Anti-Infectives hcl famciclovir fluconazole fluconazole in dextrose fluconazole in saline FLUCONAZOLE POWDER flucytosine FLUCYTOSINE POWDER FORTAZ IN …

2018 Enhanced Formulary

1 Last Updated: December 31, 2017

The 2018 AscellaHealth Enhanced Formulary list is listed below. Last updated October 2016 and subject to change at any time. Inclusion on this list does not guarantee coverage. Coverage is based on your specific benefit plan.

KEY: [INJ], [inj] - Injectable Drug [OTC], [otc] - Over the Counter [SP], [sp] - Specialty Drug Brand name drugs are listed in CAPITAL letters. Example: ABILIFY. Generic drugs are listed in lower-case letters. Example: altavera

Generic medications contain the same active ingredients as their corresponding brand name medications, though they may appear different in shape and color. They have been FDA -approved under strict standards.

Anti-Infectives

abacavir

abacavir sulfate/lamivudine

abacavir/lamivudine/zidovud

ine

acyclovir

adefovir dipivoxil

ALBENZA

ALINIA

amantadine hcl

AMANTADINE HCL POWDER

AMBISOME [INJ]

AMIKACIN [INJ]

AMIKACIN POWDER [INJ]

amoxicillin

AMOXICILLIN POWDER

amoxicillin/clavulanate er

amphotericin [INJ]

AMPHOTERICIN POWDER

[INJ]

ampicillin [INJ]

ampicillin/sulbactam [INJ]

APTIVUS

atovaquone

atovaquone/proguanil hcl

ATRIPLA

AUGMENTIN 125-31.25

MG/5ML

AVELOX IV [INJ]

AVYCAZ

AZACTAM-ISO-OSMOTIC

DEXTROSE [INJ]

azithromycin [INJ]

AZITHROMYCIN POWDER

[INJ]

aztreonam [INJ]

bacitracin [INJ]

BACITRACIN POWDER [INJ]

BETHKIS

BICILLIN C-R [INJ]

BICILLIN L-A [INJ]

BILTRICIDE

CANCIDAS [INJ]

CAPASTAT SULFATE [INJ]

CAYSTON

cefaclor

cefazolin [INJ]

cefdinir

cefepime [INJ]

cefotaxime [INJ]

cefotetan [INJ]

cefoxitin [INJ]

cefoxitin/dextrose [INJ]

cefpodoxime proxetil

cefprozil

ceftazidime

CEFTAZIDIME IV PIGGYBACK

ceftibuten

ceftriaxone [INJ]

CEFUROXIME 75G BULK BAG

cefuroxime axetil

cefuroxime sodium

cephalexin

CHLORAMPHENICOL [INJ]

chloroquine phosphate

CHLOROQUINE PHOSPHATE

POWDER

cidofovir [INJ]

ciprofloxacin

ciprofloxacin er

ciprofloxacin suspension

ciprofloxacin/dextrose [INJ]

clarithromycin

clarithromycin er

CLARITHROMYCIN POWDER

clindamycin hcl

CLINDAMYCIN HCL POWDER

clindamycin palmitate hcl

clindamycin phosphate [INJ]

CLINDAMYCIN PHOSPHATE

[INJ]

clindamycin

phosphate/dextrose [INJ]

COARTEM

colistimethate [INJ]

COLISTIMETHATE POWDER

[INJ]

COMPLERA



CRESEMBA

CRIXIVAN

CUBICIN RF

DAKLINZA

DALVANCE [INJ]

dapsone

DAPSONE POWDER

daptomycin

DARAPRIM

demeclocycline hcl

DEMECLOCYCLINE HCL

POWDER

DESCOVY

dicloxacillin sodium

didanosine

DORIBAX

doxycycline hyclate

DOXYCYCLINE HYCLATE

POWDER

doxycycline monohydrate

EDURANT

EMTRIVA

EMVERM

entecavir

EPCLUSA

ERYTHROCIN LACTOBIONATE

[INJ]

erythromycin

erythromycin del rel

erythromycin ethylsuccinate

ERYTHROMYCIN

ETHYLSUCCINATE POWDER

ERYTHROMYCIN POWDER

erythromycin stearate

erythromycin/sulfisoxazole

ethambutol hcl

famciclovir

fluconazole

fluconazole in dextrose

fluconazole in saline

FLUCONAZOLE POWDER

flucytosine

FLUCYTOSINE POWDER

FORTAZ IN ISO-OSMOTIC

DEXTROSE [INJ]

fosamprenavir calcium

foscarnet sodium

FUZEON [INJ]

ganciclovir

gentamicin sulfate [INJ]

gentamicin sulfate in ns

GENTAMICIN SULFATE IN NS

100MG/50ML

GENVOYA

griseofulvin

GRISEOFULVIN POWDER

griseofulvin ultramicrosize

HARVONI

hydroxychloroquine sulfate

HYDROXYCHLOROQUINE

SULFATE POWDER

imipenem-cilastatin [INJ]

IMPAVIDO

INTELENCE

INVANZ [INJ]

INVIRASE

ISENTRESS

isoniazid

ISONIAZID POWDER

itraconazole

ITRACONAZOLE POWDER

ivermectin

IVERMECTIN POWDER

KALETRA TABLETS

kanamycin sulfate [INJ]

KANAMYCIN SULFATE

POWDER [INJ]

ketoconazole

KETOCONAZOLE POWDER

KITABIS PAK

LAMISIL

lamivudine

lamivudine hbv

lamivudine/zidovudine

LEVOFLOXACIN

HEMIHYDRATE POWDER

levofloxacin/d5w [INJ]

LEXIVA ORAL SUSP

linezolid

lopinavir-ritonavir oral soln

MAVYRET

mefloquine hcl

MEROPENEM - 0.9% NACL

[INJ]

methenamine hippurate

methenamine mandelate

METHENAMINE MANDELATE

POWDER

methylene blue [INJ]

metronidazole

METRONIDAZOLE POWDER

[INJ]

MINOCIN 100MG VIAL

minocycline hcl

minocycline hcl er

MINOCYCLINE HCL POWDER

moxifloxacin hcl

MOXIFLOXACIN HCL IV

PIGGYBACK

MYCAMINE [INJ]

nafcillin dextrose [INJ]

nafcillin sodium [INJ]

NEBUPENT [INJ]

neomycin sulfate

NEOMYCIN SULFATE

POWDER

nevirapine er

nitrofurantoin

nitrofurantoin macrocrystal

NITROFURANTOIN POWDER

NORVIR

NOXAFIL

nystatin



NYSTATIN

ocudox

ODEFSEY

ofloxacin tablets

ORACEA

oseltamivir phosphate

capsule

oxacillin sodium [INJ]

paromomycin sulfate

PAROMOMYCIN SULFATE

POWDER

penicillin g potassium [INJ]

penicillin g procaine

penicillin g sodium [INJ]

PENICILLIN GK-ISO-OSM

DEXTROSE

penicillin v potassium

piperacillin-tazobactam [INJ]

polymyxin b sulfate [INJ]

POLYMYXIN B SULFATE

POWDER [INJ]

PREZISTA

PRIFTIN

PRIMAQUINE

pyrazinamide

quinine sulfate

QUININE SULFATE POWDER

RAPIVAB

RELENZA

RESCRIPTOR

RETROVIR VIAL [INJ]

REYATAZ

ribavirin

RIBAVIRIN POWDER

rifabutin

rimantadine hcl

RUBRACA

SELZENTRY

SIRTURO

SIVEXTRO VIAL [INJ]

SOLODYN ER

SOVALDI

SPINRAZA

SPORANOX SOLUTION

stavudine

STREPTOMYCIN SULFATE

[INJ]

STRIBILD

sulfadiazine

SULFADIAZINE POWDER

sulfamethoxazole/trimethop

rim

SUSTIVA

SYNERCID [INJ]

TAMIFLU ORAL SUSPENSION

TECHNIVIE

TEFLARO [INJ]

terbinafine

TERBINAFINE

TETRACYCLINE

TIMENTIN [INJ]

tinidazole

TINIDAZOLE POWDER

TIVICAY

TOBI PODHALER

tobramycin sulfate [INJ]

tobramycin sulfate in ns

TOBRAMYCIN SULFATE

POWDER [INJ]

trimethoprim

TRIMETHOPRIM POWDER

TRIUMEQ

TRUVADA

TYGACIL [INJ]

valacyclovir

VALACYCLOVIR POWDER

valganciclovir hcl

vancomycin hcl [INJ]

VANCOMYCIN HCL [INJ]

VEMLIDY

VIBATIV [INJ]

VICTRELIS

VIDEX

VIEKIRA PAK

VIEKIRA XR

VIRACEPT

VIREAD

voriconazole

VORICONAZOLE POWDER

VOSEVI

XIFAXAN

ZEPATIER

ZERBAXA

zidovudine

ZOSYN IV SOLUTION [INJ]

Antineoplastic &

Immunosuppresants

ABRAXANE [INJ]

ADCETRIS [INJ]

