Trustmark/Starmark Formulary Drug List April 2008 - Resource ...

Trustmark/Starmark Formulary Drug List 

April 2008 

Introduction 

Trustmark and Starmark are pleased to provide the Trustmark/Starmark Formulary Drug List as 

a useful reference tool to assist you and your provider in selecting clinically appropriate and 

cost-effective drugs. 

The Trustmark/Starmark Formulary Drug List is organized by therapeutic class (e.g., 

cardiovascular) and further divided by subclasses of drugs that work similarly in the body (e.g., 

hypotensives, vasodilators). Unless exceptions are noted, applicable dosage forms and strengths 

of the drugs listed are included in the formulary. 

If you use a PC, you may search for a specific drug by holding down your CTRL and F keys and 

entering the name of the drug. If you use a Mac, hold down your Command and F keys, and 

enter the name of the drug. 

Lowering Out-of-Pocket Costs with the Three-Tiered Format 

To keep your out-of-pocket costs as low as possible, consider the following: generic drugs are 

typically available at the lowest cost, preferred brand-name drugs will generally cost more than 

generics, and nonpreferred brand-name drugs will generally cost the most and may require a 

prior authorization. 

The tiered format places drugs into tiers or levels of cost-sharing as follows: 

Tier 1 (Generic): Lowest copay. This includes generic drugs on the formulary as well as those 

not considered formulary products. 

Tier 2 (Preferred Brand): Intermediate copay; branded products selected for Tier 2. 

Tier 3 (Nonpreferred Brand): Branded products not selected for Tier 2, as well as all 

nonformulary branded products. Drugs in this category may be subject to prior authorization. In 

most cases, there will be reasonable alternatives in Tier 1 or Tier 2 for products found on this 

highest tier. 

Administration and Formulary Information 

WellPoint NextRx administers the pharmacy benefit for Trustmark and Starmark. The 

Trustmark/Starmark Formulary Drug List is reflective of current clinical guidelines as of the date 

of review. 

Your pharmacy benefit may impose restrictions or not reimburse some drugs and/or supplies. 

Over-the-counter (OTC) products, with the possible exception of insulin and diabetes monitoring 

products, are usually not included in the pharmacy benefit and may not be listed in this 

document. This document does not guarantee coverage of any drug or supply; refer to your 

Policy / Certificate of Insurance for specific details relating to inclusions and exclusions under 

your pharmacy benefit. 

The information contained in this formulary is provided purely for informational purposes. 

Trustmark and Starmark do not warrant or ensure accuracy of such information, nor is it intended 

to be comprehensive in nature. This formulary is not intended to be a substitute for the

knowledge, expertise, skill and judgment of your medical provider in his or her choice of 

prescription drugs. The final prescribing choice remains between you and your provider. 

Pharmacy & Therapeutics (P&T) Committee 

The WellPoint NextRx National P&T committee consists of two interdependent subcommittees: 

the Clinical Review Committee (CRC) and the Value Assessment Committee (VAC). These 

committees work together in the decision-making process to ensure a check and a balance to one 

another. They meet quarterly to review, add and delete drugs from the formulary, and to establish 

therapy guidelines and drug utilization policies and practices. 

The CRC consists of clinical pharmacists, practicing physicians, medical directors and quality 

assurance nurses. These professionals access a rigorous review of current clinical guidelines, 

treatment criteria, major medical publications, professional journals and medical specialists. The 

second committee, the VAC, reviews the financial information (i.e., average wholesale price, 

rebates, ingredient cost, cost of care, copays, coinsurance), market factors and customer impact. 

Together, they work to help maintain an outcomes-based formulary, which offers you access to 

cost-effective drugs. 

Notice 

When viewing this formulary via the Internet, please be advised that the formulary is 

updated periodically and changes may appear prior to their effective date to allow for 

notification. 

For More Information 

For the most up-to-date formulary information, or if you have any questions, please call 

WellPoint NextRx Customer Service at 866.841.8951. 

Trustmark Companies 

Health plans administered by Starmark are fully insured by Trustmark Life Insurance Company. 

TMK-SMK/TMK_lob59_tier0108

Brand Name Generic Name Tier Form 

ANALGESICS 

ANALGESICS, NARCOTICS 

SUBUTEX BUPRENORPHINE HCL 3 Tablet, Sublingual 

SUBOXONE BUPRENORPHINE HCL/NALOXONE HCL 3 Tablet, Sublingual 

BUTORPHANOL TARTRATE BUTORPHANOL TARTRATE 1 Aerosol, Spray (ml) 

ACETAMINOPHEN W/CODEINE CODEINE PHOS/ACETAMINOPHEN 2 Elixir 

ACETAMINOPHEN W/CODEINE CODEINE PHOS/ACETAMINOPHEN 1 Tablet 

ASPIRIN W/CODEINE CODEINE PHOS/ASPIRIN 1 Tablet 

CARISOPRODOL COMPOUND/CODEINE CODEINE PHOS/CARISOPRODOL/ASA 1 Tablet 

SOMA COMPOUND W/CODEINE CODEINE PHOS/CARISOPRODOL/ASA 3 Tablet 

CODEINE SULFATE CODEINE SULF 1 Tablet 

CODEINE SULFATE CODEINE SULF 3 Tablet 

PANLOR DC DHCODEINE BT/ACETAMINOPHN/CAFF 3 Capsule (Hard, Soft, etc.) 

TREZIX DHCODEINE BT/ACETAMINOPHN/CAFF 1 Capsule (Hard, Soft, etc.) 

APAP-CAFFEINE-DIHYDROCODEINE DHCODEINE BT/ACETAMINOPHN/CAFF 1 Tablet 

PANLOR SS DHCODEINE BT/ACETAMINOPHN/CAFF 3 Tablet 

ZERLOR DHCODEINE BT/ACETAMINOPHN/CAFF 1 Tablet 

SYNALGOS-DC DIHYDROCODEINE/ASPIRIN/CAFFEIN 3 Capsule (Hard, Soft, etc.) 

DURAGESIC FENTANYL 3 Patch, Transdermal 72 Hr 

FENTANYL FENTANYL 1 Patch, Transdermal 72 Hr 

ACTIQ FENTANYL CITRATE 3 Lozenge on a Handle 

FENTANYL CITRATE FENTANYL CITRATE 1 Lozenge on a Handle 

FENTORA FENTANYL CITRATE 3 Tablet, Effervescent 

DOLOREX FORTE HYDROCODONE BIT/ACETAMINOPHEN 1 Capsule (Hard, Soft, etc.) 

HYDROCET HYDROCODONE BIT/ACETAMINOPHEN 1 Capsule (Hard, Soft, etc.) 

HYDROCODONE W/ACETAMINOPHEN HYDROCODONE BIT/ACETAMINOPHEN 1 Capsule (Hard, Soft, etc.) 

MARGESIC H HYDROCODONE BIT/ACETAMINOPHEN 1 Capsule (Hard, Soft, etc.) 

STAGESIC HYDROCODONE BIT/ACETAMINOPHEN 1 Capsule (Hard, Soft, etc.) 

HYCET HYDROCODONE BIT/ACETAMINOPHEN 3 Solution, Oral 

HYDROCODONE-ACETAMINOPHEN HYDROCODONE BIT/ACETAMINOPHEN 1 Solution, Oral 

LIQUICET HYDROCODONE BIT/ACETAMINOPHEN 3 Solution, Oral 

LORTAB HYDROCODONE BIT/ACETAMINOPHEN 3 Solution, Oral 

CO-GESIC HYDROCODONE BIT/ACETAMINOPHEN 1 Tablet 

HYDROCODONE W/ACETAMINOPHEN HYDROCODONE BIT/ACETAMINOPHEN 1 Tablet 

LORCET 10/650 HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

LORCET PLUS HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

LORTAB HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

MAXIDONE HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

NORCO HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

STAGESIC-10 HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

VICODIN HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

VICODIN ES HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

VICODIN HP HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

XODOL 10/300 HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

XODOL 5-300 HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

XODOL 7.5-300 HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

ZYDONE HYDROCODONE BIT/ACETAMINOPHEN 3 Tablet 

DILAUDID-5 HYDROMORPHONE HCL 3 Liquid (ml) 

HYDROMORPHONE HCL HYDROMORPHONE HCL 1 Liquid (ml) 

DILAUDID HYDROMORPHONE HCL 3 Suppository, Rectal 

HYDROMORPHONE HCL HYDROMORPHONE HCL 1 Suppository, Rectal 

DILAUDID HYDROMORPHONE HCL 3 Tablet 

HYDROMORPHONE HCL HYDROMORPHONE HCL 1 Tablet 

LEVO-DROMORAN LEVORPHANOL TARTRATE 3 Tablet 

LEVORPHANOL TARTRATE LEVORPHANOL TARTRATE 1 Tablet 

MEPERIDINE HCL MEPERIDINE HCL 1 Solution, Oral 

DEMEROL MEPERIDINE HCL 3 Tablet 

MEPERIDINE HCL MEPERIDINE HCL 1 Tablet 

MEPERITAB MEPERIDINE HCL 1 Tablet 

MEPERIDINE W/PROMETHAZINE MEPERIDINE HCL/PROMETH HCL 1 Capsule (Hard, Soft, etc.) 

MEPERIDINE-PROMETHAZINE MEPERIDINE HCL/PROMETH HCL 1 Capsule (Hard, Soft, etc.) 

MEPROZINE MEPERIDINE HCL/PROMETH HCL 1 Capsule (Hard, Soft, etc.) 

METHADONE METHADONE HCL 1 Concentrate, Oral 

METHADONE INTENSOL METHADONE HCL 1 Concentrate, Oral 

METHADOSE METHADONE HCL 3 Concentrate, Oral 

METHADONE HCL METHADONE HCL 3 Solution, Oral 

DOLOPHINE HCL METHADONE HCL 1 Tablet 

DOLOPHINE HCL METHADONE HCL 3 Tablet 

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METHADONE HCL METHADONE HCL 1 Tablet 

METHADONE HCL METHADONE HCL 3 Tablet 

METHADOSE METHADONE HCL 1 Tablet 

METHADONE HCL METHADONE HCL 1 Tablet, Soluble 

METHADONE HCL METHADONE HCL 3 Tablet, Soluble 

METHADOSE METHADONE HCL 1 Tablet, Soluble 

AVINZA MORPHINE SULFATE 3 Capsule, Multiphasic 24 Hr 

KADIAN MORPHINE SULFATE 3 Capsule, Sustained Release Pellets 

MORPHINE SULFATE MORPHINE SULFATE 1 Solution, Oral 

MSIR MORPHINE SULFATE 3 Solution, Oral 

ROXANOL MORPHINE SULFATE 1 Solution, Oral 

MORPHINE SULFATE MORPHINE SULFATE 3 Suppository, Rectal 

MORPHINE SULFATE MORPHINE SULFATE 1 Suppository, Rectal 

MORPHINE SULFATE MORPHINE SULFATE 1 Tablet 

MORPHINE SULFATE MORPHINE SULFATE 3 Tablet 

MORPHINE SULFATE MORPHINE SULFATE 1 Tablet, Sustained Action 

MS CONTIN MORPHINE SULFATE 3 Tablet, Sustained Action 

ORAMORPH SR MORPHINE SULFATE 1 Tablet, Sustained Action 

OPIUM OPIUM 3 Tincture 

B & O SUPPRETTES NO.15-A OPIUM/BELLADONNA ALKALOIDS 3 Suppository, Rectal 

B & O SUPPRETTES NO.16-A OPIUM/BELLADONNA ALKALOIDS 3 Suppository, Rectal 

BELLADONNA & OPIUM OPIUM/BELLADONNA ALKALOIDS 1 Suppository, Rectal 

OXYCODONE HCL OXYCODONE HCL 1 Capsule (Hard, Soft, etc.) 

OXYIR OXYCODONE HCL 2 Capsule (Hard, Soft, etc.) 

ETH-OXYDOSE OXYCODONE HCL 1 Concentrate, Oral 

OXYCODONE HCL OXYCODONE HCL 1 Concentrate, Oral 

OXYDOSE OXYCODONE HCL 1 Concentrate, Oral 

ROXICODONE INTENSOL OXYCODONE HCL 2 Concentrate, Oral 

OXYCODONE HCL OXYCODONE HCL 1 Solution, Oral 

ROXICODONE OXYCODONE HCL 2 Solution, Oral 

OXYCODONE HCL OXYCODONE HCL 1 Tablet 

PERCOLONE OXYCODONE HCL 2 Tablet 

ROXICODONE OXYCODONE HCL 2 Tablet 

OXYCODONE HCL OXYCODONE HCL 1 Tablet, Sustained Release 12 Hr 

OXYCONTIN OXYCODONE HCL 2 Tablet, Sustained Release 12 Hr 

OXYCODONE W/ACETAMINOPHEN OXYCODONE HCL/ACETAMINOPHEN 1 Capsule (Hard, Soft, etc.) 

TYLOX OXYCODONE HCL/ACETAMINOPHEN 3 Capsule (Hard, Soft, etc.) 

ROXICET OXYCODONE HCL/ACETAMINOPHEN 3 Solution, Oral 

ALCET OXYCODONE HCL/ACETAMINOPHEN 3 Tablet 

ENDOCET OXYCODONE HCL/ACETAMINOPHEN 1 Tablet 

LYNOX OXYCODONE HCL/ACETAMINOPHEN 3 Tablet 

MAGNACET OXYCODONE HCL/ACETAMINOPHEN 3 Tablet 

NARVOX OXYCODONE HCL/ACETAMINOPHEN 1 Tablet 

OXYCODONE HCL-ACETAMINOPHEN OXYCODONE HCL/ACETAMINOPHEN 1 Tablet 

PERCOCET OXYCODONE HCL/ACETAMINOPHEN 3 Tablet 

PERLOXX OXYCODONE HCL/ACETAMINOPHEN 1 Tablet 

ROXICET OXYCODONE HCL/ACETAMINOPHEN 1 Tablet 

ROXICET OXYCODONE HCL/ACETAMINOPHEN 3 Tablet 

ENDODAN OXYCODONE HCL/ASPIRIN 1 Tablet 

PERCODAN OXYCODONE HCL/ASPIRIN 3 Tablet 

OXYCODONE-ASPIRIN OXYCODONE/ASPIRIN 1 Tablet 

NUMORPHAN OXYMORPHONE HCL 3 Suppository, Rectal 

OPANA OXYMORPHONE HCL 3 Tablet 

OPANA ER OXYMORPHONE HCL 3 Tablet, Sustained Release 12 Hr 

PENTAZOCINE/ACETAMINOPHEN PENTAZOCINE HCL/ACETAMINOPHEN 1 Tablet 

TALACEN PENTAZOCINE HCL/ACETAMINOPHEN 3 Tablet 

PENTAZOCINE AND NALOXONE HCL PENTAZOCINE HCL/NALOXONE HCL 1 Tablet 

PENTAZOCINE/NALOXONE PENTAZOCINE HCL/NALOXONE HCL 1 Tablet 

TALWIN NX PENTAZOCINE HCL/NALOXONE HCL 3 Tablet 

DARVON PROPOXYPHENE HCL 3 Capsule (Hard, Soft, etc.) 

PROPOXYPHENE HCL PROPOXYPHENE HCL 1 Capsule (Hard, Soft, etc.) 

PROPOXYPHENE HCL-APAP PROPOXYPHENE HCL/ACETAMINOPHEN 1 Tablet 

DARVON-N PROPOXYPHENE NAPSYL 3 Tablet 

BALACET 325 PROPOXYPHENE/ACETAMINOPHEN 1 Tablet 

DARVOCET A500 PROPOXYPHENE/ACETAMINOPHEN 3 Tablet 

DARVOCET-N 100 PROPOXYPHENE/ACETAMINOPHEN 3 Tablet 

DARVOCET-N 50 PROPOXYPHENE/ACETAMINOPHEN 3 Tablet 

PROPOXYPHENE NAPSYLATE W/APAP PROPOXYPHENE/ACETAMINOPHEN 1 Tablet 

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TRAMADOL HCL TRAMADOL HCL 1 Tablet 

ULTRAM TRAMADOL HCL 3 Tablet 

ULTRAM ER TRAMADOL HCL 3 Tablet, Sustained Release 24 Hr 

TRAMADOL HCL-ACETAMINOPHEN TRAMADOL HCL/ACETAMINOPHEN 1 Tablet 

ULTRACET TRAMADOL HCL/ACETAMINOPHEN 3 Tablet 

ANALGESIC/ANTIPYRETICS, SALICYLATES 

LEVACET ASA/SALICYLAM/ACETAMINOPH/CAFF 1 Tablet 

ASPIRIN ASPIRIN 1 Tablet, Delayed Release (Enteric Coated) 

EASPRIN ASPIRIN 3 Tablet, Delayed Release (Enteric Coated) 

ZORPRIN ASPIRIN 3 Tablet, Sustained Action 

EQUAGESIC ASPIRIN/MEPROBAMATE 3 Tablet 

CHOLINE MAG TRISALICYLATE CHOL SAL/MAGNESIUM SALICYLATE 1 Liquid (ml) 

CHOLINE MAG TRISALICYLATE CHOL SAL/MAGNESIUM SALICYLATE 1 Tablet 

TRICOSAL CHOL SAL/MAGNESIUM SALICYLATE 1 Tablet 

DIFLUNISAL DIFLUNISAL 1 Tablet 

MAGAN MAGNESIUM SALICYLATE 3 Tablet 

MST 600 MAGNESIUM SALICYLATE 1 Tablet 

NOVASAL MAGNESIUM SALICYLATE 3 Tablet 

CAFGESIC SAL-AMIDE/ACETAMIN/P-TLOX/CAFF 1 Capsule (Hard, Soft, etc.) 

COMBIFLEX SAL-AMIDE/ACETAMIN/P-TLOX/CAFF 1 Capsule (Hard, Soft, etc.) 

DURABAC SAL-AMIDE/ACETAMIN/P-TLOX/CAFF 3 Capsule (Hard, Soft, etc.) 

ASP SAL-AMIDE/ACETAMINOPHN/P-TLOX 1 Capsule (Hard, Soft, etc.) 

BE-FLEX PLUS SAL-AMIDE/ACETAMINOPHN/P-TLOX 1 Capsule (Hard, Soft, etc.) 

BY-ACHE SAL-AMIDE/ACETAMINOPHN/P-TLOX 1 Capsule (Hard, Soft, etc.) 

DOLOREX SAL-AMIDE/ACETAMINOPHN/P-TLOX 1 Capsule (Hard, Soft, etc.) 

DURAXIN SAL-AMIDE/ACETAMINOPHN/P-TLOX 3 Capsule (Hard, Soft, etc.) 

ED-FLEX SAL-AMIDE/ACETAMINOPHN/P-TLOX 1 Capsule (Hard, Soft, etc.) 

ANABAR SAL-AMIDE/ACETAMINOPHN/P-TLOX 1 Tablet 

DOLOREX SAL-AMIDE/ACETAMINOPHN/P-TLOX 1 Tablet 

FRENADOL SALICYLAMIDE/ACETAMINOPHEN 3 Tablet 

ANALGESIC/ANTIPYRETICS, NON-SALICYLATE 

REPAN-CF ACETAMINOPHEN/BUTALBITAL 1 Tablet 

AMERICET ACETAMINOPHEN/CAFFEINE/BUTALB 1 Tablet 

FLEXTRA PLUS ACETAMINOPHEN/PHENYLTOLOX/CAFF 3 Capsule (Hard, Soft, etc.) 

ANTIMIGRAINE PREPARATIONS 

AXERT ALMOTRIPTAN MALATE 3 Tablet 

MIGRANAL DIHYDROERGOTAMINE MESYLATE 2 Aerosol, Spray w/Pump (ml) 

RELPAX ELETRIPTAN HYDROBROMIDE 3 Tablet 

ERGOMAR ERGOTAMINE TARTRATE 3 Tablet, Sublingual 

MIGERGOT ERGOTAMINE TARTRATE/CAFFEINE 1 Suppository, Rectal 

CAFERGOT ERGOTAMINE TARTRATE/CAFFEINE 1 Tablet 

ERGOTAMINE-CAFFEINE ERGOTAMINE TARTRATE/CAFFEINE 1 Tablet 

FROVA FROVATRIPTAN SUCCINATE 3 Tablet 

APAP/DICHLPHEN/ISOMETHEPTENE ISOMETHEPT/ACETAMINOP/DICHLPHN 1 Capsule (Hard, Soft, etc.) 

ISOMETH-D-CHLORALPHENAZ-APAP ISOMETHEPT/ACETAMINOP/DICHLPHN 1 Capsule (Hard, Soft, etc.) 

MIDRIN ISOMETHEPT/ACETAMINOP/DICHLPHN 2 Capsule (Hard, Soft, etc.) 

MIGRAL ISOMETHEPTENE MUCATE 3 Tablet 

MIGRATEN ISOMETHEPTENE/ACETAMINOPH/CAFF 1 Capsule (Hard, Soft, etc.) 

MIGRALAM ISOMETHEPTENE/APAP/CAFFEIN 3 Capsule (Hard, Soft, etc.) 

EPIDRIN ISOMETHEPTENE/APAP/DICHLPHEN 1 Capsule (Hard, Soft, etc.) 

AMERGE NARATRIPTAN HCL 3 Tablet 

MAXALT RIZATRIPTAN BENZOATE 2 Tablet 

MAXALT MLT RIZATRIPTAN BENZOATE 2 Tablet, Rapid Dissolve 

IMITREX SUMATRIPTAN 2 Spray, Non-Aerosol (EA) 

IMITREX SUMATRIPTAN SUCCINATE 2 Cartridge (EA) 

IMITREX SUMATRIPTAN SUCCINATE 2 Pen Injector Kit (EA) 

IMITREX SUMATRIPTAN SUCCINATE 2 Tablet 

IMITREX SUMATRIPTAN SUCCINATE 2 Vial (SDV, MDV or Additive) (ml) 

ZOMIG ZOLMITRIPTAN 2 Spray, Non-Aerosol (EA) 

ZOMIG ZOLMITRIPTAN 2 Tablet 

ZOMIG ZMT ZOLMITRIPTAN 2 Tablet, Rapid Dissolve 

NSAIDS, CYCLOOXYGENASE INHIBITOR - TYPE 

CATAFLAM DICLOFENAC POTASSIUM 3 Tablet 

DICLOFENAC POTASSIUM DICLOFENAC POTASSIUM 1 Tablet 

KETOROLAC TROMETHAMINE KETOROLAC TROMETHAMINE 1 Tablet 

MEFENAMIC ACID MEFENAMIC ACID 1 Capsule (Hard, Soft, etc.) 

PONSTEL MEFENAMIC ACID 3 Capsule (Hard, Soft, etc.) 

ELMIRON PENTOSAN POLYSULFATE SODIUM 3 Capsule (Hard, Soft, etc.) 

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ANALGESICS, MIXED-1ST GEN ANTIHISTAMINE-XANTHINE 

CAFGESIC FORTE MG SAL/ACETAMINPHN/P-TLOX/CAFF 1 Tablet 

COMBIFLEX ES MG SAL/ACETAMINPHN/P-TLOX/CAFF 1 Tablet 

DURABAC FORTE MG SAL/ACETAMINPHN/P-TLOX/CAFF 3 Tablet 

ANALGESICS, NARCOTIC AGONIST AND NSAID COMBINATION 

HYDROCODONE BIT-IBUPROFEN HYDROCODONE/IBUPROFEN 1 Tablet 

REPREXAIN HYDROCODONE/IBUPROFEN 1 Tablet 

REPREXAIN HYDROCODONE/IBUPROFEN 3 Tablet 

VICOPROFEN HYDROCODONE/IBUPROFEN 3 Tablet 

COMBUNOX IBUPROFEN/OXYCODONE HCL 3 Tablet 

OXYCODONE HCL-IBUPROFEN IBUPROFEN/OXYCODONE HCL 1 Tablet 

ANALGESICS, NARCOTICS/DIETARY SUPPLEMENT COMBINATION 

THERACODOPHEN-325 HYDROCODONE/ACETAM/DIET.SUP.11 3 Combination Package (EA) 

THERACODOPHEN-650 HYDROCODONE/ACETAM/DIET.SUP.11 3 Combination Package (EA) 

THERACODOPHEN-LOW-90 HYDROCODONE/ACETAM/DIET.SUP.11 3 Combination Package (EA) 

THERATRAMADOL-60 TRAMADOL/DIETARY SUPP. NO. 11 3 Combination Package (EA) 

THERATRAMADOL-90 TRAMADOL/DIETARY SUPP. NO. 11 3 Combination Package (EA) 

ANALGESIC, NON-SALICYLATE & BARBITURATE COMBINATION 

PHRENILIN FORTE BUTALBITAL/ACETAMINOPHEN 3 Capsule (Hard, Soft, etc.) 

ACETAMINOPHEN W/BUTALBITAL BUTALBITAL/ACETAMINOPHEN 1 Tablet 

BUPAP BUTALBITAL/ACETAMINOPHEN 1 Tablet 

CEPHADYN BUTALBITAL/ACETAMINOPHEN 1 Tablet 

MARTEN-TAB BUTALBITAL/ACETAMINOPHEN 1 Tablet 

PHRENILIN BUTALBITAL/ACETAMINOPHEN 3 Tablet 

PROMACET BUTALBITAL/ACETAMINOPHEN 1 Tablet 

SEDAPAP BUTALBITAL/ACETAMINOPHEN 1 Tablet 

TENCON BUTALBITAL/ACETAMINOPHEN 1 Tablet 

ANALGESIC, NON-SALICYLATE, BARBITURATE, & XANTHINE COMBINATION 

ANOLOR-300 BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

BUTALBITAL/APAP/CAFFEINE BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

ESGIC BUTALB/ACETAMINOPHEN/CAFFEINE 3 Capsule (Hard, Soft, etc.) 

ESGIC-PLUS BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

GEONE BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

MARGESIC BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

MEDIGESIC BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

TRIAD BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

ZEBUTAL BUTALB/ACETAMINOPHEN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

DOLGIC LQ BUTALB/ACETAMINOPHEN/CAFFEINE 3 Elixir 

BUTALBITAL/APAP/CAFFEINE BUTALB/ACETAMINOPHEN/CAFFEINE 1 Tablet 

DOLGIC PLUS BUTALB/ACETAMINOPHEN/CAFFEINE 3 Tablet 

ESGIC BUTALB/ACETAMINOPHEN/CAFFEINE 3 Tablet 

ESGIC-PLUS BUTALB/ACETAMINOPHEN/CAFFEINE 3 Tablet 

FIORICET BUTALB/ACETAMINOPHEN/CAFFEINE 3 Tablet 

REPAN BUTALB/ACETAMINOPHEN/CAFFEINE 1 Tablet 

NARCOTICS & NON-SALICYLATE ANALGESIC, BARBITURATE & XANTHINE COMBINATION 

FIORICET W/CODEINE CODEINE/BUTALBIT/ACETAMIN/CAFF 3 Capsule (Hard, Soft, etc.) 

PHRENILIN W/CAFFEINE & CODEINE CODEINE/BUTALBIT/ACETAMIN/CAFF 1 Capsule (Hard, Soft, etc.) 

BUTALBITAL/CAFF/APAP/CODEINE CODEINE/BUTALBUT/ACETAMIN/CAFF 1 Capsule (Hard, Soft, etc.) 

ANALGESIC, SALICYLATE, BARBITURATE, & XANTHINE COMBINATION 

BUTALBITAL COMPOUND BUTALBITAL/ASPIRIN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

BUTALBITAL-ASPIRIN-CAFFEINE BUTALBITAL/ASPIRIN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

FARBITAL BUTALBITAL/ASPIRIN/CAFFEINE 1 Capsule (Hard, Soft, etc.) 

FIORINAL BUTALBITAL/ASPIRIN/CAFFEINE 3 Capsule (Hard, Soft, etc.) 

BUTALBITAL COMPOUND BUTALBITAL/ASPIRIN/CAFFEINE 1 Tablet 

BUTALBITAL-ASPIRIN-CAFFEINE BUTALBITAL/ASPIRIN/CAFFEINE 1 Tablet 

FARBITAL BUTALBITAL/ASPIRIN/CAFFEINE 1 Tablet 

NARCOTIC & SALICYLATE ANALGESICS, BARBITURATE & XANTHINE 

ASA-BUTALB-CAFFEINE-CODEINE CODEINE/BUTALBITAL/ASA/CAFFEIN 1 Capsule (Hard, Soft, etc.) 

ASCOMP W/CODEINE CODEINE/BUTALBITAL/ASA/CAFFEIN 1 Capsule (Hard, Soft, etc.) 

BUTALBITAL COMPOUND W/CODEINE CODEINE/BUTALBITAL/ASA/CAFFEIN 1 Capsule (Hard, Soft, etc.) 

FIORINAL W/CODEINE #3 CODEINE/BUTALBITAL/ASA/CAFFEIN 3 Capsule (Hard, Soft, etc.) 

NARCOTIC ANALGESIC & NON-SALICYLATE ANALGESIC COMBINATION 

ACETAMINOPHEN W/CODEINE ACETAMINOPHEN WITH CODEINE 1 Elixir 

CAPITAL W-CODEINE ACETAMINOPHEN WITH CODEINE 3 Suspension, Oral (Final Dose Form) 

ACETAMINOPHEN W/CODEINE ACETAMINOPHEN WITH CODEINE 1 Tablet 

TYLENOL W/CODEINE NO.4 ACETAMINOPHEN WITH CODEINE 3 Tablet 

TYLENOL-CODEINE NO.3 ACETAMINOPHEN WITH CODEINE 1 Tablet 

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VOPAC ACETAMINOPHEN WITH CODEINE 3 Tablet 

ANALGESIC AND ANTIHISTAMINE COMBINATION 

ANALGESIC, NON-SALICYLATE – 1ST GENERATION ANTIHISTAMINE 

DOLOGESIC ACETAMINOPHEN/PHENYLTOLX CIT 1 Capsule (Hard, Soft, etc.) 

DOLOREX ACETAMINOPHEN/PHENYLTOLX CIT 1 Capsule (Hard, Soft, etc.) 

DOLOREX ACETAMINOPHEN/PHENYLTOLX CIT 3 Capsule (Hard, Soft, etc.) 

DOLOGESIC ACETAMINOPHEN/PHENYLTOLX CIT 3 Liquid (ml) 

ACUFLEX ACETAMINOPHEN/PHENYLTOLX CIT 3 Tablet 

ALI-FLEX ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

ALPAIN ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

BEFLEX ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

DOLOGEN ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

DOLOGESIC ACETAMINOPHEN/PHENYLTOLX CIT 3 Tablet 

FLEXTRA-650 ACETAMINOPHEN/PHENYLTOLX CIT 3 Tablet 

FLEXTRA-DS ACETAMINOPHEN/PHENYLTOLX CIT 3 Tablet 

HYFLEX-DS ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

NOVAGESIC ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

RELAGESIC ACETAMINOPHEN/PHENYLTOLX CIT 3 Tablet 

RHINOFLEX ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

RHINOFLEX-650 ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

STAFLEX ACETAMINOPHEN/PHENYLTOLX CIT 3 Tablet 

VISTRA 650 ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet 

LAGESIC ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet, Sustained Action 

MYOPHEN ACETAMINOPHEN/PHENYLTOLX CIT 3 Tablet, Sustained Action 

QFLEX ACETAMINOPHEN/PHENYLTOLX CIT 1 Tablet, Sustained Action 

ANESTHETICS 

LOCAL ANESTHETICS 

ORASEP B-CAINE/TAN AC/MENTH/CPYRD 3 Aerosol, Spray (ml) 

ORASEP B-CAINE/TAN AC/MENTH/CPYRD 3 Solution, Non-Oral 

BUCALSEP B-CAINE/ZINC CL/PINE/CPYRD 3 Aerosol, Spray (ml) 

BUCALSEP B-CAINE/ZINC CL/PINE/CPYRD 3 Solution, Non-Oral 

ANESTACON LIDOCAINE HCL 1 Gel (ml) 

LIDOCAINE HCL LIDOCAINE HCL 1 Gel (ml) 

XYLOCAINE LIDOCAINE HCL 3 Gel (ml) 

LIDOCAINE HCL VISCOUS LIDOCAINE HCL 1 Solution, Non-Oral 

LIDOMAR VISCOUS LIDOCAINE HCL 1 Solution, Non-Oral 

XYLOCAINE LIDOCAINE HCL 3 Solution, Non-Oral 

XYLOCAINE VISCOUS LIDOCAINE HCL 1 Solution, Non-Oral 

URINARY TRACT ANESTHETIC/ANALGESIC AGENT (AZO-DYE) 

PHENAZOPYRIDINE PLUS PHENAZOPY HCL/HYOSCY/BUTABARB 1 Tablet 

PYRELLE HB PHENAZOPY HCL/HYOSCY/BUTABARB 1 Tablet 

PYRIDIUM PLUS PHENAZOPY HCL/HYOSCY/BUTABARB 3 Tablet 

PHENAZOPYRIDINE HCL PHENAZOPYRIDINE HCL 1 Tablet 

PYRIDIUM PHENAZOPYRIDINE HCL 2 Tablet 

URODOL PHENAZOPYRIDINE HCL 1 Tablet 

ANTI-OBESTITY DRUGS 

ANOREXIC AGENTS 

BENZPHETAMINE HCL BENZPHETAMINE HCL 1 Tablet 

DIDREX BENZPHETAMINE HCL 3 Tablet 

DIETHYLPROPION HCL DIETHYLPROPION HCL 1 Tablet 

DIETHYLPROPION HCL DIETHYLPROPION HCL 1 Tablet, Sustained Action 

BONTRIL SLOW-RELEASE PHENDIMETRAZINE TARTRATE 1 Capsule, Sustained Action 

PHENDIMETRAZINE TARTRATE PHENDIMETRAZINE TARTRATE 1 Capsule, Sustained Action 

BONTRIL PDM PHENDIMETRAZINE TARTRATE 1 Tablet 

PHENDIMETRAZINE TARTRATE PHENDIMETRAZINE TARTRATE 1 Tablet 

ADIPEX-P PHENTERMINE HCL 3 Capsule (Hard, Soft, etc.) 

PHENTERMINE HCL PHENTERMINE HCL 1 Capsule (Hard, Soft, etc.) 

PHENTERMINE HCL PHENTERMINE HCL 3 Capsule (Hard, Soft, etc.) 

PRO-FAST HS PHENTERMINE HCL 3 Capsule (Hard, Soft, etc.) 

PRO-FAST SR PHENTERMINE HCL 1 Capsule (Hard, Soft, etc.) 

ADIPEX-P PHENTERMINE HCL 3 Tablet 

PHENTERMINE HCL PHENTERMINE HCL 1 Tablet 

PRO-FAST SA PHENTERMINE HCL 3 Tablet 

IONAMIN PHENTERMINE RESIN 3 Capsule, Sustained Action 

MERIDIA SIBUTRAMINE HCL M-HYDRATE 3 Capsule (Hard, Soft, etc.) 

FAT ABSORPTION DECREASING AGENTS 

Page 5


XENICAL ORLISTAT 2 Capsule (Hard, Soft, etc.) 

WEIGHT LOSS PLANNING AIDS WITH A DIETARY SUPPLEMNTANOREXIC AGENTS 

APPTRIM PROGRAM WEIGHT LOSS/CAF/CHOL/AA7/HR125 3 Capsule (Hard, Soft, etc.) 

ANTIDOTES 

NARCOTIC ANTAGONISTS 

DEPADE NALTREXONE HCL 1 Tablet 

NALTREXONE HYDROCHLORIDE NALTREXONE HCL 1 Tablet 

REVIA NALTREXONE HCL 1 Tablet 

REVIA NALTREXONE HCL 3 Tablet 

ANTIARTHRITICS 

HYPERURICEMIA TX – PURINE INHIBITORS 

ALLOPURINOL ALLOPURINOL 1 Tablet 

ZYLOPRIM ALLOPURINOL 3 Tablet 

ANALGESIC/ANTIPYRETICS, SALICYLATES 

SALFLEX SALSALATE 1 Tablet 

SALFLEX SALSALATE 3 Tablet 

SALSALATE SALSALATE 1 Tablet 

URICOSURIC AGENTS 

PROBENECID PROBENECID 1 Tablet 

COLCHICINE 

COLCHICINE COLCHICINE 1 Tablet 

PROBENECID-COLCHICINE COLCHICINE/PROBENECID 1 Tablet 

NSAIDS, CYCLOOXYGENASE INHIBITOR – TYPE 

CELEBREX CELECOXIB 3 Capsule (Hard, Soft, etc.) 

DICLOFENAC SODIUM DICLOFENAC SODIUM 1 Tablet, Delayed Release (Enteric Coated) 

VOLTAREN DICLOFENAC SODIUM 3 Tablet, Delayed Release (Enteric Coated) 

DICLOFENAC SODIUM DICLOFENAC SODIUM 1 Tablet, Sustained Release 24 Hr 

VOLTAREN-XR DICLOFENAC SODIUM 3 Tablet, Sustained Release 24 Hr 

ARTHROTEC 50 DICLOFENAC SODIUM/MISOPROSTOL 3 Tablet, Delayed Release (Enteric Coated) 

ARTHROTEC 75 DICLOFENAC SODIUM/MISOPROSTOL 3 Tablet, Delayed Release (Enteric Coated) 

ETODOLAC ETODOLAC 1 Capsule (Hard, Soft, etc.) 

ETODOLAC ETODOLAC 1 Tablet 

ETODOLAC ETODOLAC 1 Tablet, Sustained Release 24 Hr 

NALFON FENOPROFEN CALCIUM 3 Capsule (Hard, Soft, etc.) 

FENOPROFEN CALCIUM FENOPROFEN CALCIUM 1 Tablet 

ANSAID FLURBIPROFEN 3 Tablet 

FLURBIPROFEN FLURBIPROFEN 1 Tablet 

MOTRIN IBUPROFEN 3 Suspension, Drops(Final Dosage Form)(ml) 

IBUPROFEN IBUPROFEN 1 Suspension, Oral (Final Dose Form) 

IBUPROFEN IBUPROFEN 2 Suspension, Oral (Final Dose Form) 

IBUPROFEN IBUPROFEN 1 Tablet 

IBUPROHM IBUPROFEN 1 Tablet 

MOTRIN IBUPROFEN 3 Tablet 

INDOMETHACIN INDOMETHACIN 1 Capsule (Hard, Soft, etc.) 

INDOCIN SR INDOMETHACIN 3 Capsule, Sustained Action 

INDOMETHACIN INDOMETHACIN 1 Capsule, Sustained Action 

INDOCIN INDOMETHACIN 1 Suppository, Rectal 

INDOMETHACIN INDOMETHACIN 1 Suppository, Rectal 

INDOCIN INDOMETHACIN 3 Suspension, Oral (Final Dose Form) 

KETOPROFEN KETOPROFEN 1 Capsule (Hard, Soft, etc.) 

KETOPROFEN KETOPROFEN 1 Capsule, 24Hr Sustained Release Pellets 

MECLOFENAMATE SODIUM MECLOFENAMATE SODIUM 1 Capsule (Hard, Soft, etc.) 

MELOXICAM MELOXICAM 1 Suspension, Oral (Final Dose Form) 

MOBIC MELOXICAM 3 Suspension, Oral (Final Dose Form) 

MELOXICAM MELOXICAM 1 Tablet 

MOBIC MELOXICAM 3 Tablet 

NABUMETONE NABUMETONE 1 Tablet 

NAPROSYN NAPROXEN 2 Suspension, Oral (Final Dose Form) 

NAPROXEN NAPROXEN 1 Suspension, Oral (Final Dose Form) 

NAPROSYN NAPROXEN 3 Tablet 

NAPROXEN NAPROXEN 1 Tablet 

EC-NAPROSYN NAPROXEN 3 Tablet, Delayed Release (Enteric Coated) 

NAPROXEN NAPROXEN 1 Tablet, Delayed Release (Enteric Coated) 

ANAPROX NAPROXEN SODIUM 3 Tablet 

ANAPROX DS NAPROXEN SODIUM 3 Tablet 

NAPROXEN SODIUM NAPROXEN SODIUM 1 Tablet 

Page 6


NAPRELAN NAPROXEN SODIUM 3 Tablet, Sustained Action 

NAPRELAN NAPROXEN SODIUM 3 Tablet, Sustained Action 

NAPROXEN SODIUM NAPROXEN SODIUM 1 Tablet, Sustained Action 

DAYPRO OXAPROZIN 3 Tablet 

OXAPROZIN OXAPROZIN 1 Tablet 

FELDENE PIROXICAM 3 Capsule (Hard, Soft, etc.) 

PIROXICAM PIROXICAM 1 Capsule (Hard, Soft, etc.) 

CLINORIL SULINDAC 3 Tablet 

SULINDAC SULINDAC 1 Tablet 

TOLMETIN SODIUM TOLMETIN SODIUM 1 Capsule (Hard, Soft, etc.) 

TOLMETIN SODIUM TOLMETIN SODIUM 1 Tablet 

TOLMETIN SODIUM TOLMETIN SODIUM 3 Tablet 

GOLD SALTS 

RIDAURA AURANOFIN 2 Capsule (Hard, Soft, etc.) 

ANTI-INFLAMMATORY/ANTIARTHRITICS AGENTS, MISC. 

PRYFLEX GLUCOSAM SU/CHONDROITIN/AO MV5 3 Tablet 

TREPADONE GLUCOSAM/CHONDROITIN/DIET CB13 3 Capsule (Hard, Soft, etc.) 

RELAMINE GLUCOSAM/CHONDROITIN/MV ANTOX5 3 Tablet 

NSAID, COX INHIBITOR-TYPE & PROTON PUMP INHIBITOR COMBINATION 

PREVACID NAPRAPAC LANSOPRAZOLE/NAPROXEN 2 Combination Package (EA) 

ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR INHIBITOR 

HUMIRA ADALIMUMAB 3 Kit 

HUMIRA ADALIMUMAB 3 Pen Injector Kit (EA) 

ENBREL ETANERCEPT 3 Disposable Syringe (ml) 

ENBREL ETANERCEPT 3 Kit 

ENBREL ETANERCEPT 3 Pen Injector (ml) 

ANTI-INFLAMMATORY, PYRIMIDINE SYNTHESIS INHIBITOR 

ARAVA LEFLUNOMIDE 3 Tablet 

LEFLUNOMIDE LEFLUNOMIDE 1 Tablet 

ANTI-ARTHRITIC, FOLATE ANTAGONIST AGENTS 

RHEUMATREX METHOTREXATE SODIUM 2 Tablet, Dose Pack 

ANTI-ARTHRITIC AND CHELATING AGENTS 

CUPRIMINE PENICILLAMINE 2 Capsule (Hard, Soft, etc.) 

DEPEN PENICILLAMINE 3 Tablet 

ANTI-FLAM. INTERLEUKIN-1 RECEPTOR ANTAGONIST 

KINERET ANAKINRA 3 Disposable Syringe (ml) 

ANTINFLAMMATORY, SEL.COSTIM.MOD., T-CELL INHIBITOR 

ORENCIA ABATACEPT/MALTOSE 3 Vial (SDV, MDV or Additive) (EA) 

NSAIDS/DIETARY SUPPLEMENT COMBINATIONS 

THERAPROFEN-60 IBUPROFEN/DIET. SUPP 11 3 Combination Package (EA) 

THERAPROFEN-90 IBUPROFEN/DIET. SUPP 11 3 Combination Package (EA) 

THERAPROXEN NAPROXEN/DIET. SUPP 11 3 Combination Package (EA) 

THERAPROXEN-90 NAPROXEN/DIET. SUPP 11 3 Combination Package (EA) 

THERAFELDAMINE PIROXICAM/DIET. SUPP 11 3 Combination Package (EA) 

XANTHINES 

AMINOPHYLLINE AMINOPHYLLINE 1 Liquid (ml) 

AMINOPHYLLINE AMINOPHYLLINE 1 Tablet 

DYLIX DYPHYLLINE 1 Elixir 

LUFYLLIN DYPHYLLINE 3 Tablet 

LUFYLLIN-400 DYPHYLLINE 3 Tablet 

LUFYLLIN-400 DYPHYLLINE 3 Tablet 

THEO-24 THEOPHYLLINE ANHYDROUS 2 Capsule, Sustained Release 24 Hr 

ELIXOPHYLLIN THEOPHYLLINE ANHYDROUS 2 Elixir 

THEOPHYLLINE THEOPHYLLINE ANHYDROUS 1 Elixir 

THEOPHYLLINE THEOPHYLLINE ANHYDROUS 2 Solution, Oral 

THEOPHYLLINE THEOPHYLLINE ANHYDROUS 1 Tablet, Sustained Action 

UNIPHYL THEOPHYLLINE ANHYDROUS 2 Tablet, Sustained Action 

THEOCHRON THEOPHYLLINE ANHYDROUS 1 Tablet, Sustained Release 12 Hr 

THEOCHRON THEOPHYLLINE ANHYDROUS 2 Tablet, Sustained Release 12 Hr 

THEOPHYLLINE ANHYDROUS THEOPHYLLINE ANHYDROUS 1 Tablet, Sustained Release 12 Hr 

GENERAL BRONCHODILATOR AGENTS 

BRONCOMAR-1 GUAIFEN/THEOP ANHYD/P-EPHED 3 Elixir 

DYPHYLLINE GG GUAIFENESIN/DYPHYLLINE 1 Elixir 

LUFYLLIN-GG GUAIFENESIN/DYPHYLLINE 3 Elixir 

DIFIL-G FORTE GUAIFENESIN/DYPHYLLINE 1 Liquid (ml) 

DILEX-G GUAIFENESIN/DYPHYLLINE 1 Liquid (ml) 

Page 7


DY-G LIQUID GUAIFENESIN/DYPHYLLINE 1 Liquid (ml) 

DILEX-G 200 GUAIFENESIN/DYPHYLLINE 3 Syrup 

JAY-PHYL GUAIFENESIN/DYPHYLLINE 1 Syrup 

PANFIL G GUAIFENESIN/DYPHYLLINE 1 Syrup 

COPD GUAIFENESIN/DYPHYLLINE 1 Tablet 

DIFIL-G GUAIFENESIN/DYPHYLLINE 3 Tablet 

DILEX-G GUAIFENESIN/DYPHYLLINE 1 Tablet 

DILEX-G 400 GUAIFENESIN/DYPHYLLINE 3 Tablet 

DYFLEX-G GUAIFENESIN/DYPHYLLINE 1 Tablet 

DYPHYLLINE GG GUAIFENESIN/DYPHYLLINE 1 Tablet 

QUIBRON GUAIFENESIN/THEOPHYLLINE 3 Capsule (Hard, Soft, etc.) 

BRONCOMAR GG GUAIFENESIN/THEOPHYLLINE 3 Elixir 

ED-BRON G GUAIFENESIN/THEOPHYLLINE 1 Liquid (ml) 

MYCI BRON-G GUAIFENESIN/THEOPHYLLINE 3 Liquid (ml) 

THEOMAR GG GUAIFENESIN/THEOPHYLLINE 3 Liquid (ml) 

ATROVENT HFA IPRATROPIUM BROMIDE 2 Aerosol w/Adapter (gm) 

IPRATROPIUM BROMIDE IPRATROPIUM BROMIDE 1 Solution, Non-Oral 

SPIRIVA TIOTROPIUM BROMIDE 2 Capsule, with Inhalation Device 

ADRENERGIC AGENTS,CATECHOLAMINES 

ISOETHARINE HCL ISOETHARINE HCL 3 Solution, Non-Oral 

BETA-ADRENERGIC AGENTS 

ALBUTEROL ALBUTEROL 1 Aerosol (gm) 

PROVENTIL ALBUTEROL 3 Aerosol (gm) 

ALBUTEROL ALBUTEROL 1 Aerosol Refill (gm) 

PROVENTIL ALBUTEROL 3 Aerosol REFILL (gm) 

PROAIR HFA ALBUTEROL SULFATE 2 HFA Aerosol with Adapter (gm) 

PROVENTIL HFA ALBUTEROL SULFATE 2 HFA Aerosol with Adapter (gm) 

VENTOLIN HFA ALBUTEROL SULFATE 3 HFA Aerosol with Adapter (gm) 

AIRET ALBUTEROL SULFATE 3 Solution, Non-Oral 

ALBUTEROL SULFATE ALBUTEROL SULFATE 1 Solution, Non-Oral 

ALBUTEROL SULFATE ALBUTEROL SULFATE 1 Syrup 

ALBUTEROL SULFATE ALBUTEROL SULFATE 1 Tablet 

ALBUTEROL SULFATE ALBUTEROL SULFATE 1 Tablet, Sustained Release 12 Hr 

VOSPIRE ER ALBUTEROL SULFATE 3 Tablet, Sustained Release 12 Hr 

ALBUTEROL SULFATE ALBUTEROL SULFATE 1 Vial, Nebulizer (EA) 

ACCUNEB ALBUTEROL SULFATE 3 Vial, Nebulizer (ml) 

ALBUTEROL SULFATE ALBUTEROL SULFATE 1 Vial, Nebulizer (ml) 

PROVENTIL ALBUTEROL SULFATE 3 Vial, Nebulizer (ml) 

BROVANA ARFORMOTEROL TARTRATE 3 Vial, Nebulizer (ml) 

FORADIL FORMOTEROL FUMARATE 2 Capsule, with Inhalation Device 

PERFOROMIST FORMOTEROL FUMARATE 3 Vial, Nebulizer (ml) 

XOPENEX LEVALBUTEROL HCL 3 Vial, Nebulizer (EA) 

XOPENEX LEVALBUTEROL HCL 3 Vial, Nebulizer (ml) 

XOPENEX HFA LEVALBUTEROL TARTRATE 2 HFA Aerosol with Adapter (gm) 

ALUPENT METAPROTERENOL SULFATE 3 Aerosol w/Adapter (gm) 

METAPROTERENOL SULFATE METAPROTERENOL SULFATE 1 Solution, Non-Oral 

METAPROTERENOL SULFATE METAPROTERENOL SULFATE 1 Syrup 

METAPROTERENOL SULFATE METAPROTERENOL SULFATE 2 Tablet 

MAXAIR AUTOHALER PIRBUTEROL ACETATE 3 Aerosol, Breath Activated 

SEREVENT DISKUS SALMETEROL XINAFOATE 2 Disk, with Inhalation Device 

TERBUTALINE SULFATE TERBUTALINE SULFATE 1 Tablet 

MONOCLONAL ANTIBODIES TO IMMUNOGLOBULIN E(IGE) 

XOLAIR OMALIZUMAB 3 Vial (SDV, MDV or Additive) (EA) 

MAST CELL STABILIZERS 

INTAL CROMOLYN SODIUM 2 Aerosol (gm) 

CROMOLYN SODIUM CROMOLYN SODIUM 1 Ampul for Nebulization (ml) 

INTAL CROMOLYN SODIUM 3 Ampul for Nebulization (ml) 

GASTROCROM CROMOLYN SODIUM 3 Solution, Oral 

TILADE NEDOCROMIL SODIUM 3 Aerosol w/Adapter (gm) 

LEUKOTRIENE RECEPTOR ANTAGONISTS 

SINGULAIR MONTELUKAST SODIUM 3 Granules in Packet (EA) 

SINGULAIR MONTELUKAST SODIUM 3 Tablet 

SINGULAIR MONTELUKAST SODIUM 3 Tablet, Chewable 

ACCOLATE ZAFIRLUKAST 2 Tablet 

BETA-ADRENERGIC AND GLUCOCORTICOID COMBINATIONS 

SYMBICORT BUDESONIDE/FORMOTEROL FUMARATE 3 HFA Aerosol with Adapter (gm) 

ADVAIR HFA FLUTICASONE/SALMETEROL 2 Aerosol w/Adapter (gm) 

Page 8


ADVAIR DISKUS FLUTICASONE/SALMETEROL 2 Disk, with Inhalation Device 

5-LIPOXYGENASE INHIBITORS 

ZYFLO ZILEUTON 3 Tablet 

ZYFLO CR ZILEUTON 3 Tablet, Multiphasic Release 12 Hr 

XANTHINES/DIETARY SUPPLEMENT COMBINATIONS 

PULMOPHYLLINE THEOPHYLL/CAFF/AA13/CINN/HC135 3 Combination Package (EA) 

SENOPHYLLINE THEOPHYLLINE/DIETARY SUP.CMB9 3 Combination Package (EA) 

BETA-ADRENERGIC AND ANTICHOLINERGIC COMBINATIONS 

COMBIVENT IPRATROPIUM/ALBUTEROL SULFATE 2 Aerosol w/Adapter (gm) 

DUONEB IPRATROPIUM/ALBUTEROL SULFATE 2 Ampul for Nebulization (ml) 

IPRATROPIUM-ALBUTEROL IPRATROPIUM/ALBUTEROL SULFATE 1 Ampul for Nebulization (ml) 

ANTIHISTAMINES 

ANTIHISTAMINES – 1ST GENERATION 

LODRANE 24 BROMPHENIRAMINE MALEATE 3 Capsule, Sustained Release 24 Hr 

J-TAN PD BROMPHENIRAMINE MALEATE 3 Drops 

VAZOL BROMPHENIRAMINE MALEATE 3 Liquid (ml) 

BIDHIST BROMPHENIRAMINE MALEATE 1 Tablet, Sustained Release 12 Hr 

BPM BROMPHENIRAMINE MALEATE 1 Tablet, Sustained Release 12 Hr 

LODRANE BROMPHENIRAMINE MALEATE 3 Tablet, Sustained Release 12 Hr 

LOHIST 12HR BROMPHENIRAMINE MALEATE 1 Tablet, Sustained Release 12 Hr 

RESPA-BR BROMPHENIRAMINE MALEATE 1 Tablet, Sustained Release 12 Hr 

BROMPHENIRAMINE TANNATE BROMPHENIRAMINE TANNATE 1 Suspension, Oral (Final Dose Form) 

BROVEX BROMPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

B-VEX BROMPHENIRAMINE TANNATE 1 Suspension, Oral (Final Dose Form) 

CONEX BROMPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

J-TAN BROMPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

LODRANE XR BROMPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

P-TEX BROMPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

TANACOF XR BROMPHENIRAMINE TANNATE 1 Suspension, Oral (Final Dose Form) 

BROMPHENIRAMINE TANNATE BROMPHENIRAMINE TANNATE 1 Tablet, Chewable 

BROVEX CT BROMPHENIRAMINE TANNATE 3 Tablet, Chewable 

ALA-HIST BROMPHENIRAMINE/DIPHENHYDRAM 3 Tablet, Sustained Release 12 Hr 

CARBINOXAMINE MALEATE CARBINOXAMINE MALEATE 1 Liquid (ml) 

PALGIC CARBINOXAMINE MALEATE 1 Liquid (ml) 

CARBINOXAMINE MALEATE CARBINOXAMINE MALEATE 1 Tablet 

PALGIC CARBINOXAMINE MALEATE 3 Tablet 

CPM 12 CHLORPHENIRAMINE MALEATE 1 Capsule, Multiphasic Release 

CHLORPHENIRAMINE MALEATE CHLORPHENIRAMINE MALEATE 1 Capsule, Sustained Action 

ED CHLORPED CHLORPHENIRAMINE TANNATE 1 Drops 

MYCI CHLORPED CHLORPHENIRAMINE TANNATE 3 Drops 

TANAHIST-PD CHLORPHENIRAMINE TANNATE 1 Drops 

CHLORTAN CHLORPHENIRAMINE TANNATE 1 Suspension, Oral (Final Dose Form) 

PEDIAPHYL CHLORPHENIRAMINE TANNATE 1 Suspension, Oral (Final Dose Form) 

PEDIATAN CHLORPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

PEDIOX-S CHLORPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

P-TANN CHLORPHENIRAMINE TANNATE 1 Suspension, Oral (Final Dose Form) 

RICOBID-H CHLORPHENIRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

AHIST CHLORPHENIRAMINE TANNATE 3 Tablet 

ED-CHLOR-TAN CHLORPHENIRAMINE TANNATE 1 Tablet 

MYCI CHLOR-TAN CHLORPHENIRAMINE TANNATE 3 Tablet 

CLEMASTINE FUMARATE CLEMASTINE FUMARATE 1 Syrup 

CLEMASTINE FUMARATE CLEMASTINE FUMARATE 1 Tablet 

CYPROHEPTADINE HCL CYPROHEPTADINE HCL 1 Syrup 

CYPROHEPTADINE HCL CYPROHEPTADINE HCL 1 Tablet 

DEXCHLORPHENIRAMINE MALEATE DEXCHLORPHENIRAMINE MALEATE 3 Syrup 

DEXCHLORPHENIRAMINE MALEATE DEXCHLORPHENIRAMINE MALEATE 1 Tablet, Sustained Action 

DEXCHLORPHENIRAMINE MALEATE DEXCHLORPHENIRAMINE MALEATE 3 Tablet, Sustained Action 

COMPLETE ALLERGY MEDICINE DIPHENHYDRAMINE HCL 1 Capsule (Hard, Soft, etc.) 

DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL 1 Capsule (Hard, Soft, etc.) 

DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL 1 Elixir 

DYTUSS DIPHENHYDRAMINE HCL 1 Syrup 

BEN-TANN DIPHENHYDRAMINE TANNATE 1 Suspension, Oral (Final Dose Form) 

DYTAN DIPHENHYDRAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

DIPHENMAX DIPHENHYDRAMINE TANNATE 1 Tablet, Chewable 

DYTAN DIPHENHYDRAMINE TANNATE 3 Tablet, Chewable 

ALDEX AN DOXYLAMINE SUCCINATE 3 Liquid (ml) 

HYDROXYZINE HCL HYDROXYZINE HCL 1 Syrup 

Page 9


HYDROXYZINE HCL HYDROXYZINE HCL 1 Tablet 

HYDROXYZINE PAMOATE HYDROXYZINE PAMOATE 1 Capsule (Hard, Soft, etc.) 

HYDROXYZINE PAMOATE HYDROXYZINE PAMOATE 1 Capsule (Hard, Soft, etc.) 

VISTARIL HYDROXYZINE PAMOATE 3 Capsule (Hard, Soft, etc.) 

