral tablet OTC
ferrex 150 forte oral capsule OTC
ferrex 150 forte plus oral capsule OTC
ferrex 150 plus oral capsule OTC
ferrex 28 oral tablet OTC
ferrocite plus oral tablet OTC
ferrous sulfate oral syringe OTC
46
Drug Name Reference Notes
folivane-f oral capsule OTC
folivane-plus oral capsule OTC
hematinic plus vit/minerals oral tablet OTC
hematinic/folic acid oral tablet OTC
hematogen fa oral capsule OTC
hematogen forte oral capsule OTC
hematogen oral capsule OTC
hemetab oral tablet OTC; QL
iferex 150 forte oral capsule OTC
infed injection solution
iron chews oral tablet,chewable OTC
iron, carbonyl oral tablet Feosol OTC
multigen folic oral tablet OTC
multigen oral tablet OTC
multigen plus oral tablet OTC
myferon 150 forte oral capsule OTC
poly-iron 150 forte oral capsule OTC
sodium ferric gluconat-sucrose intravenous solution
Ferrlecit
taron forte oral capsule OTC
tl icon oral capsule OTC
tricon oral capsule OTC
trigels-f forte oral capsule OTC
wee care oral suspension OTC
IRRIGATION SOLUTIONS
sodium chloride irrigation solution Aqua Care Sodium Chloride
sterile saline irrigation solution OTC
MINERALS AND ELECTROLYTES AGENTS
av-phos 250 neutral oral tablet OTC
calcium-magnesium-copper-zinc oral tablet
OTC
k-phos-neutral oral tablet OTC
mag-g oral tablet OTC
magnesium gluconate oral tablet Mag-G OTC
phospha 250 neutral oral tablet OTC
phospho-trin 250 neutral oral tablet OTC
virt-phos 250 neutral oral tablet OTC
47
Drug Name Reference Notes
MULTIVITAMINS
a thru z high potency oral tablet OTC
a thru z select oral tablet OTC
a thru z select women's oral tablet OTC
actical oral capsule OTC
apatate forte oral liquid OTC
bee-zee oral tablet OTC
biocel (with lutein) oral tablet OTC
biosupp oral liquid OTC
biotect plus oral liquid OTC
biovol oral syrup OTC
calcium citrate plus (vit b6) oral tablet OTC
central-vite cardio oral tablet OTC
centravites oral tablet OTC
century cardio oral tablet OTC
century mature oral tablet OTC
century ultimate women's oral tablet OTC
cerovite senior oral tablet OTC
certa plus oral tablet OTC
certavite-antioxid (iron gluc) oral liquid OTC
complete multivitamin oral tablet OTC
complete premium vitamin oral tablet OTC
corvita oral tablet OTC
daily multiple for men oral tablet OTC
daily multivitamin-minerals oral tablet OTC
daily vitamin formula-minerals oral tablet OTC
e-400 c-500 and beta carotene oral tablet OTC
eldertonic oral elixir OTC
essential daily oral tablet OTC
fosfree oral tablet OTC
hair,skin and nails oral tablet OTC
ICAPS PLUS ORAL TABLET OTC
m.v.i. adult intravenous solution
macuvite eye care oral tablet OTC
maximum daily multivitamin oral tablet OTC
mega multi for women oral tablet OTC
mega multiple/chelated mineral oral tablet OTC
48
Drug Name Reference Notes
mega multivitamin for men oral tablet OTC
mega multivitamin with mineral oral tablet OTC
men's daily multivit-mineral oral tablet OTC
men's one daily oral tablet OTC
milltrium senior oral tablet OTC
multi for her oral tablet OTC
multi-delyn with iron oral liquid OTC
multilex-t and m oral tablet OTC
multiple vitamin, womens oral tablet OTC
multiple vitamin-minerals oral tablet OTC
multivitamin 50 plus oral tablet OTC
multivitamin with minerals oral tablet Bee-Zee OTC
multi-vite (with folic acid) oral tablet OTC
multivit-min-iron fum-folic ac oral tablet OTC
my-vitalife oral capsule OTC
ocutabs oral tablet OTC
omnicap oral tablet OTC
one daily calcium/iron oral tablet OTC
one daily complete oral tablet OTC
one daily energy oral tablet OTC
one daily essential oral tablet OTC
one daily for men oral tablet OTC
one daily for women oral tablet OTC
one daily maximum oral tablet OTC
one daily oral tablet OTC
one daily plus minerals oral tablet OTC
one daily women 50 plus oral tablet OTC
one daily womens 50 plus oral tablet OTC
one daily women's oral tablet OTC
ONE-A-DAY MAXIMUM FORMULA ORAL TABLET
OTC
one-tablet-daily oral tablet OTC
purevit dualfe plus oral capsule OTC
quintabs-m iron free oral tablet OTC
se-tan plus oral capsule OTC
spectravite men's oral tablet OTC
spectravite ultra women's sr oral tablet OTC
49
Drug Name Reference Notes
sunvite oral tablet OTC
super antioxidant oral capsule OTC
support oral liquid OTC
theralogix companion oral tablet OTC
thera-m oral tablet OTC
therapeutic-m vitamin/minerals oral tablet OTC
theratrum complete 50 plus/lut oral tablet OTC
theratrum complete with lutein oral tablet OTC
therems-m oral tablet OTC
totalday multiple oral tablet extended release
OTC
tyr cooler oral liquid OTC
ultimate women's complete 50+ oral tablet OTC
urosex oral tablet OTC
v-c forte oral capsule OTC
vic-forte oral capsule OTC
vit 3 oral capsule OTC
vitalee oral tablet OTC
vitamins a and d oral capsule OTC
vitrum senior oral tablet OTC
women's daily formula oral tablet OTC
women's daily multivitamin oral tablet OTC
NUTRITIONAL PRODUCTS
GERBER GOOD START GLUCOSE ORAL SOLUTION
OTC
MSUD EXPRESS15 ORAL POWDER IN PACKET
OTC
PEDIATRIC VITAMIN PREPARATIONS
children's chewable multivitmn oral tablet,chewable
OTC
children's chewable oral tablet,chewable OTC
children's chewables extra c oral tablet,chewable
OTC
children's chewables oral tablet,chewable OTC
children's chewables with iron oral tablet,chewable
OTC
FLINTSTONES MULTI-VIT GUMMIES ORAL TABLET,CHEWABLE
OTC
50
Drug Name Reference Notes
FLINTSTONES TAB CHEW ORAL TABLET,CHEWABLE
OTC
gummy dinos oral tablet,chewable OTC
multi-vit with fluoride-iron oral drops OTC
multi-vitamin with fluoride oral drops OTC
multivitamin with fluoride oral tablet,chewable
OTC
multi-vitamin with fluoride oral tablet,chewable
OTC
multivitamins with fluoride oral tablet,chewable
OTC
multi-vitamins with iron oral tablet,chewable
OTC
mvc-fluoride oral tablet,chewable OTC
PEDIA POLY-VITE ORAL DROPS OTC
POLY-VI-SOL ORAL DROPS OTC
POLY-VI-SOL WITH IRON ORAL DROPS
OTC
triple vitamin with fluoride oral drops OTC
tri-vitamin with fluoride oral drops OTC
tri-vite with fluoride oral drops OTC
vitalets oral tablet,chewable OTC
vitamins a,c,d and fluoride oral drops OTC
zoo friends original oral tablet,chewable OTC
POTASSIUM REMOVING RESINS
sodium polystyrene (sorb free) oral suspension
sodium polystyrene sulfonate oral suspension
sodium polystyrene (sorb free)
sodium polystyrene sulfonate rectal enema
sps (with sorbitol) oral suspension
