RegenceRx Preferred Medication List/Formulary

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Generic Non-Preferred/Non- Formulary Brand Name L labetalol tablet Trandate ® lactulose syrup Enulose ® lamotrigine tablet Lamictal ® ** leflunomide tablet Arava ® leucovorin tablet Wellcovorin ® leuprolide non-depot injection levobunolol ophthalmic solution Betagan ® levothyroxine sodium tablet lidocaine viscous solution Xylocaine ® lindane lotion, shampoo Kwell ® lisinopril tablet Zestril ® , Prinivil ® lisinopril/HCTZ tablet Zestoretic ® lithium carbonate capsule Eskalith ® lithium citrate syrup loperamide capsule, liquid Imodium ® lorazepam tablet Ativan ® lovastatin tablet Mevacor ® loxapine succinate capsule Loxitane ® M maprotiline tablet Ludiomil ® mebendazole chewtabs Vermox ® meclizine tablet Antivert ® meclofenamate capsule Meclomen ® medroxyprogesterone acetate tablet megestrol tablet, syrup Megace ® meloxicam tablet Mobic ® menest tablet meperidine tablet, syrup Demerol ® mesalamine enema Rowasa ® metaproterenol tablet, syrup, inhalation solution Alupent ® metformin ER tablet Glucophage ® XR metformin tablet Glucophage ® methadone tablet, solution, concentrate Dolophine ® methazolamide tablet Neptazane ® methenamine hippurate tablet Hiprex ® methenamine mandelate tablet Mandelamine ® methimazole tablet Tapazole ® methocarbamol tablet Robaxin ® methocarbamol/ASA tablet Robaxisal ® methotrexate tablet Rheumatrex ® methyclothiazide tablet Enduron ® methyldopa tablet Aldomet ® methylphenidate ER tablet Ritalin ® SR methylphenidate tablet Ritalin ® methylprednisolone tablet Medrol ® metoclopramide tablet, syrup Reglan ® metolazone tablet Zaroxolyn ® metoprolol tablet Lopressor ® metoprolol succinate tablet Toprol XL ® metronidazole tablet Flagyl ® *May not be a covered benefit under some plans. **This brand is preferred/formulary. 15 Generic Non-Preferred/Non- Formulary Brand Name metronidazole vaginal gel MetroGel-Vaginal ® mexiletine capsule Mexitil ® midodrine tablet Proamatine ® minocycline capsule Minocin ® minoxidil tablet Loniten ® mirtazapine tablet Remeron ® misoprostil tablet Cytotec ® moexipril HCL tablet Univasc ® moexipril/HCTZ tablet Uniretic ® mometasone cream, lotion, ointment Elocon ® morphine SR tablet MS Contin ® mupirocin ointment Bactroban ® N nabumetone tablet Relafen ® nadolol tablet Corgard ® naphazoline ophthalmic solution Vasocon ® naproxen tablet Naprosyn ® nefazodone tablet Serzone ® neo/polymyx/dexamethasone ophthalmic suspension, ointment nicardipine capsule Cardene ® nifedipine capsule Procardia ® nifedipine SA tablet Adalat ® CC nimodipine capsule Nimotop ® nitrofurantoin capsule Macrodantin ® , Macrobid ® nitroglycerin capsule NitroTime ® nitroglycerin patch Minitran ® , Nitro-Dur ® nora-BE tablet* Nor-Q-D ® *,** nortriptyline capsule Pamelor ® nystatin suspension, tablet Mycostatin ® O octreotide injection Sandostatin ® ofloxacin tablet Floxin ® omeprazole capsule Prilosec ® ondansetron Zofran ODT ® ondansetron HCL Zofran ® oxaprozin tablet Daypro ® oxazepam capsule Serax ® oxcarbazepine tablet Trileptal ® oxybutynin tablet Ditropan ® oxybutynin chloride ER tablet Ditropan ® XL oxycodone capsule OxyIR ® oxycodone SR tablet OxyContin ® oxycodone/APAP tablet Percocet ® oxycodone/ASA tablet Percodan ® P pantoprazole sodium tablet Protonix ® paroxetine tablet Paxil ® penicillin V potassium tablet, suspension Veetids ® pentoxifylline tablet Trental ® permethrin 5% cream Elimite ® Effective February 1, 2008 ©2008. RegenceRx. All Rights Reserved.
