| Generic |
Non-Preferred/Non-Formulary Brand
Name |
A |
| abacavir tablet |
Ziagen® |
| acarbose tablet |
Precose® |
| acebutolol capsule |
Sectral® |
| acetazolamide tablet |
|
| acetazolamide SR capsule |
Diamox Sequels® |
| acetic acid otic |
Acetasol® |
| acetic acid/hydrocortisone otic |
Acetasol®-HC |
| acetylcysteine solution |
|
| acyclovir tablet, capsule, suspension |
Zovirax® |
| adapalene cream |
Differin® |
albuterol
inhalation solution, tablet, syrup
|
Proventil® |
| alendronate sodium tablet, solution |
Fosamax® |
| alfuzosin tablet |
Uroxatral® |
| allopurinol tablet |
Zyloprim® |
| alprazolam ODT tablet |
Niravam® |
| alprazolam tablet |
Xanax® |
| alprazolam ER tablet |
Xanax XR |
| altavera tablet* |
Nordette®** |
| amantadine capsule, syrup |
|
| amcinonide cream, ointment,
lotion |
|
| amethia tablet* |
Seasonique®* |
| amethyst tablet* |
Lybrel® |
| amiloride tablet |
|
| amiloride/HCTZ tablet |
|
| aminocaproic acid tablet |
Amicar® |
| amiodarone tablet |
Cordarone® |
| amitriptyline tablet |
|
| amlodipine besylate/benazepril |
Lotrel® |
| amlodipine besylate tablet |
Norvasc® |
| amoxapine tablet |
Asendin® |
| amoxicillin capsule, tablet, suspension,
chews, drops |
Amoxil® |
| amoxicillin/pot. clavulanate tabs, chews,
suspension |
Augmentin® |
| amphetamine/dextroamphetamine SR capsule |
Adderall XR® |
| anagrelide capsule |
Agrylin® |
| anastrozole tablet |
Arimidex® |
| apraclonidine ophthalmic solution |
Iopidine® |
| apri tablet* |
Ortho Cept®** |
| aranelle tablet* |
Tri-Norinyl®** |
| atenolol tablet |
Tenormin® |
| atenolol/chlorthalidone tablet |
Tenoretic® |
| atorvastatin tablet |
Lipitor® |
| atovaquone-proguanil tablet |
Malarone® |
| atropine ophthalmic solution |
|
| aviane tablet* |
|
| azathioprine tablet |
Imuran® |
| azelastine nasal spray |
Astelin® |
| azelastine ophthalmic solution |
Optivar® |
| azithromycin tablet, packet, suspension |
Zithromax® |
| azurette tablet* |
Mircette® |
| « Back to
top » |
B |
| bacitracin ophthalmic solution |
|
| bacitracin/polymyxin ophthalmic ointment |
|
| baclofen tablet |
|
| balziva tablet* |
Ovcon-35® |
| benazepril tablet |
Lotensin® |
| benazepril HCL tablet |
Lotensin® |
| benzocaine/antipyrine otic |
Aurodex® |
| benzonatate capsule |
Tessalon® |
| benztropine tablet |
Cogentin® |
| betamethasone dipropionate
cream, gel, lotion, ointment |
Diprolene® |
| betamethasone valerate cream,
lotion |
Beta-val® |
| betamethasone/clotrimazole cream |
Lotrisone® |
| betamethasone dipropionate augmented cream |
Diprolene® AF |
| betaxolol ophthalmic solution |
|
| betaxolol tablet |
Kerlone® |
| bethanechol tablet |
Urecholine® |
| bicalutamide tablet++ |
Casodex® |
| briellyn tablet* |
Ovcon-35® |
| brimonidine ophthalmic solution |
Alphagan® |
| bromfenac ophthalmic solution |
Xibrom® |
| bromocriptine tablet, capsule |
Parlodel® |
| budeprion SR tablet |
Wellbutrin SR® |
| budeprion XL tablet |
Wellbutrin XL® |
| bumetanide tablet |
|
| bupropion SR tablet |
Wellbutrin SR® |
| bupropion XL tablet |
Wellbutrin XL® |
| buspirone tablet |
BuSpar® |
| « Back to
top » |
C |
| cabergoline tablet |
|
| calcipotriene solution |
