docANTIFUNGALS PENICILLINS NSAIDS CEPHALOSPORINS
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ANTIFUNGALS PENICILLINS NSAIDS CEPHALOSPORINS
t cefuroxime sodium cephalexin tazicef catamaran NON PREFERRED January 2013 Cedax Ceftin Claforan Fortaz Keflex Rocephin Spectracef Suprax Zinacef NATIONAL FORMULARY DRUG LIST University of Toledo The Catamaran Drug List is a guide identifying preferred brand-name medicines within select therapeutic categories. The Drug List may not include all drugs covered by your prescription drug benefit. Generic medicines are available within many of the therapeutic categories listed, in addition to categories not listed, and should be considered as the first line of prescribing. For benefit coverage or restrictions please check your benefit plan document(s). This listing is revised periodically as new drugs and new prescribing information becomes available. It is recommended that you bring this list of medications when you or a covered family member sees a physician or other healthcare provider. ANTIFUNGALS GENERIC amphotericin b fluconazole flucytosine griseofulvin microsize griseofulvin ultramicrosize amoxicillin amoxicillin/clavulanate potassium amoxicillin/clavulanate potassium er amoxicillin/potassium clavulanate ampicillin ampicillin sodium ampicillin-sulbactam dicloxacillin sodium nafcillin sodium oxacillin sodium penicillin g potassium penicillin g procaine penicillin g sodium penicillin v potassium pfizerpen-g PREFERRED BRAND nystatin terbinafine hcl Augmentin Es-600 Augmentin Xr Bicillin C-r Bicillin L-a Moxatag Unasyn Unasyn Bulk Pack Noxafil NON PREFERRED Ancobon Bio-statin Diflucan Grifulvin V Gris-peg Lamisil Onmel Sporanox Sporanox Pulsepak Terbinex Vfend CEPHALOSPORINS GENERIC cefaclor cefaclor er cefadroxil cefazolin sodium cefdinir Cefditoren Pivoxil cefepime cefotaxime sodium cefotetan cefoxitin sodium cefpodoxime proxetil cefprozil ceftazidime ceftriaxone sodium cefuroxime axetil Effective January 1, 2013 Adoxa Pak 11150 Adoxa Pak 2/100 AIodox Convenience Kit Doryx Dynacin Minocin Minocin Kit Monodox Nutridox Ocudox Oraxyl Solodyn Vibramycin GENERIC Augmentin PREFERRED BRAND NON PREFERRED Adoxa Adoxa Pak 1/100 PENICILLINS itraconazole ketoconazole voriconazole tetracycline hcl NON PREFERRED QUlNOLONES GENERIC PÿlIElÿl iIÿ.'I ÿliÿ P".III I[O] =!b'dl NSAIDS GENERIC diclofenac potassium diclofenac sodium dr diclofenac sodium er Diclofenac Sodium Xr diclofenac sodium/misoprostol etodolac etodolac er fenoprofen calcium flurbiprofen ibuprofen indomethacin indomethacin er ketoprofen ketoprofen er ketorolac tromethamine meclofenamate sodium mefenamic acid Meloxicam nabumetone naproxen naproxen dr naproxen sodium oxaprozin ciprofloxacin er ciprofloxacin hcl levofloxacin ofloxacin piroxicam sulindac tolmetin sodium PREFERRED BRAND Celebrex Vimovo Avelox Avelox Abc Pack NON PREFERRED PREFERRED BRAND NON PREFERRED TETRACYCLINES Anaprox Anaprox Ds Arthrotec 50 Arthrotec 75 Cataflam Clinoril Daypro Duexis GENERIC Ec-naprosyn avidoxy demeclocycline hcl doxycycline doxycycline hyclate doxycycline monohydrate minocycline hcl minocycline hcl er morgidox lxl 00rag morgidox 2xl00mg