ANTIFUNGALS
(Systemic)
fluconazole tablet, oral suspension
(Diflucan®)
griseofulvin ultramicronized
tablet (Fulvicin® P/G)
ketoconazole
tablet (Nizoral®)
nystatin
suspension, tablet (Mycostatin®)
terbinafine HCL tablet (Lamisil®)
Ancobon® capsule
Grifulvin V® oral susp
Mycelex® Troche
Sporanox® capsule, solution*
ANTI-INFECTIVES
amoxicillin capsule, suspension, tablet, chews,
drops (Amoxil®)
amoxicillin/pot.
clavulanate tabs, chews, suspension (Augmentin®)
azithromycin tablet, packet, suspension (Zithromax®)
cefaclor capsule, suspension (Ceclor®)
cefadroxil capsule, tablet (Duricef®)
cefdinir capsule, suspension (Omnicef®)
cefuroxime tablet (Ceftin®)
cephalexin capsule (Keflex®)
cephradine capsule (Velosef®)
chloroquine tablet (Aralen®)
ciprofloxacin tablet, suspension (Cipro®)
clindamycin capsule (Cleocin®)
dicloxacillin capsule (Dynapen®)
doxycycline capsule, tablet (Vibramycin®)
erythromycin base EC tablet (Emycin®)
erythromycin ethylsuc tablet, suspension
(EES®)
erythromycin/sulfisoxazole suspension
(Pediazole®)
ethambutol tablet
(Myambutol®)
hydroxychloroquine tablet
(Plaquenil®)
isoniazid tablet
mebendazole chewtabs (Vermox®)
metronidazole tablet (Flagyl®)
minocycline capsule (Minocin®)
nitrofurantoin capsule (Macrodantin®,
Macrobid®)
penicillin V potassium tablet,
suspension (Veetids®)
primaquine
phosphate tablet
pyrazinamide tablet
rifampin capsule (Rifadin®)
rimantadine tablet (Flumadine®)
sulfamethoxazole/trimethoprim tablet, suspension (Bactrim®, Septra®)
sulfadiazine
tablet (Microsulfon®)
sulfisoxazole
tablet, suspension (Gantrisin®)
tetracycline
capsule (Achromycin®)
trimethoprim
tablet (Proloprim®)
Albenza® tablet
Alinia® tablet, suspension
Augmentin ES-600® oral suspension
Avelox® tablet
Biltricide® tablet
Cefzil®oral suspension
Dapsone® tablet
Daraprim® tablet
Fansidar® tablet
Fungizone® oral suspension
Furadantin® oral suspension
Furoxone® tablet, oral suspension
Humatin® capsule
Lamprene® capsule
Lariam® tablet
Mepron® oral suspension
Mintezol® oral suspension, chewable
Mycobutin® capsule
Periostat® tablet
Primaquine® tablet
Seromycin® capsule
Stromectal® tablet
Vfend® tablet, oral suspension
Yodoxin® tablet
Zyvox® tablet, oral suspension
ANTINEOPLASTICS++
cyclophosphamide tablet (Cytoxan®)
etoposide capsule (Toposar®, Vepesid®)
flutamide capsule (Eulexin®)
hydroxyurea capsule (Hydrea®)
leucovorin tablet (Wellcovorin®)
megestrol tablet, syrup (Megace®)
tamoxifen tablet (Nolvadex®)
tretinoin capsule (Vesanoid®)
Alkeran® tablet
Arimidex® tablet
Aromasin® tablet
Casodex® tablet
CeeNu® capsule
Droxia® capsule
Emcyt® capsule
Fareston® tablet
Femara® tablet
Gleevec® tablet, capsule
Hexalen® capsule
Leukeran® tablet
Lysodren® tablet
Matulane® capsule
Mesnex® tablet
Myleran® tablet
Nexavar® tablet
Nolvadex® tablet
Purinethol® tablet
Revlimid® capsule
Temodar® capsule
Thioguanine® tablet
Xeloda® tablet
ANTI-VIRALS/HIV/AIDS
acyclovir tablet, capsule, suspension (Zovirax®)
amantadine capsule, syrup (Symmetrel®)
famciclovir tablet (Famvir®)
ganciclovir capsule (Cytovene®)
ribavirin capsule (Rebetol®)
