To order additional copies, please call Massachusetts Medical

Xxxxxx Analgesics Xxxxxx (Narcotic/Opiate)
4
Name AETNA BCBSMA BMCHP FCHP HPHC HNE NHP NTWK MAHLTH THP
PROPOXyPHENE/ACETAMINOPHEN X NC PA X NC PA X
[Darvocet–N]
TAPENTADOL [Nucynta] X NC X PA NC DL
TRAMADOL extended release [Ryzolt] X NC X NC NC
Analgesics (Non-narcotic/Non-opiate)
ACETAMINOPHEN (OTC) NC NC DL NC X 1 X X
AsPIRIN (OTC) NC NC DL NC X 1 X X
CELECOXIB [Celebrex] DL FE DL sT PA X PA DL PA sT PA 2 PA
PA
CHOLINE MAgNEsIUM X* X* X X X X X X X
TRIsALICyLATE
DICLOFENAC X* X* X X X X X X X X
DICLOFENAC [zipsor] X NC X PA NC
DICLOFENAC ER X X* X X PA X
DICLOFENAC topical gel
[Voltaren gel]
DL sT* NC PA X NC PA PA DL
DICLOFENAC topical patch
[Flector patch]
DL FE NC PA X NC PA PA NC
DIFLUNIsAL X* X* X X X X X X X X
ETODOLAC X* X* X X X X X X X X
ETODOLAC [Lodine] FE NC PA X NC PA X
ETODOLAC XR FE X* X X X X X X PA X
FENOPROFEN X* X* X X X X X X PA X
FLURBIPROFEN X* X* X X X X X X X X
gABAPENTIN DL* X* X X X X X X X X
IBUPROFEN X* X* X X X X X X X X
IBUPROFEN [Motrin] X X DL X NC PA X
INDOMETHACIN X* X* X X X X X X X X
INDOMETHACIN ER X* X* X X PA X
KETOPROFEN X* X* X X X X X X X X
KETOPROFEN ER X X* X X PA X
KETOROLAC DL* X* X X DL X X X DL X
MECLOFENAMATE X* X* X X X X X X X X
1 MassHealth members only
2 ≤59 yrs old