PROMETHAZINE HCL PROMETHAZINE HCL 1 Syrup 

PROMETHAZINE HCL PROMETHAZINE HCL 1 Tablet 

PROMETHAZINE HCL PROMETHAZINE HCL 2 Tablet 

POLY TAN PYRILAMINE MAL/DEXBROMPHEN TAN 3 Suspension, Oral (Final Dose Form) 

PYRLEX PYRILAMINE TANNATE 3 Suspension, Oral (Final Dose Form) 

TRIPOHIST TRIPROLIDINE HCL 1 Syrup 

TRIPROLIDINE HCL TRIPROLIDINE HCL 1 Syrup 

ZYMINE TRIPROLIDINE HCL 3 Syrup 

ZYMINE XR TRIPROLIDINE TANNATE 3 Suspension, Oral (Final Dose Form) 

EYE ANTIHISTAMINES 

OPTIVAR AZELASTINE HCL 3 Drops 

EMADINE EMEDASTINE DIFUMARATE 3 Drops 

ELESTAT EPINASTINE HCL 3 Drops 

KETOTIFEN FUMARATE KETOTIFEN FUMARATE 1 Drops 

PATADAY OLOPATADINE HCL 3 Drops 

PATANOL OLOPATADINE HCL 2 Drops 

ANTIHISTAMINES – 2ND GENERATION 

ZYRTEC CETIRIZINE HCL 3 Syrup 

ZYRTEC CETIRIZINE HCL 3 Tablet 

ZYRTEC CETIRIZINE HCL 3 Tablet, Chewable 

CLARINEX DESLORATADINE 3 Syrup 

CLARINEX DESLORATADINE 3 Tablet 

CLARINEX DESLORATADINE 3 Tablet, Rapid Dissolve 

ALLEGRA FEXOFENADINE HCL 3 Suspension, Oral (Final Dose Form) 

ALLEGRA FEXOFENADINE HCL 3 Tablet 

FEXOFENADINE HCL FEXOFENADINE HCL 1 Tablet 

ALLEGRA ODT FEXOFENADINE HCL 3 Tablet, Rapid Dissolve 

XYZAL LEVOCETIRIZINE DIHYDROCHLORIDE 3 Tablet 

ANTIHISTAMINE AND DECONGESTANT COMBINATION 

1ST GEN ANTIHISTAMINE & DECONGESTANT COMBINATIONS 

ALA-HIST D BROMPHENIR/DIPHENHYD/PHENYLEPH 3 Tablet, Sustained Release 12 Hr 

POLY TAN D PE TAN/PYRIL MAL/DEXBROMPH TAN 3 Suspension, Oral (Final Dose Form) 

PHENA-S 12 PE/PE & PYRILAMINE TANNATE/CPM 3 Suspension, Oral (Final Dose Form) 

BROVEX PD P-EPD TAN/BROMPHENIRAMIN 3 Suspension, Oral (Final Dose Form) 

B-VEX PD P-EPD TAN/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

LODRANE D P-EPD TAN/BROMPHENIRAMIN 3 Suspension, Oral (Final Dose Form) 

C-PHED TANNATE P-EPD TAN/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

DICEL P-EPD TAN/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

SUDAL 12 P-EPD TAN/CHLOR-TAN 3 Tablet, Chewable 

BROMFENEX P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Action 

BROMFENEX-PD P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Action 

PSEUBROM P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Action 

PSEUBROM-PD P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Action 

RESPAHIST P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Action 

TOURO ALLERGY P-EPHED HCL/BROMPHENIRAMIN 3 Capsule, Sustained Action 

ULTRABROM P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Action 

ULTRABROM PD P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Action 

BROMPHENIRAMINE-PSEUDOEPHEDR P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Release 12 Hr 

BROVEX SR P-EPHED HCL/BROMPHENIRAMIN 3 Capsule, Sustained Release 12 Hr 

HISTEX SR P-EPHED HCL/BROMPHENIRAMIN 1 Capsule, Sustained Release 12 Hr 

LODRANE 24D P-EPHED HCL/BROMPHENIRAMIN 3 Capsule, Sustained Release 24 Hr 

BROMHIST P-EPHED HCL/BROMPHENIRAMIN 1 Drops 

BROMHIST-NR P-EPHED HCL/BROMPHENIRAMIN 1 Drops 

J-TAN D PD P-EPHED HCL/BROMPHENIRAMIN 3 Drops 

LOHIST-PD P-EPHED HCL/BROMPHENIRAMIN 1 Drops 

LODRANE P-EPHED HCL/BROMPHENIRAMIN 3 Liquid (ml) 

PSE BPM P-EPHED HCL/BROMPHENIRAMIN 1 Liquid (ml) 

ANDEHIST P-EPHED HCL/BROMPHENIRAMIN 1 Syrup 

BROFED P-EPHED HCL/BROMPHENIRAMIN 3 Syrup 

SILDEC P-EPHED HCL/BROMPHENIRAMIN 1 Syrup 

BPM PSEUDO P-EPHED HCL/BROMPHENIRAMIN 1 Tablet, Sustained Release 12 Hr 

HISTEX SR P-EPHED HCL/BROMPHENIRAMIN 3 Tablet, Sustained Release 12 Hr 

LODRANE P-EPHED HCL/BROMPHENIRAMIN 1 Tablet, Sustained Release 12 Hr 

Page 10


LOHIST 12D P-EPHED HCL/BROMPHENIRAMIN 1 Tablet, Sustained Release 12 Hr 

SINUHIST P-EPHED HCL/BROMPHENIRAMIN 1 Tablet, Sustained Release 12 Hr 

TOURO ALLERGY P-EPHED HCL/BROMPHENIRAMIN 1 Tablet, Sustained Release 12 Hr 

DISOPHROL P-EPHED HCL/D-BROMP MAL 3 Tablet 

TRIPOHIST D P-EPHED HCL/TRIPROLIDINE HCL 1 Liquid (ml) 

ZYMINE-D P-EPHED HCL/TRIPROLIDINE HCL 3 Liquid (ml) 

PREHIST PHENYLEPHRINE HCL/CHLOR-MAL 3 Capsule, Sustained Action 

DALLERGY-JR PHENYLEPHRINE HCL/CHLOR-MAL 3 Capsule, Sustained Release 12 Hr 

PHENYLEPHRINE HCL-CHLOR-MAL PHENYLEPHRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

CARDEC PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

CERON PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

CP DEC PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

C-PHEN DROPS PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

DALLERGY PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

NASOHIST PHENYLEPHRINE HCL/CHLOR-MAL 3 Drops 

PD-HIST D PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

RONDEC PHENYLEPHRINE HCL/CHLOR-MAL 3 Drops 

RONDEX PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

SILDEC-PE PHENYLEPHRINE HCL/CHLOR-MAL 1 Drops 

ED A-HIST PHENYLEPHRINE HCL/CHLOR-MAL 1 Liquid (ml) 

TUSSANIL PHENYLEPHRINE HCL/CHLOR-MAL 1 Liquid (ml) 

CARDEC PHENYLEPHRINE HCL/CHLOR-MAL 1 Syrup 

CERON PHENYLEPHRINE HCL/CHLOR-MAL 1 Syrup 

CP DEC PHENYLEPHRINE HCL/CHLOR-MAL 1 Syrup 

C-PHEN Syrup PHENYLEPHRINE HCL/CHLOR-MAL 1 Syrup 

PD-HIST D PHENYLEPHRINE HCL/CHLOR-MAL 1 Syrup 

RONDEC PHENYLEPHRINE HCL/CHLOR-MAL 3 Syrup 

RONDEX PHENYLEPHRINE HCL/CHLOR-MAL 1 Syrup 

SILDEC-PE PHENYLEPHRINE HCL/CHLOR-MAL 1 Syrup 

ALERSULE PHENYLEPHRINE HCL/CHLOR-MAL 1 Tablet, Sustained Action 

ED A-HIST PHENYLEPHRINE HCL/CHLOR-MAL 1 Tablet, Sustained Action 

NOHIST PHENYLEPHRINE HCL/CHLOR-MAL 1 Tablet, Sustained Action 

PHENABID PHENYLEPHRINE HCL/CHLOR-MAL 3 Tablet, Sustained Action 

RESCON-JR PHENYLEPHRINE HCL/CHLOR-MAL 3 Tablet, Sustained Action 

PROMETHAZINE VC PHENYLEPHRINE HCL/PROMETH HCL 1 Syrup 

PROMETHAZINE VC PHENYLEPHRINE HCL/PROMETH HCL 3 Syrup 

BROM TANN-PE TANN PHENYLEPHRINE/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

BROMAPHEDRINE D PHENYLEPHRINE/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

BROMPHENIRAMINE-PHENYLEPHRINE PHENYLEPHRINE/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

BROVEX ADT PHENYLEPHRINE/BROMPHENIRAMIN 3 Suspension, Oral (Final Dose Form) 

BROVEX-D PHENYLEPHRINE/BROMPHENIRAMIN 3 Suspension, Oral (Final Dose Form) 

B-VEX D PHENYLEPHRINE/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

C-TAN D PHENYLEPHRINE/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

J-TAN D PHENYLEPHRINE/BROMPHENIRAMIN 3 Suspension, Oral (Final Dose Form) 

TANABID DA PHENYLEPHRINE/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

VAZOBID PHENYLEPHRINE/BROMPHENIRAMIN 1 Suspension, Oral (Final Dose Form) 

BROMFED PHENYLEPHRINE/BROMPHENIRAMINE 3 Capsule, Sustained Release 12 Hr 

BROMFED-PD PHENYLEPHRINE/BROMPHENIRAMINE 3 Capsule, Sustained Release 12 Hr 

PHENYLEPHRINE-BROMPHENIRAMIN PHENYLEPHRINE/BROMPHENIRAMINE 1 Capsule, Sustained Release 12 Hr 

ALACOL PHENYLEPHRINE/BROMPHENIRAMINE 3 Drops 

ALENAZE-D NR PHENYLEPHRINE/BROMPHENIRAMINE 1 Liquid (ml) 

BPM PE PHENYLEPHRINE/BROMPHENIRAMINE 1 Liquid (ml) 

VAZOL-D PHENYLEPHRINE/BROMPHENIRAMINE 3 Liquid (ml) 

ALACOL PHENYLEPHRINE/BROMPHENIRAMINE 3 Syrup 

RESPAHIST-II PHENYLEPHRINE/BROMPHENIRAMINE 3 Tablet, Sustained Release 12 Hr 

ED CHLORPED D PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Drops(Final Dosage Form)(ml) 

MYCI CHLORPED D PHENYLEPHRINE/CHLOR-TAN 3 Suspension, Drops(Final Dosage Form)(ml) 

TANAHIST D PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Drops(Final Dosage Form)(ml) 

ALLANTAN PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

ALLERX PHENYLEPHRINE/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

BP ALLERGY JUNIOR PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

CHLORTAN D PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

DALLERGY-JR PHENYLEPHRINE/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

NUHIST PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

PE TANN-CP TANN PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

PEDIAPHYL D PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

PEDIATAN D PHENYLEPHRINE/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

PHENYL CHLOR-TAN PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

Page 11


P-TANN D PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

RICOBID PHENYLEPHRINE/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

RINATE PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

R-TANNA PEDIATRIC PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

RYNATAN PHENYLEPHRINE/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

TANNATE PHENYLEPHRINE/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

NY-TANNIC PHENYLEPHRINE/CHLOR-TAN 1 Tablet 

R-TANNA PHENYLEPHRINE/CHLOR-TAN 1 Tablet 

RYNATAN PHENYLEPHRINE/CHLOR-TAN 3 Tablet 

RYNATAN PEDIATRIC PHENYLEPHRINE/CHLOR-TAN 3 Tablet, Chewable 

RICOBID PHENYLEPHRINE/CHLOR-TAN 3 Tablet, Sustained Action 

RHINAHIST PHENYLEPHRINE/DEXCHLORPHENIRAM 3 Tablet, Sustained Release 12 Hr 

D-TANN PHENYLEPHRINE/DP-HYDRAM TAN 1 Suspension, Oral (Final Dose Form) 

DYTAN-D PHENYLEPHRINE/DP-HYDRAM TAN 3 Suspension, Oral (Final Dose Form) 

ALDEX-CT PHENYLEPHRINE/DP-HYDRAM TAN 3 Tablet, Chewable 

DIPHENMAX D PHENYLEPHRINE/DP-HYDRAM TAN 1 Tablet, Chewable 

D-TANN PHENYLEPHRINE/DP-HYDRAM TAN 1 Tablet, Chewable 

DYTAN-D PHENYLEPHRINE/DP-HYDRAM TAN 1 Tablet, Chewable 

NALEX-A PHENYLEPHRINE/P-TLOX CI/CP 3 Liquid (ml) 

NOHIST-A PHENYLEPHRINE/P-TLOX CI/CP 1 Liquid (ml) 

PHENYLTOLOXAMINE PE CPM PHENYLEPHRINE/P-TLOX CI/CP 1 Liquid (ml) 

RHINACON A PHENYLEPHRINE/P-TLOX CI/CP 1 Liquid (ml) 

COMHIST PHENYLEPHRINE/P-TLOX CI/CP 3 Tablet 

BLANEX-A PHENYLEPHRINE/P-TLOX CI/CP 1 Tablet, Sustained Action 

CHLOREX-A PHENYLEPHRINE/P-TLOX CI/CP 1 Tablet, Sustained Action 

NALEX-A PHENYLEPHRINE/P-TLOX CI/CP 3 Tablet, Sustained Action 

RHINACON A PHENYLEPHRINE/P-TLOX CI/CP 1 Tablet, Sustained Action 

MYHIST-PD PHENYLEPHRINE/PYRIL MAL/CP 1 Liquid (ml) 

PHENA-S PHENYLEPHRINE/PYRIL MAL/CP 3 Liquid (ml) 

POLY HIST PD PHENYLEPHRINE/PYRIL MAL/CP 3 Liquid (ml) 

PHENA-PLUS PHENYLEPHRINE/PYRIL MAL/CP 3 Tablet 

POLY HIST FORTE PHENYLEPHRINE/PYRIL MAL/CP 3 Tablet, Sustained Action 

RU-HIST FORTE PHENYLEPHRINE/PYRIL MAL/CP 1 Tablet, Sustained Action 

RYNA-12 S PHENYLEPHRINE/PYRIL TAN 3 Suspension, Oral (Final Dose Form) 

RY-T-12 PHENYLEPHRINE/PYRIL TAN 1 Suspension, Oral (Final Dose Form) 

RYNA-12 PHENYLEPHRINE/PYRIL TAN 3 Tablet 

ALLERTAN PHENYLEPHRINE/PYRIL TAN/CP 3 Suspension, Oral (Final Dose Form) 

CHLOREX-A 12 PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

CHLOR-TAN A 12 PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

CONAL PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

NALEX A 12 PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

R-TANNAMINE PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

TRI-HIST PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

TRIOTANN PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

TRIOTANN-S PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

TRIPLE TANNATE PEDIATRIC PHENYLEPHRINE/PYRIL TAN/CP 1 Suspension, Oral (Final Dose Form) 

ALDEX D PHENYLEPHRINE/PYRILAMINE TAN 3 Suspension, Oral (Final Dose Form) 

ALLANVAN-S PHENYLEPHRINE/PYRILAMINE TAN 1 Suspension, Oral (Final Dose Form) 

K-TAN 4 PHENYLEPHRINE/PYRILAMINE TAN 1 Suspension, Oral (Final Dose Form) 

PYRLEX PD PHENYLEPHRINE/PYRILAMINE TAN 3 Suspension, Oral (Final Dose Form) 

RYNESA 12S PHENYLEPHRINE/PYRILAMINE TAN 1 Suspension, Oral (Final Dose Form) 

RY-T-12 PHENYLEPHRINE/PYRILAMINE TAN 1 Suspension, Oral (Final Dose Form) 

V-TANN PHENYLEPHRINE/PYRILAMINE TAN 1 Suspension, Oral (Final Dose Form) 

K-TAN PHENYLEPHRINE/PYRILAMINE TAN 1 Tablet 

DECONSAL CT PHENYLEPHRINE/PYRILAMINE TAN 3 Tablet, Chewable 

V-TANN PHENYLEPHRINE/PYRILAMINE TAN 3 Tablet, Chewable 

NALFRX PSEUDOEPH/PYRIL/DEXCHLOR TANN 3 Suspension, Oral (Final Dose Form) 

ZYMINE DXR PSEUDOEPH/TRIPROLIDIN TANNATES 3 Suspension, Oral (Final Dose Form) 

SUDAL-12 PSEUDOEPHED PL/CHLORPHEN POLAC 3 Tablet, Chewable 

ALLERDUR PSEUDOEPHED TAN/DEXCHLOR TAN 3 Suspension, Oral (Final Dose Form) 

DUOTAN PD PSEUDOEPHED TAN/DEXCHLOR TAN 1 Suspension, Oral (Final Dose Form) 

SUTAN PSEUDOEPHED TAN/DEXCHLOR TAN 1 Suspension, Oral (Final Dose Form) 

VIRAVAN-P PSEUDOEPHED TAN/PYRILAMINE TAN 3 Suspension, Oral (Final Dose Form) 

PSEUDOEPHEDRINE-CHLORPHENIRAMI PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Multiphasic 24 Hr 

D-AMINE-SR PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

DECONAMINE SR PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Capsule, Sustained Release 12 Hr 

DYNAHIST ER PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

HISTADE PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

Page 12


PSE-CPM PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

PSEUDOEPHEDRINE W/CHLORPHENIR PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

SUCLOR PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

TIME-HIST PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Capsule, Sustained Release 12 Hr 

DURATUSS DA PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Capsule, Sustained Release 24 Hr 

ACCUHIST PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Drops 

NEUTRAHIST PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Drops 

CPM PSE PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Liquid (ml) 

DECONAMINE PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Liquid (ml) 

LOHIST-D PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Liquid (ml) 

RE2+30 PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Liquid (ml) 

DECONAMINE PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Tablet 

KLERIST-D PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Tablet 

PSE CPM PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Tablet, Chewable 

PSEUDOEPHEDRINE-CHLORPHENIRAMI PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Tablet, Sustained Release 12 Hr 

SUDAHIST PSEUDOEPHEDRINE HCL/CHLOR-MAL 1 Tablet, Sustained Release 12 Hr 

TIBAMINE LA PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Tablet, Sustained Release 12 Hr 

2ND GEN ANTIHISTAMINE & DECONGESTANT COMBINATIONS 

ZYRTEC-D P-EPHED HCL/CETIRIZINE HCL 3 Tablet, Sustained Release 12 Hr 

ALLEGRA-D P-EPHED HCL/FEXOFENADINE HCL 3 Tablet, Sustained Release 12 Hr 

ALLEGRA-D 24 HOUR P-EPHED HCL/FEXOFENADINE HCL 3 Tablet, Sustained Release 24 Hr 

CLARINEX-D 12 HOUR P-EPHED SUL/DESLORATADINE 3 Tablet, Multiphasic Release 12 Hr 

CLARINEX-D 24 HOUR P-EPHED SUL/DESLORATADINE 3 Tablet, Multiphasic Release 24 Hr 

SEMPREX-D PSEUDOEPHEDRINE HCL/ACRIVAS 3 Capsule (Hard, Soft, etc.) 

ANTIINFECTIVES 

VAGINAL ANTIFUNGALS 

GYNAZOLE-1 BUTOCONAZOLE NITRATE 2 Cream, Sustained Release (gm) 

MICONAZOLE 3 MICONAZOLE NITRATE 1 Suppository, Vaginal 

NYSTATIN NYSTATIN 1 Tablet 

TERAZOL 3 TERCONAZOLE 2 Cream with Applicator 

TERAZOL 7 TERCONAZOLE 2 Cream with Applicator 

TERCONAZOLE TERCONAZOLE 1 Cream with Applicator 

ZAZOLE TERCONAZOLE 1 Cream with Applicator 

TERAZOL 3 TERCONAZOLE 3 Suppository, Vaginal 

TERCONAZOLE TERCONAZOLE 1 Suppository, Vaginal 

ZAZOLE TERCONAZOLE 1 Suppository, Vaginal 

VAGINAL SULFONAMIDES 

AVC SULFANILAMIDE 3 Cream with Applicator 

DAYTO-SULF SULFATHIAZ/SULFACET/S-BENZ/URE 3 Cream (Grams) 

VAGINAL ANTIBIOTICS 

CLEOCIN CLINDAMYCIN PHOSPHATE 2 Cream with Applicator 

CLINDAMAX CLINDAMYCIN PHOSPHATE 1 Cream with Applicator 

CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE 1 Cream with Applicator 

CLINDESSE CLINDAMYCIN PHOSPHATE 3 Cream, Sustained Release (gm) 

CLEOCIN CLINDAMYCIN PHOSPHATE 2 Suppository, Vaginal 

METROGEL-VAGINAL METRONIDAZOLE 1 Gel with Applicator (gm) 

METRONIDAZOLE METRONIDAZOLE 1 Gel with Applicator (gm) 

VANDAZOLE METRONIDAZOLE 1 Gel with Applicator (gm) 

PENICILLINS 

AMOCLAN AMOX TR/POTASSIUM CLAVULANATE 1 Suspension, Reconstituted, Oral (ml) 

AMOX TR-POTASSIUM CLAVULANATE AMOX TR/POTASSIUM CLAVULANATE 1 Suspension, Reconstituted, Oral (ml) 

AUGMENTIN AMOX TR/POTASSIUM CLAVULANATE 2 Suspension, Reconstituted, Oral (ml) 

AUGMENTIN ES-600 AMOX TR/POTASSIUM CLAVULANATE 2 Suspension, Reconstituted, Oral (ml) 

AMOX TR-POTASSIUM CLAVULANATE AMOX TR/POTASSIUM CLAVULANATE 1 Tablet 

AUGMENTIN AMOX TR/POTASSIUM CLAVULANATE 2 Tablet 

AMOX TR-POTASSIUM CLAVULANATE AMOX TR/POTASSIUM CLAVULANATE 1 Tablet, Chewable 

AUGMENTIN AMOX TR/POTASSIUM CLAVULANATE 2 Tablet, Chewable 

AUGMENTIN XR AMOX TR/POTASSIUM CLAVULANATE 2 Tablet, Sustained Release 12 Hr 

AMOXICILLIN AMOXICILLIN TRIHYDRATE 1 Capsule (Hard, Soft, etc.) 

AMOXICILLIN AMOXICILLIN TRIHYDRATE 1 Capsule (Hard, Soft, etc.) 

AMOXIL AMOXICILLIN TRIHYDRATE 1 Capsule (Hard, Soft, etc.) 

AMOXIL AMOXICILLIN TRIHYDRATE 2 Drops, Reconstituted, Oral 

AMOXICILLIN AMOXICILLIN TRIHYDRATE 1 Suspension, Reconstituted, Oral (ml) 

AMOXIL AMOXICILLIN TRIHYDRATE 1 Suspension, Reconstituted, Oral (ml) 

AMOXIL AMOXICILLIN TRIHYDRATE 2 Suspension, Reconstituted, Oral (ml) 

AMOXICILLIN AMOXICILLIN TRIHYDRATE 1 Tablet 

AMOXIL AMOXICILLIN TRIHYDRATE 2 Tablet 

Page 13


AMOXICILLIN AMOXICILLIN TRIHYDRATE 1 Tablet, Chewable 

AMOXIL AMOXICILLIN TRIHYDRATE 2 Tablet, Chewable 

AMPICILLIN TRIHYDRATE AMPICILLIN TRIHYDRATE 1 Capsule (Hard, Soft, etc.) 

AMPICILLIN TRIHYDRATE AMPICILLIN TRIHYDRATE 1 Suspension, Reconstituted, Oral (ml) 

DICLOXACILLIN SODIUM DICLOXACILLIN SODIUM 1 Capsule (Hard, Soft, etc.) 

BACTOCILL OXACILLIN SODIUM 3 Capsule (Hard, Soft, etc.) 

OXACILLIN SODIUM OXACILLIN SODIUM 1 Suspension, Reconstituted, Oral (ml) 

PENICILLIN V POTASSIUM PENICILLIN V POTASSIUM 1 Suspension, Reconstituted, Oral (ml) 

PENICILLIN V POTASSIUM PENICILLIN V POTASSIUM 1 Tablet 

TETRACYCLINES 

DECLOMYCIN DEMECLOCYCLINE HCL 3 Tablet 

DEMECLOCYCLINE HCL DEMECLOCYCLINE HCL 1 Tablet 

VIBRAMYCIN DOXYCYCLINE CALCIUM 2 Syrup 

DOXYCYCLINE HYCLATE DOXYCYCLINE HYCLATE 1 Capsule (Hard, Soft, etc.) 

DOXY-LEMMON DOXYCYCLINE HYCLATE 1 Capsule (Hard, Soft, etc.) 

ED DOXY-CAPS DOXYCYCLINE HYCLATE 1 Capsule (Hard, Soft, etc.) 

VIBRAMYCIN DOXYCYCLINE HYCLATE 3 Capsule (Hard, Soft, etc.) 

DOXYCYCLINE HYCLATE DOXYCYCLINE HYCLATE 1 Capsule,Delayed Release (Enteric Coated) 

DOXYCYCLINE HYCLATE DOXYCYCLINE HYCLATE 2 Capsule,Delayed Release (Enteric Coated) 

DOXYCYCLINE HYCLATE DOXYCYCLINE HYCLATE 1 Tablet 

DOXY-LEMMON DOXYCYCLINE HYCLATE 1 Tablet 

VIBRA-TABS DOXYCYCLINE HYCLATE 2 Tablet 

DORYX DOXYCYCLINE HYCLATE 3 Tablet, Delayed Release (Enteric Coated) 

ADOXA CK DOXYCYCLINE MONOHY/SKIN CLNSR9 3 Combination Package, Capsule & PAD 

ADOXA TT DOXYCYCLINE MONOHY/SKIN CLNSR9 3 Combination Package, Tablet & PAD 

ADOXA DOXYCYCLINE MONOHYDRATE 3 Capsule (Hard, Soft, etc.) 

DOXYCYCLINE MONOHYDRATE DOXYCYCLINE MONOHYDRATE 1 Capsule (Hard, Soft, etc.) 

MONODOX DOXYCYCLINE MONOHYDRATE 3 Capsule (Hard, Soft, etc.) 

ORACEA DOXYCYCLINE MONOHYDRATE 3 Capsule, Multiphasic 24 Hr 

VIBRAMYCIN DOXYCYCLINE MONOHYDRATE 2 Suspension, Reconstituted, Oral (ml) 

ADOXA DOXYCYCLINE MONOHYDRATE 3 Tablet 

ADOXA PAK DOXYCYCLINE MONOHYDRATE 3 Tablet 

DOXYCYCLINE DOXYCYCLINE MONOHYDRATE 1 Tablet 

DOXYCYCLINE MONOHYDRATE DOXYCYCLINE MONOHYDRATE 1 Tablet 

DYNACIN MINOCYCLINE HCL 3 Capsule (Hard, Soft, etc.) 

MINOCIN MINOCYCLINE HCL 3 Capsule (Hard, Soft, etc.) 

MINOCYCLINE HCL MINOCYCLINE HCL 1 Capsule (Hard, Soft, etc.) 

DYNACIN MINOCYCLINE HCL 3 Tablet 

MINOCYCLINE HCL MINOCYCLINE HCL 1 Tablet 

MYRAC MINOCYCLINE HCL 1 Tablet 

SOLODYN MINOCYCLINE HCL 3 Tablet, Sustained Release 24 Hr 

ALA-TET TETRACYCLINE HCL 2 Capsule (Hard, Soft, etc.) 

TETRACYCLINE HCL TETRACYCLINE HCL 1 Capsule (Hard, Soft, etc.) 

SUMYCIN TETRACYCLINE HCL 3 Suspension, Oral (Final Dose Form) 

MACROLIDES 

AZITHROMYCIN AZITHROMYCIN 1 Packet 

ZITHROMAX AZITHROMYCIN 3 Packet 

AZITHROMYCIN AZITHROMYCIN 1 Suspension, Reconstituted, Oral (ml) 

ZITHROMAX AZITHROMYCIN 3 Suspension, Reconstituted, Oral (ml) 

ZMAX AZITHROMYCIN 3 Suspension, Sustained Release, Reconst. 

AZITHROMYCIN AZITHROMYCIN 1 Tablet 

ZITHROMAX AZITHROMYCIN 3 Tablet 

ZITHROMAX TRI-PAK AZITHROMYCIN 3 Tablet 

BIAXIN CLARITHROMYCIN 3 Suspension, Reconstituted, Oral (ml) 

CLARITHROMYCIN CLARITHROMYCIN 1 Suspension, Reconstituted, Oral (ml) 

BIAXIN CLARITHROMYCIN 3 Tablet 

CLARITHROMYCIN CLARITHROMYCIN 1 Tablet 

BIAXIN XL CLARITHROMYCIN 2 Tablet, Sustained Release 24 Hr 

CLARITHROMYCIN ER CLARITHROMYCIN 1 Tablet, Sustained Release 24 Hr 

ERYTHROMYCIN W/SULFISOXAZOLE ERY E-SUCC/SULFISOXAZOLE 1 Suspension, Reconstituted, Oral (ml) 

ERYTHROMYCIN-SULFISOXAZOLE ERY E-SUCC/SULFISOXAZOLE 1 Suspension, Reconstituted, Oral (ml) 

ERYTHROMYCIN-SULFISOXAZOLE ERY E-SUCC/SULFISOXAZOLE 3 Suspension, Reconstituted, Oral (ml) 

ERYTHROMYCIN ERYTHROMYCIN BASE 1 Capsule,Delayed Release (Enteric Coated) 

ERYTHROMYCIN ERYTHROMYCIN BASE 1 Tablet 

ERYTHROMYCIN ERYTHROMYCIN BASE 3 Tablet 

ERY-TAB ERYTHROMYCIN BASE 3 Tablet, Delayed Release (Enteric Coated) 

PCE ERYTHROMYCIN BASE 3 Tablet, Particles/Crystals in 

ERYPED ERYTHROMYCIN ETHYLSUCCINATE 3 Drops 

Page 14


E.E.S. 200 ERYTHROMYCIN ETHYLSUCCINATE 1 Suspension, Oral (Final Dose Form) 

E.E.S. 400 ERYTHROMYCIN ETHYLSUCCINATE 1 Suspension, Oral (Final Dose Form) 

ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN ETHYLSUCCINATE 1 Suspension, Oral (Final Dose Form) 

E.E.S. 200 ERYTHROMYCIN ETHYLSUCCINATE 3 Suspension, Reconstituted, Oral (ml) 

ERYPED 200 ERYTHROMYCIN ETHYLSUCCINATE 3 Suspension, Reconstituted, Oral (ml) 

ERYPED 400 ERYTHROMYCIN ETHYLSUCCINATE 3 Suspension, Reconstituted, Oral (ml) 

ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN ETHYLSUCCINATE 1 Suspension, Reconstituted, Oral (ml) 

E.E.S. 400 ERYTHROMYCIN ETHYLSUCCINATE 1 Tablet 

ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN ETHYLSUCCINATE 1 Tablet 

ERYTHROCIN STEARATE ERYTHROMYCIN STEARATE 1 Tablet 

AMINOGLYCOSIDES 

NEO-FRADIN NEOMYCIN SULFATE 3 Solution, Oral 

NEOMYCIN SULFATE NEOMYCIN SULFATE 1 Tablet 

TOBRAMYCIN SULFATE TOBRAMYCIN SULFATE 3 Vial with Threaded Port (ml) 

TOBI TOBRAMYCIN/0.25 NORMAL SALINE 3 Ampul for Nebulization (ml) 

ANTITUBERCULAR ANTIBIOTICS 

SEROMYCIN CYCLOSERINE 3 Capsule (Hard, Soft, etc.) 

RIFADIN RIFAMPIN 3 Capsule (Hard, Soft, etc.) 

RIFAMPIN RIFAMPIN 1 Capsule (Hard, Soft, etc.) 

RIFATER RIFAMPIN/INH/PYRAZINAMIDE 2 Tablet 

ISONARIF RIFAMPIN/ISONIAZID 1 Capsule (Hard, Soft, etc.) 

RIFAMATE RIFAMPIN/ISONIAZID 2 Capsule (Hard, Soft, etc.) 

PRIFTIN RIFAPENTINE 3 Tablet 

VANCOMYCIN AND DERIVATIVES 

VANCOCIN HCL VANCOMYCIN HCL 3 Capsule (Hard, Soft, etc.) 

LINCOSAMIDES 

CLEOCIN HCL CLINDAMYCIN HCL 3 Capsule (Hard, Soft, etc.) 

CLINDAMYCIN HCL CLINDAMYCIN HCL 1 Capsule (Hard, Soft, etc.) 

CLEOCIN PALMITATE CLINDAMYCIN PALMITATE 3 Solution, Reconstituted, Oral 

ABSORBABLE SULFONAMIDES 

SULFADIAZINE SULFADIAZINE 1 Tablet 

SULFAMETHOXAZOLE-TRIMETHOPRIM SULFAMETHOXAZOLE/TRIMETHOPRIM 1 Suspension, Oral (Final Dose Form) 

SULFATRIM SULFAMETHOXAZOLE/TRIMETHOPRIM 1 Suspension, Oral (Final Dose Form) 

BACTRIM SULFAMETHOXAZOLE/TRIMETHOPRIM 3 Tablet 

BACTRIM DS SULFAMETHOXAZOLE/TRIMETHOPRIM 3 Tablet 

BETHAPRIM DS SULFAMETHOXAZOLE/TRIMETHOPRIM 1 Tablet 

SEPTRA SULFAMETHOXAZOLE/TRIMETHOPRIM 3 Tablet 

SEPTRA DS SULFAMETHOXAZOLE/TRIMETHOPRIM 3 Tablet 

SULFAMETHOXAZOLE-TRIMETHOPRIM SULFAMETHOXAZOLE/TRIMETHOPRIM 1 Tablet 

AZULFIDINE SULFASALAZINE 3 Tablet 

SULFASALAZINE SULFASALAZINE 1 Tablet 

SULFAZINE SULFASALAZINE 1 Tablet 

AZULFIDINE SULFASALAZINE 3 Tablet, Delayed Release (Enteric Coated) 

SULFASALAZINE DR SULFASALAZINE 1 Tablet, Delayed Release (Enteric Coated) 

SULFAZINE EC SULFASALAZINE 1 Tablet, Delayed Release (Enteric Coated) 

GANTRISIN SULFISOXAZOLE ACETYL 2 Suspension, Oral (Final Dose Form) 

NITROFURAN DERIVATIVES 

FUROXONE FURAZOLIDONE 3 Suspension, Oral (Final Dose Form) 

FUROXONE FURAZOLIDONE 3 Tablet 

FURADANTIN NITROFURANTOIN 2 Suspension, Oral (Final Dose Form) 

MACRODANTIN NITROFURANTOIN MACROCRYSTAL 2 Capsule (Hard, Soft, etc.) 

NITROFURANTOIN NITROFURANTOIN MACROCRYSTAL 1 Capsule (Hard, Soft, etc.) 

NITROFURANTOIN MACROCRYSTAL NITROFURANTOIN MACROCRYSTAL 1 Capsule (Hard, Soft, etc.) 

MACROBID NITROFURANTOIN/NITROFURAN MAC 3 Capsule (Hard, Soft, etc.) 

NITROFURANTOIN MACROCRYSTAL NITROFURANTOIN/NITROFURAN MAC 1 Capsule (Hard, Soft, etc.) 

ANTI-INFECTIVES, MISC. (ANTIBACTERIALS) 

RIMSO-50 DIMETHYL SULFOXIDE 3 Solution, Non-Oral 

OXAZOLIDINONES 

ZYVOX LINEZOLID 3 Suspension, Reconstituted, Oral (ml) 

ZYVOX LINEZOLID 3 Tablet 

CEPHALOSPORINS - 1ST GENERATION 

CEFADROXIL CEFADROXIL HYDRATE 1 Capsule (Hard, Soft, etc.) 

DURICEF CEFADROXIL HYDRATE 3 Capsule (Hard, Soft, etc.) 

CEFADROXIL CEFADROXIL HYDRATE 1 Suspension, Reconstituted, Oral (ml) 

DURICEF CEFADROXIL HYDRATE 3 Suspension, Reconstituted, Oral (ml) 

CEFADROXIL CEFADROXIL HYDRATE 1 Tablet 

CEPHALEXIN CEPHALEXIN MONOHYDRATE 1 Capsule (Hard, Soft, etc.) 

Page 15


KEFLEX CEPHALEXIN MONOHYDRATE 3 Capsule (Hard, Soft, etc.) 

KEFLEX CEPHALEXIN MONOHYDRATE 3 Capsule (Hard, Soft, etc.) 

CEPHALEXIN CEPHALEXIN MONOHYDRATE 1 Suspension, Reconstituted, Oral (ml) 

CEPHALEXIN CEPHALEXIN MONOHYDRATE 1 Tablet 

VELOSEF CEPHRADINE 3 Capsule (Hard, Soft, etc.) 

CEPHALOSPORINS - 2ND GENERATION 

CEFACLOR CEFACLOR 1 Capsule (Hard, Soft, etc.) 

CEFACLOR CEFACLOR 1 Suspension, Reconstituted, Oral (ml) 

CEFACLOR CEFACLOR 1 Suspension, Reconstituted, Oral (ml) 

RANICLOR CEFACLOR 3 Tablet, Chewable 

CEFACLOR ER CEFACLOR 1 Tablet, Sustained Release 12 Hr 

CEFPROZIL CEFPROZIL 1 Suspension, Reconstituted, Oral (ml) 

CEFZIL CEFPROZIL 3 Suspension, Reconstituted, Oral (ml) 

CEFPROZIL CEFPROZIL 1 Tablet 

CEFZIL CEFPROZIL 3 Tablet 

CEFTIN CEFUROXIME AXETIL 2 Suspension, Reconstituted, Oral (ml) 

CEFTIN CEFUROXIME AXETIL 3 Tablet 

CEFUROXIME CEFUROXIME AXETIL 1 Tablet 

CEPHALOSPORINS - 3RD GENERATION 

CEFDINIR CEFDINIR 1 Capsule (Hard, Soft, etc.) 

OMNICEF CEFDINIR 2 Capsule (Hard, Soft, etc.) 

CEFDINIR CEFDINIR 1 Suspension, Reconstituted, Oral (ml) 

OMNICEF CEFDINIR 2 Suspension, Reconstituted, Oral (ml) 

SPECTRACEF CEFDITOREN PIVOXIL 3 Tablet 

SUPRAX CEFIXIME 3 Suspension, Reconstituted, Oral (ml) 

CEFPODOXIME PROXETIL CEFPODOXIME PROXETIL 1 Suspension, Reconstituted, Oral (ml) 

CEFPODOXIME PROXETIL CEFPODOXIME PROXETIL 1 Tablet 

VANTIN CEFPODOXIME PROXETIL 2 Tablet 

CEDAX CEFTIBUTEN DIHYDRATE 3 Capsule (Hard, Soft, etc.) 

CEDAX CEFTIBUTEN DIHYDRATE 3 Suspension, Reconstituted, Oral (ml) 

KETOLIDES 

KETEK TELITHROMYCIN 2 Tablet 

PERIODONTAL TETRACYCLINE ANTIINFECTIVE, LOCAL 

ATRIDOX DOXYCYCLINE HYCLATE 3 GEL, Sustained Release (EA) 

ARESTIN MINOCYCLINE HCL MICROSPHERES 3 Cartridge (EA) 

ANTIINFECTIVES/MISCELLANEOUS 

VAGINAL ANTISEPTICS 

ACID JELLY ACETIC AC/RICINOLEIC/OXYQUINOL 3 Jelly with Applicator (gm) 

FEM PH ACETIC ACID/OXYQUIN SO4 1 Jelly with Applicator (gm) 

RELAGARD ACETIC ACID/OXYQUIN SO4 3 Jelly with Applicator (gm) 

ANTI-MYCOBACTERIUM AGENTS 

PASER AMINOSALICYLIC ACID 3 Packet 

ETHAMBUTOL HCL ETHAMBUTOL HCL 1 Tablet 

ETHAMBUTOL HYDROCHLORIDE ETHAMBUTOL HCL 1 Tablet 

MYAMBUTOL ETHAMBUTOL HCL 2 Tablet 

TRECATOR ETHIONAMIDE 3 Tablet 

ISONIAZID ISONIAZID 2 Syrup 

ISONIAZID ISONIAZID 1 Tablet 

PYRAZINAMIDE PYRAZINAMIDE 1 Tablet 

PYRAZINAMIDE PYRAZINAMIDE 2 Tablet 

MYCOBUTIN RIFABUTIN 2 Capsule (Hard, Soft, etc.) 

CHEMOTHERAPEUTICS, ANTIBACTERIAL, MISC. 

MONUROL FOSFOMYCIN TROMETHAMINE 3 Packet 

PROSED/DS METH/METH BLUE/BA/SALICY/HYOS 3 Tablet 

HIPREX METHENAMINE HIPPURATE 3 Tablet 

METHENAMINE HIPPURATE METHENAMINE HIPPURATE 1 Tablet 

MANDELAMINE METHENAMINE MANDELATE 2 Tablet 

MANDELAMINE HAFGRAMS METHENAMINE MANDELATE 2 Tablet 

METHENAMINE MANDELATE METHENAMINE MANDELATE 1 Tablet 

UROLENE BLUE METHYLENE BLUE 3 Tablet 

UTA MTH/ME BLUE/SALICY/NA PHOS/HYO 3 Capsule (Hard, Soft, etc.) 

URELLE MTH/ME BLUE/SALICY/NA PHOS/HYO 3 Tablet 

URETRON D/S MTH/ME BLUE/SALICY/NA PHOS/HYO 1 Tablet 

URIMAR-T MTH/ME BLUE/SALICY/NA PHOS/HYO 1 Tablet 

UROGESIC-BLUE MTH/ME BLUE/SALICY/NA PHOS/HYO 1 Tablet 

UTIRA-C MTH/ME BLUE/SALICY/NA PHOS/HYO 1 Tablet 

UTRONA MTH/ME BLUE/SALICY/NA PHOS/HYO 1 Tablet 

Page 16


URO BLUE MTH/ME BLUE/SALICY/NA PHOS/HYO 1 Tablet, Delayed Release (Enteric Coated) 

UTIRA MTH/ME BLUE/SALICY/NA PHOS/HYO 1 Tablet, Delayed Release (Enteric Coated) 

URIN D.S. MTH/ME BLUE/SOD PHOS/PHEN/HYOS 1 Tablet 

PRIMSOL TRIMETHOPRIM 3 Solution, Oral 

TRIMETHOPRIM TRIMETHOPRIM 1 Tablet 

TRIMPEX TRIMETHOPRIM 3 Tablet 

ANTIFUNGAL ANTIBIOTICS 

GRIS-PEG GRISEOFULVIN ULTRAMICROSIZE 3 Tablet 

GRIFULVIN V GRISEOFULVIN,MICROSIZE 3 Suspension, Oral (Final Dose Form) 

GRISEOFULVIN GRISEOFULVIN,MICROSIZE 1 Suspension, Oral (Final Dose Form) 

FULVICIN U/F GRISEOFULVIN,MICROSIZE 3 Tablet 

GRIFULVIN V GRISEOFULVIN,MICROSIZE 3 Tablet 

NYSTATIN NYSTATIN 1 Powder (EA) 

NYSTATIN NYSTATIN 2 Powder (EA) 

NYSTATIN NYSTATIN 1 Powder (gm) 


NYSTATIN NYSTATIN 1 Suspension, Oral (Final Dose Form) 

MYCOSTATIN NYSTATIN 1 Tablet 

NYSTATIN NYSTATIN 1 Tablet 

ANTIFUNGAL AGENTS 

CLOTRIMAZOLE CLOTRIMAZOLE 1 Troche 

MYCELEX CLOTRIMAZOLE 2 Troche 

DIFLUCAN FLUCONAZOLE 3 Suspension, Reconstituted, Oral (ml) 

FLUCONAZOLE FLUCONAZOLE 1 Suspension, Reconstituted, Oral (ml) 

DIFLUCAN FLUCONAZOLE 3 Tablet 

FLUCONAZOLE FLUCONAZOLE 1 Tablet 

ANCOBON FLUCYTOSINE 3 Capsule (Hard, Soft, etc.) 

ITRACONAZOLE ITRACONAZOLE 1 Capsule (Hard, Soft, etc.) 

SPORANOX ITRACONAZOLE 3 Capsule (Hard, Soft, etc.) 

SPORANOX ITRACONAZOLE 3 Solution, Oral 

KETOCONAZOLE KETOCONAZOLE 1 Tablet 

NIZORAL KETOCONAZOLE 3 Tablet 

NOXAFIL POSACONAZOLE 3 Suspension, Oral (Final Dose Form) 

LAMISIL TERBINAFINE HCL 2 Tablet 

TERBINAFINE HCL TERBINAFINE HCL 1 Tablet 

VFEND VORICONAZOLE 3 Suspension, Reconstituted, Oral (ml) 

VFEND VORICONAZOLE 3 Tablet 

ANTIMALARIAL DRUGS 

MALARONE ATOVAQUONE/PROGUANIL HCL 3 Tablet 

ARALEN PHOSPHATE CHLOROQUINE PHOSPHATE 2 Tablet 

CHLOROQUINE PHOSPHATE CHLOROQUINE PHOSPHATE 1 Tablet 

HALFAN HALOFANTRINE HCL 3 Tablet 

HYDROXYCHLOROQUINE SULFATE HYDROXYCHLOROQUINE SULFATE 1 Tablet 

PLAQUENIL HYDROXYCHLOROQUINE SULFATE 3 Tablet 

LARIAM MEFLOQUINE HCL 3 Tablet 

MEFLOQUINE HCL MEFLOQUINE HCL 1 Tablet 

PRIMAQUINE PRIMAQUINE PHOSPHATE 2 Tablet 

DARAPRIM PYRIMETHAMINE 2 Tablet 

FANSIDAR PYRIMETHAMINE/SULFADOXINE 2 Tablet 

QUALAQUIN QUININE SULFATE 2 Capsule (Hard, Soft, etc.) 

QUININE SULFATE QUININE SULFATE 1 Tablet 

AMEBACIDES 

YODOXIN IODOQUINOL 2 Tablet 

HUMATIN PAROMOMYCIN SULFATE 3 Capsule (Hard, Soft, etc.) 

PAROMOMYCIN SULFATE PAROMOMYCIN SULFATE 1 Capsule (Hard, Soft, etc.) 

ANAEROBIC ANTIPROTOZOAL-ANTIBACTERIAL AGENTS 

FLAGYL 375 METRONIDAZOLE 3 Capsule (Hard, Soft, etc.) 

METRONIDAZOLE METRONIDAZOLE 1 Capsule (Hard, Soft, etc.) 

FLAGYL METRONIDAZOLE 3 Tablet 

METRONIDAZOLE METRONIDAZOLE 1 Tablet 

METRYL METRONIDAZOLE 1 Tablet 

FLAGYL ER METRONIDAZOLE 3 Tablet, Sustained Action 

ANTIPROTOZOAL DRUGS, MISCELLANEOUS 

MEPRON ATOVAQUONE 2 Suspension, Oral (Final Dose Form) 

NEBUPENT PENTAMIDINE ISETHIONATE 3 Vial (SDV, MDV or Additive) (EA) 

ANTHELMINTICS 

ALBENZA ALBENDAZOLE 3 Tablet 

Page 17


STROMECTOL IVERMECTIN 3 Tablet 

MEBENDAZOLE MEBENDAZOLE 1 Tablet, Chewable 

BILTRICIDE PRAZIQUANTEL 3 Tablet 

ANTIPARASITICS 

ALINIA NITAZOXANIDE 3 Suspension, Reconstituted, Oral (ml) 

ALINIA NITAZOXANIDE 3 Tablet 

ANTILEPROTICS 

DAPSONE DAPSONE 3 Tablet 

ANTIVIRALS, GENERAL 

ACYCLOVIR ACYCLOVIR 1 Capsule (Hard, Soft, etc.) 

ZOVIRAX ACYCLOVIR 3 Capsule (Hard, Soft, etc.) 

ACYCLOVIR ACYCLOVIR 1 Suspension, Oral (Final Dose Form) 

ZOVIRAX ACYCLOVIR 3 Suspension, Oral (Final Dose Form) 

ACYCLOVIR ACYCLOVIR 1 Tablet 

ZOVIRAX ACYCLOVIR 3 Tablet 

FAMCICLOVIR FAMCICLOVIR 1 Tablet 

FAMVIR FAMCICLOVIR 3 Tablet 

GANCICLOVIR GANCICLOVIR 1 Capsule (Hard, Soft, etc.) 

CYTOVENE GANCICLOVIR SODIUM 3 Vial (SDV, MDV or Additive) (EA) 

TAMIFLU OSELTAMIVIR PHOSPHATE 3 Capsule (Hard, Soft, etc.) 

TAMIFLU OSELTAMIVIR PHOSPHATE 3 Suspension, Reconstituted, Oral (ml) 

VIRAZOLE RIBAVIRIN 3 Vial (SDV, MDV or Additive) (EA) 

FLUMADINE RIMANTADINE HCL 3 Syrup 

FLUMADINE RIMANTADINE HCL 3 Tablet 

RIMANTADINE HCL RIMANTADINE HCL 1 Tablet 

VALTREX VALACYCLOVIR HCL 2 Tablet 

VALCYTE VALGANCICLOVIR HYDROCHLORIDE 3 Tablet 

RELENZA ZANAMIVIR 3 Disk, with Inhalation Device 

ANTIBACTERIAL AGENTS,MISCELLANEOUS 

AMINOACETIC ACID GLYCINE 1 Solution, Irrigation 

GLYCINE GLYCINE 1 Solution, Irrigation 

UROLOGIC SOLUTION G UROLOGIC SOLUTION-G 3 Solution, Irrigation 

QUINOLONES 

CIPRO CIPROFLOXACIN 2 Suspension, Microcapsule Reconstituted 

CIPRO CIPROFLOXACIN HCL 3 Tablet 

CIPROFLOXACIN HCL CIPROFLOXACIN HCL 1 Tablet 

CIPROFLOXACIN HCL CIPROFLOXACIN HCL 1 Tablet 

PROQUIN XR CIPROFLOXACIN HCL 3 Tablet, Sustained Release 24 Hr 

CIPRO XR CIPROFLOXACIN/CIPROFLOXA HCL 3 Tablet, Multiphasic Release 24 Hr 

CIPROFLOXACIN ER CIPROFLOXACIN/CIPROFLOXA HCL 1 Tablet, Multiphasic Release 24 Hr 

FACTIVE GEMIFLOXACIN MESYLATE 3 Tablet 

LEVAQUIN LEVOFLOXACIN 3 Solution, Oral 

LEVAQUIN LEVOFLOXACIN 2 Tablet 

MAXAQUIN LOMEFLOXACIN HCL 3 Tablet 

AVELOX MOXIFLOXACIN HCL 3 Tablet 

AVELOX ABC PACK MOXIFLOXACIN HCL 3 Tablet 

NEGGRAM NALIDIXIC ACID 3 Tablet 

NOROXIN NORFLOXACIN 3 Tablet 

OFLOXACIN OFLOXACIN 1 Tablet 

OFLOXACIN OFLOXACIN 3 Tablet 

ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITORS 

AGENERASE AMPRENAVIR/VITAMIN E/PROP GLY 3 Solution, Oral 

REYATAZ ATAZANAVIR SULFATE 3 Capsule (Hard, Soft, etc.) 

LEXIVA FOSAMPRENAVIR CALCIUM 3 Suspension, Oral (Final Dose Form) 

LEXIVA FOSAMPRENAVIR CALCIUM 3 Tablet 

CRIXIVAN INDINAVIR SULFATE 3 Capsule (Hard, Soft, etc.) 

VIRACEPT NELFINAVIR MESYLATE 3 Powder (gm) 

VIRACEPT NELFINAVIR MESYLATE 3 Tablet 

NORVIR RITONAVIR 3 Capsule (Hard, Soft, etc.) 

NORVIR RITONAVIR 3 Solution, Oral 

INVIRASE SAQUINAVIR MESYLATE 3 Capsule (Hard, Soft, etc.) 

INVIRASE SAQUINAVIR MESYLATE 3 Tablet 

ANTIVIRAL MONOCLONAL ANTIBODIES 

SYNAGIS PALIVIZUMAB 3 Vial (SDV, MDV or Additive) (ml) 

HEPATITIS B TREATMENT AGENTS 

HEPSERA ADEFOVIR DIPIVOXIL 3 Tablet 

BARACLUDE ENTECAVIR 3 Solution, Oral 

Page 18


BARACLUDE ENTECAVIR 3 Tablet 

EPIVIR HBV LAMIVUDINE 3 Solution, Oral 

EPIVIR HBV LAMIVUDINE 3 Tablet 

TYZEKA TELBIVUDINE 3 Tablet 

HEPATITIS C TREATMENT AGENTS 

INFERGEN INTERFERON ALFACON-1 3 Vial (SDV, MDV or Additive) (ml) 

PEGASYS PEGINTERFERON ALFA-2A 3 Kit 

PEGASYS PEGINTERFERON ALFA-2A 3 Vial (SDV, MDV or Additive) (ml) 

PEG-INTRON PEGINTERFERON ALFA-2B 3 Kit 

PEGINTRON REDIPEN PEGINTERFERON ALFA-2B 3 Pen Injector Kit (EA) 

REBETOL RIBAVIRIN 3 Capsule (Hard, Soft, etc.) 

RIBASPHERE RIBAVIRIN 1 Capsule (Hard, Soft, etc.) 

RIBAVIRIN RIBAVIRIN 1 Capsule (Hard, Soft, etc.) 

REBETOL RIBAVIRIN 3 Solution, Oral 

COPEGUS RIBAVIRIN 3 Tablet 

RIBASPHERE RIBAVIRIN 1 Tablet 

RIBATAB RIBAVIRIN 3 Tablet 

RIBAVIRIN RIBAVIRIN 1 Tablet 

RIBAPAK RIBAVIRIN 1 Tablet, Dose Pack 

RIBATAB RIBAVIRIN 3 Tablet, Dose Pack 

REBETRON 1000 RIBAVIRIN/INTERFERON A-2B 3 Kit 



RIFAMYCINS AND RELATED DERIVATIVE ANTIBIOTICS 

XIFAXAN RIFAXIMIN 3 Tablet 

ANTIVIRALS, HIV-SPECIFIC, NUCLEOSIDE-NUCLEOTIDE ANALOG 

TRUVADA EMTRICITABINE/TENOFOVIR 3 Tablet 

ANTIVIRALS, HIV-SPECIFIC, NUCLEOTIDE ANALOG, RTI 

ZIAGEN ABACAVIR SULFATE 3 Solution, Oral 

ZIAGEN ABACAVIR SULFATE 3 Tablet 

DIDANOSINE DIDANOSINE 1 Capsule,Delayed Release (Enteric Coated) 

VIDEX EC DIDANOSINE 3 Capsule,Delayed Release (Enteric Coated) 

VIDEX EC DIDANOSINE 3 Capsule,Delayed Release (Enteric Coated) 

VIDEX DIDANOSINE 3 Solution, Reconstituted, Oral 

EMTRIVA EMTRICITABINE 3 Capsule (Hard, Soft, etc.) 

EMTRIVA EMTRICITABINE 3 Solution, Oral 

EPIVIR LAMIVUDINE 3 Solution, Oral 

EPIVIR LAMIVUDINE 3 Tablet 

ZERIT STAVUDINE 3 Capsule (Hard, Soft, etc.) 

ZERIT STAVUDINE 3 Solution, Reconstituted, Oral 

VIREAD TENOFOVIR DISOPROXIL FUMARATE 3 Tablet 

RETROVIR ZIDOVUDINE 3 Capsule (Hard, Soft, etc.) 

ZIDOVUDINE ZIDOVUDINE 1 Capsule (Hard, Soft, etc.) 

RETROVIR ZIDOVUDINE 3 Syrup 

ZIDOVUDINE ZIDOVUDINE 1 Syrup 

RETROVIR ZIDOVUDINE 3 Tablet 

ZIDOVUDINE ZIDOVUDINE 1 Tablet 

ANTIVIRALS, HIV-SPECIFIC, NON-NUCLEOSIDE, RTI 

RESCRIPTOR DELAVIRDINE MESYLATE 3 Tablet 

RESCRIPTOR DELAVIRDINE MESYLATE 3 Tablet, Dispersible 

SUSTIVA EFAVIRENZ 3 Capsule (Hard, Soft, etc.) 

SUSTIVA EFAVIRENZ 3 Tablet 

INTELENCE ETRAVIRINE 3 Tablet 

VIRAMUNE NEVIRAPINE 3 Suspension, Oral (Final Dose Form) 

VIRAMUNE NEVIRAPINE 3 Tablet 

ANTIVIRALS, HIV-SPECIFIC, NUCLEOSIDE ANALOG, RTI COMBINATION 

EPZICOM ABACAVIR SULFATE/LAMIVUDINE 3 Tablet 

TRIZIVIR ABACAVIR/LAMIVUDINE/ZIDOVUDINE 3 Tablet 

COMBIVIR LAMIVUDINE/ZIDOVUDINE 3 Tablet 

ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITOR COMBINATION 

KALETRA LOPINAVIR/RITONAVIR 3 Solution, Oral 

KALETRA LOPINAVIR/RITONAVIR 3 Tablet 

KALETRA RITONAVIR/LOPINAVIR 3 Capsule (Hard, Soft, etc.) 

ANTIVIRALS, HIV-SPECIFIC, FUSION INHIBITORS 

FUZEON ENFUVIRTIDE 3 Kit 

2ND GEN. ANAEROBIC ANTIPROTOZOAL-ANTIBACTERIAL 

TINDAMAX TINIDAZOLE 3 Tablet 

Page 19


ANTIVIRALS, HIV-SPECIFIC, NON-PEPTIDIC PROTEASE INHIBITOR 

PREZISTA DARUNAVIR ETHANOLATE 3 Tablet 

APTIVUS TIPRANAVIR 3 Capsule (Hard, Soft, etc.) 

ARTV CMB NUCLEOSIDE,NUCLEOTIDE,&NON-NUCLEOSIDE RTI 

ATRIPLA EFAVIRENZ/EMTRICITAB/TENOFOVIR 3 Tablet 

ANTIVIRALS, GENERAL/DIETARY SUPPLEMENT COMBINATION 

RIMANTALIST RIMANTADINE HCL/DIET.SUPP #14 3 Combination Package (EA) 

ANTIVIRALS, HIV-SPECIFIC, CCR5 CO-RECEPTOR ANTAG. 

SELZENTRY MARAVIROC 3 Tablet 

ANTIVIRALS, HIV-1 INTEGRASE STRAND TRANSFER INHIBITOR 

ISENTRESS RALTEGRAVIR POTASSIUM 3 Tablet 

ANTINEOPLASTICS 

TOPICAL ANTINEOPLASTIC & PREMALIGNANT LESION AGENTS 

PANRETIN ALITRETINOIN 3 Gel (gm) 

TARGRETIN BEXAROTENE 3 Gel (gm) 

SOLARAZE DICLOFENAC SODIUM 3 Gel (gm) 

CARAC FLUOROURACIL 2 Cream (Grams) 

EFUDEX FLUOROURACIL 2 Cream (Grams) 

FLUOROPLEX FLUOROURACIL 2 Cream (Grams) 

FLUOROURACIL FLUOROURACIL 1 Cream (Grams) 

EFUDEX FLUOROURACIL 2 Solution, Non-Oral 

FLUOROURACIL FLUOROURACIL 1 Solution, Non-Oral 

EFUDEX FLUOROURACIL/ADHESIVE BANDAGE 3 Kit 

ALKYLATING AGENTS 

HEXALEN ALTRETAMINE 3 Capsule (Hard, Soft, etc.) 

MYLERAN BUSULFAN 3 Tablet 

LEUKERAN CHLORAMBUCIL 3 Tablet 

CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE 1 Tablet 

CYTOXAN CYCLOPHOSPHAMIDE 3 Tablet 

DROXIA HYDROXYUREA 3 Capsule (Hard, Soft, etc.) 

HYDREA HYDROXYUREA 3 Capsule (Hard, Soft, etc.) 

HYDROXYUREA HYDROXYUREA 1 Capsule (Hard, Soft, etc.) 

CEENU LOMUSTINE 3 Capsule (Hard, Soft, etc.) 

ALKERAN MELPHALAN 3 Tablet 

TEMODAR TEMOZOLOMIDE 3 Capsule (Hard, Soft, etc.) 

ANTIMETABOLITES 

XELODA CAPECITABINE 3 Tablet 

MERCAPTOPURINE MERCAPTOPURINE 1 Tablet 

PURINETHOL MERCAPTOPURINE 3 Tablet 

METHOTREXATE METHOTREXATE SODIUM 1 Tablet 

TREXALL METHOTREXATE SODIUM 2 Tablet 

THIOGUANINE THIOGUANINE 3 Tablet 

STEROID ANTINEOPLASTICS 

EMCYT ESTRAMUSTINE PHOSPHATE SODIUM 3 Capsule (Hard, Soft, etc.) 

MEGESTROL ACETATE MEGESTROL ACETATE 1 Tablet 

TESLAC TESTOLACTONE 3 Tablet 

ANTINEOPLASTICS,MISCELLANEOUS 

ARIMIDEX ANASTROZOLE 3 Tablet 

ETOPOSIDE ETOPOSIDE 1 Capsule (Hard, Soft, etc.) 

AROMASIN EXEMESTANE 3 Tablet 

FEMARA LETROZOLE 3 Tablet 

LYSODREN MITOTANE 3 Tablet 

MITOXANTRONE HCL MITOXANTRONE HCL 1 Vial (SDV, MDV or Additive) (ml) 

NOVANTRONE MITOXANTRONE HCL 3 Vial (SDV, MDV or Additive) (ml) 

MATULANE PROCARBAZINE HCL 3 Capsule (Hard, Soft, etc.) 

TRETINOIN TRETINOIN 1 Capsule (Hard, Soft, etc.) 

VESANOID TRETINOIN 3 Capsule (Hard, Soft, etc.) 

IMMUNOMODULATORS 

PROLEUKIN ALDESLEUKIN 3 Vial (SDV, MDV or Additive) (EA) 

ROFERON-A INTERFERON ALFA-2A,RECOMB. 3 Kit 

INTRON A INTERFERON ALFA-2B,RECOMB. 3 Pen Injector Kit (EA) 

ACTIMMUNE INTERFERON GAMMA-1B,RECOMB. 3 Vial (SDV, MDV or Additive) (ml) 

ANTIANDROGENIC AGENTS 

CASODEX BICALUTAMIDE 3 Tablet 

FLUTAMIDE FLUTAMIDE 1 Capsule (Hard, Soft, etc.) 

NILANDRON NILUTAMIDE 3 Tablet 

Page 20


ANTINEOPLASTIC IMMUNOMODULATOR AGENTS 

REVLIMID LENALIDOMIDE 3 Capsule (Hard, Soft, etc.) 

SELECTIVE RETINOID X RECEPTOR AGONISTS (RXR) 

TARGRETIN BEXAROTENE 3 Capsule (Hard, Soft, etc.) 

ANTINEOPLASTIC LHRH(GNRH) AGONIST, PITUITARY SUPPR. 

ELIGARD LEUPROLIDE ACETATE 3 Disposable Syringe (EA) 

LUPRON DEPOT LEUPROLIDE ACETATE 3 Disposable Syringe (EA) 

LEUPROLIDE ACETATE LEUPROLIDE ACETATE 1 Kit 

LUPRON LEUPROLIDE ACETATE 3 Kit 

LUPRON DEPOT LEUPROLIDE ACETATE 3 Kit 

LUPRON LEUPROLIDE ACETATE 3 Vial (SDV, MDV or Additive) (ml) 

PHOTOACTIVATED, ANTINEOPLS. & PREMALIGNANT LESIONS 

LEVULAN AMINOLEVULINIC ACID HCL 3 Solution with Applicator (EA) 

ANTINEOPLASTIC SYSTEMIC ENZYME INHIBITORS 

SPRYCEL DASATINIB 3 Tablet 

TARCEVA ERLOTINIB HCL 3 Tablet 

IRESSA GEFITINIB 3 Tablet 

GLEEVEC IMATINIB MESYLATE 3 Tablet 

TYKERB LAPATINIB DITOSYLATE 3 Tablet 

TASIGNA NILOTINIB HYDROCHLORIDE 3 Capsule (Hard, Soft, etc.) 

NEXAVAR SORAFENIB TOSYLATE 3 Tablet 

SUTENT SUNITINIB MALATE 3 Capsule (Hard, Soft, etc.) 

SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERM) 

SOLTAMOX TAMOXIFEN CITRATE 3 Solution, Oral 

TAMOXIFEN CITRATE TAMOXIFEN CITRATE 1 Tablet 

FARESTON TOREMIFENE CITRATE 3 Tablet 

ANTINEOPLASTIC, HISTONE DEACETYLASE INHIBITORS, HDIS 

ZOLINZA VORINOSTAT 3 Capsule (Hard, Soft, etc.) 

ANTIPARKINSON DRUGS 

DECARBOXYLASE INHIBITORS 

LODOSYN CARBIDOPA 3 Tablet 

ANTIPARKINSONISM DRUGS, OTHER 

AMANTADINE AMANTADINE HCL 1 Capsule (Hard, Soft, etc.) 

AMANTADINE HCL AMANTADINE HCL 1 Capsule (Hard, Soft, etc.) 

AMANTADINE AMANTADINE HCL 1 Syrup 

AMANTADINE HCL AMANTADINE HCL 1 Syrup 

AMANTADINE AMANTADINE HCL 1 Tablet 

APOKYN APOMORPHINE HCL 3 Cartridge (ml) 

BROMOCRIPTINE MESYLATE BROMOCRIPTINE MESYLATE 1 Capsule (Hard, Soft, etc.) 

PARLODEL BROMOCRIPTINE MESYLATE 3 Capsule (Hard, Soft, etc.) 

BROMOCRIPTINE MESYLATE BROMOCRIPTINE MESYLATE 1 Tablet 

PARLODEL BROMOCRIPTINE MESYLATE 3 Tablet 

CARBIDOPA/LEVODOPA CARBIDOPA/LEVODOPA 1 Tablet 

SINEMET-10/100 CARBIDOPA/LEVODOPA 3 Tablet 



PARCOPA CARBIDOPA/LEVODOPA 3 Tablet, Rapid Dissolve 

CARBIDOPA/LEVODOPA CARBIDOPA/LEVODOPA 1 Tablet, Sustained Action 

SINEMET CR CARBIDOPA/LEVODOPA 3 Tablet, Sustained Action 

STALEVO 100 CARBIDOPA/LEVODOPA/ENTACAPONE 3 Tablet 




COMTAN ENTACAPONE 2 Tablet 

MIRAPEX PRAMIPEXOLE DI-HCL 2 Tablet 

AZILECT RASAGILINE MESYLATE 3 Tablet 

REQUIP ROPINIROLE HCL 2 Tablet 

NEUPRO ROTIGOTINE 3 Patch, Transdermal 24 Hr 

ELDEPRYL SELEGILINE HCL 3 Capsule (Hard, Soft, etc.) 

SELEGILINE HCL SELEGILINE HCL 1 Capsule (Hard, Soft, etc.) 

SELEGILINE HCL SELEGILINE HCL 1 Tablet 

ZELAPAR SELEGILINE HCL 3 Tablet, Rapid Dissolve 

TASMAR TOLCAPONE 3 Tablet 

ANTIPARKINSONISM DRUGS, ANTICHOLINERGIC 

BENZTROPINE MESYLATE BENZTROPINE MESYLATE 1 Tablet 

KEMADRIN PROCYCLIDINE HCL 3 Tablet 

Page 21


TRIHEXYPHENIDYL HCL TRIHEXYPHENIDYL HCL 1 Elixir 

TRIHEXYPHENIDYL HCL TRIHEXYPHENIDYL HCL 2 Elixir 

TRIHEXYPHENIDYL HCL TRIHEXYPHENIDYL HCL 1 Tablet 

AUTONOMIC DRUGS 

PARASYMPATHETIC AGENTS 

BETHANECHOL CHLORIDE BETHANECHOL CHLORIDE 1 Tablet 

URECHOLINE BETHANECHOL CHLORIDE 1 Tablet 

EVOXAC CEVIMELINE HCL 2 Capsule (Hard, Soft, etc.) 

GUANIDINE HCL GUANIDINE HCL 3 Tablet 

PILOCARPINE HCL PILOCARPINE HCL 1 Tablet 

SALAGEN PILOCARPINE HCL 2 Tablet 

CHOLINESTERASE INHIBITORS 

MYTELASE AMBENONIUM CHLORIDE 3 Tablet 

ARICEPT DONEPEZIL HCL 2 Tablet 

ARICEPT ODT DONEPEZIL HCL 2 Tablet, Rapid Dissolve 

RAZADYNE ER GALANTAMINE HYDROBROMIDE 3 Capsule, 24Hr Sustained Release Pellets 

RAZADYNE GALANTAMINE HYDROBROMIDE 3 Solution, Oral 

RAZADYNE GALANTAMINE HYDROBROMIDE 3 Tablet 

PROSTIGMIN NEOSTIGMINE BROMIDE 3 Tablet 

MESTINON PYRIDOSTIGMINE BROMIDE 3 Syrup 

MESTINON PYRIDOSTIGMINE BROMIDE 3 Tablet 

PYRIDOSTIGMINE BROMIDE PYRIDOSTIGMINE BROMIDE 1 Tablet 

MESTINON PYRIDOSTIGMINE BROMIDE 3 Tablet, Sustained Action 

EXELON RIVASTIGMINE 2 Patch, Transdermal 24 Hr 

EXELON RIVASTIGMINE TARTRATE 2 Capsule (Hard, Soft, etc.) 

EXELON RIVASTIGMINE TARTRATE 3 Solution, Oral 

COGNEX TACRINE HCL 3 Capsule (Hard, Soft, etc.) 

ADRENERGICS, AROMATIC, NON-CATECHOLAMINE 

ADDERALL XR AMPHET ASP/AMPHET/D-AMPHET 2 Capsule, Sustained Release 24 Hr 

ADDERALL AMPHET ASP/AMPHET/D-AMPHET 3 Tablet 

AMPHETAMINE SALT COMBO AMPHET ASP/AMPHET/D-AMPHET 1 Tablet 

DEXEDRINE D-AMPHETAMINE SULFATE 3 Capsule, Sustained Action 

DEXTROAMPHETAMINE SULFATE D-AMPHETAMINE SULFATE 1 Capsule, Sustained Action 

DEXTROAMPHETAMINE SULFATE D-AMPHETAMINE SULFATE 1 Tablet 

DEXTROSTAT D-AMPHETAMINE SULFATE 1 Tablet 

DESOXYN METHAMPHETAMINE HCL 3 Tablet 

ALPHA-ADRENERGIC BLOCKING AGENTS 

DIBENZYLINE PHENOXYBENZAMINE HCL 3 Capsule (Hard, Soft, etc.) 

BETA-ADRENERGIC BLOCKING AGENTS 

ACEBUTOLOL HCL ACEBUTOLOL HCL 1 Capsule (Hard, Soft, etc.) 

SECTRAL ACEBUTOLOL HCL 3 Capsule (Hard, Soft, etc.) 

ATENOLOL ATENOLOL 1 Tablet 

TENORMIN ATENOLOL 3 Tablet 

BETAXOLOL HCL BETAXOLOL HCL 1 Tablet 

KERLONE BETAXOLOL HCL 3 Tablet 

BISOPROLOL FUMARATE BISOPROLOL FUMARATE 1 Tablet 

ZEBETA BISOPROLOL FUMARATE 3 Tablet 

METOPROLOL SUCCINATE METOPROLOL SUCCINATE 1 Tablet, Sustained Release 24 Hr 

TOPROL XL METOPROLOL SUCCINATE 2 Tablet, Sustained Release 24 Hr 

LOPRESSOR METOPROLOL TARTRATE 3 Tablet 

METOPROLOL TARTRATE METOPROLOL TARTRATE 1 Tablet 

METOPROLOL TARTRATE METOPROLOL TARTRATE 3 Tablet 

CORGARD NADOLOL 3 Tablet 

NADOLOL NADOLOL 1 Tablet 

BYSTOLIC NEBIVOLOL HCL 3 Tablet 

LEVATOL PENBUTOLOL SULFATE 3 Tablet 

PINDOLOL PINDOLOL 1 Tablet 

INDERAL LA PROPRANOLOL HCL 3 Capsule, Sustained Action 24 Hr 

PROPRANOLOL HCL PROPRANOLOL HCL 1 Capsule, Sustained Action 24 Hr 

INNOPRAN XL PROPRANOLOL HCL 3 Capsule, Sustained Release 24 Hr 

PROPRANOLOL HCL PROPRANOLOL HCL 3 Solution, Oral 

PROPRANOLOL HCL PROPRANOLOL HCL 1 Tablet 

BETAPACE SOTALOL HCL 3 Tablet 

BETAPACE AF SOTALOL HCL 2 Tablet 

SORINE SOTALOL HCL 1 Tablet 

SOTALOL SOTALOL HCL 1 Tablet 

SOTALOL AF SOTALOL HCL 1 Tablet 

Page 22


SOTALOL HCL SOTALOL HCL 1 Tablet 

TIMOLOL MALEATE TIMOLOL MALEATE 1 Tablet 

NEUROMUSCULAR BLOCKING AGENTS 

BOTOX BOTULINUM TOXIN TYPE A 3 Vial (SDV, MDV or Additive) (EA) 

BOTOX COSMETIC BOTULINUM TOXIN TYPE A 3 Vial (SDV, MDV or Additive) (EA) 

MYOBLOC BOTULINUM TOXIN TYPE B 3 Vial (SDV, MDV or Additive) (ml) 

SUX-CERT 1000 SUCCINYLCHOLINE CHLORIDE 3 Solution, Irrigation 

SUX-CERT 500 SUCCINYLCHOLINE CHLORIDE 3 Solution, Irrigation 

ANAPHYLAXIS THERAPY AGENTS 

TWINJECT EPINEPHRINE 3 Combination Package (EA) 

EPIPEN EPINEPHRINE 2 Pen Injector (EA) 

EPIPEN JR EPINEPHRINE 2 Pen Injector (EA) 

ADRENERGIC VASOPRESSOR AGENTS 

MIDODRINE HCL MIDODRINE HCL 1 Tablet 

PROAMATINE MIDODRINE HCL 3 Tablet 

BETA-ADRENERGIC BLOCKING AGENTS/DIETARY SUPP COMB. 

HYPERTENSOLOL METOPROLOL/DIETARY SUPPL.CMB10 3 Combination Package (EA) 

BLOOD 

ANTIHEMOPHILIC FACTORS 

HUMATE-P AHF,HUMAN/VWF,HUMAN 3 Kit 

KOGENATE ANTIHEMOPHILIC FACTOR, HUM REC 3 Kit 

REFACTO ANTIHEMOPHILIC FACTOR, HUM REC 3 Kit 

HELIXATE FS ANTIHEMOPHILIC FACTOR, HUM REC 1 Vial (SDV, MDV or Additive) (EA) 

HELIXATE FS ANTIHEMOPHILIC FACTOR, HUM REC 3 Vial (SDV, MDV or Additive) (EA) 

KOGENATE FS ANTIHEMOPHILIC FACTOR, HUM REC 1 Vial (SDV, MDV or Additive) (EA) 

KOGENATE FS ANTIHEMOPHILIC FACTOR, HUM REC 3 Vial (SDV, MDV or Additive) (EA) 

RECOMBINATE ANTIHEMOPHILIC FACTOR, HUM REC 1 Vial (SDV, MDV or Additive) (EA) 

KOATE-DVI ANTIHEMOPHILIC FACTOR,HUMAN 1 Kit 

KOATE-DVI ANTIHEMOPHILIC FACTOR,HUMAN 3 Kit 

MONOCLATE-P ANTIHEMOPHILIC FACTOR,HUMAN 3 Kit 

MONOCLATE-P ANTIHEMOPHILIC FACTOR,HUMAN 3 Kit 

ALPHANATE ANTIHEMOPHILIC FACTOR,HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

HEMOFIL M ANTIHEMOPHILIC FACTOR,HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

MONARC-M ANTIHEMOPHILIC FACTOR,HUMAN 1 Vial (SDV, MDV or Additive) (EA) 

MONARC-M ANTIHEMOPHILIC FACTOR,HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

FEIBA VH IMMUNO ANTI-INHIBITOR COAGULANT COMP. 3 Vial (SDV, MDV or Additive) (EA) 

NOVOSEVEN FACTOR VIIA,RECOMB(BHK CELLS) 3 Vial (SDV, MDV or Additive) (EA) 

FACTOR IX PREPARATIONS 

ALPHANINE SD FACTOR IX 3 Vial (SDV, MDV or Additive) (EA) 

MONONINE FACTOR IX 3 Vial (SDV, MDV or Additive) (EA) 

BEBULIN VH IMMUNO FACTOR IX COMPLEX HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

PROFILNINE SD FACTOR IX COMPLEX HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

PROPLEX T FACTOR IX COMPLEX HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

BENEFIX FACTOR IX HUMAN RECOMBINANT 3 Kit 

TOPICAL HEMOSTATICS 

ASTRINGYN FERRIC SUBSULFATE 3 Solution (gm) 

GELFOAM GELATIN SPONGE,ABSORBABLE 1 Powder (gm) 

SURGIFOAM GELATIN SPONGE,ABSORBABLE 1 Powder (gm) 

GELFOAM GELATIN SPONGE,ABSORBABLE 3 Sponge 

GELFOAM GELATIN SPONGE,ABSORBABLE 3 Sponge 

GELFOAM COMPRESSED GELATIN SPONGE,ABSORBABLE 3 Sponge 

GELFOAM PACKS GELATIN SPONGE,ABSORBABLE 3 Sponge 

SURGIFOAM GELATIN SPONGE,ABSORBABLE 1 Sponge 

SURGIFOAM GELATIN SPONGE,ABSORBABLE 3 Sponge 

HELITENE MICROFIBRILLAR COLLAGEN 1 Each 

HELITENE MICROFIBRILLAR COLLAGEN 3 Each 

INSTAT MCH MICROFIBRILLAR COLLAGEN 1 Each 

AVITENE MICROFIBRILLAR COLLAGEN 3 Powder (gm) 

AVITENE MICROFIBRILLAR COLLAGEN 3 Sheet (EA) 

ENDO-AVITENE MICROFIBRILLAR COLLAGEN 3 Sheet (EA) 

ULTRAFOAM MICROFIBRILLAR COLLAGEN 3 Sponge 

THROMBI-PAD THROMB-CA-CELL-DRESSING, HEMOS 3 Pads, Medicated (EA) 

THROMBIN-JMI THROMBIN (BOVINE) 3 Kit 

THROMBOGEN THROMBIN (BOVINE) 1 Kit 

THROMBOGEN THROMBIN (BOVINE) 3 Kit 

THROMBIN-JMI THROMBIN (BOVINE) 3 Vial (SDV, MDV or Additive) (EA) 

THROMBIN-JMI THROMBIN (BOVINE) 3 Vial (SDV, MDV or Additive) (EA) 

Page 23


THROMBOGEN THROMBIN (BOVINE) 1 Vial (SDV, MDV or Additive) (EA) 

THROMBOGEN THROMBIN (BOVINE) 3 Vial (SDV, MDV or Additive) (EA) 

RECOTHROM THROMBIN (RECOMBINANT) 3 Vial (SDV, MDV or Additive) (EA) 

TISSEEL VHSD THROMBIN(HUM PLAS)/FIB/APRO/CA 3 Disposable Syringe (ml) 

TISSEEL VH THROMBIN(HUM PLAS)/FIB/APRO/CA 3 Kit 

EVICEL THROMBIN(HUM PLAS)/FIBRINOG/CA 3 Vial (SDV, MDV or Additive) (ml) 

THROMBI-GEL THROMBIN/CA/CMC/GEL/DRESS, HEM 3 Pads, Medicated (EA) 

HEMASEEL APR THROMBIN/FIBRINOGEN/APRO/CAL 1 Kit 

TISSEEL VH THROMBIN/FIBRINOGEN/APRO/CAL 1 Kit 

ANTIFIBRINOLYTIC AGENTS 

AMICAR AMINOCAPROIC ACID 3 Syrup 

AMINOCAPROIC ACID AMINOCAPROIC ACID 1 Syrup 

AMICAR AMINOCAPROIC ACID 3 Tablet 

AMICAR AMINOCAPROIC ACID 3 Tablet 

AMINOCAPROIC ACID AMINOCAPROIC ACID 1 Tablet 

HEPARIN AND RELATED PREPARATIONS 

FRAGMIN DALTEPARIN SODIUM,PORCINE 3 Disposable Syringe (ml) 

FRAGMIN DALTEPARIN SODIUM,PORCINE 3 Vial (SDV, MDV or Additive) (ml) 

LOVENOX ENOXAPARIN SODIUM 3 Disposable Syringe (ml) 

LOVENOX ENOXAPARIN SODIUM 3 Vial (SDV, MDV or Additive) (ml) 

ARIXTRA FONDAPARINUX SODIUM 3 Disposable Syringe (ml) 

INNOHEP TINZAPARIN SODIUM,PORCINE 3 Vial (SDV, MDV or Additive) (ml) 

ANTICOAGULANTS, COUMARIN TYPE 

COUMADIN WARFARIN SODIUM 3 Tablet 

JANTOVEN WARFARIN SODIUM 1 Tablet 

WARFARIN SODIUM WARFARIN SODIUM 1 Tablet 

HEMORRHEOLOGIC AGENTS 

PENTOXIFYLLINE PENTOXIFYLLINE 1 Tablet, Sustained Action 

PENTOXIL PENTOXIFYLLINE 1 Tablet, Sustained Action 

TRENTAL PENTOXIFYLLINE 3 Tablet, Sustained Action 

HEMATINICS, OTHER 

ARANESP DARBEPOETIN ALFA IN POLYSORBAT 3 Pen Injector (ml) 

LEUKOCYTE (WBC) STIMULANTS 

NEULASTA PEGFILGRASTIM 3 Disposable Syringe (ml) 

PLATELET AGGREGATION INHIBITORS 

AGGRENOX ASPIRIN/DIPYRIDAMOLE 2 Capsule, Multiphasic Release 12 Hr 

CILOSTAZOL CILOSTAZOL 1 Tablet 

PLETAL CILOSTAZOL 3 Tablet 

PLAVIX CLOPIDOGREL BISULFATE 3 Tablet 

DIPYRIDAMOLE DIPYRIDAMOLE 1 Tablet 

PERSANTINE DIPYRIDAMOLE 3 Tablet 

TICLID TICLOPIDINE HCL 3 Tablet 

TICLOPIDINE HCL TICLOPIDINE HCL 1 Tablet 

PLATELET REDUCING AGENTS 

AGRYLIN ANAGRELIDE HCL 2 Capsule (Hard, Soft, etc.) 

ANAGRELIDE HCL ANAGRELIDE HCL 1 Capsule (Hard, Soft, etc.) 

PLATELET PROLIFERATION STIMULANTS 

NEUMEGA OPRELVEKIN 3 Vial (SDV, MDV or Additive) (EA) 

THROMBIN INHIBITORS, SEL., DIRECT, & REV.-HIRUDIN TYPE 

REFLUDAN LEPIRUDIN,RECOMBINANT 3 Vial (SDV, MDV or Additive) (EA) 

CARDIAC DRUGS 

DIGITALIS GLYCOSIDES 

LANOXICAPS DIGOXIN 2 Capsule (Hard, Soft, etc.) 

DIGOXIN DIGOXIN 1 Solution, Oral 

DIGITEK DIGOXIN 1 Tablet 

DIGITEK DIGOXIN 3 Tablet 

DIGOXIN DIGOXIN 1 Tablet 

LANOXIN DIGOXIN 3 Tablet 

ANTIARRHYTHMICS 

AMIODARONE HCL AMIODARONE HCL 1 Tablet 

CORDARONE AMIODARONE HCL 2 Tablet 

PACERONE AMIODARONE HCL 1 Tablet 

PACERONE AMIODARONE HCL 2 Tablet 

DISOPYRAMIDE PHOSPHATE DISOPYRAMIDE PHOSPHATE 1 Capsule (Hard, Soft, etc.) 

NORPACE DISOPYRAMIDE PHOSPHATE 2 Capsule (Hard, Soft, etc.) 

DISOPYRAMIDE PHOSPHATE DISOPYRAMIDE PHOSPHATE 1 Capsule, Sustained Action 

Page 24


NORPACE CR DISOPYRAMIDE PHOSPHATE 2 Capsule, Sustained Action 

NORPACE CR DISOPYRAMIDE PHOSPHATE 2 Capsule, Sustained Action 

TIKOSYN DOFETILIDE 3 Capsule (Hard, Soft, etc.) 

FLECAINIDE ACETATE FLECAINIDE ACETATE 1 Tablet 

TAMBOCOR FLECAINIDE ACETATE 3 Tablet 

MEXILETINE HCL MEXILETINE HCL 1 Capsule (Hard, Soft, etc.) 

MEXILETINE HCL MEXILETINE HCL 1 Capsule (Hard, Soft, etc.) 

ETHMOZINE MORICIZINE HCL 3 Tablet 

PRONESTYL PROCAINAMIDE HCL 2 Capsule (Hard, Soft, etc.) 

PRONESTYL PROCAINAMIDE HCL 2 Tablet 

PROCAINAMIDE HCL PROCAINAMIDE HCL 1 Tablet, Sustained Action 

PRONESTYL-SR PROCAINAMIDE HCL 2 Tablet, Sustained Action 

PROCANBID PROCAINAMIDE HCL 2 Tablet, Sustained Release 12 Hr 

RYTHMOL SR PROPAFENONE HCL 3 Capsule, Sustained Release 12 Hr 

PROPAFENONE HCL PROPAFENONE HCL 1 Tablet 

RYTHMOL PROPAFENONE HCL 3 Tablet 

QUINIDINE GLUCONATE QUINIDINE GLUCONATE 1 Tablet, Sustained Action 

QUINIDINE SULFATE QUINIDINE SULFATE 1 Tablet 

QUINIDINE SULFATE QUINIDINE SULFATE 1 Tablet, Sustained Action 

VASODILATORS, CORONARY 

AMYL NITRITE AMYL NITRITE 3 Ampul (EA) 

DILATRATE-SR ISOSORBIDE DINITRATE 2 Capsule, Sustained Action 

ISORDIL ISOSORBIDE DINITRATE 3 Tablet 

ISORDIL ISOSORBIDE DINITRATE 2 Tablet 

ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE 1 Tablet 

ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE 1 Tablet, Sublingual 

ISOCHRON ISOSORBIDE DINITRATE 2 Tablet, Sustained Action 

ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE 1 Tablet, Sustained Action 

ISMO ISOSORBIDE MONONITRATE 3 Tablet 

ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATE 1 Tablet 

MONOKET ISOSORBIDE MONONITRATE 3 Tablet 

IMDUR ISOSORBIDE MONONITRATE 3 Tablet, Sustained Release 24 Hr 

ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATE 1 Tablet, Sustained Release 24 Hr 

NITROGLYCERIN NITROGLYCERIN 1 Capsule, Sustained Action 

NITROGLYCERIN NITROGLYCERIN 2 Capsule, Sustained Action 

NITRO-TIME NITROGLYCERIN 1 Capsule, Sustained Action 

NITRO-BID NITROGLYCERIN 2 Ointment (gm) 

MINITRAN NITROGLYCERIN 2 Patch, Transdermal 24 Hr 

NITRO-DUR NITROGLYCERIN 2 Patch, Transdermal 24 Hr 

NITROGLYCERIN NITROGLYCERIN 1 Patch, Transdermal 24 Hr 

NITROGLYCERIN PATCH NITROGLYCERIN 1 Patch, Transdermal 24 Hr 

NITROGLYCERIN TRANSDERMAL NITROGLYCERIN 1 Patch, Transdermal 24 Hr 

NITROLINGUAL NITROGLYCERIN 2 Spray, Non-Aerosol (gm) 

NITROGLYCERIN NITROGLYCERIN 1 Tablet, Sublingual 

NITROQUICK NITROGLYCERIN 1 Tablet, Sublingual 

NITROSTAT NITROGLYCERIN 2 Tablet, Sublingual 

CALCIUM CHANNEL BLOCKING AGENTS 

AMLODIPINE BESYLATE AMLODIPINE BESYLATE 1 Tablet 

NORVASC AMLODIPINE BESYLATE 2 Tablet 

DILACOR XR DILTIAZEM HCL 3 Capsule, Degradable Controlled-Release 

DILTIA XT DILTIAZEM HCL 1 Capsule, Degradable Controlled-Release 

DILTIAZEM ER DILTIAZEM HCL 1 Capsule, Degradable Controlled-Release 

DILTIAZEM HCL DILTIAZEM HCL 1 Capsule, Degradable Controlled-Release 

DILTIAZEM XR DILTIAZEM HCL 1 Capsule, Degradable Controlled-Release 

DILT-XR DILTIAZEM HCL 1 Capsule, Degradable Controlled-Release 

DILTIAZEM ER DILTIAZEM HCL 1 Capsule, Sustained Action 

TAZTIA XT DILTIAZEM HCL 1 Capsule, Sustained Action 

TIAZAC DILTIAZEM HCL 3 Capsule, Sustained Action 

DILTIAZEM ER DILTIAZEM HCL 1 Capsule, Sustained Release 12 Hr 

CARDIZEM CD DILTIAZEM HCL 3 Capsule, Sustained Release 24 Hr 

CARTIA XT DILTIAZEM HCL 1 Capsule, Sustained Release 24 Hr 

DILT-CD DILTIAZEM HCL 1 Capsule, Sustained Release 24 Hr 

DILTIAZEM ER DILTIAZEM HCL 1 Capsule, Sustained Release 24 Hr 

DILTIAZEM HCL DILTIAZEM HCL 1 Capsule, Sustained Release 24 Hr 

CARDIZEM DILTIAZEM HCL 3 Tablet 

DILTIAZEM HCL DILTIAZEM HCL 1 Tablet 

CARDIZEM LA DILTIAZEM HCL 3 Tablet, Sustained Release 24 Hr 

FELODIPINE ER FELODIPINE 1 Tablet, Sustained Release 24 Hr 

Page 25


PLENDIL FELODIPINE 3 Tablet, Sustained Release 24 Hr 

ISRADIPINE ISRADIPINE 1 Capsule (Hard, Soft, etc.) 

ISRADIPINE ISRADIPINE 3 Capsule (Hard, Soft, etc.) 

DYNACIRC CR ISRADIPINE 3 Tablet, SR Osmotic Push 24 Hr 

CARDENE NICARDIPINE HCL 3 Capsule (Hard, Soft, etc.) 

NICARDIPINE HCL NICARDIPINE HCL 1 Capsule (Hard, Soft, etc.) 

CARDENE SR NICARDIPINE HCL 3 Capsule, Sustained Action 

NIFEDIPINE NIFEDIPINE 1 Capsule (Hard, Soft, etc.) 

NIFEDIPINE NIFEDIPINE 1 Capsule (Hard, Soft, etc.) 

PROCARDIA NIFEDIPINE 3 Capsule (Hard, Soft, etc.) 

NIFEDICAL XL NIFEDIPINE 1 Tablet, SR Osmotic Push 24 Hr 

NIFEDIPINE ER NIFEDIPINE 1 Tablet, SR Osmotic Push 24 Hr 

PROCARDIA XL NIFEDIPINE 3 Tablet, SR Osmotic Push 24 Hr 

ADALAT CC NIFEDIPINE 3 Tablet, Sustained Action 

AFEDITAB CR NIFEDIPINE 1 Tablet, Sustained Action 

NIFEDIAC CC NIFEDIPINE 1 Tablet, Sustained Action 

NIFEDIPINE ER NIFEDIPINE 1 Tablet, Sustained Action 

NIMODIPINE NIMODIPINE 1 Capsule (Hard, Soft, etc.) 

NIMOTOP NIMODIPINE 3 Capsule (Hard, Soft, etc.) 

SULAR NISOLDIPINE 2 Tablet, Sustained Release 24 Hr 

VERAPAMIL ER VERAPAMIL HCL 1 Capsule, 24Hr Sustained Release Pellets 

VERAPAMIL HCL VERAPAMIL HCL 1 Capsule, 24Hr Sustained Release Pellets 

VERELAN VERAPAMIL HCL 3 Capsule, 24Hr Sustained Release Pellets 

VERELAN PM VERAPAMIL HCL 3 Capsule, 24Hr Sustained Release Pellets 

CALAN VERAPAMIL HCL 3 Tablet 

VERAPAMIL HCL VERAPAMIL HCL 1 Tablet 

COVERA-HS VERAPAMIL HCL 3 Tablet, SR Osmotic Push 24 Hr 

CALAN SR VERAPAMIL HCL 3 Tablet, Sustained Action 

ISOPTIN SR VERAPAMIL HCL 1 Tablet, Sustained Action 

ISOPTIN SR VERAPAMIL HCL 3 Tablet, Sustained Action 

VERAPAMIL HCL VERAPAMIL HCL 1 Tablet, Sustained Action 

ANTIANGINAL & ANTI-ISCHEMIC AGENTS, NON-HEMODYNAMIC 

RANEXA RANOLAZINE 3 Tablet, Sustained Release 12 Hr 

CARDIOVASCULAR 

ANTIHYPERTENSIVES, VASODILATORS 

HYDRALAZINE HCL HYDRALAZINE HCL 1 Tablet 

HYDRA-ZIDE HYDRALAZINE/HYDROCHLOROTHIAZID 1 Capsule (Hard, Soft, etc.) 

HYDRA-ZIDE HYDRALAZINE/HYDROCHLOROTHIAZID 3 Capsule (Hard, Soft, etc.) 

UNI-SERP HYDRALAZINE/RESERPIN/HCTZ 3 Tablet 

MINODIXIL MINOXIDIL 1 Tablet 

MINOXIDIL MINOXIDIL 1 Tablet 

ANTIHYPERTENSIVES, SYMPATHOLYTIC 

CATAPRES-TTS 1 CLONIDINE HCL 3 Patch, Transdermal Weekly 



CATAPRES CLONIDINE HCL 3 Tablet 

CLONIDINE HCL CLONIDINE HCL 1 Tablet 

CLORPRES CLONIDINE HCL/CHLORTHALIDONE 3 Tablet 

GUANABENZ ACETATE GUANABENZ ACETATE 1 Tablet 

GUANFACINE HCL GUANFACINE HCL 1 Tablet 

TENEX GUANFACINE HCL 3 Tablet 

ALDOMET METHYLDOPA 2 Tablet 

METHYLDOPA METHYLDOPA 1 Tablet 

ALDORIL-D50 METHYLDOPA/HYDROCHLOROTHIAZIDE 3 Tablet 

METHYLDOPA-HYDROCHLOROTHIAZIDE METHYLDOPA/HYDROCHLOROTHIAZIDE 1 Tablet 

RESERPINE RESERPINE 1 Tablet 

RESERPINE RESERPINE 3 Tablet 

ANTIHYPERTENSIVES, GANGLIONIC BLOCKERS 

INVERSINE MECAMYLAMINE HCL 3 Tablet 

ANTIHYPERTENSIVES, ACE INHIBITORS 

BENAZEPRIL HCL BENAZEPRIL HCL 1 Tablet 

LOTENSIN BENAZEPRIL HCL 3 Tablet 

CAPOTEN CAPTOPRIL 3 Tablet 

CAPTOPRIL CAPTOPRIL 1 Tablet 

ENALAPRIL MALEATE ENALAPRIL MALEATE 1 Tablet 

ENALAPRIL MALEATE ENALAPRIL MALEATE 3 Tablet 

VASOTEC ENALAPRIL MALEATE 3 Tablet 

Page 26


FOSINOPRIL SODIUM FOSINOPRIL SODIUM 1 Tablet 

MONOPRIL FOSINOPRIL SODIUM 3 Tablet 

LISINOPRIL LISINOPRIL 1 Tablet 

LISINOPRIL LISINOPRIL 3 Tablet 

PRINIVIL LISINOPRIL 1 Tablet 

PRINIVIL LISINOPRIL 3 Tablet 

ZESTRIL LISINOPRIL 3 Tablet 

MOEXIPRIL HCL MOEXIPRIL HCL 1 Tablet 

UNIVASC MOEXIPRIL HCL 3 Tablet 

ACEON PERINDOPRIL ERBUMINE 3 Tablet 

ACCUPRIL QUINAPRIL HCL 3 Tablet 

QUINAPRIL HCL QUINAPRIL HCL 1 Tablet 

ALTACE RAMIPRIL 2 Capsule (Hard, Soft, etc.) 

RAMIPRIL RAMIPRIL 1 Capsule (Hard, Soft, etc.) 

ALTACE RAMIPRIL 2 Tablet 

MAVIK TRANDOLAPRIL 3 Tablet 

TRANDOLAPRIL TRANDOLAPRIL 1 Tablet 

ANTIHYPERTENSIVES, MISCELLANEOUS 

ATENOLOL W/CHLORTHALIDONE ATENOLOL/CHLORTHALIDONE 1 Tablet 

TENORETIC 100 ATENOLOL/CHLORTHALIDONE 3 Tablet 

TENORETIC 50 ATENOLOL/CHLORTHALIDONE 3 Tablet 

BISOPROLOL FUMARATE/HCTZ BISOPROL/HYDROCHLOROTHIAZIDE 1 Tablet 

ZIAC BISOPROL/HYDROCHLOROTHIAZIDE 3 Tablet 

LOPRESSOR HCT METOPROL/HYDROCHLOROTHIAZIDE 3 Tablet 

METOPROLOL-HYDROCHLOROTHIAZIDE METOPROL/HYDROCHLOROTHIAZIDE 1 Tablet 

DEMSER METYROSINE 3 Capsule (Hard, Soft, etc.) 

CORZIDE NADOLOL/BENDROFLUMETHIAZIDE 3 Tablet 

NADOLOL-BENDROFLUMETHIAZIDE NADOLOL/BENDROFLUMETHIAZIDE 1 Tablet 

PROPRANOLOL HCL W/HCTZ PROPRANOLOL/HYDROCHLOROTHIAZID 1 Tablet 

VASODILATORS, PERIPHERAL 

ERGOLOID MESYLATES ERGOLOID MESYLATES 1 Tablet 

ISOVEX ETHAVERINE HCL 3 Capsule (Hard, Soft, etc.) 

ISOXSUPRINE HCL ISOXSUPRINE HCL 1 Tablet 

VASODILAN ISOXSUPRINE HCL 3 Tablet 

PAPAVERINE HCL PAPAVERINE HCL 1 Capsule, Sustained Action 

PARA-TIME PAPAVERINE HCL 1 Capsule, Sustained Action 

BILE SALT SEQUESTRANTS 

CHOLESTYRAMINE LIGHT CHOLESTYRAMINE/ASPARTAME 1 Packet 

PREVALITE CHOLESTYRAMINE/ASPARTAME 1 Packet 

QUESTRAN LIGHT CHOLESTYRAMINE/ASPARTAME 1 Packet 

CHOLESTYRAMINE LIGHT CHOLESTYRAMINE/ASPARTAME 1 Powder (gm) 

PREVALITE CHOLESTYRAMINE/ASPARTAME 1 Powder (gm) 

QUESTRAN LIGHT CHOLESTYRAMINE/ASPARTAME 1 Powder (gm) 

CHOLESTYRAMINE CHOLESTYRAMINE/SUCROSE 1 Packet 

QUESTRAN CHOLESTYRAMINE/SUCROSE 3 Packet 

CHOLESTYRAMINE CHOLESTYRAMINE/SUCROSE 1 Powder (gm) 

QUESTRAN CHOLESTYRAMINE/SUCROSE 3 Powder (gm) 

WELCHOL COLESEVELAM HCL 3 Tablet 

COLESTID COLESTIPOL HCL 1 Granules; Power-Like, Non-Effervescent (gm) 

COLESTID COLESTIPOL HCL 2 Granules; Power-Like, Non-Effervescent (gm) 

COLESTIPOL HCL COLESTIPOL HCL 1 Granules; Power-Like, Non-Effervescent (gm) 

COLESTID COLESTIPOL HCL 2 Packet 

COLESTIPOL HCL COLESTIPOL HCL 1 Packet 

COLESTID COLESTIPOL HCL 2 Tablet 

COLESTIPOL HCL COLESTIPOL HCL 1 Tablet 

ALPHA/BETA-ADRENERGIC BLOCKING AGENTS 

CARVEDILOL CARVEDILOL 1 Tablet 

COREG CARVEDILOL 2 Tablet 

COREG CR CARVEDILOL PHOSPHATE 2 Capsule, Multiphasic 24 Hr 

LABETALOL HCL LABETALOL HCL 1 Tablet 

TRANDATE LABETALOL HCL 3 Tablet 

ALPHA-ADRENERGIC BLOCKING AGENTS 

CARDURA DOXAZOSIN MESYLATE 3 Tablet 

DOXAZOSIN MESYLATE DOXAZOSIN MESYLATE 1 Tablet 

CARDURA XL DOXAZOSIN MESYLATE 3 Tablet, SR Osmotic Push 24 Hr 

MINIPRESS PRAZOSIN HCL 3 Capsule (Hard, Soft, etc.) 

PRAZOSIN HCL PRAZOSIN HCL 1 Capsule (Hard, Soft, etc.) 

Page 27


HYTRIN TERAZOSIN HCL 3 Capsule (Hard, Soft, etc.) 

TERAZOSIN HCL TERAZOSIN HCL 1 Capsule (Hard, Soft, etc.) 

LIPOTROPICS 

LIPITOR ATORVASTATIN CALCIUM 2 Tablet 

CLOFIBRATE CLOFIBRATE 3 Capsule (Hard, Soft, etc.) 

ZETIA EZETIMIBE 3 Tablet 

VYTORIN EZETIMIBE/SIMVASTATIN 3 Tablet 

LIPOFEN FENOFIBRATE 3 Capsule (Hard, Soft, etc.) 

TRIGLIDE FENOFIBRATE 3 Tablet 

TRICOR FENOFIBRATE NANOCRYSTALLIZED 2 Tablet 

ANTARA FENOFIBRATE,MICRONIZED 2 Capsule (Hard, Soft, etc.) 

FENOFIBRATE FENOFIBRATE,MICRONIZED 1 Capsule (Hard, Soft, etc.) 

LOFIBRA FENOFIBRATE,MICRONIZED 3 Capsule (Hard, Soft, etc.) 

FENOFIBRATE FENOFIBRATE,MICRONIZED 1 Tablet 

LOFIBRA FENOFIBRATE,MICRONIZED 3 Tablet 

LESCOL FLUVASTATIN SODIUM 3 Capsule (Hard, Soft, etc.) 

LESCOL XL FLUVASTATIN SODIUM 3 Tablet, Sustained Release 24 Hr 

GEMFIBROZIL GEMFIBROZIL 1 Tablet 

LOPID GEMFIBROZIL 3 Tablet 

LOVASTATIN LOVASTATIN 1 Tablet 

MEVACOR LOVASTATIN 3 Tablet 

ALTOPREV LOVASTATIN 3 Tablet, Sustained Release 24 Hr 

LIPOCHOL PLUS METHIONINE/INOSITOL/CHOLINE/FA 3 Tablet 

NIACOR NIACIN 3 Tablet 

NIASPAN NIACIN 2 Tablet, Sustained Action 

ADVICOR NIACIN/LOVASTATIN 3 Tablet, Multiphasic Release 24 Hr 

PRAVACHOL PRAVASTATIN SODIUM 3 Tablet 

PRAVASTATIN SODIUM PRAVASTATIN SODIUM 1 Tablet 

CRESTOR ROSUVASTATIN CALCIUM 3 Tablet 

SIMVASTATIN SIMVASTATIN 1 Tablet 

ZOCOR SIMVASTATIN 3 Tablet 

ANTIHYPERTENSIVES, ANGIOTENSIN RECEPTOR ANTAGONIST 

ATACAND CANDESARTAN CILEXETIL 3 Tablet 

TEVETEN EPROSARTAN MESYLATE 3 Tablet 

AVAPRO IRBESARTAN 2 Tablet 

COZAAR LOSARTAN POTASSIUM 3 Tablet 

BENICAR OLMESARTAN MEDOXOMIL 3 Tablet 

MICARDIS TELMISARTAN 3 Tablet 

DIOVAN VALSARTAN 2 Tablet 

ANTIHYPERLIP - HMG-COA&CALCIUM CHANNEL BLOCKER COMBINATION 

CADUET AMLODIPINE/ATORVAST CAL 2 Tablet 

ACE INHIBITOR/CALCIUM CHANNEL BLOCKER COMBINATION 

AMLODIPINE BESYLATE-BENAZEPRIL AMLODIPINE BESYLATE/BENAZEPRIL 1 Capsule (Hard, Soft, etc.) 

LOTREL AMLODIPINE BESYLATE/BENAZEPRIL 2 Capsule (Hard, Soft, etc.) 

LEXXEL ENALAPRIL MALEATE/FELODIPINE 3 Tablet, Sustained Action 

TARKA TRANDOLAPRIL/VERAPAMIL HCL 3 Tablet, Multiphasic Release 24 Hr 

PULMONARY ANTIHYPERTENSIVES, PROSTACYCLIN-TYPE 

FLOLAN EPOPROSTENOL NA 3 Vial (SDV, MDV or Additive) (EA) 

VENTAVIS ILOPROST 3 Ampul for Nebulization (ml) 

PULM.ANTI-HTN, SEL.C-GMP PHOSPHODIESTERASE T5 INHIB 

REVATIO SILDENAFIL CITRATE 3 Tablet 

VASODILATORS, COMBINATION 

BIDIL ISOSORB DINIT/HYDRALAZINE HCL 2 Tablet 

ANTIHYPERTENSIVES, ACE INHIBITOR/DIETARY SUPP. COMBINATION 

LYTENSOPRIL LISINOPRIL/DIETARY SUP.CMB10 3 Combination Package (EA) 

LYTENSOPRIL-90 LISINOPRIL/DIETARY SUP.CMB10 3 Combination Package (EA) 

ANGIOTENSIN RECEPTOR ANTAGONIST & CALC. CHANNEL BLOCKER 

AZOR AMLODIPINE BES/OLMESARTAN MED 3 Tablet 

EXFORGE AMLODIPINE/VALSARTAN 3 Tablet 

RENIN INHIBITOR, DIRECT 

TEKTURNA ALISKIREN HEMIFUMARATE 3 Tablet 

PULMONARY ANTIHYPERTENSIVES, CGMP PATHWAY, GASES 

INOMAX NITRIC OXIDE 3 Gas (EA) 

ACE INHIBITOR/THIAZIDE & THIAZIDE-LIKE DIURETIC 

BENAZEPRIL HCL-HCTZ BENAZEPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

LOTENSIN HCT BENAZEPRIL/HYDROCHLOROTHIAZIDE 3 Tablet 

Page 28


CAPOZIDE CAPTOPRIL/HYDROCHLOROTHIAZIDE 3 Tablet 

CAPTOPRIL-HYDROCHLOROTHIAZIDE CAPTOPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

ENALAPRIL MALEATE-HCTZ ENALAPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

VASERETIC ENALAPRIL/HYDROCHLOROTHIAZIDE 3 Tablet 

FOSINOPRIL-HYDROCHLOROTHIAZIDE FOSINOPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

MONOPRIL HCT FOSINOPRIL/HYDROCHLOROTHIAZIDE 3 Tablet 

LISINOPRIL-HCTZ LISINOPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

PRINZIDE LISINOPRIL/HYDROCHLOROTHIAZIDE 3 Tablet 

ZESTORETIC LISINOPRIL/HYDROCHLOROTHIAZIDE 3 Tablet 

MOEXIPRIL-HYDROCHLOROTHIAZIDE MOEXIPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

UNIRETIC MOEXIPRIL/HYDROCHLOROTHIAZIDE 2 Tablet 

ACCURETIC QUINAPRIL/HYDROCHLOROTHIAZIDE 3 Tablet 

QUINAPRIL-HYDROCHLOROTHIAZIDE QUINAPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

QUINARETIC QUINAPRIL/HYDROCHLOROTHIAZIDE 1 Tablet 

ANGIOTENSIN RECEPTOR ANTAG./THIAZIDE DIURETIC COMB 

ATACAND HCT CANDESARTAN/HYDROCHLOROTHIAZID 3 Tablet 

TEVETEN HCT EPROSARTAN/HYDROCHLOROTHIAZIDE 3 Tablet 

AVALIDE IRBESARTAN/HYDROCHLOROTHIAZIDE 2 Tablet 

HYZAAR LOSARTAN/HYDROCHLOROTHIAZIDE 3 Tablet 

BENICAR HCT OLMESARTAN/HYDROCHLOROTHIAZIDE 3 Tablet 

MICARDIS HCT TELMISARTAN/HYDROCHLOROTHIAZID 3 Tablet 

DIOVAN HCT VALSARTAN/HYDROCHLOROTHIAZIDE 2 Tablet 

RENIN INHIBITOR, DIRECT/THIAZIDE DIURETIC COMB 

TEKTURNA HCT ALISKIREN/HYDROCHLOROTHIAZIDE 3 Tablet 

CNS DRUGS 

XANTHINES 

CAFCIT CAFFEINE CITRATED 3 Solution, Oral 

CAFFEINE CITRATE CAFFEINE CITRATED 1 Solution, Oral 

ANTICONVULSANTS 

CARBATROL CARBAMAZEPINE 3 Capsule, Multiphasic Release 12 Hr 

EQUETRO CARBAMAZEPINE 3 Capsule, Multiphasic Release 12 Hr 

CARBAMAZEPINE CARBAMAZEPINE 1 Suspension, Oral (Final Dose Form) 

TEGRETOL CARBAMAZEPINE 2 Suspension, Oral (Final Dose Form) 

CARBAMAZEPINE CARBAMAZEPINE 1 Tablet 

EPITOL CARBAMAZEPINE 1 Tablet 

TEGRETOL CARBAMAZEPINE 2 Tablet 

CARBAMAZEPINE CARBAMAZEPINE 1 Tablet, Chewable 

TEGRETOL CARBAMAZEPINE 2 Tablet, Chewable 

TEGRETOL XR CARBAMAZEPINE 2 Tablet, Sustained Release 12 Hr 

CEBERCLON CLONAZEPAM 1 Tablet 

CLONAZEPAM CLONAZEPAM 1 Tablet 

KLONOPIN CLONAZEPAM 3 Tablet 

CLONAZEPAM CLONAZEPAM 1 Tablet, Rapid Dissolve 

KLONOPIN CLONAZEPAM 3 Tablet, Rapid Dissolve 

DIASTAT DIAZEPAM 2 Kit 

DIASTAT ACUDIAL DIAZEPAM 2 Kit 

DEPAKOTE SPRINKLE DIVALPROEX SODIUM 3 Capsule, Sprinkle 

DEPAKOTE DIVALPROEX SODIUM 3 Tablet, Delayed Release (Enteric Coated) 

DEPAKOTE ER DIVALPROEX SODIUM 3 Tablet, Sustained Release 24 Hr 

ETHOSUXIMIDE ETHOSUXIMIDE 1 Capsule (Hard, Soft, etc.) 

ZARONTIN ETHOSUXIMIDE 3 Capsule (Hard, Soft, etc.) 

ETHOSUXIMIDE ETHOSUXIMIDE 1 Syrup 

ZARONTIN ETHOSUXIMIDE 3 Syrup 

PEGANONE ETHOTOIN 3 Tablet 

FELBATOL FELBAMATE 2 Suspension, Oral (Final Dose Form) 

FELBATOL FELBAMATE 2 Tablet 

GABAPENTIN GABAPENTIN 1 Capsule (Hard, Soft, etc.) 

GABAPENTIN GABAPENTIN 3 Capsule (Hard, Soft, etc.) 

NEURONTIN GABAPENTIN 3 Capsule (Hard, Soft, etc.) 

NEURONTIN GABAPENTIN 3 Solution, Oral 

GABAPENTIN GABAPENTIN 1 Tablet 

GABAPENTIN GABAPENTIN 3 Tablet 

NEURONTIN GABAPENTIN 3 Tablet 

LAMICTAL LAMOTRIGINE 3 Tablet 

LAMICTAL LAMOTRIGINE 3 Tablet, Dispersible 

LAMOTRIGINE LAMOTRIGINE 1 Tablet, Dispersible 

LAMICTAL (BLUE) LAMOTRIGINE 3 Tablet, Dose Pack 

Page 29


LAMICTAL (GREEN) LAMOTRIGINE 3 Tablet, Dose Pack 

LAMICTAL (ORANGE) LAMOTRIGINE 3 Tablet, Dose Pack 

KEPPRA LEVETIRACETAM 2 Solution, Oral 

KEPPRA LEVETIRACETAM 2 Tablet 

MEBARAL MEPHOBARBITAL 3 Tablet 

MEPHOBARBITAL MEPHOBARBITAL 1 Tablet 

CELONTIN METHSUXIMIDE 3 Capsule (Hard, Soft, etc.) 

TRILEPTAL OXCARBAZEPINE 2 Suspension, Oral (Final Dose Form) 

OXCARBAZEPINE OXCARBAZEPINE 1 Tablet 

TRILEPTAL OXCARBAZEPINE 2 Tablet 

DILANTIN-125 PHENYTOIN 3 Suspension, Oral (Final Dose Form) 

PHENYTOIN PHENYTOIN 1 Suspension, Oral (Final Dose Form) 

DILANTIN PHENYTOIN 3 Tablet, Chewable 

DILANTIN PHENYTOIN SODIUM EXTENDED 3 Capsule (Hard, Soft, etc.) 

PHENYTEK PHENYTOIN SODIUM EXTENDED 3 Capsule (Hard, Soft, etc.) 

PHENYTOIN SODIUM PHENYTOIN SODIUM EXTENDED 1 Capsule (Hard, Soft, etc.) 

PHENYTOIN SODIUM EXTENDED PHENYTOIN SODIUM EXTENDED 1 Capsule (Hard, Soft, etc.) 

LYRICA PREGABALIN 3 Capsule (Hard, Soft, etc.) 

MYSOLINE PRIMIDONE 3 Tablet 

PRIMIDONE PRIMIDONE 1 Tablet 

GABITRIL TIAGABINE HCL 2 Tablet 

TOPAMAX TOPIRAMATE 3 Capsule, Sprinkle 

TOPAMAX TOPIRAMATE 3 Tablet 

DEPAKENE VALPROATE SODIUM 3 Syrup 

VALPROIC ACID VALPROATE SODIUM 1 Syrup 

DEPAKENE VALPROIC ACID 3 Capsule (Hard, Soft, etc.) 

VALPROIC ACID VALPROIC ACID 1 Capsule (Hard, Soft, etc.) 

ZONEGRAN ZONISAMIDE 2 Capsule (Hard, Soft, etc.) 

ZONISAMIDE ZONISAMIDE 1 Capsule (Hard, Soft, etc.) 

AMYOTROPHIC LATERAL SCLEROSIS AGENTS 

RILUTEK RILUZOLE 3 Tablet 

ANTICONVULSANTSALZHEIMER'S THERAPY, NMDA RECEPTOR ANTAGONISTS 

NAMENDA MEMANTINE HCL 3 Solution, Oral 

NAMENDA MEMANTINE HCL 2 Tablet 

NAMENDA MEMANTINE HCL 2 Tablet, Dose Pack 

ANTICONVULSANTS/DIETARY SUPPLEMENT COMBINATIONS 

THERAPENTIN-60 GABAPENTIN/DIETARY SUPPL NO.11 3 Capsule (Hard, Soft, etc.) 

THERAPENTIN-90 GABAPENTIN/DIETARY SUPPL NO.11 3 Capsule (Hard, Soft, etc.) 

CONTRACEPTIVES 

CONTRACEPTIVES, ORAL 

APRI DESOGESTREL-ETHINYL ESTRADIOL 1 Tablet 

CESIA DESOGESTREL-ETHINYL ESTRADIOL 1 Tablet 

CYCLESSA DESOGESTREL-ETHINYL ESTRADIOL 2 Tablet 

DESOGEN DESOGESTREL-ETHINYL ESTRADIOL 3 Tablet 

ORTHO-CEPT DESOGESTREL-ETHINYL ESTRADIOL 3 Tablet 

RECLIPSEN DESOGESTREL-ETHINYL ESTRADIOL 1 Tablet 

SOLIA DESOGESTREL-ETHINYL ESTRADIOL 1 Tablet 

VELIVET DESOGESTREL-ETHINYL ESTRADIOL 1 Tablet 

KARIVA DESOG-ET ESTRA/ETHIN ESTRA 1 Tablet 

MIRCETTE DESOG-ET ESTRA/ETHIN ESTRA 3 Tablet 

YASMIN 28 ETHINYL ESTRADIOL/DROSPIRENONE 2 Tablet 

YAZ ETHINYL ESTRADIOL/DROSPIRENONE 2 Tablet 

DEMULEN 1/50-21 ETHYNODIOL D-ETHINYL ESTRADIOL 3 Tablet 

KELNOR 1/35 ETHYNODIOL D-ETHINYL ESTRADIOL 1 Tablet 

ZOVIA 1/35E ETHYNODIOL D-ETHINYL ESTRADIOL 1 Tablet 

ZOVIA 1/50E ETHYNODIOL D-ETHINYL ESTRADIOL 1 Tablet 

PLAN B LEVONORGESTREL 2 Tablet 

AVIANE LEVONORGESTREL-ETH ESTRA 1 Tablet 

ENPRESSE LEVONORGESTREL-ETH ESTRA 1 Tablet 

LESSINA LEVONORGESTREL-ETH ESTRA 1 Tablet 

LEVLEN 28 LEVONORGESTREL-ETH ESTRA 1 Tablet 

LEVORA-28 LEVONORGESTREL-ETH ESTRA 1 Tablet 

LUTERA LEVONORGESTREL-ETH ESTRA 1 Tablet 

LYBREL LEVONORGESTREL-ETH ESTRA 2 Tablet 

NORDETTE-28 LEVONORGESTREL-ETH ESTRA 3 Tablet 

PORTIA LEVONORGESTREL-ETH ESTRA 1 Tablet 

SRONYX LEVONORGESTREL-ETH ESTRA 1 Tablet 

Page 30


TRIPHASIL-28 LEVONORGESTREL-ETH ESTRA 3 Tablet 

TRIVORA-28 LEVONORGESTREL-ETH ESTRA 1 Tablet 

JOLESSA LEVONORGESTREL-ETH ESTRA 1 Tablet, Dose Pack, 3 Months 

QUASENSE LEVONORGESTREL-ETH ESTRA 1 Tablet, Dose Pack, 3 Months 

SEASONALE LEVONORGESTREL-ETH ESTRA 3 Tablet, Dose Pack, 3 Months 

SEASONIQUE L-NORGEST-ETH ESTR/ETHIN ESTRA 2 Tablet, Dose Pack, 3 Months 

ESTROSTEP FE NORETH A-ET ESTRA/FE FUMARATE 3 Tablet 

JUNEL FE NORETH A-ET ESTRA/FE FUMARATE 1 Tablet 

LOESTRIN 24 FE NORETH A-ET ESTRA/FE FUMARATE 3 Tablet 

LOESTRIN FE NORETH A-ET ESTRA/FE FUMARATE 3 Tablet 

MICROGESTIN FE NORETH A-ET ESTRA/FE FUMARATE 1 Tablet 

TILIA FE NORETH A-ET ESTRA/FE FUMARATE 1 Tablet 

TRI-LEGEST FE NORETH A-ET ESTRA/FE FUMARATE 1 Tablet 

FEMCON FE NORETH-ETHINYL ESTRADIOL/IRON 3 Tablet, Chewable 

OVCON FE NORETH-ETHINYL ESTRADIOL/IRON 3 Tablet, Chewable 

CAMILA NORETHINDRONE 1 Tablet 

ERRIN NORETHINDRONE 1 Tablet 

JOLIVETTE NORETHINDRONE 1 Tablet 

NORA-BE NORETHINDRONE 1 Tablet 

NOR-Q-D NORETHINDRONE 3 Tablet 

ORTHO MICRONOR NORETHINDRONE 3 Tablet 

JUNEL NORETHINDRONE A-E ESTRADIOL 1 Tablet 

LOESTRIN NORETHINDRONE A-E ESTRADIOL 3 Tablet 

MICROGESTIN NORETHINDRONE A-E ESTRADIOL 1 Tablet 

ARANELLE NORETHINDRONE-ETHINYL ESTRAD 1 Tablet 

BALZIVA NORETHINDRONE-ETHINYL ESTRAD 1 Tablet 

BREVICON NORETHINDRONE-ETHINYL ESTRAD 3 Tablet 

LEENA NORETHINDRONE-ETHINYL ESTRAD 1 Tablet 

MODICON NORETHINDRONE-ETHINYL ESTRAD 3 Tablet 

NECON NORETHINDRONE-ETHINYL ESTRAD 1 Tablet 

NORINYL 1+35 NORETHINDRONE-ETHINYL ESTRAD 3 Tablet 

NORTREL NORETHINDRONE-ETHINYL ESTRAD 1 Tablet 

ORTHO-NOVUM NORETHINDRONE-ETHINYL ESTRAD 3 Tablet 

OVCON-35 NORETHINDRONE-ETHINYL ESTRAD 3 Tablet 

OVCON-50 NORETHINDRONE-ETHINYL ESTRAD 3 Tablet 

TRI-NORINYL NORETHINDRONE-ETHINYL ESTRAD 3 Tablet 

ZENCHENT NORETHINDRONE-ETHINYL ESTRAD 1 Tablet 

NECON NORETHINDRONE-MESTRANOL 1 Tablet 

NORINYL 1+50 NORETHINDRONE-MESTRANOL 3 Tablet 

ORTHO-NOVUM NORETHINDRONE-MESTRANOL 3 Tablet 

MONONESSA NORGESTIMATE-ETHINYL ESTRADIOL 1 Tablet 

ORTHO TRI-CYCLEN NORGESTIMATE-ETHINYL ESTRADIOL 3 Tablet 

ORTHO TRI-CYCLEN LO NORGESTIMATE-ETHINYL ESTRADIOL 2 Tablet 

ORTHO-CYCLEN NORGESTIMATE-ETHINYL ESTRADIOL 3 Tablet 

PREVIFEM NORGESTIMATE-ETHINYL ESTRADIOL 1 Tablet 

SPRINTEC NORGESTIMATE-ETHINYL ESTRADIOL 1 Tablet 

TRINESSA NORGESTIMATE-ETHINYL ESTRADIOL 1 Tablet 

TRI-PREVIFEM NORGESTIMATE-ETHINYL ESTRADIOL 1 Tablet 

TRI-SPRINTEC NORGESTIMATE-ETHINYL ESTRADIOL 1 Tablet 

CRYSELLE NORGESTREL-ETHINYL ESTRADIOL 1 Tablet 

LO/OVRAL-28 NORGESTREL-ETHINYL ESTRADIOL 3 Tablet 

LOW-OGESTREL NORGESTREL-ETHINYL ESTRADIOL 1 Tablet 

OGESTREL NORGESTREL-ETHINYL ESTRADIOL 1 Tablet 

DIAPHRAGMS/CERVICAL CAP 

FEMCAP CERVICAL CAP 3 Each 

LEA'S SHIELD CONTRACEPT BARRIER DEV, VENTED 3 Each 

ORTHO-DIAPHRAGM DIAPHRAGMS, ARC-SPRING 3 Kit 

ORTHO-DIAPHRAGM DIAPHRAGMS, COIL SPRING 3 Kit 

ORTHO-DIAPHRAGM DIAPHRAGMS, FLAT SPRING 3 Kit 

WIDE SEAL DIAPHRAGM DIAPHRAGMS, WIDE SEAL 3 Diaphragm 

INTRA-UTERINE DEVICES (IUD'S) 

PARAGARD T 380-A INTRA-UTERINE DEVICE (IUD) 3 Each 

MIRENA LEVONORGESTREL 3 Intrauterine Device 

CONTRACEPTIVES, TRANSDERMAL 

ORTHO EVRA ETHINYL ESTRADIOL/NORELGEST 2 Patch, Transdermal Weekly 

CONTRACEPTIVES, INTRAVAGINAL, SYSTEMIC 

NUVARING ETONOGESTREL/ETHINYL ESTRADIOL 2 Ring, Vaginal 

Page 31


COUGH/COLD PREPARATIONS 

EXPECTORANTS 

GANIDIN NR GUAIFENESIN 1 Liquid (ml) 

GUAIFENESIN NR GUAIFENESIN 1 Liquid (ml) 

IOPHEN NR GUAIFENESIN 1 Liquid (ml) 

ORGANIDIN NR GUAIFENESIN 3 Liquid (ml) 

VITA-NUMONYL EX GUAIFENESIN 3 Solution, Oral 

ALLFEN JR GUAIFENESIN 1 Tablet 

GG 200 NR GUAIFENESIN 1 Tablet 

GUAIFENESIN GUAIFENESIN 1 Tablet 

LIQUIBID GUAIFENESIN 1 Tablet 

ORGAN-I NR GUAIFENESIN 1 Tablet 

ORGANIDIN NR GUAIFENESIN 3 Tablet 

ALLFEN-M GUAIFENESIN 1 Tablet, Sustained Action 

AQUAMIST GUAIFENESIN 1 Tablet, Sustained Action 

GUAIFENESIN LA GUAIFENESIN 1 Tablet, Sustained Action 

LIQUIBID 1200 GUAIFENESIN 1 Tablet, Sustained Release 12 Hr 

GRIPEX PE GUAIFENESIN/PHENYLEPHRINE HCL 1 Drops 

ZOTEX-GP GUAIFENESIN/PHENYLEPHRINE HCL 3 Tablet 

YODEFAN-NF POTASSIUM GUAIACOLSULFONATE 3 Liquid (ml) 

COUGH AND/OR COLD PREPARATIONS 

TRIONATE CAR-B-PEN TA/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

QUADTANN CAR-B-PEN TA/EPHED TAN/PE/CP 3 Suspension, Oral (Final Dose Form) 

C-TANNA 12D CAR-B-PEN TA/PHENYLEPHRINE/PYR 1 Suspension, Oral (Final Dose Form) 

C-TANNA 12D CAR-B-PEN TA/PHENYLEPHRINE/PYR 1 Tablet 

DUONATE-12 PHENYLEPHRINE/PYRIL TAN 3 Suspension, Oral (Final Dose Form) 

DURA-TAP/PD PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Capsule (Hard, Soft, etc.) 