Dovonex® |
| calcitonin-salmon nasal spray |
Fortical®, Miacalcin® |
| calcitriol capsule |
Rocaltrol® |
| calcium acetate capsule |
PhosLo® |
| camila tablet* |
Ortho Micronor®** |
| camrese tablet* |
Seasonique®* |
| captopril tablet |
|
| captopril/HCTZ tablet |
|
| carbamazepine capsule |
Carbatrol® |
| carbamazepine tablet, chews, suspension |
Tegretol® |
| carbidopa/levodopa tablet |
Sinemet® |
| carisoprodol tablet |
Soma® |
| carisoprodol/ASA tablet |
|
| carteolol ophthalmic solution |
|
| carvedilol tablet |
Coreg® |
| caziant tablet* |
Cyclessa® |
| cefaclor capsule, suspension |
|
| cefadroxil capsule, tablet, suspension |
Duricef® |
| cefdinir capsule, suspension |
|
| cefditoren tablet |
Spectracef® |
| cefprozil tablet, suspension |
|
| cefuroxime tablet |
Ceftin® |
| centany ointment |
|
| cephalexin capsule |
Keflex® |
| chateal tablet* |
Nordette-28®** |
| chloral hydrate capsule |
|
| chlordiazepoxide capsule |
|
| chlorhexidine gluconate
oral rinse |
Peridex® |
| chloroquine tablet |
Aralen® |
| chlorothiazide tablet |
|
| chlorpromazine tablet |
|
| chlorpropamide tablet |
|
| chlorthalidone tablet |
|
| cholestyramine/sucrose powder |
Questran® |
| ciclopirox cream, gel, shampoo, topical suspension |
Loprox® |
| ciclopirox topical solution |
Penlac® |
| cilostazol tablet |
Pletal® |
| cimetidine tablet, liquid |
Tagamet® |
| ciprofloxacin ER tablet |
Cipro XR® |
| ciprofloxacin tablet, suspension |
Cipro® |
| ciprofloxacin HCL ophthalmic solution |
Ciloxan® |
| citalopram tablet |
Celexa® |
| citric acid/sodium citrate solution |
Bicitra® |
| clarithromycin tablet |
Biaxin® |
| clarithromycin ER tablet |
Biaxin XL® |
| clemastine tablet |
Tavist® |
| clindamycin capsule |
Cleocin® |
| clindamycin topical gel,
lotion, solution |
Cleocin® |
| clindamycin/benzoyl peroxide |
BenzaClin® |
| clobetasol propionate cream,
lotion, ointment |
Temovate® |
| clomiphene citrate tablet* |
Clomid®* |
| clomipramine capsule |
Anafranil® |
| clonazepam tablet |
Klonopin® |
| clonidine patch |
Catapres-TTS® |
| clonidine tablet |
Catapres® |
| clorazepate tablet |
Tranxene® |
| clotrimazole troche |
|
| clozapine tablet |
Clozaril® |
| codeine/APAP tablet |
Tylenol® #3 |
| colestipol HCL granules, tablet |
Colestid® |
| compro rectal suppository |
|
| cortisone acetate tablet |
Cortone® |
| cromolyn ophthalmic solution |
Crolom® |
| cromolyn neb sodium solution |
|
| cryselle tablet* |
Lo/Ovral-28®** |
| cyanocobalamin injection |
|
| cyclafem tablet* |
Ortho Novum®** |
| cyclobenzaprine ER capsule |
Amrix® |
| cyclobenzaprine tablet |
Flexeril® |
| cyclophosphamide tablet++ |
|
| cyclosporine capsule, solution |
Sandimmune® |
| cyclosporine, modified capsule, solution |
Neoral® |
| « Back to
top » |
D |
| dantrolene capsule |
Dantrium ® |
| danazol capsule |
|
| dapsone tablet |
|
| daysee tablet* |
Seasonique® |
| desipramine tablet |
Norpramin® |
| desloratadine tablet |
Clarinex® |
| desmopressin tablet, nasal spray, nasal solution |
DDAVP® |
| desonide cream |
|
| desoximetasone gel, ointment,
cream |
Topicort®, Topicort LP® |
| dexamethasone intensol oral solution |
|
| dexamethasone sod phos ophthalmic
