`Ohana Medicaid Comprehensive Preferred Drug List (QExA)

Transcription

2014
‘Ohana Medicaid Comprehensive
Preferred Drug List (QExA)
(List of Covered Drugs)
‘Ohana Health Plan
00
Please read: This document contains information about the drugs we cover in this
plan.
Please note that the ‘Ohana Health Plan Preferred Drug List (QExA) is updated
quarterly.
Providers, please visit our website at
https://www.ohanahealthplan.com/provider/pharmacy to view updates to the preferred
drug list.
Members, please visit our website at
https://www.ohanahealthplan.com/member/QExA/pharmacy to view updates to the
preferred drug list.
Last updated (01/01/2014)
Hawaii Medicaid Cough & Cold Drug List
Non-Preferred Drugs
Preferred Drugs
ANTITUSSIVES,NON-NARCOTIC
Benzonatate
TESSALON 200 MG CAPSULE
BENZONATATE 100 MG CAPSULE
BENZONATATE 200 MG CAPSULE
Dextromethorphan Polistirex
DELSYM 30 MG/5 ML EXTENDED-RELEASE SUSPENSION
Dextromethorphan HBr
ROBITUSSIN PEDIATRIC COUGH SYP
Dextromethorphan HBr/Menthol
DELSYM COUGH RELIEF PLUS LOZENGE
NON-NARC ANTITUSS-1ST GEN. ANTIHISTAMINE-DECONGEST
Brompheniramine/Dextromethorphan HBr/Pseudoephedrine HCl
ALLANHIST PDX DROPS
BROMFED DM SYRUP
BROMHIST PDX DROPS
ENDACOF-PD DROPS
BROTAPP DM LIQUID
Q-TAPP DM ELIXIR
Brophenaramine/Dextromethorphan HBr/Phenylephrine HCl
COLD/COUGH CHILDRENS ELIXIR
RYNEX DM
DIMAPHEN DM ELIXIR
Chlorpheniramine/Dextromethorphan HBr/Phenylephrine HCl
C-PHEN DM
PD-COF SYRUP
RONDEX-DM SYRUP
SILDEC PE-DM SYRUP
DE-CHLOR DM LIQUID
CORFEN DM
NOHIST-DM
TRI-DEX PE
Chlorpheniramine/Dextromethorphan HBr/Pseudoephedrine HCl
PEDIATRIC COUGH-COLD LIQUID
KIDKARE COUGH/COLD
MESEHIST DM
Dexchlorpheniramine/Pseudoephedrine HCl/Chlophedianol HCl
VANACOF LIQUID
Chlorpheniramine/Dextromethorphan HBr
DIMETAPP LONG-ACTING COUGH LIQ
ROBITUSSIN LONG ACTING LIQUID
Promethazine HCl/Dextromethorphan HBr
PROMETHAZINE-DM SYRUP
NON-NARC ANTITUSS-1ST GEN. ANTIHIST-ANALGESIC COMBINATION
Dextromethorphan HBr/Acetaminophen/Doxylamine
DELSYM NIGHTTIME MULTI-SYMPTOM
EXPECTORANTS
DECONGESTANT-EXPECTORANT COMBINATIONS
Guaifenesin/Phenylephrine HCl
DONATUSSIN DROPS
PE-GUAI DROPS
DESPEC LIQUID
RESCON-GG LIQUID
NON-NARCOTIC DECONGESTANT-EXPECTORANT-ANTITUSSIVE
Guaifenesin/Dextromethorphan HBr/Phenylephreine
ROBAFEN CF SYRUP
Last updated 01/01/14
Page 1 of 2
Hawaii Medicaid Cough & Cold Drug List
Non-Preferred Drugs
Preferred Drugs
NON-NARCOTIC ANTITUSSIVE AND EXPECTORANT COMB.
Dextromethorphan HBr/Guaifenesin
DURATUSS DM ELIXIR
SIMUC-DM ELIXIR
SU-TUSS DM ELIXIR
MUCUS RELIEF COUGH LIQUID
DIABETIC TUSSIN DM LIQUID
GUAIFENESIN DM SYRUP
Q-TUSSIN-DM SYRUP
EXTRA ACTION COUGH
SILTUSSIN DM COUGH SYRUP
REFENESEN DM
SILTUSSIN DM DAS COUGH SYRUP
MUCOSA DM
ROBITUSSIN COUGH CHEST CONGESTION DM LIQUID
NARCOTIC ANTITUSSIVE-1ST GENERATION ANTIHISTAMINE
Chlorpheniramine/Hydrocodone Polistirex
TUSSIONEX PENNKINETIC SUSP
TUSSICAPS (min. age 6 years old)
HYDROCODONE-CHLORPHENIRAMINE
SUSPENSION (min. age 6 years old)
Codeine Phosphate/Promethazine HCl
PROMETHAZINE-CODEINE SYRUP (min. age 6 years old)
NARCOTIC ANTITUSSIVE-1ST GEN. ANTIHISTAMINE-DECONGESTANT
Dexbrompheniramine/Hydrocodone Bit/Phenylephrine HCl
CYTUSS-HC NR SYRUP
HC 2.5-PE 5-DBROM 1 MG SYRUP
HC/PE/DBROM SYRUP
Codeine/Phenylephrine HCl/Promethazine
PROMETH VC W/COD SYRUP
PROMETHAZINE VC/COD SYRUP
Pseudoephedrine HCl/Codeine/Chlorpheniramine
PHENYLHISTINE DH
NARCOTIC ANTITUSSIVE-ANTICHOLINERGIC COMBINATION
Hydrocodone Bit/Homatropine
HYDROCODONE-HOMATROPINE
HYDROMET SYRUP
NARCOTIC ANTITUSSIVE-EXPECTORANT COMBINATION
Guaifenesin/Hydrocodone Bit
HYDROCODONE-GUAIFENESIN SYRUP
NARCOF SYRUP
Codeine Phosphate/Guaifenesin
TUSSICLEAR DH SYRUP
CHERATUSSIN AC SYRUP
GUAIFENESIN-CODEINE SYRUP
IOPHEN C-NR
NARCOTIC ANTITUSSIVE-DECONGESTANT-EXPECTORANT COMBINATIONS
Codeine Phosphate/Guaifenesin/Pseudoephedrine HCl
CHERATUSSIN DAC SYRUP
Last updated 01/01/14
Page 2 of 2
Vaccines: Vaccines are covered under the Vaccines for Children program for members through 18 years of age.
Coverage beyond the age of 18 is evaluated through the PA process.
UPPERCASE = Brand name drugs
italics = Generic drugs
Drug Name
Preference Details
P = Preferred
Dagger (†) = N/A
Asterisk (*) = N/A
Asterisk (**) = N/A
Asterisk (***) = N/A
XX = N/A
Coverage Details
PA = Prior Authorization
ST = Step Therapy
QL = Quantity Limit
AL = Age Limit
OTC = OTC- Covered w/Rx
Preference Details Coverage Details
*Adhd/Anti-Narcolepsy/Anti-Obesity/Anorexia
nts*
*Amphetamines**
*Amphetamine Mixtures***
ADDERALL XR ORAL CAPSULE
EXTENDED RELEASE 24 HOUR 10 MG,
15 MG, 20 MG, 25 MG, 30 MG, 5 MG
P
Amphetamine-Dextroamphet ER ORAL
CAPSULE EXTENDED RELEASE 24
HOUR 10 MG, 15 MG, 20 MG, 25 MG, 30
MG, 5 MG
P
Amphetamine-Dextroamphetamine ORAL
TABLET 10 MG, 12.5 MG, 15 MG, 20 MG, 30
MG, 5 MG, 7.5 MG
P
*Amphetamines***
Dextroamphetamine Sulfate ORAL TABLET
10 MG, 5 MG
P
Dextroamphetamine Sulfate ER ORAL
HOUR 10 MG, 15 MG, 5 MG
P
Methamphetamine HCl ORAL TABLET 5 MG
P
PROCENTRA ORAL SOLUTION 5
MG/5ML
P
1
Drug Name
VYVANSE ORAL CAPSULE 20 MG, 30
MG, 40 MG, 50 MG, 60 MG, 70 MG
P
ZENZEDI ORAL TABLET 2.5 MG, 7.5 MG
P
*Anti-Obesity Agents**
*Lipase Inhibitors***
XENICAL ORAL CAPSULE 120 MG
P
*Attention-Deficit/Hyperactivity Disorder
(Adhd) Agents**
*Adhd Agent - Selective Alpha Adrenergic
Agonists***
CloNIDine HCl ER ORAL TABLET
EXTENDED RELEASE 12 HR* 0.1 MG
P
INTUNIV ORAL TABLET EXTENDED
RELEASE 24 HR* 1 MG, 2 MG, 3 MG, 4
MG
P
KAPVAY ORAL TABLET EXTENDED
RELEASE 12 HR* 0.1 MG
P
*Adhd Agent - Selective Norepinephrine
Reuptake Inhibitor***
STRATTERA ORAL CAPSULE 10 MG, 100
MG, 18 MG, 25 MG, 40 MG, 60 MG, 80 MG
P
*Stimulants - Misc.**
*Stimulants - Misc.***
DAYTRANA TRANSDERMAL PATCH 10
MG/9HR, 15 MG/9HR, 20 MG/9HR, 30
MG/9HR
P
Dexmethylphenidate HCl ORAL TABLET 10
MG, 2.5 MG, 5 MG
P
FOCALIN XR ORAL CAPSULE
15 MG, 20 MG, 25 MG, 30 MG, 35 MG, 40
MG, 5 MG
P
METADATE ER ORAL TABLET
EXTENDEDRELEASE* 20 MG
P
METHYLIN ORAL TABLET CHEWABLE
10 MG, 2.5 MG, 5 MG
P
Methylphenidate HCl ORAL SOLUTION 10
MG/5ML, 5 MG/5ML
P
Methylphenidate HCl ORAL TABLET 10 MG,
20 MG, 5 MG
P
2
PA
Drug Name
Methylphenidate HCl ER ORAL TABLET
EXTENDEDRELEASE* 10 MG, 18 MG, 20
MG, 27 MG, 36 MG, 54 MG
P
Methylphenidate HCl ER (CD) ORAL
CAPSULE EXTENDED RELEASE* 10 MG,
20 MG, 30 MG, 40 MG, 50 MG, 60 MG
P
Methylphenidate HCl ER (LA) ORAL
HOUR 20 MG, 30 MG, 40 MG
P
QUILLIVANT XR ORAL SUSPENSION
RECONSTITUTED 25 MG/5ML
P
RITALIN LA ORAL CAPSULE
EXTENDED RELEASE 24 HOUR 10 MG
P
*Alternative Medicines*
*Alternative Medicine - M's**
*Alternative Medicine - Me's***
Melatonin Maximum Strength ORAL
TABLET 5 MG
P
OTC
*Aminoglycosides*
*Aminoglycosides**
*Aminoglycosides***
Neomycin Sulfate ORAL TABLET 500 MG
P
TOBI INHALATION NEBULIZATION
SOLUTION 300 MG/5ML
P
PA
HUMIRA SUBCUTANEOUS* KIT 20
MG/0.4ML, 40 MG/0.8ML
P
PA
HUMIRA PEN SUBCUTANEOUS* KIT 40
MG/0.8ML
P
PA
HUMIRA PEN-CROHNS STARTER
SUBCUTANEOUS* KIT 40 MG/0.8ML
P
PA
SIMPONI SUBCUTANEOUS* SOLUTION
100 MG/ML, 50 MG/0.5ML
P
PA
*Analgesics - Anti-Inflammatory*
*Anti-Tnf-Alpha - Monoclonal Antibodies**
*Anti-Tnf-Alpha - Monoclonal Antibodies***
*Gold Compounds**
*Gold Compounds***
RIDAURA ORAL CAPSULE 3 MG
P
3
Drug Name
*Nonsteroidal Anti-Inflammatory Agents
(Nsaids)**
*Cyclooxygenase 2 (Cox-2) Inhibitors***
CELEBREX ORAL CAPSULE 100 MG, 200
MG, 400 MG, 50 MG
P
ST; QL (31 EA per 31 day(s))
Childrens Ibuprofen ORAL SUSPENSION 40
MG/ML
P
OTC
Diclofenac Potassium ORAL TABLET 50 MG
P
Diclofenac Sodium ORAL TABLET
DELAYED RELEASE 25 MG, 50 MG, 75 MG
P
Diclofenac Sodium ER ORAL TABLET
EXTENDED RELEASE 24 HR* 100 MG
P
Etodolac ORAL CAPSULE 200 MG, 300 MG
P
Etodolac ORAL TABLET 400 MG, 500 MG
P
Fenoprofen Calcium ORAL TABLET 600 MG
P
Flurbiprofen ORAL TABLET 100 MG, 50 MG
P
Ibuprofen ORAL SUSPENSION 100
MG/5ML
P
OTC
Ibuprofen ORAL TABLET 200 MG
P
OTC
Ibuprofen ORAL TABLET 400 MG, 600 MG,
800 MG
P
Ibuprofen Junior Strength ORAL TABLET
CHEWABLE 100 MG
P
Indomethacin ORAL CAPSULE 25 MG, 50
MG
P
Ketoprofen ORAL CAPSULE 50 MG, 75 MG
P
Ketorolac Tromethamine ORAL TABLET 10
MG
P
Meloxicam ORAL TABLET 15 MG, 7.5 MG
P
Nabumetone ORAL TABLET 500 MG, 750
MG
P
Naproxen ORAL SUSPENSION 125
MG/5ML
P
Naproxen ORAL TABLET 250 MG, 375 MG,
500 MG
P
Naproxen DR ORAL TABLET DELAYED
RELEASE 500 MG
P
*Nonsteroidal Anti-Inflammatory Agents
(Nsaids)***
4
OTC
QL (20 EA per 31 day(s))
QL (2000 ML per 31 day(s))
Drug Name
Naproxen Sodium ORAL TABLET 275 MG,
550 MG
P
Oxaprozin ORAL TABLET 600 MG
P
Piroxicam ORAL CAPSULE 10 MG, 20 MG
P
Sulindac ORAL TABLET 150 MG, 200 MG
P
Tolmetin Sodium ORAL CAPSULE 400 MG
P
*Pyrimidine Synthesis Inhibitors**
*Pyrimidine Synthesis Inhibitors***
Leflunomide ORAL TABLET 10 MG, 20 MG
P
*Analgesics - Nonnarcotic*
*Analgesic Combinations**
*Analgesics-Sedatives***
Butalbital-Acetaminophen ORAL TABLET
50-325 MG
P
Butalbital-APAP-Caffeine ORAL CAPSULE
50-325-40 MG
P
Butalbital-APAP-Caffeine ORAL TABLET
50-325-40 MG, 50-500-40 MG
P
Butalbital-ASA-Caffeine ORAL CAPSULE
50-325-40 MG
P
TENCON ORAL TABLET 50-650 MG
P
ZEBUTAL ORAL CAPSULE 50-500-40 MG
P
ACEPHEN RE SUPPOSITORY 120 MG, 325
MG, 650 MG
P
OTC
Acetaminophen ORAL SOLUTION 160
MG/5ML
P
OTC
Acetaminophen ORAL TABLET 325 MG
P
OTC; QL (279 EA per 31 day(s))
Acetaminophen ORAL TABLET 500 MG
P
Acetaminophen ORAL TABLET CHEWABLE
80 MG
P
OTC
Childrens Silapap ORAL LIQUID† 160
MG/5ML
P
OTC
FEVERALL RE SUPPOSITORY 650 MG, 80
MG
P
OTC
Infants Silapap ORAL SOLUTION 100
MG/ML
P
OTC
*Analgesics Other**
*Analgesics Other***
5
Drug Name
JUNIOR MAPAP ORAL TABLET
DISPERSIBLE 160 MG
P
OTC
Mapap ORAL CAPSULE 500 MG
P
Mapap ORAL LIQUID† 160 MG/5ML
P
OTC
Mapap Arthritis Pain ORAL TABLET
P
MAPAP CHILDRENS ORAL
SUSPENSION 160 MG/5ML
P
OTC
Nortemp Infants ORAL SUSPENSION 80
MG/0.8ML
P
OTC
Pain & Fever Childrens ORAL SOLUTION
160 MG/5ML
P
OTC
*Salicylates**
*Salicylate Combinations***
Choline & Mag Trisalicylate ORAL TABLET
1000 MG
P
Choline-Mag Trisalicylate ORAL LIQUID†
500 MG/5ML
P
Tri-Buffered Aspirin ORAL TABLET 325 MG
P
OTC
Aspirin ORAL TABLET 325 MG, 81 MG
P
OTC
Aspirin ORAL TABLET CHEWABLE 81 MG
P
OTC
Aspirin RE SUPPOSITORY 300 MG, 600 MG
P
OTC
Aspirin EC ORAL TABLET DELAYED
RELEASE 325 MG
P
OTC
Aspirin Low Dose ORAL TABLET 81 MG
P
OTC
Diflunisal ORAL TABLET 500 MG
P
Salsalate ORAL TABLET 500 MG, 750 MG
P
*Salicylates***
*Analgesics - Opioid*
*Opioid Agonists**
*Opioid Agonists***
Codeine Phosphate INJECTION SOLUTION
15 MG/ML, 30 MG/ML
P
Codeine Sulfate ORAL TABLET 15 MG, 30
MG, 60 MG
P
FentaNYL TRANSDERMAL PATCH 72 HR
100 MCG/HR, 12 MCG/HR, 25 MCG/HR, 50
MCG/HR, 75 MCG/HR
P
PA; QL (10 EA per 30 day(s))
6
Drug Name
HYDROmorphone HCl ORAL LIQUID† 1
MG/ML
P
HYDROmorphone HCl ORAL TABLET 2
MG, 4 MG, 8 MG
P
HYDROmorphone HCl RE SUPPOSITORY 3
MG
P
Methadone HCl ORAL SOLUTION 10
MG/5ML, 5 MG/5ML
P
Methadone HCl ORAL TABLET 10 MG, 5
MG
P
METHADOSE ORAL TABLET 10 MG
P
Morphine Sulfate INJECTION SOLUTION 10
MG/ML, 15 MG/ML, 5 MG/ML, 8 MG/ML
P
Morphine Sulfate INTRAVENOUS*
SOLUTION 1 MG/ML, 25 MG/ML, 50
MG/ML
P
Morphine Sulfate ORAL SOLUTION 10
MG/5ML, 20 MG/5ML
P
Morphine Sulfate ORAL TABLET 15 MG, 30
MG
P
Morphine Sulfate RE SUPPOSITORY 10 MG,
20 MG, 30 MG, 5 MG
P
Morphine Sulfate (Concentrate) ORAL
SOLUTION 20 MG/ML
P
Morphine Sulfate (PF) INJECTION
SOLUTION 0.5 MG/ML
P
Morphine Sulfate (PF) INTRAVENOUS*
SOLUTION 8 MG/ML
P
Morphine Sulfate ER ORAL TABLET
EXTENDEDRELEASE* 100 MG, 15 MG, 200
MG, 30 MG, 60 MG
P
OxyCODONE HCl ORAL CAPSULE 5 MG
P
OxyCODONE HCl ORAL SOLUTION 5
MG/5ML
P
OxyCODONE HCl ORAL TABLET 10 MG,
15 MG, 20 MG, 5 MG
P
OxyCODONE HCl ORAL TABLET 30 MG
P
TraMADol HCl ORAL TABLET 50 MG
P
*Opioid Combinations**
*Codeine Combinations***
7
Drug Name
Acetaminophen-Codeine ORAL SOLUTION
120-12 MG/5ML
P
Acetaminophen-Codeine #2 ORAL TABLET
300-15 MG
P
300-30 MG
P
300-60 MG
P
ASCOMP-CODEINE ORAL CAPSULE
50-325-40-30 MG
P
Butalbital-APAP-Caff-Cod ORAL CAPSULE
50-325-40-30 MG
P
Butalbital-ASA-Caff-Codeine ORAL
CAPSULE 50-325-40-30 MG
P
*Hydrocodone Combinations***
Hydrocodone-Acetaminophen ORAL
SOLUTION 7.5-325 MG/15ML, 7.5-500
MG/15ML
P
Hydrocodone-Acetaminophen ORAL TABLET
10-325 MG, 10-500 MG, 10-650 MG, 10-660
MG, 10-750 MG, 2.5-500 MG, 5-325 MG,
5-500 MG, 7.5-325 MG, 7.5-500 MG, 7.5-650
MG, 7.5-750 MG
P
Hydrocodone-Ibuprofen ORAL TABLET
7.5-200 MG
P
HYDROGESIC ORAL CAPSULE 5-500 MG
P
ENDOCET ORAL TABLET 10-325 MG,
5-325 MG, 7.5-325 MG, 7.5-500 MG
P
ENDOCET ORAL TABLET 10-650 MG
P
Oxycodone-Acetaminophen ORAL CAPSULE
5-500 MG
P
Oxycodone-Acetaminophen ORAL TABLET
10-325 MG, 5-325 MG, 7.5-325 MG, 7.5-500
MG
P
Oxycodone-Acetaminophen ORAL TABLET
10-650 MG
P
Oxycodone-Aspirin ORAL TABLET
4.8355-325 MG
P
ROXICET ORAL TABLET 5-325 MG
P
*Opioid Combinations***
8
Drug Name
*Opioid Partial Agonists**
*Opioid Partial Agonists***
Buprenorphine HCl SUBLINGUAL TABLET
SUBLINGUAL 2 MG, 8 MG
P
PA
Butorphanol Tartrate NASAL SOLUTION 10
MG/ML
P
Pentazocine-Naloxone HCl ORAL TABLET
50-0.5 MG
P
SUBOXONE SUBLINGUAL FILM 12-3
MG, 2-0.5 MG, 4-1 MG, 8-2 MG
P
PA
P
PA
*Androgens-Anabolic*
*Anabolic Steroids**
*Anabolic Steroids***
Oxandrolone ORAL TABLET 10 MG, 2.5 MG
*Androgens**
*Androgens***
Danazol ORAL CAPSULE 100 MG, 200 MG,
50 MG
P
Methitest ORAL TABLET 10 MG
P
TESTIM TRANSDERMAL GEL 50
MG/5GM
P
Testosterone Cypionate INTRAMUSCULAR*
OIL 100 MG/ML, 200 MG/ML
P
Testosterone Enanthate INTRAMUSCULAR*
OIL 200 MG/ML
P
PA
*Anorectal Agents*
*Intrarectal Steroids**
*Intrarectal Steroids***
Hydrocortisone RE ENEMA 100 MG/60ML
P
*Rectal Steroids**
*Rectal Steroids***
PROCTOSOL HC RE CREAM 2.5 %
P
PROCTOZONE-HC RE CREAM 2.5 %
P
*Antacids*
*Antacid Combinations**
*Antacid & Simethicone***
Antacid ORAL SUSPENSION 200-200-20
MG/5ML
P
OTC
9
Drug Name
*Antacids - Aluminum Salts**
*Antacids - Aluminum Salts***
Aluminum Hydroxide Gel ORAL
P
OTC
P
OTC
Antacid ORAL TABLET CHEWABLE 500
MG
P
OTC
Calcium Antacid Extra Strength ORAL
TABLET CHEWABLE 750 MG
P
OTC
Calcium Carbonate Antacid ORAL TABLET
648 MG
P
OTC
Calcium Carbonate Antacid ORAL TABLET
CHEWABLE 500 MG
P
OTC
P
OTC
ALBENZA ORAL TABLET 200 MG
P
PA
BILTRICIDE ORAL TABLET 600 MG
P
PA
Reeses Pinworm Medicine ORAL
SUSPENSION 144 MG/ML
P
OTC
STROMECTOL ORAL TABLET 3 MG
P
*Antacids - Bicarbonate**
*Antacids - Bicarbonate***
Sodium Bicarbonate ORAL TABLET 325 MG,
650 MG
*Antacids - Calcium Salts**
*Antacids - Calcium Salts***
*Antacids - Magnesium Salts**
*Antacids - Magnesium Salts***
Magnesium Oxide ORAL TABLET 250 MG,
420 MG
*Anthelmintics*
*Anthelmintics**
*Anthelmintics***
*Antianginal Agents*
*Nitrates**
*Nitrates***
Isosorbide Dinitrate ORAL TABLET 10 MG,
20 MG, 30 MG, 5 MG
P
Isosorbide Dinitrate ER ORAL TABLET
P
10
Drug Name
Isosorbide Mononitrate ORAL TABLET 10
MG, 20 MG
P
Isosorbide Mononitrate ER ORAL TABLET
EXTENDED RELEASE 24 HR* 120 MG, 30
MG, 60 MG
P
NITRO-BID TRANSDERMAL
OINTMENT 2 %
P
Nitroglycerin TRANSDERMAL PATCH 24
HR 0.1 MG/HR, 0.2 MG/HR, 0.4 MG/HR, 0.6
MG/HR
P
NITROSTAT SUBLINGUAL TABLET
SUBLINGUAL 0.3 MG, 0.4 MG, 0.6 MG
P
*Antianxiety Agents*
*Antianxiety Agents - Misc.**
*Antianxiety Agents - Misc.***
BusPIRone HCl ORAL TABLET 10 MG, 15
MG, 30 MG, 5 MG, 7.5 MG
P
HydrOXYzine HCl ORAL SOLUTION 10
MG/5ML
P
HydrOXYzine HCl ORAL SYRUP 10
MG/5ML
P
HydrOXYzine HCl ORAL TABLET 10 MG,
25 MG, 50 MG
P
HydrOXYzine Pamoate ORAL CAPSULE 100
MG, 25 MG, 50 MG
P
Meprobamate ORAL TABLET 200 MG, 400
MG
P
*Benzodiazepines**
*Benzodiazepines***
ALPRAZolam ORAL TABLET 0.25 MG, 0.5
MG, 1 MG, 2 MG
P
ALPRAZolam ORAL TABLET
DISPERSIBLE 0.25 MG, 0.5 MG, 1 MG, 2
MG
P
ALPRAZolam ER ORAL TABLET
EXTENDED RELEASE 24 HR* 0.5 MG, 1
MG, 2 MG, 3 MG
P
ALPRAZolam XR ORAL TABLET
MG, 2 MG, 3 MG
P
11
Drug Name
ChlordiazePOXIDE HCl ORAL CAPSULE 10
MG, 25 MG, 5 MG
P
Clorazepate Dipotassium ORAL TABLET 15
MG, 3.75 MG, 7.5 MG
P
Diazepam INJECTION SOLUTION 5
MG/ML
P
Diazepam ORAL SOLUTION 1 MG/ML
P
Diazepam ORAL TABLET 10 MG, 2 MG, 5
MG
P
LORazepam INJECTION SOLUTION 2
MG/ML, 4 MG/ML
P
LORazepam ORAL TABLET 0.5 MG, 1 MG,
2 MG
P
LORAZEPAM INTENSOL ORAL
CONCENTRATE 2 MG/ML
P
Oxazepam ORAL CAPSULE 10 MG, 15 MG,
30 MG
P
*Antiarrhythmics*
*Antiarrhythmics Type I-A**
*Antiarrhythmics Type I-A***
Disopyramide Phosphate ORAL CAPSULE
100 MG, 150 MG
P
Procainamide HCl INJECTION SOLUTION
100 MG/ML, 500 MG/ML
P
QuiNIDine Gluconate INJECTION
SOLUTION 80 MG/ML
P
QuiNIDine Gluconate ER ORAL TABLET
P
QuiNIDine Sulfate ORAL TABLET 300 MG
P
*Antiarrhythmics Type I-B**
*Antiarrhythmics Type I-B***
Lidocaine HCl (Cardiac) INTRAVENOUS*
SOLUTION 20 MG/ML
P
Mexiletine HCl ORAL CAPSULE 150 MG,
200 MG, 250 MG
P
*Antiarrhythmics Type I-C**
*Antiarrhythmics Type I-C***
Flecainide Acetate ORAL TABLET 100 MG,
150 MG, 50 MG
12
P
AL (Min 9 Years)
Drug Name
Propafenone HCl ORAL TABLET 150 MG,
225 MG, 300 MG
P
*Antiarrhythmics Type Iii**
*Antiarrhythmics Type Iii***
Amiodarone HCl INTRAVENOUS*
SOLUTION 150 MG/3ML
P
Amiodarone HCl ORAL TABLET 200 MG,
400 MG
P
PACERONE ORAL TABLET 200 MG, 400
MG
P
*Antiasthmatic And Bronchodilator Agents*
*Antiasthmatic - Monoclonal Antibodies**
*Anti-Ige Monoclonal Antibodies***
XOLAIR SUBCUTANEOUS* SOLUTION
RECONSTITUTED 150 MG
P
PA
*Anti-Inflammatory Agents**
*Anti-Inflammatory Agents***
Cromolyn Sodium INHALATION
NEBULIZATION SOLUTION 20 MG/2ML
P
*Bronchodilators - Anticholinergics**
*Bronchodilators - Anticholinergics***
ATROVENT HFA INHALATION
AEROSOL, SOLUTION 17 MCG/ACT
P
QL (25.8 GM per 31 day(s))
Ipratropium Bromide INHALATION
SOLUTION 0.02 %
P
TUDORZA PRESSAIR INHALATION
AEROSOL POWDER, BREATH
ACTIVATED 400 MCG/ACT
P
*Leukotriene Modulators**
*Leukotriene Receptor Antagonists***
Montelukast Sodium ORAL PACKET 4 MG
P
Montelukast Sodium ORAL TABLET 10 MG
P
Montelukast Sodium ORAL TABLET
CHEWABLE 4 MG, 5 MG
P
Zafirlukast ORAL TABLET 10 MG, 20 MG
P
*Steroid Inhalants**
*Steroid Inhalants***
13
Drug Name
ASMANEX 120 METERED DOSES
INHALATION AEROSOL POWDER,
BREATH ACTIVATED 220 MCG/INH
P
BREATH ACTIVATED 110 MCG/INH, 220
MCG/INH
P
BREATH ACTIVATED 220 MCG/INH
P
Budesonide INHALATION SUSPENSION
0.25 MG/2ML, 0.5 MG/2ML
P
QL (120 ML per 31 day(s)); AL
(Max 8 Years)
FLOVENT DISKUS INHALATION
ACTIVATED 100 MCG/BLIST, 250
MCG/BLIST, 50 MCG/BLIST
P
FLOVENT HFA INHALATION
AEROSOL† 110 MCG/ACT, 220 MCG/ACT
P
QL (12 GM per 30 day(s))
FLOVENT HFA INHALATION
AEROSOL† 44 MCG/ACT
P
PULMICORT INHALATION
SUSPENSION 1 MG/2ML
P
(Max 8 Years)
QVAR INHALATION AEROSOL,
SOLUTION 40 MCG/ACT
P
QVAR INHALATION AEROSOL,
SOLUTION 80 MCG/ACT
P
ADVAIR DISKUS INHALATION
ACTIVATED 100-50 MCG/DOSE, 250-50
MCG/DOSE, 500-50 MCG/DOSE
P
ADVAIR HFA INHALATION AEROSOL†
115-21 MCG/ACT, 230-21 MCG/ACT, 45-21
MCG/ACT
P
COMBIVENT INHALATION AEROSOL†
18-103 MCG/ACT
P
COMBIVENT RESPIMAT INHALATION
AEROSOL, SOLUTION 20-100 MCG/ACT
P
DULERA INHALATION AEROSOL† 100-5
MCG/ACT, 200-5 MCG/ACT
P
*Sympathomimetics**
*Adrenergic Combinations***
14
Drug Name
Ipratropium-Albuterol INHALATION
SOLUTION 0.5-2.5 (3) MG/3ML
P
SYMBICORT INHALATION AEROSOL†
160-4.5 MCG/ACT, 80-4.5 MCG/ACT
P
Albuterol Sulfate INHALATION
NEBULIZATION SOLUTION (2.5
MG/3ML) 0.083%
P
NEBULIZATION SOLUTION (5 MG/ML)
0.5%
P
NEBULIZATION SOLUTION 0.63
MG/3ML, 1.25 MG/3ML
P
Albuterol Sulfate ORAL SYRUP 2 MG/5ML
P
Albuterol Sulfate ORAL TABLET 2 MG, 4
MG
P
FORADIL AEROLIZER INHALATION
CAPSULE 12 MCG
P
Metaproterenol Sulfate ORAL SYRUP 10
MG/5ML
P
SEREVENT DISKUS INHALATION
ACTIVATED 50 MCG/DOSE
P
Terbutaline Sulfate INJECTION SOLUTION
1 MG/ML
P
Terbutaline Sulfate ORAL TABLET 2.5 MG, 5
MG
P
VENTOLIN HFA INHALATION
AEROSOL, SOLUTION 108 (90 BASE)
MCG/ACT
P
*Beta Adrenergics***
*Xanthines**
*Xanthines***
Aminophylline INTRAVENOUS* SOLUTION
25 MG/ML
P
ELIXOPHYLLIN ORAL ELIXIR 80
MG/15ML
P
Theophylline ORAL SOLUTION 80
MG/15ML
P
15
Drug Name
Theophylline ER ORAL TABLET
MG, 300 MG, 450 MG
P
Theophylline ER ORAL TABLET
MG
P
*Anticoagulants*
*Coumarin Anticoagulants**
*Coumarin Anticoagulants***
JANTOVEN ORAL TABLET 1 MG, 10 MG,
2 MG, 2.5 MG, 3 MG, 4 MG, 5 MG, 6 MG,
7.5 MG
P
Warfarin Sodium ORAL TABLET 1 MG, 10
MG, 2 MG, 2.5 MG, 3 MG, 4 MG, 5 MG, 6
MG, 7.5 MG
P
*Direct Factor Xa Inhibitors**
*Direct Factor Xa Inhibitors***
XARELTO ORAL TABLET 10 MG
P
Enoxaparin Sodium INJECTION SOLUTION
300 MG/3ML
P
Enoxaparin Sodium SUBCUTANEOUS*
SOLUTION 100 MG/ML, 150 MG/ML
P
SOLUTION 120 MG/0.8ML, 80 MG/0.8ML
P
QL (22.4 ML per 31 day(s))
P
SOLUTION 60 MG/0.6ML
P
Fondaparinux Sodium SUBCUTANEOUS*
P
SOLUTION 2.5 MG/0.5ML
P
SOLUTION 5 MG/0.4ML
P
P
*Heparins And Heparinoid-Like Agents**
*Low Molecular Weight Heparins***
*Synthetic Heparinoid-Like Agents***
*Anticonvulsants*
16
Drug Name
*Anticonvulsants - Benzodiazepines**
*Anticonvulsants - Benzodiazepines***
ClonazePAM ORAL TABLET 0.5 MG, 1 MG,
2 MG
P
ClonazePAM ORAL TABLET
DISPERSIBLE 0.125 MG, 0.25 MG, 0.5 MG,
1 MG, 2 MG
P
Diazepam RE GEL 10 MG, 2.5 MG, 20 MG
P
ONFI ORAL SUSPENSION 2.5 MG/ML
P
ONFI ORAL TABLET 10 MG, 20 MG, 5
MG
P
*Anticonvulsants - Misc.**
*Anticonvulsants - Misc.***
BANZEL ORAL SUSPENSION 40 MG/ML
P
BANZEL ORAL TABLET 200 MG
P
BANZEL ORAL TABLET 400 MG
P
CarBAMazepine ORAL SUSPENSION 100
MG/5ML
P
CarBAMazepine ORAL TABLET 200 MG
P
CarBAMazepine ORAL TABLET
CHEWABLE 100 MG
P
CarBAMazepine ER ORAL CAPSULE
P
P
P
CarBAMazepine ER ORAL TABLET
P
CarBAMazepine ER ORAL TABLET
P
EPITOL ORAL TABLET 200 MG
P
Gabapentin ORAL CAPSULE 100 MG
P
P
P
Gabapentin ORAL SOLUTION 250 MG/5ML
P
Gabapentin ORAL TABLET 600 MG, 800 MG
P
17
Drug Name
LAMICTAL ODT ORAL KIT 25 & 50 & 100
MG
P
LAMICTAL ODT ORAL TABLET
DISPERSIBLE 100 MG, 200 MG
P
LAMICTAL ODT ORAL TABLET
P
LAMICTAL STARTER ORAL KIT 25 (35)
MG, 25 (42)-100 (7) MG, 25 (84)-100(14) MG
P
LAMICTAL XR ORAL KIT 25 (21)-50 (7)
MG
P
LamoTRIgine ORAL TABLET 100 MG, 150
MG, 200 MG
P
LamoTRIgine ORAL TABLET 25 MG
P
LamoTRIgine ORAL TABLET CHEWABLE
25 MG, 5 MG
P
LamoTRIgine ER ORAL TABLET
MG, 250 MG, 300 MG
P
LamoTRIgine ER ORAL TABLET
MG
P
LevETIRAcetam INTRAVENOUS*
SOLUTION 500 MG/5ML
P
LevETIRAcetam ORAL SOLUTION 100
MG/ML
P
LevETIRAcetam ORAL TABLET 1000 MG,
500 MG, 750 MG
P
LevETIRAcetam ORAL TABLET 250 MG
P
LevETIRAcetam ER ORAL TABLET
MG
P
Levetiracetam in NaCl INTRAVENOUS*
SOLUTION 1000 MG/100ML, 1500
MG/100ML, 500 MG/100ML
P
OXcarbazepine ORAL SUSPENSION 300
MG/5ML
P
OXcarbazepine ORAL TABLET 150 MG
P
P
P
18
Drug Name
OXTELLAR XR ORAL TABLET
EXTENDED RELEASE 24 HR* 150 MG,
300 MG, 600 MG
P
POTIGA ORAL TABLET 200 MG, 300 MG,
400 MG, 50 MG
P
Primidone ORAL TABLET 250 MG
P
Primidone ORAL TABLET 50 MG
P
TEGRETOL-XR ORAL TABLET
P
Topiramate ORAL CAPSULE SPRINKLE 15
MG, 25 MG
P
Topiramate ORAL TABLET 100 MG, 25 MG,
50 MG
P
Topiramate ORAL TABLET 200 MG
P
TROKENDI XR ORAL CAPSULE
200 MG, 25 MG, 50 MG
P
VIMPAT INTRAVENOUS* SOLUTION 200
MG/20ML
P
VIMPAT ORAL SOLUTION 10 MG/ML
P
VIMPAT ORAL TABLET 100 MG, 150 MG,
200 MG, 50 MG
P
Zonisamide ORAL CAPSULE 100 MG
P
P
P
Felbamate ORAL SUSPENSION 600
MG/5ML
P
Felbamate ORAL TABLET 400 MG
P
Felbamate ORAL TABLET 600 MG
P
*Carbamates**
*Carbamates***
*Gaba Modulators**
*Gaba Modulators***
GABITRIL ORAL TABLET 12 MG, 16 MG
P
SABRIL ORAL PACKET 500 MG
P
SABRIL ORAL TABLET 500 MG
P
TiaGABine HCl ORAL TABLET 2 MG, 4 MG
P
*Hydantoins**
19
Drug Name
*Hydantoins***
DILANTIN ORAL CAPSULE 30 MG
P
Fosphenytoin Sodium INJECTION
SOLUTION 100 MG PE/2ML, 500 MG
PE/10ML
P
PEGANONE ORAL TABLET 250 MG
P
Phenytoin ORAL SUSPENSION 125
MG/5ML
P
Phenytoin ORAL TABLET CHEWABLE 50
MG
P
Phenytoin Sodium INJECTION SOLUTION
50 MG/ML
P
Phenytoin Sodium Extended ORAL CAPSULE
100 MG, 200 MG, 300 MG
P
*Succinimides**
*Succinimides***
CELONTIN ORAL CAPSULE 300 MG
P
Ethosuximide ORAL CAPSULE 250 MG
P
Ethosuximide ORAL SOLUTION 250
MG/5ML
P
Divalproex Sodium ORAL CAPSULE
SPRINKLE 125 MG
P
Divalproex Sodium ORAL TABLET
DELAYED RELEASE 125 MG, 250 MG
P
Divalproex Sodium ORAL TABLET
DELAYED RELEASE 500 MG
P
Divalproex Sodium ER ORAL TABLET
P
Divalproex Sodium ER ORAL TABLET
P
STAVZOR ORAL CAPSULE DELAYED
RELEASE 125 MG, 250 MG
P
STAVZOR ORAL CAPSULE DELAYED
RELEASE 500 MG
P
Valproate Sodium INTRAVENOUS*
SOLUTION 100 MG/ML
P
Valproic Acid ORAL CAPSULE 250 MG
P
*Valproic Acid**
*Valproic Acid***
20
Drug Name
Valproic Acid ORAL SOLUTION 250
MG/5ML
P
Valproic Acid ORAL SYRUP 250 MG/5ML
P
*Antidepressants*
*Alpha-2 Receptor Antagonists (Tetracyclics)**
*Alpha-2 Receptor Antagonists
(Tetracyclics)***
Mirtazapine ORAL TABLET 15 MG, 30 MG,
45 MG, 7.5 MG
P
Mirtazapine ORAL TABLET DISPERSIBLE
15 MG, 30 MG, 45 MG
P
*Antidepressants - Misc.**
*Antidepressants - Misc.***
APLENZIN ORAL TABLET EXTENDED
RELEASE 24 HR* 348 MG, 522 MG
P
BUDEPRION SR ORAL TABLET
P
BuPROPion HCl ORAL TABLET 100 MG, 75
MG
P
BuPROPion HCl ER (SR) ORAL TABLET
MG, 200 MG
P
BuPROPion HCl ER (XL) ORAL TABLET
MG
P
FORFIVO XL ORAL TABLET
P
Maprotiline HCl ORAL TABLET 25 MG, 50
MG, 75 MG
P
*Modified Cyclics**
*Modified Cyclics***
BRINTELLIX ORAL TABLET 10 MG, 20
MG, 5 MG
P
Nefazodone HCl ORAL TABLET 100 MG, 150
MG, 200 MG, 250 MG, 50 MG
P
OLEPTRO ORAL TABLET EXTENDED
P
TraZODone HCl ORAL TABLET 100 MG,
150 MG, 300 MG, 50 MG
P
VIIBRYD ORAL KIT 10 & 20 & 40 MG
P
21
Drug Name
VIIBRYD ORAL TABLET 10 MG, 20 MG,
40 MG
P
*Monoamine Oxidase Inhibitors (Maois)**
*Monoamine Oxidase Inhibitors (Maois)***
EMSAM TRANSDERMAL PATCH 24 HR
12 MG/24HR, 6 MG/24HR, 9 MG/24HR
P
MARPLAN ORAL TABLET 10 MG
P
Phenelzine Sulfate ORAL TABLET 15 MG
P
Tranylcypromine Sulfate ORAL TABLET 10
MG
P
*Selective Serotonin Reuptake Inhibitors
(Ssris)**
*Selective Serotonin Reuptake Inhibitors
(Ssris)***
Citalopram Hydrobromide ORAL SOLUTION
10 MG/5ML
P
Citalopram Hydrobromide ORAL TABLET 10
MG, 20 MG, 40 MG
P
Escitalopram Oxalate ORAL SOLUTION 5
MG/5ML
P
Escitalopram Oxalate ORAL TABLET 10 MG,
20 MG, 5 MG
P
FLUoxetine HCl ORAL CAPSULE 10 MG, 20
MG, 40 MG
P
FLUoxetine HCl ORAL CAPSULE
P
FLUoxetine HCl ORAL SOLUTION 20
MG/5ML
P
FLUoxetine HCl ORAL TABLET 10 MG, 20
MG, 60 MG
P
FluvoxaMINE Maleate ORAL TABLET 100
MG, 25 MG, 50 MG
P
FluvoxaMINE Maleate ER ORAL CAPSULE
150 MG
P
PARoxetine HCl ORAL TABLET 10 MG, 20
MG, 30 MG, 40 MG
P
PARoxetine HCl ER ORAL TABLET
MG, 37.5 MG
P
22
Drug Name
PAXIL ORAL SUSPENSION 10 MG/5ML
P
PEXEVA ORAL TABLET 10 MG, 20 MG,
30 MG, 40 MG
P
Sertraline HCl ORAL CONCENTRATE 20
MG/ML
P
Sertraline HCl ORAL TABLET 100 MG, 25
MG, 50 MG
P
*Serotonin-Norepinephrine Reuptake Inhibitors
(Snris)**
*Serotonin-Norepinephrine Reuptake Inhibitors
(Snris)***
Desvenlafaxine ER ORAL TABLET
MG
P
DULoxetine HCl ORAL CAPSULE
DELAYED RELEASE PARTICLES 20 MG,
30 MG, 60 MG
P
FETZIMA ORAL CAPSULE EXTENDED
RELEASE 24 HOUR 120 MG, 20 MG, 40
MG, 80 MG
P
KHEDEZLA ORAL TABLET EXTENDED
P
PRISTIQ ORAL TABLET EXTENDED
P
Venlafaxine HCl ORAL TABLET 100 MG, 25
MG, 37.5 MG, 50 MG, 75 MG
P
Venlafaxine HCl ER ORAL CAPSULE
37.5 MG, 75 MG
P
Venlafaxine HCl ER ORAL TABLET
MG, 37.5 MG, 75 MG
P
*Tricyclic Agents**
*Tricyclic Agents***
Amitriptyline HCl ORAL TABLET 10 MG,
100 MG, 150 MG, 25 MG, 50 MG, 75 MG