sps (with sorbitol) rectal enema
POTASSIUM REPLACEMENT
effer-k oral tablet, effervescent
k-effervescent oral tablet, effervescent
klor-con 10 oral tablet extended release
klor-con 8 oral tablet extended release
51
Drug Name Reference Notes
klor-con m10 oral tablet,er particles/crystals
klor-con m15 oral tablet,er particles/crystals
klor-con m20 oral tablet,er particles/crystals
klor-con oral packet
klor-con/ef oral tablet, effervescent
k-tab oral tablet extended release
potassium bicarb and chloride oral tablet, effervescent
potassium bicarb-citric acid oral tablet, effervescent
Effer-K
potassium chloride oral capsule, extended release
potassium chloride oral liquid
potassium chloride oral packet Klor-Con
potassium chloride oral tablet extended release
K-Tab
potassium chloride oral tablet,er particles/crystals
Klor-Con M20
potassium gluconate oral tablet OTC
PRENATAL VITAMIN PREPARATIONS
daily prenatal oral combo pack OTC; QL
kpn oral tablet OTC; QL
one daily prenatal oral combo pack OTC; QL
perry prenatal oral capsule OTC; QL
prenatal + dha oral combo pack OTC; QL
prenatal 19 (with docusate) oral tablet OTC; QL
prenatal 19 oral tablet,chewable OTC; QL
prenatal complete oral tablet OTC; QL
prenatal multi-dha (algal oil) oral capsule OTC; QL
PRENATAL MULTIVITAMINS ORAL TABLET
OTC; QL
prenatal one daily oral tablet OTC; QL
prenatal tablet oral tablet OTC; QL
prenatal vitamin oral tablet OTC; QL
prenatal vitamin with minerals oral tablet OTC; QL
52
Drug Name Reference Notes
prenatal vit-iron fum-folic ac oral tablet Prenatal Tablet OTC; QL
VITAMIN B PREPARATIONS
apetigen plus oral liquid OTC
b complex 100 injection solution
b complex 100 oral tablet OTC
b-100 complex oral tablet extended release
OTC
balanced b-100 complex oral tablet extended release
OTC
balanced b-100 oral tablet OTC
b-complex with vitamin c oral tablet OTC
cyanocobalamin (vitamin b-12) injection solution
dialyvite oral tablet OTC
fabb oral tablet OTC
folbee oral tablet OTC
folbee plus oral tablet OTC
folbic oral tablet OTC
folic acid-vit b6-vit b12 oral tablet Folplex 2.2 OTC
folplex 2.2 oral tablet OTC
foltabs 800 oral tablet OTC
hydroxocobalamin intramuscular solution
kobee oral tablet OTC
mynephrocaps oral capsule OTC
mynephron oral capsule OTC
natural b-100 complex oral tablet OTC
nephplex rx oral tablet OTC
nephronex oral liquid OTC
nephronex-sl oral tablet,disintegrating OTC
nephro-vite rx oral tablet OTC
niacin (inositol niacinate) oral capsule Niacin Flush Free OTC
niacin flush free oral capsule OTC
pantothenic acid (vit b5) oral tablet OTC
pyridoxine (vitamin b6) injection solution
renal caps oral capsule OTC
rena-vite rx oral tablet OTC
reno caps oral capsule OTC
riboflavin (vitamin b2) oral tablet Vitamin B-2 OTC
53
Drug Name Reference Notes
stress b plus zinc oral tablet OTC
stress formula plus iron oral tablet OTC
stress formula with iron(sulf) oral tablet OTC
super b maxi complex oral tablet OTC
super quints oral tablet OTC
thiamine hcl (vitamin b1) injection solution
thiamine mononitrate (vit b1) oral tablet Vitamin B-1 (mononitrate) OTC
tl gard rx oral tablet OTC
triphrocaps oral capsule OTC
virt-gard oral tablet OTC
virt-vite oral tablet OTC
vitamin b complex-folic acid oral tablet B Complex 100 OTC
vitamin b-1 (mononitrate) oral tablet OTC
vitamin b-2 oral tablet OTC
vp-vite rx oral tablet OTC
VITAMIN C PREPARATIONS
acerola c-500 oral wafer OTC
ascorbate calcium oral tablet OTC
ascorbic acid (vitamin c) injection solution
zinc and c oral lozenge OTC
VITAMIN D PREPARATIONS
calcitriol oral capsule Rocaltrol PA
calcitriol oral solution Rocaltrol PA
CHOLECALCIFEROL (VITAMIN D3) ORAL CAPSULE
Decara OTC
ergocalciferol (vitamin d2) oral capsule Drisdol
vitamin d2 oral capsule
VITAMIN E PREPARATIONS
vitamin e acetate oral capsule OTC
vitamin e mixed oral capsule OTC
vitamin e oral capsule OTC
wheat germ oil oral capsule OTC
VITAMIN K PREPARATIONS
phytonadione (vitamin k1) oral tablet 100 mcg
OTC
phytonadione (vitamin k1) oral tablet 5 mg Mephyton
vitamin k injection solution
54
Drug Name Reference Notes
vitamin k1 injection solution
ZINC REPLACEMENT
chelated zinc oral tablet OTC
zinc oral tablet Chelated Zinc OTC
zinc-vit c-pyridoxine (vit b6) oral lozenge OTC
ENDOCRINE
ANDROGENIC AGENTS
ANDROGEL TRANSDERMAL GEL IN METERED-DOSE PUMP
PA; AL
ANDROGEL TRANSDERMAL GEL IN PACKET 1 % (25 MG/2.5GRAM), 1 % (50 MG/5 GRAM)
PA
ANDROGEL TRANSDERMAL GEL IN PACKET 1.62 % (20.25 MG/1.25 GRAM), 1.62 % (40.5 MG/2.5 GRAM)
PA; AL
testosterone cypionate intramuscular oil Depo-Testosterone PA
testosterone enanthate intramuscular oil PA
ANTIDIURETIC AND VASOPRESSOR HORMONES
desmopressin nasal spray with pump DDAVP
desmopressin nasal spray,non-aerosol
desmopressin oral tablet DDAVP QL
ANTIHYPERGLYCEMIC, INCRETIN MIMETIC (GLP-1 RECEPTOR AGONIST)
BYDUREON SUBCUTANEOUS PEN INJECTOR
BYDUREON SUBCUTANEOUS SUSPENSION,EXTENDED REL RECON
BYETTA SUBCUTANEOUS PEN INJECTOR
VICTOZA 2-PAK SUBCUTANEOUS PEN INJECTOR
VICTOZA 3-PAK SUBCUTANEOUS PEN INJECTOR
ANTITHYROID PREPARATIONS
methimazole oral tablet Tapazole
propylthiouracil oral tablet
55
Drug Name Reference Notes
BONE RESORPTION INHIBITORS
alendronate oral tablet
CALCITONINS
calcitonin (salmon) nasal spray,non-aerosol
DIPEPTIDYL PEPTIDASE - IV INHIBITOR & COMBINATIONS
GLYXAMBI ORAL TABLET
JANUMET ORAL TABLET
JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR
JANUVIA ORAL TABLET
JENTADUETO ORAL TABLET
TRADJENTA ORAL TABLET
ESTROGENIC AGENTS
amabelz oral tablet
estradiol oral tablet Estrace
estradiol transdermal patch weekly Climara QL
estradiol-norethindrone acet oral tablet Activella
estropipate oral tablet
fyavolv oral tablet
jevantique lo oral tablet
jinteli oral tablet
lopreeza oral tablet
mimvey lo oral tablet
mimvey oral tablet
norethindrone ac-eth estradiol oral tablet Fyavolv
PREMPHASE ORAL TABLET
PREMPRO ORAL TABLET
raloxifene oral tablet Evista
FERTILITY ENHANCER
MAKENA (PF) SUBCUTANEOUS AUTO-INJECTOR
QL
GLUCOCORTICOIDS
a-hydrocort injection recon soln
dexamethasone oral solution
dexamethasone oral tablet Decadron
56
Drug Name Reference Notes
dexamethasone sodium phosphate injection solution
hydrocortisone oral tablet Cortef
methylprednisolone acetate injection suspension
Depo-Medrol
methylprednisolone oral tablet Medrol
methylprednisolone oral tablets,dose pack Medrol (Pak)