AFINITOR

AFINITOR DISPERZ

ALECENSA

ALIMTA [INJ]

amifostine [INJ]

anastrozole

ANASTROZOLE POWDER

ARRANON [INJ]

ARZERRA [INJ]

AVASTIN [INJ]

azacitidine [INJ]

azathioprine

AZATHIOPRINE POWDER

azathioprine sodium [INJ]

BAVENCIO

BENDEKA

BESPONSA

BEXXAR 14MG/ML [INJ]

bicalutamide

BICNU [INJ]

bleomycin [INJ]

BLINCYTO



BOSULIF

BUSULFEX [INJ]

calcium folinate [INJ]

CALCIUM FOLINATE POWDER

[INJ]

capecitabine

CAPRELSA

carboplatin [INJ]

CEENU

CELLCEPT 500MG VIAL [INJ]

cisplatin [INJ]

CISPLATIN POWDER [INJ]

cladribine [INJ]

CLOLAR [INJ]

COTELLIC

cyclophosphamide [INJ]

CYCLOPHOSPHAMIDE [INJ]

cyclosporine [INJ]

CYCLOSPORINE POWDER

[INJ]

CYRAMZA

cytarabine [INJ]

dacarbazine [INJ]

dactinomycin [INJ]

DARZALEX

daunorubicin [INJ]

DAUNOXOME [INJ]

decitabine [INJ]

DEPOCYT [INJ]

dexrazoxane [INJ]

DOCEFREZ [INJ]

docetaxel [INJ]

doxorubicin hcl [INJ]

doxorubicin hcl liposomal

[INJ]

DROXIA

ELIGARD

ELITEK [INJ]

ELSPAR

EMCYT

epirubicin hcl [INJ]

ERBITUX [INJ]

ERIVEDGE

ETOPOPHOS [INJ]

etoposide

ETOPOSIDE POWDER

exemestane

FARESTON

FASLODEX

FIRMAGON

floxuridine [INJ]

FLOXURIDINE POWDER [INJ]

fludarabine phosphate [INJ]

flutamide

FOLOTYN [INJ]

GAZYVA [INJ]

gemcitabine hcl [INJ]

GILOTRIF

GLEOSTINE

HALAVEN [INJ]

HERCEPTIN [INJ]

HEXALEN

HYCAMTIN CAPSULES

hydroxyurea

HYDROXYUREA POWDER

IBRANCE

ICLUSIG

idarubicin hcl [INJ]

IDHIFA

ifosfamide [INJ]

ifosfamide-mesna

imatinib mesylate

IMBRUVICA

INLYTA

IODOPEN [INJ]

irinotecan hcl [INJ]

ISTODAX [INJ]

IXEMPRA [INJ]

JAKAFI

JEVTANA [INJ]

KADCYLA [INJ]

KEPIVANCE [INJ]

KEYTRUDA

KYPROLIS [INJ]

LARTRUVO

LENVIMA

letrozole

LETROZOLE POWDER

leucovorin calcium

LEUCOVORIN CALCIUM

POWDER

LEUKERAN

leuprolide acetate [INJ]

LEUPROLIDE ACETATE

POWDER [INJ]

levoleucovorin calcium [INJ]

LOMUSTINE

LONSURF

LUPRON DEPOT 11.25MG

[INJ]

LUPRON DEPOT 3.75MG

LUPRON DEPOT-PED [INJ]

LYNPARZA

LYSODREN

MARQIBO

MATULANE

megestrol acetate

MEGESTROL ACETATE

POWDER

MEKINIST

melphalan hcl [INJ]

mercaptopurine

MERCAPTOPURINE POWDER

mesna [INJ]

MESNEX 400MG TABLET

methotrexate

METHOTREXATE POWDER

mitomycin [INJ]

MITOMYCIN POWDER [INJ]

mitoxantrone [INJ]

MUSTARGEN [INJ]

mycophenolate acid del rel

mycophenolate mofetil



mycophenolic acid del rel

MYLERAN

NERLYNX

NEXAVAR

nilutamide

NINLARO

NULOJIX [INJ]

octreotide acetate [INJ]

ONCASPAR

ONIVYDE

ONTAK [INJ]

OPDIVO

oxaliplatin

paclitaxel [INJ]

PERJETA [INJ]

PHOTOFRIN [INJ]

POMALYST

PROGRAF 5MG/ML AMPUL

PROVENGE [INJ]

PURIXAN

RAPAMUNE SOLUTION

RASUVO

REVLIMID

RITUXAN [INJ]

RITUXAN HYCELA

RYDAPT

SANDIMMUNE SOLUTION

100MG/ML SOLUTION

SANDOSTATIN KIT [INJ]

SANDOSTATIN LAR DEPOT

SIGNIFOR [INJ]

SIMULECT [INJ]

sirolimus

SIROLIMUS POWDER

SOMATULINE DEPOT [INJ]

SPRYCEL

STIVARGA

SUTENT

SYLVANT [INJ]

SYNRIBO [INJ]

TABLOID

tacrolimus

TACROLIMUS POWDER

TAFINLAR

TAGRISSO

tamoxifen citrate

TAMOXIFEN CITRATE

POWDER

TARCEVA

TARGRETIN GEL

TASIGNA

TECENTRIQ

TEMODAR 100MG VIAL [INJ]

temozolomide

TENIPOSIDE [INJ]

THALOMID

thiotepa [INJ]

THIOTEPA POWDER [INJ]

topotecan hcl [INJ]

TORISEL [INJ]

TREANDA [INJ]

TRELSTAR VIAL

tretinoin cap

TRETINOIN POWDER

TRISENOX [INJ]

TYKERB

UNITUXIN

VALCHLOR

VALSTAR [INJ]

VANTAS

VECTIBIX [INJ]

VELCADE [INJ]

VENCLEXTA

VENCLEXTA STARTER PACK

vinblastine sulfate

VISTOGARD

VORAXAZE [INJ]

VOTRIENT

VUMON [INJ]

VYXEOS LIPOSOME

XALKORI

XERMELO

XGEVA [INJ]

XOFIGO [INJ]

XTANDI

YERVOY [INJ]

YONDELIS

ZALTRAP [INJ]

ZANOSAR [INJ]

ZEJULA

ZELBORAF

ZEVALIN

ZOLADEX

ZOLINZA

ZORTRESS

ZYDELIG

ZYKADIA

ZYTIGA

Autonomic, Neurology

and Psych

ABILIFY MAINTENA, ER

acetaminophen/codeine

acetaminophen-

diphenhydramine

alfentanil hcl [INJ]

alprazolam

alprazolam er

alprazolam ODT

ALPRAZOLAM POWDER

amitriptyline hcl

AMITRIPTYLINE HCL

POWDER

amitriptyline/chlordiazepoxi

de

amoxapine 150mg

amoxapine 25mg

amphetamine salt combo er

AMPYRA

AMYTAL [INJ]

anectine [INJ]

APOKYN [INJ]



aripiprazole ODT

aripiprazole tablets

ARISTADA

armodafinil

atomoxetine hcl

baclofen

BACLOFEN POWDER

BANZEL

benztropine [INJ]

benztropine mesylate

BRISDELLE

buprenorphine [INJ]

BUPRENORPHINE POWDER

[INJ]

buprenorphine/naloxone

bupropion er (12 hour)

bupropion hcl

bupropion hcl er

BUPROPION HCL POWDER

bupropion hcl xl er

bupropion sr

buspirone hcl

BUSPIRONE HCL POWDER

butalbital compound

butalbital

compound/codeine

butalbital/apap/caffeine

butalbital/aspirin/caffeine

butalbital/caff/apap/codeine

butorphanol [INJ]

BUTORPHANOL POWDER

[INJ]

BUTRANS

carbamazepine

carbamazepine er

CARBAMAZEPINE POWDER

carbidopa/levodopa

carbidopa/levodopa er

carbidopa/levodopa ODT

carbidopa/levodopa/entacap

one

celecoxib

CELECOXIB POWDER

CELONTIN

chlordiazepoxide hcl

chlorpromazine [INJ]