suspension |
|
| dexamethasone tablet, elixir |
|
| dextroamphetamine tablet |
Dexedrine® |
| dextroamphetamine SR capsule |
Dexedrine Spansule® |
| diazepam tablet, solution |
Valium® |
| diclofenac sod ophthalmic
solution |
|
| diclofenac tablet |
|
| diclofenac-misoprostol tablet |
Arthrotec® |
| dicyclomine capsule, tablet |
Bentyl® |
| didanosine capsule |
Videx EC® |
| diflorasone ointment, cream |
|
| diflunisal tablet |
|
| digoxin tablet, elixir |
Lanoxin®** |
| diltiazem SR capsule |
Cardizem® CD |
| diltiazem SR capsule |
Dilacor® XR |
| diltiazem tablet |
Cardizem® |
| diphenoxylate/atropine tablet |
Lomotil® |
| dipyridamole tablet |
Persantine® |
| disopyramide & ER capsule |
Norpace®, Norpace CR®** |
| disulfiram tablet |
Antabuse® |
| divalproex sodium tablet |
Depakote® |
| divalproex sodium ER tablet |
Depakote® ER |
| divalproex sodium sprinkle capsule |
Depakote Sprinkle® capsule |
| donepezil tablet |
Aricept® |
| donepezil ODT tablet |
Aricept ODT® |
| dorzolamide HCL ophthalmic solution |
Trusopt® |
| dorzolamide-timolol ophthalmic solution |
Cosopt® |
| doxazosin tablet |
Cardura® |
| doxepin capsule |
|
| doxycycline capsule, tablet |
Vibramycin® |
| dronabinol capsule |
Marinol® |
| drospirenone/ethinyl estradiol tablet* |
Yasmin® |
| dyphylline tablet |
Lufyllin® |
| « Back to
top » |
E |
| emoquette tablet* |
Ortho Cept®** |
| enalapril tablet |
Vasotec® |
| enalapril/HCTZ tablet |
Vaseretic® |
| enoxaparin injection |
Lovenox® |
| enpresse tablet* |
Triphasil®** |
| epinastine ophthalmic solution |
Elestat® |
| epitol tablet |
|
| ergotamine/caffeine tablet, suppository |
Cafergot® |
| errin tablet* |
Ortho Micronor®** |
| erythrocin stearate tablet |
|
| erythromycin base EC tablet |
Emycin® |
| erythromycin base ophthalmic ointment |
|
| erythromycin base/benzoyl peroxide gel |
Benzamycin® |
| erythromycin ethylsuc tablet, suspension |
E.E.S.® |
| erythromycin/sulfisoxazole suspension |
|
| escitalopram tablet |
Lexapro® |
| estazolam tablet |
|
| estradiol-norethindrone tablet |
Activella® |
| estradiol tablet |
Estrace® |
| estradiol transdermal patch |
Climara® |
| estropipate tablet |
|
| ethambutol tablet |
Myambutol® |
| ethosuximide syrup |
Zarontin®** |
| etidronate disodium |
Didronel® |
| etodolac capsule, tablet |
|
| etoposide capsule++ |
|
| exemestane tablet++ |
Aromasin®++ |
| « Back to
top » |
F |
| famciclovir tablet |
Famvir® |
| famotidine tablet |
Pepcid® |
| felbamate tablet, oral suspension |
Felbatol® |
| felodipine tablet |
|
| fenofibrate capsule, tablet |
|
| fenoprofen tablet |
Nalfon® capsule |
| fexofenadine |
Allegra® |
| fentanyl patch |
Duragesic® |
| finasteride tablet |
Proscar® |
| flecainide tablet |
Tambocor® |
| fluconazole tablet, oral suspension |
Diflucan® |
| flucytosine capsule |
Ancobon® |
| fludrocortisone tablet |
|
| flunisolide nasal spray |
|
| fluocinolone acetonide cream,
ointment |
|
| fluocinolone acetonide oil |
Derma-Smoothe/FS® oil |
| fluocinonide cream, ointment,
solution, gel |
|
| fluoride drops |
|
| fluorometholone ophthalmic
suspension |
Fluor-Op® |
| fluorouracil cream, solution |
Efudex® |
