Preferred Drug List 2013 Standard Formulary with ... - Express Scripts

TABLE OF CONTENTSChapterChapter 1Chapter 2Chapter 3Chapter 4Chapter 5Chapter 6Chapter 7Chapter 8Chapter 9Chapter 10Chapter 11Chapter 12Chapter 13Chapter 14Chapter 15Chapter 16Chapter 17Chapter 18NameANESTHETICSANTIINFECTIVESANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGSCARDIOVASCULAR MEDICATIONSAUTONOMIC & CNS MEDICATIONSDERMATOLOGICAL MEDICATIONSEAR-NOSE-THROAT MEDICATIONSENDOCRINE MEDICATIONSGASTROINTESTINAL MEDICATIONSIMMUNOLOGICALS & VACCINESMUSCULOSKELETAL MEDICATIONSNUTRITION, BLOODOBSTETRICAL & GYNECOLOGICAL MEDICATIONSOPHTHALMIC MEDICATIONSRESPIRATORY MEDICATIONSUROLOGICAL MEDICATIONSDIAGNOSTIC & MISCELLANEOUS MEDICATIONSMEDICAL (MISCELLANEOUS) SUPPLIESDRUG NAMETIER1 2 3 4CHAPTER 1: ANESTHETICS1.2 TOPICAL ANESTHETICSlidocaine hcl Xlidocaine‐prilocaine XLIDODERM XCHAPTER 2: ANTIINFECTIVESSUGGESTED PREFFERED ALTERNATIVES2.1.1 CEPHALOSPORINScefaclor er Xcefadroxil Xcefdinir Xcefpodoxime proxetil Xcefprozil Xcefuroxime Xcephalexin XCEDAX X cefpodoxime,cefuroxime,cefdinrSUPRAX X cefpodoxime,cefuroxime,cefdinr2.1.3 CLINDAMYCINSclindamycin hcl Xclindamycin phosphate X2.1.4 ERYTHROMYCINSerythromycin X2.1.4.1 OTHER MACROLIDESazithromycin Xclarithromycin/er X

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESribapak Xribavirin PA Xvalacyclovir XBARACLUDE XDENAVIR XEPIVIR HBV XRELENZA XTAMIFLU XVALTREX X valacyclovir2.6 TOPICAL ANTIVIRAL DRUGSXERESE XZOVIRAX X2.7.2 ANTITUBERCULOSIS DRUGSisoniazid Xrifampin X2.7.3 PLASMODICIDESatovaquone‐proguanil hcl Xhydroxychloroquine sulfate Xmefloquine hcl XMALARONE X atovaquone/proguanil hclQUALAQUIN X quinine sulfate2.7.4 SULFONESDAPSONE X2.7.5 TRICHOMONOCIDESmetronidazole Xtinidazole X2.8 OTHER ANTIINFECTIVE DRUGSbacitracin Xvancomycin hcl XDIFICID X metronidazoleVANCOCIN HCL X vancomycinXIFAXAN XZYVOX X2.8.2 AMINOGLYCOSIDESgentamicin sulfate Xtobramycin sulfate XTOBI XCHAPTER 3: ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS3.0 ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGSanagrelide hcl Xanastrozole Xazathioprine Xbicalutamide Xcyclosporine modified inj XTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVEScyclosporine modified other doseforms Xexemestane Xhydroxyurea Xleflunomide Xletrozole Xleucovorin calcium inj Xleucovorin calcium tab, pwd Xmegestrol acetate Xmercaptopurine Xmethotrexate inj Xmethotrexate tab, pwd Xmycophenolate mofetil Xtacrolimus Xtamoxifen citrate Xtretinoin XARIMIDEX X anastrozoleCELLCEPT vial X mycophenolate mofetilCELLCEPT oral X mycophenolate mofetilCIMZIA PA X ENBREL, HUMIRAELIGARD PA XENBREL PA XFEMARA X letrozoleGLEEVEC XHUMIRA PA XMEGACE ES X megestrol acetateMYFORTIC XORENCIA PA XPROGRAF inj X tacrolimusPROGRAF cap, susp X tacrolimusRAPAMUNE XREVLIMID XSANDOSTATIN LAR XSIMPONI PA X ENBREL, HUMIRASOMATULINE DEPOT XSTELARA PA XTYKERB XXELODA XCHAPTER 4: CARDIOVASCULAR MEDICATIONS4.1 CARDIAC GLYCOSIDESdigoxin XLANOXIN X digoxin4.2 CALCIUM ANTAGONISTSamlodipine besylate XTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVEScartia xt Xdiltiazem/er Xfelodipine er Xnifediac cc Xnifedical xl Xnifedipine er Xnisoldipine Xverapamil Xverapamil er pm XCARDENE SR X immediate‐release nicardipineCARDIZEM LA X diltiazem 24 hr erSULAR X nisoldipine er4.3.1 LOOP DIURETICSbumetanide Xfurosemide Xtorsemide X4.3.2 THIAZIDE AND RELATED DRUGSchlorthalidone Xhydrochlorothiazide Xindapamide Xmetolazone X4.3.3 POTASSIUM SPARING DIURETICSamiloride hcl Xeplerenone Xspironolactone Xspironolactone‐hctz Xtriamterene‐hctz Xtriamterene‐hydrochlorothiazid X4.4 BETA‐ADRENERGIC ANTAGONIST DRUGSacebutolol hcl Xatenolol Xbisoprolol fumarate Xcarvedilol Xlabetalol hcl Xmetoprolol succinate Xmetoprolol tartrate Xnadolol Xpindolol Xpropranolol hcl Xtimolol maleate XBYSTOLIC XCOREG CR XTOPROL XL X metoprolol succinate erTIER

DRUG NAMETIER1 2 3 4SUGGESTED PREFFERED ALTERNATIVES4.5.1 VASODILATOR ANTIHYPERTENSIVESdoxazosin mesylate Xminoxidil Xprazosin hcl Xterazosin hcl XCARDURA XL X alfuzosn er,tamsulosn,RAPAFLO4.5.2 CENTRALLY ACTING ANTIHYPERTENSIVESclonidine Xclonidine hcl Xguanfacine hcl Xmethyldopa X4.5.4.1 ANGIOTENSIN CONVERTING ENZYME INHIBITORSbenazepril hcl Xcaptopril Xenalapril maleate Xfosinopril sodium Xlisinopril Xmoexipril hcl Xquinapril hcl Xramipril Xtrandolapril X4.5.4.2 ANGIOTENSIN II RECEPTOR ANTAGONISTSeprosartan mesylate Xirbesartan Xlosartan potassium XATACAND ST X losartan, BENICAR, DIOVANATACAND HCT ST X candesartan/hydrochlorothiazdeAVALIDE ST X irbesartan/hydrochlorothiazideAVAPRO ST X irbesartanBENICAR ST XBENICAR HCT ST XCOZAAR ST X losartan potassiumDIOVAN ST XDIOVAN HCT ST X valsartan/hydrochlorthiazideEDARBI X losartan, BENICAR, DIOVANHYZAAR ST X losartan‐hctzMICARDIS ST X losartan, BENICAR, DIOVANMICARDIS HCT ST X losar‐ht,valsar‐ht,BENICAR HCTTEVETEN ST X eprosartanTEVETEN HCT ST X losar‐ht,valsar‐ht,BENICAR HCT4.5.6 OTHER ANTIHYPERTENSIVESamlodipine besylate‐benazepril Xatenolol‐chlorthalidone Xbenazepril‐hydrochlorothiazide X

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESbisoprolol‐hydrochlorothiazide Xcaptopril‐hydrochlorothiazide Xenalapril‐hydrochlorothiazide Xfosinopril‐hydrochlorothiazide Xirbesartan‐hydrochlorothiazide Xlisinopril‐hydrochlorothiazide Xlosartan‐hydrochlorothiazide Xmetoprolol‐hydrochlorothiazide Xmoexipril‐hydrochlorothiazide Xquinapril‐hydrochlorothiazide XAMTURNIDE XAZOR ST XEDARBYCLOR X losar‐ht,valsar‐ht,BENICAR HCTEXFORGE ST XEXFORGE HCT ST XLOTREL X amlodipine‐benazeprilTARKA XTEKAMLO XTEKTURNA XTEKTURNA HCT XTRIBENZOR ST XTWYNSTA ST X AZOR, EXFORGE/HCT, TRIBENZOR4.6.1 NITRATESisosorbide Xisosorbide dinitrate Xnitroglycerin Xnitroglycerin patch XNITROSTAT X4.6.2 OTHER VASODILATING DRUGSADCIRCA XBIDIL X isosorbide dn + hydralazineREVATIO X sildenafil4.6.3 ENDOTHELIN RECEPTOR ANTAGONISTLETAIRIS XTRACLEER X4.7.1.3 CLASS 1Cflecainide acetate Xpropafenone hcl XRYTHMOL SR X propafenone er4.7.3 AMIODARONESamiodarone hcl X4.7.5 OTHER ANTIARRHYTHMICSsotalol XMULTAQ X amiodaroneTIER

DRUG NAME1 2 3 4TIKOSYN XTIERSUGGESTED PREFFERED ALTERNATIVES4.8.1 HYPOLIPOPROTEINEMICScholestyramine Xcolestipol hcl Xfenofibrate Xfenofibric acid Xgemfibrozil XANTARA X fenofibrate, TRICOR, TRILPIXFENOGLIDE X fenofibrate, TRICOR, TRILPIXFIBRICOR X fenofibric acidLIPOFEN X fenofibrate, TRICOR, TRILPIXLOVAZA XNIASPAN XTRICOR XTRIGLIDE X fenofibrate, TRICOR, TRILPIXTRILIPIX XWELCHOL XZETIA X4.8.2 HMG‐COA REDUCTASE INHIBITORSatorvastatin calcium Xfluvastatin sodium Xlovastatin Xpravastatin sodium Xsimvastatin XALTOPREV ST X atorvastatn,simvastatn,CRESTORCRESTOR ST XLESCOL ST X fluvastatinLESCOL XL ST X atorvastatn,simvastatn,CRESTORLIPITOR ST X atorvastatinLIVALO ST X atorvastatn,simvastatn,CRESTOR4.8.2.1 HMG‐COA COMBINATIONSamlodipine‐atorvastatin XADVICOR ST XCADUET ST X amlodipine/atorvastatinCADUET ST X amlodipine/atorvastatinSIMCOR ST XVYTORIN ST X simvastatin + ZETIA, CRESTORVYTORIN ST X simvastatin + ZETIA, CRESTOR4.9 OTHER CARDIOVASCULAR DRUGSpentoxifylline XRANEXA XCHAPTER 5: AUTONOMIC AND CNS MEDICATIONS5.1.1 ANALGESICSbutorphanol tartrate X