CHLORPROMAZINE POWDER

[INJ]

chlorzoxazone

choline mag trisalicylate

CHOLINE MAG

TRISALICYLATE POWDER

citalopram hbr

clomipramine hcl

CLOMIPRAMINE HCL

POWDER

clonazepam

clonazepam ODT

CLONAZEPAM POWDER

clonidine [INJ]

clonidine hcl er

clorazepate dipotassium

clozapine

clozapine ODT

codeine sulfate

cyclobenzaprine hcl

CYCLOBENZAPRINE HCL

dantrolene sodium

DANTROLENE SODIUM

POWDER

DAYTRANA

desipramine hcl

DESIPRAMINE HCL POWDER

desvenlafaxine succinate er

dexmethylphenidate er

dextroamphetamine sulfate

dextroamphetamine sulfate

er

diazepam

DIAZEPAM POWDER

diazepam rectal gel

diclofenac potassium

diclofenac sodium

DICLOFENAC SODIUM

POWDER

diclofenac

sodium/misoprostol del rel

diflunisal

dihydroergotamine mesylate

DIHYDROERGOTAMINE

MESYLATE

DILANTIN 30MG

diphenhydramine hcl

divalproex sodium

divalproex sodium er

donepezil hcl

doxepin hcl

DOXEPIN HCL POWDER

DOXYLAMINE SUCCINATE

duloxetine

EDROPHONIUM CHLORIDE

eletriptan hbr

entacapone

ergoloid mesylates

ERGOLOID MESYLATES

POWDER

ergotamine-caffeine

escitalopram oxalate

ethosuximide

ETHOSUXIMIDE POWDER

etodolac

etodolac er

ETODOLAC POWDER

EVEKEO

felbamate

fenoprofen calcium

fentanyl

fentanyl citrate

FENTANYL CITRATE POWDER

FETZIMA

FLECTOR

flumazenil [INJ]

fluoxetine



FLUOXETINE POWDER

fluphenazine decanoate [INJ]

FLUPHENAZINE DECANOATE

2.5% [INJ]

fluphenazine hcl

flurazepam hcl

flurbiprofen

FLURBIPROFEN POWDER

fluvoxamine maleate er

fosphenytoin sodium

FYCOMPA

gabapentin

GABAPENTIN POWDER

GABITRIL 12MG, 16 MG

GABLOFEN [INJ]

galantamine

GILENYA

GLATOPA

GRALISE

guanfacine er

guanidine hcl

haloperidol

haloperidol decanoate [INJ]

HALOPERIDOL DECANOATE

POWDER [INJ]

haloperidol lactate [INJ]

HALOPERIDOL POWDER

hydrocodone/acetaminophe

n

hydrocodone/ibuprofen

hydromorphone hcl

HYDROMORPHONE HCL 1GM

POWDER

ibuprofen

ibuprofen lysine

IBUPROFEN POWDER

imipramine hcl

IMIPRAMINE HCL POWDER

imipramine pamoate

indomethacin

indomethacin er

INDOMETHACIN POWDER

INFUMORPH

ISOMETHEPTENE MUCATE

ketoprofen er

KETOPROFEN ER POWDER

ketorolac tromethamine

KETOROLAC

TROMETHAMINE POWDER

lamotrigine

lamotrigine er

LAMOTRIGINE POWDER

LATUDA

LEMTRADA

levetiracetam

levetiracetam er

LEVETIRACETAM POWDER

levorphanol tartrate

LEVORPHANOL TARTRATE

POWDER

LIORESAL [INJ]

lithium carbonate

lithium carbonate er

LITHIUM CARBONATE

POWDER

lorazepam

LORAZEPAM POWDER

loxapine succinate

LOXAPINE SUCCINATE

POWDER

LYRICA

meclofenamate sodium

MECLOFENAMATE SODIUM

POWDER

mefenamic acid

MEFENAMIC ACID POWDER

meloxicam

MELOXICAM POWDER

memantine

MEPERIDINE HCL POWDER

MESTINON SYRUP

methadone hcl

METHADONE HCL POWDER

methamphetamine hcl

methocarbamol

METHOCARBAMOL POWDER

methylphenidate cd

methylphenidate er

methylphenidate hcl

METHYLPHENIDATE HCL

POWDER

methylphenidate la

midazolam hcl

MIDAZOLAM HCL POWDER

mirtazapine

mirtazapine disintegrating

MIRTAZAPINE POWDER

MITIGARE

modafinil

MONOVISC [INJ]

morphine sulfate

morphine sulfate cr

morphine sulfate er

MORPHINE SULFATE TABLET

POWDER

MOVANTIK

MYDAYIS

nabumetone

nalbuphine hcl [INJ]

NALBUPHINE HCL POWDER

[INJ]

naloxone hcl [INJ]

NALOXONE HCL POWDER

[INJ]

naltrexone hydrochloride

NALTREXONE

HYDROCHLORIDE POWDER

NAMENDA XR

NAMZARIC

NAMZARIC THERAPY PACK

naproxen

NAPROXEN POWDER

naproxen sodium



NAPROXEN SODIUM

POWDER

naratriptan hcl

NARCAN

NEMBUTAL SODIUM [INJ]

neostigmine methylsulfate

[INJ]

NEOSTIGMINE

METHYLSULFATE POWDER

[INJ]

nortriptyline hcl

NORTRIPTYLINE HCL

POWDER

NUCYNTA

NUCYNTA ER

NUEDEXTA

OCREVUS

OFIRMEV [INJ]

olanzapine

olanzapine ODT

olanzapine/fluoxetine hcl

ONFI

orphenadrine citrate [INJ]

ORPHENADRINE CITRATE

POWDER [INJ]

orphenadrine compound

ORTHOVISC [INJ]

oxaprozin

oxazepam

oxcarbazepine

oxycodone hcl

OXYCODONE HCL POWDER

oxycodone hcl/ibuprofen

oxycodone w/aspirin

oxycodone/acetaminophen

OXYCONTIN ER

oxymorphone hcl

oxymorphone hcl er

paroxetine hcl

paroxetine hcl er

PEGANONE

pentazocine lactate

perphenazine

perphenazine/amitriptyline

phenelzine sulfate

PHENELZINE SULFATE

POWDER

phenobarbital

PHENOBARBITAL POWDER

phenobarbital sodium [INJ]

PHENOBARBITAL SODIUM

POWDER [INJ]

phenytoin

PHENYTOIN POWDER

phenytoin sodium

PHENYTOIN SODIUM

POWDER

piroxicam

PIROXICAM POWDER

POTIGA

pramipexole er

PRIALT [INJ]

primidone

PRIMIDONE POWDER

pyridostigmine bromide

PYRIDOSTIGMINE BROMIDE

POWDER

QUADRAMET [INJ]

QUDEXY XR

quetiapine fumarate

quetiapine fumarate er

QUILLICHEW ER

QUILLIVANT XR

RADICAVA

rasagiline mesylate

RISPERDAL CONSTA [INJ]

risperidone

rivastigmine

rizatriptan

rizatriptan disintegrating

tablets

ropinirole hcl

ropinirole hcl er

ROZEREM

SABRIL

SALICYLAMIDE

salsalate

SALSALATE POWDER

seconal sodium

selegiline hcl

SELEGILINE HCL POWDER

SUBOXONE

sufentil 50mcg/ml ampul

[INJ]

SUFENTIL POWDER [INJ]

sulindac

SULINDAC POWDER

sumatriptan succinate

SUMATRIPTAN SUCCINATE

POWDER

TECFIDERA

temazepam

thioridazine hcl

THIORIDAZINE HCL POWDER

thiothixene

tiagabine hcl

tizanidine hcl

TIZANIDINE HCL POWDER

tolmetin sodium

topiramate

TOPIRAMATE POWDER

tramadol hcl

tramadol hcl er

TRAMADOL HCL POWDER

tramadol/acetaminophen

tranylcypromine sulfate

trazodone hcl

TRAZODONE HCL POWDER

triazolam

trifluoperazine hcl

trihexyphenidyl hcl

trimipramine maleate

TYSABRI [INJ]



ULTIVA [INJ]

valproate sodium

VALPROATE SODIUM

POWDER

valproic acid

VALPROIC ACID

venlafaxine hcl

venlafaxine hcl er

VIIBRYD

VIMIZIM

VIMPAT [INJ]

VIVITROL [INJ]

VYVANSE

XYREM

zaleplon

ziprasidone hcl

zolmitriptan

zolmitriptan ODT

zolpidem tartrate

zolpidem tartrate er

ZOMIG SPRAY

zonisamide

ZUBSOLV

Cardiovascular,

Hypertension & Lipids

acebutolol hcl

ACEBUTOLOL HCL POWDER

ACTIVASE [INJ]

adenosine [INJ]

ADENOSINE POWDER [INJ]

ADVATE [INJ]

ADVATE H [INJ]

ADVATE L [INJ]

ADVATE N [INJ]

ADVATE SH [INJ]

ADVATE UH [INJ]

ADYNOVATE

AFSTYLA

ALPHANATE [INJ]

ALPHANINE SD [INJ]

ALPROLIX [INJ]

AMICAR

amiloride hcl

AMILORIDE HCL POWDER

amiloride hcl w/hctz

amiodarone hcl

AMIODARONE HCL POWDER

amlodipine besylate

AMLODIPINE BESYLATE

POWDER

amlodipine/olmesartan

amlodipine/valsartan

amlodipine/valsartan/hctz

amlodipine-atorvastatin

aspirin / dipyridamole er

atenolol

ATENOLOL POWDER

atenolol/chlorthalidone

atorvastatin calcium

BEBULIN [INJ]

BEBULIN VH IMMUNO [INJ]

benazepril hcl

BENAZEPRIL HCL POWDER

benazepril/hctz

BENEFIX [INJ]

betaxolol hcl

bisoprolol fumarate

bisoprolol fumarate/hctz

bivalirudin

BRILINTA

bumetanide

BYSTOLIC

BYVALSON

candesartan cilexetil

candesartan/hydrochlorothia

zide

captopril

CAPTOPRIL POWDER

captopril/hydrochlorothiazid

e

CATHFLO ACTIVASE [INJ]

