dru g formulary - Kern Health Systems

24GENERIC BRAND FORMSKFHC DRUG FORMULARYHormone – Antidiabetic Other AgentsMetformin is a valuable medication for the treatment of diabetes. A specific advantage ofMetformin is that it can help minimize weight gain. Patients who try generic Metformin and havenausea may be considered for Glucophage XR®. G Glucagon1mg kit G Insulin, Human Apidra ® Humalog® 100 units/ml Regular, Lente, NPH, 50-50, 70-30 mix,Novolog® Lantus® 500 units/ml RegularRestriction: U-500 allowed for plan endocrinologists. G Metformin Glucophage® 500mg, 850mg, 1000mg tablet, 500mg cr tabletGlucophage XR®Hormone – Antidiabetic Sulfonylureas G Glimepiride Amaryl® 1mg, 2mg, 4mg tablet G Glipizide Glucotrol® 5mg, 10mg tablet G Glyburide Diabeta® 1.25mg, 2.5mg, 5mg tabletHormone – Antidiabetic ThiazolidinedioneThese agents are reserved for patients who fail or cannot take Metformin. KHS recommends usingMetformin prior to “Glitazone” therapy for diabetic patients since it helps patients minimizeweight gain. Prior authorization will be considered for patients who cannot tolerate Metformin orshould not take Metformin (renal patients).Pioglitazone Actos® 15mg, 30mg, 45mg tabletRestriction: Restricted to pts. on Metformin or cannot take or have failed Metformin.Rosiglitazone Avandia® 2mg, 4mg, 8mg tabletRestriction: Restricted to pts. on Metformin or cannot take or have failed Metformin. Not recommended for new starts.Hormone – Anti-thyroid G Propylthiouracil PTU® 50mg tabletHormone – EndocrineCinacalcet Sensipar® 30mg, 60mg, 90mg tabletRestriction: Prior authorization required. G Desmopressin acetate DDAVP® 0.1mg, 0.2mg tabletRestriction: Prior authorization required. Not indicated for nocturnal enuresis.