Feldene Ibuprofen Comfort Pac Cipro Cipro Xr Factive Levaquin Noroxin Ic 400 Ic 800 Indocin Meloxicam Comfort Pac Mobic Nalfon Naprelan Naprosyn Naproxen Comfort Pac Ponstel Sprix Voltaren-xr Wound Gel Zipsor betaxolol hcl bisoprolol fumarate metoprolol succinate er metoprolol tartrate nadolol pindolol propranolol hcl propranolol hc! er Nimotop Norvasc Procardia Procardia XI Sular Tiazac Verelan Verelan Pm sorine sotalol hcl NITRATES & NITRITES PREFERRED BRAND sotalol hcl (af) Enbrel Enbrel Sureclick Humira Humira Pen timolol maleate Humira Pen-crohns Diseasestarter Betapace Betapace Af Corgard Inderal La Innopran Xl Kerlone Levatol amyl nitrite isochron isoditrate er isosorbide dinitrate isosorbide dinitrate er isosorbide mononitrate isosorbide mononitrate er minitran nitroglycerin Nitroglycerin Lingual nitroglycerin transdermal Humira Pen-psoriasis Starter NON PREFERRED Cimzia Cimzia Starter Kit Kineret Orencia Simponi Xeljanz ACE-INHIBITORS GENERIC benazepril hcl captopril enalapril maleate fosinopril sodium lisinopril moexipril hcl perindopril erbumine quinapril hcl ramipril trandolapril NON PREFERRED Accupril Aceon Altace Lotensin Mavik Prinivil Univasc Vasotec Zestril ANGIOTENSlN RCPTR BLOCKER GENERIC eprosartan mesylate irbesartan iosartan potassium PREFERRED BRAND Atacand Benicar Diovan Micardis NON PREFERRED Avapro Cozaar Edarbi Teveten BETA BLOCKERS GENERIC acebutolol hcl atenolol Effective January l, 2013 PREFERRED BRAND Bystolic NON PREFERRED GENERIC Lopressor PREFERRED BRAND Metoprolol Sectral Dilatrate Sr Nitro-bid Tenormin Nitro-dur Toprol XI Zebeta Nitrolingual Pumpspray Nitrostat NON PREFERRED CALCIUM CHANNEL BLOCKERS GENERIC afeditab cr amlodipine besylate cartia xt dilt-cd Imdur Isordil Titradose Monoket Nitromist ANTI-HTN COMBINATIONS dilt-xr GENERIC diltiazem cd diltiazem hcl Diltiazem Hcl Cd diltiazem hcl er diltzac felodipine er isradipine matzim la nicardipine hcl nifediac cc nifedical xl nifedipine nifedipine er nimodipine nisoldipine nisoldipine er taztia xt verapamil hcl verapamil hcl er Verapamil Hcl Sr amlodipine besylate/benazepril hcl amlodipine besylate/benazepril hydrochloride atenolol/chlorthalidone benazepril hc!/hydrochlorothiazide bisoprolol fumarate/hydrochlorothiazide PREFERRED BRAND Cardizem La NON PREFERRED Adalat Cc Calan Calan Sr Cardene Sr Cardizem Cardizem Cd Covera-hs Dilacor Xr Dynacirc Cr Isoptin Sr candesartan cilexetil/hyd rochlorothiazide captopril/hydrochlorothiazide enalapril maleate/hyd rochlorothiazide fosinopril sodium/hydrochlorothiazide irbesartan/hydrochlorothiazide lisinopril/hydrochlorothiazide Iosartan potassium/hydrochlorothiazide methyldopa/hydrochlorothiazide metoprolol/hyd rochlorothiazide moexipril/hydrochlorothiazide nadolol/bendroflumethiazide propranolol/hyd rochlorothiazide q uinapril/hydrochlorothiazide valsartan/hydrochlorothiazide PREFERRED BRAND Amturnide Azor Benicar Hct Exforge Exforge Hct Micardis Hct Tarka Tekamlo Tekturna Hct Tribenzor Twynsta Valturna prevalite myorisan PREFERRED BRAND oscion cleanser NON PREFERRED Welchol Accuretic Atacand Hct Avalide Clorpres Corzide Diovan Hct Dutoprol Edarbyclor Hypertensolol Hyzaar Lopressor Hct Lotensin