CEPROTIN [INJ]

chlorothiazide

chlorothiazide sodium [INJ]

chlorthalidone

cholestyramine

cholestyramine light

CHOLESTYRAMINE POWDER

cilostazol

clonidine hcl

CLONIDINE HCL POWDER

clonidine/chlorthalidone

clopidogrel

COAGADEX

colestipol hcl

COREG CR

CORIFACT [INJ]

CORLANOR

COUMADIN 5MG VIAL [INJ]

DEMSER

digoxin

DIGOXIN POWDER

DILATRATE-SR

diltiazem [INJ]

diltiazem 24hr cd

diltiazem er

diltiazem er 24 hour

diltiazem hcl

DILTIAZEM HCL POWDER

DILUENT FOR REMODULIN

dipyridamole [INJ]

DIPYRIDAMOLE POWDER

[INJ]

dobutamine [INJ]

dobutamine/dextrose [INJ]

dofetilide

dopamine hcl [INJ]

dopamine hcl in 5% dextrose

DOPAMINE HCL POWDER

[INJ]

doxazosin mesylate



EDARBI

EDARBYCLOR

ELIQUIS

enalapril maleate

ENALAPRIL MALEATE

POWDER

enalapril maleate/hctz

enalaprilat [INJ]

enoxaparin sodium [INJ]

ENTRESTO

eplerenone

epoprostenol [INJ]

epoprostenol diluent [INJ]

eptifibatide

ethacrynate sodium

ezetimibe

ezetimibe/simvastatin

FEIBA NF [INJ]

felodipine er

fenofibrate

fenofibric acid

fenofibric acid dr

flecainide acetate

fluvastatin sodium

fondaparinux sodium

fosinopril sodium

fosinopril/hydrochlorothiazid

e

FRAGMIN

furosemide

FUROSEMIDE POWDER

gemfibrozil

GEMFIBROZIL POWDER

guanfacine hcl

HELIXATE FS [INJ]

HEMOFIL [INJ]

heparin lock flush [INJ]

heparin sodium in 0.45% nacl

[INJ]

heparin sodium in 5%

dextrose [INJ]

heparin sodium syringe

HUMATE-P [INJ]

hydralazine hcl

HYDRALAZINE HCL POWDER

hydrochlorothiazide

HYDROCHLOROTHIAZIDE

POWDER

ibutilide fumarate [INJ]

indapamide

irbesartan

irbesartan/hydrochlorothiazi

de

isosorbide dinitrate

isosorbide mononitrate

isosorbide mononitrate er

isradipine

IXINITY

JUXTAPID

KOGENATE FS

KOVALTRY

labetalol hcl

LABETALOL HCL POWDER

LANOXIN PEDIATRIC

lidocaine hcl in 7.5%

dextrose [INJ]

LIPOFEN

lisinopril

LISINOPRIL POWDER

lisinopril/hctz

LIVALO

losartan potassium

losartan/hydrochlorothiazide

lovastatin

mannitol

MANNITOL POWDER

MEPHYTON

methyclothiazide

methyldopa

methyldopa/hydrochlorothia

zide

methyldopate hcl [INJ]

metolazone

metoprolol succinate er

metoprolol tartrate

METOPROLOL TARTRATE

POWDER

metoprolol/hydrochlorothiaz

ide

mexiletine hcl

MEXILETINE HCL POWDER

milrinone in 5% dextrose

milrinone lactate [INJ]

minoxidil

MINOXIDIL POWDER

moexipril hcl

moexipril/hydrochlorothiazid

e

MONOCLATE-P [INJ]

MONONINE [INJ]

nadolol

NADOLOL POWDER

nadolol-bendroflumethiazide

NATRECOR [INJ]

NEXTERONE

niacin er

nicardipine hcl

nimodipine

nitroglycerin

nitroglycerin er

nitroglycerin in d5w [INJ]

nitroglycerin spray

nitroglycerin tablets

norepinephrine bitartrate

[INJ]

NOVOEIGHT

NOVOSEVEN RT [INJ]

NPLATE [INJ]

OBIZUR

olmesartan medoxomil

olmesartan medoxomil/hctz

olmesartan/amlodipine/hctz

omega-3-acid ethyl esters



papaverine hcl [INJ]

papaverine hcl er

PAPAVERINE HCL POWDER

[INJ]

pentoxifylline

PENTOXIFYLLINE POWDER

perindopril erbumine

phentolamine mesylate [INJ]

PHENTOLAMINE MESYLATE

POWDER [INJ]

phenylephrine hcl [INJ]

PHENYLEPHRINE HCL

POWDER [INJ]

phenylephrine hcl-ns

PHENYLEPHRINE HCL-NS

PHYTONADIONE

pindolol

PRALUENT PEN

PRALUENT SYRINGE

prasugrel hcl

pravastatin sodium

prazosin hcl

procainamide hcl [INJ]

PROCAINAMIDE HCL

POWDER [INJ]

PROFILNINE SD [INJ]

PROMACTA

propafenone hcl

propafenone hcl er

propranolol hcl

propranolol hcl er

PROPRANOLOL HCL POWDER

propranolol/hctz

protamine sulfate [INJ]

PROTAMINE SULFATE

POWDER [INJ]

quinapril

quinapril/hydrochlorothiazid

e

quinidine gluconate [INJ]

quinidine gluconate er

quinidine sulfate

QUINIDINE SULFATE

ramipril

RANEXA

REFLUDAN [INJ]

REMODULIN [INJ]

REOPRO [INJ]

REPATHA PUSHTRONEX

REPATHA SURECLICK

REPATHA SYRINGE

RESECTISOL

reserpine

RESERPINE POWDER

RETAVASE

RIASTAP

rosuvastatin

simvastatin

SIMVASTATIN POWDER

sotalol

SOTALOL HCL [INJ]

SOTYLIZE

spironolactone

SPIRONOLACTONE POWDER

spironolactone/hctz

TEKTURNA

TEKTURNA HCT

terazosin hcl

THROMBATE III [INJ]

timolol maleate

TIMOLOL MALEATE POWDER

torsemide

trandolapril

trandolapril/verapamil er

tranexamic acid

TRANEXAMIC ACID POWDER

TRETTEN

UPTRAVI

valsartan

valsartan/hydrochlorothiazid

e

VASCEPA

verapamil er

verapamil er pm

verapamil hcl [INJ]

VERAPAMIL HCL POWDER

[INJ]

VONVENDI

warfarin sodium

WARFARIN SODIUM

POWDER

WELCHOL

WILATE [INJ]

XARELTO

XYNTHA [INJ]

ZONTIVITY

Dermatological & Topical

Therapy

ABSORICA

acitretin

acyclovir 5% oint

ACYCLOVIR POWDER

adapalene cream, gel

alclometasone dipropionate

alphaquin hp

ALUMINUM CHLORIDE

POWDER

aluminum chloride topical

amcinonide

ammonium lactate

AMMONIUM LACTATE

ANTHRALIN

avo cream

bacitracin

bacitracin/polymyxin ophth

oint

benprox

BENZOCAINE

benzoyl peroxide

BENZOYL PEROXIDE POWDER

betamethasone dipropionate



augment

BETAMETHASONE

DIPROPIONATE AUGMENT

POWDER

betamethasone valerate

BETAMETHASONE VALERATE

POWDER

bupivacaine hcl

BUPIVACAINE HCL POWDER

bupivacaine/epinephrine

[INJ]

calcipotriene

CALCIPOTRIENE POWDER

CARAC

chlorhexidine gluconate

CHLORHEXIDINE GLUCONATE

0.2 SOLUTION

chloroprocaine [INJ]

ciclopirox

clindamycin phosphate

topical

clindamycin phos-tretinoin

clindamycin/benzoyl

peroxide

clobetasol e

clobetasol propionate

CLOBETASOL PROPIONATE

POWDER

clotrimazole

CLOTRIMAZOLE POWDER

clotrimazole/betamethasone

cocaine hcl

COCAINE HCL

COSENTYX

desonide

DESONIDE POWDER

desoximetasone

DESOXIMETASONE POWDER

dexpanthenol

DEXPANTHENOL

diflorasone diacetate

DUPIXENT [INJ]

econazole nitrate

ECONAZOLE NITRATE

POWDER

eletone

ELIDEL

emulsion sb

ENSTILAR

EPIDUO

EPIDUO FORTE

erythromycin solution

erythromycin-benzoyl

peroxide

ETHYL ALCOHOL

ethyl chloride

FINACEA

fluocinolone acetonide

FLUOCINOLONE ACETONIDE

POWDER

fluocinonide

FLUOCINONIDE POWDER

fluorouracil

FLUOROURACIL POWDER

fluticasone propionate

FLUTICASONE PROPIONATE

POWDER

gentamicin sulfate

GENTAMICIN SULFATE

POWDER

halobetasol propionate

hpr

hpr plus

hydrocortisone

hydrocortisone acetate

HYDROCORTISONE ACETATE

POWDER

hydrocortisone butyrate

hydrocortisone

butyrate/emoll

hydrocortisone valerate

hydroquinone cream

hydroquinone er cream

HYDROQUINONE POWDER

imiquimod

IMIQUIMOD POWDER

lactic acid

LACTIC ACID 88 TO 92 %

lidocaine

lidocaine hcl

LIDOCAINE HCL POWDER

lidocaine hcl w/epinephrine

[INJ]