P
Amoxapine ORAL TABLET 100 MG, 150 MG,
25 MG, 50 MG
P
ClomiPRAMINE HCl ORAL CAPSULE 25
MG, 50 MG, 75 MG
P
23
Drug Name
Desipramine HCl ORAL TABLET 10 MG, 100
MG, 150 MG, 25 MG, 50 MG, 75 MG
P
Doxepin HCl ORAL CAPSULE 10 MG, 100
MG, 150 MG, 25 MG, 50 MG, 75 MG
P
Doxepin HCl ORAL CONCENTRATE 10
MG/ML
P
Imipramine HCl ORAL TABLET 10 MG, 25
MG, 50 MG
P
Imipramine Pamoate ORAL CAPSULE 100
MG, 125 MG, 150 MG, 75 MG
P
Nortriptyline HCl ORAL CAPSULE 10 MG,
25 MG, 50 MG, 75 MG
P
Nortriptyline HCl ORAL SOLUTION 10
MG/5ML
P
Protriptyline HCl ORAL TABLET 10 MG, 5
MG
P
SURMONTIL ORAL CAPSULE 100 MG, 25
MG, 50 MG
P
*Antidiabetics*
*Alpha-Glucosidase Inhibitors**
*Alpha-Glucosidase Inhibitors***
Acarbose ORAL TABLET 100 MG, 25 MG, 50
MG
P
*Antidiabetic Combinations**
*Dipeptidyl Peptidase-4 Inhibitor-Biguanide
Combinations***
JANUMET ORAL TABLET 50-1000 MG,
50-500 MG
P
ST
JANUMET XR ORAL TABLET
EXTENDED RELEASE 24 HR* 100-1000
MG, 50-1000 MG, 50-500 MG
P
ST
JENTADUETO ORAL TABLET 2.5-1000
MG, 2.5-500 MG, 2.5-850 MG
P
*Sulfonylurea-Biguanide Combinations***
GlipiZIDE-MetFORMIN HCl ORAL
TABLET 2.5-250 MG, 2.5-500 MG, 5-500 MG
P
GlyBURIDE-MetFORMIN ORAL TABLET
1.25-250 MG, 2.5-500 MG, 5-500 MG
P
*Sulfonylurea-Thiazolidinedione
Combinations***
24
Drug Name
AVANDARYL ORAL TABLET 4-1 MG, 4-2
MG, 4-4 MG, 8-2 MG, 8-4 MG
P
ST
AVANDAMET ORAL TABLET 2-1000 MG,
2-500 MG, 4-1000 MG, 4-500 MG
P
ST
Pioglitazone HCl-Metformin HCl ORAL
TABLET 15-500 MG, 15-850 MG
P
ST
*Thiazolidinedione-Biguanide Combinations***
*Biguanides**
*Biguanides***
MetFORMIN HCl ORAL TABLET 1000 MG,
500 MG, 850 MG
P
MetFORMIN HCl ER ORAL TABLET
MG
P
MetFORMIN HCl ER (OSM) ORAL
TABLET EXTENDED RELEASE 24 HR*
500 MG
P
RIOMET ORAL SOLUTION 500 MG/5ML
P
GLUCAGEN INJECTION SOLUTION
RECONSTITUTED 1 MG
P
GLUCAGEN HYPOKIT INJECTION
SOLUTION RECONSTITUTED 1 MG
P
GLUCAGON EMERGENCY INJECTION
KIT 1 MG
P
Glucose ORAL TABLET CHEWABLE 4 GM
P
OTC
JANUVIA ORAL TABLET 100 MG, 25 MG,
50 MG
P
ST
TRADJENTA ORAL TABLET 5 MG
P
ST; QL (31 EA per 31 Day(s))
P
*Diabetic Other**
*Diabetic Other***
*Dipeptidyl Peptidase-4 (Dpp-4) Inhibitors**
*Dipeptidyl Peptidase-4 (Dpp-4) Inhibitors***
*Incretin Mimetic Agents (Glp-1 Receptor
Agonists)**
*Incretin Mimetic Agents (Glp-1 Receptor
Agonists)***
BYDUREON SUBCUTANEOUS*
SUSPENSION RECONSTITUTED 2 MG
*Insulin Sensitizing Agents**
25
Drug Name
*Thiazolidinediones***
AVANDIA ORAL TABLET 2 MG, 4 MG, 8
MG
P
ST
Pioglitazone HCl ORAL TABLET 15 MG, 30
MG, 45 MG
P
ST
APIDRA INJECTION SOLUTION 100
UNIT/ML
P
APIDRA SOLOSTAR SUBCUTANEOUS*
SOLUTION 100 UNIT/ML
P
HUMALOG SUBCUTANEOUS*
P
HUMALOG KWIKPEN
SUBCUTANEOUS* SOLUTION 100
UNIT/ML
P
HUMALOG MIX 50/50 SUBCUTANEOUS*
SUSPENSION (50-50) 100 UNIT/ML
P
HUMALOG MIX 50/50 KWIKPEN
SUBCUTANEOUS* SUSPENSION (50-50)
100 UNIT/ML
P
HUMALOG MIX 75/25 SUBCUTANEOUS*
P
HUMALOG MIX 75/25 KWIKPEN
SUBCUTANEOUS* SUSPENSION (75-25)
100 UNIT/ML
P
HUMULIN 70/30 SUBCUTANEOUS*
P
OTC; QL (60 ML per 31 day(s))
HUMULIN 70/30 PEN SUBCUTANEOUS*
P
HUMULIN N SUBCUTANEOUS*
SUSPENSION 100 UNIT/ML
P
HUMULIN N PEN SUBCUTANEOUS*
P
HUMULIN R INJECTION SOLUTION 100
UNIT/ML
P
HUMULIN R U-500 (CONCENTRATED)
UNIT/ML
P
LANTUS SUBCUTANEOUS* SOLUTION
100 UNIT/ML
P
*Insulin**
*Human Insulin***
26
Drug Name
LANTUS SOLOSTAR SUBCUTANEOUS*
P
*Sulfonylureas**
*Sulfonylureas***
ChlorproPAMIDE ORAL TABLET 100 MG,
250 MG
P
Glimepiride ORAL TABLET 1 MG, 2 MG, 4
MG
P
GlipiZIDE ORAL TABLET 10 MG, 5 MG
P
GlipiZIDE ER ORAL TABLET EXTENDED
RELEASE 24 HR* 10 MG, 2.5 MG, 5 MG
P
GLIPIZIDE XL ORAL TABLET
EXTENDED RELEASE 24 HR* 10 MG, 2.5
MG, 5 MG
P
GlyBURIDE ORAL TABLET 1.25 MG, 2.5
MG, 5 MG
P
GlyBURIDE Micronized ORAL TABLET 1.5
MG, 3 MG, 6 MG
P
*Antidiarrheals*
*Antidiarrheal Agents - Misc.**
*Antidiarrheal Agents - Misc.***
Bismatrol ORAL SUSPENSION 262
MG/15ML
P
OTC
Pink Bismuth ORAL TABLET CHEWABLE
262 MG
P
OTC
Stomach Relief Plus ORAL SUSPENSION
525 MG/15ML
P
OTC
*Antiperistaltic Agents**
*Antiperistaltic Agents***
Diphenoxylate-Atropine ORAL LIQUID†
2.5-0.025 MG/5ML
P
Diphenoxylate-Atropine ORAL TABLET
2.5-0.025 MG
P
LONOX ORAL TABLET 2.5-0.025 MG
P
Loperamide HCl ORAL CAPSULE 2 MG
P
Loperamide HCl ORAL LIQUID† 1 MG/5ML
P
OTC
*Antidotes*
*Antidotes - Chelating Agents**
*Antidotes - Chelating Agents***
27
Drug Name
EXJADE ORAL TABLET SOLUBLE 125
MG, 250 MG, 500 MG
P
PA
*Antidotes**
*Antidotes***
Deferoxamine Mesylate INJECTION
SOLUTION RECONSTITUTED 2 GM, 500
MG
P
*Opioid Antagonists**
*Opioid Antagonists***
Naltrexone HCl ORAL TABLET 50 MG
P
*Antiemetics*
*5-Ht3 Receptor Antagonists**
*5-Ht3 Receptor Antagonists***
Ondansetron ORAL TABLET DISPERSIBLE
4 MG, 8 MG
P
Ondansetron HCl ORAL SOLUTION 4
MG/5ML
P
Ondansetron HCl ORAL TABLET 4 MG, 8
MG
P
*Antiemetics - Anticholinergic**
*Antiemetics - Anticholinergic***
DimenhyDRINATE ORAL TABLET 50 MG
P
OTC
Meclizine HCl ORAL TABLET 12.5 MG, 25
MG
P
OTC
Meclizine HCl ORAL TABLET CHEWABLE
25 MG
P
OTC
Travel Sickness ORAL TABLET CHEWABLE
25 MG
P
OTC
Griseofulvin Microsize ORAL SUSPENSION
125 MG/5ML
P
Griseofulvin Microsize ORAL TABLET 500
MG
P
Griseofulvin Ultramicrosize ORAL TABLET
125 MG, 250 MG
P
Nystatin ORAL TABLET 500000 UNIT
P
*Antifungals*
*Antifungals**
*Antifungals***
28
Drug Name
Terbinafine HCl ORAL TABLET 250 MG
P
*Imidazole-Related Antifungals**
*Imidazoles***
Ketoconazole ORAL TABLET 200 MG
P
*Triazoles***
Fluconazole ORAL SUSPENSION
RECONSTITUTED 10 MG/ML, 40 MG/ML
P
Fluconazole ORAL TABLET 100 MG, 150
MG, 200 MG, 50 MG
P
*Antihistamines*
*Antihistamines - Alkylamines**
*Antihistamines - Alkylamines***
P
OTC
Aler-Dryl ORAL TABLET 50 MG
P
OTC
BENADRYL ALLERGY CHILDRENS
ORAL LIQUID† 12.5 MG/5ML
P
OTC
Diphenhist ORAL LIQUID† 12.5 MG/5ML
P
OTC
DiphenhydrAMINE HCl ORAL CAPSULE 25
MG, 50 MG
P
OTC
DiphenhydrAMINE HCl ORAL TABLET 25
MG
P
OTC
ALLEGRA ALLERGY CHILDRENS
ORAL TABLET 30 MG
P
OTC
Allergy ORAL TABLET DISPERSIBLE 10
MG
P
OTC
Cetirizine HCl ORAL SYRUP 1 MG/ML, 5
MG/5ML
P
Cetirizine HCl ORAL TABLET 10 MG, 5 MG
P
OTC
Cetirizine HCl Childrens ORAL SOLUTION 1
MG/ML
P
Childrens Loratadine ORAL SYRUP 5
MG/5ML
P
Fexofenadine HCl ORAL TABLET 180 MG,
60 MG
P
OTC
Allergy ORAL TABLET 4 MG
*Antihistamines - Ethanolamines**
*Antihistamines - Ethanolamines***
*Antihistamines - Non-Sedating**
*Antihistamines - Non-Sedating***
29
Drug Name
Loratadine ORAL TABLET 10 MG
P
OTC
*Antihistamines - Phenothiazines**
*Antihistamines - Phenothiazines***
Promethazine HCl INJECTION SOLUTION
25 MG/ML
P
Promethazine HCl ORAL SYRUP 6.25
MG/5ML
P
Promethazine HCl ORAL TABLET 12.5 MG,
25 MG, 50 MG
P
Promethazine HCl RE SUPPOSITORY 25
MG
P
PROMETHEGAN RE SUPPOSITORY 25
MG, 50 MG
P
*Antihistamines - Piperidines**
*Antihistamines - Piperidines***
Cyproheptadine HCl ORAL SYRUP 2
MG/5ML
P
Cyproheptadine HCl ORAL TABLET 4 MG
P
*Antihyperlipidemics*
*Antihyperlipidemics - Combinations**
*Intest Cholest Absorp Inhib-Hmg Coa
Reductase Inhib Comb***
VYTORIN ORAL TABLET 10-10 MG, 10-20
MG, 10-40 MG, 10-80 MG
P
*Bile Acid Sequestrants**
*Bile Acid Sequestrants***
Cholestyramine ORAL PACKET 4 GM
P
Cholestyramine ORAL POWDER 4
GM/DOSE
P
Cholestyramine Light ORAL PACKET 4 GM
P
Cholestyramine Light ORAL POWDER 4
GM/DOSE
P
*Fibric Acid Derivatives**
*Fibric Acid Derivatives***
Fenofibrate ORAL TABLET 160 MG, 54 MG
P
Fenofibrate Micronized ORAL CAPSULE 134
MG, 200 MG, 67 MG
P
Gemfibrozil ORAL TABLET 600 MG
P
30
PA
Drug Name
*Hmg Coa Reductase Inhibitors**
*Hmg Coa Reductase Inhibitors***
Atorvastatin Calcium ORAL TABLET 10 MG,
20 MG, 40 MG, 80 MG
P
Lovastatin ORAL TABLET 10 MG, 20 MG, 40
MG
P
Pravastatin Sodium ORAL TABLET 10 MG,
20 MG, 40 MG, 80 MG
P
Simvastatin ORAL TABLET 10 MG, 20 MG,
40 MG, 5 MG, 80 MG
P
ST
*Intestinal Cholesterol Absorption Inhibitors**
*Intestinal Cholesterol Absorption Inhibitors***
ZETIA ORAL TABLET 10 MG
P
PA
*Nicotinic Acid Derivatives**
*Nicotinic Acid Derivatives***
NIACOR ORAL TABLET 500 MG
P
*Antihypertensives*
*Ace Inhibitors**
*Ace Inhibitors***
Benazepril HCl ORAL TABLET 10 MG, 20
MG, 40 MG, 5 MG
P
Captopril ORAL TABLET 100 MG, 12.5 MG,
25 MG, 50 MG
P
Enalapril Maleate ORAL TABLET 10 MG, 2.5
MG, 20 MG, 5 MG
P
Fosinopril Sodium ORAL TABLET 10 MG, 20
MG, 40 MG
P
Lisinopril ORAL TABLET 10 MG, 2.5 MG, 20
MG, 30 MG, 40 MG, 5 MG
P
Quinapril HCl ORAL TABLET 10 MG, 20
MG, 40 MG, 5 MG
P
Ramipril ORAL CAPSULE 1.25 MG, 10 MG,
2.5 MG, 5 MG
P
*Angiotensin Ii Receptor Antagonists**
*Angiotensin Ii Receptor Antagonists***
Losartan Potassium ORAL TABLET 100 MG,
25 MG, 50 MG
P
*Antiadrenergic Antihypertensives**
31
Drug Name
*Antiadrenergics - Centrally Acting***
CloNIDine HCl ORAL TABLET 0.1 MG, 0.2
MG, 0.3 MG
P
GuanFACINE HCl ORAL TABLET 1 MG, 2
MG
P
Methyldopa ORAL TABLET 250 MG, 500 MG
P
*Antiadrenergics - Peripherally Acting***
Doxazosin Mesylate ORAL TABLET 1 MG, 2
MG, 4 MG, 8 MG
P
Prazosin HCl ORAL CAPSULE 1 MG, 2 MG,
5 MG
P
Terazosin HCl ORAL CAPSULE 1 MG, 10
MG, 2 MG, 5 MG
P
*Antihypertensive Combinations**
*Ace Inhibitors & Thiazide/Thiazide-Like***
Benazepril-Hydrochlorothiazide ORAL
TABLET 10-12.5 MG, 20-12.5 MG, 20-25 MG,
5-6.25 MG
P
Captopril-Hydrochlorothiazide ORAL
TABLET 25-15 MG, 25-25 MG, 50-15 MG,
50-25 MG
P
Enalapril-Hydrochlorothiazide ORAL
TABLET 10-25 MG, 5-12.5 MG
P
Lisinopril-Hydrochlorothiazide ORAL
TABLET 10-12.5 MG, 20-12.5 MG, 20-25 MG
P
*Angiotensin Ii Receptor Antag &
Thiazide/Thiazide-Like***
Losartan Potassium-HCTZ ORAL TABLET
100-12.5 MG, 100-25 MG, 50-12.5 MG
P
*Beta Blocker & Diuretic Combinations***
Atenolol-Chlorthalidone ORAL TABLET
100-25 MG, 50-25 MG
P
Bisoprolol-Hydrochlorothiazide ORAL
TABLET 10-6.25 MG, 2.5-6.25 MG, 5-6.25
MG
P
Propranolol-HCTZ ORAL TABLET 40-25
MG, 80-25 MG
P
*Vasodilators**
*Vasodilators***
32
Drug Name
HydrALAZINE HCl INJECTION
SOLUTION 20 MG/ML
P
HydrALAZINE HCl ORAL TABLET 10 MG,
100 MG, 25 MG, 50 MG
P
Minoxidil ORAL TABLET 10 MG, 2.5 MG
P
*Anti-Infective Agents - Misc.*
*Anti-Infective Agents - Misc.**
*Anti-Infective Agents - Misc.***
MetroNIDAZOLE ORAL TABLET 250 MG,
500 MG
P
Trimethoprim ORAL TABLET 100 MG
P
Vancomycin HCl INTRAVENOUS*
SOLUTION RECONSTITUTED 1000 MG,
500 MG, 750 MG
P
Vancomycin HCl ORAL CAPSULE 125 MG,
250 MG
P
PA
*Anti-Infective Misc. - Combinations**
*Anti-Infective Misc. - Combinations***
Erythromycin-Sulfisoxazole ORAL
SUSPENSION RECONSTITUTED 200-600
MG/5ML
P
Sulfamethoxazole-TMP DS ORAL TABLET
800-160 MG
P
Sulfamethoxazole-Trimethoprim ORAL
SUSPENSION 200-40 MG/5ML
P
Sulfamethoxazole-Trimethoprim ORAL
TABLET 400-80 MG
P
*Antiprotozoal Agents**
*Antiprotozoal Agents***
MEPRON ORAL SUSPENSION 750
MG/5ML
P
*Lincosamides**
*Lincosamides***
Clindamycin HCl ORAL CAPSULE 150 MG,
300 MG, 75 MG
P
Clindamycin Palmitate HCl ORAL
SOLUTION RECONSTITUTED 75 MG/5ML
P
33
Drug Name
Clindamycin Phosphate INJECTION
SOLUTION 300 MG/2ML, 600 MG/4ML, 9
GM/60ML, 900 MG/6ML
P
Clindamycin Phosphate INTRAVENOUS*
SOLUTION 300 MG/2ML
P
*Antimalarials*
*Antimalarial Combinations**
*Antimalarial Combinations***
Atovaquone-Proguanil HCl ORAL TABLET
250-100 MG, 62.5-25 MG
P
*Antimalarials**
*Antimalarials***
DARAPRIM ORAL TABLET 25 MG
P
Hydroxychloroquine Sulfate ORAL TABLET
200 MG
P
Mefloquine HCl ORAL TABLET 250 MG
P
Primaquine Phosphate ORAL TABLET 26.3
MG
P
*Antimyasthenic/Cholinergic Agents*
*Antimyasthenic/Cholinergic Agents**
*Antimyasthenic/Cholinergic Agents***
MESTINON ORAL SYRUP 60 MG/5ML
P
MESTINON ORAL TABLET
P
PROSTIGMIN ORAL TABLET 15 MG
P
Pyridostigmine Bromide ORAL TABLET 60
MG
P
*Antineoplastics And Adjunctive Therapies*
*Alkylating Agents**
*Alkylating Agents***
HEXALEN ORAL CAPSULE 50 MG
P
PA
MYLERAN ORAL TABLET 2 MG
P
PA
P
PA
P
PA
*Imidazotetrazines***
Temozolomide ORAL CAPSULE 100 MG, 140
MG, 180 MG, 20 MG, 250 MG, 5 MG
*Nitrogen Mustards***
ALKERAN ORAL TABLET 2 MG
34
Drug Name
Cyclophosphamide ORAL TABLET 25 MG, 50
MG
P
LEUKERAN ORAL TABLET 2 MG
P
PA
P
PA
ADRUCIL INTRAVENOUS* SOLUTION
500 MG/10ML
P
PA
Fluorouracil INTRAVENOUS* SOLUTION
500 MG/10ML
P
PA
Gemcitabine HCl INTRAVENOUS*
SOLUTION 1 GM/26.3ML, 2 GM/52.6ML,
200 MG/5.26ML
P
PA
Gemcitabine HCl INTRAVENOUS*
SOLUTION RECONSTITUTED 1 GM, 2
GM, 200 MG
P
PA
Mercaptopurine ORAL TABLET 50 MG
P
Methotrexate ORAL TABLET 2.5 MG
P
Methotrexate Sodium INJECTION
SOLUTION 25 MG/ML
P
Methotrexate Sodium INJECTION
SOLUTION RECONSTITUTED 1 GM
P
Methotrexate Sodium (PF) INJECTION
SOLUTION 25 MG/ML
P
TABLOID ORAL TABLET 40 MG
P
PA
XELODA ORAL TABLET 150 MG, 500 MG
P
PA
P
PA
P
PA
*Nitrosoureas***
Lomustine ORAL CAPSULE 10 MG, 100 MG,
40 MG
*Antimetabolites**
*Antimetabolites***
*Antineoplastic - Angiogenesis Inhibitors**
*Vascular Endothelial Growth Factor (Vegf)
Inhibitors***
AVASTIN INTRAVENOUS* SOLUTION
100 MG/4ML, 400 MG/16ML
*Antineoplastic - Hedgehog Pathway
Inhibitors**
*Antineoplastic - Hedgehog Pathway
Inhibitors***
ERIVEDGE ORAL CAPSULE 150 MG
35
Drug Name
*Antineoplastic - Hormonal And Related
Agents**
*Antiadrenals***
LYSODREN ORAL TABLET 500 MG
P
PA
P
PA
*Antiandrogens***
XTANDI ORAL CAPSULE 40 MG
*Antiestrogens***
Tamoxifen Citrate ORAL TABLET 10 MG, 20
MG
P
*Aromatase Inhibitors***
Anastrozole ORAL TABLET 1 MG
P
Letrozole ORAL TABLET 2.5 MG
P
*Estrogens-Antineoplastic***
EMCYT ORAL CAPSULE 140 MG
P
PA
TRELSTAR DEPOT INTRAMUSCULAR*
SUSPENSION RECONSTITUTED 3.75 MG
P
PA
TRELSTAR DEPOT MIXJECT
INTRAMUSCULAR* SUSPENSION
RECONSTITUTED 3.75 MG
P
PA
TRELSTAR LA INTRAMUSCULAR*
SUSPENSION RECONSTITUTED 11.25
MG
P
PA
TRELSTAR LA MIXJECT
P
PA
TRELSTAR MIXJECT
P
PA
Megestrol Acetate ORAL SUSPENSION 40
MG/ML
P
Megestrol Acetate ORAL TABLET 20 MG, 40
MG
P
*Lhrh Analogs***
*Progestins-Antineoplastic***
*Antineoplastic Enzyme Inhibitors**
*Antineoplastic - Braf Kinase Inhibitors***
ZELBORAF ORAL TABLET 240 MG
*Antineoplastic - Histone Deacetylase
Inhibitors***
36
P
PA
Drug Name
ZOLINZA ORAL CAPSULE 100 MG
P
PA
P
PA
STIVARGA ORAL TABLET 40 MG
P
PA
SUTENT ORAL CAPSULE 12.5 MG, 25
MG, 50 MG
P
PA
BOSULIF ORAL TABLET 100 MG, 500 MG
P
PA
CAPRELSA ORAL TABLET 100 MG, 300
MG
P
PA
GILOTRIF ORAL TABLET 20 MG, 30 MG,
40 MG
P
PA
GLEEVEC ORAL TABLET 100 MG, 400
MG
P
PA
ICLUSIG ORAL TABLET 15 MG, 45 MG
P
PA
SPRYCEL ORAL TABLET 100 MG, 140
MG, 20 MG, 50 MG, 70 MG, 80 MG
P
PA
TARCEVA ORAL TABLET 100 MG, 150
MG, 25 MG
P
PA
TASIGNA ORAL CAPSULE 150 MG, 200
MG
P
PA
TYKERB ORAL TABLET 250 MG
P
PA
XALKORI ORAL CAPSULE 200 MG, 250
MG
P
PA
P
PA
P
PA
Hydroxyurea ORAL CAPSULE 500 MG
P
PA
INTRON-A INJECTION SOLUTION
10000000 UNIT/ML, 6000000 UNIT/ML
P
*Antineoplastic - Mtor Kinase Inhibitors***
AFINITOR ORAL TABLET 10 MG, 2.5
MG, 5 MG, 7.5 MG
*Antineoplastic - Multikinase Inhibitors***
*Antineoplastic - Tyrosine Kinase Inhibitors***
*Janus Associated Kinase (Jak) Inhibitors***
JAKAFI ORAL TABLET 10 MG, 15 MG, 20
MG, 25 MG, 5 MG
*Antineoplastic Enzymes**
*Antineoplastic Enzymes***
ERWINAZE INTRAMUSCULAR*
SOLUTION RECONSTITUTED 10000
UNIT
*Antineoplastics Misc.**
*Antineoplastics Misc.***
37
Drug Name
INTRON-A INJECTION SOLUTION
RECONSTITUTED 10000000 UNIT,
18000000 UNIT, 50000000 UNIT
P
*Chemotherapy Rescue/Antidote Agents**
*Folic Acid Antagonists Rescue Agents***
Leucovorin Calcium INJECTION SOLUTION
RECONSTITUTED 100 MG, 200 MG, 350
MG
P
Leucovorin Calcium INTRAVENOUS*
SOLUTION 10 MG/ML
P
Leucovorin Calcium ORAL TABLET 10 MG,
15 MG, 25 MG, 5 MG
P
*Mitotic Inhibitors**
*Mitotic Inhibitors***
Etoposide ORAL CAPSULE 50 MG
P
*Antiparkinson Agents*
*Antiparkinson Anticholinergics**
*Antiparkinson Anticholinergics***
Benztropine Mesylate ORAL TABLET 0.5
MG, 1 MG, 2 MG
P
Trihexyphenidyl HCl ORAL ELIXIR 0.4
MG/ML
P
Trihexyphenidyl HCl ORAL TABLET 2 MG, 5
MG
P
*Antiparkinson Dopaminergics**
*Antiparkinson Dopaminergics***
Amantadine HCl ORAL CAPSULE 100 MG
P
Amantadine HCl ORAL SYRUP 50 MG/5ML
P
Amantadine HCl ORAL TABLET 100 MG
P
Bromocriptine Mesylate ORAL CAPSULE 5
MG
P
Bromocriptine Mesylate ORAL TABLET 2.5
MG
P
*Levodopa Combinations***
Carbidopa-Levodopa ORAL TABLET 10-100
MG, 25-100 MG, 25-250 MG
P
Carbidopa-Levodopa ER ORAL TABLET
EXTENDEDRELEASE* 25-100 MG, 50-200
MG
P
38
PA
Drug Name
*Nonergoline Dopamine Receptor Agonists***
Pramipexole Dihydrochloride ORAL TABLET
0.125 MG, 0.25 MG, 0.5 MG, 0.75 MG, 1 MG,
1.5 MG
P
ROPINIRole HCl ORAL TABLET 0.25 MG,
0.5 MG, 1 MG, 2 MG, 3 MG, 4 MG, 5 MG
P
ST
*Antiparkinson Monoamine Oxidase
Inhibitors**
*Antiparkinson Monoamine Oxidase
Inhibitors***
Selegiline HCl ORAL CAPSULE 5 MG
P
Selegiline HCl ORAL TABLET 5 MG
P
*Antipsychotics/Antimanic Agents*
*Antimanic Agents**
*Antimanic Agents***
Lithium Carbonate ORAL CAPSULE 150 MG,
300 MG, 600 MG
P
Lithium Carbonate ORAL TABLET 300 MG
P
Lithium Carbonate ER ORAL TABLET
EXTENDEDRELEASE* 300 MG, 450 MG
P
Lithium Citrate ORAL SOLUTION 8
MEQ/5ML
P
*Antipsychotics - Misc.**
*Antipsychotics - Misc.***
EQUETRO ORAL CAPSULE EXTENDED
MG
P
GEODON INTRAMUSCULAR*
P
LATUDA ORAL TABLET 120 MG, 20 MG,
40 MG, 60 MG, 80 MG
P
Ziprasidone HCl ORAL CAPSULE 20 MG, 40
MG, 60 MG, 80 MG
P
*Benzisoxazoles**
*Benzisoxazoles***
FANAPT ORAL TABLET 1 MG, 10 MG, 12
MG, 2 MG, 4 MG, 6 MG, 8 MG
P
FANAPT TITRATION PACK ORAL
TABLET 1 & 2 & 4 & 6 MG
P
39
Drug Name
INVEGA ORAL TABLET EXTENDED
RELEASE 24 HR* 1.5 MG, 3 MG, 6 MG, 9
MG
P
INVEGA SUSTENNA
INTRAMUSCULAR* SUSPENSION 117
MG/0.75ML, 156 MG/ML, 234 MG/1.5ML,
39 MG/0.25ML, 78 MG/0.5ML
P
RISPERDAL CONSTA
RECONSTITUTED 12.5 MG, 25 MG, 37.5
MG, 50 MG
P
RisperiDONE ORAL SOLUTION 1 MG/ML
P
RisperiDONE ORAL TABLET 0.25 MG, 0.5
MG, 1 MG, 2 MG, 3 MG, 4 MG
P
RisperiDONE ORAL TABLET
DISPERSIBLE 0.25 MG, 0.5 MG, 1 MG, 2
MG, 3 MG, 4 MG
P
RISPERIDONE M-TAB ORAL TABLET
DISPERSIBLE 0.5 MG, 1 MG, 2 MG, 3 MG,
4 MG
P
*Butyrophenones**
*Butyrophenones***
HALDOL DECANOATE
INTRAMUSCULAR* SOLUTION 50
MG/ML
P
Haloperidol ORAL TABLET 0.5 MG, 1 MG,
10 MG, 2 MG, 20 MG, 5 MG
P
Haloperidol Decanoate INTRAMUSCULAR*
P
Haloperidol Lactate INJECTION SOLUTION
5 MG/ML
P
Haloperidol Lactate ORAL CONCENTRATE
2 MG/ML
P
*Dibenzapines**
*Dibenzodiazepines***
CloZAPine ORAL TABLET 100 MG, 200
MG, 25 MG, 50 MG
P
CloZAPine ORAL TABLET DISPERSIBLE
100 MG, 12.5 MG, 25 MG
P
FAZACLO ORAL TABLET DISPERSIBLE
150 MG, 200 MG
P
40
Drug Name
*Dibenzo-Oxepino Pyrroles***
SAPHRIS SUBLINGUAL TABLET
P
*Dibenzothiazepines***
QUEtiapine Fumarate ORAL TABLET 100
MG, 200 MG, 25 MG, 300 MG, 400 MG, 50
MG
P
SEROQUEL XR ORAL TABLET
EXTENDED RELEASE 24 HR* 150 MG,
200 MG, 300 MG, 400 MG, 50 MG
P
*Dibenzoxazepines***
Loxapine Succinate ORAL CAPSULE 10 MG,
25 MG, 5 MG, 50 MG
P
*Thienbenzodiazepines***
OLANZapine INTRAMUSCULAR*
P
OLANZapine ORAL TABLET 10 MG, 15
MG, 2.5 MG, 20 MG, 5 MG, 7.5 MG
P
OLANZapine ORAL TABLET
DISPERSIBLE 10 MG, 15 MG, 20 MG, 5 MG
P
ZYPREXA RELPREVV
RECONSTITUTED 210 MG, 300 MG, 405
MG
P
*Phenothiazines**
*Phenothiazines***
ChlorproMAZINE HCl INJECTION
SOLUTION 25 MG/ML
P
ChlorproMAZINE HCl ORAL TABLET 10
MG, 100 MG, 200 MG, 25 MG, 50 MG
P
FluPHENAZine Decanoate INJECTION
SOLUTION 25 MG/ML
P
FluPHENAZine HCl INJECTION
SOLUTION 2.5 MG/ML
P
FluPHENAZine HCl ORAL
CONCENTRATE 5 MG/ML
P
FluPHENAZine HCl ORAL ELIXIR 2.5
MG/5ML
P
FluPHENAZine HCl ORAL TABLET 1 MG,
10 MG, 2.5 MG, 5 MG
P
41
Drug Name
Perphenazine ORAL TABLET 16 MG, 2 MG,
4 MG, 8 MG
P
Prochlorperazine RE SUPPOSITORY 25 MG
P
Prochlorperazine Maleate ORAL TABLET 10
MG, 5 MG
P
Thioridazine HCl ORAL TABLET 10 MG, 100
MG, 25 MG, 50 MG
P
Trifluoperazine HCl ORAL TABLET 1 MG, 10
MG, 2 MG, 5 MG
P
*Quinolinone Derivatives**
*Quinolinone Derivatives***
ABILIFY INTRAMUSCULAR*
P
ABILIFY ORAL SOLUTION 1 MG/ML
P
ABILIFY ORAL TABLET 10 MG, 15 MG, 2
MG, 20 MG, 30 MG, 5 MG
P
ABILIFY DISCMELT ORAL TABLET
P
ABILIFY MAINTENA
RECONSTITUTED 300 MG, 400 MG
P
*Thioxanthenes**
*Thioxanthenes***
Thiothixene ORAL CAPSULE 1 MG, 10 MG,
2 MG, 5 MG
P
*Antiseptics & Disinfectants*
*Chlorine Antiseptics**
*Chlorine Antiseptics***
Chlorhexidine Gluconate EXTERNAL
LIQUID† 4 %
P
P
OTC
*Iodine Antiseptics**
*Iodine Antiseptics***
Povidone-Iodine EXTERNAL SOLUTION 10
%
*Antivirals*
*Antiretrovirals**
*Antiretroviral Combinations***
ATRIPLA ORAL TABLET 600-200-300 MG
42
P
Drug Name
COMPLERA ORAL TABLET 200-25-300
MG
P
EPZICOM ORAL TABLET 600-300 MG
P
KALETRA ORAL SOLUTION 400-100
MG/5ML
P
KALETRA ORAL TABLET 100-25 MG,
200-50 MG
P
Lamivudine-Zidovudine ORAL TABLET
150-300 MG
P
STRIBILD ORAL TABLET 150-150-200-300
MG
P
TRIZIVIR ORAL TABLET 300-150-300 MG
P
TRUVADA ORAL TABLET 200-300 MG
P
*Antiretrovirals - Ccr5 Antagonists (Entry
Inhibitor)***
SELZENTRY ORAL TABLET 150 MG, 300
MG
P
*Antiretrovirals - Fusion Inhibitors***
FUZEON SUBCUTANEOUS* SOLUTION
RECONSTITUTED 90 MG
P
*Antiretrovirals - Integrase Inhibitors***
ISENTRESS ORAL TABLET 400 MG
P
ISENTRESS ORAL TABLET CHEWABLE
100 MG, 25 MG
P
TIVICAY ORAL TABLET 50 MG
P
*Antiretrovirals - Protease Inhibitors***
APTIVUS ORAL CAPSULE 250 MG
P
APTIVUS ORAL SOLUTION 100 MG/ML
P
CRIXIVAN ORAL CAPSULE 200 MG, 400
MG
P
INVIRASE ORAL CAPSULE 200 MG
P
INVIRASE ORAL TABLET 500 MG
P
LEXIVA ORAL SUSPENSION 50 MG/ML
P
LEXIVA ORAL TABLET 700 MG
P
NORVIR ORAL CAPSULE 100 MG
P
NORVIR ORAL SOLUTION 80 MG/ML
P
NORVIR ORAL TABLET 100 MG
P
43
Drug Name
PREZISTA ORAL SUSPENSION 100
MG/ML
P
PREZISTA ORAL TABLET 150 MG, 400
MG, 600 MG, 75 MG, 800 MG
P
REYATAZ ORAL CAPSULE 150 MG, 200
MG, 300 MG
P
VIRACEPT ORAL TABLET 250 MG, 625
MG
P
*Antiretrovirals - Rti-Non-Nucleoside
Analogues***
EDURANT ORAL TABLET 25 MG
P
INTELENCE ORAL TABLET 100 MG, 200
MG, 25 MG
P
Nevirapine ORAL SUSPENSION 50 MG/5ML
P
Nevirapine ORAL TABLET 200 MG
P
RESCRIPTOR ORAL TABLET 100 MG, 200
MG
P
SUSTIVA ORAL CAPSULE 200 MG, 50 MG
P
SUSTIVA ORAL TABLET 600 MG
P
*Antiretrovirals - Rti-Nucleoside
Analogues-Purines***
Abacavir Sulfate ORAL TABLET 300 MG
P
Didanosine ORAL CAPSULE DELAYED
RELEASE 125 MG, 200 MG, 250 MG, 400
MG
P
VIDEX ORAL SOLUTION
RECONSTITUTED 2 GM, 4 GM
P
ZIAGEN ORAL SOLUTION 20 MG/ML
P
Analogues-Pyrimidines***
EMTRIVA ORAL CAPSULE 200 MG
P
EMTRIVA ORAL SOLUTION 10 MG/ML
P
EPIVIR ORAL SOLUTION 10 MG/ML
P
EPIVIR HBV ORAL SOLUTION 5 MG/ML
P
EPIVIR HBV ORAL TABLET 100 MG
P
LamiVUDine ORAL TABLET 150 MG, 300
MG
P
Analogues-Thymidines***
44
Drug Name
Stavudine ORAL CAPSULE 15 MG, 20 MG,
30 MG, 40 MG
P
Stavudine ORAL SOLUTION
RECONSTITUTED 1 MG/ML
P
Zidovudine ORAL CAPSULE 100 MG
P
Zidovudine ORAL SYRUP 50 MG/5ML
P
Zidovudine ORAL TABLET 300 MG
P
*Antiretrovirals - Rti-Nucleotide Analogues***
VIREAD ORAL TABLET 150 MG, 200 MG,
250 MG, 300 MG
P
*Hepatitis Agents**
*Hepatitis B Agents***
Adefovir Dipivoxil ORAL TABLET 10 MG
P
BARACLUDE ORAL SOLUTION 0.05
MG/ML
P
BARACLUDE ORAL TABLET 0.5 MG, 1
MG
P
TYZEKA ORAL TABLET 600 MG
P
*Hepatitis C Agents***
INCIVEK ORAL TABLET 375 MG
P
INFERGEN SUBCUTANEOUS*
INJECTABLE 15 MCG/0.5ML, 9
MCG/0.3ML
P
PEG-INTRON SUBCUTANEOUS* KIT 120
MCG/0.5ML, 150 MCG/0.5ML, 50
MCG/0.5ML, 80 MCG/0.5ML
P
PEG-INTRON REDIPEN
SUBCUTANEOUS* KIT 120 MCG/0.5ML,
150 MCG/0.5ML, 50 MCG/0.5ML, 80
MCG/0.5ML
P
PEG-INTRON REDIPEN PAK 4
SUBCUTANEOUS* KIT 120 MCG/0.5ML,
150 MCG/0.5ML, 50 MCG/0.5ML, 80
MCG/0.5ML
P
PEGASYS SUBCUTANEOUS* KIT 180
MCG/0.5ML
P
PEGASYS SUBCUTANEOUS* SOLUTION
180 MCG/0.5ML, 180 MCG/ML
P
45
Drug Name
PEGASYS PROCLICK SUBCUTANEOUS*
SOLUTION 135 MCG/0.5ML, 180
MCG/0.5ML
P
REBETOL ORAL SOLUTION 40 MG/ML
P
RIBASPHERE ORAL TABLET 200 MG
P
Ribavirin ORAL TABLET 200 MG
P
VICTRELIS ORAL CAPSULE 200 MG
P
*Herpes Agents**
*Herpes Agents - Purine Analogues***
Acyclovir ORAL CAPSULE 200 MG
P
Acyclovir ORAL SUSPENSION 200 MG/5ML
P
Acyclovir ORAL TABLET 400 MG, 800 MG
P
ValACYclovir HCl ORAL TABLET 1 GM,
500 MG
P
*Influenza Agents**
*Influenza Agents***
Rimantadine HCl ORAL TABLET 100 MG
P
*Neuraminidase Inhibitors***
RELENZA DISKHALER INHALATION
ACTIVATED 5 MG/BLISTER
P
QL (40 EA per 365 day(s)); AL
(Min 7 Years)
TAMIFLU ORAL CAPSULE 30 MG
P
TAMIFLU ORAL CAPSULE 45 MG, 75 MG
P
TAMIFLU ORAL SUSPENSION
P
(Max 18 Years)
P
PA
P
PA
*Assorted Classes*
*Immunomodulators**
*Antileprotics***
THALOMID ORAL CAPSULE 100 MG, 150
MG, 200 MG, 50 MG
*Immunomodulators For Myelodysplastic
Syndromes***
REVLIMID ORAL CAPSULE 10 MG, 15
MG, 2.5 MG, 20 MG, 25 MG, 5 MG
*Immunosuppressive Agents**
*Cyclosporine Analogs***
CycloSPORINE INTRAVENOUS*
SOLUTION 50 MG/ML
46
P
Drug Name
CycloSPORINE ORAL CAPSULE 100 MG,
25 MG
P
CycloSPORINE Modified ORAL CAPSULE
100 MG, 25 MG, 50 MG
P
CycloSPORINE Modified ORAL SOLUTION
100 MG/ML
P
GENGRAF ORAL CAPSULE 100 MG, 25
MG
P
GENGRAF ORAL SOLUTION 100 MG/ML
P
SANDIMMUNE ORAL SOLUTION 100
MG/ML
P
*Inosine Monophosphate Dehydrogenase
Inhibitors***
CELLCEPT ORAL SUSPENSION
P
CELLCEPT INTRAVENOUS
INTRAVENOUS* SOLUTION
P
Mycophenolate Mofetil ORAL CAPSULE 250
MG
P
Mycophenolate Mofetil ORAL TABLET 500
MG
P
MYFORTIC ORAL TABLET DELAYED
RELEASE 180 MG, 360 MG
P
*Macrolide Immunosuppressants***
HECORIA ORAL CAPSULE 0.5 MG, 1 MG,
5 MG
P
PROGRAF INTRAVENOUS* SOLUTION 5
MG/ML
P
RAPAMUNE ORAL SOLUTION 1 MG/ML
P
RAPAMUNE ORAL TABLET 0.5 MG, 1
MG, 2 MG
P
Tacrolimus ORAL CAPSULE 0.5 MG, 1 MG,
5 MG
P
ZORTRESS ORAL TABLET 0.25 MG, 0.5
MG, 0.75 MG
P
*Monoclonal Antibodies***
SIMULECT INTRAVENOUS* SOLUTION
P
*Purine Analogs***
47
Drug Name
AzaTHIOprine ORAL TABLET 50 MG
P
AzaTHIOprine Sodium INJECTION
P
*Selective T-Cell Costimulation Blockers***
NULOJIX INTRAVENOUS* SOLUTION
P
*Potassium Removing Resins**
*Potassium Removing Resins***
Sodium Polystyrene Sulfonate ORAL
POWDER
P
SPS ORAL SUSPENSION 15 GM/60ML
P
*Beta Blockers*
*Alpha-Beta Blockers**
*Alpha-Beta Blockers***
Carvedilol ORAL TABLET 12.5 MG, 25 MG,
3.125 MG, 6.25 MG
P
Labetalol HCl INTRAVENOUS* SOLUTION
5 MG/ML
P
Labetalol HCl ORAL TABLET 100 MG, 200
MG, 300 MG
P
*Beta Blockers Cardio-Selective**
*Beta Blockers Cardio-Selective***
Atenolol ORAL TABLET 100 MG, 25 MG, 50
MG
P
Bisoprolol Fumarate ORAL TABLET 10 MG,
5 MG
P
Metoprolol Succinate ER ORAL TABLET
MG, 25 MG, 50 MG
P
Metoprolol Tartrate INTRAVENOUS*
SOLUTION 1 MG/ML
P
Metoprolol Tartrate ORAL TABLET 100 MG,
25 MG, 50 MG
P
*Beta Blockers Non-Selective**
*Beta Blockers Non-Selective***
Nadolol ORAL TABLET 20 MG, 40 MG, 80
MG
P
Pindolol ORAL TABLET 10 MG, 5 MG
P
48
Drug Name
Propranolol HCl INTRAVENOUS*
SOLUTION 1 MG/ML
P
Propranolol HCl ORAL TABLET 10 MG, 20
MG, 40 MG, 60 MG, 80 MG
P
Propranolol HCl ER ORAL CAPSULE
160 MG, 60 MG, 80 MG
P
SORINE ORAL TABLET 120 MG, 160 MG,
240 MG, 80 MG
P
Sotalol HCl ORAL TABLET 120 MG, 160
MG, 240 MG, 80 MG
P
Sotalol HCl (AF) ORAL TABLET 120 MG,
160 MG, 80 MG
P
Timolol Maleate ORAL TABLET 10 MG, 20
MG, 5 MG
P
*Calcium Channel Blockers*
*Calcium Channel Blockers**
*Calcium Channel Blockers***
AmLODIPine Besylate ORAL TABLET 10
MG, 2.5 MG, 5 MG
P
CARTIA XT ORAL CAPSULE
180 MG, 240 MG, 300 MG
P
Dilt-XR ORAL CAPSULE EXTENDED
MG
P
Diltiazem HCl INTRAVENOUS* SOLUTION
125 MG/25ML, 25 MG/5ML, 50 MG/10ML
P
Diltiazem HCl ORAL TABLET 120 MG, 30
MG, 60 MG, 90 MG
P
Diltiazem HCl ER ORAL CAPSULE
60 MG, 90 MG
P
Diltiazem HCl ER Beads ORAL CAPSULE