DRUG NAME1 2 3 4tramadol hcl/er Xtramadol hcl‐acetaminophen XTIERSUGGESTED PREFFERED ALTERNATIVES5.1.1.1 CLASS II NARCOTICSendocet Xfentanyl Xhydromorphone hcl Xmethadone hcl Xmorphine sulfate/er Xoxycodone hcl Xoxycodone‐acetaminophen Xoxymorphone hcl Xroxicet XABSTRAL XAVINZA X gen,NUCYN ER,OPANA ER,OXYCONTNEXALGO X gen,NUCYN ER,OPANA ER,OXYCONTNFENTORA XKADIAN X gen,NUCYN ER,OPANA ER,OXYCONTNLAZANDA X fentanyl citra,ABSTRAL,FENTORANUCYNTA/ER XONSOLIS X fentanyl citra,ABSTRAL,FENTORAOPANA X oxymorphoneOPANA ER XOXYCONTIN XSUBSYS X fentanyl citra,ABSTRAL,FENTORA5.1.1.2 CLASS III NARCOTICSacetaminophen‐codeine Xbuprenorphine hcl Xhydrocodone bit‐ibuprofen Xhydrocodone‐acetaminophen Xreprexain Xzamicet XBUTRANS XSUBOXONE X5.1.1.3 CLASS IV NARCOTICSbuprenorphine hcl X5.1.2 DRUGS TO PREVENT AND TREAT HEADACHESbutalbital compound‐codeine Xbutalbital‐aspirin‐caffeine Xnaratriptan hcl Xsumatriptan XAXERT ST X sumatriptan, RELPAX, ZOMIG/ZMTFROVA ST X sumatriptan, RELPAX, ZOMIG/ZMTIMITREX ST X sumatriptanMAXALT/MLT ST X sumatriptan, RELPAX, ZOMIG/ZMT

DRUG NAME1 2 3 4MIGRANAL XRELPAX ST XSUMAVEL DOSEPRO ST XTREXIMET ST XZOMIG/ZMT ST X5.2.1 ANXIOLYTICSalprazolam/er/xr Xbuspirone hcl Xchlordiazepoxide hcl Xclorazepate dipotassium Xdiazepam Xlorazepam Xoxazepam XTIERSUGGESTED PREFFERED ALTERNATIVES5.2.2 SEDATIVE/HYPNOTIC DRUGSestazolam Xflurazepam hcl Xtemazepam Xtriazolam Xzaleplon Xzolpidem tartrate/er XAMBIEN ST X zolpidemAMBIEN CR ST X zolpidem erEDLUAR ST X zolpidem immed‐rel/er, LUNESTAINTERMEZZO ST X zolpidem immed‐rel/er, LUNESTALUNESTA ST XLUNESTA ST XROZEREM ST XSILENOR ST X zolpidem immed‐rel/er, LUNESTAZOLPIMIST ST X zolpidem tablet5.3 ANTIMANIA DRUGSlithium carbonate X5.4.1 CARBAMAZEPINEScarbamazepine/er/xr Xoxcarbazepine XCARBATROL X carbamazepine erTEGRETOL XR XTEGRETOL XR X carbamazepine xr5.4.2 ANTICONVULSANT BENZODIAZEPINESclonazepam Xdiazepam X5.4.3 HYDANTOINSphenytoin sodium extended XDILANTIN XPHENYTEK X phenytoin sodium extended

DRUG NAMETIER1 2 3 45.4.4 VALPROIC ACID AND DERIVATIVESdivalproex sodium/er XVALPROIC ACID XDEPAKOTE ER X divalproex sodium er5.4.6 ANTICONVULSANT BARBITURATESphenobarbital Xprimidone XSUGGESTED PREFFERED ALTERNATIVES5.4.7 OTHER ANTICONVULSANTSgabapentin Xlamotrigine Xlevetiracetam Xtopiramate Xzonisamide XGRALISE ST X gabapentinHORIZANT ST X gabapentinKEPPRA X levetiracetamKEPPRA XR X levetiracetam erLAMICTAL X lamotrigineLAMICTAL ODT XLAMICTAL XR XLYRICA ST XPOTIGA XTOPAMAX X topiramate sprinkle capsVIMPAT PA X5.5.1.1 TERTIARY AMINESamitriptyline hcl Xclomipramine hcl Xdoxepin hcl Ximipramine hcl X5.5.1.2 SECONDARY AMINESdesipramine hcl Xnortriptyline hcl X5.5.1.3 SELECTIVE SEROTONIN REUPTAKE INHIBITORScitalopram Xcitalopram hbr Xescitalopram oxalate Xfluoxetine hcl Xfluvoxamine maleate Xparoxetine hcl Xsertraline hcl XLEXAPRO X escitalopramLUVOX CR X generic SSRIs, VIIBRYDVIIBRYD ST X

DRUG NAMETIER1 2 3 4SUGGESTED PREFFERED ALTERNATIVES5.5.1.4 OTHER ANTIDEPRESSANTSbupropion hcl Xbupropion hcl sr Xbupropion xl Xmirtazapine Xtrazodone hcl Xvenlafaxine hcl Xvenlafaxine hcl er XVENLAFAXINE HCL ER ST X venlafax er(NOT UCB NDCS‐65580CYMBALTA PA XEFFEXOR XR ST X venlafax er(NOT UCB NDCS‐65580PRISTIQ ER ST XSAVELLA PA XWELLBUTRIN XL X bupropion xl5.5.2 MAO INHIBITORStranylcypromine sulfate X5.6 ANTIVERTIGO AND ANTIEMETIC DRUGSdronabinol Xgranisetron hcl Xmeclizine hcl Xondansetron hcl Xondansetron odt Xprochlorperazine maleate Xpromethazine hcl Xpromethegan XEMEND XSANCUSO XTRANSDERM‐SCOP X meclizineZUPLENZ X ondansetron odt5.7.1 ANTIPARKINSON ANTICHOLINERGIC DRUGSbenztropine mesylate Xtrihexyphenidyl hcl X5.7.2 OTHER ANTIPARKINSON DRUGSbromocriptine mesylate Xcarbidopa‐levodopa Xcarbidopa‐levodopa‐entacapone Xpramipexole dihydrochloride Xropinirole hcl XAZILECT XCOMTAN X entacaponeMIRAPEX X pramipexoleMIRAPEX ER XNEUPRO X pramipex,ropinir/er,MIRAPEX ERREQUIP XL X ropinirole er

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESSTALEVO 100 X carbidopa/levodopa/entacapone5.8 ANTIPSYCHOTIC DRUGSclozapine Xfluphenazine hcl Xhaloperidol Xolanzapine Xolanzapine odt Xperphenazine Xquetiapine fumarate Xrisperidone Xthioridazine hcl Xthiothixene Xtrifluoperazine hcl Xziprasidone hcl XABILIFY XABILIFY DISCMELT XFANAPT Xgeneric, ABILIFY/DISC, LATUDA, SEROQUELXRGEODON X ziprasidoneINVEGA Xgeneric, ABILIFY/DISC, LATUDA, SEROQUELXRLATUDA XRISPERDAL CONSTA XSAPHRIS Xgeneric, ABILIFY/DISC, LATUDA, SEROQUELXRSEROQUEL X quetiapine fumarateSEROQUEL XR XZYPREXA X olanzapineZYPREXA ZYDIS X olanzapine odt5.8.1 ALIPHATIC PHENOTHIAZINESchlorpromazine hcl X5.8.1.1 PSYCHOTHERAPEUTIC COMBINATIONSolanzapine‐fluoxetine hcl XSYMBYAX XSYMBYAX X olanzapine/fluoxetine hcl5.9.1 CNS STIMULANT DRUGSamphetamine salt combo Xdexmethylphenidate hcl Xdextroamphetamine sulfate Xdextroamphetamine‐amphetamine Xmethylphenidate er Xmethylphenidate hcl Xmethylphenidate sr Xmodafinil PA XADDERALL XR ST X dextroamphetamne‐amphetamne erTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESCONCERTA ST X methylphenidate erDAYTRANA ST X methylphenidate cd, er,VYVANSEFOCALIN XR ST X methylphenidate cd, er,VYVANSEMETADATE CD ST X methylphenidate cdNUVIGIL PA X modafinilPROVIGIL PA X modafinilRITALIN LA ST X methylphenidate cd, er,VYVANSEVYVANSE ST X5.9.2 OTHER CNS/AUTONOMIC DRUGSatropine sulfate Xnaltrexone hcl Xpyridostigmine bromide XNUEDEXTA X5.9.3 ANTIDEMENTIA DRUGSdonepezil hcl Xgalantamine hbr Xrivastigmine XARICEPT X donepezilARICEPT ODT X donepezil odtEXELON X rivastigmineNAMENDA X5.9.4 DRUGS TO TREAT MULTIPLE SCLEROSISAMPYRA X5.9.5 SMOKING CESSATION PRODUCTSbupropion hcl sr XCHANTIX X5.9.6 OTHER DRUGS FOR ADHDINTUNIV X methylphenidate erKAPVAY X generic clonidine(imm release)STRATTERA XCHAPTER 6: DERMATOLOGICAL MEDICATIONS6.1 TOPICAL CORTICOSTEROID DRUGSalclometasone dipropionate Xbetamethasone dipropionate Xbetamethasone valerate Xclobetasol emollient Xclobetasol propionate Xdesonide Xdesoximetasone Xfluocinolone acetonide Xfluocinonide Xfluticasone propionate Xhalobetasol propionate Xhydrocortisone XTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVEShydrocortisone butyrate Xhydrocortisone valerate Xmometasone furoate Xtriamcinolone acetonide XCLOBEX X clobetasol solutionHALOG X betmeth val, triamcin 0.1% crmKENALOG X triamcinolone acetonideLOCOID X hydrocortisone butyrateLOCOID LIPOCREAM X hydrocortisone butyrateOLUX X clobetasol propion 0.05% foamOLUX‐E X clobetasol propionate crm,ointPRAMOSONE X hydrocort 2.5/pramoxine 1% crmPRAMOSONE E X hydrocort 2.5/pramoxine 1% crmULTRAVATE PAC X halobetasol propionate oint6.2 ANTIPRURITIC DRUGShydroxyzine X6.3 ANTIACNE DRUGSadapalene Xbenzoyl peroxide Xclindamycin phosphate Xclindamycin‐benzoyl peroxide Xerythromycin Xerythromycin‐benzoyl peroxide Xmetronidazole Xsodium sulfacetamide‐sulfur Xtretinoin XACANYA XATRALIN XBENZACLIN XDIFFERIN X adapaleneDUAC X clindamycin phos/benzoyl peroxEPIDUO XFINACEA XMETROGEL XRETIN‐A MICRO X generics, ATRALIN, DIFFERIN LOTN, EPIDUORETIN‐A MICRO PUMP X generics, ATRALIN, DIFFERIN LOTN, EPIDUOVELTIN XZIANA X generics, ACANYA, BENZACLIN, VELTIN6.3.1 ACCUTANESisotretinoin X6.7 KERATOLYTIC DRUGSCONDYLOX X podofilox6.8 ANTIPSORIASIS AND ANTIECZEMA DRUGScalcipotriene XTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVEScalcitrene Xselenium sulfide Xsulfacetamide sodium XDOVONEX X calcipotrieneSORILUX X calcipotriene,TACLONEXTACLONEX XTAZORAC XVECTICAL X calcitriol6.9.2 TOPICAL DERMATOLOGICAL DRUGSfluorouracil Ximiquimod Xtretinoin XCARAC XELIDEL XEPICERAM X emulsion sb, tl‐cermideFLUOROPLEX X fluorouracil, imiquimod, ZYCLARAPICATO X fluorouracil, imiquimod, ZYCLARAPROMISEB X selenium sulfide, sod sulfacetPROTOPIC XSANTYL XSOLARAZE XVEREGEN X imiquimod, podofiloxZYCLARA X6.9.3 SCABICIDESpermethrin XEURAX XULESFIA X permethrin6.9.5 TOPICAL ANTI‐INFLAMMATORY DRUGSFLECTOR XPENNSAID X FLECTOR, VOLTAREN GELVOLTAREN XCHAPTER 7: EAR‐NOSE‐THROAT MEDICATIONS7.1 DRUGS AFFECTING THE EARantipyrine‐benzocaine Xneomycin‐polymyxin‐hc Xneomycin‐polymyxin‐hydrocort Xofloxacin XCETRAXAL X ciprofloxacin 0.2% oticCIPRO HC X CIPRODEXCIPRODEX X7.2 DRUGS AFFECTING THE NOSEazelastine hcl Xflunisolide Xfluticasone propionate XTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESipratropium bromide Xtriamcinolone acetonide XASTELIN X azelastineASTEPRO XBECONASE AQ ST X flunisoli, flutic, NASONEX,QNASLDYMISTA ST X azelastine + fluticasoneNASACORT AQ ST X triamcinolone acetonideNASONEX ST XOMNARIS ST X flunisoli, flutic, NASONEX,QNASLPATANASE X azelastine, ASTEPROQNASL ST XRHINOCORT AQUA ST X flunisoli, flutic, NASONEX, QNASLVERAMYST ST X flunisoli, flutic, NASONEX, QNASLZETONNA ST X flunisoli, flutic, NASONEX, QNASL7.3 DRUGS AFFECTING THE THROAT AND MOUTHdoxycycline hyclate Xpilocarpine hcl Xtriamcinolone acetonide XCHAPTER 8: ENDOCRINE MEDICATIONS8.1.1 INSULINAPIDRA/SOLOSTAR X HUMALOG, NOVOLOGHUMALOG products XHUMULIN products XLANTUS/SOLOSTAR XLEVEMIR/FLEXPEN XNOVOLIN products X HUMULINNOVOLOG products X8.1.2 ORAL HYPOGLYCEMIC DRUGSacarbose Xglimepiride Xglipizide/er Xglipizide‐metformin Xglyburide Xglyburide micronized Xglyburide‐metformin hcl Xmetformin hcl Xmetformin hcl er Xnateglinide XFORTAMET X metformin hcl erPRANDIMET XPRANDIN XRIOMET X8.1.3 INSULIN SENSITIZERSACTOPLUS MET X pioglitazone/metforminTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESACTOPLUS MET XR XACTOS X pioglitazoneAVANDAMET X pioglit+metfor, ACTOPLUS MET XRAVANDARYL X pioglitzone/glimepirideAVANDIA X pioglitazoneDUETACT X pioglitazone/glimepiride8.1.4 AMYLIN ANALOGUESSYMLINPEN X8.1.5.1 INCRETIN MIMETICSBYDUREON XBYETTA XVICTOZA X8.1.5.2 DIPEPTIDYL PEPTIDASE‐IV INHIBITORSJANUMET/XR XJANUVIA XJENTADUETO XJUVISYNC XKOMBIGLYZE XR XONGLYZA XTRADJENTA X8.2 GLUCOSE ELEVATING DRUGSGLUCAGEN XGLUCAGON EMERGENCY KIT X8.3.1 GLUCOCORTICOID DRUGSdexamethasone Xdexamethasone sodium phosphate Xhydrocortisone Xmethylprednisolone Xprednisolone Xprednisolone sodium phosphate Xprednisone Xveripred 20 XRAYOS X immediate‐release prednisone8.3.2 MINERALOCORTICOID DRUGSfludrocortisone acetate X8.4.1 THYROID SUPPLEMENTSlevothyroxine sodium Xlevoxyl XARMOUR THYROID XCYTOMEL X liothyronineSYNTHROID X levothyroxine sodium8.4.2 ANTITHYROID DRUGSmethimazole Xpropylthiouracil XTIER

