L.A. Care Covered Drug Formulary (pdf)
L.A. Care Covered Drug Formulary (pdf)
L.A. Care Covered Drug Formulary (pdf)
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Commercial <strong>Formulary</strong>T1 etodolacT1 fenoprofen calciumT2 fenoprofen calciumT1 flurbiprofenT1 flurbiprofenT1 ibuprofenT2 indomethacinT1 indomethacinT1 indomethacinT1 ketoprofenT1 ketorolactromethamineT1 ketorolactromethamineT3 ketorolactromethamineT3 ketorolactromethamineT1 meclofenamatesodiumT1 mefenamic acidT3 mefenamic acidT1 meloxicamT1 nabumetoneT1 naproxenT1 naproxenT1 naproxenT1 naproxen sodiumT1 naproxen sodiumT3 naproxen sodiumT3 naproxen sodiumT1 oxaprozinT1 phenylbutazoneT1 piroxicamT1 piroxicamT1 sulindacT1 sulindacT1 tolmetin sodiumUnknownT3 ibuprofen/irr cnt-irritcmb #2T3 meloxicam/irr cntr-irrcmb #2T3 naproxen/irr cntr-irritcmb #2LOCAL ANESTHESIALocal AnestheticsT3 b-caine/zinccl/pine/cpyrdT3 benzocaine/tanac/menth/cpyrdT1 lidocaine hclETODOLACFENOPROFENCALCIUMNALFONANSAIDFLURBIPROFENIBUPROFENINDOCININDOCIN SRINDOMETHACINKETOPROFENKETOROLACTROMETHAMINETORADOL(CARTRIDGE)(15 MG/ML)TORADOL(CARTRIDGE)(15 MG/ML)TORADOL(CARTRIDGE)(30 MG/ML)MECLOFENAMATESODIUMPONSTEL(CAP)(250MG)PONSTEL(CAP)(250MG)MOBICNABUMETONEEC-NAPROSYNNAPROSYNNAPROXENANAPROXANAPROX DSNAPRELANNAPRELAN CR DOSECARDDAYPROPHENYLBUTAZONEFELDENEPIROXICAMCLINORILSULINDACTOLMETIN SODIUMCOMFORT PAC-IBUPROFENCOMFORT PAC-MELOXICAMCOMFORT PAC-NAPROXENBUCALSEPORASEPLIDOCAINE HCLVISCOUSLOWER GASTROINTESTINALDISORDERS - BOWEL INFLAMMATBowel Antiinflamatory AgentsT1 sulfadiazineT1 sulfasalazineSULFADIAZINESULFASALAZINEChronic Inflam. Colon Dx, 5-a-salicylat,rectalTxT2 mesalamineT1 mesalaminew/cleansing wipesCANASAROWASAaminosalicylatT1 balsalazide disodium COLAZALT3 balsalazide disodium GIAZO STT2 mesalamine APRISOT2 mesalamine ASACOLT3 mesalamine ASACOL HD STT3 mesalamine DELZICOL STT3 mesalamine LIALDA STT3 mesalamine PENTASA STT3 olsalazine sodium DIPENTUM ST<strong>Drug</strong>s To Tx Chronic Inflamm. Disease OfColonT4 certolizumab pegol CIMZIA PAHemorrhoidal Prep, Anti-infam Steroid/localAnesth<strong>Drug</strong> Tx-chronic Inflam. Colon Dx,5-T3 hydrocort/pramoxin/eANALPRAM Emol/pram#1T1 hydrocort/pramoxin/eHYDROCORTISONE-mol/pram#1 PRAMOXINET3 hydrocort/pramoxn/skn PRAM-HCAclnsr#16T1 hydrocort/pramoxn/s ZYPRAMkn clnsr#16T3 hydrocortisone ANAMANTLE HCac/lidocaineT1 hydrocortisone ANAMANTLE HCac/lidocaine FORTET1 hydrocortisone LIDOCAINEac/lidocaineHYDROCORTISONET3 hydrocortisone PERANEX HCac/lidocaineT1 hydrocortisone/lidoc LIDOCAINEaine/aloeHYDROCORTISONET1 hydrocortisone/lidoc PERANEX HCaine/aloeT1 hydrocortisone/lidoc RECTAGEL HCaine/aloeT2 hydrocortisone/pramox ANALPRAM HCinePage 43 of 91
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