ANTI-INFECTIVES - Emdeon · Updated August 1, 2017 Page 1 ANTI-INFECTIVES .....5

Updated August 1, 2017

ANTI-INFECTIVES ......................................................................................................................................................................... 5

PENICILLINS ....................................................................................................................................................................................... 5 TETRACYCLINES .............................................................................................................................................................................. 5 CEPHALOSPORINS .......................................................................................................................................................................... 5

FIRST GENERATION CEPHALOSPORINS .............................................................................................................................. 5 SECOND GENERATION CEPHALOSPORINS ........................................................................................................................ 5 THIRD GENERATION CEPHALOSPORINS ............................................................................................................................. 5

ERYTHROMYCINS & OTHER MACROLIDES ............................................................................................................................... 5 FLOUROQUINOLONES .................................................................................................................................................................... 6 SULFA'S & RELATED AGENTS ....................................................................................................................................................... 6 URINARY TRACT AGENTS .............................................................................................................................................................. 6 ANTIVIRALS ........................................................................................................................................................................................ 6 HIV/AIDS THERAPY .......................................................................................................................................................................... 6 ANTIFUNGAL AGENTS..................................................................................................................................................................... 7 VANCOMYCIN .................................................................................................................................................................................... 7 MISC. ANTI-INFECTIVES ................................................................................................................................................................. 7 ANTIPARASITICS .............................................................................................................................................................................. 7 ANTIMALARIALS................................................................................................................................................................................ 8 ANTIMYCOBACTERIALS ................................................................................................................................................................. 8

ANTINEOPLASTIC & IMMUNOSUPPRESANT DRUGS ........................................................................................................... 8

ALKYLATING AGENTS ..................................................................................................................................................................... 8 ANTIMETABOLITIES ......................................................................................................................................................................... 8 HORMONES ....................................................................................................................................................................................... 8 ANTIESTROGENS ............................................................................................................................................................................. 8 ANTIANDROGENS ............................................................................................................................................................................ 9 RADIOPHARMACEUTICALS ........................................................................................................................................................... 9 IMMUNOSUPPRESSANT DRUGS .................................................................................................................................................. 9 MISC. ANTINEOPLASTIC DRUGS .................................................................................................................................................. 9 ADJUNCTIVE AGENTS ................................................................................................................................................................... 10

AUTONOMIC & CNS DRUGS, NEUROLOGY & PSYCH ......................................................................................................... 10

NARCOTIC ANALGESICS .............................................................................................................................................................. 10 COMBINATION NARCOTIC/ANALGESICS ................................................................................................................................. 11 NSAIDS .............................................................................................................................................................................................. 11 NSAIDS-SPECIFIC COX II INHIBITORS ...................................................................................................................................... 11 SALICYLATES .................................................................................................................................................................................. 11 MISC. ANALGESICS ........................................................................................................................................................................ 11 NARCOTIC ANTAGONISTS ........................................................................................................................................................... 12 HEADACHE THERAPY ................................................................................................................................................................... 12 ANTIPARKINSONISM AGENTS .................................................................................................................................................... 12 ANTICONVULSANTS ...................................................................................................................................................................... 12 MISC. NEUROLOGICAL THERAPY .............................................................................................................................................. 13 MUSCLE RELAXANTS & ANTISPASMODIC AGENTS ............................................................................................................. 13 HYPNOTIC AGENTS ....................................................................................................................................................................... 13 TRICYCLICS ..................................................................................................................................................................................... 13 MISC. ANTIDEPRESSANTS .......................................................................................................................................................... 13 MAO INHIBITORS ............................................................................................................................................................................ 14 SELECTIVE SEROTONIN REUPTAKE INHIBITORS ................................................................................................................. 14 PHENOTHIAZINES .......................................................................................................................................................................... 14 BUTYROPHENONES ...................................................................................................................................................................... 14 MISC. ANTIPSYCHOTICS .............................................................................................................................................................. 14 MISCELLANEOUS PSYCHOTHERAPEUTIC AGENTS ............................................................................................................ 14


ANXIOLYTICS ................................................................................................................................................................................... 14

CARDIOVASCULAR, HYPERTENSION & LIPIDS ................................................................................................................... 15

ANTIARRHYTHMIC AGENTS ........................................................................................................................................................ 15 CARDIAC GLYCOSIDES ................................................................................................................................................................ 15 RAPID ACTING NITRATES ............................................................................................................................................................ 15 LONG ACTING NITRATES ............................................................................................................................................................. 15 ANTICOAGULANTS ........................................................................................................................................................................ 15 ANTIPLATELET DRUGS ................................................................................................................................................................. 15 HEPARIN ........................................................................................................................................................................................... 15 VITAMIN K ......................................................................................................................................................................................... 16 HEMOSTATICS ................................................................................................................................................................................ 16 MISC. COAGULATION AGENTS ................................................................................................................................................... 16 THIAZIDE & RELATED DIURETICS .............................................................................................................................................. 16 BETA BLOCKERS ............................................................................................................................................................................ 16 CALCIUM CHANNEL BLOCKERS/ NON-DIHYDROPYRIDINES ............................................................................................. 17 CALCIUM CHANNEL BLOCKERS/DIHYDROPYRIDINES ........................................................................................................ 17 ACE INHIBITORS ............................................................................................................................................................................. 17 ADRENERGIC ANTAGONISTS & RELATED DRUGS ............................................................................................................... 17 AGENTS FOR PHEOCHROMOCYTOMA .................................................................................................................................... 17 VASODILATORS .............................................................................................................................................................................. 17 OTHER ANTIHYPERTENSIVE COMBINATIONS ....................................................................................................................... 17 ANGIOTENSIN II RECEPTOR BLOCKERS & RENIN INHIBITOR ........................................................................................... 18 LIPID/CHOLESTEROL LOWERING AGENTS ............................................................................................................................. 18 MISC. CARDIOVASCULAR AGENTS ........................................................................................................................................... 18

DERMATOLOGICAL/TOPICAL THERAPY ............................................................................................................................... 18

TOPICAL CORTICOSTEROIDS VERY HIGH POTENCY .......................................................................................................... 18 TOPICAL CORTICOSTEROIDS HIGH POTENCY...................................................................................................................... 18 TOPICAL CORTICOSTEROIDS MEDIUM POTENCY ............................................................................................................... 19 TOPICAL CORTICOSTEROIDS LOW POTENCY ...................................................................................................................... 19 TOPICAL ANESTHETICS ............................................................................................................................................................... 19 THERAPY FOR ACNE ..................................................................................................................................................................... 19 TOPICAL ANTIBACTERIALS ......................................................................................................................................................... 19 TOPICAL ANTIFUNGALS ............................................................................................................................................................... 20 TOPICAL ANTIVIRALS .................................................................................................................................................................... 20 BURN THERAPY .............................................................................................................................................................................. 20 TOPICAL ENZYMES ........................................................................................................................................................................ 20 KERATOLYTICS ............................................................................................................................................................................... 20 ANTIPSORIATICS/ANTISEBORRHEIC ....................................................................................................................................... 20 TOPICAL SCABICIDES/PEDICULICIDES ................................................................................................................................... 20 MISC. DERMATOLOGICALS ......................................................................................................................................................... 20

EAR, NOSE & THROAT MEDICATIONS ................................................................................................................................... 21

MISCELLANEOUS OTIC PREPARATIONS ................................................................................................................................. 21 OTIC STEROID / ANTIBIOTIC ........................................................................................................................................................ 21 MISCELLANEOUS AGENTS .......................................................................................................................................................... 21

ENDOCRINE/DIABETES ............................................................................................................................................................. 21

ANTITHYROID AGENTS ................................................................................................................................................................. 21 THYROID HORMONES ................................................................................................................................................................... 21 ADRENAL HORMONES .................................................................................................................................................................. 21 ANDROGENS ................................................................................................................................................................................... 22 OVULATORY STIMULANTS .......................................................................................................................................................... 22


MISCELLANEOUS AGENTS .......................................................................................................................................................... 22 GONADOTROPIN & RELATED AGENTS .................................................................................................................................... 22 INSULIN THERAPY .......................................................................................................................................................................... 22 NON-INSULIN HYPOGLYCEMIC AGENTS ................................................................................................................................ 22 GLUCOSE ELEVATING AGENTS ................................................................................................................................................. 23 INSULIN SYRINGES/MISCELLANEOUS DME ........................................................................................................................... 23 BLOOD GLUCOSE MONITORING DEVICES & SUPPLIES ...................................................................................................... 23

GASTROENTEROLOGY ............................................................................................................................................................. 23

H2 ANTAGONISTS .......................................................................................................................................................................... 23 PROSTAGLANDINS ........................................................................................................................................................................ 24 OTHER ULCER THERAPY ............................................................................................................................................................. 24 PROTON PUMP INHIBITORS ........................................................................................................................................................ 24 ANTIDIARRHEALS .......................................................................................................................................................................... 24 ANTISPASMODICS ......................................................................................................................................................................... 24 BILE ACIDS ....................................................................................................................................................................................... 24 DIGESTIVE ENZYMES .................................................................................................................................................................... 24 MISC. GASTROINTESTINAL AGENTS ........................................................................................................................................ 24 ANTIVERTIGO & ANTIEMETIC AGENTS .................................................................................................................................... 25 BOWEL EVACUANTS ..................................................................................................................................................................... 25

IMMUNOLOGY, VACCINES & BIOTECHNOLOGY ................................................................................................................. 25

ERYTHROID STIMULANTS ........................................................................................................................................................... 25 MYELOID STIMULANTS ................................................................................................................................................................. 25 INTERFERONS ................................................................................................................................................................................ 25 GROWTH HORMONES................................................................................................................................................................... 25 INTERLEUKINS ................................................................................................................................................................................ 25 VACCINES & MISCELLANEOUS IMMUNOLOGICALS ............................................................................................................. 25

MUSCULOSKELETAL & RHEUMATOLOGY ........................................................................................................................... 26

GOUT THERAPY .............................................................................................................................................................................. 26 OTHER RHEUMATOLOGICALS.................................................................................................................................................... 26 OSTEOPOROSIS THERAPY ......................................................................................................................................................... 26

OBSTETRICS & GYNECOLOGY ............................................................................................................................................... 26

MONOPHASIC /BIPHASIC /TRIPHASIC AGENTS ..................................................................................................................... 26 OXYTOCICS ..................................................................................................................................................................................... 27 PROGESTINS ................................................................................................................................................................................... 27 ESTROGENS .................................................................................................................................................................................... 27 ESTROGEN COMBINATIONS ....................................................................................................................................................... 28 VAGINAL CLEANSER /ANTIINFECTIVES ................................................................................................................................... 28 VAGINAL ANTIFUNGALS ............................................................................................................................................................... 28 SPECIALIZED OB/GYN DRUGS.................................................................................................................................................... 28 DIAPHRAGMS AND OTHER NON-ORAL CONTRACEPTIVES ............................................................................................... 28

OPHTHALMOLOGY ..................................................................................................................................................................... 28

BETA-BLOCKERS ............................................................................................................................................................................ 28 CHOLINESTERASE INHIBITOR MIOTICS .................................................................................................................................. 28 DIRECT ACTING MIOTICS ............................................................................................................................................................. 28 OTHER GLAUCOMA DRUGS ........................................................................................................................................................ 28 ORAL DRUGS FOR GLAUCOMA .................................................................................................................................................. 28 CYCLOPLEGIC MYDRIATICS ....................................................................................................................................................... 28 NON-STEROIDAL ANTI-INFLAMMATORY AGENTS ................................................................................................................ 29 VASOCONSTRICTOR DECONGESTANTS ................................................................................................................................ 29


ANTIBIOTICS .................................................................................................................................................................................... 29 SULFONAMIDES.............................................................................................................................................................................. 29 STEROIDS ......................................................................................................................................................................................... 29 STEROID-ANTIBIOTIC COMBINATIONS .................................................................................................................................... 29 STEROID-SULFONAMIDE COMBINATIONS .............................................................................................................................. 29 SYMPATHOMIMETICS ................................................................................................................................................................... 29 MISCELLANEOUS OPHTHALMOLOGICS .................................................................................................................................. 29 ANTIVIRALS ...................................................................................................................................................................................... 29