180 MG, 240 MG, 300 MG, 360 MG, 420 MG
P
Diltiazem HCl ER Coated Beads ORAL
HOUR 120 MG, 180 MG, 240 MG, 300 MG,
360 MG
P
49
Drug Name
MATZIM LA ORAL TABLET EXTENDED
RELEASE 24 HR* 180 MG, 240 MG, 300
MG, 360 MG, 420 MG
P
NIFEDIAC CC ORAL TABLET
MG, 90 MG
P
NIFEDICAL XL ORAL TABLET
MG
P
NIFEdipine ORAL CAPSULE 10 MG
P
NIFEdipine ER Osmotic ORAL TABLET
MG, 90 MG
P
Verapamil HCl ORAL TABLET 120 MG, 40
MG, 80 MG
P
Verapamil HCl ER ORAL CAPSULE
120 MG, 180 MG, 200 MG, 240 MG, 300 MG,
360 MG
P
Verapamil HCl ER ORAL TABLET
EXTENDEDRELEASE* 120 MG, 180 MG,
240 MG
P
*Cardiotonics*
*Cardiac Glycosides**
*Cardiac Glycosides***
Digoxin INJECTION SOLUTION 0.25
MG/ML
P
Digoxin ORAL SOLUTION 0.05 MG/ML
P
Digoxin ORAL TABLET 0.125 MG, 0.25 MG
P
*Cardiovascular Agents - Misc.*
*Pulmonary Hypertension - Endothelin
Receptor Antagonists**
*Pulmonary Hypertension - Endothelin
Receptor Antagonists***
LETAIRIS ORAL TABLET 10 MG, 5 MG
P
PA
P
PA
*Pulmonary Hypertension - Phosphodiesterase
Inhibitors**
*Pulmonary Hypertension - Phosphodiesterase
Inhibitors***
Sildenafil Citrate ORAL TABLET 20 MG
50
Drug Name
*Cephalosporins*
*Cephalosporins - 1St Generation**
*Cephalosporins - 1St Generation***
Cefadroxil ORAL CAPSULE 500 MG
P
Cefadroxil ORAL SUSPENSION
RECONSTITUTED 250 MG/5ML, 500
MG/5ML
P
Cefadroxil ORAL TABLET 1 GM
P
Cephalexin ORAL CAPSULE 250 MG, 500
MG, 750 MG
P
Cephalexin ORAL SUSPENSION
P
Cephalexin ORAL SUSPENSION
P
*Cephalosporins - 2Nd Generation**
*Cephalosporins - 2Nd Generation***
Cefaclor ORAL CAPSULE 250 MG, 500 MG
P
Cefprozil ORAL SUSPENSION
MG/5ML
P
Cefprozil ORAL TABLET 250 MG, 500 MG
P
Cefuroxime Axetil ORAL SUSPENSION
P
Cefuroxime Axetil ORAL TABLET 250 MG,
500 MG
P
*Cephalosporins - 3Rd Generation**
*Cephalosporins - 3Rd Generation***
Cefdinir ORAL CAPSULE 300 MG
P
Cefdinir ORAL SUSPENSION
MG/5ML
P
Cefpodoxime Proxetil ORAL SUSPENSION
MG/5ML
P
Cefpodoxime Proxetil ORAL TABLET 100
MG, 200 MG
P
*Contraceptives*
*Combination Contraceptives - Oral**
*Biphasic Contraceptives - Oral***
51
Drug Name
KARIVA ORAL TABLET 0.15-0.02/0.01 MG
(21/5)
P
*Combination Contraceptives - Oral***
ALTAVERA ORAL TABLET 0.15-30
MG-MCG
P
APRI ORAL TABLET 0.15-30 MG-MCG
P
AVIANE ORAL TABLET 0.1-20 MG-MCG
P
BALZIVA ORAL TABLET 0.4-35 MG-MCG
P
Briellyn ORAL TABLET 0.4-35 MG-MCG
P
CRYSELLE-28 ORAL TABLET 0.3-30
MG-MCG
P
EMOQUETTE ORAL TABLET 0.15-30
MG-MCG
P
ESTARYLLA ORAL TABLET 0.25-35
MG-MCG
P
GIANVI ORAL TABLET 3-0.02 MG
P
JUNEL 1.5/30 ORAL TABLET 1.5-30
MG-MCG
P
JUNEL 1/20 ORAL TABLET 1-20 MG-MCG
P
JUNEL FE 1.5/30 ORAL TABLET 1.5-30
MG-MCG
P
JUNEL FE 1/20 ORAL TABLET 1-20
MG-MCG
P
KELNOR 1/35 ORAL TABLET 1-35
MG-MCG
P
LESSINA ORAL TABLET 0.1-20 MG-MCG
P
LEVORA 0.15/30 (28) ORAL TABLET
0.15-30 MG-MCG
P
LORYNA ORAL TABLET 3-0.02 MG
P
LOW-OGESTREL ORAL TABLET 0.3-30
MG-MCG
P
LUTERA ORAL TABLET 0.1-20 MG-MCG
P
MICROGESTIN 1.5/30 ORAL TABLET
1.5-30 MG-MCG
P
MICROGESTIN 1/20 ORAL TABLET 1-20
MG-MCG
P
MICROGESTIN FE 1.5/30 ORAL TABLET
1.5-30 MG-MCG
P
52
Drug Name
MICROGESTIN FE 1/20 ORAL TABLET
1-20 MG-MCG
P
MONONESSA ORAL TABLET 0.25-35
MG-MCG
P
NECON 0.5/35 (28) ORAL TABLET 0.5-35
MG-MCG
P
NECON 1/35 (28) ORAL TABLET 1-35
MG-MCG
P
NECON 1/50 (28) ORAL TABLET 1-50
MG-MCG
P
NORTREL 0.5/35 (28) ORAL TABLET
0.5-35 MG-MCG
P
NORTREL 1/35 (21) ORAL TABLET 1-35
MG-MCG
P
NORTREL 1/35 (28) ORAL TABLET 1-35
MG-MCG
P
OCELLA ORAL TABLET 3-0.03 MG
P
OGESTREL ORAL TABLET 0.5-50
MG-MCG
P
PORTIA-28 ORAL TABLET 0.15-30
MG-MCG
P
PREVIFEM ORAL TABLET 0.25-35
MG-MCG
P
RECLIPSEN ORAL TABLET 0.15-30
MG-MCG
P
SOLIA ORAL TABLET 0.15-30 MG-MCG
P
SPRINTEC 28 ORAL TABLET 0.25-35
MG-MCG
P
SRONYX ORAL TABLET 0.1-20 MG-MCG
P
SYEDA ORAL TABLET 3-0.03 MG
P
ZENCHENT FE ORAL TABLET
CHEWABLE 0.4-35 MG-MCG
P
ZOVIA 1/35E (28) ORAL TABLET 1-35
MG-MCG
P
ZOVIA 1/50E (28) ORAL TABLET 1-50
MG-MCG
P
*Extended-Cycle Contraceptives - Oral***
QUASENSE ORAL TABLET 0.15-0.03 MG
P
*Triphasic Contraceptives - Oral***
53
Drug Name
CAZIANT ORAL TABLET 0.1/0.125/0.15
-0.025 MG
P
ENPRESSE-28 ORAL TABLET
P
NECON 7/7/7 ORAL TABLET 0.5/0.75/1-35
MG-MCG
P
NORTREL 7/7/7 ORAL TABLET
0.5/0.75/1-35 MG-MCG
P
TRI-ESTARYLLA ORAL TABLET
0.18/0.215/0.25 MG-35 MCG
P
TRI-PREVIFEM ORAL TABLET
0.18/0.215/0.25 MG-35 MCG
P
TRI-SPRINTEC ORAL TABLET
0.18/0.215/0.25 MG-35 MCG
P
TRINESSA (28) ORAL TABLET
0.18/0.215/0.25 MG-35 MCG
P
TRIVORA (28) ORAL TABLET
P
VELIVET ORAL TABLET 0.1/0.125/0.15
-0.025 MG
P
*Combination Contraceptives - Vaginal**
*Combination Contraceptives - Vaginal***
NUVARING VAGINAL RING 0.12-0.015
MG/24HR
P
*Emergency Contraceptives**
*Emergency Contraceptives***
Levonorgestrel ORAL TABLET 0.75 MG
P
PLAN B ONE-STEP ORAL TABLET 1.5
MG
P
OTC
P
*Progestin Contraceptives - Injectable**
*Progestin Contraceptives - Injectable***
MedroxyPROGESTERone Acetate
INTRAMUSCULAR* SUSPENSION 150
MG/ML
*Progestin Contraceptives - Oral**
*Progestin Contraceptives - Oral***
CAMILA ORAL TABLET 0.35 MG
P
ERRIN ORAL TABLET 0.35 MG
P
JOLIVETTE ORAL TABLET 0.35 MG
P
NOR-QD ORAL TABLET 0.35 MG
P
54
Drug Name
NORA-BE ORAL TABLET 0.35 MG
P
*Corticosteroids*
*Glucocorticosteroids**
*Glucocorticosteroids***
A-METHAPRED INJECTION SOLUTION
P
CELESTONE ORAL SOLUTION 0.6
MG/5ML
P
Cortisone Acetate ORAL TABLET 25 MG
P
Dexamethasone ORAL ELIXIR 0.5 MG/5ML
P
Dexamethasone ORAL SOLUTION 0.5
MG/5ML
P
Dexamethasone ORAL TABLET 0.5 MG, 0.75
MG, 1 MG, 1.5 MG, 2 MG, 4 MG, 6 MG
P
Dexamethasone Sodium Phosphate
INJECTION SOLUTION 10 MG/ML, 4
MG/ML
P
Hydrocortisone ORAL TABLET 10 MG, 20
MG, 5 MG
P
MethylPREDNISolone ORAL TABLET 16
MG, 32 MG, 8 MG
P
MethylPREDNISolone (Pak) ORAL
TABLET 4 MG
P
MethylPREDNISolone Acetate INJECTION
SUSPENSION 40 MG/ML, 80 MG/ML
P
MethylPREDNISolone Sodium Succ
INJECTION SOLUTION
RECONSTITUTED 1 GM, 1000 MG, 125
MG, 40 MG
P
PrednisoLONE ORAL SOLUTION 15
MG/5ML
P
PrednisoLONE Sodium Phosphate ORAL
SOLUTION 15 MG/5ML, 6.7 (5 Base)
MG/5ML
P
PredniSONE ORAL SOLUTION 5 MG/5ML
P
PredniSONE ORAL TABLET 1 MG, 10 MG,
2.5 MG, 20 MG, 5 MG, 50 MG
P
*Mineralocorticoids**
*Mineralocorticoids***
55
Drug Name
Fludrocortisone Acetate ORAL TABLET 0.1
MG
P
*Cough/Cold/Allergy*
*Cough/Cold/Allergy Combinations**
*Decongestant & Antihistamine***
ALAVERT ALLERGY/SINUS ORAL
5-120 MG
P
OTC
ALLEGRA-D ALLERGY & CONGESTION
ORAL TABLET EXTENDED RELEASE 12
HR* 60-120 MG
P
OTC
Allergy Relief/Nasal Decongest ORAL
10-240 MG
P
OTC
Antihistamine Decongestant ORAL TABLET
2.5-60 MG
P
OTC
BROTAPP ORAL LIQUID† 1-15 MG/5ML
P
OTC
Cetirizine-Pseudoephedrine ER ORAL
5-120 MG
P
OTC
Cold & Allergy ORAL ELIXIR 1-2.5 MG/5ML
P
OTC
DELSYM NGHT TIME CGH/CLD CHILD
ORAL LIQUID† 12.5-5 MG/5ML
P
OTC
DELSYM NIGHT TIME COUGH/COLD
ORAL LIQUID† 6.25-2.5 MG/5ML
P
OTC
Fexofenadine-Pseudoephed ER ORAL
180-240 MG
P
OTC
Q-TAPP ORAL ELIXIR 1-15 MG/5ML
P
OTC
Mucus Relief ORAL TABLET 400 MG
P
OTC
Refenesen ORAL TABLET 200 MG
P
OTC
Refenesen 400 ORAL TABLET 400 MG
P
OTC
Robafen ORAL SYRUP 100 MG/5ML
P
OTC
P
OTC
*Expectorants**
*Expectorants***
*Misc. Respiratory Inhalants**
*Misc. Respiratory Inhalants***
BRONCHO SALINE INHALATION
AEROSOL, SOLUTION 0.9 %
56
Drug Name
Sodium Chloride INHALATION
NEBULIZATION SOLUTION 0.9 %
P
OTC
*Mucolytics**
*Mucolytics***
Acetylcysteine INHALATION SOLUTION 10
%, 20 %
P
*Dermatologicals*
*Acne Products**
*Acne Antibiotics***
Clindamycin Phosphate EXTERNAL GEL 1 %
P
Clindamycin Phosphate EXTERNAL LOTION
1%
P
Clindamycin Phosphate EXTERNAL
SOLUTION 1 %
P
Ery EXTERNAL PAD 2 %
P
Erythromycin EXTERNAL GEL 2 %
P
Erythromycin EXTERNAL SOLUTION 2 %
P
Sulfacetamide Sodium EXTERNAL
SUSPENSION 10 %
P
*Acne Combinations***
Benzoyl Peroxide-Erythromycin EXTERNAL
GEL 5-3 %
P
*Acne Products***
Acne Medication EXTERNAL LOTION 10 %
P
OTC
Acne Medication 5 EXTERNAL LOTION 5 %
P
OTC
AMNESTEEM ORAL CAPSULE 10 MG, 20
MG, 40 MG
P
ST; QL (62 EA per 31 day(s));
AL (Min 12 Years and Max 20
Years)
AVITA EXTERNAL CREAM 0.025 %
P
QL (45 GM per 31 day(s)); AL
(Max 20 Years)
AVITA EXTERNAL GEL 0.025 %
P
(Max 20 Years)
Benzoyl Peroxide EXTERNAL GEL 10 %, 5 %
P
OTC
CLARAVIS ORAL CAPSULE 10 MG, 20
MG, 30 MG, 40 MG
P
ST; QL (62 EA per 31 day(s));
AL (Min 12 Years and Max 20
Years)
LAVOCLEN-4 CREAMY WASH
EXTERNAL LIQUID† 4 %
P
57
Drug Name
LAVOCLEN-8 CREAMY WASH
P
Tretinoin EXTERNAL CREAM 0.025 %, 0.05
%, 0.1 %
P
(Max 20 Years)
Tretinoin EXTERNAL GEL 0.01 %, 0.025 %
P
(Max 20 Years)
Double Antibiotic EXTERNAL OINTMENT
500-10000 UNIT/GM
P
OTC
Triple Antibiotic EXTERNAL OINTMENT
3.5-400-5000 , 5-400-5000
P
OTC
*Antibiotics - Topical**
*Antibiotic Mixtures Topical***
*Antibiotic Steroid Combinations - Topical***
CORTISPORIN EXTERNAL OINTMENT 1
%
P
*Antibiotics - Topical***
Bacitracin EXTERNAL OINTMENT 500
UNIT/GM
P
OTC
Bacitracin Zinc EXTERNAL OINTMENT 500
UNIT/GM
P
OTC
Gentamicin Sulfate EXTERNAL CREAM 0.1
%
P
Gentamicin Sulfate EXTERNAL OINTMENT
0.1 %
P
Mupirocin EXTERNAL OINTMENT 2 %
P
*Antifungals - Topical**
*Antifungals - Topical***
Ciclopirox EXTERNAL SOLUTION 8 %
P
Ciclopirox Olamine EXTERNAL CREAM 0.77
%
P
Ciclopirox Olamine EXTERNAL
SUSPENSION 0.77 %
P
Nystatin EXTERNAL CREAM 100000
UNIT/GM
P
Nystatin EXTERNAL OINTMENT 100000
UNIT/GM
P
Nystatin EXTERNAL POWDER 100000
UNIT/GM
P
Terbinafine HCl EXTERNAL CREAM 1 %
P
58
OTC
Drug Name
*Imidazole-Related Antifungals - Topical***
Baza Antifungal EXTERNAL CREAM 2 %
P
OTC
Clotrimazole EXTERNAL CREAM 1 %
P
OTC
Clotrimazole EXTERNAL SOLUTION 1 %
P
OTC
Econazole Nitrate EXTERNAL CREAM 1 %
P
Ketoconazole EXTERNAL CREAM 2 %
P
Ketoconazole EXTERNAL SHAMPOO 2 %
P
*Anti-Inflammatory Agents - Topical**
*Anti-Inflammatory Agents - Topical***
VOLTAREN TRANSDERMAL GEL 1 %
P
Fluorouracil EXTERNAL CREAM 5 %
P
PA
Fluorouracil EXTERNAL SOLUTION 2 %, 5
%
P
PA
*Antineoplastic Or Premalignant Lesion Agents
- Topical**
*Antineoplastic Antimetabolites - Topical***
*Antipsoriatics**
*Antipsoriatics***
Calcipotriene EXTERNAL CREAM 0.005 %
P
Calcipotriene EXTERNAL OINTMENT 0.005
%
P
Calcipotriene EXTERNAL SOLUTION 0.005
%
P
DRITHO-CREME HP EXTERNAL
CREAM 1 %
P
TAZORAC EXTERNAL CREAM 0.05 %,
0.1 %
P
(Max 20 Years)
TAZORAC EXTERNAL GEL 0.05 %, 0.1 %
P
(Max 20 Years)
*Antiseborrheic Products**
*Antiseborrheic Products***
Selenium Sulfide EXTERNAL LOTION 2.5 %
P
*Antivirals - Topical**
*Antivirals - Topical***
DENAVIR EXTERNAL CREAM 1 %
P
ST
ZOVIRAX EXTERNAL CREAM 5 %
P
ST
*Burn Products**
59
Drug Name
*Burn Products***
Silver Sulfadiazine EXTERNAL CREAM 1 %
P
SSD EXTERNAL CREAM 1 %
P
*Corticosteroids - Topical**
*Corticosteroids - Topical***
Alclometasone Dipropionate EXTERNAL
CREAM 0.05 %
P
Alclometasone Dipropionate EXTERNAL
OINTMENT 0.05 %
P
Betamethasone Dipropionate EXTERNAL
CREAM 0.05 %
P
LOTION 0.05 %
P
OINTMENT 0.05 %
P
Betamethasone Dipropionate Aug EXTERNAL
CREAM 0.05 %
P
Betamethasone Valerate EXTERNAL CREAM
0.1 %
P
Betamethasone Valerate EXTERNAL
LOTION 0.1 %
P
Betamethasone Valerate EXTERNAL
OINTMENT 0.1 %
P
Clobetasol Propionate EXTERNAL CREAM
0.05 %
P
Clobetasol Propionate EXTERNAL GEL 0.05
%
P
Clobetasol Propionate EXTERNAL
OINTMENT 0.05 %
P
DEMAREST DRICORT EXTERNAL
CREAM 1 %
P
Desonide EXTERNAL CREAM 0.05 %
P
Fluocinolone Acetonide EXTERNAL CREAM
0.01 %, 0.025 %
P
Fluocinolone Acetonide EXTERNAL
OINTMENT 0.025 %
P
Fluocinolone Acetonide EXTERNAL
SOLUTION 0.01 %
P
Fluocinolone Acetonide Body EXTERNAL OIL
0.01 %
P
60
OTC
Drug Name
Fluocinolone Acetonide Scalp EXTERNAL OIL
0.01 %
P
Fluocinonide EXTERNAL CREAM 0.05 %
P
Fluocinonide EXTERNAL GEL 0.05 %
P
Fluocinonide EXTERNAL OINTMENT 0.05
%
P
Fluocinonide EXTERNAL SOLUTION 0.05 %
P
Fluocinonide-E EXTERNAL CREAM 0.05 %
P
Fluticasone Propionate EXTERNAL CREAM
0.05 %
P
Fluticasone Propionate EXTERNAL
OINTMENT 0.005 %
P
Halobetasol Propionate EXTERNAL CREAM
0.05 %
P
Halobetasol Propionate EXTERNAL
OINTMENT 0.05 %
P
Hydrocortisone EXTERNAL CREAM 0.5 %, 1
%
P
OTC
Hydrocortisone EXTERNAL LOTION 1 %
P
OTC
Hydrocortisone EXTERNAL LOTION 2.5 %
P
Hydrocortisone EXTERNAL OINTMENT 0.5
%, 1 %
P
Hydrocortisone EXTERNAL OINTMENT 2.5
%
P
Hydrocortisone Valerate EXTERNAL
CREAM 0.2 %
P
Hydrocortisone Valerate EXTERNAL
OINTMENT 0.2 %
P
Mometasone Furoate EXTERNAL CREAM
0.1 %
P
Mometasone Furoate EXTERNAL
OINTMENT 0.1 %
P
Triamcinolone Acetonide EXTERNAL
CREAM 0.025 %, 0.1 %, 0.5 %
P
Triamcinolone Acetonide EXTERNAL
OINTMENT 0.1 %
P
OTC
*Emollient/Keratolytic Agents**
*Emollient/Keratolytic Agents***
REMEVEN EXTERNAL CREAM 50 %
P
61
Drug Name
Urea EXTERNAL CREAM 40 %
P
X-VIATE EXTERNAL CREAM 40 %
P
*Emollients**
*Emollients***
AMLACTIN EXTERNAL LOTION 12 %
P
OTC; QL (400 GM per 31
day(s))
Ammonium Lactate EXTERNAL CREAM 12
%
P
day(s))
Ammonium Lactate EXTERNAL LOTION 12
%
P
day(s))
P
PA
P
ST; QL (30 GM per 31 day(s))
CLEAR AWAY 1-STEP WART REMOVER
EXTERNAL PAD 40 %
P
OTC
COMPOUND W EXTERNAL LIQUID† 17
%
P
OTC
COMPOUND W MAXIMUM STRENGTH
EXTERNAL GEL 17 %
P
OTC
CONDYLOX EXTERNAL GEL 0.5 %
P
PA
FREEZONE EXTERNAL LIQUID† 17.6 %
P
OTC
Podofilox EXTERNAL SOLUTION 0.5 %
P
SALACTIC FILM EXTERNAL SOLUTION
17 %
P
OTC
Capsaicin EXTERNAL CREAM 0.025 %
P
OTC
Lidocaine EXTERNAL OINTMENT 5 %
P
Lidocaine HCl EXTERNAL GEL 2 %
P
Lidocaine HCl EXTERNAL SOLUTION 4 %
P
*Enzymes - Topical**
*Enzymes - Topical***
SANTYL EXTERNAL OINTMENT 250
UNIT/GM
*Immunosuppressive Agents - Topical**
*Macrolide Immunosuppressants - Topical***
ELIDEL EXTERNAL CREAM 1 %
*Keratolytic/Antimitotic Agents**
*Keratolytic/Antimitotic Agents***
*Local Anesthetics - Topical**
*Local Anesthetics - Topical***
*Topical Anesthetic Combinations***
62
Drug Name
Lidocaine-Prilocaine EXTERNAL CREAM
2.5-2.5 %
P
Lidocaine-Prilocaine EXTERNAL KIT 2.5-2.5
%
P
*Misc. Topical**
*Misc. Topical***
HYPERCARE EXTERNAL SOLUTION 20
%
P
PREPARATION H EXTERNAL PAD 50 %
P
OTC
*Rosacea Agents**
*Rosacea Agents***
MetroNIDAZOLE EXTERNAL CREAM 0.75
%
P
MetroNIDAZOLE EXTERNAL GEL 1 %
P
*Scabicides & Pediculicides**
*Scabicides & Pediculicides***
ACTICIN EXTERNAL CREAM 5 %
P
OVIDE EXTERNAL LOTION 0.5 %
P
(Min 6 Years)
Permethrin EXTERNAL CREAM 5 %
P
Permethrin EXTERNAL LOTION 1 %
P
*Diagnostic Products*
*Diagnostic Drugs**
*Diagnostic Drugs***
Dipyridamole INTRAVENOUS* SOLUTION
5 MG/ML
P
*Diagnostic Tests**
*Diagnostic Tests***
ACCU-CHEK ACTIVE IN VITRO STRIP
P
ACCU-CHEK AVIVA PLUS IN VITRO
STRIP
P
ACCU-CHEK COMFORT CURVE IN
VITRO STRIP
P
ACCU-CHEK COMPACT IN VITRO STRIP
P
ACCU-CHEK COMPACT TEST DRUM IN
VITRO STRIP
P
ACCU-CHEK SMARTVIEW IN VITRO
STRIP
P
63
Drug Name
CLINISTIX IN VITRO STRIP
P
DIASTIX IN VITRO STRIP
P
FREESTYLE INSULINX TEST IN VITRO
STRIP
P
FREESTYLE LITE TEST IN VITRO STRIP
P
FREESTYLE TEST IN VITRO STRIP
P
KETOSTIX IN VITRO STRIP
P
PRECISION XTRA BLOOD GLUCOSE IN
VITRO STRIP
P
PRECISION XTRA KETONE IN VITRO
STRIP
P
OTC
*Digestive Aids*
*Digestive Enzymes**
*Digestive Enzymes***
CREON ORAL CAPSULE DELAYED
RELEASE PARTICLES 12000 UNIT, 24000
UNIT, 3000-9500 UNIT, 36000 UNIT, 6000
UNIT
P
PERTZYE ORAL CAPSULE DELAYED
RELEASE PARTICLES 16000 UNIT, 8000
UNIT
P
*Diuretics*
*Carbonic Anhydrase Inhibitors**
*Carbonic Anhydrase Inhibitors***
AcetaZOLAMIDE ORAL TABLET 125 MG,
250 MG
P
Methazolamide ORAL TABLET 25 MG, 50
MG
P
*Diuretic Combinations**
*Diuretic Combinations***
Amiloride-Hydrochlorothiazide ORAL
TABLET 5-50 MG
P
Spironolactone-HCTZ ORAL TABLET 25-25
MG
P
Triamterene-HCTZ ORAL CAPSULE 37.5-25
MG
P
Triamterene-HCTZ ORAL TABLET 37.5-25
MG, 75-50 MG
P
*Loop Diuretics**
64
Drug Name
*Loop Diuretics***
Bumetanide INJECTION SOLUTION 0.25
MG/ML
P
Bumetanide ORAL TABLET 0.5 MG, 1 MG, 2
MG
P
Furosemide ORAL SOLUTION 10 MG/ML, 8
MG/ML
P
Furosemide ORAL TABLET 20 MG, 40 MG,
80 MG
P
Torsemide ORAL TABLET 10 MG, 100 MG,
20 MG, 5 MG
P
*Potassium Sparing Diuretics**
*Potassium Sparing Diuretics***
Spironolactone ORAL TABLET 100 MG, 25
MG, 50 MG
P
*Thiazides And Thiazide-Like Diuretics**
*Thiazides And Thiazide-Like Diuretics***
Chlorothiazide ORAL TABLET 250 MG, 500
MG
P
Chlorthalidone ORAL TABLET 25 MG, 50
MG
P
Hydrochlorothiazide ORAL CAPSULE 12.5
MG
P
Hydrochlorothiazide ORAL TABLET 12.5
MG, 25 MG, 50 MG
P
Indapamide ORAL TABLET 1.25 MG, 2.5 MG
P
Metolazone ORAL TABLET 10 MG, 2.5 MG,
5 MG
P
*Endocrine And Metabolic Agents - Misc.*
*Bone Density Regulators**
*Bisphosphonates***
Alendronate Sodium ORAL TABLET 10 MG,
35 MG, 40 MG, 5 MG, 70 MG
P
*Calcitonins***
Calcitonin (Salmon) NASAL SOLUTION 200
UNIT/ACT
P
FORTICAL NASAL SOLUTION 200
UNIT/ACT
P
*Rank Ligand (Rankl) Inhibitors***
65
Drug Name
PROLIA SUBCUTANEOUS* SOLUTION
60 MG/ML
P
PA
P
PA
*Growth Hormones**
*Growth Hormones***
TEV-TROPIN SUBCUTANEOUS*
*Hormone Receptor Modulators**
*Selective Estrogen Receptor Modulators
(Serms)***
EVISTA ORAL TABLET 60 MG
P
*Metabolic Modifiers**
*Carnitine Replenisher - Agents***
LevOCARNitine INTRAVENOUS*
SOLUTION 200 MG/ML
P
LevOCARNitine ORAL SOLUTION 1
GM/10ML
P
LevOCARNitine ORAL TABLET 330 MG
P
*Gaa Deficiency Treatment - Agents***
LUMIZYME INTRAVENOUS*
P
*Hyperparathyroid Treatment - Vitamin D
Analogs***
Calcitriol INTRAVENOUS* SOLUTION 1
MCG/ML
P
Calcitriol ORAL CAPSULE 0.25 MCG, 0.5
MCG
P
Calcitriol ORAL SOLUTION 1 MCG/ML
P
*Posterior Pituitary Hormones**
*Vasopressin***
Desmopressin Ace Rhinal Tube NASAL
SOLUTION 0.01 %
P
Desmopressin Ace Spray Refrig NASAL
SOLUTION 0.01 %
P
Desmopressin Acetate ORAL TABLET 0.1
MG, 0.2 MG
P
Desmopressin Acetate Spray NASAL
SOLUTION 0.01 %
P
*Estrogens*
*Estrogen Combinations**
66
PA
Drug Name
*Estrogen & Progestin***
Estradiol-Norethindrone Acet ORAL TABLET
0.5-0.1 MG, 1-0.5 MG
P
PREMPHASE ORAL TABLET 0.625-5 MG
P
PREMPRO ORAL TABLET 0.3-1.5 MG,
0.45-1.5 MG, 0.625-2.5 MG, 0.625-5 MG
P
*Estrogens**
*Estrogens***
Estradiol ORAL TABLET 0.5 MG, 1 MG, 2
MG
P
Estradiol TRANSDERMAL PATCH
WEEKLY 0.025 MG/24HR, 0.0375 MG/24HR,
0.05 MG/24HR, 0.06 MG/24HR, 0.075
MG/24HR, 0.1 MG/24HR
P
Estropipate ORAL TABLET 0.75 MG, 1.5
MG, 3 MG
P
PREMARIN INJECTION SOLUTION
RECONSTITUTED 25 MG
P
PREMARIN ORAL TABLET 0.3 MG, 0.45
MG, 0.625 MG, 0.9 MG, 1.25 MG
P
*Fluoroquinolones*
*Fluoroquinolones**
*Fluoroquinolones***
Ciprofloxacin HCl ORAL TABLET 250 MG,
500 MG, 750 MG
P
Levofloxacin ORAL TABLET 250 MG, 500
MG, 750 MG
P
Simethicone ORAL SUSPENSION 40
MG/0.6ML
P
OTC
Simethicone ORAL TABLET CHEWABLE 80
MG
P
OTC
*Gastrointestinal Agents - Misc.*
*Antiflatulents**
*Antiflatulents***
*Gallstone Solubilizing Agents**
*Gallstone Solubilizing Agents***
Ursodiol ORAL CAPSULE 300 MG
P
*Gastrointestinal Stimulants**
*Gastrointestinal Stimulants***
67
Drug Name
Metoclopramide HCl ORAL SOLUTION 5
MG/5ML
P
Metoclopramide HCl ORAL TABLET 10 MG,
5 MG
P
*Inflammatory Bowel Agents**
*Inflammatory Bowel Agents***
APRISO ORAL CAPSULE EXTENDED
RELEASE 24 HOUR 0.375 GM
P
Balsalazide Disodium ORAL CAPSULE 750
MG
P
Mesalamine RE ENEMA 4 GM
P
SulfaSALAzine ORAL TABLET 500 MG
P
SulfaSALAzine ORAL TABLET DELAYED
RELEASE 500 MG
P
*Intestinal Acidifiers**
*Intestinal Acidifiers***
P
Calcium Acetate ORAL CAPSULE 667 MG
P
ELIPHOS ORAL TABLET 667 MG
P
RENVELA ORAL PACKET 0.8 GM, 2.4
GM
P
RENVELA ORAL TABLET 800 MG
P
Generlac ORAL SOLUTION 10 GM/15ML
*Phosphate Binder Agents**
*Phosphate Binder Agents***
*Genitourinary Agents - Miscellaneous*
*Alkalinizers**
*Citrates***
Cytra-2 ORAL SOLUTION 500-334 MG/5ML
P
CYTRA-3 ORAL SYRUP 550-500-334
MG/5ML
P
Sodium Citrate ORAL GRANULES
P
*Genitourinary Irrigants**
*Genitourinary Irrigants***
ARGYLE STERILE SALINE IRRIGATION
SOLUTION 0.9 %
P
Sodium Chloride IRRIGATION SOLUTION
0.9 %
P
*Prostatic Hypertrophy Agents**
68
Drug Name
*5-Alpha Reductase Inhibitors***
AVODART ORAL CAPSULE 0.5 MG
P
Finasteride ORAL TABLET 5 MG
P
*Alpha 1-Adrenoceptor Antagonists***
Tamsulosin HCl ORAL CAPSULE 0.4 MG
P
*Urinary Analgesics**
*Urinary Analgesics***
Phenazopyridine HCl ORAL TABLET 100
MG, 200 MG
P
*Gout Agents*
*Gout Agent Combinations**
*Gout Agent Combinations***
Colchicine-Probenecid ORAL TABLET 0.5-500
MG
P
*Gout Agents**
*Gout Agents***
Allopurinol ORAL TABLET 100 MG, 300 MG
P
COLCRYS ORAL TABLET 0.6 MG
P
*Uricosurics**
*Uricosurics***
Probenecid ORAL TABLET 500 MG
P
*Hematological Agents - Misc.*
*Bradykinin B2 Receptor Antagonists**
*Bradykinin B2 Receptor Antagonists***
FIRAZYR SUBCUTANEOUS* SOLUTION
30 MG/3ML
P
PA
*Hematorheologic Agents**
*Hematorheologic Agents***
Pentoxifylline ER ORAL TABLET
P
*Platelet Aggregation Inhibitors**
*Phosphodiesterase Iii Inhibitors***
Cilostazol ORAL TABLET 100 MG, 50 MG
P
*Platelet Aggregation Inhibitors***
Dipyridamole ORAL TABLET 25 MG, 50 MG,
75 MG
P
69
Drug Name
*Quinazoline Agents***
Anagrelide HCl ORAL CAPSULE 0.5 MG, 1
MG
P
*Thienopyridine Derivatives***
Clopidogrel Bisulfate ORAL TABLET 75 MG
P
*Hematopoietic Agents*
*Cobalamins**
*Cobalamins***
Cyanocobalamin INJECTION SOLUTION
1000 MCG/ML
P
Vitamin B-12 ORAL TABLET 1000 MCG, 250
MCG, 500 MCG
P
OTC
Vitamin B-12 SUBLINGUAL TABLET
SUBLINGUAL 1000 MCG
P
OTC
Vitamin B-12 ER ORAL TABLET
EXTENDEDRELEASE* 1000 MCG
P
OTC
P
OTC
P
PA
P
PA
*Folic Acid/Folates**
*Folic Acid/Folates***
Folic Acid ORAL TABLET 1 MG, 400 MCG,
800 MCG
*Hematopoietic Growth Factors**
*Erythropoiesis-Stimulating Agents (Esas)***
PROCRIT INJECTION SOLUTION 10000
UNIT/ML, 2000 UNIT/ML, 20000
UNIT/ML, 3000 UNIT/ML, 4000 UNIT/ML,
40000 UNIT/ML
*Granulocyte Colony-Stimulating Factors
(G-Csf)***
NEUPOGEN INJECTION SOLUTION 300
MCG/0.5ML, 300 MCG/ML, 480
*Hematopoietic Mixtures**
*Iron Combinations***
CENTRATEX ORAL CAPSULE 106-1 MG
P
FE C PLUS ORAL TABLET 100-250-0.025-1
MG
P
MULTIGEN ORAL TABLET 70 MG
P
Poly-Iron 150 Forte ORAL CAPSULE
150-25-1 MG-MCG-MG
P
70
Drug Name
*Iron**
*Iron***
Ferrous Gluconate ORAL TABLET 324 (38
Fe) MG
P
OTC
Ferrous Sulfate ORAL ELIXIR 220 (44 Fe)
MG/5ML
P
OTC
Ferrous Sulfate ORAL SOLUTION 75 (15 Fe)
MG/ML
P
OTC
Ferrous Sulfate ORAL TABLET 325 (65 Fe)
MG
P
OTC
Ferrous Sulfate ORAL TABLET DELAYED
RELEASE 324 (65 Fe) MG, 325 (65 Fe) MG
P
OTC
POLY-IRON 150 ORAL CAPSULE 150 MG
P
OTC
Slow Release Iron ORAL TABLET
EXTENDEDRELEASE* 160 (50 Fe) MG
P
OTC
PHENobarbital ORAL ELIXIR 20 MG/5ML
P
PHENobarbital ORAL TABLET 100 MG, 30
MG, 32.4 MG, 60 MG, 64.8 MG, 97.2 MG
P
PHENobarbital ORAL TABLET 15 MG
P
PHENobarbital ORAL TABLET 16.2 MG
P
PHENobarbital Sodium INJECTION
P
*Hypnotics*
*Barbiturate Hypnotics**
*Barbiturate Hypnotics***
*Non-Barbiturate Hypnotics**
*Benzodiazepine Hypnotics***
Estazolam ORAL TABLET 1 MG, 2 MG
P
Flurazepam HCl ORAL CAPSULE 15 MG, 30
MG
P
Temazepam ORAL CAPSULE 15 MG, 30 MG
P
Triazolam ORAL TABLET 0.125 MG, 0.25
MG
P
AL (Min 18 Years)
P
QL (31 EA per 31 day(s)); AL
(Min 18 Years)
*Non-Benzodiazepine - Gaba-Receptor
Modulators***
Zolpidem Tartrate ORAL TABLET 10 MG, 5
MG
*Laxatives*
71
Drug Name
*Bulk Laxatives**
*Bulk Laxatives***
METAMUCIL ORAL CAPSULE 0.52 GM
P
OTC
METAMUCIL ORAL WAFER
P
OTC
METAMUCIL SMOOTH TEXTURE ORAL
POWDER 28.3 %, 58.6 %
P
OTC
Natural Fiber Therapy ORAL POWDER 30.9
%, 48.57 %
P
OTC
GAVILYTE-G ORAL SOLUTION
RECONSTITUTED 236 GM
P
GAVILYTE-N WITH FLAVOR PACK
ORAL SOLUTION RECONSTITUTED 420
GM
P
GOLYTELY ORAL SOLUTION
RECONSTITUTED 227.1 GM
P
PEG 3350-KCl-Na Bicarb-NaCl ORAL
SOLUTION RECONSTITUTED 420 GM
P
PEG 3350/Electrolytes ORAL SOLUTION
P
PEG-3350/Electrolytes ORAL SOLUTION
P
TRILYTE ORAL SOLUTION
P
P
OTC
Lactulose ORAL SOLUTION 10 GM/15ML
P
Polyethylene Glycol 3350 ORAL POWDER
P
day(s))
Sorbitol ORAL SOLUTION 70 %
P
OTC; QL (1500 ML per 31
day(s))
Mineral Oil ORAL OIL
P
OTC
Mineral Oil Heavy ORAL OIL
P
*Laxative Combinations**
*Bowel Evacuant Combinations***
*Laxatives & Dss***
Senna-Docusate Sodium ORAL TABLET
8.6-50 MG
*Laxatives - Miscellaneous**
*Laxatives - Miscellaneous***
*Lubricant Laxatives**
*Lubricant Laxatives***
72
Drug Name
*Saline Laxatives**
*Saline Laxative Mixtures***
FLEET PEDIATRIC RE ENEMA 3.5-9.5
GM/59ML
P
OTC
RA Saline Enema RE ENEMA 19-7
GM/118ML
P
OTC
Magnesium Citrate ORAL SOLUTION 1.745
GM/30ML
P
OTC
Milk of Magnesia ORAL SUSPENSION 400
MG/5ML, 7.75 %
P
OTC
EX-LAX ORAL TABLET CHEWABLE 15
MG
P
OTC
Laxative RE SUPPOSITORY 10 MG
P
OTC
Senna ORAL SYRUP 8.8 MG/5ML
P
OTC
Senna ORAL TABLET 8.6 MG
P
OTC
Stimulant Laxative ORAL TABLET
P
OTC
Docusate Sodium ORAL TABLET 100 MG
P
OTC
ENEMEEZ MINI RE ENEMA 283 MG
P
OTC
Silace ORAL LIQUID† 150 MG/15ML
P
OTC
Stool Softener ORAL CAPSULE 100 MG, 250
MG
P
OTC
Stool Softener Laxative DC ORAL CAPSULE
240 MG
P
OTC
*Saline Laxatives***
*Stimulant Laxatives**
*Stimulant Laxatives***
*Surfactant Laxatives**
*Surfactant Laxatives***
*Local Anesthetics-Parenteral*
*Local Anesthetics - Amides**
*Local Anesthetics - Amides***
Lidocaine HCl INJECTION SOLUTION 0.5
%, 1 %, 1.5 %
P
Lidocaine HCl (PF) INJECTION
SOLUTION 2 %
P
*Macrolides*
*Azithromycin**
73
Drug Name
*Azithromycin***
Azithromycin INTRAVENOUS* SOLUTION
P
Azithromycin ORAL SUSPENSION
MG/5ML
P
Azithromycin ORAL TABLET 250 MG
P
Azithromycin ORAL TABLET 500 MG, 600
MG
P
Azithromycin Hydrogencitrate
P
*Clarithromycin**
*Clarithromycin***
Clarithromycin ORAL SUSPENSION
MG/5ML
P
Clarithromycin ORAL TABLET 250 MG, 500
MG
P
*Erythromycins**
*Erythromycins***
E.E.S. GRANULES ORAL SUSPENSION
P
ERY-TAB ORAL TABLET DELAYED
RELEASE 250 MG, 333 MG, 500 MG
P
ERYPED 200 ORAL SUSPENSION
P
ERYPED 400 ORAL SUSPENSION
P
ERYTHROCIN STEARATE ORAL
TABLET 250 MG
P
Erythromycin Base ORAL CAPSULE
DELAYED RELEASE PARTICLES 250 MG
P
Erythromycin Base ORAL TABLET 250 MG,
500 MG
P
Erythromycin Ethylsuccinate ORAL TABLET
400 MG
P
*Medical Devices*
*Diabetic Supplies**
*Glucose Monitoring Test Supplies***
74
Drug Name
ACCU-CHEK AVIVA PLUS XX KIT
W/DEVICE
P
ACCU-CHEK COMPACT PLUS CARE XX
KIT
P
ACCU-CHEK NANO SMARTVIEW XX
KIT W/DEVICE
P
FREESTYLE FREEDOM LITE XX KIT
W/DEVICE
P
FREESTYLE INSULINX SYSTEM XX KIT
W/DEVICE
P
FREESTYLE LITE XX DEVICE
P
Glucose Control IN VITRO SOLUTION
P
OTC
Lancet Device XX MISC
P
OTC
Lancets XX MISC
P
OTC
PRECISION XTRA XX DEVICE
P
P
OTC
BD INSULIN SYRINGE ULTRAFINE XX
MISC 31G X 5/16" 1 ML
P
EXEL PEN NEEDLES 1/3" XX MISC 31G X
8 MM
P
Insulin Syringe XX MISC 29G X 1/2" 0.3 ML,
30G X 5/16" 0.3 ML
P
NOVOPEN 3 XX MISC
P
OTC
P
ACE AEROSOL CLOUD ENHANCER XX
MISC
P
IN-CHECK DIAL FLOW TRAINER XX
DEVICE
P
PFLEX XX MISC
P
THRESHOLD IMT XX MISC
P
THRESHOLD PEP XX DEVICE
P
*Misc. Devices**
*Applicators,Cotton Balls,Etc***
Alcohol Pads XX PAD 70 %
*Parenteral Therapy Supplies**
*Needles & Syringes***
*Respiratory Therapy Supplies**
*Peak Flow Meters***
Peak Flow Meter XX DEVICE
*Respiratory Therapy Supplies***
75
Drug Name
WINDMILL TRAINER XX MISC
P
AEROCHAMBER MV XX MISC
P
AEROCHAMBER PLUS FLO-VU XX
MISC
P
AEROCHAMBER PLUS FLO-VU LARGE
XX MISC
P
AEROCHAMBER PLUS FLO-VU SMALL
XX MISC
P
AEROCHAMBER PLUS FLO-VU
W/MASK XX MISC
P
AEROCHAMBER W/FLOWSIGNAL XX
MISC
P
AEROCHAMBER Z-STAT PLUS XX MISC
P
AEROCHAMBER Z-STAT PLUS
CHAMBR XX MISC
P
E-Z SPACER XX DEVICE
P
EASIVENT XX MISC
P
MICROCHAMBER XX MISC
P
MICROSPACER XX MISC
P
OPTICHAMBER ADVANTAGE XX MISC
P
OPTICHAMBER ADVANTAGE-LG MASK
XX MISC
P
OPTICHAMBER ADVANTAGE-MED
MASK XX MISC
P