prednisolone oral solution
prednisolone sodium phosphate oral solution 15 mg/5 ml (3 mg/ml), 25 mg/5 ml (5 mg/ml), 5 mg base/5 ml (6.7 mg/5 ml)
prednisolone sodium phosphate oral solution 15 mg/5 ml (5 ml)
prednisone oral solution
prednisone oral tablet
prednisone oral tablets,dose pack
GROWTH HORMONES
GENOTROPIN MINIQUICK SUBCUTANEOUS SYRINGE
PA; AL
GENOTROPIN SUBCUTANEOUS CARTRIDGE
PA; AL
NUTROPIN AQ NUSPIN SUBCUTANEOUS PEN INJECTOR
PA; AL
HYPERGLYCEMICS
dex4 glucose bits oral tablet,chewable OTC
dex4 glucose oral tablet,chewable OTC
dex4 glucose pouch pack oral tablet,chewable
OTC
dex4 glucose quick dissolve oral tablet,chewable
OTC
dextrose oral gel Dex4 Glucose OTC
GLUCAGEN HYPOKIT INJECTION RECON SOLN
GLUCAGON EMERGENCY KIT (HUMAN) INJECTION RECON SOLN
gluco burst oral gel OTC
glucose bits oral tablet,chewable OTC
glucose gel oral gel OTC
glucose oral tablet,chewable Dex4 Glucose OTC
57
Drug Name Reference Notes
HYPOGLYCEMICS, ALPHA GLUCOSIDASE INHIBITOR TYPE
acarbose oral tablet Precose
HYPOGLYCEMICS, BIGUANIDINE TYPE
metformin oral tablet Glucophage
metformin oral tablet extended release 24 hr
Glucophage XR
metformin oral tablet,er gast.retention 24 hr
Glumetza PA
HYPOGLYCEMICS, INSULIN - RELEASE STIMULANT TYPE
glimepiride oral tablet Amaryl
glipizide oral tablet Glucotrol
glipizide oral tablet extended release 24hr Glucotrol XL
glyburide micronized oral tablet Glynase
glyburide oral tablet
glyburide-metformin oral tablet
nateglinide oral tablet Starlix
repaglinide oral tablet Prandin
HYPOGLYCEMICS, INSULIN - RESPONSE ENHANCER
pioglitazone oral tablet Actos
INSULINS
HUMALOG MIX 50-50 INSULN U-100 SUBCUTANEOUS SUSPENSION
HUMALOG MIX 75-25(U-100)INSULN SUBCUTANEOUS SUSPENSION
HUMALOG U-100 INSULIN SUBCUTANEOUS SOLUTION
HUMULIN 70/30 U-100 INSULIN SUBCUTANEOUS SUSPENSION
OTC
HUMULIN N NPH U-100 INSULIN SUBCUTANEOUS SUSPENSION
OTC
HUMULIN R REGULAR U-100 INSULN INJECTION SOLUTION
OTC
HUMULIN R U-500 (CONC) INSULIN SUBCUTANEOUS SOLUTION
HUMULIN R U-500 (CONC) KWIKPEN SUBCUTANEOUS INSULIN PEN
58
Drug Name Reference Notes
LANTUS SOLOSTAR U-100 INSULIN SUBCUTANEOUS INSULIN PEN
LANTUS U-100 INSULIN SUBCUTANEOUS SOLUTION
LEVEMIR FLEXTOUCH U-100 INSULN SUBCUTANEOUS INSULIN PEN
LEVEMIR U-100 INSULIN SUBCUTANEOUS SOLUTION
NOVOLOG FLEXPEN U-100 INSULIN SUBCUTANEOUS INSULIN PEN
NOVOLOG MIX 70-30 U-100 INSULN SUBCUTANEOUS SOLUTION
NOVOLOG MIX 70-30FLEXPEN U-100 SUBCUTANEOUS INSULIN PEN
NOVOLOG PENFILL U-100 INSULIN SUBCUTANEOUS CARTRIDGE
NOVOLOG U-100 INSULIN ASPART SUBCUTANEOUS SOLUTION
MINERALOCORTICOIDES
fludrocortisone oral tablet
OXYTOCICS
METHYLERGONOVINE INJECTION SOLUTION
methylergonovine oral tablet Methergine
PITUITARY SUPPRESSIVE AGENTS
cabergoline oral tablet QL
PROGESTATIONAL AGENTS
MAKENA (PF) SUBCUTANEOUS AUTO-INJECTOR
QL
medroxyprogesterone oral tablet Provera
norethindrone acetate oral tablet Aygestin
progesterone in oil intramuscular oil
progesterone intramuscular oil Progesterone in Oil
progesterone micronized oral capsule Prometrium
SODIUM GLUCOSE (SGLT2) INHIBITORS
FARXIGA ORAL TABLET PA; AL
INVOKANA ORAL TABLET AL
JARDIANCE ORAL TABLET AL
59
Drug Name Reference Notes
SYNJARDY ORAL TABLET AL
THYROID HORMONES
levothyroxine oral tablet Levo-T
levoxyl oral tablet
liothyronine oral tablet Cytomel
nature-throid oral tablet
np thyroid oral tablet
thyroid (pork) oral tablet Armour Thyroid
unithroid oral tablet
westhroid oral tablet
GASTROINTESTINAL THERAPY AGENTS
ANTACIDS
alum-mag hydroxide-simeth oral suspension
Advanced Antacid-Antigas OTC
antacid (calcium carb-mag hyd) oral tablet,chewable
OTC
ANTACID (CALCIUM CARBONATE) ORAL TABLET,CHEWABLE
OTC
antacid supreme oral suspension OTC
liquid antacid oral suspension OTC
mi-acid oral tablet,chewable OTC
ri-mag oral suspension OTC
ri-mag plus oral suspension OTC
ANTIDIARRHEALS
bismuth subsalicylate oral suspension Anti-Diarrheal OTC; QL
diphenoxylate-atropine oral liquid
diphenoxylate-atropine oral tablet Lomotil
loperamide oral capsule Anti-Diarrheal (loperamide) OTC; QL
ANTIEMETIC/ANTIVERTIGO AGENTS
anti-nausea oral solution OTC
dronabinol oral capsule Marinol
formula em oral solution OTC
meclizine oral tablet OTC
nausea control oral solution OTC
nausea relief oral solution OTC
ondansetron hcl oral tablet 24 mg QL
60
Drug Name Reference Notes
ondansetron hcl oral tablet 4 mg, 8 mg Zofran
ondansetron oral tablet,disintegrating
phenadoz rectal suppository 12.5 mg
phenadoz rectal suppository 25 mg AL
phenergan rectal suppository AL
prochlorperazine edisylate injection solution
prochlorperazine maleate oral tablet Compazine
prochlorperazine rectal suppository Compazine
promethazine oral syrup
promethazine oral tablet
promethazine rectal suppository 12.5 mg Phenadoz AL
promethazine rectal suppository 25 mg Phenadoz
promethegan rectal suppository
ANTIFLATULENTS
GAS RELIEF ORAL CAPSULE OTC
SIMETHICONE ORAL CAPSULE Anti-Gas Ultra Strength OTC
ANTISPASMODICS
dicyclomine oral capsule
dicyclomine oral solution
dicyclomine oral tablet
glycopyrrolate oral tablet
hyoscyamine sulfate oral drops Hyosyne
hyoscyamine sulfate oral elixir Hyosyne
hyoscyamine sulfate oral tablet Levsin
hyoscyamine sulfate oral tablet extended release 12 hr
Levbid
hyoscyamine sulfate oral tablet,disintegrating
Anaspaz
hyoscyamine sulfate sublingual tablet Levsin/SL
hyosyne oral drops
hyosyne oral elixir
oscimin oral tablet
oscimin oral tablet,disintegrating
oscimin sl sublingual tablet
oscimin sr oral tablet extended release 12 hr
propantheline oral tablet
61
Drug Name Reference Notes
symax fastabs oral tablet,disintegrating
symax-sr oral tablet extended release 12 hr
BILE SALTS
ursodiol oral tablet URSO 250
CHRONIC IIDOPATHIC CONST. AGENTS - GUANYLATE CYCLASE-C (GC-C) AGONISTS
LINZESS ORAL CAPSULE PA; AL
CHRONIC INFLAMMATION, COLON DISEASE, 5-AMINOSALICYLATES
APRISO ORAL CAPSULE,EXTENDED RELEASE 24HR
CANASA RECTAL SUPPOSITORY
LIALDA ORAL TABLET,DELAYED RELEASE (DR/EC)
mesalamine rectal enema Rowasa
PENTASA ORAL CAPSULE, EXTENDED RELEASE
sulfasalazine oral tablet Azulfidine
sulfasalazine oral tablet,delayed release (dr/ec)
Azulfidine EN-tabs
GASTRIC ACID SECRETION REDUCERS
CARAFATE ORAL SUSPENSION
famotidine (pf) intravenous solution
famotidine oral tablet 20 mg Acid Controller OTC
famotidine oral tablet 40 mg Pepcid
misoprostol oral tablet Cytotec
