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Preferred Medication List/Formulary (PML)

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Generics Alphabetical List
Effective February 28, 2014
Updated March 3, 2014

This list can be used to assist you and your doctor in choosing a generic.
  • Generic medications are listed in lower case bold.
  • Non-preferred/non-formulary brands are listed only as a reference for generically available medications.
  • Not all generics are listed. Those listed are examples of some of the generic medications available.

Additional Information:

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A   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   W   X   Y   Z  

Generic Non-Preferred/Non-Formulary Brand Name
A
abacavir tablet Ziagen®
abacavir-lamivud-zidovud tablet Trizivir®
acamprosate calcium tablet Campral®
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  
acitretin capsule Soriatane®
acyclovir tablet, capsule, suspension Zovirax®
adapalene cream Differin® cream, gel
adefovir dipivoxil tablet Hepsera®
albuterol inhalation solution AccuNeb®
albuterol 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-atorvastatin Caduet®
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®
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®
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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 valerate foam Luxiq®
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®
buprenorphrine-naloxone tablet Suboxone®
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®
butalbital-aspirin-caffeine-codeine capsule Fiorinal-Codeine #3®
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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®*
candesartan tablet Atacand®
candesartan-hctz tablet Atacand HCT®
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®
cevimeline capsule Evoxac®
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 HCL ER tablet Kapvay®
clonidine patch Catapres-TTS®
clonidine tablet Catapres®  
clopidogrel tablet Plavix®
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®
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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  
dexmethylphenidate ER capsule Focalin XR®
dexmethylphenidate tablet Focalin®
dextroamphetamine tablet Dexedrine®
dextroamphetamine SR capsule Dexedrine Spansule®
diazepam tablet, solution Valium®
diclofenac gel Solaraze®
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®
doxycycline monohydrate tablet Adoxa®
dronabinol capsule Marinol®
drospirenone/ethinyl estradiol tablet* Yasmin®
duloxetine capsule Cymbalta®
dyphylline tablet Lufyllin®
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E
emoquette tablet* Ortho Cept®**
enalapril tablet Vasotec®
enalapril/HCTZ tablet Vaseretic®
enoxaparin injection Lovenox®
enpresse tablet* Triphasil®**
entacapone tablet Comtan®
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  
eszopiclone tablet Lunesta®
ethambutol tablet Myambutol®
ethosuximide syrup Zarontin®**
etidronate disodium Didronel®
etodolac capsule, tablet  
etoposide capsule++  
exemestane tablet++ Aromasin®++
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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 otic oil Dermotic®
fluocinolone acetonide topical 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®
fluvastatin capsule Lescol®
fluvoxamine tablet Luvox®
folbic Foltx®
folic acid tablet  
fondaparinux injection Arixtra®
fosinopril tablet  
fosinopril/HCTZ tablet  
furosemide tablet Lasix®
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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®
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H
halobetasol propionate cream, ointment Ultravate®
haloperidol tablet, solution  
heparin sodium injection  
homatropine ophthalmic solution  
hydralazine tablet Apresoline®
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®
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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®*
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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  
ketodan topical Extina®
ketoprofen capsule  
ketoprofen ER capsule  
ketorolac 0.4% ophthalmic solution Acular LS®
ketorolac 0.5% ophthalmic solution Acular®
kurvelo tablet* Nordette®**
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L
labetalol tablet Trandate®
lactulose solution  
lamotrigine Lamictal®
lamivudine tablet Epivir®, Epivir HBV®
lamivudine/zidovudine tablet Combivir®
lansoprazole-amoxicillin-clarithro capsule Prevpac®
lansoprazole capsule Prevacid®
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 patch Lidoderm®
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  
lomustine capsule++ CeeNu®
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*  
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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®
methamphetamine HCL Desoxyn®
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 CD capsule Metadate® CD
methylphenidate ER tablet 10mg, 20mg Ritalin® SR
methylphenidate ER tablet 18mg, 27mg, 36mg, 54mg Concerta®
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 gel MetroGel®
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®
moderiba tablet  
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®
moxifloxacin Avelox®
mupirocin cream, ointment Bactroban®
mycophenolate mofetil capsule, tablet Cellcept®
mycophenolic acid Myfortic®
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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®
niacin ER tablet Niaspan®
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  
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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® 
omega-3 acid ethyl esters capsule Lovaza® 
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®
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P
pantoprazole tablet Protonix®
paricalcitol capsule Zemplar®
paroxetine tablet Paxil®
peg-3350/kcl sol/sodium Nulytely®
penicillin V potassium tablet, suspension  
pentoxifylline tablet Trental®
perindopril erbumine tablet Aceon®
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-glimepiride tablet Duetact®
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
rabeprazole tablet Aciphex®
raloxifene tablet Evista®
ramipril capsule Altace®
ranitidine tablet, syrup Zantac®
reclipsen tablet* Ortho Cept®**
repaglinide tablet Prandin®
ribavirin capsule Rebetol®**
ribavirin tablet Copegus®
rifabutin capsule Mycobutin®
rifampin capsule Rifadin®
riluzole tablet Rilutek®
rimantadine tablet Flumadine®
risperidone tablet, solution Risperdal®
risperidone ODT tablet Risperdal M-Tab®
rivastigmine capsule Exelon®
rizatriptan tablet Maxalt®
rizatriptan ODT tablet Maxalt® MLT
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®
sirolimus tablet Rapamune®
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®
telmisartan tablet Micardis®
telmisartan/HCTZ Micardis HCT®
telmisartan-amlodipine tablet Twynsta®
temazepam capsule Restoril®
temozolomide capsule++ Temodar®
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 oral inhalation solution Tobi®
tobramycin ophthalmic solution Tobrex®
tobramycin/dexamethasone ophthalmic suspension Tobradex®
tolazamide tablet  
tolbutamide tablet  
tolmetin tablet  
tolterodine tablet Detrol®
tolterodine ER capsule Detrol LA®
topiramate capsule Topamax® Sprinkle
topiramate tablet Topamax®
torsemide tablet Demadex®
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®*
tretinoin microsphere gel* Retin-A Micro® gel
triamcinolone acetonide cream, ointment  
triamcinolone nasal spray Nasacort AQ®
triamterene-HCTZ capsule Dyazide®
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®
trospium ER capsule Sanctura XR®
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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, suspension Vfend®
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W
warfarin tablet Coumadin®**
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X
xulane patch Ortho Evra®
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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®
ziprasidone capsule Geodon®
zolmitriptan tablet Zomig®
zolmitriptan ODT tablet Zomig-ZMT®
zolpidem tartrate ER tablet Ambien CR®
zolpidem tartrate tablet Ambien®
zonisamide capsule Zonegran®
zovia tablet*  
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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.

