Trustmark/Starmark Formulary Drug List April 2008 - Resource ...
Trustmark/Starmark Formulary Drug List April 2008 - Resource ...
Trustmark/Starmark Formulary Drug List April 2008 - Resource ...
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Brand Name Generic Name Tier Form<br />
TUSSICAPS HYDROCODONE/CHLORPHEN POLIS 3 Capsule, Sustained Release 12 Hr<br />
TUSSIONEX HYDROCODONE/CHLORPHEN POLIS 3 Suspension, 12 Hr Sustained Release<br />
NON-NARCOTIC ANTITUSSIVE-1ST GEN ANTIHISTAMINE COMBINATION<br />
D-TANN AT CARBETAPENT TAN/DIPHENHYDR TAN 1 Suspension, Oral (Final Dose Form)<br />
DYTAN-AT CARBETAPENT TAN/DIPHENHYDR TAN 3 Suspension, Oral (Final Dose Form)<br />
PYRLEX CB CARBETAPENTANE TAN/PYRILAM TAN 3 Suspension, Oral (Final Dose Form)<br />
C-TANNA 12 CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form)<br />
TANNATE 12 S CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form)<br />
TANNIC-12 S CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form)<br />
TANNIHIST-12 RF CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form)<br />
TRIONATE CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form)<br />
TUSSI-12 S CAR-B-PEN TA/CHLOR-TAN 3 Suspension, Oral (Final Dose Form)<br />
TUSSIZONE-12 RF CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form)<br />
TUSTAN 12S CAR-B-PEN TA/CHLOR-TAN 1 Suspension, Oral (Final Dose Form)<br />
CAR-B-PEN TA/CHLOR-TAN CAR-B-PEN TA/CHLOR-TAN 1 Tablet<br />
TANNIC-12 CAR-B-PEN TA/CHLOR-TAN 1 Tablet<br />
TRIONATE NF CAR-B-PEN TA/CHLOR-TAN 1 Tablet<br />
TUSSI-12 CAR-B-PEN TA/CHLOR-TAN 3 Tablet<br />
TUSSIZONE-12 RF CAR-B-PEN TA/CHLOR-TAN 1 Tablet<br />
PROMETHAZINE W/DM D-METHORPHAN HB/PROMETH HCL 1 Syrup<br />
PROMETHAZINE-DM D-METHORPHAN HB/PROMETH HCL 1 Syrup<br />
NON-NARC ANTITUSSIVE-1ST GEN ANTIHIST-EXPECT COMBINATION<br />
TUSNEL GUAIFEN/D-METHORPHAN HB/BPM 3 Capsule (Hard, Soft, etc.)<br />
TRISPEC SFX GUAIFEN/D-METHORPHAN HB/BPM 3 Liquid (ml)<br />
TUSNEL GUAIFEN/D-METHORPHAN HB/BPM 3 Liquid (ml)<br />
TUSSI PRES-B GUAIFEN/D-METHORPHAN HB/BPM 1 Liquid (ml)<br />
NARCOTIC ANTITUSS-1ST GEN ANTIHIST-DECONGST-EXPECT<br />
DROTUSS GUAIFEN/P-EPHED HCL/HCOD/CP 1 Liquid (ml)<br />
ZHIST GUAIFEN/P-EPHED HCL/HCOD/CP 1 Liquid (ml)<br />
Z-TUSS 2 GUAIFEN/P-EPHED HCL/HCOD/CP 3 Liquid (ml)<br />
NARCOTIC ANTITUSSIVE-DECONGESTANT COMBINATIONS<br />
SYMTAN P-EPD TAN/HYDROCODONE TANNATE 3 Suspension, Oral (Final Dose Form)<br />
COLDCOUGH HCM P-EPHED HCL/HYDROCODONE BIT 1 Syrup<br />
PHENYLEPHRINE HD PHENYLEPHRINE HCL/HYDROCODONE 1 Liquid (ml)<br />
TUSDEC-HC PHENYLEPHRINE HCL/HYDROCODONE 1 Liquid (ml)<br />
NUCOFED PSEUDOEPHEDRINE HCL/CODEINE 3 Capsule (Hard, Soft, etc.)<br />
NON-NARCOTIC ANTITUSSIVE-DECONGESTANT COMBINATIONS<br />
ALLRES D CAR-B-PEN TA/P-EPD TAN 1 Suspension, Oral (Final Dose Form)<br />
ALLRES PD CAR-B-PEN TA/P-EPD TAN 1 Suspension, Oral (Final Dose Form)<br />
RESPI-TANN CAR-B-PEN TA/P-EPD TAN 3 Suspension, Oral (Final Dose Form)<br />
RESPI-TANN PD CAR-B-PEN TA/P-EPD TAN 3 Suspension, Oral (Final Dose Form)<br />
PSEUDACARB CAR-B-PEN TA/P-EPD TAN 1 Tablet, Chewable<br />
RESPI-TANN CAR-B-PEN TA/P-EPD TAN 3 Tablet, Chewable<br />
CARBETAPLEX TS CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form)<br />
CARB-PHENYL-12 CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form)<br />
DYNEX 12 CAR-B-PEN TA/PHENYLEPHRINE 3 Suspension, Oral (Final Dose Form)<br />
L-ALL 12 CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form)<br />
L-ALL 12 NF CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form)<br />
LEVALL-12 CAR-B-PEN TA/PHENYLEPHRINE 3 Suspension, Oral (Final Dose Form)<br />
RE ALL 12 CAR-B-PEN TA/PHENYLEPHRINE 1 Suspension, Oral (Final Dose Form)<br />
CARBATUSS-12 CAR-PEN/CAR-PEN TAN/PE TAN/PE 3 Suspension, Oral (Final Dose Form)<br />
ALBATUSSIN PEDIATRIC D-METHORPHAN HB/PHENYLEPHRINE 3 Drops<br />
ALBATUSSIN PEDIATRIC D-METHORPHAN HB/PHENYLEPHRINE 3 Syrup<br />
NARCOTIC ANTITUSS-1ST GEN ANTIHIST-DECONGEST-ANALGESIC<br />
COLREX COMPOUND PHENYLEPHRINE/COD/APAP/CP 3 Capsule (Hard, Soft, etc.)<br />
NON-NARCOTIC ANTITUSS-DECONGESTANT-ANALGESIC-EXPECT CB<br />
DURAFLU GUAIFEN/DM/P-EPHED/ACETAMINOPH 3 Tablet<br />
FLUTABS GUAIFEN/DM/P-EPHED/ACETAMINOPH 1 Tablet<br />
MAXIFLU DM GUAIFEN/DM/P-EPHED/ACETAMINOPH 3 Tablet<br />
MAXIFLU-G GUAIFEN/DM/P-EPHED/ACETAMINOPH 3 Tablet<br />
PHENFLU G GUAIFN/DM/PHENYLEPH/ACETAMINOP 3 Tablet<br />
NARCOTIC ANTITUSS-DECONGESTANT-EXPECTORANT COMBINATION<br />
DESPEC-EXP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup<br />
DIHYDRO-GP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup<br />
HYDRO-TUSSIN EXP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup<br />
WELLTUSS EXP GUAIFEN/P-EPHED HCL/DIHY-COD 1 Syrup<br />
KG-FED GUAIFENESIN/P-EPHED HCL/COD 1 Syrup<br />
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