| fluoxetine capsule |
Prozac® |
| fluphenazine tablet |
|
| flurazepam capsule |
|
| flurbiprofen ophthalmic
solution |
Ocufen® |
| flurbiprofen tablet |
Ansaid® |
| flutamide capsule++ |
|
| fluticasone propionate cream, lotion, ointment |
Cutivate® |
| fluticasone propionate nasal spray |
Flonase® |
| fluvoxamine tablet |
Luvox® |
| folbic |
Foltx® |
| folic acid tablet |
|
| fondaparinux injection |
Arixtra® |
| fosinopril tablet |
|
| fosinopril/HCTZ tablet |
|
| furosemide tablet |
Lasix® |
| « Back to
top » |
G |
| gabapentin capsule, tablet |
Neurontin® |
| galantamine HBR tablet, oral solution |
Razadyne™ |
| gemfibrozil capsule |
Lopid® |
| gentamicin cream, ointment |
|
| gentamicin ophthalmic solution |
|
| gianvi tablet* |
Yaz®* |
| gildagia tablet* |
Ovcon-35® |
| gildess tablet* |
Loestrin®* |
| gildess fe tablet* |
Loestrin Fe®** |
| glimepiride tablet |
Amaryl® |
| glipizide tablet |
Glucotrol® |
| glipizide ER tablet |
Glucotrol® XL |
| glipizide-metformin tablet |
Metaglip™ |
| glyburide tablet |
Diabeta® |
| glyburide, micronized tablet |
Glynase® |
| granisetron HCL tablet, solution |
Kytril® |
| griseofulvin microsize tablet |
Grifulvin V® |
| griseofulvin tablet |
Gris-Peg® |
| guanfacine tablet |
Tenex® |
| « Back to
top » |
H |
| halobetasol propionate cream, ointment |
Ultravate® |
| haloperidol tablet, solution |
|
| heparin sodium injection |
|
| homatropine ophthalmic solution |
|
| hydralazine tablet |
Apresoline® |
| hydralazine/HCTZ tablet |
Apresazide® |
| hydrochlorothiazide tablet |
|
| hydrocodone/APAP tablet |
Vicodin® |
| hydrocodone/chlorpheniramine suspension |
Tussionex® Pennkinetic |
| hydrocodone/homatropine tablet, syrup |
|
| hydrocodone/ibuprofen tablet |
Vicoprofen® |
| hydrocort/polymyx/neomycin otic |
Cortisporin® Otic |
| hydrocortisone butyrate cream, ointment,
solution |
Locoid® |
| hydrocortisone cream, ointment, lotion |
Ala-cort® |
| hydromorphone tablet |
Dilaudid® |
| hydroxychloroquine tablet |
Plaquenil® |
| hydroxyurea capsule++ |
Hydrea®++ |
| hydroxyzine HCL tablet |
Atarax® |
| hydroxyzine pamoate capsule |
Vistaril® |
| « Back to
top » |
I |
| ibandronate tablet |
Boniva® |
| ibuprofen tablet |
Motrin® |
| imipramine tablet |
Tofranil® |
| imiquimod |
Aldara® |
| indapamide tablet |
|
| indomethacin capsule |
|
| introvale tablet* |
Seasonale®* |
| ipratropium bromide solution |
Atrovent® |
| ipratropium nasal spray |
Atrovent® |
| ipratropium-albuterol inhalation solution |
Duoneb® |
| irbesartan tablet |
Avapro® |
| irbesartan/hctz tablet |
Avalide® |
| isoniazid tablet |
|
| isopto homatropine ophthalmic solution |
|
| isosorbide dinitrate & ER tablet |
Isordil® & Dilatrate® SR |
| isosorbide mononitrate & ER tablet |
Imdur® |
| isotretinoin (claravis, sotret, amnesteem) capsule |
Accutane® |
| isradipine capsule |
DynaCirc® |
| itraconazole capsule* |
Sporanox®* |
| « Back to
top » |
J |
| jolessa tablet* |
Seasonale®* |
| jolivette tablet* |
Ortho Micronor®** |
| junel tablet* |
Loestrin®** |
| junel fe tablet* |
Loestrin Fe®** |
K |
| kariva tablet* |
Mircette® |
| kelnor tablet* |
|
| ketoconazole shampoo |
Nizoral® |