Agenerase® capsule, oral solution
Atripla® tablet
Baraclude® tablet
Combivir® tablet
Copegus® tablet
Crixivan® capsule
Emtriva® capsule
Epivir® tablet, oral solution
Epivir HBV® tablet, oral solution
Epzicom ® tablet
Fortovase® capsule
Hivid® tablet
Invirase® capsule
Isentress™ tablet
Kaletra® capsule, oral solution
Lexiva® tablet, oral suspension
Norvir® capsule, oral solution
Prezista® tablet
Rebetol® capsule, oral solution
Rescriptor® tablet
Retrovir® capsule, tablet, syrup
Reyataz® capsule
Selzentry™ tablet
Sustiva® capsule, tablet
Trizivir® tablet
Valtrex® tablet
Videx® chew tab, solution, packet
Videx® EC capsule
Viracept® tablet, powder for oral solution
Viramune® tablet, oral suspension
Viread® tablet
Zerit® capsule, oral solution
Ziagen® tablet, oral solution
BEHAVIOR MODIFICATION
amphetamine/dextroamphetamine tablet
(Adderall®)
dextroamphetamine SR capsule
(Dexedrine Spansule®)
dextroamphetamine
tablet (Dexedrine®)
disulfiram
tablet (Antabuse®)
methylphenidate
tablet (Ritalin®)
methylphenidate
ER tablet (Ritalin® SR)
pemoline
tab, chewtab (Cylert®)
Adderall XR™ capsule
Antabuse® tablet
Metadate® CD capsule
Vyvanse® capsule
BLOOD MODIFIERS
dipyridamole tablet (Persantine®)
pentoxifylline tablet (Trental®)
ticlopidine tablet (Ticlid®)
warfarin tablet (Coumadin®)
Agrylin® capsule
Coumadin® tablet
Mephyton® tablet
Plavix® tablet
BONE & JOINT
alendronate sodium tablet (Fosamax®)
allopurinol tablet (Zyloprim®)
colchicine tablet
etidronate disodium (Didronel®)
methotrexate tablet (Rheumatrex®)
probenecid
tablet (Benemid®)
sulfasalazine
tablet (Azulfidine® EN-tabs®)
Actonel® tablet
Arava® tablet
Cuprimine® capsule
Depen® tablet
Evista® tablet
Fosamax® oral solution
Miacalcin® nasal spray
Ridaura® capsule
CARDIOVASCULAR
acebutolol capsule (Sectral®)
amiloride tablet (Midamor®)
amiloride/HCTZ tablet (Moduretic®)
aminocaproic acid tablet (Amicar®)
amiodarone tablet (Cordarone®)
amlodipine besylate/benazepril (Lotrel®)
amlodipine besylate tablet (Norvasc®)
atenolol tablet (Tenormin®)
atenolol/chlorthalidone tablet (Tenoretic®)
benazepril HCL tablet (Lotensin®)
betaxolol tablet (Kerlone®)
bumetanide tablet (Bumex®)
captopril tablet (Capoten®)
captopril/HCTZ tablet (Capozide®)
carvedilol tablet (Coreg®)
chlorothiazide tablet (Diuril®)
chlorthalidone tablet (Hygroton®)
clonidine tablet (Catapres®)
digoxin tablet, elixir (Lanoxin®)
diltiazem tablet (Cardizem®)
diltiazem SR capsule (Cardizem®
SR)
diltiazem SR capsule (Cardizem®
CD)
diltiazem SR capsule (Dilacor®
XR)
disopyramide & ER capsule (Norpace®, Norpace CR®)
doxazosin
tablet (Cardura®)
enalapril
tablet (Vasotec®)
enalapril/HCTZ
tablet (Vaseretic®)
felodipine
tablet (Plendil®)
flecainide
tablet (Tambocor®)
fosinopril
tablet (Monopril®)
furosemide
tablet (Lasix®)
guanfacine
tablet (Tenex®)
hydralazine
tablet (Apresoline®)
hydralazine/HCTZ
tablet (Apresazide®)
hydrochlorothiazide
tablet (Oretic®)
indapamide
tablet (Lozol®)
isosorbide
dinitrate & ER tablet (Isordil® &
Dilatrate® SR)
isosorbide mononitrate
& ER tablet (Ismo® & Imdur®)
labetalol tablet (Trandate®)