LIDOCAINE POWDER

lidocaine/prilocaine

lidocaine-hc

lindane

lustra-ultra

mafenide acetate

MAFENIDE ACETATE

POWDER

malathion

mb hydrogel

MEPIVACAINE HCL POWDER

MIRVASO

mometasone furoate

MOMETASONE FUROATE

POWDER

mupirocin

MUPIROCIN POWDER

nuquin hp

nystatin

NYSTATIN

nystatin w/triamcinolone

ONEXTON

OXSORALEN 1% LOTION

permethrin

PERMETHRIN

PICATO

podofilox

pruclair

prumyx

prutect



REGRANEX

ropivacaine

ROPIVACAINE POWDER

salicylic acid

SALICYLIC ACID

SANTYL

selenium sulfide

SELENIUM SULFIDE POWDER

sensorcaine 5MG/ML VIAL

[INJ]

silver sulfadiazine

SILVER SULFADIAZINE

POWDER

sodium sulfacetamide/sulfur

sonafine

SOOLANTRA

spinosad

STELARA [INJ]

sulfacetamide sodium

SULFAMYLON CREAM

SULFAMYLON PACKET

TACLONEX SUSPENSION

tazarotene cream

TAZORAC GEL

tl-cermide

tretinoin

tretinoin microsphere

TRIAMCINOLONE

ACETONIDE POWDER

urea

UREAM POWDER, BEADS

ZOVIRAX 5% CREAM

Ear, Nose & Throat

acetic acid otic solution

acetic acid/aluminum otic sol

acetic acid/hydrocortisone

otic sol

antipyrine/benzocaine otic

sol

antipyrine/benzocaine/poly

otic sol

azelastine hcl

BRINEURA

chloroxylenol/benzocaine/hc

acetate otic susp

CIPRODEX

ciprofloxacin hcl

CIPROFLOXACIN HCL

FIRST-BXN

FIRST-MOUTHWASH BLM

ipratropium bromide spray

MYALEPT

neomycin/polymyxin/hc otic

susp & soln

ofloxacin otic drops

OTOVEL

oxymetazoline hcl 12 hour

OXYMETAZOLINE HCL

POWDER

sodium chloride

sodium fluoride

SODIUM FLUORIDE

SODIUM FLUORIDE POWDER

Endocrine/Diabetes

1ST CHOICE LANCETS

acarbose

ACCU-CHEK FASTCLIX,

MULTICLIX, SOFTCLIX

LANCETS

ACCU-CHEK SOFTCLIX

LANCETS DEVICE

ACTHREL [INJ]

a-hydrocort [INJ]

ALDURAZYME [INJ]

ANDRODERM

ARISTOSPAN [INJ]

ARMOUR THYROID

BETAMETHASONE

BETAMETHASONE ACETATE

BETAMETHASONE SODIUM

PHOSPHATE

BYDUREON [INJ]

BYDUREON PEN

BYETTA [INJ]

cabergoline

calcitonin salmon nasal

calcitriol [INJ]

CERDELGA

CEREZYME [INJ]

chorionic gonadotropin [INJ]

CHORIONIC GONADOTROPIN

POWDER [INJ]

clomiphene citrate

CLOMIPHENE CITRATE

POWDER

cortisone acetate

CORTISONE ACETATE

POWDER

cosyntropin [INJ]

danazol

DANAZOL POWDER

desmopressin acetate [INJ]

DESMOPRESSIN ACETATE

POWDER [INJ]

dexamethasone

DEXAMETHASONE POWDER

dexamethasone sodium

phosphate

DEXAMETHASONE SODIUM

PHOSPHATE POWDER

DEXCOM G4 METER

DEXCOM G4 SENSOR

DEXCOM G4 TRANSMITTER

DEXCOM G5 METER

DEXCOM G5 TRANSMITTER

doxercalciferol

ELAPRASE [INJ]

ELELYSO [INJ]

FABRAZYME [INJ]



FEMCAP

fludrocortisone acetate

FLUDROCORTISONE ACETATE

POWDER

FLUOXYMESTERONE

FORA LANCING DEVICE

FREESTYLE CONTROL

SOLUTION

FREESTYLE FREEDOM KIT

FREESTYLE FREEDOM LITE

FREESTYLE FREEDOM LITE

METER

FREESTYLE INSULINX

FREESTYLE INSULINX

GLUCOSE SYSTEM

FREESTYLE INSULINX TEST

STRIPS

FREESTYLE LITE METER

FREESTYLE LITE TEST STRIPS

FREESTYLE TEST STRIPS

glimepiride

glipizide

glipizide er

GLIPIZIDE POWDER

GLUCAGEN [INJ]

glyburide

glyburide micronized

GLYBURIDE POWDER

glyburide/metformin hcl

GLYXAMBI

GONAL-F

GONAL-F RFF

GONAL-F RFF REDI-JECT

HUMALOG [INJ]

HUMALOG JUNIOR KWIKPEN

HUMULIN 70/30 KWIKPEN

[INJ]

HUMULIN N KWIKPEN [INJ]

HUMULIN R 500 UNITS [INJ]

HUMULIN R U-500 KWIKPEN

INVOKAMET

INVOKAMET XR

INVOKANA

JANUMET

JANUMET XR

JANUVIA

JENTADUETO

JENTADUETO XR

JUVISYNC

KALYDECO

KUVAN

LANTUS [INJ]

LANTUS SOLOSTAR [INJ]

LEVEMIR [INJ]

LEVEMIR, FLEXTOUCH

levothyroxine sodium

LEVOTHYROXINE SODIUM

liothyronine sodium

LIOTHYRONINE SODIUM

POWDER

LUMIZYME [INJ]

MEDISENSE

MEDISENSE GLUCOSE

KETONE CONTR

MENOPUR [INJ]

metformin hcl

metformin hcl er

METFORMIN HCL POWDER

methimazole

METHIMAZOLE POWDER

METHITEST

methylprednisolone

methylprednisolone acetate

[INJ]

METHYLPREDNISOLONE

POWDER

methylprednisolone sod succ

[INJ]

METHYLPREDNISOLONE SOD

SUCC POWDER [INJ]

MIACALCIN VIAL [INJ]

MINIMED

MINIMED RESERVOIR

MYOZYME [INJ]

NAGLAZYME [INJ]

nateglinide

NOVAREL 5000 UNIT

NOVOFINE

NOVOFINE AUTOCOVER

NOVOLIN 70-30

NOVOLIN N

NOVOLIN R

NOVOLOG [INJ]

NOVOLOG FLEXPEN

NOVOLOG MIX 70-30

ONE TOUCH ULTRA 2

ONE TOUCH ULTRA TEST

STRIPS

ONE TOUCH VERIO

ONE TOUCH VERIO FLEX

ONE TOUCH VERIO IQ

ONE TOUCH VERIO SYNC

oxandrolone

OXANDROLONE POWDER

pamidronate disodium [INJ]

PARADIGM INFUSION

PARADIGM INSULIN PUMP

PARADIGM SILHOUETTE

paricalcitol

pioglitazone hcl

pioglitazone/glimepiride

pioglitazone/metformin

POLYFIN QR

PRECISION XTRA B-KETONE

STRIPS

PRECISION XTRA MONITOR

PRECISION XTRA TEST STRIPS

prednisolone

PREDNISOLONE POWDER

prednisolone sodium

phosphate

prednisone

PREDNISONE POWDER



PRODIGY INSULIN SYRINGE

PRODIGY PEN NEEDLE

PROGLYCEM

propylthiouracil

PROPYLTHIOURACIL

POWDER

QUICK RELEASE SOFT TEFLON

repaglinide/metformin

SAMSCA

SENSIPAR

SILHOUETTE

SNAP INSULIN PUMP

CONTROLLER

SOF-SET

SOF-SET MICRO

SOFT TOUCH

SOLIQUA 100-33

SOLOSITE

SOLU-CORTEF [INJ]

SOMAVERT [INJ]

STIMATE SPRAY

SURE-T PARADIGM

SYMLINPEN 120

SYMLINPEN 60 [INJ]

SYNAREL

SYNJARDY

SYNJARDY XR

testosterone cypionate [INJ]

TESTOSTERONE CYPIONATE

POWDER [INJ]

testosterone enanthate [INJ]