HISTAFED-LA PSEUDOEPHEDRINE HCL/CHLOR-MAL 3 Capsule, Sustained Action 

ANTITUSSIVES, NON-NARCOTIC 

BENZONATATE BENZONATATE 1 Capsule (Hard, Soft, etc.) 

TESSALON BENZONATATE 3 Capsule (Hard, Soft, etc.) 

TESSALON PERLE BENZONATATE 3 Capsule (Hard, Soft, etc.) 

SOLOTUSS CARBETAPENTANE TANNATE 3 Suspension, Oral (Final Dose Form) 

SYMPATHOMIMETIC AGENTS 

AH-CHEW D PHENYLEPHRINE HCL 3 Tablet, Chewable 

GILCHEW IR PHENYLEPHRINE HCL 3 Tablet, Chewable 

NASOP PHENYLEPHRINE HCL 3 Tablet, Rapid Dissolve 

AH-CHEW D PHENYLEPHRINE TANNATE 3 Suspension, Oral (Final Dose Form) 

NASOP PHENYLEPHRINE TANNATE 3 Suspension, Oral (Final Dose Form) 

NASOP 12 PHENYLEPHRINE TANNATE 3 Tablet, Chewable 

SLOFED 60 PSEUDOEPHEDRINE HCL 3 Capsule, Sustained Action 

PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL 1 Tablet 

ENTEX PSEUDOEPHEDRINE TANNATE 3 Suspension, Oral (Final Dose Form) 

NASOFED PSEUDOEPHEDRINE TANNATE 3 Suspension, Oral (Final Dose Form) 

1ST GEN ANTIHISTAMINE-DECONGESTANT-ANALGESIC COMBINATION 

NOREL SR PHENYLEPH/ACETAMINOP/P-TLOX/CP 3 Tablet, Sustained Release 12 Hr 

PROTID PHENYLEPHRINE/ACETAMINOPHN/CP 3 Tablet, Sustained Action 

NARCOTIC ANTITUSS-1ST GEN. ANTIHISTAMINE-DECONGEST 

VAZOTUSS HC PE/HYDROCODONE/BROMPHEN TANNTS 3 Suspension, Oral (Final Dose Form) 

CYTUSS-HC PE/HYDROCODONE/DEXBROMPHENIRMN 1 Liquid (ml) 

HC-PE-DBROM PE/HYDROCODONE/DEXBROMPHENIRMN 1 Liquid (ml) 

HISTUSSIN HC PE/HYDROCODONE/DEXBROMPHENIRMN 3 Liquid (ml) 

RELATUSS HC PE/HYDROCODONE/DEXBROMPHENIRMN 1 Liquid (ml) 

TUSSINAL 12 PE/HYDROCODONE/DEXCHLOR TANNTS 3 Suspension, Oral (Final Dose Form) 

STATUSS GREEN PE/P-EPHEDRINE/HCOD/PYRIL/CP 3 Liquid (ml) 

COLDCOUGH P-EPHED HCL/DHCODEINE BT/CP 1 Syrup 

DIHYDRO-CP P-EPHED HCL/DHCODEINE BT/CP 1 Syrup 

HYDRO-TUSSIN DHC P-EPHED HCL/DHCODEINE BT/CP 1 Syrup 

HPR END P-EPHED HCL/HYDROCODONE/BPM 3 Liquid (ml) 

J-TAN D HC P-EPHED HCL/HYDROCODONE/BPM 3 Liquid (ml) 

M-END P-EPHED HCL/HYDROCODONE/BPM 1 Liquid (ml) 

ANAPLEX HD P-EPHED HCL/HYDROCODONE/BPM 1 Solution, Oral 

BROMPHENEX HD P-EPHED HCL/HYDROCODONE/BPM 1 Solution, Oral 

BROMPLEX HD P-EPHED HCL/HYDROCODONE/BPM 1 Solution, Oral 

ENDACOF-HC P-EPHED HCL/HYDROCODONE/BPM 3 Solution, Oral 

BROMCOMP HC P-EPHED HCL/HYDROCODONE/BPM 1 Syrup 

ATUSS HD P-EPHED HCL/HYDROCODONE/CP 3 Capsule, Multiphasic Release 

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COLDCOUGH HC P-EPHED HCL/HYDROCODONE/CP 1 Liquid (ml) 

DETUSS P-EPHED HCL/HYDROCODONE/CP 1 Liquid (ml) 

HYDRON PSC P-EPHED HCL/HYDROCODONE/CP 1 Liquid (ml) 

NOTUSS-FORTE P-EPHED HCL/HYDROCODONE/CP 3 Liquid (ml) 

HYPHED P-EPHED HCL/HYDROCODONE/CP 1 Syrup 

KG-TUSSIN P-EPHED HCL/HYDROCODONE/CP 1 Syrup 

PROMETHAZINE VC-CODEINE PHENYLEPHRINE HCL/COD/PROMETH 1 Syrup 

NOVAHISTINE DH PHENYLEPHRINE/DHCODEINE BT/CP 3 Liquid (ml) 

BALTUSSIN PHENYLEPHRINE/DHCODEINE BT/CP 3 Syrup 

COLDCOUGH PD PHENYLEPHRINE/DHCODEINE BT/CP 1 Syrup 

DESPEC-PD PHENYLEPHRINE/DHCODEINE BT/CP 1 Syrup 

DIHYDRO-PE PHENYLEPHRINE/DHCODEINE BT/CP 1 Syrup 

PANCOF PD PHENYLEPHRINE/DHCODEINE BT/CP 1 Syrup 

PHENA-HC PHENYLEPHRINE/HCOD BT/PYRIL/CP 3 Liquid (ml) 

DYTAN-HC PHENYLEPHRINE/HCOD TAN/DPHA 3 Suspension, Oral (Final Dose Form) 

HPB MAX PHENYLEPHRINE/HYDROCODONE/BPM 3 Liquid (ml) 

M-END MAX PHENYLEPHRINE/HYDROCODONE/BPM 1 Liquid (ml) 

COUGHTUSS PHENYLEPHRINE/HYDROCODONE/CP 1 Liquid (ml) 

DROTUSS-CP PHENYLEPHRINE/HYDROCODONE/CP 3 Liquid (ml) 

MAXI-TUSS HCX PHENYLEPHRINE/HYDROCODONE/CP 3 Liquid (ml) 

NEO HC PHENYLEPHRINE/HYDROCODONE/CP 3 Liquid (ml) 

RELASIN HC PHENYLEPHRINE/HYDROCODONE/CP 1 Solution, Oral 

CHLORPHEN HD PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

CYTUSS HC PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

DE-CHLOR HC PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

ED TUSS HC PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

ED-TLC PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

HISTINEX HC PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

HYDRO PC II PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

HYDROCOD BIT-PHENYLEPHRINE-CP PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

HYDROCODONE CP PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

HYDROCODONE HD PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

HYDRON CP PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

HYDRO-PC II PLUS PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

KG-DAL HD PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

KG-DAL HD PLUS PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

MINTUSS HC PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

MINTUSS MS PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

RINDAL HD PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

RINDAL HD PLUS PHENYLEPHRINE/HYDROCODONE/CP 1 Syrup 

CODIMAL DH PHENYLEPHRINE/HYDROCODONE/D-CP 3 Liquid (ml) 

ENDACOF-PLUS PHENYLEPHRINE/HYDROCODONE/D-CP 1 Liquid (ml) 

ZOTEX-HC PHENYLEPHRINE/HYDROCODONE/D-CP 3 Liquid (ml) 

ENDAL HD PHENYLEPHRINE/HYDROCODONE/DPHA 3 Syrup 

HYDRO-DP PHENYLEPHRINE/HYDROCODONE/DPHA 1 Syrup 

PHENDACOF PLUS PHENYLEPHRINE/HYDROCODONE/PYR 1 Liquid (ml) 

TUSSPLEX PHENYLEPHRINE/HYDROCODONE/PYR 1 Liquid (ml) 

CODAL-DH PHENYLEPHRINE/HYDROCODONE/PYR 1 Syrup 

DE-CHLOR MR PHENYLEPHRINE/HYDROCODONE/PYR 1 Syrup 

HYDROPHENE DH PHENYLEPHRINE/HYDROCODONE/PYR 1 Syrup 

MINTUSS MR PHENYLEPHRINE/HYDROCODONE/PYR 1 Syrup 

PRO-RED PHENYLEPHRINE/HYDROCODONE/PYR 3 Syrup 

SYMTAN A PSEUDOEPH/HYDROCOD/BROMPH TANS 3 Suspension, Oral (Final Dose Form) 

ATUSS HS PSEUDOEPH/HYDROCODON/CP TANNS 3 Suspension, Oral (Final Dose Form) 

NON-NARCOTIC ANTITUSS-1ST GEN. ANTIHISTAMINE-DECONGEST 

SERADEX CARBETAPEN CIT/PE/BROMPHEN MAL 3 Liquid (ml) 

QUAD TANN PEDIATRIC CAR-B-PEN TA/EPHED TAN/PE/CP 1 Suspension, Oral (Final Dose Form) 

QUAD-TUSS TANNATE CAR-B-PEN TA/EPHED TAN/PE/CP 1 Suspension, Oral (Final Dose Form) 

QUAD TANN CAR-B-PEN TA/EPHED TAN/PE/CP 1 Tablet 

RYNATUSS CAR-B-PEN TA/EPHED TAN/PE/CP 3 Tablet 

D-TANN CD CAR-B-PEN TA/PE/DP-HYDRAMINE 1 Suspension, Oral (Final Dose Form) 

D-TANN CT CAR-B-PEN TA/PE/DP-HYDRAMINE 1 Suspension, Oral (Final Dose Form) 

DYTAN CD CAR-B-PEN TA/PE/DP-HYDRAMINE 3 Suspension, Oral (Final Dose Form) 

DYTAN-CS CAR-B-PEN TA/PE/DP-HYDRAMINE 3 Suspension, Oral (Final Dose Form) 

D-TANN CT CAR-B-PEN TA/PE/DP-HYDRAMINE 1 Tablet 

DYTAN-CS CAR-B-PEN TA/PE/DP-HYDRAMINE 3 Tablet 

BETATAN CAR-B-PEN TA/PHENYLEPHRINE/BPM 3 Suspension, Oral (Final Dose Form) 

PULMARI CAR-B-PEN TA/PHENYLEPHRINE/BPM 1 Suspension, Oral (Final Dose Form) 

Page 33


VAZOTAN CAR-B-PEN TA/PHENYLEPHRINE/BPM 3 Suspension, Oral (Final Dose Form) 

CARBAPHEN 12 CAR-B-PEN TA/PHENYLEPHRINE/CP 3 Suspension, Oral (Final Dose Form) 

CARBAPHEN 12 PED CAR-B-PEN TA/PHENYLEPHRINE/CP 3 Suspension, Oral (Final Dose Form) 

PENTUSS CAR-B-PEN TA/PHENYLEPHRINE/CP 1 Suspension, Oral (Final Dose Form) 

RICOTUSS CAR-B-PEN TA/PHENYLEPHRINE/CP 1 Tablet 

XIRATUSS CAR-B-PEN TA/PHENYLEPHRINE/CP 1 Tablet 

TUSSI-12D S CAR-B-PEN TA/PHENYLEPHRINE/PYR 3 Suspension, Oral (Final Dose Form) 

TUSSI-12D CAR-B-PEN TA/PHENYLEPHRINE/PYR 3 Tablet 

ALACOL DM DEXTROMETHORPHAN/PE/BROMPHENIR 3 Drops 

BROMTUSS DM DEXTROMETHORPHAN/PE/BROMPHENIR 1 Liquid (ml) 

LORTUSS DM DEXTROMETHORPHAN/PE/BROMPHENIR 3 Liquid (ml) 

TUSDEC-DM DEXTROMETHORPHAN/PE/BROMPHENIR 1 Liquid (ml) 

ALACOL DM DEXTROMETHORPHAN/PE/BROMPHENIR 3 Syrup 

BALACALL DM DEXTROMETHORPHAN/PE/BROMPHENIR 1 Syrup 

BROM-PE-DM DEXTROMETHORPHAN/PE/BROMPHENIR 1 Syrup 

DURAVENT-DPB DEXTROMETHORPHAN/PE/BROMPHENIR 1 Syrup 

DONATUSSIN DM DM TAN/PE TAN/DEXCHLORPHEN TAN 3 Suspension, Oral (Final Dose Form) 

POLY TAN DM DM TAN/PE TAN/PYRIL/D-BROM TAN 3 Suspension, Oral (Final Dose Form) 

VIRAVAN-PDM DM,P-EPHED,PYRILAMINE TANNATES 3 Suspension, Oral (Final Dose Form) 

D-TANN DM DM/PHENYLEPH/DIPHENHYDRAM TANN 1 Suspension, Oral (Final Dose Form) 

DURATUSS AC 12 DM/PHENYLEPH/DIPHENHYDRAM TANN 3 Suspension, Oral (Final Dose Form) 

DYTAN-DM DM/PHENYLEPH/DIPHENHYDRAM TANN 3 Suspension, Oral (Final Dose Form) 

CORYZA-DM DM/PHENYLEPH/PYRIL/DEXCHLROPHE 1 Solution, Oral 

P-HIST DM/PHENYLEPH/PYRIL/DEXCHLROPHE 1 Solution, Oral 

PROHIST DM/PHENYLEPH/PYRIL/DEXCHLROPHE 3 Solution, Oral 

RESPERAL DM/PHENYLEPH/PYRIL/DEXCHLROPHE 1 Solution, Oral 

BP NEW ALLERGY DM D-METHORP TAN/PE/BR-PHENIR 1 Suspension, Oral (Final Dose Form) 

BROMATAN-DM D-METHORP TAN/PE/BR-PHENIR 1 Suspension, Oral (Final Dose Form) 

DM TANN-PE TANN-BROM TANN D-METHORP TAN/PE/BR-PHENIR 1 Suspension, Oral (Final Dose Form) 

DURATAN DM D-METHORP TAN/PE/BR-PHENIR 3 Suspension, Oral (Final Dose Form) 

DUR-TANN DM D-METHORP TAN/PE/BR-PHENIR 1 Suspension, Oral (Final Dose Form) 

NEO DM D-METHORP TAN/PE/BR-PHENIR 3 Suspension, Oral (Final Dose Form) 

ANAPLEX DMX D-METHORP TAN/P-EPD TAN/BPM 1 Suspension, Oral (Final Dose Form) 

BROM TANN-DM TANN-PSE TANN D-METHORP TAN/P-EPD TAN/BPM 1 Suspension, Oral (Final Dose Form) 

ATUSS DS D-METHORP TAN/P-EPD TAN/CP 3 Suspension, Oral (Final Dose Form) 

DICEL DM D-METHORP TAN/P-EPD TAN/CP 3 Suspension, Oral (Final Dose Form) 

T-TANNA DM D-METHORP TAN/P-EPD TAN/CP 1 Suspension, Oral (Final Dose Form) 

BROMATAN PLUS D-METHORP TAN/P-EPD TAN/D-CP 1 Suspension, Oral (Final Dose Form) 

C-PHED DPD TANNATE D-METHORP TAN/P-EPD TAN/D-CP 1 Suspension, Oral (Final Dose Form) 

DURATAN FORTE D-METHORP TAN/P-EPD TAN/D-CP 3 Suspension, Oral (Final Dose Form) 

DUR-TANN FORTE D-METHORP TAN/P-EPD TAN/D-CP 1 Suspension, Oral (Final Dose Form) 

SUTAN-DM D-METHORP TAN/P-EPD TAN/D-CP 1 Suspension, Oral (Final Dose Form) 

TANAFED DMX D-METHORP TAN/P-EPD TAN/D-CP 3 Suspension, Oral (Final Dose Form) 

TANDUR DM D-METHORP TAN/P-EPD TAN/D-CP 3 Suspension, Oral (Final Dose Form) 

TANNATE DMP-DEX D-METHORP TAN/P-EPD TAN/D-CP 1 Suspension, Oral (Final Dose Form) 

TANNATE PD-DM D-METHORP TAN/P-EPD TAN/D-CP 1 Suspension, Oral (Final Dose Form) 

MAXIPHEN ADT D-METHORP TAN/PHENYLEPHRINE/CP 3 Tablet 

BRONKIDS D-METHORPHAN HB/PE/CHLORPHENIR 3 Drops 

CARDEC DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

CERON-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

CP DEC-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

C-PHEN DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

DM-PE-CHLOR D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

DONATUSSIN DM D-METHORPHAN HB/PE/CHLORPHENIR 3 Drops 

NASOHIST DM D-METHORPHAN HB/PE/CHLORPHENIR 3 Drops 

NEO DM D-METHORPHAN HB/PE/CHLORPHENIR 3 Drops 

QUARTUSS DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

RONDEC-DM D-METHORPHAN HB/PE/CHLORPHENIR 3 Drops 

RONDEX-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

SILDEC PE-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Drops 

CORFEN-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Solution, Oral 

DEXTROMETHORPHAN-PE-CPM D-METHORPHAN HB/PE/CHLORPHENIR 1 Solution, Oral 

ED-A-HIST DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Solution, Oral 

NOREL DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Solution, Oral 

TRITAL DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Solution, Oral 

RICOTUSS D-METHORPHAN HB/PE/CHLORPHENIR 3 Suspension, Oral (Final Dose Form) 

BRONKIDS D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

CARDEC DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

Page 34


CERON-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

CP DEC-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

C-PHEN DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

DE-CHLOR DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

DE-CHLOR DR D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

DEX PC D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

DEXTROMETHORPHAN-PE-CPM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

MINTUSS DR D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

PD-COF D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

PE-HIST DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

POLY-TUSSIN DM D-METHORPHAN HB/PE/CHLORPHENIR 3 Syrup 

REME TUSSIN DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

RONDEC-DM D-METHORPHAN HB/PE/CHLORPHENIR 3 Syrup 

RONDEX-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

SILDEC PE-DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

STATUSS DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

TRI-VENT DPC D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

TUSSPLEX DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Syrup 

ALBATUSSIN SR D-METHORPHAN HB/PE/CHLORPHENIR 3 Tablet, Sustained Release 12 Hr 

PHENABID DM D-METHORPHAN HB/PE/CHLORPHENIR 1 Tablet, Sustained Release 12 Hr 

ZOTEX-12D D-METHORPHAN HB/PE/CHLORPHENIR 1 Tablet, Sustained Release 12 Hr 

TUSSALL D-METHORPHAN HB/PE/D-BP 3 Syrup 

TUSSALL-ER D-METHORPHAN HB/PE/D-BP 3 Tablet, Sustained Release 12 Hr 

Y-COF DM D-METHORPHAN HB/PE/D-BP 1 Tablet, Sustained Release 12 Hr 

MYHIST-DM D-METHORPHAN HB/PE/PYRIL 1 Liquid (ml) 

POLY HIST DM D-METHORPHAN HB/PE/PYRIL 3 Liquid (ml) 

REME HIST DM D-METHORPHAN HB/PE/PYRIL 1 Liquid (ml) 

TRIPLEX DM D-METHORPHAN HB/PE/PYRIL 1 Liquid (ml) 

CODAL-DM D-METHORPHAN HB/PE/PYRIL 1 Syrup 

ACCUHIST DM D-METHORPHAN HB/P-EPD HCL/BPM 3 Drops 

ALLANHIST PDX D-METHORPHAN HB/P-EPD HCL/BPM 1 Drops 

BROMHIST PDX D-METHORPHAN HB/P-EPD HCL/BPM 1 Drops 

BROMHIST-DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Drops 

ENDACOF-PD D-METHORPHAN HB/P-EPD HCL/BPM 1 Drops 

PEDIAHIST DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Drops 

P-HIST DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Drops 

PROHIST DM D-METHORPHAN HB/P-EPD HCL/BPM 3 Drops 

RESPERAL-DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Drops 

DALLERGY DM D-METHORPHAN HB/P-EPD HCL/BPM 3 Liquid (ml) 

DELTUSS DMX D-METHORPHAN HB/P-EPD HCL/BPM 3 Liquid (ml) 

NEO DM D-METHORPHAN HB/P-EPD HCL/BPM 3 Liquid (ml) 

ANAPLEX DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

ANDEHIST-DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

BROMETANE DX D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

BROMFED-DM D-METHORPHAN HB/P-EPD HCL/BPM 3 Syrup 

BROMPHENEX DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

BROMPLEX DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

CARBODEX DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

CARBOFED DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

ENDACOF-DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

MYPHETANE DX D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

PSE BROM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

SILDEC-DM D-METHORPHAN HB/P-EPD HCL/BPM 1 Syrup 

ACCUHIST PDX D-METHORPHAN HB/P-EPHED HCL/CP 3 Drops 

NEUTRAHIST PDX D-METHORPHAN HB/P-EPHED HCL/CP 1 Drops 

HDC DM D-METHORPHAN HB/P-EPHED HCL/CP 3 Syrup 

M-END DM D-METHORPHAN HB/P-EPHED HCL/CP 1 Syrup 

ALDEX DM DM-PE-PYRILAMINE TANNATES 3 Suspension, Oral (Final Dose Form) 

ALLANVAN-DM DM-PE-PYRILAMINE TANNATES 1 Suspension, Oral (Final Dose Form) 

SINADEX 12 DM-PE-PYRILAMINE TANNATES 3 Suspension, Oral (Final Dose Form) 

TANNATE-V-DM DM-PE-PYRILAMINE TANNATES 1 Suspension, Oral (Final Dose Form) 

VIRATAN-DM DM-PE-PYRILAMINE TANNATES 1 Suspension, Oral (Final Dose Form) 

ZOTEX 12 DM-PE-PYRILAMINE TANNATES 1 Suspension, Oral (Final Dose Form) 

DECONSAL DM DM-PE-PYRILAMINE TANNATES 3 Tablet, Chewable 

VIRATAN-DM DM-PE-PYRILAMINE TANNATES 1 Tablet, Chewable 

NON-NARCOTIC ANTITUSSIVE AND EXPECTORANT COMBINATION 

SORBUTUSS GUAIFEN/D-METHORPHAN HB/K CIT 3 Liquid (ml) 

DYNEX VR GUAIFENESIN/CARBETAPENTANE CIT 3 Capsule, Multiphasic Release 12 Hr 

Page 35


CARBA-XP GUAIFENESIN/CARBETAPENTANE CIT 3 Liquid (ml) 

EXPECTUSS GUAIFENESIN/CARBETAPENTANE CIT 1 Liquid (ml) 

ORATUSS GUAIFENESIN/CARBETAPENTANE CIT 3 Liquid (ml) 

BETAVENT GUAIFENESIN/CARBETAPENTANE CIT 1 Syrup 

PULMARI-GP GUAIFENESIN/CARBETAPENTANE CIT 1 Syrup 

ALLRES G GUAIFENESIN/CARBETAPENTANE TAN 1 Suspension, Oral (Final Dose Form) 

RESPI-TANN G GUAIFENESIN/CARBETAPENTANE TAN 3 Suspension, Oral (Final Dose Form) 

DURATUSS DM 12 GUAIFENESIN/DM TANNATE 3 Suspension, Oral (Final Dose Form) 

ALBATUSSIN DM GUAIFENESIN/D-METHORPHAN HB 3 Drops 

TRISPEC DMX GUAIFENESIN/D-METHORPHAN HB 3 Drops 

HT-TUSS DM GUAIFENESIN/D-METHORPHAN HB 1 Elixir 

HYDRO-TUSSIN DM GUAIFENESIN/D-METHORPHAN HB 1 Elixir 

SU-TUSS DM GUAIFENESIN/D-METHORPHAN HB 1 Elixir 

DEX-TUSS DM GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

DM-GUAI GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

GANI-TUSS-DM NR GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

GUAIFENESIN DM NR GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

GUAL-DEX GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

IOPHEN DM GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

MAXI-TUSS DM GUAIFENESIN/D-METHORPHAN HB 3 Liquid (ml) 

NORTUSS-EX GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

TRISPEC DMX GUAIFENESIN/D-METHORPHAN HB 3 Liquid (ml) 

TUSNEL DIABETIC GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

TUSSIDEN DM GUAIFENESIN/D-METHORPHAN HB 1 Liquid (ml) 

TUSSI-ORGANIDIN DM NR GUAIFENESIN/D-METHORPHAN HB 3 Liquid (ml) 

TUSSI-ORGANIDIN DM-S NR GUAIFENESIN/D-METHORPHAN HB 3 Liquid (ml) 

DURATUSS DM GUAIFENESIN/D-METHORPHAN HB 3 Solution, Oral 

SIMUC-DM GUAIFENESIN/D-METHORPHAN HB 1 Solution, Oral 

VITA-NUMONYL DM GUAIFENESIN/D-METHORPHAN HB 3 Solution, Oral 

GUIADEX DM POT GUAIACO/D-METHORPHAN HB 1 Liquid (ml) 

PROLEX DM POT GUAIACO/D-METHORPHAN HB 3 Liquid (ml) 

NON-NARCOTIC ANTITUS-1ST GEN ANTIHIST-DECONGEST-EXPECT 

BROMHIST-DM GUAIFEN/DM HB/P-EPHEDRINE/BPM 1 Syrup 

HISTACOL DM GUAIFEN/DM HB/P-EPHEDRINE/BPM 1 Syrup 

PEDIAHIST DM GUAIFEN/DM HB/P-EPHEDRINE/BPM 1 Syrup 

NEOTUSS-D GUAIFEN/DM HB/P-EPHEDRINE/CP 3 Liquid (ml) 

DEKA GUAIFEN/DM HB/P-EPHEDRINE/D-BP 3 Liquid (ml) 

PANATUSS DXP GUAIFEN/DM HB/PHENYLEPH/D-BP 3 Drops 

PANATUSS DXP GUAIFEN/DM HB/PHENYLEPH/D-BP 3 Liquid (ml) 

ALLANHIST PDX GUAIFEN/D-METHORPHAN HB/PE/BPM 1 Syrup 

BROMHIST-PDX GUAIFEN/D-METHORPHAN HB/PE/BPM 1 Syrup 

DONATUSSIN GUAIFEN/D-METHORPHAN HB/PE/CP 3 Liquid (ml) 

QUARTUSS GUAIFEN/D-METHORPHAN HB/PE/CP 1 Liquid (ml) 

CHLORDEX GP GUAIFEN/D-METHORPHAN HB/PE/CP 1 Syrup 

QUAL-TUSSIN GUAIFEN/D-METHORPHAN HB/PE/CP 3 Syrup 

ZOTEX-DM GUAIFEN/D-METHORPHAN HB/PE/CP 3 Syrup 

ALBATUSSIN SR SENIOR POT GUAIACO/DM HB/PE/PYRIL 3 Capsule (Hard, Soft, etc.) 

VITA-NUMONYL POT GUAIACO/DM HB/PE/PYRIL 1 Liquid (ml) 

VITA-NUMONYL POT GUAIACO/DM HB/PE/PYRIL 3 Liquid (ml) 

ALBATUSSIN-NN POT GUAIACO/DM HB/PE/PYRIL 3 Solution, Oral 

1ST GEN ANTIHIST-DECONGEST-ANTICHOLINERGIC COMBINATION 

SYMPAK II BROMPHEN/PSE - CPM/PE/METHSCOP 3 Tablet,Sustained Release 12 Hr Sequential 

DALLERGY PE CHLOR-MAL/PHENYLEPH/METHSCOP 3 Liquid (ml) 

RESPA A.R. P-EPHED HCL/CHLOR-MAL/BELL ALK 3 Tablet, Sustained Release 12 Hr 

RU-TUSS P-EPHED HCL/CHLOR-MAL/BELL ALK 1 Tablet, Sustained Release 12 Hr 

ALLERX P-EPHED HCL/CHLOR-MAL/SCOP 3 Tablet, Sequential 

VISRX P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sequential 

AMDRY-C P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

COLDAMINE P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

CPM 8-PSE 90-MSC 2.5 P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

DURAHIST P-EPHED HCL/CHLOR-MAL/SCOP 3 Tablet, Sustained Release 12 Hr 

HISTA-VENT PSE P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

PCM LA P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

PSEUDO CM P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

RELCOF PSE P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

SCOPOHIST P-EPHED HCL/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

TIME-HIST QD P-EPHED HCL/CHLOR-MAL/SCOP 3 Tablet, Sustained Release 24 Hr 

STAHIST P-EPHED HCL/CPMM/ATP/SCOP/HYOS 3 Tablet, Sustained Release 12 Hr 

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D-HIST D P-EPHED HCL/DEXCHLORPHEN/SCOP 1 Tablet, Sustained Release 12 Hr 

DURAHIST D P-EPHED HCL/DEXCHLORPHEN/SCOP 3 Tablet, Sustained Release 12 Hr 

EXTENDRYL PHENYLEPH/DEXCHLOR/METHSCOPOL 3 Solution, Oral 

RE-DRYLEX PHENYLEPH/DEXCHLOR/METHSCOPOL 1 Solution, Oral 

DEHISTINE PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Solution, Oral 

DURADRYL PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Solution, Oral 

AEROKID PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Syrup 

CHLOR-MES D PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Syrup 

CPM-PE-MSC PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Syrup 

DALLERGY PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Syrup 

QV-ALLERGY PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Syrup 

TRIALL PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Syrup 

WE ALLERGY PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Syrup 

DALLERGY PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet 

SYMPAK PDX PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, CHEW Sequential 

AH-CHEW II PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Chewable 

DURAVENT Chewable PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Chewable 

EXTENDRYL PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Chewable 

PCM PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Chewable 

RESCON PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Multiphasic Release 12 Hr 

EXTENDRYL JR PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Sustained Action 

NOHIST-PLUS JR PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Action 

RE-DRYLEX JR PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Action 

ALLERX PE PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Sustained Action Sequential 

AEROHIST PLUS PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

CHLOR-MES PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

CPM 8/PE 20/MSC 1.25 PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

DALLERGY PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Sustained Release 12 Hr 

DRIHIST SR PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

DRYSEC PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

DURAHIST PE PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Sustained Release 12 Hr 

EXTENDRYL SR PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

HISTATAB PH PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

HISTA-VENT DA PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

NOHIST-PLUS PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

OMNIHIST II LA PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Sustained Release 12 Hr 

OMNIHIST L.A. PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

PCM ALLERGY PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

PHENYLEPHRINE CM PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

PREHIST D PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

RELCOF PE PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

RESCON-MX PHENYLEPHRINE/CHLOR-MAL/SCOP 3 Tablet, Sustained Release 12 Hr 

SCOPOHIST-PE PHENYLEPHRINE/CHLOR-MAL/SCOP 1 Tablet, Sustained Release 12 Hr 

AH-CHEW PHENYLEPHRINE/CHLOR-TAN/SCOP 1 Suspension, Oral (Final Dose Form) 

AH-CHEW ULTRA PHENYLEPHRINE/CHLOR-TAN/SCOP 1 Suspension, Oral (Final Dose Form) 

DURATAN PE PHENYLEPHRINE/CHLOR-TAN/SCOP 1 Suspension, Oral (Final Dose Form) 

REDUR-PCM PHENYLEPHRINE/CHLOR-TAN/SCOP 1 Suspension, Oral (Final Dose Form) 

AH-CHEW ULTRA PHENYLEPHRINE/CHLOR-TAN/SCOP 3 Tablet, Chewable 

HISTACOL LA PHENYLEPHRINE/CPMM/BELLAD ALK 1 Tablet, Sustained Release 12 Hr 

1ST GEN ANTIHISTAMINE-DECONGESTANT-EXPECTORANT COMBINATION 

DECON-G GUAIFEN/PHENYLEPHRINE/BPM 3 Drops 

P CHLOR GUAIFEN/PHENYLEPHRINE/CP 1 Drops 

QUAL-TUSSIN GUAIFEN/PHENYLEPHRINE/CP 1 Drops 

A-TAN 12X GUAIFEN/PHENYLEPHRINE/PYRIL 1 Suspension, Oral (Final Dose Form) 

RYNA-12X GUAIFEN/PHENYLEPHRINE/PYRIL 3 Suspension, Oral (Final Dose Form) 

RYNA-12X GUAIFEN/PHENYLEPHRINE/PYRIL 3 Tablet 

NARCOTIC ANTITUSSIVE-ANTICHOLINERGIC COMBINATION 

HYCODAN HYDROCODONE BIT/HOMATROPINE 3 Syrup 

HYDROCODONE COMPOUND HYDROCODONE BIT/HOMATROPINE 1 Syrup 

HYDROMET HYDROCODONE BIT/HOMATROPINE 1 Syrup 

HYCODAN HYDROCODONE BIT/HOMATROPINE 3 Tablet 

HYDROCODONE BT/HOMATROPINE MBR HYDROCODONE BIT/HOMATROPINE 1 Tablet 

TUSSIGON HYDROCODONE BIT/HOMATROPINE 1 Tablet 

NARCOTIC ANTITUSSIVE-1ST GENERATION ANTIHISTAMINE 

COTAB AX CHLORPHENIRAMINE/CODEINE PHOS 3 Tablet 

PROMETHAZINE W/CODEINE CODEINE/PROMETHAZINE HCL 1 Syrup 

PROMETHAZINE-CODEINE CODEINE/PROMETHAZINE HCL 1 Syrup 

NOVASUS HYDROCODONE TANNATE/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

Page 37


TUSSICAPS HYDROCODONE/CHLORPHEN POLIS 3 Capsule, Sustained Release 12 Hr 

TUSSIONEX HYDROCODONE/CHLORPHEN POLIS 3 Suspension, 12 Hr Sustained Release 

NON-NARCOTIC ANTITUSSIVE-1ST GEN ANTIHISTAMINE COMBINATION 

D-TANN AT CARBETAPENT TAN/DIPHENHYDR TAN 1 Suspension, Oral (Final Dose Form) 

DYTAN-AT CARBETAPENT TAN/DIPHENHYDR TAN 3 Suspension, Oral (Final Dose Form) 

PYRLEX CB CARBETAPENTANE TAN/PYRILAM TAN 3 Suspension, Oral (Final Dose Form) 

C-TANNA 12 CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

TANNATE 12 S CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

TANNIC-12 S CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

TANNIHIST-12 RF CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

TRIONATE CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

TUSSI-12 S CAR-B-PEN TA/CHLOR-TAN 3 Suspension, Oral (Final Dose Form) 

TUSSIZONE-12 RF CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

TUSTAN 12S CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form) 

CAR-B-PEN TA/CHLOR-TAN CAR-B-PEN TA/CHLOR-TAN 1 Tablet 

TANNIC-12 CAR-B-PEN TA/CHLOR-TAN 1 Tablet 

TRIONATE NF CAR-B-PEN TA/CHLOR-TAN 1 Tablet 

TUSSI-12 CAR-B-PEN TA/CHLOR-TAN 3 Tablet 

TUSSIZONE-12 RF CAR-B-PEN TA/CHLOR-TAN 1 Tablet 

PROMETHAZINE W/DM D-METHORPHAN HB/PROMETH HCL 1 Syrup 

PROMETHAZINE-DM D-METHORPHAN HB/PROMETH HCL 1 Syrup 

NON-NARC ANTITUSSIVE-1ST GEN ANTIHIST-EXPECT COMBINATION 

TUSNEL GUAIFEN/D-METHORPHAN HB/BPM 3 Capsule (Hard, Soft, etc.) 

TRISPEC SFX GUAIFEN/D-METHORPHAN HB/BPM 3 Liquid (ml) 

TUSNEL GUAIFEN/D-METHORPHAN HB/BPM 3 Liquid (ml) 

TUSSI PRES-B GUAIFEN/D-METHORPHAN HB/BPM 1 Liquid (ml) 

NARCOTIC ANTITUSS-1ST GEN ANTIHIST-DECONGST-EXPECT 

DROTUSS GUAIFEN/P-EPHED HCL/HCOD/CP 1 Liquid (ml) 

ZHIST GUAIFEN/P-EPHED HCL/HCOD/CP 1 Liquid (ml) 

Z-TUSS 2 GUAIFEN/P-EPHED HCL/HCOD/CP 3 Liquid (ml) 

NARCOTIC ANTITUSSIVE-DECONGESTANT COMBINATIONS 

SYMTAN P-EPD TAN/HYDROCODONE TANNATE 3 Suspension, Oral (Final Dose Form) 

COLDCOUGH HCM P-EPHED HCL/HYDROCODONE BIT 1 Syrup 

PHENYLEPHRINE HD PHENYLEPHRINE HCL/HYDROCODONE 1 Liquid (ml) 

TUSDEC-HC PHENYLEPHRINE HCL/HYDROCODONE 1 Liquid (ml) 

NUCOFED PSEUDOEPHEDRINE HCL/CODEINE 3 Capsule (Hard, Soft, etc.) 

NON-NARCOTIC ANTITUSSIVE-DECONGESTANT COMBINATIONS 

ALLRES D CAR-B-PEN TA/P-EPD TAN 1 Suspension, Oral (Final Dose Form) 

ALLRES PD CAR-B-PEN TA/P-EPD TAN 1 Suspension, Oral (Final Dose Form) 

RESPI-TANN CAR-B-PEN TA/P-EPD TAN 3 Suspension, Oral (Final Dose Form) 

RESPI-TANN PD CAR-B-PEN TA/P-EPD TAN 3 Suspension, Oral (Final Dose Form) 

PSEUDACARB CAR-B-PEN TA/P-EPD TAN 1 Tablet, Chewable 

RESPI-TANN CAR-B-PEN TA/P-EPD TAN 3 Tablet, Chewable 

CARBETAPLEX TS CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form) 

CARB-PHENYL-12 CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form) 

DYNEX 12 CAR-B-PEN TA/PHENYLEPHRINE 3 Suspension, Oral (Final Dose Form) 

L-ALL 12 CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form) 

L-ALL 12 NF CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form) 

LEVALL-12 CAR-B-PEN TA/PHENYLEPHRINE 3 Suspension, Oral (Final Dose Form) 

RE ALL 12 CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form) 

CARBATUSS-12 CAR-PEN/CAR-PEN TAN/PE TAN/PE 3 Suspension, Oral (Final Dose Form) 

ALBATUSSIN PEDIATRIC D-METHORPHAN HB/PHENYLEPHRINE 3 Drops 

ALBATUSSIN PEDIATRIC D-METHORPHAN HB/PHENYLEPHRINE 3 Syrup 

NARCOTIC ANTITUSS-1ST GEN ANTIHIST-DECONGEST-ANALGESIC 

COLREX COMPOUND PHENYLEPHRINE/COD/APAP/CP 3 Capsule (Hard, Soft, etc.) 

NON-NARCOTIC ANTITUSS-DECONGESTANT-ANALGESIC-EXPECT CB 

DURAFLU GUAIFEN/DM/P-EPHED/ACETAMINOPH 3 Tablet 

FLUTABS GUAIFEN/DM/P-EPHED/ACETAMINOPH 1 Tablet 

MAXIFLU DM GUAIFEN/DM/P-EPHED/ACETAMINOPH 3 Tablet 

MAXIFLU-G GUAIFEN/DM/P-EPHED/ACETAMINOPH 3 Tablet 

PHENFLU G GUAIFN/DM/PHENYLEPH/ACETAMINOP 3 Tablet 

NARCOTIC ANTITUSS-DECONGESTANT-EXPECTORANT COMBINATION 

DESPEC-EXP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup 

DIHYDRO-GP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup 

HYDRO-TUSSIN EXP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup 

WELLTUSS EXP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup 

KG-FED GUAIFENESIN/P-EPHED HCL/COD 1 Syrup 

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KG-FED PEDIATRIC GUAIFENESIN/P-EPHED HCL/COD 1 Syrup 

SU-TUSS HD GUAIFENESIN/P-EPHED HCL/HCOD 1 Elixir 

VANACON GUAIFENESIN/P-EPHED HCL/HCOD 1 Expectorant 

HYDRO-TUSSIN HD GUAIFENESIN/P-EPHED HCL/HCOD 1 Solution, Oral 

KG-TUSS HD GUAIFENESIN/P-EPHED HCL/HCOD 1 Solution, Oral 

DYNEX HD GUAIFENESIN/P-EPHED HCL/HCOD 3 Syrup 

PSEUDATEX HC GUAIFENESIN/P-EPHED HCL/HCOD 1 Syrup 

GILTUSS PED-C GUAIFENESIN/PHENYLEPHRINE/COD 3 Liquid (ml) 

DURATUSS HD GUAIFENESIN/PHENYLEPHRINE/HCOD 3 Solution, Oral 

EXETUSS-HC GUAIFENESIN/PHENYLEPHRINE/HCOD 1 Solution, Oral 

GENTEX HC GUAIFENESIN/PHENYLEPHRINE/HCOD 3 Solution, Oral 

SIMUC-HD GUAIFENESIN/PHENYLEPHRINE/HCOD 1 Solution, Oral 

CRANTEX HC GUAIFENESIN/PHENYLEPHRINE/HCOD 1 Syrup 

DE-CHLOR G GUAIFENESIN/PHENYLEPHRINE/HCOD 1 Syrup 

DONATUSSIN DC GUAIFENESIN/PHENYLEPHRINE/HCOD 3 Syrup 

HYDRO GP GUAIFENESIN/PHENYLEPHRINE/HCOD 1 Syrup 

HYDROFED GUAIFENESIN/PHENYLEPHRINE/HCOD 3 Syrup 

MINTUSS G GUAIFENESIN/PHENYLEPHRINE/HCOD 1 Syrup 

PHENDACOF HC GUAIFENESIN/PHENYLEPHRINE/HCOD 1 Syrup 

TUSSAFED-HCG GUAIFENESIN/PHENYLEPHRINE/HCOD 3 Syrup 

SUTTAR-2 P-EPHED HCL/CODEINE/GUAIFEN 1 Syrup 

SUTTAR-SF P-EPHED HCL/CODEINE/GUAIFEN 1 Syrup 

TUSNEL C P-EPHED HCL/CODEINE/GUAIFEN 1 Syrup 

TUSNEL PED-C P-EPHED HCL/CODEINE/GUAIFEN 3 Syrup 

MAXIFED CD P-EPHED HCL/CODEINE/GUAIFEN 3 Tablet 

MAXIFED CDX P-EPHED HCL/CODEINE/GUAIFEN 3 Tablet 

MAXIFED-G CD P-EPHED HCL/CODEINE/GUAIFEN 3 Tablet 

MAXIFED-G CDX P-EPHED HCL/CODEINE/GUAIFEN 3 Tablet 

NON-NARCOTIC ANTITUSS-DECONGESTANT-EXPECTORANT COMBINATION 

ALBATUSSIN CF D-METHORPHAN HB/PE/SODIUM CIT 3 Drops 

GENTEX 30 GUAIFEN/CAR-B-PENTANE/PE 3 Liquid (ml) 

LEVALL GUAIFEN/CAR-B-PENTANE/PE 3 Solution, Oral 

CARBATUSS GUAIFEN/CAR-B-PENTANE/PE 1 Syrup 

CARBETAPENTANE-PE-GUAIFENESIN GUAIFEN/CAR-B-PENTANE/PE 1 Syrup 

CARBETAPLEX GUAIFEN/CAR-B-PENTANE/PE 1 Syrup 

GENTEX LQ GUAIFEN/CAR-B-PENTANE/PE 3 Syrup 

PHENCARB GG GUAIFEN/CAR-B-PENTANE/PE 1 Syrup 

DESPEC GUAIFEN/DM HB/P-EPHEDRINE 3 Drops 

TRISPEC PSE GUAIFEN/DM HB/P-EPHEDRINE 3 Drops 

TUSNEL-DM GUAIFEN/DM HB/P-EPHEDRINE 3 Drops 

DONATUSSIN DM GUAIFEN/DM HB/P-EPHEDRINE 3 Liquid (ml) 

RELACON-DM NR GUAIFEN/DM HB/P-EPHEDRINE 1 Liquid (ml) 

RU-TUSS DM GUAIFEN/DM HB/P-EPHEDRINE 1 Liquid (ml) 

RU-TUSS DM GUAIFEN/DM HB/P-EPHEDRINE 3 Liquid (ml) 

TRISPEC PSE GUAIFEN/DM HB/P-EPHEDRINE 3 Liquid (ml) 

TUSNEL PEDIATRIC GUAIFEN/DM HB/P-EPHEDRINE 3 Liquid (ml) 

LIQUICOUGH DM GUAIFEN/DM HB/P-EPHEDRINE 1 Solution, Oral 

PSEUDO COUGH GUAIFEN/DM HB/P-EPHEDRINE 1 Solution, Oral 

RELASIN DM GUAIFEN/DM HB/P-EPHEDRINE 1 Solution, Oral 

TUSNEL GUAIFEN/DM HB/P-EPHEDRINE 3 Solution, Oral 

BRONCOTRON-D GUAIFEN/DM HB/P-EPHEDRINE 3 Suspension, Oral (Final Dose Form) 

PSEUDO DM GG GUAIFEN/DM HB/P-EPHEDRINE 1 Syrup 

TRI-VENT DM GUAIFEN/DM HB/P-EPHEDRINE 1 Syrup 

MAXIFED DM GUAIFEN/DM HB/P-EPHEDRINE 3 Tablet 

MAXIFED DMX GUAIFEN/DM HB/P-EPHEDRINE 3 Tablet 

Z-COF 12DM GUAIFEN/D-METHORP TAN/P-EPHED 3 Suspension, Oral (Final Dose Form) 

GILTUSS PEDIATRIC GUAIFEN/D-METHORPHAN HB/PE 1 Drops 

NUMONYL DX GUAIFEN/D-METHORPHAN HB/PE 3 Drops 

TUSSAFED EX GUAIFEN/D-METHORPHAN HB/PE 3 Liquid (ml) 

TUSSI-PRES GUAIFEN/D-METHORPHAN HB/PE 3 Liquid (ml) 

NUMONYL DX GUAIFEN/D-METHORPHAN HB/PE 3 Solution, Oral 

BRONTUSS SF GUAIFEN/D-METHORPHAN HB/PE 3 Syrup 

DESPEC DM GUAIFEN/D-METHORPHAN HB/PE 3 Syrup 

TUSSO-XR GUAIFENESIN/DM TANNATE/PE TANN 3 Suspension, Oral (Final Dose Form) 

TUSSO-DMR GUAIFENESIN/D-METHORPHAN HB/PE 3 Capsule (Hard, Soft, etc.) 

Z-DEX GUAIFENESIN/D-METHORPHAN HB/PE 1 Drops 

ZOTEX GUAIFENESIN/D-METHORPHAN HB/PE 3 Dropss 

BIOTUSS GUAIFENESIN/D-METHORPHAN HB/PE 1 Liquid (ml) 

Page 39


GILTUSS GUAIFENESIN/D-METHORPHAN HB/PE 1 Liquid (ml) 

TUSSI-PRES GUAIFENESIN/D-METHORPHAN HB/PE 3 Liquid (ml) 

TUSSI-PRES PEDIATRIC GUAIFENESIN/D-METHORPHAN HB/PE 1 Liquid (ml) 

TUSSI-PRES PEDIATRIC GUAIFENESIN/D-METHORPHAN HB/PE 3 Liquid (ml) 

Z-TUSS DM GUAIFENESIN/D-METHORPHAN HB/PE 3 Liquid (ml) 

BRONCOTRON-D GUAIFENESIN/D-METHORPHAN HB/PE 3 Suspension, Oral (Final Dose Form) 

DACEX-DM GUAIFENESIN/D-METHORPHAN HB/PE 1 Syrup 

DYNATUSS-EX GUAIFENESIN/D-METHORPHAN HB/PE 1 Syrup 

PDM GG GUAIFENESIN/D-METHORPHAN HB/PE 1 Syrup 

TRITUSS GUAIFENESIN/D-METHORPHAN HB/PE 3 Syrup 

Z-DEX Syrup GUAIFENESIN/D-METHORPHAN HB/PE 1 Syrup 

ZOTEX GUAIFENESIN/D-METHORPHAN HB/PE 3 Syrup 

ZOTEX-G GUAIFENESIN/D-METHORPHAN HB/PE 3 Syrup 

SINUTUSS DM GUAIFENESIN/D-METHORPHAN HB/PE 1 Tablet 

CARBATUSS-CL POT GUAIACO/CAR-B-PENTANE/PE 3 Liquid (ml) 

ALBATUSSIN CF POT GUAIACO/D-METHORPHAN HB/PE 3 Drops 

ALBATUSSIN SR POT GUAIACO/D-METHORPHAN HB/PE 3 Tablet, Sustained Release 12 Hr 

ALBATUSSIN SR F POT GUAIACO/D-METHORPHAN HB/PE 3 Tablet, Sustained Release 12 Hr 

NON-NARCOTIC ANTITUSS-DECONGESTANT-EXPECTORANT COMBINATION 

DEX-TUSS GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

GANI-TUSS NR GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

GUAIFENESIN-CODEINE GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

GUAL-CO GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

IOPHEN-C NR GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

MYCI-GC GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

TUSSIDEN C GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

TUSSI-ORGANIDIN NR GUAIFENESIN/CODEINE PHOS 2 Liquid (ml) 

TUSSI-ORGANIDIN-S NR GUAIFENESIN/CODEINE PHOS 2 Liquid (ml) 

TUSSO-C GUAIFENESIN/CODEINE PHOS 1 Liquid (ml) 

GUAIFENESIN-CODEINE GUAIFENESIN/CODEINE PHOS 1 Syrup 

ROBAFEN AC GUAIFENESIN/CODEINE PHOS 1 Syrup 

ALLFEN CD GUAIFENESIN/CODEINE PHOS 3 Tablet 

ALLFEN CDX GUAIFENESIN/CODEINE PHOS 3 Tablet 

BRONTEX GUAIFENESIN/CODEINE PHOS 3 Tablet 

GUAIFENESIN/CODEINE PHOSPHATE GUAIFENESIN/CODEINE PHOS 1 Tablet 

A-COF DH GUAIFENESIN/HYDROCODONE BIT 1 Liquid (ml) 

CODICLEAR DH GUAIFENESIN/HYDROCODONE BIT 3 Liquid (ml) 

HC-GUAI GUAIFENESIN/HYDROCODONE BIT 1 Liquid (ml) 

CONDASIN GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

ENDACOF-XP GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

EXECLEAR GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

EXECOF-XP GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

HYDROCODONE GF GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

HYDROCODONE-GUAIFENESIN GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

KWELCOF GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

MAXI-TUSS HCG GUAIFENESIN/HYDROCODONE BIT 3 Syrup 

NARCOF GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

PNEUMOTUSSIN GUAIFENESIN/HYDROCODONE BIT 3 Syrup 

TUSSICLEAR DH GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

VITUSSIN GUAIFENESIN/HYDROCODONE BIT 1 Syrup 

ENDACOF GUAIFENESIN/HYDROCODONE BIT 1 Tablet 

HY-KXP POT GUAIACO/HYDROCODONE BIT 1 Syrup 

MARCOF POT GUAIACO/HYDROCODONE BIT 1 Syrup 

MC COUGH POT GUAIACO/HYDROCODONE BIT 3 Syrup 

MC JR COUGH POT GUAIACO/HYDROCODONE BIT 3 Syrup 

M-CLEAR POT GUAIACO/HYDROCODONE BIT 1 Syrup 

MINTUSS NX POT GUAIACO/HYDROCODONE BIT 1 Syrup 

PRO-CLEAR POT GUAIACO/HYDROCODONE BIT 3 Syrup 

DECONGESTANT-ANTICHOLINERGIC COMBINATIONS 

ALLERX-D P-EPHED HCL/METHSCOPOLAMN 3 Tablet, Sustained Release 12 Hr 

EXTENDRYL PSE P-EPHED HCL/METHSCOPOLAMN 1 Tablet, Sustained Release 12 Hr 

SUDATRATE P-EPHED HCL/METHSCOPOLAMN 1 Tablet, Sustained Release 12 Hr 

AMDRY-D P-EPHED HCL/SCOP ME-NITRATE 1 Tablet, Sustained Release 12 Hr 

PSE 120/MSC 2.5 P-EPHED HCL/SCOP ME-NITRATE 1 Tablet, Sustained Release 12 Hr 

DECONGESTANT-EXPECTORANT COMBINATIONS 

VITA-NUMONYL GUAIFEN/PHENYLEPHRINE/K CIT 3 Solution, Oral 

BRONCHOLATE GUAIFENESIN/EPHEDRINE HCL 3 Syrup 

PSEUDOVENT GUAIFENESIN/P-EPHED HCL 1 Capsule, Multiphasic Release 12 Hr 

Page 40


PSEUDOVENT 400 GUAIFENESIN/P-EPHED HCL 1 Capsule, Multiphasic Release 12 Hr 

PSEUDOVENT PED GUAIFENESIN/P-EPHED HCL 1 Capsule, Multiphasic Release 12 Hr 

NALEX JR GUAIFENESIN/P-EPHED HCL 1 Capsule, Sustained Action 

TUSNEL PEDIATRIC GUAIFENESIN/P-EPHED HCL 1 Drops 

PSEUDOEPHEDRINE GG GUAIFENESIN/P-EPHED HCL 1 Syrup 

SUDATEX GUAIFENESIN/P-EPHED HCL 1 Syrup 

AMBI 60-580 GUAIFENESIN/P-EPHED HCL 1 Tablet 

MAXIFED GUAIFENESIN/P-EPHED HCL 3 Tablet 

MAXIFED-G GUAIFENESIN/P-EPHED HCL 3 Tablet 

MAXIFED-G GUAIFENESIN/P-EPHED HCL 3 Tablet 

CONPEC L.A. GUAIFENESIN/P-EPHED HCL 3 Tablet, Sustained Release 12 Hr 

EUDAL-SR GUAIFENESIN/P-EPHED HCL 1 Tablet, Sustained Release 12 Hr 

GP-500 GUAIFENESIN/P-EPHED HCL 1 Tablet, Sustained Release 12 Hr 

PROFED GUAIFENESIN/P-EPHED HCL 1 Tablet, Sustained Release 12 Hr 

SINA-12X GUAIFENESIN/PHENYLEPHRINE 3 Suspension, Oral (Final Dose Form) 

SINA-12X GUAIFENESIN/PHENYLEPHRINE 3 Tablet 

PHENAVENT GUAIFENESIN/PHENYLEPHRINE HCL 1 Capsule, Multiphasic Release 12 Hr 

PHENAVENT LA GUAIFENESIN/PHENYLEPHRINE HCL 1 Capsule, Multiphasic Release 12 Hr 

PHENAVENT PED GUAIFENESIN/PHENYLEPHRINE HCL 1 Capsule, Multiphasic Release 12 Hr 

DONATUSSIN GUAIFENESIN/PHENYLEPHRINE HCL 3 Drops 

NUMONYL PEDIATRIC GUAIFENESIN/PHENYLEPHRINE HCL 3 Drops 

PE-GUAI GUAIFENESIN/PHENYLEPHRINE HCL 1 Drops 

DESPEC GUAIFENESIN/PHENYLEPHRINE HCL 3 Liquid (ml) 

NARIZ GUAIFENESIN/PHENYLEPHRINE HCL 3 Liquid (ml) 

NAZARIN GUAIFENESIN/PHENYLEPHRINE HCL 1 Liquid (ml) 

NUMONYL GUAIFENESIN/PHENYLEPHRINE HCL 3 Liquid (ml) 

SITREX PD GUAIFENESIN/PHENYLEPHRINE HCL 3 Liquid (ml) 

ZYRPHEN GUAIFENESIN/PHENYLEPHRINE HCL 1 Liquid (ml) 

CONPEC GUAIFENESIN/PHENYLEPHRINE HCL 3 Solution, Oral 

CRANTEX GUAIFENESIN/PHENYLEPHRINE HCL 1 Syrup 

J-MAX GUAIFENESIN/PHENYLEPHRINE HCL 3 Syrup 

QUINTEX GUAIFENESIN/PHENYLEPHRINE HCL 1 Syrup 

SIL-TEX GUAIFENESIN/PHENYLEPHRINE HCL 1 Syrup 

SINUVENT PE GUAIFENESIN/PHENYLEPHRINE HCL 1 Tablet 

ZOTEX-GP GUAIFENESIN/PHENYLEPHRINE HCL 3 Tablet 

DYNEX LA GUAIFENESIN/PHENYLEPHRINE HCL 3 Tablet, Multiphasic Release 12 Hr 

LUSONAL POT GUAIACO/PHENYLEPHRINE HCL 3 Liquid (ml) 

1ST GENERATION ANTIHISTAMINE-ANTICHOLINERGIC COMBINATIONS 

ALLERX DF CHLOR-MAL/METHSCOPOLAMINE NIT 3 Tablet, Sequential 

ALLERX DF 30 CHLOR-MAL/METHSCOPOLAMINE NIT 3 Tablet, Sequential 

AEROHIST CHLOR-MAL/METHSCOPOLAMINE NIT 3 Tablet, Sustained Release 12 Hr 

NOHIST-EXT CHLOR-MAL/METHSCOPOLAMINE NIT 1 Tablet, Sustained Release 12 Hr 

RYNEZE CHLOR-MAL/METHSCOPOLAMINE NIT 1 Tablet, Sustained Release 12 Hr 

DEXODRYL CHLORPHENIRAMINE TAN/METHSCOP 3 Suspension, Oral (Final Dose Form) 

DEXODRYL CHLORPHENIRAMINE TAN/METHSCOP 3 Tablet, Chewable 

NON-NARC ANTITUSS-1ST GEN ANTIHIST-ANTICHOLINERGIC 

EXTENDRYL DM D-METHORPHAN HB/CHLOR-MAL/SCOP 3 Tablet, Sustained Release 12 Hr 

1ST GEN ANTIHISTAMINE-DECONGESTANT WITH ZINC COMBINATIONS 

ZINX PE/CHLORPHEN/METHSCOP/ZINC AC 3 Kit 

ZINX P-EPHED HCL/CHLOR-MAL/ZINC AC 3 Combination Package, CAP 12HR & Lozenge 

1ST GEN. ANTIHIST-DECONG-ANTICHOLIN-EXPECT COMBINATIONS 

SYMPAK GUAIFEN/PE/CHLORPH/METHSCOP 3 Tablet, Sustained Action Sequential 

NARCOTIC ANTITUSS-DECONGESTANT-ANALGESIC-EXPECT CB 

PHENFLU CD PHENYLEPH/CODEINE/ACET/GUAIFEN 3 Tablet 

MAXIFLU CD PSEUDOEPH/CODEINE/ACET/GUAIFEN 3 Tablet 

NARC ANTITUSS-1ST GEN ANTIHISTAMINE-ANALG, N-SAL CB 

COTABFLU CHLOR-MAL/CODEINE/ACETAMINOPHN 3 Tablet 

NON-NARC ANTITUSS-1ST GEN ANTIHIS-DECON-EXP-ANTICHO 

SYMPAK DM GUAIFEN/DM/PE/CPM/METHSCOPOLAM 3 Tablet,Sustained Release 12 Hr Sequential 

DIAGNOSTIC 

GASTROINTESTINAL RADIOPAQUE DIAGNOSTICS 

E-Z-PASTE BARIUM SULFATE 3 Cream (Grams) 

E-Z-DOSE BARIUM SULFATE 3 Enema (ml) 

E-Z-CAT BARIUM SULFATE 3 Suspension, Oral (Final Dose Form) 

LIQUID E-Z PAQUE BARIUM SULFATE 3 Suspension, Oral (Final Dose Form) 

LIQUID POLIBAR PLUS BARIUM SULFATE 3 Suspension, Oral (Final Dose Form) 

Page 41


READI-CAT BARIUM SULFATE 3 Suspension, Oral (Final Dose Form) 

READI-CAT 2 BARIUM SULFATE 3 Suspension, Oral (Final Dose Form) 

TAGITOL BARIUM SULFATE 3 Suspension, Oral (Final Dose Form) 

VOLUMEN BARIUM SULFATE 3 Suspension, Oral (Final Dose Form) 

E-Z-CAT BARIUM SULFATE 3 Suspension, Reconstituted, Oral (gm) 

E-Z-HD BARIUM SULFATE 3 Suspension, Reconstituted, Oral (ml) 

BAR-TEST BARIUM SULFATE 3 Tablet 

ENTERO VU BARIUM SULFATE/METHYLCELLULOSE 3 Liquid (ml) 

ENTERO VU BARIUM SULFATE/METHYLCELLULOSE 3 Packet 

GASTROMARK FERUMOXSIL 3 Suspension, Oral (Final Dose Form) 

GASTRIC FUNCTION DIAGNOSTICS 

BAROS GRANULES SIMETHICONE/SOD BICARB/TTA 3 Granules, Effervescent 

BILIARY DIAGNOSTICS, RADIOPAQUE 

ORAGRAFIN SODIUM IPODATE SODIUM 3 Capsule (Hard, Soft, etc.) 