omeprazole oral capsule,delayed release(dr/ec)
pantoprazole oral tablet,delayed release (dr/ec)
Protonix
PRILOSEC OTC ORAL TABLET,DELAYED RELEASE (DR/EC)
OTC
ranitidine hcl oral syrup
ranitidine hcl oral tablet 150 mg Acid Control (ranitidine) OTC
ranitidine hcl oral tablet 300 mg Zantac
sucralfate oral suspension Carafate
62
Drug Name Reference Notes
sucralfate oral tablet Carafate
INFLAMMATORY BOWEL AGENTS
budesonide oral capsule,delayed,extend.release
Entocort EC
budesonide oral tablet,delayed and ext.release
Uceris PA
colocort rectal enema
HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT
AL
HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT
AL
HUMIRA PEN PSORIASIS-UVEITIS SUBCUTANEOUS PEN INJECTOR KIT
AL
HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT
AL
HUMIRA SUBCUTANEOUS SYRINGE KIT
AL
hydrocortisone rectal enema Colocort
INTESTINAL MOTILITY STIMULANTS
metoclopramide hcl oral solution
metoclopramide hcl oral tablet Reglan
IRRITABLE BOWEL SYNDROME (IBS) AGENTS
AMITIZA ORAL CAPSULE PA; AL
LINZESS ORAL CAPSULE PA; AL
LAXATIVES AND CATHARTICS
constulose oral solution QL
easy fiber oral powder OTC
enulose oral solution
epsom salt oral granules OTC
fiber (dextrin) oral powder OTC
FIBER (PSYLLIUM HUSK/SUGAR) ORAL POWDER
OTC
fiber supplement (inulin) oral tablet,chewable
OTC
gavilax oral powder in packet OTC; QL
gavilyte-c oral recon soln QL
gavilyte-g oral recon soln QL
63
Drug Name Reference Notes
gavilyte-n oral recon soln QL
generlac oral solution
KONSYL FORMULA-D ORAL POWDER OTC
lactulose oral solution 10 gram/15 ml Constulose QL
lactulose oral solution 10 gram/15 ml (15 ml)
QL
lactulose oral solution 20 gram/30 ml
mineral oil extra heavy oral oil OTC
mineral oil laxative oral oil OTC
NATURAL FIBER LAXATIVE (SUGAR) ORAL POWDER
OTC
natural fiber laxative(aspart) oral powder OTC
peg 3350-electrolytes oral recon soln GaviLyte-G QL
peg-3350 with flavor packs oral recon soln QL
peg-electrolyte soln oral recon soln GaviLyte-N QL
polyethylene glycol 3350 oral powder ClearLax OTC
polyethylene glycol 3350 oral powder in packet
ClearLax OTC; QL
reguloid (dextrose) oral powder OTC
senna concentrate oral tablet OTC
senna-gen oral tablet OTC
sennosides oral tablet Evac-U-Gen (sennosides) OTC
stool softener oral capsule OTC
trilyte with flavor packets oral recon soln QL
PANCREATIC ENZYMES
CREON ORAL CAPSULE,DELAYED RELEASE(DR/EC)
PA
dairy aid oral tablet,chewable OTC
dairy digestive oral tablet OTC
dairy digestive supplement oral tablet OTC
dairy relief oral tablet OTC
dairy relief oral tablet,chewable OTC
lac-dose oral tablet OTC
lactase fast acting oral tablet OTC
lactase fast acting oral tablet,chewable OTC
lactase oral tablet Dairy Relief OTC
ultra dairy digestive oral tablet OTC
64
Drug Name Reference Notes
ZENPEP ORAL CAPSULE,DELAYED RELEASE(DR/EC)
PA
PEPTIC ULCER TREATMENT AGENTS
PYLERA ORAL CAPSULE
GENITOURINARY THERAPY
BENIGN PROSTATIC HYPERTROPHY/MICTURITION AGENTS
alfuzosin oral tablet extended release 24 hr
Uroxatral
dutasteride oral capsule Avodart
finasteride oral tablet Proscar
tamsulosin oral capsule Flomax
BLOOD DETOXICANTS
calcium acetate oral capsule
RENAGEL ORAL TABLET
RENVELA ORAL TABLET
PARASYMPATHETIC AGENTS
bethanechol chloride oral tablet Urecholine
URINARY ACIDIFIER
av-phos 250 neutral oral tablet OTC
k-phos-neutral oral tablet OTC
phospha 250 neutral oral tablet OTC
phospho-trin 250 neutral oral tablet OTC
virt-phos 250 neutral oral tablet OTC
URINARY ANTIBACTERIAL AGENTS
methenamine hippurate oral tablet Hiprex
methenamine mandelate oral tablet
nitrofurantoin macrocrystal oral capsule Macrodantin
nitrofurantoin monohyd/m-cryst oral capsule
Macrobid
URINARY PH MODIFIERS
cytra k crystals oral packet
cytra-2 oral solution OTC
cytra-3 oral solution OTC
cytra-k oral solution OTC
65
Drug Name Reference Notes
potassium citrate oral tablet extended release
Urocit-K 10
potassium citrate-citric acid oral solution Cytra-K OTC
sodium citrate-citric acid oral solution Cytra-2 OTC
tricitrates oral solution OTC
virtrate-k oral solution OTC
URINARY TRACT ANESTHETIC/ANALGESIC AGENT
phenazopyridine oral tablet Pyridium
urinary pain relief oral tablet OTC
urinary tract oral tablet OTC
URINARY TRACT ANTISPASMODIC/ANTI-INCONTINENCE AGENT
oxybutynin chloride oral syrup
oxybutynin chloride oral tablet
oxybutynin chloride oral tablet extended release 24hr
TOVIAZ ORAL TABLET EXTENDED RELEASE 24 HR
VESICARE ORAL TABLET
GOUT AND HYPERURICEMIA THERAPY
COLCHICINE COMBINATION
probenecid-colchicine oral tablet
COLCHICINES
COLCHICINE ORAL CAPSULE Mitigare
HYPERURICEMIA TREATMENT - PURINE INHIBITORS
allopurinol oral tablet Zyloprim
URICOSURIC AGENTS
probenecid oral tablet
HEMATOLOGICAL AGENTS
ANTIFIBRINOLYTIC AGENTS
tranexamic acid oral tablet Lysteda QL
C1 ESTERASE INHIBITOR AGENTS
BERINERT INTRAVENOUS KIT
66
Drug Name Reference Notes
CINRYZE INTRAVENOUS RECON SOLN
HEMATINICS, OTHER
ARANESP (IN POLYSORBATE) INJECTION SOLUTION
ARANESP (IN POLYSORBATE) INJECTION SYRINGE
PROCRIT INJECTION SOLUTION
HEMORRHEOLOGIC AGENTS
pentoxifylline oral tablet extended release
HEPARIN AND RELATED PREPARATIONS
enoxaparin subcutaneous solution Lovenox
enoxaparin subcutaneous syringe Lovenox
heparin (porcine) injection cartridge
heparin (porcine) injection solution
heparin (porcine) injection syringe
heparin, porcine (pf) injection solution
heparin, porcine (pf) injection syringe
ORAL ANTICOAGULANTS
ELIQUIS ORAL TABLET
ELIQUIS ORAL TABLETS,DOSE PACK
jantoven oral tablet
warfarin oral tablet Coumadin
XARELTO ORAL TABLET
PLATELET AGGREGATION INHIBITORS
adult low dose aspirin oral tablet,delayed release (dr/ec)
OTC
anagrelide oral capsule Agrylin
BRILINTA ORAL TABLET
cilostazol oral tablet
clopidogrel oral tablet Plavix
dipyridamole intravenous solution
dipyridamole oral tablet
enteric coated aspirin oral tablet,delayed release (dr/ec)
OTC
67
Drug Name Reference Notes
lo-dose aspirin oral tablet,delayed release (dr/ec)
OTC
prasugrel oral tablet Effient
SICKLE CELL ANEMIA AGENTS
DROXIA ORAL CAPSULE
THROMBIN INHIBITORS
PRADAXA ORAL CAPSULE
IMMUNOSUPPRESSIVE AGENTS
IMMUNOSUPRESSANTS
azathioprine oral tablet Imuran
cyclosporine modified oral capsule Gengraf
cyclosporine modified oral solution Gengraf
cyclosporine oral capsule Sandimmune
gengraf oral capsule
gengraf oral solution