OPTICHAMBER ADVANTAGE-SM
MASK XX MISC
P
OPTICHAMBER FACE MASK-LARGE XX
MISC
P
OPTICHAMBER FACE MASK-MEDIUM
XX MISC
P
OPTICHAMBER FACE MASK-SMALL XX
MISC
P
OPTIHALER XX DEVICE
P
OPTIHALER XX MISC
P
POCKET CHAMBER XX DEVICE
P
POCKET SPACER XX DEVICE
P
WATCHHALER XX DEVICE
P
*Spacer/Aerosol-Holding Chambers &
Supplies***
76
Drug Name
*Migraine Products*
*Serotonin Agonists**
*Selective Serotonin Agonists 5-Ht(1)***
Naratriptan HCl ORAL TABLET 1 MG, 2.5
MG
P
SUMAtriptan NASAL SOLUTION 20
MG/ACT, 5 MG/ACT
P
SUMAtriptan Succinate ORAL TABLET 100
MG, 25 MG, 50 MG
P
SUMAtriptan Succinate SUBCUTANEOUS*
P
SUMAtriptan Succinate Refill
MG/0.5ML, 6 MG/0.5ML
P
CALCITRATE ORAL TABLET 315-250
MG-UNIT
P
OTC
Calcium Carbonate-Vitamin D ORAL
TABLET 600-400 MG-UNIT
P
OTC
Calcium Citrate + D ORAL TABLET 315-200
MG-UNIT
P
OTC
Oyst-Cal D ORAL TABLET 250-125
MG-UNIT
P
OTC
Oyster Shell Calcium + D ORAL TABLET
500-400 MG-UNIT
P
OTC
Oyster Shell Calcium/D ORAL TABLET
250-125 MG-UNIT, 500-200 MG-UNIT
P
OTC
Cal-Lac ORAL CAPSULE 500 MG
P
OTC
Calcium Acetate (Phos Binder) ORAL
TABLET 667 MG
P
Calcium Carbonate ORAL SUSPENSION
1250 MG/5ML
P
OTC
Calcium Carbonate ORAL TABLET 1250 MG,
600 MG
P
OTC
Calcium Lactate ORAL TABLET 648 MG
P
OTC
*Minerals & Electrolytes*
*Calcium**
*Calcium Combinations***
*Calcium***
*Electrolyte Mixtures**
77
Drug Name
*Electrolytes Oral***
ORALYTE ORAL SOLUTION
P
day(s))
ORALYTE FREEZER POPS ORAL
SOLUTION
P
day(s))
*Fluoride**
*Fluoride Combinations***
FLUOR-A-DAY ORAL TABLET
CHEWABLE 0.25 (F)-236.79 MG, 0.5
(F)-236.79 MG, 1 (F)-236.79 MG
P
*Fluoride***
NAFRINSE DROPS ORAL SOLUTION
0.275 (0.125 F) MG/DROP
P
Sodium Fluoride ORAL SOLUTION 1.1 (0.5
F) MG/ML
P
Sodium Fluoride ORAL TABLET
CHEWABLE 0.55 (0.25 F) MG, 1.1 (0.5 F)
MG, 2.2 (1 F) MG
P
*Iodine Products**
*Iodine Products***
SSKI ORAL SOLUTION 1 GM/ML
P
*Magnesium**
*Magnesium***
Mag-Delay ORAL TABLET
EXTENDEDRELEASE* 535 (64 Mg) MG
P
OTC
Mag-SR ORAL TABLET
EXTENDEDRELEASE* 535 (64 Mg) MG
P
OTC
MAG64 ORAL TABLET
EXTENDEDRELEASE* 535 (64 MG) MG
P
OTC
Magnesium ORAL TABLET 250 MG
P
OTC
Magnesium Oxide ORAL TABLET 400 (240
Mg) MG, 500 MG
P
OTC
*Phosphate**
*Phosphate***
K-PHOS-NEUTRAL ORAL TABLET
155-852-130 MG
*Potassium**
*Potassium***
78
P
Drug Name
KLOR-CON ORAL TABLET
EXTENDEDRELEASE* 8 MEQ
P
KLOR-CON 10 ORAL TABLET
P
KLOR-CON M10 ORAL TABLET
P
KLOR-CON M20 ORAL TABLET
P
Potassium Chloride INTRAVENOUS*
SOLUTION 0.4 MEQ/ML, 10 MEQ/100ML,
2 MEQ/ML, 30 MEQ/100ML, 40
MEQ/100ML
P
Potassium Chloride ORAL LIQUID† 20
MEQ/15ML (10%), 40 MEQ/15ML (20%)
P
Potassium Chloride ORAL SOLUTION 20
MEQ/15ML (10%)
P
Potassium Chloride Crys ER ORAL TABLET
EXTENDEDRELEASE* 10 MEQ, 20 MEQ
P
Potassium Chloride ER ORAL TABLET
EXTENDEDRELEASE* 10 MEQ, 8 MEQ
P
*Sodium**
*Sodium***
Normal Saline Flush INTRAVENOUS*
SOLUTION 0.9 %
P
Saline Flush INTRAVENOUS* SOLUTION
0.9 %
P
Sodium Chloride INJECTION SOLUTION 0.9
%
P
Sodium Chloride INTRAVENOUS*
SOLUTION 0.9 %
P
Sodium Chloride ORAL TABLET 1 GM
P
OTC
Zinc Sulfate ORAL CAPSULE 220 MG
P
OTC
Zinc Sulfate ORAL TABLET 220 (50 Zn) MG
P
OTC
*Zinc**
*Zinc***
*Mouth/Throat/Dental Agents*
*Anesthetics Topical Oral**
*Anesthetics Topical Oral***
79
Drug Name
Lidocaine Viscous MOUTH/THROAT
SOLUTION 2 %
P
*Anti-Infectives - Throat**
*Anti-Infectives - Throat***
Clotrimazole MOUTH/THROAT LOZENGE
10 MG
P
Clotrimazole MOUTH/THROAT TROCHE
10 MG
P
Nystatin MOUTH/THROAT SUSPENSION
100000 UNIT/ML
P
Chlorhexidine Gluconate MOUTH/THROAT
SOLUTION 0.12 %
P
PERIOGARD MOUTH/THROAT
SOLUTION 0.12 %
P
*Antiseptics - Mouth/Throat**
*Antiseptics - Mouth/Throat***
*Dental Products**
*Fluoride Dental Products***
CAVAREST DENTAL GEL 1.1 %
P
CONTROLRX DENTAL CREAM 1.1 %
P
DENTA 5000 PLUS DENTAL CREAM 1.1
%
P
DENTAGEL DENTAL GEL 1.1 %
P
FLUORIDEX DAILY DEFENSE DENTAL
GEL 1.1 %
P
KARIGEL DENTAL GEL 1.1 %
P
KARIGEL-N DENTAL GEL 1.1 %
P
NEUTRAGARD ADVANCED DENTAL
GEL 1.1 %
P
PHOS-FLUR DENTAL GEL 1.1 %
P
SF DENTAL GEL 1.1 %
P
SF 5000 Plus DENTAL CREAM 1.1 %
P
*Steroids - Mouth/Throat**
*Steroids - Mouth/Throat***
Triamcinolone Acetonide MOUTH/THROAT
PASTE 0.1 %
*Throat Products - Misc.**
*Saliva Stimulants***
80
P
Drug Name
Pilocarpine HCl ORAL TABLET 5 MG, 7.5
MG
P
*Multivitamins*
*B-Complex Vitamins**
*B-Complex Vitamins***
B Complex ORAL TABLET
P
OTC
B Complex 50 ORAL TABLET
P
OTC
B Complex Vitamins ORAL CAPSULE
P
OTC
B-Complex/B-12 ORAL TABLET
P
OTC
Vitamin B Complex ORAL TABLET
P
OTC
Vitamin-B Complex ORAL TABLET
P
OTC
Stress Formula/Zinc ORAL TABLET
P
OTC
Stress Plus Zinc ORAL TABLET
P
OTC
Better B Complex ORAL TABLET
P
OTC
Vitamin B Complex-C ORAL CAPSULE
P
OTC
*B-Complex W/ C**
*B-Complex W/ C & E + Zn***
*B-Complex W/ C***
*B-Complex W/ Folic Acid**
*B-Complex W/ C & Folic Acid***
NEPHRONEX ORAL TABLET
P
RENAL ORAL CAPSULE 1 MG
P
Reno Caps ORAL CAPSULE 1 MG
P
*B-Complex W/Biotin & Folic Acid***
B Complete ORAL TABLET
P
OTC
Balanced B Complex ORAL TABLET
P
OTC
BIG 100 ORAL TABLET
P
OTC
SUPER B-50 B COMPLEX ORAL
CAPSULE
P
OTC
SUPER QUINTS B-50 ORAL TABLET
P
OTC
YL Balanced B-100 ORAL TABLET
P
OTC
P
OTC
*Bioflavonoid Products**
*Bioflavonoid Products***
Vitamin C ER ORAL TABLET
EXTENDEDRELEASE* 1000-100 MG
*Multiple Vitamins W/ Minerals**
81
Drug Name
*Multiple Vitamins W/ Minerals***
Centavite A-Z Complete-Mineral ORAL
TABLET
P
OTC
CEROVITE ADVANCED FORMULA
ORAL TABLET
P
OTC
CERTAVITE SENIOR/ANTIOXIDANT
ORAL TABLET
P
OTC
CERTAVITE/ANTIOXIDANTS ORAL
LIQUID†
P
OTC
Formula Twenty-One ORAL TABLET
P
OTC
Gerivite Complete ORAL TABLET
P
OTC
Golden Age Vitamin/Minerals ORAL
LIQUID†
P
OTC
Multivitamin & Mineral ORAL LIQUID†
P
OTC
Thera Vital M ORAL TABLET
P
OTC
Therabasic-M ORAL TABLET
P
OTC
Therapeutic Liquid ORAL SOLUTION
P
OTC
Therapeutic-M ORAL TABLET
P
OTC
THERATRUM COMPLETE ORAL
TABLET
P
OTC
Vision Vitamins ORAL TABLET
P
OTC
VITRUM SENIOR ORAL TABLET
P
OTC
Daily Multiple Vitamins ORAL TABLET
P
OTC
Multi-Vitamin ORAL TABLET
P
OTC
Multi-Vitamins ORAL TABLET
P
OTC
Once Daily ORAL TABLET
P
OTC
Thera-Tabs ORAL TABLET
P
OTC
*Multivitamins**
*Multivitamins***
*Ped Multi Vitamins W/Fl & Fe**
*Ped Multi Vitamins W/Fl & Fe***
Multi-Vit/Fluoride/Iron ORAL SOLUTION
0.25-10 MG/ML
P
*Ped Vitamins Acd Fluoride & Iron***
Tri-Vit/Fluoride/Iron ORAL SOLUTION
0.25-10 MG/ML
*Ped Mv W/ Fluoride**
82
P
Drug Name
*Ped Mv W/ Fluoride***
Multi-Vit/Fluoride ORAL SOLUTION 0.25
MG/ML, 0.5 MG/ML
P
Multi-Vitamin/Fluoride ORAL TABLET
CHEWABLE 0.25 MG, 0.5 MG, 1 MG
P
Multivitamin/Fluoride ORAL TABLET
CHEWABLE 0.25 MG, 0.5 MG, 1 MG
P
*Ped Vitamins Acd W/ Fluoride***
Tri-Vit/Fluoride ORAL SOLUTION 0.25
MG/ML
P
Tri-Vitamin/Fluoride ORAL SOLUTION 0.5
MG/ML
P
Vitamins ACD-Fluoride ORAL SOLUTION
0.25 MG/ML
P
*Ped Mv W/ Iron**
*Ped Mv W/ Iron***
Poly-Vitamin/Iron ORAL SOLUTION 10
MG/ML
P
OTC
P
OTC
P
OTC
*Pediatric Multiple Vitamins**
*Pediatric Multiple Vitamins W/ C***
Poly-Vitamin ORAL SOLUTION 35 MG/ML
*Pediatric Vitamins**
*Pediatric Vitamins A & D W/ C***
Tri-Vitamin ORAL SOLUTION 1500-400-35
*Prenatal Vitamins**
*Prenatal Mv & Min W/Fe-Fa***
ELITE-OB ORAL TABLET 50-1.25 MG
P
MYNATAL ADVANCE ORAL TABLET
P
Mynatal-Z ORAL TABLET
P
Mynate 90 Plus ORAL TABLET
EXTENDEDRELEASE*
P
Prenatabs OBN ORAL TABLET 29-1 MG
P
PRENATABS RX ORAL TABLET 29-1 MG
P
Prenatal ORAL TABLET 28-0.8 MG
P
Prenatal 19 ORAL TABLET CHEWABLE
P
Prenatal Low Iron ORAL TABLET 27-0.8 MG
P
Prenatal Plus ORAL TABLET 27-1 MG
P
OTC
OTC
83
Drug Name
Prenatal Plus Iron ORAL TABLET 29-1 MG
P
Trinatal Rx 1 ORAL TABLET 60-1 MG
P
TRINATE ORAL TABLET
P
TRIVEEN-U ORAL CAPSULE 106.5-1 MG
P
UltimateCare Combo ORAL MISC 30-1 MG
P
VINATE AZ ORAL TABLET 27-1 MG
P
VINATE AZ EXTRA ORAL TABLET 29-1
MG
P
VINATE GT ORAL TABLET 90-1 MG
P
VINATE II ORAL TABLET 29-1 MG
P
VINATE M ORAL TABLET 27-1 MG
P
*Prenatal Mv & Min W/Fe-Fa-Ca-Omega 3
Fish Oil***
PR NATAL 400 EC ORAL MISC 29-1-200 &
400 MG (DR)
P
*Prenatal Vitamins***
FOLBECAL ORAL TABLET 1 MG
P
*Specialty Vitamins Products**
*Specialty Vitamins Products***
P
OTC
B Complex Formula 1 ORAL TABLET
P
OTC
B-100 ORAL TABLET
P
OTC
Balance B-100 ORAL TABLET
P
OTC
P
OTC
Balanced B-100 ORAL TABLET
P
OTC
P
OTC
Balanced B-50 Complex ORAL CAPSULE
P
OTC
Balanced B-50 Complex ORAL TABLET
P
OTC
Vitamins for Hair ORAL TABLET
*Vitamins W/ Lipotropics**
*Vitamins W/ Lipotropics***
*Musculoskeletal Therapy Agents*
*Central Muscle Relaxants**
*Central Muscle Relaxants***
Baclofen ORAL TABLET 10 MG, 20 MG
P
Carisoprodol ORAL TABLET 350 MG
P
Chlorzoxazone ORAL TABLET 500 MG
P
84
Drug Name
Cyclobenzaprine HCl ORAL TABLET 10 MG,
5 MG
P
Methocarbamol ORAL TABLET 500 MG, 750
MG
P
*Direct Muscle Relaxants**
*Direct Muscle Relaxants***
Dantrolene Sodium ORAL CAPSULE 100
MG, 25 MG, 50 MG
P
*Viscosupplements**
*Viscosupplements***
SUPARTZ INTRA-ARTICULAR*
P
PA
P
OTC
*Nasal Agents - Systemic And Topical*
*Nasal Agents - Misc.**
*Nasal Agents - Misc.***
Saline Nasal Spray NASAL SOLUTION 0.65
%
*Nasal Antiallergy**
*Nasal Antihistamines***
Azelastine HCl NASAL SOLUTION 137
MCG/SPRAY
P
*Nasal Mast Cell Stabilizers***
Cromolyn Sodium NASAL AEROSOL,
SOLUTION 5.2 MG/ACT
P
OTC
*Nasal Anticholinergics**
*Nasal Anticholinergics***
Ipratropium Bromide NASAL SOLUTION
0.03 %, 0.06 %
P
*Nasal Steroids**
*Nasal Steroids***
Flunisolide NASAL SOLUTION 25
MCG/ACT (0.025%)
P
Fluticasone Propionate NASAL
SUSPENSION 50 MCG/ACT
P
*Sympathomimetic Decongestants**
*Systemic Decongestants***
Childrens Silfedrine ORAL LIQUID† 15
MG/5ML
P
OTC
85
Drug Name
Nasal Decongestant ORAL LIQUID† 30
MG/5ML
P
OTC
Pseudoephedrine HCl ORAL TABLET 30 MG,
60 MG
P
OTC
SUDAFED 12 HOUR ORAL TABLET
P
OTC
Artificial Tears OPHTHALMIC OINTMENT
83-15 %
P
OTC
HYPOTEARS OPHTHALMIC SOLUTION
1-1 %
P
OTC
P
OTC
P
*Ophthalmic Agents*
*Artificial Tears And Lubricants**
*Artificial Tear And Lubricant
Combinations***
*Artificial Tear Ointments***
Tears Again OPHTHALMIC OINTMENT
*Artificial Tears And Lubricants***
Artificial Tears OPHTHALMIC SOLUTION
1.4 %
*Beta-Blockers - Ophthalmic**
*Beta-Blockers - Ophthalmic Combinations***
Dorzolamide HCl-Timolol Mal
OPHTHALMIC SOLUTION 22.3-6.8
MG/ML
P
*Beta-Blockers - Ophthalmic***
Betaxolol HCl OPHTHALMIC SOLUTION
0.5 %
P
BETOPTIC-S OPHTHALMIC
SUSPENSION 0.25 %
P
Carteolol HCl OPHTHALMIC SOLUTION 1
%
P
Levobunolol HCl OPHTHALMIC
SOLUTION 0.25 %, 0.5 %
P
Metipranolol OPHTHALMIC SOLUTION 0.3
%
P
Timolol Maleate OPHTHALMIC GEL
FORMING SOLUTION 0.25 %, 0.5 %
P
Timolol Maleate OPHTHALMIC SOLUTION
0.25 %, 0.5 %
P
86
Drug Name
*Cycloplegic Mydriatics**
*Cycloplegic Mydriatic Combinations***
CYCLOMYDRIL OPHTHALMIC
SOLUTION 0.2-1 %
P
*Cycloplegic Mydriatics***
Atropine Sulfate OPHTHALMIC
OINTMENT 1 %
P
Atropine Sulfate OPHTHALMIC SOLUTION
1%
P
Atropine-Care OPHTHALMIC SOLUTION 1
%
P
ISOPTO HYOSCINE OPHTHALMIC
SOLUTION 0.25 %
P
*Ophthalmic Adrenergic Agents**
*Ophthalmic Selective Alpha Adrenergic
Agonists***
Brimonidine Tartrate OPHTHALMIC
SOLUTION 0.2 %
P
*Ophthalmic Anti-Infectives**
*Ophthalmic Antibiotics***
Ciprofloxacin HCl OPHTHALMIC
SOLUTION 0.3 %
P
Erythromycin OPHTHALMIC OINTMENT 5
MG/GM
P
Gentamicin Sulfate OPHTHALMIC
OINTMENT 0.3 %
P
Gentamicin Sulfate OPHTHALMIC
SOLUTION 0.3 %
P
Ofloxacin OPHTHALMIC SOLUTION 0.3 %
P
Tobramycin Sulfate OPHTHALMIC
SOLUTION 0.3 %
P
*Ophthalmic Anti-Infective Combinations***
AK-Poly-Bac OPHTHALMIC OINTMENT
500-10000 UNIT/GM
P
Bacitracin-Polymyxin B OPHTHALMIC
OINTMENT 500-10000 UNIT/GM
P
Neomycin-Bacitracin Zn-Polymyx
OPHTHALMIC OINTMENT 5-400-10000
P
87
Drug Name
Neomycin-Polymyxin-Gramicidin
OPHTHALMIC SOLUTION 1.75-10000-0.25
P
Polycin B OPHTHALMIC OINTMENT
500-10000 UNIT/GM
P
Polymyxin B-Trimethoprim OPHTHALMIC
SOLUTION 10000-0.1 UNIT/ML-%
P
*Ophthalmic Antivirals***
Trifluridine OPHTHALMIC SOLUTION 1 %
P
*Ophthalmic Sulfonamides***
Sulfacetamide Sodium OPHTHALMIC
SOLUTION 10 %
P
*Ophthalmic Immunomodulators**
*Ophthalmic Immunomodulators***
RESTASIS OPHTHALMIC EMULSION
0.05 %
P
*Ophthalmic Steroids**
*Ophthalmic Steroid Combinations***
Neomycin-Polymyxin-Dexameth
OPHTHALMIC OINTMENT 3.5-10000-0.1
P
OPHTHALMIC SUSPENSION 3.5-10000-0.1
P
Neomycin-Polymyxin-HC OPHTHALMIC
SUSPENSION 3.5-10000-1
P
Poly-Dex OPHTHALMIC OINTMENT
3.5-10000-0.1
P
PRED-G OPHTHALMIC SUSPENSION
0.3-1 %
P
Sulfacetamide-Prednisolone OPHTHALMIC
SOLUTION 10-0.23 %
P
TOBRADEX OPHTHALMIC OINTMENT
0.3-0.1 %
P
*Ophthalmic Steroids***
Dexamethasone Sodium Phosphate
OPHTHALMIC SOLUTION 0.1 %
P
Fluorometholone OPHTHALMIC
SUSPENSION 0.1 %
P
FML FORTE OPHTHALMIC
SUSPENSION 0.25 %
P
88
Drug Name
LOTEMAX OPHTHALMIC SUSPENSION
0.5 %
P
MAXIDEX OPHTHALMIC SUSPENSION
0.1 %
P
PrednisoLONE Acetate OPHTHALMIC
SUSPENSION 1 %
P
VEXOL OPHTHALMIC SUSPENSION 1 %
P
*Ophthalmics - Misc.**
*Ophthalmic Antiallergic***
Cromolyn Sodium OPHTHALMIC
SOLUTION 4 %
P
Ketotifen Fumarate OPHTHALMIC
SOLUTION 0.025 %
P
OTC
*Ophthalmic Carbonic Anhydrase Inhibitors***
AZOPT OPHTHALMIC SUSPENSION 1 %
P
Dorzolamide HCl OPHTHALMIC
SOLUTION 2 %
P
*Ophthalmic Irrigation Solutions***
OPTICS EYE WASH OPHTHALMIC
SOLUTION 0.9 %
P
OTC
*Ophthalmic Nonsteroidal Anti-Inflammatory
Agents***
Diclofenac Sodium OPHTHALMIC
SOLUTION 0.1 %
P
Flurbiprofen Sodium OPHTHALMIC
SOLUTION 0.03 %
P
*Prostaglandins - Ophthalmic**
*Prostaglandins - Ophthalmic***
Latanoprost OPHTHALMIC SOLUTION
0.005 %
P
*Otic Agents*
*Otic Agents - Miscellaneous**
*Otic Agents - Miscellaneous***
Acetic Acid-Aluminum Acetate OTIC
SOLUTION 2 %
P
Earwax Treatment Drops OTIC SOLUTION
6.5 %
P
OTC
*Otic Anti-Infectives**
*Otic Anti-Infectives***
89
Drug Name
Ofloxacin OTIC SOLUTION 0.3 %
P
*Otic Combinations**
*Otic Analgesic Combinations***
Antipyrine-Benzocaine OTIC SOLUTION
5.4-1.4 %, 54-14 MG/ML
P
Oticin OTIC LIQUID† 1-0.1 %
P
*Otic Steroid-Anti-Infective Combinations***
CIPRODEX OTIC SUSPENSION 0.3-0.1 %
P
Neomycin-Polymyxin-HC OTIC SOLUTION
3.5-10000-1
P
Neomycin-Polymyxin-HC OTIC
P
ST; AL (Max 8 Years)
*Oxytocics*
*Oxytocics**
*Oxytocics***
Methylergonovine Maleate INJECTION
SOLUTION 0.2 MG/ML
P
Methylergonovine Maleate ORAL TABLET
0.2 MG
P
*Passive Immunizing Agents*
*Monoclonal Antibodies**
*Antiviral Monoclonal Antibodies***
SYNAGIS INTRAMUSCULAR*
SOLUTION 100 MG/ML, 50 MG/0.5ML
P
PA
*Penicillins*
*Aminopenicillins**
*Aminopenicillins***
Amoxicillin ORAL CAPSULE 250 MG, 500
MG
P
Amoxicillin ORAL SUSPENSION
MG/5ML, 250 MG/5ML, 400 MG/5ML
P
Amoxicillin ORAL TABLET 500 MG, 875 MG
P
Amoxicillin ORAL TABLET CHEWABLE
125 MG, 250 MG
P
Ampicillin ORAL CAPSULE 250 MG, 500 MG
P
90
Drug Name
Ampicillin ORAL SUSPENSION
MG/5ML
P
*Natural Penicillins**
*Natural Penicillins***
BICILLIN L-A INTRAMUSCULAR*
SUSPENSION 1200000 UNIT/2ML, 2400000
UNIT/4ML, 600000 UNIT/ML
P
Penicillin G Procaine INTRAMUSCULAR*
P
Penicillin V Potassium ORAL SOLUTION
MG/5ML
P
Penicillin V Potassium ORAL TABLET 250
MG, 500 MG
P
PFIZERPEN-G INJECTION SOLUTION
RECONSTITUTED 20000000 UNIT,
5000000 UNIT
P
*Penicillin Combinations**
*Penicillin Combinations***
Amoxicillin-Pot Clavulanate ORAL
SUSPENSION RECONSTITUTED 200-28.5
MG/5ML, 250-62.5 MG/5ML, 400-57
MG/5ML, 600-42.9 MG/5ML
P
Amoxicillin-Pot Clavulanate ORAL TABLET
250-125 MG, 500-125 MG, 875-125 MG
P
Amoxicillin-Pot Clavulanate ORAL TABLET
CHEWABLE 200-28.5 MG, 400-57 MG
P
BICILLIN C-R INTRAMUSCULAR*
SUSPENSION 1200000 UNIT/2ML
P
BICILLIN C-R 900/300
900000-300000 UNIT/2ML
P
*Penicillinase-Resistant Penicillins**
*Penicillinase-Resistant Penicillins***
Dicloxacillin Sodium ORAL CAPSULE 250
MG, 500 MG
P
Oxacillin Sodium INJECTION SOLUTION
RECONSTITUTED 1 GM, 10 GM, 2 GM
P
*Progestins*
91
Drug Name
*Progestins**
*Progestins***
MAKENA INTRAMUSCULAR* OIL 250
MG/ML
P
MedroxyPROGESTERone Acetate ORAL
TABLET 10 MG, 2.5 MG, 5 MG
P
Norethindrone Acetate ORAL TABLET 5 MG
P
PA
*Psychotherapeutic And Neurological Agents Misc.*
*Agents For Chemical Dependency**
*Alcohol Deterrents***
Acamprosate Calcium ORAL TABLET
P
Disulfiram ORAL TABLET 250 MG, 500 MG
P
*Antidementia Agents**
*Cholinomimetics - Ache Inhibitors***
Donepezil HCl ORAL TABLET 10 MG, 5 MG
P
EXELON TRANSDERMAL PATCH 24 HR
13.3 MG/24HR, 4.6 MG/24HR, 9.5
MG/24HR
P
Rivastigmine Tartrate ORAL CAPSULE 1.5
MG, 3 MG, 4.5 MG, 6 MG
P
*N-Methyl-D-Aspartate (Nmda) Receptor
Antagonists***
NAMENDA ORAL SOLUTION 10
MG/5ML
P
NAMENDA ORAL TABLET 10 MG, 5 MG
P
NAMENDA TITRATION PAK ORAL
TABLET 5 (28)-10 (21) MG
P
*Combination Psychotherapeutics**
*Benzodiazepines & Tricyclic Agents***
Chlordiazepoxide-Amitriptyline ORAL
TABLET 10-25 MG, 5-12.5 MG
P
*Phenothiazines & Tricyclic Agents***
Perphenazine-Amitriptyline ORAL TABLET
2-10 MG, 2-25 MG, 4-10 MG, 4-25 MG, 4-50
MG
*Thienbenzodiazepines & Ssris***
92
P
Drug Name
OLANZapine-FLUoxetine HCl ORAL
CAPSULE 12-25 MG, 12-50 MG, 3-25 MG,
6-25 MG, 6-50 MG
P
*Fibromyalgia Agents**
*Fibromyalgia Agent - Snris***
SAVELLA ORAL TABLET 100 MG, 12.5
MG, 25 MG, 50 MG
P
SAVELLA TITRATION PACK ORAL
MISC 12.5 & 25 & 50 MG
P
*Multiple Sclerosis Agents**
*Ms Agents - Pyrimidine Synthesis
Inhibitors***
AUBAGIO ORAL TABLET 14 MG, 7 MG
P
PA
EXTAVIA SUBCUTANEOUS* KIT 0.3 MG
P
PA
REBIF SUBCUTANEOUS* SOLUTION 22
P
PA
REBIF REBIDOSE SUBCUTANEOUS*
MCG/0.5ML
P
PA
REBIF REBIDOSE TITRATION PACK
SUBCUTANEOUS* SOLUTION 6X8.8 &
6X22 MCG
P
PA
REBIF TITRATION PACK
SUBCUTANEOUS* SOLUTION 6X8.8 &
6X22 MCG
P
PA
P
PA
*Multiple Sclerosis Agents - Interferons***
*Multiple Sclerosis Agents***
COPAXONE SUBCUTANEOUS* KIT 20
MG/ML
*Psychotherapeutic And Neurological Agents Misc.**
*Psychotherapeutic And Neurological Agents Misc.***
ORAP ORAL TABLET 1 MG, 2 MG
P
*Smoking Deterrents**
*Smoking Deterrents***
BUPROBAN ORAL TABLET EXTENDED
RELEASE 12 HR* 150 MG
P
CHANTIX ORAL TABLET 0.5 MG, 1 MG
P
93
Drug Name
CHANTIX CONTINUING MONTH PAK
ORAL TABLET 1 MG
P
CHANTIX STARTING MONTH PAK
ORAL TABLET 0.5 MG X 11 & 1 MG X 42
P
Nicotine TRANSDERMAL PATCH 24 HR 14
MG/24HR, 21 MG/24HR, 7 MG/24HR
P
Nicotine Polacrilex MOUTH/THROAT GUM
2 MG, 4 MG
P
OTC; QL (2016 EA per 365
day(s))
Nicotine Polacrilex MOUTH/THROAT
LOZENGE 2 MG, 4 MG
P
OTC; QL (1680 EA per 365
day(s))
NICOTROL INHALATION INHALER 10
MG
P
NICOTROL NS NASAL SOLUTION 10
MG/ML
P
*Vasomotor Symptom Agents**
*Vasomotor Symptom Agents - Ssris***
BRISDELLE ORAL CAPSULE 7.5 MG
P
*Respiratory Agents - Misc.*
*Cystic Fibrosis Agents**
*Cftr Potentiators***
KALYDECO ORAL TABLET 150 MG
P
PA
P
PA
*Hydrolytic Enzymes***
PULMOZYME INHALATION SOLUTION
1 MG/ML
*Tetracyclines*
*Tetracyclines**
*Tetracyclines***
DOXY 100 INTRAVENOUS* SOLUTION
P
Doxycycline Hyclate ORAL CAPSULE 100
MG, 50 MG
P
PA
Doxycycline Hyclate ORAL TABLET 100 MG
P
PA
Doxycycline Hyclate ORAL TABLET 20 MG
P
Minocycline HCl ORAL CAPSULE 100 MG,
50 MG, 75 MG
P
Tetracycline HCl ORAL CAPSULE 250 MG,
500 MG
P
*Thyroid Agents*
94
Drug Name
*Antithyroid Agents**
*Antithyroid Agents***
Methimazole ORAL TABLET 10 MG, 5 MG
P
Propylthiouracil ORAL TABLET 50 MG
P
*Thyroid Hormones**
*Thyroid Hormones***
ARMOUR THYROID ORAL TABLET 120
MG, 15 MG, 180 MG, 240 MG, 30 MG, 300
MG, 60 MG, 90 MG
P
Levothyroxine Sodium INTRAVENOUS*
SOLUTION RECONSTITUTED 100 MCG,
500 MCG
P
Levothyroxine Sodium ORAL TABLET 100
MCG, 112 MCG, 125 MCG, 137 MCG, 150
MCG, 175 MCG, 200 MCG, 25 MCG, 300
MCG, 50 MCG, 75 MCG, 88 MCG
P
Liothyronine Sodium ORAL TABLET 25
MCG, 5 MCG, 50 MCG
P
NATURE-THROID ORAL TABLET 113.75
MG, 130 MG, 146.25 MG, 16.25 MG, 162.5
MG, 195 MG, 260 MG, 32.5 MG, 325 MG,
48.75 MG, 65 MG, 81.25 MG, 97.5 MG
P
NP Thyroid ORAL TABLET 30 MG, 60 MG,
90 MG
P
THYROLAR-1 ORAL TABLET 60 (12.5-50)
MG (MCG)
P
THYROLAR-1/2 ORAL TABLET 30
(6.25-25) MG (MCG)
P
THYROLAR-1/4 ORAL TABLET 15
(3.1-12.5) MG (MCG)
P
THYROLAR-2 ORAL TABLET 120 (25-100)
MG (MCG)
P
THYROLAR-3 ORAL TABLET 180
(37.5-150) MG (MCG)
P
UNITHROID ORAL TABLET 100 MCG,
112 MCG, 125 MCG, 137 MCG, 150 MCG,
175 MCG, 200 MCG, 25 MCG, 300 MCG, 50
MCG, 75 MCG, 88 MCG
P
UNITHROID DIRECT ORAL TABLET 150
MCG
P
95
Drug Name
WESTHROID ORAL TABLET 113.75 MG,
130 MG, 146.25 MG, 16.25 MG, 162.5 MG,
195 MG, 260 MG, 32.5 MG, 325 MG, 48.75
MG, 65 MG, 81.25 MG, 97.5 MG
P
*Ulcer Drugs*
*Antispasmodics**
*Antispasmodics***
Dicyclomine HCl ORAL CAPSULE 10 MG
P
Dicyclomine HCl ORAL SOLUTION 10
MG/5ML
P
Dicyclomine HCl ORAL TABLET 20 MG
P
*Quaternary Anticholinergics***
Glycopyrrolate ORAL TABLET 1 MG, 2 MG
P
Propantheline Bromide ORAL TABLET 15
MG
P
*H-2 Antagonists**
*H-2 Antagonists***
Cimetidine ORAL TABLET 200 MG
P
Cimetidine ORAL TABLET 300 MG, 400 MG,
800 MG
P
Cimetidine HCl ORAL SOLUTION 300
MG/5ML
P
Famotidine INTRAVENOUS* SOLUTION 10
MG/ML
P
Famotidine ORAL TABLET 10 MG
P
Famotidine ORAL TABLET 20 MG, 40 MG
P
Famotidine Premixed INTRAVENOUS*
SOLUTION 20-0.9 MG/50ML-%
P
Ranitidine Acid Reducer ORAL TABLET 75
MG
P
Ranitidine HCl INJECTION SOLUTION 1000
MG/40ML, 150 MG/6ML, 50 MG/2ML
P
Ranitidine HCl ORAL CAPSULE 150 MG,
300 MG
P
Ranitidine HCl ORAL SYRUP 15 MG/ML
P
Ranitidine HCl ORAL TABLET 150 MG
P
OTC
Ranitidine HCl ORAL TABLET 300 MG
P
*Misc. Anti-Ulcer**
96
OTC
OTC
OTC
Drug Name
*Misc. Anti-Ulcer***
CARAFATE ORAL SUSPENSION 1
GM/10ML
P
Sucralfate ORAL TABLET 1 GM
P
*Proton Pump Inhibitors**
*Proton Pump Inhibitors***
Lansoprazole ORAL CAPSULE DELAYED
RELEASE 15 MG
P
ST; OTC
Lansoprazole ORAL CAPSULE DELAYED
RELEASE 30 MG
P
ST
Omeprazole ORAL CAPSULE DELAYED
RELEASE 10 MG, 20 MG, 40 MG
P
Pantoprazole Sodium ORAL TABLET
DELAYED RELEASE 20 MG, 40 MG
P
*Ulcer Drugs - Prostaglandins**
*Ulcer Drugs - Prostaglandins***
Misoprostol ORAL TABLET 100 MCG, 200
MCG
P
*Urinary Anti-Infectives*
*Urinary Anti-Infective Combinations**
*Urinary Antiseptic-Antispasmodic &/Or
Analgesics***
URETRON D/S ORAL TABLET
P
Uticap ORAL CAPSULE 120 MG
P
*Urinary Anti-Infectives**
*Urinary Anti-Infectives***
MACRODANTIN ORAL CAPSULE 25 MG
P
Nitrofurantoin Macrocrystal ORAL CAPSULE
100 MG, 50 MG
P
Nitrofurantoin Monohyd Macro ORAL
CAPSULE 100 MG
P
AL (Max 8 Years)
*Urinary Antispasmodics*
*Urinary Antispasmodics**
*Urinary Antispasmodics***
Bethanechol Chloride ORAL TABLET 10 MG,
25 MG, 5 MG, 50 MG
P
Oxybutynin Chloride ORAL SYRUP 5
MG/5ML
P
97
Drug Name
Oxybutynin Chloride ORAL TABLET 5 MG
P
Oxybutynin Chloride ER ORAL TABLET
MG, 5 MG
P
Trospium Chloride ORAL TABLET 20 MG
P
*Vaginal Products*
*Vaginal Anti-Infectives**
*Imidazole-Related Antifungals***
3 Day Vaginal VAGINAL CREAM 2 %
P
OTC
Clotrimazole VAGINAL CREAM 1 %
P
OTC
Miconazole 3 VAGINAL SUPPOSITORY 200
MG
P
Miconazole 3 Combo Pack VAGINAL KIT
200-2 MG-% (9GM)
P
OTC
Miconazole Nitrate VAGINAL CREAM 2 %
P
OTC
Miconazole Nitrate VAGINAL
SUPPOSITORY 100 MG
P
OTC
MONISTAT 1 COMBO PACK VAGINAL
KIT 1200-2 MG-%
P
OTC
MONISTAT 3 VAGINAL CREAM 4 %
P
OTC
Terconazole VAGINAL CREAM 0.4 %, 0.8 %
P
Terconazole VAGINAL SUPPOSITORY 80
MG
P
*Vaginal Anti-Infectives***
Clindamycin Phosphate VAGINAL CREAM 2
%
P
MetroNIDAZOLE VAGINAL GEL 0.75 %
P
VANDAZOLE VAGINAL GEL 0.75 %
P
*Vaginal Estrogens**
*Vaginal Estrogens***
PREMARIN VAGINAL CREAM 0.625
MG/GM
P
*Vaginal Progestins**
*Vaginal Progestins***
ENDOMETRIN VAGINAL INSERT 100
MG
P
FIRST-PROGESTERONE VGS 100
VAGINAL SUPPOSITORY 100 MG
P
98
Drug Name
P
P
P
P
*Vasopressors*
*Anaphylaxis Therapy Agents**
*Anaphylaxis Therapy Agents***
EPIPEN 2-PAK INJECTION DEVICE 0.3
MG/0.3ML
P
EPIPEN JR 2-PAK INJECTION DEVICE
0.15 MG/0.3ML
P
*Vasopressors**
*Vasopressors***
Midodrine HCl ORAL TABLET 10 MG, 2.5
MG, 5 MG
P
*Vitamins*
*Oil Soluble Vitamins**
*Vitamin A***
Vitamin A ORAL CAPSULE 10000 UNIT,
8000 UNIT
P
OTC
Vitamin D (Ergocalciferol) ORAL CAPSULE
50000 UNIT
P
QL (4 EA per 28 Day(s))
Vitamin D3 ORAL CAPSULE 2000 UNIT
P
OTC
Vitamin D3 ORAL TABLET 1000 UNIT, 400
UNIT
P
OTC
P
OTC
*Vitamin D***
*Vitamin E***
E-400 ORAL CAPSULE 400 UNIT
*Vitamin K***
MEPHYTON ORAL TABLET 5 MG
P
Vitamin K (Phytonadione) ORAL TABLET
100 MCG
P
OTC
*Water Soluble Vitamins**
*Biotin***
99
Drug Name
Biotin ORAL CAPSULE 5 MG, 5000 MCG
P
OTC
Biotin 5000 ORAL CAPSULE 5 MG
P
OTC
Biotin Maximum Strength ORAL CAPSULE
5000 MCG
P
OTC
*Vitamin B-1***
Thiamine HCl INJECTION SOLUTION 100
MG/ML
P
Vitamin B-1 ORAL TABLET 100 MG, 250
MG, 50 MG
P
OTC
Niacin ORAL TABLET 100 MG, 250 MG, 50
MG, 500 MG
P
OTC
Niacin ER ORAL CAPSULE EXTENDED
RELEASE* 500 MG
P
OTC
Niacin ER ORAL TABLET
P
OTC
NIACOR ORAL TABLET 500 MG
P
*Vitamin B-3***
*Vitamin B-6***
Pyridoxine HCl INJECTION SOLUTION 100
MG/ML
P
Vitamin B-6 ORAL TABLET 100 MG, 25 MG,
250 MG, 50 MG, 500 MG
P
OTC
P
OTC
C-500 ORAL TABLET CHEWABLE 500 MG
P
OTC
Vitamin C ORAL SYRUP 500 MG/5ML
P
OTC
Vitamin C ORAL TABLET 100 MG, 1000
MG, 250 MG, 500 MG
P
OTC
Vitamin C ORAL TABLET CHEWABLE 100
MG, 250 MG
P
OTC
Vitamin C ER ORAL CAPSULE EXTENDED
RELEASE* 500 MG
P
OTC
500 MG
P
OTC
Vitamin C-Rose Hips ORAL TABLET 1000
MG, 250 MG, 500 MG
P
OTC
*Vitamin C***
100
Drug Name
Vitamin C-Rose Hips ORAL TABLET
CHEWABLE 500 MG
P
OTC
Vitamin C-Rose Hips ER ORAL TABLET
500 MG
P
OTC
101
102
Index
3 Day Vaginal VAGINAL
CREAM 2 % ...................................................... 98
Abacavir Sulfate ORAL
TABLET 300 MG ...................................... 44
ABILIFY DISCMELT ORAL
TABLET DISPERSIBLE 10
MG, 15 MG ........................................................ 42
ABILIFY
INTRAMUSCULAR*
................................................................................................ 42
ABILIFY MAINTENA
INTRAMUSCULAR*
SUSPENSION
RECONSTITUTED 300 MG,
400 MG ..................................................................... 42
ABILIFY ORAL SOLUTION 1
MG/ML .................................................................... 42
ABILIFY ORAL TABLET 10
MG, 15 MG, 2 MG, 20 MG, 30
MG, 5 MG ........................................................... 42
Acamprosate Calcium ORAL
TABLET DELAYED RELEASE
333 MG ...................................................................... 92
Acarbose ORAL TABLET 100
MG, 25 MG, 50 MG ................................ 24
ACCU-CHEK ACTIVE IN
VITRO STRIP ............................................... 63
ACCU-CHEK AVIVA PLUS IN
VITRO STRIP ............................................... 63
ACCU-CHEK AVIVA PLUS
XX KIT W/DEVICE ............................ 75
ACCU-CHEK COMFORT
CURVE IN VITRO STRIP
................................................................................................ 63
ACCU-CHEK COMPACT IN
VITRO STRIP ............................................... 63
ACCU-CHEK COMPACT
PLUS CARE XX KIT ........................ 75
ACCU-CHEK COMPACT
TEST DRUM IN VITRO
STRIP .......................................................................... 63
ACCU-CHEK NANO
SMARTVIEW XX KIT
W/DEVICE ......................................................... 75
ACCU-CHEK SMARTVIEW
IN VITRO STRIP ..................................... 63
ACE AEROSOL CLOUD
ENHANCER XX MISC ................ 75
ACEPHEN RE SUPPOSITORY
120 MG, 325 MG, 650 MG
.................................................................................................... 5
Acetaminophen ORAL
SOLUTION 160 MG/5ML .............. 5