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Preferred/Formulary Brands Alphabetical List
Effective October 1, 2014
Updated October 3, 2014

This list can assist you in choosing a preferred/formulary brand medication.
  • Preferred/formulary products are limited to the dosage form and strength listed; if no strength is listed, all strengths for the listed dosage form are preferred/formulary.
  • Sustained action/release (SA/SR), extended release (ER/XR), long-acting (LA), and enteric coated (EC) medications are only preferred or formulary if listed.
  • Occasionally, preferred/formulary medications may be contract exclusions and therefore are not covered.
  • Some medications may require prior authorization or have quantity limits.
  • If you can't find the medication you are looking for here, try the Rx Price guide or Alternatives to Non-Formulary Medications.
  • Please note that this list may change.

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A   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   W   X   Y   Z  

A
Abilify® tablet, solution
Abilify Discmelt® tablet
Aclovate® cream, ointment
Actonel® tablet
Actonel® with Calcium tablet
Adderall XR® capsule
Advair Diskus® oral inhaler
Advair® HFA oral inhaler
Albenza® tablet
Alinia® tablet, suspension
Alkeran® tablet++
Alocril® ophthalmic solution
Alora® patch
Alphagan® P ophthalmic solution
Alrex®ophthalmic suspension
Alvesco® oral inhaler
Analpram-HC® rectal cream, lotion
Androgel® gel
Apokyn® injection
Apriso® capsule
Aranesp® injection
Armour® Thyroid tablet
Asacol® tablet, oral solution
Asacol® HD tablet
Asmanex® twisthaler
Atelvia™ tablet
Atripla® tablet
Atrovent HFA® oral inhaler
Avodart® capsule
Avonex® injection
Azelex® cream
Azilect® tablet
Azopt® ophthalmic suspension