RESPIRATORY, ALLERGY, COUGH & COLD......................................................................................................................... 30

ANTIHISTAMINES ............................................................................................................................................................................ 30 ADRENERGICS ................................................................................................................................................................................ 30 ANTITUSSIVE COMBINATIONS ................................................................................................................................................... 30 DECONGESTANT / ANTIHISTAMINES ........................................................................................................................................ 30 XANTHINES ...................................................................................................................................................................................... 30 BETA AGONISTS ORAL ................................................................................................................................................................. 30 BETA AGONISTS INHALERS ........................................................................................................................................................ 30 INHALED CORTICOSTEROIDS .................................................................................................................................................... 31 INTRANASAL STEROIDS ............................................................................................................................................................... 31 MISCELLANEOUS PULMONARY AGENTS ................................................................................................................................ 31

UROLOGICALS ............................................................................................................................................................................ 31

CHOLINERGIC STIMULANTS ....................................................................................................................................................... 31 ANTICHOLINERGICS & ANTISPASMODICS .............................................................................................................................. 31 URINARY ANESTHETICS .............................................................................................................................................................. 31 MISCELLANEOUS UROLOGICALS .............................................................................................................................................. 31 BENIGN PROSTATIC HYPERPLASIA (BPH) THERAPY .......................................................................................................... 32

VITAMINS, HEMATINICS & ELECTROLYTES ......................................................................................................................... 32

VITAMINS & HEMATINICS ............................................................................................................................................................. 32 POTASSIUM ..................................................................................................................................................................................... 33 OTHER ELECTROLYTES ............................................................................................................................................................... 33 MISCELLANEOUS NUTRITION PRODUCTS ............................................................................................................................. 34 BLOOD DERIVATIVES .................................................................................................................................................................... 34

DIAGNOSTICS & MISCELLANEOUS AGENTS ....................................................................................................................... 34

MISCELLANEOUS AGENTS .......................................................................................................................................................... 34 SMOKING DETERRENTS .............................................................................................................................................................. 35 ANOREXIANTS ................................................................................................................................................................................ 35 NEUTRACEUTICALS ...................................................................................................................................................................... 35 IRRIGATING SOLUTIONS .............................................................................................................................................................. 35 ANTIDOTES ...................................................................................................................................................................................... 35


ANTI-INFECTIVES

PENICILLINS GENERIC amoxicillin amoxicillin/clavulanate er ampicillin ampicillin/sulbactam dicloxacillin sodium nafcillin dextrose nafcillin sodium oxacillin sodium penicillin g potassium penicillin g procaine penicillin g sodium penicillin v potassium piperacillin-tazobactam

PREFERRED AMOXICILLIN POWDER AUGMENTIN 125-31.25 MG/5ML BICILLIN C-R BICILLIN L-A PENICILLIN GK-ISO-OSM DEXTROSE TIMENTIN ZOSYN IV SOLUTION

NON PREFERRED AUGMENTIN ZOSYN VIAL

TETRACYCLINES GENERIC demeclocycline hcl doxycycline hyclate doxycycline monohydrate minocycline hcl minocycline hcl er ocudox

PREFERRED DEMECLOCYCLINE HCL POWDER DOXYCYCLINE HYCLATE POWDER MINOCIN 100MG VIAL MINOCYCLINE HCL POWDER ORACEA SOLODYN ER TETRACYCLINE

NON PREFERRED DOXYCYCLINE MONOHYDRATE POWDER MINOCIN

CEPHALOSPORINS

FIRST GENERATION CEPHALOSPORINS

GENERIC cefazolin cephalexin

NON PREFERRED CEFAZOLIN/DEXTROSE KEFLEX

SECOND GENERATION CEPHALOSPORINS

GENERIC cefaclor cefoxitin cefoxitin/dextrose cefpodoxime proxetil cefprozil cefuroxime axetil cefuroxime sodium

PREFERRED CEFUROXIME 75G BULK BAG

NON PREFERRED ZINACEF

THIRD GENERATION CEPHALOSPORINS

GENERIC cefdinir cefepime cefotaxime cefotetan ceftazidime ceftibuten ceftriaxone

PREFERRED AVYCAZ CEFTAZIDIME IV PIGGYBACK FORTAZ IN ISO-OSMOTIC DEXTROSE TEFLARO ZERBAXA

NON PREFERRED CEFEPIME/DEXTROSE CEFTRIAXONE 100G BULK BAG

ERYTHROMYCINS & OTHER MACROLIDES GENERIC azithromycin clarithromycin clarithromycin er erythromycin erythromycin del rel erythromycin ethylsuccinate erythromycin stearate erythromycin/sulfisoxazole

PREFERRED AZITHROMYCIN POWDER CLARITHROMYCIN POWDER ERYTHROCIN LACTOBIONATE ERYTHROMYCIN ETHYLSUCCINATE POWDER ERYTHROMYCIN POWDER


NON PREFERRED E.E.S.200MG/5ML ORAL RECON SUSP ZITHROMAX

FLOUROQUINOLONES GENERIC ciprofloxacin ciprofloxacin er ciprofloxacin suspension ciprofloxacin/dextrose levofloxacin/d5w moxifloxacin hcl ofloxacin tablets

PREFERRED AVELOX IV LEVOFLOXACIN HEMIHYDRATE POWDER MOXIFLOXACIN HCL IV PIGGYBACK

NON PREFERRED LEVOFLOXACIN HEMIHYDRATE SOLUTION MOXIFLOXACIN HCL POWDER

SULFA'S & RELATED AGENTS GENERIC sulfadiazine sulfamethoxazole/trimethoprim

PREFERRED SULFADIAZINE POWDER

NON PREFERRED BACTRIM BACTRIM DS

URINARY TRACT AGENTS GENERIC methenamine hippurate methenamine mandelate methylene blue nitrofurantoin nitrofurantoin macrocrystal trimethoprim

PREFERRED METHENAMINE MANDELATE POWDER NITROFURANTOIN POWDER TRIMETHOPRIM POWDER

NON PREFERRED MACROBID MACRODANTIN

ANTIVIRALS GENERIC acyclovir adefovir dipivoxil amantadine hcl cidofovir entecavir famciclovir foscarnet sodium ganciclovir oseltamivir phosphate capsule ribavirin

rimantadine hcl valacyclovir valganciclovir hcl

PREFERRED AMANTADINE HCL POWDER DAKLINZA EPCLUSA RAPIVAB RELENZA RIBAVIRIN POWDER SOVALDI TAMIFLU ORAL SUSPENSION TECHNIVIE TYZEKA VALACYCLOVIR POWDER VEMLIDY VICTRELIS ZEPATIER

NON PREFERRED CIDOFOVIR TAMIFLU CAPSULE VALCYTE

HIV/AIDS THERAPY GENERIC abacavir abacavir sulfate/lamivudine abacavir/lamivudine/zidovudine didanosine lamivudine lamivudine hbv lamivudine/zidovudine lopinavir-ritonavir oral soln nevirapine er stavudine zidovudine

PREFERRED APTIVUS ATRIPLA COMPLERA CRIXIVAN DESCOVY EDURANT EMTRIVA FUZEON GENVOYA INTELENCE INVIRASE ISENTRESS KALETRA TABLETS LEXIVA NORVIR ODEFSEY PREZISTA RESCRIPTOR RETROVIR VIAL REYATAZ SELZENTRY STRIBILD SUSTIVA TIVICAY TRIUMEQ TRUVADA VIDEX VIRACEPT VIREAD


ZIAGEN SOLUTION

NON PREFERRED EPZICOM KALETRA ORAL SOLN RETROVIR VIRAMUNE ZIAGEN TABLET

ANTIFUNGAL AGENTS GENERIC amphotericin fluconazole fluconazole in dextrose fluconazole in saline flucytosine griseofulvin griseofulvin ultramicrosize itraconazole ketoconazole nystatin terbinafine voriconazole

PREFERRED AMBISOME AMPHOTERICIN POWDER CANCIDAS CRESEMBA FLUCONAZOLE POWDER FLUCYTOSINE POWDER GRISEOFULVIN POWDER ITRACONAZOLE POWDER KETOCONAZOLE POWDER LAMISIL MYCAMINE NOXAFIL NYSTATIN SPORANOX SOLUTION TERBINAFINE VIBATIV VORICONAZOLE POWDER

NON PREFERRED FLUCONAZOLE 100MG/50ML PIGGYBACK ITRACONAZOLE 1GM POWDER KETOCONAZOLE CRYSTALS LAMISIL 250MG TABLET NYSTATIN 100MM POWDER SPORANOX CAPSULE

VANCOMYCIN GENERIC vancomycin hcl

PREFERRED VANCOMYCIN HCL

NON PREFERRED VANCOMYCIN HCL 750 VIAL W/THREADPORT

MISC. ANTI-INFECTIVES GENERIC aztreonam bacitracin clindamycin hcl clindamycin palmitate hcl

clindamycin phosphate clindamycin phosphate/dextrose colistimethate dapsone daptomycin gentamicin sulfate gentamicin sulfate in ns imipenem-cilastatin kanamycin sulfate linezolid neomycin sulfate polymyxin b sulfate tobramycin sulfate tobramycin sulfate in ns

PREFERRED AMIKACIN AMIKACIN POWDER AZACTAM-ISO-OSMOTIC DEXTROSE BACITRACIN POWDER BETHKIS CAYSTON CHLORAMPHENICOL CLINDAMYCIN HCL POWDER CLINDAMYCIN PHOSPHATE COLISTIMETHATE POWDER CUBICIN RF DALVANCE DAPSONE POWDER DORIBAX GENTAMICIN SULFATE IN NS 100MG/50ML INVANZ KANAMYCIN SULFATE POWDER KITABIS PAK MEROPENEM - 0.9% NACL NEOMYCIN SULFATE POWDER POLYMYXIN B SULFATE POWDER SIVEXTRO VIAL SYNERCID TOBI PODHALER TOBRAMYCIN SULFATE POWDER TYGACIL XIFAXAN

NON PREFERRED ACZONE CUBICIN GENTAMICIN SULFATE 60MG/ML VIAL GENTAMICIN SULFATE IN NS 120MG/0.1L ORABACTIV SIVEXTRO TABLET TOBRAMYCIN SULFATE 300MG/5ML AMPUL

ANTIPARASITICS GENERIC atovaquone ivermectin metronidazole paromomycin sulfate tinidazole

PREFERRED ALBENZA ALINIA BILTRICIDE EMVERM IMPAVIDO IVERMECTIN POWDER METRONIDAZOLE POWDER


NEBUPENT PAROMOMYCIN SULFATE POWDER TINIDAZOLE POWDER

NON PREFERRED FLAGYL MEPRON STROMECTOL TINDAMAX

ANTIMALARIALS GENERIC atovaquone/proguanil hcl chloroquine phosphate hydroxychloroquine sulfate mefloquine hcl quinine sulfate

PREFERRED CHLOROQUINE PHOSPHATE POWDER COARTEM DARAPRIM HYDROXYCHLOROQUINE SULFATE POWDER PRIMAQUINE QUININE SULFATE POWDER

NON PREFERRED MALARONE

ANTIMYCOBACTERIALS GENERIC ethambutol hcl isoniazid pyrazinamide rifabutin

PREFERRED CAPASTAT SULFATE ISONIAZID POWDER PRIFTIN SIRTURO STREPTOMYCIN SULFATE

NON PREFERRED PYRAZINAMIDE POWDER RIFADIN

ANTINEOPLASTIC & IMMUNOSUPPRESANT DRUGS

ALKYLATING AGENTS GENERIC carboplatin cisplatin cyclophosphamide ifosfamide ifosfamide-mesna melphalan hcl oxaliplatin temozolomide thiotepa