lisinopril tablet (Zestril®, Prinivil®)
lisinopril/HCTZ tablet (Zestoretic®)
methyclothiazide tablet (Enduron®)
methyldopa tablet (Aldomet®)
metolazone tablet (Zaroxolyn®)
metoprolol tablet (Lopressor®)
metoprolol succinate tablet (Toprol XL®)
methazolamide tablet (Neptazane®)
mexiletine capsule (Mexitil®)
minoxidil tablet (Loniten®)
moexipril HCL tablet (Univasc®)
moexipril/HCTZ tablet (Uniretic®)
nadolol tablet (Corgard®)
nicardipine
capsule (Cardene®)
nifedipine
capsule (Procardia®)
nifedipine
SA tablet (Adalat® CC)
nimodipine capsule (Nimotop®)
nitroglycerin
patch (Minitran®, Nitro-Dur®)
nitroglycerin
capsule (NitroTime®)
pindolol
tablet (Visken®)
potassium
chloride tablet (K-Dur®)
prazosin
capsule (Minipress®)
procainamide
capsule (Pronestyl®)
procainamide
SA tablet (Pronestyl SR®)
propafenone
tablet (Rythmol®)
propranolol
tablet (Inderal®)
propranolol HCL SA capsule (Inderal® LA)
propranolol/HCTZ
tablet (Inderide®)
quinidine
gluconate tablet (Quinaglute®)
quinidine
sulfate tablet (Quinidex®)
ramipril capsule (Altace®)
sotalol
tablet (Betapace®)
spironolactone
tablet (Aldactone®)
spironolactone/HCTZ
tablet (Aldactazide®)
terazosin
capsule (Hytrin®)
timolol maleate
tablet (Blocadren®)
trandolapril tablet (Mavik®)
triamterene/HCTZ
tablet (Maxzide®)
verapamil
tablet (Calan®)
Benicar® tablet
Benicar HCT® tablet
Catapres-TTS® patch
Cordarone® tablet
Kaon-CL-10® tablet
K-Dur® tablet
K-Lyte® DS tablet
Lanoxicaps®
Lanoxin® tablet, elixir
Micardis® tablet
Micardis HCT® tablet
Micro-K® capsule
Norpace® CR capsule
Procanbid® tablet
Sular® tablet
Tikosyn® capsule
Zaroxolyn® tablet
CHOLESTEROL LOWERING
cholestyramine/sucrose powder (Questran®)
colestipol HCL granules, tablet (Colestid®)
gemfibrozil capsule (Lopid®)
lovastatin tablet (Mevacor®)
Crestor® tablet
Niaspan® tablet
Vytorin® tablet
DIABETES
acarbose tablet (Precose®)
acetohexamide tablet (Dymelor®)
chlorpropamide tablet (Diabinese®)
glipizide tablet (Glucotrol®)
glipizide ER tablet (Glucotrol®
XL)
glyburide tablet (Diabeta®)
glyburide, micronized tablet (Glynase®)
metformin tablet (Glucophage®)
metformin ER tablet (Glucophage®
XR)
tolazamide tablet (Tolinase®)
tolbutamide tablet (Orinase®)
Actos® tablet
Avandia® tablet
Glucagen® injection
Glucagon® injection
Humalog® insulins
Humulin® insulins
Lantus® insulin
Lantus® SoloSTAR® insulin
Novolin® insulins
Novolog® insulins
Prandin® tablet
Proglycem® capsule, oral suspension
DIABETIC SUPPLIES
| Please check if these are covered by your prescription
benefit: |
| Ascensia® test strips*
Ascensia Breeze® 2 test strips*
Ascensia Contour® test strips*
Lancets, needles, syringes (all products) |
EAR/NOSE/THROAT
acetic acid otic (Acetasol®)
acetic acid/hydrocortisone otic (Acetasol®-HC)
benzocaine/antipyrine otic (Aurodex®)
benzonatate capsule (Tessalon®)
clemastine tablet (Tavist®)
flunisolide nasal spray (Nasalide®)
fluticasone propionate nasal spray (Flonase®)
hydrocort/polymyx/neomycin otic (Cortisporin®
Otic)
ipratropium nasal spray (Atrovent®)
Astelin®nasal spray
BromHist® oral solution
Carboxine-PSE® liquid
