RegenceRx Preferred Medication List/Formulary
RegenceRx Preferred Medication List/Formulary
RegenceRx Preferred Medication List/Formulary
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Generic<br />
Non-<strong>Preferred</strong>/Non-<br />
<strong>Formulary</strong> Brand Name<br />
L<br />
labetalol tablet Trandate ®<br />
lactulose syrup Enulose ®<br />
lamotrigine tablet Lamictal ® **<br />
leflunomide tablet Arava ®<br />
leucovorin tablet Wellcovorin ®<br />
leuprolide non-depot injection<br />
levobunolol ophthalmic<br />
solution<br />
Betagan ®<br />
levothyroxine sodium tablet<br />
lidocaine viscous solution Xylocaine ®<br />
lindane lotion, shampoo Kwell ®<br />
lisinopril tablet Zestril ® , Prinivil ®<br />
lisinopril/HCTZ tablet Zestoretic ®<br />
lithium carbonate capsule Eskalith ®<br />
lithium citrate syrup<br />
loperamide capsule, liquid Imodium ®<br />
lorazepam tablet Ativan ®<br />
lovastatin tablet Mevacor ®<br />
loxapine succinate capsule Loxitane ®<br />
M<br />
maprotiline tablet Ludiomil ®<br />
mebendazole chewtabs Vermox ®<br />
meclizine tablet Antivert ®<br />
meclofenamate capsule Meclomen ®<br />
medroxyprogesterone acetate<br />
tablet<br />
megestrol tablet, syrup Megace ®<br />
meloxicam tablet Mobic ®<br />
menest tablet<br />
meperidine tablet, syrup Demerol ®<br />
mesalamine enema Rowasa ®<br />
metaproterenol tablet, syrup,<br />
inhalation solution<br />
Alupent ®<br />
metformin ER tablet Glucophage ® XR<br />
metformin tablet Glucophage ®<br />
methadone tablet, solution,<br />
concentrate<br />
Dolophine ®<br />
methazolamide tablet Neptazane ®<br />
methenamine hippurate tablet Hiprex ®<br />
methenamine mandelate tablet Mandelamine ®<br />
methimazole tablet Tapazole ®<br />
methocarbamol tablet Robaxin ®<br />
methocarbamol/ASA tablet Robaxisal ®<br />
methotrexate tablet Rheumatrex ®<br />
methyclothiazide tablet Enduron ®<br />
methyldopa tablet Aldomet ®<br />
methylphenidate ER tablet Ritalin ® SR<br />
methylphenidate tablet Ritalin ®<br />
methylprednisolone tablet Medrol ®<br />
metoclopramide tablet, syrup Reglan ®<br />
metolazone tablet Zaroxolyn ®<br />
metoprolol tablet Lopressor ®<br />
metoprolol succinate tablet Toprol XL ®<br />
metronidazole tablet Flagyl ®<br />
*May not be a covered benefit under some plans.<br />
**This brand is preferred/formulary.<br />
15<br />
Generic<br />
Non-<strong>Preferred</strong>/Non-<br />
<strong>Formulary</strong> Brand Name<br />
metronidazole vaginal gel MetroGel-Vaginal ®<br />
mexiletine capsule Mexitil ®<br />
midodrine tablet Proamatine ®<br />
minocycline capsule Minocin ®<br />
minoxidil tablet Loniten ®<br />
mirtazapine tablet Remeron ®<br />
misoprostil tablet Cytotec ®<br />
moexipril HCL tablet Univasc ®<br />
moexipril/HCTZ tablet Uniretic ®<br />
mometasone cream, lotion,<br />
ointment<br />
Elocon ®<br />
morphine SR tablet MS Contin ®<br />
mupirocin ointment Bactroban ®<br />
N<br />
nabumetone tablet Relafen ®<br />
nadolol tablet Corgard ®<br />
naphazoline ophthalmic<br />
solution<br />
Vasocon ®<br />
naproxen tablet Naprosyn ®<br />
nefazodone tablet Serzone ®<br />
neo/polymyx/dexamethasone<br />
ophthalmic suspension,<br />
ointment<br />
nicardipine capsule Cardene ®<br />
nifedipine capsule Procardia ®<br />
nifedipine SA tablet Adalat ® CC<br />
nimodipine capsule Nimotop ®<br />
nitrofurantoin capsule Macrodantin ® , Macrobid ®<br />
nitroglycerin capsule NitroTime ®<br />
nitroglycerin patch Minitran ® , Nitro-Dur ®<br />
nora-BE tablet* Nor-Q-D ® *,**<br />
nortriptyline capsule Pamelor ®<br />
nystatin suspension, tablet Mycostatin ®<br />
O<br />
octreotide injection Sandostatin ®<br />
ofloxacin tablet Floxin ®<br />
omeprazole capsule Prilosec ®<br />
ondansetron Zofran ODT ®<br />
ondansetron HCL Zofran ®<br />
oxaprozin tablet Daypro ®<br />
oxazepam capsule Serax ®<br />
oxcarbazepine tablet Trileptal ®<br />
oxybutynin tablet Ditropan ®<br />
oxybutynin chloride ER tablet Ditropan ® XL<br />
oxycodone capsule OxyIR ®<br />
oxycodone SR tablet OxyContin ®<br />
oxycodone/APAP tablet Percocet ®<br />
oxycodone/ASA tablet Percodan ®<br />
P<br />
pantoprazole sodium tablet Protonix ®<br />
paroxetine tablet Paxil ®<br />
penicillin V potassium tablet,<br />
suspension<br />
Veetids ®<br />
pentoxifylline tablet Trental ®<br />
permethrin 5% cream Elimite ®<br />
Effective February 1, 2008<br />
©2008. <strong>RegenceRx</strong>. All Rights Reserved.