PREFERRED ALKERAN 2MG BENDEKA BICNU

BUSULFEX CEENU CISPLATIN POWDER CYCLOPHOSPHAMIDE GLEOSTINE LEUKERAN LOMUSTINE MUSTARGEN MYLERAN TEMODAR 100MG VIAL THIOTEPA POWDER TREANDA VALCHLOR ZANOSAR

NON PREFERRED ALKERAN 50MG TEMODAR CAPSULES

ANTIMETABOLITIES GENERIC azacitidine capecitabine cytarabine decitabine floxuridine fludarabine phosphate gemcitabine hcl mercaptopurine methotrexate

PREFERRED ALIMTA ARRANON CLOLAR DEPOCYT FLOXURIDINE POWDER FOLOTYN MERCAPTOPURINE POWDER METHOTREXATE POWDER RASUVO TABLOID TREXALL

NON PREFERRED FLUOROURACIL 0.005 CREAM

HORMONES GENERIC megestrol acetate

PREFERRED MEGESTROL ACETATE POWDER

ANTIESTROGENS GENERIC anastrozole exemestane letrozole tamoxifen citrate

PREFERRED ANASTROZOLE POWDER FARESTON FASLODEX LETROZOLE POWDER


TAMOXIFEN CITRATE POWDER

NON PREFERRED ARIMIDEX AROMASIN FEMARA

ANTIANDROGENS GENERIC bicalutamide flutamide nilutamide

PREFERRED ZYTIGA

NON PREFERRED NILANDRON XTANDI

RADIOPHARMACEUTICALS PREFERRED IODOPEN XOFIGO

IMMUNOSUPPRESSANT DRUGS GENERIC azathioprine azathioprine sodium cyclosporine mycophenolate acid del rel mycophenolate mofetil mycophenolic acid del rel sirolimus tacrolimus

PREFERRED AZASAN AZATHIOPRINE POWDER CELLCEPT 500MG VIAL CYCLOSPORINE POWDER NULOJIX PROGRAF 5MG/ML AMPUL RAPAMUNE SOLUTION SANDIMMUNE SOLUTION 100MG/ML SOLUTION SIMULECT SIROLIMUS POWDER TACROLIMUS POWDER ZORTRESS

NON PREFERRED CELLCEPT ORAL SUSP PROGRAF CAPSULES RAPAMUNE SANDIMMUNE SOLUTION

MISC. ANTINEOPLASTIC DRUGS GENERIC bleomycin cladribine dacarbazine dactinomycin daunorubicin docetaxel doxorubicin hcl doxorubicin hcl liposomal

epirubicin hcl etoposide hydroxyurea idarubicin hcl imatinib mesylate irinotecan hcl leuprolide acetate mitomycin mitoxantrone octreotide acetate paclitaxel topotecan hcl tretinoin cap vinblastine sulfate

PREFERRED ABRAXANE ADCETRIS AFINITOR AFINITOR DISPERZ ARZERRA AVASTIN BAVENCIO BEXXAR 14MG/ML BLINCYTO BOSULIF CAPRELSA COTELLIC CYRAMZA DARZALEX DAUNOXOME DOCEFREZ DROXIA ELIGARD ELSPAR EMCYT ERBITUX ERIVEDGE ETOPOPHOS ETOPOSIDE POWDER FIRMAGON GAZYVA GILOTRIF HALAVEN HERCEPTIN HEXALEN HYCAMTIN CAPSULES HYDROXYUREA POWDER IBRANCE ICLUSIG IMBRUVICA INLYTA ISTODAX IXEMPRA JAKAFI JEVTANA KADCYLA KEYTRUDA KYPROLIS LARTRUVO LENVIMA LEUPROLIDE ACETATE POWDER LONSURF LUPRON DEPOT LUPRON DEPOT 11.25MG LUPRON DEPOT-PED LYNPARZA LYSODREN MARQIBO MATULANE MEKINIST


MITOMYCIN POWDER NEXAVAR NINLARO ONCASPAR ONIVYDE ONTAK OPDIVO PERJETA PHOTOFRIN POMALYST PROVENGE PURIXAN REVLIMID RITUXAN RUBRACA RYDAPT SANDOSTATIN KIT SANDOSTATIN LAR DEPOT SIGNIFOR SOMATULINE DEPOT SPRYCEL STIVARGA SUTENT SYLVANT SYNRIBO TAFINLAR TAGRISSO TARCEVA TARGRETIN GEL TASIGNA TECENTRIQ TENIPOSIDE THALOMID TORISEL TRELSTAR VIAL TRETINOIN POWDER TRISENOX TYKERB UNITUXIN VALSTAR VANTAS VECTIBIX VELCADE VENCLEXTA VENCLEXTA STARTER PACK VOTRIENT VUMON XALKORI XERMELO YERVOY YONDELIS ZALTRAP ZEJULA ZELBORAF ZEVALIN ZOLADEX ZOLINZA ZYDELIG ZYKADIA

NON PREFERRED BEXXAR HYCAMTIN 4MG VIAL SANDOSTATIN TARGRETIN 75 CAPSULE TRELSTAR MIXJECT (LA)

ADJUNCTIVE AGENTS GENERIC amifostine calcium folinate dexrazoxane leucovorin calcium levoleucovorin calcium mesna

PREFERRED CALCIUM FOLINATE POWDER ELITEK KEPIVANCE LEUCOVORIN CALCIUM POWDER MESNEX 400MG TABLET VISTOGARD VORAXAZE XGEVA

NON PREFERRED FUSILEV MESNEX 100MG/ML VIAL

Autonomic & CNS Drugs, Neurology & Psych

NARCOTIC ANALGESICS GENERIC alfentanil hcl buprenorphine codeine sulfate fentanyl fentanyl citrate hydromorphone hcl levorphanol tartrate methadone hcl morphine sulfate morphine sulfate cr morphine sulfate er oxycodone hcl oxymorphone hcl oxymorphone hcl er sufentil 50mcg/ml ampul

PREFERRED BUPRENORPHINE POWDER BUTRANS FENTANYL CITRATE POWDER HYDROMORPHONE HCL 1GM POWDER INFUMORPH LEVORPHANOL TARTRATE POWDER MEPERIDINE HCL POWDER METHADONE HCL POWDER MORPHINE SULFATE TABLET POWDER OPANA ER OXYCODONE HCL POWDER OXYCONTIN ER SUFENTIL POWDER ULTIVA


NON PREFERRED CODEINE SULFATE SOLUTION DILAUDID-HP FENTANYL FENTANYL CITRATE 100MCG/2ML HYDROMORPHONE HCL 0.5MG/0.5ML SYRINGE meperidine hcl MORPHINE SULFATE SUFENTIL 50MCG/ML VIAL

COMBINATION NARCOTIC/ANALGESICS GENERIC acetaminophen/codeine butalbital compound butalbital compound/codeine butalbital/apap/caffeine butalbital/aspirin/caffeine butalbital/caff/apap/codeine hydrocodone/acetaminophen hydrocodone/ibuprofen oxycodone hcl/ibuprofen oxycodone w/acetaminophen oxycodone w/aspirin

NON PREFERRED HYDROCODONE/ACETAMINOPHEN

NSAIDS GENERIC diclofenac potassium diclofenac sodium diclofenac sodium/misoprostol del rel etodolac etodolac er fenoprofen calcium flurbiprofen ibuprofen ibuprofen lysine indomethacin indomethacin er ketoprofen er ketorolac tromethamine meclofenamate sodium mefenamic acid meloxicam nabumetone naproxen naproxen sodium oxaprozin piroxicam sulindac tolmetin sodium

PREFERRED DICLOFENAC SODIUM POWDER ETODOLAC POWDER FLECTOR FLURBIPROFEN POWDER IBUPROFEN POWDER INDOMETHACIN POWDER KETOPROFEN ER POWDER KETOROLAC TROMETHAMINE POWDER MECLOFENAMATE SODIUM POWDER MEFENAMIC ACID POWDER MELOXICAM POWDER MITIGARE NAPROXEN POWDER NAPROXEN SODIUM POWDER PIROXICAM POWDER

SULINDAC POWDER ZORVOLEX

NON PREFERRED FENOPROFEN CALCIUM NABUMETONE POWDER NEOPROFEN

NSAIDS-SPECIFIC COX II INHIBITORS GENERIC celecoxib

PREFERRED CELECOXIB POWDER

NON PREFERRED CELEBREX

SALICYLATES GENERIC choline mag trisalicylate diflunisal SALICYLAMIDE salsalate

PREFERRED CHOLINE MAG TRISALICYLATE POWDER SALSALATE POWDER

NON PREFERRED DISALCID

MISC. ANALGESICS GENERIC acetaminophen-diphenhydramine butorphanol clonidine nalbuphine hcl pentazocine lactate tramadol hcl tramadol hcl er tramadol/acetaminophen

PREFERRED BUTORPHANOL POWDER MONOVISC NALBUPHINE HCL POWDER NUCYNTA NUCYNTA ER OFIRMEV ORTHOVISC PRIALT QUADRAMET SYNVISC SYNVISC-ONE TRAMADOL HCL POWDER

NON PREFERRED TALWIN TRAMADOL HCL ER


NARCOTIC ANTAGONISTS GENERIC buprenorphine/naloxone naloxone hcl naltrexone hydrochloride

PREFERRED MOVANTIK NALOXONE HCL POWDER NALTREXONE HYDROCHLORIDE POWDER NARCAN SUBOXONE ZUBSOLV

NON PREFERRED SUBOXONE TABLET

HEADACHE THERAPY GENERIC dihydroergotamine mesylate ergotamine-caffeine naratriptan hcl rizatriptan rizatriptan disintegrating tablets sumatriptan succinate zolmitriptan zolmitriptan ODT

PREFERRED DIHYDROERGOTAMINE MESYLATE ISOMETHEPTENE MUCATE RELPAX SUMATRIPTAN SUCCINATE POWDER SUMAVEL DOSEPRO VIVITROL ZOMIG SPRAY

NON PREFERRED TREXIMET ZOLMITRIPTAN ZOMIG TABLET

ANTIPARKINSONISM AGENTS GENERIC benztropine benztropine mesylate carbidopa/levodopa carbidopa/levodopa er carbidopa/levodopa ODT carbidopa/levodopa/entacapone entacapone pramipexole er rasagiline mesylate ropinirole hcl ropinirole hcl er selegiline hcl trihexyphenidyl hcl

PREFERRED APOKYN SELEGILINE HCL POWDER

NON PREFERRED AZILECT

ANTICONVULSANTS GENERIC carbamazepine carbamazepine er clonazepam clonazepam ODT diazepam diazepam rectal gel divalproex sodium divalproex sodium er ethosuximide felbamate fosphenytoin sodium gabapentin lamotrigine lamotrigine er levetiracetam levetiracetam er oxcarbazepine phenobarbital phenobarbital sodium phenytoin phenytoin sodium primidone tiagabine hcl topiramate valproate sodium valproic acid zonisamide

PREFERRED BANZEL CARBAMAZEPINE POWDER CELONTIN CLONAZEPAM POWDER DIAZEPAM POWDER DILANTIN 30MG ETHOSUXIMIDE POWDER FYCOMPA GABAPENTIN POWDER GABITRIL 12MG, 16 MG GRALISE LAMICTAL XR LAMOTRIGINE POWDER LEVETIRACETAM POWDER LYRICA ONFI PEGANONE PHENOBARBITAL POWDER PHENOBARBITAL SODIUM POWDER PHENYTOIN POWDER PHENYTOIN SODIUM POWDER POTIGA PRIMIDONE POWDER QUDEXY XR SABRIL TOPIRAMATE POWDER VALPROATE SODIUM POWDER VALPROIC ACID VIMPAT

NON PREFERRED DILANTIN GABITRIL 2MG, 4MG LAMICTAL XR OXTELLAR XR ZONISAMIDE


MISC. NEUROLOGICAL THERAPY GENERIC donepezil hcl galantamine memantine rivastigmine

PREFERRED AMPYRA GILENYA GLATOPA LEMTRADA NAMENDA XR NAMZARIC NAMZARIC THERAPY PACK NUEDEXTA OCREVUS SPINRAZA TECFIDERA TYSABRI