mycophenolate mofetil oral capsule CellCept
mycophenolate mofetil oral suspension for reconstitution
CellCept
mycophenolate mofetil oral tablet CellCept
mycophenolate sodium oral tablet,delayed release (dr/ec)
Myfortic
RAPAMUNE ORAL SOLUTION
SANDIMMUNE ORAL SOLUTION
sirolimus oral tablet Rapamune
tacrolimus oral capsule Prograf
IMPOTENCE AGENTS
IMPOTENCE AGENTS
sildenafil oral tablet Viagra
LOCOMOTOR SYSTEM
MUSCULOSKELETAL THERAPY AGENTS
EUFLEXXA INTRA-ARTICULAR SYRINGE
PA; QL
GELSYN-3 INTRA-ARTICULAR SYRINGE
PA; QL
SUPARTZ FX INTRA-ARTICULAR SYRINGE
PA; QL
68
Drug Name Reference Notes
OTHER CNS/AUTONOMIC DRUGS
MESTINON ORAL SYRUP
pyridostigmine bromide oral tablet Mestinon
pyridostigmine bromide oral tablet extended release
Mestinon Timespan
SKELETAL MUSCLE RELAXANTS
baclofen oral tablet 10 mg, 20 mg
BACLOFEN ORAL TABLET 5 MG
chlorzoxazone oral tablet
cyclobenzaprine oral tablet
dantrolene oral capsule Dantrium
methocarbamol oral tablet Robaxin
riluzole oral tablet Rilutek PA
tizanidine oral tablet
MEDICAL SUPPLIES AND DURABLE MEDICAL EQUIPMENT (DME)
ANTISEPTICS - OTHER
alcoh-wipe towelette OTC
BLOOD SUGAR DIAGNOSTICS
TRUE METRIX GLUCOSE TEST STRIP STRIP
OTC; QL
CONDOMS
AIMSCO LATEX CONDOM DEVICE OTC; QL
CONDOMS-PREM LUBRICATED DEVICE
OTC
FANTASY CONDOM DEVICE OTC; QL
FC2 FEMALE CONDOM OTC
KIMONO CONDOMS(NON-LUBRICATED) DEVICE
OTC
KIMONO MAXX CONDOMS DEVICE OTC
KIMONO MICROTHIN AQUA LUBE CON DEVICE
OTC
KIMONO MICROTHIN CONDOMS DEVICE
OTC
KIMONO MICROTHIN LARGE CONDOMS DEVICE
OTC
KIMONO TEXTURED CONDOMS DEVICE
OTC
69
Drug Name Reference Notes
TRUSTEX LATEX CONDOM DEVICE OTC
TRUSTEX LUBRICATED CONDOMS DEVICE
OTC
TRUSTEX NON-LUB CONDOMS DEVICE
OTC
TRUSTEX-RIA LUB/SPERMICIDE DEVICE
OTC
TRUSTEX-RIA LUBRICATED CONDOMS DEVICE
OTC
TRUSTEX-RIA NON-LUB CONDOMS DEVICE
OTC
DIAPHRAGMS/CERVICAL CAP
WIDE-SEAL DIAPHRAGM 60 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 65 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 70 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 75 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 80 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 85 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 90 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 95 VAGINAL DIAPHRAGM
MEDICAL SUPPLIES AND DME - GLUCOSE MONITORING TEST SUPPLIES
1ST TIER UNILET COMFORTOUCH OTC; QL
ACCU-CHEK SOFTCLIX LANCET DEV OTC
ADJUSTABLE LANCING DEVICE OTC
ADVANCED TRAVEL LANCETS OTC; QL
ADVOCATE LANCING DEVICE OTC
ADVOCATE RAPID-SAFE LANCING OTC
ALTERNATE SITE LANCET OTC; QL
ALTERNATE SITE LANCING DEVICE OTC
AQUA LANCE LANCING DEVICE OTC
70
Drug Name Reference Notes
ASSURE HAEMOLANCE PLUS OTC; QL
ASSURE LANCE OTC; QL
ASSURE LANCE PLUS OTC; QL
AUTO-LANCET MINI OTC
AUTOLET IMPRESSION LANC DEV KIT OTC
AUTOLET LANCING DEVICE OTC
AUTOLET PLUS LANCING DEVICE OTC
CAREONE LANCING DEVICE OTC
CAREONE THIN LANCET OTC; QL
CAREONE ULTRA THIN LANCET OTC; QL
CARETOUCH LANCING DEVICE OTC
CARETOUCH TWIST LANCET OTC; QL
COLOR LANCETS OTC; QL
COMFORT LANCETS OTC; QL
DROPLET LANCING DEVICE OTC
EASY MINI EJECT LANCING DEVICE OTC
EASY TOUCH LANCETS OTC; QL
EASY TOUCH LANCING DEVICE OTC
EASY TOUCH SAFETY LANCETS OTC; QL
EASY TOUCH TWIST LANCETS OTC; QL
E-Z JECT LANCETS OTC; QL
E-Z JECT THIN LANCETS OTC; QL
EZ SMART LANCETS OTC; QL
FINE 30 UNIVERSAL LANCETS OTC; QL
FORA LANCING DEVICE OTC
FORACARE LANCETS OTC; QL
GLUCOCOM LANCETS OTC; QL
HEALTHY ACCENTS AUTOLET OTC
HEALTHY ACCENTS UNILET LANCET OTC; QL
HYPOLANCE AST LANCING KIT OTC
INCONTROL LANCING DEVICE OTC
INCONTROL SUPER THIN LANCETS OTC; QL
INCONTROL ULTRA THIN LANCETS OTC; QL
INVACARE LANCETS OTC; QL
LANZO LANCING DEVICE KIT OTC
LITE TOUCH LANCING DEVICE OTC
MICRO THIN LANCETS OTC; QL
71
Drug Name Reference Notes
MICROLET NEXT LANCING DEVICE KIT
OTC
MINI LANCING DEVICE OTC
MONOLET LANCETS OTC; QL
MONOLET THIN LANCETS OTC; QL
MULTI-LANCET DEVICE 2 KIT OTC
MYGLUCOHEALTH LANCETS OTC; QL
ON CALL LANCING DEVICE OTC
ON CALL PLUS LANCING DEVICE OTC
ON-THE-GO LANCETS OTC; QL
PRODIGY LANCING DEVICE OTC
RELIAMED MINI LANCING DEVICE OTC
RELION THIN LANCETS OTC; QL
RELION ULTRA THIN PLUS LANCETS OTC; QL
RIGHTEST GD500 LANCING DEVICE OTC
RIGHTEST GL300 LANCETS OTC; QL
SMART SENSE LANCETS OTC; QL
SMARTDIABETES VANTAGE OTC
STERILANCE TL OTC; QL
SUPER THIN LANCETS OTC; QL
SURE COMFORT LANCING PEN OTC
SUREFLEX LANCING DEVICE OTC
SURE-PEN LANCING DEVICE OTC
TECHLITE LANCETS OTC; QL
THIN LANCETS OTC; QL
TOPCARE UNIVERSAL1 LANCET OTC; QL
TRUE METRIX LEVEL 1 SOLUTION OTC
TRUE METRIX LEVEL 2 SOLUTION OTC
TRUE METRIX LEVEL 3 SOLUTION OTC
TRUEDRAW LANCING DEVICE OTC
TRUEPLUS LANCETS OTC; QL
TWIST LANCETS OTC; QL
ULTI-LANCE OTC
ULTRA THIN LANCETS OTC; QL
ULTRA THIN PLUS LANCETS OTC; QL
ULTRA-CARE LANCETS OTC; QL
UNILET COMFORTOUCH LANCET OTC; QL
72
Drug Name Reference Notes
UNILET EXCELITE II LANCET OTC; QL
UNILET EXCELITE LANCET OTC; QL
UNILET GP LANCET OTC; QL
UNILET LANCET OTC; QL
UNILET LANCETS OTC; QL
UNILET SUPER THIN LANCETS OTC; QL
UNISTIK 2 DEVICE KIT OTC
UNISTIK 3 COMFORT DEVICE KIT OTC
UNISTIK 3 COMFORT LANCET OTC; QL
UNISTIK 3 EXTRA LANCET OTC; QL
UNISTIK 3 GENTLE OTC; QL
UNISTIK 3 KIT OTC
UNISTIK 3 LANCETS OTC; QL
UNISTIK 3 NEONATAL DEVICE KIT OTC
UNISTIK 3 NEONATAL KIT OTC
UNISTIK 3 NORMAL LANCET OTC; QL
UNISTIK CZT LANCET OTC; QL
UNISTIK PRO LANCET OTC; QL
UNISTIK SAFETY OTC; QL
UNISTIK TOUCH LANCETS OTC; QL
UNIVERSAL 1 LANCETS OTC; QL
MEDICAL SUPPLIES AND DME - PEAK FLOW METERS
AIRZONE PEAK FLOW METER DEVICE OTC; QL
ASTHMA CHECK METER DEVICE OTC; QL
IN-CHECK NASAL WITH MASK DEVICE OTC
IN-CHECK ORAL FLOW METER DEVICE
OTC
MICROLIFE PEAK FLOW METER DEVICE
OTC; QL
MINI WRIGHT PEAK FLOW METER DEVICE
QL
PEAK AIR PEAK FLOW METER DEVICE
OTC; QL
PERSONAL BEST FULL RANGE DEVICE
OTC; QL
PERSONAL BEST LOW RANGE DEVICE
OTC; QL
PIKO 1 DEVICE OTC; QL
73
Drug Name Reference Notes
POCKET PEAK FLOW METER DEVICE OTC; QL
TRUZONE PEAK FLOW METER DEVICE
QL
NEEDLES/NEEDLELESS DEVICES, SYRINGES AND ACCESSORIES
BD AUTOSHIELD DUO PEN NEEDLE NEEDLE
OTC
BD ECLIPSE LUER-LOK SYRINGE OTC
BD INSULIN SYRINGE HALF UNIT SYRINGE
OTC
BD INSULIN SYRINGE MICRO-FINE SYRINGE
OTC
BD INSULIN SYRINGE SAFETY-LOK SYRINGE
OTC
BD INSULIN SYRINGE SLIP TIP SYRINGE
OTC
BD INSULIN SYRINGE SYRINGE OTC
BD INSULIN SYRINGE U-500 SYRINGE
BD INSULIN SYRINGE ULTRA-FINE SYRINGE
OTC