Acetaminophen ORAL TABLET
325 MG .......................................................................... 5
500 MG .......................................................................... 5
CHEWABLE 80 MG ................................ 5
Acetaminophen-Codeine #2
ORAL TABLET 300-15 MG
.................................................................................................... 8
.................................................................................................... 8
.................................................................................................... 8
Acetaminophen-Codeine ORAL
SOLUTION 120-12 MG/5ML
.................................................................................................... 8
AcetaZOLAMIDE ORAL
TABLET 125 MG, 250 MG
................................................................................................ 64
Acetic Acid-Aluminum Acetate
OTIC SOLUTION 2 % ...................... 89
Acetylcysteine INHALATION
SOLUTION 10 %, 20 % ................... 57
Acne Medication 5 EXTERNAL
LOTION 5 % .................................................... 57
Acne Medication EXTERNAL
LOTION 10 % ................................................. 57
ACTICIN EXTERNAL
CREAM 5 % ..................................................... 63
Acyclovir ORAL CAPSULE 200
MG ................................................................................... 46
Acyclovir ORAL SUSPENSION
200 MG/5ML .................................................... 46
Acyclovir ORAL TABLET 400
MG, 800 MG ...................................................... 46
ADDERALL XR ORAL
CAPSULE EXTENDED
RELEASE 24 HOUR 10 MG, 15
MG, 20 MG, 25 MG, 30 MG, 5
MG ...................................................................................... 1
Adefovir Dipivoxil ORAL
TABLET 10 MG .......................................... 45
ADRUCIL INTRAVENOUS*
SOLUTION 500 MG/10ML
................................................................................................ 35
ADVAIR DISKUS
INHALATION AEROSOL
POWDER, BREATH
ACTIVATED 100-50
MCG/DOSE, 250-50
MCG/DOSE, 500-50
MCG/DOSE ...................................................... 14
ADVAIR HFA INHALATION
AEROSOL† 115-21 MCG/ACT,
230-21 MCG/ACT, 45-21
MCG/ACT ........................................................... 14
AEROCHAMBER MV XX
MISC ............................................................................ 76
AEROCHAMBER PLUS
FLO-VU LARGE XX MISC
................................................................................................ 76
AEROCHAMBER PLUS
FLO-VU SMALL XX MISC
................................................................................................ 76
AEROCHAMBER PLUS
FLO-VU W/MASK XX MISC
................................................................................................ 76
AEROCHAMBER PLUS
FLO-VU XX MISC ................................ 76
AEROCHAMBER
W/FLOWSIGNAL XX MISC
................................................................................................ 76
AEROCHAMBER Z-STAT
PLUS CHAMBR XX MISC
................................................................................................ 76
AEROCHAMBER Z-STAT
PLUS XX MISC ......................................... 76
AFINITOR ORAL TABLET 10
MG, 2.5 MG, 5 MG, 7.5 MG
................................................................................................ 37
AK-Poly-Bac OPHTHALMIC
OINTMENT 500-10000
UNIT/GM .............................................................. 87
ALAVERT ALLERGY/SINUS
ORAL TABLET EXTENDED
RELEASE 12 HR* 5-120 MG
................................................................................................ 56
ALBENZA ORAL TABLET 200
MG .................................................................................. 10
NEBULIZATION SOLUTION
(2.5 MG/3ML) 0.083% ...................... 15
(5 MG/ML) 0.5% ...................................... 15
103
0.63 MG/3ML, 1.25 MG/3ML
................................................................................................ 15
Albuterol Sulfate ORAL SYRUP
2 MG/5ML ........................................................... 15
Albuterol Sulfate ORAL
TABLET 2 MG, 4 MG ........................ 15
Alclometasone Dipropionate
EXTERNAL CREAM 0.05 %
................................................................................................ 60
Alclometasone Dipropionate
EXTERNAL OINTMENT 0.05
% ......................................................................................... 60
Alcohol Pads XX PAD 70 %
................................................................................................ 75
Alendronate Sodium ORAL
TABLET 10 MG, 35 MG, 40
MG, 5 MG, 70 MG ................................... 65
Aler-Dryl ORAL TABLET 50
MG ................................................................................... 29
ALKERAN ORAL TABLET 2
MG .................................................................................. 34
ALLEGRA ALLERGY
CHILDRENS ORAL TABLET
30 MG ......................................................................... 29
ALLEGRA-D ALLERGY &
CONGESTION ORAL
TABLET EXTENDED
................................................................................................ 56
Allergy ORAL TABLET 4 MG
................................................................................................ 29
Allergy ORAL TABLET
DISPERSIBLE 10 MG ...................... 29
Allergy Relief/Nasal Decongest
................................................................................................ 56
Allopurinol ORAL TABLET 100
MG, 300 MG ...................................................... 69
ALPRAZolam ER ORAL
TABLET EXTENDED
RELEASE 24 HR* 0.5 MG, 1
MG, 2 MG, 3 MG ....................................... 11
0.25 MG, 0.5 MG, 1 MG, 2 MG
................................................................................................ 11
DISPERSIBLE 0.25 MG, 0.5
MG, 1 MG, 2 MG ....................................... 11
104
ALPRAZolam XR ORAL
TABLET EXTENDED
MG, 2 MG, 3 MG ....................................... 11
ALTAVERA ORAL TABLET
0.15-30 MG-MCG .................................... 52
Aluminum Hydroxide Gel ORAL
................................................................................................ 10
Amantadine HCl ORAL
CAPSULE 100 MG ................................. 38
Amantadine HCl ORAL SYRUP
50 MG/5ML ........................................................ 38
Amantadine HCl ORAL
TABLET 100 MG ...................................... 38
A-METHAPRED INJECTION
SOLUTION
RECONSTITUTED 125 MG, 40
MG .................................................................................. 55
Amiloride-Hydrochlorothiazide
ORAL TABLET 5-50 MG ............. 64
Aminophylline INTRAVENOUS*
SOLUTION 25 MG/ML .................. 15
Amiodarone HCl
150 MG/3ML .................................................... 13
Amiodarone HCl ORAL
................................................................................................ 13
Amitriptyline HCl ORAL
MG, 25 MG, 50 MG, 75 MG
................................................................................................ 23
AMLACTIN EXTERNAL
LOTION 12 % ................................................ 62
AmLODIPine Besylate ORAL
................................................................................................ 49
Ammonium Lactate EXTERNAL
CREAM 12 % .................................................. 62
Ammonium Lactate EXTERNAL
LOTION 12 % ................................................. 62
AMNESTEEM ORAL
CAPSULE 10 MG, 20 MG, 40
MG .................................................................................. 57
Amoxapine ORAL TABLET 100
MG, 150 MG, 25 MG, 50 MG
................................................................................................ 23
Amoxicillin ORAL CAPSULE
250 MG, 500 MG ......................................... 90
Amoxicillin ORAL
SUSPENSION
RECONSTITUTED 125
MG/5ML, 200 MG/5ML, 250
MG/5ML, 400 MG/5ML .................. 90
Amoxicillin ORAL TABLET 500
MG, 875 MG ...................................................... 90
Amoxicillin ORAL TABLET
CHEWABLE 125 MG, 250 MG
................................................................................................ 90
Amoxicillin-Pot Clavulanate
ORAL SUSPENSION
RECONSTITUTED 200-28.5
MG/5ML, 250-62.5 MG/5ML,
400-57 MG/5ML, 600-42.9
MG/5ML ................................................................. 91
ORAL TABLET 250-125 MG,
500-125 MG, 875-125 MG .............. 91
ORAL TABLET CHEWABLE
200-28.5 MG, 400-57 MG ............... 91
Amphetamine-Dextroamphet ER
ORAL CAPSULE EXTENDED
MG, 20 MG, 25 MG, 30 MG, 5
MG ....................................................................................... 1
Amphetamine-Dextroamphetamin
e ORAL TABLET 10 MG, 12.5
MG, 15 MG, 20 MG, 30 MG, 5
MG, 7.5 MG ........................................................... 1
Ampicillin ORAL CAPSULE 250
MG, 500 MG ...................................................... 90
Ampicillin ORAL SUSPENSION
RECONSTITUTED 125
MG/5ML, 250 MG/5ML .................. 91
Anagrelide HCl ORAL
CAPSULE 0.5 MG, 1 MG ............ 70
Anastrozole ORAL TABLET 1
MG ................................................................................... 36
Antacid ORAL SUSPENSION
200-200-20 MG/5ML ................................ 9
Antacid ORAL TABLET
CHEWABLE 500 MG ........................ 10
Antihistamine Decongestant
ORAL TABLET 2.5-60 MG
................................................................................................ 56
Antipyrine-Benzocaine OTIC
SOLUTION 5.4-1.4 %, 54-14
MG/ML ..................................................................... 90
APIDRA INJECTION
................................................................................................ 26
APIDRA SOLOSTAR
SUBCUTANEOUS*
26
APLENZIN ORAL TABLET
EXTENDED RELEASE 24
HR* 348 MG, 522 MG ...................... 21
APRI ORAL TABLET 0.15-30
MG-MCG ............................................................. 52
APRISO ORAL CAPSULE
EXTENDED RELEASE 24
HOUR 0.375 GM ...................................... 68
APTIVUS ORAL CAPSULE
250 MG ..................................................................... 43
APTIVUS ORAL SOLUTION
100 MG/ML ....................................................... 43
ARGYLE STERILE SALINE
IRRIGATION SOLUTION 0.9
% ......................................................................................... 68
ARMOUR THYROID ORAL
MG, 240 MG, 30 MG, 300 MG,
60 MG, 90 MG .............................................. 95
Artificial Tears OPHTHALMIC
OINTMENT 83-15 % ........................... 86
Artificial Tears OPHTHALMIC
SOLUTION 1.4 % .................................... 86
ASCOMP-CODEINE ORAL
CAPSULE 50-325-40-30 MG
.................................................................................................... 8
ASMANEX 120 METERED
DOSES INHALATION
AEROSOL POWDER,
BREATH ACTIVATED 220
MCG/INH ............................................................ 14
ASMANEX 30 METERED
DOSES INHALATION
AEROSOL POWDER,
MCG/INH, 220 MCG/INH
................................................................................................ 14
ASMANEX 60 METERED
DOSES INHALATION
AEROSOL POWDER,
MCG/INH ............................................................ 14
Aspirin EC ORAL TABLET
.................................................................................................... 6
Aspirin Low Dose ORAL
TABLET 81 MG .............................................. 6
Aspirin ORAL TABLET 325
MG, 81 MG ............................................................. 6
................................................................................................
Aspirin ORAL TABLET
CHEWABLE 81 MG ................................ 6
Aspirin RE SUPPOSITORY 300
MG, 600 MG ......................................................... 6
Atenolol ORAL TABLET 100
MG, 25 MG, 50 MG ................................ 48
Atenolol-Chlorthalidone ORAL
TABLET 100-25 MG, 50-25 MG
................................................................................................ 32
Atorvastatin Calcium ORAL
MG, 80 MG ......................................................... 31
Atovaquone-Proguanil HCl
62.5-25 MG .......................................................... 34
ATRIPLA ORAL TABLET
600-200-300 MG .......................................... 42
OINTMENT 1 % ........................................ 87
SOLUTION 1 % .......................................... 87
Atropine-Care OPHTHALMIC
SOLUTION 1 % .......................................... 87
ATROVENT HFA
INHALATION AEROSOL,
SOLUTION 17 MCG/ACT
................................................................................................ 13
AUBAGIO ORAL TABLET 14
MG, 7 MG ........................................................... 93
AVANDAMET ORAL
TABLET 2-1000 MG, 2-500
MG, 4-1000 MG, 4-500 MG
................................................................................................ 25
AVANDARYL ORAL
TABLET 4-1 MG, 4-2 MG, 4-4
MG, 8-2 MG, 8-4 MG ........................ 25
AVANDIA ORAL TABLET 2
MG, 4 MG, 8 MG ..................................... 26
AVASTIN INTRAVENOUS*
MG/16ML ............................................................ 35
AVIANE ORAL TABLET
0.1-20 MG-MCG ........................................ 52
AVITA EXTERNAL CREAM
0.025 % ....................................................................... 57
AVITA EXTERNAL GEL 0.025
% ......................................................................................... 57
AVODART ORAL CAPSULE
0.5 MG ....................................................................... 69
AzaTHIOprine ORAL TABLET
50 MG .......................................................................... 48
AzaTHIOprine Sodium
INJECTION SOLUTION
48
Azelastine HCl NASAL
SOLUTION 137 MCG/SPRAY
................................................................................................ 85
Azithromycin Hydrogencitrate
................................................................................................ 74
Azithromycin INTRAVENOUS*
SOLUTION
................................................................................................ 74
Azithromycin ORAL
SUSPENSION
RECONSTITUTED 100
MG/5ML, 200 MG/5ML .................. 74
Azithromycin ORAL TABLET
250 MG ...................................................................... 74
Azithromycin ORAL TABLET
500 MG, 600 MG ......................................... 74
AZOPT OPHTHALMIC
SUSPENSION 1 % .................................. 89
B Complete ORAL TABLET
................................................................................................ 81
B Complex 50 ORAL TABLET
................................................................................................ 81
B Complex Formula 1 ORAL
TABLET .............................................................. 84
B Complex ORAL TABLET
................................................................................................ 81
B Complex Vitamins ORAL
CAPSULE ........................................................ 81
B-100 ORAL TABLET ................... 84
Bacitracin EXTERNAL
OINTMENT 500 UNIT/GM
................................................................................................ 58
Bacitracin Zinc EXTERNAL
................................................................................................ 58
Bacitracin-Polymyxin B
OPHTHALMIC OINTMENT
500-10000 UNIT/GM ............................ 87
Baclofen ORAL TABLET 10
MG, 20 MG ......................................................... 84
................................................................................................ 84
................................................................................................ 84
Balanced B Complex ORAL
TABLET .............................................................. 81
................................................................................................
105
................................................................................................ 84
Balanced B-50 Complex ORAL
CAPSULE ........................................................ 84
Balanced B-50 Complex ORAL
TABLET .............................................................. 84
................................................................................................ 84
Balsalazide Disodium ORAL
CAPSULE 750 MG ................................. 68
BALZIVA ORAL TABLET
0.4-35 MG-MCG ........................................ 52
BANZEL ORAL SUSPENSION
40 MG/ML ........................................................... 17
BANZEL ORAL TABLET 200
MG .................................................................................. 17
BANZEL ORAL TABLET 400
MG .................................................................................. 17
BARACLUDE ORAL
SOLUTION 0.05 MG/ML ........... 45
BARACLUDE ORAL TABLET
0.5 MG, 1 MG ................................................ 45
Baza Antifungal EXTERNAL
CREAM 2 % ...................................................... 59
B-Complex/B-12 ORAL
TABLET .............................................................. 81
BD INSULIN SYRINGE
ULTRAFINE XX MISC 31G X
5/16" 1 ML ............................................................ 75
BENADRYL ALLERGY
CHILDRENS ORAL LIQUID†
12.5 MG/5ML ................................................. 29
Benazepril HCl ORAL TABLET
10 MG, 20 MG, 40 MG, 5 MG
................................................................................................ 31
Benazepril-Hydrochlorothiazide
ORAL TABLET 10-12.5 MG,
20-12.5 MG, 20-25 MG, 5-6.25
MG ................................................................................... 32
Benzoyl Peroxide EXTERNAL
GEL 10 %, 5 % ................................................ 57
Benzoyl Peroxide-Erythromycin
EXTERNAL GEL 5-3 % .................. 57
Benztropine Mesylate ORAL
TABLET 0.5 MG, 1 MG, 2 MG
................................................................................................ 38
Betamethasone Dipropionate Aug
................................................................................................ 60
Betamethasone Dipropionate
................................................................................................ 60
106
EXTERNAL LOTION 0.05 %
................................................................................................
60
% ......................................................................................... 60
Betamethasone Valerate
................................................................................................ 60
EXTERNAL LOTION 0.1 %
................................................................................................ 60
EXTERNAL OINTMENT 0.1 %
................................................................................................ 60
Betaxolol HCl OPHTHALMIC
SOLUTION 0.5 % .................................... 86
Bethanechol Chloride ORAL
TABLET 10 MG, 25 MG, 5 MG,
50 MG .......................................................................... 97
BETOPTIC-S OPHTHALMIC
SUSPENSION 0.25 % ........................ 86
Better B Complex ORAL
TABLET .............................................................. 81
BICILLIN C-R 900/300
INTRAMUSCULAR*
SUSPENSION 900000-300000
UNIT/2ML .......................................................... 91
BICILLIN C-R
INTRAMUSCULAR*
SUSPENSION 1200000
UNIT/2ML .......................................................... 91
BICILLIN L-A
INTRAMUSCULAR*
SUSPENSION 1200000
UNIT/2ML, 2400000
UNIT/4ML, 600000 UNIT/ML
................................................................................................ 91
BIG 100 ORAL TABLET ............. 81
BILTRICIDE ORAL TABLET
600 MG ..................................................................... 10
Biotin 5000 ORAL CAPSULE 5
MG ............................................................................... 100
Biotin Maximum Strength ORAL
CAPSULE 5000 MCG .................... 100
Biotin ORAL CAPSULE 5 MG,
5000 MCG ......................................................... 100
Bismatrol ORAL SUSPENSION
262 MG/15ML ................................................ 27
Bisoprolol Fumarate ORAL
TABLET 10 MG, 5 MG .................... 48
Bisoprolol-Hydrochlorothiazide
2.5-6.25 MG, 5-6.25 MG ................... 32
BOSULIF ORAL TABLET 100
MG, 500 MG .................................................... 37
Briellyn ORAL TABLET 0.4-35
MG-MCG ............................................................... 52
Brimonidine Tartrate
OPHTHALMIC SOLUTION
0.2 % .............................................................................. 87
BRINTELLIX ORAL TABLET
10 MG, 20 MG, 5 MG ........................ 21
BRISDELLE ORAL CAPSULE
7.5 MG ....................................................................... 94
Bromocriptine Mesylate ORAL
CAPSULE 5 MG ........................................ 38
Bromocriptine Mesylate ORAL
TABLET 2.5 MG ........................................ 38
BRONCHO SALINE
INHALATION AEROSOL,
SOLUTION 0.9 % .................................... 56
BROTAPP ORAL LIQUID†
1-15 MG/5ML ................................................. 56
BUDEPRION SR ORAL
TABLET EXTENDED
................................................................................................ 21
Budesonide INHALATION
SUSPENSION 0.25 MG/2ML,
0.5 MG/2ML ...................................................... 14
Bumetanide INJECTION
SOLUTION 0.25 MG/ML ............ 65
Bumetanide ORAL TABLET 0.5
MG, 1 MG, 2 MG ....................................... 65
Buprenorphine HCl
SUBLINGUAL TABLET
.................................................................................................... 9
BUPROBAN ORAL TABLET
EXTENDED RELEASE 12
HR* 150 MG .................................................... 93
BuPROPion HCl ER (SR)
RELEASE 12 HR* 100 MG, 150
MG, 200 MG ...................................................... 21
BuPROPion HCl ER (XL)
MG ................................................................................... 21
BuPROPion HCl ORAL
TABLET 100 MG, 75 MG ............. 21
BusPIRone HCl ORAL TABLET
10 MG, 15 MG, 30 MG, 5 MG,
7.5 MG ........................................................................ 11
Butalbital-Acetaminophen ORAL
TABLET 50-325 MG ................................ 5
Butalbital-APAP-Caff-Cod
ORAL CAPSULE 50-325-40-30
MG ....................................................................................... 8
Butalbital-APAP-Caffeine ORAL
CAPSULE 50-325-40 MG ................. 5
Butalbital-APAP-Caffeine ORAL
TABLET 50-325-40 MG,
50-500-40 MG ...................................................... 5
Butalbital-ASA-Caff-Codeine
ORAL CAPSULE 50-325-40-30
MG ....................................................................................... 8
Butalbital-ASA-Caffeine ORAL
CAPSULE 50-325-40 MG ................. 5
Butorphanol Tartrate NASAL
SOLUTION 10 MG/ML ..................... 9
BYDUREON
SUBCUTANEOUS*
SUSPENSION
RECONSTITUTED 2 MG
................................................................................................ 25
C-500 ORAL TABLET
CHEWABLE 500 MG ..................... 100
Calcipotriene EXTERNAL
CREAM 0.005 % ......................................... 59
OINTMENT 0.005 % ........................... 59
SOLUTION 0.005 % ............................. 59
Calcitonin (Salmon) NASAL
SOLUTION 200 UNIT/ACT
................................................................................................ 65
CALCITRATE ORAL
................................................................................................ 77
Calcitriol INTRAVENOUS*
SOLUTION 1 MCG/ML ................ 66
Calcitriol ORAL CAPSULE 0.25
MCG, 0.5 MCG ............................................. 66
Calcitriol ORAL SOLUTION 1
MCG/ML ............................................................... 66
Calcium Acetate (Phos Binder)
ORAL TABLET 667 MG ............... 77
Calcium Acetate ORAL
CAPSULE 667 MG ................................. 68
Calcium Antacid Extra Strength
750 MG ...................................................................... 10
Calcium Carbonate Antacid
ORAL TABLET 648 MG ............... 10
Calcium Carbonate Antacid
500 MG ...................................................................... 10
Calcium Carbonate ORAL
................................................................................................ 77
Calcium Carbonate ORAL
................................................................................................ 77
Calcium Carbonate-Vitamin D
ORAL TABLET 600-400
MG-UNIT ............................................................. 77
Calcium Citrate + D ORAL
................................................................................................ 77
Calcium Lactate ORAL TABLET
648 MG ...................................................................... 77
Cal-Lac ORAL CAPSULE 500
MG ................................................................................... 77
CAMILA ORAL TABLET 0.35
MG .................................................................................. 54
CAPRELSA ORAL TABLET
100 MG, 300 MG ....................................... 37
Capsaicin EXTERNAL CREAM
0.025 % ....................................................................... 62
Captopril ORAL TABLET 100
MG, 12.5 MG, 25 MG, 50 MG
................................................................................................ 31
Captopril-Hydrochlorothiazide
25-25 MG, 50-15 MG, 50-25 MG
................................................................................................ 32
CARAFATE ORAL
SUSPENSION 1 GM/10ML
................................................................................................ 97
CarBAMazepine ER ORAL
CAPSULE EXTENDED
RELEASE 12 HOUR 100 MG
................................................................................................ 17
CAPSULE EXTENDED
................................................................................................ 17
CAPSULE EXTENDED
................................................................................................ 17
TABLET EXTENDED
................................................................................................ 17
TABLET EXTENDED
................................................................................................ 17
CarBAMazepine ORAL
................................................................................................