DRUG NAMETIER1 2 3 48.6 OTHER ENDOCRINE DRUGSalendronate sodium Xcalcitonin nasal spray Xdesmopressin acetate inj Xdesmopressin acetate other doseforms Xetidronate disodium Xibandronate sodium XACTONEL ST XATELVIA ST XBINOSTO ST XFORTEO PA XSUGGESTED PREFFERED ALTERNATIVESalendronate, ibandronate, ACTONEL,ATELVIAFOSAMAX PLUS D ST Xalendronate, ibandronate, ACTONEL,ATELVIASENSIPAR XCHAPTER 9: GASTROINTESTINAL MEDICATIONS9.1.2 OTC H2 ANTAGONISTSfamotidine X9.2 ANTIDIARRHEAL DRUGSdiphenoxylate‐atropine Xloperamide X9.3 ANTISPASMODICS/DRUGS AFFECT GI MOTILITYchlordiazepoxide‐clidinium Xdicyclomine hcl Xhyoscyamine sulfate Xmetoclopramide hcl X9.4 ANTIULCER DRUGScimetidine Xfamotidine Xnizatidine Xranitidine hcl X9.4.1 OTHER ANTIULCER DRUGSmisoprostol Xsucralfate XCARAFATE X sucralfate9.4.2 PROTON PUMP INHIBITORSlansoprazole Xomeprazole Xomeprazole‐sodium bicarbonate ST Xpantoprazole sodium XACIPHEX ST X generics, NEXIUMDEXILANT ST X generics, NEXIUMNEXIUM ST XPREVACID ST X lansoprazole

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESPROTONIX ST X pantoprazole sodiumZEGERID ST X generics, NEXIUM9.4.2.1 PROTON PUMP INHIBITORS ‐ OTComeprazole X9.4.3 HELICOBACTER PYLORI DRUGSHELIDAC X bismuth+metroni+tetracy, PYLERAOMECLAMOX‐PAK X omepraz+clarithro+amox, PYLERAPREVPAC X amox+clarith+lansoprazo, PYLERAPYLERA X9.5 LAXATIVES AND CATHARTICSOSMOPREP X generic, HALFLYT, MOVIPRP,SUPREP9.6 OTHER GI DRUGSanucort‐hc Xbalsalazide disodium Xbudesonide ec Xhydrocortisone Xhydrocortisone acetate Xpancrelipase 5,000 Xpeg 3350‐electrolyte Xproctosol‐hc Xproctozone‐hc Xsulfasalazine Xtrilyte with flavor packets Xursodiol XANALPRAM ADVANCED X hydrocortisone/pramoxine creamANALPRAM E X hydrocortisone/pramoxine creamANALPRAM HC X hydrocortisone/pramoxine creamAPRISO X balsalazide, ASACOL/HD, LIALDA, PENTASAASACOL XASACOL HD XCANASA XCREON XDIPENTUM X balsalazide, ASACOL/HD, LIALDA, PENTASAGOLYTELY X generics, HALFLYTELY, MOVIPREP, SUPREPHALFLYTELY‐BISACODYL XLIALDA XMOVIPREP XNULYTELY WITH FLAVOR PACKS X peg‐3350 w/flavor packs solnPANCREAZE X generics, CREON, ZENPEPPENTASA XPERTZYE X generics, CREON, ZENPEPPREPOPIK X generics, HALFLYTELY, MOVIPREP, SUPREPRELISTOR XSFROWASA X mesalamine 4 gm/60 ml enemaTIER

DRUG NAME1 2 3 4SUPREP XZENPEP X9.7 IRRITABLE BOWEL DRUGSAMITIZA XLINZESS XCHAPTER 10: IMMUNOLOGICALS AND VACCINES10.0 IMMUNOLOGICALS AND VACCINESSYNAGIS XZOSTAVAX X10.2.1 MYELOID STIMULANTSNEULASTA XNEUPOGEN X10.2.2 ERYTHROID STIMULANTSARANESP XPROCRIT XTIERSUGGESTED PREFFERED ALTERNATIVES10.2.3 INTERFERONSAVONEX PA XAVONEX ADMINISTRATION PACK PA XAVONEX PEN PA XBETASERON PA XCOPAXONE XEXTAVIA PA X AVONEX, BETASERON, REBIFPEGASYS/PROCLICK XPEGINTRON/REDIPEN XREBIF PA X10.2.4 GROWTH HORMONES AND RELATED DRUGSGENOTROPIN PA XHUMATROPE PA XNORDITROPIN FLEXPRO PA X GENOTROP,HUMATROP,NUTROPIN/AQNORDITROPIN NORDIFLEX PA X GENOTROP,HUMATROP,NUTROPIN/AQNUTROPIN/AQ/AQ NUSPIN PA XOMNITROPE PA X GENOTROP,HUMATROP,NUTROPIN/AQSAIZEN PA X GENOTROP,HUMATROP,NUTROPIN/AQTEV‐TROPIN PA X GENOTROP,HUMATROP,NUTROPIN/AQ10.2.6 INTERLEUKIN RECEPTOR ANTAGONISTKINERET PA X ORENCIA10.2.7 IMMUNOGLOBULIN ANTIBODIESXOLAIR XCHAPTER 11: MUSCULOSKELETAL MEDICATIONS11.1.1 SALICYLATES AND RELATED DRUGSaspirin Xaspirin ec Xcholine mag trisalicylate Xdiflunisal X

DRUG NAME1 2 3 4salsalate XTIERSUGGESTED PREFFERED ALTERNATIVES11.1.2 NON‐STEROIDAL ANTIINFLAMMATORY AGENTSdiclofenac potassium Xdiclofenac sodium Xetodolac Xflurbiprofen Xibuprofen Xindomethacin Xketoprofen Xketorolac tromethamine Xmeloxicam Xnabumetone Xnaproxen Xnaproxen sodium Xoxaprozin Xpiroxicam Xsulindac XCAMBIA X diclofenac potassiumCELEBREX XDUEXIS X ibuprofen plus famotidineNAPRELAN X naproxen sodiumVIMOVO X11.2 DRUGS TO PREVENT AND TREAT GOUTallopurinol Xprobenecid XCOLCRYS XULORIC ST X11.3.1 DIRECT MUSCLE RELAXANTSbaclofen Xtizanidine hcl X11.3.2 CNS MUSCLE RELAXANTSchlorzoxazone Xcyclobenzaprine hcl Xmetaxalone Xmethocarbamol Xorphenadrine citrate XAMRIX X immed‐release cyclobenzaprineSKELAXIN X metaxaloneSOMA X metaxalone, tizanidineCHAPTER 12: NUTRITION,BLOOD12.1.2 VITAMINS & MINERALS & RELATED PRODUCTSBIFERA RX X hemetab iron supplement tabsCEREFOLIN X folic acidCEREFOLIN NAC X folic acid