Cerumenex® otic solution
Cipro® HC otic suspension
Ciprodex® otic suspension
Nasacort® AQ nasal spray
Nasonex® nasal spray
Relacon-HC® syrup
Rescon JR® capsule
Rhinocort® Aqua® nasal spray
GASTROINTESTINAL
cimetidine tablet, liquid (Tagamet®)
dicyclomine capsule, tablet (Bentyl®)
diphenoxylate/atropine tablet (Lomotil®)
famotidine tablet (Pepcid®)
granisetron HCL tablet, solution (Kytril®)
hyoscyamine capsule (Cystospaz-M®)
lactulose syrup (Enulose®)
loperamide capsule, liquid (Imodium®)
meclizine tablet (Antivert®)
mesalamine enema (Rowasa®)
metoclopramide tablet, syrup (Reglan®)
misoprostil tablet (Cytotec®)
omeprazole capsule (Prilosec®)
ondansetron HCL tablet, oral solution (Zofran®)
ondansetron tablet (Zofran ODT®)
pantoprazole sodium tablet (Protonix®)
polyethylene glycol/electrolyte solution
prochlorperazine tablet (Compazine®)
promethazine tablet, suppository (Phenergan®)
ranitidine tablet, syrup (Zantac®)
sucralfate tablet (Carafate®)
sulfasalazine tablet (Azulfidine®
EN-tabs®)
trimethobenzamide capsule,
suppository (Tigan®)
ursodiol
capsule (Actigall®)
Analpram HC® rectal cream, rectal lotion
Anzemet® tablet
Asacol® ®tablet, oral solution
Canasa® rectal suppository
Colyte® powder for reconstitution
Compro® rectal suppository
Cortifoam® rectal foam
Creon® capsule
Dipentum® capsule
Epifoam® topical foam
Golytely® powder for reconstitution, packets
Helidac® combopak
Kristalose® packet
Kutrase® capsule
Ku-zyme® capsule
Ku-zyme® HP capsule
NuLytely® powder for reconstitution
Pancrease® capsule
Pancrease® MT capsule
Pancrecarb MS® capsule
Pentasa® capsule
Prevacid® capsule, suspension, solutab
PrevPac®
Prilosec OTC™ - Available at the generic copay.
ProctoFoam®-HC rectal foam
Ultrase® capsule
Ultrase® MT capsule
URSO®tablet
Viokase® tablet, powder
Visicol® tablet
HORMONE/ENDOCRINE (also see
WOMEN'S HEALTH)
calcitriol capsule (Rocaltrol®)
cortisone acetate tablet (Cortone®)
desmopressin nasal solution (DDAVP®)
dexamethasone tablet, elixir (Decadron®)
fludrocortisone tablet (Florinef®)
folic acid tablet (Folvite®)
levothyroxine sodium tablet
methimazole tablet (Tapazole®)
methylprednisolone
tablet (Medrol®)
prednisolone
15mg/5ml syrup (Prelone®)
prednisone
tablet, solution (Deltasone®)
propylthiouracil
tablet
thyroid dessicated tablet
triamcinolone tablet (Aristocort®)
unithroid tablet
Armour® Thyroid tablet
Cytomel®tablet
DDAVP® tablet, nasal spray, nasal solution
Dexamethasone Intensol® oral solution
Levothroid® tablet
Levoxyl® tablet
Methitest® tablet
Nilandron® tablet
Orapred® oral solution
Pediapred® oral solution
Prednisone Intensol® oral concentrate
Stimate® nasal spray
Synthroid® tablet
Teslac® tablet
Testred® tablet
Thyrolar® tablet
Westhroid® tablet
Winstrol® tablet
IMMUNOSUPPRESSANTS
azathioprine tablet (Imuran®)
cyclosporine, modified capsule, solution
(Neoral®)
cyclosporine capsule, solution
(Sandimmune®)
CellCept® tablet, capsule, suspension
Myfortic® ER tablet
Prograf® capsule
Rapamune® tablet, solution
Sandimmune® capsule, solution |
MENTAL HEALTH
alprazolam tablet (Xanax®)