BLOOD SUGAR DIAGNOSTICS 

ACCU-CHEK BLOOD SUGAR DIAGNOSTIC 2 Strip 

ACCU-CHEK BLOOD SUGAR DIAGNOSTIC 2 Strip 

ACCU-CHEK SIMPLICITY BLOOD SUGAR DIAGNOSTIC 2 Strip 

ADVANCE BLOOD SUGAR DIAGNOSTIC 3 Strip 

ADVANCE INTUITION BLOOD SUGAR DIAGNOSTIC 3 Strip 

ADVOCATE REDI-CODE BLOOD SUGAR DIAGNOSTIC 3 Strip 

ADVOCATE TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

ALBERTSONS TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASCENSIA CONTOUR BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASCENSIA ELITE BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASSURE BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASSURE 3 BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASSURE 4 BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASSURE II BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASSURE PRO BLOOD SUGAR DIAGNOSTIC 3 Strip 

AT-LAST TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

AT-LAST TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

BD TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

BIONIME RIGHTEST TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

BLOOD GLUCOSE BLOOD SUGAR DIAGNOSTIC 3 Strip 

BLOOD GLUCOSE STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

BLOOD GLUCOSE TEST BLOOD SUGAR DIAGNOSTIC 3 Strip 

BRITE LIFE TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

CHEMSTRIP BG BLOOD SUGAR DIAGNOSTIC 2 Strip 

CLEVER CHEK TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

CONTROL BLOOD SUGAR DIAGNOSTIC 3 Strip 

CONTROL G3 BLOOD SUGAR DIAGNOSTIC 3 Strip 

DEXTROSTIX REAGENT BLOOD SUGAR DIAGNOSTIC 3 Strip 

DISCOUNT DRUG MART BLOOD SUGAR DIAGNOSTIC 3 Strip 

DUANE READE TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

DUO-CARE BLOOD SUGAR DIAGNOSTIC 3 Strip 

EASY GLUCO G2 BLOOD SUGAR DIAGNOSTIC 3 Strip 

EASYGLUCO BLOOD SUGAR DIAGNOSTIC 3 Strip 

EASYPRO BLOOD SUGAR DIAGNOSTIC 3 Strip 

EVENCARE BLOOD SUGAR DIAGNOSTIC 3 Strip 

EXACTECH BLOOD SUGAR DIAGNOSTIC 3 Strip 

EXACTECH RSG BLOOD SUGAR DIAGNOSTIC 3 Strip 

EXPRESS MED TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

EZ SMART BLOOD SUGAR DIAGNOSTIC 3 Strip 

EZ SMART PLUS BLOOD SUGAR DIAGNOSTIC 3 Strip 

FAST TAKE BLOOD SUGAR DIAGNOSTIC 2 Strip 

FREESTYLE BLOOD SUGAR DIAGNOSTIC 3 Strip 

FREESTYLE LITE STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

FREESTYLE TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

GLUCOCARD X-SENSOR BLOOD SUGAR DIAGNOSTIC 3 Strip 

GLUCOCOM GLUCOSE BLOOD SUGAR DIAGNOSTIC 3 Strip 

GLUCOFILM BLOOD SUGAR DIAGNOSTIC 3 Strip 

GLUCOLAB BLOOD SUGAR DIAGNOSTIC 3 Strip 

GLUCOLEADER BLOOD SUGAR DIAGNOSTIC 3 Strip 

GOOD NEIGH TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

HEALTH ALLIANCE STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

KERR TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

KEYNOTE BLOOD SUGAR DIAGNOSTIC 3 Strip 

Page 42


KINRAY TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

LEADER TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

LONG TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

MAX GLUCOSE TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

MEIJER TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

MICRODOT BLOOD SUGAR DIAGNOSTIC 3 Strip 

NAVARRO TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

ONE TOUCH TEST STRIPS BLOOD SUGAR DIAGNOSTIC 2 Strip 

ONE TOUCH ULTRA TEST STRIPS BLOOD SUGAR DIAGNOSTIC 2 Strip 

OPTIUM BLOOD SUGAR DIAGNOSTIC 3 Strip 

POCKETCHEM EZ BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRECISION PCX BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRECISION PCX PLUS BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRECISION POINT OF CARE BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRECISION Q-I-D BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRECISION SOF-TACT BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRECISION XTRA BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRESTIGE BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRESTIGE SMART SYSTEM BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRODIGY BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRODIGY AUTOCODE BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRODIGY EJECT BLOOD SUGAR DIAGNOSTIC 3 Strip 

PRODIGY VOICE BLOOD SUGAR DIAGNOSTIC 3 Strip 

PSS TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

QUICK-CHECK FILM BLOOD SUGAR DIAGNOSTIC 3 Strip 

QUICK-CHECK II BLOOD SUGAR DIAGNOSTIC 3 Strip 

QUICK-CHECK ONE BLOOD SUGAR DIAGNOSTIC 3 Strip 

QUICKTEK BLOOD SUGAR DIAGNOSTIC 3 Strip 

REAGENT STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

RELIEF PLUS BLOOD SUGAR DIAGNOSTIC 3 Strip 

SHOPRITE TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

SMARTEST TEST BLOOD SUGAR DIAGNOSTIC 3 Strip 

SOF-TACT BLOOD SUGAR DIAGNOSTIC 3 Strip 

SUPREME TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

SURECHEK TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

SURESTEP BLOOD SUGAR DIAGNOSTIC 2 Strip 

SURESTEP PRO BLOOD SUGAR DIAGNOSTIC 2 Strip 

TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

TRACER BG BLOOD SUGAR DIAGNOSTIC 2 Strip 

TRUETRACK BLOOD SUGAR DIAGNOSTIC 3 Strip 

TT STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

UNI-CHECK BLOOD SUGAR DIAGNOSTIC 3 Strip 

VALUSTRIP TEST STRIPS BLOOD SUGAR DIAGNOSTIC 3 Strip 

V-R GLUCOSE TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

WALGREENS TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

W-D TEST STRIP BLOOD SUGAR DIAGNOSTIC 3 Strip 

ASCENSIA AUTODISC BLOOD SUGAR DIAGNOSTIC, DISC 3 Strip 

ASCENSIA BREEZE 2 BLOOD SUGAR DIAGNOSTIC, DISC 3 Strip 

ACCU-CHEK BLOOD SUGAR DIAGNOSTIC, DRUM 2 Strip 

DIURETICS 

CARBONIC ANHYDRASE INHIBITORS 

DIAMOX SEQUELS ACETAZOLAMIDE 3 Capsule, Sustained Action 

ACETAZOLAMIDE ACETAZOLAMIDE 1 Tablet 

METHAZOLAMIDE METHAZOLAMIDE 1 Tablet 

THIAZIDE AND RELATED DIURETICS 

NATURETIN-5 BENDROFLUMETHIAZIDE 3 Tablet 

DIURIL CHLOROTHIAZIDE 3 Suspension, Oral (Final Dose Form) 

CHLOROTHIAZIDE CHLOROTHIAZIDE 1 Tablet 

CHLORTHALIDONE CHLORTHALIDONE 1 Tablet 

THALITONE CHLORTHALIDONE 2 Tablet 

HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE 1 Capsule (Hard, Soft, etc.) 

MICROZIDE HYDROCHLOROTHIAZIDE 3 Capsule (Hard, Soft, etc.) 

HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE 2 Solution, Oral 

HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE 1 Tablet 

HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE 2 Tablet 

SALURON HYDROFLUMETHIAZIDE 3 Tablet 

INDAPAMIDE INDAPAMIDE 1 Tablet 

Page 43


METHYCLOTHIAZIDE METHYCLOTHIAZIDE 1 Tablet 

METOLAZONE METOLAZONE 1 Tablet 

ZAROXOLYN METOLAZONE 2 Tablet 

POTASSIUM SPARING DIURETICS 

AMILORIDE HCL AMILORIDE HCL 1 Tablet 

INSPRA EPLERENONE 3 Tablet 

ALDACTONE SPIRONOLACTONE 3 Tablet 

SPIRONOLACTONE SPIRONOLACTONE 1 Tablet 

DYRENIUM TRIAMTERENE 3 Capsule (Hard, Soft, etc.) 

DIURETICS, MISCELLANEOUS 

ISMOTIC ISOSORBIDE 3 Solution, Oral 

POTASSIUM SPARING DIURETICS IN COMBINATION 

AMILORIDE HCL W/HCTZ AMILORIDE/HYDROCHLOROTHIAZIDE 1 Tablet 

ALDACTAZIDE SPIRONOLACT/HYDROCHLOROTHIAZID 3 Tablet 

SPIRONOLACTONE/HCTZ SPIRONOLACT/HYDROCHLOROTHIAZID 1 Tablet 

TRIAMTERENE W/HCTZ TRIAMTERENE/HCTZ 1 Tablet 

DYAZIDE TRIAMTERENE/HYDROCHLOROTHIAZID 3 Capsule (Hard, Soft, etc.) 

TRIAMTERENE W/HCTZ TRIAMTERENE/HYDROCHLOROTHIAZID 1 Capsule (Hard, Soft, etc.) 

MAXZIDE TRIAMTERENE/HYDROCHLOROTHIAZID 3 Tablet 

MAXZIDE-25MG TRIAMTERENE/HYDROCHLOROTHIAZID 3 Tablet 

LOOP DIURETICS 

BUMETANIDE BUMETANIDE 1 Tablet 

BUMEX BUMETANIDE 3 Tablet 

EDECRIN ETHACRYNIC ACID 3 Tablet 

FUROSEMIDE FUROSEMIDE 1 Solution, Oral 

FUROSEMIDE FUROSEMIDE 2 Solution, Oral 

FUROSEMIDE FUROSEMIDE 1 Tablet 

LASIX FUROSEMIDE 3 Tablet 

DEMADEX TORSEMIDE 3 Tablet 

TORSEMIDE TORSEMIDE 1 Tablet 

TORSEMIDE TORSEMIDE 3 Tablet 

ELECT/CALORIC/H2O 

ELECTROLYTE DEPLETERS 

PHOSLO CALCIUM ACETATE 2 Capsule (Hard, Soft, etc.) 

MAGNEBIND 400 RX CALCIUM CARBONATE/MAG CARB/FA 3 Tablet 

FOSRENOL LANTHANUM CARBONATE 2 Tablet, Chewable 

RENVELA SEVELAMER CARBONATE 3 Tablet 

RENAGEL SEVELAMER HCL 2 Tablet 

SODIUM POLYSTYRENE SULFONATE SODIUM POLYSTYRENE SULFONATE 1 Enema (ml) 

SODIUM POLYSTYRENE SULFONATE SODIUM POLYSTYRENE SULFONATE 3 Enema (ml) 

SPS SODIUM POLYSTYRENE SULFONATE 1 Enema (ml) 

KAYEXALATE SODIUM POLYSTYRENE SULFONATE 3 Powder (gm) 

KIONEX SODIUM POLYSTYRENE SULFONATE 1 Powder (gm) 

MARLEXATE SODIUM POLYSTYRENE SULFONATE 1 Powder (gm) 

SODIUM POLYSTYRENE SULFONATE SODIUM POLYSTYRENE SULFONATE 1 Powder (gm) 

SODIUM POLYSTYRENE SULFONATE SODIUM POLYSTYRENE SULFONATE 3 Suspension, Oral (Final Dose Form) 

SPS SODIUM POLYSTYRENE SULFONATE 1 Suspension, Oral (Final Dose Form) 

POTASSIUM REPLACEMENT 

K-LYTE/CL POT CHLORIDE/POT BICARB/CIT AC 3 Tablet, Effervescent 

K-LYTE/CL POT CHLORIDE/POT BICARB/CIT AC 3 Tablet, Effervescent 

POTASSIUM CHLORIDE POT CHLORIDE/POT BICARB/CIT AC 1 Tablet, Effervescent 

EFFER-K POTASSIUM BICARBONATE/CIT AC 1 Tablet, Effervescent 

EFFER-K POTASSIUM BICARBONATE/CIT AC 3 Tablet, Effervescent 

K Effervescent POTASSIUM BICARBONATE/CIT AC 1 Tablet, Effervescent 

KLOR-CON/EF POTASSIUM BICARBONATE/CIT AC 1 Tablet, Effervescent 

K-LYTE POTASSIUM BICARBONATE/CIT AC 3 Tablet, Effervescent 

POTASSIUM BICARBONATE POTASSIUM BICARBONATE/CIT AC 1 Tablet, Effervescent 

MICRO-K POTASSIUM CHLORIDE 2 Capsule, Sustained Action 

MICRO-K 10 POTASSIUM CHLORIDE 2 Capsule, Sustained Action 

POTASSIUM CHLORIDE POTASSIUM CHLORIDE 1 Capsule, Sustained Action 

KAOCHLOR POTASSIUM CHLORIDE 2 Liquid (ml) 

KAY CIEL POTASSIUM CHLORIDE 2 Liquid (ml) 

POTASSIUM CHLORIDE POTASSIUM CHLORIDE 1 Liquid (ml) 

KAY CIEL POTASSIUM CHLORIDE 2 Packet 

K-LOR POTASSIUM CHLORIDE 2 Packet 

KLOR-CON POTASSIUM CHLORIDE 1 Packet 

KLOR-CON/25 POTASSIUM CHLORIDE 2 Packet 

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KLOR-CON M10 POTASSIUM CHLORIDE 1 Tablet, Sust.Release, Particles/Crystals 



POTASSIUM CHLORIDE POTASSIUM CHLORIDE 1 Tablet, Sust.Release, Particles/Crystals 

POTASSIUM CHLORIDE POTASSIUM CHLORIDE 2 Tablet, Sust.Release, Particles/Crystals 

KAON-CL 10 POTASSIUM CHLORIDE 1 Tablet, Sustained Action 

KLOR-CON 10 POTASSIUM CHLORIDE 1 Tablet, Sustained Action 

KLOR-CON 8 POTASSIUM CHLORIDE 1 Tablet, Sustained Action 

KLOTRIX POTASSIUM CHLORIDE 2 Tablet, Sustained Action 

K-TAB POTASSIUM CHLORIDE 2 Tablet, Sustained Action 

POTASSIUM CHLORIDE POTASSIUM CHLORIDE 1 Tablet, Sustained Action 

KAOCHLOR-EFF POTASSIUM CHLORIDE/POT BICARB 3 Tablet, Effervescent 

CALCIUM REPLACEMENT 

OSTIVA CACO3/D3/MGOX/B12/LM-FOLATE/B6 3 Tablet 

FOLGARD OS CAL CARB/MGOX/D3/B12/FA/B6/BOR 3 Tablet 

CALCIFOL CAL CARB/MGOX/D3/B12/FA/B6/BOR 3 Wafer 

CALCIFOLIC-D CAL CARB/MGOX/D3/B12/FA/B6/BOR 3 Wafer 

IRON REPLACEMENT 

NIFEREX GOLD FE BISGLY/FE P/DOSS/C/FA/MV 14 3 Tablet 

FERRO-PLEX HEMATINIC FE FUM/DOSS NA/C/E/B12-IF/FA 3 Tablet 

MULTIFOL FE FUMARATE/CAL/E/FA/MULTIVIT 1 Tablet 

VITAFOL FE FUMARATE/CAL/E/FA/MULTIVIT 2 Tablet 

NEPHRON FA FE FUMARATE/DOSS/FA/BCOMP&C 3 Tablet 

HEMOCYTE PLUS FE FUMARATE/FA/VIT BCOMP&C/MIN 3 Capsule (Hard, Soft, etc.) 

REOCYTE PLUS FE FUMARATE/FA/VIT BCOMP&C/MIN 1 Capsule (Hard, Soft, etc.) 

RE DUALVIT F FE FUMARATE/FE PS CMPLX/FA 1 Capsule (Hard, Soft, etc.) 

TANDEM F FE FUMARATE/FE PS CMPLX/FA 3 Capsule (Hard, Soft, etc.) 

HEMATOGEN FE FUMARATE/VIT C/B12/STOMC 1 Capsule (Hard, Soft, etc.) 

CONISON FE FUMARATE/VIT C/B12-IF/FA 1 Capsule (Hard, Soft, etc.) 

FEROCON FE FUMARATE/VIT C/B12-IF/FA 1 Capsule (Hard, Soft, etc.) 

FEROTRINSIC FE FUMARATE/VIT C/B12-IF/FA 1 Capsule (Hard, Soft, etc.) 

FOLTRIN FE FUMARATE/VIT C/B12-IF/FA 1 Capsule (Hard, Soft, etc.) 

TRICON FE FUMARATE/VIT C/B12-IF/FA 1 Capsule (Hard, Soft, etc.) 

TRINSICON FE FUMARATE/VIT C/B12-IF/FA 2 Capsule (Hard, Soft, etc.) 

FERROGELS FORTE FE FUMARATE/VIT C/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

HEMATOGEN FA FE FUMARATE/VIT C/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

HEMATOGEN FORTE FE FUMARATE/VIT C/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

PROFERRIN-FORTE FE HEME POLYPEPTIDE/FOLIC ACID 3 Tablet 

HEMATRON FERRIC AMCIT/CYANOCOBALAMIN/FA 3 Drops 

HEMATRON FERRIC AMCIT/LYS/VIT B COMP/FA 3 Liquid (ml) 

FERROMAR FERROUS FUMARATE 3 Capsule, Sustained Action 

FERROCITE-F FERROUS FUMARATE/FOLIC ACID 1 Tablet 

HEMATINIC W/FOLIC ACID FERROUS FUMARATE/FOLIC ACID 1 Tablet 

HEMOCYTE-F FERROUS FUMARATE/FOLIC ACID 3 Tablet 

IRCON-FA FERROUS FUMARATE/FOLIC ACID 3 Tablet 

FETRIN FERROUS FUMARATE/VIT C/B12-IF 3 Capsule, Sustained Action 

FUMATINIC FERROUS FUMARATE/VIT C/B12-IF 3 Capsule, Sustained Action 

IBERET-FOLIC 500 FERROUS SULFATE/FA/VIT BCOMP&C 3 Tablet, Sustained Action 

MULTI-RET FOLIC 500 FERROUS SULFATE/FA/VIT BCOMP&C 1 Tablet, Sustained Action 

FERO-FOLIC-500 FERROUS SULFATE/VIT C/FA 3 Tablet, Sustained Action 

FOLITAB 500 FERROUS SULFATE/VIT C/FA 1 Tablet, Sustained Action 

ERITROGEN FESO4EX/C/B12/LV-STM/IF/FA 3 Tablet 

ALBAFORT FESO4EX/DSS/C/B12IF/STOMC/FA 3 Tablet 

REPLIVA 21/7 IRON AG&FUM/C/FA/MV CMB11/CA-T 3 Tablet 

CHROMAGEN IRON AG/C/B12/CA/SUC.ACID/STOM 3 Tablet 

NIFEREX-150 FORTE IRON ASPGLY&PS/C/B12/FA/CA/SUC 3 Capsule (Hard, Soft, etc.) 

CHROMAGEN FA IRON ASPGLY/C/B12/FA/CA-TH/SUC 3 Tablet 

CHROMAGEN FORTE IRON FUM & AG/C/B12/FA/CA/SUCC 3 Tablet 

IFEREX 150 IRON POLYSACCHARIDES COMPLEX 1 Capsule (Hard, Soft, etc.) 

FERREX 150 FORTE IRON PS CMPLX/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

IFEREX 150 FORTE IRON PS CMPLX/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

MYFERON-150 FORTE IRON PS CMPLX/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

POLY-IRON 150 FORTE IRON PS CMPLX/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

POLYSACCHARIDE IRON FORTE IRON PS CMPLX/VIT B12/FA 1 Capsule (Hard, Soft, etc.) 

HEMOCYTE-F IRON PS CMPLX/VIT B12/FA 3 Solution, Oral 

VITAFOL IRON PYROPHOS/B12/FA/NIAC/B-6 3 Syrup 

CORVITE 150 IRON, CARBONYL/FA/C/B-6/B12/ZN 3 Tablet 

HEMATRON-AF IRON,CARB/DSS/B12IF/FA/MV-MN 3 Tablet, Sustained Release 24 Hr 

Page 45


HEMAX IRON,CARB/DSS/B12IF/FA/MV-MN 3 Tablet, Sustained Release 24 Hr 

SIDEROL IRON/FA/VITAMIN B COMP W-C/MIN 3 Liquid (ml) 

FERROCITE PLUS IRON/FA/VITAMIN B COMP W-C/MIN 1 Tablet 

HEMATINIC PLUS IRON/FA/VITAMIN B COMP W-C/MIN 1 Tablet 

IROFOL IRON/FOLIC ACID 3 Liquid (ml) 

IROFOL IRON/FOLIC ACID 3 Tablet 

SIDEROL IRON/LIVER EXT/VIT BCOMP&C/MIN 3 Tablet 

RE DUALVIT PLUS MV COMB18/FEFM-FEPOL CB1/FA 1 Capsule (Hard, Soft, etc.) 

TANDEM PLUS MV COMB18/FEFM-FEPOL CB1/FA 3 Capsule (Hard, Soft, etc.) 

FERRLECIT SOD FERRIC GLUC COMPLX/SUCROSE 3 Ampul (ml) 

ZINC REPLACEMENT 

ZINC SULFATE ZINC SULFATE 1 Capsule (Hard, Soft, etc.) 

ZINCATE ZINC SULFATE 1 Capsule (Hard, Soft, etc.) 

MAR-ZINC ZINC SULFATE 1 Tablet 

POTASSIUM REPLACEMENTIODINE CONTAINING AGENTS 

YODEFAN POTASSIUM IODIDE 3 Liquid (ml) 

SSKI POTASSIUM IODIDE 3 Solution, Oral 

LUGOL'S POTASSIUM IODIDE/IODINE 1 Solution, Oral 

STRONG IODINE POTASSIUM IODIDE/IODINE 1 Solution, Oral 

MINERAL REPLACEMENT, MISCELLANEOUS 

GLUTOFAC-MX DOCUSATE NA/FA/M-VITS-FE/MIN 3 Tablet 

PROTEIN REPLACEMENT 

ALBALYBE LYSINE/CALCIUM/VIT B COMP 3 Syrup 

LYSIPLEX LYSINE/VIT E/FA/VIT BCOMP&C/ZN 3 Tablet 

LYSIPLEX PLUS LYSINE/VIT E/FA/VIT BCOMP&C/ZN 3 Tablet 

DIETARY SUPPLEMENT, MISCELLANEOUS 

FOSTEUM GENISTEIN/CIT ZN BISGLY/VIT D3 3 Capsule (Hard, Soft, etc.) 

FLUORIDE PREPARATIONS 

CONTROL RX SODIUM FLUORIDE 3 Cream (Grams) 

DENTA 5000 PLUS SODIUM FLUORIDE 1 Cream (Grams) 

ETHEDENT SODIUM FLUORIDE 1 Cream (Grams) 

PREVIDENT 5000 PLUS SODIUM FLUORIDE 3 Cream (Grams) 

SF 5000 PLUS SODIUM FLUORIDE 1 Cream (Grams) 

FLUORABON SODIUM FLUORIDE 3 Drops 

FLUOR-A-DAY SODIUM FLUORIDE 3 Drops 

FLUORITAB SODIUM FLUORIDE 1 Drops 

FLURA-DROPS SODIUM FLUORIDE 1 Drops 

LURIDE SODIUM FLUORIDE 1 Drops 

SODIUM FLUORIDE SODIUM FLUORIDE 1 Drops 

SODIUM FLUORIDE SODIUM FLUORIDE 3 Drops 

THERA-FLUR-N SODIUM FLUORIDE 3 Drops 

CAVAREST SODIUM FLUORIDE 3 Gel (gm) 

DENTAGEL SODIUM FLUORIDE 1 Gel (gm) 

ETHEDENT SODIUM FLUORIDE 1 Gel (gm) 

FLUORIDEX DAILY DEFENSE SODIUM FLUORIDE 3 Gel (gm) 

FLUORIDEX DEFENSE WHITENING SODIUM FLUORIDE 3 Gel (gm) 

NEUTRAGARD SODIUM FLUORIDE 1 Gel (gm) 

NEUTRAGARD ADVANCED SODIUM FLUORIDE 1 Gel (gm) 

PHOS-FLUR SODIUM FLUORIDE 3 Gel (gm) 

PREVIDENT SODIUM FLUORIDE 3 Gel (gm) 

SF SODIUM FLUORIDE 1 Gel (gm) 

FLUORIDE LOZ SODIUM FLUORIDE 1 Lozenge 

FLURA SODIUM FLUORIDE 1 Lozenge 

PREVIDENT SODIUM FLUORIDE 3 Paste (ml) 

CAVIRINSE SODIUM FLUORIDE 3 Solution, Non-Oral 

PREVIDENT SODIUM FLUORIDE 1 Solution, Non-Oral 

SODIUM FLUORIDE SODIUM FLUORIDE 1 Solution, Non-Oral 

FLURA-TAB SODIUM FLUORIDE 1 Tablet 

SODIUM FLUORIDE SODIUM FLUORIDE 3 Tablet 

ETHEDENT SODIUM FLUORIDE 1 Tablet, Chewable 

FLUORABON SODIUM FLUORIDE 1 Tablet, Chewable 

FLUOR-A-DAY SODIUM FLUORIDE 1 Tablet, Chewable 

LURIDE SODIUM FLUORIDE 3 Tablet, Chewable 

PHARMAFLUR SODIUM FLUORIDE 1 Tablet, Chewable 

SODIUM FLUORIDE SODIUM FLUORIDE 1 Tablet, Chewable 

SODIUM FLUORIDE SODIUM FLUORIDE 3 Tablet, Chewable 

FLUORIDEX SENSITIVITY RELIEF SODIUM FLUORIDE/POT NITRATE 3 Gel (gm) 

Page 46


PREVIDENT 5000 SENSITIVE SODIUM FLUORIDE/POT NITRATE 3 Paste (ml) 

EASYGEL STANNOUS FLUORIDE 1 Gel (gm) 

OMNII MED STANNOUS FLUORIDE 1 Gel (gm) 

STANIMAX STANNOUS FLUORIDE 1 Gel (gm) 

GEL-KAM STANNOUS FLUORIDE 3 Solution (gm) 

PERIO MED STANNOUS FLUORIDE 1 Solution (gm) 

STANNOUS FLUORIDE STANNOUS FLUORIDE 1 Solution (gm) 

HYPERGLYCEMICS 

GLUCAGEN GLUCAGON,HUMAN RECOMBINANT 1 Kit 

GLUCAGON EMERGENCY Kit GLUCAGON,HUMAN RECOMBINANT 2 Kit 

URINARY PH MODIFIERS 

RENACIDIN CITRIC ACID/G-LACTONE/MAG CARB 3 Solution, Irrigation 

CYTRA-K CITRIC ACID/POTASSIUM CITRATE 1 Packet 

POLYCITRA-K CITRIC ACID/POTASSIUM CITRATE 3 Packet 

CYTRA-K CITRIC ACID/POTASSIUM CITRATE 1 Solution, Oral 

POLYCITRA-K CITRIC ACID/POTASSIUM CITRATE 3 Solution, Oral 

POTASSIUM CITRATE/CITRIC ACID CITRIC ACID/POTASSIUM CITRATE 1 Solution, Oral 

BICITRA CITRIC ACID/SODIUM CITRATE 3 Solution, Oral 

CYTRA-2 CITRIC ACID/SODIUM CITRATE 1 Solution, Oral 

LIQUI-DUALCITRA CITRIC ACID/SODIUM CITRATE 1 Solution, Oral 

ORACIT CITRIC ACID/SODIUM CITRATE 3 Solution, Oral 

SODIUM CITRATE & CITRIC ACID CITRIC ACID/SODIUM CITRATE 1 Solution, Oral 

UROQID-ACID NO.2 METHEN MAND/NAPHOS M-B M-H 3 Tablet 

VISQID A/A METHEN MAND/NAPHOS M-B M-H 1 Tablet 

K-PHOS M.F. NA PHOS,M-B/K PHOS,MONOB 3 Tablet 

K-PHOS NO.2 NA PHOS,M-B/K PHOS,MONOB 3 Tablet 

K-PHOS NEUTRAL PHOSPHORUS #1 1 Tablet 

PHOSPHA 250 NEUTRAL PHOSPHORUS #1 1 Tablet 

VIS-PHOS N PHOSPHORUS #1 1 Tablet 

POTASSIUM CITRATE POTASSIUM CITRATE 1 Tablet, Sustained Action 

UROCIT-K POTASSIUM CITRATE 3 Tablet, Sustained Action 

K-PHOS ORIGINAL POTASSIUM PHOSPHATE,MONOBASIC 2 Tablet 

PEDAMETH RACEMETHIONINE 3 Capsule (Hard, Soft, etc.) 

PEDAMETH RACEMETHIONINE 3 Liquid (ml) 

POLYCITRA SOD/POT/K & SOD CIT/C AC/SUCRO 3 Solution, Oral 

TRICITRATES SOD/POT/K & SOD CIT/C AC/SUCRO 1 Solution, Oral 

CYTRA-3 SOD/POTASS/K CIT/SODIUM CIT/CA 1 Solution, Oral 

POLYCITRA-LC SOD/POTASS/K CIT/SODIUM CIT/CA 3 Solution, Oral 

TRICITRATES SOD/POTASS/K CIT/SODIUM CIT/CA 1 Solution, Oral 

EENT PREPARATIONS 

EYE ANTI-INFECTIVES (RX ONLY) 

BETADINE POVIDONE-IODINE 3 Solution, Non-Oral 

EYE VASOCONSTRICTORS (RX ONLY) 

AK-CON NAPHAZOLINE HCL 1 Drops 

ALBALON NAPHAZOLINE HCL 3 Drops 

ALLERSOL NAPHAZOLINE HCL 1 Drops 

NAPHAZOLINE HCL NAPHAZOLINE HCL 1 Drops 

AK-DILATE PHENYLEPHRINE HCL 1 Drops 

ALTAFRIN PHENYLEPHRINE HCL 1 Drops 

MYDFRIN PHENYLEPHRINE HCL 3 Drops 

NEOFRIN PHENYLEPHRINE HCL 1 Drops 

PHENYLEPHRINE HCL PHENYLEPHRINE HCL 1 Drops 

EYE IRRIGATIONS 

IOCARE BALANCED SALT SODIUM/CAL/MG SLT(REP)/POTASS 3 Solution, Non-Oral 

MIOTICS/OTHER INTRAOC. PRESSURE REDUCERS 

IOPIDINE APRACLONIDINE HCL 3 Dropperette, Single-Use Drop Dispenser 

IOPIDINE APRACLONIDINE HCL 3 Drops 

BETAXOLOL HCL BETAXOLOL HCL 2 Drops 

BETAXOLOL HCL BETAXOLOL HCL 1 Drops 

BETOPTIC S BETAXOLOL HCL 2 Suspension, Drops(Final Dosage Form)(ml) 

LUMIGAN BIMATOPROST 3 Drops 

ALPHAGAN P BRIMONIDINE TARTRATE 2 Drops 

BRIMONIDINE TARTRATE BRIMONIDINE TARTRATE 1 Drops 

COMBIGAN BRIMONIDINE TARTRATE/TIMOLOL 3 Drops 

AZOPT BRINZOLAMIDE 2 Suspension, Drops(Final Dosage Form)(ml) 

ISOPTO CARBACHOL CARBACHOL 2 Drops 

ISOPTO CARBACHOL CARBACHOL 2 Drops 

Page 47


CARTEOLOL HCL CARTEOLOL HCL 1 Drops 

HUMORSOL DEMECARIUM BROMIDE 3 Drops 

TRUSOPT DORZOLAMIDE HCL 2 Drops 

PHOSPHOLINE IODIDE ECHOTHIOPHATE IODIDE 3 Drops 

XALATAN LATANOPROST 2 Drops 

BETAGAN LEVOBUNOLOL HCL 3 Drops 

LEVOBUNOLOL HCL LEVOBUNOLOL HCL 1 Drops 

METIPRANOLOL METIPRANOLOL 1 Drops 

OPTIPRANOLOL METIPRANOLOL 3 Drops 

ISOPTO CARPINE PILOCARPINE HCL 3 Drops 

PILOCARPINE HCL PILOCARPINE HCL 3 Drops 

PILOCARPINE HCL PILOCARPINE HCL 1 Drops 

PILOPINE HS PILOCARPINE HCL 3 Gel (gm) 

BETIMOL TIMOLOL 2 Drops 

TIMOPTIC TIMOLOL MALEATE 2 Dropperette, Single-Use Drop Dispenser 

TIMOLOL MALEATE TIMOLOL MALEATE 1 Drops 

TIMOPTIC TIMOLOL MALEATE 3 Drops 

ISTALOL TIMOLOL MALEATE 3 Drops, Once Daily 

TIMOLOL MALEATE TIMOLOL MALEATE 1 Gel-Forming Solution 

TIMOPTIC-XE TIMOLOL MALEATE 3 Gel-Forming Solution 

COSOPT TIMOLOL MALEATE/DORZOLAM HCL 2 Drops 

TRAVATAN Z TRAVOPROST 2 Drops 

TRAVATAN TRAVOPROST (BENZALKONIUM) 2 Drops 

EYE LOCAL ANESTHETICS 

ALTAFLUOR BENOXINATE HCL/FLUORESCEIN NA 3 Drops 

FLUORESCEIN-BENOXINATE BENOXINATE HCL/FLUORESCEIN NA 1 Drops 

FLURATE BENOXINATE HCL/FLUORESCEIN NA 3 Drops 

FLURESS BENOXINATE HCL/FLUORESCEIN NA 1 Drops 

FLUROX BENOXINATE HCL/FLUORESCEIN NA 1 Drops 

FLUCAINE PROPARAC HCL/FLUORESCEIN NA 1 Drops 

FLUORACAINE PROPARAC HCL/FLUORESCEIN NA 3 Drops 

ALCAINE PROPARACAINE HCL 3 Drops 

OPHTHETIC PROPARACAINE HCL 1 Drops 

PARCAINE PROPARACAINE HCL 1 Drops 

PROPARACAINE PROPARACAINE HCL 1 Drops 

PROPARACAINE HCL PROPARACAINE HCL 1 Drops 

TETRACAINE HCL TETRACAINE HCL 3 Dropperette, Single-Use Drop Dispenser 

TETCAINE TETRACAINE HCL 1 Drops 

TETRACAINE HCL TETRACAINE HCL 1 Drops 

TETRACAINE HCL TETRACAINE HCL 3 Drops 

TETRAVISC TETRACAINE HCL 3 Drops, Viscous 

MYDRIATICS 

ATROPINE CARE ATROPINE SULFATE 1 Drops 

ATROPINE SULFATE ATROPINE SULFATE 1 Drops 

ISOPTO ATROPINE ATROPINE SULFATE 2 Drops 

ATROPINE SULFATE ATROPINE SULFATE 1 Ointment (gm) 

AK-PENTOLATE CYCLOPENTOLATE HCL 1 Drops 

CYCLOGYL CYCLOPENTOLATE HCL 3 Drops 

CYCLOGYL CYCLOPENTOLATE HCL 3 Drops 

CYCLOPENTOLATE HCL CYCLOPENTOLATE HCL 1 Drops 

CYLATE CYCLOPENTOLATE HCL 1 Drops 

DIPIVEFRIN HCL DIPIVEFRIN HCL 1 Drops 

PROPINE DIPIVEFRIN HCL 3 Drops 

EPINAL EPINEPHRYL BORATE 3 Drops 

HOMATROPAIRE HOMATROPINE HBR 1 Drops 

ISOPTO HOMATROPINE HOMATROPINE HBR 3 Drops 

PAREMYD HYDROXYAMPHETAMINE/TROPICAMIDE 3 Drops 

MUROCOLL-2 PHENYLEPHRINE HCL/SCOPOL HB 3 Drops 

CYCLOMYDRIL PHENYLEPHRINE/CYCLOPENT HCL 3 Drops 

ISOPTO HYOSCINE SCOPOLAMINE HYDROBROMIDE 3 Drops 

MYDRAL TROPICAMIDE 1 Drops 

MYDRIACYL TROPICAMIDE 3 Drops 

TROPICACYL TROPICAMIDE 1 Drops 

TROPICAMIDE TROPICAMIDE 1 Drops 

EYE ANTIINFLAMMATORY AGENTS 

XIBROM BROMFENAC SODIUM 3 Drops 

MAXIDEX DEXAMETHASONE 2 Suspension, Drops(Final Dosage Form)(ml) 

DEXAMETHASONE SODIUM PHOSPHATE DEXAMETHASONE SOD PHOSPHATE 1 Drops 

Page 48


DEXASOL DEXAMETHASONE SOD PHOSPHATE 1 Drops 

DECADRON DEXAMETHASONE SOD PHOSPHATE 2 Ointment (gm) 

DICLOFENAC SODIUM DICLOFENAC SODIUM 1 Drops 

VOLTAREN DICLOFENAC SODIUM 3 Drops 

FML S.O.P. FLUOROMETHOLONE 2 Ointment (gm) 

FLUOROMETHOLONE FLUOROMETHOLONE 1 Suspension, Drops(Final Dosage Form)(ml) 

FML FLUOROMETHOLONE 3 Suspension, Drops(Final Dosage Form)(ml) 

FML FORTE FLUOROMETHOLONE 2 Suspension, Drops(Final Dosage Form)(ml) 

FLAREX FLUOROMETHOLONE ACETATE 3 Suspension, Drops(Final Dosage Form)(ml) 

FLURBIPROFEN SODIUM FLURBIPROFEN SODIUM 1 Drops 

OCUFEN FLURBIPROFEN SODIUM 3 Drops 

ACULAR PF KETOROLAC TROMETHAMINE 3 Dropperette, Single-Use Drop Dispenser 

ACULAR KETOROLAC TROMETHAMINE 3 Drops 

ACULAR LS KETOROLAC TROMETHAMINE 3 Drops 

ALREX LOTEPREDNOL ETABONATE 3 Suspension, Drops(Final Dosage Form)(ml) 

LOTEMAX LOTEPREDNOL ETABONATE 3 Suspension, Drops(Final Dosage Form)(ml) 

NEVANAC NEPAFENAC 3 Suspension, Drops(Final Dosage Form)(ml) 

ECONOPRED PLUS PREDNISOLONE ACETATE 3 Suspension, Drops(Final Dosage Form)(ml) 

OMNIPRED PREDNISOLONE ACETATE 3 Suspension, Drops(Final Dosage Form)(ml) 

PRED FORTE PREDNISOLONE ACETATE 3 Suspension, Drops(Final Dosage Form)(ml) 

PRED MILD PREDNISOLONE ACETATE 2 Suspension, Drops(Final Dosage Form)(ml) 

PREDNISOLONE ACETATE PREDNISOLONE ACETATE 1 Suspension, Drops(Final Dosage Form)(ml) 

PREDNISOL PREDNISOLONE SOD PHOSPHATE 1 Drops 

PREDNISOLONE SODIUM PHOSPHATE PREDNISOLONE SOD PHOSPHATE 1 Drops 

VEXOL RIMEXOLONE 3 Suspension, Drops(Final Dosage Form)(ml) 

EYE SULFONAMIDES 

OPTIMYD NA SULFACETM/PREDNIS SP 3 Drops 

SULFACETAMIDE W-PREDNISOLONE NA SULFACETM/PREDNIS SP 1 Drops 

SULFACETAMIDE-PREDNISOLONE NA SULFACETM/PREDNIS SP 1 Drops 

BLEPHAMIDE S.O.P. NA SULFACETM/PREDNISOL AC 2 Ointment (gm) 

BLEPHAMIDE NA SULFACETM/PREDNISOL AC 2 Suspension, Drops(Final Dosage Form)(ml) 

BLEPH-10 SULFACETAMIDE SODIUM 3 Drops 

SULFAC SULFACETAMIDE SODIUM 1 Drops 

SULFACETAMIDE SODIUM SULFACETAMIDE SODIUM 1 Drops 

SULFAMIDE SULFACETAMIDE SODIUM 1 Drops 

SULFACETAMIDE SODIUM SULFACETAMIDE SODIUM 1 Ointment (gm) 

ARTIFICIAL TEARS 

FRESHKOTE EYE LUBRICANT COMBINATION NO.1 3 Drops 

LACRISERT HYDROXYPROPYL CELLULOSE 3 Insert 

EYE ANTIVIRALS 

TRIFLURIDINE TRIFLURIDINE 1 Drops 

VIROPTIC TRIFLURIDINE 2 Drops 

OPHTHALMIC ANTIBIOTICS 

AZASITE AZITHROMYCIN 3 Drops 

BACITRACIN BACITRACIN 1 Ointment (gm) 

AK-POLY-BAC BACITRACIN/POLYMYXIN B SULFATE 1 Ointment (gm) 

BACITRACIN/POLYMYXIN B BACITRACIN/POLYMYXIN B SULFATE 1 Ointment (gm) 

POLYCIN-B BACITRACIN/POLYMYXIN B SULFATE 1 Ointment (gm) 

CHLORAMPHENICOL CHLORAMPHENICOL 3 Ointment (gm) 

CILOXAN CIPROFLOXACIN HCL 3 Drops 

CIPROFLOXACIN HCL CIPROFLOXACIN HCL 1 Drops 

CILOXAN CIPROFLOXACIN HCL 3 Ointment (gm) 

ERYTHROMYCIN ERYTHROMYCIN BASE 1 Ointment (gm) 

ROMYCIN ERYTHROMYCIN BASE 1 Ointment (gm) 

ZYMAR GATIFLOXACIN 3 Drops 

GENTAK GENTAMICIN SULFATE 1 Drops 

GENTAMICIN SULFATE GENTAMICIN SULFATE 1 Drops 

GENTASOL GENTAMICIN SULFATE 1 Drops 

GENTAK GENTAMICIN SULFATE 3 Ointment (gm) 

GENTAMICIN SULFATE GENTAMICIN SULFATE 1 Ointment (gm) 

IQUIX LEVOFLOXACIN 3 Drops 

QUIXIN LEVOFLOXACIN 3 Drops 

VIGAMOX MOXIFLOXACIN HCL 2 Drops 

NATACYN NATAMYCIN 3 Suspension, Drops(Final Dosage Form)(ml) 

NEOMYCIN-BACITRACIN-POLYMYXIN NEOMY SULF/BACITRA/POLYMYXIN B 1 Ointment (gm) 

NEOCIN-PG NEOMY SULF/GRAMICID D/POLY 1 Drops 

NEOMYCIN/POLYMYXIN/GRAMICIDIN NEOMY SULF/GRAMICID D/POLY 1 Drops 

NEOCIDIN NEOMYCIN/POLYMYXN B/GRAMICIDIN 1 Drops 

Page 49


NEOMYCIN-POLYMYXIN-GRAMICIDIN NEOMYCIN/POLYMYXN B/GRAMICIDIN 1 Drops 

NEOSPORIN NEOMYCIN/POLYMYXN B/GRAMICIDIN 3 Drops 

OCUFLOX OFLOXACIN 3 Drops 

OFLOXACIN OFLOXACIN 1 Drops 

TERAK OXY-TCN HCL/POLYMYX B SULF 3 Ointment (gm) 

TERRAMYCIN W/POLYMYXIN OXY-TCN HCL/POLYMYX B SULF 1 Ointment (gm) 

POLYMYXIN B SUL/TRIMETHOPRIM POLYMYXIN B SULFATE/TMP 1 Drops 

POLYTRIM POLYMYXIN B SULFATE/TMP 3 Drops 

AKTOB TOBRAMYCIN SULFATE 1 Drops 

TOBRAMYCIN SULFATE TOBRAMYCIN SULFATE 1 Drops 

TOBRASOL TOBRAMYCIN SULFATE 1 Drops 

TOBREX TOBRAMYCIN SULFATE 3 Drops 

TOBREX TOBRAMYCIN SULFATE 3 Ointment (gm) 

NOSE PREPARATIONS, MISCELLANEOUS (RX) 

ATROVENT IPRATROPIUM BROMIDE 3 Aerosol, Spray (ml) 

IPRATROPIUM BROMIDE IPRATROPIUM BROMIDE 1 Aerosol, Spray (ml) 

NOSE PREPARATIONS, VASOCONSTRICTORS (RX) 

ADRENALIN CHLORIDE EPINEPHRINE 3 Solution, Non-Oral 

TYZINE TETRAHYDROZOLINE HCL 3 Aerosol, Spray (ml) 

TYZINE TETRAHYDROZOLINE HCL 3 Drops 

NASAL ANTI-INFLAMMATORY STEROIDS 

BECONASE AQ BECLOMETHASONE DIPROPIONATE 3 Aerosol, Spray (gm) 

RHINOCORT AQUA BUDESONIDE 3 Spray, Non-Aerosol (gm) 

FLUNISOLIDE FLUNISOLIDE 1 Aerosol, Spray (ml) 

NASAREL FLUNISOLIDE 3 Aerosol, Spray (ml) 

VERAMYST FLUTICASONE FUROATE 3 Spray, Suspension 

FLONASE FLUTICASONE PROPIONATE 2 Spray, Suspension 

FLUTICASONE PROPIONATE FLUTICASONE PROPIONATE 1 Spray, Suspension 

NASONEX MOMETASONE FUROATE 2 Spray, Non-Aerosol (gm) 

NASACORT AQ TRIAMCINOLONE ACETONIDE 3 Aerosol, Spray (gm) 

NOSE PREPARATIONS ANTIBIOTICS 

BACTROBAN NASAL MUPIROCIN CALCIUM 3 Ointment (gm) 

EAR PREPARATIONS, MISC. ANTI-INFECTIVES 

ACETIC ACID ACETIC ACID 1 Solution, Non-Oral 

ACETIC ACID/ALUMINUM ACETIC ACID/ALUMINUM ACETATE 1 Drops 

BOROFAIR ACETIC ACID/ALUMINUM ACETATE 1 Drops 

DOMEBORO ACETIC ACID/ALUMINUM ACETATE 3 Drops 

ACETASOL HC ACETIC ACID/HYDROCORTISONE 1 Drops 

ACETIC ACID-HYDROCORTISONE ACETIC ACID/HYDROCORTISONE 1 Drops 

OTOMYCET-HC ACETIC ACID/HYDROCORTISONE 1 Drops 

OTOSPORIN ALUM ACET COMB#1/BORIC/ACETIC 3 Drops 

CRESYLATE CRESYL ACE/BEN ALC/BUTANOL/IPA 3 Drops 

CORTANE-B HC/PRAMOX HCL/CL-XYLENOL/WATER 1 Drops 

ZOTANE HC HC/PRAMOX HCL/CL-XYLENOL/WATER 1 Drops 

AERO OTIC HC HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

CORTIC HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

CORTIC-ND HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

EXOTIC-HC HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

OTIRX HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

OTO-END 10 HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

OTOMAR HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

OTOMAX-HC HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

OTOZONE HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

ZOLENE HC HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Drops 

ZOTO-HC HC/PRAMOXINE HCL/CHLOROXYLENOL 3 Drops 

CORTAMOX HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Lotion (ml) 

CORTANE-B HC/PRAMOXINE HCL/CHLOROXYLENOL 3 Lotion (ml) 

IVDERM HC/PRAMOXINE HCL/CHLOROXYLENOL 1 Lotion (ml) 

EAR PREPARATIONS, LOCAL ANESTHETICS 

AURALGAN AA/ANTPY/BCAINE/POLICO/AL ACET 1 Drops 

OTILAM ANTIPYRINE/BENZOCAINE/GLY/UREA 3 Drops 

A/B OTIC ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

ANTIPYRINE W/BENZOCAINE ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

ANTIPYRINE-BENZOCAINE ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

AURODEX EAR DROPS ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

AUROGUARD ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

BENZOTIC ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

Page 50


DOLOTIC ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

OTOGESIC ANTIPYRINE/BENZOCAINE/GLYCERIN 2 Drops 

OTRA NR ANTIPYRINE/BENZOCAINE/GLYCERIN 1 Drops 

OMEDIA OTIC BENZOCAINE 1 Drops 

OTICAINE BENZOCAINE 1 Drops 

EAR-GESIC PHENYLEPHRINE/ANTIPY/B-CAINE 1 Drops 

OTOGESIC PHENYLEPHRINE/ANTIPY/B-CAINE 1 Drops 

ALBA-3 PRAMOXINE/CHLOROXYLENOL/BAK 3 Drops 

EAR PREPARATIONS ANTI-INFLAMMATORY 

DERMOTIC FLUOCINOLONE ACETONIDE OIL 3 Drops 

HYDRO HC/PRAMOXINE/CHLOROXYLENOL/BAK 1 Drops 

OTICIN HC HC/PRAMOXINE/CHLOROXYLENOL/BAK 3 Drops 

EAR PREPARATIONS, ANTIBIOTICS 

PEDIOTIC NEO SUL/PLYMX B SU/BUFFERS/HC 2 Suspension, Drops(Final Dosage Form)(ml) 

COLY-MYCIN S NEOMY SULF/COLIST SUL/HC/THONZ 3 Suspension, Drops(Final Dosage Form)(ml) 

CORTISPORIN-TC NEOMY SULF/COLIST SUL/HC/THONZ 3 Suspension, Drops(Final Dosage Form)(ml) 

CORTISPORIN NEOMY SULF/POLYMYX B SULF/HC 3 Solution, Non-Oral 

CORTOMYCIN NEOMY SULF/POLYMYX B SULF/HC 1 Solution, Non-Oral 

NEOMYCIN-POLYMYXIN-HC NEOMY SULF/POLYMYX B SULF/HC 1 Solution, Non-Oral 

OTICIN HC NEOMY SULF/POLYMYX B SULF/HC 1 Solution, Non-Oral 

OTIMAR NEOMY SULF/POLYMYX B SULF/HC 1 Solution, Non-Oral 

OTOCIDIN NEOMY SULF/POLYMYX B SULF/HC 1 Solution, Non-Oral 

CORTISPORIN NEOMY SULF/POLYMYX B SULF/HC 3 Suspension, Drops(Final Dosage Form)(ml) 

CORTOMYCIN NEOMY SULF/POLYMYX B SULF/HC 1 Suspension, Drops(Final Dosage Form)(ml) 

NEOMYCIN-POLYMYXIN-HC NEOMY SULF/POLYMYX B SULF/HC 1 Suspension, Drops(Final Dosage Form)(ml) 

OTICIN HC NEOMY SULF/POLYMYX B SULF/HC 1 Suspension, Drops(Final Dosage Form)(ml) 

OTIMAR NEOMY SULF/POLYMYX B SULF/HC 1 Suspension, Drops(Final Dosage Form)(ml) 

FLOXIN OFLOXACIN 2 Dropperette, Single-Use Drop Dispenser 

FLOXIN OFLOXACIN 2 Drops 

OFLOXACIN OFLOXACIN 1 Drops 

MOUTHWASHES 

FIRST-MOUTHWASH BLM MAG HYDROX/ALH/SMC/DPHA/LIDO 3 Mouthwash 

NASAL ANTIHISTAMINE 

ASTELIN AZELASTINE HCL 2 Aerosol, Spray w/Pump (ml) 

EYE ANTIBIOTIC-CORTICOID COMBINATIONS 

PRED-G GENTAMICIN/PREDNISOL AC 3 Ointment (gm) 

PRED-G GENTAMICIN/PREDNISOL AC 3 Suspension, Drops(Final Dosage Form)(ml) 

MAXITROL NEO/POLYMYX B SULF/DEXAMETH 3 Ointment (gm) 

NEO/POLYMYXIN/DEXAMETHASONE NEO/POLYMYX B SULF/DEXAMETH 1 Ointment (gm) 

NEOMYCIN-POLYMYXIN-DEXAMETH NEO/POLYMYX B SULF/DEXAMETH 1 Ointment (gm) 

POLY-DEX NEO/POLYMYX B SULF/DEXAMETH 1 Ointment (gm) 

MAXITROL NEO/POLYMYX B SULF/DEXAMETH 3 Suspension, Drops(Final Dosage Form)(ml) 

METHADEX NEO/POLYMYX B SULF/DEXAMETH 1 Suspension, Drops(Final Dosage Form)(ml) 

NEOMYCIN/POLYMYXIN/DEXAMETH NEO/POLYMYX B SULF/DEXAMETH 1 Suspension, Drops(Final Dosage Form)(ml) 

POLY-DEX NEO/POLYMYX B SULF/DEXAMETH 1 Suspension, Drops(Final Dosage Form)(ml) 

NEOMYCIN/BACITRACIN/POLY/HC NEOMY SULF/BACITRAC ZN/POLY/HC 1 Ointment (gm) 

NEOMYCIN-BACITRACIN-POLY-HC NEOMY SULF/BACITRAC ZN/POLY/HC 1 Ointment (gm) 

CORTISPORIN NEOMY SULF/POLYMYX B SULF/HC 3 Suspension, Drops(Final Dosage Form)(ml) 

NEOMYCIN-POLYMYXIN-HC NEOMY SULF/POLYMYX B SULF/HC 1 Suspension, Drops(Final Dosage Form)(ml) 

POLY-PRED NEOMY SULF/POLYMYX B SULF/PRED 3 Suspension, Drops(Final Dosage Form)(ml) 

TOBRADEX TOBRAMYCIN SULFATE/DEXAMETH 2 Ointment (gm) 

TOBRADEX TOBRAMYCIN SULFATE/DEXAMETH 2 Suspension, Drops(Final Dosage Form)(ml) 

ZYLET TOBRAMYCIN/LOTEPRED ETAB 3 Suspension, Drops(Final Dosage Form)(ml) 

OTIC PREPARATIONS,ANTI-INFLAMMATORY-ANTIBIOTICS 

CIPRODEX CIPROFLOXACIN HCL/DEXAMETH 2 Suspension, Drops(Final Dosage Form)(ml) 

CIPRO HC CIPROFLOXACIN HCL/HC 3 Suspension, Drops(Final Dosage Form)(ml) 

OPHTHALMIC MAST CELL STABILIZERS 

CROLOM CROMOLYN SODIUM 3 Drops 

CROMOLYN SODIUM CROMOLYN SODIUM 1 Drops 

ALOMIDE LODOXAMIDE TROMETHAMINE 3 Drops 

ALOCRIL NEDOCROMIL SODIUM 3 Drops 

ALAMAST PEMIROLAST POTASSIUM 3 Drops 

OPHTHALMIC ANTI-INFLAMMATORY IMMUNOMODULATOR-TYPE 

RESTASIS CYCLOSPORINE 2 Dropperette, Single-Use Drop Dispenser 

OTIC, ANTIINFECTIVE-LOCAL ANESTHETIC COMBINATIONS 

CHLOROXYLENOL-PRAMOXINE HCL CHLOROXYLENOL/PRAMOXINE HCL 1 Drops 

PRAMOTIC CHLOROXYLENOL/PRAMOXINE HCL 3 Drops 

Page 51


ZINOTIC CHLOROXYLNL/PRAMOX HCL/ZINC AC 3 Drops 

GASTROINTESTINAL 

ANTI-ULCER PREPARATIONS 

CYTOTEC MISOPROSTOL 3 Tablet 

MISOPROSTOL MISOPROSTOL 1 Tablet 

CARAFATE SUCRALFATE 2 Suspension, Oral (Final Dose Form) 

SUCRALFATE SUCRALFATE 2 Suspension, Oral (Final Dose Form) 

CARAFATE SUCRALFATE 3 Tablet 

SUCRALFATE SUCRALFATE 1 Tablet 

GASTRIC ENZYMES 

DIGEX CELL/AMY/LIP/PROTE/P-TLOX/HYOS 3 Capsule (Hard, Soft, etc.) 

GASTRINEX CELL/AMY/LIP/PROTE/P-TLOX/HYOS 3 Capsule (Hard, Soft, etc.) 

DIGESPLEN PLUS PEP/CELL/SIMETH/BILE/PANCREAT 3 Tablet, Delayed Release (Enteric Coated) 

SUCRAID SACROSIDASE 3 Solution, Oral 

ANTIDIARRHEALS 

MOTOFEN DIFENOXIN HCL/ATROPINE SULFATE 3 Tablet 

DIPHENOXYLATE W/ATROPINE DIPHENOXYLATE HCL/ATROP SULF 1 Liquid (ml) 

LOMOTIL DIPHENOXYLATE HCL/ATROP SULF 3 Liquid (ml) 

DIPHENOXYLATE W/ATROPINE DIPHENOXYLATE HCL/ATROP SULF 1 Tablet 

LOMOTIL DIPHENOXYLATE HCL/ATROP SULF 3 Tablet 

LONOX DIPHENOXYLATE HCL/ATROP SULF 1 Tablet 

LOPERAMIDE HCL LOPERAMIDE HCL 1 Capsule (Hard, Soft, etc.) 

PAREGORIC PAREGORIC 1 Liquid (ml) 

PAREGORIC PAREGORIC 3 Liquid (ml) 

LAXATIVES AND CATHARTICS 

HALFLYTELY BISAC/NACL/NAHCO3/KCL/PEG 3350 3 Kit 

HALFLYTELY WITH FLAVOR PACKS BISAC/NACL/NAHCO3/KCL/PEG 3350 3 Kit 

HALFLYTELY-BISACODYL BISAC/NACL/NAHCO3/KCL/PEG 3350 3 Kit 

KRISTALOSE LACTULOSE 3 Packet 

CONSTULOSE LACTULOSE 1 Solution, Oral 

LACTULOSE LACTULOSE 1 Solution, Oral 


AMITIZA LUBIPROSTONE 3 Capsule (Hard, Soft, etc.) 

VISICOL NA PHOS MONO&DIBASIC/CELLULOSE 3 Tablet 

OSMOPREP NAPHOS M-B M-H/NA PHOS,DI-BA 3 Tablet 

GOLYTELY PEG 3350/NA SULF,BICARB,CL/KCL 3 Powder in Packet 

COLYTE PEG 3350/NA SULF,BICARB,CL/KCL 3 Solution, Reconstituted, Oral 

COLYTE WITH FLAVOR PacketS PEG 3350/NA SULF,BICARB,CL/KCL 3 Solution, Reconstituted, Oral 

GOLYTELY PEG 3350/NA SULF,BICARB,CL/KCL 3 Solution, Reconstituted, Oral 

PEG 3350/ELECTROLYTE PEG 3350/NA SULF,BICARB,CL/KCL 1 Solution, Reconstituted, Oral 

MOVIPREP PEG3350/SOD SUL/NACL/ASB/C/KCL 3 Powder in Packet 

GLYCOLAX POLYETHYLENE GLYCOL 3350 1 Powder (gm) 

POLYETHYLENE GLYCOL POLYETHYLENE GLYCOL 3350 1 Powder (gm) 

MIRALAX POLYETHYLENE GLYCOL 3350 3 Powder in Packet 

POLYETHYLENE GLYCOL 3350 POLYETHYLENE GLYCOL 3350 1 Powder in Packet 

NULYTELY SOD CHLORIDE/NAHCO3/KCL/PEG'S 3 Solution, Reconstituted, Oral 

NULYTELY WITH FLAVOR PACKS SOD CHLORIDE/NAHCO3/KCL/PEG'S 3 Solution, Reconstituted, Oral 

TRILYTE WITH FLAVOR PacketS SOD CHLORIDE/NAHCO3/KCL/PEG'S 3 Solution, Reconstituted, Oral 

OCL SOD SULF/SOD/NAHCO3/KCL/PEG'S 2 Solution, Oral 

BILE SALTS 

ACTIGALL URSODIOL 3 Capsule (Hard, Soft, etc.) 

URSODIOL URSODIOL 1 Capsule (Hard, Soft, etc.) 

URSO URSODIOL 2 Tablet 

URSO FORTE URSODIOL 2 Tablet 

PANCREATIC ENZYMES 

DYGASE AMYLASE/LIPASE/PROTEASE 1 Capsule (Hard, Soft, etc.) 

KUTRASE AMYLASE/LIPASE/PROTEASE 2 Capsule (Hard, Soft, etc.) 

KU-ZYME AMYLASE/LIPASE/PROTEASE 2 Capsule (Hard, Soft, etc.) 

KU-ZYME HP AMYLASE/LIPASE/PROTEASE 2 Capsule (Hard, Soft, etc.) 

LAPASE AMYLASE/LIPASE/PROTEASE 1 Capsule (Hard, Soft, etc.) 

CREON 10 AMYLASE/LIPASE/PROTEASE 2 Capsule,Delayed Release (Enteric Coated) 



LIPRAM AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

LIPRAM-PN10 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 



Page 52


LIPRAM-UL12 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 



PALCAPS 10 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PALCAPS 20 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANCREASE MT 10 AMYLASE/LIPASE/PROTEASE 2 Capsule,Delayed Release (Enteric Coated) 




PANCRECARB MS-16 AMYLASE/LIPASE/PROTEASE 2 Capsule,Delayed Release (Enteric Coated) 



PANCRELIPASE AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANGESTYME CN 10 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANGESTYME CN 20 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANGESTYME EC AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANGESTYME MT 16 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANGESTYME UL 12 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 



PANOCAPS AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANOCAPS MT 16 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

PANOCAPS MT 20 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

ULTRACAPS MT 20 AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

ULTRASE AMYLASE/LIPASE/PROTEASE 1 Capsule,Delayed Release (Enteric Coated) 

ULTRASE MT 12 AMYLASE/LIPASE/PROTEASE 2 Capsule,Delayed Release (Enteric Coated) 




VIOKASE AMYLASE/LIPASE/PROTEASE 2 Powder (gm) 

PANCRELIPASE AMYLASE/LIPASE/PROTEASE 1 Tablet 

PANCRELIPASE 8,000 AMYLASE/LIPASE/PROTEASE 1 Tablet 

PANOKASE AMYLASE/LIPASE/PROTEASE 1 Tablet 

PANOKASE-16 AMYLASE/LIPASE/PROTEASE 1 Tablet 

PLARETASE 8000 AMYLASE/LIPASE/PROTEASE 1 Tablet 

VIOKASE AMYLASE/LIPASE/PROTEASE 2 Tablet 

ENZYMAX PANCREATIN 3 Tablet 

AMMONIA INHIBITORS 

LITHOSTAT ACETOHYDROXAMIC ACID 3 Tablet 

ENULOSE LACTULOSE 1 Solution, Oral 

GENERLAC LACTULOSE 1 Solution, Oral 


UCEPHAN SODIUM BENZOATE/NA PH-ACETATE 3 Solution, Oral 

BUPHENYL SODIUM PHENYLBUTYRATE 3 Powder (gm) 

BUPHENYL SODIUM PHENYLBUTYRATE 3 Tablet 

EMETICS 

IPECAC IPECAC 1 Syrup 

ANTIEMETIC/ANTIVERTIGO AGENTS 

EMEND APREPITANT 3 Capsule (Hard, Soft, etc.) 

