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

Brand Name Generic Name Tier Form
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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