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

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Brand Name Generic Name Tier Form 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
Brand Name Generic Name Tier Form 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
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Trustmark/Starmark Formulary Drug List April 2008 - Resource ...

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