Hct Lotrel Lytensopril Lytensopril-90 Prinzide Tenoretic 100 Tenoretic 50 Teveten Hct Uniretic Vaseretic Zestoretic Ziac NON PREFERRED Colestid Colestid Flavored pacnex wash pr benzoyl peroxide wash prascion prascion fc Questran prascion ra with sunscreens Questran Light ra renewal medicated acne treatment maximum strength ANTIHYPERLIPIDEMICS S TA TINS GENERIC atorvastatin calcium fluvastatin Iovastatin pravastatin sodium simvastatin PREFERRED BRAND Altoprev Crestor NON PREFERRED Lescol Lescol XI Lipitor Livalo Mevacor Pravachol Zocor FIBRA TES GENERIC Fenofibrate fenofibrate micronized Fenofibric Acid gemfibrozil PREFERRED BRAND Antara Fenoglide Lipofen Triglide Trilipix NON PREFERRED Fibricor Lofibra Lopid Tricor BILE ACID SEQUESTRANTS GENERIC cholestyramine cholestyramine light colestipol hcl colestipol hcl for oral suspension Micronized Colestipol Hcl Effective Janual2¢ l, 2013 CHOLEST ABS INHBTR/COMBO PREFERRED BRAND Vytorin Zetia rosadan rosanil cleanser Niaspan Simcor se bpo wash se bpo 3% foaming cloths se bpo 6% foaming cloths se bpo 7-5.5 wash kit se bpo 9% foaming cloths NON PREFERRED se 10-5 ss Advicor Sodium Sulfacetamide sodium sulfacetamide/sulfur sodium sulfacetamide/sulfur cleanser sodium sulfacetamide/sulfur cleanser NIA CIN/C OMBINA TIONS PREFERRED BRAND OMEGA-3 FATTY AClDS PREFERRED BRAND Lovaza in urea ACNE GENERIC adapalene amnesteem avar cleanser avar-e emollient avar-e green Avita benzepro benzepro short contact benziq wash benzoyl peroxide benzoyl peroxide cleanser benzoyl peroxide cleansing benzoyl peroxide short contact benzoyl peroxide wash benzoyl peroxide wash acne treatment pack bp cleanser bp cleansing wash bp wash bp 10-1 bpo bpo creamy wash complete pack bpo 3% foaming cloths bpo 6% foaming cloths bpo 9% foaming cloths cerisa wash claravis claris clarifying wash clearplex x clenia clenia foaming wash clindacin-p clindamax clindamycin phosphate clindamycin/benzoyl peroxide clindareach ery erythromycin erythromycin/benzoyl peroxide lavoclen-4 acne wash kit lavoclen-4 creamy wash lavoclen-8 acne wash kit lavoclen-8 creamy wash metronidazole sodium sulfacetamide/sulfur cleansing cloths sodium sulfacetamide/sulfur green sodium sulfacetamide/sulfur in urea sodium sulfacetamide/sulfur wash sotret sulfacetamide sodium sulfacetamide sodium/sulfur cleanser sulfacleanse 8/4 suphera tl bpo mx cleanser Tretinoin virti-sulf vitazol zaclir cleansing zencia PREFERRED BRAND Acanya Aczone Atralin Azelex Epiduo Finacea Metrogel Oracea Veltin NON PREFERRED Absorica Akne-mycin Avar Ls Cleanser Avar-e Ls Benzac Ac Wash Benzac W Wash Benzaclin Benzaclin With Pump Benzamycin Benzamycinpak Benzefoam Benzefoamultra Benziq Benziq Ls Clarifoam Ef Cleocin-t Clindacin Pac Clindagel Delos Desquam-x Wash Differin Duac Evoclin Finacea Plus Inova Inova 4/1 Acne Control Therapy Inova 8/2 Acne Control Therapy Klaron Metrocream Metrolotion Neobenz Micro Neobenz Micro Plus Pack Neobenz Micro Sd Neobenz Micro Wash Neobenz Micro Wash Plus Pack Noritate Nuox Pacnex Hp Pacnex Lp Pacnex Mx Plexion Cleanser Plexion Cleansing Cloth Plexion Sct fluocinonide emollient base fluocinonide-e fluticasone propionate halac halobetasol