| ketoconazole tablet |
|
| ketoprofen capsule |
|
| ketoprofen ER capsule |
|
| ketorolac 0.4% ophthalmic solution |
Acular LS® |
| ketorolac 0.5% ophthalmic solution |
Acular® |
| kurvelo tablet* |
Nordette®** |
| « Back to
top » |
L |
| labetalol tablet |
Trandate® |
| lactulose solution |
|
| lamotrigine |
Lamictal® |
| lamivudine/zidovudine tablet |
Combivir® |
| lansoprazole capsule |
Prevacid® |
| lansoprazole ODT tablet |
Prevacid® solutab |
| latanoprost ophthalmic solution |
Xalatan® |
| leena tablet* |
Tri-Norinyl®** |
| leflunomide tablet |
Arava® |
| lessina tablet* |
|
| letrozole tablet++ |
Femara®++ |
| leuprolide non-depot injection |
|
| levetiracetam tablet, solution |
Keppra® |
| levobunolol ophthalmic solution |
Betagan® |
| levocetirizine tablet |
Xyzal® |
| levofloxacin ophthalmic solution |
Quixin® |
| levora-28 tablet* |
Nordette®** |
| levothyroxine sodium tablet |
|
| lidocaine viscous solution |
Xylocaine® |
| lindane lotion, shampoo |
|
| liothyronine sodium tablet |
Cytomel® |
| lisinopril tablet |
Zestril®, Prinivil® |
| lisinopril/HCTZ tablet |
Zestoretic® |
| lithium carbonate capsule, tablet |
|
| lithium citrate syrup |
|
| loperamide capsule |
|
| lorazepam intensol oral concentrate |
|
| lorazepam tablet |
Ativan® |
| loryna tablet* |
Yaz®* |
| losartan tablet |
Cozaar® |
| losartan/hctz tablet |
Hyzaar® |
| lovastatin tablet |
Mevacor® |
| low-ogestrel tablet* |
Lo/Ovral-28®** |
| loxapine succinate capsule |
Loxitane® |
| lutera tablet* |
|
| « Back to
top » |
M |
| malathion lotion |
Ovide® |
| maprotiline tablet |
|
| marlissa tablet* |
Nordette®** |
| meclizine tablet |
Antivert® |
| meclofenamate capsule |
|
| medroxyprogesterone acetate tablet |
|
| mefenamic acid capsule |
Ponstel® |
| megestrol tablet, syrup++ |
Megace®++ |
| meloxicam tablet |
Mobic® |
| menest tablet |
|
| meperidine tablet, syrup |
Demerol® |
| mesalamine enema |
Rowasa® |
| metaproterenol tablet, syrup |
|
| metaxalone tablet |
Skelaxin® |
| metformin ER tablet |
Glucophage® XR |
| metformin tablet |
Glucophage® |
| methadone tablet, solution, concentrate |
Dolophine® |
| methazolamide tablet |
|
| methenamine hippurate tablet |
Hiprex® |
| methenamine mandelate tablet |
|
| methimazole tablet |
Tapazole® |
| methocarbamol tablet |
Robaxin® |
| methotrexate tablet |
Rheumatrex® |
| methyclothiazide tablet |
|
| methyldopa tablet |
Aldomet® |
| methylergonovine tablet |
Methergine® |
| methylphenidate ER tablet 10mg, 20mg |
Ritalin® SR |
| methylphenidate tablet |
Ritalin® |
| methylprednisolone tablet |
Medrol® |
| metipranolol ophthalmic solution |
OptiPranolol® |
| metoclopramide tablet, syrup |
Reglan® |
| metolazone tablet |
Zaroxolyn® |
| metoprolol tablet |
Lopressor® |
| metoprolol succinate tablet |
Toprol XL® |
| metronidazole cream |
MetroCream® |
| metronidazole lotion |
MetroLotion® |
| metronidazole tablet |
Flagyl® |
| metronidazole vaginal gel |
MetroGel-Vaginal® |
| mexiletine capsule |
|
| microgestin tablet* |
Loestrin®** |
| microgestin fe tablet* |
Loestrin® Fe** |
| midodrine tablet |
Proamatine® |
| mimvey tablet |
Activella® |
| minitran patch |
Nitro-Dur® |
| minocycline capsule |