TESTOSTERONE ENANTHATE

POWDER [INJ]

testosterone gel

TESTOSTERONE POWDER

THYROID

tolazamide

tolbutamide

TOUJEO SOLOSTAR

TRADJENTA

TRESIBA FLEXTOUCH U-100

TRESIBA FLEXTOUCH U-200

TRULICITY

vasopressin [INJ]

vasopressin-ns

veripred 20

VGO 20

VGO 30

VGO 40

VICTOZA [INJ]

VPRIV [INJ]

XIGDUO XR

XULTOPHY 100-3.6

ZAVESCA

zoledronic acid [INJ]

ZOMETA INFUSION BOTTLE

[INJ]

Gastroenterology

AKYNZEO

ALOXI [INJ]

AMITIZA

aprepitant capsule, dose

pack

ASACOL HD

balsalazide disodium

budesonide

budesonide ec

CANASA

carafate

CHENODAL

CHOLBAM

cimetidine

CIMETIDINE POWDER

CITRA PH

CORTIFOAM

CREON

CYSTADANE

DELZICOL

dicyclomine hcl

DICYCLOMINE HCL POWDER

dimenhydrinate [INJ]

DIMENHYDRINATE POWDER

[INJ]

diphenoxylate/atropine

dronabinol

droperidol [INJ]

DROPERIDOL POWDER [INJ]

EMEND EMEND 40MG;

125MG CAPSULE

ENTYVIO

esomeprazole

famotidine

FAMOTIDINE POWDER

glycopyrrolate

GLYCOPYRROLATE POWDER

granisetron hcl

granisol

hydrocortisone

HYDROCORTISONE POWDER

hydrocortisone/pramoxine

hyoscyamine sulfate

hyoscyamine sulfate

disinegrating tablets

hyoscyamine sulfate er

HYOSCYAMINE SULFATE

POWDER

KINEVAC [INJ]

lactulose

lansoprazole

LANSOPRAZOLE POWDER

lansoprazole/amoxicillin/clari

thromycin

LEVSIN 0.5MG/ML AMPUL

LINZESS

loperamide hcl

LOPERAMIDE HCL

meclizine hcl

MECLIZINE HCL POWDER

mesalamine

MESALAMINE POWDER

metoclopramide hcl



METOCLOPRAMIDE HCL

POWDER

misoprostol

MISOPROSTOL POWDER

NEXIUM (RX) SUSP

NEXIUM 24HR

nizatidine

OCALIVA

omeprazole

OMEPRAZOLE POWDER

omeprazole sodium

bicarbonate

ondansetron hcl

ONDANSETRON HCL

POWDER

ondansetron ODT

opium

pancrelipase

pantoprazole sodium

paregoric

peg 3350-electrolyte

PENTASA

polyethylene glycol

POLYETHYLENE GLYCOL

pramcort

PREPOPIK

prochlorperazine edisylate

[INJ]

PROCHLORPERAZINE

EDISYLATE POWDER [INJ]

prochlorperazine maleate

PROCHLORPERAZINE

MALEATE POWDER

ranitidine hcl

RANITIDINE HCL POWDER

RECTIV

RELISTOR [INJ]

REMICADE [INJ]

SANCUSO

SCOPOLAMINE

HYDROBROMIDE

sodium bicarbonate [INJ]

SODIUM BICARBONATE

POWDER [INJ]

SUCLEAR

SUCRAID

sucralfate

SUCRALFATE POWDER

sulfasalazine

sulfasalazine dr

SULFASALAZINE POWDER

SUPREP

trimethobenzamide hcl

TRIMETHOBENZAMIDE HCL

POWDER

UCERIS EXTENDED RELEASE

ursodiol

URSODIOL POWDER

VARUBI

VIBERZI

VIOKACE

ZENPEP DEL-REL

Immunology, Vaccines &

Biotechnology

ACTHIB [INJ]

ACTIMMUNE [INJ]

ADACEL [INJ]

AFLURIA 2017-2018

AFLURIA QUAD 2017-2018

ALFERON N [INJ]

APLISOL [INJ]

ARANESP [INJ]

ARCALYST [INJ]

ATGAM [INJ]

AVONEX [INJ]

BETASERON

BEXSERO

BIOTHRAX [INJ]

BOOSTRIX [INJ]

BOTOX [INJ]

candin

CERVARIX [INJ]

COMVAX [INJ]

CROFAB [INJ]

CYTOGAM [INJ]

EGRIFTA [INJ]

ENGERIX-B [INJ]

EXTAVIA

FLUAD 2017-2018

FLUARIX

FLUBLOK 2017-2018

FLUBLOK QUAD 2017-2018

FLUCELVAX QUAD 2017-2018

FLULAVAL 2017-2018

FLULAVAL QUAD 2017-2018

FLUMIST

FLUVIRIN 2017-2018

FLUZONE [INJ]

FLUZONE HIGH-DOSE 2017-

2018

FLUZONE INTRADERM QUAD

2017-18

FLUZONE QUAD 2017-2018

FLUZONE QUAD PEDI 2017-

2018

fomepizole

GAMASTAN S-D [INJ]

GAMMAGARD LIQUID [INJ]

GAMMAGARD S-D [INJ]

GAMUNEX [INJ]

GAMUNEX-C [INJ]

GARDASIL 9 [INJ]

GENOTROPIN

GRANIX [INJ]

GRASTEK

HAVRIX [INJ]

HEPAGAM B [INJ]

HIZENTRA [INJ]

HUMATROPE [INJ]

HYPERHEP B S-D [INJ]

HYPERRAB S-D [INJ]



HYPERRHO S-D

HYPERTET S-D

ILARIS [INJ]

IMOGAM RABIES-HT [INJ]

IMOVAX RABIES VACCINE

[INJ]

INFANRIX [INJ]

INTRON A [INJ]

IPOL [INJ]

IXIARO [INJ]

LEUKINE [INJ]

MENACTRA [INJ]

MENOMUNE-A-C-Y-W-135

[INJ]

M-M-R II VACCINE

W/DILUENT [INJ]

MOZOBIL [INJ]

MYOBLOC [INJ]

NEULASTA [INJ]

NEUPOGEN [INJ]

NORDITROPIN

PEDIARIX [INJ]

PEDVAXHIB [INJ]

PEGASYS [INJ]

PEGASYS PROCLICK [INJ]

PENTACEL

PLEGRIDY

PNEUMOVAX 23 [INJ]

PREVNAR 13

PRIVIGEN [INJ]

PROCRIT [INJ]

PROLEUKIN [INJ]

PROQUAD [INJ]

QUADRACEL DTAP-IPV

RABAVERT

RAGWITEK

REBIF

REBIF REBIDOSE

RECOMBIVAX HB [INJ]

ROTATEQ

SEROSTIM [INJ]

STAMARIL

SYLATRON

SYNAGIS [INJ]

TETANUS DIPHTHERIA

TOXOIDS [INJ]

TETANUS DIPHTHERIA

TOXOIDS - PED [INJ]

tetanus toxoid

THERACYS [INJ]

THYMOGLOBULIN [INJ]

TICE BCG [INJ]

TRUMENBA

TUBERSOL [INJ]

TWINRIX [INJ]

TYPHIM VI [INJ]

VAQTA VIAL

VARIVAX VACCINE [INJ]

VARIZIG [INJ]

VAXCHORA VACCINE

VIVOTIF BERNA DEL REL

YF-VAX [INJ]

ZARXIO [INJ]

Miscellaneous &

Diagnostic Agents

acamprosate calcium

ACETIC ACID

acetic acid irrigation

ADAGEN [INJ]

AMMONUL [INJ]

anagrelide hydrochloride

ARALAST NP [INJ]

benzphetamine hcl

BREVITAL [INJ]

BROMHEXINE

HYDROCHLORIDE

bupivacaine/dextrose [INJ]

caffeine citrated

CAFFEINE CITRATED

POWDER

CARBAGLU

cevimeline hcl

CHANTIX

CHEMET

citric acid

CITRIC ACID POWDER

deferoxamine [INJ]

delflex w/dextrose

dextrose in lactated ringers

dextrose in water

dextrose with sodium

chloride

diethylpropion hcl

DIETHYLPROPION HCL

POWDER

disulfiram

DISULFIRAM POWDER

EOVIST [INJ]

ETHAMOLIN

etidronate disodium

etomidate [INJ]

ETOMIDATE POWDER [INJ]

EXJADE

EXTRANEAL ICODEXTRIN

DIALYSIS

FERRIPROX

FOSRENOL ORAL POWDER

HEXTEND LACTATED

ELECTROLYTE

INCRELEX [INJ]

JADENU

JADENU SPRINKLE

KANUMA

ketamine hcl [INJ]

KETAMINE HCL POWDER

[INJ]

lanthanum carbonate

levocarnitine

LEVOCARNITINE POWDER

LEXISCAN

md-gastroview



midodrine hcl

NATPARA

neomycin-polymyxin b [INJ]

NITYR

OMNIPAQUE

ORFADIN

PANHEMATIN [INJ]

phendimetrazine tartrate

phendimetrazine tartrate er

phentermine hcl

PHENTERMINE HCL POWDER

pilocarpine hcl

PROLASTIN C [INJ]

propofol

PROTOPAM CHLORIDE [INJ]