propionate halonate pac hydrocortisone hydrocortisone acetate/aloe hydrocortisone butyrate hydrocortisone in absorbase hydrocortisone valerate Lokara mometasone furoate pramcor[ prednicarbate scalacort synalar triamcinolone acetonide triamcinolone acetonide in absorbase trianex triderm Retin-a Retin-a Micro u-cort Retin-a Micro Pump Rosadan Kit Rosanil Capex Cordran Tape Halog Kenalog Locoid Lipocream Sss 10-4 Sulfoam Sumadan Kit Sumadan Wash Sumaxin Sumaxin Cp Kit Sumaxin Ts Sumaxin Wash Tretin-x Triaz Triaz Cleanser Triaz Foaming Cloths Vanoxide Hc Vanoxide-hc Zacare 4% Kit Zacare 8% Kit Ziana TOPICAL ANTI-INFLAMMATORY GENERIC ala cort alclometasone dipropionate alphatrex amcinonide apexicon apexicon e augmented betamethasone dipropionate betamethasone dipropionate betamethasone valerate clobetasol propionate clobetasol propionate e clobetasol propionate emollient cormax cormax scalp application cor[alo desonide PREFERRED BRAND Taclonex NON PREFERRED Aclovate Ala Scalp Aqua Glycolic Hc Scalp & Body Carmol-hc CIobeta Cream Clobeta Ointment Clobex Cloderm Cloderm Pump Cordran Cordran Sp Cutivate Derma-smoothe/fs Body Oil Derma-smoothe/fs Scalp Oil Dermatop Synalar Cream Kit Synalar Ointment Kit Synalar Ts Temovate Temovate E Texacort Topicort Ultravate Ultravate Pac Ultravate X Vanos Verdeso Westcort CONTRACEPTIVE AGENTS PREFERRED BRAND Depo-provera ESTROGENS/COMBINATIONS GENERIC estradiol estradiol valerate estradiol/norethindrone acetate estropipate Jevantique jinteli mimvey or[ho-est PREFERRED BRAND Cenestin Combipatch Enjuvia Estring Evamist Premphase Prempro Vagifem Vivelle-dot NON PREFERRED Activella Alora Angeliq Desonate Climara Climara Pro Delestrogen Desonil Depo-estradiol Desowen Divigel Desowen Cream/cetaphil Lotion Desowen Lotion/cetaphil Cream Desowen Ointment/cetaphil Lotion Diprolene Diprolene Af Elocon Epifoam First-hydrocortisone Halonate Lidamantle Hc Locoid Luxiq Momexin Nucort Elestrin Estrace Estraderm Estrasorb Estrogel Femhrt Low Dose Femhrt 1/5 Femring Femtrace Menest Menostar Minivelle Prefest Premarin Nuzon desoximetasone Olux diflorasone diacetate fluocinolone acetonide fluocinolone acetonide body fluocinolone acetonide scalp fluocinonide Olux-e Pandel Pediaderm Hc Pediaderm Ta TESTOSTERONE AGENTS GENERIC danazol testosterone cypionate testosterone enanthate Pramosone Scalacort Dk Effective January 1,2013 4 PREFERRED BRAND Androderm Androgel Androgel Pump Androxy Axiron Fortesta Methitest NON PREFERRED android Delatestryl Depo-testosterone First-testosterone Avandia PREFERRED BRAND Januvia Onglyza Tradjenta BIGUANIDE/DPP-4 COMB. PREFERRED BRAND Janumet Janumet Xr Jentadueto Kombiglyze Xr SULFONYLUREAS First-testosterone Mc Compounding GENERIC Kit chlorpropamide glimepiride Striant Testim Testopel testred INSULIN PREFERRED BRAND Apidra Apidra Solostar Humalog Humalog Kwikpen Humalog Mix 50/50 Humalog Mix 50/50 Kwikpen Humalog Mix 75/25 Humalog Mix 75/25 Kwikpen Humulin R U-500 (concentrated) Lantus Lantus Solostar Levemir Levemir Flexpen Novolog Novolog Flexpen Novolog Mix 70/30 Novolog Mix 70/30 Prefilled Flexpen Novolog Penfill NON-INSULIN HYPOGLYCEMICS BIGUANIDES GENERIC metformin hcl metformin