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

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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
Page 4: TABLE OF CONTENTSChapterChapter 1Ch
Page 8 and 9: DRUG NAME1 2 3 4 SUGGESTED PREFFERE
Page 10 and 11: DRUG NAMETIER1 2 3 4SUGGESTED PREFF
Page 12 and 13: DRUG NAME1 2 3 4TIKOSYN XTIERSUGGES
Page 14 and 15: DRUG NAME1 2 3 4MIGRANAL XRELPAX ST
Page 16 and 17: DRUG NAMETIER1 2 3 4SUGGESTED PREFF
Page 26 and 27: DRUG NAME1 2 3 4salsalate XTIERSUGG
Page 34 and 35: DRUG NAMETIER1 2 3 415.1.4 LEUKOTRI
Page 36 and 37: DRUG NAME1 2 3 4PARADIGM XPARADIGM
Page 38 and 39: IndexABILIFY 5.8ABILIFY DISCMELT 5.
Page 40 and 41: carbidopa‐levodopaentacapone5.7.2
Page 42 and 43: EVISTA 13.4.3EXALGO 5.1.1.1EXELDERM
Page 44 and 45: LEXIVA 2.5.1LIALDA 9.6lidocaine hcl
Page 46 and 47: oxycodone‐acetaminophen 5.1.1.1OX
Page 48 and 49: SUMAVEL DOSEPRO 5.1.2SUPRAX 2.1.1SU

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

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