NON PREFERRED COPAXONE MEMANTINE DOSE PACK XENAZINE

MUSCLE RELAXANTS & ANTISPASMODIC AGENTS GENERIC anectine baclofen chlorzoxazone cyclobenzaprine hcl dantrolene sodium methocarbamol neostigmine methylsulfate orphenadrine citrate orphenadrine compound pyridostigmine bromide tizanidine hcl

PREFERRED BACLOFEN POWDER CYCLOBENZAPRINE HCL DANTROLENE SODIUM POWDER EDROPHONIUM CHLORIDE GABLOFEN LIORESAL MESTINON SYRUP METHOCARBAMOL POWDER NEOSTIGMINE METHYLSULFATE POWDER ORPHENADRINE CITRATE POWDER PYRIDOSTIGMINE BROMIDE POWDER TIZANIDINE HCL POWDER

NON PREFERRED MESTINON MESTINON ER NEOSTIGMINE METHYLSULFATE ROBAXIN

HYPNOTIC AGENTS GENERIC diphenhydramine hcl flurazepam hcl seconal sodium temazepam triazolam zaleplon

zolpidem tartrate zolpidem tartrate er

PREFERRED AMYTAL DOXYLAMINE SUCCINATE NEMBUTAL SODIUM ROZEREM

NON PREFERRED AMBIEN AMBIEN CR SONATA

TRICYCLICS GENERIC amitriptyline hcl amoxapine 150mg amoxapine 25mg clomipramine hcl desipramine hcl doxepin hcl imipramine hcl imipramine pamoate nortriptyline hcl trimipramine maleate

PREFERRED AMITRIPTYLINE HCL POWDER CLOMIPRAMINE HCL POWDER DESIPRAMINE HCL POWDER DOXEPIN HCL POWDER IMIPRAMINE HCL POWDER NORTRIPTYLINE HCL POWDER

MISC. ANTIDEPRESSANTS GENERIC amitriptyline/chlordiazepoxide bupropion er (12 hour) bupropion hcl bupropion hcl er bupropion hcl xl er bupropion sr desvenlafaxine succinate er duloxetine mirtazapine mirtazapine disintegrating perphenazine/amitriptyline trazodone hcl venlafaxine hcl venlafaxine hcl er

PREFERRED BUPROPION HCL POWDER FETZIMA MIRTAZAPINE POWDER TRAZODONE HCL POWDER

NON PREFERRED DULOXETINE POWDER EFFEXOR XR PRISTIQ REMERON REMERON ODT


MAO INHIBITORS GENERIC phenelzine sulfate tranylcypromine sulfate

PREFERRED PHENELZINE SULFATE POWDER

SELECTIVE SEROTONIN REUPTAKE INHIBITORS GENERIC citalopram hbr escitalopram oxalate fluoxetine fluvoxamine maleate er paroxetine hcl paroxetine hcl er

PREFERRED BRISDELLE FLUOXETINE POWDER VIIBRYD

NON PREFERRED CELEXA FLUOXETINE 60MG PROZAC

PHENOTHIAZINES GENERIC chlorpromazine fluphenazine decanoate fluphenazine hcl perphenazine thioridazine hcl trifluoperazine hcl

PREFERRED CHLORPROMAZINE POWDER FLUPHENAZINE DECANOATE 2.5% THIORIDAZINE HCL POWDER

NON PREFERRED FLUPHENAZINE DECANOATE 1GM LIQUID PERPHENAZINE

BUTYROPHENONES GENERIC haloperidol haloperidol decanoate haloperidol lactate

PREFERRED HALOPERIDOL DECANOATE POWDER HALOPERIDOL POWDER

NON PREFERRED HALDOL HALDOL DECANOATE

MISC. ANTIPSYCHOTICS GENERIC aripiprazole ODT aripiprazole tablets clozapine clozapine ODT

loxapine succinate olanzapine olanzapine ODT olanzapine/fluoxetine hcl quetiapine fumarate quetiapine fumarate er risperidone thiothixene ziprasidone hcl

PREFERRED ABILIFY MAINTENA, ER ARISTADA LATUDA LOXAPINE SUCCINATE POWDER RISPERDAL CONSTA VIMIZIM

NON PREFERRED CLOZAPINE ODT RISPERDAL RISPERDAL M-TAB DISINTEGRATING

MISCELLANEOUS PSYCHOTHERAPEUTIC AGENTS GENERIC amphetamine salt combo,er armodafinil clonidine hcl er dexmethylphenidate er dextroamphetamine sulfate dextroamphetamine sulfate er ergoloid mesylates flumazenil guanfacine er guanidine hcl lithium carbonate lithium carbonate er methamphetamine hcl methylphenidate cd methylphenidate er methylphenidate hcl methylphenidate la modafinil

PREFERRED DAYTRANA ERGOLOID MESYLATES POWDER EVEKEO LITHIUM CARBONATE POWDER METHYLPHENIDATE HCL POWDER QUILLICHEW ER QUILLIVANT XR VYVANSE XYREM

NON PREFERRED FLUMAZENIL POWDER FOCALIN XR

ANXIOLYTICS GENERIC alprazolam alprazolam er alprazolam ODT buspirone hcl chlordiazepoxide hcl clorazepate dipotassium lorazepam


midazolam hcl oxazepam

PREFERRED ALPRAZOLAM POWDER BUSPIRONE HCL POWDER LORAZEPAM POWDER MIDAZOLAM HCL POWDER

NON PREFERRED midazolam hcl XANAX XANAX XR

Cardiovascular, Hypertension & Lipids

ANTIARRHYTHMIC AGENTS GENERIC adenosine amiodarone hcl dofetilide flecainide acetate ibutilide fumarate lidocaine hcl in 7.5% dextrose mexiletine hcl procainamide hcl propafenone hcl propafenone hcl er quinidine gluconate quinidine gluconate er quinidine sulfate sotalol

PREFERRED ADENOSINE POWDER AMIODARONE HCL POWDER MEXILETINE HCL POWDER NEXTERONE PROCAINAMIDE HCL POWDER QUINIDINE SULFATE SOTALOL HCL SOTYLIZE

NON PREFERRED BETAPACE BETAPACE AF

CARDIAC GLYCOSIDES GENERIC digoxin

PREFERRED DIGOXIN POWDER LANOXIN PEDIATRIC

NON PREFERRED LANOXIN

RAPID ACTING NITRATES GENERIC nitroglycerin nitroglycerin in d5w nitroglycerin spray nitroglycerin tablets

NON PREFERRED NITROSTAT

LONG ACTING NITRATES GENERIC isosorbide dinitrate isosorbide mononitrate isosorbide mononitrate er nitroglycerin er PREFERRED DILATRATE-SR

NON PREFERRED NITRO-DUR

ANTICOAGULANTS GENERIC warfarin sodium

PREFERRED ARGATROBAN COUMADIN 5MG VIAL ELIQUIS PRADAXA REFLUDAN WARFARIN SODIUM POWDER XARELTO

NON PREFERRED COUMADIN

ANTIPLATELET DRUGS GENERIC aspirin / dipyridamole er cilostazol clopidogrel dipyridamole eptifibatide

PREFERRED BRILINTA DIPYRIDAMOLE POWDER EFFIENT REOPRO ZONTIVITY

NON PREFERRED AGGRASTAT INTEGRILIN

HEPARIN GENERIC enoxaparin sodium fondaparinux sodium heparin lock flush heparin sodium in 0.45% nacl heparin sodium in 5% dextrose heparin sodium syringe

PREFERRED FRAGMIN


NON PREFERRED HEPARIN SODIUM IN 0.45% NACL 12500/500

VITAMIN K PREFERRED MEPHYTON PHYTONADIONE

HEMOSTATICS GENERIC tranexamic acid

PREFERRED AMICAR HUMATE-P NOVOSEVEN RT NPLATE PROMACTA TRANEXAMIC ACID POWDER WILATE

NON PREFERRED CYKLOKAPRON LYSTEDA

MISC. COAGULATION AGENTS GENERIC bivalirudin pentoxifylline protamine sulfate

PREFERRED ADVATE ADVATE H ADVATE L ADVATE N ADVATE SH ADVATE UH ADYNOVATE ALPHANATE ALPHANINE SD ALPROLIX BEBULIN BEBULIN VH IMMUNO BENEFIX CEPROTIN COAGADEX CORIFACT ELOCTATE FEIBA NF HELIXATE FS HEMOFIL IXINITY KOATE-DVI KOGENATE FS MONOCLATE-P MONONINE OBIZUR PENTOXIFYLLINE POWDER PROFILNINE SD PROTAMINE SULFATE POWDER RECOMBINATE RIASTAP THROMBATE III TRETTEN VONVENDI

XYNTHA

NON PREFERRED ANGIOMAX ATRYN

THIAZIDE & RELATED DIURETICS GENERIC amiloride hcl amiloride hcl w/hctz bumetanide chlorothiazide chlorothiazide sodium chlorthalidone eplerenone ethacrynate sodium furosemide hydrochlorothiazide indapamide mannitol methyclothiazide metolazone spironolactone spironolactone/hctz torsemide

PREFERRED AMILORIDE HCL POWDER FUROSEMIDE POWDER HYDROCHLOROTHIAZIDE POWDER MANNITOL POWDER RESECTISOL SPIRONOLACTONE POWDER

NON PREFERRED EDECRIN TABLET EDECRIN VIAL FUROSEMIDE 40MG/4ML SOLUTION TORSEMIDE

BETA BLOCKERS GENERIC acebutolol hcl atenolol betaxolol hcl bisoprolol fumarate labetalol hcl metoprolol succinate er metoprolol tartrate nadolol pindolol propranolol hcl propranolol hcl er timolol maleate

PREFERRED ACEBUTOLOL HCL POWDER ATENOLOL POWDER BYSTOLIC COREG CR LABETALOL HCL POWDER METOPROLOL TARTRATE POWDER NADOLOL POWDER PROPRANOLOL HCL POWDER TIMOLOL MALEATE POWDER


NON PREFERRED SECTRAL TENORMIN

CALCIUM CHANNEL BLOCKERS/ NON-DIHYDROPYRIDINES

GENERIC diltiazem diltiazem 24hr cd diltiazem er diltiazem er 24 hour diltiazem hcl nimodipine verapamil er verapamil er pm verapamil hcl

PREFERRED DILTIAZEM HCL POWDER VERAPAMIL HCL POWDER

NON PREFERRED NIMODIPINE POWDER

CALCIUM CHANNEL BLOCKERS/DIHYDROPYRIDINES GENERIC amlodipine besylate felodipine er isradipine nicardipine hcl

PREFERRED AMLODIPINE BESYLATE POWDER

NON PREFERRED CLEVIPREX

ACE INHIBITORS GENERIC benazepril hcl captopril enalapril maleate enalaprilat fosinopril sodium lisinopril moexipril hcl perindopril erbumine quinapril ramipril trandolapril

PREFERRED BENAZEPRIL HCL POWDER CAPTOPRIL POWDER ENALAPRIL MALEATE POWDER LISINOPRIL POWDER

NON PREFERRED MAVIK VASOTEC

ADRENERGIC ANTAGONISTS & RELATED DRUGS GENERIC clonidine hcl clonidine/chlorthalidone

doxazosin mesylate guanfacine hcl methyldopa methyldopate hcl prazosin hcl reserpine terazosin hcl

PREFERRED CLONIDINE HCL POWDER RESERPINE POWDER

NON PREFERRED PRAZOSIN HCL POWDER

AGENTS FOR PHEOCHROMOCYTOMA GENERIC phentolamine mesylate

PREFERRED DEMSER PHENTOLAMINE MESYLATE POWDER

NON PREFERRED PHENTOLAMINE MESYLATE VIAL

VASODILATORS GENERIC epoprostenol epoprostenol diluent hydralazine hcl minoxidil papaverine hcl papaverine hcl er