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B
Bactroban Nasal® ointment
Baraclude® tablet
Benicar® tablet
Benicar HCT® tablet
Betimol® ophthalmic solution
Betoptic S® ophthalmic suspension
Biltricide® tablet
Blephamide® S.O.P. ophthalmic ointment
Buphenyl® tablet
Bydureon™ injection
Byetta® injection

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C
Canasa® rectal suppository
Capex® shampoo
Carac®cream++
Carnitor® tablet, liquid
Cayston® inhalation solution
Cellcept® suspension
Celontin® tablet, capsule
Chemet® capsule
Ciloxan® ophthalmic ointment
Ciprodex® otic suspension
Cipro HC® otic suspension
Cloderm® cream
Coartem® tablet
Colcrys® tablet
Combivent® oral inhaler
Combivent® Respimat® oral inhaler
Complera® tablet
Condylox® gel, solution
Copaxone® injection
Cordran® lotion, tape, ointment, cream
Cortifoam® rectal foam
Coumadin® tablet
Creon® capsule
Crestor® tablet
Crixivan® capsule
Cuprimine® capsule
Cyclogyl® ophthalmic solution
Cystadane® oral powder

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D
Daraprim® tablet
Depen® tablet
Desogen® tablet*
Dexilant™ capsule
Diabetic supplies: lancets, needles, syringes
   - Please check if these are covered by your prescription benefit.
Dialyvite® tablet
Diaphragms*
Diastat® rectal gel
Diastat® AcuDial™ rectal gel
Dilantin® capsule, chews, suspension
Dipentum® capsule
Divigel®
Droxia®capsule++
Dulera® oral inhaler

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E
Edurant® tablet
Eliphos™ tablet
Eliquis® tablet
Elmiron® capsule
Emcyt® capsule++
Emend® capsule
Emtriva® capsule
Enbrel® injection
Enjuvia® tablet
Epifoam® topical foam
Epipen® injection
Epipen® Jr injection
Epivir® solution
Epivir HBV® solution
Epogen® injection
Epzicom® tablet
Ergomar® tablet
Eurax® cream, lotion
Exelon® solution, patch

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F
Fareston® tablet++
FemHRT® tablet
Firazyr® injection
Flovent® Diskus® oral inhaler
Flovent® HFA oral inhaler
Fluoroplex® cream++
FML® S.O.P. ointment
Foradil® oral inhaler
Fragmin® injection
Fuzeon® injection

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G
Gabitril® tablet
Galzin® capsule
Gleevec® tablet++
Glucagon® injection

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H
Helidac® combo pak
Hexalen® capsule++
Humalog® insulins
Humira® injection
Humulin® insulins

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I
Incivek® tablet
Increlex™ injection
Innopran XL™ capsule
Intelence® tablet
Intron® A injection
Invirase® capsule
Isentress® tablet
Isopto® Atropine ophthalmic solution

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J
Jalyn™ capsule
Janumet® tablet
Janumet XR® tablet
Januvia® tablet
Juvisync™ tablet

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K
Kaletra® tablet, solution
Kalydeco™ tablet
Kristalose® packet
K-Tab® tablet

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L
Lanoxin® tablet, elixir
Lantus® insulin
Lantus® SoloSTAR® insulin
Letairis® tablet
Leukeran® tablet++
Leukine® injection
Levemir® insulin
Levothroid® tablet
Levoxyl® tablet
Lexiva® tablet, oral suspension
Lithobid® tablet
Loestrin® Fe tablet*
Lotemax® ophthalmic suspension
Lysodren® tablet++

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M
Matulane® capsule++
Mephyton® tablet
Mepron® oral suspension
Mesnex® tablet++
Mestinon® tablet, syrup
Methitest® tablet
Miacalcin® injection
Micronor® tablet*
Migranal® nasal spray
Modicon® tablet*
Myleran® tablet++
Mysoline® tablet