RAVICTI

riluzole

ringers irrigation

SEROTONIN HCL

sevelamer carbonate

sodium chloride

sodium phenylbutyrate

SODIUM PHOSPHATE [INJ]

sodium phosphate

3mmol/ml vial [INJ]

sodium polystyrene

sulfonate

sodium thiosulfate [INJ]

SODIUM THIOSULFATE [INJ]

SOLIRIS [INJ]

SOTRADECOL [INJ]

STRENSIQ

THYROGEN [INJ]

TRYPSIN

UVA URSI LEAF FLUID

EXTRACT

VELPHORO

VELTASSA

water [INJ]

WATER [INJ]

water intravenous solution

water solution; irrigation

XIAFLEX [INJ]

XURIDEN

ZEMAIRA [INJ]

Musculoskeletal &

Rheumatology

ACTEMRA [INJ]

alendronate sodium

allopurinol

ALLOPURINOL POWDER

allopurinol sodium

BENLYSTA [INJ]

COLCHICINE POWDER

COLCRYS

DEPEN

ENBREL [INJ]

FORTEO [INJ]

HUMIRA [INJ]

ibandronate [INJ]

ibandronate sodium

KRYSTEXXA [INJ]

leflunomide

OTREXUP

probenecid

RIDAURA

risedronate dr

risedronate sodium

SAVELLA

SIMPONI 100MG/ML

TYMLOS

ULORIC

XELJANZ

XELJANZ XR

Obstetrics & Gynecology

altavera

alyacen

amethia

amethia lo

amethyst

apri

aranelle

aubra [INJ]

aviane

azurette

balziva

briellyn

CALDOLOR [INJ]

camrese

camrese lo

caziant

chateal

clindamycin phosphate

vaginal

COMBIPATCH

CRINONE

cryselle

cyclafem

dasetta

daysee

DEPO-ESTRADIOL [INJ]

DEPO-PROVERA 400 MG/ML

[INJ]

DIVIGEL

drospirenone/eth

estra/levomef

DUAVEE

elinest

emoquette

enpresse

enskyce

ERGONOVINE MALEATE

errin

estarylla

ESTRACE CREAM

estradiol

estradiol patch

estradiol valerate [INJ]

ESTRADIOL VALERATE



POWDER [INJ]

estradiol/norethindrone

acetate

ESTRING

estrogen/methyltestosteron

e

estropipate

falmina

gianvi

gildagia

gildess

gildess fe

heather

HEMABATE [INJ]

IMPLANON

introvale

isoxsuprine hcl

ISOXSUPRINE HCL POWDER

jencycla

jolessa

jolivette

junel

junel fe

kariva

kelnor 1-35

kurvelo

KYLEENA

leena

lessina

levonorgestrel

levora

LO LOESTRIN FE

loryna

low-ogestrel

lutera

lyza

MAKENA [INJ]

marlissa

medroxyprogesterone

acetate [INJ]

methylergonovine maleate

miconazole 1

MICONAZOLE 1

microgestin

microgestin fe

MINIVELLE

MIRENA

mono-linyah

mononessa

myzilra

NATAZIA

necon

NEXPLANON

nora-be

norethindrone acetate

NORETHINDRONE ACETATE

POWDER

norethindrone/eth

estradiol/iron

norethindrone/ethinyl

estradiol

norethin-eth estra ferrous

fum

nortrel

NUVARING

ocella

ogestrel

orsythia

ORTHO-DIAPHRAGM

oxytocin [INJ]

OXYTOCIN POWDER [INJ]

philith

pirmella

portia

PREMARIN

PREMARIN CREAM

PREMPHASE

PREMPRO

progesterone in oil [INJ]

progesterone micronized

PROGESTERONE

MICRONIZED POWDER

quasense

reclipsen

SAFYRAL

SKYLA

sprintec

sronyx

syeda

TAYTULLA

terconazole

tilia fe

TODAY CONTRACEPTIVE

SPONGE

tri-estarylla

tri-legest fe

tri-linyah

trinessa

trivora

velivet

vestura

viorele

wera

wymzya fe

yuvafem

zarah

zenchent

zenchent fe

zeosa

zovia

Ophthalmology

acetazolamide

acetazolamide er

ACETAZOLAMIDE POWDER

ALPHAGAN P 0.001%

ALREX

apraclonidine ophth solution

atropine sulfate

ATROPINE SULFATE POWDER

AZASITE

azelastine hcl ophth solution



balanced salt ophth irrigation

BEPREVE

betaxolol ophth solution

bimatoprost

brimonidine ophth solution

BRIMONIDINE POWDER

bromfenac ophth

CARBACHOL [INJ]

carteolol hcl

ciprofloxacin ophth solution

COMBIGAN

cromolyn sodium

cyclopentolate ophth

solution

CYCLOPENTOLATE POWDER

CYSTARAN

dexamethasone sod phos

ophth

dorzolamide hcl

dorzolamide/timolol

epinastine hcl

erythromycin ointment

EYLEA [INJ]

FLUORESCEIN SODIUM

fluorometholone

FLUOROMETHOLONE

POWDER

flurbiprofen sodium

gatifloxacin

gentasol

homatropine hydrobromide

HOMATROPINE

HYDROBROMIDE

ILEVRO

ISOPTO CARBACHOL 0.015

JETREA [INJ]

ketorolac tromethamine

drops

latanoprost drops

levobunolol hcl drops

levofloxacin hemihydrate

LOTEMAX

LUCENTIS [INJ]

methazolamide

METHAZOLAMIDE POWDER

metipranolol drops

MOXEZA

naphazoline hcl

NAPHAZOLINE HCL POWDER

NATACYN

neomycin/bacitracin/poly/hc

neomycin/polymyxin/gramici

din

NEVANAC

ofloxacin

olopatadine hcl (ophthalmic)

PAZEO

PHOSPHOLINE IODIDE

DROPS

physostigmine salicylate [INJ]

PHYSOSTIGMINE SALICYLATE

[INJ]

pilocarpine hcl

PILOCARPINE HCL POWDER

PILOPINE HS

prednisolone acetate

PREDNISOLONE ACETATE

POWDER

prednisolone sodium

phosphate drops

PREDNISOLONE SODIUM

PHOSPHATE DROPS POWDER

PROLENSA

proparacaine hcl

PROPARACAINE HCL

POWDER

proparacaine/fluorescein

RESTASIS

RESTASIS MULTIDOSE

sodium chloride drops

sulfacetamide sodium

sulfacetamide

w/prednisolone

tetcaine drops

TOBRADEX OINTMENT

TOBRADEX ST

tobramycin sulfate drops

TOBRAMYCIN SULFATE

POWDER

tobramycin/dexamethasone

TRAVATAN Z

travoprost

trifluridine

TRIFLURIDINE POWDER

tropicamide

TROPICAMIDE POWDER

VISUDYNE [INJ]

XIIDRA

ZYLET

Respiratory, Allergy,

Cough & Cold

acetylcysteine

ACETYLCYSTEINE POWDER

ADCIRCA

ADEMPAS

ADVAIR DISKUS

ADVAIR HFA

ALBUTEROL

albuterol sulfate

ALBUTEROL SULFATE

POWDER

aminophylline [INJ]

AMINOPHYLLINE POWDER

[INJ]

ANORO ELLIPTA

arbinoxa

ARCAPTA NEOHALER

ARMONAIR RESPICLICK

ARNUITY ELLIPTA

ASMANEX, HFA

benzonatate



BERINERT

BEVESPI AEROSPHERE

BREO ELLIPTA

brompheniramine/pseudoep

hedrine

budesonide

BUDESONIDE POWDER

caffeine/sodium benzoate

[INJ]

carbinoxamine

cetirizine syrup

chlorphen/pse/dm tannate

CINRYZE [INJ]

clemastine fumarate

CLEMASTINE FUMARATE

POWDER

COMBIVENT RESPIMAT

cromolyn sodium

CROMOLYN SODIUM

POWDER

cyproheptadine hcl

CYPROHEPTADINE HCL

POWDER

DALIRESP

D-

CHLORPHENIRA/PSE/CHLOP

HEDIAN 12.5CPD-1DCPM-

30PSE

desloratadine

desloratadine disintegrating

tablets

dexchlorpheniramine

maleate er

DEXTROMETHORPHAN HBR

difil-g

dihydrocodeine/aspirin/caffe

ine

dihydrocodeine/bpm/pe

diphenhydramine [INJ]

DIPHENHYDRAMINE

POWDER [INJ]

DM/PHENYLEPH/CHLORPHE

NIRAMINE 10PEH-4CPM-

20DM

DULERA

DYMISTA

ephedrine sulfate

EPHEDRINE SULFATE

POWDER

epinephrine ampule/vial

EPINEPHRINE AUTO-

INJECTOR [INJ]

EPINEPHRINE POWDER

EPIPEN

EPIPEN JR.