BD LO-DOSE MICRO-FINE IV SYRINGE OTC
BD LO-DOSE ULTRA-FINE SYRINGE OTC
BD LUER-LOK SYRINGE SYRINGE OTC
BD SAFETYGLIDE INSULIN SYRINGE SYRINGE
OTC
BD ULTRA-FINE MICRO PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE MINI PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE NANO PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE ORIG PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE SHORT PEN NEEDLE NEEDLE
OTC
BD VEO INSULIN SYR HALF UNIT SYRINGE
OTC
BD VEO INSULIN SYRINGE UF SYRINGE
OTC
insulin syringe microfine syringe OTC
insulin syringe needleless syringe BD Insulin Syringe Slip Tip OTC
74
Drug Name Reference Notes
INSULIN SYRINGE SYRINGE OTC
insulin syringe-needle u-100 syringe BD Insulin Syringe OTC
RESPIRATORY AIDS, SPACERS, DEVICES AND EQUIPMENT
ACE AEROSOL CLOUD ENHANCER SPACER
QL
AEROTRACH PLUS SPACER QL
AEROVENT PLUS SPACER QL
BREATHERITE MDI SPACER SPACER QL
BREATHERITE SPACER-MASK, NEO. SPACER
QL
BREATHERITE SPACER-MASK,ADULT SPACER
QL
BREATHERITE SPACER-MASK,CHILD SPACER
QL
BREATHERITE SPACER-MASK,INFANT SPACER
QL
BREATHERITE SPACER-MASK,S.CHLD SPACER
QL
BREATHERITE VALVED MDI CHAMBER SPACER
QL
BREATHERITE VALVED MDI SPACER SPACER
QL
COMPACT SPACE CHAMBER SPACER QL
COMPACT SPACE CHAMBER-LRG MASK SPACER
QL
COMPACT SPACE CHAMBER-MED MASK SPACER
QL
COMPACT SPACE CHAMBER-SM MASK SPACER
QL
LITEAIRE MDI CHAMBER SPACER QL
MICROCHAMBER SPACER QL
MICROSPACER SPACER QL
OPTICHAMBER ADULT MASK-LARGE DEVICE
QL
OPTICHAMBER DIAMOND LG MASK SPACER
QL
OPTICHAMBER DIAMOND VHC SPACER
QL
OPTICHAMBER DIAMOND-MED MSK SPACER
QL
75
Drug Name Reference Notes
OPTICHAMBER DIAMOND-SML MASK SPACER
QL
PANDA MASK DEVICE OTC; QL
PEDIATRIC MEDIUM MASK DEVICE OTC; QL
PEDIATRIC PANDA MASK DEVICE OTC; QL
PEDIATRIC SMALL MASK DEVICE OTC; QL
POCKET CHAMBER SPACER QL
PRIMEAIRE SPACER QL
PROCHAMBER SPACER QL
RITEFLO AEROCHAMBER SPACER QL
SIDESTREAM PEDIATRIC FACE MASK DEVICE
OTC; QL
VORTEX HOLDING CHAMBER CHILD SPACER
QL
VORTEX HOLDING CHAMBER SPACER
QL
VORTEX HOLDING CHAMBER TODDLER SPACER
QL
VORTEX VHC FROG MASK-CHILD SPACER
QL
VORTEX VHC LADYBUG MASK-TODDLR SPACER
QL
URINE KETONE TEST AIDS
KETONE CARE STRIP OTC; QL
KETONE URINE TEST STRIP OTC; QL
KETOSTIX STRIP OTC; QL
TRUEPLUS KETONE STRIP OTC; QL
METABOLIC MODIFIERS
METABOLIC DEFICIENCY AGENTS
calcitriol oral capsule Rocaltrol PA
calcitriol oral solution Rocaltrol PA
levocarnitine oral tablet Carnitor OTC
sodium phenylbutyrate oral powder Buphenyl PA; QL
sodium phenylbutyrate oral tablet Buphenyl QL
PHARMACOENHANCER - CYTOCHROME P450 INHIBITORS
TYBOST ORAL TABLET
76
Drug Name Reference Notes
OPHTHALMIC AGENTS
ARTIFICIAL TEARS
advanced eye relief ophthalmic (eye) drops
OTC
artificial tears(glycerin-peg) ophthalmic (eye) drops
OTC
artificial tears(pg-hypm-glyc) ophthalmic (eye) drops
OTC
dry eye relief ophthalmic (eye) drops OTC
eye drop tears ophthalmic (eye) drops OTC
eye drops (with povidone) ophthalmic (eye) drops
OTC
eye drops advanced relief ophthalmic (eye) drops
OTC
lubricant (p-glycol-glycerin) ophthalmic (eye) drops
OTC
moisture drops ophthalmic (eye) drops OTC
tearfair ophthalmic (eye) drops OTC
MIOTICS/OTHER INTRAOCULAR PRESSURE REDUCERS
ALPHAGAN P OPHTHALMIC (EYE) DROPS
AZOPT OPHTHALMIC (EYE) DROPS,SUSPENSION
brimonidine ophthalmic (eye) drops
carteolol ophthalmic (eye) drops
dorzolamide ophthalmic (eye) drops Trusopt
latanoprost ophthalmic (eye) drops Xalatan
levobunolol ophthalmic (eye) drops
metipranolol ophthalmic (eye) drops
timolol maleate ophthalmic (eye) drops Timoptic
timolol maleate ophthalmic (eye) drops, once daily
Istalol
timolol maleate ophthalmic (eye) gel forming solution
Timoptic-XE
TRAVATAN Z OPHTHALMIC (EYE) DROPS
MYDRIATICS
atropine ophthalmic (eye) drops Isopto Atropine QL
atropine ophthalmic (eye) ointment QL
77
Drug Name Reference Notes
OPHTHALMIC ANTIBIOTIC - CORTICOID COMBINATIONS
neomycin-polymyxin b-dexameth ophthalmic (eye) drops,suspension
Maxitrol
neomycin-polymyxin b-dexameth ophthalmic (eye) ointment
Maxitrol
TOBRADEX OPHTHALMIC (EYE) DROPS,SUSPENSION
TOBRADEX OPHTHALMIC (EYE) OINTMENT
OPHTHALMIC ANTIBIOTICS
ciprofloxacin hcl ophthalmic (eye) drops Ciloxan
erythromycin ophthalmic (eye) ointment
gentak ophthalmic (eye) ointment
gentamicin ophthalmic (eye) drops
gentamicin ophthalmic (eye) ointment Gentak
MOXEZA OPHTHALMIC (EYE) DROPS, VISCOUS
ofloxacin ophthalmic (eye) drops Ocuflox
polymyxin b sulf-trimethoprim ophthalmic (eye) drops
Polytrim
tobramycin ophthalmic (eye) drops Tobrex
VIGAMOX OPHTHALMIC (EYE) DROPS
OPHTHALMIC ANTIHISTAMINES
PAZEO OPHTHALMIC (EYE) DROPS
redness reliever lubricant ophthalmic (eye) drops
OTC
ZADITOR OPHTHALMIC (EYE) DROPS OTC
OPHTHALMIC ANTI-INFLAMMATORY AGENTS
diclofenac sodium ophthalmic (eye) drops
DUREZOL OPHTHALMIC (EYE) DROPS
fluorometholone ophthalmic (eye) drops,suspension
FML Liquifilm
flurbiprofen sodium ophthalmic (eye) drops
ketorolac ophthalmic (eye) drops Acular
PREDNISOLONE ACETATE (PF) OPHTHALMIC (EYE) DROPS,SUSPENSION
78
Drug Name Reference Notes
prednisolone acetate ophthalmic (eye) drops,suspension
Omnipred
XIIDRA OPHTHALMIC (EYE) DROPPERETTE
PA; QL
OPHTHALMIC ANTIVIRALS
trifluridine ophthalmic (eye) drops Viroptic QL
OPHTHALMIC BETA BLOCKERS
COMBIGAN OPHTHALMIC (EYE) DROPS
DORZOLAMIDE-TIMOLOL (PF) OPHTHALMIC (EYE) DROPS
dorzolamide-timolol ophthalmic (eye) drops
Cosopt
OPHTHALMIC DECONGESTANT
eye drops allergy relief ophthalmic (eye) drops
OTC; QL
phenylephrine hcl ophthalmic (eye) drops
redness reliever lubricant ophthalmic (eye) drops
OTC
tetrahydrozoline ophthalmic (eye) drops Altazine OTC; QL
OPHTHALMIC MAST CELL STABILIZERS
cromolyn ophthalmic (eye) drops
OPHTHALMIC, OTHER
SIMBRINZA OPHTHALMIC (EYE) DROPS,SUSPENSION
OTIC
OTIC PREPARATIONS, MISCELLANEOUS ANTI-INFECTIVES
acetic acid otic (ear) solution
carbamide peroxide otic (ear) drops Carbamoxide Ear Drops OTC
CIPRODEX OTIC (EAR) DROPS,SUSPENSION
ear wax drops otic (ear) drops OTC
79
Drug Name Reference Notes
RESPIRATORY AIDS, SPACERS, DEVICES AND EQUIPMENT
RESPIRATORY AIDS, SPACERS, DEVICES AND EQUIPMENT
1ST TIER UNILET COMFORTOUCH OTC; QL
ACCU-CHEK SOFTCLIX LANCET DEV OTC
ACE AEROSOL CLOUD ENHANCER SPACER
QL
ADJUSTABLE LANCING DEVICE OTC
ADVANCED TRAVEL LANCETS OTC; QL
ADVOCATE LANCING DEVICE OTC
ADVOCATE RAPID-SAFE LANCING OTC
AEROTRACH PLUS SPACER QL
AEROVENT PLUS SPACER QL