hcl er PREFERRED BRAND glipizide glipizide er NON PREFERRED Glucovance Metaglip BIGUAN/THIAZOLIDEINEDIONE GENERIC Pioglitazone Hcl Pioglitazone Hcl/metformin Hcl PREFERRED BRAND Actoplus Met Xr NON PREFERRED Actoplus Met Actos Avandamet Effective January 1, 2013 PREFERRED BRAND Carafate NON PREFERRED Axid Cytotec Pepcid Zantac NON PREFERRED SULFONYLUREA/TZD COMB. PREFERRED BRAND Duetact NON PREFERRED Avandaryl INCRETINS PREFERRED BRAND Bydureon Byetta Victoza AMYLIN ANALOGS PREFERRED BRAND Symlin Symlinpen 120 Symlinpen 60 A N TIH YPO GL YCEMIC A GENTS PREFERRED BRAND Glucagon Emergency Kit NON PREFERRED glipizide/metformin hcl glyburide/metformin hcl cimetidine cimetidine hcl famotidine misoprostol nizatidine ranitidine hcl sucralfate Amaryl Diabeta Glucotrol Glucotrol XI Glynase Glucagen Glucagen Hypokit Proglycem GENERIC GENERIC glyburide micronized tolazamide tolbutamide NON PREFERRED BIGUAN/SULFONYLUREA COMB. ULCER DRUGS Glipizide Xl glyburide Riomet Fortamet Glucophage Glucophage Xr Glumetza Protonix DPP-4 INHIBITORS PROTON PUMP INHIBITORS GENERIC lansoprazole Lansoprazole Odt omeprazole Pantoprazole Sodium PREFERRED BRAND Nexium NON PREFERRED Aciphex Dexilant ANTIVIRALS GENERIC ribapak ribasphere ribatab ribavirin NON PREFERRED Copegus Rebetol INTERFERONS PREFERRED BRAND Peg-intron Peg-intron Redipen Peg-intron Redipen Pak 4 Pegasys Pegasys Proclick NON PREFERRED Infergen First-lansoprazole First-omeprazole PROTEASE INHIBITORS Prevacid Prevacid Solutab Prilosec Incivek Victrelis PREFERRED BRAND Potiga PREFERRED BRAND GENERIC Vimpat azelastine hcl cromolyn sodium epinastine hcl Ampyra NON PREFERRED Avonex Carbatrol Depakene Depakote Depakote Er Depakote Sprinkles diastat acudial Dilantin Felbatol Avonex Pen Copaxone Rebif Rebif Titration Pack NON PREFERRED Aubagio Betaseron Extavia Gilenya ALZHEIMER'S DISEASE GENERIC donepezil hcl galantamine galantamine hydrobromide rivastigmine tartrate PREFERRED BRAND Namenda Namenda Titration Pak NON PREFERRED Aricept Aricept Odt Exelon Razadyne Razadyne Er ANTICONVULSANTS GENERIC carbamazepine Carbamazepine Er Gabitril Keppra Keppra Xr Klonopin Lamictal Lamictal Chewable Dispersible Lamictal Starter/not Taking Carbamazepine Lamictal Starter/taking Carbamazepine/not Taking Valproate Lamictal Startedtaking Valproate Mysoline Neurontin Onfi Phenytek Sabril Stavzor Tegretol Therapentin-60 Therapentin-90 Topamax Topamax Sprinkle Trileptal Zarontin Zonegran clonazepam clonazepam odt Diazepam divalproex sodium divalproex sodium dr divalproex sodium er epitol ethosuximide Felbamate fosphenytoin sodium gabapentin lamotrigine levetiracetam levetiracetam er oxcarbazepine phenytoin phenytoin sodium phenytoin sodium extended primidone tiagabine hydrochloride topiragen topiramate valproic acid zonisamide PREFERRED BRAND Banzel Celontin diastat pediatric Dilantin Infatabs Lamictal Odt Lamictal Xr Lyrica Peganone Effective January 1,2013 ANTI-ALLERGIC AGENTS Tegretol-xr MIGRAINE/HEADACHE GENERIC dihydroergotamine mesylate naratriptan hcl Sumatriptan sumatriptan succinate Sumatriptan Succinate Refill PREFERRED BRAND Cafergot Ergomar Maxalt Maxalt-mlt Relpax Treximet Zomig Zomig Zmt NON