EMEND APREPITANT 3 Capsule, Dose Pack 

ANZEMET DOLASETRON MESYLATE 3 Tablet 

MARINOL DRONABINOL 2 Capsule (Hard, Soft, etc.) 

KYTRIL GRANISETRON HCL 2 Solution, Oral 

GRANISETRON HCL GRANISETRON HCL 1 Tablet 

KYTRIL GRANISETRON HCL 2 Tablet 

ANTIVERT MECLIZINE HCL 2 Tablet 

MECLIZINE HCL MECLIZINE HCL 1 Tablet 

UNIVERT MECLIZINE HCL 1 Tablet 

VERTIN-32 MECLIZINE HCL 2 Tablet 

VERTIN-32 MECLIZINE HCL 2 Tablet, Chewable 

CESAMET NABILONE 3 Capsule (Hard, Soft, etc.) 

ONDANSETRON ODT ONDANSETRON 1 Tablet, Rapid Dissolve 

ZOFRAN ODT ONDANSETRON 3 Tablet, Rapid Dissolve 

ONDANSETRON HCL ONDANSETRON HCL 1 Solution, Oral 

ZOFRAN ONDANSETRON HCL 3 Solution, Oral 

ONDANSETRON HCL ONDANSETRON HCL 1 Tablet 

ZOFRAN ONDANSETRON HCL 3 Tablet 

COMPAZINE PROCHLORPERAZINE EDISYLATE 2 Syrup 

Page 53


COMPRO PROCHLORPERAZINE MALEATE 1 Suppository, Rectal 

PROCHLORPERAZINE MALEATE PROCHLORPERAZINE MALEATE 1 Suppository, Rectal 

PROCHLORPERAZINE MALEATE PROCHLORPERAZINE MALEATE 1 Tablet 

PHENADOZ PROMETHAZINE HCL 1 Suppository, Rectal 

PROMETHAZINE HCL PROMETHAZINE HCL 1 Suppository, Rectal 

PROMETHEGAN PROMETHAZINE HCL 1 Suppository, Rectal 

TRANSDERM-SCOP SCOPOLAMINE HYDROBROMIDE 2 Patch, Transdermal 72 Hr 

MALDEMAR SCOPOLAMINE HYDROBROMIDE 3 Tablet 

SCOPACE SCOPOLAMINE HYDROBROMIDE 3 Tablet 

TIGAN TRIMETHOBENZAMIDE HCL 2 Capsule (Hard, Soft, etc.) 

TRIMETHOBENZAMIDE HCL TRIMETHOBENZAMIDE HCL 1 Capsule (Hard, Soft, etc.) 

TRIMETHOBENZAMIDE HCL TRIMETHOBENZAMIDE HCL/B-CAINE 1 Suppository, Rectal 

BELLADONNA ALKALOIDS 

COLYTROL ATROP SULF/SCOPOL HB/HYOSCY 3 Suspension, Oral (Final Dose Form) 

SIMETYL ATROP SULF/SCOPOL HB/HYOSCY 3 Tablet 

SAL-TROPINE ATROPINE SULFATE 3 Tablet 

COLYTROL BELLADONNA ALKALOIDS 3 Tablet 

SPACOL BELLADONNA ALKALOIDS 3 Tablet 

ANTISPASMODIC BELLADONNA ALKALOIDS/PHENOBARB 1 Elixir 

BELLADONNA W/PHENOBARBITAL BELLADONNA ALKALOIDS/PHENOBARB 1 Elixir 

COLIDROPS BELLADONNA ALKALOIDS/PHENOBARB 1 Elixir 

DONNATAL BELLADONNA ALKALOIDS/PHENOBARB 2 Elixir 

BARBIDONNA BELLADONNA ALKALOIDS/PHENOBARB 2 Tablet 

BELLADONNA W/PHENOBARBITAL BELLADONNA ALKALOIDS/PHENOBARB 1 Tablet 

DONNATAL BELLADONNA ALKALOIDS/PHENOBARB 2 Tablet 

HYOSCYAMINE HYOSCYAMINE 1 Tablet 

CYSTOSPAZ-M HYOSCYAMINE SULFATE 1 Capsule, Sustained Release 12 Hr 

HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE 1 Capsule, Sustained Release 12 Hr 

LEVSINEX HYOSCYAMINE SULFATE 3 Capsule, Sustained Release 12 Hr 

COLIDROPS HYOSCYAMINE SULFATE 1 Drops 

COLYTROL HYOSCYAMINE SULFATE 3 Drops 

HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE 1 Drops 

HYOSYNE HYOSCYAMINE SULFATE 1 Drops 

LEVSIN HYOSCYAMINE SULFATE 3 Drops 

SPACOL I.D. HYOSCYAMINE SULFATE 1 Drops 

SPASDEL HYOSCYAMINE SULFATE 1 Drops 

HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE 1 Elixir 

HYOSYNE HYOSCYAMINE SULFATE 1 Elixir 

LEVSIN HYOSCYAMINE SULFATE 3 Elixir 

IB-STAT HYOSCYAMINE SULFATE 3 Spray, Non-Aerosol (ml) 

ANASPAZ HYOSCYAMINE SULFATE 1 Tablet 

DONNAMAR HYOSCYAMINE SULFATE 3 Tablet 

HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE 1 Tablet 

LEVSIN HYOSCYAMINE SULFATE 3 Tablet 

SPASDEL HYOSCYAMINE SULFATE 1 Tablet 

SYMAX DUOTAB HYOSCYAMINE SULFATE 3 Tablet, Multiphasic Release 

DISPAS HYOSCYAMINE SULFATE 1 Tablet, Rapid Dissolve 

HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE 1 Tablet, Rapid Dissolve 

MAR-SPAS HYOSCYAMINE SULFATE 3 Tablet, Rapid Dissolve 

PRO-HYO HYOSCYAMINE SULFATE 1 Tablet, Rapid Dissolve 

SYMAX HYOSCYAMINE SULFATE 1 Tablet, Rapid Dissolve 

HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE 1 Tablet, Sublingual 

LEVSIN/SL HYOSCYAMINE SULFATE 3 Tablet, Sublingual 

SYMAX-SL HYOSCYAMINE SULFATE 1 Tablet, Sublingual 

HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE 1 Tablet, Sustained Release 12 Hr 

LEVBID HYOSCYAMINE SULFATE 3 Tablet, Sustained Release 12 Hr 

SPACOL T/S HYOSCYAMINE SULFATE 1 Tablet, Sustained Release 12 Hr 

SYMAX-SR HYOSCYAMINE SULFATE 1 Tablet, Sustained Release 12 Hr 

METHSCOPOLAMINE BROMIDE METHSCOPOLAMINE BROMIDE 1 Tablet 

PAMINE FORTE METHSCOPOLAMINE BROMIDE 3 Tablet 

DONNATAL PHENOBARB/HYOSCY/ATROPINE/SCOP 2 Tablet, Sustained Action 

SERVIRA PHENOBARB/HYOSCY/ATROPINE/SCOP 3 Tablet, Sustained Action 

PAMINE SCOPOLAMINE METHYLBROMIDE 3 Tablet 

SIMETYL SIMETHICONE/BELLAD ALK 3 Elixir 

ANTICHOLINERGICS, QUATERNARY AMMONIUM 

CLIDINIUM W/CHLORDIAZEPOXIDE CLIDINIUM BR/CHLORDIAZEPOXIDE 1 Capsule (Hard, Soft, etc.) 

CLIDINIUM-CHLORDIAZEPOXIDE CLIDINIUM BR/CHLORDIAZEPOXIDE 1 Capsule (Hard, Soft, etc.) 

LIBRAX CLIDINIUM BR/CHLORDIAZEPOXIDE 3 Capsule (Hard, Soft, etc.) 

Page 54


LIDOX CLIDINIUM BR/CHLORDIAZEPOXIDE 1 Capsule (Hard, Soft, etc.) 

QUARZAN CLIDINIUM BROMIDE 3 Capsule (Hard, Soft, etc.) 

GLYCOPYRROLATE GLYCOPYRROLATE 1 Tablet 

ROBINUL GLYCOPYRROLATE 3 Tablet 

ROBINUL FORTE GLYCOPYRROLATE 3 Tablet 

CANTIL MEPENZOLATE BROMIDE 3 Tablet 

PRO-BANTHINE PROPANTHELINE BROMIDE 2 Tablet 

PROPANTHELINE BROMIDE PROPANTHELINE BROMIDE 1 Tablet 

ANTICHOLINERGICS/ANTISPASMODICS 

BENTYL DICYCLOMINE HCL 2 Capsule (Hard, Soft, etc.) 

DICYCLOMINE HCL DICYCLOMINE HCL 1 Capsule (Hard, Soft, etc.) 

BENTYL DICYCLOMINE HCL 3 Syrup 

DICYCLOMINE HCL DICYCLOMINE HCL 1 Syrup 

BENTYL DICYCLOMINE HCL 3 Tablet 

DICYCLOMINE HCL DICYCLOMINE HCL 1 Tablet 

INTESTINAL MOTILITY STIMULANTS 

METOCLOPRAMIDE HCL INTENSOL METOCLOPRAMIDE HCL 2 Concentrate, Oral 

METOCLOPRAMIDE HCL METOCLOPRAMIDE HCL 1 Solution, Oral 

METOCLOPRAMIDE HCL METOCLOPRAMIDE HCL 1 Tablet 

REGLAN METOCLOPRAMIDE HCL 3 Tablet 

LIPOTROPICS 

LECITHIN LECITHIN 3 Granules; Power-Like, Non-Effervescent (gm) 

LOVAZA OMEGA-3 ACID ETHYL ESTERS 2 Capsule (Hard, Soft, etc.) 

RECTAL PREPARATIONS 

PROCTOFOAM-HC HC ACETATE/PRAMOXINE HCL 2 Foam (gm) 

CHILDRENS FEVER HOMEOPATHIC DRUGS 3 Suppository, Rectal 

ANUSOL-HC HYDROCORTISONE 3 Cream (Grams) 

PROCTOCORT HYDROCORTISONE 3 Cream (Grams) 

PROCTOCREAM-HC HYDROCORTISONE 1 Cream (Grams) 

PROCTO-Kit HYDROCORTISONE 1 Cream (Grams) 

PROCTO-PAK HYDROCORTISONE 1 Cream (Grams) 

PROCTOSOL-HC HYDROCORTISONE 1 Cream (Grams) 

PROCTOZONE-HC HYDROCORTISONE 1 Cream (Grams) 

PROCTO-Kit HYDROCORTISONE 3 Cream with Applicator 

HYDROCORTISONEACETATE HYDROCORTISONE ACETATE 3 Cream with Applicator 

ANUCORT-HC HYDROCORTISONE ACETATE 1 Suppository, Rectal 

ANUDIL HC HYDROCORTISONE ACETATE 1 Suppository, Rectal 

ANUMED-HC HYDROCORTISONE ACETATE 1 Suppository, Rectal 

ANUSOL-HC HYDROCORTISONE ACETATE 3 Suppository, Rectal 

ENCORT HYDROCORTISONE ACETATE 1 Suppository, Rectal 

HEMORRHOIDAL HC HYDROCORTISONE ACETATE 1 Suppository, Rectal 

HEMRIL HYDROCORTISONE ACETATE 1 Suppository, Rectal 

HYDROCORTISONE ACETATE HYDROCORTISONE ACETATE 1 Suppository, Rectal 

PROCTOCORT HYDROCORTISONE ACETATE 1 Suppository, Rectal 

PROCTOSERT HC HYDROCORTISONE ACETATE 1 Suppository, Rectal 

HEMORRHOIDAL PREPARATIONS 

ANALPRAM-HC HC ACETATE/PRAMOXINE HCL 3 Cream with Applicator 

ANALPRAM-HC HC ACETATE/PRAMOXINE HCL 3 Lotion (ml) 

PROCTOFOAM PRAMOXINE HCL 3 Foam (gm) 

ANTI-ULCER-H.PYLORI AGENTS 

HELIDAC BISMUTH SAL/METRONID/TETRACYC 3 Combination Package (EA) 

PYLERA BISMUTH/METRONID/TETRACYCLINE 3 Capsule (Hard, Soft, etc.) 

PREVPAC LANSOPRAZOLE/AMOX TR/CLARITH 2 Combination Package (EA) 

ANTIDIARRHEAL MICROORGANISMS AGENTS 

VSL#3 DS LACT CMB2/S.THERMOPHL/BIF CMB1 3 Packet 

DRUGS TO TX CHRONIC INFLAMM. DISEASE OF COLON 

REMICADE INFLIXIMAB 3 Vial (SDV, MDV or Additive) (EA) 

GASTRIC ACID SECRETION REDUCERS 

CIMETIDINE CIMETIDINE 1 Tablet 

TAGAMET CIMETIDINE 3 Tablet 

CIMETIDINE CIMETIDINE HCL 1 Liquid (ml) 

NEXIUM ESOMEPRAZOLE MAG TRIHYDRATE 2 Capsule,Delayed Release (Enteric Coated) 

NEXIUM ESOMEPRAZOLE MAG TRIHYDRATE 3 Susp for Recon, Delayed Rel. in a Packet 

PEPCID FAMOTIDINE 3 Suspension, Oral (Final Dose Form) 

FAMOTIDINE FAMOTIDINE 1 Tablet 

FAMOTIDINE FAMOTIDINE 3 Tablet 

PEPCID FAMOTIDINE 3 Tablet 

Page 55


PEPCID RPD FAMOTIDINE 3 Tablet, Rapid Dissolve 

PREVACID LANSOPRAZOLE 2 Capsule,Delayed Release (Enteric Coated) 

PREVACID LANSOPRAZOLE 2 Suspension,Delayed Release,RECONST. 

PREVACID LANSOPRAZOLE 2 Tablet, Rapid Dissolve, Delayed Release 

AXID NIZATIDINE 3 Capsule (Hard, Soft, etc.) 

NIZATIDINE NIZATIDINE 1 Capsule (Hard, Soft, etc.) 

AXID NIZATIDINE 3 Solution, Oral 

OMEPRAZOLE OMEPRAZOLE 1 Capsule,Delayed Release (Enteric Coated) 

PRILOSEC OMEPRAZOLE 3 Capsule,Delayed Release (Enteric Coated) 

ZEGERID OMEPRAZOLE/SODIUM BICARBONATE 3 Capsule (Hard, Soft, etc.) 

ZEGERID OMEPRAZOLE/SODIUM BICARBONATE 3 Packet 

PANTOPRAZOLE SODIUM PANTOPRAZOLE SODIUM 1 Tablet, Delayed Release (Enteric Coated) 

PROTONIX PANTOPRAZOLE SODIUM 3 Tablet, Delayed Release (Enteric Coated) 

ACIPHEX RABEPRAZOLE SODIUM 3 Tablet, Delayed Release (Enteric Coated) 

RANITIDINE HCL RANITIDINE HCL 1 Capsule (Hard, Soft, etc.) 

TALADINE RANITIDINE HCL 3 Capsule (Hard, Soft, etc.) 

RANITIDINE HCL RANITIDINE HCL 1 Syrup 

ZANTAC RANITIDINE HCL 3 Syrup 

RANITIDINE HCL RANITIDINE HCL 1 Tablet 

ZANTAC RANITIDINE HCL 3 Tablet 

ZANTAC 25 RANITIDINE HCL 3 Tablet, Effervescent 

IRRITABLE BOWEL SYNDROME AGENT, 5HT-3 ANTAGONIST-TYPE 

LOTRONEX ALOSETRON HCL 3 Tablet 

KERATINOCYTE GROWTH FACTOR (KGF) 

KEPIVANCE PALIFERMIN 3 Vial (SDV, MDV or Additive) (EA) 

DRUG TX-CHRONIC INFLAM. COLON DX,5-AMINOSALICYLAT 

BALSALAZIDE DISODIUM BALSALAZIDE DISODIUM 1 Capsule (Hard, Soft, etc.) 

COLAZAL BALSALAZIDE DISODIUM 2 Capsule (Hard, Soft, etc.) 

PENTASA MESALAMINE 2 Capsule, Sustained Action 

ASACOL MESALAMINE 2 Tablet, Delayed Release (Enteric Coated) 

LIALDA MESALAMINE 3 Tablet, Delayed Release (Enteric Coated) 

DIPENTUM OLSALAZINE SODIUM 2 Capsule (Hard, Soft, etc.) 

CHRONIC INFLAM. COLON DX, 5-A-SALICYLAT,RECTAL TX 

MESALAMINE MESALAMINE 1 Enema (ml) 

ROWASA MESALAMINE 3 Enema (ml) 

CANASA MESALAMINE 2 Suppository, Rectal 

HEMORRHOIDAL PREP, ANTI-INFAM STEROID/LOCAL ANESTH 

RECTAGEL HC HC ACETATE/LIDOCAIN HCL/ALO V 3 Gel with Applicator (gm) 

ANAMANTLE HC HC ACETATE/LIDOCAIN HCL/ALO V 3 Kit 

LIDOCAINE-HYDROCORTISONE HC ACETATE/LIDOCAIN HCL/ALO V 1 Kit 

PERANEX HC HC ACETATE/LIDOCAIN HCL/ALO V 3 Kit 

ANAMANTLE HC HC ACETATE/LIDOCAINE HCL 3 Cream with Applicator 

LIDAZONE HC HC ACETATE/LIDOCAINE HCL 1 Cream with Applicator 

LIDOCAINE-HYDROCORTISONE HC ACETATE/LIDOCAINE HCL 1 Cream with Applicator 

ANAMANTLE HC HC ACETATE/LIDOCAINE HCL 3 Kit 

ANAMANTLE HC FORTE HC ACETATE/LIDOCAINE HCL 3 Kit 

LIDAZONE HC HC ACETATE/LIDOCAINE HCL 1 Kit 

LIDOCAINE-HYDROCORTISONE HC ACETATE/LIDOCAINE HCL 1 Kit 

PERANEX HC HC ACETATE/LIDOCAINE HCL 3 Pads, Medicated (EA) 

HISTAMINE H2-RECEPTOR INHIBITORS/DIETARY SUPP.CMB. 

SENTRADINE RANITIDINE HCL/DIET.SUPP NO.8 3 Combination Package (EA) 

GABITIDINE RANITIDINE HCL/DIET.SUPP NO.17 3 Combination Package (EA) 

ANTICHOLINERGICS/MICROORGANISMS COMBINATIONS 

PAMINE FQ METHSCP BR/LA/S.THM/L.PARA/BIF 3 Combination Package (EA) 

HORMONES 

ANDROGENIC AGENTS 

ANDROXY FLUOXYMESTERONE 3 Tablet 

ANDROID METHYLTESTOSTERONE 3 Capsule (Hard, Soft, etc.) 

TESTRED METHYLTESTOSTERONE 3 Capsule (Hard, Soft, etc.) 

METHITEST METHYLTESTOSTERONE 3 Tablet 

OXANDRIN OXANDROLONE 3 Tablet 

OXANDROLONE OXANDROLONE 1 Tablet 

ANADROL-50 OXYMETHOLONE 3 Tablet 

TESTIM TESTOSTERONE 2 Gel (gm) 

ANDROGEL TESTOSTERONE 2 Gel in Metered-Dose Pump 

ANDROGEL TESTOSTERONE 2 Gel in Packet (gm) 

Page 56


STRIANT TESTOSTERONE 3 Mucoadhesive System, 12 Hr Sust.Release 

ANDRODERM TESTOSTERONE 2 Patch, Transdermal 24 Hr 

DEPO-TESTOSTERONE TESTOSTERONE CYPIONATE 3 Vial (SDV, MDV or Additive) (ml) 

TESTOSTERONE CYPIONATE TESTOSTERONE CYPIONATE 1 Vial (SDV, MDV or Additive) (ml) 

DELATESTRYL TESTOSTERONE ENANTHATE 3 Disposable Syringe (ml) 

DELATESTRYL TESTOSTERONE ENANTHATE 3 Vial (SDV, MDV or Additive) (ml) 

FIRST-TESTOSTERONE MC TESTOSTERONE PROPIONATE 3 Cream (Grams) 

FIRST-TESTOSTERONE TESTOSTERONE PROPIONATE 3 Ointment (gm) 

ESTROGENIC AGENTS 

ESTRASORB ESTRADIOL 3 Emulsion in Packet 

ELESTRIN ESTRADIOL 3 Gel in Metered-Dose Pump 

ESTROGEL ESTRADIOL 3 Gel in Metered-Dose Pump 

DIVIGEL ESTRADIOL 3 Gel in Packet (EA) 

DIVIGEL ESTRADIOL 3 Gel in Packet (gm) 

ALORA ESTRADIOL 2 Patch, Transdermal Semiweekly 

ESTRADERM ESTRADIOL 2 Patch, Transdermal Semiweekly 

VIVELLE ESTRADIOL 2 Patch, Transdermal Semiweekly 

VIVELLE-DOT ESTRADIOL 2 Patch, Transdermal Semiweekly 

CLIMARA ESTRADIOL 2 Patch, Transdermal Weekly 

ESTRADIOL ESTRADIOL 1 Patch, Transdermal Weekly 

ESTRADIOL TRANSDERMAL PATCH ESTRADIOL 1 Patch, Transdermal Weekly 

MENOSTAR ESTRADIOL 3 Patch, Transdermal Weekly 

ESTRACE ESTRADIOL 3 Tablet 

ESTRADIOL ESTRADIOL 1 Tablet 

FEMTRACE ESTRADIOL ACETATE 3 Tablet 

DELESTROGEN ESTRADIOL VALERATE 3 Vial (SDV, MDV or Additive) (ml) 

CLIMARA PRO ESTRADIOL/LEVONORGESTREL 2 Patch, Transdermal Weekly 

COMBIPATCH ESTRADIOL/NORETH AC 3 Patch, Transdermal Semiweekly 

ACTIVELLA ESTRADIOL/NORETH AC 3 Tablet 

PREFEST ESTRADIOL/NORGESTIMATE 2 Tablet 

PREMPHASE ESTROGEN,CON/M-PROGEST ACET 2 Tablet 

PREMPRO ESTROGEN,CON/M-PROGEST ACET 2 Tablet 

CENESTIN ESTROGENS,CONJ.,SYNTHETIC A 2 Tablet 

ENJUVIA ESTROGENS,CONJ.,SYNTHETIC B 3 Tablet 

PREMARIN ESTROGENS,CONJUGATED 2 Tablet 

MENEST ESTROGENS,ESTERIFIED 2 Tablet 

ESTROPIPATE ESTROPIPATE 1 Tablet 

OGEN ESTROPIPATE 3 Tablet 

FEMHRT NORETHIND AC/ETHINYL ESTRADIOL 3 Tablet 

ESTROGEN/ANDROGEN COMBINATIONS 

COVARYX ESTROGEN,ESTER/ME-TESTOSTERONE 1 Tablet 

COVARYX H.S. ESTROGEN,ESTER/ME-TESTOSTERONE 1 Tablet 

EEMT ESTROGEN,ESTER/ME-TESTOSTERONE 1 Tablet 

EEMT H.S. ESTROGEN,ESTER/ME-TESTOSTERONE 1 Tablet 

EEMT H.S. ESTROGEN,ESTER/ME-TESTOSTERONE 3 Tablet 

ESSIAN ESTROGEN,ESTER/ME-TESTOSTERONE 1 Tablet 

ESSIAN H.S. ESTROGEN,ESTER/ME-TESTOSTERONE 1 Tablet 

ESTRATEST ESTROGEN,ESTER/ME-TESTOSTERONE 3 Tablet 

ESTRATEST H.S. ESTROGEN,ESTER/ME-TESTOSTERONE 3 Tablet 

ESTROGEN & METHYLTESTOSTERONE ESTROGEN,ESTER/ME-TESTOSTERONE 1 Tablet 

PROGESTATIONAL AGENTS 

MEDROXYPROGESTERONE ACETATE MEDROXYPROGESTERONE ACET 1 Tablet 

PROVERA MEDROXYPROGESTERONE ACET 3 Tablet 

AYGESTIN NORETHINDRONE ACETATE 3 Tablet 

NORETHINDRONE ACETATE NORETHINDRONE ACETATE 1 Tablet 

PROMETRIUM PROGESTERONE,MICRONIZED 2 Capsule (Hard, Soft, etc.) 

PROCHIEVE PROGESTERONE,MICRONIZED 3 Gel with Prefilled Applicator (gm) 

OXYTOCICS 

PREPIDIL DINOPROSTONE 3 Gel with Prefilled Applicator (gm) 

CERVIDIL DINOPROSTONE 3 Insert, Sustained Release 

PROSTIN E2 VAGINAL SUPPOSITORY DINOPROSTONE 3 Suppository, Vaginal 

ERGOTRATE ERGONOVINE MALEATE 3 Tablet 

METHERGINE METHYLERGONOVINE MALEATE 3 Tablet 

FERTILITY STIMULATING PREPARATIONS,NON-FSH 

CLOMID CLOMIPHENE CITRATE 3 Tablet 

CLOMIPHENE CITRATE CLOMIPHENE CITRATE 1 Tablet 

SEROPHENE CLOMIPHENE CITRATE 1 Tablet 

Page 57


FOLLICLE STIM./LUTEINIZING HORMONES 

GONAL-F RFF FOLLITROPIN ALPHA,RECOMB 3 Pen Injector (ml) 

GONAL-F FOLLITROPIN ALPHA,RECOMB 3 Vial (SDV, MDV or Additive) (EA) 

GONAL-F RFF FOLLITROPIN ALPHA,RECOMB 3 Vial (SDV, MDV or Additive) (EA) 

FOLLISTIM AQ FOLLITROPIN BETA,RECOMB 3 Cartridge (ml) 

CHORIONIC GONADOTROPIN GONADOTROPIN,CHORIONIC,HUMAN 1 Vial (SDV, MDV or Additive) (EA) 

NOVAREL GONADOTROPIN,CHORIONIC,HUMAN 1 Vial (SDV, MDV or Additive) (EA) 

PREGNYL GONADOTROPIN,CHORIONIC,HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

PROFASI GONADOTROPIN,CHORIONIC,HUMAN 3 Vial (SDV, MDV or Additive) (EA) 

OVIDREL HCG ALPHA,RECOMBINANT 3 Disposable Syringe (ml) 

MENOPUR MENOTROPINS 3 Vial (SDV, MDV or Additive) (EA) 

FERTINEX UROFOLLITROPIN (FSH) 3 Ampul (EA) 

GROWTH HORMONES 

GENOTROPIN SOMATROPIN 3 Cartridge (EA) 

SAIZEN SOMATROPIN 3 Cartridge (EA) 

NORDITROPIN SOMATROPIN 3 Cartridge (ml) 

NUTROPIN AQ SOMATROPIN 3 Cartridge (ml) 

GENOTROPIN SOMATROPIN 3 Disposable Syringe (EA) 

NORDITROPIN NORDIFLEX SOMATROPIN 3 Pen Injector (ml) 

NORDITROPIN SOMATROPIN 3 Vial (SDV, MDV or Additive) (EA) 

NORDITROPIN SOMATROPIN 3 Vial (SDV, MDV or Additive) (EA) 

NUTROPIN SOMATROPIN 3 Vial (SDV, MDV or Additive) (EA) 

OMNITROPE SOMATROPIN 3 Vial (SDV, MDV or Additive) (EA) 

SAIZEN SOMATROPIN 3 Vial (SDV, MDV or Additive) (EA) 

SEROSTIM SOMATROPIN 3 Vial (SDV, MDV or Additive) (EA) 

TEV-TROPIN SOMATROPIN 1 Vial (SDV, MDV or Additive) (EA) 

ZORBTIVE SOMATROPIN 3 Vial (SDV, MDV or Additive) (EA) 

NUTROPIN AQ SOMATROPIN 3 Vial (SDV, MDV or Additive) (ml) 

SOMATOSTATIC AGENTS 

SANDOSTATIN LAR OCTREOTIDE ACETATE 3 Kit 

PITUITARY SUPPRESSIVE AGENTS 

CABERGOLINE CABERGOLINE 1 Tablet 

DANAZOL DANAZOL 1 Capsule (Hard, Soft, etc.) 

DANAZOL DANAZOL 2 Capsule (Hard, Soft, etc.) 

ANTIDIURETIC AND VASOPRESSOR HORMONES 

DDAVP DESMOPRESSIN (NONREFRIGERATED) 1 Aerosol, Spray w/Pump (ml) 

DESMOPRESSIN ACETATE DESMOPRESSIN (NONREFRIGERATED) 1 Aerosol, Spray w/Pump (ml) 

STIMATE DESMOPRESSIN ACETATE 3 Aerosol, Spray w/Pump (ml) 

DDAVP DESMOPRESSIN ACETATE 2 Ampul (ml) 

DESMOPRESSIN ACETATE DESMOPRESSIN ACETATE 1 Ampul (ml) 

DDAVP DESMOPRESSIN ACETATE 2 Solution, Non-Oral 

DESMOPRESSIN ACETATE DESMOPRESSIN ACETATE 1 Solution, Non-Oral 

DDAVP DESMOPRESSIN ACETATE 2 Tablet 

DESMOPRESSIN ACETATE DESMOPRESSIN ACETATE 1 Tablet 

DDAVP DESMOPRESSIN ACETATE 2 Vial (SDV, MDV or Additive) (ml) 

DESMOPRESSIN ACETATE DESMOPRESSIN ACETATE 1 Vial (SDV, MDV or Additive) (ml) 

BONE RESORPTION INHIBITORS 

FORTICAL CALCITONIN,SALMON,SYNTHETIC 1 Aerosol, Spray w/Pump (ml) 

MIACALCIN CALCITONIN,SALMON,SYNTHETIC 3 Aerosol, Spray w/Pump (ml) 

GLUCOCORTICOIDS 

QVAR BECLOMETHASONE DIPROPIONATE 2 Aerosol w/Adapter (gm) 

CELESTONE BETAMETHASONE 3 Solution, Oral 

PULMICORT FLEXHALER BUDESONIDE 2 Aerosol Powder, Breath Activated (EA) 

PULMICORT BUDESONIDE 2 Ampul for Nebulization (ml) 

ENTOCORT EC BUDESONIDE 2 Capsule, Sustained Release 24 Hr 

CORTISONE CORTISONE ACETATE 1 Tablet 

DEXAMETHASONE INTENSOL DEXAMETHASONE 3 Drops 

DEXAMETHASONE DEXAMETHASONE 1 Elixir 

DEXAMETHASONE DEXAMETHASONE 3 Solution, Oral 

DEXAMETHASONE DEXAMETHASONE 1 Tablet 

DEXPAK DEXAMETHASONE 3 Tablet, Dose Pack 

DEXPAK JR. DEXAMETHASONE 3 Tablet, Dose Pack 

AEROBID FLUNISOLIDE 3 Aerosol w/Adapter (gm) 

AEROBID-M FLUNISOLIDE/MENTHOL 3 Aerosol w/Adapter (gm) 

FLOVENT HFA FLUTICASONE PROPIONATE 2 Aerosol w/Adapter (gm) 

FLOVENT DISKUS FLUTICASONE PROPIONATE 2 Disk, with Inhalation Device 

CORTEF HYDROCORTISONE 3 Tablet 

Page 58


HYDROCORTISONE HYDROCORTISONE 1 Tablet 

MEDROL METHYLPREDNISOLONE 2 Tablet 

METHYLPREDNISOLONE METHYLPREDNISOLONE 1 Tablet 

MEDROL METHYLPREDNISOLONE 2 Tablet, Dose Pack 

MEPROLONE UNIPAK METHYLPREDNISOLONE 1 Tablet, Dose Pack 

METHYLPREDNISOLONE METHYLPREDNISOLONE 1 Tablet, Dose Pack 

ASMANEX MOMETASONE FUROATE 2 Aerosol Powder, Breath Activated (gm) 

PREDNISOLONE PREDNISOLONE 1 Solution, Oral 

PRELONE PREDNISOLONE 3 Solution, Oral 

PREDNISOLONE PREDNISOLONE 1 Tablet 

PREDNISOLONE PREDNISOLONE 3 Tablet 

ORAPRED PREDNISOLONE SOD PHOSPHATE 2 Solution, Oral 

PEDIAPRED PREDNISOLONE SOD PHOSPHATE 3 Solution, Oral 

PREDNISOLONE SOD PHOSPHATE PREDNISOLONE SOD PHOSPHATE 1 Solution, Oral 

PREDNISOLONE SODIUM PHOSPHATE PREDNISOLONE SOD PHOSPHATE 1 Solution, Oral 

ORAPRED ODT PREDNISOLONE SOD PHOSPHATE 3 Tablet, Rapid Dissolve 

PREDNISONE INTENSOL PREDNISONE 2 Concentrate, Oral 

PREDNISONE PREDNISONE 2 Solution, Oral 

PREDNISONE PREDNISONE 1 Tablet 

PREDNISONE PREDNISONE 1 Tablet, Dose Pack 

STERAPRED PREDNISONE 2 Tablet, Dose Pack 

STERAPRED DS PREDNISONE 2 Tablet, Dose Pack 

AZMACORT TRIAMCINOLONE ACETONIDE 2 Aerosol w/Adapter (gm) 

MINERALOCORTICOIDS 

FLUDROCORTISONE ACETATE FLUDROCORTISONE ACETATE 1 Tablet 

VAGINAL ESTROGEN PREPARATIONS 

ESTRACE ESTRADIOL 3 Cream with Applicator 

ESTRING ESTRADIOL 2 Ring, Vaginal 

VAGIFEM ESTRADIOL 2 Tablet 

FEMRING ESTRADIOL ACETATE 3 Ring, Vaginal 

PREMARIN ESTROGENS,CONJUGATED 2 Cream with Applicator 

PREGNANCY FACILITATING/MAINTAINING AGENT, HORMONAL 

FIRST-PROGESTERONE VGS 100 PROGESTERONE 3 Suppository, Vaginal 





CRINONE PROGESTERONE,MICRONIZED 3 Gel with Prefilled Applicator (gm) 

PROCHIEVE PROGESTERONE,MICRONIZED 3 Gel with Prefilled Applicator (gm) 

ENDOMETRIN PROGESTERONE,MICRONIZED 3 Insert 

RECTAL/LOWER BOWEL PREP.,GLUCOCORT. (NON-HEMORR) 

COLOCORT HYDROCORTISONE 3 Enema (ml) 

CORTENEMA HYDROCORTISONE 3 Enema (ml) 

HYDROCORTISONE HYDROCORTISONE 1 Enema (ml) 

CORTIFOAM HYDROCORTISONE ACETATE 2 Aerosol, Foam with Applicator (gm) 

GROWTH HORMONE RELEASING HORMONE (GHRH) & ANALOGS 

GEREF SERMORELIN ACETATE 3 Vial (SDV, MDV or Additive) (EA) 

LHRH(GNRH) ANTAGONIST, PITUITARY SUPPRESSANT AGENTS 

CETROTIDE CETRORELIX ACETATE 3 Kit 

GANIRELIX ACETATE GANIRELIX ACETATE 3 Disposable Syringe (ml) 

LHRH(GNRH) AGONIST ANALOG PITUITARY SUPPRESSANTS 

LUPRON DEPOT LEUPROLIDE ACETATE 3 Kit 

SYNAREL NAFARELIN ACETATE 3 Aerosol, Spray (ml) 

LHRH(GNRH)AGNST PIT.SUP-CENTRAL PRECOCIOUS PUBERTY 

LUPRON DEPOT-PED LEUPROLIDE ACETATE 3 Kit 

ESTROGEN & PROGESTIN WITH ANTIMINERALOCORTICOID CB 

ANGELIQ ESTRADIOL/DROSPIRENONE 3 Tablet 

HYPOGLYCEMICS 

INSULINS 

NOVOLIN 70/30 HUM INSULIN NPH/REG INSULIN HM 2 Cartridge (ml) 

HUMULIN 70/30 HUM INSULIN NPH/REG INSULIN HM 2 Insulin Pen (ml) 

NOVOLIN 70/30 INNOLET HUM INSULIN NPH/REG INSULIN HM 2 Insulin Pen (ml) 

RELION NOVOLIN 70/30 INNOLET HUM INSULIN NPH/REG INSULIN HM 3 Insulin Pen (ml) 

HUMULIN 50/50 HUM INSULIN NPH/REG INSULIN HM 2 Vial (SDV, MDV or Additive) (ml) 

HUMULIN 70/30 HUM INSULIN NPH/REG INSULIN HM 2 Vial (SDV, MDV or Additive) (ml) 

NOVOLIN 70/30 HUM INSULIN NPH/REG INSULIN HM 2 Vial (SDV, MDV or Additive) (ml) 

Page 59


NOVOLIN 70/30 HUM INSULIN NPH/REG INSULIN HM 2 Vial (SDV, MDV or Additive) (ml) 

NOVOLOG INSULIN ASPART 2 Cartridge (ml) 

NOVOLOG INSULIN ASPART 2 Insulin Pen (ml) 

NOVOLOG INSULIN ASPART 2 Vial (SDV, MDV or Additive) (ml) 

LEVEMIR INSULIN DETEMIR 2 Insulin Pen (ml) 

LEVEMIR INSULIN DETEMIR 2 Vial (SDV, MDV or Additive) (ml) 

LANTUS INSULIN GLARGINE,HUM.REC.ANLOG 2 Cartridge (ml) 

LANTUS SOLOSTAR INSULIN GLARGINE,HUM.REC.ANLOG 2 Insulin Pen (ml) 

LANTUS INSULIN GLARGINE,HUM.REC.ANLOG 2 Vial (SDV, MDV or Additive) (ml) 

APIDRA INSULIN GLULISINE 3 Cartridge (ml) 

APIDRA INSULIN GLULISINE 3 Vial (SDV, MDV or Additive) (ml) 

HUMALOG INSULIN LISPRO 2 Insulin Pen (ml) 

HUMALOG INSULIN LISPRO,HUMAN REC.ANLOG 2 Cartridge (ml) 

HUMALOG INSULIN LISPRO,HUMAN REC.ANLOG 2 Insulin Pen (ml) 

HUMALOG INSULIN LISPRO,HUMAN REC.ANLOG 2 Vial (SDV, MDV or Additive) (ml) 

NOVOLIN N INSULIN NPH HUMAN RECOM 2 Cartridge (ml) 

NOVOLIN N INSULIN NPH HUMAN RECOM 2 Vial (SDV, MDV or Additive) (ml) 

HUMALOG MIX 50/50 INSULIN NPL/INSULIN LISPRO 2 Insulin Pen (ml) 

HUMALOG MIX 75/25 INSULIN NPL/INSULIN LISPRO 2 Insulin Pen (ml) 

HUMALOG MIX 50/50 INSULIN NPL/INSULIN LISPRO 2 Vial (SDV, MDV or Additive) (ml) 

HUMALOG MIX 75/25 INSULIN NPL/INSULIN LISPRO 2 Vial (SDV, MDV or Additive) (ml) 

NOVOLIN R INSULIN REGULAR HUMAN REC 2 Cartridge (ml) 

NOVOLIN R INSULIN REGULAR HUMAN REC 2 Insulin Pen (ml) 

HUMULIN R INSULIN REGULAR HUMAN REC 2 Vial (SDV, MDV or Additive) (ml) 

NOVOLIN R INSULIN REGULAR HUMAN REC 2 Vial (SDV, MDV or Additive) (ml) 

HUMULIN R INSULIN REGULAR, HUMAN 2 Vial (SDV, MDV or Additive) (ml) 

NOVOLIN R INSULIN REGULAR, HUMAN 2 Vial (SDV, MDV or Additive) (ml) 

EXUBERA COMBINATION PACK 12 INSULIN REGULAR,HUMAN&REL.UNT 3 Combination Package (EA) 

EXUBERA COMBINATION PACK 15 INSULIN REGULAR,HUMAN&REL.UNT 3 Combination Package (EA) 

EXUBERA PATIENT PACK INSULIN REGULAR,HUMAN&REL.UNT 3 Combination Package (EA) 

NOVOLOG MIX 70/30 INSULN ASP PRT/INSULIN ASPART 2 Cartridge (ml) 

NOVOLOG MIX 70/30 INSULN ASP PRT/INSULIN ASPART 2 Insulin Pen (ml) 

NOVOLOG MIX 70/30 INSULN ASP PRT/INSULIN ASPART 2 Vial (SDV, MDV or Additive) (ml) 

HUMULIN N NPH, HUMAN INSULIN ISOPHANE 2 Insulin Pen (ml) 

NOVOLIN N INNOLET NPH, HUMAN INSULIN ISOPHANE 2 Insulin Pen (ml) 

RELION NOVOLIN N INNOLET NPH, HUMAN INSULIN ISOPHANE 3 Insulin Pen (ml) 

HUMULIN N NPH, HUMAN INSULIN ISOPHANE 2 Vial (SDV, MDV or Additive) (ml) 

NOVOLIN N NPH, HUMAN INSULIN ISOPHANE 2 Vial (SDV, MDV or Additive) (ml) 

EXUBERA KIT REG INSULIN HM/RLSE/CHBR/IHLR 3 Inhaler Kit (EA) 

ANTIHYPERGLYCEMIC, INSULIN-RELEASE STIMULANT TYPE 

CHLORPROPAMIDE CHLORPROPAMIDE 1 Tablet 

DIABINESE CHLORPROPAMIDE 3 Tablet 

AMARYL GLIMEPIRIDE 3 Tablet 

GLIMEPIRIDE GLIMEPIRIDE 1 Tablet 

GLIPIZIDE GLIPIZIDE 1 Tablet 

GLUCOTROL GLIPIZIDE 3 Tablet 

GLIPIZIDE ER GLIPIZIDE 1 Tablet, SR Osmotic Push 24 Hr 

GLIPIZIDE XL GLIPIZIDE 1 Tablet, SR Osmotic Push 24 Hr 

GLUCOTROL XL GLIPIZIDE 3 Tablet, SR Osmotic Push 24 Hr 

GLIPIZIDE-METFORMIN GLIPIZIDE/METFORMIN HCL 1 Tablet 

METAGLIP GLIPIZIDE/METFORMIN HCL 3 Tablet 

DIABETA GLYBURIDE 3 Tablet 

GLYBURIDE GLYBURIDE 1 Tablet 

MICRONASE GLYBURIDE 3 Tablet 

GLYBURIDE MICRONIZED GLYBURIDE,MICRONIZED 1 Tablet 

GLYNASE GLYBURIDE,MICRONIZED 3 Tablet 

STARLIX NATEGLINIDE 2 Tablet 

PRANDIN REPAGLINIDE 2 Tablet 

TOLAZAMIDE TOLAZAMIDE 1 Tablet 

TOLBUTAMIDE TOLBUTAMIDE 1 Tablet 

TOLBUTAMIDE TOLBUTAMIDE 3 Tablet 

ANTIHYPERGLYCEMIC, BIGUANIDE TYPE (NON-SULFONYLUREA) 

RIOMET METFORMIN HCL 3 Solution, Oral 

GLUCOPHAGE METFORMIN HCL 3 Tablet 

METFORMIN HCL METFORMIN HCL 1 Tablet 

FORTAMET METFORMIN HCL 3 Tablet, SR Osmotic Push 24 Hr 

GLUMETZA METFORMIN HCL 3 Tablet, Sust.Rel.,Gastric Retention 24Hr 

GLUCOPHAGE XR METFORMIN HCL 3 Tablet, Sustained Release 24 Hr 

Page 60


METFORMIN HCL ER METFORMIN HCL 1 Tablet, Sustained Release 24 Hr 

ANTIHYPERGLYCEMIC, ALPHA-GLUCOSIDASE INHIB (N-S) 

PRECOSE ACARBOSE 2 Tablet 

GLYSET MIGLITOL 2 Tablet 

ANTIHYPERGLYCEMIC, INSULIN-RESPONSE ENHANCER (N-S) 

ACTOS PIOGLITAZONE HCL 2 Tablet 

ACTOPLUS MET PIOGLITAZONE HCL/METFORMIN HCL 2 Tablet 

AVANDIA ROSIGLITAZONE MALEATE 2 Tablet 

ANTIHYPERGLYCEMIC, AMYLIN ANALOG-TYPE 

SYMLINPEN 120 PRAMLINTIDE ACETATE 2 Pen Injector (ml) 

SYMLINPEN 60 PRAMLINTIDE ACETATE 2 Pen Injector (ml) 

SYMLIN PRAMLINTIDE ACETATE 2 Vial (SDV, MDV or Additive) (ml) 

ANTIHYPERGLYCEMIC, INCRETIN MIMETIC (GLP-1 RECEP.AGONIST) 

BYETTA EXENATIDE 3 Pen Injector (ml) 

ANTIHYPERGLYCEMIC, INSULIN-RESPONSE & RELEASE COMB. 

DUETACT PIOGLITAZONE/GLIMEPIRIDE 2 Tablet 

AVANDARYL ROSIGLITAZONE/GLIMEPIRIDE 2 Tablet 

ANTIHYPERGLYCEMIC, INSULIN-REL STIM.& BIGUANIDE CMB 

GLUCOVANCE GLYBURIDE/METFORMIN HCL 3 Tablet 

GLYBURIDE-METFORMIN HCL GLYBURIDE/METFORMIN HCL 1 Tablet 

ANTIHYPERGLYCEMIC, INSUL-RESP.ENHANCER & BIGUANIDE CMB 

AVANDAMET ROSIGLITAZONE/METFORMIN HCL 2 Tablet 

ANTIHYPERGLYCEMIC, DPP-4 INHIBITORS 

JANUVIA SITAGLIPTIN PHOSPHATE 3 Tablet 

ANTIHYPERGLYCEMIC, BIGUANIDE & DIETARY SUPP. COMB. 

APPFORMIN-D METFORMIN/AA COMB.#7/HC#125/CH 3 Combination Package (EA) 

APPFORMIN METFORMIN/CAFF/AA7/HRB125/CHOL 3 Combination Package (EA) 

ANTIHYPERGLYCEMIC, (DPP-4) INHIBITOR & BIGUANIDE COMB. 

JANUMET SITAGLIPTIN PHOS/METFORMIN HCL 3 Tablet 

IMMUNOSUPPRESANT 

IMMUNOSUPPRESSIVES 

AZASAN AZATHIOPRINE 2 Tablet 

AZATHIOPRINE AZATHIOPRINE 1 Tablet 

IMURAN AZATHIOPRINE 3 Tablet 

CYCLOSPORINE CYCLOSPORINE 1 Capsule (Hard, Soft, etc.) 

SANDIMMUNE CYCLOSPORINE 2 Capsule (Hard, Soft, etc.) 

CYCLOSPORINE CYCLOSPORINE 1 Solution, Oral 

SANDIMMUNE CYCLOSPORINE 2 Solution, Oral 

CYCLOSPORINE CYCLOSPORINE, MODIFIED 1 Capsule (Hard, Soft, etc.) 

CYCLOSPORINE CYCLOSPORINE, MODIFIED 2 Capsule (Hard, Soft, etc.) 

GENGRAF CYCLOSPORINE, MODIFIED 1 Capsule (Hard, Soft, etc.) 

NEORAL CYCLOSPORINE, MODIFIED 2 Capsule (Hard, Soft, etc.) 

CYCLOSPORINE CYCLOSPORINE, MODIFIED 1 Solution, Oral 

GENGRAF CYCLOSPORINE, MODIFIED 1 Solution, Oral 

NEORAL CYCLOSPORINE, MODIFIED 2 Solution, Oral 

CELLCEPT MYCOPHENOLATE MOFETIL 2 Capsule (Hard, Soft, etc.) 

CELLCEPT MYCOPHENOLATE MOFETIL 2 Suspension, Reconstituted, Oral (ml) 

CELLCEPT MYCOPHENOLATE MOFETIL 2 Tablet 

MYFORTIC MYCOPHENOLATE SODIUM 3 Tablet, Delayed Release (Enteric Coated) 

RAPAMUNE SIROLIMUS 3 Solution, Oral 

RAPAMUNE SIROLIMUS 3 Tablet 

PROGRAF TACROLIMUS ANHYDROUS 3 Capsule (Hard, Soft, etc.) 

TOPICAL IMMUNOSUPPRESSIVE AGENTS 

ELIDEL PIMECROLIMUS 3 Cream (Grams) 

PROTOPIC TACROLIMUS 3 Ointment (gm) 

MUSCLE RELAXANTS 

SKELETAL MUSCLE RELAXANTS 

BACLOFEN BACLOFEN 1 Tablet 

CARISOPRODOL CARISOPRODOL 1 Tablet 

SOMA CARISOPRODOL 3 Tablet 

CARISOPRODOL COMPOUND CARISOPRODOL/ASPIRIN 1 Tablet 

SOMA COMPOUND CARISOPRODOL/ASPIRIN 3 Tablet 

CHLORZOXAZONE CHLORZOXAZONE 1 Tablet 

CHLORZOXAZONE CHLORZOXAZONE 1 Tablet 

PARAFON FORTE DSC CHLORZOXAZONE 3 Tablet 

Page 61


AMRIX CYCLOBENZAPRINE HCL 3 Capsule, Sustained Release 24 Hr 

CYCLOBENZAPRINE HCL CYCLOBENZAPRINE HCL 1 Tablet 

FEXMID CYCLOBENZAPRINE HCL 3 Tablet 

FLEXERIL CYCLOBENZAPRINE HCL 3 Tablet 

DANTRIUM DANTROLENE SODIUM 2 Capsule (Hard, Soft, etc.) 

DANTROLENE SODIUM DANTROLENE SODIUM 1 Capsule (Hard, Soft, etc.) 

SKELAXIN METAXALONE 3 Tablet 

METHOCARBAMOL METHOCARBAMOL 1 Tablet 

ROBAXIN METHOCARBAMOL 3 Tablet 

ROBAXIN-750 METHOCARBAMOL 3 Tablet 

METHOCARBAMOL W/ASPIRIN METHOCARBAMOL/ASPIRIN 1 Tablet 

ORPHENADRINE CITRATE ORPHENADRINE CITRATE 1 Tablet, Sustained Action 

ORPHENADRINE COMPOUND ORPHENADRINE/ASPIRIN/CAFFEINE 1 Tablet 

ORPHENADRINE COMPOUND FORTE ORPHENADRINE/ASPIRIN/CAFFEINE 1 Tablet 

ZANAFLEX TIZANIDINE HCL 3 Capsule (Hard, Soft, etc.) 

TIZANIDINE HCL TIZANIDINE HCL 1 Tablet 

ZANAFLEX TIZANIDINE HCL 3 Tablet 

SKELETAL MUSCLE RELAXANTS/DIETARY SUPPLEMENT COMB. 

PRAZOLAMINE CARISOPRODOL/DIET. SUPP 11 3 Combination Package (EA) 

THERABENZAPRINE-60 CYCLOBENZAPRINE/DIET. SUPP. 11 3 Combination Package (EA) 

THERABENZAPRINE-90 CYCLOBENZAPRINE/DIET. SUPP. 11 3 Combination Package (EA) 

PSYCHOTHERAPEUTIC DRUGS 

ANTI-ANXIETY DRUGS 

ALPRAZOLAM INTENSOL ALPRAZOLAM 3 Concentrate, Oral 

ALPRAZOLAM ALPRAZOLAM 1 Tablet 

XANAX ALPRAZOLAM 3 Tablet 

NIRAVAM ALPRAZOLAM 3 Tablet, Rapid Dissolve 

ALPRAZOLAM ER ALPRAZOLAM 1 Tablet, Sustained Release 24 Hr 

ALPRAZOLAM XR ALPRAZOLAM 1 Tablet, Sustained Release 24 Hr 

XANAX XR ALPRAZOLAM 3 Tablet, Sustained Release 24 Hr 

BUSPAR BUSPIRONE HCL 3 Tablet 

BUSPIRONE HCL BUSPIRONE HCL 1 Tablet 

VANSPAR BUSPIRONE HCL 3 Tablet 

CHLORDIAZEPOXIDE HCL CHLORDIAZEPOXIDE HCL 1 Capsule (Hard, Soft, etc.) 

LIBRIUM CHLORDIAZEPOXIDE HCL 3 Capsule (Hard, Soft, etc.) 

CLORAZEPATE DIPOTASSIUM CLORAZEPATE DIPOTASSIUM 1 Tablet 

TRANXENE T-TAB CLORAZEPATE DIPOTASSIUM 3 Tablet 

TRANXENE SD CLORAZEPATE DIPOTASSIUM 3 Tablet, Sustained Action 

DIAZEPAM DIAZEPAM 2 Concentrate, Oral 

DIAZEPAM DIAZEPAM 2 Solution, Oral 

DIAZEPAM DIAZEPAM 1 Tablet 

VALIUM DIAZEPAM 3 Tablet 

LORAZEPAM INTENSOL LORAZEPAM 2 Concentrate, Oral 

ATIVAN LORAZEPAM 3 Tablet 

LORAZEPAM LORAZEPAM 1 Tablet 

MEPROBAMATE MEPROBAMATE 1 Tablet 

MILTOWN MEPROBAMATE 3 Tablet 

OXAZEPAM OXAZEPAM 1 Capsule (Hard, Soft, etc.) 

ANTI-PSYCHOTICS, PHENOTHIAZINES 

CHLORPROMAZINE HCL CHLORPROMAZINE HCL 1 Concentrate, Oral 

CHLORPROMAZINE HCL CHLORPROMAZINE HCL 1 Tablet 

FLUPHENAZINE HCL FLUPHENAZINE HCL 1 Concentrate, Oral 

FLUPHENAZINE HCL FLUPHENAZINE HCL 1 Elixir 

FLUPHENAZINE HCL FLUPHENAZINE HCL 1 Tablet 

PROLIXIN FLUPHENAZINE HCL 3 Tablet 

PERPHENAZINE PERPHENAZINE 1 Tablet 

THIORIDAZINE HCL THIORIDAZINE HCL 1 Concentrate, Oral 

THIORIDAZINE HCL THIORIDAZINE HCL 1 Tablet 

TRIFLUOPERAZINE HCL TRIFLUOPERAZINE HCL 1 Tablet 

MONOAMINE OXIDASE (MAO) INHIBITORS 

EMSAM SELEGILINE 3 Patch, Transdermal 24 Hr 

ANTI-MANIA DRUGS 

ESKALITH LITHIUM CARBONATE 1 Capsule (Hard, Soft, etc.) 

LITHIUM CARBONATE LITHIUM CARBONATE 1 Capsule (Hard, Soft, etc.) 

LITHIUM CARBONATE LITHIUM CARBONATE 2 Capsule (Hard, Soft, etc.) 

LITHIUM CARBONATE LITHIUM CARBONATE 1 Tablet 

LITHIUM CARBONATE LITHIUM CARBONATE 1 Tablet, Sustained Action 

Page 62


LITHIUM CARBONATE LITHIUM CARBONATE 2 Tablet, Sustained Action 

LITHOBID LITHIUM CARBONATE 2 Tablet, Sustained Action 

LITHIUM CITRATE LITHIUM CITRATE 1 Solution, Oral 

LITHIUM CITRATE LITHIUM CITRATE 2 Solution, Oral 

TX FOR ATTENTION DEFICIT-HYPERACT(ADHD)/NARCOLEPSY 

FOCALIN XR DEXMETHYLPHENIDATE HCL 3 Capsule, Multiphasic Release 50-50 

DEXMETHYLPHENIDATE HCL DEXMETHYLPHENIDATE HCL 1 Tablet 

FOCALIN DEXMETHYLPHENIDATE HCL 3 Tablet 

DAYTRANA METHYLPHENIDATE 3 Patch, Transdermal 24 Hr 

METADATE CD METHYLPHENIDATE HCL 3 Capsule, Multiphasic Release 30-70 

RITALIN LA METHYLPHENIDATE HCL 3 Capsule, Multiphasic Release 50-50 

METHYLIN METHYLPHENIDATE HCL 3 Solution, Oral 

METHYLIN METHYLPHENIDATE HCL 1 Tablet 

METHYLPHENIDATE HCL METHYLPHENIDATE HCL 1 Tablet 

RITALIN METHYLPHENIDATE HCL 3 Tablet 

METHYLIN METHYLPHENIDATE HCL 3 Tablet, Chewable 

CONCERTA METHYLPHENIDATE HCL 2 Tablet, SR Osmotic Push 24 Hr 

METADATE ER METHYLPHENIDATE HCL 1 Tablet, Sustained Action 

METHYLIN ER METHYLPHENIDATE HCL 1 Tablet, Sustained Action 

METHYLPHENIDATE ER METHYLPHENIDATE HCL 1 Tablet, Sustained Action 

METHYLPHENIDATE HCL METHYLPHENIDATE HCL 1 Tablet, Sustained Action 

METHYLPHENIDATE SR METHYLPHENIDATE HCL 1 Tablet, Sustained Action 

RITALIN-SR METHYLPHENIDATE HCL 3 Tablet, Sustained Action 

PROVIGIL MODAFINIL 3 Tablet 

ADRENERGICS, AROMATIC, NON-CATECHOLAMINE 

VYVANSE LISDEXAMFETAMINE DIMESYLATE 3 Capsule (Hard, Soft, etc.) 

SSRI & ANTIPSYCH, ATYP, DOPAMINE & SEROTONIN ANTAG COMBINATION 

SYMBYAX OLANZAPINE/FLUOXETINE HCL 3 Capsule (Hard, Soft, etc.) 

SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRIS) 

CELEXA CITALOPRAM HYDROBROMIDE 3 Solution, Oral 

CITALOPRAM CITALOPRAM HYDROBROMIDE 1 Solution, Oral 

CELEXA CITALOPRAM HYDROBROMIDE 3 Tablet 

CITALOPRAM HBR CITALOPRAM HYDROBROMIDE 1 Tablet 

LEXAPRO ESCITALOPRAM OXALATE 2 Solution, Oral 

LEXAPRO ESCITALOPRAM OXALATE 2 Tablet 

FLUOXETINE HCL FLUOXETINE HCL 1 Capsule (Hard, Soft, etc.) 

PROZAC FLUOXETINE HCL 3 Capsule (Hard, Soft, etc.) 

SARAFEM FLUOXETINE HCL 3 Capsule (Hard, Soft, etc.) 

PROZAC WEEKLY FLUOXETINE HCL 3 Capsule,Delayed Release (Enteric Coated) 

FLUOXETINE HCL FLUOXETINE HCL 1 Solution, Oral 

PROZAC FLUOXETINE HCL 3 Solution, Oral 

FLUOXETINE HCL FLUOXETINE HCL 1 Tablet 

RAPIFLUX FLUOXETINE HCL 3 Tablet 

FLUVOXAMINE MALEATE FLUVOXAMINE MALEATE 1 Tablet 

PAROXETINE HCL PAROXETINE HCL 1 Suspension, Oral (Final Dose Form) 

PAXIL PAROXETINE HCL 3 Suspension, Oral (Final Dose Form) 

PAROXETINE HCL PAROXETINE HCL 1 Tablet 

PAXIL PAROXETINE HCL 3 Tablet 

PAXIL CR PAROXETINE HCL 3 Tablet, Sustained Release 24 Hr 

PEXEVA PAROXETINE MESYLATE 3 Tablet 

SERTRALINE HCL SERTRALINE HCL 1 Concentrate, Oral 

ZOLOFT SERTRALINE HCL 3 Concentrate, Oral 

SERTRALINE HCL SERTRALINE HCL 1 Tablet 

ZOLOFT SERTRALINE HCL 3 Tablet 

TRICYCLIC ANTIDEPRESSANTS & REL. NON-SEL. RU-INHIB 

AMITRIPTYLINE HCL AMITRIPTYLINE HCL 1 Tablet 

ENDEP AMITRIPTYLINE HCL 1 Tablet 

AMOXAPINE AMOXAPINE 1 Tablet 

AMOXAPINE AMOXAPINE 3 Tablet 

ANAFRANIL CLOMIPRAMINE HCL 3 Capsule (Hard, Soft, etc.) 

CLOMIPRAMINE HCL CLOMIPRAMINE HCL 1 Capsule (Hard, Soft, etc.) 

DESIPRAMINE HCL DESIPRAMINE HCL 1 Tablet 

NORPRAMIN DESIPRAMINE HCL 3 Tablet 

DOXEPIN HCL DOXEPIN HCL 1 Capsule (Hard, Soft, etc.) 

DOXEPIN HCL DOXEPIN HCL 1 Capsule (Hard, Soft, etc.) 