17
CarBAMazepine ORAL
TABLET 200 MG ...................................... 17
CarBAMazepine ORAL
................................................................................................ 17
Carbidopa-Levodopa ER ORAL
TABLET
EXTENDEDRELEASE* 25-100
MG, 50-200 MG ............................................ 38
Carbidopa-Levodopa ORAL
TABLET 10-100 MG, 25-100
MG, 25-250 MG ............................................ 38
Carisoprodol ORAL TABLET
350 MG ...................................................................... 84
Carteolol HCl OPHTHALMIC
SOLUTION 1 % .......................................... 86
CARTIA XT ORAL CAPSULE
EXTENDED RELEASE 24
HOUR 120 MG, 180 MG, 240
MG, 300 MG .................................................... 49
Carvedilol ORAL TABLET 12.5
MG, 25 MG, 3.125 MG, 6.25 MG
................................................................................................ 48
CAVAREST DENTAL GEL 1.1
% ......................................................................................... 80
CAZIANT ORAL TABLET
0.1/0.125/0.15 -0.025 MG ................ 54
Cefaclor ORAL CAPSULE 250
MG, 500 MG ...................................................... 51
Cefadroxil ORAL CAPSULE
500 MG ...................................................................... 51
Cefadroxil ORAL
SUSPENSION
RECONSTITUTED 250
MG/5ML, 500 MG/5ML .................. 51
Cefadroxil ORAL TABLET 1
GM ................................................................................... 51
Cefdinir ORAL CAPSULE 300
MG ................................................................................... 51
Cefdinir ORAL SUSPENSION
RECONSTITUTED 125
MG/5ML, 250 MG/5ML .................. 51
Cefpodoxime Proxetil ORAL
SUSPENSION
RECONSTITUTED 100
MG/5ML, 50 MG/5ML ..................... 51
Cefpodoxime Proxetil ORAL
................................................................................................ 51
107
Cefprozil ORAL SUSPENSION
RECONSTITUTED 125
MG/5ML, 250 MG/5ML .................. 51
Cefprozil ORAL TABLET 250
MG, 500 MG ...................................................... 51
Cefuroxime Axetil ORAL
SUSPENSION
RECONSTITUTED 125
MG/5ML ................................................................. 51
Cefuroxime Axetil ORAL
................................................................................................ 51
CELEBREX ORAL CAPSULE
100 MG, 200 MG, 400 MG, 50
MG ...................................................................................... 4
CELESTONE ORAL
SOLUTION 0.6 MG/5ML ........... 55
CELLCEPT INTRAVENOUS
................................................................................................ 47
CELLCEPT ORAL
SUSPENSION
RECONSTITUTED 200
MG/ML .................................................................... 47
CELONTIN ORAL CAPSULE
300 MG ..................................................................... 20
Centavite A-Z Complete-Mineral
ORAL TABLET ....................................... 82
CENTRATEX ORAL
CAPSULE 106-1 MG .......................... 70
Cephalexin ORAL CAPSULE
250 MG, 500 MG, 750 MG ........... 51
Cephalexin ORAL
SUSPENSION
RECONSTITUTED 125
MG/5ML ................................................................. 51
Cephalexin ORAL
SUSPENSION
RECONSTITUTED 250
MG/5ML ................................................................. 51
CEROVITE ADVANCED
FORMULA ORAL TABLET
................................................................................................ 82
CERTAVITE
SENIOR/ANTIOXIDANT
ORAL TABLET ......................................... 82
CERTAVITE/ANTIOXIDANT
S ORAL LIQUID† .................................. 82
Cetirizine HCl Childrens ORAL
SOLUTION 1 MG/ML ..................... 29
Cetirizine HCl ORAL SYRUP 1
MG/ML, 5 MG/5ML ............................. 29
108
Cetirizine HCl ORAL TABLET
10 MG, 5 MG .................................................... 29
Cetirizine-Pseudoephedrine ER
................................................................................................ 56
CHANTIX CONTINUING
MONTH PAK ORAL TABLET
1 MG ............................................................................. 94
CHANTIX ORAL TABLET 0.5
MG, 1 MG ........................................................... 93
CHANTIX STARTING
MONTH PAK ORAL TABLET
0.5 MG X 11 & 1 MG X 42
................................................................................................ 94
Childrens Ibuprofen ORAL
SUSPENSION 40 MG/ML
.................................................................................................... 4
Childrens Loratadine ORAL
SYRUP 5 MG/5ML ................................ 29
Childrens Silapap ORAL
LIQUID† 160 MG/5ML ...................... 5
Childrens Silfedrine ORAL
LIQUID† 15 MG/5ML ...................... 85
ChlordiazePOXIDE HCl ORAL
MG ................................................................................... 12
Chlordiazepoxide-Amitriptyline
5-12.5 MG .............................................................. 92
Chlorhexidine Gluconate
................................................................................................ 42
Chlorhexidine Gluconate
MOUTH/THROAT SOLUTION
0.12 % ........................................................................... 80
Chlorothiazide ORAL TABLET
250 MG, 500 MG ......................................... 65
ChlorproMAZINE HCl
INJECTION SOLUTION 25
MG/ML ..................................................................... 41
ChlorproMAZINE HCl ORAL
MG, 25 MG, 50 MG ................................ 41
ChlorproPAMIDE ORAL
................................................................................................ 27
Chlorthalidone ORAL TABLET
25 MG, 50 MG ................................................ 65
Chlorzoxazone ORAL TABLET
500 MG ...................................................................... 84
Cholestyramine Light ORAL
PACKET 4 GM ............................................. 30
Cholestyramine Light ORAL
POWDER 4 GM/DOSE ................... 30
Cholestyramine ORAL PACKET
4 GM ............................................................................. 30
Cholestyramine ORAL
POWDER 4 GM/DOSE ................... 30
Choline & Mag Trisalicylate
ORAL TABLET 1000 MG ............... 6
Choline-Mag Trisalicylate ORAL
LIQUID† 500 MG/5ML ...................... 6
Ciclopirox EXTERNAL
SOLUTION 8 % .......................................... 58
CREAM 0.77 % ............................................. 58
SUSPENSION 0.77 % ........................ 58
Cilostazol ORAL TABLET 100
MG, 50 MG ......................................................... 69
Cimetidine HCl ORAL
SOLUTION 300 MG/5ML .......... 96
Cimetidine ORAL TABLET 200
MG ................................................................................... 96
Cimetidine ORAL TABLET 300
MG, 400 MG, 800 MG ........................ 96
CIPRODEX OTIC
SUSPENSION 0.3-0.1 % ................ 90
Ciprofloxacin HCl
OPHTHALMIC SOLUTION
0.3 % .............................................................................. 87
Ciprofloxacin HCl ORAL
TABLET 250 MG, 500 MG, 750
MG ................................................................................... 67
Citalopram Hydrobromide ORAL
SOLUTION 10 MG/5ML .............. 22
Citalopram Hydrobromide ORAL
TABLET 10 MG, 20 MG, 40 MG
................................................................................................ 22
CLARAVIS ORAL CAPSULE
10 MG, 20 MG, 30 MG, 40 MG
................................................................................................ 57
Clarithromycin ORAL
SUSPENSION
RECONSTITUTED 125
MG/5ML, 250 MG/5ML .................. 74
Clarithromycin ORAL TABLET
250 MG, 500 MG ......................................... 74
CLEAR AWAY 1-STEP WART
REMOVER EXTERNAL PAD
40 % ................................................................................ 62
Clindamycin HCl ORAL
MG ................................................................................... 33
Clindamycin Palmitate HCl
ORAL SOLUTION
RECONSTITUTED 75
MG/5ML ................................................................. 33
Clindamycin Phosphate
EXTERNAL GEL 1 % ........................ 57
EXTERNAL LOTION 1 %
................................................................................................ 57
EXTERNAL SOLUTION 1 %
................................................................................................ 57
MG/2ML, 600 MG/4ML, 9
GM/60ML, 900 MG/6ML .............. 34
300 MG/2ML .................................................... 34
VAGINAL CREAM 2 % ................. 98
CLINISTIX IN VITRO STRIP
................................................................................................ 64
Clobetasol Propionate
................................................................................................ 60
EXTERNAL GEL 0.05 % .............. 60
% ......................................................................................... 60
ClomiPRAMINE HCl ORAL
MG ................................................................................... 23
0.5 MG, 1 MG, 2 MG ............................ 17
MG, 0.5 MG, 1 MG, 2 MG ........... 17
CloNIDine HCl ER ORAL
TABLET EXTENDED
RELEASE 12 HR* 0.1 MG
.................................................................................................... 2
CloNIDine HCl ORAL TABLET
0.1 MG, 0.2 MG, 0.3 MG ................ 32
Clopidogrel Bisulfate ORAL
TABLET 75 MG .......................................... 70
Clorazepate Dipotassium ORAL
TABLET 15 MG, 3.75 MG, 7.5
MG ................................................................................... 12
Clotrimazole EXTERNAL
CREAM 1 % ...................................................... 59
Clotrimazole EXTERNAL
SOLUTION 1 % .......................................... 59
Clotrimazole MOUTH/THROAT
LOZENGE 10 MG ................................... 80
Clotrimazole MOUTH/THROAT
TROCHE 10 MG ........................................ 80
Clotrimazole VAGINAL
CREAM 1 % ...................................................... 98
CloZAPine ORAL TABLET 100
MG, 200 MG, 25 MG, 50 MG
................................................................................................ 40
CloZAPine ORAL TABLET
DISPERSIBLE 100 MG, 12.5
MG, 25 MG ......................................................... 40
Codeine Phosphate INJECTION
SOLUTION 15 MG/ML, 30
MG/ML ........................................................................ 6
Codeine Sulfate ORAL TABLET
15 MG, 30 MG, 60 MG .......................... 6
Colchicine-Probenecid ORAL
TABLET 0.5-500 MG .......................... 69
COLCRYS ORAL TABLET 0.6
MG .................................................................................. 69
Cold & Allergy ORAL ELIXIR
1-2.5 MG/5ML ................................................ 56
COMBIVENT INHALATION
AEROSOL† 18-103 MCG/ACT
................................................................................................ 14
COMBIVENT RESPIMAT
INHALATION AEROSOL,
SOLUTION 20-100 MCG/ACT
................................................................................................ 14
COMPLERA ORAL TABLET
200-25-300 MG .............................................. 43
COMPOUND W EXTERNAL
LIQUID† 17 % .............................................. 62
COMPOUND W MAXIMUM
STRENGTH EXTERNAL GEL
17 % ................................................................................ 62
CONDYLOX EXTERNAL
GEL 0.5 % ............................................................ 62
CONTROLRX DENTAL
CREAM 1.1 % ............................................... 80
COPAXONE
SUBCUTANEOUS* KIT 20
MG/ML .................................................................... 93
Cortisone Acetate ORAL
TABLET 25 MG .......................................... 55
CORTISPORIN EXTERNAL
OINTMENT 1 % ....................................... 58
CREON ORAL CAPSULE
DELAYED RELEASE
PARTICLES 12000 UNIT,
24000 UNIT, 3000-9500 UNIT,
36000 UNIT, 6000 UNIT ............... 64
CRIXIVAN ORAL CAPSULE
200 MG, 400 MG ....................................... 43
Cromolyn Sodium
INHALATION
20 MG/2ML ........................................................ 13
Cromolyn Sodium NASAL
AEROSOL, SOLUTION 5.2
MG/ACT ................................................................. 85
Cromolyn Sodium
OPHTHALMIC SOLUTION 4
% ......................................................................................... 89
CRYSELLE-28 ORAL
TABLET 0.3-30 MG-MCG
................................................................................................ 52
Cyanocobalamin INJECTION
SOLUTION 1000 MCG/ML
................................................................................................ 70
Cyclobenzaprine HCl ORAL
TABLET 10 MG, 5 MG .................... 85
CYCLOMYDRIL
OPHTHALMIC SOLUTION
0.2-1 % ........................................................................ 87
Cyclophosphamide ORAL
TABLET 25 MG, 50 MG ................ 35
CycloSPORINE
50 MG/ML ........................................................... 46
CycloSPORINE Modified ORAL
MG ................................................................................... 47
CycloSPORINE Modified ORAL
SOLUTION 100 MG/ML .............. 47
CycloSPORINE ORAL
CAPSULE 100 MG, 25 MG
................................................................................................ 47
Cyproheptadine HCl ORAL
SYRUP 2 MG/5ML ................................ 30
Cyproheptadine HCl ORAL
TABLET 4 MG .............................................. 30
Cytra-2 ORAL SOLUTION
500-334 MG/5ML ...................................... 68
CYTRA-3 ORAL SYRUP
550-500-334 MG/5ML ........................ 68
Daily Multiple Vitamins ORAL
TABLET .............................................................. 82
Danazol ORAL CAPSULE 100
MG, 200 MG, 50 MG ................................ 9
Dantrolene Sodium ORAL
MG ................................................................................... 85
DARAPRIM ORAL TABLET
25 MG ......................................................................... 34
109
DAYTRANA
TRANSDERMAL PATCH 10
MG/9HR, 15 MG/9HR, 20
MG/9HR, 30 MG/9HR ........................ 2
Deferoxamine Mesylate
INJECTION SOLUTION
RECONSTITUTED 2 GM, 500
MG ................................................................................... 28
DELSYM NGHT TIME
CGH/CLD CHILD ORAL
LIQUID† 12.5-5 MG/5ML
................................................................................................ 56
DELSYM NIGHT TIME
COUGH/COLD ORAL
LIQUID† 6.25-2.5 MG/5ML
................................................................................................ 56
DEMAREST DRICORT
EXTERNAL CREAM 1 %
................................................................................................ 60
DENAVIR EXTERNAL
CREAM 1 % ..................................................... 59
DENTA 5000 PLUS DENTAL
CREAM 1.1 % ............................................... 80
DENTAGEL DENTAL GEL
1.1 % .............................................................................. 80
Desipramine HCl ORAL
MG, 25 MG, 50 MG, 75 MG
................................................................................................ 24
Desmopressin Ace Rhinal Tube
NASAL SOLUTION 0.01 %
................................................................................................ 66
Desmopressin Ace Spray Refrig
................................................................................................ 66
Desmopressin Acetate ORAL
TABLET 0.1 MG, 0.2 MG ............ 66
Desmopressin Acetate Spray
................................................................................................ 66
Desonide EXTERNAL CREAM
0.05 % ........................................................................... 60
Desvenlafaxine ER ORAL
TABLET EXTENDED
MG ................................................................................... 23
Dexamethasone ORAL ELIXIR
0.5 MG/5ML ...................................................... 55
Dexamethasone ORAL
SOLUTION 0.5 MG/5ML ............ 55
Dexamethasone ORAL TABLET
0.5 MG, 0.75 MG, 1 MG, 1.5
MG, 2 MG, 4 MG, 6 MG ................. 55
110
Dexamethasone Sodium
Phosphate INJECTION
MG/ML ..................................................................... 55
Dexamethasone Sodium
Phosphate OPHTHALMIC
SOLUTION 0.1 % .................................... 88
Dexmethylphenidate HCl ORAL
.................................................................................................... 2
Dextroamphetamine Sulfate ER
MG, 5 MG ................................................................. 1
Dextroamphetamine Sulfate
ORAL TABLET 10 MG, 5 MG
.................................................................................................... 1
DIASTIX IN VITRO STRIP
................................................................................................ 64
Diazepam INJECTION
SOLUTION 5 MG/ML ..................... 12
Diazepam ORAL SOLUTION 1
MG/ML ..................................................................... 12
Diazepam ORAL TABLET 10
MG, 2 MG, 5 MG ....................................... 12
Diazepam RE GEL 10 MG, 2.5
MG, 20 MG ......................................................... 17
Diclofenac Potassium ORAL
TABLET 50 MG .............................................. 4
Diclofenac Sodium ER ORAL
TABLET EXTENDED
.................................................................................................... 4
Diclofenac Sodium
OPHTHALMIC SOLUTION
0.1 % .............................................................................. 89
Diclofenac Sodium ORAL
25 MG, 50 MG, 75 MG .......................... 4
Dicloxacillin Sodium ORAL
................................................................................................ 91
Dicyclomine HCl ORAL
CAPSULE 10 MG .................................... 96
SOLUTION 10 MG/5ML .............. 96
TABLET 20 MG .......................................... 96
Didanosine ORAL CAPSULE
DELAYED RELEASE 125 MG,
200 MG, 250 MG, 400 MG ........... 44
Diflunisal ORAL TABLET 500
MG ....................................................................................... 6
Digoxin INJECTION
SOLUTION 0.25 MG/ML ............ 50
Digoxin ORAL SOLUTION 0.05
MG/ML ..................................................................... 50
Digoxin ORAL TABLET 0.125
MG, 0.25 MG .................................................... 50
DILANTIN ORAL CAPSULE
30 MG ......................................................................... 20
Diltiazem HCl ER Beads ORAL
CAPSULE EXTENDED
RELEASE 24 HOUR 120 MG,
180 MG, 240 MG, 300 MG, 360
MG, 420 MG ...................................................... 49
Diltiazem HCl ER Coated Beads
180 MG, 240 MG, 300 MG, 360
MG ................................................................................... 49
Diltiazem HCl ER ORAL
CAPSULE EXTENDED
60 MG, 90 MG ................................................ 49
Diltiazem HCl
125 MG/25ML, 25 MG/5ML, 50
MG/10ML ............................................................. 49
Diltiazem HCl ORAL TABLET
120 MG, 30 MG, 60 MG, 90 MG
................................................................................................ 49
Dilt-XR ORAL CAPSULE
EXTENDED RELEASE 24
HOUR 120 MG, 180 MG, 240
MG ................................................................................... 49
DimenhyDRINATE ORAL
TABLET 50 MG .......................................... 28
Diphenhist ORAL LIQUID† 12.5
MG/5ML ................................................................. 29
DiphenhydrAMINE HCl ORAL
CAPSULE 25 MG, 50 MG ........... 29
DiphenhydrAMINE HCl ORAL
TABLET 25 MG .......................................... 29
Diphenoxylate-Atropine ORAL
LIQUID† 2.5-0.025 MG/5ML
................................................................................................ 27
Diphenoxylate-Atropine ORAL
TABLET 2.5-0.025 MG ..................... 27
Dipyridamole INTRAVENOUS*
SOLUTION 5 MG/ML ..................... 63
Dipyridamole ORAL TABLET 25
MG, 50 MG, 75 MG ................................ 69
Disopyramide Phosphate ORAL
................................................................................................ 12
Disulfiram ORAL TABLET 250
MG, 500 MG ...................................................... 92
Divalproex Sodium ER ORAL
TABLET EXTENDED
................................................................................................ 20
Divalproex Sodium ER ORAL
TABLET EXTENDED
................................................................................................ 20
Divalproex Sodium ORAL
CAPSULE SPRINKLE 125 MG
................................................................................................ 20
125 MG, 250 MG ......................................... 20
500 MG ...................................................................... 20
Docusate Sodium ORAL
TABLET 100 MG ...................................... 73
Donepezil HCl ORAL TABLET
10 MG, 5 MG .................................................... 92
Dorzolamide HCl
% ......................................................................................... 89
Dorzolamide HCl-Timolol Mal
OPHTHALMIC SOLUTION
22.3-6.8 MG/ML .......................................... 86
Double Antibiotic EXTERNAL
OINTMENT 500-10000
UNIT/GM .............................................................. 58
Doxazosin Mesylate ORAL
TABLET 1 MG, 2 MG, 4 MG, 8
MG ................................................................................... 32
Doxepin HCl ORAL CAPSULE
10 MG, 100 MG, 150 MG, 25
MG, 50 MG, 75 MG ................................ 24
Doxepin HCl ORAL
CONCENTRATE 10 MG/ML
................................................................................................ 24
DOXY 100 INTRAVENOUS*
SOLUTION
................................................................................................ 94
Doxycycline Hyclate ORAL
................................................................................................ 94
TABLET 100 MG ...................................... 94
TABLET 20 MG .......................................... 94
DRITHO-CREME HP
EXTERNAL CREAM 1 %
................................................................................................
59
DULERA INHALATION
AEROSOL† 100-5 MCG/ACT,
200-5 MCG/ACT ........................................ 14
DULoxetine HCl ORAL
CAPSULE DELAYED
RELEASE PARTICLES 20 MG,
30 MG, 60 MG ................................................ 23
E.E.S. GRANULES ORAL
SUSPENSION
RECONSTITUTED 200
MG/5ML ................................................................ 74
E-400 ORAL CAPSULE 400
UNIT ............................................................................ 99
Earwax Treatment Drops OTIC
SOLUTION 6.5 % .................................... 89
EASIVENT XX MISC ...................... 76
Econazole Nitrate EXTERNAL
CREAM 1 % ...................................................... 59
EDURANT ORAL TABLET 25
MG .................................................................................. 44
ELIDEL EXTERNAL CREAM
1 % .................................................................................... 62
ELIPHOS ORAL TABLET 667
MG .................................................................................. 68
ELITE-OB ORAL TABLET
50-1.25 MG ......................................................... 83
ELIXOPHYLLIN ORAL
ELIXIR 80 MG/15ML ....................... 15
EMCYT ORAL CAPSULE 140
MG .................................................................................. 36
EMOQUETTE ORAL TABLET
0.15-30 MG-MCG .................................... 52
EMSAM TRANSDERMAL
PATCH 24 HR 12 MG/24HR, 6
MG/24HR, 9 MG/24HR ................. 22
EMTRIVA ORAL CAPSULE
200 MG ..................................................................... 44
EMTRIVA ORAL SOLUTION
10 MG/ML ........................................................... 44
Enalapril Maleate ORAL
TABLET 10 MG, 2.5 MG, 20
MG, 5 MG ............................................................. 31
Enalapril-Hydrochlorothiazide
5-12.5 MG .............................................................. 32
ENDOCET ORAL TABLET
10-325 MG, 5-325 MG, 7.5-325
MG, 7.5-500 MG ............................................ 8
ENDOCET ORAL TABLET
10-650 MG ............................................................... 8
ENDOMETRIN VAGINAL
INSERT 100 MG ....................................... 98
ENEMEEZ MINI RE ENEMA
283 MG ..................................................................... 73
Enoxaparin Sodium INJECTION
SOLUTION 300 MG/3ML .......... 16
Enoxaparin Sodium
SUBCUTANEOUS*
MG/ML ..................................................................... 16
Enoxaparin Sodium
SUBCUTANEOUS*
SOLUTION 120 MG/0.8ML, 80
MG/0.8ML ........................................................... 16
Enoxaparin Sodium
SUBCUTANEOUS*
MG/0.4ML ........................................................... 16
Enoxaparin Sodium
SUBCUTANEOUS*
................................................................................................ 16
ENPRESSE-28 ORAL TABLET
................................................................................................ 54
EPIPEN 2-PAK INJECTION
DEVICE 0.3 MG/0.3ML ................ 99
EPIPEN JR 2-PAK
INJECTION DEVICE 0.15
MG/0.3ML .......................................................... 99
EPITOL ORAL TABLET 200
MG .................................................................................. 17
EPIVIR HBV ORAL
SOLUTION 5 MG/ML .................... 44
EPIVIR HBV ORAL TABLET
100 MG ..................................................................... 44
EPIVIR ORAL SOLUTION 10
MG/ML .................................................................... 44
EPZICOM ORAL TABLET
600-300 MG ........................................................ 43
EQUETRO ORAL CAPSULE
EXTENDED RELEASE 12
HOUR 100 MG, 200 MG, 300
MG .................................................................................. 39
ERIVEDGE ORAL CAPSULE
150 MG ..................................................................... 35
ERRIN ORAL TABLET 0.35
MG .................................................................................. 54
ERWINAZE
INTRAMUSCULAR*
SOLUTION
RECONSTITUTED 10000
UNIT ............................................................................ 37
Ery EXTERNAL PAD 2 %
................................................................................................ 57
111
ERYPED 200 ORAL
SUSPENSION
RECONSTITUTED 200
MG/5ML ................................................................ 74
ERYPED 400 ORAL
SUSPENSION
RECONSTITUTED 400
MG/5ML ................................................................ 74
ERY-TAB ORAL TABLET
333 MG, 500 MG ....................................... 74
ERYTHROCIN STEARATE
ORAL TABLET 250 MG ............. 74
Erythromycin Base ORAL
CAPSULE DELAYED
RELEASE PARTICLES 250
MG ................................................................................... 74
Erythromycin Base ORAL
................................................................................................ 74
Erythromycin Ethylsuccinate
ORAL TABLET 400 MG ............... 74
Erythromycin EXTERNAL GEL
2 % .................................................................................... 57
Erythromycin EXTERNAL
SOLUTION 2 % .......................................... 57
Erythromycin OPHTHALMIC
OINTMENT 5 MG/GM ................... 87
Erythromycin-Sulfisoxazole
ORAL SUSPENSION
RECONSTITUTED 200-600
MG/5ML ................................................................. 33
Escitalopram Oxalate ORAL
SOLUTION 5 MG/5ML .................. 22
Escitalopram Oxalate ORAL
................................................................................................ 22
ESTARYLLA ORAL TABLET
0.25-35 MG-MCG .................................... 52
Estazolam ORAL TABLET 1
MG, 2 MG ............................................................. 71
Estradiol ORAL TABLET 0.5
MG, 1 MG, 2 MG ....................................... 67
Estradiol TRANSDERMAL
PATCH WEEKLY 0.025
MG/24HR, 0.0375 MG/24HR,
0.05 MG/24HR, 0.06 MG/24HR,
0.075 MG/24HR, 0.1 MG/24HR
................................................................................................ 67
Estradiol-Norethindrone Acet
ORAL TABLET 0.5-0.1 MG,
1-0.5 MG .................................................................. 67
Estropipate ORAL TABLET 0.75
MG, 1.5 MG, 3 MG ................................. 67
112
Ethosuximide ORAL CAPSULE
250 MG ...................................................................... 20
Ethosuximide ORAL
SOLUTION 250 MG/5ML .......... 20
Etodolac ORAL CAPSULE 200
MG, 300 MG ......................................................... 4
Etodolac ORAL TABLET 400
MG, 500 MG ......................................................... 4
Etoposide ORAL CAPSULE 50
MG ................................................................................... 38
EVISTA ORAL TABLET 60
MG .................................................................................. 66
EXEL PEN NEEDLES 1/3" XX
MISC 31G X 8 MM ............................... 75
EXELON TRANSDERMAL
PATCH 24 HR 13.3 MG/24HR,
4.6 MG/24HR, 9.5 MG/24HR
................................................................................................ 92
EXJADE ORAL TABLET
SOLUBLE 125 MG, 250 MG,
500 MG ..................................................................... 28
EX-LAX ORAL TABLET
CHEWABLE 15 MG ........................... 73
EXTAVIA SUBCUTANEOUS*
KIT 0.3 MG ....................................................... 93
E-Z SPACER XX DEVICE
................................................................................................ 76
Famotidine INTRAVENOUS*
SOLUTION 10 MG/ML .................. 96
Famotidine ORAL TABLET 10
MG ................................................................................... 96
Famotidine ORAL TABLET 20
MG, 40 MG ......................................................... 96
Famotidine Premixed
20-0.9 MG/50ML-% ................................ 96
FANAPT ORAL TABLET 1
MG, 10 MG, 12 MG, 2 MG, 4
MG, 6 MG, 8 MG ..................................... 39
FANAPT TITRATION PACK
ORAL TABLET 1 & 2 & 4 & 6
MG .................................................................................. 39
FAZACLO ORAL TABLET
DISPERSIBLE 150 MG, 200
MG .................................................................................. 40
FE C PLUS ORAL TABLET
100-250-0.025-1 MG .............................. 70
Felbamate ORAL SUSPENSION
600 MG/5ML .................................................... 19
Felbamate ORAL TABLET 400
MG ................................................................................... 19
Felbamate ORAL TABLET 600
MG ................................................................................... 19
Fenofibrate Micronized ORAL
MG ................................................................................... 30
Fenofibrate ORAL TABLET 160
MG, 54 MG ......................................................... 30
Fenoprofen Calcium ORAL
TABLET 600 MG .......................................... 4
FentaNYL TRANSDERMAL
PATCH 72 HR 100 MCG/HR,
12 MCG/HR, 25 MCG/HR, 50
MCG/HR, 75 MCG/HR ....................... 6
Ferrous Gluconate ORAL
TABLET 324 (38 Fe) MG ............ 71
Ferrous Sulfate ORAL ELIXIR
220 (44 Fe) MG/5ML .......................... 71
Ferrous Sulfate ORAL
SOLUTION 75 (15 Fe) MG/ML
................................................................................................ 71
Ferrous Sulfate ORAL TABLET
325 (65 Fe) MG ............................................ 71
Ferrous Sulfate ORAL TABLET
DELAYED RELEASE 324 (65
Fe) MG, 325 (65 Fe) MG .............. 71
FETZIMA ORAL CAPSULE
EXTENDED RELEASE 24
HOUR 120 MG, 20 MG, 40
MG, 80 MG ........................................................ 23
FEVERALL RE
SUPPOSITORY 650 MG, 80
MG ...................................................................................... 5
Fexofenadine HCl ORAL
TABLET 180 MG, 60 MG ............. 29
Fexofenadine-Pseudoephed ER
................................................................................................ 56
Finasteride ORAL TABLET 5
MG ................................................................................... 69
FIRAZYR SUBCUTANEOUS*
SOLUTION 30 MG/3ML ............. 69
FIRST-PROGESTERONE VGS
100 VAGINAL SUPPOSITORY
100 MG ..................................................................... 98
200 MG ..................................................................... 99
25 MG ......................................................................... 99
400 MG ..................................................................... 99
50 MG ......................................................................... 99
Flecainide Acetate ORAL
MG ................................................................................... 12
FLEET PEDIATRIC RE
ENEMA 3.5-9.5 GM/59ML
................................................................................................ 73
FLOVENT DISKUS
INHALATION AEROSOL
POWDER, BREATH
ACTIVATED 100 MCG/BLIST,
250 MCG/BLIST, 50
MCG/BLIST ..................................................... 14
FLOVENT HFA
INHALATION AEROSOL† 110
MCG/ACT, 220 MCG/ACT
................................................................................................ 14
FLOVENT HFA
INHALATION AEROSOL† 44
MCG/ACT ........................................................... 14
Fluconazole ORAL
SUSPENSION
RECONSTITUTED 10 MG/ML,
40 MG/ML ........................................................... 29
Fluconazole ORAL TABLET 100
MG, 150 MG, 200 MG, 50 MG
................................................................................................ 29
Fludrocortisone Acetate ORAL
TABLET 0.1 MG ........................................ 56
Flunisolide NASAL SOLUTION
25 MCG/ACT (0.025%) ................... 85
Fluocinolone Acetonide Body
EXTERNAL OIL 0.01 % ................ 60
Fluocinolone Acetonide
EXTERNAL CREAM 0.01 %,
0.025 % ....................................................................... 60
% ......................................................................................... 60
EXTERNAL SOLUTION 0.01 %
................................................................................................ 60
Fluocinolone Acetonide Scalp
EXTERNAL OIL 0.01 % ................ 61
Fluocinonide EXTERNAL
CREAM 0.05 % ............................................. 61
Fluocinonide EXTERNAL GEL
0.05 % ........................................................................... 61
OINTMENT 0.05 % ............................... 61
SOLUTION 0.05 % ................................. 61
Fluocinonide-E EXTERNAL
CREAM 0.05 % ............................................. 61
FLUOR-A-DAY ORAL
TABLET CHEWABLE 0.25
(F)-236.79 MG, 0.5 (F)-236.79
MG, 1 (F)-236.79 MG ......................... 78
FLUORIDEX DAILY
DEFENSE DENTAL GEL 1.1
% ......................................................................................... 80
Fluorometholone
OPHTHALMIC SUSPENSION
0.1 % .............................................................................. 88
Fluorouracil EXTERNAL
CREAM 5 % ...................................................... 59
Fluorouracil EXTERNAL
SOLUTION 2 %, 5 % ........................... 59
Fluorouracil INTRAVENOUS*
................................................................................................ 35
FLUoxetine HCl ORAL
MG ................................................................................... 22
FLUoxetine HCl ORAL
CAPSULE DELAYED
RELEASE 90 MG ..................................... 22
FLUoxetine HCl ORAL
SOLUTION 20 MG/5ML .............. 22
FLUoxetine HCl ORAL
................................................................................................ 22
FluPHENAZine Decanoate
MG/ML ..................................................................... 41
FluPHENAZine HCl
INJECTION SOLUTION 2.5
MG/ML ..................................................................... 41
CONCENTRATE 5 MG/ML
................................................................................................ 41
ELIXIR 2.5 MG/5ML .......................... 41
TABLET 1 MG, 10 MG, 2.5 MG,
5 MG ............................................................................. 41
Flurazepam HCl ORAL
CAPSULE 15 MG, 30 MG ........... 71
Flurbiprofen ORAL TABLET 100
MG, 50 MG ............................................................. 4
Flurbiprofen Sodium
OPHTHALMIC SOLUTION
0.03 % ........................................................................... 89
Fluticasone Propionate
................................................................................................ 61
Fluticasone Propionate
% ......................................................................................... 61
Fluticasone Propionate NASAL
SUSPENSION 50 MCG/ACT
................................................................................................ 85
FluvoxaMINE Maleate ER
150 MG ...................................................................... 22
FluvoxaMINE Maleate ORAL
MG ................................................................................... 22
FML FORTE OPHTHALMIC
SUSPENSION 0.25 % ........................ 88
FOCALIN XR ORAL
CAPSULE EXTENDED
MG, 20 MG, 25 MG, 30 MG, 35
MG, 40 MG, 5 MG ..................................... 2
FOLBECAL ORAL TABLET 1
MG .................................................................................. 84
Folic Acid ORAL TABLET 1
MG, 400 MCG, 800 MCG .............. 70
Fondaparinux Sodium
SUBCUTANEOUS*
................................................................................................ 16
Fondaparinux Sodium
SUBCUTANEOUS*
................................................................................................ 16
Fondaparinux Sodium
SUBCUTANEOUS*
SOLUTION 5 MG/0.4ML ............ 16
Fondaparinux Sodium
SUBCUTANEOUS*
................................................................................................ 16
FORADIL AEROLIZER
INHALATION CAPSULE 12
MCG ............................................................................. 15
FORFIVO XL ORAL TABLET
EXTENDED RELEASE 24
HR* 450 MG .................................................... 21
Formula Twenty-One ORAL
TABLET .............................................................. 82
FORTICAL NASAL
SOLUTION 200 UNIT/ACT
................................................................................................ 65
Fosinopril Sodium ORAL
................................................................................................ 31
113
Fosphenytoin Sodium
MG PE/2ML, 500 MG PE/10ML
................................................................................................ 20
FREESTYLE FREEDOM LITE
XX KIT W/DEVICE ............................ 75
FREESTYLE INSULINX
SYSTEM XX KIT W/DEVICE
................................................................................................ 75
FREESTYLE INSULINX TEST
IN VITRO STRIP ..................................... 64
FREESTYLE LITE TEST IN
VITRO STRIP ............................................... 64
FREESTYLE LITE XX
DEVICE .................................................................. 75
FREESTYLE TEST IN VITRO
STRIP .......................................................................... 64
FREEZONE EXTERNAL
LIQUID† 17.6 % ......................................... 62
Furosemide ORAL SOLUTION
10 MG/ML, 8 MG/ML ....................... 65
Furosemide ORAL TABLET 20
MG, 40 MG, 80 MG ................................ 65
FUZEON SUBCUTANEOUS*
SOLUTION
RECONSTITUTED 90 MG
................................................................................................ 43
Gabapentin ORAL CAPSULE
100 MG ...................................................................... 17
300 MG ...................................................................... 17
400 MG ...................................................................... 17
Gabapentin ORAL SOLUTION
250 MG/5ML .................................................... 17
Gabapentin ORAL TABLET 600
MG, 800 MG ...................................................... 17
GABITRIL ORAL TABLET 12
MG, 16 MG ........................................................ 19
GAVILYTE-G ORAL
SOLUTION
................................................................................................ 72
GAVILYTE-N WITH FLAVOR
PACK ORAL SOLUTION
................................................................................................ 72
Gemcitabine HCl
1 GM/26.3ML, 2 GM/52.6ML,
200 MG/5.26ML ........................................... 35
114
Gemcitabine HCl
GM, 200 MG ...................................................... 35
Gemfibrozil ORAL TABLET 600
MG ................................................................................... 30
Generlac ORAL SOLUTION 10
GM/15ML ............................................................. 68
GENGRAF ORAL CAPSULE
100 MG, 25 MG ........................................... 47
GENGRAF ORAL SOLUTION
100 MG/ML ....................................................... 47
Gentamicin Sulfate EXTERNAL
CREAM 0.1 % ................................................ 58
Gentamicin Sulfate EXTERNAL
OINTMENT 0.1 % .................................. 58
Gentamicin Sulfate
OPHTHALMIC OINTMENT
0.3 % .............................................................................. 87
Gentamicin Sulfate
OPHTHALMIC SOLUTION
0.3 % .............................................................................. 87
GEODON
INTRAMUSCULAR*
SOLUTION
RECONSTITUTED 20 MG
................................................................................................ 39
Gerivite Complete ORAL
TABLET .............................................................. 82
GIANVI ORAL TABLET 3-0.02
MG .................................................................................. 52
GILOTRIF ORAL TABLET 20
MG, 30 MG, 40 MG ............................. 37
GLEEVEC ORAL TABLET 100
MG, 400 MG .................................................... 37
Glimepiride ORAL TABLET 1
MG, 2 MG, 4 MG ....................................... 27
GlipiZIDE ER ORAL TABLET
EXTENDED RELEASE 24 HR*
10 MG, 2.5 MG, 5 MG ........................ 27
GlipiZIDE ORAL TABLET 10
MG, 5 MG ............................................................. 27
GLIPIZIDE XL ORAL
TABLET EXTENDED
RELEASE 24 HR* 10 MG, 2.5
MG, 5 MG ........................................................... 27
GlipiZIDE-MetFORMIN HCl
ORAL TABLET 2.5-250 MG,
2.5-500 MG, 5-500 MG ....................... 24
GLUCAGEN HYPOKIT
INJECTION SOLUTION
RECONSTITUTED 1 MG
................................................................................................ 25
GLUCAGEN INJECTION
SOLUTION
RECONSTITUTED 1 MG
25
GLUCAGON EMERGENCY
INJECTION KIT 1 MG ................. 25
Glucose Control IN VITRO
SOLUTION .................................................... 75
Glucose ORAL TABLET
CHEWABLE 4 GM ................................ 25
GlyBURIDE Micronized ORAL
TABLET 1.5 MG, 3 MG, 6 MG
................................................................................................ 27
GlyBURIDE ORAL TABLET
1.25 MG, 2.5 MG, 5 MG .................. 27
GlyBURIDE-MetFORMIN
ORAL TABLET 1.25-250 MG,
2.5-500 MG, 5-500 MG ....................... 24
Glycopyrrolate ORAL TABLET
1 MG, 2 MG ....................................................... 96
Golden Age Vitamin/Minerals
ORAL LIQUID† ..................................... 82
GOLYTELY ORAL
SOLUTION
................................................................................................ 72
Griseofulvin Microsize ORAL
................................................................................................ 28
Griseofulvin Microsize ORAL
TABLET 500 MG ...................................... 28
Griseofulvin Ultramicrosize
ORAL TABLET 125 MG, 250
MG ................................................................................... 28
GuanFACINE HCl ORAL
TABLET 1 MG, 2 MG ........................ 32
HALDOL DECANOATE
INTRAMUSCULAR*
SOLUTION 50 MG/ML ................. 40
Halobetasol Propionate
................................................................................................ 61
Halobetasol Propionate
% ......................................................................................... 61
Haloperidol Decanoate
INTRAMUSCULAR*
MG/ML ..................................................................... 40
Haloperidol Lactate INJECTION
SOLUTION 5 MG/ML ..................... 40
Haloperidol Lactate ORAL
CONCENTRATE 2 MG/ML
................................................................................................ 40
................................................................................................
Haloperidol ORAL TABLET 0.5
MG, 1 MG, 10 MG, 2 MG, 20
MG, 5 MG ............................................................. 40
HECORIA ORAL CAPSULE
0.5 MG, 1 MG, 5 MG ......................... 47
HEXALEN ORAL CAPSULE
50 MG ......................................................................... 34
HUMALOG KWIKPEN
SUBCUTANEOUS*
................................................................................................ 26
HUMALOG MIX 50/50
KWIKPEN
SUBCUTANEOUS*
SUSPENSION (50-50) 100
UNIT/ML ............................................................. 26
HUMALOG MIX 50/50
SUBCUTANEOUS*
UNIT/ML ............................................................. 26
HUMALOG MIX 75/25
KWIKPEN
SUBCUTANEOUS*
UNIT/ML ............................................................. 26
HUMALOG MIX 75/25
SUBCUTANEOUS*
UNIT/ML ............................................................. 26
HUMALOG
SUBCUTANEOUS*
................................................................................................ 26
HUMIRA PEN
MG/0.8ML .............................................................. 3
HUMIRA PEN-CROHNS
STARTER SUBCUTANEOUS*
KIT 40 MG/0.8ML ..................................... 3
HUMIRA SUBCUTANEOUS*
KIT 20 MG/0.4ML, 40
MG/0.8ML .............................................................. 3
HUMULIN 70/30 PEN
SUBCUTANEOUS*
UNIT/ML ............................................................. 26
HUMULIN 70/30
SUBCUTANEOUS*
UNIT/ML ............................................................. 26
HUMULIN N PEN
SUBCUTANEOUS*
................................................................................................ 26
HUMULIN N
SUBCUTANEOUS*
................................................................................................
HUMULIN R INJECTION
................................................................................................
HUMULIN R U-500
(CONCENTRATED)
SUBCUTANEOUS*
26
26
26
HydrALAZINE HCl
MG/ML ..................................................................... 33
HydrALAZINE HCl ORAL
MG, 50 MG ......................................................... 33
Hydrochlorothiazide ORAL
CAPSULE 12.5 MG ............................... 65
Hydrochlorothiazide ORAL
TABLET 12.5 MG, 25 MG, 50
MG ................................................................................... 65
Hydrocodone-Acetaminophen
ORAL SOLUTION 7.5-325
MG/15ML, 7.5-500 MG/15ML
.................................................................................................... 8
Hydrocodone-Acetaminophen
10-500 MG, 10-650 MG, 10-660
MG, 10-750 MG, 2.5-500 MG,
5-325 MG, 5-500 MG, 7.5-325
MG, 7.5-500 MG, 7.5-650 MG,
7.5-750 MG .............................................................. 8
Hydrocodone-Ibuprofen ORAL
TABLET 7.5-200 MG .............................. 8
Hydrocortisone EXTERNAL
CREAM 0.5 %, 1 % ................................. 61
LOTION 1 % .................................................... 61
LOTION 2.5 % ............................................... 61
OINTMENT 0.5 %, 1 % ................... 61
OINTMENT 2.5 % .................................. 61
Hydrocortisone ORAL TABLET
10 MG, 20 MG, 5 MG .......................... 55
Hydrocortisone RE ENEMA 100
MG/60ML ................................................................. 9
Hydrocortisone Valerate
................................................................................................ 61
................................................................................................