amitriptyline tablet (Elavil®)
amoxapine tablet (Asendin®)
bupropion SR tablet (Wellbutrin SR®)
buspirone tablet (BuSpar®)
chloral hydrate capsule
chlordiazepoxide
capsule (Librium®)
chlorpromazine
tablet, drops, syrup (Thorazine®)
citalopram
tablet (Celexa®)
clomipramine
capsule (Anafranil®)
clonazepam
tablet (Klonopin®)
clorazepate
tablet (Tranxene®)
clozapine
tablet (Clozaril®)
desipramine
tablet (Norpramin®)
diazepam
tablet, solution (Valium®)
doxepin
capsule (Sinequan®)
estazolam
tablet (Prosom®)
fluoxetine
capsule (Prozac®)
fluphenazine
tablet, concentrate, elixir (Prolixin®)
flurazepam capsule (Dalmane®)
fluvoxamine tablet (Luvox®)
haloperidol tablet, solution (Haldol®)
hydroxyzine HCL tablet (Atarax®)
hydroxyzine pamoate capsule (Vistaril®)
imipramine tablet (Tofranil®)
lithium carbonate capsule (Eskalith®)
lithium citrate syrup
lorazepam
tablet (Ativan®)
loxapine succinate
capsule (Loxitane®)
maprotiline
tablet (Ludiomil®)
mirtazapine
tablet (Remeron®)
nefazodone
tablet (Serzone®)
nortriptyline
capsule (Pamelor®)
oxazepam
capsule (Serax®)
paroxetine
tablet (Paxil®)
perphenazine
tablet (Trilafon®)
phenobarbital
tablet, elixir
protriptyline tablet
(Vivactil®)
sertraline tablet (Zoloft®)
temazepam capsule (Restoril®)
thioridazine tablet,
solution (Mellaril®)
thiothixene
capsule (Navane®)
tranylcypromine sulfate tablet (Parnate®)
trazodone
tablet (Desyrel®)
triazolam
tablet (Halcion®)
trifluoperazine
tablet (Stelazine®)
venlafaxine HCL tablet (Effexor®)
zolpidem tartrate tablet (Ambien®)
Effexor XR® capsule
Eskalith® capsule, tablet
Eskalith CR® tablet
Lithobid® tablet
Lorazepam Intensol® oral concentrate
Moban® tablet, oral concentrate
Nardil® tablet
Orap® tablet
Risperdal® tablet, solution
Seroquel® tablet
Zyprexa® tablet
Zyprexa® Zydis® tablet
MUSCLE
RELAXANTS
baclofen tablet (Lioresal®)
carisoprodol tablet (Soma®)
carisoprodol/ASA tablet (Soma®
Compound)
cyclobenzaprine tablet
(Flexeril®)
methocarbamol tablet
(Robaxin®)
methocarbamol/ASA tablet
(Robaxisal®)
Dantrium® capsule
NEUROLOGICAL
benztropine tablet (Cogentin®)
bromocriptine tablet (Parlodel®)
carbamazepine tablet, chews, suspension (Tegretol®)
carbidopa/levodopa tablet (Sinemet®)
ethosuximide syrup (Zarontin®)
oxcarbazepine tablet (Trileptal®)
phenytoin sodium capsule (Dilantin®)
primidone tablet (Mysoline®)
ropinirole HCL tablet (Requip®)
selegiline tablet, capsule (Eldepryl®)
trihexyphenidyl tablet (Artane®)
valproic acid capsule, syrup (Depakene®)
Aricept® tablet
Carbatrol® capsule
Celontin® tablet, capsule
Cognex® capsule
Comtan® tablet
Depakote® tablet
Depakote® ER tablet
Depakote Sprinkle® capsule
Diastat® rectal gel
Dilantin® capsule, chews, suspension
Epitol® tablet
Exelon® capsule, solution
Felbatol® tablet, oral suspension
Gabitril® tablet
Kemadrin® tablet
Keppra® tablet, solution
Lamictal® tablet
Mebaral® tablet
Mestinon® tablet, syrup
Mirapex® tablet
Mysoline® tablet, oral suspension
Neurontin® capsule, tablet, solution
Parlodel® capsule only
Phenytek® capsule
Reminyl® tablet, solution
Rilutek® tablet
Stalevo® tablet
Tegretol® XR tablet