PREFERRED Alsuma Amerge Axert Cambia D.h.e. 45 Frova Imitrex Imitrex Statdose Refill Imitrex Statdose System Migergot Migral Migranal Sumavel Dosepro PREFERRED BRAND Pataday Patanol NON PREFERRED Alamast Alocril Alomide Bepreve Elestat Emadine Lastacaft Optivar ANTI-GLAUCOMA AGENTS GENERIC apraclonidine betaxolol hcl brimonidine tartrate carteolol hcl dorzolamide hcl dorzolamide hcl/timolol maleate latanoprost levobunolol hcl Metipranolol timolol maleate Timolol Maleate Ophthalmic Gel Forming PREFERRED BRAND Azopt Betoptic-s Combigan Lumigan Travatan Z NON PREFERRED Alphagan P Betagan Betimol Cosopt Cosopt Pf Iopidine Istalol Optipranolol Timoptic Timoptic Ocudose Timoptic-xe Trusopt Xalatan Zioptan ANTI-INFECTIVES GENERIC bacitracin ciprofloxacin hcl erythromycin garamycin gentak gentamicin sulfate ilotycin levofloxacin ofloxacin romycin tobramycin sulfate tobrasol PREFERRED BRAND MIOTICS Besivance Ciloxan GENERIC Moxeza PREFERRED BRAND Vigamox Zymaxid Isopto Carbachol Phospholine iodide Pilopine Hs pilocarpine hcl NON PREFERRED Azasite Iquix Mitosol Ocuflox Quixin Tobrex NON PREFERRED Isopto Carpine MISCELLANEOUS PREFERRED BRAND Lacrisert Restasis ANTI-INFLAMMATORY AGENTS GENERIC bromfenac cromolyn sodium diclofenac sodium flurbiprofen sodium ketorolac tromethamine BISPHOSPHONATES GENERIC_ alendronate sodium etidronate disodium ibandronate sodium PREFERRED BRAND PREFERRED BRAND Acuvail Bromday Actonel Atelvia Nevanac NON PREFERRED NON PREFERRED Binosto Boniva Didronel Acular Acular Ls Ilevro Ocufen Voltaren CORTICOSTEROIDS/RELATED GENERIC dexamethasone sodium phosphate fluor-op Fluorometholone neomycinlpolymyxinlbacitracinlhydroco rtisone neomycin/polymyxin/dexamethasone neomycin/polymyxin/hydrocortisone poly-dex Prednisolone Acetate prednisolone sodium phosphate sulfacetamide sodium/prednisolone sodium phosphate tobramycin/dexamethasone PREFERRED BRAND Alrex Blephamide S.o.p. Durezol Fml Lotemax Pred Mild Tobradex St Zylet NON PREFERRED Blephamide Flarex Fml Forte Fml Liquifilm Maxidex Maxitrol Omnipred Poly-pred Pred Forte Pred-g Pred-g S.o.p. Tobradex Vexol Effective January l, 2013 Fosamax Fosamax Plus D Skelid SERM PREFERRED BRAND Evista Iÿ.'ÿ'ÿ1: [oÿ:[uJnl[o.];.l ATYPICAL ANTIPSYCHOTICS GENERIC chlorpromazine hcl clozapine Clozapine Odt compro fluphenazine decanoate fluphenazine hcl haloperidol haloperidol decanoate haloperidol lactate Lithium Carbonate lithium carbonate er Lithium Citrate Ioxapine Ioxapine succinate olanzapine olanzapine odt perphenazine prochlorperazine prochlorperazine edisylate prochlorperazine maleate quetiapine fumarate risperidone Risperidone M-tab risperidone odt thioridazine hcl thiothixene trifluoperazine hcl ziprasidone hcl PREFERRED BRAND Abilify Abilify Discmelt Latuda Seroquel Xr NON PREFERRED Clozaril Equetro Fanapt Fanapt Titration Pack Fazaclo Geodon Haldol Haldol Decanoate 100 Haldol Decanoate 50 Invega Invega Sustenna Lithobid Loxitane Navane Risperdal Risperdal Consta Risperdal M-tab Saphris Seroquel Zyprexa Zyprexa Relprevv Zyprexa Zydis CNS STIMULANTS GENERIC Amphetamine/dextroamphetamine dexmethylphenidate hcl dextroamphetamine sulfate dextroamphetamine sulfate er metadate