Generic Non-Preferred/Non- Formulary Brand Name perphenazine tablet Trilafon ® phenazopyridine tablet Pyridium ® phenobarbital tablet, elixir phenylephrine ophthalmic solution phenytoin sodium capsule Dilantin ® ** pilocarpine ophthalmic solution Adsorbocarpine ® pilocarpine tablet Salagen ® pindolol tablet Visken ® piroxicam capsule Feldene ® polyethylene glycol/electrolyte solution potassium chloride tablet K-Dur ® ** potassium citrate tablet Urocit-K ® pravastatin Pravachol ® prazosin capsule Minipress ® prednisolone 15mg/5ml syrup Prelone ® prednisolone acetate ophthalmic suspension Pred Forte ® prednisolone sod phosphate ophthalmic solution Inflamase Forte ® prednisolone sod phosphate oral solution Orapred ® prednisone tablet, solution Deltasone ® previfem tablet primaquine phosphate tablet primidone tablet Mysoline ® ** probenecid tablet procainamide capsule Pronestyl ® procainamide SA tablet Pronestyl SR ® prochlorperazine tablet Compazine ® promethazine tablet, suppository Phenergan ® propafenone tablet Rythmol ® propoxyphene/APAP tablet Darvocet N ® -100 propranolol tablet Inderal ® propranolol/HCTZ tablet Inderide ® propylthiouracil tablet protriptyline tablet Vivactil ® pyrazinamide tablet Q quinapril tablet Accupril ® quinapril/ HCTZ tablet Accuretic ® quinidine gluconate tablet Quinaglute ® quinidine sulfate tablet Quinidex ® R ramipril capsule Altace ® ranitidine tablet, syrup Zantac ® ribavirin capsule Rebetol ® ribavirin tablet Copegus ® rifampin capsule Rifadin ® rifampin/isoniazid capsule Rifamate ® rimantadine tablet Flumadine ® S salsalate tablet Disalcid ® *May not be a covered benefit under some plans. **This brand is preferred/formulary. 16 Generic Non-Preferred/Non- Formulary Brand Name selegiline tablet, capsule Eldepryl ® sertraline tablet Zoloft ® silver sulfadiazine cream Silvadene ® simvastatin tablet Zocor ® sotalol tablet Betapace ® spironolactone tablet Aldactone ® spironolactone/HCTZ tablet Aldactazide ® sucralfate tablet Carafate ® sulfacetamide ophthalmic solution Bleph ® -10 sulfacetamide sodium/sulfur emulsion, medicated pad Plexion ® sulfadiazine tablet Microsulfon ® sulfamethoxazole/trimethoprim tablet, suspension Bactrim ® , Septra ® sulfasalazine tablet Azulfidine ® EN-tabs ® sulfisoxazole tablet, suspension Gantrisin ® sulindac tablet Clinoril ® T tamoxifen tablet Nolvadex ® ** temazepam capsule Restoril ® terazosin capsule Hytrin ® terbinafine HCL tablet* Lamisil ® tetracycline capsule Achromycin ® theophylline tablet, capsule, elixir thioridazine tablet, solution Mellaril ® thiothixene capsule Navane ® thyroid dessicated tablet ticlopidine tablet Ticlid ® tilia FE tablet Estrostep ® FE timolol maleate ophthalmic solution Betimol ® ** timolol maleate tablet Blocadren ® tizanidine tablet Zanaflex ® tobramycin ophthalmic solution Tobrex ® tolazamide tablet Tolinase ® tolbutamide tablet Orinase ® tolmetin tablet Tolectin ® tramadol tablet Ultram ® tramadol/APAP tablet Ultracet ® trandolapril tablet Mavik ® tranylcypromine sulfate tablet Parnate ® trazodone tablet Desyrel ® tretinoin capsule Vesanoid ® tretinoin cream, gel, lotion* Retin A ® * triamcinolone acetonide cream, ointment Aristocort ® triamcinolone tablet Aristocort ® triamterene/HCTZ tablet Maxzide ® triazolam tablet Halcion ® trifluoperazine tablet Stelazine ® Effective February 1, 2008 ©2008. RegenceRx. All Rights Reserved.
Page 1 and 2: RegenceRx Preferred Medication List
Page 3 and 4: RegenceRx is dedicated to provide t
Page 5 and 6: Preferred/Formulary Medications: By
Page 7 and 8: CARDIOVASCULAR (cont.) amlodipine b
Page 9 and 10: IMMUNOSUPPRESSANTS azathioprine tab
Page 11 and 12: RESPIRATORY (cont.) Flovent ® Disk
Page 13 and 14: A to Z Listing: Generics Effective
Page 15: Generic Non-Preferred/Non- Formular
Page 19 and 20: A to Z Listing: Preferred/Formulary
Page 21 and 22: Invirase ® capsule, tablet Isopto
Page 23 and 24: Visicol ® tablet Vivelle ® patch
Page 25 and 26: Non-Preferred/ Non-Formulary Brand
Page 27 and 28: Non-Preferred/ Non-Formulary Brand
Page 29: P.O. Box 1271, Portland, OR 97207-1

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