Topamax® tablet, sprinkle
Zarontin® capsule, syrup
Zonegran® capsule
OPHTHALMIC
acetazolamide tablet (Diamox®)
atropine ophthalmic solution (Atropair®)
bacitracin ophthalmic solution
betaxolol ophthalmic solution
brimonidine ophthalmic solution (Alphagan®)
carteolol ophthalmic solution
cromolyn ophthalmic solution (Crolom®)
dexamethasone sod phos ophthalmic suspension
diclofenac sod ophthalmic solution
dipivefrin ophthalmic solution (Propine®)
erythromycin base ophthalmic ointment
fluorometholone ophthalmic suspension (Fluor-Op®)
flurbiprofen ophthalmic solution (Ocufen®)
gentamicin ophthalmic solution (Genoptic®)
homatropine ophthalmic solution (Isopto®
Homatropine)
ketotifen fumarate ophthalmic solution (Zaditor®)
levobunolol ophthalmic solution (Betagan®)
naphazoline ophthalmic
solution (Vasocon®)
neo/polymyx/dexamethasone
ophthalmic suspension,
ointment
phenylephrine ophthalmic solution
pilocarpine ophthalmic solution (Adsorbocarpine®)
prednisolone acetate ophthalmic suspension (Pred Forte®)
prednisolone sod phosphate
ophthalmic solution (Inflamase Forte®)
sulfacetamide/prednisolone ophthalmic suspension (Blephamide®)
sulfacetamide
ophthalmic solution (Bleph®-10)
timolol
maleate ophthalmic solution (Betimol®)
tobramycin ophthalmic solution (Tobrex®)
trifluridine ophthalmic solution (Viroptic®)
Acular® ophthalmic solution
Acular LS™ ophthalmic solution
Acular® PF ophthalmic droperette
Alocril® ophthalmic solution
Alphagan® P ophthalmic solution
Alrex® ophthalmic suspension
Azopt® ophthalmic suspension
Betimol® ophthalmic solution
Betoptic S® ophthalmic suspension
Blephamide® S.O.P. ophthalmic ointment
Ciloxan® ophthalmic solution, ointment
Cosopt® ophthalmic solution
Cyclogyl® ophthalmic solution
Diamox Sequels® capsule
FML® S.O.P. ophthalmic ointment
Isopto® Atropine ophthalmic solution
Isopto® Homatropine ophthalmic solution
Lotemax® ophthalmic suspension
Lumigan® ophthalmic solution
Ocuflox® ophthalmic solution
Ocupress® ophthalmic solution
Patanol® ophthalmic solution
Pilopine HS® ophthalmic gel
Pred-Mild® ophthalmic suspension
Timoptic-XE® ophthalmic sol-gel
TobraDex® ophthalmic suspension, ointment
Travatan® ophthalmic solution
Trusopt® ophthalmic solution
PAIN & INFLAMMATORY DISEASE
choline mag trisalicylate tablet (Trilisate®)
codeine/APAP tablet (Tylenol® #3)
diclofenac tablet (Voltaren®)
diflunisal tablet (Dolobid®)
ergotamine/caffeine tablet, suppository (Cafergot®)
etodolac capsule (Lodine®)
fenoprofen tablet, capsule (Nalfon®)
fentanyl patch(Duragesic®)
flurbiprofen tablet (Ansaid®)
hydrocodone/APAP tablet (Vicodin®)
hydrocodone/homatropine tablet, syrup (Hycodan®)
hydromorphone tablet (Dilaudid®)
ibuprofen tablet (Motrin®)
indomethacin capsule (Indocin®)
ketoprofen capsule (Orudis®)
ketoprofen ER capsule (Oruvail®
SR)
meclofenamate capsule (Meclomen®)
meperidine tablet, syrup (Demerol®)
methadone tablet, solution, concentrate
(Dolophine®)
morphine SR tablet (MS
Contin®)
nabumetone tablet (Relafen®)
naproxen tablet (Naprosyn®)
oxaprozin tablet (Daypro®)
oxycodone capsule (OxyIR®)