DRUG NAMETIER1 2 3 4SUGGESTED PREFFERED ALTERNATIVES12.1.3 THERAPEUTIC VITAMINS & MINERALScalcitriol Xcalcium acetate Xeliphos Xfolic acid Xlevocarnitine Xvitamin d XDEPLIN X folic acidHECTOROL XNASCOBAL XPHOSLYRA X calcium acetate caps, ELIPHOSZEMPLAR X12.1.4 FLUORIDE PRODUCTSsodium fluoride X12.2 POTASSIUM SUPPLEMENTSpotassium chloride X12.3.1 ORAL ANTICOAGULANTS, VITAMIN Kwarfarin sodium XCOUMADIN X warfarin sodium12.3.2 HEPARIN AND HEPARIN ANTAGONISTSenoxaparin sodium Xfondaparinux sodium Xheparin sodium XARIXTRA X fondaparinux sodiumFRAGMIN X enoxaparin, fondaparinuxLOVENOX X enoxaparin12.3.3 OTHER DRUGS AFFECTING COAGULATIONXARELTO X12.3.5 THROMBIN INHIBITORSPRADAXA X12.4 ANTIPLATELET DRUGScilostazol Xdipyridamole XAGGRENOX XBRILINTA XEFFIENT XPLAVIX X clopidogrel12.5 HEMOSTATICSLYSTEDA X12.7 BLOOD DETOXICANTSenulose Xlactulose XFOSRENOL XRENAGEL X

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESRENVELA XCHAPTER 13: OBSTETRICAL & GYNECOLOGICAL MEDICATIONS13.1.1 PRENATAL VITAMINSNEEVO DHA X generic Rx prenatal vitamansPREFERA OB X hemenatal ob tabsPREFERA‐OB ONE X prenatal mv & min capsulePREFERA‐OB PLUS DHA X hemenatal ob+dha combo pkPRENATE DHA X generic Rx prenatal vitamansPRENATE ELITE X generic Rx prenatal vitamansPRENATE ESSENTIAL X generic Rx prenatal vitamans13.1.2 SPECIALIZED OB/GYN DRUGSleuprolide acetate PA Xnovarel XCETROTIDE XGANIRELIX ACETATE XLUPRON DEPOT PA X ELIGARD, TRELSTAROVIDREL X ch.gonadotrpin,novarel13.1.3 OB/GYN TOPICAL ANTIINFECTIVESclindamycin phosphate Xmetronidazole Xvandazole X13.2 OVULATORY STIMULANTSclomiphene citrate XBRAVELLE X GONAL‐F/RFFFOLLISTIM AQ X GONAL‐F/RFFGONAL‐F/RFF X13.3 ANDROGEN DRUGStestosterone cypionate XANDRODERM XANDROGEL XAXIRON XFORTESTA X ANDRODERM, ANDROGEL, AXIRONSTRIANT X ANDRODERM, ANDROGEL, AXIRONTESTIM X ANDRODERM, ANDROGEL, AXIRON13.4 ESTROGEN DRUGSestradiol Xestrogen & methyltestosterone Xestrogen‐methyltestosterone Xestropipate XCENESTIN XDIVIGEL XELESTRIN X estradiol ptch, DIVIGEL, EVAMISTENJUVIA XESTRACE X VAGIFEMTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESESTRASORB X estradiol ptch, DIVIGEL, EVAMISTESTRING X VAGIFEMESTROGEL X estradiol ptch, DIVIGEL, EVAMISTEVAMIST XMENEST X estradiol, CENESTIN, ENJUVIA, PREMARNMENOSTAR X gen estradiol ptch, VIVELLE‐DOTPREMARIN XVAGIFEM XVIVELLE‐DOT X13.4.1 ESTROGEN/PROGESTIN COMBINATIONSjinteli XACTIVELLA X estradiol/noreth acetateANGELIQ X ee/noreth ac, PREMPHASE/PREMPROCLIMARA PRO XCOMBIPATCH XFEMHRT X ee/noreth ac, PREMPHASE/PREMPROPREFEST X ee/noreth ac, PREMPHASE/PREMPROPREMPHASE XPREMPRO X13.4.3 SELECTIVE ESTROGEN RECEPTOR MODULATOREVISTA X13.5 PROGESTIN DRUGScamila Xerrin Xjolivette Xmedroxyprogesterone acetate Xnora‐be Xnorethindrone Xnorethindrone acetate Xprogesterone in oil XCRINONE XENDOMETRIN XMAKENA XPROMETRIUM X progesterone13.7 CONTRACEPTIVESaltavera Xapri Xaranelle Xaviane Xazurette Xbalziva Xcamrese Xcesia Xcryselle XTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVEScyclafem Xenpresse Xgildess fe Xjolessa Xjunel Xjunel fe Xkariva Xkelnor 1‐35 Xleena Xlessina Xlevora‐28 Xloryna Xlow‐ogestrel Xlutera Xmicrogestin Xmicrogestin fe Xmononessa Xnecon Xnortrel Xocella Xogestrel Xportia Xprevifem Xquasense Xreclipsen Xsolia Xsprintec Xsronyx Xsyeda Xtilia fe Xtri‐legest fe Xtrinessa Xtri‐previfem Xtri‐sprintec Xtrivora‐28 Xvelivet Xzarah Xzenchent Xzovia 1‐35e Xzovia 1‐50e XBEYAZ XFEMCON FE X zenchent fe chewable, zeosaGENERESS FE X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,NATAZIA, NUVARING, SAFYRALTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESLO LOESTRIN FE XLOESTRIN 24 FE XLOSEASONIQUE X amethia lo, camrese loNATAZIA XNUVARING XORTHO EVRA X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,NATAZIA, NUVARING, SAFYRALORTHO TRI‐CYCLEN X trinesa, tri‐previ, tri‐sprintORTHO TRI‐CYCLEN LO X generics, BEYAZ, LOESTRIN 24/LO LOESTRIN,NATAZIA, NUVARING, SAFYRALSAFYRAL XSEASONIQUE X amethia, camreseYASMIN 28 X ocella,syeda,zarahYAZ X gianvi, loryna, vesturaCHAPTER 14: OPHTHALMIC MEDICATIONS14.1.1 OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGSbacitracin Xbacitracin‐polymyxin Xciprofloxacin hcl Xerythromycin Xgentamicin sulfate Xneomycin‐bacitracin‐polymyxin Xofloxacin Xpolymyxin b sul‐trimethoprim Xsulfacetamide sodium XAZASITE XBESIVANCE X generic, MOXEZA, VIGAMOX, ZYMAXIDMOXEZA XVIGAMOX XZYMAXID X14.1.2 OPHTHALMIC TOPICAL ANTIVIRAL DRUGStrifluridine X14.2 OPHTHALMIC CORTICOSTEROID DRUGSfluorometholone Xprednisolone acetate XALREX X azelastine, PATADAY, PATANOLDUREZOL XFML FORTE X generics, DUREZOL, LOTEMAX SOLNLOTEMAX XVEXOL X generics, DUREZOL, LOTEMAX SOLN14.3 OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDSneomycin‐polymyxin‐dexameth Xneomycin‐polymyxin‐hc Xtobramycin‐dexamethasone XTIER

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESTOBRADEX X tobramycin sulfate/dexamethTOBRADEX ST XZYLET X14.5 ANTIGLAUCOMA DRUGSacetazolamide Xbrimonidine tartrate Xdorzolamide hcl Xdorzolamide‐timolol Xlatanoprost Xlevobunolol hcl Xpilocarpine hcl Xtimolol maleate XALPHAGAN P X brimonidine tartrateAZOPT XBETIMOL X generic, ALPHAGAN P, AZOPT, COMBIGANCOMBIGAN XCOSOPT PF X generic, ALPHAGAN P, AZOPT, COMBIGANISTALOL X generic, ALPHAGAN P, AZOPT, COMBIGANLUMIGAN ST XTIMOPTIC OCUDOSE X timolol maleateTRAVATAN Z ST XXALATAN ST X latanoprostZIOPTAN ST X latanoprost, LUMIGAN, TRAVATAN Z14.6 OTHER OPHTHALMIC DRUGSatropine sulfate Xazelastine hcl Xcromolyn sodium Xdiclofenac sodium Xepinastine hcl Xketotifen fumarate XACUVAIL XALOCRIL X azelastine, PATADAY, PATANOLALOMIDE X azelastine, PATADAY, PATANOLBEPREVE X azelastine, PATADAY, PATANOLBOTOX XBROMDAY XEMADINE X azelastine, PATADAY, PATANOLLASTACAFT X azelastine, PATADAY, PATANOLNEVANAC XPATADAY XPATANOL XRESTASIS XTIER

TIERDRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESCHAPTER 15: RESPIRATORY MEDICATIONS15.1.1 BETA‐2 ADRENERGIC DRUGSalbuterol sulfate Xmetaproterenol sulfate XARCAPTA NEOHALER X FORADIL, SEREVENTBROVANA X PERFOROMISTFORADIL XMAXAIR AUTOHALER X PROAIR HFA, VENTOLIN HFAPERFOROMIST XPROAIR HFA XPROVENTIL HFA X PROAIR HFA, VENTOLIN HFASEREVENT DISKUS XVENTOLIN HFA XXOPENEX X levalbuterolXOPENEX CONCENTRATE X levalbuterolXOPENEX HFA ST X PROAIR HFA, VENTOLIN HFA15.1.2 METHYL XANTHINE DRUGStheophylline Xtheophylline anhydrous X15.1.3 OTHER DRUGS FOR ASTHMAbudesonide Xcromolyn sodium Xepinephrine Xipratropium bromide Xipratropium‐albuterol XADVAIR DISKUS XADVAIR HFA XALVESCO X ASMANEX, PULMICORT FLEX, QVARASMANEX XATROVENT HFA XCOMBIVENT XCOMBIVENT RESPIMAT XDULERA XEPIPEN 2‐PAK XEPIPEN JR 2‐PAK XFLOVENT DISKUS X ASMANEX, PULMICORT FLEX, QVARFLOVENT HFA X ASMANEX, PULMICORT FLEX, QVARPULMICORT XPULMICORT FLEXHALER XQVAR XSPIRIVA XSYMBICORT XTUDORZA PRESSAIR X

DRUG NAMETIER1 2 3 415.1.4 LEUKOTRIENE MODIFIERSmontelukast sodium Xzafirlukast XACCOLATE ST X zafirlukastSINGULAIR ST X montelukast15.2.1 ANTIHISTAMINESarbinoxa Xcetirizine Xcyproheptadine hcl Xdiphenhydramine hcl Xfexofenadine hcl Xlevocetirizine dihydrochloride Xloratadine Xpromethazine hcl XCLARINEX X desloratadineXYZAL X levocetirizineZYRTEC X15.2.3 ANTIHISTAMINE/DECONGESTANT COMBINATIONSpromethazine vc XALLEGRA‐D 24 HOUR XCLARINEX‐D 12 HOUR X desloratadineCLARINEX‐D 24 HOUR X desloratadineZYRTEC‐D XSUGGESTED PREFFERED ALTERNATIVES15.3 ANTITUSSIVE AND EXPECTORANT DRUGSbenzonatate Xguaifenesin/codiene Xguaifenesin‐codeine Xpromethazine vc‐codeine Xpromethazine‐codeine Xpromethazine‐dm XREZIRA X promethazine vc with codeineTUSSICAPS XTUSSIONEX X hydrocodone/chlorphen polisZUTRIPRO X promethazine vc with codeine15.4 OTHER RESPIRATORY DRUGSDALIRESP XPULMOZYME XCHAPTER 16: UROLOGICAL MEDICATIONS16.1.1 ANTICHOLINERGIC ANTISPASMODICSoxybutynin chloride Xoxybutynin chloride er Xtolterodine tartrate XDETROL ST X tolterodineDETROL LA ST X