Hydrocortisone Valerate
................................................................................................ 61
HYDROGESIC ORAL
CAPSULE 5-500 MG ............................. 8
HYDROmorphone HCl ORAL
LIQUID† 1 MG/ML ................................. 7
HYDROmorphone HCl ORAL
.................................................................................................... 7
HYDROmorphone HCl RE
SUPPOSITORY 3 MG ......................... 7
Hydroxychloroquine Sulfate
ORAL TABLET 200 MG ............... 34
Hydroxyurea ORAL CAPSULE
500 MG ...................................................................... 37
HydrOXYzine HCl ORAL
SOLUTION 10 MG/5ML .............. 11
SYRUP 10 MG/5ML ............................ 11
................................................................................................ 11
HydrOXYzine Pamoate ORAL
MG ................................................................................... 11
HYPERCARE EXTERNAL
SOLUTION 20 % ...................................... 63
HYPOTEARS OPHTHALMIC
SOLUTION 1-1 % .................................... 86
Ibuprofen Junior Strength ORAL
.................................................................................................... 4
Ibuprofen ORAL SUSPENSION
100 MG/5ML ........................................................ 4
Ibuprofen ORAL TABLET 200
MG ....................................................................................... 4
Ibuprofen ORAL TABLET 400
MG, 600 MG, 800 MG ............................ 4
ICLUSIG ORAL TABLET 15
MG, 45 MG ........................................................ 37
Imipramine HCl ORAL TABLET
10 MG, 25 MG, 50 MG ...................... 24
Imipramine Pamoate ORAL
CAPSULE 100 MG, 125 MG,
150 MG, 75 MG ............................................ 24
IN-CHECK DIAL FLOW
TRAINER XX DEVICE ............... 75
INCIVEK ORAL TABLET 375
MG .................................................................................. 45
Indapamide ORAL TABLET 1.25
MG, 2.5 MG ....................................................... 65
Indomethacin ORAL CAPSULE
25 MG, 50 MG .................................................... 4
115
Infants Silapap ORAL
SOLUTION 100 MG/ML .................. 5
INFERGEN
SUBCUTANEOUS*
INJECTABLE 15 MCG/0.5ML,
9 MCG/0.3ML ................................................ 45
Insulin Syringe XX MISC 29G X
1/2" 0.3 ML, 30G X 5/16" 0.3 ML
................................................................................................ 75
INTELENCE ORAL TABLET
100 MG, 200 MG, 25 MG ............. 44
INTRON-A INJECTION
SOLUTION 10000000
UNIT/ML, 6000000 UNIT/ML
................................................................................................ 37
INTRON-A INJECTION
SOLUTION
RECONSTITUTED 10000000
UNIT, 18000000 UNIT,
50000000 UNIT ............................................ 38
INTUNIV ORAL TABLET
EXTENDED RELEASE 24
HR* 1 MG, 2 MG, 3 MG, 4 MG
.................................................................................................... 2
INVEGA ORAL TABLET
EXTENDED RELEASE 24
HR* 1.5 MG, 3 MG, 6 MG, 9
MG .................................................................................. 40
INVEGA SUSTENNA
INTRAMUSCULAR*
SUSPENSION 117 MG/0.75ML,
156 MG/ML, 234 MG/1.5ML, 39
MG/0.25ML, 78 MG/0.5ML
................................................................................................ 40
INVIRASE ORAL CAPSULE
200 MG ..................................................................... 43
INVIRASE ORAL TABLET
500 MG ..................................................................... 43
Ipratropium Bromide
INHALATION SOLUTION 0.02
% ......................................................................................... 13
Ipratropium Bromide NASAL
SOLUTION 0.03 %, 0.06 %
................................................................................................ 85
Ipratropium-Albuterol
INHALATION SOLUTION
0.5-2.5 (3) MG/3ML ............................. 15
ISENTRESS ORAL TABLET
400 MG ..................................................................... 43
ISENTRESS ORAL TABLET
................................................................................................ 43
116
ISOPTO HYOSCINE
OPHTHALMIC SOLUTION
0.25 % ........................................................................... 87
Isosorbide Dinitrate ER ORAL
TABLET
................................................................................................ 10
Isosorbide Dinitrate ORAL
MG, 5 MG ............................................................. 10
Isosorbide Mononitrate ER
MG, 60 MG ......................................................... 11
Isosorbide Mononitrate ORAL
TABLET 10 MG, 20 MG ................ 11
JAKAFI ORAL TABLET 10
MG, 15 MG, 20 MG, 25 MG, 5
MG .................................................................................. 37
JANTOVEN ORAL TABLET 1
MG, 10 MG, 2 MG, 2.5 MG, 3
MG, 4 MG, 5 MG, 6 MG, 7.5
MG .................................................................................. 16
JANUMET ORAL TABLET
50-1000 MG, 50-500 MG ................ 24
JANUMET XR ORAL
TABLET EXTENDED
RELEASE 24 HR* 100-1000
MG, 50-1000 MG, 50-500 MG
................................................................................................ 24
JANUVIA ORAL TABLET 100
MG, 25 MG, 50 MG ............................. 25
JENTADUETO ORAL
TABLET 2.5-1000 MG, 2.5-500
MG, 2.5-850 MG ........................................ 24
JOLIVETTE ORAL TABLET
0.35 MG ................................................................... 54
JUNEL 1.5/30 ORAL TABLET
1.5-30 MG-MCG ........................................ 52
JUNEL 1/20 ORAL TABLET
1-20 MG-MCG .............................................. 52
JUNEL FE 1.5/30 ORAL
................................................................................................ 52
JUNEL FE 1/20 ORAL
TABLET 1-20 MG-MCG ............. 52
JUNIOR MAPAP ORAL
MG ...................................................................................... 6
KALETRA ORAL SOLUTION
400-100 MG/5ML ...................................... 43
KALETRA ORAL TABLET
100-25 MG, 200-50 MG ................... 43
KALYDECO ORAL TABLET
150 MG ..................................................................... 94
KAPVAY ORAL TABLET
EXTENDED RELEASE 12
HR* 0.1 MG ......................................................... 2
KARIGEL DENTAL GEL 1.1
% ......................................................................................... 80
KARIGEL-N DENTAL GEL
1.1 % .............................................................................. 80
KARIVA ORAL TABLET
0.15-0.02/0.01 MG (21/5) ................. 52
KELNOR 1/35 ORAL TABLET
1-35 MG-MCG .............................................. 52
Ketoconazole EXTERNAL
CREAM 2 % ...................................................... 59
Ketoconazole EXTERNAL
SHAMPOO 2 % ........................................... 59
Ketoconazole ORAL TABLET
200 MG ...................................................................... 29
Ketoprofen ORAL CAPSULE 50
MG, 75 MG ............................................................. 4
Ketorolac Tromethamine ORAL
TABLET 10 MG .............................................. 4
KETOSTIX IN VITRO STRIP
................................................................................................ 64
Ketotifen Fumarate
OPHTHALMIC SOLUTION
0.025 % ....................................................................... 89
KHEDEZLA ORAL TABLET
EXTENDED RELEASE 24
HR* 100 MG, 50 MG ......................... 23
KLOR-CON 10 ORAL
TABLET
EXTENDEDRELEASE* 10
MEQ .............................................................................. 79
KLOR-CON M10 ORAL
TABLET
EXTENDEDRELEASE* 10
MEQ .............................................................................. 79
KLOR-CON M20 ORAL
TABLET
EXTENDEDRELEASE* 20
MEQ .............................................................................. 79
KLOR-CON ORAL TABLET
EXTENDEDRELEASE* 8
MEQ .............................................................................. 79
K-PHOS-NEUTRAL ORAL
TABLET 155-852-130 MG .......... 78
Labetalol HCl INTRAVENOUS*
SOLUTION 5 MG/ML ..................... 48
Labetalol HCl ORAL TABLET
100 MG, 200 MG, 300 MG ........... 48
Lactulose ORAL SOLUTION 10
GM/15ML ............................................................. 72
LAMICTAL ODT ORAL KIT
25 & 50 & 100 MG .................................... 18
LAMICTAL ODT ORAL
MG, 200 MG .................................................... 18
LAMICTAL ODT ORAL
MG, 50 MG ........................................................ 18
LAMICTAL STARTER ORAL
KIT 25 (35) MG, 25 (42)-100 (7)
MG, 25 (84)-100(14) MG ................ 18
LAMICTAL XR ORAL KIT 25
(21)-50 (7) MG ................................................ 18
LamiVUDine ORAL TABLET
150 MG, 300 MG ......................................... 44
Lamivudine-Zidovudine ORAL
TABLET 150-300 MG ......................... 43
LamoTRIgine ER ORAL
TABLET EXTENDED
MG, 250 MG, 300 MG ........................ 18
LamoTRIgine ER ORAL
TABLET EXTENDED
MG ................................................................................... 18
LamoTRIgine ORAL TABLET
100 MG, 150 MG, 200 MG ........... 18
25 MG .......................................................................... 18
................................................................................................ 18
Lancet Device XX MISC .............. 75
Lancets XX MISC .................................. 75
Lansoprazole ORAL CAPSULE
................................................................................................ 97
Lansoprazole ORAL CAPSULE
................................................................................................ 97
LANTUS SOLOSTAR
SUBCUTANEOUS*
................................................................................................ 27
LANTUS SUBCUTANEOUS*
................................................................................................ 26
Latanoprost OPHTHALMIC
SOLUTION 0.005 % ............................. 89
LATUDA ORAL TABLET 120
MG, 20 MG, 40 MG, 60 MG, 80
MG .................................................................................. 39
LAVOCLEN-4 CREAMY
WASH EXTERNAL LIQUID†
4 % .................................................................................... 57
LAVOCLEN-8 CREAMY
WASH EXTERNAL LIQUID†
8 % .................................................................................... 58
Laxative RE SUPPOSITORY 10
MG ................................................................................... 73
Leflunomide ORAL TABLET 10
MG, 20 MG ............................................................. 5
LESSINA ORAL TABLET
0.1-20 MG-MCG ........................................ 52
LETAIRIS ORAL TABLET 10
MG, 5 MG ........................................................... 50
Letrozole ORAL TABLET 2.5
MG ................................................................................... 36
Leucovorin Calcium INJECTION
SOLUTION
200 MG, 350 MG ......................................... 38
Leucovorin Calcium
10 MG/ML ........................................................... 38
Leucovorin Calcium ORAL
MG, 5 MG ............................................................. 38
LEUKERAN ORAL TABLET 2
MG .................................................................................. 35
LevETIRAcetam ER ORAL
TABLET EXTENDED
MG ................................................................................... 18
Levetiracetam in NaCl
1000 MG/100ML, 1500
MG/100ML, 500 MG/100ML
................................................................................................ 18
LevETIRAcetam
500 MG/5ML .................................................... 18
LevETIRAcetam ORAL
SOLUTION 100 MG/ML .............. 18
LevETIRAcetam ORAL
TABLET 1000 MG, 500 MG, 750
MG ................................................................................... 18
LevETIRAcetam ORAL
TABLET 250 MG ...................................... 18
Levobunolol HCl
OPHTHALMIC SOLUTION
0.25 %, 0.5 % ..................................................... 86
LevOCARNitine
200 MG/ML ........................................................ 66
LevOCARNitine ORAL
SOLUTION 1 GM/10ML .............. 66
LevOCARNitine ORAL
TABLET 330 MG ...................................... 66
Levofloxacin ORAL TABLET
250 MG, 500 MG, 750 MG ........... 67
Levonorgestrel ORAL TABLET
0.75 MG .................................................................... 54
LEVORA 0.15/30 (28) ORAL
................................................................................................ 52
Levothyroxine Sodium
RECONSTITUTED 100 MCG,
500 MCG ................................................................. 95
Levothyroxine Sodium ORAL
TABLET 100 MCG, 112 MCG,
125 MCG, 137 MCG, 150 MCG,
175 MCG, 200 MCG, 25 MCG,
300 MCG, 50 MCG, 75 MCG, 88
MCG .............................................................................. 95
LEXIVA ORAL SUSPENSION
50 MG/ML ........................................................... 43
LEXIVA ORAL TABLET 700
MG .................................................................................. 43
Lidocaine EXTERNAL
OINTMENT 5 % ........................................ 62
Lidocaine HCl (Cardiac)
20 MG/ML ........................................................... 12
Lidocaine HCl (PF)
INJECTION SOLUTION 2 %
................................................................................................ 73
Lidocaine HCl EXTERNAL GEL
2 % .................................................................................... 62
Lidocaine HCl EXTERNAL
SOLUTION 4 % .......................................... 62
Lidocaine HCl INJECTION
SOLUTION 0.5 %, 1 %, 1.5 %
................................................................................................ 73
Lidocaine Viscous
MOUTH/THROAT SOLUTION
2 % .................................................................................... 80
Lidocaine-Prilocaine
EXTERNAL CREAM 2.5-2.5 %
................................................................................................ 63
Lidocaine-Prilocaine
EXTERNAL KIT 2.5-2.5 %
................................................................................................ 63
Liothyronine Sodium ORAL
TABLET 25 MCG, 5 MCG, 50
MCG .............................................................................. 95
117
Lisinopril ORAL TABLET 10
MG, 2.5 MG, 20 MG, 30 MG, 40
MG, 5 MG ............................................................. 31
Lisinopril-Hydrochlorothiazide
20-12.5 MG, 20-25 MG ....................... 32
Lithium Carbonate ER ORAL
TABLET
EXTENDEDRELEASE* 300
MG, 450 MG ...................................................... 39
Lithium Carbonate ORAL
600 MG ...................................................................... 39
Lithium Carbonate ORAL
TABLET 300 MG ...................................... 39
Lithium Citrate ORAL
SOLUTION 8 MEQ/5ML ............ 39
Lomustine ORAL CAPSULE 10
MG, 100 MG, 40 MG ............................ 35
LONOX ORAL TABLET
2.5-0.025 MG .................................................... 27
Loperamide HCl ORAL
CAPSULE 2 MG ........................................ 27
Loperamide HCl ORAL
LIQUID† 1 MG/5ML ......................... 27
Loratadine ORAL TABLET 10
MG ................................................................................... 30
LORazepam INJECTION
SOLUTION 2 MG/ML, 4
MG/ML ..................................................................... 12
LORAZEPAM INTENSOL
ORAL CONCENTRATE 2
MG/ML .................................................................... 12
LORazepam ORAL TABLET 0.5
MG, 1 MG, 2 MG ....................................... 12
LORYNA ORAL TABLET
3-0.02 MG ............................................................. 52
Losartan Potassium ORAL
MG ................................................................................... 31
Losartan Potassium-HCTZ
100-25 MG, 50-12.5 MG ................... 32
LOTEMAX OPHTHALMIC
SUSPENSION 0.5 % ............................ 89
Lovastatin ORAL TABLET 10
MG, 20 MG, 40 MG ................................ 31
LOW-OGESTREL ORAL
................................................................................................ 52
Loxapine Succinate ORAL
MG, 50 MG ......................................................... 41
118
LUMIZYME
RECONSTITUTED 50 MG
................................................................................................ 66
LUTERA ORAL TABLET
0.1-20 MG-MCG ........................................ 52
LYSODREN ORAL TABLET
500 MG ..................................................................... 36
MACRODANTIN ORAL
CAPSULE 25 MG .................................... 97
MAG64 ORAL TABLET
(64 MG) MG ..................................................... 78
Mag-Delay ORAL TABLET
(64 Mg) MG ..................................................... 78
Magnesium Citrate ORAL
SOLUTION 1.745 GM/30ML
................................................................................................ 73
Magnesium ORAL TABLET 250
MG ................................................................................... 78
Magnesium Oxide ORAL
................................................................................................ 10
Magnesium Oxide ORAL
TABLET 400 (240 Mg) MG, 500
MG ................................................................................... 78
Mag-SR ORAL TABLET
(64 Mg) MG ..................................................... 78
MAKENA
INTRAMUSCULAR* OIL 250
MG/ML .................................................................... 92
Mapap Arthritis Pain ORAL
TABLET
MG ....................................................................................... 6
MAPAP CHILDRENS ORAL
.................................................................................................... 6
Mapap ORAL CAPSULE 500
MG ....................................................................................... 6
Mapap ORAL LIQUID† 160
MG/5ML ..................................................................... 6
Maprotiline HCl ORAL
................................................................................................ 21
MARPLAN ORAL TABLET 10
MG .................................................................................. 22
MATZIM LA ORAL TABLET
EXTENDED RELEASE 24
HR* 180 MG, 240 MG, 300 MG,
360 MG, 420 MG ....................................... 50
MAXIDEX OPHTHALMIC
SUSPENSION 0.1 % ............................ 89
Meclizine HCl ORAL TABLET
12.5 MG, 25 MG .......................................... 28
Meclizine HCl ORAL TABLET
CHEWABLE 25 MG ............................ 28
MedroxyPROGESTERone
Acetate INTRAMUSCULAR*
................................................................................................ 54
MedroxyPROGESTERone
Acetate ORAL TABLET 10 MG,
2.5 MG, 5 MG .................................................. 92
Mefloquine HCl ORAL TABLET
250 MG ...................................................................... 34
Megestrol Acetate ORAL
SUSPENSION 40 MG/ML
................................................................................................ 36
Megestrol Acetate ORAL
TABLET 20 MG, 40 MG ................ 36
Melatonin Maximum Strength
ORAL TABLET 5 MG .......................... 3
Meloxicam ORAL TABLET 15
MG, 7.5 MG ........................................................... 4
MEPHYTON ORAL TABLET
5 MG ............................................................................. 99
Meprobamate ORAL TABLET
200 MG, 400 MG ......................................... 11
MEPRON ORAL
................................................................................................ 33
Mercaptopurine ORAL TABLET
50 MG .......................................................................... 35
Mesalamine RE ENEMA 4 GM
................................................................................................ 68
MESTINON ORAL SYRUP 60
MG/5ML ................................................................ 34
MESTINON ORAL TABLET
MG .................................................................................. 34
METADATE ER ORAL
TABLET
EXTENDEDRELEASE* 20
MG ...................................................................................... 2
METAMUCIL ORAL
CAPSULE 0.52 GM .............................. 72
METAMUCIL ORAL WAFER
................................................................................................ 72
METAMUCIL SMOOTH
TEXTURE ORAL POWDER
28.3 %, 58.6 % .................................................. 72
Metaproterenol Sulfate ORAL
SYRUP 10 MG/5ML ............................ 15
MetFORMIN HCl ER (OSM)
................................................................................................ 25
MetFORMIN HCl ER ORAL
TABLET EXTENDED
MG ................................................................................... 25
MetFORMIN HCl ORAL
TABLET 1000 MG, 500 MG, 850
MG ................................................................................... 25
Methadone HCl ORAL
MG/5ML ..................................................................... 7
Methadone HCl ORAL TABLET
10 MG, 5 MG ....................................................... 7
METHADOSE ORAL TABLET
10 MG ............................................................................. 7
Methamphetamine HCl ORAL
TABLET 5 MG ................................................. 1
Methazolamide ORAL TABLET
25 MG, 50 MG ................................................ 64
Methimazole ORAL TABLET 10
MG, 5 MG ............................................................. 95
Methitest ORAL TABLET 10
MG ....................................................................................... 9
Methocarbamol ORAL TABLET
500 MG, 750 MG ......................................... 85
Methotrexate ORAL TABLET
2.5 MG ........................................................................ 35
Methotrexate Sodium (PF)
MG/ML ..................................................................... 35
Methotrexate Sodium
MG/ML ..................................................................... 35
Methotrexate Sodium
INJECTION SOLUTION
RECONSTITUTED 1 GM .......... 35
Methyldopa ORAL TABLET 250
MG, 500 MG ...................................................... 32
Methylergonovine Maleate
MG/ML ..................................................................... 90
Methylergonovine Maleate ORAL
TABLET 0.2 MG ........................................ 90
METHYLIN ORAL TABLET
CHEWABLE 10 MG, 2.5 MG, 5
MG ...................................................................................... 2
Methylphenidate HCl ER (CD)
RELEASE* 10 MG, 20 MG, 30
MG, 40 MG, 50 MG, 60 MG
.................................................................................................... 3
Methylphenidate HCl ER (LA)
MG, 40 MG ............................................................. 3
Methylphenidate HCl ER ORAL
TABLET
EXTENDEDRELEASE* 10
MG, 18 MG, 20 MG, 27 MG, 36
MG, 54 MG ............................................................. 3
Methylphenidate HCl ORAL
MG/5ML ..................................................................... 2
Methylphenidate HCl ORAL
.................................................................................................... 2
MethylPREDNISolone (Pak)
ORAL TABLET 4 MG ....................... 55
MethylPREDNISolone Acetate
INJECTION SUSPENSION 40
MG/ML, 80 MG/ML ............................. 55
MethylPREDNISolone ORAL
................................................................................................ 55
MethylPREDNISolone Sodium
Succ INJECTION SOLUTION
MG, 125 MG, 40 MG ............................ 55
Metipranolol OPHTHALMIC
SOLUTION 0.3 % .................................... 86
Metoclopramide HCl ORAL
SOLUTION 5 MG/5ML .................. 68
Metoclopramide HCl ORAL
TABLET 10 MG, 5 MG .................... 68
Metolazone ORAL TABLET 10
MG, 2.5 MG, 5 MG ................................. 65
Metoprolol Succinate ER ORAL
TABLET EXTENDED
MG, 25 MG, 50 MG ................................ 48
Metoprolol Tartrate
1 MG/ML ............................................................... 48
Metoprolol Tartrate ORAL
MG ................................................................................... 48
MetroNIDAZOLE EXTERNAL
CREAM 0.75 % ............................................. 63
MetroNIDAZOLE EXTERNAL
GEL 1 % ................................................................... 63
MetroNIDAZOLE ORAL
................................................................................................ 33
MetroNIDAZOLE VAGINAL
GEL 0.75 % .......................................................... 98
Mexiletine HCl ORAL
250 MG ...................................................................... 12
Miconazole 3 Combo Pack
VAGINAL KIT 200-2 MG-%
(9GM) ........................................................................ 98
Miconazole 3 VAGINAL
SUPPOSITORY 200 MG .............. 98
CREAM 2 % ...................................................... 98
SUPPOSITORY 100 MG .............. 98
MICROCHAMBER XX MISC
................................................................................................ 76
MICROGESTIN 1.5/30 ORAL
................................................................................................ 52
MICROGESTIN 1/20 ORAL
TABLET 1-20 MG-MCG ............. 52
MICROGESTIN FE 1.5/30
ORAL TABLET 1.5-30
MG-MCG ............................................................. 52
MICROGESTIN FE 1/20
ORAL TABLET 1-20 MG-MCG
................................................................................................ 53
MICROSPACER XX MISC
................................................................................................ 76
Midodrine HCl ORAL TABLET
10 MG, 2.5 MG, 5 MG ........................ 99
Milk of Magnesia ORAL
SUSPENSION 400 MG/5ML,
7.75 % ........................................................................... 73
Mineral Oil Heavy ORAL OIL
................................................................................................ 72
Mineral Oil ORAL OIL ................. 72
Minocycline HCl ORAL
MG ................................................................................... 94
Minoxidil ORAL TABLET 10
MG, 2.5 MG ....................................................... 33
Mirtazapine ORAL TABLET 15
MG, 30 MG, 45 MG, 7.5 MG
................................................................................................ 21
Mirtazapine ORAL TABLET
DISPERSIBLE 15 MG, 30 MG,
45 MG .......................................................................... 21
Misoprostol ORAL TABLET 100
MCG, 200 MCG ........................................... 97
Mometasone Furoate
................................................................................................ 61
Mometasone Furoate
................................................................................................ 61
119
MONISTAT 1 COMBO PACK
VAGINAL KIT 1200-2 MG-%
................................................................................................ 98
MONISTAT 3 VAGINAL
CREAM 4 % ..................................................... 98
MONONESSA ORAL TABLET
0.25-35 MG-MCG .................................... 53
Montelukast Sodium ORAL
PACKET 4 MG ............................................. 13
TABLET 10 MG .......................................... 13
TABLET CHEWABLE 4 MG, 5
MG ................................................................................... 13
Morphine Sulfate (Concentrate)
ORAL SOLUTION 20 MG/ML
.................................................................................................... 7
Morphine Sulfate (PF)
MG/ML ........................................................................ 7
Morphine Sulfate (PF)
8 MG/ML ................................................................... 7
Morphine Sulfate ER ORAL
TABLET
MG, 15 MG, 200 MG, 30 MG, 60
MG ....................................................................................... 7
Morphine Sulfate INJECTION
MG/ML, 5 MG/ML, 8 MG/ML
.................................................................................................... 7
Morphine Sulfate
1 MG/ML, 25 MG/ML, 50
MG/ML ........................................................................ 7
Morphine Sulfate ORAL
MG/5ML ..................................................................... 7
Morphine Sulfate ORAL
TABLET 15 MG, 30 MG .................... 7
Morphine Sulfate RE
SUPPOSITORY 10 MG, 20 MG,
30 MG, 5 MG ....................................................... 7
Mucus Relief ORAL TABLET
400 MG ...................................................................... 56
MULTIGEN ORAL TABLET
70 MG ......................................................................... 70
Multi-Vit/Fluoride ORAL
SOLUTION 0.25 MG/ML, 0.5
MG/ML ..................................................................... 83
Multi-Vit/Fluoride/Iron ORAL
SOLUTION 0.25-10 MG/ML
................................................................................................ 82
120
Multivitamin & Mineral ORAL
LIQUID† ............................................................ 82
Multi-Vitamin ORAL TABLET
................................................................................................ 82
Multivitamin/Fluoride ORAL
MG, 0.5 MG, 1 MG ................................. 83
Multi-Vitamin/Fluoride ORAL
MG, 0.5 MG, 1 MG ................................. 83
Multi-Vitamins ORAL TABLET
................................................................................................ 82
Mupirocin EXTERNAL
OINTMENT 2 % ........................................ 58
Mycophenolate Mofetil ORAL
CAPSULE 250 MG ................................. 47
Mycophenolate Mofetil ORAL
TABLET 500 MG ...................................... 47
MYFORTIC ORAL TABLET
360 MG ..................................................................... 47
MYLERAN ORAL TABLET 2
MG .................................................................................. 34
MYNATAL ADVANCE ORAL
TABLET ................................................................. 83
Mynatal-Z ORAL TABLET
................................................................................................ 83
Mynate 90 Plus ORAL TABLET
EXTENDEDRELEASE* ........... 83
Nabumetone ORAL TABLET
500 MG, 750 MG ............................................ 4
Nadolol ORAL TABLET 20 MG,
40 MG, 80 MG ................................................ 48
NAFRINSE DROPS ORAL
SOLUTION 0.275 (0.125 F)
MG/DROP .......................................................... 78
Naltrexone HCl ORAL TABLET
50 MG .......................................................................... 28
NAMENDA ORAL
SOLUTION 10 MG/5ML ............. 92
NAMENDA ORAL TABLET
10 MG, 5 MG .................................................. 92
NAMENDA TITRATION PAK
ORAL TABLET 5 (28)-10 (21)
MG .................................................................................. 92
Naproxen DR ORAL TABLET
.................................................................................................... 4
Naproxen ORAL SUSPENSION
125 MG/5ML ........................................................ 4
Naproxen ORAL TABLET 250
MG, 375 MG, 500 MG ............................ 4
Naproxen Sodium ORAL
....................................................................................................
5
Naratriptan HCl ORAL
TABLET 1 MG, 2.5 MG .................. 77
Nasal Decongestant ORAL
LIQUID† 30 MG/5ML ...................... 86
Natural Fiber Therapy ORAL
POWDER 30.9 %, 48.57 % .......... 72
NATURE-THROID ORAL
TABLET 113.75 MG, 130 MG,
146.25 MG, 16.25 MG, 162.5
MG, 195 MG, 260 MG, 32.5
MG, 325 MG, 48.75 MG, 65
MG, 81.25 MG, 97.5 MG .............. 95
NECON 0.5/35 (28) ORAL
................................................................................................ 53
NECON 1/35 (28) ORAL
TABLET 1-35 MG-MCG ............. 53
NECON 1/50 (28) ORAL
TABLET 1-50 MG-MCG ............. 53
NECON 7/7/7 ORAL TABLET
0.5/0.75/1-35 MG-MCG ................... 54
Nefazodone HCl ORAL
TABLET 100 MG, 150 MG, 200
MG, 250 MG, 50 MG ............................ 21
Neomycin Sulfate ORAL
TABLET 500 MG .......................................... 3
Neomycin-Bacitracin Zn-Polymyx
OPHTHALMIC OINTMENT
5-400-10000 ........................................................ 87
OPHTHALMIC OINTMENT
3.5-10000-0.1 .................................................... 88
3.5-10000-0.1 .................................................... 88
Neomycin-Polymyxin-Gramicidin
OPHTHALMIC SOLUTION
1.75-10000-0.25 ............................................ 88
Neomycin-Polymyxin-HC
3.5-10000-1 ......................................................... 88
SOLUTION 3.5-10000-1 ................ 90
................................................................................................ 90
NEPHRONEX ORAL TABLET
................................................................................................ 81
NEUPOGEN INJECTION
SOLUTION 300 MCG/0.5ML,
300 MCG/ML, 480
................................................................................................ 70
NEUTRAGARD ADVANCED
DENTAL GEL 1.1 % .......................... 80
Nevirapine ORAL
................................................................................................ 44
Nevirapine ORAL TABLET 200
MG ................................................................................... 44
Niacin ER ORAL CAPSULE
EXTENDED RELEASE* 500
MG ............................................................................... 100
Niacin ER ORAL TABLET
MG ............................................................................... 100
Niacin ORAL TABLET 100 MG,
250 MG, 50 MG, 500 MG ........... 100
NIACOR ORAL TABLET 500
MG .................................................................................. 31
NIACOR ORAL TABLET 500
MG .............................................................................. 100
Nicotine Polacrilex
MOUTH/THROAT GUM 2 MG,
4 MG ............................................................................. 94
Nicotine Polacrilex
MOUTH/THROAT LOZENGE
2 MG, 4 MG ....................................................... 94
Nicotine TRANSDERMAL
PATCH 24 HR 14 MG/24HR, 21
MG/24HR, 7 MG/24HR ................... 94
NICOTROL INHALATION
INHALER 10 MG ................................... 94
NICOTROL NS NASAL
SOLUTION 10 MG/ML ................. 94
NIFEDIAC CC ORAL
TABLET EXTENDED
MG, 90 MG ........................................................ 50
NIFEDICAL XL ORAL
TABLET EXTENDED
MG .................................................................................. 50
NIFEdipine ER Osmotic ORAL
TABLET EXTENDED
MG, 90 MG ......................................................... 50
NIFEdipine ORAL CAPSULE 10
MG ................................................................................... 50
NITRO-BID TRANSDERMAL
OINTMENT 2 % ....................................... 11
Nitrofurantoin Macrocrystal
ORAL CAPSULE 100 MG, 50
MG ................................................................................... 97
Nitrofurantoin Monohyd Macro
ORAL CAPSULE 100 MG
................................................................................................ 97
Nitroglycerin TRANSDERMAL
PATCH 24 HR 0.1 MG/HR, 0.2
MG/HR, 0.4 MG/HR, 0.6
MG/HR ..................................................................... 11
NITROSTAT SUBLINGUAL
TABLET SUBLINGUAL 0.3
MG, 0.4 MG, 0.6 MG ......................... 11
NORA-BE ORAL TABLET
0.35 MG ................................................................... 55
Norethindrone Acetate ORAL
TABLET 5 MG .............................................. 92
Normal Saline Flush
0.9 % .............................................................................. 79
NOR-QD ORAL TABLET 0.35
MG .................................................................................. 54
Nortemp Infants ORAL
SUSPENSION 80 MG/0.8ML
.................................................................................................... 6
NORTREL 0.5/35 (28) ORAL
................................................................................................ 53
NORTREL 1/35 (21) ORAL
TABLET 1-35 MG-MCG ............. 53
NORTREL 1/35 (28) ORAL
TABLET 1-35 MG-MCG ............. 53
NORTREL 7/7/7 ORAL
TABLET 0.5/0.75/1-35
MG-MCG ............................................................. 54
Nortriptyline HCl ORAL
MG, 75 MG ......................................................... 24
Nortriptyline HCl ORAL
SOLUTION 10 MG/5ML .............. 24
NORVIR ORAL CAPSULE 100
MG .................................................................................. 43
NORVIR ORAL SOLUTION
80 MG/ML ........................................................... 43
NORVIR ORAL TABLET 100
MG .................................................................................. 43
NOVOPEN 3 XX MISC ................. 75
NP Thyroid ORAL TABLET 30
MG, 60 MG, 90 MG ................................ 95
NULOJIX INTRAVENOUS*
SOLUTION
................................................................................................ 48
NUVARING VAGINAL RING
0.12-0.015 MG/24HR ........................... 54
Nystatin EXTERNAL CREAM
100000 UNIT/GM ...................................... 58
Nystatin EXTERNAL
................................................................................................ 58
Nystatin EXTERNAL POWDER
100000 UNIT/GM ...................................... 58
Nystatin MOUTH/THROAT
SUSPENSION 100000
UNIT/ML .............................................................. 80
Nystatin ORAL TABLET 500000
UNIT ............................................................................ 28
OCELLA ORAL TABLET
3-0.03 MG ............................................................. 53
Ofloxacin OPHTHALMIC
SOLUTION 0.3 % .................................... 87
Ofloxacin OTIC SOLUTION 0.3
% ......................................................................................... 90
OGESTREL ORAL TABLET
0.5-50 MG-MCG ........................................ 53
OLANZapine
INTRAMUSCULAR*
SOLUTION
RECONSTITUTED 10 MG
................................................................................................ 41
10 MG, 15 MG, 2.5 MG, 20 MG,
5 MG, 7.5 MG .................................................. 41
DISPERSIBLE 10 MG, 15 MG,
20 MG, 5 MG .................................................... 41
OLANZapine-FLUoxetine HCl
ORAL CAPSULE 12-25 MG,
12-50 MG, 3-25 MG, 6-25 MG,
6-50 MG .................................................................... 93
OLEPTRO ORAL TABLET
EXTENDED RELEASE 24
HR* 150 MG, 300 MG ...................... 21
Omeprazole ORAL CAPSULE
20 MG, 40 MG ................................................ 97
Once Daily ORAL TABLET
................................................................................................ 82
Ondansetron HCl ORAL
SOLUTION 4 MG/5ML .................. 28
Ondansetron HCl ORAL
TABLET 4 MG, 8 MG ........................ 28
Ondansetron ORAL TABLET
................................................................................................ 28
ONFI ORAL SUSPENSION 2.5
MG/ML .................................................................... 17
121
ONFI ORAL TABLET 10 MG,
20 MG, 5 MG .................................................. 17
OPTICHAMBER
ADVANTAGE XX MISC ........... 76
OPTICHAMBER
ADVANTAGE-LG MASK XX
MISC ............................................................................ 76
OPTICHAMBER
ADVANTAGE-MED MASK
XX MISC ............................................................... 76
OPTICHAMBER
ADVANTAGE-SM MASK XX
MISC ............................................................................ 76
OPTICHAMBER FACE
MASK-LARGE XX MISC
................................................................................................ 76
OPTICHAMBER FACE
MASK-MEDIUM XX MISC
................................................................................................ 76
OPTICHAMBER FACE
MASK-SMALL XX MISC
................................................................................................ 76
OPTICS EYE WASH
OPHTHALMIC SOLUTION
0.9 % .............................................................................. 89
OPTIHALER XX DEVICE
................................................................................................ 76
OPTIHALER XX MISC ................ 76
ORALYTE FREEZER POPS
ORAL SOLUTION ............................... 78
ORALYTE ORAL SOLUTION
................................................................................................ 78
ORAP ORAL TABLET 1 MG, 2
MG .................................................................................. 93
Oticin OTIC LIQUID† 1-0.1 %
................................................................................................ 90
OVIDE EXTERNAL LOTION
0.5 % .............................................................................. 63
Oxacillin Sodium INJECTION
SOLUTION
GM, 2 GM ............................................................. 91
Oxandrolone ORAL TABLET 10
MG, 2.5 MG ........................................................... 9
Oxaprozin ORAL TABLET 600
MG ....................................................................................... 5
Oxazepam ORAL CAPSULE 10
MG, 15 MG, 30 MG ................................ 12
OXcarbazepine ORAL
................................................................................................ 18
OXcarbazepine ORAL TABLET
150 MG ...................................................................... 18
122
300 MG ...................................................................... 18
600 MG ...................................................................... 18
OXTELLAR XR ORAL
TABLET EXTENDED
MG, 600 MG .................................................... 19
Oxybutynin Chloride ER ORAL
TABLET EXTENDED
MG, 5 MG ............................................................. 98
Oxybutynin Chloride ORAL
SYRUP 5 MG/5ML ................................ 97
Oxybutynin Chloride ORAL
TABLET 5 MG .............................................. 98
OxyCODONE HCl ORAL
CAPSULE 5 MG ............................................ 7
OxyCODONE HCl ORAL
SOLUTION 5 MG/5ML ..................... 7
OxyCODONE HCl ORAL
MG, 5 MG ................................................................. 7
OxyCODONE HCl ORAL
TABLET 30 MG .............................................. 7
Oxycodone-Acetaminophen
ORAL CAPSULE 5-500 MG
.................................................................................................... 8
5-325 MG, 7.5-325 MG, 7.5-500
MG ....................................................................................... 8
.................................................................................................... 8
Oxycodone-Aspirin ORAL
TABLET 4.8355-325 MG ................... 8
Oyst-Cal D ORAL TABLET
250-125 MG-UNIT ................................... 77
Oyster Shell Calcium + D ORAL
................................................................................................ 77
Oyster Shell Calcium/D ORAL
TABLET 250-125 MG-UNIT,
500-200 MG-UNIT ................................... 77
PACERONE ORAL TABLET
200 MG, 400 MG ....................................... 13
Pain & Fever Childrens ORAL
SOLUTION 160 MG/5ML .............. 6
Pantoprazole Sodium ORAL
20 MG, 40 MG ................................................ 97
PARoxetine HCl ER ORAL
TABLET EXTENDED
MG, 37.5 MG .................................................... 22
PARoxetine HCl ORAL
MG, 40 MG ......................................................... 22
PAXIL ORAL SUSPENSION
10 MG/5ML ....................................................... 23
Peak Flow Meter XX DEVICE
................................................................................................ 75
PEG 3350/Electrolytes ORAL
SOLUTION
................................................................................................ 72
PEG 3350-KCl-Na Bicarb-NaCl
ORAL SOLUTION
................................................................................................ 72
PEG-3350/Electrolytes ORAL
SOLUTION
................................................................................................ 72
PEGANONE ORAL TABLET
250 MG ..................................................................... 20
PEGASYS PROCLICK
SUBCUTANEOUS*
180 MCG/0.5ML ........................................ 46
PEGASYS SUBCUTANEOUS*
KIT 180 MCG/0.5ML ......................... 45
PEGASYS SUBCUTANEOUS*
180 MCG/ML .................................................. 45
PEG-INTRON REDIPEN PAK
4 SUBCUTANEOUS* KIT 120
MCG/0.5ML, 150 MCG/0.5ML,
50 MCG/0.5ML, 80
MCG/0.5ML ..................................................... 45
PEG-INTRON REDIPEN
50 MCG/0.5ML, 80
MCG/0.5ML ..................................................... 45
PEG-INTRON
50 MCG/0.5ML, 80
MCG/0.5ML ..................................................... 45
Penicillin G Procaine
INTRAMUSCULAR*
SUSPENSION 600000
UNIT/ML .............................................................. 91
Penicillin V Potassium ORAL
SOLUTION
RECONSTITUTED 125
MG/5ML, 250 MG/5ML .................. 91
Penicillin V Potassium ORAL
................................................................................................ 91
Pentazocine-Naloxone HCl
ORAL TABLET 50-0.5 MG
.................................................................................................... 9
Pentoxifylline ER ORAL
TABLET
MG ................................................................................... 69
PERIOGARD
MOUTH/THROAT
SOLUTION 0.12 % ................................ 80
Permethrin EXTERNAL
CREAM 5 % ...................................................... 63
Permethrin EXTERNAL
LOTION 1 % .................................................... 63
Perphenazine ORAL TABLET 16
MG, 2 MG, 4 MG, 8 MG ................. 42
Perphenazine-Amitriptyline
ORAL TABLET 2-10 MG, 2-25
MG, 4-10 MG, 4-25 MG, 4-50
MG ................................................................................... 92
PERTZYE ORAL CAPSULE
DELAYED RELEASE
PARTICLES 16000 UNIT, 8000
UNIT ............................................................................ 64
PEXEVA ORAL TABLET 10
MG, 20 MG, 30 MG, 40 MG
................................................................................................ 23
PFIZERPEN-G INJECTION
SOLUTION
RECONSTITUTED 20000000
UNIT, 5000000 UNIT ........................ 91
PFLEX XX MISC .................................... 75
Phenazopyridine HCl ORAL
................................................................................................ 69
Phenelzine Sulfate ORAL
TABLET 15 MG .......................................... 22
PHENobarbital ORAL ELIXIR
20 MG/5ML ........................................................ 71
PHENobarbital ORAL TABLET
100 MG, 30 MG, 32.4 MG, 60
MG, 64.8 MG, 97.2 MG .................... 71
15 MG .......................................................................... 71
16.2 MG .................................................................... 71
PHENobarbital Sodium
MG/ML, 65 MG/ML ............................. 71
Phenytoin ORAL SUSPENSION
125 MG/5ML .................................................... 20
Phenytoin ORAL TABLET
CHEWABLE 50 MG ............................ 20