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N
Natacyn® ophthalmic suspension
Natroba™ topical suspension
Nebupent® aerosol powder for inhalation
Neupogen® injection
Nexavar® tablet++
Nilandron® tablet++
Nordette® tablet*
Norinyl® tablet*
Noritate® cream
Norpace® CR capsule
Nor-QD® tablet*
Norvir®
Novolin® insulins
Novolog® insulins
Noxafil® suspension
Nutropin® injection*•
Nutropin AQ® injection*•
NuvaRing®

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O
Omnitrope®*• injection
OneTouch® test strips*
   - Please check if these are covered by your prescription benefit.
OneTouch® Ultra test strips*
OneTouch® Verio test strips*
Orap® tablet
Ortho Cept® tablet*
Ortho Cyclen® tablet*
Ortho Micronor® tablet*
Ortho Novum® tablet*
Ortho Tri-Cyclen® tablet*
Ortho Tri-Cyclen® Lo tablet*

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P
Pancreaze™ capsule
Pataday™ ophthalmic solution
Patanol® ophthalmic solution
Peak Flow Meters
Pegasys® injection
Peg-Intron® injection
Peg-Intron® Redipen injection
Pentasa® capsule
Phenytek® capsule
Phisohex® liquid
Pilopine HS® ophthalmic gel
Plavix® tablet
Pradaxa® capsule
Pred Mild® ophthalmic suspension
Prefest® tablet
Premarin® tablet
Premarin® vaginal cream
Premphase® tablet
Prempro® tablet
Prezista® tablet, suspension
ProAir® HFA oral inhaler
Procrit® injection
ProctoFoam®-HC rectal foam
Proglycem® oral suspension
Protopic® ointment
Pulmicort® oral inhaler
Pulmicort® respules
Pulmozyme® inhalation solution
Purinethol® tablet++

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Q
QVAR® oral inhaler

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R
Rapamune® solution
Rebetol® oral solution
Rebif® injection
Relpax® tablet
Remicade® - Covered only under the medical benefit.
Rescriptor® tablet
Revlimid® capsule
Reyataz® capsule
Ridaura® capsule

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S
Selzentry® tablet
Sensipar® tablet
Serevent Diskus® oral inhaler
Seromycin® capsule
Serophene® tablet*
Seroquel XR tablet
Simponi® injection
Sovaldi™ tablet
Spacer Devices
Spiriva® oral inhaler
Sporanox®, solution*
Sprycel® tablet
Stalevo® tablet
Stelara® injection
Stimate® nasal spray
Stribild tablet
Stromectol® tablet
Suboxone® SL film
Sustiva® capsule, tablet
Sutent® capsule
Synthroid® tablet
Syprine® capsule

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T
Tabloid® tablet++
Tamiflu® capsule, suspension
Tarceva® tablet
Tasigna® capsule
Tazorac® cream, gel
Tegretol® XR tablet
Terazol® vaginal cream
Testred® capsule
Thyrolar® tablet
Tikosyn® capsule
TobraDex® ointment
Toviaz® tablet
Tracleer® tablet
Travatan Z® ophthalmic solution
Tri-Norinyl® tablet*
Triphasil® tablet*
Truvada® tablet

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U
Ulesfia® lotion
Uloric® tablet

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V
Vagifem® vaginal tablet
Valcyte® tablet, solution
Ventavis® inhalation solution
Ventolin® HFA oral inhaler
Vesicare® tablet
Viagra® tablet
Victrelis™ capsule
Videx® solution
Viracept® tablet
Viread® tablet
Visicol® tablet
Vivelle-DOT® patch
Voltaren® gel
Vyvanse® capsule

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X
Xarelto® tablet
Xeloda® tablet++

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Y
Yodoxin® tablet

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Z
Zarontin® capsule, syrup
Zelboraf® tablet
Zenpep® capsule
Ziagen® oral solution
Zytiga® tablet
Zyvox® tablet, oral suspension

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* 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.

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