Minocin® |
| minocycline ER tablet |
Solodyn® |
| minoxidil tablet |
|
| mirtazapine tablet |
Remeron® |
| misoprostol tablet |
Cytotec® |
| moexipril/HCTZ tablet |
Uniretic® |
| moexipril HCL tablet |
Univasc® |
| mometasone cream, lotion, ointment |
Elocon® |
| mononessa tablet* |
Ortho-Cyclen®** |
| montelukast tablet, chew tab, granules |
Singulair® |
| morphine SR tablet |
MS Contin® |
| mupirocin cream, ointment |
Bactroban® |
| mycophenolate mofetil capsule, tablet |
Cellcept® |
| « Back to
top » |
N |
| nabumetone tablet |
|
| nadolol tablet |
Corgard® |
| naproxen tablet |
Naprosyn® |
| naratriptan tablet |
Amerge® |
| nateglinide tablet |
Starlix® |
| necon tablet* |
|
| nefazodone tablet |
|
| neo/polymyx/dexamethasone ophthalmic suspension,
ointment |
|
| nevirapine tablet, oral suspension |
Viramune® |
| next choice tablet* |
Plan B® |
| nicardipine capsule |
Cardene® |
| nifedipine capsule |
Procardia® |
| nifedipine SA tablet |
Adalat® CC |
| nimodipine capsule |
Nimotop® |
| nisoldipine tablet |
Sular® |
| nitrofurantoin capsule |
Macrodantin®, Macrobid® |
| nitrofurantoin oral suspension |
Furadantin® |
| nitro-time capsule |
|
| nitroglycerin capsule |
|
| nitroglycerin patch |
Nitro-Dur® |
| nora-BE tablet* |
Ortho Micronor®** |
| nortrel tablet* |
Modicon®** |
| nortriptyline capsule |
Pamelor® |
| nystatin suspension, tablet |
|
| « Back to
top » |
O |
| ocella tablet* |
Yasmin®* |
| octreotide acetate injection |
Sandostatin® |
| ofloxacin ophthalmic solution |
Ocuflox® |
| ofloxacin tablet |
|
| ogestrel tablet* |
|
| olanzapine tablet |
Zyprexa® |
| olanzapine/fluoxetine capsule |
Symbyax® |
| olanzapine ODT tablet |
Zyprexa Zydis® |
| omeprazole capsule |
Prilosec® |
| omeprazole-sodium bicarbonate capsule |
Zegerid® |
| ondansetron HCL tablet, oral solution |
Zofran® |
| ondansetron ODT tablet |
Zofran ODT® |
| opium tincture |
|
| orsythia tablet* |
|
| oxaprozin tablet |
Daypro® |
| oxazepam capsule |
|
| oxcarbazepine tablet |
Trileptal® |
| oxybutynin tablet |
Ditropan® |
| oxybutynin chloride ER |
Ditropan XL® |
| oxycodone capsule |
|
| oxycodone/APAP tablet |
Percocet® |
| oxycodone/ASA tablet |
Percodan® |
| oxymorphone tablet |
Opana® |
| « Back to
top » |
P |
| pantoprazole tablet |
Protonix® |
| paroxetine tablet |
Paxil® |
| peg-3350/kcl sol/sodium |
Nulytely® |
| penicillin V potassium tablet, suspension |
|
| pentoxifylline tablet |
Trental® |
| periogard oral liquid |
|
| permethrin 5% cream |
Elimite® |
| perphenazine tablet |
|
| phenazopyridine tablet |
Pyridium® |
| phenelzine tablet |
Nardil® |
| phenobarbital tablet, elixir |
|
| phenylbutyrate sodium oral powder |
Buphenyl® |
| phenylephrine ophthalmic
solution |
|
| phenytoin sodium capsule |
Dilantin®** |
| philith tablet* |
Ovcon-35® |
| pilocarpine ophthalmic solution |
Isopto Carpine® |
| pilocarpine tablet |
Salagen® |
| pindolol tablet |
|
| pioglitazone tablet |
Actos® |
| pioglitazone-metformin tablet |
Actoplus Met® |
| piroxicam capsule |
Feldene® |
| polyethylene glycol/electrolyte solution |
|
| portia tablet* |
Nordette®** |
| potassium chloride tablet |
|
| potassium chloride CR capsule |