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESENABLEX ST XGELNIQUE ST XOXYTROL ST XSANCTURA XR ST X trospium erTOVIAZ ST XVESICARE ST X16.1.2 CHOLINERGIC STIMULANTSbethanechol chloride X16.1.3 URINARY ANESTHETICSphenazopyridine hcl X16.1.4 OTHER GENITOURINARY PRODUCTSalfuzosin hcl Xfinasteride Xpotassium citrate Xtamsulosin hcl XAVODART X finasterideCIALIS XELMIRON XFLOMAX X tamsulosin hclJALYN X alfuzosn, finasterid, tamsulosLEVITRA X CIALIS, VIAGRAMUSE XMYRBETRIQ XRAPAFLO XSTAXYN X CIALIS, VIAGRAVIAGRA XCHAPTER 17: DIAGNOSTIC & MISCELLANEOUS MEDICATIONS17.1 DIAGNOSTIC PRODUCTSMINILINK REAL‐TIME TRANSMITTER XPARADIGM REAL‐TIME XPRECISION XTRA XSOF‐SENSOR X ACCU‐CHEK, ONE TOUCH17.2 MISCELLANEOUS DRUGSTHALOMID X17.3.1 APPETITE SUPPRESSANTSphentermine hcl XQSYMIA X benzphet,diethylprop,phentermCHAPTER 18: MEDICAL (MISCELLANEOUS) SUPPLIES18.0 MEDICAL (MISCELLANEOUS) SUPPLIESAEROCHAMBER XCONCEPTION XMINIMED XMINIMED RESERVOIR XOPTICHAMBER XTIER

DRUG NAME1 2 3 4PARADIGM XPARADIGM INFUSION XPARADIGM SILHOUETTE XPOLYFIN XPOLYFIN QR XPRIMABELLA XQUICK RELEASE SOFT TEFLON XSILHOUETTE XSOF‐SET XSOF‐SET MICRO XSURE‐T XTIERSUGGESTED PREFFERED ALTERNATIVES18.1 DIABETIC SUPPLIESACCU‐CHEK XACCU‐CHEK ACTIVE XACCU‐CHEK AVIVA XACCU‐CHEK AVIVA PLUS XACCU‐CHEK COMFORT CURVE XACCU‐CHEK COMPACT XACCU‐CHEK COMPACT BLUE CONTROL XACCU‐CHEK FASTCLIX XACCU‐CHEK NANO SMARTVIEW XACCU‐CHEK SMARTVIEW XACCU‐CHEK SOFTCLIX XASCENSIA AUTODISC X ACCU‐CHEK, ONE TOUCHAUTODISC NORMAL X ACCU‐CHEK, ONE TOUCHBREEZE 2 X ACCU‐CHEK, ONE TOUCHCONTOUR X ACCU‐CHEK, ONE TOUCHCONTOUR NEXT X ACCU‐CHEK, ONE TOUCHCONTOUR NEXT EZ X ACCU‐CHEK, ONE TOUCHCONTOUR USB X ACCU‐CHEK, ONE TOUCHCONTROL SOLUTION X ACCU‐CHEK, ONE TOUCHFORA LANCETS XFORA LANCING DEVICE XFORA TEST STRIP X ACCU‐CHEK, ONE TOUCHFORA V30A X ACCU‐CHEK, ONE TOUCHFREESTYLE FREEDOM LITE X ACCU‐CHEK, ONE TOUCHFREESTYLE INSULINX X ACCU‐CHEK, ONE TOUCHFREESTYLE INSULINX TEST STRIPS X ACCU‐CHEK, ONE TOUCHFREESTYLE LITE METER X ACCU‐CHEK, ONE TOUCHFREESTYLE LITE STRIPS X ACCU‐CHEK, ONE TOUCHFREESTYLE TEST STRIPS X ACCU‐CHEK, ONE TOUCHGLUCOSE TEST STRIP X ACCU‐CHEK, ONE TOUCHGUARDIAN RT STARTER KIT XNOVOFINE X

DRUG NAME1 2 3 4 SUGGESTED PREFFERED ALTERNATIVESNOVOFINE 32 XNOVOFINE AUTOCOVER XONE TOUCH LANCETS XONE TOUCH TEST STRIPS XONE TOUCH ULTRA 2 XONE TOUCH ULTRA SMART XONE TOUCH ULTRA SYSTEM XONE TOUCH ULTRA TEST STRIPS XONE TOUCH ULTRAMINI XONE TOUCH VERIO XONE TOUCH VERIO IQ XPRECISION XPRECISION XTRA XPRODIGY X ACCU‐CHEK, ONE TOUCHPRODIGY INSULIN SYRINGE XPRODIGY NO CODING X ACCU‐CHEK, ONE TOUCHPRODIGY PEN NEEDLE XPRODIGY POCKET X ACCU‐CHEK, ONE TOUCHPRODIGY VOICE X ACCU‐CHEK, ONE TOUCHSOFT TOUCH XSOFTCLIX XSURESTEP XTRUE2GO BLOOD GLUCOSE SYSTEM X ACCU‐CHEK, ONE TOUCHTRUERESULT BLOOD GLUCOSE SYSTM X ACCU‐CHEK, ONE TOUCHTRUETEST TEST STRIPS X ACCU‐CHEK, ONE TOUCHTRUETRACK SMART SYSTEM X ACCU‐CHEK, ONE TOUCHTRUETRACK TEST STRIP X ACCU‐CHEK, ONE TOUCHVGO 20 XVGO 30 XVGO 40 XTIER

IndexABILIFY 5.8ABILIFY DISCMELT 5.8ABSTRAL 5.1.1.1ACANYA 6.3acarbose 8.1.2ACCOLATE 15.1.4ACCU‐CHEK 18.1ACCU‐CHEK ACTIVE 18.1ACCU‐CHEK AVIVA 18.1ACCU‐CHEK AVIVA PLUS 18.1ACCU‐CHEK COMFORT 18.1CURVEACCU‐CHEK COMPACT 18.1ACCU‐CHEK COMPACT BLUE 18.1CONTROLACCU‐CHEK FASTCLIX 18.1ACCU‐CHEK NANO18.1SMARTVIEWACCU‐CHEK SMARTVIEW 18.1ACCU‐CHEK SOFTCLIX 18.1acebutolol hcl 4.4acetaminophen‐codeine 5.1.1.2acetazolamide 14.5ACIPHEX 9.4.2ACTIVELLA 13.4.1ACTONEL 8.6ACTOPLUS MET 8.1.3ACTOPLUS MET XR 8.1.3ACTOS 8.1.3ACUVAIL 14.6acyclovir 2.5.2adapalene 6.3ADCIRCA 4.6.2ADDERALL XR 5.9.1ADVAIR DISKUS 15.1.3ADVAIR HFA 15.1.3ADVICOR 4.8.2.1AEROCHAMBER 18AGGRENOX 12.4albuterol sulfate 15.1.1alclometasone dipropionate 6.1alendronate sodium 8.6alfuzosin hcl 16.1.4ALLEGRA‐D 24 HOUR 15.2.3allopurinol 11.2ALOCRIL 14.6ALOMIDE 14.6ALPHAGAN P 14.5alprazolam/er/xr 5.2.1ALREX 14.2ALTABAX 2.2altavera 13.7ALTOPREV 4.8.2ALVESCO 15.1.3amantadine 2.5.2AMBIEN 5.2.2AMBIEN CR 5.2.2amiloride hcl 4.3.3amiodarone hcl 4.7.3AMITIZA 9.7amitriptyline hcl 5.5.1.1amlodipine besylate 4.2amlodipine besylatebenazepril4.5.6amlodipine‐atorvastatin 4.8.2.1amox tr‐potassium 2.1.5clavulanateamoxicillin 2.1.5amoxicillin‐clavulanate er 2.1.5amphetamine salt combo 5.9.1AMPYRA 5.9.4AMRIX 11.3.2AMTURNIDE 4.5.6anagrelide hcl 3ANALPRAM ADVANCED 9.6ANALPRAM E 9.6ANALPRAM HC 9.6anastrozole 3ANDRODERM 13.3ANDROGEL 13.3ANGELIQ 13.4.1ANTARA 4.8.1antipyrine‐benzocaine 7.1anucort‐hc 9.6APIDRA/SOLOSTAR 8.1.1apri 13.7APRISO 9.6aranelle 13.7ARANESP 10.2.2arbinoxa 15.2.1ARCAPTA NEOHALER 15.1.1ARICEPT 5.9.3ARICEPT ODT 5.9.3ARIMIDEX 3ARIXTRA 12.3.2ARMOUR THYROID 8.4.1ASACOL 9.6ASACOL HD 9.6ASCENSIA AUTODISC 18.1ASMANEX 15.1.3aspirin 11.1.1aspirin ec 11.1.1ASTELIN 7.2ASTEPRO 7.2ATACAND 4.5.4.2ATACAND HCT 4.5.4.2ATELVIA 8.6atenolol 4.4

atenolol‐chlorthalidone 4.5.6atorvastatin calcium 4.8.2atovaquone‐proguanil hcl 2.7.3ATRALIN 6.3ATRIPLA 2.5.1atropine sulfate 14.6atropine sulfate 5.9.2ATROVENT HFA 15.1.3AUTODISC NORMAL 18.1AVALIDE 4.5.4.2AVANDAMET 8.1.3AVANDARYL 8.1.3AVANDIA 8.1.3AVAPRO 4.5.4.2AVELOX/ABC PACK 2.1.9aviane 13.7AVINZA 5.1.1.1AVODART 16.1.4AVONEX 10.2.3AVONEX ADMINISTRATION 10.2.3PACKAVONEX PEN 10.2.3AXERT 5.1.2AXIRON 13.3AZASITE 14.1.1azathioprine 3azelastine hcl 7.2azelastine hcl 14.6AZILECT 5.7.2azithromycin 2.1.4.1AZOPT 14.5AZOR 4.5.6azurette 13.7bacitracin 2.8bacitracin 14.1.1bacitracin‐polymyxin 14.1.1baclofen 11.3.1BACTROBAN 2.2balsalazide disodium 9.6balziva 13.7BARACLUDE 2.5.2BECONASE AQ 7.2benazepril hcl 4.5.4.1benazeprilhydrochlorothiazide4.5.6BENICAR 4.5.4.2BENICAR HCT 4.5.4.2BENZACLIN 6.3benzonatate 15.3benzoyl peroxide 6.3benztropine mesylate 5.7.1BEPREVE 14.6BESIVANCE 14.1.1betamethasone6.1dipropionatebetamethasone valerate 6.1BETASERON 10.2.3bethanechol chloride 16.1.2BETIMOL 14.5BEYAZ 13.7bicalutamide 3BIDIL 4.6.2BIFERA RX 12.1.2BINOSTO 8.6bisoprolol fumarate 4.4bisoprololhydrochlorothiazide4.5.6BOTOX 14.6BRAVELLE 13.2BREEZE 2 18.1BRILINTA 12.4brimonidine tartrate 14.5BROMDAY 14.6bromocriptine mesylate 5.7.2BROVANA 15.1.1budesonide 15.1.3budesonide ec 9.6bumetanide 4.3.1buprenorphine hcl 5.1.1.2buprenorphine hcl 5.1.1.3bupropion hcl 5.5.1.4bupropion hcl sr 5.5.1.4bupropion hcl sr 5.9.5bupropion xl 5.5.1.4buspirone hcl 5.2.1butalbital compoundcodeine5.1.2butalbital‐aspirin‐caffeine 5.1.2butorphanol tartrate 5.1.1BUTRANS 5.1.1.2BYDUREON 8.1.5.1BYETTA 8.1.5.1BYSTOLIC 4.4CADUET 4.8.2.1CADUET 4.8.2.1calcipotriene 6.8calcitonin nasal spray 8.6calcitrene 6.8calcitriol 12.1.3calcium acetate 12.1.3CAMBIA 11.1.2camila 13.5camrese 13.7CANASA 9.6captopril 4.5.4.1captoprilhydrochlorothiazide4.5.6CARAC 6.9.2CARAFATE 9.4.1carbamazepine/er/xr 5.4.1CARBATROL 5.4.1carbidopa‐levodopa 5.7.2