ESBRIET

FIRAZYR [INJ]

FLOVENT DISKUS

FLOVENT HFA

flunisolide nasal spray

FLUNISOLIDE POWDER

fluticasone nasal spray

guaifenesin/codeine

hydrocodone/chlorpheniram

ine er

hydrocodone/homatropine

hydroxyzine hcl

HYDROXYZINE HCL POWDER

hydroxyzine pamoate

HYDROXYZINE PAMOATE

POWDER

INCRUSE ELLIPTA

ipratropium bromide

IPRATROPIUM BROMIDE

POWDER

ipratropium/albuterol

nebulization

LETAIRIS

levalbuterol hcl

LEVALBUTEROL HCL

POWDER

levocetirizine

dihydrochloride

LEVOCETIRIZINE

DIHYDROCHLORIDE POWDER

metaproterenol sulfate

METAPROTERENOL SULFATE

POWDER

mometasone furoate nasal

montelukast sodium

MONTELUKAST SODIUM

POWDER

NUCALA

OPSUMIT

ORKAMBI

PERFOROMIST [INJ]

phenylephrine/chlorphenira

mine 10peh-4cpm

PROAIR HFA

PROAIR RESPICLICK

promethazine hcl

PROMETHAZINE HCL

POWDER

PROMETHAZINE HCL

TABLETS POWDER

promethazine vc/codeine

promethazine w/codeine

promethazine/dextromethor

phan

promethegan

pseudoephedrine hcl

PSEUDOEPHEDRINE HCL

pseudoephedrine hcl er

PULMICORT FLEXHALER

PULMOZYME

QNASL

QVAR

SEEBRI NEOHALER

SEREVENT DISKUS

sildenafil citrate

SILDENAFIL CITRATE

POWDER

sodium chloride



SPIRIVA RESPIMAT

STIOLTO RESPIMAT

STRIVERDI RESPIMAT

SYMBICORT

terbutaline sulfate

TERBUTALINE SULFATE

POWDER

theophylline anhydrous

drops er 12 hr

theophylline anhydrous er

THEOPHYLLINE ANHYDROUS

POWDER

TRACLEER

triamcinolone acetonide

TUDORZA PRESSAIR

TYVASO

UTIBRON NEOHALER

VENTAVIS

VENTOLIN HFA

XOLAIR [INJ]

zafirlukast

Urologicals

alfuzosin hcl er

alprostadil [INJ]

ALPROSTADIL POWDER [INJ]

AMINOACETIC ACID

AMMONIUM CHLORIDE [INJ]

bethanechol chloride

BETHANECHOL CHLORIDE

POWDER

CAVERJECT [INJ]

CIALIS

CYSTAGON

darifenacin er

ELMIRON

finasteride

FINASTERIDE POWDER

flavoxate hcl

GELNIQUE

glycine

GLYCINE POWDER

hyophen

K-PHOS ORIGINAL

MUSE

MYRBETRIQ ER 24 HR

oxybutynin chloride

oxybutynin chloride er

OXYBUTYNIN CHLORIDE

POWDER

phenazopyridine hcl

PHENAZOPYRIDINE HCL

POWDER

phenazopyridine plus

phosphasal

potassium citrate er

RAPAFLO

RENACIDIN

tamsulosin hcl er 24 hr

tolterodine tartrate

TOVIAZ

tricitrates

trospium chloride er

uretron d-s

urimar-t

urin d.s.

urogesic

ustell

VESICARE

VIAGRA

Vitamins, Hematinics &

Electrolytes

ADDAMEL N [INJ]

advanced am/pm

albumin [INJ]

amino acid [INJ]

AMINOSYN [INJ]

AQUASOL A [INJ]

ascorbic acid [INJ]

ASCORBIC ACID [INJ]

BAL IN OIL [INJ]

bal-care dha

b-complex

calcium acetate

CALCIUM ACETATE POWDER

calcium chloride [INJ]

CALCIUM CHLORIDE [INJ]

calcium gluconate [INJ]

CALCIUM GLUCONATE 61MG

CALCIUM GLUCONATE

POWDER [INJ]

cavan-alpha kit

cavan-ec sod dha

centratex

choice-ob + dha

choice-tabs

chromium chloride [INJ]

CLINIMIX [INJ]

CLINIMIX E

complete natal dha

copper chloride [INJ]

corvita

CUPRIC SULFATE [INJ]

dailyvite

dexferrum

dialyvite 800

eliphos

elite ob

elite-ob

elite-ob 400

fabb

fe 90 plus

fe c

FERAHEME

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 POWDER

folic

acid/cyancobal/pyridoxine

folivane-f

folivane-ob

folivane-plus

folivane-prx dha nf

folplex 2.2

foltanx

FREAMINE HBC

freamine iii

FREAMINE III

GLYCOPHOS [INJ]

hematinic plus

hematinic with folic acid

hematogen

hematogen fa

hematogen forte

hemenatal ob

hemenatal ob + dha

hemetab

HEPATAMINE [INJ]

HEPATASOL [INJ]

hetastarch w/sodium

chloride [INJ]

hydroxocobalamin

HYDROXOCOBALAMIN

POWDER

iferex 150 forte

inatal advance

inatal gt

inatal ultra

infed [INJ]

INFUVITE [INJ]

intralipid

IONOSOL B WITH DEXTROSE

5%

ISOLYTE S [INJ]

k-phos neutral

LEVOMEFOLATE DHA

l-mefolate-pyridox-

mecobalamin

l-methyl-b6-b12

l-methylfolate calcium

L-METHYLFOLATE CALCIUM

POWEDER

l-methylfolate-mecobalamin-

nac

m.v.i. adult [INJ]

M.V.I. PEDIATRIC [INJ]

M.V.I.-12 [INJ]

macnatal cn dha

magnesium chloride [INJ]

MAGNESIUM CHLORIDE [INJ]

magnesium sulfate [INJ]

MAGNESIUM SULFATE [INJ]

MAGNESIUM SULFATE IN

DEXTROSE [INJ]

manganese [INJ]

manganese sulfate [INJ]

MANGANESE SULFATE

POWDER [INJ]

mefolate-pyridox-

mecobalamin

metafolbic

metafolbic plus

methyl-b6-b12

multigen

multigen folic

multigen plus

multitrace-4 [INJ]

MULTITRACE-4 [INJ]

MULTITRACE-5 [INJ]

multivitamin w/fluoride &

iron

multivitamin with fluoride

mynatal

mynatal advance

mynatal caps

mynatal plus

mynatal-z

mynate 90 plus er

mynephrocaps

NASCOBAL [INJ]

natal-v rx

natalvirt 90 dha

natalvirt ca

natalvirt flt

nephplex rx

NEPHRAMINE [INJ]

nephro-vite rx

NEUT [INJ]

NORMOSOL-M AND

DEXTROSE [INJ]

NORMOSOL-R AND

DEXTROSE [INJ]

NORMOSOL-R PH 7.4 [INJ]

nutrilyte [INJ]

nutrilyte ii [INJ]

nutri-tab ob

obstetrix dha

PEDITRACE [INJ]

PHOSLYRA

PLASMA-LYTE 148 [INJ]

pnv ob+dha

pnv-dha

pnv-first

pnv-omega

pnv-select

pnv-total

poly-iron 150 forte

polysaccharide iron forte

pot chloride/dextrose/ns

[INJ]



potassium acetate [INJ]

POTASSIUM ACETATE [INJ]

potassium bicarbonate

POTASSIUM BICARBONATE

potassium chl-normal saline

[INJ]

potassium chloride

POTASSIUM CHLORIDE

potassium chloride/dextrose

[INJ]

pr natal 400

pr natal 400 ec

pr natal 430

pr natal 430 ec

prefol-dha

premasol [INJ]

PREMASOL [INJ]

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

PROCALAMINE

PROSOL

pyridoxine hcl

PYRIDOXINE HCL

relnate dha

renal caps

renalpren

rena-vite rx

reno caps

ringers [INJ]

selenium [INJ]

se-natal 19

se-tan dha prenatal

se-tan plus

setonet

setonet ec

sodium acetate [INJ]

SODIUM ACETATE POWDER

[INJ]

sodium chloride [INJ]

sodium lactate [INJ]

SODIUM LACTATE [INJ]

strovite

taron forte

taron prenatal

taron-bc

taron-c dha

taron-duo ec

therapeutic hematinic

therapeutic vitamin/minerals

thiamine hcl

THIAMINE HCL POWDER

tl gard rx

tl g-fol os

tl icon

tl-care dha

tl-fol 500 er

tl-hem 150 er 24 hr

tl-select

TPN ELECTROLYTES 18-18-

5MEQ [INJ]

TRACE ELEMENTS [INJ]

travasol [INJ]

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

TROPHAMINE [INJ]

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

VENOFER [INJ]

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-pn



vitamin a

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

vp-zel

zatean-ch

zatean-pn

zatean-pn dha

zatean-pn plus

zinc chloride

ZINC CHLORIDE

zinc sulfate

ZINC SULFATE

zingiber

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