|
| pramipexole tablet |
Mirapex® |
| pravastatin tablet |
Pravachol® |
| prazosin capsule |
Minipress® |
| prednicarbate cream, ointment |
Dermatop® |
| prednisolone 15mg/5ml syrup |
Prelone® |
| prednisolone acetate ophthalmic
suspension |
Pred Forte® |
| prednisolone sod phosphate
ophthalmic solution |
|
| prednisolone sod phosphate oral solution |
Orapred® |
| prednisone intensol oral concentrate |
|
| prednisone tablet, solution |
|
| previfem tablet* |
Ortho Cyclen®** |
| primaquine phosphate tablet |
|
| primidone tablet |
Mysoline®** |
| probenecid tablet |
|
| prochlorperazine tablet |
|
| promethazine tablet, suppository |
|
| propafenone tablet |
Rythmol® |
| propranolol tablet |
|
| propranolol HCL SA capsule |
Inderal® LA |
| propranolol/HCTZ tablet |
|
| propylthiouracil tablet |
|
| protriptyline tablet |
Vivactil® |
| pyrazinamide tablet |
|
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Q |
| quasense tablet* |
Seasonale®* |
| quetiapine tablet |
Seroquel® |
| quinapril tablet |
Accupril® |
| quinapril/HCTZ tablet |
Accuretic® |
| quinidine gluconate tablet |
|
| quinidine sulfate tablet |
|
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R |
| ramipril capsule |
Altace® |
| ranitidine tablet, syrup |
Zantac® |
| reclipsen tablet* |
Ortho Cept®** |
| ribavirin capsule |
Rebetol®** |
| ribavirin tablet |
Copegus® |
| rifampin capsule |
Rifadin® |
| rimantadine tablet |
Flumadine® |
| risperidone tablet, solution |
Risperdal® |
| risperidone ODT tablet |
Risperdal M-Tab® |
| rivastigmine capsule |
Exelon® |
| ropinirole HCL tablet |
Requip® |
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S |
| salsalate tablet |
|
| selegiline tablet, capsule |
Eldepryl® |
| sertraline tablet |
Zoloft® |
| sildenafil tablet |
Revatio® |
| silver sulfadiazine cream |
Silvadene® |
| simvastatin tablet |
Zocor® |
| solia tablet* |
Ortho Cept®** |
| sotalol tablet |
Betapace® |
| spironolactone tablet |
Aldactone® |
| spironolactone/HCTZ tablet |
Aldactazide® |
| sprintec tablet* |
Ortho Cyclen®** |
| sronyx tablet* |
|
| stavudine capsule, oral solution |
Zerit® |
| sucralfate tablet |
Carafate® |
| sulfacetamide ophthalmic solution |
Bleph®-10 |
| sulfacetamide sodium topical suspension |
Klaron® |
| sulfadiazine tablet |
|
| sulfamethoxazole/trimethoprim tablet, suspension |
Bactrim® |
| sulfasalazine tablet |
Azulfidine® EN-tabs® |
| sulindac tablet |
Clinoril® |
| sumatriptan succinate injection, tablet |
Imitrex® injection, tablet |
| sumatriptan nasal spray |
Imitrex® nasal spray |
| syeda tablet* |
Yasmin® |
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T |
| tacrolimus capsule |
Prograf® |
| tamoxifen tablet++ |
|
| tamsulosin capsule |
Flomax® |
| temazepam capsule |
Restoril® |
| terbinafine HCL tablet |
Lamisil® |
| terazosin capsule |
|
| tetracycline capsule |
|
| theophylline tablet, solution |
|
| thioridazine tablet, solution |
|
| thiothixene capsule |
Navane® |
| thyroid dessicated tablet |
|
| tiagabine tablet |
Gabitril® |
| ticlopidine tablet |
|
| tilia FE tablet |
Estrostep® FE |
| timolol maleate ophthalmic
solution |
Timoptic® |