oxycodone/APAP tablet (Percocet®)
oxycodone/ASA tablet (Percodan®)
piroxicam capsule (Feldene®)
propoxyphene/APAP tablet (Darvocet
N®-100)
salsalate tablet (Disalcid®)
sulindac tablet (Clinoril®)
tolmetin tablet (Tolectin®)
tramadol tablet (Ultram®)
Ergomar® tablet
Imitrex® tablet, nasal spray, injection
Kadian® capsule
Maxalt® tablet
Maxalt®-MLT tablet
Migranal® nasal spray
Phrenalin® with caffeine/codeine capsule
Relpax® tablet
Zomig® tablet, nasal spray
Zomig-ZMT™ tablet
RESPIRATORY
acetylcysteine solution (Mucomyst®)
albuterol oral inhaler, inhalation solution,
tablet, syrup (Proventil®)
aminophylline
tablet, liquid
cromolyn sodium solution (Intal®)
dyphylline
tablet (Lufyllin®)
ipratropium
bromide solution (Atrovent®)
ipratropium-albuterol inhalation solution (Duoneb®)
metaproterenol
tablet, syrup, inhalation solution (Alupent®)
theophylline tablet, capsule, elixir
Accolate® tablet
Advair Diskus® oral inhaler
Advair® HFA oral inhaler
Atrovent® oral inhaler
Azmacort® oral inhaler
Beclovent® oral inhaler
Combivent® oral inhaler
Flovent® Diskus® oral inhaler
Flovent® HFA oral inhaler
Foradil® oral inhaler
Intal® oral inhaler
Letairis™ tablet
Nebupent® powder for inhalation
Peak Flow Meters
ProAir® HFA oral inhaler
Proventil HFA® oral inhaler
Pulmicort Respules®
Pulmicort® oral inhaler
Pulmozyme® inhalation solution
QVAR® oral inhaler
Serevent Diskus® oral inhaler
Singulair® tablet, granules, chews
Spacer devices
Spiriva® oral inhaler
Tilade® oral inhaler
Tobi® oral inhalation solution
Tracleer® tablet
Uniphyl® tablet
Ventolin® HFA oral inhaler
SKIN/TOPICAL
amcinonide cream, ointment, lotion
(Cyclocort®)
bacitracin/polymyxin ointment
(Polysporin®)
betamethasone
dipropionate cream, gel, lotion, ointment (Diprolene®)
betamethasone dipropionate augmented cream (Diprolene® AF cream)
betamethasone valerate liquid, lotion (Beta-val®)
betamethasone/clotrimazole cream (Lotrisone®)
calcipotriene solution (Dovonex®)
ciclopirox cream, gel, topical suspension (Loprox®)
ciclopirox topical solution (Penlac®)
clindamycin topical gel, lotion, solution
(Cleocin®)
clobetasol propionate cream,
lotion, ointment (Temovate®)
desonide/petrolatum
cream (Desonide®)
desoximetasone
gel, ointment, cream (Topicort®)
diflorasone
diacetate ointment, cream (Psorcon®)
erythromycin base/benzoyl peroxide gel (Benzamycin®)
fluocinolone acetonide cream, ointment (Synalar®)
fluocinonide cream, ointment, solution, gel
(Lidex®)
gentamicin cream, ointment
(Garamycin®)
hydrocortisone
cream, ointment, lotion (Ala-cort®)
isotretinoin (claravis, sotret, amnesteem) capsule (Accutane®)
ketoconazole shampoo (Nizoral®)
lidocaine viscous solution (Xylocaine®)
lindane lotion, shampoo (Kwell®)
mometasone cream, ointment (Elocon®)
mupirocin ointment (Bactroban®)
permethrin 5% cream (Elimite®)
silver sulfadiazine cream (Silvadene®)
tretinoin cream, gel, lotion (Retin
A®)*
triamcinolone acetonide cream,
ointment (Aristocort®)
Aclovate® cream, ointment
Azelex® cream
Bactroban® cream
Bactroban® nasal ointment
Benzac W® gel
Capex® shampoo
Carac® cream
Centany® ointment