carbidopa‐levodopaentacapone5.7.2CARDENE SR 4.2CARDIZEM LA 4.2CARDURA XL 4.5.1cartia xt 4.2carvedilol 4.4CEDAX 2.1.1cefaclor er 2.1.1cefadroxil 2.1.1cefdinir 2.1.1cefpodoxime proxetil 2.1.1cefprozil 2.1.1cefuroxime 2.1.1CELEBREX 11.1.2CELLCEPT oral 3CELLCEPT vial 3CENESTIN 13.4cephalexin 2.1.1CEREFOLIN 12.1.2CEREFOLIN NAC 12.1.2cesia 13.7cetirizine 15.2.1CETRAXAL 7.1CETROTIDE 13.1.2CHANTIX 5.9.5chlordiazepoxide hcl 5.2.1chlordiazepoxide‐clidinium 9.3chlorpromazine hcl 5.8.1chlorthalidone 4.3.2chlorzoxazone 11.3.2cholestyramine 4.8.1choline mag trisalicylate 11.1.1CIALIS 16.1.4ciclopirox 2.4.2cilostazol 12.4cimetidine 9.4CIMZIA 3CIPRO HC 7.1CIPRODEX 7.1ciprofloxacin er 2.1.9ciprofloxacin hcl 14.1.1ciprofloxacin hcl 2.1.9citalopram 5.5.1.3citalopram hbr 5.5.1.3CLARINEX 15.2.1CLARINEX‐D 12 HOUR 15.2.3CLARINEX‐D 24 HOUR 15.2.3clarithromycin/er 2.1.4.1CLIMARA PRO 13.4.1clindamycin hcl 2.1.3clindamycin phosphate 6.3clindamycin phosphate 13.1.3clindamycin phosphate 2.1.3clindamycin‐benzoyl 6.3peroxideclobetasol emollient 6.1clobetasol propionate 6.1CLOBEX 6.1clomiphene citrate 13.2clomipramine hcl 5.5.1.1clonazepam 5.4.2clonidine 4.5.2clonidine hcl 4.5.2clorazepate dipotassium 5.2.1clotrimazole 2.4.1clotrimazole 2.4.2clotrimazolebetamethasone2.4.3clozapine 5.8COLCRYS 11.2colestipol hcl 4.8.1COMBIGAN 14.5COMBIPATCH 13.4.1COMBIVENT 15.1.3COMBIVENT RESPIMAT 15.1.3COMBIVIR 2.5.1COMPLERA 2.5.1COMTAN 5.7.2CONCEPTION 18CONCERTA 5.9.1CONDYLOX 6.7CONTOUR 18.1CONTOUR NEXT 18.1CONTOUR NEXT EZ 18.1CONTOUR USB 18.1CONTROL SOLUTION 18.1COPAXONE 10.2.3COREG CR 4.4COSOPT PF 14.5COUMADIN 12.3.1COZAAR 4.5.4.2CREON 9.6CRESTOR 4.8.2CRINONE 13.5cromolyn sodium 14.6cromolyn sodium 15.1.3cryselle 13.7cyclafem 13.7cyclobenzaprine hcl 11.3.2cyclosporine modified inj 3cyclosporine modified other 3dose formsCYMBALTA 5.5.1.4cyproheptadine hcl 15.2.1CYTOMEL 8.4.1DALIRESP 15.4DAPSONE 2.7.4DAYTRANA 5.9.1DENAVIR 2.5.2DEPAKOTE ER 5.4.4DEPLIN 12.1.3

desipramine hcl 5.5.1.2desmopressin acetate inj 8.6desmopressin acetate other 8.6dose formsdesonide 6.1desoximetasone 6.1DETROL 16.1.1DETROL LA 16.1.1dexamethasone 8.3.1dexamethasone sodium 8.3.1phosphateDEXILANT 9.4.2dexmethylphenidate hcl 5.9.1dextroamphetamine sulfate 5.9.1dextroamphetamineamphetamine5.9.1diazepam 5.2.1diazepam 5.4.2diclofenac potassium 11.1.2diclofenac sodium 14.6diclofenac sodium 11.1.2dicloxacillin sodium 2.1.5dicyclomine hcl 9.3DIFFERIN 6.3DIFICID 2.8diflunisal 11.1.1digoxin 4.1DILANTIN 5.4.3diltiazem/er 4.2DIOVAN 4.5.4.2DIOVAN HCT 4.5.4.2DIPENTUM 9.6diphenhydramine hcl 15.2.1diphenoxylate‐atropine 9.2dipyridamole 12.4divalproex sodium/er 5.4.4DIVIGEL 13.4donepezil hcl 5.9.3DORYX 2.1.7dorzolamide hcl 14.5dorzolamide‐timolol 14.5DOVONEX 6.8doxazosin mesylate 4.5.1doxepin hcl 5.5.1.1doxycycline hyclate 7.3doxycycline hyclate 2.1.7doxycycline monohydrate 2.1.7dronabinol 5.6DUAC 6.3DUETACT 8.1.3DUEXIS 11.1.2DULERA 15.1.3DUREZOL 14.2DYMISTA 7.2econazole nitrate 2.4.2EDARBI 4.5.4.2EDARBYCLOR 4.5.6EDLUAR 5.2.2EFFEXOR XR 5.5.1.4EFFIENT 12.4ELESTRIN 13.4ELIDEL 6.9.2ELIGARD 3eliphos 12.1.3ELMIRON 16.1.4EMADINE 14.6EMEND 5.6ENABLEX 16.1.1enalapril maleate 4.5.4.1enalaprilhydrochlorothiazide4.5.6ENBREL 3endocet 5.1.1.1ENDOMETRIN 13.5ENJUVIA 13.4enoxaparin sodium 12.3.2enpresse 13.7enulose 12.7EPICERAM 6.9.2EPIDUO 6.3epinastine hcl 14.6epinephrine 15.1.3EPIPEN 2‐PAK 15.1.3EPIPEN JR 2‐PAK 15.1.3EPIVIR 2.5.1EPIVIR HBV 2.5.2eplerenone 4.3.3eprosartan mesylate 4.5.4.2EPZICOM 2.5.1errin 13.5ERTACZO 2.4.2erythromycin 6.3erythromycin 14.1.1erythromycin 2.1.4erythromycin‐benzoyl 6.3peroxideescitalopram oxalate 5.5.1.3estazolam 5.2.2ESTRACE 13.4estradiol 13.4ESTRASORB 13.4ESTRING 13.4ESTROGEL 13.4estrogen &13.4methyltestosteroneestrogenmethyltestosterone13.4estropipate 13.4etidronate disodium 8.6etodolac 11.1.2EURAX 6.9.3EVAMIST 13.4

EVISTA 13.4.3EXALGO 5.1.1.1EXELDERM 2.4.2EXELON 5.9.3exemestane 3EXFORGE 4.5.6EXFORGE HCT 4.5.6EXTAVIA 10.2.3FACTIVE 2.1.9famciclovir 2.5.2famotidine 9.4famotidine 9.1.2FANAPT 5.8felodipine er 4.2FEMARA 3FEMCON FE 13.7FEMHRT 13.4.1fenofibrate 4.8.1fenofibric acid 4.8.1FENOGLIDE 4.8.1fentanyl 5.1.1.1FENTORA 5.1.1.1fexofenadine hcl 15.2.1FIBRICOR 4.8.1FINACEA 6.3finasteride 16.1.4flecainide acetate 4.7.1.3FLECTOR 6.9.5FLOMAX 16.1.4FLOVENT DISKUS 15.1.3FLOVENT HFA 15.1.3fluconazole 2.3fludrocortisone acetate 8.3.2flunisolide 7.2fluocinolone acetonide 6.1fluocinonide 6.1fluorometholone 14.2FLUOROPLEX 6.9.2fluorouracil 6.9.2fluoxetine hcl 5.5.1.3fluphenazine hcl 5.8flurazepam hcl 5.2.2flurbiprofen 11.1.2fluticasone propionate 6.1fluticasone propionate 7.2fluvastatin sodium 4.8.2fluvoxamine maleate 5.5.1.3FML FORTE 14.2FOCALIN XR 5.9.1folic acid 12.1.3FOLLISTIM AQ 13.2fondaparinux sodium 12.3.2FORA LANCETS 18.1FORA LANCING DEVICE 18.1FORA TEST STRIP 18.1FORA V30A 18.1FORADIL 15.1.1FORTAMET 8.1.2FORTEO 8.6FORTESTA 13.3FOSAMAX PLUS D 8.6fosinopril sodium 4.5.4.1fosinoprilhydrochlorothiazide4.5.6FOSRENOL 12.7FRAGMIN 12.3.2FREESTYLE FREEDOM LITE 18.1FREESTYLE INSULINX 18.1FREESTYLE INSULINX TEST 18.1STRIPSFREESTYLE LITE METER 18.1FREESTYLE LITE STRIPS 18.1FREESTYLE TEST STRIPS 18.1FROVA 5.1.2furosemide 4.3.1gabapentin 5.4.7galantamine hbr 5.9.3GANIRELIX ACETATE 13.1.2GELNIQUE 16.1.1gemfibrozil 4.8.1GENERESS FE 13.7GENOTROPIN 10.2.4gentamicin sulfate 2.2gentamicin sulfate 14.1.1gentamicin sulfate 2.8.2GEODON 5.8gildess fe 13.7GLEEVEC 3glimepiride 8.1.2glipizide/er 8.1.2glipizide‐metformin 8.1.2GLUCAGEN 8.2GLUCAGON EMERGENCY 8.2KITGLUCOSE TEST STRIP 18.1glyburide 8.1.2glyburide micronized 8.1.2glyburide‐metformin hcl 8.1.2GOLYTELY 9.6GONAL‐F/RFF 13.2GRALISE 5.4.7granisetron hcl 5.6GRIFULVIN V 2.3griseofulvin 2.3guaifenesin/codiene 15.3guaifenesin‐codeine 15.3guanfacine hcl 4.5.2GUARDIAN RT STARTER KIT 18.1HALFLYTELY‐BISACODYL 9.6halobetasol propionate 6.1HALOG 6.1haloperidol 5.8