er methamphetamine hcl methylin methylin er methylphenidate hcl methylphenidate hcl cd methylphenidate hcl er Methylphenidate Hcl Sr methylphenidate hydrochloride modafinil PREFERRED BRAND Daytrana Intuniv Vyvanse NON PREFERRED Adderall Adderall Xr Concerta Desoxyn Dexedrine Focalin Focalin Xr Kapvay Kapvay Dose Pack Metadate Cd Nuvigil Procentra Provigil Quillivant Xr Ritalin Ritalin La Ritalin Sr SNRI ANTIDEPRESSANTS GENERIC venlafaxine hcl venlafaxine hcl er PREFERRED BRAND Cymbalta Pristiq NON PREFERRED Effexor Xr PREFERRED BRAND GENERIC citalopram hydrobromide escitalopram oxalate fluoxetine dr fluoxetine hcl fluvoxamine maleate paroxetine hcl paroxetine hcl er sertraline hcl PREFERRED BRAND PREFERRED BRAND Advair Diskus Advair Hfa Dulera Symbicort NON PREFERRED Accuneb Arcapta Neohaler Brovana SSRI ANTIDEPRESSANTS STEROID/BETA AGONIST Foradil Aerolizer Perforomist Proair Hfa Serevent Diskus Ventolin Hfa BENIGN PRSTATC HYPRPLSIA GENERIC Isuprel Maxair Autohaler Proventil Hfa Vospire Er Xopenex Xopenex Concentrate Xopenex Hfa alfuzosin hcl er finasteride tamsulosin hcl PREFERRED BRAND Rapaflo NON PREFERRED Avodart Cardura Xl Flomax Jalyn LEUKOTRIENE RCPTR ANTGNST GENERIC Paxil montelukast sodium Zafirlukast NON PREFERRED NON PREFERRED Celexa Lexapro Accolate Singulair Proscar Uroxatral URINARY ANTISPASMODICS GENERIC Luvox Cr Paxil Cr Pexeva Prozac Prozac Weekly Zoloft ANAPHYLAXIS TX AGENTS GENERIC Epinephrine PREFERRED BRAND Epipen Epipen 2-pak Epipen-jr Epipen-jr 2-pak NON PREFERRED Twinject ANTICHOLINERGICS GENERIC GENERIC budesonide PREFERRED BRAND Alvesco Asmanex 120 Metered Doses Asmanex 14 Metered Doses Asmanex 30 Metered Doses Asmanex 60 Metered Doses Asmanex 7 Metered Doses Pulmicort Flexhaler Qvar GENERIC Atrovent Hfa Spiriva Handihaler Tudorza Pressair Astelin PREFERRED BRAND NON PREFERRED Duoneb BETA AGONISTS GENERIC albuterol sulfate albuterol sulfate er levalbuterol Levalbuterol Hcl metaproterenol sulfate terbutaline sulfate Effective January 1,2013 Detrol Ditropan XI Myrbetriq Sanctura Sanctura Xr Urecholine azelastine hcl PREFERRED BRAND Combivent Combivent Respimat NON PREFERRED NASAL ANTIHISTAMINES Astepro ipratropium bromide/albuterol sulfate Detrol La Enablex Gelnique Oxytrol Toviaz Vesicare Flovent Diskus Flovent Hfa Pulmicort PREFERRED BRAND GENERIC PREFERRED BRAND NON PREFERRED ipratropium bromide ANTICHLNRGC/BETA AGONIST bethanechol chloride flavoxate hcl oxybutynin chloride oxybutynin chloride er Tolterodine Tartrate trospium chloride trospium chloride er PULMONARY CORTICOSTEROIDS NON PREFERRED Patanase NASAL CORTICOSTEROIDS GENERIC flunisolide fluticasone propionate triamcinolone acetonide PREFERRED BRAND Nasonex Qnasl Rhinocort Aqua Veramyst NON PREFERRED Beconase Aq Flonase Nasacort Aq Omnaris Zetonna Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths. The benefit design determines what is covered and the applicable co-payment. The medications listed on this formulary are subject to change pursuant to the formulary management activities of Catamaran. The presence of a medication on this formulary list does not guarantee coverage.
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