PREFERRED DILUENT FOR REMODULIN FLOLAN HYDRALAZINE HCL POWDER MINOXIDIL POWDER PAPAVERINE HCL POWDER REMODULIN UPTRAVI

OTHER ANTIHYPERTENSIVE COMBINATIONS GENERIC amlodipine/valsartan amlodipine/valsartan/hctz amlodipine-olmesartan atenolol/chlorthalidone benazepril/hctz bisoprolol fumarate/hctz captopril/hydrochlorothiazide enalapril maleate/hctz fosinopril/hydrochlorothiazide lisinopril/hctz methyldopa/hydrochlorothiazide metoprolol/hydrochlorothiazide moexipril/hydrochlorothiazide nadolol-bendroflumethiazide olmesartan-amlodipine-hctz propranolol/hctz quinapril/hydrochlorothiazide trandolapril/verapamil er


PREFERRED BYVALSON

NON PREFERRED AZOR TARKA TRIBENZOR

ANGIOTENSIN II RECEPTOR BLOCKERS & RENIN INHIBITOR

GENERIC candesartan cilexetil candesartan/hydrochlorothiazide irbesartan irbesartan/hydrochlorothiazide losartan potassium losartan/hydrochlorothiazide olmesartan medoxomil olmesartan medoxomil/hctz valsartan valsartan/hydrochlorothiazide

PREFERRED EDARBI EDARBYCLOR TEKAMLO TEKTURNA TEKTURNA HCT

NON PREFERRED BENICAR BENICAR HCT

LIPID/CHOLESTEROL LOWERING AGENTS GENERIC amlodipine-atorvastatin atorvastatin calcium cholestyramine cholestyramine light colestipol hcl ezetimibe-simvastatin fenofibrate fenofibric acid fenofibric acid del rel fluvastatin sodium gemfibrozil lovastatin niacin er omega-3-acid ethyl esters pravastatin sodium rosuvastatin simvastatin

PREFERRED CHOLESTYRAMINE POWDER GEMFIBROZIL POWDER JUXTAPID LIPOFEN LIVALO PRALUENT PEN PRALUENT SYRINGE REPATHA PUSHTRONEX REPATHA SURECLICK REPATHA SYRINGE SIMCOR ER SIMVASTATIN POWDER VASCEPA WELCHOL

ZETIA

NON PREFERRED FENOFIBRATE LIPTRUZET VYTORIN

MISC. CARDIOVASCULAR AGENTS GENERIC dobutamine dobutamine/dextrose dopamine hcl dopamine hcl in 5% dextrose milrinone in 5% dextrose milrinone lactate norepinephrine bitartrate phenylephrine hcl phenylephrine hcl-ns

PREFERRED ACTIVASE CATHFLO ACTIVASE CORLANOR DOPAMINE HCL POWDER ENTRESTO NATRECOR PHENYLEPHRINE HCL POWDER PHENYLEPHRINE HCL-NS RANEXA RETAVASE

NON PREFERRED LEVOPHED AMPULE/VIAL PHENYLEPHRINE HCL-NS 200MCG/5ML SYRINGE PHENYLEPHRINE HCL-NS 40MG/5ML SYRINGE

Dermatological/Topical Therapy

TOPICAL CORTICOSTEROIDS VERY HIGH POTENCY GENERIC clobetasol e clobetasol propionate diflorason diacetate/emollient diflorasone diacetate oint halobetasol propionate

PREFERRED CLOBETASOL PROPIONATE POWDER

NON PREFERRED DIPROLENE OINT

TOPICAL CORTICOSTEROIDS HIGH POTENCY GENERIC amcinonide betamethasone dipropionate augment betamethasone valerate desoximetasone diflorasone diacetate cream fluocinonide


PREFERRED BETAMETHASONE DIPROPIONATE AUGMENT POWDER BETAMETHASONE VALERATE POWDER DESOXIMETASONE POWDER FLUOCINONIDE POWDER

NON PREFERRED DIPROLENE AF CREAM DIPROLENE LOTION PSORCON CREAM

TOPICAL CORTICOSTEROIDS MEDIUM POTENCY GENERIC betamethasone valerate foam fluocinolone acetonide fluticasone propionate hydrocortisone butyrate hydrocortisone butyrate/emoll hydrocortisone valerate mometasone furoate

PREFERRED FLUOCINOLONE ACETONIDE POWDER FLUTICASONE PROPIONATE POWDER MOMETASONE FUROATE POWDER TRIAMCINOLONE ACETONIDE POWDER

NON PREFERRED FLUOCINOLONE ACETONIDE POWDER FLUTICASONE PROPIONATE 50MCG SPRAY LUXIQ

TOPICAL CORTICOSTEROIDS LOW POTENCY GENERIC alclometasone dipropionate desonide hydrocortisone hydrocortisone acetate

PREFERRED DESONIDE POWDER HYDROCORTISONE ACETATE POWDER

NON PREFERRED DESONATE DESOWEN VERDESO

TOPICAL ANESTHETICS GENERIC bupivacaine hcl bupivacaine/epinephrine chloroprocaine cocaine hcl ethyl chloride lidocaine lidocaine hcl lidocaine hcl w/epinephrine lidocaine/prilocaine lidocaine-hc ropivacaine sensorcaine 5MG/ML VIAL

PREFERRED BENZOCAINE BUPIVACAINE HCL POWDER COCAINE HCL LIDOCAINE HCL POWDER LIDOCAINE POWDER MEPIVACAINE HCL POWDER ROPIVACAINE POWDER NON PREFERRED BUPIVACAINE/EPINEPHRINE CARTRIDGE CARBOCAINE LIDOCAINE LIDOCAINE HCL LIDOCAINE HCL W/EPINEPHRINE LIDOCAINE-HC MEPIVACAINE HCL 30MG/ML CARTRIDGE NESACAINE SENSORCAINE 2.5MG/ML VIAL

THERAPY FOR ACNE GENERIC adapalene cream, gel benprox benzoyl peroxide clindamycin phos/benzoyl peroxide clindamycin phosphate topical clindamycin phos-tretinoin clindamycin-benzoyl peroxide erythromycin solution erythromycin-benzoyl peroxide sodium sulfacetamide/sulfur tazarotene cream tretinoin tretinoin microsphere

PREFERRED ABSORICA BENZOYL PEROXIDE POWDER EPIDUO EPIDUO FORTE FINACEA FINACEA PLUS MIRVASO ONEXTON TAZORAC GEL

NON PREFERRED ADAPALENE LOTION DIFFERIN ISOTRETINOIN SODIUM SULFACETAMIDE/SULFUR GEL TAZORAC CREAM TRETIN-X ZIANA

TOPICAL ANTIBACTERIALS GENERIC bacitracin bacitracin/polymyxin ophth oint gentamicin sulfate mafenide acetate mupirocin sulfacetamide sodium

PREFERRED GENTAMICIN SULFATE POWDER MAFENIDE ACETATE POWDER


MUPIROCIN POWDER SULFAMYLON CREAM SULFAMYLON PACKET

NON PREFERRED SULFACETAMIDE SODIUM

TOPICAL ANTIFUNGALS GENERIC ciclopirox clotrimazole clotrimazole/betamethasone econazole nitrate nystatin nystatin w/triamcinolone

PREFERRED CLOTRIMAZOLE POWDER ECONAZOLE NITRATE POWDER NYSTATIN

NON PREFERRED LOPROX GEL & SHAMPOO PENLAC

TOPICAL ANTIVIRALS GENERIC acyclovir 5% oint

PREFERRED ACYCLOVIR POWDER ZOVIRAX 5% CREAM

NON PREFERRED ZOVIRAX 5% OINT

BURN THERAPY GENERIC silver sulfadiazine

PREFERRED SILVER SULFADIAZINE POWDER

NON PREFERRED SILVADENE

TOPICAL ENZYMES PREFERRED SANTYL

KERATOLYTICS GENERIC salicylic acid

PREFERRED SALICYLIC ACID

ANTIPSORIATICS/ANTISEBORRHEIC GENERIC acitretin calcipotriene selenium sulfide

PREFERRED ANTHRALIN CALCIPOTRIENE POWDER COSENTYX ENSTILAR SELENIUM SULFIDE POWDER STELARA TACLONEX SUSPENSION

NON PREFERRED CALCITRIOL TACLONEX OINTMENT

TOPICAL SCABICIDES/PEDICULICIDES GENERIC lindane malathion permethrin spinosad

PREFERRED PERMETHRIN

NON PREFERRED ELIMITE

MISC. DERMATOLOGICALS GENERIC alphaquin hp aluminum chloride topical ammonium lactate avo cream chlorhexidine gluconate dexpanthenol eletone emulsion sb fluorouracil hpr hpr plus hydroquinone cream hydroquinone er cream imiquimod lactic acid lustra-ultra mb hydrogel nuquin hp podofilox pruclair prumyx prutect sonafine tl-cermide urea

PREFERRED ALUMINUM CHLORIDE POWDER AMMONIUM LACTATE CARAC CHLORHEXIDINE GLUCONATE 0.2 SOLUTION CONDYLOX GEL


DEXPANTHENOL DUPIXENT ELIDEL ETHYL ALCOHOL FLUOROURACIL POWDER HYDROQUINONE POWDER IMIQUIMOD POWDER LACTIC ACID 88 TO 92 % OXSORALEN 1% LOTION PICATO REGRANEX SOOLANTRA UREAM POWDER, BEADS

NON PREFERRED CHLORHEXIDINE GLUCONATE CONDYLOX SOLUTION ETHYL ALCOHOL 1 LIQUID PODOFILOX POWDER UREA LOTION

EAR, NOSE & THROAT MEDICATIONS

MISCELLANEOUS OTIC PREPARATIONS GENERIC acetic acid otic solution acetic acid/aluminum otic sol acetic acid/hydrocortisone otic sol antipyrine/benzocaine otic sol antipyrine/benzocaine/poly otic sol chloroxylenol/benzocaine/hc acetate otic susp ciprofloxacin hcl ofloxacin otic drops

PREFERRED CIPROFLOXACIN HCL

NON PREFERRED DERMOTIC

OTIC STEROID / ANTIBIOTIC GENERIC neomycin/polymyxin/hc otic susp & soln

PREFERRED CIPRODEX OTOVEL

NON PREFERRED CIPRO HC COLY-MYCIN S

MISCELLANEOUS AGENTS GENERIC azelastine hcl ipratropium bromide spray oxymetazoline hcl 12 hour sodium fluoride

PREFERRED FIRST-BXN FIRST-MOUTHWASH BLM MYALEPT OXYMETAZOLINE HCL POWDER SODIUM FLUORIDE

SODIUM FLUORIDE POWDER

NON PREFERRED ATROVENT SPRAY AZELASTINE HCL POWDER

ENDOCRINE/DIABETES

ANTITHYROID AGENTS GENERIC methimazole propylthiouracil

PREFERRED METHIMAZOLE POWDER PROPYLTHIOURACIL POWDER

NON PREFERRED TAPAZOLE

THYROID HORMONES GENERIC levothroid levothyroxine sodium liothyronine sodium

PREFERRED ARMOUR THYROID LEVOTHYROXINE SODIUM LIOTHYRONINE SODIUM POWDER THYROID

NON PREFERRED CYTOMEL SYNTHROID TIROSINT

ADRENAL HORMONES GENERIC a-hydrocort cortisone acetate cosyntropin dexamethasone dexamethasone sodium phosphate fludrocortisone acetate methylprednisolone methylprednisolone acetate methylprednisolone sod succ prednisolone prednisolone sodium phosphate prednisone veripred 20

PREFERRED ARISTOSPAN BETAMETHASONE BETAMETHASONE ACETATE BETAMETHASONE SODIUM PHOSPHATE CORTISONE ACETATE POWDER DEXAMETHASONE POWDER DEXAMETHASONE SODIUM PHOSPHATE POWDER FLUDROCORTISONE ACETATE POWDER METHYLPREDNISOLONE POWDER METHYLPREDNISOLONE SOD SUCC POWDER PREDNISOLONE POWDER


PREDNISONE POWDER SOLU-CORTEF

NON PREFERRED COSYNTROPIN DEPO-MEDROL KENALOG MEDROL SOLU-MEDROL VIAL

ANDROGENS GENERIC danazol oxandrolone testosterone cypionate testosterone enanthate testosterone gel