DOXEPIN HCL DOXEPIN HCL 1 Concentrate, Oral 

IMIPRAMINE HCL IMIPRAMINE HCL 1 Tablet 

Page 63


TOFRANIL IMIPRAMINE HCL 3 Tablet 

IMIPRAMINE PAMOATE IMIPRAMINE PAMOATE 1 Capsule (Hard, Soft, etc.) 

TOFRANIL-PM IMIPRAMINE PAMOATE 3 Capsule (Hard, Soft, etc.) 

MAPROTILINE HCL MAPROTILINE HCL 1 Tablet 

MAPROTILINE HCL MAPROTILINE HCL 1 Tablet 

NORTRIPTYLINE HCL NORTRIPTYLINE HCL 1 Capsule (Hard, Soft, etc.) 

PAMELOR NORTRIPTYLINE HCL 3 Capsule (Hard, Soft, etc.) 

NORTRIPTYLINE HCL NORTRIPTYLINE HCL 1 Solution, Oral 

PAMELOR NORTRIPTYLINE HCL 3 Solution, Oral 

VIVACTIL PROTRIPTYLINE HCL 3 Tablet 

SURMONTIL TRIMIPRAMINE MALEATE 3 Capsule (Hard, Soft, etc.) 

TRIMIPRAMINE MALEATE TRIMIPRAMINE MALEATE 1 Capsule (Hard, Soft, etc.) 

TRICYCLIC ANTIDEPRESSANT/PHENOTHIAZINE COMBINATIONS 

PERPHENAZINE-AMITRIPTYLINE PERPHENAZINE/AMITRIPTYLINE HCL 1 Tablet 

TRICYCLIC ANTIDEPRESSANT/BENZODIAZEPINE COMBINATIONS 

AMITRIPTYLINE/CHLORDIAZEPOXIDE AMITRIP HCL/CHLORDIAZEPOXIDE 1 Tablet 

AMITRIPTYLINE-CHLORDIAZEPOXIDE AMITRIP HCL/CHLORDIAZEPOXIDE 1 Tablet 

LIMBITROL AMITRIP HCL/CHLORDIAZEPOXIDE 3 Tablet 

LIMBITROL DS AMITRIP HCL/CHLORDIAZEPOXIDE 3 Tablet 

ALPHA-2 RECEPTOR ANTAGONIST ANTIDEPRESSANTS 

MIRTAZAPINE MIRTAZAPINE 1 Tablet 

MIRTAZAPINE MIRTAZAPINE 3 Tablet 

REMERON MIRTAZAPINE 3 Tablet 

MIRTAZAPINE MIRTAZAPINE 1 Tablet, Rapid Dissolve 

REMERON MIRTAZAPINE 3 Tablet, Rapid Dissolve 

SEROTONIN-NOREPINEPHRINE REUPTAKE-INHIB (SNRIS) 

CYMBALTA DULOXETINE HCL 3 Capsule,Delayed Release (Enteric Coated) 

EFFEXOR XR VENLAFAXINE HCL 2 Capsule, Sustained Release 24 Hr 

EFFEXOR VENLAFAXINE HCL 2 Tablet 

VENLAFAXINE HCL VENLAFAXINE HCL 1 Tablet 

NOREPINEPHRINE AND DOPAMINE REUPTAKE INHIB (NDRIS) 

BUPROPION HCL BUPROPION HCL 1 Tablet 

WELLBUTRIN BUPROPION HCL 3 Tablet 

BUDEPRION SR BUPROPION HCL 1 Tablet, Sustained Action 

BUPROPION HCL SR BUPROPION HCL 1 Tablet, Sustained Action 

WELLBUTRIN SR BUPROPION HCL 3 Tablet, Sustained Action 

BUDEPRION XL BUPROPION HCL 1 Tablet, Sustained Release 24 Hr 

BUPROPION XL BUPROPION HCL 1 Tablet, Sustained Release 24 Hr 

WELLBUTRIN XL BUPROPION HCL 2 Tablet, Sustained Release 24 Hr 

SEROTONIN-2 ANTAGONIST/REUPTAKE INHIBITORS (SARIS) 

NEFAZODONE HCL NEFAZODONE HCL 1 Tablet 

DESYREL TRAZODONE HCL 3 Tablet 

TRAZODONE TRAZODONE HCL 1 Tablet 

TRAZODONE HCL TRAZODONE HCL 1 Tablet 

MAOIS - NON-SELECTIVE & IRREVERSIBLE 

MARPLAN ISOCARBOXAZID 3 Tablet 

NARDIL PHENELZINE SULFATE 3 Tablet 

PARNATE TRANYLCYPROMINE SULFATE 3 Tablet 

TRANYLCYPROMINE SULFATE TRANYLCYPROMINE SULFATE 1 Tablet 

ANTIPSYCHOTICS, DOPAMINE ANTAGONISTS, BUTYROPHENONES 

HALOPERIDOL HALOPERIDOL 1 Tablet 

HALOPERIDOL LACTATE HALOPERIDOL LACTATE 1 Concentrate, Oral 

ANTIPSYCHOTICS, DOPAMINE ANTAGONISTS, THIOXANTHENES 

NAVANE THIOTHIXENE 3 Capsule (Hard, Soft, etc.) 

THIOTHIXENE THIOTHIXENE 1 Capsule (Hard, Soft, etc.) 

ANTIPSYCHOTICS, DOPAMINE ANTAGONIST, DIPHENYLBUTYLPIPERIDINES 

ORAP PIMOZIDE 3 Tablet 

ANTIPSYCHOTICS, DOPAMINE ANTAGONIST, DIHYDROINDOLONES 

MOBAN MOLINDONE HCL 3 Tablet 

ANTIPSYCHOTICS, ATYPICAL, DOPAMINE, & SEROTONIN ANTAG 

CLOZAPINE CLOZAPINE 1 Tablet 

CLOZAPINE CLOZAPINE 2 Tablet 

FAZACLO CLOZAPINE 2 Tablet, Rapid Dissolve 

ZYPREXA OLANZAPINE 2 Tablet 

ZYPREXA ZYDIS OLANZAPINE 2 Tablet, Rapid Dissolve 

INVEGA PALIPERIDONE 2 Tablet, SR Osmotic Push 24 Hr 

Page 64


SEROQUEL QUETIAPINE FUMARATE 2 Tablet 

SEROQUEL XR QUETIAPINE FUMARATE 2 Tablet, Sustained Release 24 Hr 

RISPERDAL RISPERIDONE 2 Solution, Oral 

RISPERDAL RISPERIDONE 2 Tablet 

RISPERDAL RISPERIDONE 2 Tablet, Rapid Dissolve 

RISPERDAL M-TAB RISPERIDONE 2 Tablet, Rapid Dissolve 

RISPERDAL CONSTA RISPERIDONE MICROSPHERES 2 Disposable Syringe (EA) 

GEODON ZIPRASIDONE HCL 2 Capsule (Hard, Soft, etc.) 

GEODON ZIPRASIDONE MESYLATE 2 Vial (SDV, MDV or Additive) (EA) 

ANTIPSYCHOTICS, DOPAMINE & SEROTONIN ANTAGONISTS 

LOXAPINE LOXAPINE SUCCINATE 1 Capsule (Hard, Soft, etc.) 

LOXAPINE SUCCINATE LOXAPINE SUCCINATE 1 Capsule (Hard, Soft, etc.) 

LOXITANE LOXAPINE SUCCINATE 3 Capsule (Hard, Soft, etc.) 

ANTIPSYCHOTICS, ATYP, D2 PARTIAL AGONIST/5HT MIXED 

ABILIFY ARIPIPRAZOLE 2 Solution, Oral 

ABILIFY ARIPIPRAZOLE 2 Tablet 

ABILIFY DISCMELT ARIPIPRAZOLE 2 Tablet, Rapid Dissolve 

TX FOR ATTENTION DEFICIT-HYPERACT.(ADHD), NRI-TYPE 

STRATTERA ATOMOXETINE HCL 2 Capsule (Hard, Soft, etc.) 

SEROTONIN-2 ANTAGONIST, REUPTAKE INH/DIETARY SUPP. COMB. 

TRAZAMINE TRAZODONE HCL/DIET8 3 Combination Package (EA) 

SELECTIVE SEROTONIN INHIB. (SSRIS)/DIET SUPP CMB. 

SENTROXATINE FLUOXETINE HCL/DIET. SUPP NO.8 3 Capsule (Hard, Soft, etc.) 

GABOXETINE FLUOXETINE HCL/DIET.SUPP NO.17 3 Capsule (Hard, Soft, etc.) 

NOREPINEPHRINE & DOPAMINE INHIB.(NDRIS)/DIET SUPP 

APPBUTAMONE-D BUPROPION HCL/DIET SUPP. NO.15 3 Combination Package (EA) 

APPBUTAMONE BUPROPION HCL/DIET SUPP. NO.16 3 Combination Package (EA) 

ANTI-ANXIETY DRUGS/DIETARY SUPPLEMENT COMBINATIONS 

GABAZOLAMINE ALPRAZOLAM/DIETARY SUPPL NO.17 3 Combination Package (EA) 

SEDATIVE/HYPNOTICS 

BARBITURATES 

BUTISOL SODIUM BUTABARBITAL SODIUM 3 Elixir 

BUTISOL SODIUM BUTABARBITAL SODIUM 3 Tablet 

PHENOBARBITAL PHENOBARBITAL 1 Elixir 

PHENOBARBITAL PHENOBARBITAL 1 Tablet 

PHENOBARBITAL PHENOBARBITAL 2 Tablet 

SECONAL SODIUM SECOBARBITAL SODIUM 3 Capsule (Hard, Soft, etc.) 

SEDATIVE-HYPNOTICS, NON-BARBITURATE 

SOMNOTE CHLORAL HYDRATE 3 Capsule (Hard, Soft, etc.) 

CHLORAL HYDRATE CHLORAL HYDRATE 3 Suppository, Rectal 

CHLORAL HYDRATE CHLORAL HYDRATE 1 Syrup 

CHLORAL HYDRATE CHLORAL HYDRATE 3 Syrup 

ESTAZOLAM ESTAZOLAM 1 Tablet 

LUNESTA ESZOPICLONE 3 Tablet 

DALMANE FLURAZEPAM HCL 3 Capsule (Hard, Soft, etc.) 

FLURAZEPAM HCL FLURAZEPAM HCL 1 Capsule (Hard, Soft, etc.) 

MIDAZOLAM HCL MIDAZOLAM HCL 1 Syrup 

MIDAZOLAM HCL MIDAZOLAM HCL 3 Syrup 

DORAL QUAZEPAM 3 Tablet 

RESTORIL TEMAZEPAM 3 Capsule (Hard, Soft, etc.) 

RESTORIL TEMAZEPAM 3 Capsule (Hard, Soft, etc.) 

TEMAZEPAM TEMAZEPAM 1 Capsule (Hard, Soft, etc.) 

HALCION TRIAZOLAM 3 Tablet 

TRIAZOLAM TRIAZOLAM 1 Tablet 

SONATA ZALEPLON 3 Capsule (Hard, Soft, etc.) 

AMBIEN ZOLPIDEM TARTRATE 3 Tablet 

ZOLPIDEM TARTRATE ZOLPIDEM TARTRATE 1 Tablet 

ZOLPIDEM TARTRATE ZOLPIDEM TARTRATE 3 Tablet 

AMBIEN CR ZOLPIDEM TARTRATE 3 Tablet, Multiphasic Release 

ANTI-NARCOLEPSY & ANTI-CATAPLEXY, SEDATIVE-TYPE AGT 

XYREM SODIUM OXYBATE 2 Solution, Oral 

HYPNOTICS, MELATONIN MT1/MT2 RECEPTOR AGONISTS 

ROZEREM RAMELTEON 3 Tablet 

SEDATIVE-HYPNOTICS, NON-BARBITURATE/DIETARY SUPP. 

STRAZEPAM TEMAZEPAM/DIET8 3 Capsule (Hard, Soft, etc.) 

Page 65


SKIN PREPARATIONS 

TOPICAL/MUCOUS MEMBR./SUBCUT. ENZYMES 

ANANA BROMELAINS 3 Tablet 

ANANA FORTE BROMELAINS 3 Tablet 

SANTYL COLLAGENASE 3 Ointment (gm) 

ACCUZYME PAPAIN/UREA 3 Aerosol (ml) 

PAPTASE PAPAIN/UREA 3 Foam (gm) 

ACCUZYME PAPAIN/UREA 3 Ointment (gm) 

ALLANENZYME PAPAIN/UREA 1 Ointment (gm) 

ETHEZYME PAPAIN/UREA 3 Ointment (gm) 

ETHEZYME 650 PAPAIN/UREA 1 Ointment (gm) 

ETHEZYME 830 PAPAIN/UREA 1 Ointment (gm) 

GLADASE PAPAIN/UREA 1 Ointment (gm) 

KOVIA PAPAIN/UREA 1 Ointment (gm) 

KOVIA 6.5 PAPAIN/UREA 1 Ointment (gm) 

KOVIA OINTMENT PAPAIN/UREA 1 Ointment (gm) 

PANAFIL-WHITE PAPAIN/UREA 3 Ointment (gm) 

ACCUZYME PAPAIN/UREA 3 Spray, Non-Aerosol (ml) 

ALLANENZYME PAPAIN/UREA 1 Spray, Non-Aerosol (ml) 

PANAFIL PAPAIN/UREA/CHLOROPHYLLIN 3 Aerosol (ml) 

ALLANFILLENZYME PAPAIN/UREA/CHLOROPHYLLIN 1 Ointment (gm) 

GLADASE-C PAPAIN/UREA/CHLOROPHYLLIN 1 Ointment (gm) 

PANAFIL PAPAIN/UREA/CHLOROPHYLLIN 3 Ointment (gm) 

ZIOX PAPAIN/UREA/CHLOROPHYLLIN 1 Ointment (gm) 

ZIOX 405 PAPAIN/UREA/CHLOROPHYLLIN 1 Ointment (gm) 

ALLANFILLENZYME PAPAIN/UREA/CHLOROPHYLLIN 1 Spray, Non-Aerosol (ml) 

GRANUL-DERM TRYPSIN/BALSAM PERU/CASTOR OIL 1 Aerosol, Spray (gm) 

GRANULEX TRYPSIN/BALSAM PERU/CASTOR OIL 3 Aerosol, Spray (gm) 

TBC TRYPSIN/BALSAM PERU/CASTOR OIL 1 Aerosol, Spray (gm) 

OPTASE TRYPSIN/BALSAM PERU/CASTOR OIL 3 Gel (gm) 

ALLANDERM-T TRYPSIN/BALSAM PERU/CASTOR OIL 1 Ointment (gm) 

REVINA TRYPSIN/BALSAM PERU/CASTOR OIL 1 Ointment (gm) 

TRYPSIN TRYPSIN/BALSAM PERU/CASTOR OIL 1 Ointment (gm) 

VASOLEX TRYPSIN/BALSAM PERU/CASTOR OIL 1 Ointment (gm) 

XENADERM TRYPSIN/BALSAM PERU/CASTOR OIL 3 Ointment (gm) 

EMOLLIENTS 

VEHICLE/N ALC/ISOPROPANOL/PROP GLY/WATER 3 Solution, Non-Oral 

VEHICLE/N MILD ALC/ISOPROPANOL/PROP GLY/WATER 3 Solution, Non-Oral 

AMMONIUM LACTATE AMMONIUM LACTATE 1 Cream (Grams) 

LAC-HYDRIN AMMONIUM LACTATE 3 Cream (Grams) 

AMMONIUM LACTATE AMMONIUM LACTATE 1 Lotion (gm) 

LAC-HYDRIN AMMONIUM LACTATE 3 Lotion (gm) 

LACLOTION AMMONIUM LACTATE 1 Lotion (gm) 

ATOPICLAIR DL-E AC/GRAPE/HYALURONIC ACID 3 Cream (Grams) 

ELETONE EMOLLIENT COMBINATION NO. 25 1 Cream (Grams) 

MIMYX EMOLLIENT COMBINATION NO. 3 3 Cream (Grams) 

BIAFINE EMOLLIENT COMBINATION NO.10 3 Emulsion (gm) 

XCLAIR HYALURO/DL-E AC/E12/ALLAN/SHEA 3 Cream (ml) 

LACTIC ACID LACTIC ACID 1 Cream (Grams) 

LACTINOL-E LACTIC ACID 3 Cream (Grams) 

LACTIC ACID LACTIC ACID 1 Lotion (ml) 

LACTINOL LACTIC ACID 3 Lotion (ml) 

PROTECTIVES 

BENZOIN BENZOIN 1 Tincture 

BIONECT HYALURONATE SODIUM 3 Cream (Grams) 

BIONECT HYALURONATE SODIUM 3 Gel (gm) 

BIONECT HYALURONATE SODIUM 3 Spray, Non-Aerosol (ml) 

HYLIRA HYALURONATE SODIUM 3 Suspension, Topical (gm) 

SODIUM HYALURONATE HYALURONATE SODIUM 1 Suspension, Topical (gm) 

CONSTANT CLENS NAPH,MB-DB/K PH,MBDB/ZINC/UREA 3 Aerosol, Spray (ml) 

RADIAPLEXRX VIT E/ALLANT/MANN PS/HYALUR AC 3 Gel (gm) 

ANTIPRURITICS, TOPICAL 

PRUDOXIN DOXEPIN HCL 1 Cream (Grams) 

ZONALON DOXEPIN HCL 3 Cream (Grams) 

ASTRINGENTS 

ALUMINUM ACETATE ALUMINUM ACETATE 3 Solution, Non-Oral 

KERATOLYTICS 

Page 66


ULTRALYTIC 2 AMMONIUM LACTATE/UREA 3 Cream (Grams) 

ULTRALYTIC 2 AMMONIUM LACTATE/UREA 3 Foam (gm) 

OSCION BENZOYL PEROXIDE 1 Cleanser (gm) 

TRIAZ BENZOYL PEROXIDE 3 Cleanser (gm) 

BENZAC AC BENZOYL PEROXIDE 1 Gel (gm) 

BENZAC W 10 BENZOYL PEROXIDE 1 Gel (gm) 

BENZAC W 2.5 BENZOYL PEROXIDE 1 Gel (gm) 

BENZAC W 5 BENZOYL PEROXIDE 1 Gel (gm) 

BENZOYL PEROXIDE BENZOYL PEROXIDE 1 Gel (gm) 

BREVOXYL BENZOYL PEROXIDE 3 Gel (gm) 

CLEARPLEX V BENZOYL PEROXIDE 1 Gel (gm) 

CLEARPLEX X BENZOYL PEROXIDE 1 Gel (gm) 

CLINAC BPO BENZOYL PEROXIDE 3 Gel (gm) 

DEL-AQUA-5 BENZOYL PEROXIDE 1 Gel (gm) 

DESQUAM-E BENZOYL PEROXIDE 1 Gel (gm) 

DESQUAM-X 10 BENZOYL PEROXIDE 1 Gel (gm) 

DESQUAM-X 5 BENZOYL PEROXIDE 1 Gel (gm) 

PANOXYL 10 BENZOYL PEROXIDE 1 Gel (gm) 

PANOXYL 5 BENZOYL PEROXIDE 3 Gel (gm) 

PANOXYL AQ 10 BENZOYL PEROXIDE 1 Gel (gm) 

PANOXYL AQ 2.5 BENZOYL PEROXIDE 3 Gel (gm) 

PANOXYL AQ 5 BENZOYL PEROXIDE 3 Gel (gm) 

BENZAGEL-10 BENZOYL PEROXIDE 3 Gel, Alcohol Based 

BENZAGEL-5 BENZOYL PEROXIDE 3 Gel, Alcohol Based 

BENZOYL PEROXIDE BENZOYL PEROXIDE 1 Gel, Alcohol Based 

BENZAC AC BENZOYL PEROXIDE 1 Liquid (gm) 

BENZAC W WASH BENZOYL PEROXIDE 1 Liquid (gm) 

BENZOYL PEROXIDE BENZOYL PEROXIDE 1 Liquid (gm) 

BENZOYL PEROXIDE BENZOYL PEROXIDE 3 Liquid (gm) 

DESQUAM-X BENZOYL PEROXIDE 1 Liquid (gm) 

LAVOCLEN-4 BENZOYL PEROXIDE 3 Liquid (gm) 

LAVOCLEN-8 BENZOYL PEROXIDE 3 Liquid (gm) 

BENZAC AC BENZOYL PEROXIDE 3 Liquid (ml) 

BENZAC W WASH BENZOYL PEROXIDE 3 Liquid (ml) 

BENZOYL PEROXIDE BENZOYL PEROXIDE 1 Liquid (ml) 

BENZOYL PEROXIDE BENZOYL PEROXIDE 1 Liquid (ml) 

DESQUAM-X BENZOYL PEROXIDE 1 Liquid (ml) 

ETHEXDERM BENZOYL PEROXIDE 1 Liquid (ml) 

ZACLIR BENZOYL PEROXIDE 3 Lotion (gm) 

ZACLIR BENZOYL PEROXIDE 3 Lotion (gm) 

BENZASHAVE BENZOYL PEROXIDE 3 Medicated Shaving Cream (gm) 

BENZOYL PEROXIDE BENZOYL PEROXIDE 1 Pads, Medicated (EA) 

INOVA BENZOYL PEROXIDE 3 Pads, Medicated (EA) 

OSCION BENZOYL PEROXIDE 1 Pads, Medicated (EA) 

TRIAZ BENZOYL PEROXIDE 3 Pads, Medicated (EA) 

NEOBENZ MICRO BENZOYL PEROXIDE MICROSPHERES 3 Cream (Grams) 

NEOBENZ MICRO SD BENZOYL PEROXIDE MICROSPHERES 3 Cream in Packet 

BENZOYL PEROXIDE BENZOYL PEROXIDE&SKIN CLEANSR5 1 Kit 

BREVOXYL-4 BENZOYL PEROXIDE&SKIN CLEANSR5 3 Kit 

BREVOXYL-8 BENZOYL PEROXIDE&SKIN CLEANSR5 3 Kit 

BENPROX BENZOYL PEROXIDE/ALOE VERA 1 Gel (gm) 

BENZIQ BENZOYL PEROXIDE/ALOE VERA 3 Gel (gm) 

BENZIQ LS BENZOYL PEROXIDE/ALOE VERA 3 Gel (gm) 

BENPROX BENZOYL PEROXIDE/ALOE VERA 1 Suspension, Topical (gm) 

BENZIQ BENZOYL PEROXIDE/ALOE VERA 3 Suspension, Topical (gm) 

LAVOCLEN-4 BENZOYL PEROXIDE/SKIN CLNSR7 3 Kit 

LAVOCLEN-8 BENZOYL PEROXIDE/SKIN CLNSR7 3 Kit 

NUOX BENZOYL PEROXIDE/SULFUR 3 Gel (gm) 

SULFOXYL REGULAR BENZOYL PEROXIDE/SULFUR 3 Lotion (ml) 

SULFOXYL STRONG BENZOYL PEROXIDE/SULFUR 3 Lotion (ml) 

BENZOYL PEROXIDE BENZOYL PEROXIDE/UREA 1 Cleanser (ml) 

ZODERM BENZOYL PEROXIDE/UREA 3 Cleanser (ml) 

BENZOYL PEROXIDE BENZOYL PEROXIDE/UREA 1 Cream (ml) 

ZODERM BENZOYL PEROXIDE/UREA 3 Cream (ml) 

BENZOYL PEROXIDE BENZOYL PEROXIDE/UREA 1 Gel (ml) 

ZODERM BENZOYL PEROXIDE/UREA 3 Gel (ml) 

BENZOYL PEROXIDE BENZOYL PEROXIDE/UREA 1 Pads, Medicated (EA) 

ZODERM BENZOYL PEROXIDE/UREA 3 Pads, Medicated (EA) 

Page 67


CONDYLOX PODOFILOX 3 Gel (gm) 

CONDYLOX PODOFILOX 3 Solution, Non-Oral 

PODOFILOX PODOFILOX 1 Solution, Non-Oral 

PODOCON-25 PODOPHYLLUM RESIN 3 Liquid (ml) 

POTASSIUM HYDROXIDE POTASSIUM HYDROXIDE 3 Solution, Non-Oral 

DERMA-CAS RESORCINOL/PHENOL LIQUID 3 Gel (ml) 

SALICYLIC ACID SALICYLIC ACID 3 Cream (Grams) 

AKURZA SALICYLIC ACID 1 Cream, Sustained Release (gm) 

RE SA SALICYLIC ACID 1 Cream, Sustained Release (gm) 

SALEX SALICYLIC ACID 3 Cream, Sustained Release (gm) 

SALICYLIC ACID SALICYLIC ACID 1 Cream, Sustained Release (gm) 

SALITOP SALICYLIC ACID 1 Cream, Sustained Release (gm) 

KERALYT SALICYLIC ACID 3 Gel (gm) 

SALICYLIC ACID SALICYLIC ACID 1 Gel (gm) 

SALICYLIC ACID SALICYLIC ACID 3 Lotion (ml) 

AKURZA SALICYLIC ACID 1 Lotion, Sustained Release 

RE SA SALICYLIC ACID 1 Lotion, Sustained Release 

SALEX SALICYLIC ACID 3 Lotion, Sustained Release 

SALICYLIC ACID SALICYLIC ACID 1 Lotion, Sustained Release 

SALITOP SALICYLIC ACID 1 Lotion, Sustained Release 

ALICLEN SALICYLIC ACID 1 Shampoo 

SALEX SALICYLIC ACID 3 Shampoo 

SALICYLIC ACID SALICYLIC ACID 1 Shampoo 

EMERSAL SALICYLIC ACID/AMMONIATED HG 3 Lotion (ml) 

INOVA 4/1 SALICYLIC ACID/BENZ PER 3 Pads, Medicated (EA) 

INOVA 8/2 SALICYLIC ACID/BENZ PER 3 Pads, Medicated (EA) 

SALEX SALICYLIC ACID/CERAMIDES 3 Combination Package (ml) 

SALEX SALICYLIC ACID/CERAMIDES 3 Kit 

GORDOFILM SALICYLIC ACID/LA/COLLODION 3 Solution, Non-Oral 

SILVER NITRATE SILVER NITRATE 3 Solution, Non-Oral 

SILVER NITRATE APPLICATOR SILVER NITRATE APPLICATOR 1 Stick (EA) 

SILVER NITRATE APPLICATOR SILVER NITRATE APPLICATOR 3 Stick (EA) 

CARMOL 40 UREA 3 Cream (Grams) 

CEROVEL UREA 1 Cream (Grams) 

KERALAC UREA 3 Cream (Grams) 

KERATOL 40 UREA 1 Cream (Grams) 

U-KERA E UREA EMOLLIENT UREA 1 Cream (Grams) 

UREA UREA 1 Cream (Grams) 

UREA-C40 UREA 1 Cream (Grams) 

UREALAC UREA 1 Cream (Grams) 

VANAMIDE UREA 1 Cream (Grams) 

X-VIATE UREA 1 Cream (Grams) 

MECTALYTE UREA 1 Emulsion (gm) 

UMECTA UREA 3 Emulsion (gm) 

UREA UREA 1 Emulsion (gm) 

UMECTA PD UREA 3 Emulsion, Adhesive 

HYDRO 40 UREA 3 Foam (gm) 

KERAFOAM UREA 3 Foam (gm) 

UMECTA UREA 1 Foam (gm) 

CARMOL 40 UREA 3 Gel (ml) 

CEROVEL UREA 1 Gel (ml) 

KERALAC UREA 3 Gel (ml) 

KERATOL 40 UREA 1 Gel (ml) 

KERATOL PLUS UREA 1 Gel (ml) 

RE UREA 40 UREA 1 Gel (ml) 

UREA UREA 1 Gel (ml) 

UREALAC UREA 1 Gel (ml) 

X-VIATE UREA 1 Gel (ml) 

KERALAC UREA 3 Lotion (ml) 

KERATOL PLUS UREA 1 Lotion (ml) 

UREA UREA 1 Lotion (ml) 

UREALAC UREA 1 Lotion (ml) 

UMECTA UREA 3 Nail Film Suspension (ml) 

GORDO-UREA UREA 3 Ointment (gm) 

KERALAC UREA 3 Ointment (gm) 

UREA UREA 1 Ointment (gm) 

UREALAC UREA 1 Ointment (gm) 

KERALAC UREA 3 Solution with Prefilled Applicator (ml) 

Page 68


UREA UREA 1 Solution with Prefilled Applicator (ml) 

UREALAC UREA 1 Solution with Prefilled Applicator (ml) 

UMECTA PD UREA 3 Suspension, Adhesive 

MECTALYTE UREA 1 Suspension, Topical (gm) 

UMECTA UREA 3 Suspension, Topical (gm) 

UREA UREA 1 Suspension, Topical (gm) 

KEROL UREA 3 Towelette (EA) 

RINNOVI UREA/EMOL/BAK CL/PVP/GRP SD XT 3 Combination Package (ml) 

KEROL UREA/LACTIC ACID/SALICYL ACID 3 Suspension, Topical (gm) 

UREA UREA/LACTIC ACID/SALICYL ACID 1 Suspension, Topical (gm) 

IRRITANTS/COUNTER-IRRITANTS 

COAL TAR COAL TAR 1 Solution, Non-Oral 

METHYL SALICYLATE METHYL SALICYLATE 1 Liquid (ml) 

OXALIS OXALIC ACID 3 Ointment (gm) 

TOPICAL AGENTS, MISCELLANEOUS 

PYROGALLIC ACID PYROGALLOL 3 Ointment (gm) 

TRI-CHLOR TRICHLOROACETIC ACID 3 Solution, Non-Oral 

TRICHLOROACETIC ACID TRICHLOROACETIC ACID 3 Solution, Non-Oral 

TRICHLOROACETIC ACID TRICHLOROACETIC ACID 1 Solution, Non-Oral 

CARMOL 40 UREA 3 Lotion (ml) 

CEROVEL UREA 1 Lotion (ml) 

KERATOL 40 UREA 1 Lotion (ml) 

RE UREA 40 UREA 1 Lotion (ml) 

UREA UREA 1 Lotion (ml) 

UREA-C40 UREA 1 Lotion (ml) 

X-VIATE UREA 1 Lotion (ml) 

GORDO-UREA UREA 3 Ointment (gm) 

HYPOPIGMENTATION AGENTS 

NUQUIN HP DIOXYBENZONE/HYDROQUINONE 3 Gel (gm) 

HYDROQUINONE DIOXYBENZONE/PDO/HYDROQUINONE 1 Cream (Grams) 

NUQUIN HP DIOXYBENZONE/PDO/HYDROQUINONE 1 Cream (Grams) 

SOLAQUIN FORTE DIOXYBENZONE/PDO/HYDROQUINONE 3 Cream (Grams) 

HYDROQUINONE DIOXYBENZONE/PDO/HYDROQUINONE 1 Gel (gm) 

NUQUIN HP DIOXYBENZONE/PDO/HYDROQUINONE 1 Gel (gm) 

SOLAQUIN FORTE DIOXYBENZONE/PDO/HYDROQUINONE 3 Gel (gm) 

TRI-LUMA FLUOCIN ACET/TRETINOIN/H-QUIN 3 Cream (Grams) 

ELDOQUIN FORTE HYDROQUINONE 3 Cream (Grams) 

HYDROQUINONE HYDROQUINONE 1 Cream (Grams) 

LUSTRA HYDROQUINONE 3 Cream (Grams) 

MELQUIN HP HYDROQUINONE 1 Cream (Grams) 

OBAGI NU-DERM HYDROQUINONE 1 Cream (Grams) 

REMERGENT HQ HYDROQUINONE 3 Cream (ml) 

COMPLEX B HYDROQUINONE 3 Gel (ml) 

MELANEX HYDROQUINONE 3 Solution, Non-Oral 

MELQUIN-3 HYDROQUINONE 1 Solution, Non-Oral 

EPIQUIN MICRO HYDROQUINONE MICROSPHERES 3 Cream, Sustained Release (gm) 

EPIQUIN MICRO XD HYDROQUINONE MICROSPHERES 3 Packet 

OBAGI-C HYDROQUINONE/ASCORBIC ACID 3 Liquid (ml) 

ACLARO HYDROQUINONE/AVOBENZ/OCTINOX 3 Emulsion (gm) 

ACLARO PD HYDROQUINONE/AVOBENZ/OCTINOX 3 Emulsion, Adhesive 

ELDOPAQUE FORTE HYDROQUINONE/FERRIC OXIDE 3 Cream (Grams) 

MELPAQUE HP HYDROQUINONE/FERRIC OXIDE 1 Cream (Grams) 

OBAGI-C HYDROQUINONE/VIT C/VIT E ACET 3 Cream (Grams) 

GLYQUIN XM KERA1/OXBN/AVOBNZ/O-CRL/H-QUIN 3 Cream (Grams) 

HYDROQUINONE KERA1/OXBN/AVOBNZ/O-CRL/H-QUIN 1 Cream (Grams) 

BENOQUIN MONOBENZONE 3 Cream (Grams) 

CLARIPEL OXYBEN/AVOBENZ/OCTINOX/H-QUIN 3 Cream (Grams) 

GLYQUIN OXYBEN/PDO/OCTINOX/H-QUINONE 3 Cream (Grams) 

HYDROQUINONE OXYBEN/PDO/OCTINOX/H-QUINONE 1 Cream (Grams) 

ALPHAQUIN HP OXYBENZONE/OCTINOX/H-QUINONE 1 Cream (Grams) 

OBAGI NU-DERM OXYBENZONE/OCTINOX/H-QUINONE 3 Cream (Grams) 

SOLAGE TRETINOIN/MEQUINOL 3 Solution, Non-Oral 

LUSTRA-ULTRA VIT A/E/AVOBENZ/OCTINOX/H-QUIN 3 Cream (Grams) 

LUSTRA-AF VIT E AC/AVOBNZ/OCTINOX/H-QUIN 3 Cream (Grams) 

TOPICAL PREPARATIONS, ANTIBACTERIALS 

IODOSORB CADEXOMER IODINE 3 Gel (gm) 

IODOFLEX CADEXOMER IODINE 3 Pads, Medicated (EA) 

ALA-QUIN CLIOQUINOL/HYDROCORTISONE 3 Cream (Grams) 

Page 69


CLIOQUINOL-HYDROCORTISONE CLIOQUINOL/HYDROCORTISONE 1 Cream (Grams) 

PHISOHEX HEXACHLOROPHENE 3 Liquid (ml) 

ALCORTIN A HYDROCORTISONE/ALOE POL/IODOQU 3 Gel in Packet (gm) 

DERMAZENE HYDROCORTISONE/IODOQUINOL 1 Cream (Grams) 

HYDROCORTISONE W/IODOQUINOL HYDROCORTISONE/IODOQUINOL 1 Cream (Grams) 

VYTONE HYDROCORTISONE/IODOQUINOL 3 Cream (Grams) 

LUGOL'S IODINE/POTASSIUM IODIDE 1 Solution, Non-Oral 

FURACIN NITROFURAZONE 3 Cream (Grams) 

FURACIN NITROFURAZONE 3 Ointment (gm) 

SILVER NITRATE SILVER NITRATE 3 Ointment (gm) 

SILVER NITRATE SILVER NITRATE 3 Solution, Non-Oral 

TOPICAL ANTIFUNGALS 

BENSAL HP BENZOIC ACID/SALICYLIC ACID 3 Ointment (gm) 

MENTAX BUTENAFINE HCL 3 Cream (Grams) 

CICLOPIROX CICLOPIROX 1 Gel (gm) 

LOPROX CICLOPIROX 3 Gel (gm) 

LOPROX CICLOPIROX 2 Shampoo 

CICLOPIROX CICLOPIROX 1 Solution, Non-Oral 

PENLAC CICLOPIROX 3 Solution, Non-Oral 

CICLOPIROX CICLOPIROX OLAMINE 1 Cream (Grams) 

LOPROX CICLOPIROX OLAMINE 3 Cream (Grams) 

CICLOPIROX CICLOPIROX OLAMINE 1 Suspension, Topical (ml) 

LOPROX CICLOPIROX OLAMINE 3 Suspension, Topical (ml) 

CLOTRIMAZOLE CLOTRIMAZOLE 1 Cream (Grams) 

CLOTRIMAZOLE CLOTRIMAZOLE 1 Solution, Non-Oral 

CLOTRIMAZOLE-BETAMETHASONE CLOTRIMAZOLE/BETAMET DIPROP 1 Cream (Grams) 

LOTRISONE CLOTRIMAZOLE/BETAMET DIPROP 3 Cream (Grams) 

CLOTRIMAZOLE-BETAMETHASONE CLOTRIMAZOLE/BETAMET DIPROP 1 Lotion (ml) 

LOTRISONE CLOTRIMAZOLE/BETAMET DIPROP 2 Lotion (ml) 

ECONAZOLE NITRATE ECONAZOLE NITRATE 1 Cream (Grams) 

TRIPLE DYE GENT VIOLET/BRLNT GRN/PROFLAV 3 Swab, Medicated 

HALOTIN HALOPROGIN 3 Cream (Grams) 

KETOCONAZOLE KETOCONAZOLE 1 Cream (Grams) 

KURIC KETOCONAZOLE 1 Cream (Grams) 

EXTINA KETOCONAZOLE 3 Foam (gm) 

XOLEGEL KETOCONAZOLE 3 Gel (gm) 

KETOCONAZOLE KETOCONAZOLE 1 Shampoo 

NIZORAL KETOCONAZOLE 3 Shampoo 

XOLEGEL DUO KETOCONAZOLE/PYRITHIONE ZINC 3 Kit 

VUSION MICONAZOLE NITRATE/ZINC OXIDE 3 Ointment (gm) 

NAFTIN NAFTIFINE HCL 3 Cream (Grams) 

NAFTIN NAFTIFINE HCL 3 Gel (gm) 

NYSTATIN NYSTATIN 1 Cream (Grams) 

NYSTATIN NYSTATIN 1 Ointment (gm) 

MYCOSTATIN NYSTATIN 3 Powder (gm) 

NYAMYC NYSTATIN 1 Powder (gm) 


NYSTOP NYSTATIN 1 Powder (gm) 

PEDI-DRI NYSTATIN 1 Powder (gm) 

MYCONEL NYSTATIN/TRIAMCIN 1 Cream (Grams) 

NYSTATIN-TRIAMCINOLONE NYSTATIN/TRIAMCIN 1 Cream (Grams) 

NYSTATIN W/TRIAMCINOLONE NYSTATIN/TRIAMCIN 1 Ointment (gm) 

NYSTATIN-TRIAMCINOLONE NYSTATIN/TRIAMCIN 1 Ointment (gm) 

OXISTAT OXICONAZOLE NITRATE 3 Cream (Grams) 

OXISTAT OXICONAZOLE NITRATE 3 Lotion (ml) 

ERTACZO SERTACONAZOLE NITRATE 3 Cream (Grams) 

EXODERM SODIUM THIOSULFATE/SAL ACID 3 Lotion (ml) 

VERSICLEAR SODIUM THIOSULFATE/SAL ACID 3 Lotion (ml) 

EXELDERM SULCONAZOLE NITRATE 3 Cream (Grams) 

EXELDERM SULCONAZOLE NITRATE 3 Solution, Non-Oral 

LAMISIL TERBINAFINE HCL 3 Spray, Non-Aerosol (ml) 

TOPICAL LOCAL ANESTHETICS 

AMERICAINE BENZOCAINE 1 Aerosol (ml) 

AMERICAINE BENZOCAINE 3 Lubricant 

ANACAINE BENZOCAINE 3 Ointment (gm) 

COCAINE HCL COCAINE HCL 3 Solution, Non-Oral 

ETHYL CHLORIDE ETHYL CHLORIDE 1 Aerosol, Spray (ml) 

ETHYL CHLORIDE ETHYL CHLORIDE 3 Aerosol, Spray (ml) 

Page 70


LIDAMANTLE HC HC ACETATE/LIDOCAINE HCL 3 Cream (Grams) 

LIDOCAINE-HC HC ACETATE/LIDOCAINE HCL 1 Cream (Grams) 

LIDOCAINE-HYDROCORTISONE HC ACETATE/LIDOCAINE HCL 1 Cream (Grams) 

LIDAMANTLE HC HC ACETATE/LIDOCAINE HCL 3 Lotion (ml) 

LIDOCAINE-HYDROCORTISONE HC ACETATE/LIDOCAINE HCL 1 Lotion (ml) 

NOVACORT HC ACETATE/PRAMOX HCL/ALOE PS 3 Gel (gm) 

PRAMOSONE HC ACETATE/PRAMOXINE HCL 3 Cream (Grams) 

EPIFOAM HC ACETATE/PRAMOXINE HCL 3 Foam (gm) 

PRAMOSONE HC ACETATE/PRAMOXINE HCL 3 Lotion (ml) 

PRAMOSONE HC ACETATE/PRAMOXINE HCL 3 Ointment (gm) 

LIDODERM LIDOCAINE 3 Adhesive Patch, Medicated 

LIDAMANTLE LIDOCAINE HCL 3 Cream (Grams) 

LIDOCAINE HCL LIDOCAINE HCL 1 Cream (Grams) 

LIDAMANTLE LIDOCAINE HCL 3 Lotion (ml) 

LIDOCAINE HCL LIDOCAINE HCL 1 Lotion (ml) 

SENATEC LIDOCAINE HCL 1 Lotion (ml) 

LIDOCAINE HCL LIDOCAINE HCL 1 Ointment (gm) 

PRE-ATTACHED LTA Kit LIDOCAINE HCL 3 Solution, Oral 

LIDOSITE LIDOCAINE HCL/EPINEPHRINE 3 Patch, Ionrophoretic 

XYRALID LIDOCAINE HCL/HC ACETATE/CLNS6 3 Kit 

XYRALID LP LIDOCAINE HCL/HC ACETATE/CLNS6 3 Kit 

EMLA LIDOCAINE/PRILOCAINE 3 Cream (Grams) 

LIDOCAINE-PRILOCAINE LIDOCAINE/PRILOCAINE 1 Cream (Grams) 

EMLA LIDOCAINE/PRILOCAINE 3 Kit 

SYNERA LIDOCAINE/TETRACAINE 3 Adhesive Patch, Medicated Self-Heating 

PONTOCAINE TETRACAINE HCL 3 Solution, Non-Oral 

CETACAINE TETRACAINE/BENZOCAINE/BUTAMBEN 3 Aerosol, Spray (gm) 

EXACTACAIN TETRACAINE/BENZOCAINE/BUTAMBEN 1 Aerosol, Spray (gm) 

CETACAINE TETRACAINE/BENZOCAINE/BUTAMBEN 3 Gel (gm) 

CETACAINE TETRACAINE/BENZOCAINE/BUTAMBEN 3 Kit 

CETACAINE MEDICAL Kit E TETRACAINE/BENZOCAINE/BUTAMBEN 3 Kit 

CETACAINE TETRACAINE/BENZOCAINE/BUTAMBEN 3 Liquid (ml) 

CETACAINE TETRACAINE/BENZOCAINE/BUTAMBEN 3 Ointment (gm) 

REGENECARE VIT E/LIDOCAIN/ALO VER/COLAGN 3 Gel (gm) 

TOPICAL ANTI-INFLAMMATORY STEROIDAL 

ACLOVATE ALCLOMETASONE DIPROPIONATE 2 Cream (Grams) 

ALCLOMETASONE DIPROPIONATE ALCLOMETASONE DIPROPIONATE 1 Cream (Grams) 

ACLOVATE ALCLOMETASONE DIPROPIONATE 2 Ointment (gm) 

ALCLOMETASONE DIPROPIONATE ALCLOMETASONE DIPROPIONATE 1 Ointment (gm) 

AMCINONIDE AMCINONIDE 1 Cream (Grams) 

AMCINONIDE AMCINONIDE 1 Lotion (ml) 

AMCINONIDE AMCINONIDE 1 Ointment (gm) 

BETAMETHASONE DIPROPIONATE BETAMET DIPROP/PROP GLY 1 Cream (Grams) 

DIPROLENE AF BETAMET DIPROP/PROP GLY 3 Cream (Grams) 

BETAMETHASONE DIPROPIONATE BETAMET DIPROP/PROP GLY 1 Lotion (ml) 

DIPROLENE BETAMET DIPROP/PROP GLY 3 Lotion (ml) 

BETAMETHASONE DIPROPIONATE BETAMET DIPROP/PROP GLY 1 Ointment (gm) 

BETAMETHASONE DP AUGMENTED BETAMET DIPROP/PROP GLY 1 Ointment (gm) 

DIPROLENE BETAMET DIPROP/PROP GLY 3 Ointment (gm) 

BETAMETHASONE DIPROPIONATE BETAMETHASONE DIPROPIONATE 1 Cream (Grams) 

BETANATE BETAMETHASONE DIPROPIONATE 1 Cream (Grams) 

DEL-BETA BETAMETHASONE DIPROPIONATE 1 Cream (Grams) 

DIPROSONE BETAMETHASONE DIPROPIONATE 3 Cream (Grams) 

BETAMETHASONE DIPROPIONATE BETAMETHASONE DIPROPIONATE 1 Gel (gm) 

BETAMETHASONE DIPROPIONATE BETAMETHASONE DIPROPIONATE 1 Lotion (ml) 

DEL-BETA BETAMETHASONE DIPROPIONATE 1 Lotion (ml) 

BETAMETHASONE DIPROPIONATE BETAMETHASONE DIPROPIONATE 1 Ointment (gm) 

BETAMETHASONE VALERATE BETAMETHASONE VALERATE 1 Cream (Grams) 

BETA-VAL BETAMETHASONE VALERATE 1 Cream (Grams) 

LUXIQ BETAMETHASONE VALERATE 2 Foam (gm) 

BETAMETHASONE VALERATE BETAMETHASONE VALERATE 1 Lotion (ml) 

BETA-VAL BETAMETHASONE VALERATE 1 Lotion (ml) 

BETAMETHASONE VALERATE BETAMETHASONE VALERATE 1 Ointment (gm) 

CLOBETASOL PROPIONATE CLOBETASOL PROPIONATE 1 Cream (Grams) 

CORMAX CLOBETASOL PROPIONATE 2 Cream (Grams) 

TEMOVATE CLOBETASOL PROPIONATE 3 Cream (Grams) 

OLUX CLOBETASOL PROPIONATE 2 Foam (gm) 

CLOBETASOL PROPIONATE CLOBETASOL PROPIONATE 1 Gel (gm) 

Page 71


TEMOVATE CLOBETASOL PROPIONATE 3 Gel (gm) 

CLOBEX CLOBETASOL PROPIONATE 2 Lotion (ml) 

CLOBETASOL PROPIONATE CLOBETASOL PROPIONATE 1 Ointment (gm) 

CORMAX CLOBETASOL PROPIONATE 2 Ointment (gm) 

TEMOVATE CLOBETASOL PROPIONATE 3 Ointment (gm) 

CLOBEX CLOBETASOL PROPIONATE 2 Shampoo 

CLOBETASOL PROPIONATE CLOBETASOL PROPIONATE 1 Solution, Non-Oral 

CORMAX CLOBETASOL PROPIONATE 1 Solution, Non-Oral 

TEMOVATE CLOBETASOL PROPIONATE 3 Solution, Non-Oral 

CLOBEX CLOBETASOL PROPIONATE 2 Spray, Non-Aerosol (ml) 

CLOBETASOL E CLOBETASOL PROPIONATE/EMOLL 1 Cream (Grams) 

CLOBETASOL PROPIONATE CLOBETASOL PROPIONATE/EMOLL 1 Cream (Grams) 

TEMOVATE EMOLLIENT CLOBETASOL PROPIONATE/EMOLL 3 Cream (Grams) 

OLUX-E CLOBETASOL PROPIONATE/EMOLL 3 Foam (gm) 

CLODERM CLOCORTOLONE PIVALATE 3 Cream (Grams) 

DESONIDE DESONIDE 1 Cream (Grams) 

DESOWEN DESONIDE 3 Cream (Grams) 

TRIDESILON DESONIDE 1 Cream (Grams) 

TRIDESILON DESONIDE 3 Cream (Grams) 

VERDESO DESONIDE 3 Foam (gm) 

DESONATE DESONIDE 3 Gel (gm) 

DESONIDE DESONIDE 1 Lotion (ml) 

DESOWEN DESONIDE 3 Lotion (ml) 

LOKARA DESONIDE 1 Lotion (ml) 

DESONIDE DESONIDE 1 Ointment (gm) 

DESOWEN DESONIDE 3 Ointment (gm) 

TRIDESILON DESONIDE 1 Ointment (gm) 

DESOXIMETASONE DESOXIMETASONE 1 Cream (Grams) 

TOPICORT DESOXIMETASONE 3 Cream (Grams) 

TOPICORT LP DESOXIMETASONE 3 Cream (Grams) 

DESOXIMETASONE DESOXIMETASONE 1 Gel (gm) 

TOPICORT DESOXIMETASONE 3 Gel (gm) 

DESOXIMETASONE DESOXIMETASONE 1 Ointment (gm) 

TOPICORT DESOXIMETASONE 3 Ointment (gm) 

DIFLORASONE DIACETATE DIFLORASONE DIACETATE 1 Cream (Grams) 

APEXICON DIFLORASONE DIACETATE 1 Ointment (gm) 

DIFLORASONE DIACETATE DIFLORASONE DIACETATE 1 Ointment (gm) 

APEXICON E DIFLORASONE DIACETATE/EMOLL 1 Cream (Grams) 

PSORCON E DIFLORASONE DIACETATE/EMOLL 3 Cream (Grams) 

FLUOCINOLONE ACETONIDE FLUOCINOLONE ACETONIDE 1 Cream (Grams) 

DERMA-SMOOTHE/FS FLUOCINOLONE ACETONIDE 2 Oil 

FLUOCINOLONE ACETONIDE FLUOCINOLONE ACETONIDE 1 Ointment (gm) 

CAPEX Shampoo FLUOCINOLONE ACETONIDE 3 Shampoo 

FLUOCINOLONE ACETONIDE FLUOCINOLONE ACETONIDE 1 Solution, Non-Oral 

DERMA-SMOOTHE/FS FLUOCINOLONE/SHOWER CAP 2 Oil 

FLUOCINONIDE FLUOCINONIDE 1 Cream (Grams) 

VANOS FLUOCINONIDE 3 Cream (Grams) 

FLUOCINONIDE FLUOCINONIDE 1 Gel (gm) 

FLUOCINONIDE FLUOCINONIDE 1 Ointment (gm) 

FLUOCINONIDE FLUOCINONIDE 1 Solution, Non-Oral 

FLUOCINONIDE EMOLLIENT FLUOCINONIDE/EMOLLIENT 1 Cream (Grams) 

FLUOCINONIDE-E FLUOCINONIDE/EMOLLIENT 1 Cream (Grams) 

CORDRAN SP FLURANDRENOLIDE 3 Cream (Grams) 

CORDRAN FLURANDRENOLIDE 3 Lotion (ml) 

CORDRAN FLURANDRENOLIDE 3 Ointment (gm) 

CORDRAN FLURANDRENOLIDE 3 Tape, Medicated 

CUTIVATE FLUTICASONE PROPIONATE 3 Cream (Grams) 

FLUTICASONE PROPIONATE FLUTICASONE PROPIONATE 1 Cream (Grams) 

CUTIVATE FLUTICASONE PROPIONATE 3 Lotion (ml) 

CUTIVATE FLUTICASONE PROPIONATE 3 Ointment (gm) 

FLUTICASONE PROPIONATE FLUTICASONE PROPIONATE 1 Ointment (gm) 

HALOG HALCINONIDE 3 Cream (Grams) 

HALOG HALCINONIDE 3 Ointment (gm) 

HALOG HALCINONIDE 3 Solution, Non-Oral 

HALOBETASOL PROPIONATE HALOBETASOL PROPIONATE 1 Cream (Grams) 

ULTRAVATE HALOBETASOL PROPIONATE 2 Cream (Grams) 

HALOBETASOL PROPIONATE HALOBETASOL PROPIONATE 1 Ointment (gm) 

ULTRAVATE HALOBETASOL PROPIONATE 2 Ointment (gm) 

Page 72


HYDROCORTISONE HC/MINERAL OIL/PETROLAT,WHT 3 Ointment (gm) 

ALA-CORT HYDROCORTISONE 3 Cream (Grams) 

HYDROCORTISONE HYDROCORTISONE 1 Cream (Grams) 

HYTONE HYDROCORTISONE 3 Cream (Grams) 

FIRST-HYDROCORTISONE HYDROCORTISONE 3 Gel (gm) 

ALA-SCALP HP HYDROCORTISONE 3 Lotion (ml) 

HYDROCORTISONE HYDROCORTISONE 1 Lotion (ml) 

LACTICARE-HC HYDROCORTISONE 3 Lotion (ml) 

REDERM HYDROCORTISONE 1 Lotion (ml) 

HYCORT HYDROCORTISONE 1 Ointment (gm) 

HYDROCORTISONE HYDROCORTISONE 1 Ointment (gm) 

TEXACORT HYDROCORTISONE 3 Solution, Non-Oral 

HYDROCORTISONE ACETATE HYDROCORTISONE ACETATE/ALO VER 1 Gel (gm) 

NUZON HYDROCORTISONE ACETATE/ALO VER 3 Gel (gm) 

CARMOL HC HYDROCORTISONE ACETATE/UREA 3 Cream (Grams) 

KERATOL HC HYDROCORTISONE ACETATE/UREA 1 Cream (Grams) 

U-CORT HYDROCORTISONE ACETATE/UREA 1 Cream (Grams) 

HYDROCORTISONE BUTYRATE HYDROCORTISONE BUTYRATE 1 Cream (Grams) 

LOCOID HYDROCORTISONE BUTYRATE 1 Cream (Grams) 

HYDROCORTISONE BUTYRATE HYDROCORTISONE BUTYRATE 1 Ointment (gm) 

LOCOID HYDROCORTISONE BUTYRATE 1 Ointment (gm) 

HYDROCORTISONE BUTYRATE HYDROCORTISONE BUTYRATE 1 Solution, Non-Oral 

LOCOID HYDROCORTISONE BUTYRATE 1 Solution, Non-Oral 

LOCOID HYDROCORTISONE BUTYRATE/EMOLL 2 Cream (Grams) 

LOCOID LIPOCREAM HYDROCORTISONE BUTYRATE/EMOLL 2 Cream (Grams) 

PANDEL HYDROCORTISONE PROBUTATE 2 Cream (Grams) 

HYDROCORTISONE VALERATE HYDROCORTISONE VALERATE 1 Cream (Grams) 

WESTCORT HYDROCORTISONE VALERATE 3 Cream (Grams) 

HYDROCORTISONE VALERATE HYDROCORTISONE VALERATE 1 Ointment (gm) 

WESTCORT HYDROCORTISONE VALERATE 3 Ointment (gm) 

VANOXIDE-HC HYDROCORTISONE/BENZ PER 3 Lotion (ml) 

CORAZ HYDROCORTISONE/SAL ACID/SULFUR 3 Combination Package (ml) 

ELOCON MOMETASONE FUROATE 3 Cream (Grams) 

MOMETASONE FUROATE MOMETASONE FUROATE 1 Cream (Grams) 

ELOCON MOMETASONE FUROATE 3 Ointment (gm) 

MOMETASONE FUROATE MOMETASONE FUROATE 1 Ointment (gm) 

ELOCON MOMETASONE FUROATE 3 Solution, Non-Oral 

MOMETASONE FUROATE MOMETASONE FUROATE 1 Solution, Non-Oral 

DERMATOP PREDNICARBATE 3 Cream (Grams) 

PREDNICARBATE PREDNICARBATE 1 Cream (Grams) 

DERMATOP PREDNICARBATE 3 Ointment (gm) 

PREDNICARBATE PREDNICARBATE 1 Ointment (gm) 

AQUAPHILIC W/TRIAMCINOLONE TRIAMCIN/HYDROPHILIC OINTMENT 3 Ointment (gm) 

ZYTOPIC TRIAMCIN/SKIN CLNSR 6/EMOLL 27 3 Kit 

AQUAPHILIC W/TAC + CARBAMIDE TRIAMCIN/UREA/HYDRO OINT 3 Ointment (gm) 

KENALOG TRIAMCINOLONE ACETONIDE 3 Aerosol (gm) 

KENALOG TRIAMCINOLONE ACETONIDE 3 Cream (Grams) 

TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE 1 Cream (Grams) 

TRIDERM TRIAMCINOLONE ACETONIDE 1 Cream (Grams) 

KENALOG TRIAMCINOLONE ACETONIDE 3 Lotion (ml) 

TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE 1 Lotion (ml) 

KENALOG TRIAMCINOLONE ACETONIDE 3 Ointment (gm) 

TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE 1 Ointment (gm) 

TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE 2 Ointment (gm) 

TRIDERM TRIAMCINOLONE ACETONIDE 1 Ointment (gm) 

TOPICAL ANTIPARASITICS 

EURAX CROTAMITON 3 Cream (Grams) 

EURAX CROTAMITON 3 Lotion (ml) 

LINDANE LINDANE 3 Lotion (ml) 

LINDANE LINDANE 3 Shampoo 

OVIDE MALATHION 3 Lotion (ml) 

ACTICIN PERMETHRIN 1 Cream (Grams) 

ELIMITE PERMETHRIN 3 Cream (Grams) 

PERMETHRIN PERMETHRIN 1 Cream (Grams) 

TOPICAL SULFONAMIDES 

SULFAMYLON MAFENIDE ACETATE 3 Cream (Grams) 

SULFAMYLON MAFENIDE ACETATE 3 Packet 

PRASCION RA NA SULFACETM/AVOBENZONE/SULFUR 1 Cream (Grams) 

Page 73


ROSAC NA SULFACETM/AVOBENZONE/SULFUR 3 Cream (Grams) 

SILVADENE SILVER SULFADIAZINE 3 Cream (Grams) 

SILVER SULFADIAZINE SILVER SULFADIAZINE 1 Cream (Grams) 

SSD SILVER SULFADIAZINE 1 Cream (Grams) 

SSD AF SILVER SULFADIAZINE 1 Cream (Grams) 

THERMAZENE SILVER SULFADIAZINE 1 Cream (Grams) 

ROSULA CLK SULFACET SOD/SULF/UREA/MERA/TI 3 Kit 

ROSULA SULFACETAMIDE SOD/SULFUR/UREA 1 Cleanser (ml) 

SOD SULFACETAMIDE-SULFUR WASH SULFACETAMIDE SOD/SULFUR/UREA 1 Cleanser (ml) 

SULFATOL SULFACETAMIDE SOD/SULFUR/UREA 1 Cleanser (ml) 

ROSULA SULFACETAMIDE SOD/SULFUR/UREA 1 Gel (ml) 

SULFATOL SULFACETAMIDE SOD/SULFUR/UREA 1 Gel (ml) 

AVAR SULFACETAMIDE SODIUM/SULFUR 1 Cleanser (gm) 

CLENIA SULFACETAMIDE SODIUM/SULFUR 1 Cleanser (gm) 

PLEXION SULFACETAMIDE SODIUM/SULFUR 3 Cleanser (gm) 

PRASCION SULFACETAMIDE SODIUM/SULFUR 1 Cleanser (gm) 

PRASCION AV SULFACETAMIDE SODIUM/SULFUR 1 Cleanser (gm) 

ROSAC SULFACETAMIDE SODIUM/SULFUR 3 Cleanser (gm) 

ROSADERM SULFACETAMIDE SODIUM/SULFUR 1 Cleanser (gm) 

ROSANIL SULFACETAMIDE SODIUM/SULFUR 3 Cleanser (gm) 

SODIUM SULFACETAMIDE-SULFUR SULFACETAMIDE SODIUM/SULFUR 1 Cleanser (gm) 

ZETACET SULFACETAMIDE SODIUM/SULFUR 1 Cleanser (gm) 

AVAR-E SULFACETAMIDE SODIUM/SULFUR 1 Cream (Grams) 

AVAR-E SULFACETAMIDE SODIUM/SULFUR 3 Cream (Grams) 

CLENIA SULFACETAMIDE SODIUM/SULFUR 1 Cream (Grams) 

PLEXION SCT SULFACETAMIDE SODIUM/SULFUR 1 Cream (Grams) 

SUPHERA SULFACETAMIDE SODIUM/SULFUR 1 Cream (Grams) 

CLARIFOAM EF SULFACETAMIDE SODIUM/SULFUR 3 Foam (gm) 

AVAR SULFACETAMIDE SODIUM/SULFUR 1 Gel (gm) 

AVAR SULFACETAMIDE SODIUM/SULFUR 3 Gel (gm) 

SODIUM SULFACETAMIDE-SULFUR SULFACETAMIDE SODIUM/SULFUR 1 Lotion (gm) 

SULFACET-R SULFACETAMIDE SODIUM/SULFUR 1 Lotion (gm) 

SULFATOL-M SULFACETAMIDE SODIUM/SULFUR 1 Lotion (gm) 

PLEXION SULFACETAMIDE SODIUM/SULFUR 3 Pads, Medicated (EA) 

PRASCION FC SULFACETAMIDE SODIUM/SULFUR 1 Pads, Medicated (EA) 

SODIUM SULFACETAMIDE-SULFUR SULFACETAMIDE SODIUM/SULFUR 1 Pads, Medicated (EA) 

PRASCION TS SULFACETAMIDE SODIUM/SULFUR 1 Suspension, Topical (gm) 

SODIUM SULFACETAMIDE-SULFUR SULFACETAMIDE SODIUM/SULFUR 1 Suspension, Topical (gm) 