| timolol maleate ophthalmic gel solution |
Timoptic-XE® |
| timolol maleate tablet |
|
| tinidazole tablet |
Tindamax® |
| tizanidine tablet |
Zanaflex® |
| tobramycin ophthalmic solution |
Tobrex® |
| tobramycin/dexamethasone ophthalmic suspension |
Tobradex® |
| tolazamide tablet |
|
| tolbutamide tablet |
|
| tolmetin tablet |
|
| topiramate capsule |
Topamax® Sprinkle |
| topiramate tablet |
Topamax® |
| tramadol tablet |
Ultram® |
| tramadol ER tablet |
Ultram ER® |
| tramadol ER biphasic tablet |
Ryzolt® |
| tramadol/APAP tablet |
Ultracet® |
| trandolapril tablet |
Mavik® |
| trandolapril/verapamil tablet |
Tarka® |
| tranylcypromine sulfate tablet |
Parnate® |
| trazodone tablet |
|
| tretinoin capsule®++ |
|
| tretinoin cream, gel, lotion* |
Retin A®* |
| triamcinolone acetonide
cream, ointment |
|
| triamcinolone nasal spray |
Nasacort AQ® |
| triamterene/HCTZ tablet |
Maxzide® |
| triazolam tablet |
Halcion® |
| trifluoperazine tablet |
|
| trifluridine ophthalmic
solution |
Viroptic® |
| trihexyphenidyl tablet |
Artane® |
| tri-legest FE tablet |
Estrostep® FE |
| trimethobenzamide capsule |
Tigan® |
| trimethoprim tablet |
|
| trinessa tablet* |
Ortho Tri-Cyclen®** |
| tri-previfem tablet* |
Ortho Tri-Cyclen®** |
| tri-sprintec tablet* |
Ortho Tri-Cyclen®** |
| trivora-28 tablet* |
Triphasil®** |
| trospium tablet |
Sanctura® |
| « Back to
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U |
| unithroid tablet |
|
| urea cream, gel, lotion |
Keralac® |
| ursodiol capsule |
Actigall® |
| ursodiol tablet |
Urso 250®, Urso Forte® |
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V |
| valacyclovir HCL tablet |
Valtrex® |
| valproic acid capsule, syrup |
Depakene® |
| valproate sodium syrup |
Depakene® |
| valsartan/HCTZ tablet |
Diovan HCT® |
| velivet tablet* |
Cyclessa® |
| venlafaxine ER capsule, tablet |
Effexor XR® |
| venlafaxine HCL tablet |
Effexor® |
| verapamil tablet |
Calan® |
| verapamil SR tablet |
Calan SR® |
| viorele tablet* |
Mircette® |
| voriconazole tablet |
Vfend® |
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W |
| warfarin tablet |
Coumadin®** |
| « Back to
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Z |
| zaleplon capsule |
Sonata® |
| zarah tablet* |
Yasmin® |
| zafirlukast tablet |
Accolate® |
| zenchent tablet* |
Ovcon-35® |
| zenchent fe chew tab* |
Femcon Fe®* |
| zeosa chew tab* |
Femcon Fe® |
| zidovudine capsule, tablet, syrup |
Retrovir® |
| zolpidem tartrate ER tablet |
Ambien CR® |
| zolpidem tartrate tablet |
Ambien® |
| zonisamide capsule |
Zonegran® |
| zovia tablet* |
|
| « Back to
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* May not be a covered benefit under some plans.
** This brand is preferred/formulary.
++ Regence BlueCross BlueShield of Oregon members may have a different copay/coinsurance amount for cancer related medications. Please check your prescription benefit.
* May not be a covered benefit under some plans.
• Obtain from designated Specialty Pharmacy.
++ Regence BlueCross BlueShield of Oregon members may have a different copay/coinsurance amount for cancer related medications. Please check your prescription benefit.