PREFERRED AXIRON DANAZOL POWDER FLUOXYMESTERONE METHITEST OXANDROLONE POWDER TESTOSTERONE CYPIONATE POWDER TESTOSTERONE ENANTHATE POWDER TESTOSTERONE POWDER

NON PREFERRED TESTOSTERONE GEL

OVULATORY STIMULANTS GENERIC clomiphene citrate

PREFERRED CLOMIPHENE CITRATE POWDER FOLLISTIM AQ GONAL-F GONAL-F RFF GONAL-F RFF REDI-JECT MENOPUR REPRONEX

NON PREFERRED BRAVELLE

MISCELLANEOUS AGENTS GENERIC cabergoline calcitonin salmon nasal calcitriol desmopressin acetate doxercalciferol pamidronate disodium paricalcitol vasopressin vasopressin-ns zoledronic acid

PREFERRED ACTHREL ALDURAZYME CERDELGA CEREZYME

DESMOPRESSIN ACETATE POWDER ELAPRASE ELELYSO FABRAZYME KALYDECO KUVAN LUMIZYME MIACALCIN VIAL MYOZYME NAGLAZYME SAMSCA SENSIPAR SOMAVERT STIMATE SPRAY SYNAREL VPRIV ZAVESCA ZOMETA INFUSION BOTTLE

NON PREFERRED MIACALCIN AEROSOL PARICALCITOL ZEMPLAR ZOLEDRONIC ACID ZOMETA VIAL

GONADOTROPIN & RELATED AGENTS GENERIC chorionic gonadotropin

PREFERRED CHORIONIC GONADOTROPIN POWDER

NON PREFERRED PREGNYL

INSULIN THERAPY PREFERRED BASAGLAR KWIKPEN U-100 HUMALOG HUMULIN 70/30 KWIKPEN HUMULIN N KWIKPEN HUMULIN R 500 UNITS HUMULIN R U-500 KWIKPEN LANTUS LANTUS SOLOSTAR LEVEMIR LEVEMIR, FLEXTOUCH NOVOLOG NOVOLOG FLEXPEN NOVOLOG MIX 70-30 TOUJEO SOLOSTAR TRESIBA FLEXTOUCH U-100 TRESIBA FLEXTOUCH U-200

NON PREFERRED NOVOLIN 70-30 NOVOLIN N NOVOLIN R

NON-INSULIN HYPOGLYCEMIC AGENTS GENERIC acarbose glimepiride glipizide glipizide er


glyburide glyburide micronized glyburide/metformin hcl metformin hcl metformin hcl er nateglinide pioglitazone hcl pioglitazone/glimepiride pioglitazone/metformin repaglinide/metformin tolazamide tolbutamide

PREFERRED ACTOPLUS MET XR BYDUREON BYDUREON PEN BYETTA GLIPIZIDE POWDER GLYBURIDE POWDER GLYXAMBI INVOKAMET INVOKAMET XR INVOKANA JANUMET JANUMET XR JANUVIA JENTADUETO JENTADUETO XR JUVISYNC KOMBIGLYZE XR METFORMIN HCL POWDER ONGLYZA SYMLINPEN 60 SYNJARDY SYNJARDY XR TRADJENTA VICTOZA XIGDUO XR

NON PREFERRED ACTOS RIOMET

GLUCOSE ELEVATING AGENTS PREFERRED GLUCAGEN PROGLYCEM

NON PREFERRED GLUCAGON

INSULIN SYRINGES/MISCELLANEOUS DME PREFERRED 1ST CHOICE LANCETS ACCU-CHEK FASTCLIX, MULTICLIX, SOFTCLIX LANCETS ACCU-CHEK SOFTCLIX LANCETS DEVICE DEXCOM G4 METER DEXCOM G4 SENSOR DEXCOM G4 TRANSMITTER DEXCOM G5 METER DEXCOM G5 TRANSMITTER FEMCAP FORA LANCING DEVICE FREESTYLE CONTROL SOLUTION FREESTYLE FREEDOM LITE MEDISENSE MEDISENSE GLUCOSE KETONE CONTR

MINIMED MINIMED RESERVOIR NOVOFINE NOVOFINE AUTOCOVER ONE TOUCH ULTRA 2 ONE TOUCH VERIO ONE TOUCH VERIO FLEX ONE TOUCH VERIO IQ ONE TOUCH VERIO SYNC PARADIGM INFUSION PARADIGM INSULIN PUMP PARADIGM SILHOUETTE POLYFIN QR PRODIGY INSULIN SYRINGE PRODIGY PEN NEEDLE QUICK RELEASE SOFT TEFLON SILHOUETTE SNAP INSULIN PUMP CONTROLLER SOF-SET SOF-SET MICRO SOFT TOUCH SOLOSITE SURE-T PARADIGM VGO 20 VGO 30 VGO 40

BLOOD GLUCOSE MONITORING DEVICES & SUPPLIES PREFERRED FREESTYLE FREEDOM KIT FREESTYLE FREEDOM LITE METER FREESTYLE INSULINX FREESTYLE INSULINX GLUCOSE SYSTEM FREESTYLE INSULINX TEST STRIPS FREESTYLE LITE METER FREESTYLE LITE TEST STRIPS FREESTYLE TEST STRIPS ONE TOUCH ULTRA TEST STRIPS PRECISION XTRA B-KETONE STRIPS PRECISION XTRA MONITOR PRECISION XTRA TEST STRIPS

NON PREFERRED OPTIUM EZ

GASTROENTEROLOGY

H2 ANTAGONISTS GENERIC cimetidine famotidine nizatidine ranitidine hcl

PREFERRED CIMETIDINE POWDER FAMOTIDINE POWDER RANITIDINE HCL POWDER

NON PREFERRED ZANTAC RX


PROSTAGLANDINS GENERIC misoprostol

PREFERRED MISOPROSTOL POWDER

NON PREFERRED CYTOTEC

OTHER ULCER THERAPY GENERIC carafate lansoprazole/amoxicillin/clarithromycin sucralfate

PREFERRED SUCRALFATE POWDER

NON PREFERRED CARAFATE

PROTON PUMP INHIBITORS GENERIC esomeprazole lansoprazole del rel omeprazole del rel omeprazole sodium bicarbonate pantoprazole sodium

PREFERRED LANSOPRAZOLE POWDER NEXIUM (RX) SUSP NEXIUM 24HR OMEPRAZOLE POWDER

NON PREFERRED NEXIUM (RX) CAPSULE NEXIUM (RX) VIAL OMEPRAZOLE SODIUM BICARBONATE

ANTIDIARRHEALS GENERIC diphenoxylate/atropine loperamide hcl opium paregoric

PREFERRED LOPERAMIDE HCL

NON PREFERRED LOMOTIL TABLET

ANTISPASMODICS GENERIC dicyclomine hcl glycopyrrolate hyoscyamine sulfate hyoscyamine sulfate disinegrating tablets hyoscyamine sulfate er

PREFERRED

DICYCLOMINE HCL POWDER GLYCOPYRROLATE POWDER HYOSCYAMINE SULFATE POWDER LEVSIN 0.5MG/ML AMPUL

NON PREFERRED LEVSIN 0.125MG TABLET

BILE ACIDS GENERIC ursodiol

PREFERRED CHENODAL CHOLBAM KINEVAC URSODIOL POWDER

NON PREFERRED ACTIGALL URSO URSO FORTE

DIGESTIVE ENZYMES GENERIC pancrelipase

PREFERRED CREON SUCRAID VIOKACE ZENPEP DEL-REL

NON PREFERRED PANCREAZE

MISC. GASTROINTESTINAL AGENTS GENERIC balsalazide disodium budesonide budesonide ec CITRA PH hydrocortisone hydrocortisone/pramoxine lactulose mesalamine metoclopramide hcl pramcort sodium bicarbonate sulfasalazine sulfasalazine dr

PREFERRED AMITIZA ASACOL HD CANASA CORTIFOAM CYSTADANE DELZICOL ENTYVIO HYDROCORTISONE POWDER LIALDA LINZESS MESALAMINE POWDER METOCLOPRAMIDE HCL POWDER OCALIVA


PENTASA PROCTOFOAM-HC RECTIV RELISTOR REMICADE SODIUM BICARBONATE POWDER SULFASALAZINE POWDER UCERIS EXTENDED RELEASE VIBERZI

NON PREFERRED LOTRONEX SODIUM BICARBONATE POWDER sodium chloride/sodium bicarb UCERIS FOAM

ANTIVERTIGO & ANTIEMETIC AGENTS GENERIC aprepitant capsule, dose pack dimenhydrinate dronabinol droperidol granisetron hcl granisol meclizine hcl ondansetron hcl ondansetron ODT prochlorperazine edisylate prochlorperazine maleate trimethobenzamide hcl

PREFERRED AKYNZEO ALOXI DIMENHYDRINATE POWDER DROPERIDOL POWDER EMEND 40MG; 125MG CAPSULE MECLIZINE HCL POWDER ONDANSETRON HCL POWDER PROCHLORPERAZINE EDISYLATE POWDER PROCHLORPERAZINE MALEATE POWDER SANCUSO SCOPOLAMINE HYDROBROMIDE TRIMETHOBENZAMIDE HCL POWDER VARUBI

NON PREFERRED EMEND 125MG/80MG DOSEPACK EMEND 80MG CAPSULE

BOWEL EVACUANTS GENERIC peg 3350-electrolyte polyethylene glycol

PREFERRED POLYETHYLENE GLYCOL PREPOPIK SUCLEAR SUPREP

NON PREFERRED POLYETHYLENE GLYCOL

IMMUNOLOGY, VACCINES & BIOTECHNOLOGY

ERYTHROID STIMULANTS PREFERRED ARANESP PROCRIT

MYELOID STIMULANTS PREFERRED GRANIX LEUKINE MOZOBIL NEULASTA NEUPOGEN ZARXIO

INTERFERONS PREFERRED ACTIMMUNE ALFERON N AVONEX BETASERON INFERGEN INTRON A PEGASYS PEGASYS PROCLICK PLEGRIDY REBIF REBIF REBIDOSE SYLATRON

GROWTH HORMONES PREFERRED EGRIFTA GENOTROPIN HUMATROPE NORDITROPIN SEROSTIM

NON PREFERRED OMNITROPE

INTERLEUKINS PREFERRED ARCALYST ILARIS NEUMEGA PROLEUKIN

VACCINES & MISCELLANEOUS IMMUNOLOGICALS GENERIC candin fomepizole tetanus toxoid

PREFERRED ACTHIB ADACEL AFLURIA AFLURIA QUAD 2016-2017 APLISOL ATGAM BEXSERO


BIOTHRAX BOOSTRIX BOTOX CERVARIX COMVAX CROFAB CYTOGAM ENGERIX-B FLUAD 2016-2017 FLUARIX FLUBLOK 2016-2017 FLUCELVAX QUAD 2016-2017 FLULAVAL FLULAVAL QUAD FLUMIST FLUVIRIN FLUZONE FLUZONE HIGH-DOSE FLUZONE INTRADERM QUAD FLUZONE INTRADERM QUAD 2016-17 FLUZONE QUAD 2016-2017 FLUZONE QUAD PEDI 2016-2017 GAMASTAN S-D GAMMAGARD LIQUID GAMMAGARD S-D GAMUNEX GAMUNEX-C GARDASIL 9 GRASTEK HAVRIX HEPAGAM B HIZENTRA HYPERHEP B S-D HYPERRAB S-D HYPERRHO S-D HYPERTET S-D IMOGAM RABIES-HT IMOVAX RABIES VACCINE INFANRIX IPOL IXIARO MENACTRA MENOMUNE-A-C-Y-W-135 M-M-R II VACCINE W/DILUENT MYOBLOC PEDIARIX PEDVAXHIB PENTACEL PNEUMOVAX 23 PREVNAR 13 PRIVIGEN PROQUAD QUADRACEL DTAP-IPV RABAVERT RAGWITEK RECOMBIVAX HB ROTATEQ STAMARIL SYNAGIS TETANUS DIPHTHERIA TOXOIDS TETANUS DIPHTHERIA TOXOIDS - PED THERACYS THYMOGLOBULIN TICE BCG TRUMENBA TUBERSOL TWINRIX TYPHIM VI VAQTA VIAL VARIVAX VACCINE VARIZIG VAXCHORA VACCINE