ZETACET SULFACETAMIDE SODIUM/SULFUR 1 Suspension, Topical (gm) 

TOPICAL ANTIVIRALS 

ZOVIRAX ACYCLOVIR 3 Cream (Grams) 

ZOVIRAX ACYCLOVIR 3 Ointment (gm) 

DENAVIR PENCICLOVIR 3 Cream (Grams) 

TOPICAL ANTIBIOTICS 

EVOCLIN CLINDAMYCIN PHOSPHATE 3 Foam (gm) 

CLEOCIN T CLINDAMYCIN PHOSPHATE 3 Gel (gm) 

CLINDAMAX CLINDAMYCIN PHOSPHATE 1 Gel (gm) 

CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE 1 Gel (gm) 

CLINDAGEL CLINDAMYCIN PHOSPHATE 3 Gel (ml) 

CLINDAREACH CLINDAMYCIN PHOSPHATE 3 Kit 

CLEOCIN T CLINDAMYCIN PHOSPHATE 3 Lotion (ml) 

CLINDAMAX CLINDAMYCIN PHOSPHATE 1 Lotion (ml) 

CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE 1 Lotion (ml) 

CLEOCIN T CLINDAMYCIN PHOSPHATE 3 Solution, Non-Oral 

CLINDA-DERM CLINDAMYCIN PHOSPHATE 1 Solution, Non-Oral 

CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE 1 Solution, Non-Oral 

CLEOCIN T CLINDAMYCIN PHOSPHATE 3 Swab, Medicated 

CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE 1 Swab, Medicated 

CLINDETS CLINDAMYCIN PHOSPHATE 3 Swab, Medicated 

AKNE-MYCIN ERYTHROMYCIN BASE 2 Ointment (gm) 

DEL-MYCIN ERYTHROMYCIN BASE 2 Solution, Non-Oral 

BENZAMYCINPAK ERYTHROMYCIN BASE/BENZ PER 3 Gel (EA) 

BENZAMYCIN ERYTHROMYCIN BASE/BENZ PER 3 Gel (gm) 

ERYTHROMYCIN-BENZOYL PEROXIDE ERYTHROMYCIN BASE/BENZ PER 1 Gel (gm) 

A/T/S ERYTHROMYCIN BASE/ETHANOL 1 Gel (gm) 

EMGEL ERYTHROMYCIN BASE/ETHANOL 3 Gel (gm) 

ERYGEL ERYTHROMYCIN BASE/ETHANOL 1 Gel (gm) 

ERYGEL ERYTHROMYCIN BASE/ETHANOL 3 Gel (gm) 

Page 74


ERYTHROMYCIN BASE ERYTHROMYCIN BASE/ETHANOL 1 Gel (gm) 

A/T/S ERYTHROMYCIN BASE/ETHANOL 3 Solution, Non-Oral 

ERYDERM ERYTHROMYCIN BASE/ETHANOL 1 Solution, Non-Oral 

ERYTHROMYCIN ERYTHROMYCIN BASE/ETHANOL 1 Solution, Non-Oral 

ERY ERYTHROMYCIN BASE/ETHANOL 1 Swab, Medicated 

GENTAMICIN SULFATE GENTAMICIN SULFATE 1 Cream (Grams) 

GENTAMICIN SULFATE GENTAMICIN SULFATE 1 Ointment (gm) 

BACTROBAN MUPIROCIN 3 Ointment (gm) 

MUPIROCIN MUPIROCIN 1 Ointment (gm) 

BACTROBAN MUPIROCIN CALCIUM 3 Cream (Grams) 

OXIDIZING AGENTS 

PERIMAX PERIO RINSE HYDROGEN PEROXIDE 1 Solution, Non-Oral 

IRRIGANTS 

ACETIC ACID ACETIC ACID 1 Solution, Irrigation 

HYSKON DEXTRAN 70/DEXTROSE 10%-WATER 3 Solution, Irrigation 

SORBITOL-MANNITOL MANNITOL/SORBITOL SOLUTION 3 Solution, Irrigation 

NEOMYCIN-POLYMYXIN B NEOMY SULF/POLYMYXIN B SULFATE 1 Ampul (ml) 

NEOSPORIN G.U. IRRIGANT NEOMY SULF/POLYMYXIN B SULFATE 3 Ampul (ml) 

NEOMYCIN-POLYMYXIN B NEOMY SULF/POLYMYXIN B SULFATE 1 Vial (SDV, MDV or Additive) (ml) 

NEOSPORIN G.U. IRRIGANT NEOMY SULF/POLYMYXIN B SULFATE 3 Vial (SDV, MDV or Additive) (ml) 

PHYSIOLYTE PHYSIOLOGICAL IRRIG SOL CMB #1 1 Solution, Irrigation 

PHYSIOSOL PHYSIOLOGICAL IRRIG SOL CMB #1 1 Solution, Irrigation 

PHYSIOSOL PHYSIOLOGICAL IRRIG SOL CMB #1 3 Solution, Irrigation 

RINGERS RINGERS SOLUTION 1 Solution, Irrigation 

RINGERS IRRIGATION RINGERS SOLUTION 1 Solution, Irrigation 

RINGERS IRRIGATION RINGERS SOLUTION 3 Solution, Irrigation 

TIS-U-SOL RINGERS SOLUTION 1 Solution, Irrigation 

LACTATED RINGERS RINGERS SOLUTION,LACTATED 1 Solution, Irrigation 

SODIUM CHLORIDE SOD CHLORIDE 0.45% IRRIG. SOLN 1 Solution, Irrigation 

SODIUM CHLORIDE SODIUM CHLORIDE IRRIG SOLUTION 1 Solution, Irrigation 

SODIUM CHLORIDE SODIUM CL 0.45PC IRRIG. SOLN 1 Solution, Irrigation 

SODIUM CHLORIDE SODIUM CL 0.45PC IRRIG. SOLN 3 Solution, Irrigation 

SODIUM CHLORIDE SODIUM CL IRRIG SOLN 1 Solution, Irrigation 

SODIUM CHLORIDE SODIUM CL IRRIG SOLN 3 Solution, Irrigation 

SORBITOL SORBITOL SOLUTION 3 Solution, Irrigation 

WATER WATER FOR IRRIGATION,STERILE 1 Solution, Irrigation 

WATER WATER FOR IRRIGATION,STERILE 3 Solution, Irrigation 

IMMUNOMODULATORS 

ALDARA IMIQUIMOD 2 Packet 

ANTIPERSPIRANTS 

DRYSOL ALUMINUM CHLORIDE 3 Solution, Non-Oral 

DRYSOL DAB-O-MATIC ALUMINUM CHLORIDE 3 Solution, Non-Oral 

HYPERCARE ALUMINUM CHLORIDE 1 Solution, Non-Oral 

XERAC AC ALUMINUM CHLORIDE 3 Solution, Non-Oral 

VITAMIN A DERIVATIVES 

DIFFERIN ADAPALENE 2 Cream (Grams) 

DIFFERIN ADAPALENE 2 Gel (gm) 

DIFFERIN ADAPALENE 2 Swab, Medicated 

AVITA TRETINOIN 1 Cream (Grams) 

RETIN-A TRETINOIN 3 Cream (Grams) 

TRETINOIN TRETINOIN 1 Cream (Grams) 

ATRALIN TRETINOIN 3 Gel (gm) 

AVITA TRETINOIN 1 Gel (gm) 

RETIN-A TRETINOIN 3 Gel (gm) 

TRETINOIN TRETINOIN 1 Gel (gm) 

RETIN-A MICRO TRETINOIN MICROSPHERES 3 Gel (gm) 

RETIN-A MICRO PUMP TRETINOIN MICROSPHERES 3 Gel (gm) 

TRETIN-X TRETINOIN/EMOL 9/SKIN CLN1/GEL 3 Combination Package (EA) 

TRETIN-X TRETINOIN/EMOL CMB9/SKIN CLN1 3 Combination Package (EA) 

TOPICAL ANTI-INFLAMMATORY, NSAIDS 

FLECTOR DICLOFENAC EPOLAMINE 3 Adhesive Patch, Medicated 

ANTISEBORRHEIC AGENTS 

TERSI FOAM SELENIUM SULFIDE 3 Foam (gm) 

SELENIUM SULFIDE SELENIUM SULFIDE 1 Shampoo 

SELENOS SELENIUM SULFIDE 1 Shampoo 

SELSEB SELENIUM SULFIDE 3 Shampoo 

SELSUN RX SELENIUM SULFIDE 3 Shampoo 

Page 75


OVACE PLUS SULFACETAMIDE SODIUM 3 Cleanser (ml) 

SEB-PREV SULFACETAMIDE SODIUM 1 Cream (Grams) 

OVACE SULFACETAMIDE SODIUM 3 Foam (gm) 

SEB-PREV SULFACETAMIDE SODIUM 1 Gel (gm) 

MEXAR SULFACETAMIDE SODIUM 1 Liquid (ml) 

OVACE SULFACETAMIDE SODIUM 1 Liquid (ml) 

OVACE SULFACETAMIDE SODIUM 3 Liquid (ml) 

RE 10 SULFACETAMIDE SODIUM 1 Liquid (ml) 

SEB-PREV SULFACETAMIDE SODIUM 1 Liquid (ml) 

SEB-PREV SULFACETAMIDE SODIUM 3 Suspension, Topical (ml) 

CARMOL SCALP SULFACETAMIDE SODIUM/UREA 3 Kit 

SCALP TREATMENT SULFACETAMIDE SODIUM/UREA 1 Kit 

CARMOL SULFACETAMIDE SODIUM/UREA 3 Lotion (gm) 

SULFACETAMIDE SODIUM SULFACETAMIDE SODIUM/UREA 1 Lotion (gm) 

ROSULA NS SULFACETAMIDE SODIUM/UREA 3 Pads, Medicated (EA) 

SODIUM SULFACETAMIDE SULFACETAMIDE SODIUM/UREA 1 Pads, Medicated (EA) 

ANTIPSORIATICS AGENTS 

DRITHOCREME HP ANTHRALIN 1 Cream (Grams) 

PSORIATEC ANTHRALIN 3 Cream (Grams) 

DRITHO-SCALP ANTHRALIN 3 Cream with Applicator 

DOVONEX CALCIPOTRIENE 2 Cream (Grams) 

DOVONEX CALCIPOTRIENE 2 Solution, Non-Oral 

TAZORAC TAZAROTENE 2 Cream (Grams) 

TAZORAC TAZAROTENE 2 Gel (gm) 

ANTIPSORIATIC AGENTS, SYSTEMIC 

AMEVIVE ALEFACEPT 3 Vial (SDV, MDV or Additive) (EA) 

RAPTIVA EFALIZUMAB 3 Kit 

8-MOP METHOXSALEN 2 Capsule (Hard, Soft, etc.) 

OXSORALEN-ULTRA METHOXSALEN, RAPID 3 Capsule (Hard, Soft, etc.) 

ACNE AGENTS, TOPICAL 

AZELEX AZELAIC ACID 3 Cream (Grams) 

BENZACLIN CLINDAMYCIN PHOS/BENZOYL PEROX 3 Gel (gm) 

DUAC CLINDAMYCIN PHOS/BENZOYL PEROX 3 GEL, Sustained Release (gm) 

DUAC CS CLINDAMYCIN/BENZOYL PRX/SKN #5 3 Kit 

ZIANA CLINDAMYCIN/TRETINOIN 3 Gel (gm) 

KLARON SULFACETAMIDE SODIUM 3 Suspension, Topical (ml) 

SULFACETAMIDE SODIUM SULFACETAMIDE SODIUM 1 Suspension, Topical (ml) 

ACNE AGENTS, SYSTEMIC 

ACCUTANE ISOTRETINOIN 3 Capsule (Hard, Soft, etc.) 

AMNESTEEM ISOTRETINOIN 1 Capsule (Hard, Soft, etc.) 

CLARAVIS ISOTRETINOIN 1 Capsule (Hard, Soft, etc.) 

SOTRET ISOTRETINOIN 1 Capsule (Hard, Soft, etc.) 

TOPICAL HYPERPIGMENTATION AGENTS 

OXSORALEN METHOXSALEN 3 Lotion (ml) 

DIABETIC ULCER PREPARATIONS, TOPICAL 

REGRANEX BECAPLERMIN 2 Gel (gm) 

VITAMIN A DERIVATIVES, TOPICAL COSMETIC AGENTS 

AVAGE TAZAROTENE 3 Cream (Grams) 

RENOVA TRETINOIN/EMOLLIENT 3 Cream (Grams) 

TRETINOIN TRETINOIN/EMOLLIENT 1 Cream (Grams) 

HAIR GROWTH REDUCTION AGENTS 

VANIQA EFLORNITHINE HCL 3 Cream (Grams) 

ROSACEA AGENTS, TOPICAL 

FINACEA AZELAIC ACID 2 Gel (gm) 

METROCREAM METRONIDAZOLE 3 Cream (Grams) 

METRONIDAZOLE METRONIDAZOLE 1 Cream (Grams) 

NORITATE METRONIDAZOLE 3 Cream (Grams) 

METROGEL METRONIDAZOLE 2 Gel (gm) 

METRONIDAZOLE METRONIDAZOLE 1 Gel (gm) 

NYDAMAX METRONIDAZOLE 3 Gel (gm) 

METROLOTION METRONIDAZOLE 3 Lotion (ml) 

METRONIDAZOLE METRONIDAZOLE 1 Lotion (ml) 

METROGEL METRONIDAZOLE/SKIN CLEANSER 2 Combination Package (EA) 

TOPICAL PLEUROMUTILIN DERIVATIVES 

ALTABAX RETAPAMULIN 3 Ointment (gm) 

TOPICAL GENITAL WART-HPV TREATMENT AGENTS 

Page 76


VEREGEN SINECATECHINS 3 Ointment (gm) 

THYROID PREPARATIONS 

THYROID HORMONES 

LEVOTHROID LEVOTHYROXINE SODIUM 1 Tablet 

LEVOTHYROXINE SODIUM LEVOTHYROXINE SODIUM 1 Tablet 

LEVOXYL LEVOTHYROXINE SODIUM 1 Tablet 

L-THYROXINE LEVOTHYROXINE SODIUM 1 Tablet 

SYNTHROID LEVOTHYROXINE SODIUM 2 Tablet 

UNITHROID LEVOTHYROXINE SODIUM 1 Tablet 

CYTOMEL LIOTHYRONINE SODIUM 3 Tablet 

THYROLAR-1 LIOTRIX 3 Tablet 

THYROLAR-1/2 LIOTRIX 3 Tablet 

THYROLAR-1/4 LIOTRIX 3 Tablet 



ARMOUR THYROID THYROID 3 Tablet 

THYROID THYROID 1 Tablet 

NATURE-THROID THYROID,PORK 1 Tablet 

NATURE-THROID THYROID,PORK 3 Tablet 

WESTHROID THYROID,PORK 1 Tablet 

ANTITHYROID PREPARATIONS 

METHIMAZOLE METHIMAZOLE 1 Tablet 

METHIMAZOLE METHIMAZOLE 2 Tablet 

NORTHYX METHIMAZOLE 1 Tablet 

NORTHYX METHIMAZOLE 3 Tablet 

TAPAZOLE METHIMAZOLE 3 Tablet 

PROPYLTHIOURACIL PROPYLTHIOURACIL 1 Tablet 

BIOLOGICALS 

INFLUENZA VIRUS VACCINES 

FLUMIST INFLUENZA VACC,TRI 2007(LIVE) 3 Spray, Non-Aerosol (EA) 

ENTERIC VIRUS VACCINES 

ROTATEQ ROTAVIRUS VAC,LIVE PENTAV 3 Suspension, Oral (Final Dose Form) 

ANTISERA 

CYTOGAM CYTOMEGALOVIRUS IMMUNE GLOB 3 Vial (SDV, MDV or Additive) (ml) 

HYPERHEP B S/D HEPATITIS B IMMUNE GLOBULIN 3 Disposable Syringe (ml) 

OCTAGAM IMM GLOB,GAMM (IGG)/MALTOSE 1 Vial (SDV, MDV or Additive) (ml) 

OCTAGAM IMM GLOB,GAMM (IGG)/MALTOSE 3 Vial (SDV, MDV or Additive) (ml) 

CARIMUNE NF NANOFILTERED IMMU GLOBULIN,GAMMA (IGG) 3 Vial (SDV, MDV or Additive) (EA) 

GAMMAGARD S/D IMMU GLOBULIN,GAMMA (IGG) 1 Vial (SDV, MDV or Additive) (EA) 



IVEEGAM EN IMMU GLOBULIN,GAMMA (IGG) 1 Vial (SDV, MDV or Additive) (EA) 

POLYGAM S/D IMMU GLOBULIN,GAMMA (IGG) 1 Vial (SDV, MDV or Additive) (EA) 

POLYGAM S/D IMMU GLOBULIN,GAMMA (IGG) 3 Vial (SDV, MDV or Additive) (EA) 

FLEBOGAMMA IMMU GLOBULIN,GAMMA (IGG) 1 Vial (SDV, MDV or Additive) (ml) 

FLEBOGAMMA DIF IMMU GLOBULIN,GAMMA (IGG) 1 Vial (SDV, MDV or Additive) (ml) 

GAMASTAN S/D IMMU GLOBULIN,GAMMA (IGG) 3 Vial (SDV, MDV or Additive) (ml) 

GAMMAGARD LIQUID IMMU GLOBULIN,GAMMA (IGG) 1 Vial (SDV, MDV or Additive) (ml) 

PRIVIGEN IMMU GLOBULIN,GAMMA (IGG) 1 Vial (SDV, MDV or Additive) (ml) 

VIVAGLOBIN IMMU GLOBULIN,GAMMA (IGG) 3 Vial (SDV, MDV or Additive) (ml) 

GAMUNEX IMMUNE GLOB,GAM CAPRYLATE(IGG) 3 Vial (SDV, MDV or Additive) (ml) 

ATGAM LYMPHOCYTE IMMUNE GLOBULIN 3 Ampul (ml) 

GRAM (-) BACILLI (NON-ENTERIC) VACCINES 

VIVOTIF BERNA TYPHOID VACC,LIVE,ATTENUATED 3 Capsule,Delayed Release (Enteric Coated) 

PRE-NATAL VITAMINS 

PRENATAL VITAMIN PREPARATIONS 

PREMESIS RX CA CARBONATE/VIT B12/FA/VIT B6 3 Tablet, Multiphasic Release 24 Hr 

ED CYTE F FE FUMARATE/DOCUSATE SODIUM/FA 1 Tablet 

DUET STUARTNATAL IRON B-G SUC-P/PNV COMB.NO2/FA 3 Tablet 

ELITE-OB IRON,CARBONYL/FA/MULTIVITS-MIN 3 Tablet 

OB COMPLETE IRON,CARBONYL/FA/MULTIVITS-MIN 3 Tablet 

ICAR-C PLUS SR IRON,CARBONYL/VIT C/VIT B12/FA 3 Capsule, Multiphasic Release 

RE KAR C PLUS SR IRON,CARBONYL/VIT C/VIT B12/FA 1 Capsule, Multiphasic Release 

FE C IRON,CARBONYL/VIT C/VIT B12/FA 1 Tablet 

ICAR-C PLUS IRON,CARBONYL/VIT C/VIT B12/FA 3 Tablet 

OB COMPLETE DHA PN VIT.W-O CA #7, IRON,FA,DHA 3 Capsule (Hard, Soft, etc.) 

Page 77


PREFERA-OB PN VITS.W-O CA #8, IRON,FA 3 Tablet 

MARNATAL-F PLUS P-NAT VIT/FE P/DHA/EPA/OM-3/FA 3 Combination Package (EA) 

NATELLE PLUS PNV CMB#20/IRON BISGLY/FA/DHA 3 Combination Package (EA) 

CITRANATAL 90 DHA PNV COMB 22/IRON CB/FA/DSS/DHA 3 Combination Package (EA) 

MAXINATE PNV COMB.NO3/FE FM-FE GLU/FA 3 Tablet 

OPTINATE PNV COMB12/IRON CB/FA1/DSS/DHA 3 Combination Package (EA) 

PRENATE DHA PNV COMBO#14/FE/FA #1/DHA/DOSS 3 Capsule (Hard, Soft, etc.) 

CITRANATAL RX PNV NO.22/IRON CBN&GLUC/FA/DOS 3 Tablet 

CAL-NATE PNV NO.4/IRON CBN&GLUC/FA/DOSS 1 Tablet 

TANDEM DHA PNV NO10/IRON FUM&P/FA/OMEGA-3 3 Capsule (Hard, Soft, etc.) 

PRIMACARE ONE PNV W-CA NO9/IRON/OMEGA-3/FA 3 Capsule (Hard, Soft, etc.) 

NEEVO PNV WITH CA8/IRON/FA/LM-FOLATE 3 Tablet 

NATAFORT PNV WITHOUT CA NO.9/IRON/FA 3 Tablet 

VINATAL FORTE PNV WITHOUT CA NO.9/IRON/FA 1 Tablet 

CENOGEN ULTRA PNV W-O CA NO3/FE FUMARATE/FA 3 Capsule (Hard, Soft, etc.) 

NATACAPS PNV W-O CA NO3/FE FUMARATE/FA 1 Capsule (Hard, Soft, etc.) 

PRENATAL-H PNV W-O CA NO4/FE FUMARATE/FA 1 Capsule (Hard, Soft, etc.) 

PRENATAL-U PNV W-O CA NO5/FE FUMARATE/FA 1 Capsule (Hard, Soft, etc.) 

NATELLE C PNV W-O CA.1/FE BISGLY/FA 3 Tablet 

PRENATE ELITE PNV/FE,CARBO/DOSS/FA/LM-FOLATE 2 Tablet 

DUET STUARTNATAL PNV/IRON FUM&BIS-GLY/FA/ASP 3 Tablet, Chewable 

ICAR PRENATAL PNV/IRON,CARB/OM-3/FA/MIN AA 3 Combination Package (EA) 

DUET DHA EC STUARTNATAL PNV19/IRON BG HCL SUC-P/FA/OM3 3 Combination Package, Tablet & DR CAP 

DUET DHA STUARTNATAL PNV2/IRON BG HCL SUC-P/FA/OM-3 3 Combination Package (EA) 

CARENATAL DHA PNV2/IRON B-G SUC-P/FA/OMEGA-3 1 Combination Package (EA) 

CITRANATAL DHA PNV23/IRON CBN&GLUC/FA/DSS/DHA 3 Combination Package (EA) 

PRIMACARE PNV5/FE ASP GLY/DOSS/FA/FAT 4 3 Tablet and Capsule, Sequential 

PRECARE PREMIER PNV7/FE ASP GLY/DOCUSATE/FA 3 Tablet 

VITAFOL-OB+DHA PRENAT VIT COMB.10/IRON/FA/DHA 3 Combination Package (EA) 

ADVANCED NATALCARE PRENATAL VIT 15/IRON CB/FA/DSS 1 Tablet 

INATAL ADVANCE PRENATAL VIT 15/IRON CB/FA/DSS 1 Tablet 

MYNATAL ADVANCE PRENATAL VIT 15/IRON CB/FA/DSS 1 Tablet 

PRENATAL AD PRENATAL VIT 15/IRON CB/FA/DSS 1 Tablet 

NATALCARE PRENATAL VIT 16/IRON CB/FA/DSS 1 Tablet 

VINATE GT PRENATAL VIT 16/IRON CB/FA/DSS 1 Tablet 

ADVANCED-RF NATALCARE PRENATAL VIT 17/IRON CB/FA/DSS 1 Tablet 

INATAL ULTRA PRENATAL VIT 18/IRON CB/FA/DSS 1 Tablet 

ULTRA NATALCARE PRENATAL VIT 18/IRON CB/FA/DSS 1 Tablet 

VINATE ULTRA PRENATAL VIT 18/IRON CB/FA/DSS 1 Tablet 

VEROTIN-GR PRENATAL VIT COMB.10/IRON/FA 1 Tablet 

VITAFOL-OB PRENATAL VIT COMB.10/IRON/FA 3 Tablet 

VEROTIN-BY PRENATAL VIT COMBO.11/IRON/FA 1 Tablet 

VITAFOL-PN PRENATAL VIT COMBO.11/IRON/FA 3 Tablet 

PRENATAL 19 PRENATAL VIT/FE FUM/DOSS/FA 1 Tablet 

AMINATE W/90MG IRON PRENATAL VIT/FE FUM/DOSS/FA 1 Tablet, Sustained Action 

MYNATE 90 PLUS PRENATAL VIT/FE FUM/DOSS/FA 1 Tablet, Sustained Action 

PRENATAL MR 90 FE PRENATAL VIT/FE FUM/DOSS/FA 1 Tablet, Sustained Action 

MYNATAL PRENATAL VIT/FE FUMARATE/FA 2 Capsule (Hard, Soft, etc.) 

CO-NATAL FA PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

LACTOCAL-F PRENATAL VIT/FE FUMARATE/FA 2 Tablet 

MYNATAL PLUS PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

MYNATAL-Z PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

NATALCARE PIC PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

NATALCARE PLUS PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

NATALCARE RX PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

NATALCARE THREE PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

NATALVIT PRENATAL VIT/FE FUMARATE/FA 2 Tablet 

NATATAB FA PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

NOVASTART PRENATAL VIT/FE FUMARATE/FA 2 Tablet 

O-CAL FA PRENATAL VIT/FE FUMARATE/FA 2 Tablet 

O-CAL PRENATAL PRENATAL VIT/FE FUMARATE/FA 2 Tablet 

PRENAFIRST PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATABS FA PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATAL 1/1 PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATAL FORMULA PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATAL LOW IRON PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATAL PLUS PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATAL RX PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

Page 78


PRENATAL RX 1 PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATAL Z PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

TRICARE PRENATAL VIT/FE FUMARATE/FA 2 Tablet 

TRINATE PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

VYNATAL-FA PRENATAL VIT/FE FUMARATE/FA 1 Tablet 

PRENATAL 19 PRENATAL VIT/FE FUMARATE/FA 1 Tablet, Chewable 

STRONGSTART PRENATAL VIT/FE FUMARATE/FA 3 Tablet, Chewable 

MATERNITY PRENATAL VIT/FE FUMARATE/FA/SE 1 Tablet 

PRENATAL MTR PRENATAL VIT/FE FUMARATE/FA/SE 1 Tablet 

VINATE-M PRENATAL VIT/FE FUMARATE/FA/SE 1 Tablet 

NATALCARE PIC FORTE PRENATAL VIT/FE PS CMPLX/FA 1 Tablet 

POLY IRON PN PRENATAL VIT/FE PS CMPLX/FA 1 Tablet 

POLY IRON PN FORTE PRENATAL VIT/FE PS CMPLX/FA 1 Tablet 

INATAL GT PRENATAL VIT/IRON,CARB/DOSS/FA 1 Tablet 

MYNATAL PRENATAL VIT/IRON,CARB/DOSS/FA 1 Tablet 

OBSTETRIX-100 PRENATAL VIT/IRON,CARB/DOSS/FA 3 Tablet 

ATABEX PRENATAL VIT/IRON,CARBONYL/FA 3 Tablet 

NATATAB PRENATAL VIT/IRON,CARBONYL/FA 1 Tablet 

NATATAB CFE PRENATAL VIT/IRON,CARBONYL/FA 1 Tablet 

PRENATABS RX PRENATAL VIT/IRON,CARBONYL/FA 1 Tablet 

NATELLE PRENATAL VITAMINS/FE BISGLY/FA 3 Tablet 

NATELLE-EZ PRENATAL VITAMINS/FE BISGLY/FA 3 Tablet 

VINATE AZ PRENATAL VITAMINS/FE BISGLY/FA 1 Tablet 

VINATE II PRENATAL VITAMINS/FE BISGLY/FA 1 Tablet 

NUTRACARE PRENATAL VITAMINS/IRON/FA 3 Tablet, Chewable 

RE DUALVIT OB PRENATAL VITS CMB W-O CA NO.2 1 Capsule (Hard, Soft, etc.) 

TANDEM OB PRENATAL VITS CMB W-O CA NO.2 3 Capsule (Hard, Soft, etc.) 

PERRY PRENATAL Tablet PRENATAL VITS W-CA,FE,FA(


FOLPLEX 2.2 CYANOCOBALAMIN/FA/PYRIDOXINE 1 Tablet 

FOLTX CYANOCOBALAMIN/FA/PYRIDOXINE 3 Tablet 

NUFOL CYANOCOBALAMIN/FA/PYRIDOXINE 1 Tablet 

MYO VYT CYANOCOBALAMIN/FA/PYRIDOXINE 3 Tablet, Sustained Release 24 Hr 

FOLMOR FA/PYRIDOX HCL/VIT B12/MV-AO5 3 Tablet 

DIALYVITE 3000 FA/VIT BCOMP&C/SE/MIN AA/ZN 3 Tablet 

ZYCOSE FOLIC ACID/BENFOTIAMINE/MV-AO5 3 Tablet 

DIATX ZN FOLIC ACID/VIT BCOMP&C/CU/ZNOX 3 Tablet 

DIALYVITE ZINC FOLIC ACID/VIT BCOMP&C/ZINC 1 Tablet 

NEPHPLEX RX FOLIC ACID/VIT BCOMP&C/ZINC 3 Tablet 

NEPHROCAPS FOLIC ACID/VITAMIN B COMP W-C 3 Capsule (Hard, Soft, etc.) 

NEPHRONEX FOLIC ACID/VITAMIN B COMP W-C 1 Capsule (Hard, Soft, etc.) 

RENAL CAPS FOLIC ACID/VITAMIN B COMP W-C 1 Capsule (Hard, Soft, etc.) 

B-PLEX FOLIC ACID/VITAMIN B COMP W-C 1 Tablet 

DEXFOL FOLIC ACID/VITAMIN B COMP W-C 1 Tablet 

DIALYVITE FOLIC ACID/VITAMIN B COMP W-C 1 Tablet 

FOLBEE PLUS FOLIC ACID/VITAMIN B COMP W-C 1 Tablet 

FORMULA-B FOLIC ACID/VITAMIN B COMP W-C 1 Tablet 

NEPHRO-VITE RX FOLIC ACID/VITAMIN B COMP W-C 3 Tablet 

RENA-VITE RX FOLIC ACID/VITAMIN B COMP W-C 1 Tablet 

VG LYSIN HC/VIT E AC/FA/B&C/MN 3 Capsule (Hard, Soft, etc.) 

SUPERVITE LYSINE HCL/VIT B COMP/FA/ZINC 3 Liquid (ml) 

ALBA-LYBE LYSINE HCL/VITAMIN B COMPLEX 3 Drops 

LYSIPLEX LYSINE/VITAMIN B COMPLEX/FA/ZN 1 Syrup 

LYSIPLEX LYSINE/VITAMIN B COMPLEX/FA/ZN 3 Syrup 

METANX ME-COBALAM/LM-FOLATE/PYRIDOXAL 3 Tablet 

FOLPACE RX MGOX/E AC SUCC/B-12/FA/B6 3 Tablet 

AMINOBENZOATE POTASSIUM POTASSIUM AMINOBENZOATE 1 Capsule (Hard, Soft, etc.) 

POTABA POTASSIUM AMINOBENZOATE 3 Capsule (Hard, Soft, etc.) 

AMINOBENZOATE POTASSIUM POTASSIUM AMINOBENZOATE 1 Packet 

POTABA ENVULE POTASSIUM AMINOBENZOATE 3 Packet 

POTABA POTASSIUM AMINOBENZOATE 3 Powder (gm) 

AMINOBENZOATE POTASSIUM POTASSIUM AMINOBENZOATE 1 Tablet 

POTABA POTASSIUM AMINOBENZOATE 3 Tablet 

CEREFOLIN VIT B12/LM-FOLATE CA/VIT B6/B2 3 Tablet 

VARIDIN VITAMIN B COMPLEX 3 Tablet 

NERVO B-12 VITAMIN B COMPLEX/FOLIC ACID 3 Lozenge 

VITAMIN C PREPARATIONS 

ASCORBIC ACID ASCORBIC ACID 3 Granules; Power-Like, Non-Effervescent (gm) 

VITAMIN D PREPARATIONS 

CALCIJEX CALCITRIOL 3 Ampul (ml) 

CALCITRIOL CALCITRIOL 1 Ampul (ml) 

CALCITRIOL CALCITRIOL 3 Ampul (ml) 

CALCITRIOL CALCITRIOL 1 Capsule (Hard, Soft, etc.) 

ROCALTROL CALCITRIOL 3 Capsule (Hard, Soft, etc.) 

CALCITRIOL CALCITRIOL 1 Solution, Oral 

ROCALTROL CALCITRIOL 3 Solution, Oral 

CALCITRIOL CALCITRIOL 3 Vial (SDV, MDV or Additive) (ml) 

DHT DIHYDROTACHYSTEROL 2 Tablet 

DRISDOL ERGOCALCIFEROL 2 Capsule (Hard, Soft, etc.) 

VITAMIN D ERGOCALCIFEROL 1 Capsule (Hard, Soft, etc.) 

VITAL-D RX VIT D3/B CMPLX 4/C/FA/ZINC OX 3 Tablet 

PEDIATRIC VITAMIN PREPARATIONS 

TRI-VIT W/FLUORIDE & IRON FLUORIDE ION/IRON/VIT A,C&D 1 Drops 

TRI-VITAMIN W/IRON & FLUORIDE FLUORIDE ION/IRON/VIT A,C&D 1 Drops 

MULTIVITAMINS W/FLUORIDE FLUORIDE ION/MULTIVITAMINS 1 Drops 

POLYVITAMINS W/FLUORIDE FLUORIDE ION/MULTIVITAMINS 1 Drops 

MULTI VITA-BETS W/FLUORIDE FLUORIDE ION/MULTIVITAMINS 1 Tablet, Chewable 

MULTI VITAMINS WITH FLUORIDE FLUORIDE ION/MULTIVITAMINS 1 Tablet, Chewable 

MULTI-VITA BETS-FLUORIDE FLUORIDE ION/MULTIVITAMINS 1 Tablet, Chewable 

MULTIVITAMINS W/FLUORIDE FLUORIDE ION/MULTIVITAMINS 1 Tablet, Chewable 

MULTIVITAMINS W-FLUORIDE-IRON FLUORIDE ION/MULTIVITS W-FE 1 Drops 

POLY-VITAMIN W/IRON & FLUORIDE FLUORIDE ION/MULTIVITS W-FE 1 Drops 

MULTI-VITA BETS/FLUORIDE/IRON FLUORIDE ION/MULTIVITS W-FE 1 Tablet, Chewable 

MULTIVITAMINS W-FLUORIDE-IRON FLUORIDE ION/MULTIVITS W-FE 1 Tablet, Chewable 

FLUORABON BASIC FLUORIDE ION/VIT A,C&D 2 Drops 

TRI-VITAMIN W/FLUORIDE FLUORIDE ION/VIT A,C&D 1 Drops 

TRI-VITAMINS W/FLUORIDE FLUORIDE ION/VIT A,C&D 1 Drops 

Page 80


TRI-A-VITE W/FLUORIDE FLUORIDE ION/VIT A,C&D 1 Tablet, Chewable 

TRI-VIT/FLUORIDE FLUORIDE ION/VIT A,C&D 1 Tablet, Chewable 

TRI-VITA BETS W/FLUORIDE FLUORIDE ION/VIT A,C&D 1 Tablet, Chewable 

MYKIDZ IRON FL IRON/FLUORIDE/VITS A, C, & D3 3 Suspension, Oral (Final Dose Form) 

VITAMAX PEDIATRIC MULTIVIT #6/VIT K 3 Drops 

VITAMIN K PREPARATIONS 

MEPHYTON PHYTONADIONE 2 Tablet 

VITAMIN B12 PREPARATIONS 

NASCOBAL CYANOCOBALAMIN 3 Gel (ml) 

CALOMIST CYANOCOBALAMIN 3 Spray, Non-Aerosol (ml) 

NASCOBAL CYANOCOBALAMIN 3 Spray, Non-Aerosol (ml) 

FOLTRATE CYANOCOBALAMIN/FOLIC ACID 3 Tablet 

NEURIN-SL CYANOCOBALAMIN/METHYLCOBALAMIN 3 Tablet, Sublingual 

MARTINIC VITAMIN B12-INTRINSIC FACTOR 3 Capsule (Hard, Soft, etc.) 

FOLIC ACID PREPARATIONS 

UROSEX FA/MULTIVITS-MIN/YHBK/GIN/DAM 3 Tablet 

FOLIC ACID FOLIC ACID 1 Tablet 

SUPERVITE FOLIC ACID/MULTIVITS-MIN 3 Tablet 

SUPERVITE EC FOLIC ACID/MULTIVITS-MIN 3 Tablet 

VITACEL FOLIC ACID/MULTIVITS-MIN 1 Tablet 

DEPLIN L-METHYLFOLATE 3 Tablet 

NIACIN PREPARATIONS 

NIACIN NIACIN 1 Capsule, Sustained Action 

MULTIVITAMIN PREPARATIONS 

PROTECT PLUS NR AMINO AC/FA/MV-MN/DIETARY 2 3 Capsule (Hard, Soft, etc.) 

PROTECT PLUS AMINO ACIDS/MV,FE,OTHER MIN 3 Capsule (Hard, Soft, etc.) 

PROTECT PLUS AMINO ACIDS/MV,TH W-FE,MN 3 Liquid (ml) 

CARDIOTEK RX ARGININE HCL/VIT B12/FA/VIT B6 3 Tablet 

RENAX E AC SUCC/FA/VIT BCOMP&C/ZN/SE 3 Tablet 

GLUTOFAC-ZX FA/MULTIVITS-MIN/LYCOPENE/LUT 3 Tablet 

RE FAC-X FA/MULTIVITS-MIN/LYCOPENE/LUT 1 Tablet 

UDAMIN FA/MULTIVITS-MIN/MIN AA CHEL 3 Tablet, Sustained Action 

CORVITA FA/MU-VITS-MIN TH/LYCOPENE/LUT 3 Tablet 

CORVITE FA/MU-VITS-MIN TH/LYCOPENE/LUT 3 Tablet 

UDAMIN SP FA/MV-MN/MIN AA CHEL/SAW PAL 3 Tablet, Sustained Action 

BACMIN FE FUMARATE/FA/MV-MN/SE 3 Tablet 

DIALYVITE 800 WITH IRON FE FUMARATE/FA/VIT BCOMP&C 3 Tablet 

FEMTABS FOLIC ACID/MULTIVITS-MIN 1 Tablet 

NUTRIFAC ZX FOLIC ACID/MULTIVITS-MIN 1 Tablet 

STROVITE FORTE FOLIC ACID/MV,FE,OTHER MIN 3 Syrup 

NUTRICAP FOLIC ACID/MV,FE,OTHER MIN 3 Tablet 

NICOMIDE FOLIC ACID/NIACINAMIDE/CU/ZNOX 3 Tablet, Multiphasic Release 

NUTRIVIT IRON/LYSINE/VIT B COMP/FA 3 Liquid (ml) 

MULTICHEW MULTIVIT, IRON, MIN #4, FA 3 Tablet, Chewable 

STROVITE FORTE MULTIVIT, IRON, MIN #5, FA 3 Tablet 

VITA S FORTE MULTIVIT, IRON, MIN #5, FA 1 Tablet 

STROVITE PLUS MULTIVIT, IRON, MIN #6, FA 3 Tablet 

ELDERCAPS MULTIVITAMINS WITH MIN NO.5/FA 3 Capsule (Hard, Soft, etc.) 

THERAPEUTIC VITAMIN W/MINERALS MULTIVITAMINS WITH MIN NO.7/FA 1 Capsule (Hard, Soft, etc.) 

V-C FORTE MULTIVITAMINS WITH MIN NO.7/FA 1 Capsule (Hard, Soft, etc.) 

VI-C FORTE MULTIVITAMINS WITH MIN NO.7/FA 1 Capsule (Hard, Soft, etc.) 

VICA-FORTE MULTIVITAMINS WITH MIN NO.7/FA 1 Capsule (Hard, Soft, etc.) 

VIC-FORTE MULTIVITAMINS WITH MIN NO.7/FA 3 Capsule (Hard, Soft, etc.) 

VICON FORTE MULTIVITAMINS WITH MIN NO.7/FA 3 Capsule (Hard, Soft, etc.) 

VITACON FORTE MULTIVITAMINS WITH MIN NO.7/FA 1 Capsule (Hard, Soft, etc.) 

VITAMAX MULTIVITS CMB #20/FA/VIT K 1 Tablet, Chewable 

VITAMAX MULTIVITS CMB #20/FA/VIT K 3 Tablet, Chewable 

HEMOCYTE MULTIVITS W-FE,OTHER MIN 3 Elixir 

PROMAR MULTIVITS W-IRON,HEMATINIC 3 Capsule (Hard, Soft, etc.) 

CEFOL MULTIVITS,STRESS FORMULA 3 Tablet 

BEROCCA PLUS MULTIVITS,THERAP W-FE,HEMATIN 3 Tablet 

BETACARE PLUS MULTIVITS,THERAP W-FE,HEMATIN 1 Tablet 

B-PLEX PLUS MULTIVITS,THERAP W-FE,HEMATIN 1 Tablet 

FORMULA B PLUS MULTIVITS,THERAP W-FE,HEMATIN 1 Tablet 

THERAPEUTIC HEMATINIC MULTIVITS,THERAP W-FE,HEMATIN 1 Tablet 

THEROBEC PLUS MULTIVITS,THERAP W-FE,HEMATIN 1 Tablet 

VITALIZE PLUS MULTIVITS,THERAP W-FE,HEMATIN 1 Tablet 

Page 81


VITAPLEX PLUS MULTIVITS,THERAP W-FE,HEMATIN 1 Tablet 

CORVITE FREE MV, MIN CMB #6/FA/LUT/LYCO/Q10 3 Tablet 

FORTAVIT MV/DIETARY 4/DNA/RNA 3 Capsule (Hard, Soft, etc.) 

ENCORA OM-3/CA CARB/D3/FA/MV CMB 13 3 Combination Package (EA) 

STROVITE ADVANCE THIOCT AC/FA/MULTIVITS-MIN/LUT 3 Tablet 

SUPPORT-500 VITAMIN B COMP W-C 3 Capsule (Hard, Soft, etc.) 

BEROCCA VITAMIN B COMP W-C 3 Tablet 

STROVITE VITAMIN B COMP WITH VIT C NO.6 3 Tablet 

SMOKING DETERRENTS 

SMOKING DETERRENT AGENTS (GANGLIONIC STIM, OTHERS) 

NICOTROL NICOTINE 3 Cartridge (EA) 

NICOTINE PATCH NICOTINE 3 Patch, Transdermal 24 Hr 

NICOTROL NS NICOTINE 3 Spray, Non-Aerosol (ml) 

SMOKING DETERRENTS, OTHER 

BUPROBAN BUPROPION HCL 1 Tablet, Sustained Action 

BUPROPION HCL SR BUPROPION HCL 1 Tablet, Sustained Action 

ZYBAN BUPROPION HCL 3 Tablet, Sustained Action 

SMOKING DETERRENT-NICOTINIC RECEPT. PARTIAL AGONIST 

CHANTIX VARENICLINE TARTRATE 3 Tablet 

CHANTIX VARENICLINE TARTRATE 3 Tablet, Dose Pack 

UNCLASSIFIED DRUG PRODUCTS 

GENERAL INHALATION AGENTS 

HYPER-SAL SODIUM CL FOR INHALATION 3 Vial, Nebulizer (ml) 

SODIUM CHLORIDE SODIUM CL FOR INHALATION 1 Vial, Nebulizer (ml) 

SODIUM CHLORIDE SODIUM CL FOR INHALATION 3 Vial, Nebulizer (ml) 

MUCOLYTICS 

PULMOZYME DORNASE ALFA 3 Solution, Non-Oral 

ANTI-ALCOHOLIC PREPARATIONS 

CAMPRAL ACAMPROSATE CALCIUM 3 Tablet, Delayed Release (Enteric Coated) 

CAMPRAL ACAMPROSATE CALCIUM 3 Tablet, Dose Pack 

ANTABUSE DISULFIRAM 2 Tablet 

DIETARY SUPPLEMENT, MISCELLANEOUS 

GABADONE AA8/A-CARN HCL/GRP/COCOA/HC126 3 Capsule (Hard, Soft, etc.) 

SENTRA AM AA9/A-CARN HCL/DEX/COCOA/HC127 3 Capsule (Hard, Soft, etc.) 

SENTRA PM AA9/A-CARN HCL/DEX/COCOA/HC128 3 Capsule (Hard, Soft, etc.) 

LIMBREL BAICALIN/CATECHIN 3 Capsule (Hard, Soft, etc.) 

APPTRIM CAF/CHOL BTT/AA COMB.NO7/HC125 3 Capsule (Hard, Soft, etc.) 

PULMONA CAFFEIN/AA COMB13/CINN/HC135 3 Capsule (Hard, Soft, etc.) 

HYPERTENSA CAFFEIN/CHOL BITART/AA11/HC130 3 Capsule (Hard, Soft, etc.) 

VIRILEX CAFFEIN/CHOL/AA COMB12/HC131 3 Capsule (Hard, Soft, etc.) 

APPTRIM-D CHOL BITART/AA COMB.NO7/HC125 3 Capsule (Hard, Soft, etc.) 

THERAMINE CHOL BITART/AA10/GABA/HC129 3 Capsule (Hard, Soft, etc.) 

LISTER-V DIETARY SUPPLEMENT,MISC COMB14 3 Capsule (Hard, Soft, etc.) 

CARDIOVID PLUS FISH OIL/OM-3/DL-E/FA/B6-B12 3 Capsule (Hard, Soft, etc.) 

ANIMI-3 OMEGA-3/VIT B12/FA/PYRIDOXINE 3 Capsule (Hard, Soft, etc.) 

MI-OMEGA OMEGA-3/VIT B12/FA/PYRIDOXINE 1 Capsule (Hard, Soft, etc.) 

BONISARA STRONTIUM GLUCONATE/B6-B12-FA 3 Tablet 

CYTO-Q UBIQUINOL 3 Ampul (ml) 

DENTAL AIDS AND PREPARATIONS 

CHLORHEXIDINE GLUCONATE CHLORHEXIDINE GLUCONATE 1 Mouthwash 

PERIDEX CHLORHEXIDINE GLUCONATE 3 Mouthwash 

PERIOGARD CHLORHEXIDINE GLUCONATE 1 Mouthwash 

PERISOL CHLORHEXIDINE GLUCONATE 1 Mouthwash 

ORALONE TRIAMCINOLONE ACETONIDE 3 Paste (gm) 

TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE 1 Paste (gm) 

BUCALCIDE ZINC CL/B-CAINE/CETYLPYRD CL 3 Spray, Non-Aerosol (ml) 

BONE RESORPTION INHIBITORS 

FOSAMAX ALENDRONATE SODIUM 2 Solution, Oral 

FOSAMAX ALENDRONATE SODIUM 2 Tablet 

DIDRONEL ETIDRONATE DISODIUM 3 Tablet 

ETIDRONATE DISODIUM ETIDRONATE DISODIUM 1 Tablet 

BONIVA IBANDRONATE SODIUM 3 Syringe Kit (EA) 

BONIVA IBANDRONATE SODIUM 3 Tablet 

AREDIA PAMIDRONATE DISODIUM 3 Vial (SDV, MDV or Additive) (EA) 

PAMIDRONATE DISODIUM PAMIDRONATE DISODIUM 1 Vial (SDV, MDV or Additive) (EA) 

PAMIDRONATE DISODIUM PAMIDRONATE DISODIUM 3 Vial (SDV, MDV or Additive) (ml) 

Page 82


EVISTA RALOXIFENE HCL 2 Tablet 

ACTONEL RISEDRONATE SODIUM 3 Tablet 

SKELID TILUDRONATE DISODIUM 3 Tablet 

ZOMETA ZOLEDRONIC ACID 3 Vial (SDV, MDV or Additive) (ml) 

RECLAST ZOLEDRONIC ACID/MANNITOL/WATER 3 Infusion Bottle (ml) 

KIDNEY STONE AGENTS 

CYSTAGON CYSTEAMINE BITARTRATE 3 Capsule (Hard, Soft, etc.) 

THIOLA TIOPRONIN 3 Tablet 

CHELATING AGENTS 

GLUTATHIONE (L) REDUCED GLUTATHIONE 3 Powder (gm) 

FLAVORING AGENTS 

BENZALDEHYDE BENZALDEHYDE 1 Elixir 

ANTILEPROTICS 

THALOMID THALIDOMIDE 3 Capsule (Hard, Soft, etc.) 

SYSTEMIC ENZYME INHIBITORS 

ARALAST ALPHA-1-PROTEINASE INHIBITOR 1 Vial (SDV, MDV or Additive) (EA) 

ARALAST ALPHA-1-PROTEINASE INHIBITOR 3 Vial (SDV, MDV or Additive) (EA) 

PROLASTIN ALPHA-1-PROTEINASE INHIBITOR 1 Vial (SDV, MDV or Additive) (EA) 

ZEMAIRA ALPHA-1-PROTEINASE INHIBITOR 1 Vial (SDV, MDV or Additive) (EA) 

LUNG SURFACTANTS 

SURVANTA BERACTANT 3 Vial (SDV, MDV or Additive) (ml) 

INFASURF CALFACTANT 3 Vial (SDV, MDV or Additive) (ml) 

CUROSURF PORACTANT ALFA 3 Vial (SDV, MDV or Additive) (ml) 

CHEMOTHERAPY RESCUE/ANTIDOTE AGENTS 

ETHYOL AMIFOSTINE CRYSTALLINE 3 Vial (SDV, MDV or Additive) (EA) 

DEXRAZOXANE DEXRAZOXANE 1 Vial (SDV, MDV or Additive) (EA) 

DEXRAZOXANE DEXRAZOXANE 3 Vial (SDV, MDV or Additive) (EA) 

ZINECARD DEXRAZOXANE 3 Vial (SDV, MDV or Additive) (EA) 

LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 1 Tablet 

LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 2 Tablet 

MESNEX MESNA 3 Tablet 

MESNA MESNA 1 Vial (SDV, MDV or Additive) (ml) 

MESNEX MESNA 3 Vial (SDV, MDV or Additive) (ml) 

METABOLIC DEFICIENCY AGENTS 

CYSTADANE BETAINE 3 Powder (gm) 

CARNITOR SF LEVOCARNITINE 3 Solution, Oral 

CARNITOR LEVOCARNITINE 3 Tablet 

LEVOCARNITINE LEVOCARNITINE 1 Tablet 

CARNITOR LEVOCARNITINE (WITH SUCROSE) 3 Solution, Oral 

LEVOCARNITINE LEVOCARNITINE (WITH SUCROSE) 1 Solution, Oral 

DRUGS TO TREAT IMPOTENCY 

CAVERJECT ALPROSTADIL 2 Ampul (ml) 

CAVERJECT ALPROSTADIL 1 Kit 

EDEX ALPROSTADIL 3 Kit 

MUSE ALPROSTADIL 3 Suppository, Urethral 

CAVERJECT ALPROSTADIL 2 Vial (SDV, MDV or Additive) (EA) 

VIAGRA SILDENAFIL CITRATE 2 Tablet 

CIALIS TADALAFIL 3 Tablet 

LEVITRA VARDENAFIL HCL 3 Tablet 

DAYTO-HIMBIN YOHIMBINE HCL 1 Tablet 

TESTOMAR YOHIMBINE HCL 1 Tablet 

YOCON YOHIMBINE HCL 3 Tablet 

YOHIMBINE HCL YOHIMBINE HCL 1 Tablet 

YOHIMEX YOHIMBINE HCL 1 Tablet 

YOHIMAR YOHIMBINE HCL/ZINC SULFATE 3 Tablet 

AGENTS TO TREAT MULTIPLE SCLEROSIS 

COPAXONE GLATIRAMER ACETATE 3 Kit 

AVONEX INTERFERON BETA-1A 3 Kit 

REBIF INTERFERON BETA-1A/ALBUMIN 3 Disposable Syringe (ml) 

AVONEX ADMINISTRATION PACK INTERFERON BETA-1A/ALBUMIN 3 Kit 

BETASERON INTERFERON BETA-1B 3 Vial (SDV, MDV or Additive) (EA) 

AGENTS FOR STOMATOLOGICAL USE 

DEBACTEROL SULFURIC ACID/SULF PHENOL 3 Solution, Non-Oral 

DEBACTEROL SULFURIC ACID/SULF PHENOL 3 Swab, Medicated 

BENIGN PROSTATIC HYPERTROPHY/MICTURITION AGENTS 

UROXATRAL ALFUZOSIN HCL 3 Tablet, Sustained Release 24 Hr 

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AVODART DUTASTERIDE 2 Capsule (Hard, Soft, etc.) 

FINASTERIDE FINASTERIDE 1 Tablet 

PROSCAR FINASTERIDE 3 Tablet 

FLOMAX TAMSULOSIN HCL 2 Capsule, Sustained Release 24 Hr 

ANTIOXIDANT AGENTS 

OXIPLEN VITAMIN E/FOLIC ACID/ZINC/SE 3 Tablet 

ORAL MUCOSITIS/STOMATITIS AGENTS 

SALICEPT ACEMANNAN 3 Gel (EA) 

SALICEPT ACEMANNAN 3 Suspension, Reconstituted, Oral (ml) 

SALICEPT ACEMANNAN/ASPARTAME 3 Solution, Reconstituted, Oral 

ORAMAGICRX K SORBATE/MALTO/ALO V/MANN PS 3 Mouthwash 

GELCLAIR POT SOR/HY-ETHYLCEL/PVP/HYALUR 1 Gel in Packet (ml) 

ORAL MUCOSITIS/STOMATITIS ANTI-INFLAMMATORY AGENT 

APHTHASOL AMLEXANOX 3 Paste (gm) 

MUCOTROL MUCOSITIS & STOMATITIS COMBO 1 3 Wafer 

URINARY TRACT ANTISPASMODIC/ANTIINCONTINENCE AGENT 

FLAVOXATE HCL FLAVOXATE HCL 1 Tablet 

URISPAS FLAVOXATE HCL 3 Tablet 

OXYTROL OXYBUTYNIN 3 Patch, Transdermal Semiweekly 

DITROPAN OXYBUTYNIN CHLORIDE 3 Syrup 

OXYBUTYNIN CHLORIDE OXYBUTYNIN CHLORIDE 1 Syrup 

DITROPAN OXYBUTYNIN CHLORIDE 3 Tablet 

OXYBUTYNIN CHLORIDE OXYBUTYNIN CHLORIDE 1 Tablet 

DITROPAN XL OXYBUTYNIN CHLORIDE 3 Tablet, SR Osmotic Push 24 Hr 

OXYBUTYNIN CHLORIDE ER OXYBUTYNIN CHLORIDE 1 Tablet, SR Osmotic Push 24 Hr 

DETROL LA TOLTERODINE TARTRATE 2 Capsule, Sustained Release 24 Hr 

DETROL TOLTERODINE TARTRATE 2 Tablet 

SANCTURA XR TROSPIUM CHLORIDE 3 Capsule, Sustained Release 24 Hr 

SANCTURA TROSPIUM CHLORIDE 3 Tablet 

TOPICAL ANTIBIOTICS/ANTIINFLAMMATORY, STEROIDAL 

CORTISPORIN NEOMY SULF/POLYMYX B SULF/HC 3 Cream (Grams) 

CORTISPORIN NEOMYCIN/BACITRA/POLYMYXIN/HC 3 Ointment (gm) 

HYPERTRICHOTIC AGENTS, SYSTEMIC/INCL. COMBINATIONS 

PROPECIA FINASTERIDE 3 Tablet 

SALIVA SUBSTITUTE AGENTS 

NUMOISYN FLAXSEED 3 Liquid (ml) 

CAPHOSOL SALIVA SUBSTITUTION COMBO NO.2 3 Solution, Non-Oral 

AQUORAL SALIVA SUBSTITUTION COMBO NO.3 3 Aerosol, Spray w/Pump (ml) 

PERIODONTAL COLLAGENASE INHIBITORS 

ORAXYL DOXYCYCLINE HYCLATE 3 Capsule (Hard, Soft, etc.) 

DOXYCYCLINE HYCLATE DOXYCYCLINE HYCLATE 1 Tablet 

PERIOSTAT DOXYCYCLINE HYCLATE 2 Tablet 

SKIN TISSUE REPLACEMENT 

APLIGRAF CULT SKIN SUBST,HUMAN-BOVINE 3 Disk 

DERMAGRAFT CULT SKIN SUBST,HUMAN-BOVINE 3 Sheet (EA) 

TRANSCYTE CULT SKIN SUBST,HUMAN-PORCINE 3 Sheet (EA) 

OCULAR PHOTOACTIVATED VESSEL-OCCLUDING AGENTS 

VISUDYNE VERTEPORFIN 3 Vial (SDV, MDV or Additive) (EA) 

CALCIMIMETIC, PARATHYROID CALCIUM ENHANCER 

SENSIPAR CINACALCET HCL 3 Tablet 

URINARY TRACT ANTISPASMODIC, M(3) SELECTIVE ANTAG. 

ENABLEX DARIFENACIN HYDROBROMIDE 3 Tablet, Sustained Release 24 Hr 

VESICARE SOLIFENACIN SUCCINATE 2 Tablet 

LEUKOCYTE ADHESION INHIB,ALPHA4-MEDIAT IGG4K MC AB 

TYSABRI NATALIZUMAB 3 Vial (SDV, MDV or Additive) (ml) 

ABORTIFACIENT, PROGESTERONE RECEPTOR ANTAGONIST-TYP 

MIFEPREX MIFEPRISTONE 3 Tablet 

PULMONARY ANTI-HTN, ENDOTHELIN RECEPTOR ANTAGONIST 

LETAIRIS AMBRISENTAN 3 Tablet 

TRACLEER BOSENTAN 3 Tablet 

DRUGS TO TREAT HEREDITARY TYROSINEMIA 

ORFADIN NITISINONE 3 Capsule (Hard, Soft, etc.) 

BONE FORMATION STIM. AGENTS - PARATHYROID HORMONE 

FORTEO TERIPARATIDE 3 Pen Injector (ml) 

GROWTH HORMONE RECEPTOR ANTAGONISTS 

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SOMAVERT PEGVISOMANT 3 Vial (SDV, MDV or Additive) (EA) 

DRUGS TO TX GAUCHER DX-TYPE 1, SUBSTRATE REDUCING 

ZAVESCA MIGLUSTAT 3 Capsule (Hard, Soft, etc.) 

BONE RESORPTION INHIBITOR & VITAMIN D COMBINATIONS 

FOSAMAX PLUS D ALENDRONATE SODIUM/VITAMIN D3 2 Tablet 

BONE RESORPTION INHIBITOR & CALCIUM COMBINATIONS 

ACTONEL WITH CALCIUM RISEDRON SOD/CALCIUM CARBONATE 3 Tablet, Dose Pack 

HYPERPARATHYROID TX AGENTS - VITAMIN D ANALOG-TYPE 

HECTOROL DOXERCALCIFEROL 3 Capsule (Hard, Soft, etc.) 

ZEMPLAR PARICALCITOL 3 Capsule (Hard, Soft, etc.) 

ZEMPLAR PARICALCITOL 3 Vial (SDV, MDV or Additive) (ml) 

METABOLIC DISEASE ENZYME REPLACEMENT, FABRY'S DX 

FABRAZYME AGALSIDASE BETA 3 Vial (SDV, MDV or Additive) (EA) 

METABOLIC DISEASE ENZYME REPLACEMENT, GAUCHER'S DX 

CEREDASE ALGLUCERASE 3 Vial (SDV, MDV or Additive) (ml) 

CEREZYME IMIGLUCERASE 3 Vial (SDV, MDV or Additive) (EA) 

METABOLIC DX ENZYME REPLACE, MUCOPOLYSACCHARIDOSIS 

NAGLAZYME GALSULFASE 3 Vial (SDV, MDV or Additive) (ml) 

ALDURAZYME LARONIDASE 3 Vial (SDV, MDV or Additive) (ml) 

METABOLIC DX ENZYME REPLACEMT,SEV.COMB.IMMUNE DEF. 

ADAGEN PEGADEMASE BOVINE 3 Vial (SDV, MDV or Additive) (ml) 

APPETITE STIM. FOR ANOREXIA, CACHEXIA, WASTING SYND. 

MEGACE MEGESTROL ACETATE 3 Suspension, Oral (Final Dose Form) 

MEGACE ES MEGESTROL ACETATE 3 Suspension, Oral (Final Dose Form) 

MEGESTROL ACETATE MEGESTROL ACETATE 1 Suspension, Oral (Final Dose Form) 

SALIVA STIMULANT AGENTS 

NUMOISYN CAHPO4/SALIVA CMB 1/MALIC/SORB 3 Lozenge 

TOPICAL VIT D ANALOG/ANTIINFLAMMATORY, STEROIDAL 

TACLONEX BETAMET DIPROP/CALCIPOTRIENE 3 Ointment (gm) 

VAGINAL/CERVICAL CARE AND TREATMENT AGENTS 

AMINO ACID CERVICAL SOD PROPIONATE/INOSI/AA14/UREA 1 Cream with Applicator 

PKU TX AGENT-COFACTOR OF PHENYLALANINE HYDROXYLASE 

KUVAN SAPROPTERIN DIHYDROCHLORIDE 3 Tablet, Soluble 

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Trustmark/Starmark Formulary Drug List April 2008 - Resource ...

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