HECTOROL 12.1.3HELIDAC 9.4.3heparin sodium 12.3.2HORIZANT 5.4.7HUMALOG products 8.1.1HUMATROPE 10.2.4HUMIRA 3HUMULIN products 8.1.1hydrochlorothiazide 4.3.2hydrocodone bit‐ibuprofen 5.1.1.2hydrocodoneacetaminophen5.1.1.2hydrocortisone 6.1hydrocortisone 9.6hydrocortisone 8.3.1hydrocortisone acetate 9.6hydrocortisone butyrate 6.1hydrocortisone valerate 6.1hydromorphone hcl 5.1.1.1hydroxychloroquine sulfate 2.7.3hydroxyurea 3hydroxyzine 6.2hyoscyamine sulfate 9.3HYZAAR 4.5.4.2ibandronate sodium 8.6ibuprofen 11.1.2imipramine hcl 5.5.1.1imiquimod 6.9.2IMITREX 5.1.2INCIVEK 2.5.1indapamide 4.3.2indomethacin 11.1.2INTELENCE 2.5.1INTERMEZZO 5.2.2INTUNIV 5.9.6INVEGA 5.8ipratropium bromide 7.2ipratropium bromide 15.1.3ipratropium‐albuterol 15.1.3irbesartan 4.5.4.2irbesartanhydrochlorothiazide4.5.6ISENTRESS 2.5.1isoniazid 2.7.2isosorbide 4.6.1isosorbide dinitrate 4.6.1isotretinoin 6.3.1ISTALOL 14.5itraconazole 2.3JALYN 16.1.4JANUMET/XR 8.1.5.2JANUVIA 8.1.5.2JENTADUETO 8.1.5.2jinteli 13.4.1jolessa 13.7jolivette 13.5junel 13.7junel fe 13.7JUVISYNC 8.1.5.2KADIAN 5.1.1.1KALETRA 2.5.1KAPVAY 5.9.6kariva 13.7kelnor 1‐35 13.7KENALOG 6.1KEPPRA 5.4.7KEPPRA XR 5.4.7ketoconazole 2.3ketoconazole 2.4.2ketoprofen 11.1.2ketorolac tromethamine 11.1.2ketotifen fumarate 14.6KINERET 10.2.6KOMBIGLYZE XR 8.1.5.2labetalol hcl 4.4lactulose 12.7LAMICTAL 5.4.7LAMICTAL ODT 5.4.7LAMICTAL XR 5.4.7lamivudine 2.5.1lamivudine‐zidovudine 2.5.1lamotrigine 5.4.7LANOXIN 4.1lansoprazole 9.4.2LANTUS/SOLOSTAR 8.1.1LASTACAFT 14.6latanoprost 14.5LATUDA 5.8LAZANDA 5.1.1.1leena 13.7leflunomide 3LESCOL 4.8.2LESCOL XL 4.8.2lessina 13.7LETAIRIS 4.6.3letrozole 3leucovorin calcium inj 3leucovorin calcium tab, pwd 3leuprolide acetate 13.1.2LEVAQUIN 2.1.9LEVEMIR/FLEXPEN 8.1.1levetiracetam 5.4.7LEVITRA 16.1.4levobunolol hcl 14.5levocarnitine 12.1.3levocetirizine15.2.1dihydrochloridelevofloxacin 2.1.9levora‐28 13.7levothyroxine sodium 8.4.1levoxyl 8.4.1LEXAPRO 5.5.1.3

LEXIVA 2.5.1LIALDA 9.6lidocaine hcl 1.2lidocaine‐prilocaine 1.2LIDODERM 1.2LINZESS 9.7LIPITOR 4.8.2LIPOFEN 4.8.1lisinopril 4.5.4.1lisinoprilhydrochlorothiazide4.5.6lithium carbonate 5.3LIVALO 4.8.2LO LOESTRIN FE 13.7LOCOID 6.1LOCOID LIPOCREAM 6.1LOESTRIN 24 FE 13.7loperamide 9.2loratadine 15.2.1lorazepam 5.2.1loryna 13.7losartan potassium 4.5.4.2losartanhydrochlorothiazide4.5.6LOSEASONIQUE 13.7LOTEMAX 14.2LOTREL 4.5.6lovastatin 4.8.2LOVAZA 4.8.1LOVENOX 12.3.2low‐ogestrel 13.7LUMIGAN 14.5LUNESTA 5.2.2LUNESTA 5.2.2LUPRON DEPOT 13.1.2lutera 13.7LUVOX CR 5.5.1.3LYRICA 5.4.7LYSTEDA 12.5MAKENA 13.5MALARONE 2.7.3MAXAIR AUTOHALER 15.1.1MAXALT/MLT 5.1.2meclizine hcl 5.6medroxyprogesterone 13.5acetatemefloquine hcl 2.7.3MEGACE ES 3megestrol acetate 3meloxicam 11.1.2MENEST 13.4MENOSTAR 13.4mercaptopurine 3METADATE CD 5.9.1metaproterenol sulfate 15.1.1metaxalone 11.3.2metformin hcl 8.1.2metformin hcl er 8.1.2methadone hcl 5.1.1.1methimazole 8.4.2methocarbamol 11.3.2methotrexate inj 3methotrexate tab, pwd 3methyldopa 4.5.2methylphenidate er 5.9.1methylphenidate hcl 5.9.1methylphenidate sr 5.9.1methylprednisolone 8.3.1metoclopramide hcl 9.3metolazone 4.3.2metoprolol succinate 4.4metoprolol tartrate 4.4metoprololhydrochlorothiazide4.5.6METROGEL 6.3metronidazole 6.3metronidazole 13.1.3metronidazole 2.7.5MICARDIS 4.5.4.2MICARDIS HCT 4.5.4.2microgestin 13.7microgestin fe 13.7MIGRANAL 5.1.2MINILINK REAL‐TIME 17.1TRANSMITTERMINIMED 18MINIMED RESERVOIR 18minocycline hcl 2.1.7minoxidil 4.5.1MIRAPEX 5.7.2MIRAPEX ER 5.7.2mirtazapine 5.5.1.4misoprostol 9.4.1modafinil 5.9.1moexipril hcl 4.5.4.1moexiprilhydrochlorothiazide4.5.6mometasone furoate 6.1mononessa 13.7montelukast sodium 15.1.4morphine sulfate/er 5.1.1.1MOVIPREP 9.6MOXEZA 14.1.1MULTAQ 4.7.5mupirocin 2.2MUSE 16.1.4mycophenolate mofetil 3MYFORTIC 3MYRBETRIQ 16.1.4nabumetone 11.1.2nadolol 4.4naltrexone hcl 5.9.2

NAMENDA 5.9.3NAPRELAN 11.1.2naproxen 11.1.2naproxen sodium 11.1.2naratriptan hcl 5.1.2NASACORT AQ 7.2NASCOBAL 12.1.3NASONEX 7.2NATAZIA 13.7nateglinide 8.1.2necon 13.7NEEVO DHA 13.1.1neomycin‐bacitracinpolymyxin14.1.1neomycin‐polymyxindexameth14.3neomycin‐polymyxin‐hc 7.1neomycin‐polymyxin‐hc 14.3neomycin‐polymyxinhydrocort7.1NEULASTA 10.2.1NEUPOGEN 10.2.1NEUPRO 5.7.2NEVANAC 14.6nevirapine 2.5.1NEXIUM 9.4.2NIASPAN 4.8.1nifediac cc 4.2nifedical xl 4.2nifedipine er 4.2nisoldipine 4.2nitrofurantoin 2.1.8nitrofurantoin mono‐macro 2.1.8nitroglycerin 4.6.1nitroglycerin patch 4.6.1NITROSTAT 4.6.1nizatidine 9.4nora‐be 13.5NORDITROPIN FLEXPRO 10.2.4NORDITROPIN NORDIFLEX 10.2.4norethindrone 13.5norethindrone acetate 13.5NOROXIN 2.1.9nortrel 13.7nortriptyline hcl 5.5.1.2NORVIR 2.5.1novarel 13.1.2NOVOFINE 18.1NOVOFINE 32 18.1NOVOFINE AUTOCOVER 18.1NOVOLIN products 8.1.1NOVOLOG products 8.1.1NUCYNTA/ER 5.1.1.1NUEDEXTA 5.9.2NULYTELY WITH FLAVOR 9.6PACKSNUTROPIN/AQ/AQ NUSPIN 10.2.4NUVARING 13.7NUVIGIL 5.9.1nystatin 2.3nystatin 2.4.2nystatin‐triamcinolone 2.4.3ocella 13.7ofloxacin 7.1ofloxacin 14.1.1ofloxacin 2.1.9ogestrel 13.7olanzapine 5.8olanzapine odt 5.8olanzapine‐fluoxetine hcl 5.8.1.1OLUX 6.1OLUX‐E 6.1OMECLAMOX‐PAK 9.4.3omeprazole 9.4.2omeprazole 9.4.2.1omeprazole‐sodium 9.4.2bicarbonateOMNARIS 7.2OMNITROPE 10.2.4ondansetron hcl 5.6ondansetron odt 5.6ONE TOUCH LANCETS 18.1ONE TOUCH TEST STRIPS 18.1ONE TOUCH ULTRA 2 18.1ONE TOUCH ULTRA SMART 18.1ONE TOUCH ULTRA SYSTEM 18.1ONE TOUCH ULTRA TEST 18.1STRIPSONE TOUCH ULTRAMINI 18.1ONE TOUCH VERIO 18.1ONE TOUCH VERIO IQ 18.1ONGLYZA 8.1.5.2ONSOLIS 5.1.1.1OPANA 5.1.1.1OPANA ER 5.1.1.1OPTICHAMBER 18ORACEA 2.1.7ORAVIG 2.3ORENCIA 3orphenadrine citrate 11.3.2ORTHO EVRA 13.7ORTHO TRI‐CYCLEN 13.7ORTHO TRI‐CYCLEN LO 13.7OSMOPREP 9.5OVIDREL 13.1.2oxaprozin 11.1.2oxazepam 5.2.1oxcarbazepine 5.4.1OXISTAT 2.4.2oxybutynin chloride 16.1.1oxybutynin chloride er 16.1.1oxycodone hcl 5.1.1.1