AIMSCO LATEX CONDOM DEVICE OTC; QL
AIRZONE PEAK FLOW METER DEVICE OTC; QL
ALTERNATE SITE LANCET OTC; QL
ALTERNATE SITE LANCING DEVICE OTC
AQUA LANCE LANCING DEVICE OTC
ASSURE HAEMOLANCE PLUS OTC; QL
ASSURE LANCE OTC; QL
ASSURE LANCE PLUS OTC; QL
ASTHMA CHECK METER DEVICE OTC; QL
AUTO-LANCET MINI OTC
AUTOLET IMPRESSION LANC DEV KIT OTC
AUTOLET LANCING DEVICE OTC
AUTOLET PLUS LANCING DEVICE OTC
AZO TEST STRIPS STRIP OTC
BD AUTOSHIELD DUO PEN NEEDLE NEEDLE
OTC
BD ECLIPSE LUER-LOK SYRINGE OTC
BD INSULIN SYRINGE HALF UNIT SYRINGE
OTC
BD INSULIN SYRINGE MICRO-FINE SYRINGE
OTC
BD INSULIN SYRINGE SAFETY-LOK SYRINGE
OTC
BD INSULIN SYRINGE SLIP TIP SYRINGE
OTC
80
Drug Name Reference Notes
BD INSULIN SYRINGE SYRINGE OTC
BD INSULIN SYRINGE U-500 SYRINGE
BD INSULIN SYRINGE ULTRA-FINE SYRINGE
OTC
BD LO-DOSE MICRO-FINE IV SYRINGE OTC
BD LO-DOSE ULTRA-FINE SYRINGE OTC
BD LUER-LOK SYRINGE SYRINGE OTC
BD SAFETYGLIDE INSULIN SYRINGE SYRINGE
OTC
BD ULTRA-FINE MICRO PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE MINI PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE NANO PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE ORIG PEN NEEDLE NEEDLE
OTC
BD ULTRA-FINE SHORT PEN NEEDLE NEEDLE
OTC
BD VEO INSULIN SYR HALF UNIT SYRINGE
OTC
BD VEO INSULIN SYRINGE UF SYRINGE
OTC
BREATHERITE MDI SPACER SPACER QL
BREATHERITE SPACER-MASK, NEO. SPACER
QL
BREATHERITE SPACER-MASK,ADULT SPACER
QL
BREATHERITE SPACER-MASK,CHILD SPACER
QL
BREATHERITE SPACER-MASK,INFANT SPACER
QL
BREATHERITE SPACER-MASK,S.CHLD SPACER
QL
BREATHERITE VALVED MDI CHAMBER SPACER
QL
BREATHERITE VALVED MDI SPACER SPACER
QL
CAREONE LANCING DEVICE OTC
CAREONE THIN LANCET OTC; QL
CAREONE ULTRA THIN LANCET OTC; QL
81
Drug Name Reference Notes
CARETOUCH LANCING DEVICE OTC
CARETOUCH TWIST LANCET OTC; QL
COLOR LANCETS OTC; QL
COMFORT LANCETS OTC; QL
COMPACT SPACE CHAMBER SPACER QL
COMPACT SPACE CHAMBER-LRG MASK SPACER
QL
COMPACT SPACE CHAMBER-MED MASK SPACER
QL
COMPACT SPACE CHAMBER-SM MASK SPACER
QL
CONDOMS-PREM LUBRICATED DEVICE
OTC
DROPLET LANCING DEVICE OTC
EASY MINI EJECT LANCING DEVICE OTC
EASY TOUCH LANCETS 26 GAUGE, 30 GAUGE, 32 GAUGE
OTC; QL
EASY TOUCH LANCETS 28 GAUGE OTC
EASY TOUCH LANCING DEVICE OTC
EASY TOUCH SAFETY LANCETS OTC; QL
EASY TOUCH TWIST LANCETS OTC; QL
E-Z JECT LANCETS OTC; QL
E-Z JECT THIN LANCETS OTC; QL
EZ SMART LANCETS OTC; QL
FANTASY CONDOM DEVICE OTC; QL
FC2 FEMALE CONDOM OTC
FINE 30 UNIVERSAL LANCETS OTC; QL
FORA LANCING DEVICE OTC
FORACARE LANCETS OTC
GLUCOCOM LANCETS OTC; QL
HEALTHY ACCENTS AUTOLET OTC
HEALTHY ACCENTS UNILET LANCET OTC; QL
HYPOLANCE AST LANCING KIT OTC
IN-CHECK NASAL WITH MASK DEVICE OTC
IN-CHECK ORAL FLOW METER DEVICE
OTC
INCONTROL LANCING DEVICE OTC
INCONTROL SUPER THIN LANCETS OTC; QL
82
Drug Name Reference Notes
INCONTROL ULTRA THIN LANCETS OTC; QL
insulin syringe microfine syringe OTC
insulin syringe needleless syringe BD Insulin Syringe Slip Tip OTC
INSULIN SYRINGE SYRINGE OTC
insulin syringe-needle u-100 syringe BD Insulin Syringe OTC
INVACARE LANCETS OTC; QL
KETONE CARE STRIP OTC; QL
KETONE URINE TEST STRIP OTC; QL
KETOSTIX STRIP OTC; QL
KIMONO CONDOMS(NON-LUBRICATED) DEVICE
OTC
KIMONO MAXX CONDOMS DEVICE OTC
KIMONO MICROTHIN AQUA LUBE CON DEVICE
OTC
KIMONO MICROTHIN CONDOMS DEVICE
OTC
KIMONO MICROTHIN LARGE CONDOMS DEVICE
OTC
KIMONO TEXTURED CONDOMS DEVICE
OTC
LANZO LANCING DEVICE KIT OTC
LITE TOUCH LANCING DEVICE OTC
LITEAIRE MDI CHAMBER SPACER QL
MICRO THIN LANCETS OTC; QL
MICROCHAMBER SPACER QL
MICROLET NEXT LANCING DEVICE KIT
OTC
MICROLIFE PEAK FLOW METER DEVICE
OTC; QL
MICROSPACER SPACER QL
MINI LANCING DEVICE OTC
MINI WRIGHT PEAK FLOW METER DEVICE
QL
MONOLET LANCETS OTC; QL
MONOLET THIN LANCETS OTC; QL
MULTI-LANCET DEVICE 2 KIT OTC
MYGLUCOHEALTH LANCETS OTC; QL
ON CALL LANCING DEVICE OTC
ON CALL PLUS LANCING DEVICE OTC
83
Drug Name Reference Notes
ON-THE-GO LANCETS OTC; QL
OPTICHAMBER ADULT MASK-LARGE DEVICE
QL
OPTICHAMBER DIAMOND LG MASK SPACER
QL
OPTICHAMBER DIAMOND VHC SPACER
QL
OPTICHAMBER DIAMOND-MED MSK SPACER
QL
OPTICHAMBER DIAMOND-SML MASK SPACER
QL
PANDA MASK DEVICE OTC; QL
PEAK AIR PEAK FLOW METER DEVICE
OTC; QL
PEDIATRIC MEDIUM MASK DEVICE OTC; QL
PEDIATRIC PANDA MASK DEVICE OTC; QL
PEDIATRIC SMALL MASK DEVICE OTC; QL
PERSONAL BEST FULL RANGE DEVICE
OTC; QL
PERSONAL BEST LOW RANGE DEVICE
OTC; QL
PIKO 1 DEVICE OTC; QL
POCKET CHAMBER SPACER QL
POCKET PEAK FLOW METER DEVICE OTC; QL
PRIMEAIRE SPACER QL
PROCHAMBER SPACER QL
PRODIGY LANCING DEVICE OTC
RELIAMED MINI LANCING DEVICE OTC
RELION THIN LANCETS OTC; QL
RELION ULTRA THIN PLUS LANCETS OTC; QL
RIGHTEST GD500 LANCING DEVICE OTC
RIGHTEST GL300 LANCETS OTC; QL
RITEFLO AEROCHAMBER SPACER QL
SIDESTREAM PEDIATRIC FACE MASK DEVICE
OTC; QL
SMART SENSE LANCETS OTC; QL
SMARTDIABETES VANTAGE OTC
STERILANCE TL OTC; QL
SUPER THIN LANCETS OTC; QL
84
Drug Name Reference Notes
SURE COMFORT LANCING PEN OTC
SUREFLEX LANCING DEVICE OTC
SURE-PEN LANCING DEVICE OTC
TECHLITE LANCETS OTC; QL
THIN LANCETS OTC; QL
TOPCARE UNIVERSAL1 LANCET OTC; QL
TRUE METRIX GLUCOSE TEST STRIP STRIP
OTC; QL
TRUE METRIX LEVEL 1 SOLUTION OTC
TRUE METRIX LEVEL 2 SOLUTION OTC
TRUE METRIX LEVEL 3 SOLUTION OTC
TRUEDRAW LANCING DEVICE OTC
TRUEPLUS KETONE STRIP OTC; QL
TRUEPLUS LANCETS OTC; QL
TRUSTEX LATEX CONDOM DEVICE OTC
TRUSTEX LUBRICATED CONDOMS DEVICE
OTC
TRUSTEX NON-LUB CONDOMS DEVICE
OTC
TRUSTEX-RIA LUB/SPERMICIDE DEVICE
OTC
TRUSTEX-RIA LUBRICATED CONDOMS DEVICE
OTC
TRUSTEX-RIA NON-LUB CONDOMS DEVICE
OTC
TRUZONE PEAK FLOW METER DEVICE
QL
TWIST LANCETS OTC; QL
ULTI-LANCE OTC
ULTRA THIN LANCETS OTC; QL
ULTRA THIN PLUS LANCETS OTC; QL
ULTRA-CARE LANCETS OTC; QL
UNILET COMFORTOUCH LANCET OTC; QL
UNILET EXCELITE II LANCET OTC; QL
UNILET EXCELITE LANCET OTC; QL
UNILET GP LANCET OTC; QL
UNILET LANCET OTC; QL
UNILET LANCETS OTC; QL
UNILET SUPER THIN LANCETS OTC; QL
85
Drug Name Reference Notes
UNISTIK 2 DEVICE KIT OTC
UNISTIK 3 COMFORT DEVICE KIT OTC
UNISTIK 3 COMFORT LANCET OTC; QL
UNISTIK 3 EXTRA LANCET OTC; QL
UNISTIK 3 GENTLE OTC; QL
UNISTIK 3 KIT OTC
UNISTIK 3 LANCETS OTC; QL
UNISTIK 3 NEONATAL DEVICE KIT OTC
UNISTIK 3 NEONATAL KIT OTC
UNISTIK 3 NORMAL LANCET OTC; QL
UNISTIK CZT LANCET OTC; QL
UNISTIK PRO LANCET OTC; QL
UNISTIK SAFETY OTC; QL
UNISTIK TOUCH LANCETS OTC; QL
UNIVERSAL 1 LANCETS OTC; QL
URINARY TRACT INF.TEST (WBCS) STRIP