VIVOTIF BERNA DEL REL YF-VAX

NON PREFERRED VAQTA SYRINGES

MUSCULOSKELETAL & RHEUMATOLOGY

GOUT THERAPY GENERIC allopurinol allopurinol sodium probenecid

PREFERRED ALLOPURINOL POWDER COLCHICINE POWDER COLCRYS KRYSTEXXA ULORIC

NON PREFERRED COLCHICINE

OTHER RHEUMATOLOGICALS GENERIC leflunomide

PREFERRED ACTEMRA BENLYSTA DEPEN ENBREL HUMIRA OTREXUP RIDAURA SAVELLA SIMPONI 100MG/ML XELJANZ XELJANZ XR

NON PREFERRED CUPRIMINE ORENCIA ORENCIA CLICKJECT SIMPONI 50MG/0.5ML

OSTEOPOROSIS THERAPY GENERIC alendronate sodium ibandronate ibandronate sodium risedronate dr risedronate sodium

PREFERRED FORTEO

OBSTETRICS & GYNECOLOGY

MONOPHASIC /BIPHASIC /TRIPHASIC AGENTS GENERIC altavera alyacen


amethia amethia lo amethyst apri aranelle aubra aviane azurette balziva briellyn camrese camrese lo caziant chateal cryselle cyclafem dasetta daysee drospirenone-eth estra-levomef elinest emoquette enpresse enskyce estarylla falmina gianvi gildagia gildess gildess fe introvale jolessa junel junel fe kariva kelnor 1-35 kurvelo leena lessina levonorgestrel levora loryna low-ogestrel lutera marlissa microgestin microgestin fe mono-linyah mononessa myzilra necon norethindrone/ethinyl estradiol norethindrone/ethinyl estradiol iron norethin-eth estra ferrous fum nortrel ocella ogestrel orsythia philith pirmella portia quasense reclipsen sprintec sronyx syeda tilia fe tri-estarylla tri-legest fe tri-linyah trinessa trivora velivet

vestura viorele wera wymzya fe zarah zenchent zenchent fe zeosa zovia

PREFERRED LO LOESTRIN FE NATAZIA SAFYRAL TAYTULLA

NON PREFERRED BEYAZ MINASTRIN 24 FE

OXYTOCICS GENERIC methylergonovine maleate oxytocin

PREFERRED ERGONOVINE MALEATE HEMABATE OXYTOCIN POWDER

NON PREFERRED METHYLERGONOVINE MALEATE

PROGESTINS GENERIC errin heather jencycla jolivette lyza medroxyprogesterone acetate nora-be norethindrone acetate progesterone in oil progesterone micronized

PREFERRED CALDOLOR CRINONE DEPO-PROVERA 400 MG/ML ENDOMETRIN MAKENA NORETHINDRONE ACETATE POWDER PROGESTERONE MICRONIZED POWDER

NON PREFERRED DEPO-PROVERA MEDROXYPROGESTERONE ACETATE POWDER

ESTROGENS GENERIC estradiol estradiol patch estradiol valerate estropipate


yuvafem

PREFERRED CENESTIN DEPO-ESTRADIOL DIVIGEL ENJUVIA ESTRACE CREAM ESTRADIOL VALERATE POWDER MINIVELLE PREMARIN PREMARIN CREAM

NON PREFERRED ESTRACE TABLET

ESTROGEN COMBINATIONS GENERIC estradiol/norethindrone acetate estrogen/methyltestosterone

PREFERRED COMBIPATCH DUAVEE PREMPHASE PREMPRO

VAGINAL CLEANSER /ANTIINFECTIVES GENERIC clindamycin phosphate vaginal

VAGINAL ANTIFUNGALS GENERIC miconazole 1 terconazole

PREFERRED MICONAZOLE 1

SPECIALIZED OB/GYN DRUGS GENERIC isoxsuprine hcl

PREFERRED ISOXSUPRINE HCL POWDER OSPHENA

DIAPHRAGMS AND OTHER NON-ORAL CONTRACEPTIVES

PREFERRED IMPLANON MIRENA NEXPLANON NUVARING ORTHO-DIAPHRAGM TODAY CONTRACEPTIVE SPONGE

OPHTHALMOLOGY

BETA-BLOCKERS GENERIC betaxolol ophth solution carteolol hcl levobunolol hcl drops metipranolol drops

CHOLINESTERASE INHIBITOR MIOTICS PREFERRED PHOSPHOLINE IODIDE DROPS

DIRECT ACTING MIOTICS GENERIC pilocarpine hcl

PREFERRED PILOCARPINE HCL POWDER PILOPINE HS

OTHER GLAUCOMA DRUGS GENERIC bimatoprost dorzolamide hcl dorzolamide/timolol latanoprost drops physostigmine salicylate travoprost

PREFERRED CARBACHOL COMBIGAN ISOPTO CARBACHOL 0.015 PHYSOSTIGMINE SALICYLATE TRAVATAN Z

NON PREFERRED ISOPTO CARBACHOL 0.03 LATANOPROST DROPS 1GM OIL LUMIGAN

ORAL DRUGS FOR GLAUCOMA GENERIC acetazolamide acetazolamide er methazolamide

PREFERRED ACETAZOLAMIDE POWDER METHAZOLAMIDE POWDER

CYCLOPLEGIC MYDRIATICS GENERIC atropine sulfate cyclopentolate ophth solution homatropine hydrobromide tropicamide

PREFERRED ATROPINE SULFATE POWDER CYCLOPENTOLATE POWDER HOMATROPINE HYDROBROMIDE


TROPICAMIDE POWDER

NON-STEROIDAL ANTI-INFLAMMATORY AGENTS GENERIC bromfenac ophth flurbiprofen sodium ketorolac tromethamine drops

PREFERRED ILEVRO NEVANAC PROLENSA

NON PREFERRED BROMFENAC POWDER

VASOCONSTRICTOR DECONGESTANTS GENERIC naphazoline hcl

PREFERRED NAPHAZOLINE HCL POWDER

ANTIBIOTICS GENERIC ciprofloxacin ophth solution erythromycin ointment gatifloxacin gentasol levofloxacin hemihydrate neomycin/polymyxin/gramicidin ofloxacin tobramycin sulfate drops

PREFERRED AZASITE BESIVANCE MOXEZA NATACYN TOBRAMYCIN SULFATE POWDER VIGAMOX

SULFONAMIDES GENERIC sulfacetamide sodium

STEROIDS GENERIC fluorometholone prednisolone acetate prednisolone sodium phosphate drops

PREFERRED ALREX FLUOROMETHOLONE POWDER FML S.O.P. LOTEMAX PRED MILD PREDNISOLONE ACETATE POWDER PREDNISOLONE SODIUM PHOSPHATE DROPS POWDER

STEROID-ANTIBIOTIC COMBINATIONS GENERIC neomycin/bacitracin/poly/hc tobramycin/dexamethasone

PREFERRED TOBRADEX OINTMENT TOBRADEX ST ZYLET

NON PREFERRED TOBRADEX SUSPENSION

STEROID-SULFONAMIDE COMBINATIONS GENERIC sulfacetamide w/prednisolone

SYMPATHOMIMETICS GENERIC apraclonidine ophth solution brimonidine ophth solution

PREFERRED ALPHAGAN P 0.001% BRIMONIDINE POWDER

NON PREFERRED ALPHAGAN P 0.0015%

MISCELLANEOUS OPHTHALMOLOGICS GENERIC azelastine hcl ophth solution balanced salt ophth irrigation cromolyn sodium epinastine hcl olopatindine proparacaine hcl proparacaine/fluorescein sodium chloride drops tetcaine drops

PREFERRED BEPREVE CYSTARAN EYLEA FLUORESCEIN SODIUM JETREA LUCENTIS PATADAY PAZEO PROPARACAINE HCL POWDER RESTASIS RESTASIS MULTIDOSE VISUDYNE XIIDRA

ANTIVIRALS GENERIC trifluridine

PREFERRED TRIFLURIDINE POWDER


RESPIRATORY, ALLERGY, COUGH & COLD

ANTIHISTAMINES GENERIC arbinoxa carbinoxamine cetirizine syrup clemastine fumarate cyproheptadine hcl desloratadine desloratadine disintegrating tablets dexchlorpheniramine maleate er diphenhydramine hydroxyzine hcl hydroxyzine pamoate levocetirizine dihydrochloride promethazine hcl promethegan

PREFERRED CLEMASTINE FUMARATE POWDER CYPROHEPTADINE HCL POWDER DIPHENHYDRAMINE POWDER HYDROXYZINE HCL POWDER HYDROXYZINE PAMOATE POWDER LEVOCETIRIZINE DIHYDROCHLORIDE POWDER PROMETHAZINE HCL POWDER PROMETHAZINE HCL TABLETS POWDER

NON PREFERRED CYPROHEPTADINE HCL 4MG/10ML SYRUP HYDROXYZINE HCL 50MG/25ML SOLUTION

ADRENERGICS GENERIC epinephrine ampule/vial

PREFERRED EPINEPHRINE AUTO-INJECTOR EPINEPHRINE POWDER EPIPEN EPIPEN JR.

NON PREFERRED EPINEPHRINE 1MG/ML AMPUL EPINEPHRINE AUTO-INJECTOR

ANTITUSSIVE COMBINATIONS GENERIC benzonatate chlorphen/pse/dm tannate D-CHLORPHENIRA/PSE/CHLOPHEDIAN 12.5CPD-1DCPM-30PSE dihydrocodeine/aspirin/caffeine dihydrocodeine/bpm/pe DM/PHENYLEPH/CHLORPHENIRAMINE 10PEH-4CPM-20DM guaifenesin/codeine hydrocodone/chlorpheniramine er hydrocodone/homatropine promethazine vc/codeine promethazine/dextromethorphan

PREFERRED DEXTROMETHORPHAN HBR TUSSICAPS

NON PREFERRED GUAIFENESIN/CODEINE HYDROCODONE/HOMATROPINE PSEUDOEPH/CHLOPHEDIANOL/GG 12.5CPD-100GFN-30PSE

DECONGESTANT / ANTIHISTAMINES GENERIC brompheniramine/pseudoephedrine phenylephrine/chlorpheniramine 10peh-4cpm pseudoephedrine hcl pseudoephedrine hcl er

PREFERRED PSEUDOEPHEDRINE HCL

NON PREFERRED pseudoephedrine sulfate er

XANTHINES GENERIC aminophylline caffeine/sodium benzoate difil-g theophylline anhydrous drops er 12 hr theophylline anhydrous er

PREFERRED AMINOPHYLLINE POWDER THEOPHYLLINE ANHYDROUS POWDER

NON PREFERRED AMINOPHYLLINE 500MG/20ML AMPUL

BETA AGONISTS ORAL GENERIC albuterol sulfate ephedrine sulfate metaproterenol sulfate terbutaline sulfate

PREFERRED ALBUTEROL ALBUTEROL SULFATE POWDER EPHEDRINE SULFATE POWDER METAPROTERENOL SULFATE POWDER TERBUTALINE SULFATE POWDER

BETA AGONISTS INHALERS GENERIC levalbuterol hcl

PREFERRED ARCAPTA NEOHALER LEVALBUTEROL HCL POWDER PERFOROMIST PROAIR HFA PROAIR RESPICLICK SEREVENT DISKUS STRIVERDI RESPIMAT VENTOLIN HFA

NON PREFERRED FORADIL


INHALED CORTICOSTEROIDS GENERIC budesonide

PREFERRED ASMANEX, HFA BUDESONIDE POWDER FLOVENT DISKUS FLOVENT HFA PULMICORT FLEXHALER QVAR

INTRANASAL STEROIDS GENERIC flunisolide mometasone furoate nasal triamcinolone acetonide