Phenytoin Sodium Extended
ORAL CAPSULE 100 MG, 200
MG, 300 MG ...................................................... 20
Phenytoin Sodium INJECTION
SOLUTION 50 MG/ML .................. 20
PHOS-FLUR DENTAL GEL
1.1 % .............................................................................. 80
Pilocarpine HCl ORAL TABLET
5 MG, 7.5 MG .................................................. 81
Pindolol ORAL TABLET 10
MG, 5 MG ............................................................. 48
Pink Bismuth ORAL TABLET
CHEWABLE 262 MG ........................ 27
Pioglitazone HCl ORAL
................................................................................................ 26
Pioglitazone HCl-Metformin HCl
15-850 MG ............................................................ 25
Piroxicam ORAL CAPSULE 10
MG, 20 MG ............................................................. 5
PLAN B ONE-STEP ORAL
TABLET 1.5 MG ....................................... 54
POCKET CHAMBER XX
DEVICE .................................................................. 76
POCKET SPACER XX
DEVICE .................................................................. 76
Podofilox EXTERNAL
SOLUTION 0.5 % .................................... 62
Polycin B OPHTHALMIC
OINTMENT 500-10000
UNIT/GM .............................................................. 88
Poly-Dex OPHTHALMIC
OINTMENT 3.5-10000-0.1
................................................................................................ 88
Polyethylene Glycol 3350 ORAL
POWDER .......................................................... 72
Poly-Iron 150 Forte ORAL
CAPSULE 150-25-1
MG-MCG-MG ............................................... 70
POLY-IRON 150 ORAL
CAPSULE 150 MG ................................ 71
Polymyxin B-Trimethoprim
OPHTHALMIC SOLUTION
10000-0.1 UNIT/ML-% ..................... 88
Poly-Vitamin ORAL
SOLUTION 35 MG/ML .................. 83
Poly-Vitamin/Iron ORAL
SOLUTION 10 MG/ML .................. 83
PORTIA-28 ORAL TABLET
0.15-30 MG-MCG .................................... 53
Potassium Chloride Crys ER
ORAL TABLET
EXTENDEDRELEASE* 10
MEQ, 20 MEQ ............................................... 79
Potassium Chloride ER ORAL
TABLET
EXTENDEDRELEASE* 10
MEQ, 8 MEQ .................................................. 79
Potassium Chloride
0.4 MEQ/ML, 10 MEQ/100ML,
2 MEQ/ML, 30 MEQ/100ML, 40
MEQ/100ML .................................................... 79
Potassium Chloride ORAL
LIQUID† 20 MEQ/15ML
(10%), 40 MEQ/15ML (20%)
................................................................................................ 79
Potassium Chloride ORAL
SOLUTION 20 MEQ/15ML
(10%) ........................................................................... 79
POTIGA ORAL TABLET 200
MG, 300 MG, 400 MG, 50 MG
................................................................................................ 19
Povidone-Iodine EXTERNAL
SOLUTION 10 % ...................................... 42
PR NATAL 400 EC ORAL
MISC 29-1-200 & 400 MG (DR)
................................................................................................ 84
Pramipexole Dihydrochloride
ORAL TABLET 0.125 MG, 0.25
MG, 0.5 MG, 0.75 MG, 1 MG,
1.5 MG ........................................................................ 39
Pravastatin Sodium ORAL
MG, 80 MG ......................................................... 31
Prazosin HCl ORAL CAPSULE
1 MG, 2 MG, 5 MG ................................. 32
PRECISION XTRA BLOOD
GLUCOSE IN VITRO STRIP
................................................................................................ 64
PRECISION XTRA KETONE
IN VITRO STRIP ..................................... 64
PRECISION XTRA XX
DEVICE .................................................................. 75
PRED-G OPHTHALMIC
SUSPENSION 0.3-1 % ...................... 88
PrednisoLONE Acetate
1 % .................................................................................... 89
123
PrednisoLONE ORAL
SOLUTION 15 MG/5ML .............. 55
PrednisoLONE Sodium
Phosphate ORAL SOLUTION 15
MG/5ML, 6.7 (5 Base) MG/5ML
................................................................................................ 55
PredniSONE ORAL SOLUTION
5 MG/5ML ........................................................... 55
PredniSONE ORAL TABLET 1
MG, 10 MG, 2.5 MG, 20 MG, 5
MG, 50 MG ......................................................... 55
PREMARIN INJECTION
SOLUTION
RECONSTITUTED 25 MG
................................................................................................ 67
PREMARIN ORAL TABLET
0.3 MG, 0.45 MG, 0.625 MG, 0.9
MG, 1.25 MG .................................................. 67
PREMARIN VAGINAL
CREAM 0.625 MG/GM ................. 98
PREMPHASE ORAL TABLET
0.625-5 MG ......................................................... 67
PREMPRO ORAL TABLET
0.3-1.5 MG, 0.45-1.5 MG,
0.625-2.5 MG, 0.625-5 MG
................................................................................................ 67
Prenatabs OBN ORAL TABLET
29-1 MG .................................................................... 83
PRENATABS RX ORAL
TABLET 29-1 MG ................................... 83
Prenatal 19 ORAL TABLET
CHEWABLE ................................................ 83
Prenatal Low Iron ORAL
TABLET 27-0.8 MG .............................. 83
Prenatal ORAL TABLET 28-0.8
MG ................................................................................... 83
Prenatal Plus Iron ORAL
TABLET 29-1 MG .................................... 84
Prenatal Plus ORAL TABLET
27-1 MG .................................................................... 83
PREPARATION H
EXTERNAL PAD 50 % ................. 63
PREVIFEM ORAL TABLET
0.25-35 MG-MCG .................................... 53
PREZISTA ORAL
................................................................................................ 44
PREZISTA ORAL TABLET
150 MG, 400 MG, 600 MG, 75
MG, 800 MG .................................................... 44
Primaquine Phosphate ORAL
TABLET 26.3 MG .................................... 34
Primidone ORAL TABLET 250
MG ................................................................................... 19
124
Primidone ORAL TABLET 50
MG ................................................................................... 19
PRISTIQ ORAL TABLET
EXTENDED RELEASE 24
HR* 100 MG, 50 MG ......................... 23
Probenecid ORAL TABLET 500
MG ................................................................................... 69
Procainamide HCl INJECTION
MG/ML ..................................................................... 12
PROCENTRA ORAL
SOLUTION 5 MG/5ML .................... 1
Prochlorperazine Maleate ORAL
TABLET 10 MG, 5 MG .................... 42
Prochlorperazine RE
SUPPOSITORY 25 MG .................. 42
PROCRIT INJECTION
SOLUTION 10000 UNIT/ML,
2000 UNIT/ML, 20000
UNIT/ML, 3000 UNIT/ML,
4000 UNIT/ML, 40000
UNIT/ML ............................................................. 70
PROCTOSOL HC RE CREAM
2.5 % .................................................................................. 9
PROCTOZONE-HC RE
CREAM 2.5 % ................................................... 9
PROGRAF INTRAVENOUS*
SOLUTION 5 MG/ML .................... 47
PROLIA SUBCUTANEOUS*
SOLUTION 60 MG/ML ................. 66
Promethazine HCl INJECTION
SOLUTION 25 MG/ML .................. 30
Promethazine HCl ORAL
SYRUP 6.25 MG/5ML ...................... 30
Promethazine HCl ORAL
TABLET 12.5 MG, 25 MG, 50
MG ................................................................................... 30
Promethazine HCl RE
SUPPOSITORY 25 MG .................. 30
PROMETHEGAN RE
SUPPOSITORY 25 MG, 50 MG
................................................................................................ 30
Propafenone HCl ORAL
TABLET 150 MG, 225 MG, 300
MG ................................................................................... 13
Propantheline Bromide ORAL
TABLET 15 MG .......................................... 96
Propranolol HCl ER ORAL
CAPSULE EXTENDED
160 MG, 60 MG, 80 MG ................... 49
Propranolol HCl
1 MG/ML ............................................................... 49
Propranolol HCl ORAL
MG, 60 MG, 80 MG ................................ 49
Propranolol-HCTZ ORAL
TABLET 40-25 MG, 80-25 MG
................................................................................................ 32
Propylthiouracil ORAL TABLET
50 MG .......................................................................... 95
PROSTIGMIN ORAL TABLET
15 MG ......................................................................... 34
Protriptyline HCl ORAL
TABLET 10 MG, 5 MG .................... 24
Pseudoephedrine HCl ORAL
TABLET 30 MG, 60 MG ................ 86
PULMICORT INHALATION
SUSPENSION 1 MG/2ML
................................................................................................ 14
PULMOZYME INHALATION
SOLUTION 1 MG/ML .................... 94
Pyridostigmine Bromide ORAL
TABLET 60 MG .......................................... 34
Pyridoxine HCl INJECTION
SOLUTION 100 MG/ML .......... 100
Q-TAPP ORAL ELIXIR 1-15
MG/5ML ................................................................ 56
QUASENSE ORAL TABLET
0.15-0.03 MG .................................................... 53
QUEtiapine Fumarate ORAL
MG, 300 MG, 400 MG, 50 MG
................................................................................................ 41
QUILLIVANT XR ORAL
SUSPENSION
RECONSTITUTED 25
MG/5ML .................................................................... 3
Quinapril HCl ORAL TABLET
10 MG, 20 MG, 40 MG, 5 MG
................................................................................................ 31
QuiNIDine Gluconate ER ORAL
TABLET
MG ................................................................................... 12
QuiNIDine Gluconate
MG/ML ..................................................................... 12
QuiNIDine Sulfate ORAL
TABLET 300 MG ...................................... 12
QVAR INHALATION
AEROSOL, SOLUTION 40
MCG/ACT ........................................................... 14
QVAR INHALATION
AEROSOL, SOLUTION 80
MCG/ACT ........................................................... 14
RA Saline Enema RE ENEMA
19-7 GM/118ML .......................................... 73
Ramipril ORAL CAPSULE 1.25
MG, 10 MG, 2.5 MG, 5 MG
................................................................................................ 31
Ranitidine Acid Reducer ORAL
TABLET 75 MG .......................................... 96
Ranitidine HCl INJECTION
SOLUTION 1000 MG/40ML,
150 MG/6ML, 50 MG/2ML
................................................................................................ 96
Ranitidine HCl ORAL
................................................................................................ 96
Ranitidine HCl ORAL SYRUP
15 MG/ML ........................................................... 96
Ranitidine HCl ORAL TABLET
150 MG ...................................................................... 96
Ranitidine HCl ORAL TABLET
300 MG ...................................................................... 96
RAPAMUNE ORAL
SOLUTION 1 MG/ML .................... 47
RAPAMUNE ORAL TABLET
0.5 MG, 1 MG, 2 MG ......................... 47
REBETOL ORAL SOLUTION
40 MG/ML ........................................................... 46
REBIF REBIDOSE
SUBCUTANEOUS*
MCG/0.5ML ..................................................... 93
REBIF REBIDOSE
TITRATION PACK
SUBCUTANEOUS*
SOLUTION 6X8.8 & 6X22
MCG ............................................................................. 93
REBIF SUBCUTANEOUS*
MCG/0.5ML ..................................................... 93
REBIF TITRATION PACK
SUBCUTANEOUS*
SOLUTION 6X8.8 & 6X22
MCG ............................................................................. 93
RECLIPSEN ORAL TABLET
0.15-30 MG-MCG .................................... 53
Reeses Pinworm Medicine ORAL
................................................................................................ 10
Refenesen 400 ORAL TABLET
400 MG ...................................................................... 56
Refenesen ORAL TABLET 200
MG ................................................................................... 56
RELENZA DISKHALER
INHALATION AEROSOL
POWDER, BREATH
ACTIVATED 5 MG/BLISTER
................................................................................................ 46
REMEVEN EXTERNAL
CREAM 50 % ................................................. 61
RENAL ORAL CAPSULE 1
MG .................................................................................. 81
Reno Caps ORAL CAPSULE 1
MG ................................................................................... 81
RENVELA ORAL PACKET 0.8
GM, 2.4 GM ...................................................... 68
RENVELA ORAL TABLET
800 MG ..................................................................... 68
RESCRIPTOR ORAL TABLET
100 MG, 200 MG ....................................... 44
RESTASIS OPHTHALMIC
EMULSION 0.05 % ............................... 88
REVLIMID ORAL CAPSULE
10 MG, 15 MG, 2.5 MG, 20 MG,
25 MG, 5 MG .................................................. 46
REYATAZ ORAL CAPSULE
150 MG, 200 MG, 300 MG
................................................................................................ 44
RIBASPHERE ORAL TABLET
200 MG ..................................................................... 46
Ribavirin ORAL TABLET 200
MG ................................................................................... 46
RIDAURA ORAL CAPSULE 3
MG ...................................................................................... 3
Rimantadine HCl ORAL
TABLET 100 MG ...................................... 46
RIOMET ORAL SOLUTION
500 MG/5ML ................................................... 25
RISPERDAL CONSTA
INTRAMUSCULAR*
SUSPENSION
RECONSTITUTED 12.5 MG,
25 MG, 37.5 MG, 50 MG .............. 40
RISPERIDONE M-TAB ORAL
TABLET DISPERSIBLE 0.5
MG, 1 MG, 2 MG, 3 MG, 4 MG
................................................................................................ 40
RisperiDONE ORAL
SOLUTION 1 MG/ML ..................... 40
0.25 MG, 0.5 MG, 1 MG, 2 MG,
3 MG, 4 MG ....................................................... 40
MG, 1 MG, 2 MG, 3 MG, 4 MG
................................................................................................ 40
RITALIN LA ORAL
CAPSULE EXTENDED
3
Rivastigmine Tartrate ORAL
CAPSULE 1.5 MG, 3 MG, 4.5
MG, 6 MG ............................................................. 92
Robafen ORAL SYRUP 100
MG/5ML ................................................................. 56
ROPINIRole HCl ORAL
TABLET 0.25 MG, 0.5 MG, 1
MG, 2 MG, 3 MG, 4 MG, 5 MG
................................................................................................ 39
ROXICET ORAL TABLET
5-325 MG ................................................................... 8
SABRIL ORAL PACKET 500
MG .................................................................................. 19
SABRIL ORAL TABLET 500
MG .................................................................................. 19
SALACTIC FILM EXTERNAL
SOLUTION 17 % ...................................... 62
Saline Flush INTRAVENOUS*
SOLUTION 0.9 % .................................... 79
Saline Nasal Spray NASAL
SOLUTION 0.65 % ................................. 85
Salsalate ORAL TABLET 500
MG, 750 MG ......................................................... 6
SANDIMMUNE ORAL
SOLUTION 100 MG/ML ............. 47
SANTYL EXTERNAL
................................................................................................ 62
SAPHRIS SUBLINGUAL
TABLET SUBLINGUAL 10
MG, 5 MG ........................................................... 41
SAVELLA ORAL TABLET 100
MG, 12.5 MG, 25 MG, 50 MG
................................................................................................ 93
SAVELLA TITRATION PACK
ORAL MISC 12.5 & 25 & 50
MG .................................................................................. 93
Selegiline HCl ORAL CAPSULE
5 MG ............................................................................. 39
Selegiline HCl ORAL TABLET 5
MG ................................................................................... 39
Selenium Sulfide EXTERNAL
LOTION 2.5 % ............................................... 59
SELZENTRY ORAL TABLET
150 MG, 300 MG ....................................... 43
Senna ORAL SYRUP 8.8
MG/5ML ................................................................. 73
Senna ORAL TABLET 8.6 MG
................................................................................................ 73
....................................................................................................
125
Senna-Docusate Sodium ORAL
TABLET 8.6-50 MG .............................. 72
SEREVENT DISKUS
INHALATION AEROSOL
POWDER, BREATH
ACTIVATED 50 MCG/DOSE
................................................................................................ 15
SEROQUEL XR ORAL
TABLET EXTENDED
MG, 300 MG, 400 MG, 50 MG
................................................................................................ 41
Sertraline HCl ORAL
CONCENTRATE 20 MG/ML
................................................................................................ 23
Sertraline HCl ORAL TABLET
100 MG, 25 MG, 50 MG ................... 23
SF 5000 Plus DENTAL CREAM
1.1 % .............................................................................. 80
SF DENTAL GEL 1.1 % ................. 80
Silace ORAL LIQUID† 150
MG/15ML ............................................................. 73
Sildenafil Citrate ORAL
TABLET 20 MG .......................................... 50
Silver Sulfadiazine EXTERNAL
CREAM 1 % ...................................................... 60
Simethicone ORAL
SUSPENSION 40 MG/0.6ML
................................................................................................ 67
Simethicone ORAL TABLET
CHEWABLE 80 MG ............................ 67
SIMPONI SUBCUTANEOUS*
MG/0.5ML .............................................................. 3
SIMULECT INTRAVENOUS*
SOLUTION
RECONSTITUTED 10 MG, 20
MG .................................................................................. 47
Simvastatin ORAL TABLET 10
MG, 20 MG, 40 MG, 5 MG, 80
MG ................................................................................... 31
Slow Release Iron ORAL
TABLET
(50 Fe) MG ......................................................... 71
Sodium Bicarbonate ORAL
................................................................................................ 10
Sodium Chloride INHALATION
0.9 % .............................................................................. 57
Sodium Chloride INJECTION
SOLUTION 0.9 % .................................... 79
126
Sodium Chloride
0.9 % .............................................................................. 79
Sodium Chloride IRRIGATION
SOLUTION 0.9 % .................................... 68
Sodium Chloride ORAL
TABLET 1 GM .............................................. 79
Sodium Citrate ORAL
GRANULES .................................................. 68
Sodium Fluoride ORAL
SOLUTION 1.1 (0.5 F) MG/ML
................................................................................................ 78
Sodium Fluoride ORAL TABLET
CHEWABLE 0.55 (0.25 F) MG,
1.1 (0.5 F) MG, 2.2 (1 F) MG
................................................................................................ 78
Sodium Polystyrene Sulfonate
ORAL POWDER ................................... 48
SOLIA ORAL TABLET 0.15-30
MG-MCG ............................................................. 53
Sorbitol ORAL SOLUTION 70
% ......................................................................................... 72
SORINE ORAL TABLET 120
MG, 160 MG, 240 MG, 80 MG
................................................................................................ 49
Sotalol HCl (AF) ORAL
MG ................................................................................... 49
Sotalol HCl ORAL TABLET 120
MG, 160 MG, 240 MG, 80 MG
................................................................................................ 49
Spironolactone ORAL TABLET
100 MG, 25 MG, 50 MG ................... 65
Spironolactone-HCTZ ORAL
TABLET 25-25 MG ................................ 64
SPRINTEC 28 ORAL TABLET
0.25-35 MG-MCG .................................... 53
SPRYCEL ORAL TABLET 100
MG, 140 MG, 20 MG, 50 MG,
70 MG, 80 MG .............................................. 37
SPS ORAL SUSPENSION 15
GM/60ML ............................................................ 48
SRONYX ORAL TABLET
0.1-20 MG-MCG ........................................ 53
SSD EXTERNAL CREAM 1 %
................................................................................................ 60
SSKI ORAL SOLUTION 1
GM/ML .................................................................... 78
Stavudine ORAL CAPSULE 15
MG, 20 MG, 30 MG, 40 MG
................................................................................................ 45
Stavudine ORAL SOLUTION
................................................................................................ 45
STAVZOR ORAL CAPSULE
250 MG ..................................................................... 20
STAVZOR ORAL CAPSULE
................................................................................................ 20
Stimulant Laxative ORAL
5 MG ............................................................................. 73
STIVARGA ORAL TABLET 40
MG .................................................................................. 37
Stomach Relief Plus ORAL
................................................................................................ 27
Stool Softener Laxative DC
ORAL CAPSULE 240 MG
................................................................................................ 73
Stool Softener ORAL CAPSULE
100 MG, 250 MG ......................................... 73
STRATTERA ORAL
MG, 25 MG, 40 MG, 60 MG, 80
MG ...................................................................................... 2
Stress Formula/Zinc ORAL
TABLET .............................................................. 81
Stress Plus Zinc ORAL TABLET
.............................................................................................. 81
STRIBILD ORAL TABLET
150-150-200-300 MG ............................. 43
STROMECTOL ORAL
TABLET 3 MG ............................................ 10
SUBOXONE SUBLINGUAL
FILM 12-3 MG, 2-0.5 MG, 4-1
MG, 8-2 MG ......................................................... 9
Sucralfate ORAL TABLET 1
GM ................................................................................... 97
SUDAFED 12 HOUR ORAL
TABLET EXTENDED
................................................................................................ 86
Sulfacetamide Sodium
EXTERNAL SUSPENSION 10
% ......................................................................................... 57
Sulfacetamide Sodium
% ......................................................................................... 88
Sulfacetamide-Prednisolone
OPHTHALMIC SOLUTION
10-0.23 % ................................................................. 88
Sulfamethoxazole-TMP DS
................................................................................................ 33
Sulfamethoxazole-Trimethoprim
ORAL SUSPENSION 200-40
MG/5ML ................................................................. 33
Sulfamethoxazole-Trimethoprim
................................................................................................ 33
SulfaSALAzine ORAL TABLET
500 MG ...................................................................... 68
SulfaSALAzine ORAL TABLET
................................................................................................ 68
Sulindac ORAL TABLET 150
MG, 200 MG ......................................................... 5
SUMAtriptan NASAL
SOLUTION 20 MG/ACT, 5
MG/ACT ................................................................. 77
SUMAtriptan Succinate ORAL
MG ................................................................................... 77
SUMAtriptan Succinate Refill
SUBCUTANEOUS*
MG/0.5ML ........................................................... 77
SUMAtriptan Succinate
SUBCUTANEOUS*
MG/0.5ML ........................................................... 77
SUPARTZ
INTRA-ARTICULAR*
................................................................................................ 85
SUPER B-50 B COMPLEX
ORAL CAPSULE .................................... 81
SUPER QUINTS B-50 ORAL
TABLET ................................................................. 81
SURMONTIL ORAL
MG .................................................................................. 24
SUSTIVA ORAL CAPSULE
200 MG, 50 MG ........................................... 44
SUSTIVA ORAL TABLET 600
MG .................................................................................. 44
SUTENT ORAL CAPSULE
12.5 MG, 25 MG, 50 MG .............. 37
SYEDA ORAL TABLET 3-0.03
MG .................................................................................. 53
SYMBICORT INHALATION
AEROSOL† 160-4.5 MCG/ACT,
80-4.5 MCG/ACT ...................................... 15
SYNAGIS
INTRAMUSCULAR*
MG/0.5ML .......................................................... 90
TABLOID ORAL TABLET 40
MG .................................................................................. 35
Tacrolimus ORAL CAPSULE
0.5 MG, 1 MG, 5 MG ............................ 47
TAMIFLU ORAL CAPSULE
30 MG ......................................................................... 46
TAMIFLU ORAL CAPSULE
45 MG, 75 MG .............................................. 46
TAMIFLU ORAL
SUSPENSION
................................................................................................ 46
Tamoxifen Citrate ORAL
TABLET 10 MG, 20 MG ................ 36
Tamsulosin HCl ORAL
CAPSULE 0.4 MG .................................. 69
TARCEVA ORAL TABLET
100 MG, 150 MG, 25 MG ............. 37
TASIGNA ORAL CAPSULE
150 MG, 200 MG ....................................... 37
TAZORAC EXTERNAL
CREAM 0.05 %, 0.1 % ....................... 59
TAZORAC EXTERNAL GEL
0.05 %, 0.1 % ..................................................... 59
Tears Again OPHTHALMIC
OINTMENT .................................................. 86
TEGRETOL-XR ORAL
TABLET EXTENDED
................................................................................................ 19
Temazepam ORAL CAPSULE
15 MG, 30 MG ................................................ 71
Temozolomide ORAL CAPSULE
100 MG, 140 MG, 180 MG, 20
MG, 250 MG, 5 MG ................................ 34
TENCON ORAL TABLET
50-650 MG ............................................................... 5
Terazosin HCl ORAL CAPSULE
1 MG, 10 MG, 2 MG, 5 MG
................................................................................................ 32
Terbinafine HCl EXTERNAL
CREAM 1 % ...................................................... 58
Terbinafine HCl ORAL TABLET
250 MG ...................................................................... 29
Terbutaline Sulfate INJECTION
SOLUTION 1 MG/ML ..................... 15
Terbutaline Sulfate ORAL
TABLET 2.5 MG, 5 MG .................. 15
Terconazole VAGINAL CREAM
0.4 %, 0.8 % ......................................................... 98
Terconazole VAGINAL
SUPPOSITORY 80 MG .................. 98
TESTIM TRANSDERMAL
GEL 50 MG/5GM ........................................ 9
Testosterone Cypionate
MG/ML, 200 MG/ML ............................. 9
Testosterone Enanthate
MG/ML ........................................................................ 9
Tetracycline HCl ORAL
................................................................................................ 94
TEV-TROPIN
SUBCUTANEOUS*
SOLUTION
RECONSTITUTED 5 MG
................................................................................................ 66
THALOMID ORAL CAPSULE
100 MG, 150 MG, 200 MG, 50
MG .................................................................................. 46
Theophylline ER ORAL
TABLET EXTENDED
MG, 300 MG, 450 MG ........................ 16
Theophylline ER ORAL
TABLET EXTENDED
MG ................................................................................... 16
Theophylline ORAL SOLUTION
80 MG/15ML .................................................... 15
Thera Vital M ORAL TABLET
................................................................................................ 82
Therabasic-M ORAL TABLET
................................................................................................ 82
Therapeutic Liquid ORAL
SOLUTION .................................................... 82
Therapeutic-M ORAL TABLET
................................................................................................ 82
Thera-Tabs ORAL TABLET
................................................................................................ 82
THERATRUM COMPLETE
ORAL TABLET ......................................... 82
Thiamine HCl INJECTION
SOLUTION 100 MG/ML .......... 100
Thioridazine HCl ORAL
MG, 50 MG ......................................................... 42
Thiothixene ORAL CAPSULE 1
MG, 10 MG, 2 MG, 5 MG ............. 42
THRESHOLD IMT XX MISC
................................................................................................ 75
THRESHOLD PEP XX
DEVICE .................................................................. 75
THYROLAR-1 ORAL
TABLET 60 (12.5-50) MG
(MCG) ........................................................................ 95
127
THYROLAR-1/2 ORAL
TABLET 30 (6.25-25) MG
(MCG) ........................................................................ 95
THYROLAR-1/4 ORAL
TABLET 15 (3.1-12.5) MG
(MCG) ........................................................................ 95
THYROLAR-2 ORAL
TABLET 120 (25-100) MG
(MCG) ........................................................................ 95
THYROLAR-3 ORAL
TABLET 180 (37.5-150) MG
(MCG) ........................................................................ 95
TiaGABine HCl ORAL TABLET
2 MG, 4 MG ....................................................... 19
Timolol Maleate
OPHTHALMIC GEL
FORMING SOLUTION 0.25 %,
0.5 % .............................................................................. 86
Timolol Maleate
OPHTHALMIC SOLUTION
0.25 %, 0.5 % ..................................................... 86
Timolol Maleate ORAL
................................................................................................ 49
TIVICAY ORAL TABLET 50
MG .................................................................................. 43
TOBI INHALATION
300 MG/5ML ....................................................... 3
TOBRADEX OPHTHALMIC
OINTMENT 0.3-0.1 % ...................... 88
Tobramycin Sulfate
OPHTHALMIC SOLUTION
0.3 % .............................................................................. 87
Tolmetin Sodium ORAL
CAPSULE 400 MG .................................... 5
Topiramate ORAL CAPSULE
SPRINKLE 15 MG, 25 MG
................................................................................................ 19
Topiramate ORAL TABLET 100
MG, 25 MG, 50 MG ................................ 19
Topiramate ORAL TABLET 200
MG ................................................................................... 19
Torsemide ORAL TABLET 10
MG, 100 MG, 20 MG, 5 MG
................................................................................................ 65
TRADJENTA ORAL TABLET
5 MG ............................................................................. 25
TraMADol HCl ORAL TABLET
50 MG ............................................................................. 7
Tranylcypromine Sulfate ORAL
TABLET 10 MG .......................................... 22
Travel Sickness ORAL TABLET
CHEWABLE 25 MG ............................ 28
128
TraZODone HCl ORAL
TABLET 100 MG, 150 MG, 300
MG, 50 MG ......................................................... 21
TRELSTAR DEPOT
INTRAMUSCULAR*
SUSPENSION
................................................................................................ 36
TRELSTAR DEPOT MIXJECT
INTRAMUSCULAR*
SUSPENSION
................................................................................................ 36
TRELSTAR LA
INTRAMUSCULAR*
SUSPENSION
................................................................................................ 36
TRELSTAR LA MIXJECT
INTRAMUSCULAR*
SUSPENSION
................................................................................................ 36
TRELSTAR MIXJECT
INTRAMUSCULAR*
SUSPENSION
................................................................................................ 36
Tretinoin EXTERNAL CREAM
0.025 %, 0.05 %, 0.1 % ......................... 58
Tretinoin EXTERNAL GEL 0.01
%, 0.025 % ............................................................. 58
Triamcinolone Acetonide
EXTERNAL CREAM 0.025 %,
0.1 %, 0.5 % ......................................................... 61
................................................................................................ 61
MOUTH/THROAT PASTE 0.1
% ......................................................................................... 80
Triamterene-HCTZ ORAL
CAPSULE 37.5-25 MG ..................... 64
Triamterene-HCTZ ORAL
TABLET 37.5-25 MG, 75-50 MG
................................................................................................ 64
Triazolam ORAL TABLET 0.125
MG, 0.25 MG .................................................... 71
Tri-Buffered Aspirin ORAL
TABLET 325 MG .......................................... 6
TRI-ESTARYLLA ORAL
TABLET 0.18/0.215/0.25 MG-35
MCG ............................................................................. 54
Trifluoperazine HCl ORAL
TABLET 1 MG, 10 MG, 2 MG, 5
MG ................................................................................... 42
Trifluridine OPHTHALMIC
SOLUTION 1 % .......................................... 88
Trihexyphenidyl HCl ORAL
ELIXIR 0.4 MG/ML ............................. 38
Trihexyphenidyl HCl ORAL
TABLET 2 MG, 5 MG ........................ 38
TRILYTE ORAL SOLUTION
................................................................................................ 72
Trimethoprim ORAL TABLET
100 MG ...................................................................... 33
Trinatal Rx 1 ORAL TABLET
60-1 MG .................................................................... 84
TRINATE ORAL TABLET
................................................................................................ 84
TRINESSA (28) ORAL
TABLET 0.18/0.215/0.25 MG-35
MCG ............................................................................. 54
Triple Antibiotic EXTERNAL
OINTMENT 3.5-400-5000 ,
5-400-5000 ........................................................... 58
TRI-PREVIFEM ORAL
TABLET 0.18/0.215/0.25 MG-35
MCG ............................................................................. 54
TRI-SPRINTEC ORAL
TABLET 0.18/0.215/0.25 MG-35
MCG ............................................................................. 54
TRIVEEN-U ORAL CAPSULE
106.5-1 MG ......................................................... 84
Tri-Vit/Fluoride ORAL
SOLUTION 0.25 MG/ML ............ 83
Tri-Vit/Fluoride/Iron ORAL
SOLUTION 0.25-10 MG/ML
................................................................................................ 82
Tri-Vitamin ORAL SOLUTION
1500-400-35 ........................................................ 83
Tri-Vitamin/Fluoride ORAL
SOLUTION 0.5 MG/ML ................ 83
TRIVORA (28) ORAL TABLET
................................................................................................ 54
TRIZIVIR ORAL TABLET
300-150-300 MG .......................................... 43
TROKENDI XR ORAL
CAPSULE EXTENDED
200 MG, 25 MG, 50 MG ................ 19
Trospium Chloride ORAL
TABLET 20 MG .......................................... 98
TRUVADA ORAL TABLET
200-300 MG ........................................................ 43
TUDORZA PRESSAIR
INHALATION AEROSOL
POWDER, BREATH
ACTIVATED 400 MCG/ACT
13
TYKERB ORAL TABLET 250
MG .................................................................................. 37
TYZEKA ORAL TABLET 600
MG .................................................................................. 45
UltimateCare Combo ORAL
MISC 30-1 MG .............................................. 84
UNITHROID DIRECT ORAL
TABLET 150 MCG ................................ 95
UNITHROID ORAL TABLET
100 MCG, 112 MCG, 125 MCG,
137 MCG, 150 MCG, 175 MCG,
200 MCG, 25 MCG, 300 MCG,
50 MCG, 75 MCG, 88 MCG
................................................................................................ 95
Urea EXTERNAL CREAM 40 %
................................................................................................ 62
URETRON D/S ORAL
TABLET ................................................................. 97
Ursodiol ORAL CAPSULE 300
MG ................................................................................... 67
Uticap ORAL CAPSULE 120
MG ................................................................................... 97
ValACYclovir HCl ORAL
TABLET 1 GM, 500 MG ................ 46
Valproate Sodium
100 MG/ML ........................................................ 20
Valproic Acid ORAL CAPSULE
250 MG ...................................................................... 20
Valproic Acid ORAL
SOLUTION 250 MG/5ML .......... 21
Valproic Acid ORAL SYRUP 250
MG/5ML ................................................................. 21
Vancomycin HCl
500 MG, 750 MG ......................................... 33
Vancomycin HCl ORAL
................................................................................................ 33
VANDAZOLE VAGINAL GEL
0.75 % ........................................................................... 98
VELIVET ORAL TABLET
0.1/0.125/0.15 -0.025 MG ................ 54
Venlafaxine HCl ER ORAL
CAPSULE EXTENDED
37.5 MG, 75 MG .......................................... 23
................................................................................................
Venlafaxine HCl ER ORAL
TABLET EXTENDED
MG, 37.5 MG, 75 MG .......................... 23
Venlafaxine HCl ORAL
TABLET 100 MG, 25 MG, 37.5
MG, 50 MG, 75 MG ................................ 23
VENTOLIN HFA
INHALATION AEROSOL,
SOLUTION 108 (90 BASE)
MCG/ACT ........................................................... 15
Verapamil HCl ER ORAL
CAPSULE EXTENDED
120 MG, 180 MG, 200 MG, 240
MG, 300 MG, 360 MG ........................ 50
Verapamil HCl ER ORAL
TABLET
MG, 180 MG, 240 MG ........................ 50
Verapamil HCl ORAL TABLET
120 MG, 40 MG, 80 MG ................... 50
VEXOL OPHTHALMIC
SUSPENSION 1 % .................................. 89
VICTRELIS ORAL CAPSULE
200 MG ..................................................................... 46
VIDEX ORAL SOLUTION
GM .................................................................................. 44
VIIBRYD ORAL KIT 10 & 20
& 40 MG ................................................................. 21
VIIBRYD ORAL TABLET 10
MG, 20 MG, 40 MG ............................. 22
VIMPAT INTRAVENOUS*
................................................................................................ 19
VIMPAT ORAL SOLUTION 10
MG/ML .................................................................... 19
VIMPAT ORAL TABLET 100
MG, 150 MG, 200 MG, 50 MG
................................................................................................ 19
VINATE AZ EXTRA ORAL
TABLET 29-1 MG ................................... 84
VINATE AZ ORAL TABLET
27-1 MG ................................................................... 84
VINATE GT ORAL TABLET
90-1 MG ................................................................... 84
VINATE II ORAL TABLET
29-1 MG ................................................................... 84
VINATE M ORAL TABLET
27-1 MG ................................................................... 84
VIRACEPT ORAL TABLET
250 MG, 625 MG ....................................... 44
VIREAD ORAL TABLET 150
MG, 200 MG, 250 MG, 300 MG
................................................................................................ 45
Vision Vitamins ORAL TABLET
................................................................................................ 82
Vitamin A ORAL CAPSULE
10000 UNIT, 8000 UNIT ................. 99
Vitamin B Complex ORAL
TABLET .............................................................. 81
Vitamin B Complex-C ORAL
CAPSULE ........................................................ 81
Vitamin B-1 ORAL TABLET 100
MG, 250 MG, 50 MG ........................ 100
Vitamin B-12 ER ORAL
TABLET
MCG .............................................................................. 70
Vitamin B-12 ORAL TABLET
1000 MCG, 250 MCG, 500 MCG
................................................................................................ 70
Vitamin B-12 SUBLINGUAL
TABLET SUBLINGUAL 1000
MCG .............................................................................. 70
MG ............................................................................... 100
Vitamin B-6 ORAL TABLET 100
MG, 25 MG, 250 MG, 50 MG,
500 MG .................................................................. 100
Vitamin C ER ORAL CAPSULE
EXTENDED RELEASE* 500
MG ............................................................................... 100
MG, 1500 MG, 500 MG ................. 100
EXTENDEDRELEASE*
1000-100 MG ..................................................... 81
Vitamin C ORAL SYRUP 500
MG/5ML ............................................................. 100
Vitamin C ORAL TABLET 100
MG, 1000 MG, 250 MG, 500 MG
............................................................................................. 100
Vitamin C ORAL TABLET
............................................................................................. 100
Vitamin C-Rose Hips ER ORAL
TABLET
MG, 1500 MG, 500 MG ................. 101
Vitamin C-Rose Hips ORAL
TABLET 1000 MG, 250 MG, 500
MG ............................................................................... 100
129
Vitamin C-Rose Hips ORAL
............................................................................................. 101
Vitamin D (Ergocalciferol)
ORAL CAPSULE 50000 UNIT
................................................................................................ 99
Vitamin D3 ORAL CAPSULE
2000 UNIT ............................................................ 99
Vitamin D3 ORAL TABLET
1000 UNIT, 400 UNIT ........................ 99
Vitamin K (Phytonadione)
ORAL TABLET 100 MCG
................................................................................................ 99
Vitamin-B Complex ORAL
TABLET .............................................................. 81
Vitamins ACD-Fluoride ORAL
SOLUTION 0.25 MG/ML ............ 83
Vitamins for Hair ORAL
TABLET .............................................................. 84
VITRUM SENIOR ORAL
TABLET ................................................................. 82
VOLTAREN TRANSDERMAL
GEL 1 % .................................................................. 59
VYTORIN ORAL TABLET
10-10 MG, 10-20 MG, 10-40
MG, 10-80 MG .............................................. 30
VYVANSE ORAL CAPSULE
20 MG, 30 MG, 40 MG, 50 MG,
60 MG, 70 MG .................................................. 2
Warfarin Sodium ORAL
TABLET 1 MG, 10 MG, 2 MG,
2.5 MG, 3 MG, 4 MG, 5 MG, 6
MG, 7.5 MG ....................................................... 16
WATCHHALER XX DEVICE
................................................................................................ 76
WESTHROID ORAL TABLET
113.75 MG, 130 MG, 146.25
MG, 16.25 MG, 162.5 MG, 195
MG, 260 MG, 32.5 MG, 325
MG, 48.75 MG, 65 MG, 81.25
MG, 97.5 MG .................................................. 96
WINDMILL TRAINER XX
MISC ............................................................................ 76
XALKORI ORAL CAPSULE
200 MG, 250 MG ....................................... 37
XARELTO ORAL TABLET 10
MG .................................................................................. 16
XELODA ORAL TABLET 150
MG, 500 MG .................................................... 35
XENICAL ORAL CAPSULE
120 MG ......................................................................... 2
130
XOLAIR SUBCUTANEOUS*
SOLUTION
................................................................................................ 13
XTANDI ORAL CAPSULE 40
MG .................................................................................. 36
X-VIATE EXTERNAL
CREAM 40 % ................................................. 62
YL Balanced B-100 ORAL
TABLET .............................................................. 81
Zafirlukast ORAL TABLET 10
MG, 20 MG ......................................................... 13
ZEBUTAL ORAL CAPSULE
50-500-40 MG ..................................................... 5
ZELBORAF ORAL TABLET
240 MG ..................................................................... 36
ZENCHENT FE ORAL
TABLET CHEWABLE 0.4-35
MG-MCG ............................................................. 53
ZENZEDI ORAL TABLET 2.5
MG, 7.5 MG ......................................................... 2
ZETIA ORAL TABLET 10 MG
................................................................................................ 31
ZIAGEN ORAL SOLUTION 20
MG/ML .................................................................... 44
Zidovudine ORAL CAPSULE
100 MG ...................................................................... 45
Zidovudine ORAL SYRUP 50
MG/5ML ................................................................. 45
Zidovudine ORAL TABLET 300
MG ................................................................................... 45
Zinc Sulfate ORAL CAPSULE
220 MG ...................................................................... 79
Zinc Sulfate ORAL TABLET 220
(50 Zn) MG ....................................................... 79
Ziprasidone HCl ORAL
MG, 80 MG ......................................................... 39
ZOLINZA ORAL CAPSULE
100 MG ..................................................................... 37
Zolpidem Tartrate ORAL
TABLET 10 MG, 5 MG .................... 71
Zonisamide ORAL CAPSULE
100 MG ...................................................................... 19
Zonisamide ORAL CAPSULE 25
MG ................................................................................... 19
Zonisamide ORAL CAPSULE 50
MG ................................................................................... 19
ZORTRESS ORAL TABLET
0.25 MG, 0.5 MG, 0.75 MG
................................................................................................ 47
ZOVIA 1/35E (28) ORAL
TABLET 1-35 MG-MCG ............. 53
ZOVIA 1/50E (28) ORAL
TABLET 1-50 MG-MCG ............. 53
ZOVIRAX EXTERNAL
CREAM 5 % ..................................................... 59
ZYPREXA RELPREVV
INTRAMUSCULAR*
SUSPENSION
300 MG, 405 MG ....................................... 41

`Ohana Medicaid Comprehensive Preferred Drug List (QExA)

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