OTC
VORTEX HOLDING CHAMBER CHILD SPACER
QL
VORTEX HOLDING CHAMBER SPACER
QL
VORTEX HOLDING CHAMBER TODDLER SPACER
QL
VORTEX VHC FROG MASK-CHILD SPACER
QL
VORTEX VHC LADYBUG MASK-TODDLR SPACER
QL
WIDE-SEAL DIAPHRAGM 60 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 65 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 70 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 75 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 80 VAGINAL DIAPHRAGM
QL
WIDE-SEAL DIAPHRAGM 85 VAGINAL DIAPHRAGM
QL
86
Drug Name Reference Notes
WIDE-SEAL DIAPHRAGM 90 VAGINAL DIAPHRAGM
WIDE-SEAL DIAPHRAGM 95 VAGINAL DIAPHRAGM
RESPIRATORY THERAPY AGENTS
ALPHA/BETA ADRENERGIC AGENTS
epinephrine injection solution Adrenalin
epinephrine injection syringe
ANALGESIC/ANTIPYRETICS, NON-SALICYLATE
headache relief pm oral tablet OTC
menstrual relief oral tablet OTC
midol pm oral tablet OTC
ANTIHISTAMINE AND DECONGESTANT COMBINATIONS
allergy and sinus relief oral tablet AL; OTC
hist-pse oral liquid AL; OTC
lohist - d oral liquid AL; OTC
loratadine-pseudoephedrine oral tablet extended release 24 hr
AllerClear D-24hr AL; OTC
promethazine vc oral syrup AL
promethazine-phenylephrine oral syrup Promethazine VC AL
rynex pse oral liquid AL; OTC
ANTIHISTAMINES
24hr allergy relief oral tablet OTC
allergy relief (clemastine) oral tablet OTC
ALLERGY RELIEF(CHLORPHENIRAMN) ORAL TABLET EXTENDED RELEASE
OTC
carbinoxamine maleate oral liquid AL
carbinoxamine maleate oral tablet AL
CHILDREN'S ZYRTEC ALLERGY ORAL SOLUTION
OTC
clemastine oral tablet 1.34 mg Allergy Relief (clemastine)
clemastine oral tablet 2.68 mg
cyproheptadine oral syrup
cyproheptadine oral tablet
dayhist allergy oral tablet OTC
87
Drug Name Reference Notes
diphenhydramine hcl oral capsule Banophen OTC
diphenhydramine hcl oral elixirChildren's Allergy (diphenhyd)
OTC
levocetirizine oral tablet 24HR Allergy Relief OTC
phenadoz rectal suppository 12.5 mg
phenadoz rectal suppository 25 mg AL
phenergan rectal suppository AL
promethazine oral syrup
promethazine oral tablet
promethazine rectal suppository 12.5 mg Phenadoz AL
promethazine rectal suppository 25 mg Phenadoz
promethegan rectal suppository
restfully sleep oral tablet OTC
ASTHMA THERAPY AGENTS
ASMANEX TWISTHALER INHALATION AEROSOL POWDR BREATH ACTIVATED
cromolyn inhalation solution for nebulization
FLOVENT DISKUS INHALATION BLISTER WITH DEVICE
FLOVENT HFA INHALATION HFA AEROSOL INHALER
montelukast oral tablet Singulair
montelukast oral tablet,chewable Singulair
PULMICORT FLEXHALER INHALATION AEROSOL POWDR BREATH ACTIVATED
PULMICORT INHALATION SUSPENSION FOR NEBULIZATION
BETA-ADRENERGIC AGENTS
albuterol sulfate inhalation solution for nebulization
albuterol sulfate oral syrup
albuterol sulfate oral tablet
albuterol sulfate oral tablet extended release 12 hr
metaproterenol oral syrup
metaproterenol oral tablet
88
Drug Name Reference Notes
PROAIR HFA INHALATION HFA AEROSOL INHALER
PROVENTIL HFA INHALATION HFA AEROSOL INHALER
SEREVENT DISKUS INHALATION BLISTER WITH DEVICE
AL
terbutaline oral tablet
BETA-ADRENERGIC COMBINATION AGENTS
ANORO ELLIPTA INHALATION BLISTER WITH DEVICE
AL
BEVESPI AEROSPHERE INHALATION HFA AEROSOL INHALER
COMBIVENT RESPIMAT INHALATION MIST
ipratropium-albuterol inhalation solution for nebulization
STIOLTO RESPIMAT INHALATION MIST
AL
BETA-ADRENERGICS AND GLUCOCORTICOIDS COMBINATIONS
ADVAIR DISKUS INHALATION BLISTER WITH DEVICE
AL
DULERA INHALATION HFA AEROSOL INHALER
AL
SYMBICORT INHALATION HFA AEROSOL INHALER
AL
CYSTIC FIBROSIS THERAPY AGENTS
BETHKIS INHALATION SOLUTION FOR NEBULIZATION
AL; QL
KITABIS PAK INHALATION SOLUTION FOR NEBULIZATION
AL; QL
TOBI PODHALER INHALATION CAPSULE
TOBI PODHALER INHALATION CAPSULE, W/INHALATION DEVICE
DECONGESTANT COMBINATIONS
ibuprofen cold oral suspension AL; OTC
pain reliever pm oral tablet OTC
89
Drug Name Reference Notes
GENERAL BRONCHODILATOR AGENTS
ATROVENT HFA INHALATION HFA AEROSOL INHALER
ipratropium bromide inhalation solution
SPIRIVA WITH HANDIHALER INHALATION CAPSULE, W/INHALATION DEVICE
IMMUNOGLOBULIN ANTIBODIES
XOLAIR SUBCUTANEOUS RECON SOLN
PA
MUCOLYTICS
acetylcysteine solution
PULMOZYME INHALATION SOLUTION PA; QL
NARCOTIC ANTITUSSIVE COMBINATIONS
codeine-guaifenesin oral liquid Cheratussin AC AL; OTC
hydrocodone compound oral syrup
hydrocodone-homatropine oral syrup 5-1.5 mg/5 ml
Hydrocodone Compound AL
HYDROCODONE-HOMATROPINE ORAL SYRUP 5-1.5 MG/5 ML (5 ML)
AL
hydromet oral syrup AL
promethazine-codeine oral syrup
NASAL ANTIBIOTICS
BACTROBAN NASAL NASAL OINTMENT
NASAL ANTICHOLINERGICS
ipratropium bromide nasal spray,non-aerosol
NASAL ANTIHISTAMINES
azelastine nasal aerosol,spray
azelastine nasal spray,non-aerosol Astepro
NASAL, OTHER
nasal mist nasal aerosol,spray OTC
sodium chloride nasal aerosol,spray Altamist OTC
sterile saline nasal aerosol,spray OTC
90
Drug Name Reference Notes
NON-NARCOTIC ANTITUSSIVE COMBINATIONS
30pse-150gfn-15dm oral liquid AL; OTC
benzonatate oral capsule AL
BROMPHENEX DM ORAL SYRUP AL; OTC
COUGH DM ER ORAL SUSPENSION,EXTENDED REL 12 HR
OTC
GUIATUSS DM ORAL SYRUP OTC
head congestion cold relief oral tablets, sequential
AL; OTC
night time cold-flu oral liquid AL; OTC
nite time cold-flu formula oral capsule AL; OTC
nite-time cold-flu oral capsule AL; OTC
nite-time oral liquid AL; OTC
non-aspirin flu oral tablet OTC
promethazine-dm oral syrup AL
tussin cf oral syrup AL; OTC
XANTHINES
theochron oral tablet extended release 12 hr
theophylline oral elixir Elixophyllin
theophylline oral solution
theophylline oral tablet extended release 12 hr
Theochron
theophylline oral tablet extended release 24 hr
VAGINAL PRODUCTS
VAGINAL AGENTS
CRINONE VAGINAL GEL
VAGINAL ANTIBIOTICS
CLEOCIN VAGINAL SUPPOSITORY
CLINDESSE VAGINAL CREAM,EXTENDED RELEASE
metronidazole vaginal gel Metrogel Vaginal
vandazole vaginal gel
VAGINAL ANTIFUNGALS
MICONAZOLE NITRATE VAGINAL KIT Monistat 1 Combo Pack OTC
91
Drug Name Reference Notes
MICONAZOLE-3 PREFIL,CREAM,WIPE VAGINAL KIT
OTC
miconazole-3 vaginal suppository PA
miconazole-skin clnsr17 vaginal kitMiconazole-3 prefil,cream,wipe
OTC
terconazole vaginal cream
terconazole vaginal suppository
tioconazole vaginal ointment 1-Day OTC
tioconazole-1 vaginal ointment OTC
VAGINAL ESTROGEN PREPARATIONS
estradiol vaginal tablet Vagifem
PREMARIN VAGINAL CREAM
VAGIFEM VAGINAL TABLET
92