Cloderm® cream
Condylox® gel, solution
Cordran® lotion, tape, ointment, cream
Cutivate® cream, ointment
Derma-Smooth/FS® oil
Differin® gel, cream, solution, swabs
Efudex® cream, solution
Elocon® lotion
Eurax® cream, lotion
Fluoroplex® cream, solution
Locoid® cream, ointment, solution
Luxiq® foam
MetroCream®
MetroGel®
MetroLotion®
Nizoral® shampoo
Noritate® cream
Ovide® lotion
Phisohex® liquid
Plexion® emulsion, medicated pad
Retin A Micro® gel*
Soriatane® capsule
Soriatane® CK kit
Tazorac® cream, gel
Topicort LP® cream
Ultravate® cream, ointment
UROLOGY
citric acid/sodium citrate solution (Bicitra®)
bethanechol tablet (Urecholine®)
finasteride tablet (Proscar®)
methenamine hippurate tablet (Hiprex®)
methenamine mandelate tablet (Mandelamine®)
oxybutynin tablet (Ditropan®)
oxybutynin chloride ER (Ditropan XL®)
phenazopyridine tablet (Pyridium®)
Detrol® LA capsule
Elmiron® capsule
Uroxatral® tablet
WOMEN’S HEALTH
clomiphene citrate tablet (Clomid®)*
danazol capsule (Danocrine®)
estradiol tablet (Estrace®)
estradiol transdermal patch
estropipate tablet (Ogen®)
medroxyprogesterone
acetate tablet
ocella tablet (Yasmin®)*
tilia FE tablet (Estrostep® FE)
tri-legest FE tablet (Estrostep® FE)
Alesse® tablet*
Anemagen® capsule
Cenestin® tablet
Demulen® tablet*
Desogen® tablet*
Diaphragms*
Esclim® patch
Estraderm® patch
FemHRT® tablet
Gynazole®-1 vaginal cream
leena tablet*
Loestrin® tablet*
Loestrin® Fe tablet*
LoOvral® tablet*
Methergine® tablet
MetroGel-Vaginal®
Micronor® tablet*
Modicon® tablet*
Nestab FA® tablet
Nora-BE® tablet*
Nordette® tablet*
Norinyl® tablet*
Nor-QD® tablet*
Ortho Cept® tablet*
Ortho Cyclen® tablet*
Ortho Evra® patch*
Ortho Novum® tablet*
Ortho Prefest® tablet
Ortho Tri-Cyclen® tablet*
Ortho Tri-Cyclen® Lo tablet*
Ovral® tablet*
Ovrette® tablet*
Plan B® tablet*
Premarin® tablet
Premarin® vaginal cream
Premphase® tablet
Prempro® tablet
Serophene® tablet*
Terazol® vaginal cream
Tri-Levlen® tablet*
Tri-Norinyl® tablet*
Triphasil® tablet*
Vagifem® vaginal tablet
Vivelle® patch
Vivelle-DOT® patch
SELF-INJECTED
calcitonin salmon injection
cyanocobalamin injection
heparin sodium injection
leuprolide non-depot injection
octreotide acetate injection (Sandostatin®)
Apokyn® injection
Aranesp® injection
Avonex® injection
Copaxone® injection
Enbrel® injection
Epipen® injection
Epipen® Jr injection
Epogen® injection
Fragmin® injection
Fuzeon® injection
Humira® injection
Innohep® injection
Intron® A injection
Leukine® injection
Lovenox® injection
Miacalcin® injection
Neupogen® injection
Nutropin AQ® injection*•
Nutropin Depot® injection*•
Nutropin® injection*•
Pegasys® injection
Peg-Intron® injection
Procrit® injection
Protropin® injection*•
Rebetron® injection
Rebif® injection
Saizen® injection*•
OTHER
chlorhexidine gluconate oral rinse (Peridex®)
fluoride drops
Buphenyl® tablet, powder
Carnitor® tablet, liquid
Chemet® capsule
Cystadane® oral powder
Dialyvite® tablet
Evoxac® tablet
Galzin® capsule
PerioGard® oral liquid
PhosLo® capsule, tablet
Radiogardase® capsule
Salagen® tablet
Syprine® capsule |