oxycodone‐acetaminophen 5.1.1.1OXYCONTIN 5.1.1.1oxymorphone hcl 5.1.1.1OXYTROL 16.1.1PANCREAZE 9.6pancrelipase 5,000 9.6pantoprazole sodium 9.4.2PARADIGM 18PARADIGM INFUSION 18PARADIGM REAL‐TIME 17.1PARADIGM SILHOUETTE 18paroxetine hcl 5.5.1.3PATADAY 14.6PATANASE 7.2PATANOL 14.6peg 3350‐electrolyte 9.6PEGASYS/PROCLICK 10.2.3PEGINTRON/REDIPEN 10.2.3penicillin v potassium 2.1.5PENNSAID 6.9.5PENTASA 9.6pentoxifylline 4.9PERFOROMIST 15.1.1permethrin 6.9.3perphenazine 5.8PERTZYE 9.6phenazopyridine hcl 16.1.3phenobarbital 5.4.6phentermine hcl 17.3.1PHENYTEK 5.4.3phenytoin sodium extended 5.4.3PHOSLYRA 12.1.3PICATO 6.9.2pilocarpine hcl 7.3pilocarpine hcl 14.5pindolol 4.4piroxicam 11.1.2PLAVIX 12.4POLYFIN 18POLYFIN QR 18polymyxin b sultrimethoprim14.1.1portia 13.7potassium chloride 12.2potassium citrate 16.1.4POTIGA 5.4.7PRADAXA 12.3.5pramipexole5.7.2dihydrochloridePRAMOSONE 6.1PRAMOSONE E 6.1PRANDIMET 8.1.2PRANDIN 8.1.2pravastatin sodium 4.8.2prazosin hcl 4.5.1PRECISION 18.1PRECISION XTRA 17.1PRECISION XTRA 18.1prednisolone 8.3.1prednisolone acetate 14.2prednisolone sodium 8.3.1phosphateprednisone 8.3.1PREFERA OB 13.1.1PREFERA‐OB ONE 13.1.1PREFERA‐OB PLUS DHA 13.1.1PREFEST 13.4.1PREMARIN 13.4PREMPHASE 13.4.1PREMPRO 13.4.1PRENATE DHA 13.1.1PRENATE ELITE 13.1.1PRENATE ESSENTIAL 13.1.1PREPOPIK 9.6PREVACID 9.4.2previfem 13.7PREVPAC 9.4.3PREZISTA 2.5.1PRIMABELLA 18primidone 5.4.6PRISTIQ ER 5.5.1.4PROAIR HFA 15.1.1probenecid 11.2prochlorperazine maleate 5.6PROCRIT 10.2.2proctosol‐hc 9.6proctozone‐hc 9.6PRODIGY 18.1PRODIGY INSULIN SYRINGE 18.1PRODIGY NO CODING 18.1PRODIGY PEN NEEDLE 18.1PRODIGY POCKET 18.1PRODIGY VOICE 18.1progesterone in oil 13.5PROGRAF cap, susp 3PROGRAF inj 3promethazine hcl 5.6promethazine hcl 15.2.1promethazine vc 15.2.3promethazine vc‐codeine 15.3promethazine‐codeine 15.3promethazine‐dm 15.3promethegan 5.6PROMETRIUM 13.5PROMISEB 6.9.2propafenone hcl 4.7.1.3propranolol hcl 4.4propylthiouracil 8.4.2PROTONIX 9.4.2PROTOPIC 6.9.2PROVENTIL HFA 15.1.1PROVIGIL 5.9.1

PULMICORT 15.1.3PULMICORT FLEXHALER 15.1.3PULMOZYME 15.4PYLERA 9.4.3pyridostigmine bromide 5.9.2QNASL 7.2QSYMIA 17.3.1QUALAQUIN 2.7.3quasense 13.7quetiapine fumarate 5.8QUICK RELEASE SOFT 18TEFLONquinapril hcl 4.5.4.1quinaprilhydrochlorothiazide4.5.6QVAR 15.1.3ramipril 4.5.4.1RANEXA 4.9ranitidine hcl 9.4RAPAFLO 16.1.4RAPAMUNE 3RAYOS 8.3.1REBIF 10.2.3reclipsen 13.7RELENZA 2.5.2RELISTOR 9.6RELPAX 5.1.2RENAGEL 12.7RENVELA 12.7reprexain 5.1.1.2REQUIP XL 5.7.2RESTASIS 14.6RETIN‐A MICRO 6.3RETIN‐A MICRO PUMP 6.3REVATIO 4.6.2REVLIMID 3REYATAZ 2.5.1REZIRA 15.3RHINOCORT AQUA 7.2ribapak 2.5.2ribavirin 2.5.2rifampin 2.7.2RIOMET 8.1.2RISPERDAL CONSTA 5.8risperidone 5.8RITALIN LA 5.9.1rivastigmine 5.9.3ropinirole hcl 5.7.2roxicet 5.1.1.1ROZEREM 5.2.2RYTHMOL SR 4.7.1.3SAFYRAL 13.7SAIZEN 10.2.4salsalate 11.1.1SANCTURA XR 16.1.1SANCUSO 5.6SANDOSTATIN LAR 3SANTYL 6.9.2SAPHRIS 5.8SAVELLA 5.5.1.4SEASONIQUE 13.7selenium sulfide 6.8SENSIPAR 8.6SEREVENT DISKUS 15.1.1SEROQUEL 5.8SEROQUEL XR 5.8sertraline hcl 5.5.1.3SFROWASA 9.6SILENOR 5.2.2SILHOUETTE 18silver sulfadiazine 2.2SIMCOR 4.8.2.1SIMPONI 3simvastatin 4.8.2SINGULAIR 15.1.4SKELAXIN 11.3.2sodium fluoride 12.1.4sodium sulfacetamidesulfur6.3SOF‐SENSOR 17.1SOF‐SET 18SOF‐SET MICRO 18SOFT TOUCH 18.1SOFTCLIX 18.1SOLARAZE 6.9.2solia 13.7SOLODYN 2.1.7SOMA 11.3.2SOMATULINE DEPOT 3SORILUX 6.8sotalol 4.7.5SPIRIVA 15.1.3spironolactone 4.3.3spironolactone‐hctz 4.3.3sprintec 13.7sronyx 13.7STALEVO 100 5.7.2STAXYN 16.1.4STELARA 3STRATTERA 5.9.6STRIANT 13.3SUBOXONE 5.1.1.2SUBSYS 5.1.1.1sucralfate 9.4.1SULAR 4.2sulfacetamide sodium 6.8sulfacetamide sodium 14.1.1sulfamethoxazoletrimethoprim2.1.6sulfasalazine 9.6sulindac 11.1.2sumatriptan 5.1.2

SUMAVEL DOSEPRO 5.1.2SUPRAX 2.1.1SUPREP 9.6SURESTEP 18.1SURE‐T 18SUSTIVA 2.5.1syeda 13.7SYMBICORT 15.1.3SYMBYAX 5.8.1.1SYMBYAX 5.8.1.1SYMLINPEN 8.1.4SYNAGIS 10SYNTHROID 8.4.1TACLONEX 6.8tacrolimus 3TAMIFLU 2.5.2tamoxifen citrate 3tamsulosin hcl 16.1.4TARKA 4.5.6TAZORAC 6.8TEGRETOL XR 5.4.1TEGRETOL XR 5.4.1TEKAMLO 4.5.6TEKTURNA 4.5.6TEKTURNA HCT 4.5.6temazepam 5.2.2terazosin hcl 4.5.1terbinafine hcl 2.3terconazole 2.4.1TESTIM 13.3testosterone cypionate 13.3tetracycline hcl 2.1.7TEVETEN 4.5.4.2TEVETEN HCT 4.5.4.2TEV‐TROPIN 10.2.4THALOMID 17.2theophylline 15.1.2theophylline anhydrous 15.1.2thioridazine hcl 5.8thiothixene 5.8TIKOSYN 4.7.5tilia fe 13.7timolol maleate 4.4timolol maleate 14.5TIMOPTIC OCUDOSE 14.5tinidazole 2.7.5tizanidine hcl 11.3.1TOBI 2.8.2TOBRADEX 14.3TOBRADEX ST 14.3tobramycin sulfate 2.8.2tobramycin‐dexamethasone 14.3tolterodine tartrate 16.1.1TOPAMAX 5.4.7topiramate 5.4.7TOPROL XL 4.4torsemide 4.3.1TOVIAZ 16.1.1TRACLEER 4.6.3TRADJENTA 8.1.5.2tramadol hcl/er 5.1.1tramadol hclacetaminophen5.1.1trandolapril 4.5.4.1TRANSDERM‐SCOP 5.6tranylcypromine sulfate 5.5.2TRAVATAN Z 14.5trazodone hcl 5.5.1.4tretinoin 3tretinoin 6.3tretinoin 6.9.2TREXIMET 5.1.2triamcinolone acetonide 6.1triamcinolone acetonide 7.2triamcinolone acetonide 7.3triamterene‐hctz 4.3.3triamterenehydrochlorothiazid4.3.3triazolam 5.2.2TRIBENZOR 4.5.6TRICOR 4.8.1trifluoperazine hcl 5.8trifluridine 14.1.2TRIGLIDE 4.8.1trihexyphenidyl hcl 5.7.1tri‐legest fe 13.7TRILIPIX 4.8.1trilyte with flavor packets 9.6trimethoprim 2.1.8trinessa 13.7tri‐previfem 13.7tri‐sprintec 13.7trivora‐28 13.7TRUE2GO BLOOD GLUCOSE 18.1SYSTEMTRUERESULT BLOOD 18.1GLUCOSE SYSTMTRUETEST TEST STRIPS 18.1TRUETRACK SMART SYSTEM 18.1TRUETRACK TEST STRIP 18.1TRUVADA 2.5.1TUDORZA PRESSAIR 15.1.3TUSSICAPS 15.3TUSSIONEX 15.3TWYNSTA 4.5.6TYKERB 3ULESFIA 6.9.3ULORIC 11.2ULTRAVATE PAC 6.1ursodiol 9.6VAGIFEM 13.4valacyclovir 2.5.2

VALPROIC ACID 5.4.4VALTREX 2.5.2VANCOCIN HCL 2.8vancomycin hcl 2.8vandazole 13.1.3VECTICAL 6.8velivet 13.7VELTIN 6.3venlafaxine hcl 5.5.1.4venlafaxine hcl er 5.5.1.4VENLAFAXINE HCL ER 5.5.1.4VENTOLIN HFA 15.1.1VERAMYST 7.2verapamil 4.2verapamil er pm 4.2VEREGEN 6.9.2veripred 20 8.3.1VESICARE 16.1.1VEXOL 14.2VGO 20 18.1VGO 30 18.1VGO 40 18.1VIAGRA 16.1.4VICTOZA 8.1.5.1VICTRELIS 2.5.1VIGAMOX 14.1.1VIIBRYD 5.5.1.3VIMOVO 11.1.2VIMPAT 5.4.7VIRAMUNE 2.5.1VIRAMUNE XR 2.5.1VIREAD 2.5.1vitamin d 12.1.3VIVELLE‐DOT 13.4VOLTAREN 6.9.5voriconazole 2.3VYTORIN 4.8.2.1VYTORIN 4.8.2.1VYVANSE 5.9.1warfarin sodium 12.3.1WELCHOL 4.8.1WELLBUTRIN XL 5.5.1.4XALATAN 14.5XARELTO 12.3.3XELODA 3XERESE 2.6XIFAXAN 2.8XOLAIR 10.2.7XOPENEX 15.1.1XOPENEX CONCENTRATE 15.1.1XOPENEX HFA 15.1.1XYZAL 15.2.1YASMIN 28 13.7YAZ 13.7zafirlukast 15.1.4zaleplon 5.2.2zamicet 5.1.1.2zarah 13.7ZEGERID 9.4.2ZEMPLAR 12.1.3zenchent 13.7ZENPEP 9.6ZETIA 4.8.1ZETONNA 7.2ZIAGEN 2.5.1ZIANA 6.3ZIOPTAN 14.5ziprasidone hcl 5.8zolpidem tartrate/er 5.2.2ZOLPIMIST 5.2.2ZOMIG/ZMT 5.1.2zonisamide 5.4.7ZOSTAVAX 10zovia 1‐35e 13.7zovia 1‐50e 13.7ZOVIRAX 2.6ZUPLENZ 5.6ZUTRIPRO 15.3ZYCLARA 6.9.2ZYLET 14.3ZYMAXID 14.1.1ZYPREXA 5.8ZYPREXA ZYDIS 5.8ZYRTEC 15.2.1ZYRTEC‐D 15.2.3ZYVOX 2.8