PREFERRED DYMISTA FLUNISOLIDE POWDER VERAMYST

MISCELLANEOUS PULMONARY AGENTS GENERIC acetylcysteine cromolyn sodium ipratropium bromide ipratropium/albuterol nebulization montelukast sodium sildenafil citrate sodium chloride zafirlukast

PREFERRED ACETYLCYSTEINE POWDER ADCIRCA ADEMPAS ADVAIR DISKUS ADVAIR HFA ANORO ELLIPTA ARNUITY ELLIPTA BERINERT BEVESPI AEROSPHERE BREO ELLIPTA CINRYZE COMBIVENT RESPIMAT CROMOLYN SODIUM POWDER DALIRESP DULERA ESBRIET FIRAZYR IPRATROPIUM BROMIDE POWDER KALBITOR LETAIRIS MONTELUKAST SODIUM POWDER NUCALA OPSUMIT ORKAMBI PULMOZYME SILDENAFIL CITRATE POWDER SPIRIVA RESPIMAT STIOLTO RESPIMAT SYMBICORT TRACLEER TUDORZA PRESSAIR TYVASO

VENTAVIS XOLAIR

UROLOGICALS

CHOLINERGIC STIMULANTS GENERIC bethanechol chloride

PREFERRED BETHANECHOL CHLORIDE POWDER

ANTICHOLINERGICS & ANTISPASMODICS GENERIC darifenacin er flavoxate hcl oxybutynin chloride oxybutynin chloride er tolterodine tartrate trospium chloride er

PREFERRED GELNIQUE MYRBETRIQ ER 24 HR OXYBUTYNIN CHLORIDE POWDER TOVIAZ VESICARE

URINARY ANESTHETICS GENERIC phenazopyridine hcl phenazopyridine plus

PREFERRED PHENAZOPYRIDINE HCL POWDER

MISCELLANEOUS UROLOGICALS GENERIC alprostadil glycine hyophen phosphasal potassium citrate er tricitrates uretron d-s urimar-t urin d.s. urogesic ustell

PREFERRED ALPROSTADIL POWDER AMINOACETIC ACID AMMONIUM CHLORIDE CAVERJECT CIALIS CYSTAGON ELMIRON GLYCINE POWDER K-PHOS ORIGINAL MUSE RENACIDIN VIAGRA


NON PREFERRED AMINOACETIC ACID POWDER

BENIGN PROSTATIC HYPERPLASIA (BPH) THERAPY GENERIC alfuzosin hcl er finasteride tamsulosin hcl er 24 hr

PREFERRED FINASTERIDE POWDER RAPAFLO

VITAMINS, HEMATINICS & ELECTROLYTES

VITAMINS & HEMATINICS GENERIC advanced am/pm ascorbic acid bal-care dha b-complex cavan-alpha kit cavan-ec sod dha centratex choice-ob + dha choice-tabs complete natal dha corvita dailyvite dexferrum dialyvite 800 elite ob elite-ob elite-ob 400 fabb fe 90 plus fe c ferocon ferotrinsic ferraplus 90 ferrex 150 forte ferrex 150 forte plus ferrex 28 ferrocite plus ferrogels forte folbecal folbee folbee plus folbic folcaps folcaps omega-3 folic acid folic acid/cyancobal/pyridoxine folivane-f folivane-ob folivane-plus folivane-prx dha nf folplex 2.2 foltanx hematinic plus hematinic with folic acid hematogen hematogen fa hematogen forte hemenatal ob hemenatal ob + dha hemetab

hydroxocobalamin iferex 150 forte inatal advance inatal gt inatal ultra infed l-mefolate-pyridox-mecobalamin l-methyl-b6-b12 l-methylfolate calcium m.v.i. adult macnatal cn dha mefolate-pyridox-mecobalamin metafolbic methyl-b6-b12 multigen multigen folic multigen plus multivitamin w/fluoride & iron multivitamin with fluoride mynatal mynatal advance mynatal caps mynatal plus mynatal-z mynate 90 plus er mynephrocaps natal-v rx natalvirt 90 dha natalvirt ca natalvirt flt nephplex rx nephro-vite rx nutri-tab ob obstetrix dha pnv ob+dha pnv-dha pnv-first pnv-omega pnv-select pnv-total poly-iron 150 forte polysaccharide iron forte pr natal 400 pr natal 400 ec pr natal 430 pr natal 430 ec prefol-dha prena1 prena1 chew prena1 plus prenaissance prenaissance 90 dha prenaissance balance prenaissance dha prenaissance harmony dha prenaissance next prenaissance plus prenaplus prenatabs fa prenatabs rx prenatal ad prenatal low iron prenatal plus prenatal-u pyridoxine hcl relnate dha renal caps renalpren rena-vite rx reno caps se-natal 19 se-tan dha prenatal


se-tan plus setonet setonet ec strovite taron forte taron prenatal taron-bc taron-c dha taron-duo ec therapeutic hematinic therapeutic vitamin/minerals thiamine hcl tl gard rx tl g-fol os tl icon tl-care dha tl-fol 500 er tl-hem 150 er 24 hr tl-select tri rx triadvance tricon trigels-f forte trinatal gt trinatal rx 1 trinatal ultra trinate triphrocaps triveen-duo dha triveen-one triveen-prx rnf triveen-ten triveen-u trust natal dha ultimate ob dha ultimatecare one ultimatecare one nf v-c forte vemavite-prx 2 vena-bal dha venatal complete dha venatal-fa vinacal vinate az vinate c vinate calcium vinate dha vinate gt vinate ic vinate ii vinate one vinate ultra vinate-m virt-bal dha virt-bal dha plus virt-pn virt-pn dha virt-pn plus virt-select virt-vite virt-vite forte vitacirc-b vitafol-ob vitafol-pn vitamin a v-natal vol-care rx vol-nate vol-plus vol-tab rx vp-ch plus vp-ch-pnv

vp-era ob plus vp-ggr-b6 vp-heme one zatean-ch zatean-pn zatean-pn dha zatean-pn plus zingiber

PREFERRED AQUASOL A ASCORBIC ACID FERAHEME FOLIC ACID POWDER HYDROXOCOBALAMIN POWDER INFUVITE L-METHYLFOLATE CALCIUM POWEDER M.V.I. PEDIATRIC M.V.I.-12 NASCOBAL PYRIDOXINE HCL THIAMINE HCL POWDER TROPHAMINE VENOFER VITAMIN A

NON PREFERRED B-COMPLEX CENOLATE CONCEPTION XR MOTILITY DIALYVITE 800 DULEEK-MET NEW folbic rf FOLIC ACID 20MG CAP FOLIC ACID-VIT B12 PYRIDOXINE HCL 500MG TABLETS STUART ONE THIAMINE HCL VITAMIN A vitaspire vynatal-fa

POTASSIUM GENERIC pot chloride/dextrose/ns potassium acetate potassium bicarbonate potassium chloride potassium chloride/dextrose

PREFERRED POTASSIUM ACETATE POTASSIUM BICARBONATE POTASSIUM CHLORIDE

OTHER ELECTROLYTES GENERIC calcium acetate calcium chloride calcium gluconate chromium chloride copper chloride eliphos k-phos neutral magnesium chloride magnesium sulfate manganese manganese sulfate


multitrace-4 nutrilyte nutrilyte ii potassium chl-normal saline ringers selenium sodium acetate sodium chloride sodium lactate zinc chloride zinc sulfate

PREFERRED ADDAMEL N CALCIUM ACETATE POWDER CALCIUM CHLORIDE CALCIUM GLUCONATE 61MG CALCIUM GLUCONATE POWDER CUPRIC SULFATE GLYCOPHOS MAGNESIUM CHLORIDE MAGNESIUM SULFATE MAGNESIUM SULFATE IN DEXTROSE MANGANESE SULFATE POWDER MULTITRACE-4 MULTITRACE-5 NEUT NORMOSOL-R AND DEXTROSE PEDITRACE SODIUM ACETATE POWDER SODIUM LACTATE TPN ELECTROLYTES 18-18-5MEQ TRACE ELEMENTS ZINC CHLORIDE ZINC SULFATE

NON PREFERRED CALCIUM ACETATE CALCIUM GLUCONATE 50MG CUPRIC SULFATE MAGNESIUM SULFATE 100MG CAPSULE SELENIUM TPN ELECTROLYTES 35-20-5MEQ

MISCELLANEOUS NUTRITION PRODUCTS GENERIC amino acid freamine iii hetastarch w/sodium chloride intralipid l-methylfolate-mecobalamin-nac metafolbic plus premasol travasol vp-zel

PREFERRED AMINOSYN BAL IN OIL CLINIMIX CLINIMIX E FREAMINE HBC FREAMINE III HEPATAMINE HEPATASOL IONOSOL B WITH DEXTROSE 5% ISOLYTE S NEPHRAMINE NORMOSOL-M AND DEXTROSE

NORMOSOL-R PH 7.4 PLASMA-LYTE 148 PREMASOL PROCALAMINE PROSOL

NON PREFERRED AMINO ACID 700MG TABLETS INTRALIPID METHYLFOLATE MECOBALAMIN-NAC 6-600-2MG

BLOOD DERIVATIVES GENERIC albumin

NON PREFERRED ALBUMIN

DIAGNOSTICS & MISCELLANEOUS AGENTS

MISCELLANEOUS AGENTS GENERIC acamprosate calcium acetic acid irrigation anagrelide hydrochloride bupivacaine/dextrose caffeine citrated cevimeline hcl citric acid deferoxamine delflex w/dextrose dextrose in lactated ringers dextrose in water dextrose with sodium chloride disulfiram etidronate disodium etomidate ketamine hcl levocarnitine md-gastroview midodrine hcl pilocarpine hcl propofol riluzole sodium chloride sodium phosphate 3mmol/ml vial sodium polystyrene sulfonate sodium thiosulfate water water intravenous solution water solution; irrigation

PREFERRED ACETIC ACID ADAGEN AMMONUL ARALAST NP BREVITAL BROMHEXINE HYDROCHLORIDE BUPHENYL CAFFEINE CITRATED POWDER CARBAGLU CHEMET CITRIC ACID POWDER DISULFIRAM POWDER EOVIST ETHAMOLIN ETOMIDATE POWDER EXJADE


EXTRANEAL ICODEXTRIN DIALYSIS FERRIPROX FOSRENOL HEXTEND LACTATED ELECTROLYTE INCRELEX JADENU KANUMA KETAMINE HCL POWDER LEVOCARNITINE POWDER LEXISCAN NATPARA OMNIPAQUE ORFADIN PANHEMATIN PROLASTIN C RAVICTI RENVELA SEROTONIN HCL SODIUM PHOSPHATE SODIUM THIOSULFATE SOLIRIS SOTRADECOL STRENSIQ THALLOUS CHLORIDE TL-201 THYROGEN TRYPSIN VELTASSA WATER XIAFLEX XURIDEN ZEMAIRA

NON PREFERRED BUPHENYL POWDER DELFLEX W/DEXTROSE ISOVUE ISOVUE-M KALEXATE KETAMINE HCL 50MG/ML SYRINGE MAGNEVIST PROHANCE PROSTAMEN SODIUM POLYSTYRENE SULFONATE VISIPAQUE

SMOKING DETERRENTS PREFERRED CHANTIX

ANOREXIANTS GENERIC benzphetamine hcl diethylpropion hcl phendimetrazine tartrate phendimetrazine tartrate er phentermine hcl

PREFERRED DIETHYLPROPION HCL POWDER PHENTERMINE HCL POWDER

NEUTRACEUTICALS PREFERRED UVA URSI LEAF FLUID EXTRACT

IRRIGATING SOLUTIONS GENERIC neomycin-polymyxin b ringers irrigation

ANTIDOTES PREFERRED PROTOPAM CHLORIDE

NON PREFERRED ATROPEN

ANTI-INFECTIVES - Emdeon · Updated August 1, 2017 Page 1 ANTI-INFECTIVES .....5

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